Michelle Rupp: We’re starting today, continuing our series on catching up on those checkups, and we’ve only got a few weeks left remaining in 2021, so we want to be sure and take care of those checkups. Today, we are talking about women’s health and the importance of women’s specific checkups. Joining me today is Dr. Beth Milligan. She’s one of our doctors here at AFMC. Dr. Milligan, thank you for joining us.
Dr. Beth Milligan: Good morning, Michelle.
MR: I’m going to start by asking, just how important are women’s health checkups?
BM: They’re really important, and you know, I’m a woman, I have my own doctors, so I might speak for more personal reasons why I go to the physician. I want to talk about my risk factors, and first of all, we know that prevention is the most important thing you do. You want to see things before it becomes a whole nightmare like hypertension, high cholesterol, or heart attacks. So, it’s really important to go to your doctor early so that they can look at your risk factors and address those risk factors.
MR: What are some of the conversations we should be having with our doctors?
BM: Well, first of all, you want to make an appointment and actually go in. Don’t put it off. It’s really good not to wait till the end of the year because doctors get busy and so you need to call now because we’re in September. Get an appointment. At that point, when you go in, I suggest you have a list of questions to go over because the doctor could be very busy and you want to kind of help guide them where your concerns are. So be prepared to talk about your family history, all the things that happened to your parents, your brothers and sisters, you know, all of their medical problems. Those are important things to know. Number two, if there are any meds you are on, you can take them with you if you need to. Remind people you have them in your bag because other doctors may have prescribed them. Have those in there. And if you’ve had surgeries way back from other doctors, have that list of information also. Know if you have a pharmacy and that pharmacy’s contact information. Know your allergies to all of the medicines that you’ve taken in the past. All the information you can have to take to your provider at that point would be very helpful.
MR: Yeah, I would think the more information you as the patient can provide, the more well-rounded of a treatment plan or an assessment the doctor can provide.
BM: Absolutely. Because at that point, when they see you, depending on your age, they start measuring your risk factors and deciding what kind of things they need to focus on. You may not have a high-risk factor for heart disease, so that is more basic prevention. You might be at a really high risk for breast cancer. So, your doctor can fine-tune your prevention based on your risk factors.
MR: Customize and personalize, right?
BM: Absolutely. It’s not one size fits all. Nor should it be.
MR: No, it shouldn’t be. So, what ages and what screenings should women be getting prepared for?
BM: Well, we base that on the United States Task Force measurements. You’ll see some changes depending on if it’s the American Academy of Pediatrics or the American Academy of Family Medicine. Sometimes they’ll differ, and they’ll give different recommendations. So that’s why it’s important to sit down with your doctor and tailor that prevention to you. Some of the biggies would be, perhaps, things like the women’s gynecological exams will start somewhere between the age of 18 to 21. It’s unique to that patient. But that’s when you need to first sit down with your provider and decide what you need. Second of all, you’re talking about mammography. Assuming you do not have a lot of high-risk factors for breast cancer, they’ll start mammography at the age of 40 or 50. They’ll fine-tune it. Now, when you’re talking about gastroenterology, things like colon cancers. They’ll start those colon screenings more at the age of 50. They’ll do it younger if you have a family history of colon cancer. So, it’s not a hard answer to that. That’s why a good preventative exam will help you know when you need to do those particular prevention screenings.
MR: And having those conversations with your family members, because if you don’t know there’s something in your family history you wouldn’t know to then be able to share that with your doctor. That might trigger a screening. That might happen sooner than age 40 or 50 or what have you.
BM: You may find out you had two cousins to have colon cancer, and you want to tell your provider about that, and the doctor may say, “Hey, let’s start your colon cancer screening younger than we normally would have because you have a new cancer pop up in your family.”
MR: Yeah. Okay. I’m curious too. If just seeing a primary care physician, is that good enough?
BM: Well, that’s a loaded question, Michelle. Because some providers do a lot of the services, and they’re trained to do, you know, colonoscopies, and they’re trained to do the women’s health exams. Other doctors will sit down with you and say, “Hey, I need to send you to a gynecologist. I need to send you to a gastroenterologist to do this testing.” So that’s why it’s important to sit down with your provider and see what they can offer you at that point. So yes, you need to see a dentist because I don’t know any doctors doing dentistry and some of those extraneous specialties.
