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Four Ways To Love Your Heart Back

By: Maria Mazzotti D.O.

February is heart healthy month. There has long been a debate about which organ is more important, your heart or your brain. While both may take equal importance, February's focus on the heart has us talking about what we can do to keep our heart healthy.

At the top of the list is exercise. Even if you do not need to lose weight, cardiovascular exercise for 30 minutes, five times per week will keep your heart healthy. Besides burning calories and helping with keeping your blood pressure controlled, cardiovascular exercise helps build extra blood vessels which can save your life if any blood vessel becomes occluded. By having alternative blood vessels supplying blood to the same area of the heart that is not receiving a normal supply of blood, you avoid any permanent damage to that part of the heart.

Next and just as important is getting the proper amount of sleep. Recent studies show that getting less than 7-8 hours of sleep nightly may cause hormonal dysfunction that contribute to weight gain and elevated blood sugars. Even more obvious is that your heart rate decreases while sleeping, giving your heart time to recover from your day.

Diet is also clearly another key aspect to keeping your heart healthy. It is widely agreed that the Mediterranean diet is a heart healthy diet. The key components of this diet are: low fat proteins (beans, white meat, Tahini, low fat cheeses), olive oil, whole grains, nuts, bread (whole grain), veggies and fruit (instead of dessert). These foods should be fresh, not processed. Adding Mediterranean spices decreases the need for higher amounts of salt. An added plus is that some spices like Coriander and Rosemary are also antioxidants. To top off the diet: wine - another proven antioxidant. Because this diet is healthier and lower in calories, it often times produces weight loss. Antioxidant-rich foods are also brain friendly which keeps your brain sharper.

Hydration is another key element of heart health, especially in females who typically have lower blood pressure than men. Not being well hydrated can damage all of your organs - especially your heart. If your blood pressure is low and you are not well hydrated, you are at higher risk of getting dizzy and passing out.

While going about your days in February, let the red around you remind you that just like the four chambers in your heart, there are four easy things that you can do every day to keep your heart healthy. By giving love back to your heart, it will keep you healthy and will lead to a happy body and heart relationship!

 

ThermiVa

By: Dana Shanis, MD

ThermiVa® is a non-surgical, safe and effective procedure that uses radiofrequency heat to tighten loose, sagging skin and increase blood flow and nerve sensitivity in the vaginal area.  This procedure is used to treat many common vaginal complaints, including:

1·  Vaginal and labial laxity

Stretching of the vaginal tissues and muscles is common after childbirth and can occur with normal aging.  This can cause decreased sexual satisfaction, discomfort with exercise and bothersome urinary symptoms.   The labia (external lips around vagina) also experience sagging over time, which can cause rubbing and irritation and cause many women to feel self-conscious.  ThermiVa® can be used both internally and externally for these concerns.  The heat applied during the procedure causes the tissues to contract and increases the amount of collagen in the area.

2·  Vaginal dryness

Many medications, as well as the normal aging process can cause vaginal dryness for many women. This dryness often becomes severe after menopause or cancer treatments, causing daily discomfort and making sex painful.  Without exposure to hormones, the ThermiVa® procedure increases blood flow in the area which increases vaginal moisture and lubrication during sexual activity.

3·  Urinary incontinence and overactive bladder

Urinary complaints are common in women of all ages, most commonly incontinence (leaking urine) and overactive bladder.  The radiofrequency applied to the vaginal tissues during the ThermiVa procedure can help tighten the tissue under the urethra, which decreases the rate of leaking with cough, sneeze or exercise.  The procedure also increases nerve growth around the bladder, which can decrease bladder irritation that causes the urgency experienced in overactive bladder.

4·  Painful sex

ThermiVa® helps reduce muscle spasms in the pelvic floor that are commonly a cause of pain with sex.  Many women also report an improvement in their desire, arousal and ability to orgasm after the treatment.  Due to the small probe size, most women report little to no discomfort during the procedure even if they are unable to tolerate penetration during sex due to pain.

How is it performed?

During the procedure, a small wand is slowly moved over the areas of concern, gradually heating the tissue.  The procedure takes less than an hour, during which most women report feeling only a warm sensation and no pain.  There is no down time once completed, women can return to exercise and sexual activity immediately.  A total of three treatments, scheduled a month apart, are recommended for optimal results.

When will I see results?

