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***** Woman's Diagnostic Cyber Newsletter *****
August 15, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Ovarian cysts
2. Herniated disk - bed rest or surgery?
3. Diet or drugs for hyperlipidemia?
4. Fact sheet on ovarian cancer
5. Medicinal herbs for primary care
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Ovarian cysts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ovarian cysts can be a confusing topic. Almost
every pelvic ultrasound performed in a
reproductive age woman shows small cystic areas
in the ovary that most properly would be called
ovarian follicles (eggs). Especially a cystic area
less than an inch (2.5 cm) is not really a cyst in
the sense of something abnormal. Unfortunately
women are often told that they have "cysts" on
their ovaries. If that term creates great concern,
you may want to try to understand about ovarian
cysts.
Most cysts are the result of normal physiological
processes gone somewhat out of sync. A follicular
cyst, a corpus luteum cyst and benign dermoid
tumors account for the overwhelming majority on
ovarian cysts in women under 40.
Ovarian cysts: They're not ovarian cancer
Your doctor may order tests to be performed if the
cystic areas are thought to be something other than
normal ovarian follicles. The goal is to
differentiate an ovarian cyst into one of two
major types, those that are the result of
physiologic processes, that will go away on their
own, and tumors of the ovary that are growing on
their own, mostly benign but some occasionally
malignant.
Ovarian cysts - physician's discussion
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Herniated disk - bed rest or surgery?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A herniated disk can cause severe back and leg
pain and disable a person for many months.
Traditional treatment holds that conservative
therapy such as bedrestt, heat, physical exercises
etc. should be tried first before consideration of
surgical therapy. In most instances, surgical
therapy does seem to make people recover quicker
in the short run. In the long run, (eg., 4 years)
results are about the same for surgical or
nonsurgical treatment of herniated disks.
What can you expect as far as recovery goes if
your were to herniate a disk? The first month, you
might expect a 30-50% improvement in pain and
function. By the end of the second month an
improvement of 70-80% should be achieved. If there
is no response by this time, recovery can be
expected to be protracted. But remember that if
you are adverse to having surgery, conservative
treatment will ultimately do the trick.
Disc herniation - surgery vs conservative care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Diet or drugs for hyperlipidemia?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sometimes a high blood cholesterol can be genetic
rather than dietary. Women who have a familial
tendency toward heart disease (women relatives
with heart disease occurring at less than age 65
and male relatives occurring at less than age 55),
may need to have cholesterol lowering drugs in
addition to diet. When can you treat high
cholesterol with diet alone and when do you need
drugs? These and other issues are discussed at:
Hyperlipidemia diet and drug therapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Fact sheet on ovarian cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ovarian cancer is a disease of the 35-85 age range
in women. There are a large number of cases in the
50-65 ages. If discovered in early stages, ovarian
cancer can have over a 90% five year survival.
Unfortunately ovarian cancer can be a "silent"
disease so that the overall 5-year survival of
ovarian cancer is between 35-47%.
To look at some of the risk factors, symptoms,
diagnostic tests and ways to prevent ovarian
cancer, take a look at the fact sheet at the
National Ovarian Cancer Coalition.
Ovarian cancer fact sheet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Medicinal herbs for primary care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Among the many herbs touted to cure medical
problems, certain ones have fairly good scientific
evidence as to their efficacy for common problems.
The review below not only includes background on 8
commonly used herbs, but also instructions on how
to prepare some of the herbal remedies. If you
think you might be interested in:
Aloe Vera for superficial wounds, psoriasis and
constipation
Chamomile for irritable bowel syndrome and nausea
Garlic for hypercholesterolemia, fungal and yeast
infections
Ginger for motion sickness
Peppermint for upset stomach
St John's Wort for depression
Check out Medicinal Herbs: A Primer for Primary
Care in Hospital Practice Magazine.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Men like to barbecue. Men will cook if danger
is involved.
2. Men who have pierced ears are better prepared
for marriage. They've experienced pain and bought
jewelry.
3. Men are very confident people. My husband is
so confident that when he watches sports on
television, he thinks that if he concentrates he
can help his team. If the team is in trouble, he
coaches the players from our living room, and if
they're really in trouble, I have to get off the
phone in case they call him.
