Women's Health Newsletters 5/7/00 - 6/11/00
| Sign up for our Women's Health Email Newsletter |
***** Woman's Diagnostic Cyber Newsletter *****
May 7, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Gastro esophageal reflux disease - heartburn
2. Ductal in situ breast cancer prognostic factors
3. Reader submitted Q&A - Prolapse repair without hyst
4. Progesterone IUCDs as rx for heavy menses
5. Erythema multiforme - an allergic skin response
6. Health tip to share - Weight training for PMS
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Gastro esophageal reflux disease (GERD)- heartburn
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
About 7% of people have heartburn once a day. It
is a common condition resulting from the reflux of
stomach contents up into the esophagus. Almost a
third of people get heartburn at some time, but
the incidence rises after age 40.
Besides throat burning, pain on swallowing and
difficulty swallowing, you can also get lung or
respiratory symptoms because the acid can reflux
all the way into the trachea (windpipe). It can
cause coughing, wheezing, asthma, pneumonia and
lung stiffening as well as tooth decay, gum
disease and bad breath.
Pregnancy and the influence of progesterone can
make reflux a terrible problem because the
hormone relaxes the lower esophageal sphincter,
allowing acid reflux and the pregnant uterus
forces the stomach higher toward the diaphragm and
lung.
In nonpregnant adults, GERD is often a chronic
disease. Treatment is by change in diet,
medications and occasionally in severe cases,
surgery.
For a good tutorial from gerd.com, that really
explains what is happening in reflux disease, see:
Heartburn, gastroesophageal reflux
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Ductal in situ breast cancer prognostic factors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Carcinoma in situ is a category of cancer that is
confined to the skin lining (epithelium) and is
not invasive. In many tissues such as the vulva,
skin or cervix, if the abnormal tissue is totally
excised, carcinoma in situ is cured 99% of the
time. Breast tissue, however, is a somewhat
different problem because it is much more
difficult to make sure that all of the abnormal
ductal tissue is removed without removing the
entire breast. And yet the ultimate goal should be
to preserve the breast if there is less than a 1%
chance that the cancer has invaded somewhere along
the duct.
The article below looks at what are the risk
factors in which a breast ductal carcinoma in situ
on excisional biopsy can just be followed without
removing the breast or just be given radiation
therapy without having a mastectomy. In 575
patients in France, recurrence free survival was
96% after modified radical mastectomy and only 83%
after breast conserving treatment and
radiotherapy. Seven year metastasis free survival
was 99% and 96% after modified radical mastectomy
and just radiation therapy respectively.
The study found that recurrence and metastasis
were more common if the cancer was of a "comedo"
cell type, if it occurred in many different foci
rather than being continuous, and if the margins
of the excisional biopsy were not free of the in
situ carcinoma. On the other hand, if the margins
are free of tumor, if the lesion is not multifocal
and the cell type is not comedo, then a mastectomy
may not need to be performed.
Ductal carcinoma insitu of the breast
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Prolapse repair without hyst
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is a hysterectomy absolutely necessary in order
to repair a rectocele? Is there some procedure for
repair without having to also have a total
hysterectomy? This is after menopause, age 52,
difficult birth of a child 24 years ago, now the
herniated rectum (rectocele) is protruding through
the vagina ... not all the time...more after being
tired at the end of a day."
G.T.
The quick answer is no, hysterectomy is not
necessary in order to fix a rectocele or cystocele
or even uterine prolapse. It is not even a
necessary component in the repair of stress
urinary incontinence. As to why it is very
frequently recommended or included in the
procedures to fix pelvic organ prolapse, you may
want to read our discussion below. It can be a
complex decision. We modified and updated our
article of October 17, 1999 to "Having Prolapse,
Cystocele and Rectocele Fixed Without
Hysterectomy"
Cystocele and rectocele repair without hysterectomy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Progesterone IUCDs as rx for heavy menses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If heavy menstrual flow is not due to endometrial
polyps or fibroids, it often becomes labelled as
dysfunctional bleeding. Dysfunctional bleeding
just means we do not know the cause and think that
most of the time it is due to a dysfunction of
normal hormonal physiology. Actually there are
other causes but most of the time treatment is
hormonal supression of the heavy flow. Frequently
oral contraceptives or just progesterone tablets
are used to decrease flow.
