Google Speech-to-Text API Automatic Transcription (Chirp). Treat it as a searchable index of what was broadcast, not a quotation record.
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00:01:02The history of women's health is a complex journey that has been traced
00:01:06to ancient times. In our modern day, it has sometimes
00:01:09been shaped by superstition, misconceptions about women's bodies
00:01:13and lack of female
00:01:16of of
00:01:19of of medical professionals, but important breakthroughs in understanding women's health has improved in recent decades.
00:01:23This is certainly good
00:01:24of news as the health of our nation's women influences the wellbeing of
00:01:28us
00:01:29of all. My name's is Dr. Carise Manchester, I'm
00:01:31of the head of obstatrics and gynacology at the Joseph and France General Hospital here in
00:01:35St. Kids. I
00:01:39found
00:01:41of of in my experience as an obstatrition gynecologist and even before growing
00:01:45up and in my training that I
00:01:49guess my goal has always been that I've never
00:01:52of actually seen women really be empowered
00:01:55of to make the best reproductive choices and the best choices
00:01:59about their... health and for various reasons, but I mean
00:02:03I might be biased because I'm
00:02:04a female and I might be biased because I deal primarily with females, but I do
00:02:08believe that females and women are pretty much the
00:02:12center stone
00:02:13of the family and
00:02:15of the society and the community. I think that the
00:02:18of more we empower the women in the community and in the
00:02:21family,
00:02:22of then we're actually empowering everyone, and so
00:02:26empowering women, educating them more on their health, what...
00:02:30they should expect, what should be
00:02:32of accessible of to them, what they should be seeking out in terms
00:02:36of their health as a holistic person, I think that's where we
00:02:40should be focusing in terms of us as doctors, us
00:02:44as relatives of people who may need to access healthcare and health
00:02:47administrators, and the key is
00:02:51of education, once you educate your patient, what are the signs and symptoms to look
00:02:55for, then I think
00:02:56of they'll be able to mitigate whatever the situations may be.
00:03:00obstatrics is for pregnancy, gynaecology is women's
00:03:04health, it's a broad topic from when you're
00:03:07born until your last breath. with the fate of two
00:03:11precious lives in
00:03:12of the balance, obstetric care is an essential science.
00:03:15recent research and development in issues related specifically
00:03:19to women has improved the chances for healthy pregnancies.
00:03:23women are having children when they're older, because as opposed
00:03:27to 50 years ago women today we have things
00:03:30to do, we have goals, we have
00:03:34ambitions, we have responsibilities that we're
00:03:37focused on, and we want to achieve certain things before we
00:03:41embark on child bearing, when they achieve goals, when they're
00:03:44more, their financial health that we mentioned, their social health, all of
00:03:48that is in place and
00:03:49in a in the best state that they
00:03:52of can be in, then that helps with the obcetric outcome as
00:03:55well, more resources at your disposal, you are more
00:03:59with... you are more educated in most cases
00:04:03and that situational awareness you
00:04:06can
00:04:07you know make better choices for you and your family. the
00:04:11younger women who may not be in the best place in terms
00:04:14of the other aspects
00:04:15of their health, they end up having children
00:04:19when they may not be quite ready for it, and lot of it has to do
00:04:23with not being aware
00:04:24of the contraception options and how they work and what's best for
00:04:28them. methods
00:04:30of and lifestyle choices help to ensure pregnancies can progress
00:04:34with the help of both the
00:04:36of mother and child in mind. we always
00:04:38of encourage women young or old to plan their families, doesn't always
00:04:42work out
00:04:42in like that, but where you can, you plan your families and when you decide, okay, now
00:04:46i want to start trying for baby, that's when you go and
00:04:50see your healthcare provider, and they can give you all the tips, they
00:04:54can make
