Women's Diagnostic Cyber Newsletters 7/4/99 - 8/9/99
***** Woman's Diagnostic Cyber Newsletter ***** July 4, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Antiviral treatment during pregnancy 2. Raloxifene and breast cancer decrease 3. Meaning of a positive fecal occult blood test 4. Use of hair chemicals and pregnancy outcome 5. Gum disease and bad breath 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. Antiviral treatment during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ There are several viral diseases that, if present in a woman during pregnancy, can sometimes cause birth defects or serious diseases in the newborn baby. Several come to mind such as rubella (German measles), herpes simplex, human papilloma virus, chicken pox, and HIV viruses among others. Most antiviral medications are directed at blocking reproducing mRNA which is an essential component of all living tissue. Thus there is major concern that as antiviral medications are developed and given to pregnant women as treatment or prevention, they may cause more birth defects or complications than they prevent. A recent study in the Journal of the American Medical Association (JAMA) looked at 234 children born to mothers who tested positive for HIV but the babies did not end up having HIV. Approximately half of the mothers had been given zidovudine, an antiviral drug to try to prevent HIV transmission to the baby. The other half received a placebo medication. The investigators looked at physical growth measurements, immunologic parameters, cognitive/developmental function, occurrence of neoplasms, and mortality data assessed every 6 months for children younger than 24 months and yearly thereafter or as clinically indicated. There were no significant differences in any of the outcomes looked at between those children whose mothers took the zidovudine and those who took placebo. There were two infants with some unexplained eye findings in the zidovudine group however, which are still being followed. In general this is a very encouraging report that opens the possibility of more viral disease prevention during pregnancy. As you can imagine, it is very difficult to conduct a study like this in pregnant women for viruses that are damaging but not in the same class as HIV. Antiviral medication during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Raloxifene and breast cancer decrease ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Raloxifene is a selective estrogen receptor medicine that is closely related to tamoxifen which is used to treat breast cancer. Raloxifene is marketed under the trade name of Evista® for the prevention of osteoporosis. In the large study being done with raloxifene and a placebo medicine, the authors found that after 3 years of therapy, the new occurrence of breast cancer was only 25% of that of women on placebo. Many women are not aware that, on the average, a breast cancer detected by mammogram but not clinically palpable has been present in the body for about 6 years. A lump you can feel that is cancerous has been present in the body for about 9 years. Thus a study like this one below is interesting in that raloxifene is probably TREATING subclinical cancers before they are even detected by mammogram or exam. Raloxifene and breast cancer We have previously written about these new categories of selective estrogen receptor modulators (SERMS) at: Designer estrogens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Meaning of a positive fecal occult blood test ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Talking about testing stool for the presence of blood can be embarrassing for some, but as a screening test for colon cancer, it can detect problems early and actually prevent invasive cancer. You may have heard some people say the test is not good enough, it has too many false positives and there is some truth to that. Red meat in the diet can give a positive test as can other ingested substances, but it is still capable of detecting many serious gastrointestinal conditions other than colon cancer. There is no question that you should have this test performed if you are over age 50 or if you are having any gastrointestinal problems, but it is very important that you are armed with the information of what a positive test means so that you do not panic if you do test positive. See the discussion below or bookmark it for reference should you have a positive fecal occult blood test. Fecal occult blood testing ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Use of hair chemicals and pregnancy outcome ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ There have occasionally been concerns that toxic chemicals in hair products may be absorbed through the scalp but the data is not clear. In the study below, investigators looked at black women in North Carolina who used chemicals to straighten out hair either during pregnancy or in the 3 months preceding pregnancy. They found that there was no significant difference in preterm delivery or low birth weight among women who used or did not use these products. Hair straightener use and pregnancy outcome ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Gum disease and bad breath ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The American Dental Association has a set of frequently asked questions for consumers that you might be interested in if you are having any dental problems. One section that caught my attention was on gum disease because this is one problem that, if corrected, can head off tooth loss in later life. The section covers several questions such as: I've heard a lot about gum disease lately. How do I know if I have it? What are some of the ways to treat gum disease? What causes bad breath? What can I do about bad breath? Gum disease and bad breath ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Marina by Stan Kegel: It was a hot summer's day, and Luke was in the marina, having a few beers aboard his boat, patriotically named the "Fourth of July." He was waiting for his friend, Opie, to arrive so they could go for a cruise. Opie was late, unfortunately, because he had to pick up his wife from her appointment with the obstetrician. Her antenatal examinations were free because the doctor, a fellow named Juan, was Opie's cousin. Anyway, the appointment went over time, and Opie was late getting to the marina. Luke had been drinking all this time, and was feeling no pain. When he saw Opie finally walking down the pier, he jumped up, staggered to the side of the boat to wave to his friend, and nearly fell in! Opie got there just in time to grab Luke. ... Thus, it was that O. B. Juan's kin, Opie, saved Luke from falling to the dock side of the Fourth. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 11, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Lupus - patient care guide 2. Food allergies or intolerances 3. Hysterectomy for endometriosis in young women 4. Asthma medication during pregnancy 5. Estrogen and memory tasks 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. Lupus - guide for patients ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Lupus (systemic lupus erythematosis - SLE) can be a confusing disease. It is not only difficult to diagnose but also it is very similar to other autoimmune connective tissue diseases. A commonly used screening test is the anti-nuclear antibody (ANA) test which is positive almost all of the time with active lupus. It is also positive with other autoimmune diseases such as: mixed connective tissue disease, systemic sclerosis, primary Sjogren's syndrome, rheumatoid arthritis, and even in women with no systemic rheumatic disease. The section on laboratory tests useful in the diagnosis of lupus and other connective tissue diseases interested me but there are many different and complicated tests used. If you have a positive ANA test, you will want to see an immunology specialist to sort out all of the possibilities. There are also excellent sections on SLE symptoms, medications, psychosocial aspects and how to take care of yourself with all the different symptoms and situations that this chronic disease may present. Lupus guide ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Food allergies or intolerances ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Having a bad reaction to eating a certain food may cause you to conclude you have a food allergy to that food. Often, however, that reaction can just be an intolerance to the food or something in the food rather than a true allergic reaction. There may be a reaction to a bacteria in the food, a toxin, a histamine substance or the unpleasant effects may be due to lactose or gluten intolerance in the person eating the food. The most common food allergies in adults are to shellfish, peanuts, other tree nuts such as walnuts, eggs and fish. Whenever you have such an adverse reaction to a food, it is critical to know the difference between an allergy and an intolerance because an allergy can be life threatening by causing an immune reaction that can result in death by circulatory collapse or blocked breathing ability. If you think you may have a food allergy or even an intolerance, be sure to check the fact sheet at the National Institute of Allergy and Infectious Disease. I especially liked the section on diagnosis of how doctors go about differentiating by history and by testing whether the reaction to a food is an allergic one or just an intolerance. Did you know there is even such a thing as an exercise-induced food allergy? Food allergies versus food intolerance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Hysterectomy for endometriosis in young women ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Having endometriosis can be as bad as having cancer. While it does not cause death in a typical case, it can cause a very severe, debilitating, chronic pain. As a result, many young women with severe pain from endometriosis may choose hysterectomy as a last attempt to permanently get rid of their unrelenting pain. What can those young women expect if they forgo further childbearing just to have a more pain free life? As it turns out, many of the young women (less than 30 years of age) who have a hysterectomy for endometriosis treatment still have residual pain but mostly in the vagina (pain with sex), urinary tract (pain with voiding) and gastrointestinal tract (pain with bowel movements) but not in the pelvis (80% cure rate). Endometriosis and hysterectomy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Asthma medication during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Asthma is a much more common disease than most people realize. Up to 7% of pregnant women will have asthma and most of them are being treated with medicines that will cause worry about harm to the baby. However, as many as 10% of women with asthma during pregnancy will require an emergency treatment because of uncontrolled asthmatic breathing difficulties. Therefore medications cannot just be indiscriminately stopped because doing so may put two lives in jeopardy. Almost all asthma medications are safe during pregnancy so be sure not to stop any such treatment before consulting with your allergist and antenatal care specialist. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Estrogen and memory tasks ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ While some studies have suggested that estrogen improves memory, clinical trials have not always been clearly positive. This study looked at brain activation patterns using MRI to pinpoint which areas of the brain were more active in women taking estrogens compared with women not on estrogen. It found that certain areas of the brain associated with verbal and memory tasks were more active but in spite of this increased activity, estrogen did not affect actual performance of verbal and nonverbal memory tasks. The story on estrogens and their effect on memory is still not clear and it may not help memory and decision tasks as much as many people think. Estrogen and brain activity ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ An elderly male resident of the nursing home said to the female resident in a wheel chair, "Betcha can't guess how old I am." She replied, "I can if you take off all of your clothes." So he disrobed and she instructed him to turn around slowly. Then she said, "You're 95." "That's amazing!!" he exclaimed. "How could you tell?" "You told me at breakfast." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 18, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Mammograms and supplemental diagnostic imaging 2. Thyroid medication interactions and concerns 3. Different treatments for genital warts 4. Sperm counts and motility for IUI 5. Fitness during pregnancy 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. Mammograms and supplemental diagnostic imaging ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Imaginis.net is a web site specifically devoted to breast health. While it contains much information about breast cancer, its richness lies in the extensive descriptions of different diagnostic tests that go along with mammography and biopsies. Women who have not yet had mammograms will appreciate the concise descriptions of: Breast self-exam Screening mammography What is mammography and how is it performed? How can I prepare for my mammogram and what to expect during mammography? Where can I receive a mammogram? Women who have ever been called back by radiology or their physician to have "additional" xrays taken may panic at the thought that someone thinks there is a suspicious area on mammogram that needs to be investigated. While over 80% of women who are called back for special xrays turn out just to have benign findings, it is very reassuring to be able to look up what kind of studies are going to additionally be done and what they mean. Some of these studies might include: Special mammography: spot and magnification views Ultrasound and magnetic resonance breast imaging Ductography/Galactogram: imaging the breast ducts Sestamibi nuclear medicine breast imaging T-scan breast imaging (a new form of imaging) Book mark this site should you EVER have an abnormal mammogram xray, or if your first mammogram is coming up soon. Mammograms and breast self-exams ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Thyroid medication interactions and concerns ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Many women end up taking thyroid medication because of hypothyroidism especially around the time of menopause. What most physicians forget to tell you is that there are many other medications that can interfere with thyroid replacement therapy as well as medical problems such as gastrointestinal conditions that impair absorption. Also, thyroid medication can interfere with other medications and make them less effective such as anticoagulants, some anti- hypertensive medications, asthma medical treatments and even digitalis for the heart. We often depend upon our local pharmacist to warn us of any of these medication conflicts. Be sure to let your pharmacist know about all the medicines you take. If you are on thyroid replacement therapy and taking other prescribed drugs, you may want to look at this thyroid medication fact sheet from rxfactstat.com ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Different treatments for genital warts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Genial warts are not only embarrassing but sometimes very annoying due to their tendency to keep occurring in spite of treatment. Topical treatment either in the physician's office or by self-application at home are the standard therapies but sometimes surgical or laser treatment is needed. In women over 40, biopsy should be considered prior to treatment because there is a higher incidence of the warts representing a premalignant lesion, dysplasia, as women near and pass the menopause. Treatments are discussed at: Treatment for genital warts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Sperm counts and motility for IUI ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Intrauterine insemination of sperm (IUI) is a reproductive technique used in infertility not only for male factor problems, but also for women with cervical factor problems, ovulation dysfunction and even endometriosis. In this technique, sperm are washed in a test tube after collection and they are directly placed inside the uterus at the time of ovulation. From large studies of IUI, we can learn what sperm counts and motility percentages give the best pregnancy results. While IUI counts and results are not directly comparable to regular sperm counts from a semen analysis, a recent study of IUI in over 9900 cycles gives us some interesting statistics. Pregnancy rates were OPTIMAL (about 10-12% per cycle) when: sperm numbers were greater than 4 million sperm motility was greater than 60% a woman's age was less than 32 Even though not optimal, keep in mind that pregnancies did occur with instillations of less than 2 million sperm and motilities of less than 40% ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Fitness during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Pregnancy-info.net has an excellent collection of articles about different exercises and physical activities during pregnancy. Topics include: Exercises and Depression, Safe Exercises, Yoga and Swimming, the Benefits of Water and more. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Two men waiting at the Pearly Gates strike up a conversation. "How'd you die?" the first man asks the second. "I froze to death," says the second. "That's awful," says the first man. "How does it feel to freeze to death?" "It's very uncomfortable at first", says the second man. "You get the shakes, and you get pains in all your fingers and toes. But eventually, it's a very calm way to go. You get numb and you kind of drift off, as if you're sleeping. How about you, how did you die?" "I had a heart attack," says the first man. "You see, I knew my wife was cheating on me, so one day I showed up at home unexpectedly. I ran up to the bedroom, and found her alone, knitting. I ran down to the basement, but no one was hiding there, either. I ran up to the second floor, but no one was hiding there either. I ran as fast as I could to the attic, and just as I got there, I had a massive heart attack and died." The second man shakes his head. "That's so ironic," he says. "What do you mean?" asks the first man. " If you had only stopped to look in the freezer, we'd both still be alive." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 25, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Beauty tips for scarred skin 2. Bacterial vaginosis increases miscarriages 3. IUCD as an under-used contraceptive 4. Ovarian masses in pregnancy 5. Insomnia - its different types 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. Beauty tips for scarred skin ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Beauty is... is a great web site devoted to the self- esteem of women disfigured through accident, injury or surgery. There are articles on general scar healing and treatments, emotional issues and quite a few on burn injury. The article on skin moisturizing of a burn scar points out how a water soluble moisturizing product is needed to penetrate to the "internally dry" layer of burn scar rather than the normal oil based-moisturizing cream typically used for "externally" dry skin. Also I like the article on skin color and pigmentation where it mentioned about "medical tattooing" (tattooing to cover scars) as an alternative way of filling in normal skin color where there are small areas of de-pigmentation within a scar. Beauty is... ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Bacterial vaginosis increases miscarriages ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ While infections of any type are thought to affect fertility and the ability to carry a pregnancy, hard evidence is not available to confirm these common sense opinions. From a large in-vitro fertilization study (867 women) in Leeds, England, investigators looked at whether the presence of bacterial vaginosis (BV) affected the pregnancy conception rate. They found it did not lower the conception rate compared to women without infection (approximately 30% in both groups), but it increased the miscarriage rate by about two- fold. Women with bacterial vaginosis in this study had a miscarriage rate of 31.6% compared with 18.5% in women without BV. Effect of BV on conception and miscarriage rates ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. IUCD as an under-used contraceptive ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The intrauterine device, IUCD, got a bad rep back in the 1970's. As a result very few women in the U.S. use it even though it is a very frequently used contraceptive method internationally. While it may not be an ideal contraceptive method for all women, it has a very low long term pregnancy rate, low cost and low concern level after it has been successfully inserted. Women who do not like how they feel on hormonal contraceptives, and do not have a history of recent pelvic inflammatory disease, heavy menstrual bleeding or moderate to severe menstrual cramps may find that the IUCD is an almost IDEAL contraceptive method once they know the facts. IUCD - intrauterine contraceptive device ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Ovarian masses in pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Occasionally a routine ultrasound in pregnancy will detect a pelvic mass in the region of the ovary and a question arises as to whether there is a chance it can be malignant. Doctors certainly try to avoid surgery during pregnancy so as not to cause a premature birth but there is a tradeoff when malignancy is a concern. Traditionally, most surgery during pregnancy is put off until at least 3-4 months (about 14-18 weeks) and it is also avoided later in pregnancy. The study below indicates that up until 23 weeks the surgery is fairly safe for the baby but after that, preterm labor complications rise. It also shows that the chance of a worrisome ovarian mass (a diameter of more than about 5.9 cm/2 inches) in pregnancy is about one in 1300. Only 6% of those masses turned out to be malignant compared with about 3% in other studies. The take-home message is that if an ovarian cyst or tumor is found during pregnancy, surgery should probably be deferred until after delivery unless the ultrasound characteristics are very worrisome for possible malignancy. If surgery needs to be performed for diagnosis or any other reason, it is best to time that surgery between 14 and 23 weeks gestation, i.e., the early 2nd trimester. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Insomnia - its different types ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ There can be many different forms of sleep disorders such as insomnia, sleep apnea, restless legs syndrome, narcolepsy, and shift work sleep problems among others. Insomnia is classified into three types - transient, short-term, and long-term. It can be associated with medications, alcohol, and other ingested substances. Did you know that many antidepressant or anti-anxiety medications actually disturb sleep more that help it? Even small amounts of alcohol are not recommended as sleep aids. If you have any long term sleep problems, you may want to look at this fact sheet on insomnia from the Sleep/Wake Disorders Canada. Insomnia - the facts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Two female transplant surgeons were seen in the hospital corridor lamenting the high cost of organs and their availability for transplant. "Did you see the latest waiting list for livers?" said the first organ transplant surgeon. "Yes, I'm going broke because we can't get any" said the second, "but fortunately brains have become much more available and we have quite a few attorneys who are waiting for them (chuckle,chuckle)." "How much are they charging for the brains?" asked the first surgeon. "Well its sort of strange" said the second surgeon, " they want $100,000 for a male brain and $50,000 for a woman's brain." "What!" exclaimed the first one. "That's blatantly sexist." Why would they have such a differential price and charge so much more for a male brain?" "Well, apparently they found out that all of the female brains had been previously used!" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** Aug 1, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Pregnancy tips 3. Drugs that cause urinary incontinence 4. Hypothyroidism and depression needs extra meds 5. Pap smear reminder 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. Pregnancy tips ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ While selling you their book, pregnancy tips.com offers some free tips you may want to look at. Natural remedies for morning sickness What you need to know before you have your baby Leading New Discoveries on Nutrition During Pregnancy Breastfeeding Facts Preventing Episiotomy Prenatal Classes Kegels Planning a waterbirth Packing your bag Your Partner's Role in Childbirth Secrets to having a faster and easier Labor and Delivery Breastfeeding Tips Care of the Mother Pregnancy tips ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Drugs that cause urinary incontinence ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Many women with occasional urinary leakage will become worse when they are started on antihypertensive medications or diuretics. Even some anti-convulsant or anti-Parkisonian drugs worsen incontinence. Any medications which cause constipation or even chronic cough will turn a minor urinary loss problem into a very inconvenient one. If you suffer from even mild loss of urine with coughing or straining or urgency that causes occasional embarrassment, you may want to read about medications that can cause urinary incontinence. Drugs causing urinary incontinence ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Hypothyroidism and depression needs extra meds ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Hypothyroidism is common among women and often presents initially with main symptoms of depression in addition to fatigue and cold intolerance. Traditional medical therapy for hypothyroidism incudes only thyroid hormone (thyroxine) to the level of lowering the TSH hormone level back into normal range. Hasimoto's autoimmune thyroiditis, is a common form of hypothyroidism. The following paper discusses the use of an anti-depressant and d- amphetamine in addition to thyroid hormone replacement for thyroiditis in order to treat the symptoms of depression and fatigue which often do not resolve for a long time after adequate thyroid replacement. If you have been recently diagnosed with hypothyroidism, you may need more than just thyroid replacement: Thyroiditis and depression ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Pap smear reminder ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The College of American Pathologists has organized a service to remind you of your annual Pap smear. Just enter a date to be reminded by email and your email address and they will send you that reminder for you to call and schedule your appointment. Pap smear reminder email You may also be interested in their series on frequently asked questions (FAQs) about Pap smears at: Pap smear FAQs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The genie from the yard sale Contributed by: Katy After buying an unusual looking vase at a local yard sale, a woman was cleaning it up when a Genie popped out. Being a traditional Genie, she offered the woman three wishes before she would escape forever. The woman thought for a moment and said, "I wish I was the most beautiful twenty year old woman in the world, I wish I had more money than I knew what to do with, and I wish you would turn my cat into the most handsome prince around." The Genie nodded and after a huge cloud of dust cleared, the Genie was gone and so was the vase. The woman looked at herself and she was certainly beautiful. She was surrounded with scads of money in large bills. She flung an armful in the air and watched it flutter down around her. She giggled with delight at the mountains of cash. Then she turned to look where her adoring cat once stood. There in the feline's place stood a tall dark, handsome man with chiseled features, a washboard stomach, broad shoulders, and a soccer-player's tush. She walked over to him, he put his arms around her, brushed his hand upon her cheek, looked deep into her eyes, and whispered softly, "Now, aren't you sorry you had me neutered?" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** August 8, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Online consumer health publications 2. Progesterone cream and breast cancer 3. What is a healthy weight? 