Preventative Health Care | Dr Murray Fox, MD. | PlanoOBGYN

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Dr. Fox: http://drmurrayfoxmd.com | 972-379-2416

Dr Murray Fox, M.D. of Women's Specialists of Plano presents on a variety of preventative health care topics specific to women.

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Preventative Health Care | Dr Murray Fox, MD. | PlanoOBGYN

  1. 1. Preventive Health Care for Women Baylor Regional Medical Center Plano Women’s Center May 8, 2009   Murray E. Fox MD, FACOG Medical Director
  2. 2. Preventive Health Care for Women <ul><li>Current Health Care Recommendations </li></ul><ul><ul><li>Infant and Child Care </li></ul></ul><ul><ul><ul><li>Exams </li></ul></ul></ul><ul><ul><ul><li>Immunizations </li></ul></ul></ul><ul><ul><li>Adolescent </li></ul></ul><ul><ul><ul><li>Exams </li></ul></ul></ul><ul><ul><ul><ul><li>First Pap smear with in three years of first sexual contact </li></ul></ul></ul></ul><ul><ul><ul><li>  Immunizations </li></ul></ul></ul><ul><ul><ul><ul><li>Gardasil </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Hepatitis A and B   </li></ul></ul></ul></ul>
  3. 3. Preventive Health Care for Women <ul><li>Current Health Care Recommendations </li></ul><ul><ul><li>Adult </li></ul></ul><ul><ul><li>Exams </li></ul></ul><ul><ul><ul><li>Annual physical examination </li></ul></ul></ul><ul><ul><ul><li>Pap smear </li></ul></ul></ul><ul><ul><ul><li>Blood work </li></ul></ul></ul><ul><ul><ul><ul><li>Cholesterol Total, High Density, Low Density </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Thyroid </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Blood Sugar </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Complete blood count </li></ul></ul></ul></ul><ul><ul><ul><li>Chest X-ray </li></ul></ul></ul>
  4. 4. Preventive Health Care for Women <ul><li>Current Health Care Recommendations </li></ul><ul><ul><li>Exams </li></ul></ul><ul><ul><ul><li>EKG </li></ul></ul></ul><ul><ul><ul><li>Cardiac stress test </li></ul></ul></ul><ul><ul><ul><li>Bone density </li></ul></ul></ul><ul><ul><ul><li>Colonoscopy </li></ul></ul></ul><ul><ul><li>Immunizations </li></ul></ul><ul><ul><ul><li>Gardasil </li></ul></ul></ul><ul><ul><ul><li>Hepatitis A and B </li></ul></ul></ul>
  5. 5. Preventive Health Care for Women <ul><li>Personal Health Care </li></ul><ul><ul><li>Diet </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Dietary Supplements </li></ul></ul>
  6. 6. Preventive Health Care for Women <ul><li>Annual Physical Examination </li></ul><ul><li>Review of your health history </li></ul><ul><li>Update of family health history </li></ul><ul><ul><li>(Any new serious illnesses in your family) </li></ul></ul><ul><li>Update of life and work situation </li></ul><ul><li>Update of current medications, herbs, and supplements </li></ul><ul><ul><li>(Bring list) </li></ul></ul><ul><li>Need for medication refills </li></ul>
  7. 7. Preventive Health Care for Women <ul><li>Annual Physical Examination </li></ul><ul><li>General physical exam including blood pressure and breast and pelvic exams </li></ul><ul><li>Evaluation of need for health screening tests based on age and personal and family history </li></ul><ul><ul><li>(Such as EKG, mammogram, bone density, test for sexually transmitted diseases, and colon cancer screening) </li></ul></ul><ul><li>Update on immunizations </li></ul>
  8. 8. Preventive Health Care for Women <ul><li>American Cancer Society Recommendations </li></ul><ul><li>Breast Cancer </li></ul><ul><li>Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health. </li></ul><ul><li>Clinical breast exam (CBE) should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over. </li></ul>
  9. 9. Preventive Health Care for Women <ul><li>American Cancer Society Recommendations </li></ul><ul><li>Breast Cancer </li></ul><ul><li>Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s. </li></ul>
