Helping Your Man
Understand the PSA Test

Other than skin cancer, prostate
cancer is the most commonly
diagnosed cancer in the United...

read more

Covered California:
What You Need to Know

Chances are you may have
heard about Covered California
— and if you haven't yet...

read more

Maintaining Younger
Looking Eyes

For most women, signs of aging
first appear on the face. For many,
those signs appear around the...

read more

The Magic of the
Mommy Makeover

While having a child enriches a
woman's life and brings much
happiness, having a baby can also...

read more

The Power of Perspectacles

In religious circles there is a
lot of talk about the afterlife, about
heaven and hell. This is certainly...

read more

Helping Your Man Understand the PSA Test

Other than skin cancer, prostate cancer is the most commonly diagnosed cancer in the United States. In fact, about 238,000 American men will be diagnosed with prostate cancer this year and 1 in 6 men will be diagnosed with prostate cancer at some point in their lifetime. The good news is that while prostate cancer can be deadly for some, the majority of men diagnosed with it will not die from it. Nonetheless, the mere thought of prostate cancer can be frightening to men. Confusion surrounding the most common test for prostate cancer — known as the PSA test — can add to that fear. Here is what you and the men you care about need to know about the PSA test...

What is the PSA Test?

The PSA test measures the level of Prostate-Specific Antigen (PSA), a protein produced by the prostate, in a man's blood. While this level is often elevated in men with prostate cancer, the test was originally approved by the FDA in 1986 to monitor the progression of the disease in men already diagnosed with it NOT as a diagnostic tool. In 1994, the FDA approved the use of the PSA test as a diagnostic tool but only when used in conjunction with a digital rectal exam (DRE) to test healthy men.

There are also other benign conditions which can cause a man's PSA levels to rise, including prostatitis and benign prostatic hyperplasia.

In recent years, many doctors encouraged yearly PSA screening for men over the age of 50. However, many doctors are now recommending the test instead to men who are at higher risk for prostate cancer — namely, African American men and men whose father or brother had prostate cancer. In those cases, screening can begin as early as 40 or 45. Men are encouraged to talk with their physician about whether they should undergo a PSA test.

What do PSA Test Results Mean?

Further complicating the PSA test is that there is no specific normal or abnormal level of PSA in the blood. In the past, a PSA level of 4.0 ng/mL or lower was considered normal. However, recent studies indicate that some men with PSA levels below 4.0 ng/mL can have prostate cancer while some men with higher levels do not have it. In general, the higher a man's PSA level, the more likely he is to have prostate cancer. In addition, it can be helpful to monitor a man's level over the years and if it is continuously rising that may be cause for concern.

If a man's PSA level is high but he does not have any symptoms, his doctor may order a repeat PSA test. If a man's physician finds a lump during a DRE and his PSA level is rising or is elevated, his doctor will order additional tests to find the cause of the problem. If prostate cancer is suspected, the doctor will order a prostate biopsy.

What are the Limitations of the PSA Test?

Unlike other cancers, detecting prostate cancer early may not reduce the chance of dying from prostate cancer. A PSA test may be able to detect small tumors that are not causing symptoms, however those tumors may grow so slowly that they are unlikely to threaten a man's life. Treating such tumors would be considered "overtreatment" and can expose men unnecessarily to the potential complications and harmful side effects of cancer treatment.

The PSA test may also give false-positive by showing an elevated PSA level when no cancer is present. A false-negative can also occur when there is cancer present but the PSA level is not elevated, which can unfortunately cause a man to ignore symptoms.

Bottom line, as with all important health decisions, men need to talk with their doctor about what is the best decision for them, based on their health, their symptoms and their family history.

If you would like to hear more about how you can help keep your man healthy, attend our Keep Your Hubby Healthy Care Chat at Care Begins With Me on Tuesday, Oct 8 at the Sheraton in Sacramento. Register here and don't miss Sacramento's premier lifestyle event for women!

Return to top

Covered California: What You Need to Know


Chances are you may have heard about Covered California — and if you haven't yet, you will soon. As we head into open enrollment season (that time of year when most people are selecting their healthcare options for the coming year), there are some things you need to know about the changing face of medical insurance in America and in California in particular.

What Is Covered California?

In 2010, the federal government enacted the Patient Protection and Affordable Care Act. The goal of the act is to increase the number of Americans with medical insurance while cutting the overall costs of health care. So what does this federal law mean to most Americans? It is important to all of us because it provides financial assistance to help individuals and small businesses pay for health insurance. The law also requires that most people over the age of 18 have health insurance or pay a penalty starting in 2014. It is important to know that if you already have health insurance, you do not need to take any action, unless of course your health coverage status changes.

How Does Covered California Work?

To help people without health insurance get coverage, the Affordable Care Act also requires individual states to either set up their own marketplace to offer health insurance or to have such a marketplace set up by the federal government. These "marketplaces" provide an accessible place where you can compare health plans and buy health insurance that works best for you and your family, based on your budget and your medical needs. California chose to set up its own marketplace — Covered California — and was the first state to do so.

