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Sunday, July 06, 2014

ACOG Practice Advisory on Annual Pelvic Examination Recommendations - ACOG

ACOG Practice Advisory on Annual Pelvic Examination Recommendations - ACOG

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ACOG Practice Advisory on Annual Pelvic Examination Recommendations

June 30, 2014

Washington, DC — The American College of Obstetricians and Gynecologists (the College) has reviewed the recommendations from the American College of Physicians about annual pelvic examinations and continues to stand by its guidelines, which complement those released recently by the American College of Physicians.
The College’s guidelines, which were detailed in this year’s Committee Opinion on the Well-Woman Visit, acknowledge that no current scientific evidence supports or refutes an annual pelvic exam for an asymptomatic, low-risk patient, instead suggesting that the decision about whether to perform a pelvic examination be a shared decision between health care provider and patient, based on her own individual needs, requests, and preferences.
However, the College continues to firmly believe in the clinical value of pelvic examinations, through which gynecologists can recognize issues such as incontinence and sexual dysfunction. While not evidence-based, the use of pelvic exams is supported by the clinical experiences of gynecologists treating their patients. Pelvic examinations also allow gynecologists to explain a patient’s anatomy, reassure her of normalcy, and answer her specific questions, thus establishing open communication between patient and physician.
Of course, pelvic examinations represent just one part of the annual well-woman visit, which can help to identify health risks for women and which can also feature clinical breast examinations, immunizations, contraceptive care discussions, and health care counseling. Importantly, annual well-woman visits help to strengthen the patient-physician relationship.
“We continue to urge women to visit their health care providers for annual visits, which play a valuable role in patient care,” said John C. Jennings, MD, President of the College. “An annual well-woman visit can help physicians to promote healthy living and preventive care, to evaluate patients for risk factors for medical conditions, and to identify existing medical conditions, thereby opening the door for treatment. Annual well-woman visits are important for quality care of women and their continued health.”
For more information on well-woman visits, please visit www.acog.org/wellwoman.

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org

Wednesday, July 02, 2014

50 YEARS AGO




I am in a complete state of awe, joy, sorrow, amazement, gratefulness and peace.  The woman at the top of this page is my beloved and dearly departed mom.  She goes by Jane.  She brought me into this world on this day 50 years ago.  It breaks my heart that she is not here today as I celebrate a milestone that I thought I would never see.

In this photo we are enjoying lunch at a little place in Ballard (Seattle).    It is called "The Barking Dog".  I remember that day so much because she was so excited to sit outside and get some warmer fresh air.  In Seattle it is not common to enjoy a meal outside because it can be chilly, even in the summer.

Once we got settled onto the patio we talked, laughed and shared a nice lunch.  These simple times with mom and other times with the people I love are what make me happy. 

I am grateful for these moments.  I am grateful for every drop of daylight. Every shimmer of moonlight. I am grateful for every conversation, meal, celebration, cup of coffee, family gathering and chance to say hello. 

I am grateful for every situation that tried my patience and gave me a chance to grow.  I am grateful for every person who made me look at myself and my life and challenge me to be better.  I am grateful for every way that I could contribute and give someone else a reason to smile too.

I am grateful for my family: mom, dad, sister, brother, nieces, nephew, aunts, uncles, grandparents, cousins, and all the wonderful friends I have made along the way. I am grateful for my doctors, nurses and support persons.  I am devoted to God.  I have stories to tell about the angels and saints. 

I also am grateful for the chance to be on the Today Show with my mom.  THAT was pretty amazing.  For my sister who rode the Seattle Great Wheel with me.  For my aunt, sister and brother, old boyfriends and Barb for literally plucking me off the ground after surgery to get me to Seattle for chemo.  For countless favors and kind gestures from others to keep me here....wow!

My sister especially gave so much of her precious time, of her heart, to be there and do what needed to be done.  All those trips to chemo, hospitals.  Plus helping with mom.  Both she and my aunt stayed with me before I moved to Seattle.  Oh and my brother drove my car to Seattle for me. 

Today I am on maintenance treatment with Avastin and starting a new regemin for my rheumatoid arthtitis, that has gone out of control.  With that I am resting up from the trauma of losing mom.  I am in a much better place than before.  I feel hopeful.  I feel like I am more on purpose.  Even though many things are changing all around me, there are things I am supposed to be doing.  I want to get them done.

I am very excited about what the future can bring. 

I was not actually planning that this post would be this way.  There is lots going on, especially with recent changes in recommendations for gynecological health care exams.  Cancer changes you and everyone around you.

I can write about all that another day.  Mom would want that, she was an activist at heart.

Today my dad called.  I spoke with my sister.  I received cards from my aunt and dad.  I have a special gift from my sister later today.  I am going to be talking with my aunt and brother today. 

Woweeeeeeee!

I am thrilled to be here to do all of this! I need nothing material.  I just want to give love and be loved.

