Women's Health
by Breyanna Knoll& Deb Wezensky
Keeping yourself healthy mind, body and soul is a 24-hour, seven-day-a-week job. We're here to give you the scoop on the latest in women's health, including autoimmune disorders, thyroid health and osteoporosis, each of which affects women disproportionately, and heart health, in which women and men sometimes must be diagnosed and treated differently.
Lung Cancer Survivor
Carol Becker devotes herself to Lung Cancer Connection after overcomming the disease
In January 2005, Carol Becker enjoyed a getaway with her husband at a bed and breakfast in Hermann when her first signs of lung cancer appeared. She always lived a very healthy, active lifestyle, eating right and working out regularly. So when she came down with a fever, she knew instantly something was not right.
Something seems to be drastically wrong, Becker, 62, thought. I'm never sick.
She called her doctor, and he gave her some medication for the flu. However, she did not get better. Her doctor decided to take an X-ray of her lungs, but Becker was confused.
"I sort of was surprised because I wasn't coughing," she says.
The X-ray came back showing a spot the size of a half dollar. She had a choice to make: Leave it alone, get it removed or have a biopsy. She chose the biopsy.
"I just knew," the Manchester resident says.
On Valentine's Day, Becker's doctor broke the news to her and her husband that it was lung cancer. She soon had surgery to remove the lower right lobe of her lungs and 24 lymph nodes. Ironically, Becker had no history of lung cancer in her family and had picked up a cigarette habit for only a couple years when she was 20 but otherwise was considered a nonsmoker. The doctor concluded it may have been a bad cell, but the comments made still bother her today.
"He said, ‘Your lungs look like you're a chronic smoker,'" Becker says.
After surgery, Becker's months ahead were filled with endless pain unlike many people will ever experience from infections in her lungs to a battle with C-diff, a bacterium that commonly appears after the use of antibiotics. She even was told she would have to go through chemotherapy but eventually found out her white blood cell count was too low. In July 2005, when not much else could be done, her doctor considered her a survivor.
"‘Just consider yourself cancer free,'" the doctor told Becker. "‘Just live your life.'"
After almost 17 years of working as a licensed professional middle school counselor and part time with her private counseling practice, Becker was ready to go back to work. However, her return brought an immense amount of pain due to the injections and surgeries that left an eight-inch scar on her back.
"I remember the first time I had to sit in a chair," Becker says. "I thought I was going to pass out."
With many health problems lingering from the cancer treatment, including a decrease in energy, an episode of shingles that led to nerve damage and a mild case of fibromyalgia that still bothers her today, Becker decided she would retire.
"I did enjoy my job a lot," she says. "But you have to make choices."
Since the cancer, Becker has become heavily involved in an organization called Lung Cancer Connection Inc. after she met lung cancer survivor Cheryl Lamprecht at a Relay for Life event. Before meeting Cheryl, Becker had met only one other survivor, and she had no involvement in any organizations.
"There's just nothing out there for lung cancer survivors," she says.
Becker and the members of Lung Cancer Connection Inc. are determined to turn that around. In addition to raising awareness and research, they want to lend a hand in support and reduce the smoker's stigma on some lung cancer patients. To advertise their organization, they plan to promote jewelry carrying their logo and will also host a run/walk in November.
"The main thing is to give people hope," Becker says.
Looking to the future, Becker plans to one day write a book. She wants to laugh, live for the moment and take care of herself to improve her health. As for the organization, she has big dreams ahead.
"I hope we can grow to the size of Susan B. Komen," she laughs.
Autoimmune Disorder
Dr. Denise Hooks-Anderson knows the effects of lupus firsthand.
Dr. Denise Hooks-Anderson, a 38-year-old mother of two and family practice physician, has been living with lupus for the past decade. Lupus is a disease that causes her immune systems to attack her body's cells.
Sunlight often causes her skin to rash, redden and scar. She also experiences joint pain and stiffness. Hooks-Anderson's joint pain originally limited her mobility, but persistence and the right balance of medications have allowed her to exercise four to five times a week.
"I've taken a holistic approach to my disease," she says.
Lupus patients present a wide variety of symptoms — it can cause everything from rashes to renal failure — and she sees this spectrum in her patients.
"I truly believe I'm blessed. This disease can be a lot worse," she says.
Lupus often appears in families, although Hooks-Anderson's family has only a history of rheumatoid arthritis. Doctors associate rheumatoid arthritis closely with lupus because autoimmunity factors into lupus's onset and severity.
"Certain autoimmune diseases may be the initial manifestation of or may precede full-blown lupus," says Dr. Reema Syed, assistant professor of internal medicine and pediatrics in the division of adult and pediatric rheumatology at the Saint Louis University School of Medicine.
Like many autoimmune disorders, lupus affects more women than men. The Lupus Foundation of America reports 1.5 million Americans have some form of the disease, and 90 percent are women.
The overlapping nature of autoimmune diseases has made them difficult to study. Clinical trials recently began for a new drug called Benlysta. It acts as a kind of biological "volume control" to dial down the intensity of the immune response to lupus patients' tissues, and it is the first drug in 50 years to specifically target lupus. Researchers have also gained some insight into rheumatoid arthritis by treating it with cytokine blockades.
"Autoimmune diseases fall into the category of dysfunctioning of the immune system," says Dr. Ying Du, rheumatologist at Missouri Baptist Medical Center. "But each one needs to be studied individually because different parts of the immune system may have been involved."
