Augusta Women's Center Services

Obstetrics and Gynecology (often abbreviated to OB/GYN or O&G) are the two surgical specialties dealing with the female reproductive organs, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients.

Reproductive Endocrinology and Infertility - gynecologic subspecialty focusing on the medical and surgical evaluation of women with problems related to the menstrual cycle and fertility
Gynecological Oncology - gynecologic subspecialty focusing on the medical and surgical treatment of women with cancers of the reproductive organs
Urogynaecology and Pelvic Reconstructive Surgery - gynecologic subspecialty focusing on the diagnosis and surgical treatment of women with urinary incontinence and prolapse of the pelvic organs. Sometimes referred to (incorrectly) by laypersons as "Female Urology"
Advanced Laparoscopic Surgery
Family Planning - gynecologic subspecialty offering training in contraception
Pediatric and Adolescent Gynecology
Menopausal and Geriatric Gynecology

Information taken from www.Wikipedia.com

Annual Exams / Cervical Health

Each year, about 14,000 women are diagnosed with cervical cancer in the U.S. Cervical cancer may be fatal, but, in some cases, it can be prevented. You can help reduce your risk of cervical cancer by having Pap tests regularly; quitting smoking, if you smoke; and using latex condoms during sex to protect yourself against sexually transmitted infections. January is Cervical Health Awareness Month, so visit the following Web sites for more information about what you can do to stay healthy.

Genital Warts

Genital warts are caused by the Human papillomavirus (HPV). Some types of HPV are directly related to cancer of the cervix. You can learn more about genital warts and what you can do to protect yourself on familydoctor.org. "Human Papillomavirus Testing" provides information about HPV testing. "Pap Smears: When Yours is Slightly Abnormal" can help you understand what abnormal Pap smear results mean.

National Cervical Cancer Coalition

What is a Pap test? Why should you have one? This Web site answers these questions and more. On the National Cervical Cancer Coalition Web site, you can also find lots of helpful information about HPV infection and its association with cancer of the cervix. Information about early detection and treatment of cervical cancer is also available on the site.

American Cancer Society

Visit this site to learn more about how HPV infections can lead to cervical cancer. The American Cancer Society Web site also provides information about who should have an HPV test and how to prepare for it. Do you know the difference between a Pap smear and an HPV test? Find the answer on this Web site.

National Cancer Institute

The National Cancer Institute Web site can help you understand what cell changes in your cervix mean. On this site, you can also find information about Pap smears and HPV tests. Visit (http://www.cancer.gov/cancer topics/wyntk/cervix) to learn more about risk factors, screening, diagnosis and treatment of cervical cancer. Information taken from Family Doctor.org. Visit this site for more information.

Information taken from Family Doctor.org.

Birth Control / Family Planning

Breast and Pelvic Exams

Routine care is the best way to keep you and your breasts healthy. Although detecting breast cancer at its earliest stages is the main goal of routine breast care, other benign conditions, such as fibrocystic breasts, are often discovered through routine care.

Step 1. Breast Self-Examination (BSE)

A woman should begin practicing breast self-examination by the age of 20 and continue the practice throughout her life - even during pregnancy and after menopause. BSE should be done regularly at the same time every month. Regular BSE teaches you to know how your breasts normally feel so that you can more readily detect any change. Changes may include:

development of a lump
a discharge other than breast milk
swelling of the breast
skin irritation or dimpling
nipple abnormalities (i.e., pain, redness, scaliness, turning inward)

If you notice any of these changes, see your healthcare provider as soon as possible for evaluation.

Step 2. Clinical Examination

A breast examination by a physician or nurse trained to evaluate breast problems should be part of a woman's physical examination. The American Cancer Society recommends: Between the ages of 20 and 39, women should have a clinical breast examination by a health professional every three years. After age 40, women should have a breast examination by a health professional every year. A physical breast examination by a physician or nurse is very similar to the procedures used for breast self-examination. Women who routinely practice BSE will be prepared to ask questions and have their concerns addressed during this time.

Step 3. Mammography

Mammography is a low-dose x-ray of the breasts to find changes that may occur. It is the most common imaging technique. Mammography can detect cancer or other problems before a lump becomes large enough to be felt, as well as assist in the diagnosis of other breast problems. However, a biopsy is required to confirm the presence of cancer. Since there is controversy among cancer organizations regarding when to begin having mammograms, as well as how often, talk with your physician about a mammography schedule that is appropriate for you based on your overall health and medical history, risk factors, and personal opinion or preference.

