In less than a week, Medicare provider Innovation Health will expand its plans and services into five counties and one city in Virginia, enabling local residents to enroll for the 2020 program.
As a joint venture between two industry leaders—CVS health company Aetna and Inova Health System—Innovation Health provides health coverage for employers and individuals in the DMV.
While the company’s 2019 service area included solely counties in Northern Virginia, this new initiative will expand closer to central Virginia, affecting residents in Clarke, Fauquier, Frederick, Page and Warren counties, as well as the city of Winchester.
Recipients will be able to choose from Innovation Health’s PPO or HMO plans, which both include health and drug coverage and are multi-zero plans, meaning monthly plan premiums, preferred co-pays, deductibles on medical services, deductibles on Rx prescriptions and cost-sharing for preferred retail Tier1 drugs will all be $0.
“Medicare beneficiaries want access to a comprehensive approach to their health, and in today’s world, aging well is possible if a healthy, active life is well-supported and care is proactive and personalized,” said William Seabolt, Innovation Health’s chief Medicare officer, in a recent press release. “Innovation Health recognized this and chose to offer a wider variety of plans designed to encourage a holistic focus on mind, body and spirit.”
For more information on the Innovation Health Medicare 2020 plan, click here.
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Jessica, 49, a mom and teacher in Prince William County, remembers the moment her life changed. (For health privacy, Jessica asked we not use her real name.) She’d found a lump, seen her doctor, had mammograms, an ultrasound and surgical biopsy. She awaited results anxiously, trying to focus on teaching a classroom of kids. And then she got the call. Malignant. It was invasive ductal carcinoma, stage IIA, her surgeon said, “but you’re going to be OK.” She says she’d cling to those words of hope in the coming months. Yet in the sea of shock, she was ushered into a world where the sheer amount of information was dizzying, staggering to sift through. She needed to understand cancer terms, pathology reports, tests and procedures—stat. Consult a plastic surgeon. Choose an oncologist. Decipher published studies. Analyze treatments. Make decisions. How would she land in her brave new world? Like most, she headed online to research. But what she found was upsetting—and left her reeling.
“You’re overwhelmed with the diagnosis to begin with, and when you research it on your own, you just can’t handle it. There’s so much info and much of it tragic,” says Jessica, of her attempts to wade through information about breast cancer online. “When you’re newly diagnosed, you don’t want to read about botched procedures and horror stories and recurrence. You’re reading stories and you’re wondering, ‘Does this pertain to me? Am I like this patient? Or this one?’ It’s scary because you don’t even know if the information is current. Some information and books are outdated. Procedures change, implant information has changed, too.”
Over 300,000 people like Jessica will also hear they have breast cancer this year, according to the American Cancer Society. It stands to reason most will research online to learn about the disease. But as they analyze articles, studies and links that lead to more links, how do people make sense of seemingly countless sources? What do they need to know and ask for their care? And if the onus is on the patient to know what to ask their doctor for, or what the next steps are, meeting with your doctors can feel overwhelming.
Arming Patients with Information
John P. Williams, M.D., FACS, a breast surgeon with offices in Haymarket and Chantilly, who’s been practicing surgery in Manassas, Haymarket and Warrenton for 20 years, had been noting how family, friends and patients felt empowered when he taught them breast cancer concepts. He wanted to write a book, but the more he talked with people with cancer, he learned they go online before consulting books. They also said information was often disorganized, complex and not in modern formats.
So last year, Williams launched a free video-based tutorial website, the Breast Cancer School for Patients, breastcancercourse.org. He narrates over 50 videos, the first free video tutorial series for all breast cancer patients nationwide (content is also on YouTube, with over 500,000 views and 3,300 subscribers).
“My personal passion is educating everyone to ensure they’re making their own informed choices in their breast cancer care,” he says. “We’re blessed to have excellent care in this region. It’s easy to lose sight that many people don’t have that. That’s my mission: to improve breast cancer outcomes with online education here in Northern Virginia, our country and beyond.”
His eight- to 10-minute lessons—in the order one may encounter the next steps of breast cancer treatment—teach the gamut of breast cancer basics, like cutting-edge treatments, breast imaging and biopsy, breast cancer stages, genomic and BRCA testing, and medical and radiation oncology. Williams, on the JAMA Oncology peer review board, plans to add more content to the site as studies are published. For example, he recently added an explanation on the groundbreaking TAILORx study published in the New England Journal of Medicine, about who best benefits from chemotherapy.