00:04:55in sure all your health factors are in order, they can do tests as necessary
00:04:59to make sure that anything that needs to be modified before pregnancy to
00:05:03ensure the best outcome can be modified early
00:05:06of and a that's always better. my name is Dr. Lesan
00:05:09Christian, head
00:05:10of the pediatric department. the Millennium Heights Medical
00:05:14Complex. Before you get pregnant, I think it's a very big
00:05:17step to make, because you have to look at you, not just having the baby, but
00:05:21support after having the baby, you know, like what's the long-term
00:05:25plan, but even so you need to sit with your partner, and both of us need to look
00:05:29at our sickle cell - status to know if I have the trait, and if he
00:05:33has the trait, there is a 25% possibility the baby can have
00:05:37full-blown sicker cell disease, and so it's important for the
00:05:40partner or the couple to... to have their cycle cell screening
00:05:44done as well as even the HIV and syphilis status because these are
00:05:47things that also have different treatment in the perinatal
00:05:51period so I think planning the pregnancy is important you need to start your
00:05:55prenatal vitamins so very important your folic acid
00:05:59because deficit the folic acid in the first eight
00:06:03weeks can result in what we call neurotube defects so
00:06:06you can have like your meningo milacil which is an opening around
00:06:10the lower aspect of your spinal cord and so increasing your folic
00:06:14acid will help to reduce the chances of having neural tub defects
00:06:18and also you want to increase your iron sources because anemia in
00:06:22pregnancy can also have its own complications. folic acid
00:06:26leads to the formation of one the building blocks for blood
00:06:30cells and some the other cells that are needed
00:06:33to form these organs that come from a part the
00:06:37embryo called a neural tube as i mentioned brain, spinal cord
00:06:40etc. and so if you're deficient in
00:06:44it then that can lead to defects in the development of
00:06:48those organs and the good thing about living in the Caribbean is
00:06:52most the time we get folid from all these lovely things we eat
00:06:55mangoes and pineapple and all of those
00:06:59things tend to have fool it and the dushhing and the you know
00:07:03sweet potato and we tend to eat those things a
00:07:06lot and so most the time our population
00:07:10doesn't tend to be deficient in but you can be deficient in
00:07:14fol it and so we do require that most women take
00:07:18that supplement. in terms of throut your
00:07:21pregnancy, we encourage exercise, that's one thing we do encourage,
00:07:25moderate level exercise. if you were someone that went to the gym
00:07:28regularly before, you used to go running before, walking
00:07:32before, you can continue at whatever level your
00:07:36body was already accustomed to, and then you listen to your body, you
00:07:40know, if you find that you get more tired now than
00:07:43before, then you slow it down, you decrease the intensity, but we do
00:07:47encourage exercise during pregnancy, you can still exercise, you can
00:07:51still go to work, you can still eat most
00:07:55things, there are certain things that we try to avoid in
00:07:58pregnancy, and that's that's a specific list, you know,
00:08:02obviously we want, we don't want you to be eating raw foods, things
00:08:06like that, because then you know the bacteria in there can thrive when
00:08:09it's not cooked all the way through, so we don't encourage raw
00:08:13foods necessarily, certain vined cheeses like blue cheese
00:08:17etc. we don't encourage buse they can have certain types of bacteria in them as
00:08:20well. we actually encourage smoking sessation
00:08:24totally, and there are safe levels of caffeine you can
00:08:27take, but that's hard for the average
00:08:31woman to gauge, so we just basically tell women to
00:08:35avoid caffeine and pregnancy, and it's always safer to just avoid
00:08:39alcohol. the diabetic patient before she gets
00:08:42pregnant should have what we consider as good tight
00:08:46glucose control, so we need to make sure that her hemoglobin
00:08:50A1C is within the normal range, because
00:08:54if she gets pregnant and her hemoglobin A1C is not
00:08:58control, she has increased risk of getting congenital
