WOMEN’S HEALTH

Women are amazing. Today the number of single parent households is greater than a! any time before. And guess who heads up most of these single parent households? Women

But unfortunately there are breaking points. Women are more susceptible to alcoholism than men are. Women are more likely to admit to having emotional difficulties and more likely to seek help for them. Women are undaunted about maintaining youth and beauty. Women march into plastic surgeon’s offices more than men do. Women sweat and stretch at aerobics and jazzercise-well, some do. Women buy more than men do, Where would Madison Avenue, and Wall Street for that matter, be without women?

We are seeing more “male” health problems in women, As women joined men in the workforce, they began to develop the same illnesses traditionally suffered by men: lung disease, heart disease, and strokes. Unfortunately, now that more women smoke, more women die of lung cancer.

Increased sexual freedom has made women more susceptible to sexually transmitted diseases and cervical cancer. The medical world still doesn’t know why, but breast cancer strikes one in ten women at earlier and earlier ages.

Women tend to outlive men. Ironically, they turn around and spend most of their later years caring for either their parents or spouse Alzheirners Disease affects one family in three in the U.S. today. Two to three million Americans, men and women, suffer from this incurable affliction. And according to the Southwest Long Term Care Gerontology Center Study for the Texas Senate Committee on Health and Human Resources- 68% of the Alzheimers care-givers are women.

What is it about women then that makes them so resiliant – so adaptable -so able to get through the school years, the heartbreaks, the thrills and labor, the babies, the promotions, the depressions, the teenagers and the menopause and still have something left to give? The answer may never be known, but certainly good health and healthy psyches are key. In this section we examine health issues of particular interest to women and their families.



WOMEN AND ALCOHOLISM



The news may surprise you: women not men, are more susceptible to alcoholism, Because of a smaller body size and lighter weight, women become intoxicated more quickly, Plus women have a great deal of subtle psychological factors going.

“It used to be much more unacceptable for women to drink, “says Jack Ewing, Program Director of the St. Paul Substance Abuse Program, If she got drunk she was a lush. So the family tended to hide alcoholic women. For men, it was more accepted.”

The women stayed at home. They were closet drinkers. Men were working. They were the breadwinners and if alcoholism interfered with that role, a wife or family member got them off the bottle.

Now it is more acceptable for women to drink and to drink more. The end result, according to Ewing and other chemical dependency counselors, is a rise in the number of women alcoholics, The Department of Health and Human Services estimates that 10% of the nation’s workforce suffers from alcohol abuse. And the evidence is in the Substance Abuse programs where more women are getting help than ever before.

“We are creatures who enjoy pleasure,” says Ewing, “Eating is enjoyable. Sex is enjoyable. But society has controls on those. Exercise can be enjoyable After awhile, an enormous amount of exercise will force the body to produce endorphins, They give you a lift-you feel no pain.”

It’s that same lift that some people seem to find in a bottle of alcohol or in drugs, The liquor or the chemicals affect their victims on an emotional level. They are truly trapped into an addiction Physicians now believe that alcoholism is a physiological disease.

“As far back as 1956 the AMA said alcoholism was a disease,” says Ewing. “It’s really like diabetes. The diabetic cannot tolerate sugar. Once an alcoholic stops drinking, he cannot touch liquor in any form “

Women alcoholics, according to Ewing, often suffer from low self-esteem. They carry enormous guilt feelings and sexual problems. In his career, Ewing says he has seen twice as many female alcoholics as men report incidents of physical or sexual abuse.

“They only feel OK when they are drunk,” says Ewing.

But it’s a road to self-destruction.

The trend in treatment programs such as St. Paul’s is a shorter, 30 day length in-patient stay consisting of four components. First, the detoxification program: “We make it as comfortable as possible,” says Ewing. “No cold turkey. We may administer certain drugs.”

Next comes formal treatment such as group therapy and an introduction to Alcoholics Anonymous. The third vital component is family involvement. Often a former drinker can function without liquor in a treatment center. But the real test comes when she gets home, or back to work.

“The alcoholic’s family becomes addicted, too,” says Ewing. “They are addicted to an addict They may unconsciously set up the patient for a relapse.”

Last comes after-care Patients try their newly learned skills in their environment, coming back to the group therapy support and attending Alcoholics Anonymous meetings as long as they need them.

DEPRESSION



Women are more susceptible to depression than are men-three times more vulnerable, according to psychiatrists. There are many reasons for this, Hormones play a vital role, as does society, stress and expectations.

