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****** Woman's Diagnostic Cyber Newsletter *******
October 29, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Skin age spots need vitamin A
2. Cholesterol problems
3. Reader submitted Q&A - Endometriosis rx
4. Vulvar cancer grows from embarrassment
5. Breast cancer quiz and facts
6. Health tip to share - minor skin pain relief
7. 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.
A pregnancy newsletter is available now in which
you enter your due date and every week you will
receive information pertinent to that time in your
gestation. This has been developed by Dr. Steve
Hasley of Pittsburgh, PA who also uses our Women's
Health Newsletter for patients in his office.
Let your pregnant friends know where to sign up:
Pregnancy newsletter
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Skin age spots need vitamin A
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Age spots are usually hyperpigmented areas of the
skin brought about by excessive exposure to the
sun. Female hormones such as naturally estrogens,
oral contraceptives and postmenopausal estrogen
replacement can sometimes promote these darkened
skin areas.
High concentration vitamin A skin products can
help reduce the pigment in these skin cells but
the amount included in over-the-counter
medications and cosmetics are very unlikely to
be sufficient enough to make a difference. You
will require prescription vitamin A creams, but
even these can sometimes be too potent for your
skin and who wants to trade the age spots for
reddened, irritated skin.
The answer is to work very closely with a
dermatologist. The delicate balance of not too
little or not too much vitamin A is also
influenced by the carrying agent in the cream that
governs how much is absorbed into the skin.
Dermatologists also can prescribe and work with
you using some pigment reducing solutions,
containing hydroquinone and kojic acid, that will
lighten pigmented areas and prevent pigment
production.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Cholesterol problems
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We know that cholesterol is an important factor in
coronary artery disease and lowering one's serum
cholesterol can be beneficial in heart disease
prevention. Did you know that by raising the good
cholesterol (HDL), women benefit from a
significant lowering of heart disease?
This section at Onhealth from WebMD has some good
practical information. Some of the links include:
Finding the New Wonder Food
Garlic Pills Don't Lower Cholesterol
When Does Genetic Testing Make Sense?
Raising Good Cholesterol
Which Foods Cut Cholesterol?
Cut Down High Cholesterol
Cholesterol Doesn't Tell Whole Story
Other Ways to Lower Cholesterol
Symptom-to-Herb Checker
Women and Heart Disease Clinic
Facts About Blood Cholesterol
So You Have High Blood Cholesterol
Check Your Cholesterol and Heart Disease I.Q.
Everyone can learn some interesting cholesterol
misconceptions from these. Among them are:
seafood and garlic do not lower cholesterol
genetically caused Type II hyperlipidemia affects
only 1 in 2,500 persons
for every 1 mg./dL. increase in good cholesterol -
high density lipoprotein (HDL), coronary artery
disease risk drops by 5 percent in women
there is no one cholesterol lowering diet that is
right for everyone
Cholesterol problems
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Endometriosis treatments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Do migraines, severe low back pain, and
endometriosis have common symptoms? I am 48 years
old, irregular/painful periods until 38 when had
child c-section. Now periods are regular but pms,
low back pain, severe cramping have returned and
these symptoms are now irregular. Can have a
'good' month followed by 3-4 'bad' months or can
have several 'good' months followed by one 'Bad'
one. My doctor is now suggesting a hysterectomy."
J.A
As best I can tell, migraine headaches are
unrelated to endometriosis, with the exception
that endometriosis causes pain during the menses
and there is an entity known as a menstrual
migraine that occurs when estrogen levels are
falling during the menses.
Low back pain is commonly associated with
endometriosis especially if it does not seem to
worsen with positional changes and exercise.
Hysterectomy is certainly a definitive treatment
for endometriosis and if the ovaries are also
removed at age 48, this may lessen the migraine
headaches if they are truly menstrual migraines.
Short of hysterectomy, other treatments have been
used to decrease pain from endometriosis and also
to improve fertility from endometriosis.
Sometimes, the exact therapies which are really
successful in treating this condition have been
anecdotal rather than scientifically studied.
This review from the British Journal of Medicine
of the clinical evidence for which treatments are
effective in endometriosis indicates that it
depends upon whether the treatment is directed
toward pain caused by endometriosis or toward
fertility problems from endometriosis. For pain
problems such as painful menstrual cramps, low
back pain and pain with intercourse, successful
treatments include:
hormonal treatment (gonadotrophin releasing
hormone analogs, danazol and most progestin only
drugs such as medroxyprogesterone or gestrinone)
surgical ablation of implants and uterosacral
nerves
postoperative (after surgical ablation) hormonal
treatment
ovarian cystectomy for removal of ovarian
endometriomas (as opposed to just cyst drainage of
an endometrioma)
oral contraceptives
For fertility treatment, however, the hormonal
treatments have not been shown to be effective.