00:09:02anomalies or birth defects and
00:09:04organogenesis actually takes place within the first
00:09:07trimester, a pregnancy is divided into three
00:09:11trimes, and organogenesis, which is when you have organ
00:09:15formation, takes place in the first three months, so if
00:09:19that patient is not aware that she's pregnant, her
00:09:23sugars are not controlled, there is increased risk, so that's
00:09:27an example where pre-pregnancy counseling will come in. we also
00:09:30want to make sure that any woman who is considering getting pregnant
00:09:34should start taking folic acid. folic acid has been shown to
00:09:38help to decrease birth defects, neural tube defects, spinal if
00:09:42it does and all sorts of problems with your brains,
00:09:46so we advise you to take your medication prior to
00:09:50pregnancy. if you take the hypertensive patient who
00:09:53is thinking of getting pregnant, we may need to consider
00:09:57changing her medication to medication that is not
00:10:00tetratogenic that can cause birth effects. so she's
00:10:04hypertensive, she wants to get pregnant, she comes to
00:10:08us, we will take a good history and we may decide to change
00:10:12a medication, also even if
00:10:14you want to think about the physiology of pregnancy, during the
00:10:18first trimester, the blood pressure actually falls, so
00:10:22you may find that these women may not need to have. medication
00:10:26initially when they become pregnant because the whole physiological
00:10:29changes that takes place during pregnancy. developments and
00:10:33research has also increased the level of knowledge of many diseases which
00:10:37are particularly relevant to women. one the things i've
00:10:41recognized in my experience is not all
00:10:45women understand what a normal menstal pattern
00:10:48is. why is my period so long? why is my period so short? why i missing
00:10:52periods? all those abnormalities. "we need to educate women to be
00:10:56aware that, listen, this is not the normal pattern,
00:11:00and you should seek help, and that I think is very
00:11:03important, not just with menstrual irregularities,
00:11:06but most things with gynecology
00:11:10is for women to understand that these type
00:11:13of you know things that happen to us outside the norm
00:11:17aren't okay, but there is help, there is management for some the
00:11:20things that cause those type of
00:11:22irregularities." My
00:11:26name is Dr. Sharito, obstatucion and gynecologist here in Antigam
00:11:30Barbudo and you are watching Caribbean Medical
00:11:33TV.
00:11:36Endometriosis is when tissue that is normally found
00:11:39in the lining the womb is found in other
00:11:43areas where it should not be, when it is found around the
00:11:46ovaries, this is in the pelvis, behind the uterus, it
00:11:50can be as far as the lungs, we call it endometriosis, when that
00:11:54tissue... goes into the wall the womb, we call it
00:11:58adenomeyosis and this is very common condition that
00:12:02affects women, not just in the Caribbean but worldwide,
00:12:05unfortunately most women are diagnosed late,
00:12:08the most common presentation will be
00:12:12painful menses, especially when it's disruptive, when
00:12:15it is severe, when it is associated with nau
00:12:19and vomiting and it disrupts their daily routine so they're not able to
00:12:23go to school or they're not able to go to work, they had to be taken
00:12:27significant analges or pain medication to relieve the
00:12:30symptoms. That's a
00:12:31flag.
00:12:35Hi, I am Dr. Iran Clark, consultant radiologist,
00:12:39saying kids.
00:12:43Another pathology that I find is very frequent uh,
00:12:47polycystic ovaries, seen a lot in young
00:12:50women and also linked to hepatic
00:12:53steatosis. when i see a patient with polycystic
00:12:57ovaries, i would take a look at the liver to confirm
00:13:01that they have the hepatic steatosis and usually
00:13:05they do, the treatment for polycystic ovaries is
00:13:09the same as the as diabetes, the met
00:13:12formin, so once i see polycystic
00:13:16ovaries, i go and look for the fatty liver, the ultrasound
00:13:20can be used to check for healthy ovaries, visualizing a
00:13:24small over. without follicles usually indicate that the ovary
00:13:27may be atrophic and not producing any hormones.
