Eastern Oklahoma VA Health Care System

Women Veterans Program Newsletter
October 2024

Breast Cancer Support & Resources at VA

You have access to breast cancer support and resources through VA, including:

• Mammography on-site at over 70 VA facilities and community facilities
• Breast ultrasounds and MRI Breast biopsy and surgery
• Genetic counseling and testing
• Cancer diagnosis and treatment

If you’re diagnosed with breast cancer, you have access to comprehensive oncology services and treatments that include imaging, surgery, chemotherapy, radiation, and other advanced state-of-the-art therapies as needed, either on-site or via community referrals. You’re also eligible for enrollment into clinical trials.

Every VA facility has a Women Veterans Program Manager and Women's Health Primary Care Providers to ensure you have access to appropriate care and treatment. They will connect you with their clinical teams to coordinate all the services you may need.

One in eight women will be diagnosed with breast cancer in their lifetime. The risk of breast cancer increases with age.

Breast cancer is the most common cancer and second most common cause of cancer deaths in American women.

Black women are more likely to die from breast cancer than other races/ethnicities.

VA exceeds the private sector in mammography screening rates. The benefits of mammography are greater for older women than younger women; however, every Veteran identified by the SERVICE Act, regardless of age, is eligible for a cancer risk assessment and a mammogram, if it is determined to be clinically appropriate based on the risk assessment, regardless of whether you are enrolled in VA health care.

Mammograms can find breast cancer early, and the earlier a cancer is found, the easier it is to treat.

Both the American Cancer Society and VA no longer recommend routine breast exams, which is where your doctor will physically examine your breasts for lumps and changes. However, you should always tell your VA health care team about any changes you notice in your breasts.

While no direct link has been found between deployment and breast cancer, VA is concerned about individual reports and is continuing studies to determine if toxic exposure may be a cause of breast cancer.

The SERVICE Act guarantees that any Veteran who served in designated combat locations during specific periods will receive breast cancer risk assessments and undergo a mammogram, if it is determined to be clinically appropriate.

VA recommends the following breast cancer screening guidance (in line with the SERVICE Act and American Cancer Society guidelines):

• Age 30 or younger – VA does not recommend mammograms because they are not generally useful at this age, particularly if you have no other risk factors. If you are younger than 30 and at high risk, VA will recommend a more detailed assessment that may include genetic testing or other breast imaging (i.e., a magnetic resonance imaging, or MRI).
• Age 30-39 – Speak with your doctor to assess your risk and determine whether you should begin annual mammogram screening.
• Age 40-44 – Begin annual screening, if decided with your doctor.
• Age 45-54 – Screen yearly.
• Age 55 or older – Screen every other year or continue yearly screening.

Women Veterans, Armor Up!

When were you last vaccinated?
By Dr. Sally Haskell, Acting Chief Officer for VA Office of Women’s Health

We understand that vaccines and routine health check-ins can easily fall to the wayside. Now is a great time to look at your vaccine history and talk to your VA health care provider about which vaccines are right for you! As a woman, your health changes with time, age, reproductive life stages such as pregnancy, and overall wellness. Focusing on preventative care with vaccination is important for your overall well-being, especially if you’re pregnant or plan to become pregnant.

Don’t let the year end without making sure you’re up to date on your vaccines – it’s one of the simplest ways to invest in your health and protect yourself.

Protecting Yourself and Others

As a Veteran, you’re no stranger to protecting your community! An easy way to continue keeping others safe is by getting vaccinated. If enough people get vaccinated, large outbreaks can be avoided. By getting vaccinated, you’re also helping to stop the spread of preventable diseases to others, especially those who cannot be vaccinated because they’re too young or have a weakened immune system due to being older or having a serious health condition.

Recommended Vaccines

VA and Centers for Disease Control and Prevention (CDC) recommend several vaccines based on your age and health. These may include:

• Pneumonia: This vaccine can prevent a serious infection in the lungs (pneumonia) that can lead to respiratory complications and even death.. It is recommended for those aged 65 and older and for those younger than 65 with chronic medical conditions (such as diabetes).
• Human papillomavirus (HPV)​: HPV is a common sexually transmitted infection that is spread through sexual or skin-to-skin contact, and it can lead to cancers like cervical or vaginal cancer, mouth cancer, throat cancer, and anal cancer. The HPV vaccine is one of the only vaccines that can prevent cancer. All people through age 26 and some who are older should receive this vaccine.
• Flu: Influenza, or the flu, is a viral condition that can effect anyone but causes more severe sickness in the elderly. The vaccine, needed yearly, can prevent the flu and complications like bacterial pneumonia. Getting a flu shot while you’re pregnant can also protect your newborn by giving them immunity from the flu for the first six months of life.
• COVID-19: COVID-19 is a respiratory illness that spreads easily. It can be life-threatening in people with other conditions, such as heart disease or poor immune systems. COVID-19 vaccines are recommended for all adults, especially if you’re pregnant or planning to become pregnant.
• Tdap: The Tdap vaccine protects against three diseases, including tetanus, diphtheria, and pertussis or whooping cough. Most people should get a booster every 10 years. It is especially recommended for people who are pregnant or may come in contact with young children who are not yet vaccinated against whooping cough.
• Shingles: Shingles is a painful skin rash caused by the same virus as chicken pox. People aged 50 and older should receive this vaccine, which requires two shots, two to six months apart.
• Hepatitis: Hepatitis is a serious disease caused by a virus that attacks the liver and can cause lifelong infection, cirrhosis (or scarring) of the liver, liver cancer, liver failure, and death. The Hepatitis B vaccine is available and recommended for all age groups.
• Respiratory syncytial virus (RSV)​: The RSV vaccine can prevent lower respiratory tract disease. If you are a Veteran who is 60 years and older, talk with your VA health care provider about whether RSV vaccination is right for you, especially if you have an underlying medical condition that may put you at higher risk for severe RSV infection. If you’re pregnant, we recommend you receive an RSV vaccine between weeks 32 and 36 of your pregnancy.

Vaccines are safe, but they may come with mild side effects, including fever; tiredness; body aches; or redness, swelling, and tenderness where you received your shot. These reactions usually go away within a couple of days. Serious or long-lasting side effects are extremely rare, and vaccine safety is continually monitored.

Vaccines and Pregnancy

CDC also recommends certain vaccines before, during, and after pregnancy. Know that it’s also safe for you to receive vaccines right after giving birth, even while breast or chest wall feeding. It’s important to speak with your VA health care provider if you’re planning to become pregnant or are pregnant, so we can ensure you receive the vaccines you need to keep you and your baby safe. We can also help you understand which vaccines to avoid during your pregnancy journey. To learn more, visit the CDC Pregnancy and Vaccination page.

Vaccinate with VA

Speak with your VA health care provider about which vaccines are right for you. You can conveniently get all the vaccines you need at a VA Medical Center or clinic. We highly recommend you get vaccinated at VA, the same place you receive your other health care, so we can keep your medical files up to date and keep track of your vaccine history for you!

Call the Women Veterans Call Center at 1-855-VA-WOMEN or visit the Women’s Health Immunizations page to learn more. You can also download our Preventative Health Checklist for Women or visit VA’s Preventative Care page for women Veterans to learn more about what prevention tests and vaccines are recommended based on your age.

2024 Women Veterans Baby Shower

Jack C. Montgomery VA Medical Center
Muskogee

Ernest Childers VA Clinic
Tulsa

New Veteran Orientation

Come to our New Veteran Orientation
Held Monthly at Ernest Childers Outpatient Clinic in Tulsa

Are you new to VA health care? Are you a current VA patient, but want to learn more about what services and benefits VA has to offer and how to obtain them?

Join Us For New Veteran Orientation

When:
The 2^nd Tuesday of every month

Where:
Ernest Childers VA Clinic
8921 S. Mingo Rd.
Tulsa, OK 74113
2^nd floor, Rooms 2008 - 2010 (across from optometry)

Time:
1 p.m.

Open to all Veterans, family members, caregivers, and community partners.

• Meet representatives from various departments within the VA
• Learn about the processes for getting things done at the VA
• Learn about and sign up for Myhealthevet
• Question and answer session

It's Time To Get Your Flu Shot

It's that time of year!

Influenza, or "flu," is a contagious respiratory virus. Flu season usually begins in the fall and can continue through late spring.

Anyone can be infected by the flu virus. Flu can be mild or serious for some and deadly for others. Flu causes hospitalizations and deaths, especially among vulnerable groups such as the very young, people ages 65 and older, and those with chronic medical conditions.

Symptoms of flu

• Fever of 100°F or higher
• Body or muscle aches
• Headache
• Feeling tired or weak
• Cough
• Sore throat
• Runny or stuffy nose
• Stomach symptoms, mostly in children

Symptoms can vary in severity from mild to severe. While some people experience mild symptoms, not much different than a cold, others may get a severe infection that requires hospitalization. Know when to seek medical care.

How flu is spread

When a person with flu sneezes, coughs, talks, or laughs, flu virus can spread into the air as droplets. The droplets can spread to people and surfaces up to 6 feet away. Flu virus can spread to your hands if you touch anything that has the virus on it. If you then touch your eyes, nose, or mouth, you might get the flu.

People can spread flu to others about 1 day before they feel sick and up to 5 days after getting sick.

Who is most at risk

If you're in a high-risk group, you can become extremely ill from the flu. Be sure to take special precaution to prevent flu if you have any of the following conditions:

• Asthma
• Chronic bronchitis
• Diabetes
• Heart disease
• HIV
• Kidney disease
• Lung disease
• Weakened immune systems

Get a flu shot every year to protect yourself and help keep the flu from spreading to others. The 2024 flu vaccines at Eastern Oklahoma VA will be available after September 1st, 2024 in the vaccine clinics, or thru your Primary Care team.

