Nieca Goldberg - Dr. Nieca Goldbergs Complete Guide to Womens Health

A LSO BY N IECA G OLDBERG, M . D .

The Women's Healthy Heart Program (originally published as Women Are Not Small Men)

I dedicate this book to my parents, Minda and Leonard Goldberg, whose love and support inspired me to help others.

I T'S VERY HARD FOR MANY OF US TO TAKE CARE OF OURSELVES. WE are busy and stressed out and managing the care of the people around us and working ridiculously long hours and I bet I don't need to tell any of you who have picked up this book about juggling twenty things at once. But what happens when you don't feel quite right, not quite your normal self? Do you know what to do and when to do it? Do you know what to watch out for and what to wait out? As I know from firsthand experience, women in midlife are often busy taking care of their families, young and old, as well as advancing in their careers, and they often feel as though their bodies are changing overnight. They may lack stamina, have difficulty sleeping, find themselves gaining weight, suffer from backaches and headaches, or have other symptoms of stress. Many of us are part of the so-called sandwich generation, responsible for caring for both children and elderly parents while we work at demanding jobs. It's no wonder we don't take good care of ourselves. When you're trying to do it all and taking care of everybody else, it's very easy to neglect your own well-being.

Every day in my practice, I meet women who have gone from doctor to doctor with symptoms of exhaustion, sleeplessness, and low back pain. They have had enough blood tests and X-rays to last a lifetime, yet they have no diagnosis to explain their symptoms or any help in reducing them. None of the physicians seems to have taken the time and trouble to ask these women how they were feeling or to discuss what was going on in their lives. Maybe the physicians were pressed for time or didn't have the communication skills to elicit the information from these patients. But these women were left high and dry, without help. This is not okay! Stress takes a physical as well as emotional toll on us all, which is why it's extra important to stay fit and be healthy.

I also juggle too many things at once, and I have a family history of heart disease. I learned the hard way about how stress could lower my resistance to illness. Shortly after the publication of my first book, The Women's Healthy Heart Program (originally published as Women Are Not Small Men), I was admitted to the hospital with a fever of 104 degrees and blood pressure of 70/50'signs of a serious infection. Now, looking back on that time, I realize I was doing too much: lecturing in the evening, seeing my patients by day, constantly responding to my cell phone and e-mail, and not getting enough sleep because there was so much to do. Hindsight is always 20/20, as they say.

But at the time, all I knew was that I had a lot to do in very little time, and that everything I had to do was very importanteverything, that is, except taking care of myself. Finally, one Saturday morning I found that I couldn't get out of bed. I had a severe case of the flu and was unable to fight it off because I had such low resistance. Even though I know (I'm a doctor, after all) that stress lowers your immunity, I had to feel it firsthand to make some real changes in my life. After that experience I have become much more alert to what stresses me out and how my body reacts to being on overload. I want to share that information with youbefore you too collapse and end up in the hospital.

But it's hard to get good information, and it's even harder to know whom to get it from. Yet unless we have reliable and accurate information about our bodies and our health care, we won't have the basis to make good decisions for ourselves. Everyone I talk to, including my friends and my patients, wants advice from someone they can trust. They want to hear straight talk, with clear explanations. Let's say your arm hurts. Where do you go? To an orthopedist? Is that really the right specialty? Maybe, maybe not. How do you know? Or you are managing your elderly mother's care and she faints. What do you do? Whom do you call? Or you realize after leaving the doctor's office that there were terms you didn't understand and you want to know what they mean.

I have many friends who end up calling on me for help, and I am really glad that they do. I can interpret symptoms, explain treatments, translate medical jargon, and give them the information they need to make good decisions. I want to do the same for you in this book: teach you about your body and about good health. I want to alert you to those symptoms that should send you running to your doctor, and distinguish those from the ones that are less serious and easily treatable. Knowledge is indeed power, but only if the information is good. And it's perfectly reasonable to be confused and not know what to think. All the controversy around hormone therapy is a good example. One day estrogen is touted as the cure for everything under the sun, and the next thing you know, it's in the news that it could cause serious harm. Clearly, common sense, intelligence, and experience are needed to interpret what is being reported.

But most doctors give patients just enough time during an office visit to figure out what specialist to send them on to. My friend Genevieve complains about the forty-five minutes her doctor makes her wait, only to spend six minutes with her. She says it takes her more time to get her clothes off. The venerable old-fashioned family doctor who took you from birth to death and literally knew you inside and out is becoming a mythic figure from the past. In this era of specialists, we have trouble finding someone to filter the barrage of sometimes confusing information about medicines, treatments, and diseases that seems to be coming at us from all directions. What I hope to do in this book is to give you the inside track on how to effectively handle this information so as to better negotiate the system and improve your health.

A good friend of mine called me when her mother, Beth, was hospitalized because she needed a pacemaker. Beth had been told to stay in bed, and the doctors kept asking her if she was short of breath. My friend didn't understand why they were asking about that, and the doctors were not quick to return her phone calls. After listening to her, I asked her if anyone had said the word pneumothorax. When she said yes, I was able to tell her that her mother's lung had collapsed. I then explained the typical course of treatment, what she could expect, how long it would take, and so on, and she was comforted. Why didn't her mother's doctors give her this information? How hard is that to do? I want to be able to provide that comfort to all women.

Because of patient confidentiality, I have not used the actual names of my patients in these stories. I hear story after story after story, and I believe that by sharing them, I will be able to reassure and educate women about how to take good care of themselves. The sister of one of my patients had been recently diagnosed with breast cancer, and my patient wanted me, her cardiologist, to examine her breasts. She asked me to do it because she was afraid that another (male) doctor might think she was being hysterical. Nothing, after all, was wrong with her; it was her sister who was sick. But she sensed that I wouldn't judge her or find her fear ridiculous, and of course, she was right. I was happy to examine her and reassure her that she was fine.