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The Covid-19 pandemic and technological advancement in healthcare delivery have introduced telemedicine in prenatal care. It might seem that telemedicine is here to stay and in a few years, will become a major approach in delivering health care to pregnant women.
With telemedicine, expecting mothers receive consistent and necessary care via videoconferencing, at-home monitoring, and consultation with remote specialists. These were said to improve health outcomes while allowing for less frequent antenatal visits.
However, certain challenges may affect the use and outcome of telemedicine to provide care to patients. Below are perceived barriers to telemedicine in prenatal care.
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Several factors affect the use and health outcomes of telemedicine. Patients and healthcare providers alike play a significant role in the provision and delivery. However, other non-human factors exist which may affect the successful outcome of virtual visits and at-home monitoring.
The following are perceived barriers to telemedicine in prenatal care:
Poor internet connection and slow speed result in loss of connection, poor audio and video quality, hence affecting the smooth interaction between patients and providers. Due to poor signal, online consultations can experience multiple interruptions leading to frustration, low patient satisfaction, and reduced use of the virtual approach to healthcare delivery.
In some cases, factors such as weather conditions, living in rural areas, and home interior can affect the network service in homes and workplaces, hence reducing the frequency, duration, and efficiency of virtual visits for healthcare delivery.
Lack of technological knowledge and skills is a challenge to the use and success of telemedicine in prenatal care. Unfamiliarity with communication technology is common to both patients and providers.
Healthcare providers who have little to no knowledge on how to use communication technology may not want to take up online consultations.
Likewise, patients may find it difficult to install and navigate the telemedicine software on their digital devices. In other cases, patients lack knowledge and training on how to use certain monitoring devices. Hence, they may find it difficult or impossible to interact and provide adequate information during online consultations.
The lack of certain equipment and instruments poses a challenge to the success of telemedicine in prenatal care. Some patients may not have certain instruments such as a fetoscope, weighing scale, sphygmomanometer, amongst others, resulting in non-availability of data to work with.
Consequently, this can lead to poor monitoring which may affect health outcomes of prenatal care via telemedicine.
While patients may enjoy convenience at home, they may be faced with discussing health concerns at the risk of being heard by family members and friends.
In-person visits provide the privacy of the doctor's office which may not be possible with audio and video calls from the homes of patients. This may affect the use of telemedicine in providing and accessing prenatal care.
In other cases, the patient may feel their conversations are being recorded and hence, lose trust in both the service and the healthcare provider.
Telemedicine switches up the order of the conventional hospital visit. The presence of family members, children, colleagues, and other persons may make engagement difficult. Activities in the background may cause distraction during virtual visits.
On the other hand, certain patients may feel disconnected due to a lack of social presence and physical contact with their healthcare provider. The online interaction may be alien to some patients and affect their ability to bond with their healthcare provider.
Nonverbal communication is as effective as verbal communication and in some cases, more. Virtual visits limit communication with body language and facial expressions. Healthcare providers can read these cues during in-person visits and act accordingly.
While telemedicine might be said to save cost, it does not come cheap. Patients may lack the financial ability to buy smartphones, airtime and data, and instruments and equipment.
Unfortunately, patients may not have insurance, or their insurance companies may not cover telemedicine healthcare services.
Healthcare providers are not left out as they also need airtime and data to call and interact with patients.
Telemedicine is a novel approach to access and delivery of prenatal care. Like the conventional in-person approach of care, it has its pros and cons.
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At My Virtual Physician, our team is committed to ensuring that patients get the best of health care as needed. We provide virtual care at any point in your pregnancy while you await your appointment with your local OB doctor. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare, and Blue Cross.
When most women think about period products, they think of pads and tampons. Pads and tampons have been the go-to supplies for menstrual care for as long as we can remember.
If you’ve been to the period aisle lately, things are looking a little different these days. There are so many more products on the period aisle shelves than just pads, tampons, and pantyliners. One relatively new item that you may have noticed is the menstrual cup. Not sure what that is? No worries, we will explain:
A menstrual cup is a small, flexible, re-usable cup used to collect menstrual blood during your cycle. The cup nestles comfortably inside the vagina similar to a tampon and can be emptied, rinsed, and re-inserted as often as necessary.
Today, menstrual cups are usually made out of silicone; they have also been made from rubber or latex in the past. Although many women have never heard of the menstrual cup, it has been around for a long time (menstrual cups were patented in 1937). The fact that they are still around today shows that they have been a proven method of menstrual management throughout history.