One treatment we often forget about is use of the
progesterone intrauterine device (Progestasert
[R]). It has been used to decrease menstrual blood
loss. Some women do not like the thought of an
IUCD in their uterus but if oral contraceptives
and oral progesterone are not tolerated because of
side effects, the only other alternative short of
hysterectomy is endometrial ablation.
Does the progesterone IUCD work? This review from
the Cochrane Library Review of clinical trials
concludes that it does decrease blood loss better
than oral progesterone but not as much as
endometrial ablation. There is more breakthrough
bleeding with the IUCD and less amenorrhea than
with ablation, but apparently the satisfaction
level is the same with the IUCD as with
endometrial ablation.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Erythema multiforme - an allergic skin response
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Have you ever seen a skin rash that almost looks
like a target was painted on the skin? Erythema
multiforme is a skin reaction that almost always
is an allergic response to a medication, chemical
or other condition. You can recognize it as a red
circular area with pale but otherwise normal skin
on the inside of the circle. The lesions are not
always circular but often are and your first
response might be to think of a ringworm
infection.
Systemic symptoms besides the skin rash can
include itching, joint aches, an all over poor
feeling, and fever.
Medications that produce this rash are almost
always sulfa, penecillins, barbituates or Dilantin
[R]. Infections that can cause this are herpes
simplex virus and mycoplasma.
Treatment is directed at the underlying condition
which may mean discontinuing certain medications,
taking antibiotics or anti virals, and using anti-
histamines and occasionally steroids if the skin
condition blisters and worsens.
For pictures and more info, see this library page
at Healthcentral.com:
Erythema multiforme skin reaction
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Weight training for PMS
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Here's the tip of the week for women experiencing
extreme fatigue, irritability, and a feeling of "
I just do not want to get out of bed today" during
PMS/Perimenopause.
I have discovered that lifting weights gives me an
incredible amount of energy plus an added bonus of
feeling really good about myself. I joined a gym
that offers a class called "bodypump" using
barbells (just like the big muscle guys!) with an
hour of intense work out that will make your body
sing, your brain happy and glad that you did,
indeed, get out of bed!!
Happy bodypumping! M.L.T.
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
THE TOP TEN THINGS ONLY WOMEN UNDERSTAND
10. Cats' facial expressions.
9. The need for the same style of shoes in
different colors.
8. Why bean sprouts aren't just weeds.
7. Fat clothes.
6. Taking a car trip without trying to beat your
best time.
5. The difference between beige, ecru, cream, off-
white, and eggshell.
4. Cutting your bangs to make them grow.
3. Eyelash curlers.
2. The inaccuracy of every bathroom scale ever made.
AND,.... the Number One thing only women understand:
1. OTHER WOMEN
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter *****
May 14, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Lyme disease - What to look for
2. Depression is a risk factor for heart disease
3. Reader submitted Q&A - Possible adenomyosis
4. Osteoporosis prevention and treatment
5. Resuming intercourse after cancer therapy
6. Health tip to share - Vitamin C for heavy menses
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Lyme disease - What to look for
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With spring and summer coming and outdoor
activities on the rise, we have to keep our eye
out for us and our children to make sure that deer
ticks do not get a bite on us. They can spread
Lyme disease caused by a bacterium spirochete.
Initially the skin is infected but it spreads to
the joints and nervous system.
The first symptom is an expanding rash that gets
quite big; 5-6 inches is not uncommon. It radiates
from the tick bite and starts about 1-2 weeks
after the bite and may last 3-5 weeks. The rash
coincides with a fever, chills, fatigue and joint
aches. This can progress to more severe joint
pains, a stiff, aching neck, and a tingling or
numbness in the extremities or a facial palsy can
occur.
Early treatment with antibiotics can prevent
permanent neurological sequelae. Also, the tick
does not transmit the spirochete until after it
has been attached for 24 hours. Therefore a once a
day tick check is necessary for those spending
time outdoors. The disease can occur in any state
although the Northeast, the upper midwest and
California report more cases.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Depression is a risk factor for heart disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
According to a study in the Archives of Internal
Medicine, both men and women who have depression
have about a two-fold increased risk of coronary
heart disease events such as heart attacks or
angina. Depressed men actually had an increased
risk of fatal heart attacks while women did not.
I'm not sure what to make of this information
except that depression has manifestations beyond
that of the mind and mood.