  10. 10. Preventive Health Care for Women <ul><li>American Cancer Society Recommendations </li></ul><ul><li>Breast Cancer </li></ul><ul><li>Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%. </li></ul>
  11. 11. Preventive Health Care for Women <ul><li>American Cancer Society Colon Cancer Screening Recommendations </li></ul><ul><li>Colon and Rectal Cancer </li></ul><ul><li>Beginning at age 50, both men and women at average risk for developing colorectal cancer should use one of the screening tests below. The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests. Talk to your doctor about which test is best for you. </li></ul>
  12. 12. Preventive Health Care for Women <ul><li>American Cancer Society Colon Cancer Screening Recommendations </li></ul><ul><li>Tests that find polyps and cancer. </li></ul><ul><li>Flexible sigmoidoscopy every 5 years*  </li></ul><ul><li>Colonoscopy every 10 years  </li></ul><ul><li>Double contrast barium enema every 5 years*  </li></ul><ul><li>CT colonography (virtual colonoscopy) every 5 years* </li></ul><ul><li>* Colonoscopy should be done if test results are positive. </li></ul>
  13. 13. Preventive Health Care for Women <ul><li>American Cancer Society Colon Cancer Screening Recommendations </li></ul><ul><li>Tests that mainly find cancer. </li></ul><ul><li>Fecal occult blood test (FOBT) every year*,** </li></ul><ul><li>Fecal immunochemical test (FIT) every year*,** </li></ul><ul><li>Stool DNA test (sDNA), interval uncertain* </li></ul><ul><li>* Colonoscopy should be done if test results are positive. </li></ul><ul><li>** For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. A FOBT or FIT done during a digital rectal exam in the doctor's office is not adequate for screening. </li></ul>
  14. 14. Preventive Health Care for Women <ul><li>American Cancer Society Colon Cancer Screening Recommendations </li></ul><ul><li>Patients at Risk </li></ul><ul><li>People should talk to their doctor about starting colorectal cancer screening earlier and/or being screened more often if they have any of the following colorectal cancer risk factors: </li></ul><ul><li>A personal history of colorectal cancer or adenomatous polyps </li></ul><ul><li>A personal history of chronic inflammatory bowel disease </li></ul><ul><ul><li>(Crohns disease or ulcerative colitis) </li></ul></ul>
  15. 15. Preventive Health Care for Women <ul><li>American Cancer Society Colon Cancer Screening Recommendations </li></ul><ul><li>Patients at Risk </li></ul><ul><li>A strong family history of colorectal cancer or polyps </li></ul><ul><ul><li>(Cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 or more first-degree relatives of any age) </li></ul></ul><ul><li>A known family history of hereditary colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC) </li></ul>
  16. 16. Preventive Health Care for Women <ul><li>Testing of bone mineral density should be performed on the basis of an individual woman's risk profile and is not indicated unless the results will influence a treatment or management decision. Although not all experts or organizations agree, the following guidelines can be recommended: </li></ul><ul><li>Bone mineral density testing should be recommended to all postmenopausal women aged 65 years or older. </li></ul><ul><li>Bone mineral density testing may be recommended to postmenopausal women younger than 65 years who have 1 or more risk factors for osteoporosis </li></ul><ul><ul><li>(See Box &quot;Risk Factors for Osteoporotic Fracture in Postmenopausal Women&quot;). </li></ul></ul><ul><li>Bone mineral density testing should be performed on all postmenopausal women with fractures to confirm the diagnosis of osteoporosis and determine disease severity. </li></ul>Bone Density