The recent rebound that menstrual cups have made since the year 2000 can be attributed to the use of medical-grade silicone which is a softer, more flexible and comfortable material than what was previously used.
Menstrual cups come in a variety of options. There are multiple sizes and shapes available, different levels of rigidity/softness, and different price points. The price of a menstrual cup is generally in the range of $20-$40 depending on the brand.
The up-front cost of a menstrual cup may seem off-putting. However, most menstrual cups claim to last up to 10 years before needing to be replaced. If you calculate the cost savings of not having to buy period supplies (tampons and pads), there is a significant cost savings each month. With a menstrual cup, it’s a once in 10-year expense that equals as little as one quarter per menstrual cycle.
You can also feel great about keeping tampons and pads out of sewers and landfills. All that is needed for a menstrual cup is a little bit of silicone every 10 years or so.
Another reason women may choose a menstrual cup for their cycle is that sometimes the cotton and other chemicals in tampons and pads can be drying and irritating. Silicone menstrual cups are considered hypoallergenic because they are made of medical-grade silicone with no additional scents or chemicals.
One last perk that a menstrual cup can provide is that some women find they have to go to the restroom for changing out period care items less often. Some menstrual cups claim that you can go up to 8-12 hours depending on your flow as well as the brand and size. The smaller menstrual cups tend to have 2-3 tampon capacity and the medium cups may have a 3-4 tampon capacity.
One thing is for sure when using a menstrual cup instead of other period products; you will learn a lot about your menstrual cycle! Menstrual cups can be a useful tool for both patients and their gynecologists. If you are experiencing irregular periods, your Virtual OBGYN may suggest that you use a menstrual cup in order to observe more information about your period, including a measurable blood volume, consistency, and patterns in blood flow.
If your current period product practice isn’t working for you, bring it up during your next online gynecologist appointment. Your doctor can help you select the right period care to fit your needs.
Now you know what a menstrual cup is and why a gal might choose to use one. Is a menstrual cup something you would ever try or are you already using one? Share your thoughts or experiences about menstrual cups on our Facebook page or e-mail us!
Have you ever wondered what the anatomy of a 15-minute online OBGYN Las Vegas appointment looks like?
Traditionally, when going to see your doctor and treating a condition, most of us are used to going through a sometimes painstaking process. That process includes scheduling an appointment, taking time off work, remembering to go to your appointment, and then driving to a clinic where you’ll spend hours getting treated.
Things have shifted when it comes to your doctor visit. According to the CDC, there was a week in 2020 with a 154% increase in telehealth visits when compared to the previous year. This means more people are trying out telemedicine.
Seeing your OBGYN Las Vegas doctor online is a new experience for most women. That’s why we have written this blog post to let you know what to expect during a typical visit, from scheduling the appointment to picking up your medications at the pharmacy.
My Virtual Physician has a team of experienced board-certified doctors who have been providing virtual doctor appointments to patients for over a year now so we have settled into a system that is very comfortable for both the physicians and our patients. Here, we will explain our simple telehealth process.
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Sometimes seeing a doctor just can’t wait the weeks or months that most brick and mortar offices require. That’s why My Virtual Physician is here; we want you to have access to your OBGYN Las Vegas physician when you need it. We can get you scheduled within 24 hours, if not sooner!
Before you schedule your appointment, the first step is to verify that your symptoms can be addressed through an online virtual appointment. Click here to see a list of conditions that we can easily diagnose and treat online at this time.
Here are a handful of qualifying medical conditions we can treat online:
So you’ve confirmed that your symptoms can be diagnosed and treated using our telehealth OBGYN services. Congratulations, you are ready to schedule your first appointment with your online OBGYN! Here’s what to do:
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Everything is confirmed and you show up virtually at the scheduled date and time to meet with your online OBGYN Las Vegas doctor, what does that look like?
First, you’ll get signed into our secure portal with your mobile phone or computer (with mic and camera). Instructions on how to access the portal are provided before your appointment.
Unlike a traditional doctor’s appointment, you won’t wait hours in the lobby until your doctor is finally available to see you! Our doctors are ready for you at your scheduled time, every time.
The next part of your visit will look a lot like a typical doctor's appointment. Your OBGYN virtual physician will chat with you about your concerns and/or symptoms to get a better understanding and to make a diagnosis and provide treatment options.
