After an astonishingly fast effort to develop a safe and effective vaccine against COVID-19, the United States is on the precipice of having multiple options. Public health experts believe we’re weeks (or less) away from the first doses being available, which will be rolled out to health care workers, nursing home residents and then other high-priority groups, like older Americans and essential workers.
But what about pregnant women? Should they get vaccinated against the coronavirus — and should they be prioritized?
Here’s what we know, and don’t know, so far:
There’s no official guidance on pregnancy and COVID-19 vaccination … yet.
Because none of these vaccines are actually available yet, and all of the research we have on them is still very new, organizations like the U.S. Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists haven’t made any formal recommendations at this point.
As Dr. Christopher Zahn, ACOG’s vice president of practice activities, told HuffPost: “There isn’t a simple answer to questions about whether pregnant people, or those considering pregnancy, should take the COVID-19 vaccine, especially since no vaccine is currently approved.”
Pregnant women have NOT been included in trials.
“When the vaccines do become widely available, unfortunately, we have no data on the safety of the vaccine in pregnant and lactating individuals because they were excluded from Phase 2 and Phase 3 clinical trials for all of the COVID-19 vaccines in development,” Zahn said.
So we won’t know anything specific right off the bat about how a coronavirus vaccine might affect pregnant women, breastfeeding moms or their babies.
Despite a decadeslong push to include expectant mothers as subjects in clinical research, it’s actually not uncommon to exclude pregnant women from the early stages of vaccine development, when researchers are really testing for safety. For example, pregnant women weren’t included in initial trials for the H1N1 vaccine. So while they were identified as a high-risk population, there wasn’t readily available data about what kind of dosing they should receive.
“Certainly the lack of safety and efficacy data will need to be part of the conversation that patients who are pregnant or considering pregnancy will need to have with their obstetrician-gynecologist or other health care professional,” Zahn said about receiving a COVID-19 vaccine.
One critical note: The lack of information so far on how the vaccine might impact pregnant women does not necessarily indicate that researchers and doctors are particularly concerned that it would be harmful to them. Women get vaccinated for other illnesses during pregnancy all the time, including whooping cough and the flu. And some of the antibodies they develop pass through the placenta (or breast milk, for breastfeeding moms), which offers their baby some protection.
“There is no suspicion that the vaccine should be bad for pregnant women,” Dr. Jane Minkin, clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine, told HuffPost. “But we just do not have the information.”
Pregnant women do seem to face higher risks with COVID-19.
Unlike with the H1N1 virus, which posed a grave risk to pregnant women, the impact of the coronavirus has been less clear. But based on data collected over the past few months, the CDC and ACOG say that pregnant women are at slightly higher risk of becoming seriously ill with COVID-19. They also have a higher risk of dying from the virus than their non-pregnant counterparts.
Scientists aren’t sure yet whether the virus can cross the placenta, though one preliminary study of 31 women did find evidence of it in women’s umbilical cord blood, placenta and breast milk. However, the good news is that the CDC says it’s “uncommon” for newborns whose mothers have COVID-19 to have the virus themselves, and among those who do, it’s not clear whether they contracted the virus before, during or after delivery.
The old public health standbys remain particularly important for moms-to-be.
Because pregnant women appear to be at higher risk of severe illness, and because it may be some time before we get clear answers about COVID-19 vaccine safety for them, experts say it’s especially crucial that those women be diligent about the preventive measures we know protect against the virus.
“What do I advise pregnant women? To practice what we all should be doing: mask-wearing, hand-washing, social distancing. And please get flu shots if you haven’t had them yet ― that’s one thing we can easily do,” Minkin said. “Be careful and stay tuned.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
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How To Do A Self-Exam When You Have Lumpy Breasts
The kind of breasts you have is determined by genetics. Having lumpy or smooth breasts is just like having large or small ones; it’s out of your control and often not a cause for concern.
While having breasts that are unique to you is perfectly normal, cancer checks can be harder for people with lumpy breasts. If you notice that your breast tissue feels bumpy or even rope-like, you may be one of the many people who face this difficulty.
“Women with breasts that are lumpy-bumpy are either afraid to do any checks or note any [concerning] areas in the breast because they are worried that they’re going to think everything is cancer,” said Dr. Laura Dominici, the section chief of breast surgery at Brigham and Women’s Faulkner Hospital in Massachusetts.
This deters them from checking for any issues at all because they’re worried they aren’t going to know what they’re looking for, she added.
According to Dr. Janet Yeh, the site chief of breast surgical oncology at NYU Langone Hospital—Brooklyn in New York, the breast masses that people find during at-home self-checks are typically not concerning (as long as they’re staying up to date with their in-office appointments, too). Most signs of breast cancer are caught by the advanced technology used in imaging, like mammograms and sonograms.
But self-checks don’t have any downsides, Yeh said. In fact, they’re encouraged since some people do find notable concerns during a regular, at-home check.
If you have lumpy boobs and are afraid to do a self-exam, you are certainly not alone. Here, experts share how people with lumpy breasts can conduct at-home exams and what to look for when they do.
First, be aware of how your breasts look and feel.
