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Women's Health Feature Articles

At Atlanticare, we realize that women have special health concerns -- from pregnancy to menopause to breast cancer -- and it is our goal to answer your questions, calm your fears, and empower you to take control of your health and your future. We also know that many women actively seek out information for themselves and their families to live better, healthier lives.

That’s why we’re now offering health, safety, and wellness articles just for women. These timely and practical suggestions and “how-tos” are written with you in mind.

Current feature article

What Causes Breast Cancer?

Previous Articles

• How Do I Know my Baby is Healthy?

• AtlantiCare's New NICU at the Center for Childbirth

• Routine Gynelogical Visits

What Causes Breast Cancer?

The truth of the matter is, it’s impossible to say exactly what causes a woman’s breast cancer. However, research has shown that some factors -- both genetic and environmental -- might increase a woman’s chance of developing breast cancer.

There are several factors that are widely believed to increase the risk of getting the disease. However, regardless of how high the risk is, it doesn’t mean that you’ll definitely get breast cancer in your lifetime. Conversely, even with no or low risk factors, there is no guarantee that you will avoid it. However, it’s always prudent and wise to reduce the risks wherever possible. Here are some good guidelines:

Breast cancer risk factors that you can control

• Having had more than one drink of alcohol per day
• Taking birth control pills for 5 years or longer
• Not getting regular exercise
• Using some forms of hormone replacement therapy for 10 years or longer
• Being overweight
• Being exposed to large amounts of radiation

Breast cancer risk factors that you can't control

• Getting older
• Family history of breast cancer
• Having the mutated breast cancer genes (BRCA1 or BRCA2)
• Personal history of breast cancer
• Starting your period before age 12
• Starting menopause after age 55

Source: National Cancer Institute, 1999

In addition to knowing and trying to control the risk factors that you can, maintaining good breast health starts by following good breast health habits. Medical professionals recommend an annual mammogram (diagnostic image of the breast) beginning at age 40; receiving an annual clinical breast exam from your doctor after age 40; and performing monthly breast self-exams beginning at age 20.

Monthly self-exams are especially important because it gives you another avenue to early detection, which is so important to increased survival should you have cancer. When performing a self-exam, you should be familiar with what’s normal for you (some women naturally have more “lumps and bumps” than others) as well as knowing what changes to look and feel for, such as hard, immovable lumps.

Visually examine your breasts in a mirror. Look for any dimpling, puckering, redness or swelling. Raise your arms over your head and check for any changes in size, shape or contour. Gently squeeze both nipples and look for any discharge. Report any changes to your physician right away.

Although age is simply your biggest risk factor, don’t live with a false sense of security by thinking you’re too young for breast cancer. ALL women -- young, older, pregnant, menopausal, large-breasted or small -- should practice good breast health habits for a lifetime.

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When that little bundle of joy finally makes his long-awaited debut, he’ll not only be greeted with hugs and kisses, but lots of poking and prodding, too. But don’t worry - it’s all done in the name of good health.

As soon as your newborn arrives, the hospital staff will observe and evaluate how well she is adjusting to life outside the womb. As part of the evaluation, they will utilize a commonly used measure called “APGAR” -- named after the physician who developed the scale. This scoring process is performed at one minute after birth, and then again at five. Here’s an easy way to understand and remember how it’s done:

A is for Activity. Is your baby actively moving his arms and legs?
P is for Pulse. A pulse above 100 beats per minute is ideal.
G is for Grimace or reflex irritability. Does your baby respond to touch by pulling away? Can she cough or sneeze?
A is for Appearance of skin color. Normal, healthy color should be observed from head to toe.
R is for Respiratory Effort. A good cry is the best way to tell!

Depending on the results of these signs, your baby will be scored from 0 to 10. A baby with an Apgar score in the 7-10 range is considered healthy and normal. A score of 6 or below may indicate that your baby needs further evaluation and intervention, or possibly, resuscitation. Rest assured, however, that many babies scoring below a 7 are often perfectly healthy and have no lasting health concerns.

Soon after birth, eye ointment will be administered to prevent infection and an injection of vitamin K will be administered to assist with blood clotting.

Your baby will also receive a hearing screening, painlessly performed with electrodes while he is sleeping. Early detection and intervention for hearing loss are key.

Before discharge, blood will be drawn from your baby’s heel which will then be used to conduct a screening for a variety of birth disorders. New Jersey now requires that all newborns be tested for 20 potential disorders. Some especially important ones are:

Phenylketonuria (PKU) -- Newborns with PKU cannot break down a substance called phenylalanine, which is found in the protein of many foods. If left untreated, it can have series effects. However, it is most often treated with diet modification.

Congenital Hypothyroidism -- This results when the body does not make enough thyroid hormone. Early treatment includes thyroid replacement medicine.

Galactosemia -- This occurs when the body cannot use the part of milk sugar called galactose. Avoidance of milk and milk products is usually necessary.

Cystic Fibrosis -- Early diagnosis of this lung disorder is crucial to improve the growth and development of children with it.

Jaundice -- referring to the yellow color of the skin and of the whites of the eyes -- is a common condition in newborns and your baby will be observed to see if he exhibits any signs of it. Jaundice is caused by excess bilirubin, produced by the breakdown of red blood cells. Many newborns have difficulty excreting the excess and it builds up in the liver.

Since this condition often starts during the second or third day of life, it’s often up to the parents to look for any signs of it. In most cases it resolves on its own, but mild jaundice can be treated with phototherapy -- exposure to ultraviolet light -- and an increase in fluid intake. If the condition persists longer than a week, he may need to be admitted for treatment.