While each woman’s experience may differ, many women notice a difference within hours to days after their first treatment.  For some women it takes longer or multiple treatments.  The effects of the treatments continue to improve for several weeks and lasts up to one year on average.  A touchup session is often needed after a year to maintain the effect.

Is it safe?

Over 50,000 procedures have been performed with this technology worldwide, and no burns or significant adverse outcomes have been reported.

If you are dealing with any of these issues, you do not have to live with the discomfort any longer. Schedule a consultation with one of our Women’s Health providers to review your concerns, discuss alternative treatment options and determine if you may benefit from this procedure.  

January is National Blood Donor Month

By: Monica Duvall, MD

The start of the new year heralds the American Red Cross's annual effort to raise awareness of the critical need for blood and blood products through the winter months. Blood donations typically go down during this period, due to illness of potential donors, cancellations of blood drives due to inclement weather, and other reasons.   It is estimated that 38% of the US population is eligible to donate blood, but less than 10% of that eligible population donates, according to the Red Cross.  National Blood Donor Awareness month aims to remind the public that the need for blood is real, and to motivate first-time and previous donors to give blood or support blood donation efforts in other ways.

Over 20 million blood products are transfused in the US annually; 40% of these products come from volunteer donors to the American Red Cross.   Every 2 seconds, someone in the US needs blood, and an average transfusion requires 3 pints of blood.  A victim of a car accident may need as many as 100 pints of blood!  A typical blood donation takes about a pint of blood out of the approximately 10 pints in the average adult body--plenty for a healthy adult to spare.  Each donation can help multiple people, as components of whole blood can be separated out for different uses.  Red blood cells carry oxygen to tissues in the body, and are used in trauma, surgery, and in the treatment of severe blood loss.  Platelets are cell fragments that help with clotting--these are used in surgeries and cancer treatments.  Plasma is a clear liquid that contains proteins and clotting factors; it is commonly used in burn patients and bleeding disorders.   Although donors of all blood types are needed, certain blood types are usually in shorter supply because their blood products can be used for patients of any blood type (critical in emergency situations, when a patient may need blood before his/her blood type is known); these are Type O negative, the "universal donor" for red blood cells, and type AB positive, the "universal donor" for plasma.  Only 7% and 3% of the US population, respectively, has these blood types.

Giving blood is safe for most healthy adults, and a single donor can give blood multiple times annually.  General eligibility requirements are that donors must be at least 17 years of age, and weigh at least 100 pounds.  Additional eligibility/exclusion criteria can be found on the American Red Cross website.  To donate blood, you can download the ARC blood donor app, visit www.redcrossblood.org, or call 1-800-RED-CROSS (733-2767).   If you do not meet current eligibility criteria, you can still support blood donation efforts by spreading the word about Blood Donor Awareness month, by donating to the Red Cross, or by hosting a blood drive through your workplace or community group (such community efforts provide about 80% of Red Cross blood donations!).   Giving blood is giving the gift of life to someone in need--please consider donating this winter.

Improving Your Emotional Awareness

By Courtney N. Liggera, Psy. D.

“Educating the mind without educating the heart is no education at all.” - Aristotle

Generally, society discourages us from being in touch with our emotions.  Social media seems to encourage us only to show a happy face to the world.  Professional work environments appear to promote those who act dispassionately.


However, being in touch with your feelings--both positive and negative--will make you a better and more complete person. By understanding your emotions, you will feel better about yourself.  You will improve your confidence, knowing that you are not hiding behind a false front.

What does it mean to get in touch with your emotions?

One interpretation is being able to communicate emotions to others. A large part of emotional security is validating your own feelings by expressing them to other people.

When we choose to not to express our feelings, we punish ourselves and others. We may no longer make ourselves available to others and may withdraw, or just not be fully engaged when we do spend time with other people. At other times, if we choose not to express our emotions, we may react inappropriately because our emotions are pulling us in a different direction from where we really want or need to go. When we can express how we truly feel in healthy ways, we can solve problems, improve relationships, and enjoy life. In addition, we end up viewing our lives more positively because we are not holding on to unhealed or confusing feelings.

There are many reasons why we might feel the need to hold in our true feelings. We may feel we can’t express them without causing embarrassment or harm to another.  We may not want to unleash our feelings out of fear that once we start, we will not be able to stop. But by letting our feelings out, we are letting out what hurts, while making more room for positive thoughts and feelings. Expressing our negative emotions in a way that is considerate of others people’s feelings is actually a good way to free us from them.