Only surgical treatments such as:
laparoscopic ablation or excision of endometrial
deposits
cystectomy for ovarian endometriomas
In cases of mild endometriosis there has been only
one study that diagnosed the endometriosis by
laparoscopy, performed no treatment at all for the
placebo arm of the study and did repeat
laparoscopy after a year to see what the natural
history of the disease was. They found that only
in about half of the instances (47%) did the
endometriosis get worse. In 24% the endometriosis
disappeared without treatment and the remainder
(29%) improved or showed no change even without
any treatment.
Clinical evidence about endometriosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Vulvar cancer grows from embarrassment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women are embarrassed about lesions on the
external genitalia and as a result, there is a
delay in seeking treatment. The treatment often
involves a radical excision of skin in the
perineal area so that may further frighten women
into denying that a problem exists.
It is estimated that about 60-80% of women have a
symptom from a precancerous condition of the
vulva. They may have itching, a reddened area, or
a rough patch of skin that has been present for
months or years.
Physicians are taught that most vulvar skin
lesions occurring in a field of itching or redness
need to be biopsied, especially those occurring
after the age of 50. Vulvar cancer is a disease
of the late 60's, 70's and 80's but the
premalignant lesions may occur a decade earlier.
Smoking and a history of HPV (human papilloma
virus) infection of the vulva are predisposing
factors for vulvar cancer.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Breast cancer quiz and facts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
See if your knowledge about breast cancer is
current. This short little quiz at imammogram.com
is helpful to review your knowledge. Should you
get a yearly mammogram after 40? Can breast cancer
be prevented?
You may also be interested in assessing your risk
for breast cancer. At this quiz page there is also
a link for a 14 question breast cancer risk
calculator. It can categorize your risk into high,
medium and low.
Breast cancer quiz and facts
For our California readers, you may be interested
in purchasing a Breast Cancer Awareness license
plate for your car.
Breast cancer license plate
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - minor skin pain relief
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Domeboro (R) tablets or powders are available in
generic form, also called a modified burrow's
solution. This stuff is good for lots of problems
including athletes foot, nail fungus, diaper rash,
poison oak/ivy ..... it is very soothing and
effective. It may be used in addition to other
treatments. It would be safe to use as a vulvar
itch prep. to cleanse and soothe." Sandi
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Weather Vane
-=-=-=-=-=-=-=-=-
To Tell the weather,
Go to your back door and look for the dog.
If the dog is at the door and he is wet, it's
probably raining. But if the dog is standing
there really soaking wet, it is probably raining
really hard.
If the dog's fur looks like it's been rubbed the
wrong way, it's probably windy.
If the dog has snow on his back, it's probably
snowing.
Of course, to be able to tell the weather like
this, you have to leave the dog outside all the
time, especially if you expect bad weather.
Sincerely, The CAT
Contributed by: IFund
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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****** Woman's Diagnostic Cyber Newsletter *******
November 5, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Herb-drug adverse interactions
2. Cyber psychotherapy - Is it for you?
3. Reader submitted Q&A - What is microscopic cancer?
4. CA 125- Ovarian tumor marker
5. Review and rating of health and wellness stores
6. Health tip to share - Hot flash treatments
7. 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. Herb-drug adverse interactions
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Currently there is very little information about
interactions of herbal medicines/supplements and
physician prescribed medications. This is probably
because most herbal medicines are relatively safe
and there are not many herb drug interactions.
Some interactions have been reported, however. One
article which is a review of documented and
theoretical herb drug interactions lists several
combinations that might affect many women. If you
are taking any of these combinations, you will
want to look at the paper below:
Xanex(R) and kava - additive sedation
aspirin and ginkgo biloba - blood clotting problems
digoxin and St John's Wort - lowers digoxin levels
indinavir (an HIV med) and St. John’s Wort -
lowers indinavir levels
Levodopa (for Parkinson's) and kava - increases
tremors
phenelzine (Nardil[R]) and ginseng - increases
psychoactive stimulation
Coumadin (anticoagulant) and danshen, dong quai,
garlic gingko, ginseng - increases anticoagulation
There are also other reports of various herb-drug
interactions based upon anecdotal information that
you may want to know about.
Herb-drug interactions
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Cyber psychotherapy - Is it for you?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sometimes it can be easier to express your
personal feelings and concerns to a computer
screen on-line than it is to seek face-to-face
counselling from a professional counsellor,
psychologist or psychotherapist. From the privacy
of your home, there are now cyber psychotherapy
services available.