The little video of the bees was taped at my mom's home.  She had beautiful lavendar bushes. They attracted the most amazingly large and puffy black and white bees.

Mom, until I see you again.....

Thank you God for this day today. 

Love to all.

Denise

Wednesday, June 18, 2014

The Eyes Have It

I was riding on top of the double decker bus, the night sky was void of stars and moon.  I had been standing on my seat when the driver took a sharp turn. I was jolted back into my seat just as a bright flash shot like lightening across the sky.  

When we pulled into the camp we were met with women and children running and screaming.  Something had crashed into the stadium fields just down the road.

I was escorted off the bus to the main lodge where I took my post as hostess.  

During this dream I am asked to decorate the main lounge with a stuffed Christmas Tree.  Wierd. I see my mom's father and he is assigned to find out what has crashed in the stadium.  He smiles gently, gives me a hug, grabs my hand then slowly fades into the background. I love you Grandpa!

Next I find myself kneeling next to another very dear relative who has been brought inside for cover.  She is out of breath, restless but somewhat elated.  I am nervous because I do not know what to do.   One of the workers assures me that I am the right person to help because she trusts me.

I am terrified because she has two irises in each eye.  She says she can see me clearly.  She repeats over and over, "I stopped the medication and everything is clear now".  She just smiles and smiles, looking wondrous and happy.

Her eyes haunt me right now.  I want to know what that means...... two irises in each eye.  

Then I wake up.  It is just after noon.  I am supposed to get my Avastin at 1:00 pm.  Late again.  Thankfully they will take me later on.   I have had the worst time with being so deep in sleep/nightmares, not able to wake up.

:-)

So to lighten the mood I am sharing a video from my friend Joe Hendricks.  He is an expert hiker. He brings us to a peaceful place apart from daily troubles.

I encourage you to visit his You Tube site.  Joe lost his sweet Heidi to breast cancer.  He is a true inspiration for me.  Thank you Joe for bringing joy.

I am home from a treatment, relaxing here with my kit kat Marilyn. Counting my blessings and praying for those in harms way.

VIDEO LINK: A Hike With Joe

http://youtu.be/cLcMeYEo6Ek

Peace and Blessings to all

Denise
aka #servivorgirl

Friday, June 13, 2014

More Research for BRCA Mutation Carriers



The latest research released by Penn Medicine further supports that much consideration needs to be done when contemplating risk reducing surgery to prevent ovarian cancer.  This information is geared towards women who have a mutation of BRCA1 or BRCA2. All women can benefit from these studies.

I am linking this article along with another article involving the relationship between the fallopian tube and ovarian cancer as well. The two articles provide an interesting perspective on how preventative surgery may be managed.  There is strong hope that removing only the fallopian tubes instead of ovaries AND fallopian tubes may be adequate protection from ovarian cancer.

In my personal opinion, had I known about my BRCA1 mutation at a younger age, and if we had this research available at that time, I may have considered just removing just my fallopian tubes in order to reduce the risk of ovarian cancer.  The premature removal of our ovaries causes dramatic changes and if we can help to avert ovarian cancer with fewer negative side effects, more women would agree to undergo risk reducing surgery.

It is exciting to see that researchers are discovering more options to help prevent ovarian cancer.

Here is a link to a proof of concept study at MD Anderson on using salpingectomy with delayed oophorectomy:





http://clinicaltrials.gov/ct2/show/NCT01907789

If you are positive for one of the mutations, and have not had risk reducing surgery, please review these articles. They are meaty, but worth your time.

Thank you to my cousin for sending me this very important information from Penn Medicine!

http://www.uphs.upenn.edu/news/News_Releases/2014/05/rrso/

http://www.ajog.org/article/S0002-9378(13)00382-7/pdf

Peace and Blessings!

Denise
aka #servivorgirl

http://clinicaltrials.gov/ct2/show/NCT01907789

Wednesday, June 11, 2014

Survey Respondents Needed

Detailed Ovarian Cancer survey respondents needed!

Please help those who help.  The Ovarian Cancer National Alliance, in conjunction with Ovarian Cancer Australia and the Australia New Zealand Gynecological Oncology Group (ANZGOG), are asking women who were diagnosed with ovarian cancer at least six months ago, and received treatment, to complete a confidential survey about concerns they faced post-treatment.

This is important in order to assist in developing better treatments and interventions in the future.

The following survey should take approximately 20-30 minutes and asks about the treatment you received and the impact it had on your quality of life. All answers are confidential.

https://www.surveys.unsw.edu.au/f/158683/1409/


Thank you for your time and contribution.

PS....  I am coming up on my 5 year survival date on July 29, 2014.  I am so grateful, so humbled.

My Avastin treatment continues to chip away at my remaining tumors.   My rheumatoid arthritis is out of control, but that will hopefully get remedied soon.  Sleep ..... sleep....sleep.  Ha!

Enjoying the light and love from family and friends.  Thanking God for each new day.

Peace and blessings,

Denise Archuleta
aka  #servivorgirl