00:13:31where in turn, if there's a big ovary with
00:13:34multicist around the periphery the ovary, that is
00:13:38usually polycystic ovaries. normal
00:13:42ovary should have volume up to maybe between
00:13:46seven, almost 10, no more than 10
00:13:49centimeters cube. with that volume, the ov should have maybe
00:13:53seven eight follicles. to be considered normal
00:13:57ovary you with Dr. Leon stepens consultant ofstition
00:14:01and gynecologist here and Tegan Babudo, I'm pretty sure
00:14:05everyone in the Caribbean, black, white, Asian
00:14:08everyone at some point in time has to deal with
00:14:12uterine fibroids and if not that some sort of abnormal
00:14:15uterine bleeding. One the major things I found over the
00:14:19years that have been working is the prevalence of which we actually
00:14:23have of uterine. fibroids persons coming in
00:14:26with abnormal bleeding and statistics
00:14:30actually do state that most black women because
00:14:33of our African descent and because of
00:14:36genetics do have predisposition
00:14:40to uterine fibroids. we still are not fully sure what's the
00:14:44main cause of it, but it has been shown that race does play a
00:14:48part. we also
00:14:50see that the size of fibroids that you see in the black population is much
00:14:53much bigger than. you see in the caucasian population and there always a lot of
00:14:57myts, is it because you have too much estrogen, is it because the foods that we
00:15:01eat, not necessarily, because I
00:15:05worked four years in the UK a
00:15:08basically white caucasian population, and I certainly
00:15:12did not see the size fibroids that we see in the
00:15:16Caribbean. Thank you, Dr. Nichols, we'll continue with more on
00:15:19this topic a short while as we focus on women's health here on
00:15:23Caribbean Medical TV.
00:15:29Republic bank is more than just financial
00:15:32institution, we've been a steadfast partner in the
00:15:36communities we serve investing in their future through our
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00:15:44Our aim is to drive meaningful change, expand
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00:16:06That's why we're. limited to making a lasting,
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00:16:41operate.
00:16:47This is Caribbean Medical TV. Preventative care has
00:16:51been found to be an essential pathway to treating some the most prevalent
00:16:55diseases and conditions common among women. We now
00:16:58continue the discussion on fibroids with Dr. Camille
00:17:02Nichols. The definitive treatment for fibroids is a
00:17:05hysterectomy because can go back, we can regrow.
00:17:09anytime we have patients who are going to have myomectomy, which is
00:17:13where we're going to try and remove the fibroids and try and save
00:17:17or conserve the uterus, you have to understand that that is
00:17:21much higher risk type of
00:17:24surgery than just a hysterectomy, and these patients need
00:17:28to understand that doing myomeectomy can
00:17:32lead to a hysterectomy, so before we even
00:17:36consider doing surgery... "these patients need to be counseled,
00:17:40yes I'm going to try and save your uterus, but if we run into any
00:17:43problems, we may have to take out your uterus. cancer is
00:17:47a big thing, it's becoming more prevalent in our
00:17:51region, and sadly we are
00:17:54diagnosing most these gynecological cancers very
00:17:58late. one the reasons for that is because most
00:18:02persons wait a bit too late to actually come to the
00:18:05doctor to seek." advice and I'm just going to make a
00:18:09plee that if it is you have some issue, something that's
00:18:13not looking well, seek medical advice, that
00:18:16little step that you make to just seek medical
00:18:19advice goes very long way, and there's no
00:18:23limit, there's more price on your life, your life is very
00:18:27precious. I would encourage women the Caribbean to
00:18:31prioritize their health, even as they take care their
00:18:35families to make sure that
00:18:36they take care. themselves, they put themselves first, make sure that they're doing their
00:18:40checks, seeing their doctors every year, if you do a well woman visit
00:18:44then you can pick up things before they become a problem, if you
00:18:48get screened and you don't have to wait until you having symptoms and
00:18:52when conditions such as cancer may be more advanced and and
00:18:55encourage the men and the women to come
00:18:59together to help each other and encourage each other to do what they need to
00:19:03do to not only protect themself from cancer but many of
00:19:07the conditions that are common and prevolenter in the Caribbean.
00:19:11Cerrical cancer is a preventable cancer, so of all the
00:19:14cancers that affect women here in the Caribbean and in the world. What
00:19:18is unique about survical cancer is that we know how to prevent it all
00:19:22together, and the approach to preventing cervical
00:19:26cancer involves vaccination of boys and
00:19:30girls between the ages of 9 to 14
00:19:33ideally. Persons can be vaccinated beyond that age group, but vaccination.
00:19:37is most effective when persons receive it between the ages of 9 to
00:19:4114. the next step would be screening. we
00:19:44screening, the age group for screening varies from
00:19:48country to country. here in antiga and barbido we start screening at age
00:19:5225 and then of course after screening we talk
00:19:55about educating women about the
00:19:59signs and symptoms that may indicate cervical
00:20:03cancer. most persons are familiar with the papsmare.