Gone are the days of very dictated and specific self-exams. Now, you should just have overall self-awareness to help monitor for any signs of breast cancer, according to both Dominici and Yeh.
“It’s a really good thing for women to have a general sense [of] how their breast usually looks and feels,” Dominici said.
This way, if something is new, different or concerning, you’ll be able to make note of it and bring it to your doctor’s attention, she said.
For people with lumpy breasts, knowing when a lump is normal or abnormal can be challenging. To determine how your breasts should feel, Yeh recommended that you conduct an at-home exam within a month of a breast exam by a physician or after a mammogram indicating that everything looked OK.
If you do an at-home exam when you have a clean bill of breast health, you’ll know what lumps and bumps are normal for your boobs. So, when you conduct checks in the months and years to come, you’ll be able to recognize if any lumps pop up that aren’t normally present.
Check a few key places during your self-exam.
Though knowing your boobs is more important than conducting an at-home exam in one specific way, some tips can make your self-check more effective.
First, lift up the arm closest to the breast that you’re checking, Yeh said. Feel all around the breast, including the center area.
Lastly, don’t end right at the boob; you’ll want to check your armpit, too. Armpits have lymph nodes that can become enlarged in people with breast cancer. In such cases, those lymph nodes feel firm, Yeh said. Normally, lymph nodes are soft.
To check your armpit, “put your hand on your hip on [the] side [you’re checking],” Yeh said. “You can use your other hand to fill in your armpit.”
Also check for similar lumps in both boobs.
If you find a mass in one breast, check the other one to see whether you feel a similar lump there, Yeh said.
If you feel something of a similar size and texture in the other breast, that may just be how your tissue normally feels.
Perform your self-exams right after your period.
Many people report that their breasts feel especially tender right before and during their period, Dominici said. So, doing your breast exam may be painful at these times.
Additionally, many folks deal with swollen boobs before and during their period, which could make their breasts feel different than usual, Dominici added. This could lead to some false alarms during your check.
So, it’s best to wait for your period to end before you do a self-exam.
Dominici recommended performing self-exams at the same time every month, and having a set routine for the check may be helpful. You could consistently do your exam in the shower, in bed or in front of a mirror. That way, you’ll eventually get into a groove and know exactly how your boobs should feel in a particular position.
A concerning lump should stand out from the rest of your tissue.
“Lots of women have lumps in their breasts. What I recommend is feeling for anything that stands out,” Yeh said.
When breast cancer is palpable, it’s firm, Yeh said. She noted that a concerning lump should almost feel like a pea in mashed potatoes.
Yeh added that beyond a lump, you should let your doctor know about any redness, swelling or dimpling of the skin. Discharge from your nipple when you aren’t touching or squeezing it is another red flag.
Self-exams can only show so much. Be sure to stay on top of your breast imaging, too.
“Your breast imaging should start at 40 and [take place] every year,” Yeh said.
In some situations, that imaging is necessary at a younger age. This can be the case for people with certain gene mutations or with a significant family history.
“We recommend people start breast imaging 10 years before the closest relative was diagnosed, or at the age of 40 — whatever comes first,” Yeh said. So, if your mom was diagnosed with breast cancer at 44, you should consider starting your routine mammograms at 34.
If you do feel a concerning lump, talk to your doctor.
If you think what you’re feeling may be abnormal but are not sure, don’t be afraid to reach out to your doctor. It’s absolutely better to be safe than sorry in this situation. Plus, experts agree that it’s hard for women to know the difference between something that’s OK and not OK.
“It can be challenging for women who [have] lumpy-bumpy [breasts] because a lot of times a cyst or a fibroadenoma, which are benign findings, can feel like a firm lump,” Dominici said.
In the end, if you have any doubt, you shouldn’t assume that what you’re feeling is normal. Your doctor is there to help you and will likely be happy that you brought a potential abnormality to their attention.
Is It Normal To Have Different-Sized Boobs?
Check out more stories from Busted, our series that offers an unfiltered exploration and celebration of our boobs and ourselves during breast cancer awareness month.
If you’re a boob-having person, there may have been a specific time in your life when you started to notice your asymmetries or differences: One boob is slightly bigger than the other, or one areola appears smaller or more centered than the other ― that sort of thing.
For Jenn, a 34-year-old from Georgia, the observation occurred in college. For years, she’d been a solid 34C, but after her first year of college, she started to notice that only her left breast could fit in a 34C.
“Looking at me, clothes on or off, you can’t tell they are different sizes,” said Jenn, who didn’t want to share her full name for the sake of privacy. (Understandably, no one wants an article about boobs coming up when potential employers are Googling you.)
“The tell, though, is that my areola is bigger on my left breast as opposed to my right,” she explained. “Outside of that, they are both perky with some slight hang and equal cleavage.” (She said she’s actually gotten a ton of compliments on her unique set of boobs.)
“Any body parts that come in a set of two are never exactly a mirror image of each other.”
– Dr. Sherry Ross, an OB-GYN and author of “She-ology: The Definitive Guide to Women’s Intimate Health”
Now that she’s fitted with her proper bra size and knows which type of bras work best for her, the difference doesn’t bother her much at all.