We can get better at knowing what we are feeling and why.  This skill is called emotional awareness. Understanding our emotions can help us relate to other people, know what we want, and make choices. Even emotions we consider "negative" (like anger or sadness) can give us insight into ourselves and others.

Although emotional awareness comes more easily to some people than others, it is a skill that anyone can work on. Here are a few ways to improve your emotional awareness:

  1. Notice and name your emotions. Start by just noticing different emotions as you feel them. Name them to yourself.
  2. Track one emotion. Pick a familiar emotion — like happiness — and track it throughout the day. Notice how often you feel it and when. Whenever that emotion shows up, you can simply make a mental note to yourself or jot it down in a journal. Notice where you are, who you're with, and what you're doing when that emotion is present. Note whether the emotion is mild, medium, or strong and if it has different intensities at different times.
  3. Build your emotional vocabulary. Try going through the alphabet and thinking of one emotion for each letter.
  4. Think of related emotions that vary in intensity. See how many you can come up with.
  5. Keep a feelings journal. Take a few minutes each day to write about how you feel and why. Journaling about your experiences and feelings builds emotional awareness. You also can express an emotion creatively. Make art, write poetry, or compose music that captures a specific emotion you're feeling.
We all have emotions every day, even when we do not realize it. When we are able to be in tune with our emotions, we remain true to ourselves, and we help ourselves receive the support we need. Ignoring our feelings may be the easy choice in the moment, but it can have serious repercussions for our relationships and our mental health.  Being in touch with our emotions can help us be more empathetic, know our strengths and weaknesses, make better decisions, and ask for what we need.



Healthy New Year's Resolutions for 2018

By: Elizabeth Galbrecht, MSN, AGNP-C, WHNP-BC

Move More

Exercise is one of the most powerful things that you can use in your day-to-day life to improve your cardiovascular health, manage your weight, strengthen your bones, reduce stress, and possibly even prevent certain types of cancer. I tell all of my patients that exercise is truly like medicine for your body and for your mind. The ultimate exercise goal is to get at least 150 minutes of moderate-intensity physical activity (i.e. brisk walking) or 75 minutes of vigorous-intensity activity (i.e. jogging or running) per week, in addition to muscle-strengthening activities on 2 days out of the week. This might sound intimidating at first, but the good news is that you can spread out this time over the week in a way that is most convenient for your schedule. Even exercising just 10 minutes at a time is beneficial. You can also get creative – brisk walking and jogging aren't the only ways to exercise. Anything that gets your body moving counts as exercise, so find something that makes you happy – anything from aerial yoga to zumba - and roll with it!

Eat Better

New Years is always the time of year when trendy crash or fad diets start to surge in popularity. These are never the most effective or sustainable options and are often times flat-out unhealthy. When it comes to your diet, small changes over time can make a big difference. One of the simplest ways to modify your diet and improve your health is to focus on increasing your consumption of fruits and vegetables. It is well-known that a diet rich in fruits and vegetables can decrease the risk of heart disease, stroke, high blood pressure, and diabetes. Another strategy for the New Year is to cook at home more and eat out less. That way, you have control over portion size and also all of the ingredients (including salt, oils, butter, etc.) involved in preparing your meal. For further dietary guidance and support, you can always schedule an appointment with one of our nutritionists at RWWC.

Drink Less

Alcohol is everywhere in our culture, and drinking is encouraged on many levels. We are constantly bombarded with promotional messaging about alcohol and it can be easy to get caught up in drinking habits that might, in actuality, be harmful to your health. The Centers for Disease Control and Prevention define “heavy drinking” for women as 8 drinks or more per week. One drink is defined as either 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard alcohol. “Binge drinking” for women is defined as having more than 3 drinks on one occasion. Heavy drinking has many short-term and long-term consequences for women, and in many cases these consequences are more pronounced than they are in men. These include increased risk for alcohol-related liver disease, memory loss and shrinkage of the brain, osteoporosis, and breast cancer. There are, however, beneficial effects of certain types of alcohol that are well-documented, such as improvement in cholesterol and cardiovascular health - the key here is moderation.