You may or may not be aware that physicians and
other licensed health professionals are not
allowed to hold themselves out to the Internet
public as practicing medicine or any type of
health therapy including psychotherapy unless
they are licensed in every state. There is no
such thing as a national license at the present
time. That is why you see terms such as "medical
educational consults", "virtual therapy", or
"cyberanalysis". If one just gives advice and
listens but does not prescribe medicines or order
laboratory studies, does that constitute the
practice of a health profession or is it just like
the "radio doctor" on call-in shows?
This review of psychotherapy on the Internet at
Gomez.com raises some very interesting concepts
about what you should look for in the explanation
of services if you are thinking of signing up for
some of these sites. A counsellor at the other
end of the computer loses your facial expressions,
body language, and vocal inflections but on the
other hand a face-to-face counsellor may
misinterpret those non verbal clues and ignore the
actual words being expressed.
A second part of this Gomez review compares and
contrasts 3 different services available:
cyberanalysis.com
headworks.com
Nyonlinetherapy.com
It points out that the current rules and
regulations for psychotherapy/counseling govern
each particular therapist within his/her own
state, but at the present time, they do not yet
account for the cyberworld and its absence of
geographic barriers. As a possible user of such
therapy you will need to carefully check out the
intended mission of the interactive service, the
privacy policy and the costs among other details.
It is still buyer beware.
Cybertherapy - Is it for you?
Cybertherapy Part 2
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - What is microscopic cancer?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"What is microscopic cancer of the uterus? Is
treatment needed after surgery? I am 67 years old
and had a complete hysterectomy three weeks ago.
The report came back that I had microscopic
cancer. I had been bleeding (not heavily) for
eight months prior to seeing the doctor. Did not
tell him because I was going through a depression
since my husband's death and really thought this
was the answer to my prayers...I wanted to die.
Doctor found it on his own and said I needed
surgery. As stated this was done three weeks ago.
My doctor called me with the results of the lab
work - because it was so unexpected to me when he
called, I couldn't think of the questions I had
for him then - but will ask more at my appointment
in another week." - Evie
In this situation microscopic cancer of the uterus
refers to either an early cancer of the
endometrium or one of the cervix. It means that
the doctor could not see the cancer grossly and
only after the pathologist looked at the
hysterectomy specimen was it found that there was
a cancer. Microinvasive is also a similar term.
Whether you need further treatment or further
diagnosis to see if the cancer has spread,
depends upon the type of cancer, its grade of cell
abnormality (grade) and how far it has invaded
into the uterine or cervical muscle (stage). For a
discussion of the possibilities, see our article
at:
What is microscopic cancer of the uterus?
[ed. note - last week we mentioned that
hysterectomy is a definitive treatment for
endometriosis. One of our readers pointed out that
it is not definitive for everyone. That is
correct. About 5-15% of women may have recurrance
or persistance of endometriosis after
hysterectomy.]
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. CA 125- Ovarian tumor marker
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Cancer Antigen 125 (CA 125) is used to screen for
or to diagnose the presence of certain ovarian
cancers. The most common ovarian cancers are
epithelial cancers that will often express this
CA-125 antigen and it can be detected in blood
samples. While it seems that this test would make
early ovarian cancer diagnosable by just having
a blood drawn, the subject is much more complex
than it seems at first.
The main complicating factor is that there are
many benign conditions that can cause an elevation
of CA-125 such as:
endometriosis
fibroids
pelvic inflammatory disease
liver cirrhosis
tuberculosis
breast, colon, lung and pancreas cancer
pregnancy
Before menopause, so many benign conditions can
cause a positive CA-125 and the chance of cancer
is so small that it is not at all useful as a
screening test. However after menopause, ovarian
cancer is more common and a positive test can
indicate ovarian cancer as high as 1 out of 10
times. Unfortunately 9 out of 10 times a woman is
falsely concerned and subjected to invasive tests
and procedures. This makes it a less than perfect
screening test so insurance companies do not cover
the cost of the test for screening.
If you think you might be interested in this test
as an ovarian cancer screen and you will not
unduly panic if you end up having a positive test,
discuss with your doctor if the test can be done
at your location.
Ovarian tumor marker CA-125
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Review and rating of health and wellness stores
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gomez.com also rates many other services on the
Internet. In this article below, they have looked
at on-line health and wellness stores such as:
1. Drugstore.com
2. MotherNature.com
3. more.com
4. PlanetRx
5. DrugEmporium.com
6. SelfCare.com
7. CVS (review)
8. NetGrocer.com
9. Medicine Cabinet
10. FamilyMeds.com
11. Eckerd
12. HealthCentralRx
13. SmallFlower.com
14. Wal-Mart.com
15. VitalRx.com
16. TheBigRx.com
17. Costco
18. healthzone
and rated them according to:
Ease Of Use
Customer Confidence
On-Site Resources
Relationship Services
Their reviews and rating systems will be of
interest to anyone who does any purchasing of
health products on the Internet.
