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Paging Dr. Frischer - Health Promotion Women 50+
WRITTEN BY :   Dr. Alan Frischer

As promised, my current series of articles are devoted to specific health promotion plans for different groups. Health issues that may afflict us depend to an enormous extent on our gender and age, as well as genetics, environment and health habits.
Today, let’s address recommendations for women over 50. Of course, many of these basic measures are strongly suggested for anyone:
•Be tobacco free. The first step is deciding to quit, and for some, that’s all it takes. Many, however, have more success with various medications. The old standards typically involve some form of nicotine, whether it be administered through a patch, gum, or cigarette-type device. Chantix is the newest medication; work with your doctor to choose the best treatment for you.
•Be physically active. If you aren’t already, begin today. Start with small steps and advance gradually. Park your car further away from your destination…Use the stairs instead of the elevator…Take your children or grandchildren for a walk or to the park. In order to be physically active, you must think of yourself as an active person. This may involve a significant shift in your mind-set!
•Consume a healthy diet. Simply put, consume “real” food, not processed food. The more real the food, the more nutritionally valuable it is. Make sure that these foods are a major part of your diet: beans, nuts, fruit, vegetables, soy, low or no-fat dairy, fish, chicken, turkey, and 100% whole grains. Say no to saturated fats, trans fats, fast foods, snack foods, salt and sugar.
•Stay at a healthy weight. If your weight is rising, you are consuming more calories than your body, genetics, and level of activity demand. Balance the calories you consume with the lifestyle you lead.
•Drink alcohol in moderation. If you are over 65, consume no more than one drink per day. If you are under 65, two drinks is your maximum. Remember that one 12-ounce beer is the same as either five ounces of wine or 1.5 ounces of hard liquor.
•Take baby aspirin IF it is indicated for you for the prevention of atherosclerosis related diseases such as stroke and heart attack. Ask your doctor whether your own unique risk factors justify taking a medication that does have side effects, such as the possibility of bleeding ulcers.
•Some women have such a significant family history of breast cancer (multiple close family members) that they may consider taking medication for prevention of breast cancer. Again, speak with your own physician.
•Menopausal symptoms such as hot flashes, depression and fatigue can be debilitating. Estrogen replacement therapy (ERT) can combat these symptoms, but has become unpopular due to recent data suggesting greater cancer, stroke, and heart attack risk. Discuss this with your doctor.
•The annual flu vaccine is recommended for women over 50. There are also vaccinations for pneumonia and shingles. Tetanus vaccines are recommended every ten years for everybody. Ask your doctor which immunizations are appropriate for you.
Screening tests are extremely important:
•For breast cancer prevention, you should perform a breast self-exam at least once per month. If you are unclear about how to do it, ask your doctor for instructions. In addition, your doctor will do a breast exam at least once per year. Mammograms should be performed every year or two.
•To screen for cervical cancer, Pap smears are recommended every one to three years until age 65. After that, the recommended frequency is controversial, however a history of abnormal Pap smears will certainly increase how often you should have one.
•Colorectal cancer is now screened in a few different ways. A rectal exam will be performed at your annual physical. If blood is found, or a mass is felt, then a colonoscopy will be performed. In addition, at age 50, it is recommended that everyone get their first screening colonoscopy.
•Diabetes is screened through a blood sample taken after fasting. This test is typically part of routine labs taken by your doctor during your physical.
•High blood pressure can be detected when your doctor measures your blood pressure. Remember that regular exercise lowers blood pressure, and that salt, weight gain, and stress raise it. Your genetics are probably the most important factor in causing elevated blood pressure.
•Cholesterol levels are screened by a blood test. This too is typically part of the routine labs taken during your yearly physical. Many factors affect cholesterol, including genetics, diet, and exercise. Foods rich in omega-3 fatty acids such as fish, nuts, and dark green vegetables have shown promise in improving your cholesterol levels.
•Your doctor will order a Bone Mineral Density or DEXA scan to screen for osteoporosis. The risk of osteoporosis becomes more significant during menopause. Until age 25, bone is built, and after age 25 it begins to break down. This process accelerates after menopause due to the loss of estrogen. Exercise is very helpful, and be sure you are taking calcium and vitamin D as recommended by your doctor..
•If you are sexually active outside of a monogamous relationship, you should be screened for sexually transmitted diseases such as HIV, gonorrhea, chlamydia, genital warts and herpes.
If you wish, make up a checklist of these screening tests, and fill it in during your yearly physical. Your doctor will comment on the tests results, and what measures need to be taken to correct any problems found.
Remember what they say about an ounce of prevention. Good health to you all!
Dr. Alan Frischer is former chief of staff and current chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: January 8, 2010 – Volume 8 – Issue 38



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