HCR and Preventative Services for Women

So I’ve been hearing a lot about this so-called committee for Preventative Services for Women. A blog from NLIRH’s board member recently reminded me to look it up!

To my surprise the committee IS real (it was formed by the Institute of Medicine of the National Academies). For the next 15mos they will “review what preventive services are necessary for women's health and well-being and should be considered in the development of comprehensive guidelines for preventive services for women”. Their aim seems to be at reviewing and identifying the gaps in the guidelines set by the USPSTF, which in my opinion, are TONS!

My problem with the people over at USPSTF is that their very generalized recommendations are first, made by doctors from a WIDE array of specialties, and second are left standing alone, without any public education. We all saw what happened with their new breast cancer screening recs, women all over the nation where confused, frustrated, and furious! But that’s a side note.

Now this new committee seems to be on to something. I was very pleased to see women of color on the 14 person committee, as well as 4 men! Most importantly, I was also happy to see progressive states like mine (Cali), being repped hard. We all know we don’t want some super conservative Palin wanna-be influencing women’s HCR policy!

Although the committee’s focus is women’s health, it was not surprising to see much of the public and media clamor being focused on one thing…birth control. Apparently their first meeting touched upon whether or not insurance plans under our new HCR should eliminate co-payments for birth control. Of course I can already see where this will end up…a political debate on the ethics of contraception. Le sigh…

Hopefully they will have the sense to be able to look over this issue and see the significance of the voices that are NOT present at these meetings!

I will continue to follow the committee and their meetings, so check back for updates!

Limited English Proficiency and Health Care Disparities

Did you know, over 20 million people in the US are limited English proficient (LEP)?

The other day, we had a really cool and sexy workshop on patients who are LEP and the health care disparities they are forced to experience. It reminded me of the first time I had to use an interpreter in clinic, and how awful I felt because it seemed like most of the interview was lost in translation. Anyway, I thought these statistics were quite alarming, so I wanted to share them with all of you!

Although most physicians believe they spend more time with LEP patients, they in fact spend the same amount of time with their patient, despite the use of an interpreter.

In a study of six hospitals, 49% of adverse events experienced by LEP patients resulted in physical harm vs 29% with English speakers. 52% of these errors were more likely a result of communication problems.

Now here's the doozie:

A study of children coming from families with LEP showed that:

-these children had triple the odds of having fair to poor health statuses
-double the odds of spending at least one day in bed for illness in the past year
-and had significantly greater odds of not being brought in for needed medical care

Now ain't that something to swallow! These numbers are just ridiculously unacceptable. However, what can we do to make this better? THAT is the million dolla question. Although we don't have the end all be all answer, I think we can all agree that at least for our communities, we must recruit more native spanish speakers into medicine so that we can provide real cultural competent health care to our people.

Quote of the Week!

This week's quote isn't funny, but it is necessary!

It is an ode to my best friend in med school, my brother from another life, and my musical partner in crime....

Me: "Aye Raul...what would I do without you?"

Raul: "I'm not gunna lie Kryss....probably die...."

What's not funny is that it's true! He has saved me from falling through windows, anaphylactic shock, and of course from going crazy in med school.

Thanks for everything buddie!

What’s in my Sexy Tears?

In light of our recent eye dissection and my curious observation of ClearEyes, I wondered, what makes up tears?

Apparently it is one part water, one part oil and one part mucus. The mucus helps to keep the cornea lubricated. The oil helps the tears from evaporating. The water part is the most interesting. It is a sexy salt (saline) solution that contains many vitamins, minerals, and antibiotics.

The function of tears is to keep our eyes moist and bacteria-free.

We are constantly producing tears throughout the day which are released from our lacrimal glands and drain into our nasal cavity. When we release too much, they flow over our eyes and we notice it as crying.

Now the physiological/evolutionary purpose of crying when we are upset is, from my knowledge, unknown….but it would be interesting to hear everyone’s theories!

The B-Word

What exactly is in the word “bitch?” Well, it literally means “female dog,” but it is often used to put down outspoken and confident women and/or subordinate men.

It is such a small, yet powerful word. It has the potential of taking everything away from a woman, and making her feel worthless…powerless. Yet, woman all over the country have recently begun to embrace the term, from Clinton to Palin. Well not really embrace, but you know…

So does that mean that the word “bitch” has become no BFD? Heck no!

