Let’s face it… Pap Smears aren’t fun. The only test to sample tissue for cervical cancer just happens to be one of the most embarrassing and awkward but it can be one of the most life saving and simple. So what is it and how does it work? Here’s your questions answered.
The uterus looks similar to a light bulb. The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix. The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again. It affects nearly 13,000 and kills 4,100 women each year, rising each year. It can affect women of any age but is more common between 20 and 50.
The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18. This is acquired through unprotected sex, so condom use is encouraged. Thus it's one of the most preventable causes of cancer. Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.
Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.
Yes. Early detection is key and can be done by a Pap Smear, explained below. Multiple treatments are available including surgery, chemotherapy, radiation therapy, and targeted therapy such as Bevacizumab (Avastin®) which prevents new blood vessel growth that can feed a tumor.
The USPSTF (United States Preventive Services Task Force) recommends the following:
Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.
It is the cytology (cell analysis) of the cervix. Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it. Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.
In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus. A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia. After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.
An HPV test can be done with the cells obtained during the Pap Smear. The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.
In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear. Discuss with your medical provider when cervical cancer screening is best for you.
The concept of dental floss was first introduced in 1819 by Levi Spear Parmly, who recommended a waxed silk thread to remove food particles away from the teeth and gums. Dental floss was later patented by Johnson & Johnson in 1898 and it’s been a dental favorite ever since.
I’m a fan as too many people brush their teeth haphazardly and fail to adequately clean in between the teeth.
Now a study from the Silent Spring Institute and Public Health Institute in Berkeley, California, suggest that users may be exposing themselves to elevated levels of toxic chemicals known as perfluorocooctanesulfonic acids (PFA’s).
PFA’s are used in food packaging, commercial household products, industrial products and more. Animal studies have suggested their link to tumors such as testicular cancer, high cholesterol, liver and kidney dysfunction, and issues with one’s reproductive and immune system.
The EPA states the following:
The study was published in the Journal of Exposure Science and Environmental Epidemiology. Authors tested 18 dental floss brands, including Oral-B Glide, and found higher levels of PFA’s (perfluorohexanesulfonic acid) in the test subjects (178 California-based middle-aged women) who used the waxed dental floss.
Study author Katie Boronow, states, “This is the first study to show that using dental floss containing PFAS is associated with a higher body burden of these toxic chemicals….The good news is, based on our findings; consumers can choose flosses that don’t contain PFAS.”
Most dental floss brands, however, do not report on their packaging if they contain PFA’s or not. Unwaxed versions may be PFA free.
However, many other daily habits can expose us to PFA’s such as eating fast food packaged in waxy coated cardboard containers.
So since good dental hygiene is paramount for health, I suggest speaking to your dentist about your flossing habits and consider also using a water pick as it can be very effective at removing food particles and bacteria from one’s teeth and gums.
The CDC has reported an increase in flu activity during our 52nd week of the year ending on 12/29/18.
The CDC reports outpatient visits for influenza-like illness (ILI) jumped to 4.1%, above the national baseline of 2.2%.
The CDC states the following:
New York City and 19 states experienced high ILI activity; nine states experienced moderate ILI activity; the District of Columbia and 10 states experienced low ILI activity; and Puerto Rico and 12 states experienced minimal ILI activity.
States experiencing high ILI activity include:
States experiencing moderate ILI activity include:
Low and minimal activity (noted in yellow and green) has been reported in the remaining states as well as Puerto Rico.
Currently it appears the majority of flu cases are caused by the H1N1 Influenza A strain. Even though the H1N1 caused an epidemic in 2009, this may forebode a less severe flu season from last year’s H3N2 epidemic.
Flu season has begun already. It typically starts in the Fall, and ends late Spring. So the range is described as October to May with it peaking December to March.
It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Fluview.
The flu is caused by a virus. Multiple strains of virus’ can cause the flu. The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections. Pneumonia is the number one cause of flu-related deaths. Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have pre-existing medical conditions are urged to get vaccinated against the flu. Moreover those who qualify should get the pneumonia vaccine as well.
