Women's Diagnostic Cyber Newsletters 7/4/99 - 8/9/99
- September 26, 1999
- September 19, 1999
- September 12, 1999
- September 5, 1999
- August 29, 1999
- August 22, 1999
- August 15, 1999
***** 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** August 22, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Patient education pamphlets from ACOG 2. Contraception for women with disabilities 3. Scheduled C-section for HIV during pregnancy 4. Tips for tummy problems 5. Psychological aspects of infertility 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. Note: Some of the long URLs may not wrap as a hyperlink and you may need to cut and paste. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Patient education pamphlets from ACOG ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The American College of Obstetricians and Gynecologists (ACOG) publishes some of the most authoritative and accurate patient education pamphlets available. These are the ones given out in many Ob-Gyns offices. While they do not publish them for reading on the Net, they will send you free up to 5 pamphlets via mail. If you go to their search page and scan on "herpes" for example, you will find 27 pamphlets mentioning "herpes" including one entirely about genital herpes, one on STDs and one on vulvar diseases among others. Their list of topics is very extensive. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Contraception for women with disabilities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Women who are in a wheelchair or even bedridden still may have a need for contraception but what about their risk for thrombophlebitis from birth control pills? If a woman has a paralysis with no sensation, could she tell if she had an active infection from an IUCD? Probably not. She may need to worry about whether DepoProvera could make bone loss (osteoporosis) from her immobility even worse. If you or a friend has a physical disability and contraception is an issue, you may want to read the fact sheet on contraception: A Guide from the Center for Research on Women with Disabilities at Baylor College of Medicine. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Scheduled C-section for HIV during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If a woman has contracted HIV and become pregnant, it is now recommended that she deliver by routine scheduled Cesarean section because that seems to further reduce the incidence of transmission to the baby. Without any antiviral treatment during pregnancy, about 25% of newborns will become infected with HIV and have AIDs. With treatment, this is reduced to about 5-8%. With added, planned Cesarean section instead of vaginal delivery, this is further reduced to about 2%. /npreg2.htm#hivcs C-Section for HIV during pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Tips for tummy troubles ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ As many as one in three women are bothered by stomach disorders each day. Between heartburn, irritable bowel syndrome, ulcers, intestinal gas and bowel motility disorders, millions seek relief from these digestive problems using any means they can. Did you know: To avoid heartburn you should sleep on your left and stop all alcoholic drinks. To avoid intestinal gas, you should give up sucking hard candies, chewing gum and sipping carbonated drinks. If you have irritable bowel you should keep a symptom diary and avoid the artificial sweetener, sorbitol. With any of these concerns, you may want to read "No more tummy troubles!" at The National Women's Health Information Center. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Psychological aspects of infertility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Trying to conceive and not doing so can take quite a toll on one's psyche. It is not uncommon at sometime during the process to feel depressed, anxious, out of control and isolated. Sometimes a woman's partner is quite supportive but in other instances a partner may really not understand. If you have difficulty thinking of anything other than your infertility, it may be time to seek professional counselling. If you feel you are really "wound tight, you may want to look at this set of frequently asked questions from the Mental Health Professional Group of the American Society of Reproductive Medicine. Their answers include those to questions on: What impact does infertility have on psychological well-being? How do I know if I could benefit from psychological counseling? How can psychological treatment help me/us cope with infertility? How can I find a mental health professional experienced in working with infertility? Psychological aspects of infertility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Husband's note to wife, "Doctor's office called and the Pabst beer is normal." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. When a symptom or health problem is not yet a disease. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ P.S. Let us know what you think of the newsletter /newsfdbk.htm Feedback and suggestions Recommend this newsletter to your doctor /partners/signupmd.htm Recommend How to get off this list or change your email address: To SUBSCRIBE: /getemail.htm Subscribe To UNSUBSCRIBE: /unemail.htm Unsubscribe To CHANGE Email address: /chgemail.htm Change email address Newsletter archives: /emsample.htm Newsletter archives For our FAQ Library: /mindex.htm Library of FAQs To Join Woman's Diagnostic Cyber and subscribe to get Accurate Answers to Women's Health: /how.htm Join our practice
***** 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** 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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