Your Guide to Overall Wellness

If you think about it, most everything in our lives revolves around our health — though it may not even be something we think about every day. When you feel great, you can take on the world. When you don’t feel up to par mentally or physically, it can hinder everyday living. Being in tune with your body is step one, and step two is having the power of knowledge to make the best choices for yourself.

To better understand issues that impact many women, from breast health to skincare concerns, SSM Health tapped its medical experts to answer questions and misconceptions.

Caring for Your Breasts

Dana Henkel, MD, is a general surgeon at SSM Health in Madison. She focuses on breast health and breast surgery.

WHAT ARE SOME MISCONCEPTIONS ABOUT BREAST HEALTH?

  • That all breast lumps are cancer. There are many lumps, such as cysts and fibroadenomas, that are benign.
  • I have small breasts, so I don’t need a mammogram. The size of the breast does not matter. If you have any breast tissue, you are at risk for breast cancer.
  • Men can’t get breast cancer. False. It is rare, but men can get breast cancer. All men have a small amount of breast tissue.
  • Breast pain is a sign of breast cancer. It is rare that breast cancer causes pain. More commonly, breast pain is related to your menstrual cycle, caffeine intake or muscle pain or strain.
  • There is no breast cancer in my family, so I am not going to get breast cancer. Unfortunately, the majority of women diagnosed with breast cancer have no family history.

WHAT’S A COMMON QUESTION YOU GET?

When should I start getting mammograms? This is a tricky question, because there are different recommendations depending on which medical society you ask. My stance on this is very conservative. I tell my patients to start getting mammograms every year starting at the age of 40. If they have a family history of breast cancer, then they may have to start mammograms, and possibly MRI of the breasts, before age 40.

I also hear, “Why did I get breast cancer?” Learning you have breast cancer can be devastating news, and many times a patient will ask “why me?” I try to explain that the cause of breast cancer is multi-factorial. There are some risk factors we have no control over, such as female gender, getting older, inheriting a genetic mutation or having close family members with breast cancer. On the other hand, modifiable factors such as drinking alcohol, obesity and the use of hormone therapy can increase your chance of breast cancer.

IF THERE WAS ONE MESSAGE YOU WANT WOMEN TO WALK AWAY KNOWING, WHAT WOULD THAT BE?

Be proactive and get your mammogram! We know that women who are diagnosed with breast cancer at an early stage have the best chance of cure.

Considering Your Pelvic Health

Joy Lane, PA-C, has been with SSM Health for 20-plus years and is an advanced practitioner in pelvic health, with a specialty in treating disorders related to the vulva and vagina. Lane says 25-45% of women have some degree of incontinence, a widely-underreported health issue that can be addressed.

WHAT ARE SOME MISCONCEPTIONS ABOUT PELVIC HEALTH?

The biggest misconception is that pelvic health issues are due to the normal process of aging and nothing can be done to help. Another misconception is that pelvic health is only for women. While the majority of our patients are female, we also treat pelvic health disorders in men.

WHAT’S A COMMON QUESTION YOU GET?

How can I control my bladder? Why am I leaking urine? First of all, we need to determine the most bothersome issue. The two most common types of urinary incontinence are urinary urge and urinary stress.

Urge incontinence is that sudden feeling of the need to urinate, without being able to get to the bathroom fast enough. This can often

happen when you turn your key in the door to go into your house, or pull into your garage, or stand up to go to the bathroom. It can also occur when you run water.

Stress incontinence causes leaking of urine when you cough, sneeze, laugh, lift, squat or any physical activity.

Treatments for urinary incontinence vary, based on the type of incontinence. Many women have both stress and urge and this is called mixed incontinence. The next step is then to determine which type is more bothersome and work on that first.

Treatments typically start with more conservative therapy (lifestyle changes, strengthening pelvic floor, bladder retraining); medications for urge, if appropriate to patient; and pessaries (device that can be put in the vagina to help with stress incontinence). If these are not helpful enough, then more advanced
therapies (procedures and surgeries) could be considered.

DO YOU HAVE ANY ACTIONABLE ADVICE OUR READERS CAN USE IN REGARD TO PELVIC HEALTH?

There are many things patients can do on their own, depending on their issue. If urinary urgency is the issue, cut out bladder irritants. I like to think of the C’s: coffee, caffeine, cocktails (alcohol), carbonation (anything with bubbles) and citrus (fruit juices and lemonade).