Depression as a risk for heart attack
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Possible adenomyosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 46 and every month before I start my
period, I have really painful cramps. They are so
painful that I can barely function. What could be
the cause of this?"
Carolyn
While there are several possibilities causing this
pain including endometriosis, the most likely
cause is an entity called adenomyosis. It is a
condition like endometriosis only instead of the
growing, sloughing tissue occurring in the
abdominal cavity and on the outside of the
ovaries, tubes and uterus, this tissue is found in
islands deep into the muscle of the uterus.
It causes pain and abnormal menstrual bleeding.
The diagnosis is difficult and treatment of it
medically or surgically short of hysterectomy is
not often offered to women.
For a discussion of this topic, see:
Adenomyosis - an internal endometriosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Osteoporosis prevention and treatment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following article from the electronic Medical
Journal of Australia presents a great summary of
the current medical concepts for osteoporosis
prevention.
Estrogen therapy is first choice for osteoporosis
prevention
First choice for fracture treatment is alendronate
(Fosamax[R]) and secondly raloxifene (Evista [R]).
Housebound or institutionalized elderly women
should have Vitamin D supplementation.
Calcium supplements should be used with all the
regimens and have a better bone-sparing effect
when taken at night.
"Natural" therapies such as soy may have some
effect in preventing bone loss in animals but
there is not yet any evidence they have a
significant effect in humans.
Osteoporosis review
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Resuming intercourse after cancer therapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
After abstaining from vaginal intercourse for
months or years, vaginal dryness and loss of
elasticity takes place. Cancer patients who
undergo radiation treatments, chemotherapy and
either become menopausal or have to discontinue
their estrogen replacement therapy, are especially
hard hit by these drying vaginal changes.
Resuming vaginal intercourse under these
circumstances is not just a matter of using a
little lubricant or restarting estrogen therapy.
It is a multistep process. These "Seven Steps to
Reentering Sexuality After Cancer are described at
veryprivate.com.
Avoiding the application of more chemicals that
worsen the dryness and discomfort, and the gradual
reacquaintence of the vaginal tissue with touch
and penetration are the key components to
eventually resuming intercourse. Remember that it
is a very gradual process, not quick. It takes
patience.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Vitamin C for heavy menses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Since Vitamin C speeds up blood clotting times, I
tried taking Vit C while menstruating. I found
that taking it decreased my heavy menstrual flow
to a tolerable amount. The difference was very
noticeable. I took 500 mg a day in two 250 mg
doses (one in the morning and one at night).
Since this is anecdotal, it would be fun to be
able to hear the results of other people trying
out these remedies."
Dorothy G.
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
HUSBAND AND WIFE
A woman accompanied her husband to the doctor's
office. After his checkup, the doctor called the
wife into his office alone.
He said, "Your husband is suffering from a very
severe disease, combined with horrible stress. If
you don't do the following, your husband will
surely die: Each morning, fix him a healthy
breakfast. Be pleasant, and make sure he is in a
good mood. For lunch make him a nutritious meal.
For dinner prepare an especially nice meal for
him. Don't burden him with chores, as he probably
had a hard day. Don't discuss your problems with
him, it will only make his stress worse. And, most
importantly, make love with your husband several
times a week and satisfy his every whim. If you
can do this for the next 10 months to a year, I
think your husband will regain his health
completely."
On the way home, the husband asked his wife."What
did the doctor say?"
"You're going to die," she replied.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter *****
May 21, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Some causes of memory loss are reversible
2. Avoiding mistakes in a fitness routine
3. Reader submitted Q&A - Getting lab reports
4. Risk factors for advanced stage cervical cancer
5. Improving endometrial ablation success
6. Health tip to share - Hot flashes and Soy
7. Humor is healthy
We are honored that Health Scout.com, a web site
that rates medical web sites as stars or stinkers
gave our Woman's Diagnostic Cyber their highest
4 star rating!
Health Scout
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. Some causes of memory loss are reversible
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most memory losses are just a matter of being too
busy to let a thought or fact "settle in". But we
make jokes about getting Alzheimer's disease.
Sometimes we seriously worry that a pre senile
dementia may be occurring. A parent starts
forgetting more and more and we attribute it to
age.