4. All men are afraid of eyelash curlers. I sleep
with one under my pillow, instead of a gun.
5. A good place to meet a man is at the dry
cleaner. These men usually have jobs and bathe.
6. All men hate to hear "We need to talk about our
relationship." These seven words strike fear in
the heart of even General Schwartzkopf.
7. Men are sensitive in strange ways If a man has
built a fire and the last log does not burn, he
will take it personally.
8. Men have higher body temperatures than women. If
your heating goes out in winter, I recommend
sleeping next to a man. Men are like portable
heaters that snore.
9. Women take clothing much more seriously than
men I've never seen a man walk into a party and
say "Oh no, I'm so embarrassed; I've got to get
out of here. There's another man wearing a black
tuxedo."
10. Most men hate to shop. That's why the men's
department is usually on the first floor of a
department store, two inches from the door.
11. If a man prepares dinner for you and the salad
contains three or more types of lettuce, he is
serious.
12. Men are less sentimental than women. No man
has ever seen the movie THE WAY WE WERE twice,
voluntarily.
13. If a man says, "I'll call you," and he
doesn't, he didn't forget.. he didn't lose your
number.. he didn't die. He just didn't want to
call you.
14. Men hate to lose. I once beat my husband at
tennis I asked him, "Are we going to have sex
again?" He said, "Maybe.. next year."
15. Male menopause is a lot more fun than female
menopause. With female menopause you gain weight
and get hot flashes. Male menopause - you get to
flirt with young girls and drive motorcycles.
16. Men forget everything; women remember
everything. That's why men need instant replays in
sports They've already forgotten what happened.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. Answering women's health
questions more efficiently.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
August 22, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Patient education pamphlets from ACOG
2. Contraception for women with disabilities
3. Scheduled C-section for HIV during pregnancy
4. Tips for tummy problems
5. Psychological aspects of infertility
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Patient education pamphlets from ACOG
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The American College of Obstetricians and
Gynecologists (ACOG) publishes some of the most
authoritative and accurate patient education
pamphlets available. These are the ones given out
in many Ob-Gyns offices. While they do not publish
them for reading on the Net, they will send you
free up to 5 pamphlets via mail.
If you go to their search page and scan on
"herpes" for example, you will find 27 pamphlets
mentioning "herpes" including one entirely about
genital herpes, one on STDs and one on vulvar
diseases among others. Their list of topics is
very extensive.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Contraception for women with disabilities
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women who are in a wheelchair or even bedridden
still may have a need for contraception but what
about their risk for thrombophlebitis from birth
control pills? If a woman has a paralysis with no
sensation, could she tell if she had an active
infection from an IUCD? Probably not. She may
need to worry about whether DepoProvera could make
bone loss (osteoporosis) from her immobility even
worse.
If you or a friend has a physical disability and
contraception is an issue, you may want to read
the fact sheet on contraception: A Guide from
the Center for Research on Women with Disabilities
at Baylor College of Medicine.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Scheduled C-section for HIV during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If a woman has contracted HIV and become pregnant,
it is now recommended that she deliver by routine
scheduled Cesarean section because that seems to
further reduce the incidence of transmission to
the baby. Without any antiviral treatment during
pregnancy, about 25% of newborns will become
infected with HIV and have AIDs. With treatment,
this is reduced to about 5-8%. With added, planned
Cesarean section instead of vaginal delivery, this
is further reduced to about 2%.
/npreg2.htm#hivcs
C-Section for HIV during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Tips for tummy troubles
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As many as one in three women are bothered by
stomach disorders each day. Between heartburn,
irritable bowel syndrome, ulcers, intestinal gas
and bowel motility disorders, millions seek relief
from these digestive problems using any means they
can.
Did you know:
To avoid heartburn you should sleep on your left
and stop all alcoholic drinks.
To avoid intestinal gas, you should give up
sucking hard candies, chewing gum and sipping
carbonated drinks.
If you have irritable bowel you should keep a
symptom diary and avoid the artificial sweetener,
sorbitol.
