Tracy Carter: So, most of us are familiar with October being the pink month, breast cancer awareness month. We know at our core that we shouldn’t take our health for granted, but often we still do in so many ways. Today, we are blessed and honored to have with us pediatrician Doctor Jennifer Piscitella. Welcome, Jen.
Doctor Piscitella: Hi, thanks for having me.
TC: Thank you for being here, and thank you for all that you do. You are appreciated. As a pediatrician, you’re confronted with the topic of health and health-related issues every day on the job. I imagine that this can be stressful at times and that the long hours can sometimes take a toll on your health. How do you do it?
DP: Well, I think it’s essential. In general, women often do not put themselves first. So I try to troubleshoot problems before they happen. So I think anybody that has a busy job, I try to, you know, meal prep for my lunches for the week, make sure there’s plenty of healthy food around in case lunchtime doesn’t happen, which often, it doesn’t. And I try to make sure that I’m paying attention to my stress level as much as possible because once you get to kind of that critical mass, it’s tough not to take the easy way out, not to eat junk food, not to sleep in, not to get up, and do your exercise. So I think that things like meditation or journaling, or things like that help bring it all back in perspective so that you’re even all the time and you can be the most effective person you can be.
TC: Thank you for that because many times, we don’t think about being proactive and anticipating those stressful moments, and it sounds like you do a lot to prepare so that you can still make those healthy choices despite what might be going on around you, so to be consistent about taking care of yourself.
DP: It’s always important to do that because consistency is key. No one is perfect. You’ve just got to roll with the punches as best you can.
TC: Yes, and I can relate to sometimes in the spur of the moment if you don’t plan, you can make some unhealthy choices.
DP: Sure.
TC: Yes. Now, when did you first know that you wanted to work in the medical profession?
DP: I think I’ve always really loved science, and around the time I think I was twelve, my mom had a pituitary tumor. So it’s a tumor in the brain right in the middle; if you could make this finger and this finger touch (illustrating by placing fingers where the tumor would have been located) and she showed up to her family doctor with a terrible headache and some other symptoms. It was kind of amazing how he took one look at her and said, we have to do X, Y, and Z, and we were very quickly at this specialist, at this hospital, getting everything done. And I think it makes a big impression on a child because, arguably, when you’re younger, your mom and dad are really important people, and so I saw how just good decision-making could save her. So, that is where it started, and then I always liked kids even when I was a kid, so it was more, where did I want to be? I enjoy teaching too, and medicine gave me the ability to do all of those things. You know, I can take care of kids from birth to, you know, 22, when I try to kick him out of practice (jokingly), and I can educate the parents, but also I get medical students and residents and things like that. So, it’s just always kind of been my thing.
TC: So, you definitely can hear the passion in your voice, that you have a passion for the field you’re in, and I like there’s a personal connection there that drives you as well.
DP: Yeah, it almost has to be, I think because you do have to give up some of your free time, and it’s a lifelong learning kind of career. I’m studying and reading things all the time, and if you don’t love it, it’s hard to say current.
TC: Absolutely, I can understand that. What would you say is the most challenging part of the work that you do?
DP: I think it’s really that my patients can’t be their own advocates. My teenagers start to find their voices, and that’s wonderful. However, my little kids, it’s hard enough to be a doctor because sometimes we as adults don’t listen and, you know, we have high cholesterol when we don’t eat well or have diabetes. We don’t exercise, but my patients often can’t do the things that I need them to do, and because of that, it can be challenging as I know what’s best for them. They don’t even understand what’s best for them and can’t do anything about it.
TC: Right, right. That makes so much sense, and I can see how that would pose a challenge. What would you say is the most rewarding aspect of what you do?
DP: I think the best thing that I deal with is getting to watch the kids grow up. I get to help them navigate those challenges, which is excellent, but besides that, you know, I get to form these relationships. So I see the first sibling, you know, and then I see the little siblings. Sometimes I see little cousins, so I get to just kind of share in those family triumphs that happen or, you know, the good and sometimes the bad, which it’s nice to form that connection. So, that’s probably the most rewarding thing that I get to experience.