According to the CDC, the trivalent vaccine covers for these three strains of flu virus:
Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).
These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.
This year, those over 65 will have three options for their flu vaccine.
Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer
FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.
Flublok Quadrivalent – provides protection against 4 strains.
This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from prior years. However it is only recommended for those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.
All individuals 6 months old and older unless specified by their medical provider.
Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.
No. The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it). A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response. Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.
The average effectiveness each year hovers around 60%. Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.
For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.
A cold comes on slower and less severe. Flu symptoms are more abrupt and can include:
There are antiviral medications available, such as Tamiflu, to treat the flu. Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.
Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself. A balanced diet, exercise and sleep regimen can help boost your immune system.
Wishing you health this season!!
The holidays flew by us way too quickly and left the wind chill in its wake.
Unfortunately, with all the hustle and bustle this time of year, we tend to forget how dangerous the weather can be. It would make sense to stay indoors, and for the most part we do….except for New Years. All rules go out the door with this party. The most exciting night of the year can sometimes be the coldest night of the year. And the party ends up outside. And do we don a ski mask, goggles, gloves, galoshes, thermal underwear, winter coat and earmuffs? No. That would make the most unsexy New Year’s outfit.
Throw some alcohol into the mix and this can be a deadly combination. The CDC estimates that 1300 deaths occur each year due to hypothermia. So what is hypothermia?
Hypothermia is a dangerous drop in body temperature and can occur in minutes. Human body temperature averages around 98.6 degrees F. But hypothermia starts setting in at 95 degrees F with shivering, increase respiratory and heart rate, and even confusion. We forget that glucose stores get used up quickly so hypoglycemia can ensue as well, making matters worse, especially in someone who is intoxicated. Frostbite can occur as blood flow decreases to the tips of the ears, fingers, nose and toes. As hypothermia progresses, the shivering and muscle contractions strengthen, skin and lips become pale, and confusion worsens. This can lead to severe hypothermia, eventually causing heart failure and/or respiratory failure, leading to a coma and if not reversed, death.
Someone who is hypothermic may slur their speech, stammer around and appear uncoordinated. This sounds identical to your drunk buddy on New Year’s Eve. Unfortunately, this can be deadly as many hypothermic partiers get written off as being drunk.
So if you suspect hypothermia, call for medical assistance. Anyone you think is eliciting signs of hypothermia should be brought indoors, put in dry clothes, covered in warm blankets, and then wait for paramedics to arrive. It’s important to try to warm the central parts of the body such as head, neck, chest, and groin, but avoid direct electric blanket contact with the skin and active rubbing if the skin is showing signs of frostbite.
Hot water will be too caustic and can cause burns. Remember, the body is shunting blood away from the ears, fingers, toes, hands and feet to warm the heart, brain and other vital organs. The skin will be in a vulnerable state during hypothermia and frostbite and will burn the under perfused skin.
We’re outside in the cold, not bundling up, dancing, sweating, becoming dehydrated. Add alcohol to the mix, and its deadly. Here’s the scoop on alcohol toxicity.
When it comes to hypothermia, the best thing you can do is prevention. It’s the biggest party of the year so prepare yourself by doing the following:
Tis the season!! Unfortunately not for our hearts. A study back in 2004 found a 5% increase in heart attacks during the Christmas season. Then this month, a study published in the British Medical Journal found Christmas Eve to be especially risky for those who are prone to heart disease. Let’s dissect why….
The cold has long been associated with heart stress. Cold weather causes blood vessel constriction and this adds extra work for the heart. Moreover, it causes less oxygen to reach vital organs, including the heart.
Snow shoveling has been infamous for inciting heart attacks for this same reason. The heart demands extra blood due to the increase in activity and the cold restricts blood flow.