“Demi and plunge bras are the bra styles that compliment me best,” she said. “Sadly, going braless is not something I can pull off.”
She admits it did unnerve her a bit when she first noticed the differences.
“What I will say is that my first notice of the change sent me on a bit of a spiral because I thought others could look at me and tell, but when I realized they can’t, I was able to embrace it and work with what I have.”
Jenn has the right mentality, said Dr. Sherry Ross, an OB-GYN and author of “She-ology: The Definitive Guide to Women’s Intimate Health.”
Breast asymmetry― when one breast has a different cup size, shape, position or nipple position from the other ― is incredibly common and usually isn’t cause for concern, the doctor said.
“Any body parts that come in a set of two are never exactly a mirror image of each other,” Ross said. “Your ears, eyes, lips, breasts and labia are also slightly different in shape and size. This is completely normal. Different is normal, and this is more common than not.”
Your breast tissue can also change when you’re ovulating due to water retention and blood flow, Ross said, which is why your boobs may feel a little more sensitive or full during that time.
It’s not just your monthly menstrual cycle that can affect your boob symmetry; pregnancy, postpartum breastfeeding and menopause can affect breast tissue, too.
Sometimes differences in the breast size, shape or placement are present from birth; other times it’s related to how the breast develops during puberty.
If your breasts are still growing, be patient. They may even out, said Dr. Stephanie L. Graff, the medical adviser at the Dr. Susan Love Foundation for Breast Cancer Research and the director of breast oncology at the Lifespan Cancer Institute in Providence, Rhode Island. (For most people, their breasts stop growing by the age of 18, though in some cases they can continue to grow into your early 20s.)
“While you wait, you can wear bras that are padded or fit at a specialty bra store made for breast cancer survivors, where the staff are trained to handle asymmetries,” she said.
If breast asymmetry is drastic, plastic or reconstructive surgery to either reduce the larger size or enlarge the smaller size may be an option, Graff said. A plastic surgeon can talk you through the options that are best suited for your body.
Various and sometimes serious health conditions can affect the symmetry of your breasts as well. Below, we run down some of them.
According to the Mayo Clinic, atypical hyperplasia is a precancerous condition that affects cells in the breast. With AH, more abnormal cells line the milk ducts and lobules of the breast than usual. The condition can lead to benign, non-cancerous lumps in the breast that may affect its appearance.
Since atypical ductal hyperplasia (ADH) is a precancerous condition, it needs to be followed closely if found during a breast biopsy, Ross said.
“These pre-cancer cells can form when breast cells become abnormal in size, shape and appearance,” she said. “When they’re found during a mammogram imaging, they sometimes require surgery to remove.”
The term hypoplastic comes from Greek, as many medical terms do. “Hypo” means “under” and “plasia” means “growth,” so this condition literally means underdeveloped breasts, Graff said.
It’s not the size of the breasts that indicates hypoplasia but rather asymmetry, breast shape or placement.
Hormones could be the culprit for this one, but Graff said so could an injury or medical condition, like Poland syndrome, a birth defect that causes a lack of muscle development on one side of the body.
“In medicine, this phrase does not typically apply to adolescents who are just ‘late bloomers,’ but to persons with hormonal or genetic abnormalities that lead to absent breast development,” Graff said.
“Juvenile breast hypertrophy occurs when there is extreme breast tissue growth during a six-month period that could be in one or both breasts,” according to Dr. Christine Greves, an OB-GYN at Orlando Health Winnie Palmer Hospital for Women and Babies.
Though rare, if you notice this happening, check in with your doctor, Graff said.
“This can be scary or confusing ― as if puberty isn’t scary and confusing already ― but is not associated with cancer,” she explained. “Patients with concerns about juvenile hypertrophy should speak to their pediatrician or family physician about their concern to be evaluated for any other hormonal concerns, and when severe, it can be treated with breast-reducing surgery.”
If you have scoliosis (curvature of the spine), that may be why you’re noticing breast asymmetry.
“Women who have scoliosis may also have an increased risk of breast asymmetry, with one breast appearing larger than the other,” Greves said.
The big takeaway here? If breast asymmetry is bothering you, talk to your doctor and have a mammogram to make sure you’re not missing anything serious, Graff said.
“If your doctor does not seem to hear you or listen, try saying, ‘Listen, this is really concerning to me, and I need to make sure you are addressing it,’ which will clue them in that maybe something they think is no big deal is a big deal to you,” Graff said.
If they’re still dismissive toward you, you may want to find a new physician.
“Please know that doctors hear crazy weird body questions all day, every day ― your crazy weird body question is not going to shock or embarrass your physician,” she said. “We’re trained to handle asymmetries.”
Here Are The Benefits Of Adding Fast Intervals To Your Walk
There are even ways to make your walks more beneficial, whether that’s Nordic walking (a kind of walking that uses poles, similar to ski poles, to incorporate your upper body) or interval walking, which, according to Harvard Health, gets your heart rate up more than a regular walk.
