Are You Ready to Lose Weight?

"I'm o­n a diet." It could almost be the national slogan. With so many people attempting to lose weight, it's amazing how little weight is actually lose and kept off. o­ne of the reasons people find themselves dieting over and over again is they start their efforts without asking o­ne important question: "Am I Ready?" To help you find the answer, ask yourself a few more questions:

What's My Motivation?

Think about your reason for wanting to lose weight and decide if it's enough to support a long range commitment. Are you dieting to get ready for the swimsuit season or because your doctor told you your next heart attack could be fatal? Weight loss that's permanent is more often the result of long-term health considerations than of short-term goals such as the upcoming class reunion.

Can I cope with o­ne More Change?

If you've just gone through an important change in your life -- a divorce, job change, extra stress at work, even a positive change such as a marriage or new baby -- consider postponing changes in your diet and exercise habits. Too much change at o­nce can push you into the high-stress zone.

Am I Willing to Be Realistic?

Perhaps the major reason diets fail is the dieter hopes to shed a large amount of weight in a hurry, to get quick results -- and a quick end to the diet. If you expect to lose more than o­ne or two pounds a week, you're setting yourself up for failure. And expecting a diet to be a temporary measure rather than a life-long change in eating and exercise habits is also a surefire way to fail.

Do I Have Time and Energy?

Experts say that exercise is an important component of any weight-loss program. Are you willing to make walking, jogging, swimming or an aerobics class a permanent part of your daily life?

How Will Others React?

A supportive and understanding network of family and friends can help you enormously. Do you expect your family to partake of your new low-fat recipes? Do you want them to cheer you o­n, nag you when you lapse or just leave you alone? Talk over your plans with your loved o­nes. What are their expectations and fears? For instance, your spouse may worry that as you lose weight you will become too attractive to others.

Losing weigh permanently requires a major life change, not just another diet. Your answers to the above questions can help you decide if now is the time to start.

Breast Cancer Update

LCDR , WHNP
Family Practice Clinic, USNH Rota

You may know that breast cancer is the most common cancer among women and the second leading cancer death overall for women (behind lung cancer). But, did you know that it is the LEADING cancer death for women aged 15-54. Usually we think of breast cancer as an "after menopause" cancer, with 80% of all cases occurring in women over 50 years old. This year, more than 175,000 women will learn for the first time that they have this disease and more than 43,000 women will lose their lives. Breast cancer diagnoses have steadily increased annually by 2% since 1980. There has been an increasing incidence of lifetime risk from 1 in 20 women in 1987 to 1 in 8 women over age 80 today.

Causes for this increase may include:

* Increased average life span age for women
* More public awareness of breast cancer
* Improved mammography equipment and techniques
* Improved compliance with screening guidelines and more cases diagnosed earlier
* Increased unhealthy lifestyle practices that may be adverse influences: smoking, more alcohol consumption, obesity, high fat diet

Although breast cancer rates for Caucasian women has declined since 1992, the rate for African-American women and other minorities has increased. However, the breast cancer mortality rate, a measure of the breast cancer deaths per 100,000 women, has been decreasing during the past few years. Increased screening of women, leading to detection of cancers at an earlier stage, and more effective treatments are most likely responsible for lowering the breast cancer mortality rate.

Women are encouraged to ask their health care providers about mammography screening. Mammography (an "x-ray" picture of the breast) is the single most effective method to detect breast changes that may be cancer, long before physical symptoms can be seen or felt. Early detection, followed by up-to-date treatment, provides women with better chances for long-term freedom from the disease. But mammography screening must be done routinely.

Naval Hospital Rota's Mammography Suite and 2 trained mammography technicians enables mammograms to be done usually in 7-10 days. A Breast Care Clinic is available for self-referral for high risk women (previous history of a breast condition or a family history of breast or ovarian cancer), as well as any woman with breast concerns. Many of the medical staff have received pertinent in-depth training o­n breast cancer screening , instruction o­n BSE (Breast Self-Exam), high risk counseling, evaluation of breast problems, and fine-tuning of clinical breast exams. A computer with educational programs o­n breast cancer/breast exams (in English and Spanish), as well as a wide variety of booklets, videos, and educational information o­n breast care and women's health issues, are available for women to utilize in the comfortable and informative Family Health Education Center in Corridor D of the Naval Hospital.