Health and wellness stores rated at Gomez.com
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Hot flash treatments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are several things a woman can do to reduce
night sweats and sleep difficulties that are non
hormonal treatments. Avoid any foods, alcohol or
caffeine within 3 hours of going to bed. Avoid
exercise, hot liquids or smoking within 3 hours of
going to bed. Drop the evening thermostat by about
two or three degrees without adding more covers.
Wear light bed clothing. If you feel stressed out
from daily work or family events, take at least an
hour before bedtime for some relaxation activity
(if you cannot "afford" an hour before bedtime to
do this, there's your answer).
Non hormonal hot flash instructions
FRJ
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Advantages of Age
-=-=-=-=-=-=-=-=-=-=-=-
A list of the advantages you gain, as you grow
older:
- You can eat dinner at 4:00 p.m.
- Your investment in health insurance is finally
beginning to pay off.
- Kidnappers are not very interested in you.
- It's harder and harder for sexual harassment
charges to stick.
- If you've never smoked, you can start now and it
won't have time to hurt you.
- People no longer view you as a hypochondriac.
- Your secrets are safe with your friends because
they can't remember them, either.
- Your supply of brain cells is finally down to a
manageable level.
- Your eyes won't get much worse.
- Things you buy now don't have time to wear out.
- No one expects you to run into a burning
building.
- There's nothing left to learn the hard way.
- Your joints are more accurate than the National
Weather Service.
- In a hostage situation you are likely to be
released first.
Contributed by: Moody Fan
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
November 12, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. The pain after shingles
2. Parkinson's disease - sometimes a genetic cause
3. Reader submitted Q&A - Milky nipple discharge
4. Not all cyclic symptom changes are PMS
5. Head and body lice and crabs
6. Health tip to share - to test for early dementia
7. 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. The pain after shingles
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that the chicken pox virus never
leaves the body. It can become reactivated in
later life and produce an outbreak of "shingles".
Shingles is caused by the herpes zoster virus that
is dormant in a nerve cell and becomes activated
by a stressful event, illness, trauma or even
fatigue to cause an acute skin infection.
This causes skin lesions along a nerve pathway to
erupt. At first, there is severe pain in a narrow
band of the body such as the chest, groin, face,
one eye, or the outer side of one leg. This may be
accompanied a general sick feeling including
nausea, and vomiting. After several days, a
linear, raised skin rash develops. The skin
lesions last about 2 weeks but herpes zoster can
keep breaking out in new lesions for 4-6 weeks.
One of the worst problems is the pain that may
persist in the affected nerve. This is called
post-herpetic neuralgia if the pain continues more
than 3 months. You may want to see the article
below about the diagnosis and treatment of post
herpetic neuralgia if you ever have the misfortune
to develop it.
Post Herpetic Neuralgia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Parkinson's disease - sometimes a genetic cause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Parkinson's disease is a disorder of brain cells
that control movement. This results in tremors,
stiff muscles in the arms and legs, dementia,
depression, a decreased sense of smell and
sometimes problems with heart rate and blood
pressure. Characteristically, the handwriting of a
person who develops Parkinson's disease becomes
very small in height (micrographic). Even so,
diagnosis can be quite difficult and many times
the diagnosis is missed while at other times it is
falsely made.
There is an early onset disease before age 50
which is mostly genetic in origin, Most (90-95%)
Parkinson's disease occurs after age 50 and seems
to be more environmental than genetic. People who
live in rural areas are more likely to get
Parkinson's and there has been some recent
evidence that exposure to pesticides such as
rotenone may play a role in developing the
disease.
Rotenone exposure
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Milky nipple discharge
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been having a milky breast discharge for a
long time which I overlooked, but recently my
menstrual period ceased which I believed was as a
result of the discharge. Can it cause barrenness
in future, whom do I meet for treatment?"
"I am 29 and single, with irregular menses. The
first Doctor I saw prescribed Parlodel(R) which
makes me sick each time I take it."
Ifeoma
Milky nipple discharge can be associated with
infertility due to anovulation and menstrual
abnormalities but it is not the cause of those
problems. It is the result of an abnormality of
hormone secretion at the brain (hypothalamic
level). Usually there is too much prolactin
hormone. That can be due to different causes and
it is those causes that need to be treated first.
Prescription medications are a common cause of
galactorrhea. It is also possible that just local
breast factors or any nipple stimulation can
produce prolactin a discharge. For a discussion of
the causes and treatments of milky nipple
discharge, see our updated article at:
Breast milk hormone (prolactin) and anovulation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Not all cyclic symptom changes are PMS
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most women are aware that menstrual cramps do not
necessarily mean a woman has PMS. They are an
independent symptom that signal the onset of
menstrual bleeding. There are other non PMS
physical symptoms that may worsen premenstrual
such as migraines, irritable bowel, endometriosis,
allergies, seizures, and asthma.