  17. 17. Preventive Health Care for Women <ul><li>Risk Factors for Osteoporotic Fracture </li></ul><ul><li>in Postmenopausal Women </li></ul><ul><li>History of prior fracture </li></ul><ul><li>Family history of osteoporosis </li></ul><ul><li>Caucasian race </li></ul><ul><li>Dementia </li></ul><ul><li>Poor nutrition </li></ul><ul><li>Smoking </li></ul><ul><li>Low weight and body mass index </li></ul>
  18. 18. Preventive Health Care for Women <ul><li>Risk Factors for Osteoporotic Fracture </li></ul><ul><li>in Postmenopausal Women </li></ul><ul><li>Estrogen deficiency </li></ul><ul><ul><li>Early menopause (age younger than 45 years) or bilateral oophorectomy </li></ul></ul><ul><ul><li>Prolonged premenopausal amenorrhea (>1 year) </li></ul></ul><ul><li>Long-term low calcium intake </li></ul><ul><li>Alcoholism </li></ul><ul><li>Impaired eyesight despite adequate correction </li></ul><ul><li>History of falls </li></ul><ul><li>Inadequate physical activity </li></ul>
  19. 19. Preventive Health Care for Women <ul><li>Cholesterol </li></ul><ul><li>You can control: </li></ul><ul><li>What you eat. Certain foods have types of fat that raise your cholesterol level. </li></ul><ul><ul><li>Saturated fat raises your low-density lipoprotein (LDL) cholesterol level more than anything else in your diet. </li></ul></ul><ul><ul><li>Trans fatty acids ( trans fats) are made when vegetable oil is hydrogenated to harden it. Trans fatty acids also raise cholesterol levels. </li></ul></ul><ul><li>Cholesterol is found in foods that come from animal sources, for example, egg yolks, meat, and cheese. </li></ul><ul><li>Your weight. Being overweight tends to increase your LDL level, lower your high-density lipoprotein (HDL) level, and increase your total cholesterol level. </li></ul><ul><li>Your activity. Lack of regular exercise can lead to weight gain, which could raise your LDL cholesterol level. Regular exercise can help you lose weight and lower your LDL level. It can also help you raise your HDL level. </li></ul>
  20. 20. Preventive Health Care for Women <ul><li>Cholesterol </li></ul><ul><li>You can not control: </li></ul><ul><li>Heredity. High blood cholesterol can run in families. An inherited genetic condition (familial hypercholesterolemia) results in very high LDL cholesterol levels. It begins at birth, and may result in a heart attack at an early age. </li></ul><ul><li>Age and sex. Starting at puberty, men have lower levels of HDL than women. As women and men get older, their LDL cholesterol levels rise. Younger women have lower LDL cholesterol levels than men, but after age 55, women have higher levels than men. </li></ul>
  21. 21. Preventive Health Care for Women
  22. 22. Preventive Health Care for Women
  23. 23. Preventive Health Care for Women <ul><li>Diet </li></ul><ul><li>ADEQUATE NUTRIENTS WITHIN CALORIE NEEDS </li></ul><ul><li>Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol. </li></ul><ul><li>Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the U.S. Department of Agriculture (USDA) Food Guide or the Dietary Approaches to Stop Hypertension (DASH) Eating Plan. </li></ul>
  24. 24. Preventive Health Care for Women <ul><li>Exercise </li></ul><ul><li>2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity </li></ul><ul><ul><li>(i.e., Brisk walking) every week (see heart rate guide) </li></ul></ul><ul><li>  </li></ul><ul><li>Muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest,  shoulders, and arms) </li></ul>
  25. 25. Preventive Health Care for Women <ul><li>Vitamin and Supplement Information Websites </li></ul><ul><li>www.vitamins-supplements.org </li></ul><ul><li>  </li></ul><ul><li>www.cc. nih . gov / ccc /supplements </li></ul><ul><li>  </li></ul><ul><li>www. mayoclinic .com/health/supplements/NU00198 </li></ul><ul><li>  </li></ul><ul><li>www. americanheart .org/presenter. jhtml ?identifier=4788 </li></ul>
  26. 26. Preventive Health Care for Women

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