Womens Health

Women's Diagnostic Cyber Newsletters 7/4/99 - 8/9/99

 

 




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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 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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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 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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***** 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..........) 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 
 * 

 "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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