“Men are very tied to their masculine image,” says Dr. Manoochehr Khatami. Medical Director of the Center for Bio-Behavioral Medicine at St Paul Medical Center Dr. Khatami is also an Associate Professor of Clinical Psychiatry at The University of Texas Health Science Center. “Women are more receptive to their feelings and they seek help. Women are more idealistic. More perfect ion istic. They also get frustrated more easily than men do.”

According to Dr. Khatami, women are most vulnerable to depression in their forties and fifties. When a depression attack hits a woman before age thirty it tends to be shorter than after thirty. A complete recovery from an episode of depression occurs in 70 to 95% of documented cases.

Treatment today leans away from the Freudian model. Instead, short-term hospitalization of two to four weeks duration combined with cognitive therapy is the approach used at many modern psychiatric treatment centers.

“We work on behavior modification,” says Dr. Khatami. “We address the thoughts and attitudes of the individual. Most often their perception of what is happening to cause the depression in their lives is not rational or realistic.”

The days of long confinement for clinical depression are waning, according to Dr. Khatami, More insurance companies are covering the cost of mental health care, but they want shorter stays and results.

In the 80’s, women are also suffering from more stress, according to Dr. Khatami.

“There is more demanded from women for survival today than there was twenty years ago,” says Khatami. “Society is more complex-higher divorce rates, higher economic demands, combining a profession with motherhood and marriage.”

But he believes women have more strength than they know of Women are actually stronger than men They have higher levels of tolerance and patience History according to Dr, Khatami, has shown time and again that women are more capable than men. The psychiatrists’ job is to make her see this.

In therapy, for example, psychiatrists will help a woman convinced that she is doomed into an unhappy marriage discover herself and her own powers. She doesn’t have to be a helpless victim of society or of a man.

“The solution is internal,” says Dr. Khatami who is from Tehran, Iran. He received his training at the University of Penn-sylvania. “If I change, the world changes. Women don’t have to feel victimized if they remember they don’t have to prove anything to anybody.”



EATING YOURSELF TO DEATH: THE HIDDEN EPIDEMIC



At the peak of her illness, she was eating $100 worth of food a day. But she never gained any weight because once Diana binged on three gallons of ice cream, five bags of cookies, !wo pizzas and countless sodas she would visit the bathroom for a private ceremony between her and the toilet. She made herself vomit up the evidence of her binge, vowed never to do it again and left the bathroom convinced that she wouldn’t. Not until the next meal,

Some of them eat and then vomit. Some take laxatives and diuretics. Others just “pig out” on food. However they do it, two-thirds of American high school students have experimented with bulimarexia. For a third of those who try it, this eating disorder becomes a serious, deadly problem.

Bulimia (compulsive overeating), anorexia nervosa (starving yourself), and bulima-rexia (binge-purge eating) are three major eating disorders that psychiatrists say affect more than sixty million people. 95% of them are women. Women who come from upper middle class families. Women with college degrees and high ideals-perfectionists, achievers.

Dr. William Racier, a California psychiatrist and founder of the national chain of eating disorder clinics bearing his name says one out of 10 Americans has an alcohol problem. But one out of five Americans has an eating disorder-a way of using food as an emotional scapegoat.

“What I was doing with food,” says one former bulimarexic, “was trying to fill an emotional hole. Food had a narcotic effect on me.”

Another former anorexic says starving herself down to 75 pounds gave her a feeling of control.

“I was in high school at the time,” says Sara (not her real name). “It was a very competitive high school in a very wealthy suburb of Chicago. Grades, clothes, what you looked like and who you knew were very important values. I was obsessed with being thin.”

To this day Sara, who has a trim figure, stil looks in the mirror and sees a chubby woman. Luckily, she got help before she died from starvation.

“What happens to the body,” says Lucy Letton, a clinical coordinator with The Radar Institutes McKinney clinic, “is devastating. It basically starves to death “

Hair falls out, teeth become rotten from the contact with stomach acids; eventually they fall out. Some women quit having periods. The stomach becomes distended. The body doesn’t receive the necessary minerals and fluids, The result is cardiac arrest and an electrolyte imbalance. The victim dies. That is what happened in the well-publicized case of Karen Carpenter, a victim of anorexia nervosa and bulimia.

The bulimics and bulimarexics suffer the same physical devastation as the anorexic. In addition, they develop gastrointestinal problems: ulcers, esophogal tears, and hemorroids. If untreated, the eating disease will bring on strokes and heart attacks, arthritis and joint pain, diabetes, kidney and liver problems.