MR: My last question. How do you relieve some of the anxiety or the fear of some of these doctor appointments that you might have as you get up in age? Because our bodies are changing as we age, there may be a sense of fear that if we don’t pull back that curtain, we won’t know what’s there. Sometimes it’s easier just to keep your head buried in the sand than to face something or think that, gosh, I don’t want to know. I’m sure there’s nothing here. I just don’t want to know. What do you say to alleviate some of that?
BM: Well, Michelle, then I’m going to have to go personal in that because I’m a breast cancer survivor. So yes, I had those fears. But the way I alleviate my fears is to arm myself with information. Because information, usually the correct information for me, can alleviate a lot of my fears. And so, I think it’s important to search for that. And when you start, you know, ask your friends and relatives and your neighbors to give you advice on it, they may not give you good advice and can create more fear. So, I go to the proper sources, and I calm myself that way before going in. So, I don’t have the fear when I go for each of my preventative screenings to see if my cancer has come back.
MR: Okay, that’s good advice. That’s excellent advice. While we have you for a moment, I’d like to switch gears if you’ll let me. Talk about flu season because we are on the cusp of a flu season. And last year, we didn’t have, or at least it didn’t seem that we had, a robust flu season like what we’ve seen in years past. So how do we need to prepare for this year?
BM: Well, I have researched that, and according to the Center for Disease Control, they only had 20,000 reported cases of influenza last year. They think it’s probably because we were wearing masks, social distancing, washing our hands, and being extra careful. As a result, we didn’t see a lot of influenza because we were protecting ourselves from the COVID virus. So, as a result, they didn’t see much of it. The influenza vaccines are going to be given now. I recommend that people in the younger age groups get them before the end of October. Make that your goal. The older groups, people in the 60s and above, probably need to get it right now. And if you’re trying to get your coronavirus vaccine, spread that out by a few weeks because you might have side effects to one or the other, and you’ll know which vaccine caused the side effects. But I recommend getting an influenza vaccine in addition to the Covid vaccine.
MR: Could we be looking at a super flu, so to speak, this year or maybe just a robust flu season this year.
BM: This is what the predicted outcomes are from the CDC … We didn’t have much flu activity in the U. S. so they couldn’t create the vaccines based on the previous virus. They had to go to South America, where they still saw a lot of influenza activity, and they made the vaccine based on that particular virus floating around. So that’s what we are getting this year. They feel like initially, it’s going to do a really good job of protecting us from getting influenza. However, they’re saying towards about December to January, we may see mutations occur of the influenza virus occurring and because we’re so well protected and we’re wearing our masks, we haven’t had that natural exposure to it to create our own antibodies in addition to having the vaccine. So, we may see a super virus coming out. You might say a mutation is the correct word when it’s escaping the vaccine in January or February. Who knows, it’s what they’re saying.
MR: Let’s hope that’s not the case. I don’t know if we can take much more of these aggressive, aggressive germs.
BM: Yeah, I’m optimistic. I always go for that. I always look positive about things. So, I feel like things will get better.
MR: Yes, I’m with you on that one completely. What is the best advice on protecting against the flu? I mean, the shot, what about the nasal spray, hand washing, all that, all the regular things we know to do now?
BM: Yeah, those are all the good standbys. But I think, you know, something important is the mental health side because if you’re getting plenty of rest and trying to eat healthily, you know, getting your nutrients through good nutrition. Just good mental health will help protect your body, probably better than all the things that the doctors preach that you just mentioned. I think that it’s so important and I think you can even talk about exercise. Exercise is probably way up there on boosting your immune system. If you don’t run, that’s okay. Walk. Go outside. We are far less likely to get the virus walking outside. There are plenty of parks open right now—beautiful, beautiful Arkansas. Little Rock is so beautiful. Walk outside, take some deep breaths, and just relax and be happy you’re still healthy and alive.
MR: That’s an excellent point. You know, my mom always used to say the more run down you are, the more susceptible you are to catching a cold, and so it was, you know, an apple a day and making sure we got our vegetables and just keeping our health up so that we didn’t get run down.
BM: Yes, that’s true. All the things our grandmother told us are still true.
MR: Take care of yourself mentally and physically, and your body will then take care of you.
MR: Okay. Dr. Beth Milligan, thank you so much for joining us today. It’s always a pleasure having you.
BM: Thank you.