Wellness

The women's wellness exam promotes health and early detection of disease. It also gives you an opportunity to learn about healthy habits and ways to take care of yourself throughout your lifetime.

The annual wellness exam is conducted on a different day than your annual OB/GYN exam because insurance does not cover both exams in one day.

The exam consists of a health history with a pelvic and breast exam. Dr. Firouzbakht may ask you about your menstrual cycles, pregnancy history, contraceptive use, family history, and medical problems.

During the breast exam, Dr. Firouzbakht will evaluate the skin of the breast for any discolorations or dimpling. The breast tissue will also be touched in its entirety to evaluate for any lumps or masses under the skin.

The external genitalia (vulva) and internal organs (cervix, uterus, and ovaries) are evaluated in the pelvic exam. Dr. Firouzbakht will look at the outer areas and then insert a speculum into the vagina to see the cervix. A Pap smear may be taken, by scraping the surface of the cervix with a small brush. Samples of discharge may also be collected to check for STDs or vaginal infections. After the speculum is removed, Dr. Firouzbakht will insert two fingers into the vagina and press on your abdomen with the other hand. In this way, the size and shape of your uterus and ovaries can be evaluated to see if you have any growths or masses.

You will have the opportunity to ask Dr. Firouzbakht questions about all aspects of your health. It is a good idea to write down your questions before you come to the exam so you are sure to get all the information you need.

One of the most important aspects of the annual wellness exam with Dr. Firouzbakht is the screening for cancers of the female reproductive tract. Many of these diseases can be cured if detected early. You should call our office if you have abdominal pain, changes in your menstrual cycles, or bleeding after menopause.

Cervical cancer affects 12,000 women per year in the US, resulting in 4,000 deaths per year. Cervical cancer is the only cancer that is known to be caused by a virus, HPV. Cervical cancer and precancerous cells can be detected on a Pap smear. Therefore, women aged 21-65 should get Pap smears and HPV screening at regular intervals. In its early stages, there are no symptoms of cervical cancer. As it advances, it can be associated with irregular vaginal bleeding, bleeding after sex, or a foul vaginal discharge.

Uterine, or endometrial cancer, is the most common female reproductive cancer, affecting 50,000 women per year with about 8,000 deaths per year. While the cause of uterine cancer is unknown, it is linked to an overabundance of estrogen which causes the lining of the uterus to thicken abnormally. Risk factors include obesity, high-fat diets, and polycystic ovarian syndrome. Uterine cancer often causes vaginal bleeding after menopause or bleeding throughout the menstrual cycle. While there is no screening test for this type of cancer, an endometrial biopsy can be done when suspicious symptoms arise.

Ovarian cancer is the least common female cancer, affecting 22,000 women per year, but is responsible for the most cancer deaths, about 15,000 per year. It usually occurs in women over 50. Symptoms such as nausea, bloating, and abdominal pain, often arise only once the cancer is advanced. The best screening test for ovarian cancer is the annual pelvic exam. Blood tests, such as CA-125, and vaginal ultrasounds have not been proven to decrease ovarian cancer deaths.

Dr. Firouzbakht stresses regular exercise as an important factor in maintaining physical fitness. The benefits of regular exercise are many:

• Stress relief
• Better sleep
• Energy boosts
• Decreased risk of diabetes and high blood pressure
• Weight loss
• Improved bone density

There are various types of exercise:
Aerobic exercise increases cardiovascular endurance. It can be performed with light, moderate, or high intensity.

During light intensity exercise, such as walking or doing household chores, you can easily carry a conversation.

With moderate intensity exercise, such as walking briskly, riding a bike or playing tennis, you can talk but won't be able to sing.

High intensity exercise includes jogging, running, swimming laps, or playing basketball. During this form of exercise, you are unable to say more than a few words without catching your breath.

Anaerobic exercise increases muscle strength by training of the major muscle groups like legs, back, abdomen, chest and arms. Anaerobic exercise includes lifting weights, heavy gardening, doing exercise that uses your body's weight for resistance (sit-ups, pushups), or yoga.

The current recommendations for exercise in adults are:

• 2.5 hours of moderate intensity aerobic exercise per week plus Anaerobic exercise on two days per week OR...
• 1.25 hours of high intensity aerobic exercise per week plus Anaerobic exercise on two days per week

You should talk to Dr. Firouzbakht before starting any new exercise program regimen, especially if you have any health problems. Find activities that are convenient for you and above all, have some fun!

Food is fuel. A healthy diet is essential in maintaining your weight and giving you energy. Good nutrition isn't complicated. It starts with a well-balanced diet of fruits and vegetables, lean protein, whole grains, and healthy fats. Here are some tips for good nutrition:

• Consume 1700-2300 calories per day.
• Eat breakfast to increase your metabolism early in the day.
• Choose complex carbohydrates which are rich in fiber and fuel, such as fruits and vegetables, beans, whole grain brown rice, and quinoa.
• Avoid simple carbohydrates which provide only short term energy, such as white rice and flour and sugary foods.
• Have small snacks during the day to maintain your blood sugar and combat cravings.
• Choose unsaturated fats that are essential for brain function such as those in olive oil, avocados, fish, and nuts.
• Boost your calcium intake to 500-1000mg/day by enjoying milk, cheese and green vegetables to ensure good bone health.
• Combat the fatigue and weakness of iron deficiency by consuming lean beef, chicken, dark green vegetables, or fortified grains.
• Drink enough water so that your urine is mostly colorless. How much you need per day depends on your activity level and weight.
• Consume at least 400 mcg of folic acid every day during the childbearing years. Folic acid found in green vegetables, citrus fruit, and beans, decreases the risk of birth defects should you get pregnant.