With any of these concerns, you may want to read
"No more tummy troubles!" at The National Women's
Health Information Center.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Psychological aspects of infertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Trying to conceive and not doing so can take
quite a toll on one's psyche. It is not uncommon
at sometime during the process to feel depressed,
anxious, out of control and isolated. Sometimes a
woman's partner is quite supportive but in other
instances a partner may really not understand.
If you have difficulty thinking of anything other
than your infertility, it may be time to seek
professional counselling. If you feel you are
really "wound tight, you may want to look at this
set of frequently asked questions from the Mental
Health Professional Group of the American Society
of Reproductive Medicine. Their answers include
those to questions on:
What impact does infertility have on psychological
well-being?
How do I know if I could benefit from
psychological counseling?
How can psychological treatment help me/us cope
with infertility?
How can I find a mental health professional
experienced in working with infertility?
Psychological aspects of infertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Husband's note to wife,
"Doctor's office called and the Pabst beer is
normal."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
When a symptom or health problem is not
yet a disease.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
P.S. Let us know what you think of the newsletter
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***** Woman's Diagnostic Cyber Newsletter *****
August 29, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Cholesterol education kit
2. Very out of date physician/hospital ratings
3. Breast cancer in young women
4. Vitamin C important during pregnancy
5. Biking pain prevention tips
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Cholesterol education kit
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
September is National Cholesterol Education Month.
The National Heart, Lung and Blood Institute has
created a very handy educational tool to educate
us and your community about cholesterol and its
role in heart disease.
Remember that the key value for women is the HDL
("good") cholesterol value. Your HDL blood level
needs to be above 35 mg/dL
Cholesterol education kit
Their cholesterol fact sheet gives a comprehensive
review.
Why Blood Cholesterol Matters
The Blood Cholesterol--Heart Disease Connection
Other Risk Factors for Heart Disease
Who Can Benefit From Lowering Blood Cholesterol?
Cholesterol--In Your Blood, In Your Diet
LDL- and HDL-Cholesterol: The Bad and The Good
Things That Affect Blood Cholesterol
Have Your Blood Cholesterol Checked
Guidelines For Heart-Healthy Living
Making The Guidelines Work: Eat the Heart-Healthy
Way
Make Physical Activity Part of Your Routine
Lose Weight Sensibly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Out of date physician/hospital ratings
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As a rule, inaccurate or out-of-date sites are not
subjects of this newsletter, however a recent site
deserves mention. At Healthgrades.com, physicians
and hospitals are given report cards to allow you
to have an informed decision in choosing for your
own health care. Generally, this would be a great
concept. While I can't speak for all areas of the
country, their data for our local area was more
than 10 years out of date. Physicians who have
retired or moved 10 or more years ago were
included. Numerous, fine outstanding physicians
are not mentioned. I would be suspect of their
data.
Physician and hospital ratings
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Breast cancer in young women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most breast cancer occurs after menopause but
occasionally, premenopausal women who are more
genetically predisposed to breast cancer are
diagnosed with it. Do you know that having an aunt
with a breast cancer history is not very worrisome
but if the aunt had breast cancer in both breasts
or developed it premenopausally, then your risk
would be greater.
Can your risk ever be so high that you need to
take tamoxifen prophylactically to prevent breast
cancer or so high that prophylactic surgical
removal of the breasts should be considered? Yes,
but not under very frequent circumstances.
You may be interested in:
Breast cancer risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Vitamin C important during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Good nutrition during pregnancy is preached by
everyone as essential to a healthy baby. And yet -
- scientific studies in industrial countries do
not really show that vitamins and minerals have
any effect on birthweight. In fact during
starvation conditions in the Netherlands during
the war, babies were only 300 grams (about 10 oz.)
lower in birthweight on the average.
It is difficult to study nutrition because most
people cannot accurately recall what and how much
they ate. In a fairly good study reported in the
British Journal of Medicine, the only nutritional
element found to be predictive of a baby's weight
gain was Vitamin C. This is a new finding. Each l
mg increase in vitamin C was associated with a
50.8 g increase in baby's weight. Smoking
decreased baby's weight by about 100 mg.
