Liz Healy (Host): Welcome back to the Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Liz Healy. And I'm joined today by Dena Reddick, a Nurse Practitioner and Primary Care Provider at Riverside's Primary Care Associates in Bourbonnais. And we're here to talk about women's health and screenings. Thanks for joining us today, Dena.

Dena Reddick, NP, PhD (Guest): Thanks Liz for inviting me. Glad to be here.

Host: So before we get into today's topics can you tell us a little bit about yourself and your background.

Dena: Sure. Actually I grew up here in this area. I'm a townie. I started my nursing career at Riverside. I worked in a lot of different clinical areas, including medical, surgical, ICU, OR, ended up in maternal child. And at the end of that experience, I realized I really wanted to do something more advanced practice. And that's what brought me to Primary Care as a Family Nurse Practitioner.

Host: Oh, okay. That's interesting. So what really interests you about women's health?

Dena: Yeah I think of women's health as being sort of the center of healthcare. I mean, women make a lot of healthcare decisions for families. So, when we link into the woman and to her needs, then we just automatically bring the whole family in. And that sort of connects with me for primary care, holistic care, prevention.

Host: Okay, so you just talked about something that is interesting to me. So preventative medicine. So what type of preventative medicine can women kind of look at doing for themselves.

Dena: So for women, we start preventative care with education early on in the adolescent woman. We do that for boys too, but for women, that directly leads into what we might call gynecologic care. So we, you know, women are having babies and, or they're also preventing having babies. So we automatically see doctors more during that early youth or early adulthood period. So women just naturally flow in because they have needs. And that gives us an opportunity as providers to provide education. As well as to make educated recommendations on their prevention behaviors, such as perhaps labs, a gynecologic exam, a pap smear when it's time. Certainly breast exams. And then later on mammograms. So there are a lot of prevention behaviors that start early on for women.

Host: Yeah, for sure. It's definitely important to, you know, consider preventative medicine before it's too late in like a health journey to have preventative medicine be as effective. Can you talk about some of the screenings? I know you touched on mammograms and pap smears but can you touch on when women should start doing them? How often we should have them done?

Dena: Right. Well, pap smears have gone through quite a bit of transition over the last 20 or 30 years. We used to start doing pap smears at age 16, and then we started when you began your intimacy, then we start now at age 21, we start doing a pap smear. And at that time we do just the pap smear. Later on as you get older, we'll add in HPV screening and HPV, as some people may or may not know, human papilloma virus is a virus that literally causes cervical, oral and anogenital cancers. It happens to be a cancer, one of few that we can literally prevent by giving women, young men and women Gardasil injections up through the age of 26 and more recently approved through age 46. So truly prevention of cancer. Pretty exciting because we don't have very many options to really prevent.

Host: Yeah, that is a really exciting advancement in medicine to be able to prevent something as serious as cancer. Are there some screenings that women should get that maybe aren't just specific to women, but just people in general?

Dena: Sure. Real quick. I want to mention another specific to women, obviously, mammograms. There's a lot of controversy in the recommendations about pap smears and mammograms. We have the US Prevention Task Force. We have the American Academy of OB GYN. We have the American College of Physicians, American College of Radiologists. The American Cancer Society. And there's a little bit of discrepancy. But as a whole in America, we tend to be very prevention focused. And so for example, pap smears, might range from yearly to every five years, depending on your age and your risk. Mammograms, we start at age 40. And we recommend that you get your mammogram yearly up through at least the age of 74. At that point, we talk about, is it really clinically efficient to do mammograms after the age of 74, but I have some 90 year old women that are more active than I am. And so in general, in healthcare, we look at, if you have a 10 year active life expectancy of 10 years, so 10 years from the age that you are, you probably should still consider prevention behaviors. Right. And I have women in their eighties that are still getting their mammograms because they have easily a 10-year life expectancy.

Then we move on to other behaviors for prevention, including blood work, looking at your cholesterol, looking at diabetes screening, maybe thyroid as women get older and other people who have risk. We certainly expect you to do your colonoscopy at age 45 now because that rule changed. And now we're recommending that people start their colon cancer screening at age 45.