Covered California was designed as a marketplace where legal residents of the state can buy health coverage that cannot be denied or canceled if you are sick or have pre-existing health conditions. It is estimated that about 2.6 million Californians will qualify for federal financial assistance and an additional 2.7 million who do not qualify for assistance will still benefit from guaranteed coverage through Covered California.

Through many of the plans offered through Covered California, you can gain access to Dignity Health physicians and services.

What Does Covered California Guarantee?

All health plans purchased through Covered California must cover a range of services called Essential Health Benefits. These include services like doctor visits, hospitalization, emergency care, maternity care, pediatrics, prescriptions, medical tests, mental health care and other services. Plans must also cover preventive care such as mammograms and colonoscopies with no out-of-pocket costs to consumers. All newly sold health plans, whether offered by Covered California or sold privately will be required to meet these same basic requirements.

Who Can Use Covered California?

Covered California will begin operating later this year and will enroll eligible Californians for health coverage that will take effect January 2014. Legal residents of California who do not have health insurance from their employer or from another government program are eligible to purchase health insurance through Covered California.

Eligible consumers will be able to buy the same quality health insurance from Covered California that is available in the private market. The advantage to using Covered California is the ease of comparing different plans while also using tax credits or cost-sharing subsidies from the federal government to lower your health care costs.

Covered California will also help small business (with 50 or fewer full-time employees) provide affordable health coverage to their employees.

Covered California will be able to assist residents online, over the phone or in person and will be staffed to speak in numerous languages. For more information, call 888.975.1142 or visit

Return to top

Maintaining Younger Looking Eyes

By Mitra Ayazifar, MD

For most women, signs of aging first appear on the face. For many, those signs appear around the eyes through crow's feet, sagging skin beneath the eye, or droopy eyelids. For some women, issues such as drooping eyelids may be a medical problem but for most it is more a cosmetic issue. Regardless, there is a procedure that can help.

What is eyelid surgery?

It is important to understand what causes these changes around the eyes. With time, the tissues around the eyes and face lose their support causing them to sag. Blepharoplasty, which is plastic surgery of the eyelids, can address those changes by improving the appearance of upper lids, lower lids, or both. It provides added support to the area surrounding your eyes and helps you look more rejuvenated and rested.

What Can Blepharoplasty Treat?

Blepharoplasty includes a number of different procedures that address problems in the eye area, including:

  • Upper eyelid surgery to remove "puffiness" or excess fatty deposits
  • Loose or sagging folds of skin that can cover the lashes or even block one's peripheral vision
  • Lower eyelid blepharoplasty can remove excess skin and decrease "puffiness" by repositioning or removing fat pads from the lower lids
  • "Bags" under the eyes can be removed by trimming excess fat pads
  • Laxity of the lower lids with "scleral show" or showing of the "white of the eye" can be repaired by tightening of the lower lid during lower lid blepharoplasty

Who is a Candidate for Blepharoplasty?

Blepharoplasty can be performed for cosmetic or functional reasons. Functional blepharoplasty is done on individuals who have a documented deficit in their upper field of vision (meaning their eyesight is affected) and who show "drooping or sagging skin" which falls on their lashes or even blocks their pupil. Cosmetic blepharoplasty is not covered by insurance and is done on individuals who do not quite meet the strict "Medicare" criteria for the procedure.

Healthy individuals without serious medical conditions, non-smokers, and those without serious eye conditions are excellent candidates for blepharoplasty. Patients with high blood pressure, diabetes, clotting problems, history of keloid (hypertrophic scar tissue) formation, or severe dry eyes must consult their doctor extensively prior to making the decision regarding this elective surgery.

What Happens During Surgery?

Blepharoplasty is typically performed in an outpatient surgery center, using anesthesia ranging from MAC (monitored anesthesia care) to general anesthesia with local supplementation of anesthetic. After the eyelids have been marked and the area of excess skin and muscle has been delineated, the patient is brought to the operating room. After induction of anesthesia, and prepping of the entire face, the marked area is removed along with some underlying prolapsed fat muscle and fat. After appropriate contouring of the fat pads to remove excess "puffiness," various eyelid layers are closed with different layers of sutures. These sutures are removed at about 5-7 days later. Extensive instructions for the use of cool compresses over the first 48 hours followed by warm compresses to allow the body to absorb the bruise are discussed with the patient. Your surgeon may also provide instructions on natural food supplements that can help expedite the healing process.

What is Recovery Like?

Normally, most bruising is resolved by about 10-14 days post-op while most swelling resolves by approximately one month after surgery. In most patients, the incision line will settle at about 4 months. The only limitations in activity include no cardiovascular activity or heavy lifting for 7-10 days post procedure.

The major risks associated with eyelid surgery include infection, bleeding, risk of anesthesia, need for repeat surgery, risk of asymmetry, over correction or under-correction to name a few.

To learn more about Dr. Ayazifar's practice and the procedures she offers, visit her website or call her office at 916.241.9378. You can meet Dr. Ayazifar and hear more about blepharoplasty during her Care Chat at Care Begins With Me on Oct. 8. Register today for Sacramento's premier lifestyle event for women!