What would be a real mistake would be to assume
that someone having memory loss has Alzheimer's or
a senile memory loss when in fact they had a
reversible cause of forgetting. Reversible causes
of memory loss include:
hypertension (uncontrolled)
diabetes (uncontrolled)
depression
medication side effects
severe hypothyroidism
Vitamin B-12 (pernicious anemia)
There are also causes of permanent memory loss
other than Alzheimer's or dementia. Small strokes
can be one cause or congestive heart failure. If
you have any questions about a possible loss of
memory, be sure to see your physician. Take a look
at this article about memory loss at Mayo Health.
Reversible memory loss
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Avoiding mistakes in a fitness routine
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A steady fitness routine almost guarantees good
health and a good mind set. But sometimes we let
stress follow us there and don't warm up like we
should or we rush and skip certain parts of the
routine we may not consider as important. We may
even rush through some of the exercises or even
worse, not perform them correctly.
All of these mistakes can have consequences we
fail to think of. The muscles need their full
range of motion in order to improve. Too rapid a
set of repetitions may inhibit good muscle
development or even lead to burnout.
You may want to look at these fitness routine
mistakes at PersonalMD.com and read about their
consequences or look at some of the other fitness
mistakes such as:
wasting time
over training
not eating right
not taking enough fluids
not getting enough sleep
Avoiding mistakes in a fitness routine
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Getting lab reports
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Health Law Article
"My mother recently had an outpatient CT scan to
evaluate abdominal pain which she has had for
about 4 months. We were told it would be a few
days before receiving the results. I did not want
to wait that long and the next day I called the
radiology clinic. I was told they could not give
the report to me and that it was sent to the
doctor who ordered the scan and I would have to
get the report from him. I called the doctor's
office and the nurse told me the doctor was not in
the office that day and that she could not give
the results to me without the doctor's permission.
I asked for the results by the end of the day and
the nurse called the doctor and then called me
back saying that everything looked normal as far
as she could tell from the report but that the
doctor had not seen the report. It was two days
later before the doctor called with the report. I
know there are laws that say hospitals have to
give medical records but what about doctors or
outpatient clinics? "
anonymous
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Risk factors for advanced stage cervical cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Having regular Pap smears has significantly
decreased the incidence of advanced (late stage)
cervical cancer that doctors see. It even has
made a larger impact in decreasing early cancer
seen because treatment of dysplasia (a possible
pre cancerous change) is very common place.
When a gynecologist sees a patient with cervical
cancer nowadays, it is almost always of an
advanced stage in a woman who has not had a Pap
smear or exam in about 10 years or more. The
following article in the Archives of Family
Medicine looked at what are the factors associated
with advanced stage cervical cancer.
They found, of course, that advanced age was a
strong predictor. That is, older women are the
ones more likely to have advanced cervical cancer.
You would expect some of this because it takes
several years for cancer to get worse and spread,
but it is also true because more elderly women
tend not to continue having annual pelvic exams.
Another factor was health finances - if a woman
was indigent she had a 60% increase of having
advanced cancer. If she had commercial or HMO
health insurance, the risk is reduced by 46%.
Being unmarried also was a factor that increases
risk. One can only postulate why.
Surprisingly, race, education level, income level,
smoking status, other medical conditions, and
urban residence were not associated with stage at
diagnosis.
Cervical cancer risk factors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Improving endometrial ablation success
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Endometrial ablation is a procedure used to
decrease heavy menstrual bleeding without doing a
hysterectomy. It does not allow further
childbearing but it can prevent having to undergo
a major surgical procedure.
It is only about 65% successful in preventing the
need for further medical or surgical therapy for
the heavy bleeding. This study looked at factors
associated with the success of endometrial
ablation in 120 women who were pretreated with
either danazol (Danocrine [R], 800 mg/day orally)
or leuprolide (Lupron [R], 3.75 mg in one
intramuscular injection each month).
If there were no endometrial polyps or fibroids,
the ablation was more successful. Also women under
age 40 pretreated with danocrine had a better success
rate. This is new information so if you are
considering having an endometrial ablation,
encourage your doctor to give you danocrine prior
to the ablation. It makes the endometrial lining
thinner and more atrophic. There is less of it
present so maybe the ablation will miss less
tissue.
Endometrial ablation success
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
My sister is a 51 1/2 year old nurse. She was
struggling with hot flashes due to menopause. She
started taking an Amway product containing black
cohosh and soy and within 5 days, the hot flashes
ceased. She's been taking this product for almost
a year now and has never had a hot flash yet.
Rose
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thoughts on Cats
"There is no snooze button on a cat who wants
breakfast."
