All Posts tagged victor health clinic

Doc Talk: Who needs a mammo?

Kristen CoburnBy Kristen Coburn, FNP

First, let’s acknowledge that men can get breast cancer. The risk for males is significantly lower than the risk for females, but that doesn’t matter if you’re the man who receives this diagnosis. For the sake of simplicity, the rest of this article will refer to a female audience.

Who needs a mammogram? It seems like a simple question, but the answer isn’t the same for all.

Before we wade into the controversy, it’s important to know that a screening mammogram is different than a diagnostic mammo.

In Idaho, you can request a screening exam without a doctor’s order. If you don’t have any risk factors (age, family history, symptoms) your medical provider may recommend that you don’t need this screening. Screenings take less time, use a lower dose of radiation and provide general images of your breasts. Diagnostic mammos are prescribed by a medical provider, use a higher dose of radiation, and usually focus on specific areas of your breast(s).  Your provider may order a diagnostic mammo based on your risk factors and other indicators, or you may be asked to get a diagnostic follow-up if the results from your screening mammogram indicate the need.  Under current insurance mandates through the Affordable Care Act, screening mammos are covered by insurance, at no cost to the patient, for women 40 and over. Diagnostic mammos may or may not be covered 100% by insurance. It’s always a good idea to check with your insurer before you get a mammo or any type of medical care.

Resources on the internet offer a confusing mix of opinions on preventive mammogram screenings based on factors such as you’re under 55, over 40, overweight, underweight, a wine-drinker, vegetarian, under 25 with a family history, or menopausal. Of course, internet resources vary widely in the degree of science and research that went into the answer.

Most of us have heard the recommendation that every woman should have an initial screening at the age of 40, and every year or two after that. Over time, different medical research organizations have come forward with other studies and recommendations, not to mention all of the online experts sharing research from unsubstantiated sources. We’re frightened to hear about false-positives, false-negatives, overtreatment, under-treatment, and radiation exposure, and yes, all of these problems can occur. As with nearly every choice in life, we need to weigh potential benefits against possible harms. 

What’s a woman to do?

At Teton Valley Health Care, we agree with the position of the National Cancer Institute: Talk to your provider. Together, come up with an informed plan that fits your preventive care needs based on proven outcomes. Ask questions and share information that concerns you. Choose what’s best for you: your body, your history, and your well-being.

Through donations from Teton Valley Hospital Foundation, our community hospital offers free screening mammograms for anyone who cannot afford them. The request form is one-page, requires no financial documents, and is simple to fill-out. Funding is also available to pay toward biopsies, ultrasounds, follow-up clinic visits, surgery, and travel costs related to breast cancer prevention and diagnosis. Call (208) 354-6331 for more information about this program.

For good health, prevention is the best route to take. Make sure you’ve had your vaccinations, and take advantage of screening opportunities that are recommended for you and your family. When in doubt, talk it out with an appropriate medical provider.

Kristen Coburn is a Family Nurse Practitioner serving clients at the Teton Valley Hospital Aesthetics Clinic, and Driggs and Victor Health Clinics.


Recordings of Oct. 28 Community Meeting on Insurance

The following recordings are from the Oct. 28, 2016 Community Meeting on Insurance held at the Driggs Senior Center. Representatives from Your Health Idaho, Parker Insurance in Rexburg, and Blue Cross of Idaho spoke and took questions from the audience. These recordings are essentially unedited, and you may or may not be able to pick up the questions from the audience members in the recordings, but the presenters did wear microphones, so their voices should be clear.



Doc Talk: Got sunscreen?

By Kristen Coburn, C-FNP

Kristen Coburn head shot

Kristen Coburn, C-FNP

It’s shaping up to be another hot week here in the valley. Forecasters are predicting temperatures in the 80s and 90s and plenty of sunshine … what more could we ask for on a holiday weekend?

If you plan on spending time outdoors enjoying the sun, catching some of the Independence Day activities, or even doing yard work, make sure you drink plenty of water and take care of your skin.