4. Postpartum weight and breast changes 5. Exercise and susceptibility to infection 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. Online consumer health publications ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ You may or may not be aware that the U.S. Government publishes many documents abut various aspects of health. The Consumer Information Center at Pueblo, CO, USA is the clearing house to order many of these publications in print form. Some are free, some have charges, but on their web site, many of the publications are free to read. Urinary Tract Infections in Adults Varicose Vein Treatments. What to Do When a Friend is Depressed. So You Have High Blood Cholesterol Overcoming Infertility Laser Eye Surgery - Is It Worth Looking Into?. Hepatitis C. Fever Blisters & Canker Sores. Anxiety Disorders Walking for Exercise and Pleasure Setting Goals for Weight Loss Dieter's Brews Make Tea Time a Dangerous Affair Guide to Contraceptive Choices How Folate Can Help Prevent Birth Defects Government health publications online ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Progesterone cream and breast cancer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Originally, physicians felt that progesterone might counteract the effects of estrogen on the breast just as it does in the uterus to prevent an increased occurrence of endometrial cancer as opposed to estrogen alone situations. This was not found to be the case in the large Nurses study about hormone replacement and breast cancer in the U.S. However, a recent French study, which was performed to see if the use of progesterone cream on the breast for benign fibrocystic changes raised the incidence of breast cancer, found that not only did the progesterone cream NOT increase breast cancer, but when it was taken along with oral progesterone, breast cancer occurrence was decreased by about 50%. It would not be wise to conclude on the basis of this one study in Cancer Detection and Prevention 1999; 23(4):290-296, that progesterone protects against breast cancer. At least it is supportive evidence that it does not increase breast cancer. Progesterone cream and breast cancer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. What is a healthy weight? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Everyone tells us fat is unhealthy especially if it settles in our body. Being overweight or obese has its health hazards. Not only heart attacks and death, but diabetes, gall bladder disease and osteoarthritis are also linked to overweight individuals. Some cancers of the breast, uterus, ovary and gallbladder also are increased in incidence in overweight women. Well what should we weigh? What is ideal, what is doable? Experts recommend a 5-10% weight loss held off for a year as the most important first step for overweight or obese women. What is a healthy weight ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Postpartum weight and breast changes ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Will the pounds just melt away after delivery if you breast feed? What about the hip and tummy changes, do they go away? Getting your body back in shape after a pregnancy and delivery can be challenging and there are many rumors about how easy or hard it is. What is the experience of most women? The facts are that your body will probably not look the same after giving birth. Maybe the article below at epregnancy.com will challenge you to prove them wrong. The truth about your postpartum body ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Exercise and susceptibility to infection ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ One episode of vigorous exercise can make you more susceptible to respiratory infections but regular exercise seems to enhance the immune system so you get less infections. Many sports medicine experts are aware that excessive physical activity like running marathons, can reverse the beneficial curve of exercise and infection and suppress your immune system for hours to weeks afterward. A scientific article in Physician and Sports Medicine looks at this theory and offers evidence that increased infections after very extensive physical activity may be due to other causes rather than immune system suppression. While the article is somewhat technical, it points out how the different things affect the increased respiratory infection rate with extensive exercise. Mucous secretions which protect against viral infections may dry up with extended activity. Vitamin C supplements have been shown to reduce respiratory tract infections with sports. Runners' risk of respiratory infection over a 1- year period included running more than 15 km per week, living alone, and having a low body mass index. Keep up the exercise but if you are in extensive training or if you seem to get more colds and flu with exercise, you may want to check out: Exercise effect on immune system ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MAIL ORDER GROOM Two women in the one horse town of Parched Gulch had daughters, each of marriageable age. But there were no prospective husbands in town due to shootings, running off with outlaws and drunk riding. And there was no chance at all of any bridegrooms turning up. The two mothers pooled their meager resources, advertised, and sure enough, they got results: twin brothers in Cactus Corners looking for wives. The twin bridegrooms were sent for. Along the way the twins met up with outlaws. One was killed, the other escaped. Upon his arrival, the mothers were in immediate conflict as to whom the surviving twin belonged. They were going to kill each other over it. After all, each had a daughter's future at stake. They took the case to Judge A.K. Hornswoggle, alcoholic, disbarred, but with Solomonic frontier wisdom. After due deliberation, Hornswoggle ruled that the young man be chopped in half and one half awarded to each daughter. The first mother was outraged. If Hornswoggle wasn't drunk or stupid, he was a monster for suggesting such a thing. The second mother thought it would not be a bad solution. And pointing to the second mother, Hornswoggle said, "Your daughter gets him. You are the real mother-in-law!" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Helping women understand in order to make better self health care decisions. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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