Dr. Firouzbakht and her family have had Juice Plus+ in their diets for many years, and she recommend Juice Plus+ to all her patients to help bridge the nutritional gaps in their diets.

Everyone knows it's good to eat more fruits and vegetables, but people have found countless ways to ignore that advice. "I don't have time." "It's too much trouble." Medical science reminds us almost every day that good nutrition and good health go hand in hand, especially when it comes to the healthful benefits of eating fruits and vegetables. Unfortunately, despite the growing medical evidence, less than 2% of American adults eat the recommended daily servings of fruits and vegetables.

There is no substitute for eating a wide variety of fruits and vegetables, at least 7-13 servings every day. But if you're like most people, you don't eat enough fruits or vegetables or enough variety. And those fruits and vegetables that we do eat tend to be over processed, over-cooked, or too far removed from the field. That's why there's Juice Plus+. It's a convenient, affordable, and natural whole food based nutritional product providing nutrition from 17 vegetables, fruits, and grains.

Juice Plus+ is not a vitamin supplement, providing a limited number of handpicked nutrients. Juice Plus+ is a whole food based product providing the wide array of nutrients found in a variety of fruits, vegetables, and grains. It's the next best thing to fruits and vegetables...because we don't get nearly enough of the real thing every day.

To learn more, visit www.drf.juiceplus.com

Click here to order

Losing weight and keeping it off can lessen the many health risks that come with obesity, including heart disease, diabetes, high blood pressure, and a shorter life. We know that achieving and maintaining a healthy weight can be a struggle, and we know that it takes more than a proper diet to succeed—it takes a major lifestyle change.

At Dr. Firouzbakht's office, our focus is on helping you achieve your weight-loss goals and regain the confidence and vitality that comes with feeling healthy and in control. We want you to succeed so we searched for medically-supervised approaches to weight loss that gives you the personal support you need. Along with these approaches, we offer three FDA-approved prescription weight-loss medications:

ADIPEX-P® - an appetite suppressant used with physician-approved exercise, behavior change, and reduced-calorie diet program to help you lose weight.

CONTRAVE® - a prescription medicine that contains 2 medicines (naltrexone HCl and bupropion HCI) that may help some adults with a body mass index (BMI) of 30 kg/m or greater (obese), or adults with a BMI of 27 kg/m or greater (overweight) with at least one weight-related medical problem such as high blood pressure, high cholesterol, or type 2 diabetes, lose weight and keep the weight off.

BELVIQ® a weight-loss medication that, when used with diet and exercise, can help some overweight (Body Mass Index [BMI] ≥27 kg/m²) adults with a weight-related medical problem, or obese (BMI ≥30 kg/m²) adults, lose weight and keep it off.

If you conclude that losing weight would help you make the most of your life, please call our office so we can get you started on the path to success

Health screenings evaluate our ever changing bodies and fitness. As we age, certain diseases become more common. Screening tests can detect diseases that do not have any symptoms until they are advanced. For example, diabetes and high blood pressure are often silent until they have caused organ damage. Early detection of a disease can change its course or cure it before any long-term issues have set in.

Current guidelines for women's health screenings:

Ages 20-30

• Self breast exam monthly
• Cholesterol screening every 5 years
• Blood pressure every 1-2 years beginning at age 25
• STD screening for sexually active women yearly
• Pap test every 2-3 years

Ages 30-40

• Self breast exam monthly
• Physician breast exam yearly
• Cholesterol screening every 5 years
• Blood pressure yearly
• Pap test every 2-3 years or Pap plus HPV every 5 years

Ages 40-50

• Self breast exam monthly
• Physician breast exam yearly
• Mammogram every 1-2 years
• Cholesterol screening every 3 years beginning at age 45
• Blood pressure yearly
• Pap test every 2-3 years or Pap plus HPV every 5 years

Ages 50+

• Self breast exam monthly
• Physician breast exam yearly
• Mammogram yearly
• Cholesterol screening every 5years
• Diabetes screening every 3 years
• Blood pressure yearly
• Colonoscopy every 10 years or Fecal Occult Blood screening yearly
• Bone density testing after menopause with risk factors or after age 65 without risk factors
• Pap test every 2-3 years or Pap plus HPV every 5 years (may stop at age 65)

Dr. Firouzbakht may determine you need to have these screenings done at different intervals or different ages depending on your family history, medical problems, or test results.

Vaccinations help promote immunity to common illnesses. Most vaccines are administered during childhood. However some are recommended for adults as well.

• HPV – series of three vaccines for ages 11-26
• TDAP (diphtheria/tetanus/pertussis) – booster every 10 years
• Influenza – annually

Our office recommends pregnant moms in their third trimester be vaccinated against whooping cough, including family members who will be around the infant.