Whole Woman: Take Charge of Your Health in Every Phase of Your Life

Overview

Adolescence

Changing Anatomy, A View from Inside and Outside - Nutrition - Fitness and Self-esteem - Skin Care - Pelvic Exams - Obsessive-compulsive disorders - Pregnancy - Contraception - Sexually Transmitted Infections - Eating Disorders - Sexual Violence - Substance Abuse

The Adult Woman

Planning for Parenthood - Healthy Pregnancy - ...

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Overview

Adolescence

Changing Anatomy, A View from Inside and Outside - Nutrition - Fitness and Self-esteem - Skin Care - Pelvic Exams - Obsessive-compulsive disorders - Pregnancy - Contraception - Sexually Transmitted Infections - Eating Disorders - Sexual Violence - Substance Abuse

The Adult Woman

Planning for Parenthood - Healthy Pregnancy - Giving Birth - Conditions of the Reproductive System - Breast Health - The Female Immune System - Disorders of the Endocrine System - Mental and Physical Stress - Domestic Violence

The Perimenopausal Years

The Physical Symptoms of Menopause - Pros and Cons of Hormone Replacement - Alternatives to Hormone Replacement - The Female Heart - Preventing Osteoporosis - Protecting Your Digestive System

The Postmenopausal Years

Keeping the Body in Motion - Treating Hypertension and Stroke - Alzheimer's Disease - Preventing Respiratory Infections - Conditions of the Urinary Tract - Adapting to Changes and Living Well

The Answers You Need From A Doctor You Can Trust

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Product Details

  • ISBN-13: 9780380780815
  • Publisher: HarperCollins Publishers
  • Publication date: 5/1/1999
  • Pages: 528
  • Product dimensions: 6.03 (w) x 9.00 (h) x 1.30 (d)

Read an Excerpt

Chapter One

A New Approach toManaging Your Health

In almost, half a century of practicing medicine, I have had many satisfying, experiences — the thrill of diagnosing the correct reason for otherwise unexplained symptoms, rescuing patients from overwhelming catastrophes and bringing them back to good health. Of equal satisfaction is the feeling that I have taught a patient something about selfcare, that I have engaged her interest and empowered her to be a true partner in the lifelong effort to protect her health.

Many women physicians throughout history have felt the same way. In the nineteenth century, Elizabeth and Emily Blackwell, Marie Zakrzewska, and Mary Putnam Jacobi took very seriously the importance of educating women about their own health. These lonely pioneers in the otherwise male medical world instructed their patients on the dangers of sexually transmitted infections. They taught them personal hygiene. They encouraged them to exercise during their menstrual periods, breaking with the male physicians of the time, who advocated complete bed rest for the "delicate" time of the month.

Elizabeth Blackwell was the first woman to graduate from a "legitimate" American medical school, Geneva Medical College in New York, which is now a part of Syracuse University. Together with her sister, Emily, she started the New York Infirmary for Women and Children to treat thousands of poor immigrant women and children. Today's Beekman Downtown Hospital is the offspring of that infirmary.

The New England Hospital for Women and Children in Boston's South End wasestablished by Marie Zakrzewska in 1902. Zakrzewska, a former head nurse and midwife in a Berlin hospital, came to America and with Emily Blackwell, graduated from the Cleveland Medical College. Marie went on to establish the first medical school for women in New England.

Mary Putnam Jacobi was the first American and the first woman to graduate from the famous Faculté de Medicine in Paris. She returned to New York to practice and teach. Her lectures were so popular there was standing room only. She started the first women's medical society, currently known as Women's Medical Association of New York City, which offers an annual fellowship in her name.

While the male medical establishment overwhelmingly ignored women's health, there have always been a few exceptions. Ironically, one of the best pieces of advice I came across while researching this book is from a twentieth-century male internist, Dr. Thomas Argyros of New York, City. He believed a woman should be well educated about her body and health so that "she could become her own doctor and use her physician as a consultant."

Choosing Your Principal Physician

Whether you are moving to a new region or you simply want to find a new doctor, it is important for you to establish a relationship with a physician who will become your principal physician. Officially, this person is known as a primary care doctor. I prefer the appellation "principal physician" because this describes the person who will be principally responsible for overseeing all and any of your health needs.

Your choice of an appropriate physician is influenced by the life phase you are in. Adolescent girls, for example, overwhelmingly prefer women doctors because they do not feel as confident talking about sexual or reproductive issues with a man.

If you are planning a family, you might want to consider a gynecologist and obstetrician. On the surface, this may seem logical, but you are limiting your health concerns to your reproductive systems. Where do you go for your flu shot? Many women have doctors who specialize in one area of their health care. An older woman with heart problems, for example, may rely on her cardiologist as her primary caregiver. She might also visit an orthopedic surgeon, and possibly a urologist, but these doctors do not necessarily communicate with each other. It is important to have one physician who oversees your general health and is your principal partner in your health care.

Your best bet is to choose a well-trained internist or family practitioner with special additional training in women's health, or perhaps a gynecologist with special training in primary care. These specialties are defined below. In each case, it is not the gender, age, or even specialty that counts, but the physician's competence, attitude, and training.

How can you be sure that the physician you choose is one of the few who has cared enough for women patients to take and complete courses in women's health care? One way is to ask if the physician is a graduate of AMWA's Advanced Curriculum on Women's Health. Or, while you are sitting in the office waiting for your doctor and looking at all those framed certificates on the walls, see if there is one for completion of the course.

Another way is to ask a crucial question. (I consider this the litmus test.) Does the doctor perform a routine pelvic exam with a Pap smear on every woman seen for the first time or at periodic intervals? If the answer is no, and the doctor routinely refers patients to a gynecologist, that doctor is not a candidate for your principal physician. It is my belief that only 10 to 15 percent of primary care physicians who are internists include the pelvic exam as part of their routine checkup of women. This is mostly because it adds to the time involved in the physical exam and challenges the declining skills of a doctor who does not perform this exam routinely.

I also want to warn women that any specialist, such as a gastroenterologist, who is trying to diagnose abdominal pain must include a pelvic exam as part of the procedure. In women, abdominal pain is often caused by a condition of the reproductive or urinary system, and no accurate diagnosis of abdominal pain can be made without a pelvic examination.

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