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�risten � . Sch�all , �oard-Certified Internist , ����arna�asHealth Medical Group
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�on ’ t let fear of COVID-19makeyou neglect your annual physical exam and regular screenings . We hate to generalize . But even in normal times , women are famous for putting their own health care concerns on the back burner while tending to otherfamily members . Add to that dish adollop of pandemicprocrastination , andyou ’ vegot astewoftrouble .
Board-certifiedinternist KristenJ . Schwall , M . D ., affiliated with Saint Barnabas Medical Center �SBMC� and member of the RWJBarnabas Health Medical Group , recommends annual routine physicals forwomen and stresses that the vital role of preventive care goes on no matter what ’ s in the headlines . Inarecent interview , she shares important information for all women .
Q . What doyou say to patients who are nervous about visiting their doctor in the office due to COVID-19 ?
A . Iemphasizenot ignoring health symptoms during this crisis becauseof afearof getting COVID . At my office and at Saint Barnabas Medical Center , we are using the utmost precautions to ensure our patients ’ safety . Don ’ tneglectanacute medical condition �oraregularphysical or screening � out of fearofcontractingthe virus�
Q . What are you looking for during a physical exam ?
A . We do acardiovascular risk assessment �checking blood pressure , cholesterol , etc . � and ageneral exam in which we look forabnormalities such as a heart murmur , an abnormal mole on the skin , a lump in the breast or anything else that might triggerthe need formeto do further evaluation . We also go over lifestyle and behaviors such asexercise and healthy eating ; psychological health is a part of the visit as well , especiallyduringthis crazy time . Rarelydoes someone come in whoisnot expressing anxiety , fear or some sort of depressed mood with this pandemic . Offering support and psychological help is a big part of beingaprimary caredoctor .
Q . What preventive cancer screenings do you perform for women , and at what age is each recommended ?
A . In addition to a complete physical exam and age-appropriate labwork , the bulk of cancer prevention forwomen covers breast cancer , cervical cancer , colorectal cancer and skin cancer . Breast cancer screening includes a breast exam by a clinician and age-appropriateimaging . It ’ s recommended that people with average risk factors start screening at age 40 . For cervical cancer , average risk women ages 21-29 should getapap everythree years ; ages �0-65 should get a pap every threeyears or have pap / HPVcotesting every five years . And the recommendation for over age 65 is that if there has been adequate negative screening for years , no further papsare needed .
No ovarian cancer screenings , other than pelvic exams , are recommended forasymptomatic , averagerisk women whoare not known to have a high-risk hereditary cancersyndrome . Colorectal screening for average-risk patients is for those 50 and over . Finally , for skin cancer , high-risk people and those with a family history of melanoma need a full-body exam by aclinician withfull expertise .
Q . What vitamins and supplements do you advise female patients to take and why ?
A . Both calcium and vitamin D are recommended forskeletal homeostasis . The general recommendation forcalcium is 1000 milligrams a day for premenopausal women and 1200milligrams for postmenopausal women �the supplement dosing changes with every patient . The ideais to reach your calcium goal with diet , if youcan , by consuming dairyproducts and dark , leafy greens . It ’ s a balancing act : Too much calcium can cause plaque in thearteries , yourheart and your peripheral vascular system and trigger kidney stones , while too little calcium can lead to fractures , bone loss and osteoporosis , a common disease marked by low bone mass and skeleton fragility .
Q . What ’ sthe key topreventing osteoporosis ? A . First is a healthy lifestyle starting in adolescence , when the bones are still forming , coupled with proper nutrition , weight-bearing exercises , calcium and vitamin D intake and avoiding smoking and alcohol use . The U . S . Preventive Services Task Force recommends that all women over age 65 have a bone density test . We have a bone density center in our ambulatory carecenter .
Q . What else should otherwise healthy female patients keep inmind ?
A . Immunizations are important . People ages 6 months and over should get their annual flu shot , those over 65 should get the pneumonia vaccines , and there is a new shingles vaccine forage 50 and over . Seeing your doctor for your annual wellness visit is vital for catching thingsearly . Early treatment and early prevention are keys to longevity .
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2� SPRING 2021 | THE RECORD HEALTH QUARTERLY | PREPARED BY THE ADVERTISING DEPT .