Another interesting fact, is that colonoscopy is a prevention, not just early detection. And that is the only other cancer that we literally can prevent. So, you've got Gardasil preventing cervical anogenital and oral cancers. And then you have colonoscopy literally preventing colon cancer. So, we're really highly recommending that people do that in addition to getting their blood pressure checked. And also their physical exams so that the doctor can maybe foresee some problems that they may have. Often when people come in for a physical, they talk to us about things that they maybe wouldn't have brought u otherwise they weren't going to make a special appointment. But now that they're there and you're asking about their life about their sleep, about their habits; they remember that, oh, you know, I've really been having this problem and it gives you an opportunity to teach, to do any special testing that might need to be done, to make recommendations for staying healthy and living long, happy, healthy lives.

Host: Yeah, it's very important. Like we've said, preventative medicine is just wildly important. You can prevent so many things, keep your lifestyle active. Even those women into their eighties. That's amazing that they're still looking at a 10-year active lifestyle. I know there's some days that I'm like, I'm just going to lay on the couch all day.

Dena: Exactly.

Host: But so if a woman is, you know, worried about getting a screening, that it might show something, is there something that you could say to them to kind of lessen their fears?

Dena: Right. You know, there are women, in fact, there's whole bodies of literature that support that. A lot of times people don't do something preventatively because they're afraid to find out. So, again, part of that physical exam once a year, where you're sitting and talking and developing rapport with your patient is an opportunity to help them understand one, what the risks are and two, the benefits. And when we talk about the benefits, that is living healthy for your whole life, both for yourself, for your family, for your friends, for the people around you, where you add value to their lives. You being there, is an important factor and I mean, you could even go so far as to say that me being there healthy, helps everybody else be healthier too.

Host: Yes, encouraging healthy lifestyles is so important. Are there some things that we can do to lower our risk of I don't know, getting certain types of diseases, like you touched on heart disease or, breast cancer or cervical cancer, we can get the Gardasil. Are there other ways that we can help prevent.

Dena: Right. So secondary prevention is really early detection. So yes. Heart disease, we can literally turn around can't we with nutrition, with exercise, with weight loss, we can decrease our cardiovascular risk. And by the way, heart disease is still the number one killer of Americans. So, that's one we really focus on a lot in our offices. Certainly diabetes is another one that we can often prevent, not always, but Type 2 diabetes is a preventable and certainly manageable disease that I've seen. And I know my peers have seen many times people change their lifestyle, and they literally took the diabetes off their list. And so they dropped those meds. They increased their lifespan. And so, there are a lot of different testing that we do, both the blood work, the physical exam. And then the education that goes along with how to live healthier. Those are the things that prevent cancers. You can't really prevent, for example, breast cancer.

But early detection is key. And so getting that yearly exam, having your doctor do a breast exam and yourself pay attention to your normal. Those are the things that we can do to make sure we're finding any cancer early is being aware of my normal and getting to my doctor, if I find something that isn't normal.

Host: Okay. So, you know, getting to the doctor to find something that's not normal, that's definitely part of the annual wellness visit. If I'm someone who maybe put off going for my annual well visit and is now like, okay, maybe there's an issue, I need to go and get this addressed. Is there anything that you could say to encourage them to go and see their primary care provider?

Dena: I think often people just get more and more fearful, right? They get further and further. How long has it been going on? And then all of a sudden they're afraid to go in, but I would encourage anybody that your provider cares about doing the right thing for you and doing it as efficiently as possible. It's always going to be better to get in there, find out and really most of the time, my patients are quite relieved at what they thought was something horrible, maybe really isn't. But in finding this answer, we lead off to other areas of prevention and increased health. So, always go and don't be afraid to see your providers. They're there to help you.

Host: Okay. Is there anything else you would like to add or anything else you want women to know about staying healthy?

Dena: Yes. I think I've probably said quite a bit about women's health and prevention, but if I could say one other thing, it would be to encourage, as I said, I'm a townie, encourage my friends, my family, my patients, please get your COVID shots. And please consider that for you and your family so that we can all be healthier again.

Host: Thank you. And thank you for joining us Dena and for sharing all this great information about women's health and about screenings. And thank you listeners for tuning into the Well Within Reach podcast, brought to you by Riverside Healthcare. Are you looking for a primary care provider? Riverside has over 40 primary care providers to choose from, including Dena Reddick. Find a provider that fits your needs at myriversidedocs.com or by calling 855-404-DOCS. Again, that number is 855-404-3627.