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Women at the centre of CUH’s dedication to patient care 

The advice of healthcare staff and the personal stories of female patients show how lives are enhanced by the commitment to the wellbeing of women by the teams at Cork University Hospital and Cork University Maternity Hospital


CUH and CUMH delivering excellent care to women of all ages

enhancing the lives of female patients is the key focus of the health tips and personal patient stories told on this page, as well as in the companion booklet distributed with the Irish Examiner.


The healthcare staff of CUH, CUMH and the Lee Clinic offer advice and tell stories which deliver  valuable insights for women on health services available, as well as self-care and other tips across topics from cancer and
menopause to incontinence, fertility and bone health.

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By examining your breasts once a month you will become familiar with how they look and feel, therefore, you will notice if there is a new change. PICTURE ISTOCK

Breast cancer: Know the signs, steps to reduce the risks

Susan Walsh, Candidate Advanced Nurse Practitioner, CUH, offers vital advice on breast cancer

What is the population risk of breast cancer?

Breast cancer is a common disease. In the general population about one in eight women in Ireland will develop breast cancer before the age of 74 years. It is more common over the age of 50. 

When should you commence breast cancer screening?

Women aged 50 to 69 with an average risk of breast cancer are offered mammograms every two years via Breast Check the National Breast Screening Programme. It is important to note that screening tests have benefits and limitations; further information is available on the HSE website. You can check to ensure your name is on the register or update your details by logging onto the HSE website.

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Early detection of breast cancer is important for long-term prognosis and survival. PICTURE ISTOCK

Breast cancer awareness

As you can imagine working in a symptomatic breast clinic, I meet many women who are worried about a new change or symptom in their breast. I always ask the woman if she examines her breasts regularly. The most common answers are “No, I don’t know how to examine myself ”, “I don’t know what I’m looking for” and “my breasts are lumpy anyway, so I wouldn’t know what to look for”. The simple answer is, like the words of a famous sports slogan, “JUST DO IT”. 

By examining your breasts once a month you will become familiar with how they look and feel, therefore, you will notice if there is a new change. 

Some normal changes such as tenderness and general lumpiness can be linked to hormonal changes in your body such as your menstrual cycle, pregnancy and menopause. Early detection of breast cancer is important for long-term prognosis and survival. 


For more information: 


Irish Cancer Society
www.cancer.ie


Marie Keating Foundation 
Tel: 1800 200 700 | Tel: 01 635 3726 
www.mariekeating.ie


 Breast Cancer Ireland 
 Tel: 01 516 0331
breastcancerireland.com


Health Service Executive
www2.hse.ie

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Joanna Twomey, in re.mission from cancer thanks to a CUH clinical trial.

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Telling my kids I have cancer was the hardest thing I’ve ever had to do, but CUH support got me through it

Joanna Twomey is a mother-of-four who’s spent the past 15 years living in Cork, where she’s the manager of a busy dental practice. 

In September 2019, after a routine smear test, Joanna was diagnosed with cervical cancer. After that, her life became “a whirlwind”.

“That October, I had a radical hysterectomy and removed my ovaries, uterus, the whole lot. Despite all that, a month later the tumours had spread extensively. It was a very quick journey between my first diagnosis to discovering I had metastatic cancer.” 

During this terrifying blur of surgeries and consultations, Joanna faced the most daunting prospect of all - breaking the news to her family. 

“It actually shocked me how difficult it was to say it out loud. Telling my kids that I had cancer was probably the hardest thing I’ve ever had to do,” she reflects. 

The greatest hope that Joanna and her family clung on to during those early days was a clinical trial available at CUH. 

“Obviously it’s a risk to go on any trial, but it’s a calculated risk. There were a lot of side effects from it, I have to say, but really the results I’ve had are so worth it. I’m currently in remission, purely thanks to the trial. 

“I’ve gained so much from doing it, not just my health but also firm friendships with all the staff at CUH. From my gynaecologist, to my oncologist, my trial nurse and all the doctors there, they’re just absolutely lovely people. They’ve been brilliant, always clear about what they expected to happen from each treatment and what my options were. I can’t thank them enough.”

