When the answer is ‘it depends’

When it comes to questions about health and healthcare, sometimes the answers are perfectly clear. What should I do if I’m having severe chest pain? Call 911 immediately. Is smoking really harmful to my health? Absolutely. Do my kids need vaccines? Yes, for their own safety and for good public health in general. Should I take antibiotics when I get a cold caused by a virus? No; antibiotics are for treating bacterial infections, which are different from viruses. Do flu shots cause the flu? Unequivocally, the answer to that one is no.

But there are many questions patients have about taking care of themselves to which the answer is, “it depends.” Cortez family physician Kameo Smith, DO, said there is a great deal of health information floating around today that is inaccurate, incomplete, or that requires a doctor’s interpretation based on a patient’s individual situation. Here are several common questions of interest.

When should women get mammograms? It depends. “The guidelines are for women to get their first screening mammogram at age 40, then every 1 to 2 years until they’re 50, and then annually until they’re about 70,” said Smith. One exception is for women who have a strong family history of breast cancer (a mother, sister, or daughter diagnosed with breast cancer, especially at a young age). In this case, a woman’s doctor might recommend that regular mammograms begin long before age 40. “After the age of 70, whether or not to continue annual mammograms depends on a woman’s overall heath,” said Smith. If a women is active, in good health, and wants to continue being screened, she should ask her doctor to refer her for mammograms.

When should women get PAP smears? It depends. “It’s now recommended that women don’t need their first PAP smear until age 21, or until they’ve been sexually active for two years, whichever comes first,” said Smith. After that, most women need a PAP about every 2 to 3 years until they’re 65. Exceptions are for women who have multiple sexual partners, carry the human papilloma virus, or who smoke. In these cases, an annual PAP is still recommended. “After age 65, you don’t need to have a PAP smear anymore,” said Smith. Not needing an annual PAP smear does not mean, however, that you shouldn’t see your doctor for a physical exam each year. “The PAP is only to screen for cervical cancer,” said Smith. It’s important to have a full gynecological examination annually, even on years when a PAP is not indicated.

Is red wine really good for cardiovascular health? It depends. “Some studies have shown that one glass of red wine a day may offer some heart health benefits,” said Smith. But there are several exceptions to this popular notion. Patients who have liver problems or who take medications that may be hard on the liver (even acetaminophen) should not drink alcohol. The same holds true for patients taking any medication that might make them drowsy, such as pain pills or sedatives. Smith said moderation is the key. “More than one glass and you start getting into some of the downsides, such as consuming empty calories and the intoxicating effect of alcohol,” said Smith. And, remember, one glass of wine means 4 to 5 ounces, not a 12-ounce tumbler full.

Does cutting out carbohydrates help with weight loss? It depends. “Weight loss is a math equation,” said Smith. “When people cut out things like breads and sweets, they often lose weight, but it’s because foods that are high in carbohydrates also tend to be high in calories.” Losing weight requires using up more calories than you take in. One pound of weight equals 3,500 calories. If you burn 500 more calories than you take in each day, over the course of a week you’ll lose one pound (500 x 7 = 3,500). It’s that simple. While it’s much better to eat foods that are high in nutrition while trying to lose weight, all foods are equal when it comes to counting calories. Smith recommends www.myfitnesspal.com, a free website that helps patients track calories consumed and calories burned on a daily basis.

Are dietary supplements necessary? It depends. “In general, I believe that people in this country spend way too much money on supplements,” said Smith. Some individuals need certain supplements for specific conditions, and taking a daily multi-vitamin probably won’t do you any harm, but most people do not need to be swallowing handfuls of vitamins, supplements, and herbal remedies every day. Smith said she’s especially concerned about seniors who are often on fixed incomes being vulnerable to false claims about supplements made by vendors that are not regulated and can say anything they please. “They can claim that taking their pills will make you a millionaire,” said Smith. “I suggest that people spend their money on higher quality, more nutritious foods. If you eat sensibly, you’ll get what you need from your diet.” Of course, there are exceptions, and Smith suggests that patients speak with their healthcare providers about what, if any, supplements they might need.

Is it safe to have labor induced? It depends. “I get asked by my pregnant patients all the time if we can induce labor so they can have their babies at a convenient time,” said Smith. Because brain development continues in unborn babies right up until the time of birth, inducing labor before the 39th week of pregnancy is not considered safe, unless either the mom or the baby has a health problem that makes an early delivery necessary. “A normal pregnancy lasts 40 weeks. If a women goes 10-14 days beyond that point, we will consider medically helping her start labor. But before that, it’s best to let the baby arrive on its own schedule,” said Smith.

With so much health information available today via the internet, television, radio, and magazines, it’s sometimes hard to sort out truth from fiction. Being a smart consumer of healthcare requires getting information from reliable sources, having a primary care provider who you trust and see regularly, and being just a wee bit skeptical when you hear health claims that sound too good to be true.

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.

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