An interval walk incorporates phases of fast and moderate walking to create a heart-pumping, challenging workout. You can mix and match the duration of each pace however you like, but generally the majority of the walk is done at a moderate pace with the quicker pace sprinkled throughout. It’s common to do this workout at a 2-to-1 ratio, meaning you walk at a moderate pace for double the amount of time of a fast pace (so, walk at a moderate pace for two minutes and follow it up with a faster one-minute walk), but it’s really up to you how you split it up.
During the moderate walking pace, you should be at about 30% to 40% of your maximum effort, said Kate Lemere, chief instructor at Barry’s Chicago. In other words, your walk should be at a pace that would allow you to hold a conversation.
During vigorous, fast intervals, she said, you’ll want to be around 70% of your maximum effort, a pace at which it should be more difficult to string together a complete sentence.
Interval walking is a way to add something different to your regular walk and can make it much more efficient.
Here, experts share all of the ways interval walking is good for your health.
It shortens the amount of time you need to exercise.
“What does interval training do for you? It cuts down the amount of time you have to exercise to get the same benefit,” said Dr. Michael Ayers, a sports cardiologist at UVA Health in Virginia.
For people with busy schedules, this is a huge benefit of incorporating fast-slow intervals into a walk — or incorporating any kind of high-intensity interval training into exercise, for that matter. When you mix vigorous exercise with moderate exercise, those short bursts of vigorous exercise get you the same benefits of a slower walk in less time, Ayers said.
In other words, all of the benefits of a moderate-intensity walk can be achieved faster when you add in some quick high-intensity intervals.
“Interval training definitely shortens the amount of exercise time that you have to do per week,” he added.
It creates an endorphin rush.
Ayers noted that, overall, one of the big reasons his patients like interval training is how it makes them feel afterward.
“There’s a big endorphin kick when you go into vigorous exercise,” he said. With an interval walk, as long as you reach a vigorous pace for 30 to 60 seconds at a time, you’ll get an endorphin kick.
You could do a five-minute moderately paced interval followed by a fast minute-long interval, or one minute of moderate walking followed by 30 seconds of power walking. As long as you break up your slower intervals with at least 30 seconds of vigorous walking, you’ll be on your way to that endorphin boost.
It builds endurance.
Walking may not be the first thing you think of when considering endurance-building workouts, but walking can actually build up your aerobic endurance, according to Dr. Tamanna Singh, a clinical cardiologist and co-director of the sports cardiology center at Cleveland Clinic in Ohio.
For someone who is really pushing themselves during a walk, especially if they aren’t used to bursts of vigorous exercise, that pace acceleration “may be enough to stimulate the aerobic and anaerobic system,” she added.
This will help you build up your aerobic endurance and sustain anaerobic levels of effort moving forward, Singh said.
Plus, interval training can help you reach endurance goals related to walking farther or walking faster.
″[The] best way to increase your [walking] speed is with interval training — increasing the duration of those faster intervals over time will help you be able to do that,” Singh said.
It’s a good workout for people who are getting back into exercise.
Interval walking can also be a great progression for those who are getting back into aerobic activity after an injury or pregnancy, said Lemere.
If you fall into one of these categories, you shouldn’t just jump right into the workout. First, make sure you’re able to walk at a sustained pace and recover without pain the next day, she said. And it’s always a good idea to check with your doctor before adding something new to a post-injury workout routine.
But if you are ready to take your walking to the next level, you can increase your exercise output by adding fast-slow intervals.
Interval walks are helpful for people coming off of an injury and hoping to get back into running, too.
“Incorporating walking intervals is one of the best ways not to only increase your cardio but also to progress if your goal involves running,” Lemere noted.
It can help you feel less bored during a workout.
Variety equals excitement in most scenarios, including workouts.
A 45-minute or hourlong walk can seem daunting (and can end up being kind of boring), but when you break that walk into chunks that incorporate quick walking followed by slower-paced walking, you can make the workout a little more exciting, Singh noted.
You can try walking at a moderate pace for 10 minutes and follow it up with a fast walk for five minutes and repeat that pattern until you hit your time goal. This, she added, is also a way to stay engaged during the workout, which is another huge benefit.
“Engagement is a huge component in making sure people can commit” to exercise, Singh said.
It’s not as hard on your body as a traditional run …
When you’re not properly warming up and recovering, “running can be very painful and hard to recover from,” Lemere said.
Our bodies change with age, and running may not be something you can do anymore. That’s OK.
Interval walking is a good way to get in some brisk movement outdoors without putting all of that pressure on your joints.
But the cardiovascular benefits of walking at a sustained pace are largely the same.
Beyond the benefits above, interval walking has not proved to be any more beneficial than sustained walking when it comes to general health. You may be sweating a little more after a fast walk interval, but the overall health benefits aren’t actually going to be much different.
Walking of any sort is healthy, Ayers said. Across the board, walking increases muscular strength decreases the likelihood of diabetes, and also decreases blood pressure and cholesterol levels. It results in a lower risk of heart attack and stroke, too.
“At the end of the day, get moving [and] be very intentional about how you move your body,” Singh said. “That’s the cheapest, easiest way to stay healthy and reduce your cardiovascular risk.”