- Anonymous
"Thousands of years ago, cats were worshipped as
gods. Cats have never forgotten this."
- Anonymous
"Cats are smarter than dogs. You can't get eight
cats to pull a sled through snow."
- Jeff Valdez
"In a cat's eye, all things belong to cats."
- English proverb
"As every cat owner knows, nobody owns a cat."
- Ellen Perry Berkeley
"One cat just leads to another."
- Ernest Hemingway
"Dogs come when they're called; cats take a
message and get back to you later."
- Mary Bly
"Cats are rather delicate creatures and they are
subject to a good many ailments, but I never heard
of one who suffered from insomnia."
- Joseph Wood Krutch
"People that hate cats, will come back as mice in
their next life."
- Faith Resnick
"There are many intelligent species in the
universe. They are all owned by cats."
- Anonymous
"I have studied many philosophers and many cats.
The wisdom of cats is infinitely superior."
- Hippolyte Taine
"Some people say that cats are sneaky, evil, and
cruel. True, and they have many other fine
qualities as well."
- Missy Dizick
"You will always be lucky if you know how to
make friends with strange cats."
- Colonial American proverb
"Cats seem to go on the principle that it never
does any harm to ask for what you want."
- Joseph Wood Krutch
"Cats aren't clean, they're just covered with cat
spit."
- John S. Nichols
"Do not meddle in the affairs of cats, for they are
subtle and will pee on your computer."
- Bruce Graham
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter *****
May 28, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Treating allergies the natural way
2. Lost libido and what to do about it
3. Reader submitted Q&A - ASCUS Pap smears
4. Spontaneous change in urinary incontinence symptoms
5. USP Drug information on Medline
6. Health tip to share - Low fat, vegan diet and cramps
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Treating allergies the natural way
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You can throw antihistamines at this season of
allergies, but did you ever stop to think there
might be another way? This health newsletter at
VitaCost.com emphasizes the use of vitamins and
other natural supplements to help ease the
symptoms of hay fever or food allergies.
A first effort must include avoiding the known
allergens as much as possible as well as staying
in a very clean environment that includes allergy
filters and anti allergenic pillows, pillow cases and
mattress coverings. Pets need to stay out of the
bedroom and humidifiers can make things worse by
spreading mold.
As far as supplements go, they discuss vitamins A,
C and E as well as cofactors needed for the immune
system such as selenium, zinc, quercetin,
grapeseed extract, DHA from fish oil and green
tea.
Controlling Allergy Naturally
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Lost libido and what to do about it
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Generation A, men and women whose life begins at
50, have a place to congregate at generationA.com.
One of the topics that you might expect to be
discussed is decreased libido.
In this article below by Charlotte Slopak, Ph.D.,
there is a good review of some of the material
from a book, I'm Not in the Mood, by Julia
Reichman, M.D. Statistics show about 40% of women
lose sexual desire during menopause and about 25%
have intercourse rarely.
Low testosterone levels can sometimes play a role
although there certainly are many other factors
that can contribute to these feelings. Take glance
at:
Decreased libido
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - ASCUS Pap smears
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been having pap smears repeated every 3
months for about 9 months now per my gyn because
of an abnormal smear. He said it's a category 2,
not cancer but to keep an eye on this. Can this
turn into a pre-cancer? He mentioned squamous
cellular changes. What does all this mean? "
"Should I get a second opinion?"
Becky D.
How should an abnormal Pap smear be followed? The
different recommendations doctors give for
abnormal Pap follow up are almost as confusing as
the different categories of abnormality. In fact
these Pap classifications have changed several
times throughout the last several decades and
physicians may even mix and match these
classifications when they try to explain them to
you.
Some physicians and some patients are more likely
to want to treat mildly abnormal smears than are
other physicians and patients. Treatment can
depend upon whether an abnormality produces
excessive anxiety.
For the most part, Pap smears classified as ASCUS
(atypical cells of undetermined significance) are
followed without treatment every 4 months.
Sometimes Paps with suspected dysplasia such as
LGSIL (low grade squamous intraepithelial
neoplasia) are also followed the same way.
For a discussion of the different classes of Paps
and what they mean, see our article at:
ASCUS Pap smears
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Spontaneous change in urinary incontinence symptoms
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following article from the British Medical
Journal is quite interesting. It is a study in
which they looked at 2860 women ages 40-60 and
followed them for one year. They determined how
many women had urinary incontinence symptoms at
the beginning of the year (28.5%) and how many of
those women had regression of those symptoms to
less than once a week by the end of a year (28% of
those original 28.5% of women).
