Will You "Cervive" in 2015?

Is 2015 the year you finally truly prioritize YOUR health? The majority of Americans include weight loss and possibly exercise in their New Year's Resolutions each year...and do really well on their strict diets for a few days or maybe even a few weeks. While I absolutely applaud attention to weight and activity levels, I want to encourage you to think beyond diet and exercise for your 2015 health resolutions. (And I will spend time in future blogs this month talking more about what diets work best, but today I want to shift the focus...)

January happens to be Cervical Cancer Awareness month, so women- how about starting your 2015 Resolution list with scheduling your "annual" exam, especially if your last "annual" was way more than a year ago? The GOOD news is that screening recommendations have changed quite a bit, so women no longer need to have Pap tests every year. Current guidelines tell us for young women to have their FIRST Pap test at age 21, then (assuming tests do not show a problem) every 3 years between 21-29, and then after age 30, testing can actually occur simply every 5 years (by using both the Pap test and a specific HPV test combined).

In the United States, cervical cancer is still diagnosed in over  12,000 women per year, and tragically, still causes over 4000 deaths per year. We can do better! The vast majority of women with cervical cancer have little to NO symptoms- this is a silent killer. While prevention (with the HPV vaccine) is optimal, early detection absolutely saves lives- so do NOT put off getting your Pap test.

While most of us have run 5K's or worn PINK for breast cancer awareness, few people know or talk about their diagnosis of cervical cancer. Tamika Felder, a now 13 year survivor of cervical cancer, is leading the charge to increase personal and community support for cervical cancer. For my fellow AUSTINITES- if you or someone you love has been diagnosed with cervical cancer (whether that diagnosis was recent or many years ago), please let them know about CERVIVOR SCHOOL- a four day learning, connecting and revitalizing retreat NEXT WEEK, starting Thursday evening, 1/15/15 through Sunday afternoon.

BOTTOM LINE: Women, if you are due for a Pap test, please move that to the top of your 2015 Resolution list! 

Back to School Check Ups & Vaccines

Where did summer go? We are still having consistent 100-plus degree days here in Texas, but our kids start back to school next week already! In my office, however, we are well aware it's "back-to-school" time, as everyone is realizing that they've got school and sport physical forms to fill out, and our seventh graders are due for vaccines. Please call your family doctor RIGHT NOW and get your kids scheduled for an appointment!


Many people wonder why we prefer for kids to come in to fill out these forms, so I thought I'd take a moment to explain. First of all, kids GROW. Yes, I know this is not news to you, but when the last time we saw "Justin" was 6 months ago, before his growth spurt, if we use his height and weight from that visit, we'll be off by a couple inches and a dozen pounds. With the childhood obesity epidemic we are facing, these vital signs become even more important. I'd much rather talk to "Jessica" about food choices when she is a few pounds overweight, than waiting a year or more and then face telling a teenage girl she is 20 lbs overweight.

This "annual" exam is a wonderful window of opportunity for your physician to talk to your adolescent about all kinds of preventative issues- from helmets and limiting screen time, to diet & exercise, to dating & driving risks. Often kids will listen to their doctor, when their parent has preached the same speech to deaf ears. Feel free to give your family doctor a heads up if you have concerns about your child's behavioral, dietary, or peer choices so we can direct our education.

Finally, be aware that our immunization schedules are always changing. For example, we are now giving the meningitis vaccine and the chicken pox vaccine booster along with a tetanus shot for incoming 7th graders. (We used to wait till kids were headed to college to give the meningitis vaccine, and the chicken pox booster was only recently added in.) The immunization series for HPV (human papilloma virus) is also available for this age group.

BOTTOM LINE: Back to school preparation INCLUDES a doctor's visit for your child (unless she's recently had a checkup). Sign up now and bring those school & sport forms WITH you when you go!

To Pap, or Not to Pap...

When I was in medical school (not THAT long ago), there was no question about when women should get Pap smears. We knew that this valuable test to screen for cervical cancer saved lives, and every woman should be tested at her annual exams. Subsequently, we learned that all cervical cancer comes from HPV- the Human Papilloma Virus, which is transmitted by intimate skin-to-skin contact, primarily through sex. With that knowledge, we modified the Pap requirements to only those women who had become sexually active.
Now we know that the majority of HPV infections occur upon initiation of sexual activity, and that most of these infections are cleared by the immune system within a couple years, and do not result in cancerous changes. We also realize that invasive cervical cancer is very rare in women younger than 21, and so the current guidelines tell us that women should start having Pap smears when they turn 21 (and have had intimate relations.)
Happily, we also have vaccines to help our immune systems fight off the HPV more effectively, so with Gardasil and Cevarix immunizations, we should be seeing even less cervical cancer!
What if you are over 21? Women aged 21-29 without high risk factors (HIV, organ transplant patients, DES exposure or previous abnormal Pap smears that showed early cancerous changes) should get screening Pap tests every other year in their twenties, and every third year beyond their 30's.
Women over 30 will be tested with both the traditional Pap test and a specific test that checks for the strains of HPV that cause cancer. If you test positive for these high risk strains, your screening will be more frequent (annually.)
When can we STOP? By 70, if you have had a decade of normal results, you are done. Yea!
BOTTOM LINE: Pap tests do not need to be an automatic part of your annual pelvic exam- but YOU STILL NEED ANNUAL PELVIC EXAMS to check for sexually transmitted diseases and other gynecologic concerns (ovaries, etc.)