Strengthen your pelvic floor. Do Kegel exercises daily. Sometimes this takes direction in order to do these correctly and coordinate these muscles. Get help from a Pelvic Floor Physical Therapist.

IF THERE IS ONE MESSAGE YOU WANT WOMEN TO WALK AWAY KNOWING, WHAT WOULD THAT BE?

Ask for help. Talk to your primary provider. Say something as simple as “I can’t control my bladder.” Don’t be embarrassed. You are not alone. These are incredibly common issues and there is much that can be done about them. Let’s remove the stigma.

Monitoring Your Mental Health

Lisa “Pema” Antoniotti is a chaplain at SSM Health and has been there for three years. When she’s working with people, she likes to take into consideration their mental, physical and spiritual health.

WHAT ARE SOME MISCONCEPTIONS ABOUT MENTAL HEALTH?

Many people think there are two very distinct states of either mental health or mental illness. However, it is more accurate to think that mental health and illness exist along a spectrum. We can move up and down that spectrum as we live out our lives, and even on a daily basis. It is commonly estimated that one in five people have had a mental health issue; however, it is also estimated that about one in five people are among the most mentally healthy and are therefore very resilient in emotionally difficult situations.

Many people also think that there is nothing we can do to help prevent mental health problems from occurring. However, there are many preventive actions we can take to boost our mental “fitness,” also called resiliency.

WHAT’S A COMMON QUESTION YOU GET?

As a chaplain, most questions I receive center around how to deal with deep anxiety, workplace stress and difficult or traumatic life events. People want to know how to create a sense of meaning and purpose while coping with illness, how to develop and maintain a sense of social connection, and deepen their own inner strength. More recently, the added stress of coping in a pandemic has certainly been a factor.

DO YOU HAVE ANY ACTIONABLE ADVICE IN REGARD TO MENTAL HEALTH?

Many people I meet have rarely thought about good mental hygiene. Wherever we are on the continuum of mental health, mind-body and spirit practices help nourish and clear our minds. Among all of the meditations I teach, I most often recommend Metta meditation. Metta meditation has been shown to decrease migraines, chronic pain and symptoms of depression and PTSD. It increases compassion and sense of social connection, as well as decreases criticism of self and others. It can even positively affect the aging process and make you more resilient to stress.

Healthy Weight Management

Janet Droessler, MD, is a registered dietitian and a physician at the Weight Management Clinic at SSM Health, helping patients reach and maintain a weight that is best for their biology.

She’s been with SSM Health since 2001.

WHAT ARE SOME MISCONCEPTIONS ABOUT METABOLIC HEALTH/OBESITY?

That an individual has 100% control of their body weight and losing weight is all about will power. Also, that blame and shame motivate behavior change, exercise is the most effective way to lose weight, that “eat less and move more” is enough and metabolic surgery is “the easy way out.”

WHAT ARE SOME COMMON QUESTIONS YOU GET?

Why is it so difficult to lose weight and keep it off?

There are strong biological mechanisms that drive and sustain obesity. Body weight/body fat is regulated by our brain and biology similar to how blood pressure, blood sugar, heart rate and breathing are regulated. Body weight/body fat is similar to breathing in that we can affect it to a certain degree — we can breathe faster or hold our breath — up to a certain point and then the brain takes over. This metabolic adaptation works hard to defend and get us back to our highest weight by increasing appetite/cravings/hunger and slowing down metabolism.

What is the right diet?

In the words of food writer Michael Pollan, “Eat real food, not too much, mostly plants.” Eat the smallest amount of the most nutritious food you can enjoy. End a meal when hunger is gone and know how to manage your hunger.

IF THERE WAS ONE MESSAGE YOU WANT WOMEN TO WALK AWAY KNOWING, WHAT WOULD THAT BE?

Obesity is not a cosmetic issue. Obesity is not a voluntary choice. Obesity is not only about body size. Obesity is a disease of excess body fat accumulation that impairs health and well- being. Obesity is chronic, progressive and relapsing. There are strong biological mechanisms that drive and sustain obesity. This biology is not in our control. Also, our environment leads to weight gain for most of us. Your BEST weight is the weight your biology allows you to get to AND stay at when you are living the healthiest life you can enjoy.


Want more expert advice from SSM Health practitioners? Click here for an interview with a dermatologist about how to best care for your skin, from your 20s to your 60s.

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