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Benefits of  exercise for menopausal women

 

Liz Barry, Deputy Physiotherapy Manager, CUH/CUMH, outlines exercises that can help women reduce the impacts of menopause.

the Menopause is the time in a woman’s life when her periods have stopped for over 12 months. Women can experience menopausal symptoms such as difficulty sleeping, brain fog, hot flushes, mood changes, headaches, joint pains, low sex drive, vaginal dryness and bladder problems for a number of years leading up to her periods stopping and also for a number of years after.

 
 

Exercise can be very beneficial.

1)  Reduce the risk of heart disease and maintain healthy blood pressure and cholesterol levels.

2)  Help maintain bone density and reduce the risk of
osteoporosis and bone fractures.

3) Help to reduce body fat and maintain a healthy body weight - reducing the risk of developing Type 2 Diabetes and some cancers.

4) Improve your mood and can help reduce stress.

There are two types of exercise which should be undertaken:


Muscle Strength training
 Adults over the age of 50 experience a more rapid loss of muscle mass called sarcopenia. Therefore, muscle strength training is really important to maintain muscle mass. Strength training also helps to stimulate bone density which is effected by the lack of oestrogen experienced during the menopause. Strength training should be done at least twice per week. Strength training doesn’t have to involve going to the gym and lifting weights or using resistance machines. It can be done in a class or at home. It could be a pilates or yoga class where you are using your body weight or weight of your limbs as resistance.

Cardiovascular training: : For a healthy heart and circulation, it is recommended that adults aged 19-64 do at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.

 
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Tips for new mothers to help your recovery

 

Rest The first 6 weeks postnatal are vital for recovery whether you have had a vaginal delivery or a c-section. Listen to your body and do not push yourself. Accept offers of help from others.

Back care: Your back and pelvis are vulnerable in the first 3 months following birth as your abdominal and pelvic floor muscles are weaker. Your pregnancy hormones can also continue to have an effect on your pelvic joints. Avoid stooping, twisting or bending over from your waist. Instead try to have things up at a comfortable height so you do not have to bend over.

Feeding: Be aware of your posture when feeding your baby. When sitting ensure your feet and back are well supported. Use a small step under your feet and/or a cushion behind your back. Use some pillows under the baby to bring them closer to you. If using a breastfeeding pillow, you may need an extra pillow underneath it. Placing a pillow under your arm to support it may also help. Alternate the sides you feed and wind the baby on, particularly if you are bottle feeding.

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Hypnobirthing uses relaxation techniques, visualisation and breathing techniques to help a woman cope with the birthing experience.PICTURE ISTOCK

Hypnobirthing, for a comfortable birth

Hypnobirthing promotes an easier more comfortable birth by supporting relaxation techniques, visualisation and breathing techniques to help a woman cope with the birthing experience.

Classes at University Hospital Kerry

Hypnobirthing classes have been provided to the women booked with Maternity Services in University Hospital Kerry. 

University Hospital Kerry has also designed and developed a Home from Home room to facilitate water immersion in labour and the use of low technological supports to promote physiological birth. 

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It is important to have enough calcium in your diet and have sufficient vitamin D (sunshine vitamin) which helps you absorb calcium.PICTURE ISTOCK


Bone health: causes, diagnosis, recovery

 

Bone health advice from Aislinn Finn, Senior Physiotherapist in Pelvic Health, CUMH, Davida Hehir, Clinical Nurse Specialist in Rheumatology, CUH, and Karen Quinn, Clinical Specialist Physiotherapist in Rheumatology, CUH.

Osteoporosis is one of the most common diseases in the world. Osteoporosis affects our bone structure.  Bone is a living tissue. Osteoporosis occurs when the interior structure
of our bones becomes weaker or less dense making it easier to break or fracture a bone. 1 in 2 women and 1 in 4 men over the age of 50 will fracture a bone as a result of the condition. 

