‘For a woman to take care of her family, job or anything else, she must take care of herself and keep herself going strong,’ says Dr. Carol Harter, assistant area medical director at Kaiser Permanente in Point Loma. (photo/alandeckerphoto.com)

For today’s “I can do it all” women, many doctors give this advice: Take a break. Sit back, put up your feet and sip a cup of tea or a glass of red wine. It’s because women frequently forget to find time for themselves, allowing the advent of serious health problems.

Women’s health concerns are mostly related to breast and other cancers as well as gynecological, heart, mental, menopause and lifestyle issues. But as health information becomes more voluminous, it also seems more complicated.

“Very often what we hear from members is confusion,” says Dr. Carol Harter, assistant area medical director at Kaiser Permanente medical offices in Point Loma. “Concerns about the latest newspaper article, the latest blip on the radio, the latest magazine cover totally adds to the stress and is almost counter productive. It is fascinating how our increased access to information, programs and resources on the Internet are adding to the stress because women begin to think they need to do all this stuff in order to keep their sanity and retain their health or increase their health.”

Harter remembers when exercise and eating a healthy diet used to be the only recommendations. Now, she says, there are many choices. Even how best to relax has become part of the stress. Relaxing once was essentially limited to taking a walk, a hot bath or settling in with a book. Now it can include yoga, meditation, tai chi and exotic menus. “It is so rich to experiment, Harter says. “But don’t become a crazed consumer. It is counter productive.”

Get Back To Basics

What women need to do, says Harter, is get back to basics and then experiment. Take a look at diet and sleep and schedule a medical checkup. Try new things for yourself, but be adaptable. “Whatever works this year to make you feel fabulous probably will not work in five, 10 and 15 years from now.” she says.

“You cannot take care of yourself last,” Harter adds. “For a woman to take care of her family, job or anything else, she must take care of herself and keep herself going strong. All these other people are counting on you and putting yourself first makes women feel selfish, but that’s an important message I end up giving to so many women in my office. They need to move themselves and their whole health and well-being up the ladder. That will make everything else work better.”

Healthy Heart Is Key

Heart disease still is the No. 1 cause of death for women, but breast cancer remains the main health concern of most women. UCSD Medical Center is at the forefront of Women’s Health Initiative trials and is the workplace of Dr. Elizabeth Barrett-Connor, founder and director of the Rancho Bernardo Heart and Chronic Disease Study, now in its 30th year. Barrett-Connor says women are becoming more aware of heart disease but need to know more. “I think women were misled to think heart disease is less common and would be a better, quicker death,” she says.

Dr. Ulrika Birgersdotter-Green, co-director of UCSD’s Women’s Cardiovascular Health Program, decries the perception among women that heart disease is still a man’s disease. “About 40 percent to 60 percent of women will tell you they think they are going to die of breast cancer,” she says. “Only about 7 percent say they will die from heart disease, which is the No. 1 killer.”

One in two women will die from heart disease. Trends are declining for men and increasing for women. Women present later in the disease process and are older and more difficult to treat. “But once women are diagnosed,” Birgersdotter-Green says, “their response to treatment is excellent.”

For many women, a talk with their doctor and common sense will reveal what they need to do to be healthy. However, Barrett-Connor says, we all want it in one pill. “People expect too much from medicine,” she says.

Caring For The Future

Christine Miller

The HPV vaccine is eradicating one form of cancer in younger women, says Dr. Christine Miller, residency director and associate physician in the UCSD Department of Reproductive Med-icine. It promises to improve greatly the health of future generations of women. This is the first vaccine developed to prevent cervical cancer and other diseases in females caused by certain types of genital human papillomavirus. Although only approved for females ages 9 to 26, it shows what research and testing today can do for women down the road.

Barrett-Connor says women need to get the majority of their health care and information from a single location. The new Sulpizio Family Cardiovascular Center under construction at UCSD’s Thornton Hospital in La Jolla will include 20 examination rooms and related diagnostic and treatment services. The CVC will add four cardiac catheterization labs and other procedure rooms to the facility. Its September opening will deliver 28 additional intensive and intermediate care beds, expansion of emergency room services and four cardiac-sized operating rooms.

Knowledge Is The Best Medicine

Although most women are aware of breast cancer symptoms, they do not know how to detect heart disease, says Mary Henrickson, chief executive of Sharp Mary Birch Hospital for Women. (photo/alandeckerphoto.com)

Mary Henrikson, chief executive of Sharp Mary Birch Hospital for Women, says it is important for women to learn signs and symptoms of cardiovascular disease. Sharp provides a link to women’s health information online at sharp.com/services, in addition to classes and personalized health and fitness plans.
Because they aren’t paying attention to their hearts, “more women die of heart disease than they do breast cancer,” Henrikson says.

Treating all stages of cardiovascular disease is Dr. Erminia Guarneri at the Scripps Center for Integrative Medicine and Healing Hearts Program in La Jolla. “Women have to be proactive and that means educated,” she says. “If we start to think about what women die from, we have to look at all the risk factors for cardiovascular disease.” Those include diabetes, high blood pressure, central obesity and stress.

“Doctors need to send out the message that if you have something and you catch it early, you have a much better chance to cure it, to reverse it and to fix it,” Guarneri says. “Identify high blood pressure and treat it before the stroke.”

At the Scripps center the focus is on a mind-body-emotion-spirit approach to wellness.

The first visit to the center involves an hour of going over patient history. Guarneri wants to know a patient’s work, life and genetics. Family medical history is important and leads to in-depth blood panels. A series of physical diagnostic tests follows. With all the information in hand, Guarneri goes over the risk factors with each patient and designs a program that can range from reducing stress to learning how to shop for healthy food.

Dr. Erminia Guarneri treats all stages of cardiovascular disease at the Scripps Center for Integrative Medicine and Healing Hearts Program in La Jolla. (photo/alandeckerphoto.com)

Even if a woman does everything right, from exercise to diet, doctors say genetic markers and excessive stress will still leave them predisposed to health problems. Stress affects blood pressure, sleep patterns and the immune system. As women’s stress increases, susceptibility to illness increases.

Suzanne Weeks, 41, learned about the danger of stress the hard way a year ago. She suffered a heart attack, although she was eating healthy, exercising and doing other things she thought was right for her body. “I didn’t recognize it,” Weeks says, “even though I’m qualified to teach CPR. It’s different when it’s you.”

After heart surgery, Weeks joined the Healing Hearts program. She learned yoga and other methods of stress reduction. Group support and being able to voice her feelings to people going through similar experiences were beneficial.

Weeks says she learned the most about how her body reacts to stress and the importance of handling it. She was surprised to find that just watching the news on television impacts the stress level in the body. “I thought health was what you eat, and then you have fitness, she says. “I was missing the spirit, mind, body connection.”

Her advice to others: “Figure out what baby steps you can take today to support your health. Don’t expect miracles in a day.”