Also, they determined that the new occurrence of
urinary incontinence (both urge and stress
incontinence) was 10% within that year.
None of the women in the study had any medical
interventions performed during the year of the
study, thus this is a natural history study that
shows what the normal course of symptoms can be.
It shows that incontinence symptoms can get better
on their own. Therefore women should be cautious
about major medical or surgical procedures for
urinary incontinence until some time passes and it
is obvious the symptoms are not going to improve
on their own.
Lower urinary tract symptoms - a longitudinal study
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. USP Drug information on Medline
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medline, the service from the National Library of
Medicine that has all of the scientific Medical
Journal abstracts now offers drug information on
over 9000 prescription and over-the-counter drugs.
This resource is worth knowing about because it is
considered quite an authoritative database. The
drug information is assembled by the US
Pharmacopeia.
Medline Drug Information
Take a look at the information on a drug like
Lupron [R] (systemic luprolide) or even just oral
contraceptives. It is information you are not
likely to see in other sources.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Low fat, vegan diet and cramps
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A low fat (10%), vegetarian diet decreases the
number of days of menstrual cramps with a
menstrual cycle by about 25%.
[Editor]
We encourage you to share your health tips.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Doctor Joke
How many gynecologists does it take to change a
light bulb?
"Why don't we just take out the socket? You're not
using it any more, and it'll only cause you more
problems later on!"
Jim Sylvester
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter *****
June 4, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Food recipes for disease conditions
2. Anabolic steroid abuse and its consequences
3. Reader submitted Q&A - MD refusal of well-baby care
4. Tampons and asbestos and dioxin rumors
5. Free resources for women on cancer chemotherapy
6. Health tip to share - Relieving eye strain
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Food recipes for disease conditions
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
WholehealthMD.com has a place called a Healing
Kitchen. You can choose from many diseases and
conditions and they will print out a set of
recipes that have foods containing high levels of
vitamins and nutrients that have been shown to
help that condition.
For example if you would click on the drop down
menu and choose PMS, there is a display of recipes
high in calcium, magnesium and vitamin B6, Vitamin
E and zinc. The first three mentioned have all
been shown to improve PMS in randomized trials.
Vitamin E and zinc have weaker evidence but are
likely to benefit PMS.
The best part is the recipes. They list the
following recipes, among others, that are high in
the above nutrients and therefore should help PMS:
California Pizza
Chicken with Spinach & Cheese
Golden Vegetable Risotto
Lasagna Arrabbiata
Pasta with Spinach & Tuna
Taosenos Cornmeal Casserole
Turkey Sausage Pizza
Sauteed Greens with Garlic & Herbs
Homemade Granola
Kale & White Bean Pasta with Almonds
Spinach & Paneer over Brown Rice
Pasta with Sardines & Fennel
Chicken & Winter Squash Tagine
Stir-Fried Pork & Tofu
Spicy Kale & Potato Soup
Sicilian-Style Toasted Quinoa
Baby Bok Choy with Shiitake Mushrooms
Pork Mole
Thai Green Chicken Curry
Basmati Rice, Chick-Peas & Toasted Almonds
Tangerine & Avocado Salad
Wow. I'm ready to open a restaurant to tackle
medical diseases!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Anabolic steroid abuse and its consequences
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Some women, and many men, take steroid supplements
such as testosterone or DHEA or androstenedione
(street name Andro). If taken in small hormone
replacement doses there are usually no
complications and minimal side effects. Some
people get carried away with the doses especially
if they are trying to build muscle as part of a
bodybuilding program. About 2-3% of teenagers
report anabolic steroid use.
Another category that may abuse these steroids
have a behavioral syndrome called muscle
dysmorphia. In this condition a woman might think
she was fat and flabby even though others would
disagree. Also women who have been raped may be
more likely to use anabolic steroids.
There can be moderate health consequences in women
from using too high doses of these hormones:
increased hair growth and clitoral enlargement
acne increase
male pattern baldness
liver damage
heart attacks
tendon rupture
You may want to read about this at Behavioral
Health Online:
Anabolic steroid abuse FAQs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - MD refusal of well-baby care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is it against the law for a doctor to refuse to
attend to a baby for well-baby checks because the
parents refused to have the child vaccinated?"
