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It's Officially Flu Season

Posted on Friday, January 23, 2015, by Ashley Snyder

by Dr. Kathryne Buege

Happy New Year!

As we enter 2015, it is, naturally, the time for some life-changing decisions, fresh starts, reflection and preparation for the year ahead.  Of course, we all have our resolutions and make plans to make some changes or improvements in our lives.  I find this time of year to be a time of reflection for me, as I found myself thinking about how fortunate I was to be able to spend time with family out of state this holiday season.

Having returned to Buffalo and to work, my colleagues and I have been reminiscing about how 2014 "flu" by.  Yes, the year did seem to fly by very quickly, but more importantly the flu was especially prevalent this year.  We are faces with a staggering amount of cases of influenza in the area.  Here is a brief update on the virus, what you need to do to prevent it, and - most importantly - how to recognize the symptoms and treat them.

A few highlights of this year's flu:

  • We have seen almost three times as many cases of the flu as compared to last year
  • Hospitals have started to limit visitors
  • The general consensus: it will get worse before it gets better
  • All ages have been affected
  • Mostly seeing Influenza A
  • Emergency rooms are very busy due to the increase in flu-related complications and staff shortages due to respiratory illness

So how do you prevent the flu?  Get a flu vaccine! This is the most important preventative measure.

But how do you know if you have the flu?  The most common symptoms include:

  • Fever, but not every flu patient will have a fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Headache
  • Chills
  • Fatigue
  • Sometimes diarrhea and vomiting

What should you do if you get sick?

  • Contact your health care provider
  • Most people have mild illness and do not need medical care or antiviral drugs
  • Stay home!  
    • Rest and drink plenty of water and other clear fluids to prevent dehydration
    • Make a "sick room," if you can to isolate illness and prevent others from getting sick
    • Treat fever and cough with medications you can buy over the counter, but ask your pharmacist for advice, if needed.
  • Avoid contact with other people
  • Wear a face mask if you have one and need to leave home to seek medical care
  • Remember, most people have mild illness and the Center for Disease Control recommends staying home at least 24 hours after your fever is gone, excluding seeking medical care or other necessities.

People at high risk of developing flu-related complications:

  • Children younger than 5, especially those under the age of 2
  • Adults 65 years of age or older
  • Asthma patients
  • Blood disorder patients (i.e. sickle cell anemia)
  • Patients with kidney or endocrine disorders (i.e. diabetes)
  • Those with heart disease
  • Those with chronic lung disease
  • Patients with neurological or neurodevelopmental conditions
  • Anyone whose immune system has been weakened, either by disease or medication.  This can include, patients undergoing cancer or immunosuppressive therapy, chronic steroid users, or those with HIV or AIDS.

What are some signs that I should seek immediate medical attention?

In children, look for:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
    • Significantly fewer wet diapers
    • No tears when crying
  • Fever with rash
  • Excessive irritability and not wanting to be held
  • Not waking up or interacting

In adults, some signs are:

  • Difficulty breathing or shortness of breath
  • Confusion and dizziness
  • Severe or persistent vomiting
  • Pain or persistent vomiting
  • Return of flu-like symptoms with worsening cough or fever

When in doubt, contact your health care provider immediately.  If they are not available, get to your nearest emergency room or MASH Urgent Care.  MASH is open every day from 8:30 am to 9:00 - even on holidays.  And remember - get your flu vaccine!  It's not too late, and most health care facilities and pharmacies still have them available.  Have a safe and healthy start to the new year!

Addressing the Ebola Epidemic

Posted on Tuesday, November 04, 2014, by Ashley Snyder

by Dr. Kathryne Buege

This month's blog post is dedicated to facts and information related to the Ebola virus.  Having just traveled by airplane to visit an ill family member, I noticed people wearing masks at the terminal and on the plane.  It made me think, is that necessary?  How should I protect myself when traveling or at work? Since I was going to a hospital, luckily I was prepared with plenty of hand sanitizer, disinfectant wipes and Lysol spray.  The man in the aisle next to me even asked me why I was wiping down the tray, armrests and seat belt.  I was being extra careful since I was traveling to visit someone in the ICU, but let me tell you, I could not wait to get off the plane and out of that airport terminal. Then, upon returning home, the news about the nurse who tested positive for Ebola who traveled from Cleveland to Dallas hit.  So, I did some research and here are a few facts to be aware of.

What exactly is Ebola (Ebola hemorrhagic fever)?

