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What Does My Pap Smear Result Mean Anyway?

12/19/2017

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As a whole, women are much more faithful to their annual or wellness checkups than men, which is probably why women tend to live longer, and a big reason for that consistency is to make sure that their pap smear is up to date.  That being said, there’s often a lot of confusion if the results show up as abnormal.  The phone call to come in and review results can certainly cause some anxiety, so I’ll try to give some clarification.

What does the pap smear test for, and how reliable is it anyway?  A pap smear is a test to look for abnormal, potentially precancerous or cancerous cervical cells.  This test involves using a brush to sweep cells away from the cervix to be looked at with a microscope or even a computer for abnormal characteristics.  These cells can be low-grade (less abnormal), high-grade (more abnormal), or ASCUS (uncertain how abnormal).  Depending on a patient’s age (generally 30 or older), HPV testing may also be done at the same time.  This test uses the same cells to check for evidence of HPV (human papilloma virus) strains that may lead to cervical cancer if left untreated, and the result is either positive (the virus is present) or negative (it isn’t).  Other strains of the virus can lead to warts, either genital or elsewhere, but these aren’t tested for with a pap smear because they typically don’t cause cervical cancer.  With use of both tests together, we can detect nearly 99% of high-grade lesions (markedly abnormal precancerous cells).

I have an abnormal pap smear.  Do I have cancer?  Am I going to die?  In a study of over 200,000 women, even those with either an abnormal pap or HPV test or both had only a 0.2% chance of having cervical cancer at the time of the test.  Even for those 2 in 1,000 who have cervical cancer, it generally responds very well to treatment in early stages.

What about babies?  Am I going to be infertile?  Many women (in fact, roughly 2/3 of all women) have HPV infections at some point in their lifetimes, and most of these women go on to have children.  Many HPV infections are cleared by a women’s immune system, and even for those who require treatment of precancerous cells, pregnancies tend to be uncomplicated.

My pap smear came back abnormal.  What’s the next step?  Depending on your age (younger patients tend to be more likely to clear abnormal cells on their own) and type of lesion (low grade lesions are easier for a woman to clear than high grade ones), you may require colposcopy with cervical biopsies.  During this procedure, the doctor applies an iodine solution and/or a vinegar-based solution to see areas of abnormal cells with a microscope.  This is done using a speculum to visualize the cervix and then an instrument to take biopsies (a few millimeters in size) to make sure that a pathologist is able to see a sample from each area of abnormal cells.  If these biopsies come back either normal or only low-grade (CIN 1) in nature, then you may just have to repeat your pap and HPV test in a year.  If they are medium or high-grade (CIN 2 or 3) in nature, treatment to remove these cells may be required.

I have CIN 3.  Does that mean I am for sure getting cancer?  Even for the most abnormal precancerous cells, CIN 3, we see only about a 12% chance of developing cervical cancer, and on average, the transition from CIN 3 to cancer takes between 8-12 years.  This is why for most women with no history of abnormal pap smear, we can offer screening every 3-5 years depending on the type of testing done.  Still, we do take abnormal paps seriously, and we are very proactive in trying to prevent the development of cervical cancer from precancerous cells.  Whereas an outpatient procedure to remove a small portion of the cervix is generally adequate to treat precancerous cells, cervical cancer may not be treatable even with hysterectomy and could require chemotherapy and radiation.

How can I avoid developing abnormal cervical cells?  The most effective prevention is administration of the HPV vaccine.  This is usually given in 2 doses between ages 11-12, although it can be given from ages 9-26.  HPV is transmitted sexually (not inherited), so condom use and limiting the number of sexual partners can also reduce the chances of HPV infection.

In closing, pap smears and HPV testing are done to check for signs of precancerous changes that may develop into cervical cancer if left untreated or even signs of cervical cancer itself.  By staying up to date with your screening, you can significantly reduce the chance of your first abnormal finding (if you have one) indicating a more serious condition.  If you aren’t sure that you’re up to date on your cervical cancer screening, be sure to make an appointment with your doctor today!
​

Dr. Nick
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Does heartburn during pregnancy mean my baby will have a head full of hair?

12/12/2017

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There are so many pregnancy myths out there.  And most of them are just that.  If my baby’s heart rate is high, does that mean it’s a boy?  My belly is shaped like a basketball, does that mean it’s a boy?  My skin is so soft, does that mean it’s a girl?  My hair is so thick and luxurious, does that mean it’s a boy?  The list goes on and on.  There have not been any studies that have shown truth to any of these myths. 

However, there was a recent study that showed an association between heartburn severity during pregnancy and newborn hair.  Heartburn is such a common symptom during pregnancy and becomes even more common as the pregnancy progresses.  22% of women suffer from heartburn in the first trimester, 39% suffer from it in the second trimester, and 72% in the third trimester.  Symptoms of heartburn rapidly increases towards the end of the second trimester.  