If a woman has a preexisting problem with
depression, substance abuse, self-mutilation,
anxiety, or an eating disorder, that condition can
also worsen in the two weeks prior to menses. If
there is any question whether a symptom or a group
of symptoms represents PMS, please check with your
physician.
Other Types of Cyclic Changes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Head and body lice and crabs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Head lice, body lice, crabs, scabies - what do
they all mean? Kids can come home from nursery
school with head or body lice. Adults can get them
too from bed clothes or body contact with someone
who has an infestation. These lice are little
insect like creatures about the size of a sesame
seed but somewhat more difficult to see. Itching
is the predominant symptom.
The lice come in different types called head lice,
body lice, scabies and crab lice but they are all
very similar. They lay eggs called "nits". The
nits hatch and reproduce about 7-10 days later.
That is why at least two treatments are needed;
one to kill the existing adult lice and one about
7-10 days later to kill any hatched lice. Usually
a shampoo with 5 percent permethrin is used as
treatment.
For more information about these pesky critters,
see the FAQs at headlice.org .
FAQs about head and body lice
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - to test for early dementia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"If you are concerned that one of your forgetful
family members may be developing dementia or
Alzheimer's, there is a home test you can do that
may give an early warning sign. Have that person
draw a clock with all the numbers and place the
hands of the clock at a given time, eg., 10
minutes after 11. Someone with dementia changes
will have placed all 12 numbers with much of the
clock circle to go (eg. 18 numbers in the space
where 12 chould go). They lose spatial
discernment, and cannot place the hands of the
clock correctly either. Please have them see a
doctor for a more complete evaluation."
Dr. Rick
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Neurotics build castles in the clouds.
Psychotics live in the castles in the clouds.
Psychiatrists charge both of them rent.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
November 19, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Kidney function basics
2. Your posture defines you
3. Reader submitted Q&A - Microscopic hematuria
4. Human papilloma virus and warts
5. Something about water
6. Health tip to share - Crohn's disease
7. 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. Kidney function basics
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most women know that we try to protect the kidneys
from damage due to ascending infection from the
bladder or from toxic responses to medicines such
as non steroidal anti-inflammatory pain drugs
(NSAIDS). We know that the kidneys eliminate waste
products and urine but most people are not aware
of the other functions the kidneys provide.
As blood passes through the kidneys, about 200
quarts of water are filtered each day and all but
about 1 or 2 quarts are resorbed. The rest is
produced as urine to carry out all of the excess
salts and waste products. Hormones are secreted to
stimulate the bone marrow to produce red blood
cells. Renal disease affecting this hormone,
erythropoetin, can result in anemia. The kidney
also helps the body use vitamin D. Finally, the
kidney secretes a substance called angiotensin
which helps blood pressure under control.
Partial damage of the kidneys will affect these
hormones and may contribute to anemia but until
there is about 90% damage of both kidneys, kidney
failure will not take place. For a good
educational review of the kidneys and their
function, see kidneydirections.com.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Your posture defines you
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If your posture is not great, it can affect your
image and how people think about you. Posture
sends out non verbal messages - standing tall,
chin up is confidence. Slightly bent over, looking
down implies shyness, insecurity and a lack of
confidence.
A person with poor posture often has less energy,
cannot concentrate well and is thought of as
depressed. Even if you do not feel this way, your
posture conveys such an image. An unnatural
position, slouched over, may even take 60-70% more
energy than it does to hold the body in proper
alignment.
Few doctors are concerned about poor posture as a
medical problem so you may want to see a good
chiropractor who cares more about postural
abnormalities and spinal alignment. This article
at chiroclinix.com may stimulate you to look at
this aspect of the image you portray to others.
The Power of Postural Thinking
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Microscopic hematuria
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"What does blood in the urine from the urinalysis
indicate? You can't really see in urine, but it is
detected through the urine test. Background is a
42 year old, diabetic, who gets very sick when ill
because of diabetes" J.E.
Blood in the urine can be from infection, stones,
tumors, kidney disease and many times just due to
unknown causes. More often it is an indication of
kidney disease or damage. Medications such as non
steroidal pain medications, aspirin or even anti-
hypertensive or diuretic prescriptions can cause
kidney bleeding.
Grossly visible blood in the urine is more likely
to represent lower tract (bladder) disease or even
cancer or benign tumors. Even so, microscopic
hematuria should include a cystourethroscopy to
evaluate the bladder. This is in addition to the
laboratory studies needed and an IVP (intravenous
pyleogram) to check for damage to the kidney
itself.
