Tim Layman: Beyond the Pink Ribbon: Women’s Self-Care is a Non-negotiable

By Timothy Layman
Interim Chief Executive Officer/Chief Nursing Officer, Highlands-Cashiers Hospital


I’m a husband, son, father, and grandfather, and I know from experience that it’s easy for the women in my life to take care of others – their partners, kids, grandchildren, friends, and coworkers – before they prioritize their self-care. This comes at a price, however, and I want to encourage every woman in our community to put herself first by establishing a relationship with a primary care provider and scheduling the screenings she needs to stay on top of her health. It’s like the proverbial advice to put the oxygen over your mouth first when you’re flying on a plane, and then your child’s; if you can’t take care of yourself first, you won’t be there for those who need you.

Because of this reality and seeing that it’s also Breast Cancer Awareness Month, I want to talk about how each season of a woman’s life requires that she pay attention to specific health concerns and is screened for age-appropriate health conditions. At every age, in addition to seeing their primary care physician, women should be screened for any mental health issues they may be struggling with, from post-partum depression to anxiety, as well as whether they feels safe in their home, thus ruling out the possibility of domestic abuse.

Young women of childbearing age are faced with decisions about when or if they want to start a family, and contraception options abound. Since there are so many options available, she needs to decide on the best choice for her by consulting her gynecologist, or OB/GYN. If she plans to get pregnant, eating well, exercising regularly, and taking a folic acid supplement are all critical. Folic acid is particularly essential for women if they’re thinking of having a baby because it supports the healthy development of the baby’s neural tube, where the spinal cord and brain originate.

Additionally, starting at 21, women should receive a Pap test, which is a screening that tests for cervical cancer. If results are typical, it’s advised every three years. This screening has made cervical cancer nearly preventable. Most cases can be traced to the human papillomavirus (HPV). Fortunately, there’s an HPV vaccine that’s now an option for preteens; it’s advised that girls receive it at around age 11 or 12.

It’s still advised that women see their OB/GYN annually, however, so their doctor can answer any health questions, receive testing for sexually transmitted diseases, and receive a breast exam.
Every young woman should also start seeing a dermatologist so she can get a good baseline of her skin’s health and use that image to compare future exams so changes will be easy for the physician to see. Daily use of sunscreen, no matter what the season, is also vital for melanoma prevention.

Breast cancer is a common disease that can be deadly. It affects 1 in 8 women in their lifetime, and only lung cancer claims more lives. However, when caught early, many breast cancers can be cured. At this time, mammography is the only test that has been proven to save lives from breast cancer. According to the American College of Radiology, women should begin yearly screening mammography at age 40. Mammography technology continues to improve, and Angel Medical Center offers the latest version of mammography imaging, 3D mammography/tomosynthesis, which is a more detailed image of the breast tissue. This test has proven to find more breast cancers than conventional mammography, and it has also been shown to decrease the need for additional images. While all women should consider 3D mammography, this test is particular beneficial for women who have dense breast tissue.

Diabetes is also something to be screened for by your primary care physician. Though the standards have changed a few times in the last decade, currently a healthy fasting hemoglobin A1C (blood glucose) level is less than 100, while a reading taken about two hours after eating a meal is considered normal if it’s below 140. Your physician might choose to monitor you more closely if these numbers creep up.

Another transition that a woman’s body prepares for when she’s in her forties is menopause. Perimenopause, or the decade prior to menopause, begins when estrogen levels start to drop. This phase will often be accompanied by hints of what’s to come in the next decade, including erratic periods, mood shifts, weight gain, and even the occasional hot flash. When a woman enters her fifties, menopause symptoms typically appear front and center: hot flashes and night sweats, emotional changes, and trouble sleeping. Her physician can point her toward an array of treatments to alleviate menopausal symptoms, such as hormonal therapy and stress reduction techniques that can help both her mood and ability to sleep.

The screening for colon cancer, colonoscopy, is another screening every woman should get at 50. It’s minimally invasive, and if test results are normal, it doesn’t need to be repeated for 10 years. Women should also start getting screened for cardiovascular disease and osteoporosis, or bone loss, which puts women at risk for premature fractures and breaks.

Women over 60 should continue their standard health screenings, including mammograms, colonoscopies, and pap tests, and be sure to receive important vaccines for pneumonia and shingles, and an annual flu shot.

I certainly encourage all the women in our community to put themselves first by prioritizing self-care. Everyone at HCH and our affiliated practices are ready to provide important consultation and care as you navigate your health through every season of your life.

Finally, regarding our Cashiers physician search, we continue to source outstanding physician candidates for the Cashiers area. Once identified, we will make offers to those that best exemplify the mission and values of HCA Healthcare.



Timothy Layman, DNP, is the Interim Chief Executive Officer and Chief Nursing Officer (CNO) of Highlands-Cashiers Hospital. Layman holds a PhD in Nursing Practice from Yale University, a MS in Nursing Administration from LaRoche College and a BS in Nursing from Pennsylvania State University. Before coming to Angel Medical Center and Mission Health, he served as Vice President for Innovation and Entrepreneurship at Thomas Jefferson University. Layman currently serves on the faculty of Thomas Jefferson University and Yale University.