According to the National Cancer Institute, women in their 40s and older should begin having a screening mammogram on a regular basis, every one to two years. But, the American Cancer Society recommends that by age 40, women should have a screening mammogram every year. (A diagnostic mammogram may be required when a questionable area is found during a screening mammogram.)

Both organizations suggest that women who may be at increased risk for breast cancer should talk with their physicians about whether to begin having mammograms at an earlier age.

Information taken from St. Francis Hospital.

What is Breast Cancer?

Breast cancer is unchecked growth of abnormal breast cells.

What causes cells to become abnormal and reproduce wildly?

Damage to the DNA, the brain of the cell, which causes mutations and activation of oncogenes. Usually one mutation isn’t enough; most cells must undergo several mutations before they become cancerous. (Sometimes the mutations must occur in sequence to create a cancer, sometimes random order will do it.) What causes DNA damage? Radiation, free radicals, genetic defects, electrical fields, chemicals, drugs, viruses, and metabolic stresses.

Injury to the DNA initiates all cancer.

When mutations accumulate and oncogenes turn on, the cell is initiated. It is abnormal, but not cancerous. Initiated cells are diagnosed as atypia, dysplasia, or hyperplasia.

Damaged cells alone offer no threat to long life. To become threatening, the abnormal cells must be promoted. Promoters bring the cells nutrients so they can reproduce. (One of the strongest promoters of breast cancer is estrogen.) Although promoted cells can disguise themselves so the immune system won’t recognize them, most of them are seen and eaten, or encapsulated by the body so they do no harm. Promoted cells are called carcinoma in situ.

According to Christiane Northrup, M.D., in situ cancer cells are frequently found in the breasts of women who die of causes other than cancer. And according to Susan Love, M.D., breast cancer specialist, in situ cells are reversible without invasive treatments and shouldn’t be thought of as cancers. The cancer cascade: initiation, promotion, growth.

Promoted breast cells, no matter how many of them there are, are not classified as invasive unless they spread out of the tissues of origin and into the surrounding tissues. This is the growth phase. When promoted cells enter the growth phase, they begin to form a tumor and to recruit blood vessels to help supply their immense need for nutrients. (The tumor may grow so quickly that cells in its center die from lack of nourishment.) The diagnosis now becomes infiltrating or invasive carcinoma. The cancer cascade can be halted or reversed.

Once a mass of abnormal, quickly-replicating cells has created a network of blood vessels, individual cancer cells can separate from the tumor and travel to other parts of the body. Because the breast is not vital to life, a breast cancer that stays in the breast is not life-threatening. But if breast cancer cells get to the liver, lungs, bone marrow, or the brain and continue to grow, they can hinder the functioning of processes necessary for life. The body attempts to check this spread by locking breast cancer cells in lymph node prisons and by sending immune system cells out to eat traveling cancer cells. If cancer cells are found in the axillary lymph nodes, the diagnosis is aggressive or metastasized carcinoma.

Ninety percent of cancer deaths are from metastases.

Not everyone whose cellular DNA is damaged will get cancer. Why not? All cells have the capacity to repair themselves or to shut down if they are mutated or damaged. Good lifestyle habits and ordinary foods such as lentils also reverse DNA damage.

Special immune cells eat potential cancers.

The wear-and-tear of life gives rise to so many mutated, abnormal, initiated cells (even in a healthy person) that the immune system forms a constant stream of specialized cells to seek out and consume them. So long as the immune system is strong, and well supplied with nutrients, initiated and promoted cells can be harmlessly eliminated, checking the possibility of cancer.

Cancer cells are immature yet reproduce without limits. Living long past their normal span, they appear immortal.

Building powerful immunity isn’t always enough, though. Cancer cells can trick the immune system into leaving them alone, and they can replicate so rapidly that they overwhelm the immune system with sheer force of numbers. One of the reasons breast cancer is so difficult to treat is that cancer cells are full of life. They no longer have the inner signal that tells them to die after reproducing. Like the sorcerer’s apprentice, the woman with breast cancer finds herself with cancer cells that replicate unceasingly. Cancer cells never grow up and become productive members of their community. They simply take up space.

Breast cancer is not one disease, but many.