In March, Williams gave a TEDx Tyson’s talk entitled, “Why Online Schools for Patients Will Revolutionize Patient Education.” In the talk, he urged others in the medical community to develop patient schools for other conditions, such as diabetes or hip replacements. But he says it has been difficult getting other medical professionals to embrace the idea. Time commitment and the videos’ not-for-profit status may be reasons why he’s the first to create such a tool, but, he adamantly adheres to this philosophy: “The moment you monetize it, it loses credibility.” He says he’s accepted no corporate funding or gifts, and has no outside influences on the site.
Williams wrote and shot most of the video series on weekends and after work, giving up time with his family, he notes. But, he says, it’s been worth it. His project has helped empower patients to be at the center of discussions with their medical providers. “When you do what’s right, it takes a lot of work, but you’re rewarded in ways you couldn’t have predicted.”
Taking It National
His work has even caught the attention of the White House. He recently got an email from the administration asking him to serve as the chairman of the President’s Cancer Panel, a three-person team which monitors the National Cancer Program and reports on barriers in reducing the burden of cancer. He accepted the three-year appointment and will begin work with the panel soon.
“Cancer is not partisan,” he says, when asked about the new role. While the panel reports are to the president, they’re also for the larger group of stakeholders, he says. The panel, signed into law by Nixon in 1971, holds meetings on different topics (such as HPV vaccination, most recently) gathering input from public agencies (like HHS, NIH and NCI) and private organizations (such as universities, voluntary and advocacy groups, pharmaceutical companies and health care providers).
Yet, his appointment begs a deeper question: If the government declared war on cancer decades ago, will we see a cure in our lifetimes?
“We will always confront cancers and treating cancer. The body is not perfect,” he says with a pause, before he shares his optimism for the future. “But we are making strides in prevention, health, less toxins, better screenings to find it early, better outcomes with less human distress like surgery and chemo. When we do treat, it’s often minimally invasive and has better outcomes. All of these are part of cancer in the next century. But it’s our job to work on and improve each component. We cure more and more people who have cancer, with less suffering. I’m excited about the progress we’re making.”
As for Jessica—whose mother was just diagnosed with breast cancer, too—she’s also hopeful after her life suddenly changed. After a double mastectomy and reconstruction, and a daily Tamoxifen pill, she’s cancer-free. “I’m so grateful to be here,” she says, talking of her love of her family and her classroom. When asked if she could’ve benefited from a “school” like this, “Yes, there’s a real need for this,” she says. “If the info is recent and coming from a practicing surgeon who’s trustworthy and knowledgeable—not just a researcher—people should use the site. What he’s done will be helpful for others. He’s made it easier for them.”
Take a moment to imagine yourself doing yoga. It’s calm and peaceful. Except this time, rather than being on your mat, you’re hanging from an aerial silk attached to the ceiling.
It may sound impossible, or unthinkable. But Neelam Kataria doesn’t think so.
“This class is a feeling of letting go and trusting yourself,” says Kataria, founder and director of newly opened Shakti Aerial Yoga and Dance in Sterling. The aerial yoga practice, consisting of different grounded and suspended yoga poses, is just one of an array of classes the new location offers.
Students can find themselves gently swaying in silk during a restorative aerial class, practicing deep meditation in yoga nidra (known as a “divine sleep”) or testing their core strength at an aerial hoop class.
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“One of the reasons I decided to open a space for aerial yoga was because people loved it so much once it was making such a change in their bodies and in their lives,” says Kataria. “Once you connect with your body, there are a lot of advantages with your own feelings of your body and where you are in space.”
Kataria is also the owner of Aradia Fitness, a pole dancing studio in Ashburn that has offered aerial yoga classes, hoop classes and various fitness classes in the past. When she decided to expand to a second location in Sterling, she decided it needed to be different.
“I am at an age where yoga is really speaking to me now. I am 48 years old and I am a lover of dance and a lover of yoga, and I did not see any spaces in our area that offered a combination of the two,” says Kataria, who is also a classically trained dancer in bharatanatyam (a form of Indian traditional dance that expresses Southern Indian religious themes and spiritual ideas).
“I think dancing is an essential element for many of us, and I know that dance is a form of meditation for me. I have a total alignment of mind, body and soul, which is meditation,” says Kataria. “So, to open this studio was a perfect combination of yoga and dance.”
