All posts in Health Conditions and Pregnancy

Breast Self-Exam

It is common practice at your regular OBGYN appointment for your doctor to perform a breast
exam, by using their hands and examining the overall the look of your breasts. Though this is no
substitute for a mammogram, which adult women are advised to have done yearly, it is a useful
method to see whether there are any visible or tactile abnormalities on your breasts. In fact, 40%
of breast cancers were diagnosed because women noticed something unusual about their breasts.

Is this something I can do at home?
Absolutely—and it is a good idea to perform a self-breast examination once every month. Consider it a monthly inspection you deserve, and one that at the very least helps you learn your body better. Using your eyes and hands for this examination, you can develop your own breast awareness and be able to immediately identify changes—should there be any, fingers crossed not!

What do I do?
First and foremost, it is important to choose a time of the month when your breast will not be as tender since this can cloud the results of the inspection. Ideally, during a time when you are not menstruating or ovulating. Secondly, remember you can (and probably should) ask your doctor or nurse practitioner for a demonstration on how to do this at home.

The most effective technique is to start with a visual examination of your breasts. Stand shirtless and braless in front of the mirror, with no-shadow casting light if possible, and place your hands at your sides. Look for any changes in size, shape, possible asymmetry, dimpling, or puckering. Check to see if your nipples are inverted. Then, inspect your breasts in a similar manner but after raising your hands above your head, palms pressed together forming an A shape. You can also lift your breasts and inspect whether the ridges on the bottom are symmetrical. Should you not trust your own vision, or if you have a visual impairment, it’s a good idea to ask a partner, trusted family member or friend, to help you with this.

Is this all?
The visual inspection is the first step. Next, you want to use the pads of your three middle
fingers. If you can’t sense very well with the pads of your fingers you can use your palm or the
backs of your fingers. You can do the tactile inspection in the shower or lying down (that way,
the breast tissue spreads and it’s easier to feel).

Now, take your time, don’t rush, and establish a routine for this part. If you do it clockwise every
time, for example, and in the same order, then after a few times you will be better able to judge
any changes in the pattern of your breasts. The goal here is to feel the depths of the breast using
different levels of pressure—so you can go over the whole tissue. Closest to the skin, use light
pressure. As you go try to feel a little deeper, use medium pressure. Closest to the chest and ribs,
use firmer pressure.

Remember that you are not looking for anything in particular, you are just learning the patterns
of your breasts. So, take deep breaths, take your time, remind yourself this is being done
absolutely for preventative reasons—just like flossing!

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Healthy Pregnancy with MS

What is it?
Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system, mainly
the brain and the spinal cord. Like most autoimmune conditions, research remains inconclusive
on what causes it, other than: antibodies attack healthy tissue. In MS, your body attacks the
myelin sheath: the wiring protecting your nerve cells. This damage causes messages from your
brain to the rest of your body to slow down, or completely stop. Most common treatment for MS
is a Disease Modifying Therapy (DMT), tailored to the patient’s needs and the severity of the
condition.

DMTs and Pregnancy
Women who have been diagnosed with MS and are thinking of becoming pregnant have likely
been told that most DMTs are not safe to use during pregnancy. One of the most common
concerns with stopping DMTs is the risk of relapse after pregnancy. In fact, medical
professionals suggest you stop the therapy altogether once you embark on your pregnancy
journey.

Another research, however, has found that 12% of its women participants were taking a
DMT during the first trimester. This lowered to 3% of participants by the third trimester. This is
not to say that use of DMTs during pregnancy is safe, but it does point to the need for further
research.

What should I expect?
It’s common that during pregnancy most autoimmune diseases—including MS—quiet down:
you may not experience as many symptoms, or your symptoms may lessen. Researchers believe
this is due to the hormones your body produces during pregnancy.

There is no evidence MS causes any miscarriages, stillbirths, or congenital malfunctions. Some
research suggests that premature labor and the risk of infections have been found to be slightly
higher in women with MS. Your doctor may suggest closer monitoring of your pregnancy, more
prenatal visits, and further tests to ensure your health. It’s possible you may need to consider a
C-section, especially if your MS symptoms affect your pelvic muscles and nerves.

What about relapse?
Research has found that the risk of relapse is relatively low during pregnancy. However, it can be
treated with corticosteroids which are generally known to be safe during the first and second
trimester.

After giving birth, studies have found an increased chance of relapse in the first three months. A
significant factor is the stability of the disease prior to pregnancy, and it is used to reduce this
risk. Similar to use of corticosteroids, if you are thinking of breastfeeding, remember that DMTs
can also pass through breastmilk—their use is not recommended if you will be breastfeeding.

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