Preventative Health Lecture Follow-up: Talking with Patients and Vaccinations

After Dr. Nunez’s informative and entertaining lecture on Women’s Health and Prevention Issues this afternoon, a few additional thoughts came to mind.  As she pointed out, sometimes there’s a little bit of a disconnect (or at least order of priorities) between what the patient is seeking help for and what the physician considers most urgent.  In the case presented, the patient was concerned about joint pain (osteoarthritis), but the physician would also be concerned about cardiovascular risk (hypertension, obesity, hyperlipidemia in a post-menopausal woman).  One way of trying to tie the two together to unite common goals might be to explain to the patient that weight loss (which would benefit her lipids and blood pressure control) would also likely ease the stress on her joints (knees) and decrease some of the pain she is experiencing.

On a different note, physicians often forget about vaccinations as an effective preventive care measure.  This patient should have been receiving annual flu vaccinations (as we all should) and should also be asked about the last time she received a tetanus vaccine.  If she is due for a tetanus shot (which many adults neglect/forget since it is received ~ every 10 years), she should receive Tdap.  This tetanus toxoid combined with pertussis vaccine is now recommended for all adults who have not already received it and is especially important for those who may have small children (e.g. grandchildren) in their household, since pertussis is most serious, even potentially fatal, in infants.  When she turns 60, she will be eligible for the shingles vaccine (ZOSTAVAX) and at age 65 for two pneumococcal vaccines (PREVNAR 13 and PNEUMOVAX 23, which are recommended to be given sequentially).  If she were part of a high risk group such as individuals with diabetes, heart disease, chronic liver or lung disease, pneumococcal vaccination would be administered at a younger age.  Guidelines are currently in flux with the availability of two vaccines now for adults, so stay tuned for the CDC to issue new guidelines soon!

Resources:

http://www.cdc.gov/vaccines/schedules/hcp/adult.html

irobot singapore

Risk Factors For Heart Disease: Worse for Women & African Americans

A recent study reported in Health Day.com demonstrates the disparity felt by women and African Americans when it comes to risk factors for heart disease. In particular, diabetes and high blood pressure were found to be major contributors to this sex and race gap by increasing the chance for heart disease to develop significantly in these groups when compared to men in general.

When looking at combined risk from 5 factors (High cholesterol, smoking, high blood pressure, obesity and diabetes) blacks had an increased risk of 67% to develop heart disease as compared to 48% in whites. Women had a combined risk of 58% compared to 48% in men. These risks ultimately make these groups more likely to experience poor health outcomes, or even die from complications of heart disease and stroke.

 But why is this happening? From a clinical perspective, the article suggested that " this difference in risk could be due to the fact that heart disease has typically been considered a disease of white men, and doctors have not tackled contributing factors as much when they crop up in women and blacks." If this is the case, this image of the "typical" heart disease patient can be putting lives at risk. It is later suggested that doctors take risk factors more seriously in these populations since their chance for later development is higher.

Patients can also have an important role in bridging this gap. It is important to know your family history, be aware of the things you are at high risk for and  try your best to manage any risk factors you do have. If you don't feel like your doctor is taking your risk factors seriously, seek a second opinion. Remember, your family history does not have to be your biography. Ask your doctor what you can do to reduce your risk factors for heart disease. In some cases, small life changes can make a big difference.

Resources:

Original Article: Women, African Americans Hit Harder by Heart Disease Risk Factors, Heath Day.com

Article Referenced: Philly.com 

Article: How to Prevent and Control Coronary Heart Disease Risk Factors , NIH

Video: Heart Healthy Tips, 5 Superfoods 

Possible Health Benefits of Lower Bedroom Temperatures

You may want to think twice before turning down your air conditioner! An interesting study was released recently investigating the possible health benefits of sleeping in cooler temperatures at night. It is something we usually do not think about, but some are starting to think it can really make a difference. Specifically, researchers set out to see if it had an effect on stores of brown (good) fat which has the potential to improve metabolism.  Sponsored by the American Diabetes Association, researchers took 5 healthy young men and had them sleep in a controlled environment. During the course of the experiment, they had them all sleep in different room temperatures. It was found that when the temperature was cooler, significantly higher amounts of brown fat were found. This implies that there is possibility of metabolic benefit to sleeping in colder temperatures.

However, is the same true for women? We do not know. Since the study only included 5 men, it is impossible to know if the same results would have been found in a group of 5 women. With the possible metabolic benefits this study eludes to, it is hopeful that it will be repeated not only with women, but with a larger and more diverse group.

Resources:
Article abstract and link in PubMed

Article: Let's Cool it in the Bedroom  New York Times

Video Presentations from the Academy of Women's Health

The Academy of Women's Health is currently offering complimentary videos on their women's health website. Two talks are availible on two very interesting and important topics: fibroids and STD's. Click here to access the webpage including a short description of each talk, and a link to access them. Direct links to the YouTube videos of these talks have been posted below. Enjoy! 

Resources:

Video: Fibroids: New Options in Medical & Surgical Management

Video: Sexual Health: Do Ask, Do Tell

Academy of Women's Health Website

How Racial Stereotypes can Isolate Women Experiencing Infertility

The article Infertility, Endured Through a Prism of Race  from the New York times brings to light an issue that has gotten less attention than needed. This examined how racial stereotypes about conception can isolate minority women (specially African Americans) who are dealing with infertility. Stereotypes as well as cultural expectations, depict black women as very fertile and able to have children whenever they are ready. It is also not an issue that is talked about as much in the black community, and women of color are under-represented in the population of women seeking help to conceive.

This is the case even when black women on average, are twice as likely to experience problems with fertility as white women. However, those most often seeking help with issues of fertility are white women of higher income and education. It is explained that these women often have the best healthcare coverage and resources to work with, but this is not exclusively why they are the highest population utilizing these services. Even when all services were covered by insurance, black women were less likely to seek out fertility treatments. The article attributes this to a lack of resource information, cultural beliefs and bias from medical professionals. Many times black women are not given the same medical advising with doctors focusing more on STD's then issue of fertility.

For all women, it is important to make sure that fertility is not an issue you are experimenting alone. Speak to people you trust and your doctor about any problem you may be having. Seek out resources and talk to others who have gone through the same things. By being open and honest about your situation, you will not only help yourself but you may also help someone close to you who is dealing with the same thing.


Resources:
Article: Infertility Endured Through A Prism of Race - NY Times

Fertility for Colored Girls - Organization dedicated for fertility empowerment in African American women