From this study it appears that vitamin C helps
babies gain weight before birth but the amount is
still small. Nutrition concerns in pregnancy tend
to be overstated.
Nutrition during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Biking pain prevention tips
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If biking is a method of exercise or fitness for
you, you will be interested in these tips from
Prevention Magazine on how to prevent the pain and
discomfort from an achy back, knee pain, a sore
bottom a stiff neck or tingly hands.
While body and arm position during riding are
important, proper exercise clothes such as new
baggy style bike shorts, or even underwear
versions to wear with regular shorts can help
prevent discomfort that biking can cause.
Biking tips to prevent pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Education
An 8 year old girl goes to her dad who is working
in the yard and asks,
"Daddy, what's sex"?
The father is surprised that she would ask such a
question, but decides that if she is old enough to
ask the question, then she is old enough to get a
straight answer. He tells her about the birds and
the bees; the egg and the sperm; and the male and
female. When he has finished explaining, the
little girl is looking at him with her mouth
opened, so the father asks her,
"why did you ask this question"?
The little girl explains that
"Mom told me to tell you that dinner would be
ready ... in just a couple of secs".
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. Comfortable health
decisions based upon experienced advice.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
September 5, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Disease specific medication information
2. Memory in pregnancy - is it worse?
3. Bacterial vaginal infections in pregnancy
4. Vigorous walking as good as aerobic exercise
5. Menopause reading list
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Disease specific medication information
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Everyone reacts to medications differently and
thus a drug that is recommended for a specific
disease such as a migraine headache, may not be
tolerated by all. This results in looking for
second, third and sometimes fourth choices of
medicines to treat a medical problem. If you are a
person who seems to have many drug allergies or is
sensitive to many medications, then you would like
to see a complete listing of all drugs that are
useful in a given disease to see what ones you
might try next.
While there are many comprehensive prescription
medication lists on the Net, comprehensive disease
SPECIFIC medication lists are not as available. If
you have ever had difficulty finding the right
medication for allergies, arthritis, asthma,
cancer treatments, cholesterol management, diabetes,
headaches, or mental health adjustment, then you
may want to visit Intellihealth for these lists.
Medication selections for different diseases
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Memory in pregnancy - is it worse?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women believe that their memory becomes worse
during pregnancy and during the postpartum period.
This has not previously been well studied. An
article in the Journal of Psychosomatic Obstetrics
and Gynecology reports a study in which they
looked at never-pregnant women, pregnant women and
women within the first year after a delivery all
matched for age and educational level in
Australia.
They found that while past memory was not
affected, what is called "working memory", keeping
track of your immediate tasks, was decreased in
both pregnant women and recently pregnant women.
The investigators correlated the decreased memory
fairly directly with loss of sleep. This is the
same mechanism thought to be true for memory
decrease in menopause, i.e., mainly due to sleep
deprivation due to night sweats.
Memory in Pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Bacterial vaginal infections in pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Yeast vaginitis does not cause pregnancy
complications but bacterial infections do. They
can be associated with miscarriage, premature
labor, premature rupture of the bag of waters and
even infections in the newborn baby leading to
serious organ infections or even death. For this
reason, it is important for you to know about BV
or bacterial vaginosis.
Many women have not heard much about streptococcal
vaginitis. It can often be without any symptoms
but in pregnancy it can cause complications. There
are strategies you can use to minimize the chance
that bacterial vaginal infections will cause a
problem for you during pregnancy.
Bacterial vaginosis in pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Vigorous walking as good as aerobic exercise
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A recent study in the New England Journal of
Medicine, A "Prospective Study of Walking as
Compared with Vigorous Exercise in the Prevention
of Coronary Heart Disease in Women", looked at
whether walking as an exercise was at all
equivalent to vigorous exercise in preventing
coronary artery disease in women. They looked at
72,488 female nurses who were 40 to 65 years old
in 1986 and their level of exercise versus heart
attacks and death from coronary events.