Heart Health
Diagnosis and treatment in women may differ than that in men.
Heart disease often is characterized by chest pressure behind the breastbone, which radiates into the back, arm or jaw. But many women also experience a shortness of breath, indigestion or extreme fatigue, says Dr. Kimberly Staffey, cardiologist at Cardiac Specialists of St. Luke's Hospital.
"Women may have some atypical symptoms that you have to be aware of," she says.
Atypical symptoms like fatigue, back pain, abdominal pain and nausea are more common in women than men, although men and women exhibit typical symptoms similarly.
Although women are at risk for heart disease at any age, the average woman presents symptoms 10 years after her male counterpart. This is largely due to the protection estrogen provides to the heart and the loss of it in post-menopausal women, Staffey says.
The late onset of atypical symptoms and their lack of association with heart disease can be particularly dangerous when women delay seeking medical attention.
Women can occasionally be more difficult to diagnose, says Dr. Linda Stronach, medical director of the chest pain center at Missouri Baptist Medical Center.
"There are a lot of good diagnostic modalities for heart disease, but they're not also 100 percent accurate," Stronach says. "Women can sometimes have more false positive stress tests, and we can sometimes get around that by using some imaging with stress testing."
In the past, doctors believed certain treatments were more effective on men than women, says Dr. Jeanne Cleveland, cardiothoracic surgeon and director of women's heart and vascular health program at St. John's Mercy Health Care. Women had lower survival rates after heart surgery, but Cleveland says data now shows many surgeons would not bypass with the internal thoracic artery for a woman because of her smaller blood vessels. It is now the blood vessel of choice for all coronary artery bypass grafting.
"We just treat everybody with the best options, big or small," she says.
Thyroid Health
The gland is jey to keeping your energy level high.
Want to maintain a healthy weight and higher energy level? Pay attention to your thyroid health. Your metabolism, or how your body uses energy, is regulated by your thyroid gland. This includes how fast you burn calories and how fast your heart beats. Located in the neck, your thyroid takes the shape of a butterfly with the "wings" of the gland wrapped around the trachea, or windpipe. It produces hormones that control the function of your body's cells.
Women are more likely than men to develop thyroid health issues. Starting at age 35, women should have a thyroid-stimulating hormone test every five years.
What to watch out for
Hypothyroidism, the most common thyroid issue, occurs when your thyroid doesn't make enough thyroid hormones. Symptoms of hypothyroidism often develop slowly, over several years. You may feel tired or sluggish for long periods. Other signs include:
> Weight gain, even when you are not overeating
> Depression, memory problems or difficulty concentrating
> An inability to tolerate cold
> Constipation
> Heavy or irregular menstrual periods that may last longer than five to seven days
If you experience one or more of these symptoms over a long period, consult your health care provider.
"Most often it is not the thyroid, but some other problem," says James Etzkorn, M.D., associate clinical professor, internal medicine, Saint Louis University School of Medicine. "But it's still important to look at the thyroid to help determine a correct diagnosis." A simple blood test can determine whether your thyroid hormones are at the appropriate levels. Further tests may be necessary for more complex health situations.
People with hypothyroidism also may have high levels of LDL cholesterol, which can increase your risk for heart disease. When needed, your primary care physician may refer you to an endocrinologist.
Possible causes of hypothyroidism include Hashimoto's thyroiditis, an autoimmune disease; radiation treatment of certain cancers and thyroid removal.
Hypothyroidism is completely treatable for many people by taking one small pill a day. Most patients will need to be on the thyroid medication for the rest of their lives. "It's the recommendation of organizations such as the American Thyroid Association that you use a brand and not a generic in the case of treatment for hypothyroidism," Etzkorn says.
Osteoporosis
Take steps now to prevent bone densiy loss.
Osteoporosis often is known as the silent disease because it thins and weakens your bones over the years without symptoms.
The disease is preventable and treatable, so here are some ways to stop it today:
> Eat well. A healthy diet provides well-known bone-building nutrients like calcium. Also include vitamin D, which helps with absorption, along with potassium, magnesium and phosphorus.
> Maintain a healthy weight. Weighing less than 127 pounds or having a body mass index under 21 is a risk factor for osteoporosis. Also, if you lose weight during the menopausal transition, you are more likely to lose bone. Avoid ultra-low-calorie diets and diets that eliminate entire food groups.
> Exercise. Participate in at least 30 minutes of bone-strengthening activity most days. Include both weight-bearing activities, like running, and resistance exercises.
> Quit smoking or don’t start. Smokers lose bone faster and have higher fracture rates.
> Avoid falls. Keep floors clear of tripping hazards, make sure stairways and entrances are well lit and add bars to your bathtub or shower.
> Depression might be in your bones. Research has found links between depression and bone loss. Women with a history of major depression have lower bone density and higher levels of cortisol, a hormone related to bone loss. If you’re being treated for depression, ask your clinician about a BMD test.
> Know your history. Fair skin and Caucasian or Asian ethnicity can increase the risk for osteoporosis. Some women may also develop osteoporosis earlier in life due to heredity.
> Get tested. Most guidelines recommend osteoporosis screening through bone mineral density tests at age 65 — earlier for women who have had bone fractures.
> Consider medicines that preserve bone mass. Postmenopausal women who have had a fracture or received a BMD score of -2.5 or worse should take an osteoporosis drug.
*Compiled from the Harvard Health Publications, The National Women’s Health Resource Center and the American Academy of Orthopaedic Surgeons
