by Christina Skoski, MD
No matter what age you are or at what limbs, but there is more than enough left These issues are certainly different in
stage of life you became an amputee, it is to care about and maintain in order to our teens and 20s, our childbearing and
important for all women to make a com- function at the best of your ability. Granted, motherhood years, after menopause and
mitment to their health by taking the time it may be more inconvenient, awkward and beyond. Since our bodies are constantly
to schedule regular medical examinations difficult to schedule appointments, hop up changing as we age, our health concerns
and health screenings. No matter the cause on an exam table for a GYN exam or bal- and the tests we need will also change.
for the amputation, be it trauma, cancer, ance during a mammogram, but please, do Therefore, it’s important to partner with
complications of diabetes or vascular NOT use your amputation as an excuse to your physician or healthcare professional to
disease, you should never forget that you avoid taking care of yourself. determine an appropriate health-screening
are a woman first, and an amputee second. Health is not just the absence of disease; schedule based on your individual health
Instead of concentrating on what you have it’s the cornerstone to a happy life. It’s what issues, risk factors and needs. The routine
lost, you should concentrate on taking care gives us the ability to get out and about, to tests, physical examinations and screenings
of what you have left. live and to work, to enjoy our families and for women fall into some general catego-
The three leading causes of death for friends. Women’s health risks vary depend- ries:
women in the United States are heart ing on age, family history, personal health • General health
disease, cancer and stroke. Amputation is history and habits, lifestyle, and work and • Heart health
nowhere on this list. You may be missing home environments. • Endocrine (hormonal) health, which
To support the ACA or to become a member, call 1-888/267-5669 57
would include diabetes, thyroid, the should be continued no matter what about supplementing your diet with key
reproductive organs and sexually trans- age. (The incidence of HIV infections is vitamins and minerals. Folic acid, omega-3
mitted diseases (STDs) increasing in the over-60 population that amino acids, iron and vitamin C are ben-
• Breast health does not use appropriate protection.) eficial for both you and the growing fetus.
• Bone health • Check baseline cholesterol level at age Avoid alcohol and excessive use of caffein-
• Sensory health: vision, hearing 20. ated beverages, particularly diet colas.
• Colorectal health • Check urine or blood sugar for diabetes.
• Skin and oral health • Get a tetanus-diphtheria booster (every
• Immunizations 10 years) and vaccinations for human
• Mental health papillomavirus (HPV) and meningococ-
cal disease (which is becoming a more
Basic recommended health common reason for amputations, par-
screenings for women of all ticularly in the high school- and college-
ages age population).
• Obtain a complete, general health • A monthly mole self-exam should start at Recommendations for women
examination at least every 1 to 2 years, age 20 and should be done by a doctor in their 40s
including height, weight, blood pressure every 3 years. • Annual screening mammograms should
check and Pap smear. begin at age 40.
This is the best time in your life to • Check blood pressure every 2 years.
• Be sure all your immunizations are up to
set good health habits that will prevent • Start blood glucose tests at age 45, then
date. This should include the usual child-
problems in the future. To develop strong every 3 years (if not a known diabetic).
bones and maximum bone density, which • Have a rectal exam.
• Get cholesterol, diabetes and thyroid
will protect and prevent the development • Have an eye test every 2 to 4 years and a
checks, depending on your personal or
of osteoporosis, eat a low-fat, high-calcium hearing test every 10 years.
family medical history.
diet. If necessary, use calcium supple- • Keep immunizations up to date. Get
• Obtain regular eye exams, oral health
ments. Find activities and regular weight- hepatitis A and B vaccinations and others
exams, skin checks and hearing exams,
bearing exercises that you can do. Maintain if you travel.
depending on your personal or family
a normal weight. If you smoke, quit, and
medical history. Menopause can occur any time from
consume alcohol only in moderation.
Note: All age-specific recommendations the mid- to late-40s and 50s. During this
apply to succeeding age groups as well. time of transition, the hormonal levels are
fluctuating, causing irregular periods. It
Before & After may take up to 5 years for menstrual cycles
to cease completely; this time is called the
peri-menopause. The decline in estrogen is
a major factor in the development of heart
Recommendations for women disease in women. Bone loss also acceler-
in their 30s ates during peri-menopause, which can
• Discuss with your physician when you lead to osteoporosis. Therefore, it’s impor-
Recommendations for women should receive a baseline mammogram. tant not to wait until you’ve gone through
in their teens and 20s Depending on your family history, you menopause but to assess your personal
• Pelvic exams, including Pap tests, should should also discuss how often you risks and begin treatment early.
begin at age 18 or at the onset of sexual should obtain a routine screening mam-
• Breast self-exam should begin at age 20 • Thyroid test (TSH) should start at age 35,
and continue once a month (one week then be done every 5 years.
after your period). Clinical breast exams • Have a Pap test and pelvic exam every 1
by a trained healthcare professional to 3 years.
should start at age 20 and be repeated • Is it time for your tetanus booster?
every 3 years until age 40. Recommendations for women
• If sexually active, consider birth control This is sometimes referred to as the in their 50s
options. If multiple partners are involved, “pregnancy decade.” If you are planning to • Have a complete general physical exami-
STD screenings should be done, and get pregnant, be sure to talk to your doctor nation, which should include a baseline
58 inMotion Volume 18, Issue 2 March/April 2008
EKG, chest x-ray, blood glucose, cholesterol and lipid panel.
Know your blood pressure.
• Have a bone mineral density test.
• Colonoscopies should begin at age 50. Discuss with your health-
care provider how frequently this should be repeated. A flex-
ible sigmoidoscopy or double-contrast barium enema may be
indicated as an alternative.
• Have a rectal exam and fecal occult blood test annually.
(Screening for colorectal cancer and osteoporosis should start at
a younger age if you are at a high personal risk.)
• Immunizations: Flu and pneumococcal are recommended start-
ing at age 50 if you have diabetes or renal disease or if you are in
an immuno-compromised state.
Recommendations for women age 60 and older
Continue with all recommended screenings, as well as annual
mammography, routine bone density testing and colorectal cancer
screening as determined by your personal health risks and your
• Have a routine pneumoccocal and flu vaccination over age 65.
• Have a herpes zoster vaccine (Zostivax).
Anyone over the age of 60 who had chickenpox as a child is at
risk to develop shingles because the virus hibernates in nerve cells
for decades until erupting again. Shingles can be an excruciatingly
painful skin and nerve condition, which can now be prevented by
a new vaccine, Zostivax.
These medical examinations, tests and health screenings will
not only help to safeguard your health today, but will also help to
improve your quality of life in the years to come.
About the Author
Christina Skoski, MD, is a
retired clinical anesthesiolo-
gist with 30 years experience
and an active member of
ACA’s Medical Advisory
Committee. She has been a
since she was a teen-ager.
To support the ACA or to become a member, call 1-888/267-5669 59