Return to top

The Magic of the Mommy Makeover

By Jeffrey Sweat, MD

While having a child enriches a woman's life and brings much happiness, having a baby can also have some unwanted side effects on a woman's body. Pregnancy can stretch skin and muscle to unimaginable lengths and while diet and exercise can help repair some of the damage, for some women their taut shape never returns. In addition, the changes in breast size due to pregnancy and breastfeeding can cause previously perky breasts to sag and deflate.

So what is a woman to do? Well, if a good diet and exercise regimen aren't doing the trick, you may want to consider talking to a plastic surgeon about what is commonly known as a "mommy makeover" — one or more procedures aimed at restoring or improving a woman's post-pregnancy body. Typically these procedures may include breast augmentation and possibly breast lift, tummy tuck and/or liposuction. The areas most moms want to address are the breasts and the tummy, where stretched skin may be unsightly or droopy. In addition, moms may be concerned about fatty areas on the tummy, legs, arms, buttocks or lower back.

Before considering a mommy makeover, patients are encouraged to do what they can to address their issues using diet and exercise. Reaching your ideal weight prior to surgery is a good goal to have — this will give you a better idea of which, if any, problem areas need to be addressed surgically. The ideal patient is one who has done all that she can for her body through eating well and working out but the sagging skin or stubborn fatty areas just won't budge. In those cases, a mommy makeover may be just the trick.

Patients must understand that these procedures are invasive and while serious complications are rare, there is some pain and discomfort and the recovery period can take several days to a few weeks. This can be challenging for any woman, but particularly for one who has young children. A good support system is vital in the first few days following surgery.

If you are not feeling good about your body, do what you can through good nutrition and exercise and if that is not enough, talk to a plastic surgeon about what options may be best for you. You can reclaim your body after baby!

To learn more about the procedures Dr. Sweat and his team offer, visit their website or call their office at 536.2400. You can also learn more about Dr. Sweat and the "Mommy Makeover" during his Care Chat at Care Begins With Me on Oct. 8. Register today for Sacramento's premier lifestyle event for women!

Return to top

The Power of Perspectacles

By Glennon Doyle Melton

Famed blogger and best-selling author Glennon Doyle Melton will be the keynote speaker at Care Begins With Me on Oct. 8. Glennon writes with inspiration, humor, compassion and perspective. To hear from Glennon in person, register for Care Begins With Me, Sacramento's premier lifestyle event for women.

In religious circles there is a lot of talk about the afterlife, about heaven and hell. This is certainly important to discuss, but when I read scripture, what slaps me in the face is that Jesus (and Buddha and every other spiritual teacher) focuses on the present more than the future. He teaches often about how we turn our earthly existence into heaven or hell based on our choices and perspective, here, today, right now.

Some people understand "heaven" as a place for "believers" and "hell" as a place for "nonbelievers." Maybe. But I also think that those boundaries can't be hard and fast. Because I believe 'till the cows come home. But I still find myself, quite often actually, feeling jealous and afraid and suspicious and isolated and angry and hopeless. Which feels a little hellish. And other times, I feel loving and fearless and hopeful and connected and generous, which feels quite heavenly.

So it seems to me that the heaven and hell might also be places I shift between throughout my day, depending upon my attitude, where my heart is, how I'm looking at the world and at other people. And which kingdom I'm currently in depends on whether I've got my Jesus glasses on or not. When I'm wearing my Jesus glasses, I see other people how Jesus sees them. Through my Jesus glasses, it becomes crystal clear that every person is my equal, and so confidence and humility come easy. Through my Jesus glasses, I see, laid out in front of me, ridiculous abundance. Through my Jesus glasses, I see that there is enough, that I am enough, and so is everyone else.

When I don't feel these things, I try to catch myself and find my glasses. I call these glasses perspectacles. Because, well, because I am very, very cheesy and obsessed with puns. Also I like to use words that include everybody, not just Christians.

I used to be very suspicious of other women. I felt it was my duty to prove myself to other women. To defend my imaginary superiority. To hide my imaginary inferiority. I felt like I could never let my guard down, never relax. This was before I found my perspectacles.

Now, mostly, instead of perceiving other women as competition, I put on my glasses and I see each woman placed on my path as a gift, an invitation, a resource, sent to teach me something I don't yet know. Sent to help me heal in a specific way that only she can. Even when it becomes clear that the relationship is not going to work out, that we will have to part ways, she is still a gift because I am learning how to part ways with another woman lovingly and gracefully. And so I get to practice taking care of myself and others. And I am able to relax. To stop grabbing and hiding. To understand that God sends exactly who we need, 100 percent of the time.

This shift took a long time to happen. And it's semi-permanent. My perspectacles still fall off. But now I know that when I find myself tightening up, feeling smaller and scared and defensive, all I have to do is find my glasses, put them on, and the world and mother people will look blindingly beautiful again. And I will be able to breathe and be still in the understanding that the world is on my side.

This essay and more with Glennon is featured in the Sept./Oct. issue of Kidaround Magazine — look for it on newsstands near you!

Return to top