Shakti opened its doors in September and has been teaching people to hang, release and “fly” ever since, but it has also taught weekly lessons on belly dancing, restorative practices and odissi, a class focused on strengthening and conditioning the entire body, as well as the basics of odissi dance.
And, according to Kataria, everything is about bringing a new sense of self-awareness to those who are willing to try.
“My classes are more about finding yourself, and finding the feeling deep within you,” says Kataria. “I hope people come and discover that [feeling] for themselves. That is my intention.”
That “feeling” and self-awareness that Kataria speaks of is what inspired her to name the location after the Sanskrit word meaning “power,” or “empowerment.” Shakti, she says, is the energy that created the universe and a power that manifests itself in all of us.
As an Indian immigrant, Kataria is proud of her rich cultural roots and her ability to bring the energy and purpose into her classes, which she says, might be lost in other yoga experiences because they are rushed or too focused on other elements of the practice.
“This community was in great need of yoga,” says Kataria. // Shakti Aerial Yoga and Dance Studio: 45630 Falke Plaza, Suite 270, Sterling; class times and prices vary
Somebody should forward this information to Bernie Sanders. He could probably use it.
I don’t think this will come as all that much of a surprise, but two separate medical studies released this week have concluded that people who own dogs are less likely to die early. The phenomenon is particularly pronounced in people who have suffered a heart attack. Those in that situation who own dogs were 33% less likely to die in the first year following their cardiac event. (NBC News)
Dog owners live longer and fare better after a heart attack or stroke compared with those who have no canine companions, two studies published Tuesday suggest.
Researchers found that dog ownership was associated with a 24-percent reduced risk of death from any cause among the general public, and a 33 percent lower risk of death among heart attack survivors who live alone, according to the reports, published in the journal Circulation: Cardiovascular Quality and Outcomes.
The new studies are “interesting and provocative,” said Dr. Haider Warraich, director of the heart failure program at the Boston VA Healthcare System, an instructor at the Harvard Medical School and author of “State of the Heart: Exploring the History, Science and Future of Heart Disease.”
I was able to guess the suspected reasons cited for these results before even reading them, as I’m sure many of you will be also. The most obvious one is that people who get at least some exercise on a regular basis tend to live longer and have fewer heart problems. Dog owners have to get up and down all the time to let their pet outside, take it for walks, play fetch, etc. I know that I would certainly be doing less walking without my beagle being around.
Another factor that’s a bit more subtle is the issue of loneliness and stress. Those things can lead to health issues also, not to mention depression. Dogs are boon companions who are always glad to see you and engage with you emotionally. Just petting a dog has been shown to reduce blood pressure and relieve stress. Having a dog around every day seems like a natural boost to your health. Unless, of course, it’s a robot dog.
Notice how the study says nothing about cats. We have both (and have for years) so I feel qualified to make some comparisons here. To be clear, we love our cats. But it’s not always as obvious whether or not they actually love us in return. I’ve always felt like they “tolerate” us more than appreciate us. In fact, if they had opposable thumbs and could operate the can opener themselves, they’d probably try to get rid of us.
And then there’s the way they constantly wrap themselves around your ankles. Particularly near the top of the stairs. Are they being affectionate or actually trying to knock you down the steps? It’s still a mystery. But if cats actually led to you living a longer life it seems like these studies would have mentioned it.
The good news is it sounds like Bernie Sanders survived his heart attack and subsequent corrective surgery quite well and is on the road to recovery. And just for the record, his campaign confirmed yesterday that it was indeed a heart attack, though they chose the more clinical description of myocardial infarction. He’s already out of the hospital and getting around pretty well from the look of things. (Associated Press)
Democratic presidential candidate Bernie Sanders had a heart attack.
His campaign confirmed in a statement released Friday afternoon that the Vermont senator was diagnosed with a myocardial infarction, otherwise known as a heart attack, when he went to a hospital in Las Vegas Tuesday night…
The Vermont senator’s campaign said in a statement released Friday that he walked out of Desert Springs Hospital Medical Center feeling great and looking forward to getting back to work.
While I’m sincerely happy for Senator Sanders and grateful that this didn’t take a much darker turn, it’s impossible to ignore the political ramifications of this. It’s true that many people undergo procedures like this and go on to lead long, healthy, full lives, and I hope that’s what happens for Bernie. But he’s out on the campaign trail at least 16 hours per day and that takes a toll on people. (Speaking from first-hand experience here.) And the office of the presidency famously ages people prematurely, though thus far Donald Trump seems to be largely immune from the effect.