No, its not against the law but the doctor has to
give you notice of ending the doctor-patient
relationship with enough lead time to arrange
other care.
You might want to check your state laws about
vaccinations too because many schools, day care
centers etc., have laws about children needing to
be vaccinated.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Tampons and asbestos and dioxin rumors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Every so often an internet email appears that
warns about how women are being exposed to
asbestos and dioxin in tampons. We have mentioned
this before but it does bear repeating.
The FDA has tested tampons and there are no
asbestos fibers in them. Dioxins are sometimes
found in wood products that have been bleached but
the FDA has determined that dioxin levels in
tampons are "are at or below the detectable limit.
No risk to health would be expected from these
trace amounts."
If you have concerns, you may want to look at
articles from the FDA.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Free resources for women on cancer chemotherapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Smith Kline Beecham Oncology, makers of an ovarian
cancer chemotherapy drug called topotecan
(Hycamtin[R]) have made available some videos,
books and booklets for women who may have to take
chemotherapy.
These materials are meant as supplements and are
not intended to take the place of treatment or
discussions with physicians, counselors, family or
friends. They are meant to educate you about the
complexities of the disease, its treatments and
the ongoing symptoms.
You can order the following patient information
materials free of charge as well as get more
information about each of these materials.
Holding on to the Light (Booklet)
Courage & Commitment (Booklet)
Solving the Puzzle of Fatigue: A Program for
Coping with Fatigue (Kit)
Waiting for Spring (Video)
Myths & Facts about Ovarian Cancer: What You Need
to Know (Booklet)
My Journey: A Personal Journal for Women Living
with Cancer (Journal)
What to Eat When You Don't Feel Like Eating (Book)
Health Journeys for People Undergoing Chemotherapy
(Audiocassette)
Understanding Chemotherapy (Booklet)
Affirmations for Getting Well Again (Video)
So Many Questions (Video)
Resource Guide for Patients (Booklet)
Free booklets and videos for ovarian cancer chemo
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Relieving eye strain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Close eyes, place ring finger directly below
eyebrows, near bridge of nose. Slowly increase
pressure for 5 seconds, gently release, repeat 2-3
times.
From Visiting Nurse Services in Westchester
Eye strain
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
An expectant mother was being rushed to the
hospital, but didn't quite make it. She gave birth
to her baby on the hospital lawn. Later, the
father received a bill, listing "Delivery Room
Fee: $675."
He wrote the hospital and reminded them the baby
was born on the front lawn. A week passed, and a
corrected bill arrived: "Greens Fee: $200."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter *****
June 11, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Latex allergy
2. What is the diagnostic work-up for hypertension?
3. Reader submitted Q&A - Recurrent yeast infections
4. Cervical infections and inflammations
5. Dandruff - what is it, what to do?
6. Health tip to share-Relaxation for panic disorder
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Latex allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Latex allergy is most often manifest by itchy
hands. Latex can produce a contact allergy, and
irritant dermatitis just like a poison ivy rash.
More severe reactions can be runny nose, sneezing,
itchy eyes, scratchy throat, and asthma. Sometimes
the reaction is not until 24-48 hours after the
exposure, so the connection between the cause and
the effect may be lost. Many household sources of
latex can be found such as: carpeting, racquet
handles, shoe soles, expandable fabric
(waistbands), dishwashing gloves, hot water
bottles, and even condoms and diaphragms.
Treatment is avoidance of latex of course. But
also there needs to be a knowledge of which of
many products in the home and workplace can have
latex as a component.
This site at the Center for Disease Control,
National Institute of Occupational Safety and
Health may help explain what to do if you suspect
a latex allergy.
Latex allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. What is the diagnostic work-up for hypertension?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When hypertension is diagnosed (blood pressure of
140 over 90 or higher), it is most frequently
classified in a category called essential
hypertension. That means that we do not know the
cause of it other than the blood vessels are just
constantly under an increased tension or
hypertonus. There are other types and causes of
hypertension that although much less frequently
occurring, may be amenable to different successful
treatments.
Causes may include kidney disease, anomalies of
the kidney arteries or the large aortic artery,
and tumors or hyperfunctioning of the adrenal
gland such as pheochromocytoma, Cushing's
syndrome, and primary hyperaldosteronism. While
none of these are as common as essential
hypertension, a woman needs to know what extent
of a diagnostic work-up should take place before
assuming there is no known cause beyond the
category of essential.