As you might guess, they found that the more
exercise, the lower was the incidence of coronary
events compared with women who were mostly
sedentary. Any increased physical activity lowered
these adverse events from as little as 23% up to
54% in the group with the most vigorous aerobic
exercise. Those women who walked the equivalent of
three or more hours per week at a brisk pace, had
a 35% reduction in coronary events compared to
those women who did not walk or exercise very
much. Thus brisk walking can certainly result in a
significant reduction in heart attacks for women.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Menopause reading list
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The North American Menopause Society has put
together a recommended reading list about
menopausal topics. In addition to their Menopause
Guidebook which is online at:
Online Menopause Guidebook
they have many other recommended books and
newsletters about topics ranging from menopause,
perimenopause, heart health, sleep disturbances,
osteoporosis, estrogens, incontinence and others.
Menopause reading list
The Menopause Guidebook (50 pages) is also
available to purchase over the web at:
Menopause Guidebook (hardcopy booklet)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A couple was celebrating their Golden wedding
anniversary. Their domestic tranquility had long
been the talk of the town. A local newspaper
reporter was inquiring as to the secret of their
long and happy marriage.
Well, it dates back to our honeymoon, explained
the husband. We visited the Grand Canyon and took
a trip down to the bottom of the canyon by pack
mule. We hadn`t gone too far when my wife`s mule
stumbled. My wife quietly said `That`s once.`
We proceeded a little further when the mule
stumbled again. Once more my wife quietly said,
`That`s twice.`
We hadn`t gone a half mile when the mule stumbled
a third time.
My wife promptly removed a revolver from her purse
and shot the mule dead.
I started to protest over her treatment of the
mule when she looked at me and quietly said,
`That`s once.`
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Real world medical experience saves your time.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
September 12, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Carbon monoxide poisoning
2. Spontaneous healing of mild cervical dysplasia
3. Reader submitted question - facial hair growth
4. Beauty tips for pregnant women
5. Do women need to know about testicular cancer?
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Carbon monoxide poisoning
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Carbon monoxide is a colorless, odorless gas
formed by the incomplete combustion of oil, gas
and coal. If your house is heated with those
fuels, you may want to be on the lookout for
problems with your fuel burning appliances such as
furnaces, water heaters and clothes dryers.
Symptoms of carbon monoxide toxicity are so subtle
that most people are totally unaware of this
problem. Symptoms may include flu symptoms without
a fever, headaches, fatigue, dizziness, nausea,
vomiting, drowsiness and confusion. Typically
people feel better after leaving the home for
several hours. Carbon monoxide is particularly
dangerous because there is no odor or taste and
often the poisoning overcomes people while they
are sleeping.
If everyone in the house has similar, subtle
symptoms of just not feeling well in the mornings,
you may want to look at this article by Lee
Philips M.D., at PersonalMD.com on Carbon
Monoxide.
Carbon monoxide poisoning
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Spontaneous healing of mild cervical dysplasia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When a doctor's office calls with an abnormal Pap
result it can be quite disconcerting. Then you
have a biopsy of the cervix performed and it shows
"mild" cervical dysplasia. We have discussed
before that this level of abnormal Pap smear
usually goes away by itself, but what if your
doctor says to treat it, or what if this abnormal
finding is just so worrisome that you want it
treated?
In the article below from the American Journal of
Obstetrics and Gynecology about the "Spontaneous
resolution rate of grade 1 cervical
intraepithelial neoplasia in a private practice
population", we are again reminded that most (75%)
of these mild dysplasia changes disappear
spontaneously over a median time of 9 months.
About 5% of the time, the cervical lesions
progressed to a more severe lesion within a year
which is why doctors have you have the Pap smear
repeated every 4-6 months.
Regression of mild dysplasia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - facial hair growth
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I have recently noticed an increase in the fine
hair growth on my face extending on both sides
from in front of my ears, down my face toward the
chin. What is causing this and what can I do about
it?
I am 50 years old and about 10 years past an early
menopause. About a year ago I started taking
hormone replacement therapy and about 4 months ago
I switched to an estrogen skin preparation
compounded by a pharmacist to my doctor's
prescription. I have been putting the hormone
lotion on my face instead of my inner arms. I
follow that with a moisturizer, sometimes one with
alpha and beta hydroxys, sometimes one without.