This is definitely raising questions in the minds of voters and media analysts already. New York Times reporter (and also a physician) Lawrence K. Altman raised questions about how Sanders’ team has handled the issue. On Friday, he penned a story under the title, “Bernie Sanders Had a Common Heart Procedure. So Why the Mystery?”
That was before the official announcement from Bernie’s team about the nature of his medical procedure, but I think the question remains valid and the answer is rather obvious. They did the right thing by eventually coming clean, but no candidate wants to admit that they underwent a coronary procedure. Just the words “heart attack” raise concerns in the minds of potential supporters. The guy is well into his seventies, which might be worrisome enough to begin with. But now he’s got this story dogging him on the trail.
Frankly, I’m kind of surprised that there hasn’t been more of an effect on the polls from Joe Biden’s eye filling with blood during a debate in September. It could easily be something innocuous, but it was an alarming visual to say the least. Perhaps even more concerning are the many times that he’s seemed to become confused and begin rambling when answering questions. Neither of these men are spring chickens.
In fact, of all the septuagenarian Democratic candidates, Elizabeth Warren is the only one who seems to be plowing forward without any obvious medical concerns stemming from her age.
I’m not suggesting that anyone be eliminated from consideration because of their age. The Constitution imposes a minimum age to serve in the Oval Office, not a maximum. But that doesn’t mean that the public can’t take such factors, real or perceived, into consideration when making their choices. And we’ve definitely got some candidates in the running right now who appear to be on shaky ground in terms of health scares. There’s still a lot of race left to run and the winner will have a grueling general election battle ahead of them. If they somehow manage to unseat Donald Trump they will then be facing at least four years of shouldering the weight of all the world’s troubles.
So how are the three oldest Democrats the ones leading the pack? I’ve got a feeling that this condition may change if we see any more reports like these coming in from the field.
Addiction can be a touchy subject. It’s difficult to discuss, identify or address in almost any setting, but according to Inova, it’s time to act.
After a generous donation from the family behind NoVA-based HITT Constructing, Inova Health System has established the Act on Addiction campaign, a new initiative meant to educate the public about the reality of addiction and how those affected by it can rely on local resources for help.
We spoke with Michael R. Clark, M.D., MPH, MBA, chair of psychiatry at Inova Health System, about the program’s upcoming event on Saturday, Oct. 5, Inova Act on Addiction Summit: Bridging the Gap for Young Adults, and why this initiative has taken root in Northern Virginia.
The first-ever event will provide local resources, breakout sessions and keynote speakers that discuss addiction, prevention and more, with programming aimed at young adults. But, Clark says, those seeking more information or support should feel welcome to attend. Find out more about the event and the Act on Addiction initiative in our conversation, below.
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What sparked this initiative to address addiction in NoVA? This really originated with Joan and Russell Hitt, when they very generously donated $16 million to the Inova health system with the purpose of enhancing and expanding our existing substance abuse disorder treatment services. They had a particular interest in trying to engage family members of those affected and develop services more locally so that patients would not have to travel out of state for getting care for addiction, and also not have to lose contact with family members because of it. They also wanted to offer local support and other aspects to accommodate those seeking or obtaining treatment when they return to come back home into their local environment.
As we thought about how to do that and how to make the most with their generosity, we knew that September was a month with a strong focus on addiction, so we embarked on the campaign, Act on Addiction, to educate the public, to provide access to resources, and to make people aware of different treatment modalities for addiction. And that will all culminate on Saturday, Oct. 5, where we will bring speakers and make breakout sessions available so that family and friends, and people that are perhaps suffering from addiction, can come forward and get some information and support, and hopefully some encouragement that all of these are common problems, they’re treatable problems and our treatments do pretty well when people know how to access them and stay with them.
For the terms “addiction” and “substance abuse,” are you including all substances such as alcohol, nicotine, opioids, etc.?
It really is every abuse potential. Tobacco products are still used by 21% of the population, and nicotine is probably one of the highest addictive liability indexes of abused substances. It’s very difficult for people to stop smoking or using nicotine and it’s accompanied by just a huge array of chronic health conditions that ultimately compromise people’s longevity and quality of life. And then, of course, there is alcohol. Just like tobacco, it is legal and easily obtained, and many people are using and unfortunately kind of dependent on it and develop addictions.