There may even be a physical self-exam. You could be led by your doctor through movements or exercises to gather more information. For example, during a UTI appointment, patients may be asked to tap on different parts of their body to determine the stage and location of the infection.
The last part of a typical online OBGYN doctor appointment is where the doctor provides treatment options based on his or her observations. If the best treatment is medication, our online doctors can send prescription orders directly to your local pharmacy for pickup or delivery.
So yes, it’s really that easy! In about the time it took you to read this blog post, you could have your OBGYN appointment done and over with and be on your way to feeling better now. Once you’ve tried telemedicine once, you’ll see how convenient it is.
In fact, a recent study found that the satisfaction rate of telehealth services was as high as 99%!
Will telemedicine be your new go-to method when you need your doctor? Book an appointment now with our OBGYN Las Vegas physicians to find out!
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Many women enjoy the feel of soft-shaven skin. But the red, itchy patches that come after can be a real pain. Razor bumps in sensitive areas like the bikini line are annoying. So how can men and women deal with razor bumps down there?
Razor bumps, technically called pseudofolliculitis barbae, are a common skin complaint. Fortunately, they are preventable to some degree. By protecting skin before, during, and after hair removal, men and women can minimize the effects of razor bumps.
If you're wondering how to save your skin, check out these tips to steer clear of painful razor bumps.
Razor bumps are an uncomfortable sign of skin irritation. For those who already have them, the first step is to keep them from getting worse.
A compress made with salt water can also help soothe the skin. Saltwater cleans and heals the skin by osmosis. To make a "saline soak" at home:
Consider adding a couple of drops of an essential oil, like tea tree oil, to the saline solution for more relief.
When bumps don't go away or become more painful, it may be best to see a doctor.
A physician can tell if the problem is razor bumps or may be something else. Some doctors use antibiotic gels, steroids, or retinoids to treat severe cases.
They say an ounce of prevention is worth a pound of cure. When it comes to razor bumps, it's very true.
Here's how you can lower your risk of getting razor bumps from shaving.
Find more tips on how to prevent razor bumps here.
Taking care of skin before, during, and after hair removal can go a long way in preventing razor bumps.
If you've tried to treat pseudofolliculitis barbae yourself but find the situation getting worse, it may be time to check with a doctor.
Are you looking for a doctor near you to treat your sensitive issues? My Virtual Physician has board-certified physicians who can address gynecological and primary care problems via video visits.
If you would like to talk with a board-certified doctor, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
Women looking for a great Obstetrics and Gynecology provider (OB/GYN) in Las Vegas, Nevada, may have trouble. There is an OB/GYN physician shortage in Las Vegas. And the situation is getting worse.
Factors such as physician burnout, population growth, and competition from other parts of the country have created a shortage of OB/GYNs in Las Vegas, Nevada. As a result, some may have difficulty finding the perfect provider to care for their reproductive health.
Women and their partners want an OB/GYN they can trust. Issues like birth control, childbirth, and menopause are delicate matters. Unfortunately, a shortage means there are not enough providers to meet Las Vegas’ needs. Thus, those doctors who are available may be overworked or stretched thin.
Here is why it’s hard to find a good OB/GYN in Las Vegas and what to do about it.
When there are too few doctors to meet a city's demands, it can be hard to find a provider to respond to each patient’s needs. According to NBC News, America is facing an OB/GYN shortage.
Las Vegas, overall, has the most severe OB/GYN workforce shortage.
Other parts of Nevada face an even more serious situation. Some counties lack even one OB/GYN provider. Hence, patients face delays in care. In some cases they are forced to look far away to find a doctor.
Here’s why it is hard to find OB/GYN care in Las Vegas.
And while Las Vegas OB/GYNs may have it rough, the patients suffer too.
OB/GYNs offer services that women need. They provide health counseling, sexually transmitted infection (STI) testing, and more. From puberty to menopause, women need a health expert they can trust. Many patients depend on OB/GYN advice.
Fortunately, Las Vegas residents can now find the best OB/GYNs, right in their neighborhood.
My Virtual Physician has an answer for the physician shortage crisis. Two of the best board-certified OB/GYNs in the nation are on staff and available for appointments near you in Las Vegas.