Because there are different types of cells in the breasts (e.g., ducts and lobes) and a variety of ways that a cell can be abnormal, there are many kinds of breast cancers and many possible treatments. Of the two dozen kinds of breast cancer known, the majority originate in the duct cells.

Some breast cancers grow slowly, others quickly. Slow growing breast cancers double in size every 42–100 days or more. Quick growing breast cancers can double every 21 days. Pre- and peri-menopausal women tend to have faster growing, more aggressive breast cancers (about 10–15 percent of all breast cancers).

Post-menopausal women, who account for 60–80 percent of all breast cancer cases, usually have slow-growing cancers which rarely metastasize.

Microscopic examination of cellular tissue is the only scientifically accepted way to diagnose cancer.

The first breast surgery most women will have is a biopsy. When there is a suspicious finding on a mammogram or a palpable lump, there is no way to rule out cancer unless a piece of breast tissue is removed and examined under a microscope by a pathologist. If there is a diagnosis of cancer and further surgery is done, the breast tissues removed then are also sent to the pathologist.

The pathologist can see cancerous cells if they are present and can determine the type and state of the cancer by a variety of signs. These findings are collected into a pathology report which will, to a great degree, determine the treatment options that you will be offered. Pathology reports are based on opinion as well as fact, so many women have two, three, or even four different pathologists look at their tissue samples and give an opinion.

To judge the “stage” of a cancer, lymph glands are removed (excised) from the nearby armpit. Lymph gland excision always cuts some of the nerves to the arm. Removal of the lymph glands does nothing to treat or cure breast cancer, and may hinder the body’s ability to deal with cancer. Lymph gland removal can cause numbness as well as pain, impaired circulation, swelling (sometimes severe and long-lasting), and a life-long risk of severe infection. The more lymph nodes removed, the more severe these side effects.

Lack of cancer cells in the lymph nodes doesn’t guarantee that the cancer hasn’t metastasized (one-third of all women with negative nodes nonetheless have metastasizing cancer), but a positive finding does indicate that the cancer has metastasized and may be growing elsewhere in the body.

It is difficult to determine if a cancer will metastasize.

Aggressive (metastatic) cancer requires more vigorous treatment than invasive (non-metastatic) cancer. And treatment is more effective if undertaken before the metastasized cells begin to form masses in critical organs. But micro-metastases and small clumps of cells are extremely difficult to find.

What to do?

Orthodox treatments include: Surgery to remove the primary tumor. Radiation to eliminate any other cancer cells in the breast tissues. Chemotherapy to kill any other cancer cells in the body. (But those that survive—and some always do—mutate and become invulnerable to further chemotherapy.) And hormones such as tamoxifen to check recurrence and metastatic growth.

Alternative treatments include: Caustic herbs and pastes to burn away the primary cancer. Nourishing, tonifying, and stimulating treatments for building immune strength. And a variety of anti-cancer compounds used systemically to eliminate cancer cells in the breasts and elsewhere in the body. Exercise and a diet of healthy food, nourishing infusions, healing oils, and phytoestrogen-rich herbs to counter recurrence.

Does survival after a diagnosis of breast cancer depend on orthodox medical treatments? Women who refuse such treatments do not die sooner than women who follow orthodoxy, according to an old (1977), but still valid, study by Hardin B. Jones, professor of medical physics. (“A Report on Cancer,” is available at the library of the University of California at Berkeley.)

Colposcopies

Counseling

including but not limited to adolescent health, family planning, menopause, PMS, STD exposure

Endometrial Biopsies

Incontinence Evaluation and Treatment

What are Urogynecologic Disorders?

Our gynecology services cater to all problems women may have related to their bladder or female organs. Some primary Urogynaecology disorders are:

Urinary incontinence
Stress incontinence - involuntary loss of urine caused by strenuous physical activity, laughing, coughing or sneezing
Urge incontinence or overactive bladder - involuntary loss of urine that occurs due to a sudden urge to urinate
Fecal incontinence - the involuntary loss of solid or liquid stool that can result in impaired quality of life for an individual
Pelvic organ prolapse - described as a fallen bladder, uterus, vagina or rectum
Fistulas: vesicovaginal or rectovaginal - an opening between the wall of the vagina and the wall of the bladder or rectum which can lead to urine leakage
Complex benign conditions of the vagina and urethra such as vaginal cysts, absence of vagina, and urethral diverticulums
Other problems with urination or pelvic floor

A variety of therapies can be used to treat or manage these problems. Bladder or pelvic problems should not be considered as a result of the aging process.