Causes: We build our bone strength in our childhood and teen years. Our bones are at their strongest in our 20s. Osteoporosis most often occurs as we age and bones become thinner. Hormones play a role and women are at particular risk after they lose the protective effects of oestrogen at menopause. Excess alcohol and smoking also have a negative effect on bone health. Diseases such as rheumatoid arthritis, thyroid dysfunction, diabetes and coeliac disease also contribute to osteoporosis.

Diagnosis: A DEXA (Dual Energy X Ray Absorptiometry) scan is needed to diagnosis osteoporosis. It can be used to identify people with low bone mineral density who may be at risk of fracture and helps guide treatment. The results of a DEXA scan are based on a T-score number. Depending on the number on the T-scores you will either have osteopenia (bones thinning) or osteoporosis (more significant thinning of the bones).

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Prevention and treatment:  It is important to have enough calcium in your diet and have sufficient vitamin D (sunshine vitamin) which helps you absorb calcium. Aim for 3 to 5 servings of calcium daily such as a glass of milk or matchbox-size of cheese. Get diet advice if you need to avoid dairy products. Discuss with your pharmacist or doctor before you take calcium or vitamin D supplements. Weight-bearing exercise (tennis, hockey, football, basketball, running, skipping and dancing) is important for good bone health as it stimulates bone growth, especially in childhood. Walking is also a weight-bearing exercise; be sure to change your pace intermittently and vary your routes.

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Resistance training using weights, body weight or gym machines also promotes bone health. If you have been diagnosed with osteopenia or osteoporosis it is recommended that you be assessed by a chartered physiotherapist with an interest in bone health. You will need to avoid high impact exercises and any movements that push your back into bending or twisting positions. They will consider your DEXA scan results, your medical history and your risk of fracture before prescribing an appropriate and individualised exercise programme with fitness, strength and balance exercises for you. Osteoporosis is treatable with medications which can change the rate of bone loss and significantly reduce the risk of future fractures so talk to your doctor if you have any concerns.

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Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people globally. PICTURE ISTOCK

Coping with urinary incontinence

 

Seana Ryle, Senior Physiotherapist, CUH/CUMH, offers tips on simple measures that can help women improve the main symptoms of incontinence 

urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people globally.

The main two types are: 

1. Stress Urinary Incontinence (SUI):  The involuntary leakage of urine during activities such as coughing, sneezing, lifting, laughing or exercising. SUI affects at least 10-20% of women, many of whom do not realize that there are simple, effective treatment options available.

2. Urge incontinence:  A sudden and intense need to pass urine that cannot be put off. This can happen even when your bladder is not full.

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There are some simple measures you can do to see if they help improve your symptoms. 

These may include: 

1)  Lifestyle changes such as losing weight and cutting down on caffeine and alcohol (particularly so if you have urge symptoms).

2) Pelvic floor exercises, where you strengthen your pelvic floor muscles by squeezing them

3)  Bladder training, where you learn ways to wait longer between needing to urinate and passing urine.

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Staff from left, Denise Murphy , Aisling Finn, Orla McCarthy and Seana Ryle at the CUMH.PICTURE Eddie O'Hare

CUMH urogynaecology service at Lee Clinic

 

cUMH recently moved its urogynaecology outpatient clinics to the Lee Clinic on the Lee Road, Cork. The first CUMH nurse-led urogynaecology clinics were held at the Lee Clinic in November 2021. The facility boasts a newly fitted out procedure and consultation suite across 2 floors in the building for CUMH urogynaecology patients. The service provides investigations and management of all urogynaecological and pelvic health dysfunction for women. 

Nurse-led urogynaecology clinics are run by Ann Humphreys, Advanced Nurse Practitioner in Urogynaecology & Women’s Health and a team of Clinical and Staff Nurse Specialists. Nurse led clinics include continence advice, pessary, urodynamics and painful bladder clinics. Consultant urogynaecology clinics are led by Ms Orfhlaith O’Sullivan, Dr Suzanne O’Sullivan and Professor Barry O’Reilly. The service collaborates with colleagues in physiotherapy, colorectal and urology to deliver a holistic service to women. 

