ParentTime Live! Transcript
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Dr. Nancy Snyderman on ParentTime Live!Answers to health questions for women over 40. ParentTime
This moderated chat took place on December 20, 1996. Be sure to check the schedule of upcoming ParentTime Live! events.
Moderator: Welcome to ParentTime Live! We’re discussing health issues for women over 40 with Dr. Nancy Snyderman, medical correspondent for ABC News, a practicing physician and mother of three. MammogramsQuestion: I keep hearing different views on how often to have a mammogram. What’s the story?Dr. Snyderman: You have reason to be confused! Two years ago the National Cancer Institute stated that it wasn’t cost-effective for women in their forties to get mammograms as frequently as they had been, A lot of us in the medical community were upset with that opinion. After reconsideration, the basic rule of thumb now is this: Have a screening mammogram when you're forty. If the results normal, you can have a mammogram every other year. When you reach fifty, you should have a mammogram annually. All of this changes, however, if you have a strong family history of breast cancer or if women in your family tend to get breast cancer at an early age. If this applies to you, talk to your doctor about whether to have a mammogram in your late twenties or thirties.
 Frequent UrinationQuestion: I urinate more frequently than I used to. I even wake up in the middle of the night to got to the bathroom. Why is this happening?Dr. Snyderman: This is a common malady that strikes every woman at some time in her life, especially women who have given birth. Sometimes medication or foods can make matters worse -- for instance, alcohol and caffeinated drinks can cause more frequent urination. The first thing to do is to look at your lifestyle and see if there’s anything that can easily be changed. If not, talk to your doctor or gynecologist and go for a complete medical exam.
 MenopauseQuestion: Sometimes I wake up in the night bathed in sweat. Is this a sign that I’m menopausal?Dr. Snyderman: It sure could be. A lot of women who are pre-menopausal (entering menopause) complain of hot flashes and nighttime sweats. These episodes should come and go. Estrogen replacement therapy can help minimize the symptoms, so you might want to talk to your doctor about it. Question: My periods have become very erratic. Recently I missed a couple of cycles and then my period reappeared. Dr. Snyderman: It sounds like you are peri menopausal -- sometimes your ovaries function just fine, but they go on strike at other times. This pattern may well persist until your periods stop altogether. Remember that you can get pregnant during this time. So unless you want a mid-life surprise, plan ahead!
 Heart DiseaseQuestion: How can I tell if I’m at risk for heart disease?Dr. Snyderman: Every woman is at risk for heart disease -- especially after menopause. Heart disease will kill one in two American women this year. Know your family history. If heart disease runs in your family, watch your lifestyle very carefully. Avoid smoking, eat good foods, and get enough exercise. If you are post-menopausal, you may also want to talk to your doctor about taking estrogen.
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Breast Cancer TestQuestion: I’m an Ashkenazic Jewish woman in my thirties, and I’m wondering whether to have that new breast cancer gene test. My mother and aunt died of cancer (one breast and one ovarian).Dr. Snyderman: It wouldn’t be a bad idea, but know what you’re going to do with the results when you get them. Given your family history you are probably already vigilant about breast exams, so having the test may not change your overall plan. If you do decide to have the test, beware of insurance companies. If this information falls into their hands, you could lose your health insurance with no legal recourse. I advise everyone who wants to get genetic testing to do so anonymously though a medical center or their doctor.
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 Laser Treatment for WrinklesQuestion: I’m considering having laser treatments on my face to diminish wrinkles. What are the risks of this treatment?Dr. Snyderman: Laser treatment for wrinkles is a relatively safe procedure. The biggest risk is getting a doctor who is not adequately trained. Assuming you’ve done your homework and have found a good surgeon, there should be minimal problems. However, women with darker skin may be at risk for depigmentation. Be sure to ask your surgeon about this.
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Cervical CancerQuestion: Is there anything I can do to prevent cervical cancer?Dr. Snyderman: Yes. Stay in a monogamous sexual relationship or use condoms. Cancer of the cervix is directly related to a history of multiple sexual partners and exposure to human papilloma virus. Every sexually active woman, whether she's 13 or 93, needs an annual pelvic exam and a screening pap smear. If your pap smear is normal two years in a row and you are in a monogamous relationship, you can have the test done every other year. But if that doesn’t apply to you, I’d feel safer advising women to get annual exams. This year, 16,000 women will be diagnosed with cancer of the cervix and 5,000 will die of the disease.
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Estrogen ReplacementQuestion: I can’t decide whether to have estrogen replacement therapy. Any advice?Dr. Snyderman: This is what my ob-gyn calls “kitchen science.” There’s still so much we don’t know about estrogen replacement. But a pretty safe rule of thumb is this: If you are predisposed to heart disease or osteoporosis, consider taking estrogen. If you’ve had a recent diagnosis of cancer, you may be advised not to take estrogen. For the rest of us, it’s a crap shoot.
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 Chronic FatigueQuestion: Even when I get enough sleep, I have days when I feel extremely sluggish and can’t think clearly. Could this be a sign of chronic fatigue syndrome?Dr. Snyderman: More likely it’s indicative of a sleep disturbance. If you snore at night and are sleepy during the day, you may not be getting the quality sleep you need. However, chronic fatigue can also be indicative of illnesses like diabetes, kidney disease or chronic fatigue syndrome. See your doctor for a thorough history and physical examination.
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Vision ProblemsQuestion: I used to be able to read just fine without my glasses. Now, even with glasses, I sometimes have trouble reading fine print.Dr. Snyderman: Welcome to the club! I don't know how to break this to you gently, but you’re getting older! Go in soon for an eye exam. You probably just need a new prescription.