About two weeks ago I started putting Retin A
Cream® (my son's acne medication) on my face to
get rid of wrinkles. Don't laugh! In the mornings
I use moisturizer again followed by sunscreen of
SPF 15. I've had this "fuz" on my face for a long
time but now it is getting longer. It is not thick
hair that needs to be waxed but I don't like it. I
also have used a dietary supplement 2 or 3 times a
week that absorbs fat. It contains polyglucosamine
but I've haven't used that in the last two weeks.
See what we suggest:
Facial hair growth after menopause
To submit a question for consideration for our
weekly reader submitted question:
Submit your question
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Beauty tips for pregnant women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Pregnancy often produces a rosy skin glow due to
increased peripheral blood flow, but it also brings
bloating and weight gain. The skin undergoes
changes too. Its color becomes blotchy and many
women are prone to more oiliness and acne.
Bobbi Brown, who has her own cosmetics line, says
that many pregnant women make the mistake of
"using no makeup and also changing their hairstyle
dramatically." She provides some useful tips that
you may want to look at.
Beauty skin tips in pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Do women need to know about testicular cancer?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that testicular cancer is the most
common cancer in American men in the ages 15-35?
Since women tend to be the primary caretaker of
their families health, my answer is YES - women
need to know about testicular cancer. Women should
also know how to encourage their teenage sons or
their partners to learn monthly, testicular self-
exam just as a woman needs to learn self-breast
exams.
Is a future pregnancy out of the question once a
man has been diagnosed with testicular cancer? No.
Surgical removal of one testicle will not prevent
fertility. Chemotherapy may arrest sperm
development while it is being administered, but
after those medical courses are completed, many
men will regain fertility.
If you have a partner under age 40 or a teenage
son, you may want to check out this article at
Mayo Health O@sis:
Testicular cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Vaseline & Research
-=-=-=-=-=-=-=-=-=-=-=-=-
A market researcher called at a house and his
knock was answered by a young woman with three
small children running around her. He asked her
if she minded replying to his questions and when
she agreed, he asked her if she knew his company,
Cheeseborough-Ponds. When she said no, he
mentioned that among their many products was
Vaseline and she certainly knew of that product.
When asked if she used it, the answer was "Yes."
Asked how she used it, she said, "To assist sexual
intercourse."
The interviewer was amazed. He said, "I always
ask that question because everyone uses our
product and they always say they use it for the
child's bicycle chain, or the gate hinge; but I
know that most use it for sexual intercourse.
Since you've been so frank, could you tell me
exactly how you use it?"
"Yes, we put it on the doorknob to keep the kids
out."
Contributed by: Heywood
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
***** Woman's Diagnostic Cyber Newsletter *****
September 19, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Premenopausal endometrial cancer risk factors
3. Reader submitted Q & A - Idiopathic edema
4. Hand pain - Is it Carpal Tunnel Syndrome?
5. Male infertility causes and remedies
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Premenopausal endometrial cancer risk factors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When women have irregular menstrual bleeding it is
often because of ovarian ovulatory dysfunction.
However as women become older, there may be a risk
for uterine (endometrial) cancer. Doctors do not
usually recommend endometrial biopsies for
abnormal menstrual bleeding unless a woman is over
40 and at low risk for endometrial cancer, or over
35 and at high risk. Well what are those high risk
factors, you ask?
A recent article in the American Journal of
Obstetrics and Gynecology looked at what risk
factors might be for endometrial hyperplasia
(possibly a precursor to cancer) and endometrial
cancer. They found several factors increased a
woman's risk if she has abnormal bleeding:
body weight 90 kg (about 200 lbs),
age over 45 years,
infertility or not having had any children,
family history of colon cancer,
This study implies that in the absence of risk
factors such as weight, no children or family
history of colon cancer, that endometrial biopsies
may not need to be performed until age 45. Also,
the finding of the colon cancer family history is
an under recognized factor that doctors must add
to their thinking.
The study did not find that irregular menstrual
cycles or prolonged or menstrual bleeding were
risk factors.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted question - Idiopathic edema
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
One of our readers asks "Please guide me on
treatment options for idiopathic cyclic edema".
