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Scott Webb: Welcome to Hally Healthcast, the monthly wellness podcast from Hally health – your source for health and wellness resources, information and tips. Our topic this month is women's health. I'm Scott Webb. And joining me today is Dr. Carla Rafferty. Dr. Rafferty is an Expert in Women's Health and Family Medicine for Carle Foundation Hospital in Urbana. So welcome Dr. Rafferty, it's so nice to have you here with us today. Let's jump right in. We're exploring five health questions every woman should ask and why they're important to their health and wellbeing. So first up here, what are the most important tests and screenings to get and when should women get them?

Dr. Rafferty: That's a great question. Probably one of the most important tests starting younger in life is a pap smear. We generally start screening for pap smears at the age of 21 and a pap smear is looking for whether or not a woman has cervical cancer or signs of early progression towards cervical cancer. Apart from the Pap smear, we also recommend that women get screening mammograms. The guidelines have sort of changed a bit and there's some organizations that have some different guidelines, but for the most part starting around age 40 is when a woman should be thinking about getting her first mammogram and mammograms look for breast cancer which is an important thing to detect early as it is very treatable. The last thing is probably colorectal cancer. Generally we start screening people around the age of 50, unless you have some other risk factors that necessitate screening earlier. And colon cancer screening has had actually quite a bit of development in the last couple years. Usually we would have to do a colonoscopy and now there's been the development of some additional screening tools. One is called a colo-guard and the other is a fit test. And each of these are done through the sending of stool samples, where a lab sort of looks for markers in the stool that would tell us if there are markers that are consistent with colon cancer. So there's a couple of noninvasive ways in order to get this screening done. And so not everybody has to get the colonoscopy right off the start.

Host: Okay. Good to know. So as we transition to pregnancy, which can of course be scary for moms and dads to be, where can moms to be go to learn more about pregnancy, how it affects their health and what steps they should be taking along the way?

Dr. Rafferty: Yeah. So always start with your general practitioner, your family Doc or your adult medicine Doctor when you're thinking about becoming pregnant because there are some things that you should be doing well before you even start trying to conceive. Things like quitting smoking if you're a smoker, not drinking any alcohol, avoiding drug use. And then also starting a prenatal vitamin to help build up, in particular folic acid in our bodies, which is an important substance for developing babies very early on in pregnancy. Oftentimes, even before a woman knows that she's pregnant. So starting with your family Doc, your adult med Doc, or if you're already seeing an OB GYN, you can have those discussions very early on with them and get that sort of advice. There's also the CDC website has some good information and Mayo Clinic would be another good place to go for information and resources online. Planned Parenthood would be another place within the community. And then of course Carle Christie clinic and then Francis Nelson or Promise Healthcare would be, you know, all good clinics regardless of where you get your primary care from. That could help answer this question or any questions that you have related to pregnancy. Help Alliance has some really good resources as well. So going to their website they also have health coaches that can help educate a woman on what she needs to do prior to pregnancy as well.

Host: Yeah. So those are all great resources. And you know, Dr. Rafferty, I know that women can often feel depressed, anxious, or maybe even overstressed. So who should they talk to about caring for their mental health and where can they find the information and resources that they need?

Dr. Rafferty: As always, starting with your primary care Doctor is always a good place to start. You know, we really care for patient's mind and body. So your family Doc, your OB GYN, you know, regardless of whether you know, you go to Carl, Christie or Promise Healthcare. If you have a psychiatrist, a counselor, a therapist that you're already seeing, these are things that you can bring up with them as well. In Champaign County we have Rosencrantz providing sort of our County mental health in the champagne County area. Also social workers, you know, every primary care office has embedded social workers and even the nurses that you might talk with on the phone are a good place to start. I know our particular community has lots of private practice options as well and those are areas that you can go to. Carl in particular also has an addiction recovery department. And so if there is issues with substance abuse, whether it be alcohol or drugs and you want help with that, Carl's addiction recovery has really stepped up the resources to offer the community a lot of good information and help when they need it.

Host: It sounds like there are a lot of great resources for women in the area, so that's awesome. So if a woman thinks menopause has started, what do they need to know and what might they need to be doing differently from how they were doing things before?