A chest x-ray, EKG and laboratory blood studies
comprise the basic work-up. The chest xray and EKG
look for heat enlargement which high blood
pressure can cause over time, and heart
abnormalities. A urinalysis looks for kidney
damage as does the blood test for creatinine. A
blood count looks for anemia. Serum potassium
looks for aldosteronism and blood glucose looks
for diabetes.
Hypertension diagnosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Recurrent yeast infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"How do you get rid of recurrences of yeast
infections? This is a constant thing every month.
I need help. I don't have sugar. I have been
tested for that as well as thyroid. I am 39 years
old and I have been to several doctors and so far
I haven't been able to shake this infection
completely. What other doctor should I go to
besides a Gyn physician? ".
Many women are plagued with recurrent yeast
infections. Some of those women have a recurrent
irritant vulvitis rather than yeast vaginitis so
it is important to confirm the diagnosis with
yeast cultures.
There are risk factors for this such as oral
contraceptive use, diabetes or carbohydrate
intolerance, antibiotic or steroid use. Many
times, however, the stimulating events are not
obvious.
Dermatologists will often treat a vulvar
dermatitis as well as gynecologists.
Lifestyle habits, bodily care regimens and
prophylactic medical treatments to prevent
recurrence are discussed:
Chronic Recurrent Yeast Vaginitis - What Can Be Done?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Cervical infections and inflammations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most of the concern with diseases of the cervix
have to do with abnormal Pap smears and the
possibility that changes of cervical dysplasia may
go on to become an invasive cervical cancer. We
often forget about or treat lightly infectious
conditions of the cervix because they tend to
cause less symptoms and sometimes just clear up
their own without treatment.
The following tutorial about infectious and
inflammatory conditions of the cervix from the
Health Sciences Center at the University of
Virginia School of Medicine make interesting
reading if you have ever had an abnormal Pap with
inflammatory changes or if the doctor has
mentioned any cervicitis or other cervical
changes. They list:
noninfectious (nonspecific) cervicitis
chlamydia trachomatis cervicitis
herpes simplex virus (HSV) cervicitis
human papilloma virus (HPV) Infection
They point out that nabothian cysts (plugged
mucous glands) can develop from the cervical cells
trying to heal over that nonspecific inflammation
in a process called metaplasia. Another
interesting point is that herpes cervicitis
produces a watery discharge.
Cervical infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Dandruff - what is it, what to do?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dandruff is basically dead skin that is being shed
from the scalp. That happens all of the time for
everyone, but in some people, the production rate
of skin cell turnover increases.
A small yeast organism, Pityrosporum ovale, has
been shown to be associated with dandruff. The
question is whether it is a primary cause or
whether it just grows well where there is dead
skin. No one knows for sure.
The treatment can range anywhere from just washing
the hair twice a week with a shampoo formulated
for dry scalps, to using a selenium based, anti
dandruff shampoo, to using a shampoo with anti
yeast agents in it such as ketoconazole (Nizoral
[R]).
If there is any flaking around the eyebrows, nose
or in back of the ears, or you have a red, itchy
scalp, it is time to see a dermatologist or your
general physician.
Dandruff
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Relaxation for panic disorder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I suffer with panic disorder. I have learned to
listen to my body. When I notice my heart rate
beginning to raise or the thoughts start to come
into my mind, or general felling that something is
wrong, I have learned that the best thing to do is
concentrate on lowering my heart rate. Sort of
mind over body. I have warned my family and
friends that I feel the attack about to happen.
They keep a close eye on me without me knowing
that they are doing it. Most of the time I can
stop it if I catch it early enough. Deep
breathing, concentration, and basic relaxing
techniques. seem to be the best help."
Tracie
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Short ones
"Doctors automatically know what's wrong with you.
They have a sick sense." -- from a kid, age 10
"Doctor, Is it true that taking an aspirin every
day prevents heart attacks?"
"Yes, to prevent a heart attack take one aspirin
every day. Take it out for a jog, take it to the
gym, take it for a bike ride,,,,,"
"Doc, I can't stop singing "The Green Green Grass
of Home."
"That sounds like Tom Jones syndrome."
"Is it common?"
"It's not unusual."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
or sign up
Post a comment