Dr. Swiner’s Medical Note for the Month-March 2010-“Ask Dr. Swiner!”

ole_swiner@med.unc.edu. Enjoy………

Question 1:I have a question about a “bruise” on my right breast. I don’t remember running into anything but I’m clumsy so anything is possible. The bruise looks like a black and blue mark but it hasn’t gone away in a month!! I asked my gyno what it could be but he seemed unconcerned and called it a bruise. It’s not raised in anyway and feels no different than my skin. It’s not on the areola or nipple, just on the part of my breast kind of close to my underarm (actually, when I wear a bra, the strap pretty much goes right across the bruise).I also have a non-raised mole near the bruise but I’ve had that forever and it hasn’t changed in appearance. My question is what kind of doc should I see to check it out? A derm? My gyno again??

M.L. (black female, age late 20s)

Dear M.L.,Do you have a general/family/internal medicine doctor? If so, he or she might be the best one to ask. It’s not painful, right? I would examine it to see if I could feel any lumpiness underneath it. Even if you did have a lump, it’s still probably benign and will go away on its own. It’s probably nothing, but if it hasn’t changed in a month, I’d probably ultrasound it. Hope this helps.

Question 2:…I’ve been having a real concern for females as of late. I work on a college campus and am finding out that they are believing themselves to be virgins if they do any and everything with the exception of penis to vagina contact. I’d heard some of this when I was in college (was that 10 years ago or better, yikes!) but what is blowing my mind is that the young ladies in our African American communities are also thinking likewise. This means that parents are not having the appropriate conversations. What can we do?

T.C. (black female, early 30s)

Dear T.C.,You make great points, ones that I didn’t even realize. Clearly, any penile to orifice contact is dangerous and can lead to viral infections and sexually transmitted diseases, such has herpes, HIV, and HPV (human papilloma virus). All of us–parents, doctors, and mentors–need to be more clear when discussing this issue with teenagers nowadays and cover all types of intercourse. In all cases, use condoms. No excuses! Be more open and comfortable to talk to them. If you’re not comfortable, find someone who is.

Question 3:What are some signs and symptoms of teen depression?

J.S. (44 year old mother of 2 teenagers)

Dear J.S.,Teens with depression may have the classic signs of depression that you’d might expect an adult to have, such as decreased mood, disruptions to sleep cycles, or changes in eating habits or weight. However, they more commonly become irritable and have mood swings, withdrawn and are less social, and may become hyperactive. It can be difficult to determine this from the usual fluctuations of attitude and mood of a “normal teenager”. However, if he or she appears to be constantly disengaged, withdrawn, or has decreased concentration and focus, see a doctor.

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