Advanced Care Ob/Gyn Infertility

exams (SBE). A woman should start her SBE when mature enough to perform such an exam or by the age of 21. There are several different ways to perform an SBE. Each differs in technique, but all are equally effective. If you are not aware of how to do an SBE, we can instruct you in the office. You can also visit sites like the American Cancer Society or Web MD, which are helpful. Doing the exam empowers women to take charge of their health care and allows them to become familiar with the breast tissue. Knowing the feel of the breast tissue will help one distinguish what has been there, what is new, what may be abnormal, etc. Concerns regarding your SBE should be referred to your gynecologist for prompt evaluation.

urologic history. It would also include the examination of the breasts and abdomen, genital, and vaginal areas. I also examine the patient’s social and marital history. An important part of this exam is the psycho-social aspect of women’s health care. I try to provide an open and free-flowing environment that allows a patient to discuss other issues and aspects of her life. The annual exam allows the time to listen and provide the care each woman deserves. Annual pap screening is recommended to begin at age 21, independent of sexual activity. The pap is done with the annual gynecological exam.

part of the exam. In this age group, education is a key component of the visit. I try to really discuss with each young woman the issues of pregnancy prevention, STD protection and prevention, available human papilloma virus (HPV) vaccinations, and an awareness of her body. There may be many other psycho-social issues that surface during this time. Talking about sex in particular may be hard and uncomfortable for a mom or dad to do or for a girl to hear. But nonetheless it is very important. It may be easier to hear it from her doctor. These topics are very important for women in this stage of their lives. I always welcome and encourage women younger than 21 to have a visit with me prior to that age. Ideally, somewhere between 13 and 15 years old is a good starting point. At this visit, a young woman is introduced to the idea and concepts of a gynecologist and the care provided. I keep it upbeat and positive, and base the conversation and details on the level of maturity of each individual. I try not to scare or overwhelm them on their first visit.

I review routine health and screening recommendations. I also take a family cancer history to attempt to identify patients who are at increased risk of breast, ovarian, uterine or colorectal cancers. If patients are identified, I then review available testing for genetically linked cancers of those areas, many of which can be performed in our office.

At 35 to 39, I recommend a baseline mammogram. This allows the radiologist a reference to compare future mammograms, which should begin annually at age 40. I also screen women for HIV and vitamin D deficiency. It is recommended for all women ages 13 to 64 to have annual HIV testing, independent of risk factors. This is to identify asymptomatic HIV-positive persons. Annual vitamin D testing is done since low levels have been associated with an increased risk of colon and breast cancers. Testing allows me to identify, educate and potentially prescribe certain supplements. As an aside, the recommended daily requirement for vitamin D is 800 IU. This is available over the counter as vitamin D or D3. I generally recommend the vitamin D3.

osteoporosis. Early detection leads to early intervention and the hope of avoiding fractures related to thin bones.

As a woman, you’re probably the general or commander-in-chief of your home. There is a tremendous amount of work you do to run a smooth operation. You take care of everyone else first. Realize that you need to take care of you! You need to stay healthy to do all that you do. We at Advanced Care are here to guide you and help you on your life’s journey.

PICTURED: Salvatore A. Carfagno, DO, FACOOG, Board Certified in Obstetrics and Gynecology, with his beautiful family

Courtyard Professional Offices 707 White Horse Pike, Suite D4 • Absecon, NJ 08201 609.272.0506 • Fax: 609.272.0607 Linwood Commons 2106 New Road, Suite D10 • Linwood, NJ 08221 609.927.2244 • Fax: 609.927.2242 Affliated with: AtlantiCare Regional Medical Center and Shore Medical Center