My Virtual Physician offers OB/GYN visits in Las Vegas with flexible scheduling through telemedicine. While most providers are busy and feel the pressure to treat many patients quickly, My Virtual Physician is different. Online video visits eliminate travel time and the feel of a busy waiting room. Virtual consultations provide a relaxed, personalized, and patient-centered care experience.
During the pandemic, many patients have had questions about staying safe. Some want to know if vaccination is right for them. Women in Las Vegas can now book a visit with My Virtual Physician to discuss their concerns and get real medical advice. Booking an appointment with an OB/GYN in Las Vegas has never been easier.
Are you looking for an OBGYN near you in Las Vegas? My Virtual Physician has two board-certified physicians licensed in Nevada who can address gynecological problems via video visits.
If you would like to talk with a board-certified OB/GYN, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
This past year tested many young businesses. Telemedicine is not new. But the My Virtual Physician (MVP) business model is. The virtual doctor practice offers the best in online doctor services as a direct-to-consumer multi-specialty provider licensed in multiple states. Regardless of 2020's challenges, the MVP virtual doctor team didn't slow down. They focused on their path to becoming the #1 online doctor and forged ahead.
Over the last 12 months, MVP worked hard to bring high-quality medical care into homes in 15 states. They now offer online pediatric, gynecologic, and primary healthcare services for patients of all ages. Plus, they provide same-day scheduling for online physician appointments, some in-network insurance benefits, and five-star customer service.
As the #1 online healthcare provider, MVP doctors get to know their patients. Quality care is emphasized, and they aim to provide the best patient satisfaction in telemedicine. Here’s what patients are saying about MVP's online doctors:
“I would give My Virtual Physician more stars if I could”
“Dr. Howard has the best personality and is very friendly.”
“The future of medical visits; what better way to social distance.”
“A+ would recommend to everyone.”
Since their launch, MVP has opened new offices and added service lines such as nutrition and diabetic care. The practice has partnered with more online doctors and added office staff. Just this Spring, MVP enhanced their patient portal for self-scheduling, and integrated a program to trend patient reviews.
This one year anniversary milestone is cause for celebration. It is exciting, and this is only the beginning. Despite any challenges that lie ahead for this medical practice, their progress shows that the future is very bright for My Virtual Physician.
Congratulations to Dr. Howard, Dr. Masghati, Dr. Ayyagari, and all of the My Virtual Physician Staff.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
Welcome to Talk Tuesday. We are continuing our weekly educational series, talking with our expert physicians, exploring some common healthcare concerns, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon who is one of our telemedicine providers. We are talking about a complaint our doctors commonly see or treat, and that is URINARY TRACT INFECTIONS or UTIs.
Dr. Masghati, thank you for joining us today.
Stefanie:
So let’s cut to the chase Dr. Masghati, can cranberries cure a UTI?
Dr. Salome Masghati:
Many people believe that cranberries or cranberry juice can treat a UTI, and the answer is it's complicated.
There have been many studies on cranberries as a UTI treatment, and research has shown that an active ingredient in cranberries called “proanthocyanidins,” or PCAs for short, is effective in preventing E. Coli bacteria, the most common cause of UTI infections, from attaching to the bladder wall lining and colonizing or creating an infection.
So PCAs or cranberries may help prevent a urinary tract infection but once there is already an infection, that treatment may not be effective.
A cup of cranberry juice may only contain a small amount of this active ingredient with a lot of sugar! Cranberry tablets or pills may be another option for prevention.
Stefanie:
So if someone wants to try cranberry juice for prevention of a UTI, how much should you drink?
Dr. Masghati:
A recent article in Pharmacy Today recommends at least 36 mg of PAC daily.
For the prevention of UTIs, 300–500 mL of cranberry juice cocktail (26% cranberry juice) daily and 400–800 mg cranberry extract twice daily.
Or 36–72 mg of cranberry PAC equivalents per day, found in about 360–720 mg of cranberry extract, has been shown to be effective.2
The research shows some evidence that cranberry products may reduce the incidence of UTIs but the most effective amount and concentration of PACs that must be consumed and how long they should be taken are unknown.
Stefanie:
So cranberry juice and cranberry extract tablets together may help prevent infections but what about someone who already has a UTI?
Dr. Masghati:
Truly if someone has an infection, either their body will be able to fight off the infection, or they may need an antibiotic medication to kill the bacteria that is causing the infection.
