Health Bridge Newsletter - Volume 6

Welcome once again to Health Bridge

With half the year already gone, it is a time for us to take a look back, and to report on our achievements during that period. We will also take this opportunity to inform you on what lies ahead.

But before moving on, we would like to thank you all for your continuous support. We are extremely honoured to be your chosen health service provider, and welcome the opportunity to be of service to you at all times.

In keeping with our commitment to service, we are pleased to announce our recently formed alliance with Caribbean Star in March 2002. This agreement now compliments our existing arrangement with LIAT, thereby lowering the final cost of your patient's medical visit from any destination within the Caribbean. 

Also with service in mind, you may have already had the pleasure of meeting one of our Marketing Executives, in your Island recently. Through them, CMM aim to provide a greater regional service to you, and your patients. So take note of their direct lines noted on page 4, as they are ready to provide any assistance you may require. 

It has always been said that 'prevention is better than cure', and in this issue we feature three major health concerns that affect Women. All can be prevented with regular check ups and early detection. The first is a case study in the Management of an Abnormal Pap Smear from Dr. Tim Gopeesingh. Then we take a look at the importance of Mammograms, for the early detection of breast cancer, and finally we explore Osteoporosis - the silent disease

We are also eagerly awaiting the launch of our website in July 2002. It will be informative and interactive keeping you updated on the continuous development of our services, and those we provide you access to.

In this edition, we also introduce our new feature CMM STAFF PROFILE. This section will bring you closer to the members of our team who each perform an equally important role in delivering our quality health care service to you. Our first profile is of Mrs. Sharon Brizan, who is our longest serving employee, and CMM's Customer Service Supervisor.

We hope you enjoy this issue, and as always welcome your valuable feedback. 

Again I take this opportunity on behalf of the management and staff of CMM, to thank you for the confidence you have placed in us as your Health Care Service 
Provider.

Dominique Camacho
Chief Executive Officer

A CASE STUDY IN THE MANAGEMENT OF AN ABNORMAL PAP SMEAR

A 30 year old young, Attorney Para 2+0 presented 6 years ago with an Abnormal Pap Smear "Specimen Adequacy". Satisfactory - endocervical component is present. Diagnosis: Abnormal cells consist with a high grade lesion CINIII Carcinoma in situ" She had normal pap smears four and three years before that smear. She had none for the previous two years. Colposcopy was performed and a LLETZ Cone Biopsy procedure was performed large loop excision of the Transformation in zone (LLETZ)

Pathology Report: Microinvasine Adenocarcinoma of the Cervix showing nuclear enlargement, hyperchromaticity, mitotic activity and an increase in architectural irregularity and complexity consisting of papillary in folding, out pouching and focal cribriform pattern. There is limitation of lesion to the glandular field; no extension past the normal endocervical cysts up to 3mm in depth one margin of the Cone was involved in the Pathology.

A Type II Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy were performed subsequent to this pathologic report of the Cone Biopsy.

The pathology of the cervix was confirmed as Microinvasine Adenocarcinoma of the Cervix with parametrium free and vaginal cuff not involved. However, one of the left external iliac modes had metastatic disease. No adjuvant Radiotherapy was given.

The Patient was followed up every four months for the first two years and every six months for the next three years. Her follow up visits included, colposcopy vaginal vault smears and pelvic and abdominal examination. Now six years later she had no recurrence and considered cured.

Please note Squamous cell Microinvasine Carcinoma of the cervix should be treated by Total Abdominal Hysterectomy but Adeno Microinvasine Carcinoma of Cervix needs a Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy because of earlier metastatic spread, and being more aggressive than squamous cell disease.

Case courtesy:
Dr. Tim Gopeesingh C.M.T.
M.B.B.S., D.G.O; F.R.C.O.G; F.I.C.S, Exec. M.B.A.
Consultant Gynaecologic Oncologist
Senior Lecturer - Faculty of Medical Science - U.W.I.

MAMMOGRAMS DO SAVE LIVES

Despite advances in genetic science and medical procedures, no one really knows the complete answer to staying healthy. But one part of that answer is clear: VIGILANCE. Regular screening with mammograms is a way for women to guard against one of their worst enemies - breast cancer.

Each month, a woman's breasts go through temporary changes associated with menstruation, and a lump may form. While 80% of these growths are not cancerous, any lump should be examined immediately.

Lumps are most common in the lobules -- small sacs that produce milk -- or the ducts that carry milk to the nipple. But they occasionally start in other tissue. The two main categories of breast cancer are lobular and ductal carcinomas.

Fortunately, breast cancer is very treatable if detected early. Localized tumours can usually be treated successfully before the cancer spreads; and in nine in 10 cases, the woman will live at least another five years. Experts usually consider a five-year survival to be a cure.