Suicide Prevention

Women Veterans: Suicide is Preventable and Support is Available

Suicide has no single cause and no one approach can end it—but prevention is possible, especially when women Veterans find support before a crisis happens.

Women Veterans may have unique experiences related to military service, health and wellbeing, or trauma that can increase the risk of suicide. Some also face medical and social issues that affect relationships and quality of life. Military service can lead to readjustment issues, posttraumatic stress disorder (PTSD), trouble sleeping, or even physical injury. Additionally, reproductive health conditions that women Veterans sometimes face may take a toll on their mental health.

VA is committed to offering a growing range of resources and a network of support for all women Veterans, including those who do not, and may never, seek care within the VA health care system. Whether it's mental health care or treatment for chronic pain or other health concerns, VA can provide personalized, gender-tailored care to help women Veterans. Each VA medical center also has a Suicide Prevention Coordinator to connect women Veterans to counseling and services.

Additionally, creating a safety plan now, by identifying coping strategies and sources of support, can help give suicidal thoughts time to decrease and become more manageable in a future crisis. Download the VA Safety Plan app or create one together with your VA health care team.

The Veterans Crisis Line is free, confidential, and available 24/7. You don't have to be enrolled in VA benefits or health care to connect. Veterans, family, and friends can reach out. Dial 988 and press 1, text 828255, or chat online. Visit the VA Women’s Health suicide prevention page for more resources.

Call 1-855-VA-WOMEN (1-855-829-6636) to speak to a real person and connect to VA women’s health care.

Ask the Women Veterans Program

What is the screening process for breast cancer at VA?

Your VA health care team will begin the screening process by assessing your risk of breast cancer. This may include asking you questions about your military service and potential toxic exposures, family and personal medical history, and other risk factors. If they determine a need, you have access to mammograms through VA, where trained professionals conduct an X-ray of your breasts.

For women over 40, mammograms are the best test to look for early signs of breast cancer in individuals who have no signs or symptoms, but who may be at risk. Mammograms.

One Nurse's Journey with Breast Cancer that followed the most unexpected trail

On April 12, 2024, I was at work at the Jack C. Montgomery VA hospital in Muskogee and became ill with abdominal pain. I was seen in the ER and had a CT of the abdomen with contrast. When I was discharged from the ER, the provided stated the Radiologist saw an area on the CT on the right breast that needs further testing.

I notified my Primary Care Dr. and got a mammogram set up for the following Wednesday, April 17th at 11am. I went to the appt and had a mammogram done along with a breast ultrasound; those results showed dense breast tissue and suggested further testing-Breast MRI and Stereotactic Biopsy.

My PC Dr. called me on Thursday morning and we talked about the best facility for inclusive breast care and he stated he preferred Chapman Breast Center in Tulsa and I agreed. From there, he referred me to my breast surgeon. I became established as a new patient and on May 2, I had a stereotactic biopsy scheduled….we attempted and I was not a candidate for this type of biopsy due to my size and location of the area needing biopsied.

The next step was a breast MRI and it was completed on May 22 and I had a follow-up with my breast surgeon on May 29th. The breast MRI showed no signs of malignancy and also referenced enhancements in the area of concern on the right breast. I met with the breast surgeon on May 29th and decided due to family history to do an open biopsy of the area on my right breast and the biopsy was scheduled for June 7th.

The biopsy occurred without any issues…the surgeon told my best friend that all looked good and we should have results within the next week….On June 13th, I was sitting at work and got a notification that I had a new result in My Chart…I logged into My Chart and saw my results….

Low Density Ductal Carcinoma Insitu (DCIS). I immediately go in touch with my primary care dr and my closest friends. Needless to say, I did not sleep much, if any that night. I had a follow-up with my surgeon at 8:30 am on June 14th….my best friend went with me…the surgeon and I discussed my options which was a lumpectomy with 25 radiation treatments, 10-12 years of hormone therapy and mammograms every 6 months and an 80% survival rate; or a single or bilateral mastectomy, no radiation, no hormone and no risk of breast cancer again. After a consult with the plastic surgeon, I opted for a bilateral mastectomy. After several appointments and decisions, I had my Mastectomy and reconstruction on September 27th and though I will have some follow up appointments but my journey is now complete!

Your Eastern Oklahoma
VA Women Veterans Program Team

Michele Reeves, BSN, RN
Women Veterans Program Manager

Email: Michele.Reeves@va.gov
Phone: 918-577-4277

Makyla Clark, MSN, RN, CLC
Mammogram Navigator, Maternity Care Coordinator

Email: Makyla.Clark@va.gov
Phone: 918-577-4242