Why is this initiative important now? Do you feel more pressure to address these issues as they have become more common and discussed in everyday life? Well, I think that I personally have been concerned about these problems my entire career. I think that at the societal level and among other health care providers, we really have come through a period of 20 or 25 years where we have seen just an explosion in not only opioid prescribing, but opioid abuse disorders. There are consequences and one of those consequences is the rise in use of heroin and other illicit synthetic opioids, like fentanyl. And so, you know, we have more people dying from substance use disorders now than we’ve ever had. But we also need to recognize that our management of pain and our prescription of opioid medications really ran unchecked and without good habits.
We [as doctors] have really been part of the problem and now we have to figure out how we’re going to do better going forward. We want to raise awareness not only about opioids, nicotine and alcohol, but also the problems of heroin and others, which are instantly deadly in the wrong chances. But we also want to point out to people that substance abuse disorders are, in general, very common. Access to these substances is easier now than ever before. And we have younger and younger people using these substances than we’ve ever had. These are our children, these are our future. And if they develop a problem early in life, not only does it derail them, but it creates really decades of health care utilization and other burdens to society, as well.
What type of local resources will be available at Act on Addiction Summit: Bridging the Gap for Young Adults? There will be a number of experts from the Inova system and around the area, making those resources more accessible and also just trying to educate people about what’s out there. We’ll be introducing people to the website, and we are hoping that it has an ongoing life of its own. And we will address these issues and help people who struggle with, “How do I raise the issue with somebody in the family who I care about?” or, just give them some ideas, tools and information with which they can reassure that person that this really is a treatable condition. This is one in which you should be optimistic and not be ashamed to seek help.
What do you hope this initiative accomplishes, and what should readers know about the reality of addiction in NoVA? I hope that what it does is break down barriers to the conversations, so that we can begin talking more openly than we have about these disorders, about how prevalent they are and about ways in which we can prevent them from ever occurring. But also that at the conference, if we aren’t able to fully prevent it from happening, we can help people seek treatment, and help the community support treatment and think about ways in which to rally around their community members rather than stigmatize them or give up on them.
Act on Addiction Summit will be held at Fairfax High School on Oct. 5, from 12:45 to 4 p.m. // Fairfax High School: 3501 Rebel Rub, Fairfax; free
While having a 9 a.m. to 5 p.m. workday schedule was once universal, that is no longer the case for many Americans. And between company hours and leisure time, finding an opportunity to exercise can be a consistent challenge.
But what if the exercise comes to you? That question is part of the inspiration behind Elan Fitness and Nutrition, which offers wellness coaching for individual clients, local community centers and, most commonly, corporate offices throughout Northern Virginia.
As a registered dietitian and certified personal trainer, owner and Centreville resident Thea Boatswain is able to provide clients with a variety of health and wellness offerings, which many businesses, both small and large, inquire about on a daily basis.
Here, Boatswain takes us through a typical day as a full-time business owner, personal trainer and nutrition coach in Northern Virginia.
5-9 a.m. Each day, Boatswain has a client at a different time. Whether it be an individual training session or a company class prior to the start of the workday, it typically is scheduled between 5:30 and 7 a.m. The one ritual that does stay consistent?
“After the workout I have to take a nap because I am so not a morning person,” says Boatswain with a laugh. “I typically nap between 7 and 8:30 a.m., eventually starting my day around 9.”
9:30-10:30 a.m. Time to catch up with what she missed through the night.
“Usually, for an hour or so, I check emails and speak with my assistant to see if we have new appointments,” says Boatswain. “We usually get a few inquiry emails from the website, whether that be for online coaching or corporate fitness.”
11 a.m.-1 p.m. “I usually have a midday class that I have to leave my house in Centerville for around 10:30 a.m.,” Boatswain explains, as most of her training sessions are in corporate offices in Washington, DC, Tysons or other areas of Northern Virginia. “Most are between noon and 1 p.m., so within that block I am training in some kind of boot camp or strength training method at a corporate site.”
Due to her busy schedule, Boatswain makes an effort to stay an extra half hour or so after each training session with clients to get her own workout in.
“Yesterday, I had three classes throughout the day, and each time I stayed 30 minutes after and did legs in the morning, arms in the afternoon and core at night,” says Boatswain. “The clients actually like when I stay in their facilities because they like to know that I practice what I preach, and it’s also a time where they can ask me questions about best health practices.”
2-4:30 p.m. In the afternoons, Boatswain either heads to the office or a nearby coffee shop to wind down and plan for the coming week, write a blog post or two and take a few calls for the company’s online coaching program.
