Mammograms to remain prime water-cooler topic
The medical world has been abuzz in recent months about the U.S. Preventive Services Task Force's surprising new mammography guidelines, which Time magazine ranked the No. 1 medical breakthrough of 2009. Updated this past November, they now recommend that women begin getting routine mammograms at age 50 rather than 40 and get them every two years rather than annually. The guidelines also discourage teaching breast self-exams as a cancer-screening method because of the false positives and unnecessary biopsies they trigger. In younger women, the mammograms themselves can also produce a false positive, the task force noted.
The controversy has died down a bit now, but it's likely to continue in 2010, predicts Asheville M.D. John L. Wilson Jr. — especially since much of the recent outcry has come from women, not their physicians. "It tells you that despite agencies' issuing sweeping health-care guidelines, health-care consumers ultimately determine their own policy," notes Wilson, adding, "I applaud savvy consumers who can find their own way amid confounding advice."
Enter breast thermography. Although the technology isn't new, it could see increased popularity this year. Like mammography, thermography is a diagnostic procedure that captures an image of the breast. Unlike mammography, no radiation or compression of the breasts is involved. Instead, thermography relies on the fact that cancer cells generate more heat than the surrounding, normal tissue; sensitive infrared cameras can detect that heat. The procedure is available locally at the Great Smokies Medical Center and Asheville Integrative Medicine, among other facilities.
Acknowledging that all of the FDA-approved imaging methods used to screen for breast cancer have merit, Wilson also continues to encourage breast self-exams, noting that each year, many women are in fact able detect their own breast cancer. Women, he concludes, should consult with their doctors one-on-one this year to discuss their options.
Cold lasers also stay hot
Alice Hardin of Hardin Chiropractic, who's also a licensed massage therapist, reads several trade publications and consults with other local chiropractors to stay current. "When someone has a new toy," she notes, "they're quick to let other area practitioners know."
Hardin is particularly enthusiastic about cold lasers. Although they're not brand-new, practitioners are now using them more and seeing increased success with them, she reports. Cold lasers, it's believed, can break down scar tissue and speed up healing time — for example, to help patients who've recently undergone surgery. Hardin doesn't have the device yet, but she cites several Asheville area chiropractors who do, including Sheila Bochicchio, David Graham and Stephen Snider.
In her own practice, Hardin puts her massage training to work, loosening up a patient's muscles before making any adjustments. She's not aware of other local care providers incorporating massage into a chiropractic session, but she suspects the idea may start to catch on soon.
People continue to postpone needed therapy
Times were tough last year, and they remain so for many folks today. As a result, people are waiting longer to seek mental-health treatment, says licensed professional counselor Lynn Wadsworth. But this means that when they finally do seek treatment, they're often in a more severe crisis than they would have been if they'd been seen earlier.
This trend applies to clients of both state-run programs and private practices, Wadsworth observes. "More patients are presenting at the hospital for mental-health treatment, because they're receiving fewer services on an outpatient basis due to the state's financial constraints," she says. "In private treatment programs, we're seeing families waiting longer to make the decision for treatment and/or choosing shorter lengths of stay."
Local psychiatrists, psychologists and counselors are trying to rise to the challenge, however. "Many mental-health practitioners are attempting to provide more services during a shorter length of stay and to condense some of the interventions when appropriate," notes Wadsworth, who has a private practice and also works with the Phoenix Outdoor program for teens. And while she understands the financial strain many Ashevilleans are feeling, Wadsworth encourages people to "seek help before you are at the crisis stage, if possible," because preventive treatment is often more successful. Many local care providers, she emphasizes, have a sliding fee scale and will work with clients to make treatment affordable.
Asheville resident Maggie Cramer is a freelance writer and editor.