It is a virus that causes these early symptoms:

  • fever
  • headache
  • diarrhea
  • vomiting
  • stomach pain
  • muscle pain
  • unexplained bruising or bleeding

How is the Ebola virus transmitted?

  • DIRECT contact with:
    • Body fluids of a person who is sick with or has died from Ebola.  This includes blood, vomit, urine, stool, sweat, semen, saliva and other fluids.
    • Objects contaminated with the virus, such as needles or medical equipment
    • Infected animals, by contact with blood, fluids or infected meat
  • the virus is NOT transmitted through the air or water or, in general, by food.

What are the risks for exposure?

  • Needle stick or mucous membrane contact with blood or body fluids from Ebola patient
  • Direct skin contact with or exposure to blood or body fluids from Ebola patient
  • Fever of Ebola symptoms in a patient with recent travel to a country with wide-spread Ebola
  • Processing blood or body fluids from an Ebola patient without appropriate personal protective equipment or bio-safety precautions
  • Direct contact with a dead body (including during funeral rites) in a country with wide-spread Ebola

When can the disease be spread to others?

  • Ebola only spreads when people are sick.  A patient must have symptoms to spread the disease to others.
  • After 21 days, if an exposed person does not develop symptoms, they will not become sick with Ebola.
  • Once someone recovers from Ebola, they can no longer spread the virus.  Abstinence from sex is recommended for at least 3 months because the virus has been isolated in semen for up to 3 months post-recovery.

How is the Ebola virus treated?

  • There is NO FDA-approved vaccine or medicine (i.e. anti-viral drug) available for Ebola
  • Basic interventions, such as providing IV fluids and electrolytes help to maintain patients' blood pressure and oxygen status
  •  Experimental vaccines and treatments for Ebola are currently in development.
  • People who recover from the Ebola infection develop antibodies that can last at least 10 years or possibly longer.

When traveling, the following precautions are recommended:

  • Don't touch your face!  The Ebola virus makes its way into your body in two ways: through breaks in the skin and through your eyes, nose and mouth.
  • Stock up on hand sanitizer
  • Wash your hands often
  • Notify your flight attendant if you suspect a passenger is ill
  • Wipe down trays, armrests and seat belts with disinfectant wipes.

With influenza season just around the corner, it will become crucial for health care providers to differentiate between the two illnesses.  Medical care facilities in the area have developed phone triage and front line triage protocols to follow in order to screen for Ebola.  If you have any questions, contact your health care provider or MASH Urgent Care for recommendations and guidance.  Other great resources are the NYS Department of Health and the Centers for Disease Control and Prevention.

Fallin' For Autumn

Posted on Tuesday, September 30, 2014, by Ashley Snyder

By Dr. Kathryne Buege

What makes fall so spectacular?  The kids are back in school (woo-hoo!), football season has started, the leaves are changing colors, stylish-boot-and-sweater weather has arrived, Halloween festivities are beginning - all adding up to make this my favorite time of the year.

Although there is plenty of clean-up and preparation for winter that will keep us occupied, here are just a few helpful hints to keep in mind before you jump into that pile of leaves.  With school sports in full gear, the inevitable slip and fall may be headed your way.

The most common injuries seen by primary care physicians, urgent care centers and emergency rooms are ankle injuries.

What Is An Ankle Sprain?

An ankle is sprained when an injury occurs that causes tears the ligaments of the ankle.  This type of injury is very common, but can vary in type, location and severity.

  • Lateral Ankle Sprain - The most common type of sprain occurs when the foot rolls inward, or is inverted, pushing the ankle outward and causing damage to the lateral ligament complex on the outside of the ankle.
  • Medial Ankle Sprain - The medial deltoid ligament complex is the strongest of the ankle ligaments and is seldom injured.  Most forced eversion injuries, where the foot rolls out and forces the ankle inward, result in chip, or avulsion, fractures of the medial malleolus (ankle bone) because of the strength of the deltoid ligament complex.
  • High Ankle Sprain - Dorsioflexion, where the foot is pointed upward, with eversion may cause a high ankle sprain.  This type of sprain can lead to chronic ankle instability, which may lead to recurrent ankle sprains down the road.

When examining a sprained ankle, medical practitioners grade the sprain on a scale of I to III, based on certain clinical signs and functional loss.

