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MyHealth SPRING 2014
YO U R S O U R C E F O R WO M E N ’ S H E A LT H N E WS A N D T R E AT M E N T T R E N D S
+ Girls and the HPV vaccine PAGE 2
+ When should your daughter see an Ob-Gyn? PAGE 3
+ Is your metabolism slowing down? PAGE 3
+ Understanding inherited cancer risk PAGE 4
Integrative Medicine
G E T T H E M O S T O U T O F Y O U R H E A LT H C A R E
Maximum Health
Integrative Medicine Program helps you get the most out of your health care There’s more to health than medications and doctor visits. The Integrative Medicine Program at Baylor proves it by combining multiple approaches to help you become the healthiest you possible. “Integrative medicine is basically opening up your toolbox,” explains Carolyn Matthews, MD, a gynecologic oncologist and medical director of integrative medicine at Baylor University Medical Center at Dallas. “It’s using lifestyle medicine as well as some aspects of Ayurvedic and Chinese medicine along with traditional allopathic medical care.” While the Integrative Medicine Program operates out of Baylor Charles A. Sammons Cancer Center, patients with conditions other than cancer can also benefit from an integrative approach to medicine. “This is for people who say, ‘I want to do everything I can to be healthy,’” Dr. Matthews says.
PROMOTING OPTIMAL HEALTH AND HEALING Integrative medicine services include: • Acupuncture • Biofeedback • Individual consultations and recommendations for optimal wellness • Individual counseling • Guided imagery • Healing touch • Nutritional supplements • Relaxation techniques • Spiritual support • Group support
Find a Healthier You. To learn more, visit BaylorHealth.com/ IntegrativeMedicine or call 1.800.4BAYLOR.
SEEING THE BIG PICTURE Many of us change doctors frequently, and our doctor visits are often short, Dr. Matthews notes. “With integrative medicine, the doctor may spend 90 minutes with new patients and 30 minutes on follow-ups,” she says. This allows the doctor to offer more detailed guidance to each patient. “The program makes recommendations from a 360-degree viewpoint,” she says. “We give recommendations for diet, for exercise, for supplements, for relaxation.” Some women might walk away with instructions to exercise more vigorously, while others might get a prescription for yoga or tai chi, as well as advice for additional medication or sleep studies.
A CUSTOM PRESCRIPTION With a focus on disease prevention, integrative medicine provides a personalized approach based on each patient’s needs. “Everybody walks in the door with his or her own set of concerns and medical problems, genetics and environmental exposures. Everybody is so unique,” Dr. Matthews says. “Everyone leaves here with an integrative medicine prescription. And every single one is different.” 2 My Health / Spring 2014 Visit us at BaylorHealth.com
GIRLS AND THE HPV VACCINE You’ve heard about the importance of detecting cancer early. But what if you could prevent it? “We know that cervical cancer is caused by human papillomavirus (HPV),” explains Mark Messing, MD, a gynecologic oncologist on the medical staff at Baylor Regional Medical Center at Grapevine. “The vaccine targets two major subtypes of the virus and is highly effective at reducing future risk of cervical cancer if given prior to exposure.” The two brands on the market are both given as three injections over six months. And good news for parents worried that the vaccine leads to increased promiscuity: There is no data that suggests a connection, Dr. Messing says. But young women who get the vaccine still need Pap tests (starting at age 21), he adds. “The vaccine doesn’t protect against all types of the virus,” he says, “which is why we want them to get their screenings.”
Parental Guidance When should your
daughter see an Ob-Gyn? Your daughter is getting older, and she’s outgrown her pediatrician. But is she ready for an Ob-Gyn? Maybe. First, it’s important to recognize that while Ob-Gyn’s are specialists, adolescents (and adult women, too) can also see family medicine physicians or internists for their gynecologic needs, says Brock Pierce, MD, an Ob-Gyn on the medical staff at Baylor Medical Center at McKinney. Regardless of the type of physician, what you may want to know is whether a pelvic exam is appropriate. This, Dr. Pierce says, varies by person. “A reproductive health visit may only need to include age-appropriate education about reproductive health matters,” he explains, noting that the American Congress of Obstetricians and Gynecologists recommends that girls have their first reproductive health visit between 13 and 15. “A pelvic examination is not necessarily included unless the young lady has symptoms of a gynecological problem or is sexually active.”
FINDING THE RIGHT PHYSICIAN It may be difficult to talk to your daughter about her sexuality, but it’s important to discuss contraception and prevention of sexually transmitted infections, Dr. Pierce says. Encouraging her to establish a good relationship with an Ob-Gyn or other physician can also help ensure she gets the information she needs. When choosing a doctor for your daughter, you may want to look for those who have an interest in adolescent gynecology. “You and your daughter may feel more comfortable with this more specialized gynecologist,” Dr. Pierce says. Above all, he says, remember that it’s important for your daughter to feel comfortable with her doctor. “Interview the doctor with your daughter on her first visit,” he says. “There are a lot of Ob-Gyn doctors, all of whom interact with patients differently. Look for the doctor who best fits your daughter’s needs.”
Is Your Metabolism
SLOWING D O W N ? Discover the steps you can take to give yours a boost As you get older, maintaining your weight can be a struggle. Even if you haven’t changed your lifestyle, you might notice a few extra pounds creeping up on you. A slowing metabolism could be to blame, but there are things you can do to turn the tide.