00:20:07That's usually done every three years, however, the
00:20:11WHO has no advised that women are screened with a
00:20:15high performance tests, we now do testing for the actual virus that
00:20:19causes cervical cancer, the human papillloma virus and that
00:20:22testing is available in most islands,
00:20:25however not easily accessible in
00:20:29many, and that is much more sensitive way of
00:20:32identifying women who are risk, so HPB infection is common
00:20:36and what we are trying to do when we screen women is
00:20:40identify women who have what we call the hirus types. one
00:20:43the things i also think we're deficient in in terms
00:20:47of gynacology specifically is
00:20:51consistent cervical cancer screening, so
00:20:54papers. I have lot of women that come to me and say, "doc, I
00:20:58haven't done my popsmer in about 10 years, I haven't done
00:21:02it in 20 years, I've never done a pops mirror, and
00:21:06so that again is education, because you
00:21:10should should be doing props at least every two years
00:21:12and
00:21:14some women don't know that, some women tell me, like I didn't know I was supposed to be doing
00:21:18it, I've never been told I'm supposed to..." be doing it
00:21:21and so and and when you look at people who died from
00:21:25cervical cancer, it's people who have not been regularly screen for
00:21:28cervical cancer, and also with paps mirrors, there's
00:21:32a lot of fear with paps mirrors too, fear the discomfort, fear
00:21:36of having to, you know, it's an exposing
00:21:40type of test for women, and so yeah, there's a lot of fear
00:21:44surrounding it, and so again, it's education,
00:21:48it's encouragement, it's...
00:21:50you know risk versus benefit, mean a little bit of discomfort for few
00:21:54minutes versus not knowing that you could have very
00:21:57serious illness, and we're lucky with cervical cancer that we
00:22:01actually have a screening test for it, and there's a few cancers that we can screen for, cervical
00:22:05cancer is one, breast cancer is one cuz we have the mammogram.
00:22:09in terms of mammograms, the literature says
00:22:12start at 40, all ladies should have baseline
00:22:16mammogram done, because if there are any changes. in the
00:22:20breast, we need to go back to that baseline
00:22:24mammogram to see what the changes are or to see
00:22:28how fast is it going. i'm seeing more
00:22:32and more younger patients coming with
00:22:35breast cancers. i've had one maybe
00:22:3928 years diagnosed with breast cancer. for the
00:22:43younger patients, i would prefer ultrasound first, and if there's something that
00:22:47looks suspicious, we can move to the mammogram. I would not
00:22:51go mamogram for patient below 40 first
00:22:55and then ultrasound. I would do ultrasound and then a
00:22:58mammogram. For patient over 40,
00:23:01it's mammogram as screening. As mammogram should have
00:23:05routine screening from the age of
00:23:0840. More and more in recent years, research
00:23:12shows that mental health should not be disregarded. Woman's
00:23:16physical condition can affect her mental health and vice versa, and
00:23:20Medical professionals are staying aware the importance of sound
00:23:24mental health practices, especially at difficult periods in their
00:23:28patients lives. I think I speak for almost every patient that
00:23:32I have sat with. I often say to them
00:23:35that, I don't know how I would be if I was sitting in your
00:23:39chair. I think it's the loneliest
00:23:42moment that you could sit
00:23:44in. It is very lonely.
00:23:48The moment that I tell you what your... biopsy is people don't realize there
00:23:52other people in the room, it is where your world comes crashing
00:23:55down, and so the person that you chose to
00:23:59come with you on that day is very
00:24:03important person and it almost always is their partner, their
00:24:06husband or their loved one in that way, and
00:24:10support for that patient is extremely important, it
00:24:14will motivate her to believe that there's life to fight
00:24:18for and life to live, "the journey is not easy, but it is
00:24:22short and you will come through whole, but
00:24:25support is everything, and so I would say to the partners of
00:24:29our Caribbean women, be there for them and support them, hold their
00:24:33hand, they will get through it, but they will only get through it because
00:24:37they know that you can be there. In my practice, I see it
00:24:41as more of team approach. It's not just us, but
00:24:44also who's with her to support her, family,
00:24:48children, her. partner, her friends, the
00:24:52diagnosis is a traumatic event for
00:24:55anyone, and we would give them time and allowance
00:24:59and explain. i often invite patients to come back the next
00:25:03day and write their questions down.