Eating disorder experts say there are many puzzling reasons why women get hooked. Sometimes it’s an innocent way to try and control weight. In our society, a premium is set on thinness and good looks, In the late sixties, the “Twiggy” look was fashionable. It is particularly important to teenagers to have slim bodies. Most eating disorders are found in parts of the country where pretty bodies are in focus-California, for example, and large cities such as Dallas,

But underneath the surface, eating disorders develop out of an emotional need,

“The anorexic shoves down her feelings by not eating.” says Letton. “Yet she thinks about food constantly. She may be eating a cracker and a glass of water and exercising four to six hours a day to get rid of it. That way she has total control of her body”

The binge-purger is soothing her feelings by consuming huge quantities of food

After the Dings comes the purge because the bulimarexic feels guilty, Vomiting, says Letton, is easy -it’s a natural reflex.

At Rader, treating victims of eating disorders is similar to treating people struggling with alcohol and drug dependencies. They must learn communication skills. They must develop interpersonal skills and social dynamics. As their disorder progresses, victims of eating disorders alienate themselves from family and friends. They may steal money to buy food The patient is retrained socially to take care of her feelings without food-and nutritionally to learn what food is really about.

“The difference between the foodaholic and the alcoholic,” says Letton, “is this the alcoholic has to take her addiction three times a day and control it. That’s very hard to do.”

Like most alcohol treatment centers, Rader puts the patient’s family into a therapy program twice a week. The two-part program beings with six weeks of in-patient care, and ends with 12 weeks of out-patient programs Some patients become members of Overeaters Anonymous.

“People with eating disorders have usually forgotten how to relate to others” says Let-ton. “Or maybe they never knew. Food works so well It’s soothing, filling, and it never leaves you the way people do.”



MAMMOGRAPHY MONTH; MARCH, 1987



If you have never had a mammography, or if you’ve been putting it off for any number of reasons -stop, pick up the phone, and make an appointment this very minute.

More than 41 breast screening centers in the Dallas area are having a sale on mam-mographies this month.

It will save you S50 and can also save your life.

The 1987 Dallas/Fort Worth Breast Screening Project is being done in conjunction with a national campaign by the American Cancer Society. Health care providers have agreed to offer marnmograms at about half the price, or a cost not to exceed $50. To find out if you are eligible for a reduced cost mammogram call the American Cancer Society’s phone bank at 634-3800 from 12 noon to 12 midnight, March 2-March 6.

Two years ago when the project was launched in Chicago, eighty hospitals and screening centers offered the low-cost mammographies. With the medical community’s support and a boost from the. media, 9,000 women were examined; 43-breast cancers were found and 164 women were put on alert.

This month you’ll also be hearing more about breast screening and breast self exams.

There are three ways to examine your breasts: in the shower or bath, in front of the mirror, and while ying down In the shower While your skin is wet, your fingers flat, move them gently over each part of each breast. Check for any lumps, hard knots or thickenings. Use right hand to examine left breast, left to examine right breast.

Mirror: Inspect breasts with both arms at your side. Now raise them overhead Look for changes in the contour of the breast -swelling, dimpling of skin or changes in the nipple. Then, rest palm on hips and press firmly to flex your pectoral muscles. Check for the same changes. Incidentally, breasts may not match perfectly in size -few women’s do.

In bed Right breast: put a pillow under the right shoulder Place right hand behind your head. With left hand, fingers flat, press gently in small circular motions around an imaginary clockface. Begin at outermost top of your right breast for 12 o’clock, then move to 1 o’clock and so on around the circle back to 12. Next, move in one inch toward the nipple and keep circling to examine every part of your breast, including the nipple. This requires at least three more circles. Slowly repeat the entire procedure on your other breast. Note how your breast structure feels.

Finally, squeeze the nipple of each breast gently between thumb and index finger. If any discharge appears (provided you are not nursing)-clear or bloody, report it to your physician immediately

CANCER

Susan Rogers was 33 years old She had two children-a one year old and a six year old. She also thought she had cancer.

She was lying in a hospital recovery room, barely able to make sense out of the faces and figures that she could see Her surgeon leaned over her.

“Your growth was cancerous, Susan. I’m go:ng to have to remove your breast to save your life,” he said.

Through the druggy haze that refused to clear from her eyes, she saw his face and that of another person nearby. Another woman, and the reaction on her face was horror-as if she’d seen the ghost of death. Then Susan fell back asleep, hoping it was all a neurotic, miserable dream

It was not a dream, Once the anaesthesia had worn off, Susan awoke to a new chapter She had to lose a breast to save her life Like millions of women, she would learn to cope with life after breast cancer: daily exercises, chemotherapy, and, as she puts it, that ever-present knowledge that death sits upon your shoulder ready to strike again.