It is still fully charged with sexism and now homophobia. It is still a malicious and spiteful word. Along with gay/faggot (being misused) and illegal (as in illegal alien), it is one of four words that I will stand up and be the loud brown girl everyone thinks I am.

People throw out the word “bitch” when they feel scared and threatened, mostly due to their own insecurities.

It is not our fault that we are strong, outspoken, unapologetic, commanding women. And no, we won’t calm down to make YOU feel more comfortable. And NO we won’t allow you to use that demeaning word to help make you feel more secure about your damn self!

So moral of the story, it is NOT okay to use the word bitch, and yes it is still a BFD to give us such a label!

I LOVE Being a Girl

Somebody just reminded me of how much of an emotional creature I am.

When I get super sleep deprived I get extra emotional…probably because my hormone levels are making my brain revert to more primitive patterns of activity.

BUT I was reminded of the poem by Eve Ensler today, “I am an Emotional Creature.” It is from the book I’ve been meaning to read, but just haven’t gotten around to it. Anyway, I would like to state that I am an emotional creature…that is how HE/SHE made me. I love being a girl…period.

“I can feel what you're feeling,
 as you're feeling it inside, 
the feeling 
before.
 I am an emotional creature…These feelings make me better.
 They make me ready.
 They make me PRESENT.
 They make me STRONG. I am an emotional, devotional, 
incandotional, creature. 
And I love, hear me, 
love love love
being a girl.”

Check out the poem here. And J. Hudson vagina monologue  version!

Genetic Testing: Throwing our People Under the Bus!

Genetic testing has become increasingly popular within the past couple of years thanks to advancements in the sexy world of science. However, as with most science agendas, many people begin to throw in that little, yet oh so powerful word, "ethics."

Genetic testing/screening is usually done before two people decide to have children, during pregnancy, or right after birth. The ethical question comes into play when couples decide to test during the first trimester and later determine whether or not to keep a fetus if they come to realize that he/she will have some sort of genetic error. While it is completely up to the couple to decide what path to take (I have no right to tell you my two cents on that), MY ethical concern is, what happens to all the rest of us who can't afford a genetic test?

While most tests can run you anywhere from a few $100 to a few $1000, it is clear to see that there will be a disparity between people who can actually afford to get one done. So I pose the question....is genetic testing ethically correct?

Let's say for example, we have a genetic test that will reduce the number of children in our population with Down Syndrome. Someone recently posed this question to me saying that the test would reduce the number of children born with Down Syndrome in the US by 66% (just a hypothetical number). However, the down side would be of course, that only those who could afford the test would benefit. Would you sacrifice and essentially throw the lower class under the bus to reduce the number of Down Syndrome cases?

And of course my response was hell to the no! My initial thought was " A Brave New World."  Ha! No but really, as it is, the lower class can't afford health care period, and now we would be secluding them to deal with more diseases? The idea is simply unjust and inhumane.

But look around, it's already happening. We have so many different genetics tests and screenings that never make it out to our communities. So many affluent families are being screened for diseases and our counseled on when to have kids or to have kids at all. They are essentially only breeding the cream of their crop, while leaving us poor folk down in the dumps.

So even though I might have joked earlier, "A Brave New World" doesn't seem too far off from where we are at today.

Mmm now if that ain't food for thought, than I don't know what it is!

1000+ Hits!

Thanks for reading all! I've reached 1000+ hits in the last two weeks in FIVE different countries! Yay!

Quote of the Week!

Well more like a few weeks ago...but still funny nonetheless!


Student 1 inquiring about Student 2's PROSTATE exam: "Was your standardized patient male or female?" 

Your Mayan?!? That’s So Exotic!

I couldn’t post a piece about race without saying a few words about MY race.

So you all may or may not know that my last name is “Chan.” And although I used to love educating people, I’ve grown very tired of having to explain over and over and over again the origin of my last name, especially after moving to a new institution.

My last name is actually Mayan. “Chan” means serpent in Yucatec Maya. My entire family is from the Yucatan Peninsula and most of them are 100% indigenous. It is verrry comforting to know my exact heritage because it is something that is unique to very few people.

