Month: August 2015

Carrying baggage……

While traveling with my family on vacation, I laughed at myself as I tried to pick up my back pack, along with the kids stuff. I sang to myself, “Pack light……” If you’re a neo-soul fan, you should be very familiar with Queen Erykah Badu and her anthem, “Bag Lady”. This song has been on my mind since I went to a meeting this past month at a beast cancer support group,  called Sisters Network, and a bright, exuberant young supporter sang a piece of this song as a way to introduce some gifts she’d brought. She had some hand made cloth bags to hand out, and she used it as a metaphor for all of the “stuff” we carry around.

Before kids, I carried a nice bag, of sorts, like the new, shiny designer whatever I wanted for the day. Once I had kids, this changed to a huge diaper bag, filled with bottles, diapers, and wet wipes. To work, I carry a large computer bag and then probably 2 other bags that have my lunch and work out clothes or other stuff that I think I might need during the day. The point is, we’re all carrying too much.

Without being deep, I literally mean we’re carrying too much. Think of how many pounds a large bag weighs down on your shoulder, neck and back. No wonder mothers deal with chronic tension headaches and muscle spasms. My favorite term, that I think I came up with although I haven’t copyrighted it yet, is the “soccer mom reach back” for the strain put on your rotator cuffs when reaching to the back seat to hand the baby a cheerio, or iPad, or pacifier. We put a lot of strain and pull on those muscles over the years.

To speak metaphorically, we also carry a lot of emotional baggage. It’s difficult for some of us to move on because of a failed relationship or marriage, lost job or passing of a loved one. These negative experiences can drag you down, for longer than we realize. You think you’ve processed it and your feelings. You feel like you’ve grieved appropriately. But, on the inside, there’s still turmoil and sadness and anger. This can be dangerous. It might be hard to notice, but slowly and gradually, insomnia kicks in. Or comfort eating increases. Or you’ve suddenly become more withdrawn from the things and ones you love.

“Pack light” means let some things go. It’s not easy, but you have to. Talk to someone to help you figure out what works best for you. Take a walk. Write a blog. Join a support group. Let it go.

Love,

Dr. Swiner

So, I’m going to have a mammogram….

So, I have decided. I’m going to get an early mammogram. I’m 37 yo, without any significant family history of breast cancer, fortunately, which generally puts me at low risk. I’ve recently stopped birth control pills and breastfed 2 babies, which also puts me at low risk. However, I’m still nervous.

I treat many female patients, of all ages, and I’ve diagnosed a handful of breast cancers. Some of these women had “classic” or “textbook” risks, such as being in their late 40-60s with a family history or having an abnormal lump they found on exam. However, at least 2 or 3 within the past couple of years, had zero risks. As a matter of fact, one that struck me as a surprise, was one of my patients who was healthy as a horse, in her 30s, didn’t smoke, not on birth control, worked out all the time, no medical issues, with bloody discharge from the nipple, and that was it. We sent her for an ultrasound and mammogram, her first one ever, really just as a precaution, and it was positive for cancer. I was as astounded as she was. She looked just like me.

I’ve asked friends and family and the majority of them know someone who has been affected by cancer in their 30s or 40s, without any family history of cancer. What has caused controversy recently is the change in the recommendations for when to start and how often to do mammograms. Within the last 5 yrs, the guidelines have changed, stating that we should wait until age 50 to start doing mammograms. This would mean not starting at 40, which is what I was accustomed to doing. The frequency was to do them every other year, which would we different for most practice as well. Generally speaking, I would start at age 40 and do them every year or every other year for screening. For those who have significant family history, I would start at age 35. With the new guidelines and waiting, what happens to all of the 30 and 40 year olds that we may miss? Needless to say, I’ve been a bit of a rebel with these new rules. Now, I say maybe waiting until the early 40s is ok, but I’m definitely not waiting until 50 to screen my patients.

Then, there’s this thing with self exams. In general, I would teach all women how to examine their own breasts beginning with young adulthood. You would think, “The earlier, the better,” with being comfortable and becoming comfortable with feeling your breasts. However, with the new mammogram guidelines also came the recommendation AGAINST doing self exams. Yes, you read correctly—-against. I don’t feel great about that one either.

I have the referral, but I haven’t made the appointment yet. My Ob-gyn agrees he thinks it’s a reasonable idea, and thankfully my exam is normal without any lumps. I asked my friend, who is also an Ob-gyn, my age, and she’s already had her first one. I’ll keep you posted, and let you know how it goes.