Alcohol, especially in excessive amounts, can put stress on the heart by increasing blood pressure, worsening diabetes, and causing abnormal heart rhythms. Moreover, it interferes with the metabolisms of medications, hence many of these may not work at their best. Which brings us to…..
Medical providers take vacation too. And if a patient forgets to refill his medication he may go without during the two weeks of holiday season. Moreover many forget to pack everything they need for a Holiday trip and without anticipating delays, one could be without crucial medication dosing. The heart does not like this.
Holiday travel is never easy. Delays, long lines, the cold, traffic and then…..family. We may love our family but prefer seeing them in small doses. All the family at once can be a little overwhelming for some. As for coping with the in-laws…..well a guide is available for you all here.
Firstly, we must know our risk factors. These include:
As you can see, many of us can be at risk for heart disease. Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.
Thirdly, reduce your risk by the following:
Plan ahead by doing the following:
Holiday time should be a happy time. Let’s make it a healthy one!!!
This generation of teens communicates differently from any others as smartphone technology has outpaced the normal evolution of day-and-age vernacular. As a result, adolescents use abbreviations and emojis to convey their thoughts while parents and society scrambles to catch up.
What are you teen saying? A parents guide to teen slang.
However, within these bite-size “codes” could be volumes of meaning, some delineating at risk behavior, some foreboding suicide. These codes many times come from the letters that correspond to the keypad on a phone. So here’s a guide to some of the unfamiliar terminology the young ‘uns are using:
Drugs/Risky Behavior (to be revisited more in depth)
And the above is just a small sample of some of the terms used these days. This list continues to grow by the day so parents need to always be aware. Kids want to KPC and avoid POS so be ready for the next group of codes being created as we speak……
This week, the CDC issued a general warning that Romaine lettuce is not safe to eat.
32 people from 11 states have become ill due to this recent outbreak of E. coli.
The Shiga toxin-producing E. coli O157:H7 sickened 32 people between the dates October 8-31, 2018 and caused 13 hospitalizations, one of whom went into kidney failure.
No deaths have been reported.
On Tuesday they issued the following tweet:
Outbreak Alert: Do not eat any romaine lettuce, including whole heads and hearts, chopped, organic and salad mixes with romaine until we learn more. If you don’t know if it’s romaine or can’t confirm the source, don’t eat it. https://go.usa.gov/xPAy5
On their website, the CDC reports the following:
CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak. This investigation is ongoing and the advice will be updated as more information is available.
Symptoms of E. coli poisoning can occur anywhere from 1-10 days after ingestion.
Diarrhea, may be bloody
And if progresses, can cause
Shortness of Breath
Exposure to E. coli may occur from exposure to contaminated foods (from human or animal waste) or undercooked meats.
A recent analysis from Kaiser Family Foundation found the average younger American does not have a primary care provider (PCP).
Looking at survey answers from 1200 participants, 45% of 18 – 29 year-olds admitted to not having a PCP. 28% of those aged 30-49 and 18% of those aged 50-64 said the same. Those over age 65 were the largest group to have a primary care provider.
Those born between 1981-1996, known as the Millennials, may have different attitudes towards health care. Keep in mind, they just lived through nearly a decade of recession, computer hacks, Obamacare controversies, and societal distrust of pharmaceutical companies.
PCP’s however are the “quarterback” in one’s healthcare, keeping accurate and thorough records on one’s medical history, addressing immediate and chronic issues, and coordinating where their patient needs to go if a specialist is needed.
But Millennials, instead, are preferring urgent cares, retail clinics, emergency rooms, or using telemedicine for their medical needs.
However if one, unknowingly, suffers from a chronic condition and has various acute issues, they may be misdiagnosed because they are receiving piecemeal care without someone overseeing them and connecting the dots.
Diseases such as cancer, diabetes, heart disease, syphilis, AIDS, neurological disorders and autoimmune illnesses are just a few that may cause intermittent acute episodes before becoming deadly. Someone needs to take a step back, look at one’s medical history and properly diagnose, or simply put, see the forest from the trees.
