Dr. Diana Hookham
Dr Diana retired on the 26th August 2016 after 20 years working with her close colleague and friend, Dr Carmel O’Toole and being a founding member of BHWC
She will be greatly missed by all her patients, staff and colleagues.
She is enjoying her retirement so far!!
A Well Woman Check is a top-to-toe check of how you are going. It is usually the sort of check up that refers to women in the reproductive phase of their life and beyond.
It includes the following elements: we record your height, weight and blood pressure. We do a breast exam (and we can teach you how to do a breast self-examination at the same time). It includes a pelvic examination, to check the uterus and ovaries and a smear test to check for cervical cancer. It can also include a check of your pelvic floor, coupled with information about how to use your pelvic floor muscles. An STD check can be done at the same time, and contraceptive advice can be provided or discussed as needed.
The Well Woman Check is an ideal opportunity for you to tell your doctor about anything that is bothering you at all, including in regard to your periods, your relationships and your overall health.
This can be a particularly sensitive and demanding issue for women who are survivors of sexual assault. If you have any worries at all, speak to your doctor and let them know what is on your mind, so they can help you.
At least one of our doctors has had training through CASA (Coalition Against Sexual Assault) and a check up like this can actually help a person begin to heal from trauma if it is conducted sensitively and appropriately.
The most important thing is to have regular check ups, because it is so important to identify problems early before they get out of hand. If you are nervous, just tell us and we will do our very best to help you.
Do you know what Hypertension is?
A lot of people think it means you are very tense, but that’s not it at all. Hypertension is what we diagnose when two levels of pressure in your vascular system (blood circulation system) are higher than they should be. The first figure is called Systolic and we like that level to be ideally equal to or less than 140. The lower figure is called the Diastolic pressure, and ideally we like that to be less than 80.
Many factors can influence a person’s blood pressure and some of these things can be temporary, for example if you are in pain or unwell your blood pressure usually rises. The situation that doctors are commonly faced with is determining whether a person’s blood pressure exceeds recommended levels for lengthy periods of time. There are many ways of resolving this difficulty, including the relatively new technology of ambulatory blood pressure monitoring.
This equipment permits us to see what your blood pressure is in your normal daily life, not just when you’re in our consulting rooms.
The surgery has recently purchased this equipment, so please ask your doctor about it, if it’s relevant to you when you next visit.
What’s the actual problem with having high blood pressure anyway?
Good question. The problem is that if the pressure in the circulatory system (heart and major blood vessels) is too high, the lining of the arteries can become inflamed and if left unchecked, narrowing of arteries and reduction or blocking of circulation can occur. This is one of the processes that can lead to heart attack and stroke and many other things. Also, if your blood pressure is up for a long time, your heart has to work very hard against this high pressure, and that can have damaging consequences.
Wouldn’t I know if I had high blood pressure?
No, unfortunately 9 out of 10 people have no idea that their blood pressure is up. And so, you could have really high blood pressure without realizing it.
What’s the cause of high blood pressure?
There are a number of causes for high blood pressure, and we always look for them, but in 9 out of 10 cases we can’t precisely determine the reason.
If I’m diagnosed with high blood pressure, does that mean I’ll have to take blood pressure tablets forever?
The short answer is no, not in every case. If we find that your blood pressure is too high, we aim to lower it to a safe level. We then embark on a lifestyle modification program in partnership with you, to see what can be achieved that may result in us being able to reduce or stop medication. The principle is that it’s important that your blood pressure is at a safe level while we take time to implement whatever other solutions are possible.
This is an ideal example of where a strong collaboration between you and your doctor can achieve a great outcome if both parties work together and if you, the patient, takes ownership of the problem.
These days everyone seems to be talking about pelvic floor exercises, but what one earth does this mean? Everyone, both men and women, have pelvic floor muscles, which essentially sit in a horizontal position (when you’re standing) between your thighs. The pelvic floor muscles form a ‘figure of eight’ shape and they encircle the anus (or back passage) behind, and for women, the vagina and urethra (where urine comes out) in front.
In primitive societies, where people squat a lot more than we do in Western society, people have much more control and strength in their pelvic floor muscles. In our society, people often have to learn how to ‘recruit’ and use these muscles.
What do these muscles actually do?
When your pelvic floor muscles have good tone, you have a far greater degree of control over toileting issues. You are less likely to feel either rushed to go to the toilet, or to feel that you can’t properly empty bowel or bladder when you’re at the toilet.
The pelvic floor muscles are also connected to the coccyx (our tail bone or very end of the spine). This means that when we contract our pelvic floor muscles, we bring our back or spine into alignment better.
How can I make my pelvic floor muscles stronger?
There are two elements here. The first is that we have to check that your brain is sending the right signals to your muscles. This is called recruitment. If this isn’t happening, nothing will happen at all, even if you are trying very hard!
Your doctor can check this with you, and we can teach you how to monitor it yourself. Secondly, once you have learnt how to recruit the correct muscles, it is simply a matter of appropriate practice to strengthen those muscles.
It has been said that 70% of 70-year-old women will have some degree of incontinence, unless their pelvic floor muscles are in good shape. We don’t even know the figures for men! As per usual, there is very little data on Men’s health issues!
So ask your doctor about it when you’re next in for your check up.
Have you got a holiday planned for Spring or Summer?
If so, we can help you prepare for that holiday so that it is not spoilt by preventable illness. We have a variety of travel vaccines for every traveller and we can tailor the information exactly to your trip and your itinerary. We have a travel medicine form which we get you to complete and this will help us help you. In this form you’ll be asked to give as much information as you possibly can, so please give us as much detail as possible. We will go trough it with you when you come in, but having accurate information that you’ve researched beforehand makes it very efficient. Remember: don’t leave it until the last minute as vaccines take time to work. We would like you to ideally come in and see us 6 weeks before your intended departure date.
Dr Carmel O’Toole has been doing an update in menopause management at the Jean Hailes Medical Centre in Clayton. As part of this, she recently travelled to New Zealand for the Australasian Menopause Society’s annual conference. She has come back from this conference full of enthusiasm and new ideas, which she will be sharing with other members of the medical team. Last year, she ran a successful education evening on menopause, and she is keen to repeat this if there is interest.
It’s stating the obvious but Menopause affects all women. The interesting thing is that no two women are the same. Menopause management is now seen as an opportunity for health interventions and health promotion in the midlife transition. This is because it’s not just about the symptoms that you may experience, but also about the changes that occur in our body at this time. These changes affect your heart, your blood pressure, your cholesterol, your weight, your bones and your mood! This is the time to implement a proactive wellness strategy, and all the doctors here are ready to help you do this.
For more Information on Menopause, visit Jean Hailes on the following link. http://jeanhailes.org.au/