Stefanie:
That’s interesting, so you say in some cases a UTI can go away on its own because the body is able to fight off the infection?
Dr. Masghati:
Yes, in some cases. Approximately 25-42% of the time these uncomplicated UTIs may resolve without any medical treatment.
Stefanie:
Ok, so when would it be time for someone to see a doctor about their UTI?
Dr. Masghati:
Untreated infections can spread and become serious. You should talk to your doctor as soon as you suspect a UTI.
Also for signs such as fever, chills, flank pain, or abdominal pain with nausea or vomiting. These can be signs of a serious infection.
Stefanie:
For someone who is going to make an appointment but has not yet, is there anything that they can do to manage the UTI?
Dr. Masghati:
There are some things you can do for relief, or even after you have seen your doctor while you are waiting for an antibiotic to work.
It is important to stay hydrated, drinking plenty of water flushes out the bladder.
When going to the bathroom it is important to try to empty the bladder completely. Some adults with UTI have a frequent urge to urinate or sensation of pressure in the low abdomen which can make it feel as though you need to urinate. Going to the bathroom frequently to empty the bladder can help.
If there is pain in the low abdomen a heating pad may provide some relief.
Over the counter pain relievers such as Motrin or Tylenol can also be taken to help with discomfort.
Stefanie:
Dr. Masghati you have shared some great information today. I appreciate you joining us for Talk Tuesday and helping us understand more about UTIs and cranberry juice. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to connect with one of our board certified OB/GYNs, or for more information you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
Starting a family is a goal for many couples. Unfortunately, one in ten couples may have some difficulty getting pregnant and require medical treatment. If you've been affected, you might be wondering about infertility: when is it time to see a doctor? My Virtual Physician has board certified physicians who specialize in infertility and are available for virtual doctor visits.
Infertility is a diagnosable medical condition in which a couple cannot conceive a pregnancy despite unprotected intercourse. It can be caused by many factors.
In women, most often, abnormal ovulation causes infertility. In men, usually problems with sperm cells, such as sperm count or function, cause difficulty conceiving.
Aside from these physiological causes, factors affecting a couple's fertility include their age, health status, and lifestyle factors such as stress, diet, or smoking.
According to the American College of Obstetricians and Gynecologists, women who are overweight, underweight, or exercise too much may have difficulty getting pregnant, and men who are heavy drinkers or smoke marijuana since these are known to lower sperm count and movement.
In some cases, doctors cannot determine the cause and refer to these cases as unexplained infertility.
Generally, it is time to consult your physician about getting pregnant if you are under the age of 35 and have been unable to conceive after one year of unprotected sex. Women over the age of 35 and those who have irregular menstrual cycles or have known abnormalities with their reproductive system, should talk with their doctor much sooner, after six months.
Infertility affects both people in the relationship. There is a 30% chance the infertility is related to male factors in a traditional couple, 30% related to female factors, and a 30% chance a combination of both factors. Therefore, anyone in the relationship may need to discuss options for starting a family. Here are some reasons to see a virtual doctor:
When you consult your physician about infertility, you can expect that they will begin your care with a complete history and physical exam. They may order blood testing, urinalysis, hormone tests, or other diagnostics to check for abnormalities. It may be necessary to have your partner undergo an exam and diagnostic testing also. Your physician may order an ultrasound or an X-ray as well.
After all of the tests, you will meet with your physician to discuss the results and go over treatment options and recommendations. After you decide on the treatment plan that is best for you, you will receive support and guidance in your process to get pregnant.
Medical treatment and new technologies can increase your chances of getting pregnant. One or both partners in a couple may undergo treatment.
Medications may be taken by mouth or injected. There are drug therapies for both men and women aimed at increasing egg production or sperm count. A list of medicines frequently prescribed for infertility treatment can be found here.
In some cases, blockages, scar tissue, or abnormal growths require surgical intervention. Procedures may be laparoscopic: meaning performed through small incisions in the abdomen for a minimally-invasive procedure.
Today, the two most common infertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI is a procedure during which a physician injects sperm into the uterus at the ovulation time. This method is least invasive and most cost-effective but has lower success rates. The estimated success rate is 10-20% for a single cycle of IUI, but additional rounds increase chances, and in three to six cycles, the success rate is up to 80%.