For a discussion of microscopic hematuria and its
diagnosis, see our article:
What is the significance of microscopic
hematuria?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Human papilloma virus and warts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Human papilloma virus causes genital warts but it
is also the same 70 virus group that causes warts
on the face, hands, feet, cervix and other areas
of the skin. Some HPV virus types affecting the
cervix and vulva can be associated with cancer at
a later date.
Becoming infected is often due to contact with a
wart on another person, but HPV can also be caught
indirectly from bathroom and locker room surfaces.
Genital warts are not always contracted through
intercourse or intimate genital contact.
One of the best current treatments for genital HPV
on the perineum is imiquimod cream (Aldara(R))
which stimulates the body's own immune system to
produce an antiviral response. There are other
treatments, however, that can be used depending
upon where the wart is.
This consumer health reference at Praxis.md is a
good review of HPV.
Human papilloma virus
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Something about water
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
How much water do you need a day? The average
woman loses about 8 cups of water a day through
passing urine, bowel movements, breathing and
sweating. About half of that comes from food and
the other half from liquids you drink. In other
words if you are not restricting your food through
dieting, or sweating off extra amounts of water
because of exercise, then you need to drink about
4-5 cups of liquid per day.
These are 8 oz cups we are talking about. Three 12
oz. drinks a day may be sufficient. If you are
dieting you need to drink more and if you are
exercising you need to drink more also. Dieting
alone might mean you have to increase from 4-5
cups a day to 8 cups a day. With light exercise,
10 cups a day or 5, 16oz drinks or 7, 12 oz drinks
a day is the most you need. More than that can
wash away salts your body needs.
If you are drinking the right amount, your urine
should be a light straw color, not yellow or dark
yellow. At light straw, your hydration is just
about right. If the urine is almost water color,
you are taking in excessive amounts of water.
You may want to review this article at
stayinghealth.com:
Something about water
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Crohn's disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have had Crohn's disease for many years. I
have found that drinking small amounts (about 1/2
cup) of aloe vera juice each day is very soothing
to the digestive system and prevents severe
discomforts of diarrhea. Be careful...too much
juice will act as a laxative. I recently tried
the aloe vera capsules (2 per day) and they work
well, too, and are more convenient, especially on
trips." Donna H.
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dear Tech Support (Classic)
-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-
Dear Tech Support,
Last year I upgraded from Girlfriend 7.0 to Wife
1.0.
I soon noticed that the new program began
unexpected child processing that took up a lot of
space and valuable resources. No mention of this
was included with the product information.
In addition, Wife 1.0 installed itself into all
other programs and now launches during system
initialization, where it monitors all other system
activity.
Applications such as Poker Night 10.3, Drunken
Boys Night 2.5, Football 5.0, Hunting and Fishing
7.5 and Racing 3.6 no longer run, crashing the
system whenever selected.
I can't seem to keep Wife 1.0 in the background
while attempting to run my favorite applications.
I'm thinking about going back to Girlfriend 7.0,
but the Uninstall doesn't work on Wife 1.0. Please
help! Thanks,
Signed,
A Troubled User
REPLY:
Dear Troubled User,
This is a very common problem that men complain
about. It is due to a primary misconception among
men. Many people upgrade from Girlfriend 7.0 to
Wife 1.0 thinking that it is merely an Utilities
and Entertainment program.
Wife 1.0 is an OPERATING SYSTEM and is designed by
its creator to run everything! It is also
impossible to delete Wife 1.0 and return to
Girlfriend 7.0. Hidden operating system files
cause Girlfriend 7.0 to emulate Wife 1.0 so
nothing is gained.
It is impossible to uninstall, delete, or purge
the program files from the system once installed.
You cannot go back to Girlfriend 7.0 because Wife
1.0 is designed to not allow this. Some have tried
to install Girlfriend 8.0 or Wife 2.0 but end up
with more problems than in the original system.
Look in your Wife 1.0 manual under "Warnings:
Maintenance/Child Support".
I recommend that you keep Wife 1.0 and work on
improving the situation. I suggest installing the
background application program Yes_Dear to
alleviate software augmentation. Having installed
Wife 1.0 myself, I also suggest that you read the
entire section regarding "General Partnership
Faults (GPFs)".
You must assume all responsibility for any faults
and problems that occur, regardless of their
cause. You will also find that GPFs tend to be
somewhat cyclical, occurring approximately 28 days
apart. The best course of action is to enter the
command C:APOLOGIZE. Avoid excessive use of
C:YES_DEAR because ultimately you will have to
use the APOLOGIZE command before the system will
return to normal anyway.