Although all this testing can uncover some serious disorders, most babies go home healthy and grow normally with proper nutrition, care, and lots of love.

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When baby arrives well-ahead of her expected due date, there's plenty to worry about. Will she be able to breathe on her own? Are her brain and organs developed enough so that she'll grow normally? Will she survive?

The Neonatal Intensive Care Unit's (NICU) staff at the new Center for Childbirth in Pomona knows all too well the worries and risks that go with premature deliveries. These tiny preemies often require long hospitalizations with round-the-clock monitoring and care by an experienced staff of specialized nurses and physicians.

Claire Thies, RNC, BSN, is the clinical manager of AtlantiCare's newest baby: the brand new NICU. "Moving our Neonatal Intensive Care Unit from the city to the Mainland ( Pomona) location has allowed us to dramatically increase the size of our facility. We now have a 22 bed unit, instead of a 13 bed unit at the old location," explains Claire.

And size is not the only plus to this new unit. Every piece of equipment is new and state-of-the-art -- from monitors to incubators to lounges for the parents -- the Center for Childbirth's NICU has every detail covered when it comes to providing top-notch care and comfort to the babies and their families.

"We have a $34,000 bed -- called the Giraffe Omni bed -- which is an incredible addition to our NICU. It opens up as a radiant warmer and closes to be an incubator," says Claire. "We use it for our smallest, sickest babies and it's just unbelievable."

The unit houses a parent room where moms and dads can stay overnight to be close to their newborn during this anxiety-filled time. The traditionally harsh environment of a NICU is softened by soothing colors, painted clouds and comforting starlight.

Most importantly, the medical care provided is second to none. There is always a neonatologist in-house, not just on-call, so when a fragile baby arrives unexpectedly, there's no delay in intervention. Claire has assembled a well-seasoned nursing staff, too.

"Most of our nurses have between 15 to 25 years experience. And the ratio of nurse to babies is very low: one nurse to one or two babies in our intensive unit; and one to three or four in our stepdown unit," says Claire. The stepdown unit is part of the NICU, but it houses the babies that are not as critical as those in the intensive beds.

Claire and the Women's Center for Childbirth's NICU staff are excited that their new home will allow them to reach out to a much larger community. Women in the surrounding areas with high-risk pregnancies and premature births can feel a large measure of comfort that their babies will have access to the latest medical technology and the experience of a caring staff of NICU professionals.

As Claire explains, "We hope to increase the good outcomes for these very sick infants and send them home healthy as soon as possible. That's always been our goal."

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Routine Gynelogical Visits
Don't miss this opportunity to focus on you

There are a few essential parts to your annual exam that women of all ages could benefit from. During most regular visits, the physician will take a Pap smear. A Pap smear is where a doctor takes a sample of cells from your cervix, which can detect cancer at its earliest stages -- even before it becomes cancer. The cell sample is checked for signs that they’re changing from normal. These first signs of change can happen well before they turn into cancer cells, so that’s why it’s so important to have regular Pap smears.

A positive result, meaning that there are changes from normal cells, doesn’t necessarily mean you have or are going to get cancer. Often, inflammation from an infection or virus can produce abnormal results. However, this important test can alert you and your doctor to more serious conditions:

If you do have a positive or abnormal result, you doctor may want to repeat the smear or do a colposcopy. A colposcopy is a test where the doctor takes a tissue sample or biopsy to conduct further testing. Your doctor should then explain the results and discuss different treatment options with you.

Minimizing the Risks:
Any woman can get cervical cancer, but the chances of getting it increases when a woman:

• Starts having sex before age 18
• Has many sexual partners
• Has or has had human papilloma virus (HPV) -- a sexually transmitted disease known to cause cervical cancer or changes to normal cells
• Has or has had any sexually transmitted disease
• Is over the age of 60
• Smokes

It is generally recommended that you have your first Pap smear when you start having sex or by age 18, whichever comes first. Continue having Pap smears once a year until you’ve had at least 3 normal ones. After that, you can discuss with your doctor the frequency at which you should continue having the test done. Your schedule will depend on your age, risk factors and past history of Pap results.

Cervical cancer is a highly curable disease if caught early. Since the abnormal cells are slow to develop into cancer cells, time is somewhat on your side. However, don’t put off regular testing and be diligent with follow-up should your results be other than normal.

In addition to the Pap smear, your physician will examine you internally for any signs of redness, irritation, swelling, etc. Your doctor will also feel your ovaries for any sign of unusual size, shape or irregularities.

Other Important Issues
Another compelling reason for you to be seen on an annual basis is for breast exams. A woman's lifetime risk for breast cancer in this country is 1 in 9. It has been shown, particularly in women after the age of fifty that self breast examinations, clinical examinations by your health care provider, and mammography when appropriate, can significantly decrease the chances of death from this disease.

If you have regular mammograms in additional to a clinical exams, your chances are good that should you develop cancer, it would be caught at an early stage.

Your annual visit is also an opportunity to explore general aspects of maintenance healthcare and to discuss your risk factors for certain diseases. An updated health history should be taken at each visit to review general health status, including nutritional assessment and physical activity. Naturally, it’s a good time to discuss issues of fertility, contraception, menopause and other age or lifestyle-related concerns. Don’t be embarrassed to ask intimate questions like those pertaining to sexually transmitted diseases or sexual activity, in general.

Your physician is a professional and has probably “heard it all” so she or he should hopefully, have sensitive, thoughtful answers to your personal -- and important -- questions.

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