IVF is a complicated procedure requiring surgical retrieval of a woman's eggs, fertilization in a laboratory, and then transferring the fertilized eggs back into the uterus. Women under the age of 35 can expect a 50% success rate for IVF treatment, but this process requires intense testing and monitoring and can cost $20,000 to $50,000.
Starting a family can be challenging, and your physician may offer options to guide you through the process. Infertility is a medical condition that affects many couples, and there are treatments available.
Need to talk to a physician now? My Virtual Physician has Board-Certified OB/GYN's that are available for virtual doctor appointments and are able to answer any questions you have and guide you in the right direction. The online doctors at My Virtual Physician, not only address infertility and reproductive endocrinology, but also irregular periods and painful periods, and many more gynecological conditions.
If you still have questions or you would like to discuss your problem with our board-certified OB/GYN specialists, click below to schedule an appointment. My Virtual Physician treats conditions, including infertility, irregular periods, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
Speaker 1:
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own health care professional about all topics address on Talk Tuesdays or for any other medical problem.
Speaker 1:
Welcome, everyone. Thank you for joining us today. My name is Stephanie and I'm part of the team here at My Virtual Physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It is Talk Tuesday and we are continuing our weekly educational series to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer screening and breast cancer surgery. So thank you for joining us today. Thanks for having me. Yeah. And welcome
Speaker 2:
Back October was breast cancer awareness month. So we're going to be doing
Speaker 1:
Again a blog and an episode or two of Talk Tuesday on breast cancer screening. When would someone go in to get a mammogram or if they feel something or they have any history of breast cancer in their family, what's kind of the age range,
Speaker 2:
What to look for. Okay. So there's actually three organizations, probably more, but there's at least three organizations that have opinions on breast cancer screening, depending on which organization you listen to, it could be 40 years old, 45 years old or 50 years old, either way. Everyone agrees that by the age of 50, you should be getting a screening mammogram, most people, uh, and I believe most insurance companies go with the age of 40 breast cancer. Under the age of 40 is pretty rare. If, if you have
Speaker 1:
Breast cancer under the age of 40, usually it's associated
Speaker 2:
With some sort of genetic predisposition. There's the BRC mutation that predispose people to, to breast cancer at a younger age. But there's some other things that can, can run in families. Some other genetic diseases that predispose you at a younger age and typically cancer at a younger age is more aggressive and more advanced when it's found, because who in their thirties thinks that they're going to have breast cancer. So what we learned in residency was at the age of 40, you started getting your screening mammograms, and that's just, you have no symptoms. You have nothing going on. You're 40 years old. It's time to get a mammogram. Just like when you turn 50, you got to get a colonoscopy. It's just a way of life. Some people will come in. Well, I feel a mass I'm worried. And this also kind of depends on your age.
Speaker 2:
If you're younger, the chances of you having a mass that's breast cancer is pretty low. You, you may have these little hard nodules called fibroadenomas. They're pretty common in younger people and they grow and shrink in size with your menstrual cycle. And that's something that people usually will point out like, Oh, I noticed this, I know I was on my period last week and now I don't really feel it so much. And so that's, that's pretty common and we can actually do ultrasounds in clinic. I mean, not everyone, but if you're, if the clinic has an ultrasound, we can do an ultrasound because sometimes it's just breast cyst that can feel like a lump and they can hurt. And if it is a cyst, they can drain it in the office and, and hopefully give you some relief. So when you turn 40, get a mammogram, if you feel something that's concerning, you would need to go into your doctor, talk to them about getting an ultrasound or a mammogram.
Speaker 2:
And again, depending on your age, it may dictate what screening that they do. If you have a family history of breast cancer, then that would be something to coordinate with your doctor to get a screening done earlier. They usually recommend doing screening before 40, uh, it may be an MRI and mammogram alternating every six months starting at the age of 25 30. It just kind of depends on when your family member had breast cancer and what genetic mutation it is that you have. So I've had my screening mammogram and I got called back in for more images, do I have cancer? So not necessarily, this is something we actually deal with quite a lot. It really kind of depends on your age and your breast tissue density. It can be really hard to evaluate the breast tissue on a screening mammogram. If you have really dense breast tissue, there's actually, uh, States that have a requirement when they report on your mammogram, that they disclose to you that there are certain regions, depending on the density of your breasts, that they may not be able to see.