Remember, the system will run smoothly as long as
you take the blame for all GPFs. Wife 1.0 is a
great program, but tends to require very high
maintenance. Wife 1.0 comes with several support
programs such as Clean_and_Sweep 3.0, Cook_It 1.5
(which replaces Burn_It 1.0) and Do_Bills 4.2. You
must however be very careful how you use these
programs.
Improper use will cause the system to launch the
program Nag_Nag 9.5. Once this happens, the only
way to improve the performance of Wife 1.0 is to
purchase additional software. I recommend Flowers
2.1 and Diamonds 5.0 should this happen. WARNING!!
*DO NOT* under any circumstances, install
Secretary_With_Short_Skirt. This application is
not supported by Wife 1.0 and will cause
irreversible damage to the operating system.
Best of luck.
Tech Support
Contributed by: Koo
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
November 26, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Overactive bladder may have several causes
2. Back care basics
3. Reader submitted Q&A-Everything removed vaginally
4. Bone loss while taking HRT/ERT
5. Ten unhealthy eating behaviors women may have
6. Health tip to share - Check child's cholesterol
7. 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. Overactive bladder may be due to several diseases
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women suffer from having to urinate
frequently every day. Voiding more than 8 times
during the day or more than 1-2 at night can be
signs of bladder detrusor muscle irritability.
Various terms have been coined such as overactive
bladder or urgency frequency syndrome.
Sometimes (about 40%) frequent urination occurs
with unexpected loss of urine - leakage, or
incontinence. Most of the time, however, the
urgency just leads to frequent bathroom trips and
not to loss of urine.
Contrary to what the TV and magazine media would
have you believe, overactive bladder or urgency
frequency syndrome are merely symptom names and
not diseases. They should not be treated with
medicines until a diagnosis has been made as to
what the cause is for the bladder muscle to
contract involuntarily so frequently or at least
to rule out other serious causes.
Causes may include:
chronic bladder infections, interstitial cystitis,
spinal cord injury, multiple sclerosis, stroke,
urethral syndrome, unstable bladder, chronic
ureterovesical reflux, bladder stones or tumors.
For this reason, it is important that if you have
this problem, make sure the doctor has you undergo
a diagnostic work up before prescribing treatment.
Urinary urgency and frequency
Overactive bladder
Also, be sure to see our instruction sheet on
bladder retraining which is a mainstay of
treatment for any cause of overactive bladder.
Bladder retraining instruction sheet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Back care basics
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As we historically moved out of the fields doing
heavy labor into the office chairs staring at
computer screens, you would think that back
problems would be less frequent. It is almost the
opposite, however, because our back muscles have
weakened and are not able to protect our spines as
well as they used to.
Different causes of back muscle and joint pain
include:
strained muscles, tendons or ligaments
osteoarthritis or degenerative joint disease
sciatica
osteoporosis
"slipped" or herniated disc
Protecting your back muscles is a primary goal.
Avoid impact sports including running. Exercise
which strengthens your upper body, your stomach
muscles and you legs will help support the muscles
of the back. Watch your posture while walking and
sit properly in a good chair with back support.
Lift with your legs and arms and be sure to sleep
on your side on a slightly firm mattress.
If the cause of the back pain is muscular and not
arthritis or a slipped disc, stretching exercises
are very important to stop muscle spasm. Sometimes
it is as easy as sitting down and slowly letting
your head and upper body bend down so as to let
your head descend to between your legs if
possible. Conscious relaxation of the lower back
muscles while lowering your upper body toward the
floor is important. After the stretching exercises
come the back muscle strengthening exercises.
To read about these and other back care basics,
see the article at:
Back muscle basics
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Everything removed vaginally
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am facing a hysterectomy. Just saw the doctor
for this, but we have not discussed the procedure
yet. I want to know if the uterus, ovaries and a
bladder suspension and possible removal of the
appendix is possible all through the vagina?"
"I have fibroids causing my excessive bleeding,
but they are not large. I would like to avoid a
scar on my abdomen." L.
The hysterectomy, removal of the ovaries and
bladder suspension are all possible to do strictly
through the vagina. The appendectomy would not be
a vaginal procedure and not all the time can the
ovaries be removed vaginally.
A laparoscopic assisted vaginal hysterectomy
(LAVH) would leave some very small scars on the
abdomen, usually about 3-5. This would allow
removal of the appendix, ovaries and uterus. If
your physician is experienced in a laparoscopic
assisted bladder suspension (Burch retropubic
urethropexy) then that can be done at the same
time. If not, a needle suspension or sling
procedure can be performed vaginally by your gyn
surgeon or a urologist. All of this is under the
assumption that the fibroids are not too big.
This being said, my personal preference for this
surgery would be to do it all abdominally.