Until recently, breast cancer was the leading cancer killer among women in the U, S. Now, lung cancer has taken over the dubious lead. Even so, the American Cancer Society predicts breast cancer will strike one out of every ten American women during her lifetime in 1987. The cause is yet unknown, Early detection offers the only defense and hope of a complete cure.

Women are advised to see their physician at least once a year for a complete physical that should include a breast exam. They should also check their breast after every period. Any hardenings, lumps, or masses that can be detected with the fingers should be reported to a physician immediately.

Some masses are too small to be felt by even the most experienced fingers. That’s where mammography comes in. This gentle breast X-ray can detect even microscopic sized calcium deposits, breast tumors, and masses with an accuracy rate of 90%. In previous years women worried that yearly mammograms could actually contribute to cancer by exposing women to dangerous X-rays. Technological improvements in the photography equipment and a significant reduction in the amount of radiation needed have made mammograms as safe as taking a sunbath.

Many women wonder when they should first have a mammogram. For women ages 35 to 40, check with your physician, If there is a history of breast cancer in your family you may need one even earlier.

Between the ages of 35 and 40, a woman will have what physicians call a “screening” mammogram. That is, while she doesn’t have any symptoms, the mammogram will reveal her “normal” breast tissue. That mammogram will be kept in her files and all future ones will be compared to it. This way, physicians can note any changes m the breast tissue.

The thing to keep in mind is that mammography is safe, painless, and as necessary as a pap smear to help detect cancerous growths. Breast cancer is also one of the few cancers with an excellent recovery rate-up to 99% if detected early.

A recent Gallup survey indicated that 15% of women over the age of 50 have a mammography every year. Vet, according to the poll, three-quarters of all American women are aware that mammography exists. Why don’t more women get mammographies?

According to the American Cancer Society, some women still fear X-rays. Some women cannot afford the average $100 fee. And some women just keep putting it off, as you would a dental or gynecological exam.

“There was no history of breast cancer in our family,” says Susan, “One surgeon told me the growth was not at all malignant. Another said I had a 70% chance of not having a malignancy,”

As she was lying in her hospital bed, a volunteer from REACH TO RECOVERY, a volunteer help group made up of former mastectomy patients, contacted Susan. After breast surgery, women must begin a series of exercises to keep scar tissue in their chests and upper arms from tightening and forming adhesions,

“It’s like crepe paper,” says Susan “If needs to be stretched and moved.”

If the tissue is allowed to tighten without stretching, a woman may lose the use of her arms.

The exercises must be done on a daily basis. In addition, if the lymph nodes are removed, the arm (or arms} must be kept moving so they will not fill up with lymphatic fluids.

“A therapist once told me of a woman whose arm swelled up to 26 pounds,” says Susan.

After breast surgery, a woman has to do a lot of work to regain the full use of her arms. She may even have to undergo further treatment for the cancer, such as chemotherapy. This happened to Susan Now a Reach for Recovery Volunteer herself. Susan can relate to the patients she helps because someone helped her

“I visited a woman the other day,” says Susan. “She didn’t really want to see anyone. But I introduced myself and told her that I knew what she was going through because I had been in the same place seven years ago. She asked if I had had chemotherapy. I said yes. She asked if my hair had fallen out. I said some of it. But I just got a new haircut, a new look.”

The Reach for Recovery volunteer presents the new mastectomy patient with a small bag containing a bra and a breast form. She will talk about her own situation-not a lot of medical talk, but just enough sharing to let the recovering patient know nothing is being hidden. As her recovery progresses, the mastectomy patient can find help in support groups or therapy For Susan, it took a lot of work-physical and emotional -to help her over the shock and depression. She learned a whole new way to think. She calls it flipping a negative experience into a positive. Cancer patients, she says, learn to live for the moment, they learn to create a strong present



CANCER FACTS FOR WOMEN



The cancers that hit women the hardest: lung, breast, uterine, colon-rectal. Skin cancer actually strikes more men than women -but it’s a serious concern for anyone living in the sunbelt climate. Until recently breast cancer took the lead in the cancer death department for women. But now lung cancer kills more women than any other form of cancer. The reason, according to physicians, is smoking. During World War II and thereafter, women “came a long way, baby.” They took to cigarettes. Now that generation of women is reaching their golden years, only to find them ended by lung cancer.

