October 2007

Q. You treat hundreds of patients in your practice, so what is it about between the ages of 40 and 60 - that they tend to make more medical mistakes than others?

A. Until midlife, women caring mostly for their children and other loved ones, and except for regular GYN exam for pap test and breast exam, they had few health decisions to make for themselves. At midlife - women for the first time face a number of medical concerns and testing needs of their own - from heart disease risk, cancer screening, bone testing and hormone decisions.

Q. Describe what you mean by medical mistakes - what mistakes are women making?

A. When it comes to their own health, 1) women don't trust their own instincts. 2) they rely too much on their physicians to tell them what to do - think their physcians know more about them then they do...bottom line - 3) a woman's health radar works best - 4) they don't ask - and as a result, the physicians may not tell them what they need to do to stay healthy. Finally - almost too much information available that women don't know how to sort out what is really important for them - based on their unique risk factors and history.

Q. You would think as you get older, you'd want to see the doctor more frequently, but that isn't always the case. How often do we need a physical? And what should happen at the physical? Should we have blood work drawn and what blood work should be done?

A. That's a great question - and women over 40 don't think about getting a physical - many just have an OB/GYN.. So true - until midlife - women have relied on GYN's to do everything for them...but every woman needs a family doctor (or internist) as well. There is NO ONE SIZE FITS ALL when it comes to a physical exam but everyone should consider meeting with family doctor yearly to get tests that make sense for them. Depending on age, family history, and personal risk factors, certain tests are needed. E.g. colonoscopy and mammogram by age 40 if family history, HPV along with Pap test for women 30 and over, heart and bone assessment if high risk. Blood work makes sense too - for lipids, sugar, even kidney, liver and thyroid testing can be important.

Q. Can I trust my internist to look after my heart?

A. False. Most family doctors (over 7%) and even cardiologists (over 17%) don't realize that more women than men die each year from heart disease. That means your doc may not be sizing up your risk factors. Know your numbers: BP <120/80, LDL cholesterol under 100, HDL higher the better over 50, and TG important for women too, under 150. Glucose under 100 - borderline means heart risk too.

Q. Your advice is be on top of the doctor and bring a self-addressed envelope to get your medical report, right?

A. You are entitled to your health information - keep your own medical file, no news is NO NEWS. Know your target goals/your numbers, ask for copy and give SASE - probably does more to prevent mistakes, info falls through the cracks, etc. more than anything else. Docs don't always have tracking system to alert you to abnormal results.

Q. Do daily naps help improve you heart?

A. True. Harvard researchers found that taaking a 30 minute nap up to three times a week can reduce risk of heart death by 1/3. Napping/sleep over 7-8 hours/night reduces stress, reduce cortisol, lowers belly fat. Sleep strengthens immunity and linked to lower diabetes, better heart health.

Q. Another problem women have is not knowing when to slow down or jump start their routine. I was wondering how much exercise do we need to do to maintain a healthy quality of life?

A. When it comes to your health, EXERCISE IS KING AND DIET IS QUEEN. Tons of research has shown that minimum of 30 minutes walking 5 days/week reduces dangerous belly fat, reduces cancer risk, improves heart health, balance, bones and just about every health measure improoved. For weight loss need more - up to 60-90 minutes. Resistance exercise - using weights also critical to build muscle mass, reduce belly fat, improve bones, balance and self-esteem.

Q. Are sweating and hot flashes symptoms of menopause?

A. False. There are many things that can casue hot flashes and sweating. A recent study showed that women with hot flashes had higher risk of high blood pressure - perhaps related to adrenalin/norepinephrine which raises BP, increases sweating, etc. Other conditions include overactive thyoid, infections, autoimmune conditions and even cancers.

Q. What should we know about sweating and hotflashes?

A. Before attributing to menopause - get BP and general exam to see nothing else is wrong.

Q. Most women over 40 are afraid to go to the doctor - if you could give one bit of advice to women over 40 about going to the doctor - what would you say?

A. It is your job to take chare of YOUR HEALTH - no doctor can do that for you. Trust your own instincts - (you know more than you think you do.) Do your homework in advance, know what tests make sense for your unique circumstances, and keep track of your own test results.