Through the program, titled Direct Access, Boatswain and the other trainers at Elan Fitness lead clients both online and over the phone through a guided fitness plan that fits into their own schedule. Each individual has a goal that Boatswain assists her clients in getting to, whether that be weight loss or eating more balanced meals.
“Some days I have one or two coaching calls and others I have over four,” says Boatswain. “We do biweekly phone calls where I see what behavior has changed and whether or not the goal is being accomplished. I make sure they are feeling comfortable with their fitness and nutrition habits within the 15- to 30-minute phone call.”
5-7 p.m. Before finishing up for the day, Boatswain leads company teams in workouts ranging from boot camp to spinning to Pilates.
In addition to workout classes, Elan Fitness offers nutrition services and wellness seminars to companies in the area. Often times during a lunch break or an evening session, Boatswain will lead a lecture on how to maintain a healthy diet or share recipes for easy-to-make lunches in the office kitchen.
“There was one day where a former client had us do 15-minute nutrition consults in a six-hour span with each employee, so they could see where their overall nutrition was as a team,” Boatswain explains.
Following the evening lesson, it’s time to head home for the day.
7-8 p.m. “When I get home, that’s my real downtime,” says Boatswain. “I make myself go to sleep around 10:30 p.m. but I am really a night owl so at the end of the day I am wide awake.”
Once Boatswain shuts her eyes for the day, it’s time to get some rest before she does it all over again in the morning.
Labyrinths, unlike mazes, have one path that goes into the center and back out, making them a peaceful walk for centering, grounding or just enjoying the setting and surroundings. More than a dozen labyrinths are located throughout the Northern Virginia area. Generally, they are open from sunrise to sunset. Here are five.
Judy Lowe Neighborhood Park
Judy Lowe, known as the “First Lady of Del Ray” because of her countless hours of involvement in community programs, has a pocket park dedicated to her in the Del Ray section of Alexandria. It includes a 25-foot medieval design, seven-circuit labyrinth that’s made with bricks and pavers and surrounded by trees and benches. The park is dog-friendly and has a play area, water fountain and a dedication plaque describing some of Lowe’s activities. // 1 & 7 E. Del Ray Ave. (at Commonwealth Avenue), Alexandria
Little River United Church of Christ
One-half-mile outside the Beltway, by the cross across the street from the campus of Northern Virginia Community College, in the wooded grove behind the church is Little River United Church of Christ. The labyrinth was installed in 2007 and the congregation wants visitors to use the labyrinth as a “tool of meditation that can help us experience more deeply how God moves in us and with us on our life’s journey.” // 8410 Little River Turnpike, Annandale
Bethel Evangelical Lutheran Church
Cross the wood bridge near the picnic tables and go up the path to the right to visit the medieval Cologne cathedral-style, six-circuit octagonal labyrinth with a stylized Luther Rose in the center. It was created by Inocencio (Chencho) Orta as an Eagle Scout project and has a path wide enough for wheelchair use. More than 65 people worked on this 47-by-47-foot labyrinth that was installed in late 2015. // 8712 Plantation Lane, Manassas
United Christian Parish of Reston
When you visit the 42-foot labyrinth at the United Christian Parish of Reston, you’re asked to do so after 1 p.m. on school days because it’s used by preschool children. The patio is the result of Ian Hodges’ Eagle Scout program which, after the fundraising, took about a month to paint on concrete and seal. Join them on the annual World Labyrinth Day on the first Saturday of May at 1 p.m. // 11508 N. Shore Drive, Reston
Burke Presbyterian Church
Burke has two labyrinths. One is outdoors, a seven-circuit labyrinth in a serene, wooden Memorial Garden, near the end of the parking lot entrance. A second is a canvas that’s laid out in the Meeting House sanctuary on the first Monday of the month, 9 a.m. to 7:30 p.m. They say it’s a replica of one created circa 1200 as part of the stone floor of the cathedral at Chartres in France. // 5690 Oak Leather Drive, Burke
By Amy Banulis, M.D., OB-GYN, FACOG, and Helen Schneider, M.D.
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As doctors specializing in women’s health and as women, we can’t underscore enough the importance of October as Breast Cancer Awareness Month. Breast cancer remains the second most common cause of death among women. After skin cancer, it’s the most common cancer for women in the United States. In fact, one in eight women in our country — about 12%— will develop invasive breast cancer.
