Dear MD, We Need to Talk

© Kelly Sikkema /Unsplash

©Kelly Sikkema/Unsplash

Let’s see a show of hands - How many of you ladies have had an annual comprehensive wellness check? If you are like me, you wait until something is terribly amiss before you step foot into a doctors office, like last summer when I had crazy chest pains and spent part of a Sunday afternoon in the emergency room - turns out it was agita often caused by too much BBQ and a looming fellowship deadline. Nothing a little sugar and grain detox and extra sleep couldn't help.

And if you are like me, you likely engage in all kinds of wellness mind-body treatments - some with real preventative or curative medical value (hello good night’s sleep, regular exercise and cupping) and some that just feel good (mani-pedis)— because a healthy mind is a healthy body. Most of the time this self-care doesn’t leave the theory zone into the practice arena. Sorry Louise Hay! Thankfully, my genes and good habits have kept me incredibly healthy and well. Nonetheless, after that ER visit, I was armed with not only a will to be exceeding well, but a checklist of health points to discuss with my MD. After all, it's my body, right?

© Unsplash

© Unsplash

Whatever your age, an annual wellness check is a good idea. It takes somewhere between 30 minutes to an hour and includes a summary of your and your family’s medical history, a few standard examinations and tests and a thorough discussion regarding your concerns, complaints or generic well-being at your age. Your annual health checkup is the best time to tell your doctor about all the aches and cramps that have you awake at night with worry. Certain professions and lifestyles might put individuals at specific health risks. So you need to go over your general health status thoroughly. Mention every little thing out of the ordinary, however silly it might seem.

If you are a woman of color, living in the city and/or in a season that is economically challenged, your Dr. visit is even more important, and potentially frustrating, confusing, and discouraging. As if being “unwell” was not bad enough, gender, race, education, income, and insurance coverage contributes to health and wellness access disparities. Before you go for your annual check-up, talk to your family about their medical history. Since some diseases carry a genetic predisposition, make sure you mention everything to your doctor. If you haven’t visited your doctor in some time, go over your complete medical history as well. in case you have trouble remembering, it might be a good idea to maintain a log of it. Mention any pre-existing conditions and prescriptions you might be following.

Have a heart-to-heart talk
Heart disease is the leading cause of death in women over 40s. According to the American Heart Association (2015 data) heart disease and stroke rank as the #1 killer of Latin Americans. In 2016, around 46 of every 100,000 black women died from strokes, while 35 of every 100,000 white women did. While annual check-ups are good, make sure you keep checking your blood pressure at a more frequent interval. Also keep a check on your cholesterol and blood sugar which are the usual causes for a heat disease. While white women's diabetes diagnosis rate is 5.4 per 100, that number is 9.9 per 100 for black women, according to CDC data from 1980. In 2014—almost double. The risk of diagnosed diabetes was 66% higher among Hispanics/Latinos. Talk to your physician about the risk factors and how to limit them. And let's not forget about finally tossing that smoking habit and cutting back on stress cocktails.

Inquire about supplements
After the age of 30, 40 or 50, a woman has specific needs for certain nutrients that do not get fulfilled with regular food. Also, while taking care of everybody else, women often neglect their own health. For example, Osteoporosis affects women more since they lose bone mass faster. Vitamin D and calcium supplements help. So, make sure you talk to your doctor about filling up the gaps in your nutrition with the help of some supplements. Personally, I only take a probiotic (ActivatedYou) and I find that does the trick, meaning it aids in the digestion of all those good nutrients I'm consuming through my food intake. For many marginalized families living in food desserts, supplements are a necessity, but cannot replace the comprehensive nutritional value of eating healthy fresh food.

Menstrual cycles/ menopause/female cancers
Irregular menstrual cycles can be due a series of factors from fibroid cysts, weight fluctuations to stress and excessive soy consumption. Tests will be able to figure out the underlying cause if any. It is important to mention it to your doctor especially if you are planning a baby in the near future and/or do not wish to get pregnant. Also, after the age of 40, you need to start preparing for menopause. (I had my daughter at 43, so there are no hard set rules about female health and fertility.) Discuss with your doctor, the impact of menopause on your life and the lifestyle changes you might need to make.

Black women have a 1 in 9 chance of developing breast cancer; for white women the odds are 1 in 8, according to the American Cancer Society. And for our girls protecting themselves from the HPV virus, racial disparities are relevant here—a 2014 report from the CDC showed that around 71 percent of white girls 13 to 17 had completed the three-shot series, compared with about 62 percent of black girls in that age group.

This problem also extends to HIV/AIDS. For example, according to the CDC, in 2015, 4,524 black women were diagnosed with HIV in the United States (the number is thankfully falling), while 1,431 white women and 1,131 Hispanic/Latina women received the same diagnosis.

Contraception, pap smears, mammograms, screening for STDs are other points to discuss with your doctor. Remember, quality health care is a human and civil right. A good doctor will take the time and consideration to really connect with you and understand your unique history and any concerns. Come prepared with previous test results, a list of medications and even moral support (a trusted friend or relative) to keep you calm and centered on getting excellent health care. Good luck, be fearless with questions and stay healthy and well.