"It is through education and awareness of the importance of clinical examinations, mammography, and monthly breast self-examinations (BSE) that breast cancer mortality can be decreased while positively affecting the morale of the DoD workforce" (DoD Breast Cancer Initiative Executive Summary).

Current screening mammography guidelines recommended by the American Cancer Society are:

* Ages 20-30:

- Monthly breast self-exam
- Clinical breast exam at least every 3 years

* Ages 40 and over:

- Monthly breast self-exam
- Clinical breast exam every year
- Annual mammogram

Talk to your health care provider, obtain and read accurate and up-to-date information about breast cancer risks and preventive measures, AND be pro-active in taking charge of YOUR breast health.

Good News!!!
Eight out of ten breast lumps evaluated are NOT CANCER!!!
Seven out of eight women will NOT get breast cancer!!!
Breast cancer is usually curable if diagnosed early!!!

Personal Safety

June is National Safety Month and it is a good time to remind ourselves that a few precautions and a little common sense can be a person's first line of defense against injury and harm. Today, many folks choose to live o­n their own, and developing a "safety conscience" will help ensure that each day is a safe o­ne. Just remember a few tips to help you develop YOUR safety conscience:

Knock, knock---who's there?

Keep your door closed while you check out strangers through the peephole. Suppose it's a man in a gas company uniform who needs to "adjust the thingamajig"  Ask him to slip his I.D. under the door. Then, while he waits, call his company for verification. Look up the phone number do not use the o­ne he volunteers. The best bet is to have a friend or neighbor with you when repairmen are scheduled to visit. If you live in an apartment house, lock your door even if you are just going to take the trash out. And meet all delivery persons and guests at the building's entrance don't buzz them inside.

Personally speaking---don't!

Do not chat idly about your life in public places, like the supermarket or a club. Who knows who is idling nearby?

Never advertise your gender or marital status, either. List your phone and mail box under your first initial, or use o­nly your last name. Say "we're not here" o­n your answering machine message.

You can't huff and puff and blow my door down!

Consider the doors to your home as barriers. Doors should be solid wood or metal, and should have at least two locks. o­ne should be a dead bolt, which is harder to pick than other locks. Police say chain locks are virtually useless. Remember that sliding glass doors attract thieves. Cut a piece of broomstick or 2"x4" wood to fit snugly in the track, so that it can't be opened. Also, remember that if a window is open even a crack, someone can pry it open all the way. And burglar alarms DO work! So does a 100-pound German Sheppard, if you are an animal lover!

That lived-in look!

Make sure your house or apartment appears occupied when you are out. Leave blinds partially open, a jogging suit o­n the clothesline, and the stereo o­n. Stow a dirty pair of sneakers outside the door. Do not leave ladders lying around. At night, light is the best deterrent to unwelcome visitors. Leave random lights o­n, and invest in an outside floodlight or motion detector light. Exercise with a friend! Not o­nly is it more enjoyable to walk and jog with someone else, it is safer, too. So pick a partner to do that mile and a half, and do it in the light of day, not at night.

Car safety counts!

Do not ever leave your car doors unlocked, as back seats are great hiding places. Lock your car doors when you are driving, too. In case of car trouble, have an emergency car kit with a flashlight and a "Help" alert sign. If possible, do not get out of the car until professional help arrives. If you can afford it, a cellular phone is definitely your best friend when traveling.

By paying attention to your surroundings and living situation, you can make June, as well as the rest of the year, a safe o­ne. 

The Risks of Start and Stop Fitness

A lack of consistency in your fitness program can do you more harm than good.

For years, health expects have warned about the vicious cycle of losing and regaining weight.  Now a major scientific study concludes that yo-yo dieting may cause more harm than good.

Linked to Heart Disease

In a study of 3,130 men and women, a team of researchers found that yo-yo dieters have a greater chance (25-100 percent) of developing heart disease and an overall higher death rate than those who maintained a consistent weight.

In fact, the health risks of repeated weight loss and gain may exceed those of being overweight, according to Dr. Kelly Brownell, a psychologist at Yale who directed the study.

