Mocha Moms: What's on the Table?

This week's Mocha Moms, Cheli English-Figaro and Jolene Ivey, discuss the importance of health exams for mothers. Joining them is Dr. Yvette Gentry, an obstetrician/gynecologist, to talk about what moms need to ensure their health and about the importance of keeping up with routine tests.

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MICHEL MARTIN, host:

We're going to keep talking about women's health with the Mocha Moms. We turn to them every week for their common sense and savvy parenting advice.

On last week's program, we talked about that back-to-school checkup for the kids. But this week, we wanted to focus on the moms, because as we've discussed, being a parent sometimes means focusing on everybody else's well-being at the expense of your own health.

So to talk about what moms need to keep going strong, I'm joined by our regular Mocha Moms, Jolene Ivey and Cheli English-Figaro and special guest mom, Dr. Yvette Gentry. She's an OB-GYN with her own practice in Oakland, California. Welcome, ladies.

Ms. JOLENE IVEY (Co-Founder, Mocha Moms): Hello.

Ms. CHELI ENGLISH-FIGARO (President, Mocha Moms): Hi.

MARTIN: So, Cheli, let's start with you. Does that - what I said in the beginning sound like you at all?

Ms. ENGLISH-FIGARO: Oh, my goodness. We were just talking about how I stayed up until 4 o' clock in the morning last night trying to get some work done. So absolutely neglecting sleep, that's one thing. The French fries, oh, I ate French fries from Five Guys this weekend.

(Soundbite of laughter)

Ms. ENGLISH-FIGARO: Bad food choice, I know. But I promise, this week will be better.

MARTIN: Okay.

(Soundbite of laughter)

MARTIN: Well, how do you - whenever you get around to going to the doctor, what are you looking for in a health professional? Are you looking for personal connection? Do you look for that - the diploma on the wall? What are you looking for?

Ms. ENGLISH-FIGARO: You know, the funny thing is until, I think, two years ago, I didn't even have an internal medicine doctor. I had an OB-GYN, but I didn't have an internal medicine doctor. So, I...

MARTIN: I bet you have a pediatrician.

Ms. ENGLISH-FIGARO: I have.

MARTIN: On speed dial.

Ms. ENGLISH-FIGARO: Absolutely.

(Soundbite of laughter)

Ms. ENGLISH-FIGARO: Absolutely.

MARTIN: So you finally - got that straightened out?

Ms. ENGLISH-FIGARO: I got that squared away.

MARTIN: Mm-hmm.

Ms. ENGLISH-FIGARO: So I was looking for someone who wouldn't rush me through an examination, someone who would answer the questions that I had.

MARTIN: Jolene, what about you?

Ms. IVEY: Well, I do have an internal medicine doctor. I only go when I really, really have to. I try to go and do my once-a-year checkup, and that's kind of minimal. I feel like I should do that. But beyond that, I generally think I'm okay, and whatever is wrong with me, I don't really pay that much attention. I just keep kind of plowing through because I don't have time to stop, and I know that that's not good.

MARTIN: Dr. Gentry, are you hearing something familiar in this conversation?

Dr. YVETTE GENTRY (Obstetrics & Gynecology, University of California at Berkeley): Yeah.

MARTIN: Pretty typical scenario? What are the most important appointments that women really cannot afford to miss?

Dr. GENTRY: I think, though, the initial - I think the post-partum checkup after you deliver the baby, that is the one where you get to see it's not just a quick, uncomfortable pelvic exam and pap smear and then you don't see your doctor for a year. There are other things that are addressed at that time, like contraceptive needs.

There are already health care issues that came up during the pregnancy whether this continues, like blood pressure problems or diabetes, and - or if making sure you're on the right track to losing the weight that you gained because, as we know, obesity is much more prevalent in communities of color. Many times, I find people just skip that appointment, and they think, oh, I'm too busy.

MARTIN: There's been some confusing information out there about pap smears. Some people say every other year, others say annually. What's your take on this? At what age the women start getting regular pap smears? How often do they need to get them?

Dr. GENTRY: So most recently, some changes have come about because we know much more about cervical cancer and we know that HDV, the virus that causes cervical cancer. We know much more about just the natural history of that virus and what happens. So before we'd say what - a girl should get her first pap smear by the time she's 18, or whenever she initiates contact.

But now we know that most people - they will get infected and exposed to the HDV virus. But within three years, their body will take care of that and it will make that virus go away and it will not cause any long-term problems for their cervix, as far as with cervical cancer.

So now the recommendations are, your first pap smear at the age of 20 if you have any risk factors or sexually transmitted infections, you culture for those things, like gonorrhea and Chlamydia, and every year, getting a pap smear. After age 30, 30 and above, that's when that HDV testing will tell you the likelihood of you having any abnormal cells, pre-cancer changes to the cells. If that is negative, if you have no HDV, and if the cells on the pap smear are normal, then new recommendations are that you do not need another pap smear for three years.

MARTIN: Okay. And do you agree with that?

Dr. GENTRY: I think that people will misunderstand that, because pap smear is the actual sample of cells, but pelvic exam is needed. You know, so examining, you're looking down below, seeing if there are any lesions, or growth, feeling, make sure there's no cysts on the ovaries or pelvic growth or massive, you know, fibroids.

MARTIN: You're saying that pelvic exams still need to happen every year?

Dr. GENTRY: Yeah.

MARTIN: You want to see those women in there every year. Do you hear that, ladies? Okay.

Ms. IVEY: I hear you.

MARTIN: And what about the mammogram?