This is a condition that occurs mostly in women in
which there are large gains of fluid from morning
to evening each day. When a women is sitting or
standing, she develops moderate to severe swelling
of the legs and lower abdomen each day after
rising from sleep. See what we suggest at:
Idiopathic cyclic edema
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Hand pain - Is it Carpal Tunnel Syndrome?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Carpal Tunnel Syndrome is a condition of nerve
pressure in the wrist that produces hand pain and
numbness. The distribution is mostly the thumb and
first two fingers (index and middle) and part of
the ring finger on the palm of the hand. It almost
seems a badge of courage because it is being
diagnosed so frequently as a work-related cause of
disability.
An article in Hospital Practice points out very
effectively how other conditions such as
rheumatoid arthritis, osteoarthritis, diabetes,
thyroid disease, gout and even pregnancy can cause
this condition. They illustrate this with a case
that was thought to be work-related (card dealer)
for many years but it was finally attributed to
having hypothyroidism.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Male infertility causes and remedies
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women usually take charge of health concerns when
trying to conceive. They are aware that
infertility often can be caused from a male factor
problem. Men try to avoid this possibility like
the plague so it is frequently up to the mom-to-be
to know about male causes of infertility. This
section at Mayo Health is a good overview of male
factor infertility and what can be done.
Male infertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subject: OOOOOOOHHHHHHH
A middle-aged woman seemed sheepish as she visited
her gynecologist.
"Come now," coaxed the doctor, "you've been seeing
me for years!"
"Yes, but this time it's kind of strange....."
"Let me be the judge of that," the doctor replied
"Well," she said, "yesterday I went to the
bathroom in the morning and I heard a plink-plink
in the toilet, when I looked down, the water had
several pennies in it."
"I see."
"That afternoon I went again and there were
two nickels in the bowl."
"Uh-huh."
"Last night," she went on, "there were two dimes
and this morning there was a quarter! You've got
to tell me what's wrong with me!" she implored.
"I'm scared out of my wits!"
The gynecologist put a comforting hand on her
shoulder. "There, there, it's nothing to be scared
about........"
*
*
*
*
*
*
*
(Ready for this?????)
*
*
*
*
*
*
*
*
*
(I'm warning you.........)
*
*
*
*
*
*
*
(Still not too late..........)
*
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*
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*
*
*
*
*
*
"You are simply going through the change."
He said.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
September 26, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Repetitive strain injuries and computer use
2. Colposcopy during pregnancy
3. Reader submitted Q&A - BCPs and Pregnancy
4. Gyn exam - gender and practitioner preferences
5. Prevention of a stroke
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Repetitive strain injuries and computer use
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Repetitive strain injuries (RSI) refers to a
collection of diseases, from tendonitis of the
hand or wrist to carpal tunnel syndrome to cubital
tunnel syndrome. Basically, if your hands or
wrists hurt or go numb or tingle, that is probably
RSI. It is very often associated with computer
use. Some people do not make the connection that
these hand or arm problems are related to using a
computer because the pain may occur later after
discontinuing the harmful activity.
Both adults and kids can be affected by this. One
of the major concerns with this injury is that it
can be with you the rest of your life. In other
words, once you have injured a nerve or tendon,
that anatomical area will always become injured
easier in the future or seem to flare up for no
reason at all.
Repetitive strain nerve injuries
If you want to learn more about repetitive strain
injury, visit the RSI Help web site at:
RSI help web site
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Colposcopy during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women who have an abnormal Pap smear during
pregnancy will want to know for sure that they do
not have a cancerous lesion of the cervix, but at
the same time, they might hesitate to have any
diagnostic procedure performed for fear that it
might cause premature labor. In general there are
some different rules for diagnosing abnormal Pap
smears during pregnancy not only because of a
concern of preterm labor, but also because the
pregnant cervix bleeds much more freely than in a
woman who is not pregnant.