However, being Mayan sometimes means different things to different people. While some people may also embrace it, others may take a different path. The most annoying is when people call me “exotic.” Many of you may have seen the CNN article I posted on FB a while back commenting on the new “exotic” trend. It was describing women as flocking to surgery rooms to get the “curves” often associated with exotic-looking women. Basically, they were saying “exotic” is the new it thing.

I was so annoyed by this article because it reminded me of how much I hate it when people label me “exotic.” I absolutely despise it. Exotic is the name we give things that are imported or unusual, and for crying out loud I am not either! Exotic is what we call reptiles and colorful plants or animals. Exotic is the name we give to THINGS not people, so for the love of baby giraffes, don’t put us in the same category!

So now, don't be surprised when a fierce Latina named Dr. Chan, enters your exam room. ;-)

You Racist *&*%!

Ha, I hope that title caught your attention. Now you all know I couldn’t write a blog without talking about race, gender, religion, etc…

Today I attended a very engaging brown bag lunch for the book club UCDSOM has. Actually they are making every first year med student read the book, Why Are All the Black Kids Sitting Together in the Cafeteria? And Other Conversations About Race, by Beverly Daniel Tatum, as well.  Although I have read parts of this book before, I still find new things to take away from it.

I was also very interested to see how my fellow classmates would react to it. And well let’s just say we had very interesting sets of reactions. Ha!

So, when you think of racism, what are we REALLY thinking? How do you even define racism? It’s really hard to have these types of conversations when we don’t even have clear definitions.

In her book, Tatum defines today’s racism as being passive and more systemic/institutional than the racism of the 70’s which was active and personal. Under this definition than, she defines ALL whites as being racist, because they knowingly or sometimes unknowingly benefit from this system of advantage. Now let’s dwell on that…if you’re white, you’re racist!

However, I must disagree with her when she states that under this system minorities cannot be racists because they have always been the oppressed. I personally feel that EVERY single one of us is racist/prejudiced.

If you’ve ever taken your maleness for granted, you’re guilty. If you’ve ever taken your gender for granted, you’re guilty.  If you’ve ever taken your age for granted, you’re guilty. If you’ve ever taken you’re religion for granted, you’re guilty. You’re guilty because you have actively benefitted from the system because you were in the majority.

So first step: acknowledge that you are racist. Accept it. Yes, it might make you angry, yes it might bother you, but it’s the truth!

Now let’s deal with it. I truly believe there is not enough dialogue in homes and in schools about racism and its existence in today’s societies. Educate yourself, your friends, your kids, your significant others. Let’s start some conversation people!

HPV Vaccine...are YOU Protected?

This topic is the original reason for the birth of my blog. I recently attended a very informative conference that included a segment titled “Health Disparities and Vaccines.” While this topic will be the subject of a future blog, I wanted to take the time to educate all my beautiful minority women on the HPV vaccine and hopefully reduce your disparity!

So let’s just get down to it. How many of you have gotten the HPV vaccine? Of those of you who haven’t…why not? Well there may be a number of reasons, most of it can be blamed on the entire epic fail of a campaign called “One Less.” We all remember those commercials and ads. Anyway, that also can be a topic for a later post.

Well if you haven’t, it might not be too late. The vaccine is recommended for women ages 13-26. The vaccine has been found to be most effective around the ages of 10-14. However, most women contract an HPV infection before their 25^th birthday, so in my opinion, it is still somewhat beneficial to get vaccinated before turning 25.

Moving on, did you know there are different types of HPV vaccinations? Now bare with me, this gets a little complicated. We have HPV #2 (manufactured by GlaxoSmithKline) and HPV #4 (by Merck).

The Pros:

HPV #4 not only protects against HPV Types 16 and 18 (one of the high risk cervical cancer related types…look at my last post if you’re confused), but also against HPV Types 6 and 11, which can cause genital warts.

HPV #2 does not protect against the genital warts but after 7 months of administering the vaccine it will essentially produce more sexy soldiers against HPV Types 16 and 18 than HPV #4. So in theory, it is suppose to be a more potent vaccine against HPV Types 16 and 18 than HPV #4.

The Cons:

There are none specific to either vaccine, but in general both may cause local injection-site pain, swelling, redness, nausea, and fever. You must also wait 2 months after being vaccinated to get pregnant.

So my conclusions, GET VACCINATED! Although there is no clear choice on which HPV Vaccine # you should receive, the choice honestly depends on the nature of protection you desire.