Although the hysterectomy and ovary removal are
easily performed LAVH or vaginally, I feel I get
better long term successful suspension results
with an abdominal approach. Whenever there is
bladder relaxation, there is usually relaxation of
the upper vagina, the upper bladder and the sides
of the vagina. I am looking to have a lower
occurrence of postoperative cystocele, enterocele,
vaginal vault prolapse and recurrence of the
stress urinary incontinence. In my hands I can
accomplish this better using an abdominal approach
for all of the defects you mentioned including the
bladder suspension.
Many scientific papers would support that
an abdominal approach often yields a more
successful long term outcome whenever pelvic
relaxation is present. A good vaginal surgeon,
however has as good results with a vaginal
approach so sometimes it is very dependent upon
your surgeon's experience.
You may decide that the lack of an abdominal
incision and scar and two weeks quicker recovery
are worth a few percent less long term successes.
Be sure to talk with your gyn surgeon about the
pros and cons of the different procedures. For a
discussion of laparoscopic assisted vaginal
hysterectomy, see one of our previous articles:
Laparoscopically assisted vaginal hysterectomy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Bone loss while taking HRT/ERT
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We know that women who take postmenopausal hormone
replacement therapy will gain bone density for the
most part. We forget that this data is based on
averages and it is possible that not 100% of women
on HRT/ERT will have a positive calcium balance.
It is also just as possible that women not taking
HRT/ERT may not lose bone density, or at least not
all of them.
This study looked at clinical trials of women
taking either HRT or placebo and who were all
compliant with their medications (76%). While the
original studies all looked at the average
increase or decrease in bone density, this study
looked at how many women lost more than 1% or 3%
of bone mass at the end of one or more years.
They found that over 3 years of taking HRT,
spinal bone - 0.6% lost 3% of bone per year
8% lost 1% per year
hip bone - 0.4% lost 3% of bone per year
11.8% lost 1% per year
In other words, HRT helps 90% of women prevent
bone loss leading to osteoporosis but about 10%
may still have significant bone loss.
Of the placebo users,
spinal bone - 11.7% lost 2.5% of bone per year
hip bone - 7.9% lost 2.5% of bone per year
In other words, not all women who were not taking
HRT lost bone mass. In fact, bone loss is far from
universal.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Ten unhealthy eating behaviors women may have
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women have very unhealthy eating habits.
Sometimes they are just in a rush to lose weight
while at other times it is just a matter of not
realizing how unhealthy a given habit is. A
psychologic counsellor, Nadia Amanda Alterio, has
written an article at Whispers Magazine about
destructive eating behaviors she has observed in
women.
You're a caffeine-a-holic!
You eat only fruits and vegetables
You restrict yourself to only 1 meal a day
You avoid meat at all costs
You are addicted to aspartame
You live on salads
You abuse supplements
You never eat breakfast
You skip meals so you can eat more later
You are obsessed with counting calories and fat grams
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Check child's cholesterol
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Children can have a genetic disposition to
elevated cholesterol and thus be at risk for
premature vascular disease. Children who should be
tested at age 2 or older include those who have
any of these conditions:
1. at least one parent who has been found to have
high blood cholesterol (240 mg/dL or greater),
2. a family history of early heart disease (before
age 55 in a parent or grandparent)."
The National Cholesterol Education Program (NCEP)
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
VIEWS ON AGING
Do you realize that the only time in our lives
when we like to get old is when we're kids? If
you're less than ten years old, you're so excited
about aging that you think in fractions.
"How old are you?"
"I'm four and a half."
You're never 36 and a half ....You're four and a
half going on 5.
You get into your teens; now they can't hold you
back.
You jump to the next number. "How old are you?"
"I'm gonna be 16."
You could be 12, but you're gonna be 16.
Eventually.
Then the great day of your life; you become 21.
Even the words sound like a ceremony.
You BECOME 21....Yes!!
Then you turn 30. What happened there? Makes you
sound like bad milk. He TURNED; we had to throw
him out. What's wrong?
What changed? You BECOME 21; you TURN 30.
Then you're PUSHING 40....stay over there.
You REACH 50.
You BECOME 21; you TURN 30; You're PUSHING 40; you
REACH 50; then you MAKE IT to 60.
By then you've built up so much speed, you HIT 70.
After that,
it's a day by day thing. You HIT Wednesday...
You get into your 80's; you HIT lunch, you HIT
4:30. My Grandmother won't even buy green bananas.
"Well, it's an investment, you know, and maybe a
bad one." And it doesn't end there....
Into the 90's, you start going backwards. "I was
JUST 92."
Then a strange thing happens; if you make it over
100, you become a little kid again. "I'm 100 and a
half."
What happened to just being thankful you are
alive!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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