8 Of The Most Common Types Of Stomach Pain
Most people will experience some type of stomach pain in their lifetime.
Stomach pain, which is typically referred to as abdominal pain by doctors, can occur anywhere from the chest down to the groin. It can be a sharp pain that shoots up your abdomen or a dull ache that throbs in one spot. Abdominal pain can be caused by something as benign as gas or constipation to more severe conditions like inflammation in the colon and stomach ulcers.
The good news is that, most of the time, abdominal pain is no big deal. Even if you’re dealing with a more chronic condition, like irritable bowel syndrome (IBS) or a food intolerance, symptoms can typically be significantly improved with some dietary and lifestyle changes.
“Most of abdominal pain is caused by non-life-threatening benign issues, and most of them self resolve,” Badr Al Bawardy, a Yale Medicine gastroenterologist, told HuffPost.
Here are the most common types of stomach pain:
Stomach Pain From What Or How You Eat
Certain foods, such as high-fiber fruits and foods rich in carbohydrates, can be difficult for some people to digest and lead to gas and bloating. Overeating and eating too quickly can also lead to indigestion and discomfort.
Routinely taking certain medications, like aspirin or ibuprofen, can also cause inflammation in the stomach that may cause pain, said Dr. Lisa Ganjhu, a clinical associate professor of medicine in the divisions of gastroenterology and hepatology at NYU Langone Medical Center.
Constipation, or infrequent bowel movements, is one of the leading causes of abdominal discomfort. It’s caused by a range of health issues, including medications, a lack of exercise, diet and changes in lifestyle. Being constipated doesn’t necessarily mean that you’re dealing with some sort of underlying condition, but nonetheless, it can be painful to deal with.
“If they notice that they have pain and they haven’t emptied their bowels in a while or have incomplete bowels, then they need to either take a laxative or an enema to unplug,” Ganjhu said.
Irritable Bowel Syndrome
IBS is one of the most common causes of abdominal pain and impacts 10 to 15% of the population. To get an IBS diagnosis, patients need abdominal pain, irregular bowel habits (like diarrhea or constipation) and pain that either improves or worsens with bowel movements, Al Bawardy explained.
IBS pain can be mild or severe and include anything from stomach cramping to swelling the stomach and excessive gas. With IBS, the colon muscle contracts too frequently and triggers cramps and pain, typically in the lower half of the abdomen.
IBS can be managed by changing what you eat and drink, regularly exercising and getting enough sleep. Certain medications, like fiber supplements, laxatives and pain medications, can alleviate symptoms, too.
Pain From How Food Moves Through Your Stomach
Another condition, known as gastroparesis, occurs when the stomach has a hard time emptying food and water. These contents collect in the stomach and trigger bloating, pain, nausea and a feeling of fullness after a few bites oof food.
“The stomach doesn’t relax and is contracting when it should be relaxing,” Ganjhu said.
Gastroparesis is more prevalent in older people, along with people with anxiety and those who take antidepressants, Ganjhu said. Though there’s no cure for gastroparesis, dietary changes and medication can provide relief.
Small Bowel Bacteria Overgrowth
This condition, also known as SIBO, occurs when there’s an abnormal increase in the amount of bacteria in the small intestine. SIBO can be caused by stress, travel, antibiotic use, alcohol use and certain medications like a proton pump inhibitor. All of these things can disrupt the microbiome, according to Ganjhu.
SIBO frequently causes painful bloating when air gets trapped in the small bowel or colon, along with an uncomfortable feeling of fullness and nausea. It’s diagnosed via a breath test or small intestine fluid culture and can be treated with antibiotics and nutritional support.
Though food allergies don’t typically lead to pain, food intolerances can contribute to abdominal pain, irritating gas and causing bloating within a few hours after eating the food. With food intolerances, the digestive system lacks certain enzymes that are necessarily to break down specific foods.
The most common food intolerances include lactose (milk), histamine (chemicals that naturally occur in cheese, pineapples, bananas, avocados and chocolate) and gluten (a protein in wheat, rye and barley).
Gallstones, or pebble-like pieces of hardened bile, are pretty common, impacting about 10 to 15% of the U.S. population. This condition also tends to be more common in women, pregnant people and individuals with obesity.
While gallstones are asymptomatic in most people, some may experience intense pain in the right upper side of their abdomen. It can last a few minutes or a few hours.
This pain can really vary between patients — “sometimes it’s a cramping pain, sometimes it’s associated with nausea, sometimes it’s associated with fatty meals,” Ganjhu said. In certain cases, gallstones can be passed or dissolve with medications, however, some people may require surgery.
Period And Pelvic Pain
While nearly everyone with a uterus experiences some type of period or pelvic pain in their lifetime, certain types of pelvic pain may indicate there’s a more serious underlying health issue.
Mild to moderate cramping is considered to be a normal side effect of menstruation, but if if the cramps last longer than a few days, worsen into a sharp, stabbing or throbbing sensation or impact your ability to function, you may have a gynecologic condition like endometriosis, polycystic ovary syndrome, fibroids or adenomyosis. These conditions are often overlooked and dismissed as typical menstrual pain, so it’s crucial to advocate for yourself and find a doctor who will listen and help you find a diagnosis in order to start treatment.
