On Well Woman Exams

This is one of the things that women both dread and anticipate. A well woman's exam. During a well woman's exam, normally both a gynecological exam and a breast exam occur. Most women believe that they need to have them done annually. This is not accurate, unless something is abnormal.

I try my best to follow the guidelines set out by the ACOG: American College of Obstetrics and Gynecology. These standards do change over time, but these are the current recommendations. They recommend that cervical cancer screenings start at age 21 and end at age 65, unless some abnormal results occur. For ages 21-29, it is recommended to get a pap every 3 years, and for ages 30-65 it is recommended to get a pap every 5 years. This is assuming that your results are normal. If there are ever any abnormalities, then that would change the time period.

Women do not need to get a pap smear yearly, unless she has a history of abnormal results, or a history of cervical cancer. Part of my current practice is attempting to prevent unnecessary additional pelvic exams.

Reopening Texas

As of today, Governor Abbott, has officially started to reopen Texas again. This is in an attempt to help stabilize the economy and return life back to normal. For those of you like myself, I have been watching the curve flatten over the past few weeks, and have been very impressed by all the new guidelines that have been implemented for our safety. For example, now many places of businesses are requiring that people wear masks in order to enter, to help continue to decrease the spread of COVID-19. Let's start with what exactly Governor Abbott has stated:

People are thought to be most contagious early in their illness, but COVID-19 can be spread to others by infected persons even before they show any symptoms. That is why we must remain cautious — to avoid further spread or a new outbreak. As we begin to open Texas, we must continue to follow these critical health guidelines: 
 Stay home if you can. 
 Wash hands often and for 20 seconds, or use hand sanitizer with at least 60% alcohol. 
 Cover coughs and sneezes with a tissue, then throw the tissue away. 
 Avoid touching your eyes, nose, and mouth with unwashed hands. 
 Disinfect surfaces, buttons, handles, doorknobs, and other places touched often. 
 Avoid close contact with people who are sick.

Continue to practice social distancing, avoid crowds, and limit physical contact. The Centers for Disease Control and Prevention (CDC) also recommends using simple cloth face coverings in public to help slow the spread of the virus.

He has separate recommendations per different age groups. In his document, he starts with those individuals that are 65 years old or older:
People 65 years or older, especially people 65 years or older with medical issues like heart disease, diabetes, cancer, or a weakened immune system, are at a higher risk for getting very sick or dying from COVID-19.

1. Stay Home If You Can:

• Minimize face-to-face contact with others. Avoid young children.
• If someone is assisting you, you and your family members or caretakers should wear cloth face masks. Remember a family member or caretaker can give you the virus even if they don't appear to have symptoms.
• Try grocery or restaurant delivery, mail order prescriptions, and phone appointments with your doctor. Call 2-1-1 if you need help with essentials.
• Reach out to friends, family, or neighbors who can deliver essential items.

2. Help Save Lives:

• If you must go out, wear a cloth face mask, and stay six feet away from others.
• Wash your hands often and for at least 20 seconds, or use hand sanitizer with at least 60% alcohol.
• Disinfect surfaces, buttons, handles, knobs, and other places touched often.
• Do not share dishes, drinking glasses, cups, or eating utensils with others.
• If you have mild symptoms (difficulty breathing, or a rapidly worsening cough or fever), call your healthcare provider. If symptoms are severe, call 9-1-1.

3. Check In:

• Check in regularly with neighbors, friends, and family by calling, texting, emailing, video chatting, or even writing letters.
• Walking, gardening, digital books, games, and online religious services are great ways to stay active and connected.

For people that are younger than 65 years old, basically, you should follow the old guidelines. Continue social distancing, self screen for symptoms, and wear masks in public.

For restaurants: No tables more than 6 people. Customers should wash/sanitize hands after payment process.

Movie theaters: remote ticketing, keep at least 2 empty seats between parties in any row, alternate rows between customers, clean seats, do not leave foodware at tables.

Museums and libraries may open at 25% capacity

Outdoor sports participants: may engage in outdoor sports, no contact, no more than 4 participants per sport at a time, no public pools.

Church: at risk people should view via remote, keep at least a few seats between parties, alternate rows between attendees.

Basically, even though the state of Texas has officially "reopened", we are still to maintain the same recommendations as before, just now around others. Of course, if you are sick, STAY AT HOME!

For more specifics, please visit:
Texans Helping Texans, Reopening Texas Document