Speaker 2:
So they have to give you that information because then if you end up having breast cancer, but you've, you've had a screening mammogram, you know, why wasn't it caught well, and it, it can just really depend on the density of your arrests. So sometimes you'll get a call that you need to come back in and it's for a more formal or what we call a diagnostic mammogram. The difference in that is with a screening mammogram, you kind of just, you go into a facility, they do the mammogram and you go home. And in a couple of days, they either call you with the results or you go into your doctor's office and they give you the results, a diagnostic mammogram, you go into a facility, but the radiologist is, is physically there. And when they do the mammogram, they try and focus on that area that was questionable in your screening mammogram.
Speaker 2:
And so the radiologist can actually look at it in real-time and determine, okay, well, we need a different view here, or we need to zoom in here and take a better look at that so that you don't get called back in for even more. This is, I'm a little bit better idea of, of what they're looking at. And if it, if it is something that looks suspicious for cancer or not, some patients may actually end up needing an ultrasound to go with their mammogram or an MRI. It's all pretty personalized. So it all just depends on what your breast tissue looks like and what, what exactly it is, that's going on, what was seen, or if you're having symptoms and things like that. So it could just be that you have dense breast tissue, and it does not look abnormal when they do the more focused imaging, or could be something that, that is concerning for breast cancer. But being called back does not mean that you have cancer. You could, but they just need to get better pictures. Yeah.
Speaker 1:
Since so, after I got called in my mammogram showed an area concerning for breast cancer and I need a biopsy. Can you explain what that is?
Speaker 2:
Yeah. So when you need a biopsy, it doesn't necessarily mean that it's cancer again. So, so don't panic, but chances are, they saw something that are concerning and suspicious for cancer, and chances are it is, but I need a tissue sample to say for sure what it is. There's different types of breast cancer, there's DCIS, which maybe you've heard of, or there's invasive cancers by doing the biopsy. It gives you a little sample of tissue to be able to determine what type of cancer it is, what hormone receptors it has if it has any. And, and that helps you tailor your treatment, not only for surgery, but if you need chemo or other things, or even additional surgery, when you meet a bias, it can be done a couple of ways, the most common way, or at least the way that I'm used to it being done from when I was in residency is if you have a mask that can be felt if you came in because you had an that you found and you get a mammogram and they, they say, we need to biopsy.
Speaker 2:
If they can see it, then you can get a biopsy done with an ultrasound and you don't have to go through a mammogram again. If you can't see it on an ultrasound, then you got to get a mammogram again. So not, not super fun for everybody when they do it with under a mammogram, it's done by a radiologist typically, and it's called a stereotactic biopsy. So essentially you lay down on this table and you lay face down and there's, there's a little opening in the table. And the breast with the concerning area goes through this little hole in the table and kind of hangs blue so that the arm on this machine can get in the right position and orientation to access the delusion that the arm on the mammogram machine has a needle on it. And once the area is targeted, the needle goes in, they take a sample of the breast tissue that comes out, but there's also a clip that gets placed in the area that they biopsied.
Speaker 2:
So that on later imaging, you can say, okay, well, we already biopsy this area and everything was normal. Or this is where they had a biopsy before we don't see anything different. Or, you know, now there's something there that, that wasn't there before. And we need to re-investigate it. Sometimes you can't do the stereotactic biopsy and that's for reasons, you know, maybe you can't lay flat, maybe it's too uncomfortable, or you can't breathe. There are weight limitations. And depending on your age, I mean, it may just not be something that you're very capable of laying there because it's not, it's not a five-minute procedure. I mean, it's a 20-minute procedure or so. And it depends on where the lesion is. If it's really close to your chest wall, like the muscles underneath your breasts, they don't usually do the stereotactic biopsy. They can still do a biopsy under a mammogram. It's just done a little bit differently. This is all kind of targeted and oriented and one process. Whereas if they have to do it with, without the stereotactic part, it's done a little bit differently. Now there are some stereotactic biopsy machines where you can actually sit up. I don't know how many places have those. Like I don't, I'm not real familiar with how prevalent they are, but they do exist. So that maybe something that they could do.
Speaker 1:
Thank you so much, Dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's a pretty scary word. I appreciate you joining us for Talk Tuesdays and telling us what we need to know about breast cancer screening for everyone else. This has been Talk Tuesdays with My Virtual Physician. You can schedule a consultation with one of our doctors by visiting our website: www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week.
Speaker 1 :
Information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics addressed on Talk Tuesdays or for any other medical things.
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