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Ann Humphreys (centre), advanced nurse practitioner in Urogynaecology and women’s health, with Rachel Guerin, acting clinical nurse in Urogynaecology, and Karen Mitchell, staff nurse in Urogynaecology, at the Lee Clinic.

All patients are referred to the service by their GP or a CUMH gynaecology consultant. CUMH gynaecology consultants triage referrals and assign the appropriate investigations and assessments depending on the symptoms the patient in experiencing. CUMH is delighted to offer services to women in Ireland South to help with these often debilitating symptoms. Some women can be left housebound and suffering from anxiety and depression, straining relationships or not pursuing relationships. The use a multi-disciplinary approach to get each woman on the best individualised treatment plan that can help women get back to a better quality of life. It is important to note that while incontinence and other urogynaecological symptoms may be common, it shouldn’t be the norm. The clinics are a safe non-judgmental place for women of ages and backgrounds to voice their concerns and work in collaboration with their health care providers. 

Bladder Training, A guide for women: Ann Humphreys, Advanced Nurse Practitioner in Urogynaecology and Women’s Health at CUMH, and her team work with women to manage the three most common urinary problems, namely frequency, urgency and urge leakage. This involves training to increase the time between visits to the toilet, pelvic floor exercises and following a urinary diary. The key concepts are outlined in ‘Let’s Talk Women’s Health’, the booklet which accompanies this CUH/CUMH-led information campaign on Women’s Health; see below.  


This report on Women’s Health was also produced as an information booklet by the Irish Examiner in association with Cork University Hospital, entitled 'Let's Talk Women's Health'. It features contributions from the CUH and CUMH service teams spread across a range of departments, working to deliver healthcare services to women of all ages right across Munster, click to learn more. The CUH is currently raising funds and awareness (click) of a number of key health services for women. The Irish Examiner and CUH information booklet 'Let's Talk Women's Healthcare' is a core element in the hospital's current public information campaign on women's health services.

This CUH Women’s Health fundraising campaign is supported by Roche Diagnostics (click). Roche stated: “Roche is delighted to support the CUH charity in promoting awareness of Women's Health. At Roche we believe that Women’s Health must be a shared goal for us all. Roche is committed to women’s health at every stage of her life. We aspire to provide every woman with personalised healthcare — tailored not just to their clinical characteristics, but also to their personal preferences and priorities. These factors are front of mind when delivering the health treatments that any woman needs. We at Roche are uniquely positioned to help lead a global transformation in Women’s Health. Beyond our expertise across diagnostics and pharmaceuticals we also take an integrated approach to health care thanks to our many partnerships. Women’s Health must be a shared goal for us all.” 

 

Heartfelt thanks to the public for supporting women’s services

 

Michael Nason

CEO of CUH Charity

mothers, sisters, daughters, colleagues, friends... Investing in women’s health is an investment in our families, communities, and our companies. You may have seen our previous pieces with The Irish Examiner, which focused on specific areas of work in CUH or CUMH – like Cancer, Stroke, Emergency and Paediatrics. 

CUH Charity are delighted to take this opportunity to showcase this suite of incredibly important services including research initiatives available to women of all ages across CUH and CUMH. Established in 2012, CUH (Cork University Hospital) Charity is the nominated charity of Cork University Hospital (CUH) and Cork University Maternity Hospital (CUMH). 

We work closely with the management team and healthcare experts at CUH and CUMH to identify the hospital’s most pressing needs and provide financial support for all departments. 

Any donations made towards Women’s Health will be made available to any projects in CUH or CUMH that support our mission of ‘Saving and Changing Lives’ and is specifically supporting women in our community.


To donate please do any of the following:
Tel: 021 423 4529
www.cuhcharity.ie
Or post your donation to:
CUH Charity,
Room 8 Main Concourse,
Cork University Hospital,
Wilton,
Cork.

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