Pushin' On: UAB Spinal Cord Injury Model System Digital Newsletter Volume 34 | Number 2 - Page 3

negative attitude about helping women transfer to and from the table. Some doctors may prefer not to take women with disabilities as patients in the first place. Some doctors assume women with disabilities aren’t sexually active, so they fail to discuss important issues related to sexual and reproductive health. They may not discuss sexually-transmitted diseases with women or screen for diseases, and may not advise women about birth control. Doctors may assume that women with disabilities have no interest in having children and they may not educate them on preconception health and healthy pregnancies. Another problem is that some doctors simply don’t know about the possible complications that exist for care during pregnancies. For example, many doctors don’t know that pregnant women with spinal injury (SCI) may have issues related to autonomic dysreflexia, respiratory management, skin care, bladder management and increased risks for urinary tract infections and spasticity. Women with other disabilities may have potential problems, too. Here is the simple fact. It is your responsibility as a woman to manage your health needs and get regular mammograms and gynecological screenings. The law requires healthcare providers to offer you full and equal access to the healthcare services that all women have. The last issue of Pushin’ On features an article, The Law and Accessible Healthcare, that outlines steps you can take to work with healthcare providers to meet your needs. So what are some other suggestions women can use in the meantime? 1. Try to find healthcare providers that are open to working with you. A good provider puts your healthcare needs first. If you have a problem with access, a good provider will offer options to solve those problems. 2. Talk to your doctor about getting mammograms and Pap tests and your risk factors for developing cancer. The American Cancer Society has current guidelines that you can consider. It’s suggested that women begin annual mammogram screening at age 45. Women who have higher risk factors for cancer may need to begin at age 40. Women age 55 might get mammograms at least every two years. Some women with family history of breast cancer or other risk factors may need MRI screening in addition to a mammogram. For cervical cancer screening, the American Cancer Society suggests women begin Pap tests at age 21 and have them every three years after that. At age 30, 3. 4. 5. they may continue having them every three years or have them every five years in combination with a human papillomavirus (HPV) test. Women over 65 years of age who have had regular screening in the previous 10 years may be able to stop getting cervical cancer screenings as long as they haven’t had any serious pre-cancers found in the last 20 years. If you are having a problem with access to a mammogram, ask your doctor if an ultrasound is an option. For Pap tests, you might request a different exam table in a more accessible room, if possible. Women with disabilities should never live in fear of voicing their questions and concerns. Speak up for yourself because all women deserve access to proper healthcare. Author Note: Dr. Emily Perkins is a guest author and consumer with tetraplegia. She is a former Coordinator/Consultant for the Online Writing Center at the University of Alabama. Information found in this article is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. References are available upon request. Questions and Answers: Women’s Health after SCI Do my gynecological needs change after SCI? No. Women with spinal cord injury (SCI) have the same gynecological needs that all women have. This means you need to see a gynecologist for regular gynecological (sometimes called pelvic) examinations of your female organs. These organs include your vagina, cervix, uterus, ovaries and fallopian tubes. The exam may also include a Pap test (sometimes called a Pap smear). A Pap test is used to screen for cancer. Most cancers can be spotted early with a Pap tests. Spotting cancers early allows for the early treatment needed to help reduce deaths related to cancer. Do I need a mammogram? Yes. A mammogram (sometimes called a mammography) is an x-ray exam of the breast used to screen for breast cancer. This exam helps spot breast cancer early and allow for early treatment needed to help reduce deaths related to breast cancer. Women should talk with their doctors about when to start getting regular mammograms. Can I do breast self-exam instead of a mammogram? Yes and no. Beast self-exams do have value. Women who have good movement and sensation in their hands can do a breast self-exam to notice changes in the way their breasts look and feel. Most changes are not a sign of cancer, but it is still a good idea to talk with your doctor as soon as possible to find out if a change is a serious concern. That said, breast self-exams are not an effective way to spot breast cancer. The best way to spot breast cancer is by getting regular mammograms. UAB Spinal Cord Injury Model System 3