TC: I can relate to that because I will have to say our pediatrician is almost like a part of our family. They’ve helped us like celebrate a lot of, you know, successes that our children have because they like to get to know the whole child when we go they don’t only address the medical concerns, but also get to know the kids, and it’s nice to walk in and see that they remember the kids. They remember things about them from when they were even younger, you know, and not necessarily something that would be in a medical chart. So there’s an established relationship, and I like that about our pediatrician. I can tell that you have that same thing about you as well. So what do you think is an often overlooked aspect of women’s health?
DP: There’s probably a couple. One thing for sure is cardiovascular health. We have to have all the work. You know, we have the kids, we have the periods, and you know, in exchange for that, our hormones protect us. They protect us from myocardial infarctions, heart attacks, strokes early on, but then you know, we go through menopause, the bottom drops out, and then our rates of heart attack and stroke just like fly through the roof. I sometimes think that because we are often so worried about everybody else and taking care of the kids and doing this, we don’t focus on that as much. I think medicine in general, except for the occasional little, you know, women’s heart health month, we miss it, you know. Then suddenly, we were in our late forties, and we’re starting to see the effects of this, and when people think of heart health, they’re thinking, you know, heart attacks, but it’s also cardiovascular health. So, our blood vessels that can lead to varicose veins, leg pain, and certain types of dementia are all related. Or even like high blood pressure, which is one of those things we call the silent killer that leads to hypertensive dementia and other issues. We don’t talk about it as much because it’s just, it’s not a problem. Until it’s a problem, and by then, we were so set in our habits that it’s too late. So, that’s a really big one, and I think because it has really widespread implications. However, the biggest thing I think for women is mental health. This is not a blanket statement for every woman in the world, but we tend to be a little bit type A. We tend to want to take care of people. We tend not to want to make other people worried, by and large, and so we just kind of like cram it all down, which is ok, but up until the last 15 years or 20 years, mental health and counseling was a little taboo. And so we’ve all kind of learned to cope and deal with it, but our coping skills are not good, you know, we emotionally eat, or we have a cigarette when we’re stressed, or we have a glass of wine every day after work, or we procrastinate which develops into more problems. So, as people, I think we need to be more open with their feelings and admit “I’m having a hard time” before it becomes an addictive process or another bad coping skill that can infiltrate the rest of our lives. So I think, you know, if I had to pick, mental health is probably the most important one because it affects everything.
TC: I agree, and I’m so glad that you mentioned that because we often overlook the mental health aspect as part of our health and our overall well-being...
DP: Absolutely.
TC: ...and you’re speaking my language because I’m a licensed clinical social worker.
DP: Yay! You do God’s work there.
TC: (chuckles) It’s so interesting, and I’m glad you said this because we end up being caretakers for everyone as women. We feel that we are designed for multitasking in every situation. We neglect our mental health many times, and as you said, it is now where we feel more comfortable talking about these things more. It is ok to let people know when we need a break or when we are not doing ok and trying to find those coping skills, the healthy coping skills that we need to get through to care for others. Something that is so cliché, especially during the COVID-19 pandemic, putting our masks on for lack of a better term, it’s so important to be able to do that so that you are well and whole to be able to give. So, I always like to say we can’t pour from an empty cup.
DP: True. That’s 100% true.
TC: So yeah, thank you for sharing that...And what are some suggestions that you have regarding prevention or early detection of health issues in general, as well as for health issues that disproportionately affect women?