  • Grade I: mild stretching with microscopic tears.  No joint instability occurs and most patients are able to bear weight and are, therefore, not typically seen in a doctor's office.
  • Grade II: a partial tear of the ligament.  This is a more severe sprain where patients experience moderate pain, swelling and bruising and weight bearing is painful.
  • Grade III: a complete tear of the ligament.  Patients have severe pain, swelling and bruising, and are unable to bear weight or ambulate.

When Should You Seek Medical Care?

  • If the patient is unable to walk or bear weight
  • If there is an obvious deformity, swelling or bruising
  • Some patients complain of immediate nausea and may hear a "crack" at the time of the injury, which can indicate a fracture.
  • ANYTIME THERE IS A CONCERN!  A clinical evaluation and history will direct treatment care and determine the necessity of an x-ray or any further imaging.

Most medical practitioners utilize the Ottawa Ankle Rules when determining the need for x-ray imaging.  These guidelines require the provider to:

  • Assess for bony pain/tenderness at the ankle and foot
  • Onserve the patient's ability to bear weight
  • Note any special circumstances.  This can include patients with diminished sensation, such as diabetics with neuropathy and anyone who may have had a little too much fun at Oktoberfest!

How Are Ankle Sprains Treated?

Injuries can be treated immediately using the RICE method: Rest, Ice, Compression, Elevation.

  • Rest - limit weight-bearing and use crutches if you are unable to walk
  • Ice - or as we call it, cryotherapy.  Ice or cold water immersion is recommended for 15-20 minutes, every 2-3 hours for the first 48 hours until swelling subsides.
  • Compression - use an elastic bandage, such as ACE, to minimize swelling.  This type of bandage is preferred over tape, which can cause skin irritation.  During functional rehabilitation, patients with instability should use lace-up or semi-rigid ankle supports.
  • Elevation - elevate the leg to heart-level to further alleviate the swelling

In addition to this method, NSAID pain relievers like Aleve (Naprosyn), Motrin or Advil (Ibuprofen) can be used to help alleviate pain.  Once acute pain and swelling subside, exercises should be performed as early as possible to fast-track the healing process and maintain the ankle's range of motion.

And remember: if there are any concerns or questions about an ankle or foot injury, seek medical help with your primary physician, MASH Urgent Care or the local ER.  Enjoy the fall weather while it lasts, and GO BILLS!

The Itching Games, Part 2: "Catching Ivy"

Posted on Wednesday, August 27, 2014, by Ashley Snyder

by Dr. Kathryne Buege

Well, the odds were not in you favor and you have been thrown back into the ring. This time, the plants of the Anacardiaceae family have your name and number. They are prepared for this match and guarantee an exciting conclusion to the “Itching Games.”

With what are we dealing? In the United States, the most important members of this family are those of the genus Toxicodendron (“poisonous tree”). Common or northern poison ivy, western poison ivy, eastern poison oak, western poison oak, and poison sumac comprise this genus.

How do we identify the plant?

“Leaves of three, let them be” is a helpful reminder in helping identify these types of plants. Poison ivy and poison oak are often identified by three leaflets with flowering branches arising from axillary positions on a single stem. The leaves may be green or green-reddish and are smooth, fine-toothed, or lobed margins. They have small, yellow green flowers and cream colored fruit, which look like berries and are most often seen in the fall.

In contrast, poison sumac more often forms leaflets of five, seven or more that angle upward toward the top of the stem.

One may also find characteristic black dots on all of these plants; this black lacquer is oxidized urushiol found on the plant leaves within 10 minutes of exposure to oxygen. Many people are sensitive to urushiol, the allergic component. It is a sticky oil, and causes the rash by contact.

  • You can get the rash from touching or brushing against any part of these plants and then contacting the skin.  This can include clothing, sporting gear, gardening tools or even pet fur – 
    YES, pet fur. My mother had poison ivy dermatitis on her abdomen, and it was not from wearing a bikini in the woods (sorry mom)…her fluffy white dog Mimi was the culprit!
  • The rash is only spread through the oil. You CANNOT catch a rash from someone else by touching them or their blister fluid.
  • The rash is an allergic reaction to the oil. You become allergic to it through contact and your immune system may start to react to the oil as though it’s a harmful substance.
  • Symptoms of poison ivy dermatitis in sensitized individuals generally develop within 4-96 hours after exposure and peak between 1 and 14 days after exposure.

How do I get a rash in places I did not contact the plant/urushiol?