Prevention:

See your physician at least once a year, even if you feel great. Practice preventative medicine: a healthy balanced diet, moderation in drinking and quit smoking. Get plenty of exercise, but not in the sun. Learn to control stress naturally And screen yourself according to the following tables:

Lung Cancer

Warning signs: Difficulty breathing; persistent coughing or coughing up blood tinged sputum. Doctors say lung cancer sneaks up on you. Often by the time the lesions appear on an X-ray, the cancer has advanced beyond treatment.

Diagnostic Tests: Chest X-ray, Bron-choscopy.

Prevention Stop smoking. The evidence is clear that smoking causes cancer and a host of other illnesses. If you work in an environment where chemical gases and fumes are present, wear protective breathing gear according to OSHA standards. Always wear protective breathing gear when working with asbestos.

Number of deaths from lung cancer in the U. S, in 1986: 130,000.

Breast Cancer

Warning signs: breast changes such as lumps, thickening, swelling, dimpling; skin irritation; distortion; retraction or scaliness of the nipple; nipple discharge, pain or tenderness.

Screening tests breast self-exam; physical exam; mammography.

Prevention: None known at this time.

Number of deaths from breast cancer in the U. S. in 1986: 40,000. Colon-Rectal Cancer

Warning signs: Blood in the stool, pain upon excretion; excessive diarrhea.

Screening tests: Testing a stool specimen for occult blood.

Prevention: Not conclusive, but eating a well-balanced diet including plenty of roughage from vegetables such as broccoli, cauliflower, corn and other fibrous legumes-eating whole grain cereals and breads; cutting down on animal fat and processed foods in the diet-all of this may help reduce the chances of getting colon-rectal cancer.

Number of deaths from colon-rectal cancer in U. S. in 1986: 60,000.

Skin Cancer

Warning Signs: Any unusual skin condition, especially a change in the size or color of a mole or other darkly pigmented growth or spot,

Screening Tests Recognition of changes in your skin. You are a prime candidate if you are fair-skinned, and if you live in a hot, sunny climate. Skin cancer hits more MEN than WOMEN, probably because they do not protect their skin as much as women do, and because they are not as appearance-conscious. Educate the men in your life about the dangers of sun-exposure and pour on the sunscreen

Prevention: Avoid the sun between 10 a.m. and 3 p.m. when ultraviolet sunlight rays are strongest, if you have to go out, wear protective clothing and use a sunscreen containing ingredients such as PABA-para aminobenzoic acid, Don’t broil yourself in the sun to get a golden tan. Besides inviting skin cancers, you’ll also guarantee the early onset of wrinkles

Number of deaths from skin cancer in U. S. in 1986: 7,500.

Uterine Cancer

Warning Signs. Unusual bleeding, between periods or after the menopause. An unusual vagina! discharge Lower abdominal pain and discomfort

Screening: The Pap smear, a sample of cells from the cervix which are examined under a microscope. The smear test is painless. It is recommended once every two years for most women unless there is a history of uterine or endometrial cancer or unless the patient has had previous problems or multiple sexual partners.

Sometimes a woman’s pap smear may show cells that are in a precancerous stage Usually this condition can be cleared up by cryosurgery, a relatively painless freezing of the cells, electrocoagulation, or local surgery

Prevention: Cervical cancer has been linked to first intercourse at an early age and multiple sexual partners. Endometrial cancer is linked to a history of infertility, failure of ovulation, prolonged estrogen therapy and obesity.

Number of deaths from uterine cancer in U. S. in 1986 10,000.



OSTEOPOROSIS



Imagine a bone so transparant that you can read a newspaper through it. Imagine breaking a rib or vertebra just by sneezing. Or you get up in the middle of the night, walk to the bathroom and brush your hip against a chair. The hip breaks and you’re doomed to bedrest for weeks.

Not a take from the Twilight Zone. Fact: osteoporosis affects an estimated 20 million Americans, and up to 25% of all white women over the age of 60. Each year more than one million fractures are attributed to osteoporosis . at a cost of more than three billion dollars

What causes osteoporosis9

It’s a gradual loss of bone that begins around age 40. At menopause, because of hormonal changes, some women experience an accelerated rate of bone loss. If adequate bone hasn’t been formed before menopause, these women risk developing osteoporosis. The bones actually thin out, becoming hollow in the center Eventually they become too weak to support the weight of the body.

Is there a cure9

Osteoporosis is NOT REVERSIBLE. That is, once the damage has been done and the bones are hollow, nothing can make them completely healthy again.