At the University of Pennsylvania Oncolink site,
there is a response to a patient question about
having a colposcopy during pregnancy. They
indicate that an endocervical curettage (scraping
of tissue for diagnosis from the inside of the
cervix) is not performed and also that cone or
LEEP biopsy during pregnancy carries a greater
risk of preterm labor so it should be avoided if
possible until after pregnancy.
Many times also, an experienced colposcopist will
just look and not biopsy the cervix during
pregnancy if the colposcopic view appears to be
consistent with a mild dysplasia lesion or less
severe.
Colposcopy during pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - BCPs and Pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I want to ask you a question concerning
something. I am married, and have been for four
weeks. I have been taking birth control (although
not on time sometimes) but I have been having some
suspicion that I am pregnant. I have stopped
taking birth control in case this is true, but I
was wondering how long I need to be off birth
control before I can go get a pregnancy test at
the doctor's office.
I figure that since the tests tell if you are
pregnant by the hormone levels, and since birth
control raises the hormone, estrogen in the body,
I might need to wait a while before getting a test
done so that I can get a truthful answer. I am
aware that birth control can give me symptoms that
make me think I'm pregnant, but I have a feeling
it may not just be birth control. Please give me
your opinion as to what I should do if you can. "
The answer is that she can perform a pregnancy test
right now without the birth control pills
interfering with the test. You may want to see the
discussion about missing pills, along with the
chances of getting pregnant and what to do if you
miss taking pills for a day or more.
Missing BCPs and pregnancy concerns
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Gyn exam - gender and practitioner preferences
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A recent study in the Journal of Gender-based
Medicine reported a survey conducted at Kaiser
Permanente HMO in Norther California as to what
type of health care provider women preferred when
having a gynecologic exam.
They found of 5164 respondents (all of whom had a
primary care physician) that 60.3% reported
preferring a gynecologist for basic gynecology
care, 12.6% preferred a nurse practitioner, 13.3%
preferred their own primary care physician, and
13.8% had no preference. Also 52.2% preferred a
female provider for basic gynecological care, and
42.0% had no preference for the sex of the
provider.
Womens' preferences for who does their gyn exam
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Prevention of a stroke
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
By looking at scientific studies already
published, the American College of Physicians
Journal Club came up with a review of what
modifiable lifestyle factors and medical
conditions are risk factors for a first stroke. In
other words to decrease your chance of a stroke
("brain attack"), they found:
treat hypertension to lower blood pressure,
if neck artery narrowing (carotid stenosis) have
the artery cleaned out (carotid endarterectomy)
after a heart attack:
take aspirin therapy if no other complications
take blood thinners (warfarin, Coumadin) if
atrial fibrillation is present
use cholesterol lowering drugs (statins) for
normal to high lipid levels
if you have diabetes, keep control of blood sugar
Also, observational studies support modification
of lifestyle-related risk factors such as stopping
smoking, increase exercise, reduce alcohol
consumption, and diet moderation.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Worried Housewife
-=-=-=-=-=-=-=-=-=-=-=-
The worried housewife sprang to the telephone when
it rang and listened with relief to the kindly
voice in her ear. "How are you, darling?" she
said. "What kind of a day are you having?"
"Oh, mother," said the housewife, breaking into
bitter tears, "I've had such a bad day. The baby
won't eat and the washing machine broke down. I
haven't had a chance to go shopping, and besides,
I've just sprained my ankle and I have to hobble
around. On top of that, the house is a mess and
I'm supposed to have two couples to dinner
tonight."
The mother was shocked and was at once all
sympathy. "Oh, darling," she said, "sit down,
relax, and close your eyes. I'll be over in half
an hour. I'll do your shopping, clean up the
house, and cook your dinner for you. I'll feed
the baby and I'll call a repairman I know who'll
be at your house to fix the washing machine
promptly. Now stop crying. I'll do everything. In
fact, I'll even call George at the office and tell
him he ought to come home and help out for once."
"George?" said the housewife. "Who's George?"
"Why, George! Your husband!....Is this 223-1374?
"No, this is 223-1375."
"Oh, I'm sorry. I guess I have the wrong number."
There was a short pause and the housewife said,
"Does this mean you're not coming over?"
Contributed by: Rubin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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