METABOLISM MECHANICS Metabolism is the process your body goes through to convert food into fuel, using certain hormones and enzymes. This directly relates to how efficiently you burn calories and therefore how you gain or lose weight. Your basal metabolic rate (BMR) refers to the number of calories you’d burn in one day if you did nothing but rest. Your BMR doesn’t factor in exercise—or really, even getting out of bed. It is based on your height, weight, age and gender. Everyone’s BMR is different, but as you get older, the number decreases. So, if you don’t reduce the number of calories you consume or burn, you’ll slowly gain weight over time, explains Carrie Morris, MD, an Ob-Gyn on the medical staff at Baylor Regional Medical Center at Grapevine. “For women, when our estrogen levels start to decline, we tend to see this fat stored around our abdomen,” she adds. In general, consuming 3,500 calories more than you burn translates to about a one-pound gain. So, if your BMR slows by just 100 calories a day (equal to two cubes of cheddar cheese), you could gain about 10 pounds in a year—without making any lifestyle changes.
WHAT YOU CAN DO Take these five steps to stop this “middle-age spread” that women dread.
1
Keep moving. “Even without realizing it, we tend to become less active as we age,” Dr. Morris says. In short: don’t. Walking, swimming, dancing and gardening will boost your metabolism and minimize the slowdown while burning calories.
2
Lift weights. People with more muscle tend to have higher metabolisms, Dr. Morris says. ”If you increase your lean body mass, this will increase your body’s basal metabolic rate.” Try strength training with weights, elastic bands or yoga two days a week.
3
Eat smart. “Maintain a healthy, low-fat diet high in vegetables, fruits, whole grains and lean protein,” Dr. Morris says. Protein and highfiber foods give your metabolism a boost, while sugar and processed flours do the opposite.
4
Drink water. The amount of water each person needs is based on lifestyle and body type, but studies have shown that people who drink plenty have higher BMRs than those who are less hydrated.
5
Don’t buy into magic bullets. Stay away from medications or supplements that promise a metabolic boost, Dr. Morris says. They don’t have a proven benefit and could do more harm than good.
Need an Ob-Gyn?
Get Help Managing Your Metabolism
For a free physician referral call, 1.800.4BAYLOR or visit FindDrRight.com today.
Looking for a doctor? Visit FindDrRight.com or call 1.800.4BAYLOR. Visit us at BaylorHealth.com Spring 2014 / My Health 3
Understanding Inherited Cancer Risk Learn more about Lynch syndrome and its connection to other types of cancers
Finding the Answer in Your Genes Many cancers, including breast, ovarian and colon cancers, have a genetic component that could put you at an increased risk. If you have a personal or family history of cancer—especially if the cancer was diagnosed at a young age—you may want to consider genetic counseling, says Ann Simmons, a genetic counselor at Baylor University Medical Center at Dallas. Start by talking with your doctor, who can determine whether your family history warrants further exploration. The next step is meeting with a genetic counselor to provide more details about your health and family history.
Your risk for cancer is determined by several factors, including your diet, whether you smoke and your genetics. Certain genetic mutations increase the risk of Lynch syndrome, an inherited condition that raises a person’s risk of colorectal cancer. In fact, about 3 percent of colorectal cancer cases are caused by Lynch syndrome. But this syndrome, known as hereditary nonpolyposis colorectal cancer, also increases risk of cancers of the stomach, small intestine, liver, kidneys, ovaries, uterus and other organs.
KNOW THE ODDS If several of your family members have had colon cancer (especially younger than age 50) or other Lynch syndrome-related cancers, talk to your doctor. You also may want to talk to a genetic counselor and undergo genetic testing to better understand your own risk. Most people should begin colon cancer screenings at age 50, says C. Richard Boland, MD, a gastroenterologist on the medical staff at Baylor University Medical Center at Dallas. “In the face of a positive family history, you do colon cancer screening 10 years earlier than usual,” he says, adding that if you have the Lynch syndrome gene, you should get a colonoscopy every year. Meanwhile, women with Lynch syndrome have about a 40 percent lifetime risk of endometrial (uterine) cancer and a 10 percent risk of ovarian cancer, he says. “What I tell women is, once you’ve decided you’ve completed your family, then you have a decision about whether to have a hysterectomy to remove your uterus and ovaries,” Dr. Boland says. “It’s a reasonable option.”
Could It Run in Your Family? To learn more about Lynch syndrome or for a free physician referral, call 1.800.4BAYLOR or visit BaylorHealth.com.
“We encourage everyone to investigate their family history. Ask questions you don’t normally ask because what’s going on in your family can directly impact your health,” Simmons says. “And this information is important in our risk assessment.”
THE RIGHT CHOICE – FOR YOU Your genetic counselor may recommend specific tests, but moving forward with testing is ultimately your decision. “Some people have different psychological issues knowing that they’re at an increased risk for cancer,” Simmons says. But knowing more about your genetic risk also can be empowering. Some women choose to have their breasts or ovaries removed to reduce their chances. Others opt for a more aggressive screening schedule. “A woman’s choice often depends on her personal experience with cancer,” Simmons says. “We don’t tell women what to do. We educate them so they can make informed choices.”
The material in My Health is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment. Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers, and are neither employees nor agents of those medical centers or Baylor Health Care System. Photographs may include models or actors and may not represent actual patients. If you are receiving multiple copies, need to change your mailing address or do not wish to receive this publication, please send your mailing label(s) and the updated information to Robin Vogel, Baylor Health Care System, 2001 Bryan St., Suite 750, Dallas, TX 75201, or email the information to robinv@baylorhealth.edu. © 2014 Baylor Health Care System. BHCSWOM 51 MOD 14032. 5/14