Infertility Treatment

LEEP

Pap Smears

School and Work Physicals

Surgical Procedures

Routine medical screenings and treatments include:

Annual Pap and pelvic examinations
Contraception and family planning
Cervical Cancer screenings
Diagnosis and treatment of sexually transmitted disease
Infertility treatments and support
Abnormal Pap Smear management
Abnormal bleeding
Premenstrual syndrome
Endometriosis
Hormonal Replacement Therapy (HRT)
Menopause management and support
Menstrual irregularities
Urinary incontinence
Vaginitis

Surgical Gynecology

Our experienced gynecological surgical team offers complete minimally invasive surgical services for benign gynecological cases and major gynecological surgeries such as:

Hysterectomy
Laparoscopy
Hysteroscopy
Sterilization
Adolescent Gynecology

To meet the needs of the community, we have established an Adolescent Gynecology specialty. Through this service, we provide medical staff with expertise in gynecologic issues that are common in a younger population, as well as provide a setting which is sensitive to the concerns of adolescents.

This information has been taken from Boston Gynecology Care. Please visit this site for more information.

Laproscopy

Myomectomy

Hysterscopy

Hysterectomy

Infertility Surgery

Oopherectomy

Bladder Repair

In Office Tubal Ligation

Women who are looking for a permanent form of birth control may choose to have a tubal ligation, also known as getting your "tubes tied" or female sterilization. This surgical procedure to make a woman sterile is very effective at preventing pregnancy, with a failure rate as low as 0.4%.

What Is It?

A tubal ligation is a surgical procedure whereby a woman’s fallopian tubes are cut, clamped, blocked or tied to prevent her eggs from traveling down to her uterus. It also blocks the sperm from traveling along the tube to meet the egg. In some cases, a woman may choose to have a hysterectomy. This is when the entire uterus (and possibly the fallopian tubes, ovaries and/or cervix) is removed. Unlike a tubal ligation, a hysterectomy is not reversible.

While a tubal ligation is generally regarded as a permanent type of birth control, tubal ligation reversal surgery is available. However, depending on how your tubal ligation affected your fallopian tubes, you may not be a candidate for reversal surgery. Even if you do have your tubal ligation reversed, you may still not be able to get pregnant. Success rates for pregnancy after a tubal ligation reversal range between 70% and 80%. Additionally, there is an increased risk of experiencing an ectopic pregnancy.

How it is Done

Tubal ligations are usually done nowadays through laparoscopic surgery. This type of surgery involves making a small incision just under your navel and inserting small, thin instruments through a tiny tube to perform the procedure. The operation can be done under general or local anesthetic and is usually an outpatient procedure. In some cases, a hospital stay of one night may be required. Women can usually return to their normal activities after a week.

In 2002, a new, non-surgical method of blocking the fallopian tubes was put on the market. Essure has the same effectiveness rate as surgical sterilization and the procedure can be done in your doctor’s office. This method of tubal ligation involves having a small coil placed into your fallopian tubes thereby creating a barrier. It takes between three and six months before this type of tubal ligation becomes effective. To have the barriers removed, though, will require surgery. Therefore, this method of tubal ligation should be considered just as permanent a solution as surgical sterilization.

Risks of Tubal Ligation

As with any type of surgery, there are risks involved with having your tubes tied, including infection and uterine perforation. Additionally, women who have had their tubes tied and become pregnant are more likely to experience an ectopic pregnancy. Other possible risks associated with having your tubes tied include menstrual cycle disturbances and gynecological problems.

While a tubal ligation is an effective way of preventing pregnancy, it offers absolutely no protection against sexually transmitted diseases (STDs). Therefore, it will still be necessary to use condoms unless you are in a relationship with someone that has tested negative for STDs.

Costs

The initial cost of a tubal ligation can be expensive, ranging between $1,000 and $3,000. However, because the effects are permanent and long lasting, it may be a more cost-effective solution for some women. Some private insurance companies may also cover some of the cost. Check with your insurance provider to see if you are covered. For women that are sure that they do not want any more children, or any children at all, having a tubal ligation can be a successful means of birth control. Although tubal ligation reversal surgery is available, all women should consider having their tubes tied as a permanent solution. Therefore, it is best to take your time and talk with your doctor as well as your partner so that you can be sure that this is the right decision for you.

Information taken from Epigee Women’s Health. Visit their site for further information.