How To Cope With Stomach Pain
To alleviate abdominal pain, you first need to get a correct diagnosis because your treatment plan — whether that’s adjusting your diet, taking medications or undergoing a procedure — will really depend on what’s causing the pain.
If the pain persists, it’s worth setting up an appointment with a gastroenterologist who can run tests to pinpoint the root of your pain. Al Bawardy also recommended keeping a diet diary to see if certain foods or activities might be contributing to your abdominal pain. He also suggested partnering with a dietitian, so if you do notice any trends, you can work with a professional to modify your diet in a healthful, balanced manner.
If you experience pain and also develop bloody stools or black, tarry stools, weight loss or persistent nausea and vomiting, you’ll want to see a health care provider immediately. They could indicate you may be dealing with a more serious condition like a stomach ulcer, ulcerative colitis, Crohn’s disease or colon cancer.
“Those are what we call red alarm symptoms — if the pain is associated with them, they should seek care,” Al Bawardy said.
The One Place You’re Probably Forgetting When You Do A Breast Check
Every year, about 264,000 women in the United States are diagnosed with breast cancer. The enormity of this number underscores the importance of understanding your personal risk, abiding by guidelines for screenings and being otherwise on alert for any early signs of the disease.
Although many cancer organizations have shifted their recommendations away from monthly breast self-exams, there’s still an emphasis on familiarizing yourself with what “normal” looks and feels like for your breasts. When you’re in the shower, getting dressed or relaxing on the couch, get in the habit of periodically inspecting the area so that you have a sense of what feels typical and can detect something new or abnormal.
But there’s one area women often overlook when doing these breast checks: the underarms.
“I think a lot of people forget because they don’t consider that part of the breast,” said Dr. Janet Yeh, assistant professor at NYU Grossman School of Medicine and site chief of breast surgical oncology at NYU Langone Hospital―Brooklyn. “It’s connected to the breast, so it’s important to check there. If you were to have breast cancer, it usually starts in the breast first and then spreads to the lymph nodes, but we’ve seen situations where it shows up in the armpits first or only there. It’s rare and unusual, but it definitely happens.”
Below, Yeh and other experts break down what happens with the underarm lymph nodes in these situations and the best way to check that area.
What Exactly Are The Underarm Lymph Nodes?
“The underarm area is referred to as the axilla,” said Dr. Alyssa Cubbison, an assistant professor of radiology at the Ohio State University Wexner Medical Center. “Lymph nodes are normal and supposed to be there ― they’re called the axillary lymph nodes.”
The lymph nodes play an important role in the body, which is why they can be a major part of cancer detection.
“When breast cancer spreads, it tends to spread through the nearby lymph nodes,” explained Dr. Arif Kamal, chief patient officer at the American Cancer Society. “Lymph nodes are the checkpoint systems for the highway where immune cells in the body travel. When that checkpoint area gets enlarged, meaning you feel a lymph node in your underarm area, it can signify that there’s something going on.”
Lymph nodes generally become enlarged when there’s an infection. For example, the lymph nodes in your neck can swell when you have an upper respiratory infection.
“Enlarged lymph nodes may feel like a larger pea or a small ball of sorts,” Kamal said. “If someone feels that in their underarm area, they should report that to their clinical team.”
Keep in mind that like lumps in the breast, an enlarged lymph node or lump in the underarm area isn’t necessarily a sign of something very serious, but you’ll need a professional to assess.
“There are many benign explanations for it,” Cubbison explained. “It could just be a lymph node plumping up trying to clear an infection, but one thing we worry about is also that cancer can cause an enlarged axillary lymph node. We want to make sure we’re not missing something like that, so if it feels new to you, we always advocate to get it checked out by your doctor.”
How To Check Your Underarm Area
When it comes to inspecting the underarm area, doctors recommend the same sorts of techniques you use for your breasts. Use the pads of two fingers or your whole finger and palm area and do circular motions or wipes.
“Put your hand down on your hip like you’re doing a Wonder Woman pose,” Yeh advised. “That stretches out the pectoralis muscle and allows you to go in an feel the lymph nodes behind it. Feel for very firm or enlarged lymph nodes. You might feel something like a marble rolling around in there. If you notice anything new or different, let a professional know.”
Cubbison advised applying both superficial and deep amounts of pressure.
“As you palpate or feel the area, if you press too deep, you may miss some of the superficial lymph nodes you’re compressing down,” she explained. “If you press too lightly, you miss the deeper ones. So apply varying degrees of pressure, both soft and firm. Just make sure you include the whole area and use small motions.”
Just as the underarm isn’t commonly associated with breast cancer, there are other areas Kamal suggests including in your checks as well.
“What we should be paying attention to is not just the breast tissue itself, the superficial part, but also the underlying chest wall,” he said. “That would be slightly above the breast to where the clavicle or collarbone is. Also up into the lymph nodes into the neck. Pay attention to any abnormalities up into the neck and underarm as well.”