The study had 64 pregnant women rank the severity of their heartburn.  78% of these women had symptoms of heartburn during their pregnancies.  After the women gave birth, photographs of the babies’ heads were given to researchers to rate the amount of newborn hair.  What they found was that 23 out of 28 women with moderate to severe heartburn had babies with average or above average amounts of hair. Meanwhile 10 of the 12 women with no heartburn had babies with little or no hair.  So it looks like there is definitely an association between heartburn severity during pregnancy and newborn hair.  


So, if that’s the case, is the hair on my baby’s head causing the heartburn.  Not necessarily.  It’s not the hair that is causing the heartburn as much as the interplay of hormones that makes heartburn worse and increases the hair on your baby’s head.  High hormone levels during pregnancy can relax the sphincter of the esophagus which will cause some of your stomach acid to leak increasing the burning sensation felt with heartburn.  These same hormones allow your baby to have a fuller head of hair.  So, it’s not the hair causing the heartburn as much as the hormones causing the heartburn and the hair!!!


​Dr. Pam
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Planning a Holiday Party? A Few Tips to Get You Started

12/5/2017

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Picture
Whether it’s detailed gingerbread houses your guests can eat, or board games and ugly sweaters, movie-themed holiday parties, or clever cookie shapes, hosting your holiday get together can be stressful and chaotic. But it doesn’t have to be! In addition to party activities, music, and decorations, cooking your first big holiday meal can put you under a lot of pressure, but the work is worth it.

The Huffington Post suggests to get started by writing down your goals. Think about the kind of holiday vibe you want. Are you looking for something traditional or alternative and playful with a modern touch? This will help you in deciding Christmas decorations and meals.

Make sure to give yourself enough time for preparations and organization. Use apps like Pro Party Planner and Wunderlist that help organize to-do lists and tasks, such as picking up necessary ingredients. Don’t forget:


  • It’s ok to delegate tasks to others. It’s easy to get caught up in trying to do and think of everything, but involving friends and family in the process will not only help take some of the burden off, but it encourages others to participate and feel involved.
  • Have an approximate guest list and check cutlery, furniture, chairs, and place settings, to ensure you have enough for the potential guests.
  • Holiday calendars fill up quickly, so make sure to notify and sent out invitations early.

Dress up your House

Once you’ve envisioned and made a list of themes you want, look for DIY ideas for decorations. Online resources such as Pinterest can have plenty of creative ideas to get you started. For example:


  • Mason jar Christmas centerpiece
  • Joy wreaths
  • Mason jar flower vases
  • Ice lanterns
  • Tin can lanterns

Preparing your First Big Holiday Meal

Whether it’s a traditional holiday brandied ham or an intricate, elegant plate of creamy shrimp picata, your first holiday meal is enough to put a world of pressure on you. Make time to get ingredients with a few days in advance. Embrace cooking with friends and family the day before, ask others to help, and give yourself time so you’re not feeling rushed. Use the tools to organize yourself and spread the work out over a couple of days, rather than the day of the party.

Be Prepared for the Veggie Lovers Among You

It’s always a good idea to have some alternative options for guests with different dietary restrictions or preferences. There is surely to be a vegetarian or vegan among your friends, or maybe even someone with a nut or gluten allergy, so prepare adequately by offering a different option. The internet has an endless source of recipe options to choose from. Alternatively, you can reach out to your guests with special dietary needs and get their input. They might protest, but encourage them to share their preferences so you can provide an inclusive meal.

Don’t Forget Party Trays and Games

Stock up your pantry with crackers, cheese, or veggies to offer snack trays as people wait for the main dish. Put someone in charge of the cheese trays so you can focus on the big stuff.

The Balance has a handful of fun adult holiday party games you can try to help get people talking and laughing together. This is a great way to break the ice and get conversation going among friends or family who’ve never met.

Give Yourself Five

In between planning/making decorations, buying ingredients, gift shopping, getting the perfect outfit, and cooking, it’s easy to get wrapped up in perfection and forget that this is a time of celebration and bonding with loved ones. This is one of the biggest holiday party mistakes. So take some time in between all the tasks and enjoy, drink some eggnog, play your favorite music, call your best friend, and have fun.

Do what you can to downgrade the pressure, but all your planning will help you pull off a truly enjoyable soiree. And most importantly, don’t allow yourself to forget what the holidays are really about: enjoying all of life’s blessings with friends and loved ones, sharing the joy, and yes, a little bit of overindulgence.

Photo Credit: Pixabay

​Article by Jennifer Scott

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