  • Lesions may present at different locations at different times after exposure based upon the amount of urushiol present and thickness of the skin involved. This can give the impression that the poison ivy is spreading from one region to another. Blister fluid is not antigenic (contagious). Also, new lesions can present up to 21 days after exposure in previously unexposed individuals.
  • Rebound dermatitis (recurrence of rash) may occur if too short a course of steroid is used, for instance, a six-day course in a Medrol dose pack. Basically, your body has cells that react and activate an immune response, leading to a rebound rash when steroids are stopped.

Presentation

Intense itching and redness are the most common presenting signs of poison ivy dermatitis. Patients may develop blisters or papules, arranged in linear or streak-like configurations where the oil has contacted the skin.

  • Involvement of the face and genitals may cause significant edema (swelling) and discomfort.
    • Runners, campers, and outdoor-enthusiasts: beware of what you come in contact with if nature calls unexpectedly.
  • The rash may take more than a week to show up the first time you have a reaction to the oil. If develops sooner with later contacts after your initial exposure. You will only get a rash where the oil touched your skin, but as I mentioned earlier, there are a few exceptions.

What to do? Treatment and Prevention

The most important and effective treatment for poison ivy dermatitis is identification and avoidance of toxic plants and related allergens.

  • Protective clothing is useful, but patients should be reminded that clothing, pets and fingernails can harbor the allergic resin for many days. The oil can seep through clothing and can penetrate rubber or latex gloves, but not heavy-duty vinyl gloves.
  • Burning poison ivy is not recommended. The oil is stable at high temperatures and the plant particles dispersed in smoke are allergenic and irritant.
  • After a known exposure, patients should remove any contaminated clothing and gently wash skin with mild soap and water ASAP. Vigorous scrubbing is not useful and can exacerbate the impending dermatitis.
  • Chemical in-activators to prevent poison ivy (Tecnu) and oil removing compounds (Goop) are helpful, but expensive. Most healthcare providers suggest washing with an inexpensive mild detergent.
  • Barrier creams are controversial. Most studies suggest Ivy Block, an organoclay compound, is useful for preventing poison ivy. It must be reapplied every four hours and leaves a clay residue on skin.
  • DO NOT USE: Antihistamines applied to skin (topical – cream, spray or gel), topical anesthetics (benzocaine/Lanacane), or topical antibiotics that contain Neosporin/neomycin.
    • These may cause an allergy problem of their own in certain patients.
    • Mild rashes may be treated with calamine lotion, oatmeal baths, and cool, wet compresses.
      • Weeping lesions may be treated with topical astringents such as Burow’s solution or Domeboro used under occlusion to help dry the lesions.
      • A soap misture of Zanfel may benefit.
      • Corticosteroid pills, injections or creams may be prescribed for more severe reactions/rashes.
        • An oral dose of prednisone should be tapered over 14-21 days, but is reserved for more extensive cases of poison ivy dermatitis.
        • Sedating antihistamines (Benadryl and sometimes Zyrtec) are used to help people with severe itching to sleep. However, the itching in poison ivy is not caused by histamine release and there is little to no evidence to support their use.

The most important advice is to prevent exposure. Learn to identify these plants. Use protective clothing and use heavy-duty vinyl gloves. Wash with a mild detergent soap ASAP after exposure. For more severe or persistent rashes, seek medical attention with your primary care provider or MASH Urgent Care. Having said this, hopefully your name won’t get picked for the “Itching Games,” but if it is – you will be prepared for battle. Enjoy the rest of your summer, Buffalo.

How to Tame a Tick

Posted on Tuesday, June 17, 2014, by Ashley Snyder

By Dr. Kathryne Buege

As I mentioned in an earlier blog post, I live in Erie, PA.  We have had an increased incidence of Lyme disease in recent years, and this past spring we have had twice as many ticks reported to the Erie County Department of Health.  Why?  Despite a cold spring, the ticks are hungry and looking to feed.  Yes - the ticks are on a feeding frenzy.  You and your pets are the targets, and I have written this in order to help protect you and provide some insight into the symptoms of Lyme disease.

What should you do?

  • First, protect yourself when you go outdoors.  Wear long pants and tuck them into your socks.  (Not the most fashion forward, but worth the embarrassment compared to contracting Lyme disease!)
  • Use bug spray that contains at least 20% deet.
  • Do a thorough check for ticks when you return home.
  • Take a shower immediately after walking trails or doing yard work. You should also wash and dry your clothes right away, as the the dryer is what kills any ticks.

If you have a tick, how do you remove it?