Remember that familiarizing yourself with your “normal” and doing regular checks is not for self-diagnosis. Don’t immediately panic if you do find something different. It may well be a matter of cyclical changes in the breast related to your menstrual cycle or aging. That’s for professionals to determine.
“It’s really a way to look for something that feels different than you’d be used to and to use that as an alarm, to bring up to your clinical team, for them to follow up,” Kamal explained. “Also it’s important to recognize that a self breast exam does not replace the need for regular mammography because a mammogram is going to see things with a lot more precision and accuracy than an exam done by a patient or physician.”
What A Breast Lump Actually Feels Like
In April 2022, Clea Shearer ― co-founder of the popular organization company The Home Edit ― announced that she had breast cancer. The diagnosis came after she discovered a lump in her breast and called multiple doctors to go in for a mammogram as soon as possible.
Estimates suggest that one in eight women in the United States will develop breast cancer at some point in their life. Shearer had just turned 40 when she discovered the mass in her breast. Stories like Shearer’s highlight the value of familiarizing yourself with what is normal and abnormal for your breasts.
Although many cancer organizations no longer recommend all women conduct monthly breast self-exams due to concerns about their effectiveness and the sense of self-blame they can promote, experts do agree that awareness of how your breasts typically look and feel is useful for detecting signs and symptoms of breast cancer, like lumps.
Still, I imagine I’m not alone when I take the time to feel around that area and wonder, “What exactly am I checking for? What would a lump actually feel like? Am I even doing this right?” So, I asked a few experts to answer those very questions.
What exactly does a breast lump feel like?
“A lump often feels like a round, hard area,” said Dr. Arif Kamal, a chief patient officer at the American Cancer Society. “It can either be deep or toward the skin itself. Typically it is not painful. It’s typically not easily movable but oftentimes fixed in a particular space, meaning it doesn’t shift in its location all that easily. In terms of shape, it is oftentimes round but sometimes it can be a little bit more irregular than that.”
Some experts have suggested the size of a breast lump ranges from as small as a pea to larger than a golf ball. Indeed, Kamal noted that many of his patients have compared it to a pea.
“In my clinical experience, a lot of times patients describe it like a pea in a pod or a frozen pea ― sort of on the smaller side, of that texture, and of that hardness,” he said. “It’s generally on the smoother side for texture, generally more firm, generally not painful. And it generally does not feel like a cyst, which feels like a fluid collection ― although even if a person feels a fluid collection, they should report that to their clinical team as well.”
Dr. Alyssa Cubbison, an assistant professor of radiology at the Ohio State University Wexner Medical Center, similarly noted that cancerous lumps often feel firm and dense and can be difficult to move from side to side. However, she emphasized that all new lumps should be evaluated by a professional.
“You mainly want to feel around for something discrete in your breast that’s separate from the rest of your breast tissue,” she explained. “Because the textures and densities of masses can be so varied, you’re just feeling for anything different, as vague as that sounds. You can use your other breast as a baseline as well.”
Of course, feeling a new lump isn’t the only indication of a potential issue. Susan Brown, senior director of health information at Susan G. Komen, shared a list of eight warning signs, including visual indicators, that people should look out for.
“See a doctor if you notice any of these breast changes,” Brown advised. “Lump, hard knot or thickening inside the breast or underarm area; swelling, warmth, redness or darkening of the breast; change in the size or shape of the breast, dimpling or puckering of the skin; itchy, scaly sore or rash on the nipple; pulling in of your nipple or other parts of the breast; nipple discharge that starts suddenly or new pain in one spot that doesn’t go away.”
Although there are some common characteristics of lumps and other warning signs, there’s ultimately no one specific thing to look or feel for when it comes to your awareness of your breasts. The key is just to understand what is normal for you so that you recognize something new or different ― and seek medical attention when you do.
What’s the best way to notice or spot a breast lump?
Part of the reason many experts no longer recommend monthly breast self-exams is that there are more organic situations during everyday life that provide the opportunity to familiarize yourself with your “normal” and keep you on alert for signs and symptoms.
“Many women who discover changes in their breast or underarm area that turn out to be breast cancer don’t actually discover them on the day and time they have set aside for monthly [self-exam, but rather noticed a change incidentally at some other time, such as when showering or dressing, and recognized the change because they knew what was normal for them ― or a partner noticed it,” Brown explained.
Again, the idea is not to necessarily look for something specific, just to take note if there’s anything new or different.
“If you aren’t already checking your own body, I think a good place to start is after you go in for a regular checkup with your primary care provider or gynecologist,” said Dr. Janet Yeh, assistant professor at New York University (NYC) Grossman School of Medicine and site chief of breast surgical oncology at NYU Langone Hospital―Brooklyn. “If you recently had imaging or they did an exam and it was normal, then you can get a good idea of your baseline because you know there’s nothing there. You know the lumps and bumps you might feel are your regular breast tissue.”
She recommended checking your breasts when you’re doing something comfortable and routine, like lying in bed, watching TV, standing in front of the mirror, or taking a shower (“it’s two birds with one stone since you have to wash your body anyway”).