Sunscreen is one of the best protections against damaging ultraviolet (UV) radiation. There are two types of ultraviolet radiation: UVA and UVB. Ultraviolet radiation is part of the electromagnetic (light) spectrum that reaches the earth from the sun. It has wavelengths shorter than visible light, making it invisible to the naked eye. Ultraviolet A (UVA) is the longer wave UV that causes skin damage, skin aging and may cause skin cancer. Ultraviolet B (UVB) is the shorter wave UV ray that causes sunburn, skin damage and may cause skin cancer.

Skin Cancer Facts


Sun Protection Factor (SPF) is a measure of a sunscreen’s ability to prevent UVB and UVA from damaging the skin. Here’s how it works: If it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer or about 5 hours. Most sunscreens with an SPF of 15 or higher do an excellent job of protecting against UVB (with many brands also touting UVA protection) however, it may be overly optimistic to rely on 5 hours of continuous protection after one application.

Another way to look at it is in terms of percentages: SPF 15 filters out approximately 93 percent of all incoming UVA/UVB rays. SPF 30 keeps out 97 percent and SPF 50 screens out 98 percent. These numbers may seem like negligible differences, but if you are light-sensitive or have a history of skin cancer, those extra percentages will make a difference. And as you can see, no sunscreen can block all UV rays.

Be aware that there are problems with the SPF model: First, no sunscreen, regardless of strength, should be expected to stay effective longer than two hours without reapplication. Second, “reddening” of the skin is a reaction to UVB rays alone and tells you little about what UVA damage you may be getting. UVA radiation is more detectable over time, showing up as pre-aging of the skin via wrinkles, discolorations, and coarse texture. Plenty of damage can be done without the red flag of sunburn being raised.

Who should use sunscreen?

Anyone over the age of six months should use a sunscreen daily. Even those who work inside are exposed to ultraviolet radiation for brief periods throughout the day, especially if they work near windows, which generally filter out UVB but not UVA rays.

Children under the age of six months should not be exposed to the sun, since their skin is highly sensitive to the chemical ingredients in sunscreen as well as to the sun’s rays. Shade and protective clothing are the best ways to protect infants from the sun.

What type of sunscreen should I use?

Which sunscreen you choose depends on how much sun exposure you’re anticipating. In all cases we recommend a broad-spectrum sunscreen offering protection against both UVA and UVB rays. Many after-shave lotions and moisturizers have a sunscreen (usually SPF 15 or greater) already in them, and this is sufficient for everyday activities with a few minutes here and there in the sun. However, if you work outside or spend a lot of time outdoors, you need stronger, water-resistant, beachwear-type sunscreen that holds together on your skin. The “water resistant” and “very water resistant” types are also good for hot days or while playing sports, because they’re less likely to drip into your eyes when you sweat. However, these sunscreens may not be as good for everyday wear. They are stickier, don’t go as well with makeup, and need to be reapplied every two hours.

When shopping for sunscreen, consumers should look for The Skin Cancer Foundation’s Seal of Recommendation, which is awarded to sun protective products that meet stringent criteria for safety and effectiveness.

Despite recent claims about sunscreen safety, consumers should rest assured that sunscreen products and specifically the ingredients oxybenzone and retinyl palmitate, are safe and effective when used as directed. Of course, some people may be allergic or sensitive to the ingredients. In those instances, a healthcare professional can help recommend alternatives.

Sunscreens should be considered a vital part of a comprehensive sun protection regimen that includes seeking shade, covering up with clothing including a wide brimmed hat, UV-blocking sunglasses, avoiding tanning and UV tanning booths.

Kristen Coburn, FNP is a family practice physician who sees patients at Driggs and Victor Health Clinics. She also provides aesthetic treatments including free consultations, Botox and physician-recommended skincare products at Teton Valley Hospital’s Aesthetics Clinic

This article orignally appeared in the Teton Valley News.