Quit Smoking

It should be no surprise to anyone that smoking is extremely harmful to your health and will shorten your life. Any degree of tobacco use, whether it's smoking a pack per day or social smoking, has serious consequences. Many are aware of the risks of lung and head/neck cancers caused by smoking, but some may not know that smoking damages many other organ systems. For example, smoking is the single most common preventable risk factor for bladder and kidney cancer, which are highly aggressive malignancies with few available treatment options. Toxic carcinogens inhaled during smoking do not only contact the upper airway and lung tissue, they are also absorbed into the blood stream and penetrate into virtually every organ. The kidney and bladder are particularly susceptible to damage from smoking because these toxins are concentrated in the urine and literally bathe the kidneys and bladder before they are excreted in the urine. Even if they are discovered early, often radical and disfiguring surgeries are required to control cancers of the genitourinary tract. With regards to women's health in particular, cigarette smoking increases the risk of HPV-related cancers of the cervix and vulva and also increases the risk for recurrent vaginitis, especially bacterial vaginosis (also known as BV). If you smoke, quitting is the #1 best thing that you could do for yourself. We are here to help you if you are ready to quit smoking, so please do not hesitate to discuss this with your healthcare provider at your next visit.

Establish Care

If you have not had an annual wellness visit or gynecologic exam in some time, please be sure to put this on your to-do list for 2018. Even if you feel healthy and have not had any changes to your health in the last several years, there are likely to be preventive health measures that you might be missing out on. We can help to make sure you are up-to-date with your immunizations, cancer screenings, and routine bloodwork so that you stay as healthy as possible in the years to come.

Cannabis Education


Gov. Tom Wolf signed a law legalizing medical cannabis in Pennsylvania in April, 2016. One of the medical marijuana facts for Pennsylvania that frustrated supporters of legalization was that it took so long to happen. The Pennsylvania Senate first approved a bill legalizing medical weed in 2015, but it was not approved by the entire legislature until March, 2016. Several technical changes needed to be made before both chambers could finally agree on a final bill.


In order to be able to recommend cannabis to their patients, physicians need to complete a four-hour course. They must sign a certificate stating that the patient not only has a qualifying condition, but also that the doctor believes that patient will be able to benefit from medical cannabis use.

There are several forms of cannabis that patients can use, including oils, pills, creams, ointments, liquids, gels and more. Vaporization is allowed, but not smoking of the plant. While dispensaries are not allowed to sell edible forms of weed, the law allows patients to mix medicinal cannabis into drinks or food in order to help them ingest it.

If you are a patient in another state, you are not allowed to access medical weed in Pennsylvania.

The different types of IUDs

By: Allison Andrews WHNP

There are two different types of IUDs: hormonal and non-hormonal.
We want to answer the 2 main questions that many women ask themselves when considering an IUD:  What is the difference? Which one is right for me?

Mirena
Mirena is the hormonal IUD that has been around the longest, and is currently approved for up to 5 years. Mirena was originally intended for women who have had children. However, studies have shown that it is perfectly safe and effective for women who have never been pregnant. Mirena is recommended to help manage women who suffer from heavy or painful periods. Most women on Mirena have reported that their periods get significantly lighter or go away completely. About one in five Mirena users stop having a period after a year, and one in three if they use it for a longer period of time.

Liletta
Liletta is very similar to Mirena. It contains the same dose of hormone and is approved for use up to 4 years. This IUD has also been approved for women who have never had children. Like the Mirena, your periods can get significantly lighter or go away completely.

Kyleena
Kyleena is smaller in size then the Mirena and has a lower dose of hormone then the Mirena/Liletta. Like the Mirena the Kyleena is approved for up to 5 years and about 1 in 8 women who use it will stop having periods after a year.

All hormonal IUDs prevent pregnancy by releasing a small amount of a progestin hormone called levonorgestrel each day. The progestin acts locally in the uterus to prevent pregnancy. Hormonal IUDs do not contain estrogen and typically have fewer hormonal side effects than methods that do contain estrogen.

Paragard
ParaGard contains no hormones and is approved for up 10 years. Since this device does not contain hormones, most people who use ParaGard can experience heavier, longer, or painful periods. Studies have shown that after 6 months, many ParaGard users’ periods return to normal. If you already have really heavy or painful periods, you will most likely benefit more from a hormonal IUD.

The non-hormonal IUD prevents pregnancy by using a tiny copper filament wrapped around the T. ParaGard, making the uterus a hostile environment.

IUDs are safe, effective, and reversible. There are many different kinds of IUDs and they are not a one-size-fits all. Call today to schedule a consultation with one of our nurse practitioners and together we can decide which is best for you!