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 Sexually Transmitted DiseaseQuestion: I’m recently divorced and am concerned about re-entering the dating scene. Any tips?Dr. Snyderman: It’s a difficult time out there. Your biggest risk is the one facing any woman dating anywhere in the world: sexually transmitted disease. You must be extraordinarily vigilant and (I’m sorry to say) untrusting. Use your common sense and be sure to use a barrier method if you have sexual relations.
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VitaminsQuestion: What vitamins should I be taking?Dr. Snyderman: I’m not a big believer in extra vitamins. I know this is not a politically correct answer. But in this country if you eat enough fruits and vegetables and limit the amount of meat you eat, you’re getting plenty of vitamins. The exception, however, is calcium. It’s hard to get enough calcium from green leafy vegetables and dairy products. So I believe all women should take about 1200 mg a day of supplemental calcium.
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Post-Stroke DepressionQuestion: My 54-year-old mother has suffered two strokes and is very depressed about her handicaps. What can we do to help her?Dr. Snyderman: This is a tough one. Depending on how spiritual or religious you are, I would ask friends or ministers to help out. To suddenly have an active part of your life stripped away is difficult for anyone. Get your mother outside as often as possible and continue to include her in family activities. If nothing else works, talk to your doctor about antidepressants. Question: If she’s already on antidepressants, could the medication be causing her depressed state? Dr. Snyderman: Possibly. But it’s also possible that the medication is not the right one or that the dosage is wrong. It’s also common in older women for drug interactions to cause the problem. So a first step would be to review every medication your Mom is on. Question: When she comes home, my mother often becomes out of control. Could this be caused by the state of mind she’s in or the combination of medications she is taking? Dr. Snyderman: It could be any of those things, and it may be difficult to decipher everything. Start by looking at all of her medications. A lot of doctors are very aware of drug interactions, and if one medication is interfering with another there can be a very easy remedy. It’s also extraordinarily difficult to lose control of one’s life. And it’s hard for us to be patient with someone who is struggling. I wish there were something I could do to streamline this process for you. But you’re going to have to take a step back and carefully look at all the facets of this problem. |
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AcneQuestion: My teenage years are long gone but my skin still breaks out. Why?Dr. Snyderman: It is an unbelievable misconception that acne stops when you hit 21. Get ready for a long haul. Most over-the-counter preparations work well in treating acne but some can be difficult for aging skin to tolerate. Ten percent benzoyl peroxide is the magic ingredient. However, if it seems too strong for your skin, talk to your doctor about prescription medications that are gentler. In severe cases, Accutane can clear and cure adult acne. But beware: Accutane also causes birth defects, so don’t use it if you might be pregnant or if you’re not on birth control.
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Sleep DisturbanceQuestion: I’m a terrible sleeper (always have been!). I wake up at least once during the night and sometimes have to read for an hour before I can fall back to sleep. Is there anything I can do to get a more restful night’s sleep?Dr. Snyderman: This is a difficult situation, because it has to be very carefully individualized. Are you drinking alcohol or using marijuana? Do you take afternoon naps? Are you depressed? If your answer to any of these questions is no, you might find that adding exercise to your lifestyle helps. Some women also do well with low-dose sleeping pills. But obviously you would have to give that alternative careful consideration (and speak to your doctor).
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Bunion SurgeryQuestion: I’ve been putting off surgery for my bunions. I guess I’m just plain scared. What can I expect from this procedure?Dr. Snyderman: Most bunion surgery is very successful. Long term, you should be able to expect no more pain. Short term, you’ll have some pain during the healing process and you’ll be off your feet for a while.
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LiposuctionQuestion: I've decided to have liposuction on my thighs. What kind of results can I expect? Are there any side effects?Dr. Snyderman: There’s no way I can tell you what results to expect from liposuction. It all depends on your body type and your surgeon. This is something that, hopefully, your doctor has discussed with you by now. The biggest risk is an unevenness in skin texture which can happen even in the best medical hands.
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Multiple SclerosisQuestion: I just learned that I have MS (multiple sclerosis) and I’m very depressed. I keep hearing horror stories about this disease. I’m trying to learn as much as I can about it and would appreciate some guidance.Dr. Snyderman: First, multiple sclerosis is not a death sentence. There are thousands of people who live very productive and healthy lives with MS. Your biggest challenge will be to throttle back a little more often. Listen to your body. Be patient with yourself. And whenever you have questions, make sure that your doctor or a nurse is accessible. This is a disease that comes in all varieties and severities. Just because you’ve been newly diagnosed doesn’t necessarily mean that you’re going to have a rough time.
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Dry EyesQuestion: My eyes are extremely dry, although I frequently use eye drops. The dryness has worsened in the past five years. Why is this?Dr. Snyderman: Dry eyes can be a sign of aging. Every mucous membrane in our bodies dries as our hormones fluctuate and fall. I would recommend seeing your opthalmologist, because there are good prescription medications that can help with a shortage of tears.
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AllergiesQuestion: Is it possible to come down with allergies late in life?Dr. Snyderman: It sure is! Everything from asthma to allergies to grasses, trees and animals. If over-the-counter antihistamines don’t do the trick, you should consider seeing an allergist.
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OsteoporosisQuestion: I eat well, exercise a lot and take Tums daily for calcium. But I’m still concerned about osteoporosis. What else can I do to prevent it?Dr. Snyderman: You’re taking all the preventive steps. The only other thing to do is to avoid cigarettes and too much caffeine or alcohol.
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MigrainesQuestion: I get migraine headaches fairly regularly. They get so bad I’m sometimes laid up in bed for a day or two. Help!Dr. Snyderman: The new migraine medications have helped millions of women but don’t work for everyone. One of my favorites is Imitrex, which can be taken by injection or in pill form. If you’ve tried Imitrex and it doesn’t help, ask around for the best neurologist in your area who sub-specializes in treating migraines.
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