However, in the last ten years much information has become available on how to prevent the onset of this disease , and maybe even how to correct it. At The University of Texas Health Science Center, two major studies of osteoporosis drugs began last May.

A slow release form of sodium fluoride, a compound used by dentists to strengthen teeth, is known lor its abililty to build bone. When administered in conjunction with calcium citrate, it is capable of binding calcium to bone. This actually increases bone mass in some people.

“There is ample evidence that sodium fluoride can make more bone and prevent osteoporosis,” says Dr. Charles Y. C. Pak, chief of mineral metabolism at the Health Science Center and director of the National Institute of Health-sponsored General Clinical Research Center.

But as Dr. Pak points out, sodium fluoride itself has prevalent side effects.

What the physicians are testing, then, is a slow-release form of sodium fluoride that can safely make more bone and prevent further bone fractures in people who have osteoporosis without side effects.

“One of the major misconceptions today is that osteoporosis is inevitable and there’s nothing you can do about it,” says Dr. Sydney Bonnick. Dr. Bonnick is the only female physician whose private practice specializes in osteoporosis, according to AMI Medical Arts Hospital with whom she is affiliated.

Osteoporosis is treatable and preventable,” she says. “Ten years ago there was basically no treatment for it. But now all that has changed.”

Screening. A Must tor Every Woman

If you are under age 35, do all you can to strengthen and build strong bones: exercise, enjoy weight-bearing activities like walking, dancing, aerobics and jogging.

Eat foods rich in calcium: dairy products, spinach, broccoli, salmon and raw oysters.

Supplement your diet with calcium for a total intake of 1,000 mg per day before menopause, 1,500 mg per day after menopause. To help your body absorb the calcium, be sure to take 400 I.U, of vitamin D. But don’t overdo it. Too much calcium, or too much vitamin D, can be harmful.

Family history plays a big role. If your mother has osteoporosis, chances are you will, too. Women of northern European, Oriental or Latin American heritage; women with small bones and fair skin; women who’ve had their ovaries removed prior to age 50 or who have undergone menopause before 50; women who drink alcohol, eat lots of protein, drink little milk and smoke; women who have never had children, drink a lot of coffee and who get little or no exercise-all these are at a high risk for osteoporosis.

Men can get it, too. Those men at risk include alcoholics, smokers, men with hormone deficiencies, and men on long term medications such as insulin, diuretics, ulcer medication, anti-coagulants and steroids.

If any of these factors put you at risk, check with your doctor. You may wish to have your bones evaluated by a special type of X-ray called dual photon den-sitometry. This involves a small dose of radiation exposure to measure bone density Dual photon densitometry can tell when bones are thinning and therefore at high risk for osteoporosis, It can also measure progress once a patient is on a treatment regime

There are many orthopedic clinics and hospital diagnostic centers offering dual photon densitometry, including AMI Medical Arts Hospital, Methodist Hospital, St. Paul Medical Center, and others. Check with your physician for a referral.



COSMETIC SURGERY



In the sixties, only her hairdresser knew for sure. But in the eighties, only her plastic surgeon knows for certain. Half a million cosmetic surgery procedures are performed each year m the U. S, and most of those, according to plastic surgeons, are on women.

The plastic surgeon can fill out, uplift or reduce breasts, give eyes a better, more natural-looking lift; and while you’re at it, he can give you a two-layer face-lift, mold a better looking nose on the outside, just under the skin; give a mastectomy patient a natural looking breast outline with implants or her own tissue; and newest of the procedures, take fat from one part of your body where you don’t want it and use it to fill a wrinkle, or smooth out a scar.

It sounds heavenly, especially when you consider than many of these procedures are less painful than childbirth and can be done under local anesthesia in the surgeon’s office.

But plastic surgeons warn that increased advertising and promotion of cosmetic surgery may lead people to believe it is no longer risk-free Plastic surgery will not change your life It can, however, make you feel better about your appearance If you have had plastic surgery and you are unhappy with the results, something can be done. Techniques are more sophisticated now than they were ten years ago And there are many talented surgeons in the field

Choosing a Surgeon:

Don’t be swayed by slick ads ana glossy photographs When you select a plastic surgeon, check for reputation and results. You can ask advice from friends who have undergone plastic surgery. Your best bet is to ask your personal physician to recommend two or three doctors HE or SHE trusts,

At the consultation, ask many questions Take a look at the physician’s board certification Members of the American Society of Plastic and Reconstructive Surgeons are doctors who have completed residency programs in plastic surgery; members of the American Academy of Facial Plastic and Reconstructive Surgery are doctors who have completed residency programs in head and neck surgery.