Dr. Rafferty: Yeah, menopause is always kind of a tricky question because menopause technically is a diagnosis that we give when a woman has gone without having a menstrual period for at least one year. And oftentimes women may get irregular periods either further apart or closer together for years prior to hitting that full one year mark. And that can be sort of a scary time for women because they don't really know what's going on. And so we call that period peri-menopause where they might have irregular periods and that might last, as I said, several years. And during that time you may have things like fatigue, hot flashes, decreased libido, difficulty losing weight, mental fog, your mood may go high, may go low, may go sideways, you may have some vaginal dryness. And so all of these body changes can weigh on a woman's not only body, but also mental state as well.

Things that you should be doing to help is, you know, as always eat healthy. Exercise. We know that osteoporosis is a risk for women as they get a peri and post-menopausal. And so exercise, getting good sources of calcium and vitamin D are really important. And then menopause also increases a woman's risk of heart disease, like heart attack and stroke. And so the eating healthy and exercise are also ways to help prevent that. If you're a smoker, you know anytime you quit is the right time. So if you're still smoking at the time of menopause, it's never too late to quit smoking. And if you have excessive consumption of alcohol, you know, reducing that consumption would also be beneficial.

Host: Definitely all great tips for women dealing with menopause and maybe just any time. Yeah. So finally today Dr. Rafferty is, as women get older, what specific health conditions should they be on the lookout for?

Dr. Rafferty: So as I mentioned, osteoporosis is probably the big one. Osteoporosis is where your bones get thin and brittle. And so if you have a fall, even a minor fall or injury, you could more likely end up with a broken bone. And while that broken bone in itself, you know, can lead to its own difficulties, but it also puts you at higher risk of getting other more serious conditions. For example, if you require surgery, there's the risks related to surgery. If you end up not being as mobile as you were before, you might have risks of getting blood clots or pneumonias which could be fatal. And so we really want to prevent breakage of a bone and that starts with preventing osteoporosis. And as I said, the way to do that is making sure you get adequate levels of calcium and vitamin D, you know, Mayo Clinic website, Health Alliance website, all have good information on foods that are high in those minerals and vitamins.

And then exercise. The more weight bearing exercises you do, the stronger your bones become. So those would be the ways to help prevent Osteoporosis. And then of course, getting a bone mineral density screening test done when your primary care doctor recommends it, which may be somewhere in between 60 and 65 years of age. And that will help us track exactly how your bones are doing. So that we can anticipate if you're going to develop Osteoporosis as there are medications that can help reverse that. The other would be Alzheimer's. You know, as we get older, dementia is always a possibility. And Alzheimer's in particular being the one that we worry about, Alzheimer's is where you sort of lose short term memory and it's a progressive condition that may or may not lead to behavioral disturbances and you know, could put you at risk if you put yourself in a dangerous situation because you're unable to process what's going on around you.

And it can be hard on family having to take care of you if you have Alzheimer's. And so, you know, making sure that you stay active, that you eat healthy, always important, but also make sure that you stay social, that you read, that you continue to activate your mind in ways that you're doing higher level thinking, sort of way of exercising your brain can be helpful. And then talking with your family and your Doctors. If you start to notice signs of memory impairment or forgetfulness as, while not all signs of forgetfulness mean that you have dementia or mean that you have Alzheimer's, your family Doctor or your adult med Doctor can help you sort of delineate what could be Alzheimer's as there are medications that can be given. And the earlier they're given, the better. These medications don't reverse any of the loss but can help slow down the progression.

So the sooner you start, the more benefit you'll, you'll have. And then heart disease, like heart attack and stroke are always important things for women to be mindful of. You know, not all women present the way that we think people present with heart attack. Like there's an elephant sitting on my chest or it's going down my left arm. You know, sometimes women can present with different symptoms and so if you think you're having a heart attack or you think you're having symptoms related to stroke, it's always best to get checked out early. As they say, time is heart and time is brain. So the sooner you get checked out, the better. And you know, fast is an acronym that we use to help people determine if they're having a stroke and fast means, you know, getting to the emergency services quickly if you're having facial drooping, asymmetry, slurring of speech, you know, things like that. And so if you think something is not right, it's always better to get checked out than to delay.

Host: Yeah, absolutely. Thanks so much for being on today, Dr. Rafferty and for everything you do for Carle. And that's it for today's podcast. But tune in next month when we'll cover the compliment to today's topic, the five health questions every man should ask. And remember – Hally health is your source for a wide variety of health and wellness resources, information and tips. Visit us online at hally.com. Let us help keep you and your family healthy and well.