7 Maternal Benefits of Breastfeeding

By: Lauren O’Brien, MD

You have probably heard the phrase “Breast is Best” in reference to breastfeeding a newborn baby. The benefits of breast milk to an infant are widely touted and acknowledged.  Such benefits include: decreased risk of sudden infant death syndrome, decreased risk of obesity in the child, and a decreased risk of asthma, allergies and infections including ear infections, respiratory infections and diarrheal illnesses.  What are often not discussed are the benefits of breastfeeding to the mother.  Here we bring you 7 important maternal benefits of breastfeeding.

1) Better healing post-delivery: The act of breastfeeding stimulates the release of the hormone oxytocin. This encourages the uterus to contract, returning to its pre-pregnancy size sooner and decreasing post-partum bleeding.

2) Greater calorie burn: This allows some women to lose the pregnancy weight a bit faster.  Some studies have also demonstrated a lower amount of visceral fat in women who have breastfed.  This is the fat that is stored around the abdominal organs and predisposes an individual to cardiovascular disease.

3) Decreased risk of cancer: Moms who have breastfed have a decreased risk of breast, ovarian and endometrial cancer.  This benefit is even seen in patients with a family history of breast cancer.

4) Decreased risk of chronic disease: A number of studies have demonstrated a reduction in the risk of Type 2 Diabetes, high blood pressure and increased cholesterol among women who have breastfed.  There is also some data to suggest a potential reduction in osteoporosis risk.

5) Provides a break from menstruation: While exclusively breastfeeding, ovulation is suppressed and menstruation is delayed.  This is a convenience for the new mom and also helps with pregnancy spacing. (Though should not be considered a highly reliable form of birth control)

6)  Promotes emotional health: Oxytocin and prolactin are important hormones in a mother’s stress response. The increased levels associated with lactation allow the mother to manage stress better and have a positive impact on social behaviors including maternal-infant bonding.

7)  Saves money: It is estimated that breastfeeding an infant for the first year of life can save $400-$1000 even when accounting for the modest increase in food intake by a nursing mother.  In addition, breast fed infants have less illnesses leading to less time away from the job for working parents.  

Is Medical Marijuana right for you?

By: Bruce Saltzman M.D.
Board Certified Anesthesiologist

At Rittenhouse, we believe that medical marijuana may be useful in the treatment of the following conditions and you should be discussing these conditions at your visit:

·         Amyotrophic Lateral Sclerosis
·         Autism
·         Cancer
·         Crohn’s Disease
·         Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity
·         Epilepsy
·         Glaucoma
·         HIV (Human Immunodeficiency Virus) / AIDS (Acquired Immune Deficiency Syndrome)
·         Huntington’s Disease
·         Inflammatory Bowel Disease
·         Intractable Seizures
·         Multiple Sclerosis
·         Neuropathies
·         Parkinson’s Disease
·         Post-traumatic Stress Disorder
·         Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective
·         Sickle Cell Anemia

The State of Pennsylvania has legalized the use of medical marijuana.  Starting sometime next year, dispensaries will be opening and patients with the following serious medical conditions will be able to get medical marijuana. To purchase medical marijuana, a patient will need to be under the continuing care of a physician who is registered with the Department of Health. The physician may then provide a signed certification to the patient stating that the patient has a serious medical condition. The patient must then apply to the department for an identification card. Once the patient receives an identification card, he or she can purchase medical marijuana at an authorized dispensary.  In the upcoming months we will be discussing many of the below conditions and how medical marijuana may be useful in their treatment, and how to obtain the patient certification from our practice.
                                             
Cannabis, also known as marijuana is a psychoactive drug from the Cannabis plant used medically and recreationally.  The main psychoactive chemical of cannabis is tetrahydrocannabinol (THC) (THC); one of 483 known compounds in the plant, including at least 65 other cannabinoids.   Cannabis can be used by smoking, vaporizing, within food, or as an extract.    As early as 2737 B.C., the mystical Emperor Shen Neng of China was prescribing marijuana tea for the treatment of gout, rheumatism, malaria and poor memory.   The criminalization of Marijuana by the Harrison act inhibited medical research on the plant.  The new research on marijuana in the 21st Century has led to the characterization of two receptors for cannabis in humans, CB1 and CB2. These receptors work through a unique feedback  mechanism on G protein–coupled receptors(GPCRs), again too complex for this setting.  GPCRs, which transduce extracellular signals into intracellular effector pathways, include about 900 members and represent the most prominent family of validated pharmacological targets in biomedicine.  Advair and Abilify are among the drugs that work with this receptor.  ~4% of the protein coding genome is devoted to these receptors. 