Getting a mammogram remains your best screening option for breast cancer. But wading through often conflicting guidelines on when and how often to get mammograms can be challenging. We demystify your mammogram, below.
A screening mammogram is given annually or every two years to women after a certain age as part of their preventive health routine.
About 10% of women who receive a screening mammogram are asked to return for additional imaging (such as an ultrasound) or a diagnostic mammogram, which takes longer and allows the technologist to magnify a suspicious area to produce a more detailed picture for the doctor. Women who have had any kind of prior lump or have discharge or thickening of their breasts may receive a diagnostic mammogram as their routine mammographic screening.
While women often need to wait for results of a screening mammogram, the results of a diagnostic mammogram typically are given at the end of the appointment. Either we tell a patient that everything is fine (our favorite conversations) or we recommend a short-term follow-up, a biopsy or a follow-up within the year.
2D or 3D?
Long-term studies are still determining the benefits of 3D mammography versus 2D mammography, and for now, the latter remains the recommended screening by the United States Preventative Task Force because of proven reduction in breast cancer mortality.
When and how often to screen
You may have heard conflicting advice about when to start getting a mammogram and how often to follow up. Today there is no longer a one-size-fits-all recommendation on this. Different medical organizations have different recommendations. The bottom line is that you and your OB-GYN or primary care physician should determine when it’s best for you to start, based on your health history, age and comfort level.
We recommend our patients begin screening around age 40, unless they have additional risk factors, such as a first-degree relative with early onset breast cancer. Some medical organizations recommend beginning at age 45. Age 50, though, should be the absolute latest that you begin having regular mammograms.
Risk factors for breast cancer include family history, never giving birth, being older at the birth of your first child, lifestyle (smoking, alcohol use, a higher body mass index) and rarities, such as prior exposure to chest radiation during childhood lymphoma. It is important to remember, though, that the most significant risks for breast cancer are age and gender, not family history. In fact, 85% of breast cancers develop in women without a family history of breast cancer.
The exact guidelines of how often to screen vary, too. But generally speaking, it’s recommended that women over 50 get screened annually or every two years. We typically recommend continuing screening until age 75, but the decision as to when to stop screening is best made collaboratively with your doctor.
Preparing for your mammogram
Avoid having a mammogram the week before your period when your breasts are at their most tender.
In addition, steer clear of using deodorant, creams or powders before you go. Some of these products contain metals that can be confused with calcium deposits known as breast calcifications, which are tiny and quite common. While calcifications can indicate breast cancer, in 85% to 95% of women, calcifications are benign. Since the metals found in self-care products can make it difficult for radiologists to interpret calcifications as benign or as changes due to cancer, it’s best to avoid using these products before your screening.
Getting the most from your mammogram
Radiologists need to treat anything we haven’t seen before as new. Many women don’t realize how important it is for the radiologist to have previous views of past mammograms. If you have your screenings done at the same facility, the radiology staff will have access to your past screenings. If you are going to a new facility, bring your last two to three mammogram results on a CD (or better yet, give it to the radiologist before your appointment). Make sure that the radiology center you are using is certified by the American College of Radiology.
How long will it take to get results?
Once you’ve completed your visit, the amount of time it takes for your provider to process, analyze and then prepare your mammography study results can vary widely—from just a few minutes to over a week. Radiologists and health care teams usually take great care in their accuracy and speed in determining the result of your mammogram, and how long it takes can depend on their level of coordination.
What can you expect afterward?
For most of us, no news is good news after a mammogram, but anxiety is common, so it’s important to talk with your doctor in advance about how results will be communicated: through a letter from the radiology center, your doctor a secure portal? One option is to schedule your mammogram before your next regular exam with your doctor, so that you can discuss the results at that appointment.
Staying informed, creating open dialogue with your OB-GYN, being candid about your health history and your screening preferences are all important factors in maintaining your best breast health—this month and throughout the year.
So long to breast self-exams
If you’re like many women, you may be surprised to learn that the medical community no longer recommends monthly breast self-exams for women of average risk. That’s because there is no research to show that regular breast self-exams help to reduce deaths from breast cancer. In addition, researchers found that too many women didn’t know what to look for, and so self-exams led to more false positives and unnecessary biopsies.
The focus now is on breast awareness and being attuned to noticing a change in what is normal for your breasts. If you detect something different—a mass, nipple discharge, a redness or skin change on your breast—talk to your doctor right away.