Teli the physician what you hope to get out of this operation Take a look at his work. Physicians warn that results are never ex actly like the computer images or the photographs depicting what your remolded flesh will look like. Good results, yes. but no guarantees. And expect to be billed for a consultation with the physician.

WARNING If you find a physician who seems to be very pushy-who insists you make up your mind that day about the surgery, get a second opinion,

Fact suctioning or body sculpting is quickly outranking breast augmentation as the most popular plastic surgery procedure with women as well as men

Dr. Robert Hamas estimates at least one-third of his practice is lipo-suction. In 1984, when the technique had only just been made available in the U. S., 55,900 suctions were reported performed by the American Society of Plastic and Reconstructive Surgeons. That same year, 95,000 breast augmentations were reported.

The cannula or suction tool used to vacuum the body fat is now smaller. Basically, the physician siphons off localized fat deposits from the hips, thighs, buttocks and stomach. The technique can also be used on the neck and face in conjunction with a face-lift. Once the fat is removed, it is gone forever. The area sucked may be bruised for a while but swelling should disappear in two days to one week.

Physicians stress that lipo-suction is not a substitute for diet and exercise. It is meant to remove stubborn pockets of fat AFTER an individual has lost weight. Hamas, Gunter and others also warn patients with an interest in having the technique to find a skillful surgeon.

“You need someone who is skilled in contouring bodies,” says Hamas. “Sometimes we can combine the lipo-suction with another technique. It’s like a scalpel-be careful who’s holding the other end,”

Taking lipo-suction one step further. . . cell transfer (a nice may to say moving fat) is available now through your plastic surgeon. Available in the U. S. since last January, doctors can now transfer fat cells from where they aren’t wanted to where they are desperately needed For example, cell transfer from the abdomen can be used to fill out an injury on the cheek. Or a wrinkle on the forehead.

“It effectively uses the body’s own tissue and presents no possibility for an allergic reaction,” says James Fowler, a Dallas cosmetic surgeon,



BREAST RECONSTRUCTION… AFTER MASTECTOMY



This is one area of plastic surgery where vanity is not the issue. When a woman loses one or both breasts, she needs help from the other end of the scalpel – the one that can give her an illusion, or as natural looking a breast as science can create.

And science has gotten better in the last ten years.

“We’re now talking about an aesthetically reasonable option both in and out of clothes,” says Dr. Fritz Barton, professor and chairman of the Division of Plastic Surgery at the University of Texas Health Science Center in a recent interview for “Center Times.”

Thankfully, the more radical mastectomies that require removal of the breast tissue, skin and nipple as well as the lymph nodes under the arm are less often necessary. That’s because women are screening themselves for breast cancer through self-exam and mammography. The smaller a tumor is when found, the better the chance a woman has of saving more of her own breast tissue.

If adequate muscle, bulk and skin are available, the plastic surgeon uses silicone implants (just like the ones used in breast augmentation). They are placed under the muscle. The skin is stretched over the new breast, and a nipple and areola are created from skin grafts.

If a woman lacks enough bulk to cover an implant, tissue expansion is used. An expander implant is placed under the skin surgically. The physician injects saline solution into the expander a little at a time, gradually stretching the skin similar to the way a woman’s stomach skin stretches when she’s pregnant. Some have plastic tubes attached, but the newest ones are cleverly designed so that a surgeon can inject fluids without a tube

“Magnetic material surrounds the center opening,” explains plastic surgeon Jack Gunter, “You trace the magnet around until you have a circle on the woman’s breast.

In the very center of that circle is the opening.”

In goes the saline, When the skin has been gently stretched to the right size, the expander implant comes out and the real one goes in.

Finally, if there is not enough skin or tissue left to use implants or expanders, the surgeon will remove padding from a woman’s stomach (“rectus abdominis flap”) or back (“latissimus dorsi myocutaneous flap”) In these procedures, she will have to accept a scar on her back or abdomen as well as in her breast area.

“The breast is not exactly like a natural breast,” says Dr, Barton, “but artificial is not necessarily bad “



BEING AN OLDER MOTHER



She’s pregnant and her baby is due in one week. Nothing unusual about that in this baby boom era except that Judy Shields is 44, Her 24-year old daughter is in graduate school. Her 23 year old stepson is in college And while more of her friends are going through their menopause, Judy is decorating a nursery.

