Keep Your Family Healthy
Advice from the Best Doctors in Hawaii.
(page 2 of 3)
Dr. Barry Carlton is a psychiatrist with the University of Hawaii John A. Burns School of Medicine, specializing in adolescent psychiatry (586-2900).
Dr. Barry Carlton works with a teenaged patient.
Photo: Rae Huo
It’s OK to tell your doctor everything.
Carlton: “In the context of treatment, any discussion of sex or drugs is strictly confidential. That being said, the practitioner, if she or he is wise, will try to figure out a way for you to talk with your parents, so you feel safe doing it. But they can’t make you. The exception here is safety. If the practitioner is concerned about suicide or something along those lines, they don’t have to be absolutely confidential.”
Keep an eye out for family traits.
Carlton: “Certain psychiatric illnesses have a very strong heritability. ADHD, for example, runs in families, so early recognition and intervention can often prevent the progression and some of the more severe side effects of that particular illness.”
Parents, talk with your teenager.
Carlton: If you have any doubts about discussing an issue, just discuss it, whether it’s suicide or drugs or sex. You’re far better off doing that than leaving it alone, because teenagers are going to hear it at some point, from somewhere else. Your children may say, oh, Mom, or, oh, Dad, but it’s much better than them thinking you don’t care. Once you bring something up, it makes it an allowable topic of conversation.”
For Women of All Ages
Women make the most healthcare decisions and an ob/gyn is their entry into the healthcare system,” says Dr. Barbara Kitashima, who practices at Kapiolani Medical Center for Women and Children (942-8411). She recommends that adolescent girls and women come to her office at least once a year for a Pap test, STD testing and to discuss contraception options.
Kitashima and Dr. Shawna Brizzolara, a urogynecologist and assistant professor of obstetrics and gynecology at the John A. Burns School of Medicine at the University of Hawaii at Manoa (203-6586), remark that now, more than ever, women have a variety of birth control options to choose from, such as the pill, a vaginal ring, IUDs, the patch and even birth control injections or subdermal implants.
Although Kitashima and Brizzolara are not currently practicing obstetrics, both suggest that a woman should schedule a doctor’s appointment within two weeks to a month of learning that she’s pregnant. “She should be taking 400 micrograms of folate prior to getting pregnant if possible,” adds Brizzolara.
It’s important for patients who are going through menopause to discuss with their doctor the option of being put on hormone replacements. “It’s not for everyone,” says Brizzolara. “Only if a woman is experiencing [ongoing] symptoms.” She suggests eating a balanced diet, cutting back on alcohol and caffeine, and not smoking. Brizzolara and Kitashima have put their menopausal patients on hormone replacement treatments, but do not recommend using the controversial bioidentical hormones.
Kitashima and Brizzolara will send their patients to fertility specialists if they are having trouble conceiving or a gynecological oncologist for patients who have cancer of the reproductive organs. Not all women like to share their problems, however. Women hide urinary incontinence from her, says Brizzolara. “There are so many good new treatments and minimally invasive procedures for incontinence now that a woman should feel free to ask for help.” Kitashima adds that she has had patients try to hide risky sexual behaviors and even domestic abuse from her, while others are resistant to annual tests such as mammograms and colonoscopies. “Unfortunately, some tests are uncomfortable, but early detection can save a life,” she says. “It’s not for me, it’s for them.”
Key Advice for Women
For women between ages 11 and 26, get the three Gardasil shots that protect against certain strains of HPV, which can lead to cervical cancer.
- Perform breast self-exams.
- For women ages 35 to 40—depending on one’s family history of breast cancer—schedule a yearly mammogram.
- Before visiting the doctor, have a prepared list of the medications and vitamins you take, as well as questions and topics to discuss during the visit.
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