  • Use fine, flat tweezers and grip the tick as close to the skin as possible.
  • Pull backwards gently but firmly, using an even, steady pressure.   Do not jerk or twist.
  • Do not squeeze, crush or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
  • After removing the tick, wash the skin and hands thoroughly with soap and water.
  • If any parts of the tick's mouth remain in the skin, these should be left alone - they will be expelled on their own.  Attempts to remove these parts may result in significant skin trauma.
  • DO NOT use a smoldering match, nail polish, petroleum jelly (e.g. Vaseline), liquid soap, or any other folk remedies, as they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids deeper into the wound.

What are a tick's characteristics?

It is helpful when a patient can provide information about the size of the tick, whether it was actually attached to the skin, if it was engorged (full of blood) and how long it was attached.

  • Deer ticks are brown and approximately the size of a poppy seed or pencil point.  They may transmit Lyme disease
  • Dog ticks are brown with a white collar and are about the size of a pencil eraser.  These ticks DO NOT transmit Lyme disease.
  • Lone star ticks aren't exclusive to Texas, as its name might imply.  This type of tick is brown to black in color with a white spot on its back.  They may be transmitters of STARI (southern tick-associated rash illness), which causes a rash similar to Lyme disease, but has no other similarities.

Only ticks that are attached and have finished feeding or are near the end of their meal can transmit Lyme disease.  A tick that is not attached, easy to remove or just walking on the skin, and still flat, tiny, and not full of blood when removed could not have transmitted Lyme disease or any other infection, since it has not yet taken a blood meal.

When treatment is needed:

  • If the attached tick is identified as a deer tick
  • If the tick is estimated to have been attached for 36+ hours, based on how engorged the tick is and the amount of outdoor exposure

Treatment involves antibiotics, often administered within 72 hours of tick removal.

What are the symptoms of Lyme disease?

  • In the days and weeks after a tick bite, you may experience:
    • a red rash that may develop and expand, however some infected people may not develop a rash. This rash may be uniform in its coloring and is usually salmon in color, but can be an intense red. The rash tends to expand over the span of a few days or weeks, and can reach over 8 inches in diameter.  As the rash expands, the center can become clear with concentric rings appearing around it, giving it a "bulls eye" appearance.
    • flu-like symptoms, such as fatigue, chills, fever, stiff neck, body and head aches
    • swollen lymph nodes
    • additional rashes on the body
    • swollen and painful joints
    • neurological disorders, such as numbness or leg weakness
    • loss of muscle tone in the face
    • heart palpitations
    • dizziness
  • If a small bump or redness at the bite site goes away in 1-2 days, it most likely is not Lyme disease. 
  • Confirmed cases of Lyme disease are treated within 3-6 weeks with antibiotics, which may be given intravenously in more serious cases.

Don't get "ticked" off if you can't remove a tick or are unsure what to do.  When in doubt, seek medical attention immediately at your local MASH Urgent Care or your primary care physician.  Enjoy the outdoors this summer!




Is This The Worst Winter Ever?

Posted on Tuesday, February 11, 2014, by Ashley Snyder

By Dr. Kathryne Buege

Watching the news the other night, I heard Diane Sawyer exclaim, "Is this the worst winter ever?"  One storm after another, extreme weather, "polar vortex," icy conditions, schools shut down because of below-freezing conditions.  Thanks to Punxsutawney Phil, it looks like we have 6 more weeks to endure.  Ugh!

For me, living in Erie, PA and commuting to Buffalo has been a challenge these past few months.  Here are a few of my highlights:

  • Driving through blizzard conditions on the Thruway
  • Sliding into a ditch on my way to work
  • Buying snow tires
  • Driving through blizzard conditions on the Thruway (again)
  • Shoveling my driveway and porch in snow up to my knees
  • Straining my back, neck and shoulder
  • Driving through blizzard conditions on the Thruway...and being the last car to make it through before they shut it down.  That was pleasant.
  • Survived Polar Vortex in Olean and was the only MASH Urgent Care location open
  • Although my mother taught me never to curse or use foul language ("it means you are not smart enough to better express your thoughts of feelings" in her Southern twang), I've found myself silently "venting" as I drive clutching the wheel white-knuckled to and from work

Having said that, I thought I'd share some survival tips and remind you click our link on Facebook, "How to Survive the Freezing Cold."