“Everyone’s going to do it a little differently, and that’s OK,” Yeh explained. “Some use the tips of their fingers and go in little circles. Others might say to make the shape of a star. I like to feel with my palm and fingers and do a wiping motion. I think of the breasts as a clock and wipe all around a center point ― then press in to make sure I’m not missing anything behind.”
Lift your left arm as you check your left breast and your right arm for the right. Make sure to also check your underarms, as cancer and other issues can manifest in the form of swollen lymph nodes in that area.
“Some women have very lumpy breasts, so it’s important for those women to get used to their own lumps and bumps,” Yeh noted. “That way they can say, ‘OK in the upper outer area, I usually feel a lot of firmness and lumps.’ And if there’s something different they’re unsure about, it doesn’t hurt to get it checked out, even if it turns out to just be regular breast tissue.”
In addition to seeing a doctor when you detect any change or abnormality, make sure to schedule regular medical appointments and screenings. If you have a family history of breast cancer or personal health factors that increase your risk, talk to a doctor about that. Discuss which tests are right for you and the proper age and cadence for screenings like mammograms.
“Our technology with breast imaging is so good these days that we really do pick things up early,” Yeh said. “If you’re compliant with the guidelines and getting your mammogram, it’ll likely pick up things before you can even feel them. Fortunately, most of the breast cancer we see is so early, we can’t even feel it ourselves. Still, it remains important to let a professional know if you feel a new lump in your breast.”
Can You Mix And Match For The COVID Bivalent Booster Shot?
Pfizer and Moderna now both have new bivalent COVID booster shots that not only target the original strain of coronavirus, but also the highly contagious omicron subvariants that are dominant throughout the country.
These booster shots are readily available at pharmacies and doctor’s offices throughout the United States. You’re able to get one if you’re at least two months out from your last COVID shot or two months out from a COVID infection.
“[These] vaccines are widely available,” said Dr. Laolu Fayanju, an Ohio-based family medicine specialist with Oak Street Health. “We are a long way from the early days of 2021 when the vaccines were just rolling out.”
But if you notice that your local pharmacy only has one kind of shot available (either just Pfizer shots or just Moderna shots), do you need to look elsewhere to find the same shot maker you had last time? Here’s what to know:
Adults can get either bivalent booster.
According to Dr. Onyema Ogbuagu, an infectious diseases specialist and associate professor of medicine at the Yale School of Medicine, just like with the last COVID booster, you can get either the Pfizer shot or the Moderna shot no matter what shot you got for your primary vaccine series or your last booster.
“We’ve seen that there’s no harm from prior studies in mixing and matching mRNA [vaccines], they’re one in the same approach with subtle differences,” Ogbuagu said.
So, if your local pharmacy is only giving out shots of Pfizer, there is no reason to go search far and wide for Moderna — or vice versa. You’re good to get either shot. “Anyone should feel comfortable getting the Pfizer vaccine after Moderna and Moderna after Pfizer,” Ogbuagu said.
However, keep in mind that this only goes for people over the age of 18. The Moderna bivalent booster is not currently authorized for people age 12 to 17. Those age 12 to 17 can only get the Pfizer booster. Fayanju noted that it’s perfectly safe for people in this category to get the Pfizer booster even if they’ve only had Moderna shots previously.
There may even be benefits to mixing and matching your shot.
Research conducted on previous booster shots showed that mixing and matching your vaccine manufacturer may provide a stronger immune response than sticking with the shot-maker you got originally. Experts suspect the same holds true for the bivalent shot.
Additionally, previous studies show that the Moderna vaccine produces a higher immune response than the Pfizer vaccine. This is likely because of the differences in the dosing of each shot. According to Ogbuagu, the Pfizer shot is 30 micrograms and the Moderna shot is 50 micrograms, “so there [are] differences in the number of antigens being used,” he said.
The higher dosage of the Moderna shot links it to this higher antibody response. But keep in mind that the overall amount of additional protection is nominal — both shots provide protection from severe outcomes like hospitalization and death.
If you got Johnson & Johnson for your primary vaccine, you’ll have to switch manufacturers for your booster.
It has also always been the recommendation that people who got the Johnson & Johnson vaccine follow it up with an mRNA booster, Ogbuagu said.
In the case of the bivalent booster, there is not a Johnson & Johnson equivalent, so it’s perfectly fine (and the only option) for those who got the Johnson & Johnson shot to get either the Pfizer or Moderna bivalent booster.
If you’re unsure, talk to your doctor.
Your physician will know what’s best for you based on your health history. For example, some doctors may encourage men ages 18 to 39 to get the Pfizer booster instead of Moderna if it’s available. In very rare cases, the Moderna vaccine caused temporary heart issues in men in this age group. But, according to the American Heart Association, contracting COVID-19 is way more likely to result in heart issues than the Moderna vaccine ― so it’s still a good idea for folks in this category to get the bivalent booster.
The bottom line is that both shots are excellent ways to protect yourself from the dominant omicron subvariants. You really can’t go wrong with either ― the best approach is to get whichever one you’re able to get ASAP.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
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