In-Office permanent treatment for excessive menstruation

Ultrasound

Mamogram

What is a Mammogram?

A mammogram is an x-ray exam of the breast. It is used to detect and evaluate breast abnormalities, both in women who have no breast complaints or symptoms and in women who have breast symptoms (problems such as a lump, pain, or nipple discharge).

Although the use of x-rays to examine the breast was first introduced more than 90 years ago, modern mammography has only existed since 1969, when the first dedicated x-ray machines used just for breast imaging became available. Since then, the technology has advanced a great deal, so that today's mammogram is very different even from those of the mid-1980s.

The special type of x-ray machine used for the breasts produces lower energy x-rays that do not penetrate tissue as easily as that used for routine chest x-rays or x-rays of the arms or legs, but it does improve the contrast of the image. Modern mammography also results in a significantly lower dose of radiation to the breast compared with the earlier units.

For a mammogram, the breast is squeezed between 2 plastic plates attached to the mammogram machine unit in order to spread the tissue apart. This squeezing or compression ensures that there will be very little movement, that the image is sharper, and that the exam can be done with a lower x-ray dose. Although this compression causes some discomfort, it only lasts for a few seconds and is needed to produce a good mammogram. The entire procedure for a mammogram takes about 20 minutes.

Mammography produces a black and white image of the breast tissue on a large sheet of film, which is "read" or interpreted by a radiologist. Radiologists are doctors who have special training in diagnosing diseases by looking at images of the inside of the body produced using x-rays, sound waves, magnetic fields, or other methods. Other doctors who treat breast diseases may also look at the mammogram.

Reading mammograms is challenging. The appearance of the breast on a mammogram varies a great deal from woman to woman. And some breast cancers may produce changes in the mammogram that are hard to notice. It is very important that the radiologist has the x-ray films from previous mammograms (not just the report) for comparison. This helps the doctor find small changes and detect a cancer as early as possible. Because acquiring prior films is a challenge, it is best to find a facility that you are comfortable with and plan to get your regular mammograms there each year. That way, your prior films are easily available.

Screening Mammograms

Breast cancer takes years to develop. Early in the disease, most breast cancers cause no symptoms. When breast cancer is detected at a localized stage (it hasn’t spread to the lymph nodes), the 5-year survival rate is 98%. If the cancer has spread to nearby lymph nodes (regional disease), the rate drops to 83%. If the cancer has spread (metastasized) to distant organs such as the lungs, bone marrow, liver, or brain, the 5-year survival rate is 26%.

A screening mammogram is an x-ray exam of the breast in a woman who has no symptoms. The goal of a screening mammogram is to find cancer when it is still too small to be felt by a woman or her doctor. Finding small breast cancers early by a screening mammogram greatly improves a woman’s chance for successful treatment. A screening mammogram usually takes 2 x-ray pictures (views) of each breast. For some patients, more pictures may be needed to include as much breast tissue as possible. American Cancer Society Recommendations for Early Breast Cancer Detection. Women age 40 and older should have a screening mammogram every year, and should continue to do so for as long as they are in good health.

Current evidence supporting mammograms is even stronger than in the past. In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s. Women can feel confident about the benefits associated with regular mammograms for finding cancer early. However, mammograms also have limitations. A mammogram will miss some cancers, and it sometimes leads to follow up of findings that are not cancer, including biopsies.

Women should be told about the benefits, limitations, and potential harms associated with regular screening. While mammograms will detect most breast cancers, a small percentage will be missed. Also, sometimes signs on a mammogram that appear abnormal may require a biopsy that will turn out not be breast cancer. In this instance, a woman has undergone a procedure for an abnormality that wasn’t cancer, and she has been through a period of anxiety about the possibility of having breast cancer. However, mammograms, despite their limitations, remain the most effective and valuable tool for decreasing suffering and death from breast cancer.

There is no fixed age at which women should stop getting mammograms. Mammograms for older women (over age 65) should be based on the woman’s health and whether or not she has other serious illnesses. Age alone should not be the reason to stop having regular mammograms. As long as a woman is in good health and would be a candidate for treatment, she should continue to have mammograms.

Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year.

CBE is a complement to mammograms and an opportunity for women and their doctor or nurse to discuss changes in their breasts, early detection testing, and factors in the woman’s history that might make her more likely to have breast cancer.