Dr. Saltzman’s background in Pharmacokinetics and the dynamics of medications has led to him researching the significant benefits of medical marijuana and he has received his certification from the state of Pennsylvania and will be seeing patients at our office for medical marijuana evaluations.







Breast Cancer Awareness Month

By: Catherine McGinty

We may recognize that it is October by the smell of pumpkin spice, but if you look carefully, you should also see the pink ribbons of breast cancer awareness month. We wanted to take the opportunity this month to go over preventative measures and risk factors, screening recommendations and signs of the disease that hits close to home for so many of our patients.  


Preventing Breast Cancer

While there is no sure way to completely prevent breast cancer, there are lifestyle recommendations which can help decrease your risk of developing it.  Many of these recommendations may sound familiar; they are the same as the ones our providers counsel our patients on at annual wellness exams!   These include:

  • Alcohol:  Some studies have shown a link to an increased risk in breast cancer, as well as many other cancers, when women consume alcohol excessively.  For this reason, The American Cancer Society recommends that women drink no more than 1 alcoholic beverage a day.
  • Weight:  Research has shown that women who are overweight after menopause or women who carry more excess fat around their waist may increase their risk of breast cancer. Therefore, it is recommended that all women try to maintain a healthy weight by regularly exercising and maintaining a balanced diet.
  • Exercise:  Regular physical activity, especially after menopause, has been shown to decrease one’s risk of breast cancer.  The amount of physical activity to decrease this risk is not clear, but The American Cancer Society suggests at least 150 minutes of moderate exercise a week.
  • Children:  Women who have never had children or have their first child after age 30 may have a greater risk of certain breast cancers.
  • Breastfeeding: Some studies support that breastfeeding can decrease the risk of breast cancer.
  • Birth Control:  Research has shown that there may be a small increased risk of breast cancer in women who take contraceptives containing hormones compared to those who do not; these include birth control pills, the shot, and IUDs.  This risk seems to decrease after stopping the medication.  The choice to start or continue all forms of birth control are taken very seriously and weighed against other risk factors and benefits and should be discussed individually with your healthcare provider.
  • Hormone Replacement: Combined hormone therapy which contains estrogen and progesterone that is used for the treatment of menopause and osteoporosis has been linked to a risk of breast cancer.  This risk can decrease after 5 years of stopping the medication.  

Early Detection and Diagnosis

Many women never have symptoms before the diagnosis of breast cancer, making screenings one of the most vital components of early detection and treatment.  The American Cancer Society recommends the following screenings for women at average risk of breast cancer:

  • Mammograms: Age 40-44 may choose to start annual mammograms.  Age 45-54 should get annual mammograms. Age 55 and older may switch to every other year mammograms or continue with annual mammograms, and should continue for as long as a woman is in good health or expected to live for at least another 10 years.
  • Clinical and self breast exam: There has been little evidence to support that physical breast exams by a clinician, or individually, can detect breast cancer earlier than Mammograms.  However, it is recommended that women be familiar with their breasts in how they feel and look, so they may detect any changes as soon as possible.

Breast Cancer Signs and Symptoms

Like mentioned previously, self and clinical breast exams should not replace screening mammograms since screening tests can detect breast cancer before symptoms appear.  However, here are a list of symptoms that would warrant further evaluation:

  • A new lump or mass, especially if it is painless, hard, or has irregular edges
  • Swelling to part or all of a breast
  • Skin dimpling or changes including redness, thickening, or scaling of the breast tissue or nipple
  • Breast or nipple pain
  • Nipple retraction or nipple discharge

As October is Breast Cancer Awareness Month, we wanted to take the opportunity to remind all of our patients that there are many opportunities to decrease your risk of breast cancer or detect it early so that treatment is initiated swiftly and effectively. We encourage you to continue to maintain your healthy lifestyles of limiting alcohol to one serving a day, maintaining a well balanced diet, exercising at least 150 minutes a week, mammograms (for those in recommended age brackets) and self breast awareness.  As always, please schedule an appointment with one of our providers if you have any new symptoms or concerns.




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