Dr. GENTRY: If you have a mass or if you have a strong family history of breast cancer, to get your base line at age 35 to 40 years old. But from 40 to 50, at least every two years, and then after age 50, every year.

MARTIN: If you just joined us, we're talking to the Mocha Moms about the ways moms - and all women - can stay healthy.

Dr. Yvette Gentry is with us by phone from Oakland, California, and we have our regular Mochas with us.

Jolene, are hearing - what are you hearing? First of all, do you have any questions for Dr. Gentry? And are you hearing any questions with the Mochas that you think you want to raise?

Ms. IVEY: Well, I just think that we all need to also pay attention to the health of our heart, because women are - I think that it's like the number one thing to kill us is heart disease, and whereas I try to be good about remembering to get my pap smear and my mammograms and that kind of thing, I don't want to forget that my heart is the thing that is going to keep me going the longest.

MARTIN: Cheli, do you have any questions?

Ms. ENGLISH-FIGARO: Actually, I think what Jolene said is really important, and I'd like the doctor to talk about if she can elaborate what are the different symptoms of heart disease for women, how they differ from men.

MARTIN: That is a good question. And what about colon cancer and heart disease - those are those two things that we often associate with men. How should women be thinking about those?

Dr. GENTRY: Heart disease is a very - is like the number one killer of women, and it's something that should be addressed, not just when you're having issues as far as blood pressure may be elevated by - or perhaps having some work being - worked up or evaluated for a chest pain that you've always, for years, assumed it was heartburn or reflux.

But I think it's something that, as you go to your provider to get your healthcare maintenance - that's your annual exams - seeing what their blood pressure is when you hit 30, checking your cholesterol, finding out what your numbers are. What is your cholesterol? What is your total cholesterol, the HDO's, your LDO's, your triglycerides? Having that information, getting evaluated by age 30 because of one evaluation, and five years later having another.

And as far as the risk of colorectal cancer, we definitely are lacking in that between age 50 and 55, getting evaluated with a colonoscopy. I said - one of my appointments, I see more patients have put off. Oh, I have this lip. But I don't want to go. My friend said it was uncomfortable, or I just - that never happens in my family. But it's an important evaluation, and it's once again, is that it's caught early - if colon cancer is caught early, they could be treated, but with much less long term complications.

MARTIN: I was asking earlier, Cheli and Jolene, what they're looking for in a health professional. What are you looking for in a patient? How can a patient best help you take care of her?

Dr. GENTRY: For us, ideal patients are, ones who - when they come to their visit, when they have questions, they ask their questions and not to be intimidated or wait until the end of the visit and then they'll think, okay, now I really, really feel comfortable. Now, I'm going to ask.

In my area, in the West Coast, unfortunately, with the HMO penetration and what's happening is we are busy. We have more patients than necessarily than we want to have a day, just because the volume is increasing. So when we come in to see you, we want to address their needs. The patient's role would be have your questions available and know what your questions are and what your issues are, and we'll address them, as well as we'll bring things up to you that we think are important to address.

MARTIN: You know, we have this stereotype that I think a lot of African-American women live with of being, you know, get the neck going and always got the finger in the air, always ready to pop out and very aggressive and so forth. Are you telling me that, in fact, in the - within the confines of the examination room, you still see reticence in talking about health?

Dr. GENTRY: Yes, definitely.

MARTIN: Why do you think that is?

Dr. GENTRY: I think they've just not had an avenue where they felt comfortable to do that, and they just want to, they're used to not addressing their own issues, if that is the fact. Well, this isn't really that important. I know I'm a little - I haven't been eating well, and my diabetes isn't in its best control, I've noticed. But I can deal with that later. I'm here for this. That's one of the things. That's one. And the other issue is not having a provider that they feel comfortable talking to.

MARTIN: So if you could leave people with one thought about something they can start doing today, this week, to be healthier, more effective in dealing with health care, what would it be?

Dr. GENTRY: I think the - for the issue that happens to us more often, I'd say that that's not to be sedentary. Take the time to not only get your checkups, but to get some exercise and eat well.

MARTIN: Tall order. We're all like, get exercise, eat well. Okay. Great, doctor. Are you going to send your chef over to hook us up? Love you, but you're...

Dr. GENTRY: I'm talking about the time that we spend getting our hair and nails done, we could be taking a walk and decreasing our risk for heart disease and diabetes and hypertension.

Ms. IVEY: She's right.

Dr. GENTRY: You know, it's not popular, but when I walk into a room and I see someone as an obesity category but they see that they spend a much more time on everything else - on these other things, the priority issue is well is it's a cultural acceptance issue.

MARTIN: Okay. Well, I think she's broken it down.

Ms. IVEY: She's right.

Ms. ENGLISH-FIGARO: Absolutely.

MARTIN: Dr. Yvette Gentry joined us from her office in Oakland, California. We're also joined by our Mocha regulars: Jolene Ivey, from our New York bureau, Cheli English-Figaro here in the studio in Washington as usual. You can find links to all of our Mocha Moms and Dr. Yvette Gentry on our Web site: npr.org/tellmemore.

Dr. Gentry, hope you'll come back and talk to us again.

Dr. GENTRY: Yes, certainly.

MARTIN: Thank you, ladies.

Ms. IVEY: Thanks, Michel.

Ms. ENGLISH-FIGARO: Thank you.

Dr. GENTRY: Thank you.

(Soundbite of song, "Gonna Make You Sweat (Everybody Dance Now)")

C & C Music Factory (Music Group): (Singing) Everybody dance now. Everybody dance now.

MARTIN: And that's our program for today. I'm Michel Martin, and this is TELL ME MORE from NPR News. Let's talk more tomorrow.

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