There may be some benefit in having the CBE shortly before the mammogram because if the examiner discovers a mass, then the mammogram can focus on that area of suspicion. The exam should include instruction for the purpose of helping a woman become familiar with her own breasts. Women should also be given information about the benefits and limitations of CBE and BSE (breast self-exam). Breast cancer risk is very low for women in their 20s and gradually increases with age. Women should be told to promptly report any new breast symptoms to a health professional

Diagnostic Mammograms

A diagnostic mammogram is an x-ray exam of the breast in a woman who either has a breast complaint (for example, a breast mass, nipple discharge, etc.) or has had an abnormality found during a screening mammogram. During a diagnostic mammogram, more pictures are taken to carefully study the breast condition. In most cases, special images involve magnification to make a small area of suspicious breast tissue easier to evaluate. Many other types of x-ray pictures can be obtained, depending on the type of problem and its location in the breast. These x-rays are tailored to the patient's needs.

For example, a diagnostic mammogram may show that what appeared to be an abnormality actually was quite normal on closer exam, and the woman can then return to routine yearly screening.

It also could show that an area of abnormal tissue has a high likelihood of not being cancer (being benign). For this, it is common to ask the woman to return to be rechecked, usually in 4 to 6 months.

Finally, the diagnostic work-up may suggest that a biopsy is needed to tell whether or not the abnormal area is cancer. If your doctor recommends that you have a biopsy, it does not mean that cancer is present. About 80% of all breast changes that are biopsied are found to be benign when looked at under the microscope. If a biopsy is needed, you should discuss the different types of biopsy (see below) with your doctor to decide which method of biopsy is best for you.

Tips for Having a Mammogram

The following are useful suggestions for ensuring that you will receive a good quality mammogram:

If it is not posted visibly near the receptionist’s desk, ask to see the FDA certificate that is issued to all facilities that offer mammography. The FDA requires that all facilities meet high professional standards of safety and quality in order to be a provider of mammography services. Without certification, a facility may not provide mammography.

Use a facility that either specializes in mammography or does many mammograms a day.

If you are satisfied that the facility is of high quality, continue to go there on a regular basis so that your mammograms can be compared from year to year.

If you are going to a facility for the first time, bring a list of the places, dates of mammograms, biopsies, or other breast treatments you have had before.

If you have had mammograms at another facility, you should make every attempt to get those mammograms to bring with you to the new facility (or have them sent there) so that they can be compared to the new ones.

On the day of the exam, don’t wear deodorant or antiperspirant; some of these contain substances that can interfere with the reading of the mammogram by appearing on the x-ray film as white spots.

You may find it more convenient to wear a skirt or pants, so that you’ll only need to remove your blouse for the exam.

Schedule your mammogram when your breasts are not tender or swollen to help reduce discomfort and to assure a good picture. Try to avoid the week just before your period.

Always describe any breast symptoms or problems that you are having to the technologist who is doing the mammogram. Be prepared to describe any pertinent medical history such as prior surgeries, hormone use, family or personal history of breast cancer. Also discuss any new findings or problems in your breasts with your doctor or nurse before having a mammogram.

If you do not hear from your doctor within 10 days, do not assume that your mammogram was normal -- call your doctor or the facility.

What to Expect When You Get a Mammogram

Having a mammogram requires that you undress above the waist. A wrap will be provided by the facility for you to wear.

A technologist will be present to position your breasts for the mammogram. Most technologists are women. You and the technologist are the only ones present during the mammogram.

The whole procedure takes about 20 minutes. The actual breast compression only lasts a few seconds. You will feel some discomfort when your breasts are compressed, and for some women compression can be painful. Try not to schedule a mammogram when your breasts are likely to be tender, as they may be just before or during your period.

All mammogram facilities are now required to send your results to you within 30 days. Generally, you will be contacted within 5 working days if there is a problem with the mammogram.

Only 2 to 4 mammograms of every 1,000 lead to a diagnosis of cancer. About 10% of women who have a mammogram will require more tests, and the majority only need an additional mammogram. Don't panic if this happens to you. Only 8% to 10% of those women will need a biopsy, and most (80%) of those biopsies will not be cancer. If you are a woman and age 40 or over, you should get a mammogram every year. You can schedule the next one while you're there at the facility and/or request a reminder. Visit The American Cancer Society: Mammograms and other Breast Imaging Procedures if to learn more about Mammograms and their benefits.