Our healthcare system is changing and the needs of the younger generation appear to be better met by clinics that charge up front, address a single issue, and provide convenient hours. Therefore “primary care” providers will still be needed, however, the art of “primary care” may evolve into a whole new beast.
The Nutcracker and the Four Realms is Disney’s latest release, and not only are viewers anticipating a fairy tale story, dancing, melodious soundtrack and illuminating colors, but they are also expecting a parent to die or not be in the picture early on in the story.
It’s inescapable if you commit to emotionally investing in a Disney film. And if you look closely, it’s more often the mother.
Why? Well let’s first look at some of the classics.
1938 Snow White and the Seven Dwarfs – Snow’s biological mother died and is replaced by the Evil Queen, her stepmother.
1941 Dumbo – our favorite elephant is parent-less in the movie.
1942 Bambi – sadly, graphic content below….
1950 Cinderella – the most famous princess to ever live is motherless in the movie and haunted by her big-footed step family.
1951 Alice in Wonderland – its been postulated Alice was orphaned and taken care of by a governess.
1963 The Sword and the Stone – Arthur is a 12 year-old orphan boy.
1967 The Jungle Book – Mowgli is found parent-less.
1989 The Little Mermaid – Ariel’s mother, Queen Athena, was killed, leaving her father Triton to raise her and her sisters.
1992 – Aladdin – Princess Jasmine is motherless.
In Tarzan's, Lilo's and The Emperor's New Groove's Kuzko, all lost their parents.
In 1994 not a dry eye was in the house during the scene in which Simba loses Mufasa in The Lion King….
1995 – Pocahontas – it’s revealed her mother had passed a while back.
And the most colorful and comical of the Disney films, Finding Nemo, wasn’t exempt either, with Nemo’s Mom being eaten in the opening scene.
Multiple theories were brought forward by Disney producer, Don Hahn, in an interview to Glamour. The first was that Walt Disney tragically lost his mother when he was younger.
In 1938 the successful film producer, young Walt, purchased a home for his parents and when the gas furnace was faulty he sent his studio men over to fix it. Unfortunately the repair was not adequate and it eventually leaked, and his mother, Flora Call Disney, soon died of asphyxiation.
It’s believed the grieving son found the interweaving of this tragedy into his work as a means to deal with his guilt.
The second theory is that Disney films wanted to mix fairy tale with the reality many children face, adding a sense of “realism” to the stories.
And final theory is Walt Disney wanted children to feel like heroes, and a film in which a child battles evil without the help of Mommy and Daddy infused a sense of empowerment to his target audience.
So the idea of celebrating the triumph of the quest of a parent-less child is probably more pervasive in these movies than the purposeful injection of a gory parental death. Although this makes Disney movies more palatable, I’m still hoping Mufasa was only unconscious and recovered off the set when we weren’t looking.
As the death toll rises and thousands of acres burn between California’s Camp Fire and Woolsey Fire, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.
According to the EPA, smoke emanating from forest and community fires may include any of the following:
According to the EPA,
Smoke is composed primarily of carbon dioxide, water vapor, carbon monoxide, particulate matter, hydrocarbons and other organic chemicals, nitrogen oxides, trace minerals and several thousand other compounds. The actual composition of smoke depends on the fuel type, the temperature of the fire, and the wind conditions. Different types of wood and vegetation are composed of varying amounts of cellulose, lignin, tannins and other polyphenolics, oils, fats, resins, waxes and starches, which produce different compounds when burned.
Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart. However, many may experience:
PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings. Larger, coarse particles 10 micrometers in diameter are called PM10. Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood. Moreover the small particles can use this pathway to enter the bloodstream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.
Symptoms may begin at levels greater than 55 µg/m3 .
How can residents protect themselves?
Avoiding the area of wildfires is paramount. Additionally, the following may be considered:
Editor's note: As a companion read you might also be interested in a story we published in Sept. last year: 5 apps to help you recover from hurricanes and wildfires.