Turning Anxiety Into Opportunity

Control, commitment and openness to change are the keys. You can't always choose your destiny in life, but you can choose how you cope with it.

Why do some people blossom in the fact of stress while others wither? The determining factor may be whether or not you feel in control of your life. People who choose their path, regardless of how stressful it is, don't suffer from stress as much as those who have no choice. That's why secretaries often suffer more than business managers, or nurses more than surgeons.

Take Control.

How can you take control of your life? The first step is to get organized. Figure out what's important, then do it. Learn not to waste time o­n little things that don't matter. Many of us put off organization because it does take time and energy at first, but the benefits of being in control of your time and energy outweigh the initial investment.

Taking care of yourself also puts you in control. Be deliberate about what you eat: food that are high in energy producing complex carbohydrates and low in fat and sugar. Translation: Avoid junk food. Get energy from fresh fruits, vegetables, soups, natural snacks and sandwiches that are light o­n mayonnaise and other fatty dressings. Skip the extra cup of coffee or cocktail; caffeine and alcohol make stress feel worse. Set aside some time every day for your own mental and physical health. Exercise, relaxation activities, and fun all enhance your sense of being in control of your life.

Make a Commitment.

People who really believe their work is important and merits their best effort can often put up with enormous amounts of stress. Whenever possible, choose work that is personally meaningful to you. Even if that's not possible, you can choose to do your best at the work you've been given.

Be Open to Change.

All of us are subject to the curves life throws at us. There are two ways to react to change: by letting it buffet you about like a strong wind, or by using it to fill your sails and help you get where you want to go. Ironically, you increase your sense of control when you are open to change. Look at each change as an opportunity to gain new skills and knowledge. Not sure you like your new boss? Find out what makes her tick, and what changes you can make so that you are more valuable to her.

Control, commitment and openness to change are the keys to turning anxiety into opportunity. You can't always choose your destiny in life, but you can choose how you cope with it. The more you're "in the driver's seat," the easier it will be to cope with stress.

Why Get a Pap Smear?

Pap smears are uncomfortable and embarrassing.
Do women really need to have them done? What do you think?

Cancer of the cervix (the anatomic structure that provides entry into the uterus) accounts for 20 percent of all female cancers and is the third most prevalent form of cancer is a preventable disease and it is NOT hereditary. Some authorities consider cervical cancer to be a sexually transmitted disease. Women who first had sexual intercourse before age 16, women who have had multiple sexual partners (or a male partner who has had multiple partners), women who have had cervical warts, and women who smoke are at increased risk for developing cervical cancer. The incidence of invasive cancer has declined over the years; however, o­ne in eight women under the age 20 will have abnormal, possibly pre-cancerous cells o­n a pap smear and require further testing. Does that mean that women over 20 don't need to worry about getting a pap? No, it o­nly means that certain women may have increased risks of developing cancer. In fact, most pre-cancerous and invasive cervical cancers are detected in women over 30.

So what if your pap result card says something other than "normal" this doesn't necessarily mean that cancer cells were detected. Reasons for the card saying something other than "normal" include:

1. An inadequate specimen may have been obtained or the specimen may not have dried correctly.
2. Blood or some type of vaginal infection may have interfered with the pathologist's ability to interpret the specimen.
3. The cells in the specimen may have some degree of abnormality, but are not cancerous.
4. The cells may appear to be pre-cancerous.
5. The cells may be cancer cells.

You may be asked to have your pap smear repeated, possibly after treatment for infection, or you may be scheduled for a colposcopy. A colposcope is a microscope that allows the care provider to examine your cervix more thoroughly and aids in diagnosis of abnormal cells. The pap is o­nly a screening test and is usually not diagnostic. Referral for "colpo" DOES NOT MEAN that you have cancer.

Well, what do you think? Should "they make us get a pap every year"? I think not. We should make it a part of our resolve to take the best care of ourselves as we are able. And a yearly pap and pelvic exam is a tried and proven way to screen for cancer, and when it comes right down to it, pap smears are many times much less worse than cervical cancer. Right? Right!

Schedule your annual gynecological exam today. Get a friend to call, too.