Clearly and simply, EVERY woman is at risk of contracting some form of human papillomavirus, and if we have a solution, why not take it? Of course, the choice is yours. EDUCATE yourself and LIVE the most responsible life you can J

P.S. This has been a hot topic of debate around my circle of besties, so if you have any questions please don’t hesitate!

Human Papilloma...What?!?

Human Papillomavirus, aka HPV.

We've all heard of it and seen the commercials and read the ads...but what really is HPV? As I was writing my future post about the HPV vaccine I realized it needed some background on vaccines in general and about HPV. So here is a short and sweet summary of HPV.

Did you know there are almost 200 different known strains of HPV? I emphasize "known" because there may be 200 more that have yet to be discovered. Out of these 200, about 40 of them are known to be transmitted through sexual contact. Also about 90% (eeegh don't quote me on that number) of those 200 strains are pretty much harmless. For example, HPV Types 1, 2, 3, 4, 7, 10 and 63 cause some form of common warts.

However, some have been associated with much more serious cases. HPV Types 6, 11, 42, and 44 can lead to genital warts. Also, about 16 types have been been associated with cervical cancer. The most "high-risk" of these cervical cancer-associated HPV's are Types 16, 18, 31 and 45.

Now although it seems as though the chance of contracting one of these serious types of HPVs is very low, let me remind you that that was exactly what people though about HIV and AIDS back in the '70's. Truth is, there isn't enough research to predict the exact probability of contracting one of these HPV strains.

So moral of the story...get vaccinated (my next blog post will have more info on that) or use a frieken condom!

Vaccines and our Immune System's Sexy Soldiers

Like the attitudes some people have about the flu shot, some of us have been programmed to think that vaccinations make you sick because they introduce a virus into your otherwise, healthy body. While that is true, that is not the entire truth.

Vaccines are safe because they introduce virus and/or bacteria into your body that has been severely compromised. Most vaccines use viruses that have lost their ability to reproduce, are dead, or only contain one itty bitty protein from its cell surface in it. Thus, they do not have the capacity to make you sick.

Anyway, when our bodies are introduced to a new live virus, we fight it with our immune response, which I like to call our sexy soldiers. Some of these sexy soldiers remember what the invading virus looked like, so that next time they try to come back, they are almost instantly defeated. The cool thing about our sexy soldiers is that unlike me, they retain this memory for as long as you keep breathing (ie. your entire life).

So when we get a vaccine, we introduce a new virus into our army. And although it is dead, our sexy soldiers still produce an immune response and memorize what the invading vaccine looks like. Now next time we encounter that virus, our soldiers will know exactly what to do, and they will defeat it before we even notice!

So moral of the story...get vaccinated!

Can you Flare your Nostrils?

Most people can, but other less fortunate fools can't. Well, idk why some people can or can't, BUT thanks to a brilliant and sexy presentation on the FACE by my lab partner today, I know the muscles responsible for muscle flaring. Introducing...in no specific order, the nostril flaring muscles:

1) Levator Labii Superiouris Alaque Nassi

2) Transverse Part of the Nasalis Muscle

WheeeeeW...talk about a mouthful! I must say their names are quite sexy!

Great Job Girl, you definitely hit a homerun! 

Want to Help Provide Health Care to Those in Need?

So, among all the other things I'm involved in, this year I am helping plan UC Davis School of Medicine's 31st Annual UC Davis Wine Tasting and Auction Benefit! It helps benefit our seven awesome student-run clinics (the ones you all hear me talk your ears off about)! Well, the clinics are entirely not-for-profit and we host many small fundraisers throughout the year to be able to keep them open and continue to provide free health care to those who don't have access to it. Anyway, this Auction Benefit is where most of our funds come from.

It's basically a real fancy Wine Tasting and Auction event here at the med school where all the alumni, faculty, residents, and students come and drink a little, mingle and bid on auction items. It's like one of the biggest events the SOM puts on! Last week we just sent out the first 500 invitations to local alumni, and we will soon be sending out more invites.

The event will take place the first weekend of January, but of course we need to collect auction items now!

So if you have any special talents, services, and/or products that you would love to donate please please let me know! Also, since there will be tons of docs and faculty in attendance,  chances are your company will be highly promoted (ie. great business opportunity for ya).

Send me an email or drop me a line if you are interested so I can give you the deetz!