DP: Ok. So I think in general, the more and more we learn about, you know, just overall body health, we’re learning how important diet is really. And I don’t mean limiting this or limiting that, actually what we eat every day. And, you know, I think that what we have to focus on is just broad strokes because you know the Keto diet we’re not even going to go there about what other problems it causes. However, those restrictive or specific diets, they’re not going to work for everybody, and they’re not going to work for most people because what’s going to happen is you’re going to do it for a while, and then you’re going to fall off the wagon, and they were just in a mess. So, I think the easiest thing is to look at four significant components of diet and reexamine every year to make small changes. Everybody could eat an extra serving of vegetables a couple of times a week. I don’t talk about fruits often, but you have them for breakfast or as a snack. Veggies are a little bit of a dark horse, they’re hard, but they are packed with nutrients. So, you know, try to eat an extra serving of vegetables once or twice a week. We all could use more fiber. Women, in general, are very low on fiber, and it will get rid of cholesterol. It will help you go to the bathroom. It will feed the good bacteria in your gut, all those little probiotic buddies. Everybody could probably drink an extra glass of water and find one extra day a week to exercise, and those things are straightforward because I’m not asking you to do it to the nth degree. If you can do a little bit better this month and you did last month, you’re winning, you know, so I think that’s an excellent overall broad idea because if you’re doing that sort of thing, it’s going to impact pretty much every area of your health. Specifically for women, you know, heart health, we talked about a little bit, but there are many screening tests we do; pap smears, screening mammograms, and colonoscopies are the main ones. No one wants a colonoscopy, but these things over the years have been studied, risk-benefit cost-benefit. So we know that they’re recommended because the cost overall is low for early detection, for improving survival. So, I think those things are essential for everybody, but specifically for women because we know if we can’t get the mammogram until this day. Joe Schmo has practice, so we’re going to skip it, but we really shouldn’t be missing those things, especially colonoscopies. I have had more experience than I’d like to have with people I know who have had colon cancer or something like that because they don’t want to do it. Those things are critical. Doctors don’t make any money from it; we’re not trying to make you do them. It just helps to avoid problems later on. So I think following doctors’ advice is suitable for that. Those yearly screenings are essential.
TC: And I agree. I know that when we get busy, we think, “Ok, we can put this off for another day or another year.” However, I had some experiences where my mom, for example, following up with certain things, has helped her and saved her in many instances by getting the screenings that she needs to get because she has some pretty severe health issues. However, I think they could be much worse if she were to blow off these screenings that detected her illnesses.
DP: Yeah, and I’m sure that you help advocate for her and kind of poke her to get her to do them.
TC: Right.
DP: Not everybody has that support system, so you have to be your support.
TC: Yes, I agree. It is not easy pushing her in that direction (both chuckling)
DP: I feel you on that, for sure.
TC: I’m sure my children will probably say something similar at some point when they get old enough. (both chuckling) And are there any other things that you would like to add that you think people should know about women’s health awareness regarding physical, mental, and emotional well-being?
DP: Ok, I think one of the things that I’ve learned as I’ve grown up and become a woman myself, but also as taking care of young women is we need to speak up. As a medical professional, I would like to think this is not true, but sometimes people in medicine don’t listen. Women are seen as whiners, we’re not as strong, we’re overly emotional or anxious (stating from others’ perspectives), but no one knows your body better than you do. If there’s something wrong, speak up until it’s taken seriously. This is even worse for minorities and women of color. It is essential to speak up until you’re heard, and if you’re not heard, find another provider. I think that’s important because overall, we have to be our advocates. I think that’s important, and then probably the only other thing is I cannot overstate the benefit of exercise. You know, that’s the first thing that goes for me. I love to sleep, so if I’m busy, I’m not getting up and going to the gym, but it decreases your risk of certain types of arthritis, osteoporosis, certain types of dementia, diabetes, high blood pressure. Everything that stinks about getting old mitigates those risks. So, if you can get up and move, I think that’s probably super important about just staying healthy as we get older.
TC: That’s excellent advice, and I like that you talked about us speaking up because sometimes we do feel like we don’t want to complain, or we don’t want to feel like we’re dramatic, as some people might think. However, it is crucial to advocate for ourselves because we need to know our bodies better than anyone else canes. So, we need to speak up if something doesn’t feel right or doesn’t seem right without us feeling shamed or that it’s a sign of weakness because sometimes we push ourselves. We internalize that were supposed to be strong and keep going no matter what.
DP: Yeah, definitely true.
TC: Yes. Well, thank you so much. I appreciate you. You have given much wisdom in terms of how we can better care for ourselves, and I’m grateful to you for taking the time out to bless us with all of this information.
DP: I’m so thankful for you, taking the time to talk to people and get other opinions, but also for the work you do and getting the word out there and in your job as a social worker. I think that’s wonderful. You are a blessing.
TC: Thank you very much. Well, hopefully, this won’t be the last time we get to speak, and hopefully, you’ll be able to join us for some of our EmpowHERment events. We have many things that are coming up that are fun and exciting. So hopefully, I’ll get to see you or meet you in person soon.
DP: Ok, sounds great. Thank you so much, Tracy.
TC: Thank you, and you have a great evening.
DP: You too. Take care.