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Posts Tagged ‘Human Papilloma Virus’

Teenagers

Okay, girls, it’s time for some basic info.

Let’s start with you youngsters.  Are you between the ages of 13 and 15?  Ah, God bless ya if you are!   I remember those days well.  I can remember cute little Tommy Kosky who sat in front of me in Algebra class.  To this day, I can still smell that cheap cologne that probably cost him $2.00 a gallon.  I remember asking him dumb questions just to get him to notice me…uh, I’m sorry, I’m digressing here.

Okay, earth to Pat.

As I was saying, if you are between the ages of 13 and 15, it’s time you picked up the phone and made your first appointment with an Obstetrician-Gynecologist, otherwise known as an Ob-Gyn.  Don’t know who to call?  Well, ask around, talk to your friends.  Don’t rely on the Google-meister.

The important thing is that this first visit will help you establish a relationship with the doctor of your choice and you’ll be able to talk candidly about your medical and sexual history (even if you have not had sexual intercourse.) This is a good time to ask questions about sexually transmitted diseases and contraceptives.   In many cases, this can become a life-long relationship.

If you are 21 years or older and have not yet had a pelvic exam or a Pap test, what the frig are you waiting for?   Get on your cell phone right now!

Ob-Gyn First Visit

If you have had these tests, then the question is how long has it been since your last Pap smear and pelvic exam? According to the American College of Ob-Gyns, women 21 to 29 should get a Pap smear every year, then every other year (or as often as your doctor recommends) from ages 30 to 64.

Meanwhile you should always see your gynecologist if you experience any bleeding between periods, bleeding after sexual intercourse or an unusual or constant vaginal discharge.

If you are over 30 years old, it is not necessary to get an annual Pap smear but you still should get an annual pelvic exam to check for any other changes or infections. If you’ve had an HPV test that was negative that doesn’t mean you don’t need to have a yearly pelvic exam. And remember that with each new sexual partner your risk of getting HPV increases by 15 percent. According to the ACOG guidelines for Pap testing women diagnosed with HIV or other diseases or conditions that lower immunity should continue having annual Pap smears after age 30.  Indeed, the greatest single reason for the occurrence of cervical cancer is not having Pap smears according to recommended guidelines.

Get with the program.  Don’t be a silly girl.  After all, it’s only your life.

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Grant

President Obama recently announced the start of a new $110 million campaign that will fund programs that teach teenagers about the risks of specific sexual activity and the benefits of contraception.  Just last month, the Department of Health and Human Services awarded $75 million to 75 groups to try to reproduce some of the 28 programs deemed to have been “proven effective through rigorous evaluation.”   Then, DHHS awarded $35 million to 40 groups to test “innovative strategies” that appeared promising.

At the same time, however, in a political balancing act, the Administration also awarded twelve grants for about $9.3 million for abstinence-only programs!  What the heck?   For example, the Live the Life Ministries of

Health

Tallahassee received $891,533 for its abstinence program!   In Kansas, the “Women’s Clinic” received over $1 million and it is a crisis pregnancy center which tries to lure women in seeking abortions in the hopes of talking them out of their decision.

Of course, organizations that support abstinence only programs are disappointed that they did not receive more money.   Too bad, I say.

As for President Obama tossing some money to these groups, I say – again – “what the heck?”

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Major breakthroughs in healthcare are few. It is rare that the paradigm shifts in such a manner that our whole way of thinking about how we should address a topic radically changes. It appears this will begin to happen much more frequently as scientific breakthroughs occur at an expanding and much more rapid pace.

The HPV Vaccine may be seen as a wonderous breakthrough in science as soon as a generation has past and recieved it purported benefits.

One such example of this phenomenon is the recent approval by the FDA (Food and Drug Administration) of a vaccine for the Human Papilloma Virus. Strong evidence suggests that this intervention may grow into something just short of a panacea for cervical cancer (we know the drug manufacturers hope so!). At the same time, medical history will likely look back at this occasion as the time that vaccines were introduced to protect us from things that we never even dreamed were possible.

In the beginning of my medical career, the thought of a vaccine for a cancer seemed preposterous. Now it is reality. Only time will tell. This concept of the self correcting nature and the non dogmatic objective review of pier reviewed literature will be reviewed in an upcoming article on Science – How and why it works. However, for now we are relegated to make informed desicions as best as we can on the evidence that we have. That body of work is very strong and becoming more reliable everyday.

For over four decades the scientific community and the clinical community of basic science community and the clinical community of Obstetricians and Gynecologists, and ancillary health care professionals learned that women who had certain subtypes of HPV, were at much higher risk for bad changes in the cervical cells, and those bad changes occasionally led to the horrendous disease, cervical cancer.

In the beginning of the 1960’s we watched about 1/45 women over a lifetime DIE from this heinous illness. The introduction of aggressive cytology through pap smears with the microscope (colposcopically directed) biopsies of those sick cells led to an enormous decrease (almost 1/3, absolutely extraordinary) in the incidence of the precursor disease and the full blown out illness of cervical cancer.

HPV sadly became one of the most prevalent sexually transmitted diseases. Before the onslaught of AIDS the barrier free sexuality of the 60s and 70s facilitated the transmition of hordes of STD’s which still continues today, in not quite the same tsunami of spread.

If you desire more detailed information on these items, please say so in your comments. This will help guide the tone and theme of the site. It belongs to all of us, to make us all healthier. We benefit from that glorious communion. We will learn together how detailed, how medical, how general, we want these items to be and we will try and reach common denominator that suits the majority. We will not be perfect (who is?) but we will strive to the best education and information possible.

Very soon depending on who you are, you must engage your health care provider with the discussion: it is appropriate for me? my daughter? my significant other, to receive the HPV vaccine. This will be a difficult question. Wow, extremely difficult. Just imagine! Some of our daughters will be 11. The thought of vaccinating an 11 year old against a sexually transmitted disease is intuitively abhorrent, however, the reality is, a generation from not we may come close to eradicating one of the primary gynecologic cancers in women – using a vaccine. A cancer that strikes and kills women in their prime, as opposed to the other illesses whcih tend to have a higher prevalance as the individual gets older. This is not to be taken as it is a better cancer, but I suspect we are saddenned greatly when more of a potential life is snuffed, a mother taken from her daughter when she needs her most. The potential to rid ourselves of this monstrosity, now that is astonishing, I recommend you do your reading and education, as this is a big one.

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