The latest research shows that such screening does reduce the risk of dying from breast cancer by 21% over the long term. The benefit was greatest in women who were older and declined in younger women. Routine mammograms provided the most protection to women in there 60s, reducing their chances of dying from breast cancer by 33%.

The National Cancer Institute and the American Cancer Society recommend that women get regular mammograms beginning in there 40s.

For More Information on Mammograms ~ Contact Consolidated Medical Management
Information courtesy: Journal Sentinel & Web MD. Photograph courtesy: Web MD

OSTEOPOROSIS

What is Osteoporosis

According to the National Osteoporosis Foundation, Osteoporosis is defined as a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine and wrist.

There are two types of primary osteoporosis, Type I and Type II. Type I occurs only in women and is related to the hormonal changes taking place after the onset of menopause, typically affecting ages 50-70. Type II osteoporosis affects nearly half of all people over the age of 75. It is characterized by reduced osteoblast activity leading to decreased formation of the bone. Secondary osteoporosis may occur as a side effect of drugs such as corticosteroids and anticonvulsants.

Symptoms

People may not know that they have this condition until their bones become so weak that a sudden strain, bump, or fall causes a fracture or vetebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture.

Why is Osteoporosis of concern to Women?

Osteoporosis is most common in postmenopausal women and is less common in men. One third of all women will develop osteoporosis unless it is prevented. The incidence and prevalence of osteoporosis fractures are increasing. This is due mainly to the increase in population of women aged 45 and older. Life expectancy for women has increased this century, with women today living for 30 years or more after menopause, thus more time to lose bone mass.

This increase happens not only in the industrialized countries, but also in the developing countries as well. It is important to note that whilst osteoporosis is often thought of as an older person's disease, it can strike at any age.

What is a Bone Density Test?

A bone density test is a measurement of the density of the bone mineral, and can be taken from various places throughout the body, such as the hip, the spine, the heel, the forearm, the finger, or even the whole body. A bone density test involves the use of x-rays, in low dosages and takes only a few minutes with virtually no discomfort to the patient.

Kanis ( a bone density researcher in the United Kingdom) and the WHO (world Health Organization) Study Group say " … Where the goal is to prevent any osteoporotic fracture, measurements may be made at one of many sites…" This says that all tests, whether they measure the forearm, spine, or hip, provide physicians with important information to assess the risk of fracture.

What is the Value of Bone Density Testing

The bone density test is the single most useful procedure in the diagnosis of osteoporosis and the evaluation of fracture risk. The lower your bone density, the higher your risk of fracture. The bone density test, along with the patients medical history, determines if treatment is required.

Bone density testing is performed at LIFESTYLE MANAGEMENT LTD, courtesy of CMM.

Public Holidays in Trinidad & Tobago

Dear readers, please note that our office will be closed on the dates below over the next 6 months but our customer service representatives are always on call and in contact with the office management to ensure continuous service.

On any of the holidays you can contact (by paging service) either 
Ms. Suzette Sirjoo or Ms. Sharon Brizan at (868) 625-LISA(5472)

2002

CMM STAFF PROFILE - Mrs. Sharon Brizan

With a background in nursing and a flair for providing exceptional service, Sharon finds the combination of the two disciplines a compliment to one another in the execution of her role as Customer Service Supervisor. 

As one of the longest serving members of staff, Sharon provides an unparalleled level of service, and a willingness to go the extra mile for all patients who require our care, the doctors who refer them, and of course to her team. 

In Sharon's own words, "the last three years happened so fast. In as much as the company has developed, I too have developed. The challenges that we faced have contributed to my self-development, strengthened my existing skills and given me a greater awareness of the organizational development that we are striving for".

Supported by her family and applauded by Senior Management, Sharon's growth in CMM has no boundaries, and she will continue to be one of the jewels in our crown.

What our patients are saying about us

"CMM has always been there for me, always assisting with my medical care and never letting me down, they are my angels"
LISA - from Antigua

"The Customer Service Representatives always seemed to be very sensitive to your needs, and despite their busy schedule, you are always made to feel that their time is yours - excellent".
HUGH - from Grenada

"I must take time at this moment to express my gratitude & sincere thanks to the CMM staff. I felt like a woman's favourite gift, a diamond and was treated like one, with such great care."
MYRTLE - from St. Kitts

MARKETING EXECUTIVES

Ms. Jo Ann Nelson
Marketing Manager

Clifford A. Radhay
Marketing Executive

Adele Beckles
Marketing Executive

Tricia Ramjattan
Marketing Executive

Ms. Tricia Ramjattan
Marketing Support

CONTACT US

We value your input and would very much like to hear from you. Please feel free to visit us in person or contact us to find out how we can help each other.

CONTACT CMM
Tel: (868) 622-2413
Fax: (868) 622-1244
E-mail: cmm@wow.net