00:25:07i often say to them, the positives that we know in the
00:25:11moment that it is treatable, that
00:25:13it is curable, as long as one person has been cured of breast cancer, it
00:25:17means that you can be, and so i believe, that out the data that
00:25:21you would know, someone is not a statistic, but you can use
00:25:25statistics to help them see what is good in front
00:25:28them, and I often say to them, today is the worst
00:25:32day, tomorrow is going to be better, today is the day you got the result, it's the worst
00:25:36day, you've gone from not knowing to knowing, but tomorrow is about how do
00:25:40you fix the problem, how do you get your life back, and I have
00:25:44found that that is very important way to look at
00:25:47things, I had many women in my
00:25:50life who were diagnosed with breast cancer, including
00:25:53classmate. you don't think of entertaining a conversation about breast
00:25:57cancer as teenagers or when you were in that space of young
00:26:01adulthood. we talked about it because it was a reality of someone that I was
00:26:05close with, so that was how it all started in
00:26:092002, that's miss brafit evolved. one the things that
00:26:12stood in my mind all the time was, even though I'm doing only bra fittings,
00:26:16I am going to embark into that space where I'm going to deal with every
00:26:20pair of breasts, and then I thought, okay, I'm going to have to deal with that woman who's
00:26:24also not understanding what happens if she's had diagnosis and she
00:26:28needs to have mastectomy, either a single mastectomy.
00:26:32or bilateral mastectomy so unilateral or bilateral and all these things
00:26:36that are playing in my mind and we have to look at care
00:26:40differently. in fact the world health organization has now started to look
00:26:44at people centric care as a dialogue. you see
00:26:47diagnosis doesn't come out
00:26:49of nowhere. when it comes, it comes with hands and feet, eyes,
00:26:53ears, nose, mouth, human
00:26:55expressions, sentiments, lot
00:26:59a lot a lot of urgency in term. of
00:27:03fair and all the things that are unknown, and inside of
00:27:07that, top of that, you're going to lose your pair of breasts or a
00:27:10breast, or maybe lump is going to be removed, and the
00:27:14surgeons are amazing, they're going to work on you, they're going to make sure you're fine, but
00:27:18what about that rehabilitative experience,
00:27:22what about that expression of your femininity, what about
00:27:26returning to your activity or your productivity
00:27:29after, and what inside the... you
00:27:32as woman that it's okay to still wear a strapless
00:27:36bra or to look at your femininity
00:27:40even after losing your breast, so inside the
00:27:44work that we do at miss brafit, particularly with post surgical
00:27:47care and postmastectomy care is we advance
00:27:51that dialogue around dignity through many the things we
00:27:55do, in terms of reconstructing a breast
00:27:59that has been removed or this area that has been... moved because
00:28:03of mastectomy or because of trauma or so, it is
00:28:07something which has difficulties even in the United States when I
00:28:11was there, it took an act of congress
00:28:15to demand that woman who has had mastectomy
00:28:19has the right to breast
00:28:22reconstruction, and once that was done, the flood gates
00:28:26open, because they were struggling with this silently in many ways,
00:28:30I remember one the... did in
00:28:34the states and on her last visit to
00:28:37me, we had finished talking, take my measurements and so forth,
00:28:41told everything is going well, and then she went
00:28:44into the the locker room to change
00:28:47back, and heard this noise
00:28:50and i couldn't quite make out what she was saying or so, so i
00:28:54said so, are you okay? he says,
00:28:58yes, doc, i have breath.
00:29:02and that was she was so happy, she was giggling to
00:29:06herself, i have breas, although there are still many
00:29:09pathways in female medicine which are still to be explored, many
00:29:13years of new thinking, research and insight from female
00:29:16professionals has created important breakthroughs which has changed
00:29:20the way women are treated. with continuing awareness and
00:29:24exploration, women's healthcare will continue to
00:29:27evolve. thanks for viewing Caribbean Medical
00:29:30TV.