Dexa Bone Scan for Osteoporosis

What Is Bone?

In order to understand osteoporosis, it is important to learn about bone. Made mostly of collagen, bone is living, growing tissue. Collagen is a protein that provides a soft framework, and calcium phosphate is a mineral that adds strength and hardens the framework. This combination of collagen and calcium makes bone strong and flexible enough to withstand stress. More than 99 percent of the body's calcium is contained in the bones and teeth. The remaining 1 percent is found in the blood. There are two types of bone found in the body - cortical and trabecular. Cortical bone is dense and compact. It forms the outer layer of the bone. Trabecular bone makes up the inner layer of the bone and has a spongy, honeycomb-like structure.

Bone Remodeling

Throughout life, bone is constantly renewed through a two-part process called remodeling. This process consists of resorption and formation. During resorption, old bone tissue is broken down and removed by special cells called osteoclasts. During bone formation, new bone tissue is laid down to replace the old. This task is performed by special cells called osteoblasts. Osteoclast and osteoblast function is regulated by several hormones including calcitonin, parathyroid hormone, vitamin D, estrogen (in women) and testosterone (in men), among others.

The Bone Bank Account

Think of bone as a bank account where you "deposit" and "withdraw" bone tissue. During childhood and the teenage years, new bone is added to the skeleton faster than old bone is removed. As a result, bones become larger, heavier, and denser. For most people, bone formation continues at a faster pace than removal until bone mass peaks during the third decade of life.

Remember, in order to be able to make "deposits" of bone tissue and reach the greatest possible peak bone mass, you need to get enough calcium, vitamin D, and exercise - important factors in building bone.

After age 20, bone "withdrawals" can begin to exceed "deposits." For many people, this bone loss can be prevented by continuing to get calcium, vitamin D, and exercise and by avoiding tobacco and excessive alcohol use. Osteoporosis develops when bone removal occurs too quickly or replacement occurs too slowly or both. You are more likely to develop osteoporosis if you did not reach your maximum peak bone mass during your bone building years.

Women, Men, and Osteoporosis

Women are more likely than men to develop osteoporosis. This is because women generally have smaller, thinner bones, and because they can lose bone tissue rapidly in the first 4 to 8 years after menopause due to the sharp decline in production of the hormone estrogen. Produced by the ovaries, estrogen has been shown to have a protective effect on bone. Women usually go through menopause between ages 45 and 55. After menopause, bone loss in women greatly exceeds that in men. However, by age 65, women and men tend to lose bone tissue at the same rate. While men do not undergo the equivalent of menopause, production of the male hormone testosterone may decrease, and this can lead to increased bone loss and a greater risk of developing osteoporosis.

Osteoporosis Prevention

Osteoporosis is preventable for many people. Prevention is important because while there are treatments for osteoporosis, a cure has not yet been found. A comprehensive program that can help prevent osteoporosis includes:

a balanced diet rich in calcium and vitamin D

weight-bearing exercise

a healthy lifestyle with no smoking or excessive alcohol intake

bone density testing and, when appropriate, medication.

This information was taken from NAIMS.com, please refer to this site for more information on bone health.

Physician Assistant Exams

Nutrition, exercise and wellness program for stress and weight loss

Cryoablation

What is Cryoablation?

Cryoablation is a process that uses cold energy (cryo) to kill tissue (ablation).

Cryoablation is used in a variety of clinical applications using hollow needles (cryoprobes) through which cooled (from a peripheral freezing unit), thermally conductive, gases and fluids are circulated. Cryoprobes are inserted into or placed adjacent to tissue which is determined to be diseased in such a way that ablation will provide correction yielding benefit to the patient. When the probes are in place, the cryogenic freezing unit removes heat ("cools") from the tip of the probe and by extension from the surrounding tissues.

Ablation occurs in tissue that has been frozen by at least three mechanisms: (1) formation of ice crystals within cells thereby disrupting membranes, and interrupting cellular metabolism among other processes; (2) coagulation of blood thereby interrupting blood flow to the tissue in turn causing ischemia and cell death; and (3) induction of apoptosis, the so-called programmed cell death cascade.

The most common application of cryoablation is to ablate solid tumors found in the lung, liver, breast, kidney and prostate gland. The use in prostate and renal cryoablation are the most common. Although sometimes applied through laparoscopic or open surgical approaches, most often cryoablation is performed percutaneously (through the skin and into the target tissue containing the tumor).