First, I travel with these items:

  • rock salt and a shovel
  • blankets or a comforter
  • water and non-perishable food
  • a flashlight and batteries
  • hand and feet warmers (they even make MEGA warmers claiming instant heat for 12 hours)
  • ibuprofen
  • two guardian angel magnets for safe travels (given to me by a neighbor who was a UPS driver and had his share of driving through awful weather)
  • change of clothes, extra boots and a jacket

Yes, I've been told my packed minivan resembles The Beverly Hillbillies at times, but I'd rather be prepared than not.

My hands have poor circulation due to Reynaud's Disease, and my fingers instantly freeze in the cold weather or in response to stress.  First, they turn white and are numb, then become red and painful as the circulation returns.  Because of this, I worry about damage from the cold from frostnip or frostbite.  

What is the difference between frostnip and frostbite?

  • Frostbite is likely to happen in body parts farthest from the heart and areas exposed to the cold.  This involves tissue destruction and the initial stages are called frostnip.
  • Frostnip does not involve tissue destruction.  It is the superficial cooling of the tissues, most likely occurring, again, in exposed areas.
  • Chillblains are superficial ulcers of the skin that occur when an area is repeatedly exposed to the cold.

The treatment?  Do NOT rub, massage, shake or otherwise apply physical force or cause excessive movement in the frostbitten regions.  This can cause ice crystals that have formed in tissue to do further damage and can be HARMFUL. 

What to do?  Splint or wrap frostbitten extremities and decrease movement.  Passive rewarming involves using body heat or ambient temperature to aid the person's body in rewarming itself.  this includes wrapping in blankets or moving to a warmer environment.

Active rewarming involves immersing the injured tissue in a water bath that is held between 40 and 42º Celsius (104-108º Fahrenheit) and requires more equipment, typically found in a hospital setting.

Stay warm Buffalo, and chin up!  Even though we have 6 more weeks of winter predicted, there are a few things to look forward to: the Olympics are here and The Walking Dead is back!

What is Your Legacy?

Posted on Monday, January 13, 2014, by The PCA Group

by Dr. Kathryne Buege

For me, this year started off with a death in my family. She referred to herself as "Favorite Aunt Nancy" -- and she was. She was also a loving wife, mother, sister and dedicated RN who bravely battled breast cancer for 2 years.

A year ago, we lost another aunt to ovarian cancer. Both aunts were in their 50s. We also have an employee within the MASH family battling cancer.

My Aunt Nancy never had a screening test for breast cancer. She was diagnosed with stage IV breast cancer after going to the hospital with dehydration and nausea. My other aunt suffered with bloating and heartburn for years. She was diagnosed with stage IV ovarian cancer after going to the hospital with fluid in her lung.

Given their struggles and accomplishments, it made me that everyone should stop now and then to consider the question:

"What is your legacy?"

While you’re thinking, I’d like to remind everyone of the importance of preventive medicine.

In January, many people commit to resolutions - spending less money, losing a few pounds, etc. Why not add these key screening exams to your list and resolve to contact your primary care physician in this New Year.

First of all, screening means checking your body for cancer before you have symptoms. The CDC supports screening for breast, cervical and colorectal (colon) cancers as recommended by the U.S. Preventive Services Task Force.

Breast Cancer
A mammogram is the best method to detect breast cancer early. A clinical breast exam and self-exam is also used for screening. If you are 50-74 years old, be sure to have a mammogram every 2 years. If you are 40-49, talk to your doctor about when to start and how often to screen.

Cervical Cancer
Cervical cancer is the easiest female cancer to prevent. Pap tests (or Pap smear) look for pre-cancers or early cell changes on the cervix that might become cervical cancer. Start your Pap tests at age 21 and get regular screenings through age 65.

Colorectal Cancer
Regular screenings should begin at age 50, using high-sensitivity fecal occult blood testing, sigmoidoscopy or colonoscopy. This should continue through age 75.

Screening for lung, ovarian, and prostate and skin cancers has NOT been shown to reduce deaths from those cancers. Therefore, more information is needed before supporting use of screening tests for these cancers.

Here is my point - be proactive and take care of yourself. Call your doctor and make sure you are up to date on your screening tests for cancer. Ignorance is not bliss. Make time for not just you, but for your family and friends!

Early diagnosis and detection is instrumental in facilitating recovery.

What is my legacy? Still working on it! But I am hopeful I have years to fine-tune it. One thing I know, I am contacting my doctor to schedule my screening exams this year.

Happy New Year, and rest in peace Aunt Nancy.