Health Medicine




Annual preventative examinations for men and women
Pap smear
Well-women exams during pregnancy and after, contraceptive devices and surveillance of contraceptive devices , and menopausal women well into geriatrics.
HIV-monitoring and surveillance of status and medicine.

Chronic medication monitoring and updates as needed.


Cervical cancer screening is an essential part of a woman’s routine health care. It is a way to detect abnormal cervical cells, including precancerous cervical lesions, as well as early cervical cancers. Both precancerous lesions and early cervical cancers can be treated successfully. Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure.

The frequency of Pap tests is determined by your age, lifestyle, and other medical factors.

Pap smears are like routine car service. You’re not exactly sure what they are checking for, but you know you should do it.  Even well-informed women who know that a Pap test is primarily a screen for cervical cancer are still unsure as to whether it also checks for sexually transmitted infection, ovarian cancer, uterine cancer and general “gynecologic wellness.” So, what exactly is a Pap test?

In 1928, after spending months observing his own wife’s cervical cells under a microscope, Dr. George Papanicolaou invented the Pap smear<> as a method to detect cervical cancer. His discovery has stood the test of time. And Dr. Papanicolaou can be credited with the fact that cervical cancer is now a rare cause of death in the US in spite of the fact that it remains the leading cause of death in countries where Pap smears are not routinely done. (Though it seems Mary Papanicolaou should get at least some of the credit after submitting to countless Pap smears to support her husband’s research!)

Most women are familiar with the basic process: a speculum is inserted into the vagina in order to sample cells from the surface and canal of the cervix. The cells are then sent to a lab where they are checked for abnormal cell growth, also known as dysplasia, cervical intraepithelial neoplasia or CIN.

Every year, more than 3.5 million women get that stomach-dropping “Your Pap smear is abnormal” notification. But even if dysplasia is detected, the chance of a real cervical cancer is small. Out of that 3.5 million, only 13,000 are likely to have a true cancer. The rest will either ultimately be found to have nothing wrong with their cervix, or a dysplasia which is easily treated or, even more likely, goes away on its own.

If a Pap smear is abnormal, the next step is usually colposcopy, which is nothing more than a microscopic examination of the cervix done in the office. While a Pap smear samples random cells, colposcopy allows the gynecologist to inspect the surface of the cervix under magnification so that the area where the abnormality is can be targeted and biopsied. The small sample of tissue removed is then sent to a pathologist who will report one of the following:

Normal tissue
Frequently, the cervical cells are normal, which indicates that the cells reverted back to a normal growth pattern. Occasionally, abnormal cells are present, but are high up in the cervical canal, beyond the view of the colposcope, which is why a follow-up short interval Pap smear is always done.

HPV changes
Human Papilloma Virus (HPV) is responsible for dysplasia and cervical cancers. Sometimes, cellular changes indicate the presence of the virus, but there are still no actual pre-cancerous cells.

CIN I (mild dysplasia or low grade squamous intraepithelial lesions)

CIN II (moderate dysplasia or high grade squamous intraepithelial lesions)

CIN III (severe dysplasia, or high grade squamous intraepithelial lesions, also known as carcinoma in situ)

Invasive Cancer (true cancer which has infiltrated surrounding tissue and has the ability to spread)

Dysplasia is the result of infection with the HPV virus, which is sexually transmitted. Before you plot your boyfriend or husband’s murder when discovering you have been exposed to HPV, keep in mind that that exposure could have occurred years before dysplasia shows up and may have nothing to do with a current partner.

An important distinction: Almost all women with cancer have HPV, but most women with HPV never get dysplasia or cancer. HPV is extremely common; some studies show that it is present in the cervixes of almost 80% of sexually active women. There are over 100 subtypes of HPV, but it is the high-risk subtypes that are most likely to progress to cancer. This is why if you have HPV and your gynecologist says it is no big deal, you really shouldn’t worry about it. Really.

Most women have it drilled into them that they MUST get a Pap every year, but now the annual ritual of getting a Pap smear is not necessarily annual. Initiation of Pap smears and recommendation for frequency of Pap smears have changed, and a lot of women are confused by how often they need to get one.

Guidelines are as follows:

*   Pap tests should begin at age 21
*   From 21-30, it is fine to get a pap every 3 years instead of annually as long as you are low risk, meaning you have never had moderate or severe dysplasia, cervical cancer, HIV, or have a severe medical illness that compromises your immune system. HPV testing is not necessary.
*   After age 30, every 3 years is fine, or a combination of Pap smear and HPV testing every 5 years, if both initial tests are negative. Women with a history of dysplasia or who have other risk factors should be tested more frequently.
*   After age 65, you can cross Pap smears off your “to-do” list as long as you have had a normal test for at least 10 years with the most recent test within 5 years.
*   Women who have had a hysterectomy that included removal of the cervix need not continue to get Pap tests.

Why the change? Two reasons. Most abnormal Paps have minimal potential for progression to cancer. This is particularly true for young women. In the event that a persistent dysplasia is present, the transition from pre-cancerous cells to a true cancer takes not weeks or months, but years.

So does that mean you only have to see your gynecologist every three years? Sorry, no such luck. If you don’t need a Pap, you still need to have a breast exam, STD screen, and a pelvic exam to check your uterus and ovaries. And even if you don’t need cells sampled from the cervix, your gynecologist still needs to take a peek inside to make sure your cervix and vagina look healthy.

Also, keep in mind that Pap smears don’t detect 100% of abnormalities. I biopsied a suspicious growth on a patient’s cervix that turned out to be an early cancer.  Her Pap smear the year before was read as normal, and had she not come in for her annual exam, I would not have seen the growth.

Even if your car is not making funny noises and no warning lights are flashing, it’s a good idea to get the oil and brakes checked annually. Your uterus, cervix and vagina deserve the same attention. After all, if your gynecologist doesn’t look in your vagina, who’s going to?


While the life-expectancy gap between men and women has decreased, it’s no secret that men still need to pay more attention to their bodies. Several things work against men. They tend to smoke and drink more than women. They don’t seek medical help as often as women. Some men define themselves by their work, which can add to stress.

There are also health conditions that only affect men, such as prostate cancer and low testosterone. Many of the major health risks that men face – like colon cancer or heart disease – can be prevented and treated with early diagnosis. Screening tests can find diseases early, when they are easier to treat. It’s important to have regular checkups and screenings.

When you get a preventive medical test, you’re not just doing it for yourself. You’re doing it for your family and loved ones.

Did you know? When compared to women…

*   Men are more likely to have neglected their cholesterol tests.
*   Men are more likely to be hospitalized for congestive heart failure.
*   Men are more likely to be hospitalized for long-term complications from diabetes, such as leg or foot amputation.
*   Men are more likely to be hospitalized for pneumonia that could have been prevented by getting an immunization.

The most common men’s health conditions are:

1.  Prostate Cancer
2.  Testicular Cancer
3.  Colo rectal Cancer
4.  Skin Cancer
5.  High Blood Pressure
6.  High Cholesterol
7.  Type 2 Diabetes
8.  Eye Health


High blood pressure is called the “silent killer” because it has no symptoms. If high blood pressure remains unchecked, it can lead to stroke, heart attack, heart failure, and more. You can stop this silent killer — if you catch it in time.

IF you are worried in any way , come for a mobile 24 hour monitor – surveillance to check your blood pressure for 24 hours.