“We really want this baby,” says Judy. A second marriage for both Judy and her husband, they had all but given up on conceiving a child “We took a lot of tests to see why I wasn’t getting pregnant. I thought that after all those years maybe it would never happen,”

An amniocentesis confirmed the child’s good health and sex a boy, His future siblings are almost as thrilled as the expectant parents. Judy’s daughter Gail is studying engineering. Married, she doesn’t plan to start her family for another ten years.

“My daugher is anxious to be the caretaker. And we know that should anything happen to either one of us, our children will raise this child,” says Judy

But she admits that carrying a child at 44 is much harder physically than it was when she was 21.

“I had much more energy then,” she says. “I worked until my eighth month. Now I wonder if I’ll have enough energy to care for this child”

Childbirth procedures have changed dramatically in the 20 years since Judy last set foot in a maternity ward. She remembers a horrible experience. Her husband was not even in the hospital.

“They just handed him a clean, pink baby the following day,” she recalls. “I went on birth control for the next 12 years, that’s how awful it was.”

But this time around, Judy’s husband will be by her side as she delivers their child. She’s planning on trying an ep:dural block for anesthesia,

“We never thought this would happen to us,” says Judy. “About the only real concern I have now is finding someone my age who is also staying home and raising a child.” Women are having babies later. According to obstetricians, the average age for having a first baby now ranges from 28 to 35. OB’s attribute this to women’s changing role in society. Thirty years ago it was socially acceptable for a woman to attend college, get married and start her family. Now women start their careers after college. Pregnancy is ideally out on hold until the woman and her spouse are “ready.”

“I think it’s vital for a woman to be aware of these risks and know what she’s getting into if she plans a later-life pregnancy,” says Dr. Howard.

If a woman has been pregnant in the past-say 20 years ago- could that help improve the outcome of a later-life pregnancy?

According to Dr. Howard, no. Seven years beyond the last pregnancy the uterus behaves as if it were never pregnant.

Could later pregnancies delay the onset of a woman’s menopause? According to these physicians, no.

“But the average age of menopause is now around 50,” says Dr. Cunningham. “It has moved up from age 40 in the last three decades.”

Dr. Cunningham attributes that to overall better health -and health care for women. Which means; women are apparently taking good care of themselves. And they should.

Obstetricians generally approve, but they warn us that pregnancy past age 35 and 40 is not without risk.

The biggest risk is Down’s Syndrome. As a woman gets older, the margin narrows on her odds. At age 40. for example, there is a one in 70 chance of bearing a baby with Down’s syndrome. At 45 the odds tumble to one in 45.

“And that’s just the tip of the iceburg,” says Gary Cunningham, Professor and Chairman of the Department of Obstetrics and Gynecology at the University of Texas Health Science Center in Dallas. “Downs is just one of many chromosome abnormalities that a woman risks after age 40.”

Because of this, the obstetrician may advise an amniocentesis. If the fetus is found to have a chromosome abnormality, the parents may decide to terminate the pregnancy.

Dr. W. F, “Dub” Howard, an obstetrician-gynecologist and infertility specialist at Dedman Medical Center says an experimental procedure called choriionic villus sampling may soon replace the amniocentesis. Working through the vagina, the obstetrician will take a pinch of the placenta for testing. Chorionic sampling can be done at an earlier stage of pregnancy when aborting the fetus would be safer for the mother.

Besides chromosome abnormalities, older women may suffer from other diseases that automatically put them in the high risk category should they become pregnant. The likelihood of a woman developing diabetes, hypertension, lupus, and a host of other cumulative underlying diseases of the heart, lungs, and liver increases as she gets older. Pregnancy is a stress to the body- a dangerous stress for anyone with health problems.

Now for the flip side, If you are free from disease and in pretty good basic health at age 40, most OS’s will tell you to go for it – get pregnant

“Aside from the women with obvious medical problems, the pregnancy picture is not as bleak anymore for older women,” says Dr. Cunningham

“Having babies later in life is wonderful,” says Dr. Howard. “The latest studies on perinatal mortality now show us there really isn’t that much difference in age.”

Previous studies indicating older women stood a greater chance of losing their babies were based on women who had had multiple pregnancies. By the time they were 40, they were having their 6th and 7th children The complications were not due so much to age but to wearing out the uterus, according to Howard.

Still, you may be in for a more difficult nine months. Older gravidas (pregnant women) have a slightly higher chance of delivering prematurely They have a higher incidence of pre- eclampsia, pregnancy-induced high blood pressure. And the chances of miscarriage increase as a woman gets older.

Newsletter

Keep me up to date on the latest happenings and all that D Magazine has to offer.

Comments