Women's Health Newsletters 6/18/00 - 7/30/00
***** Woman's Diagnostic Cyber Newsletter ***** June 18, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Your community's environmental pollutants 2. Dipstrip testing for UTI not always accurate 3. Reader submitted Q&A - Perimenopausal bleeding 4. The first menstrual period 5. Sleep apnea symptoms and treatment 6. Health tip to share - Icing an amputated thumb tip 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. Your community's environmental pollutants ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Environmental Defense has a database at scorecard.org which lists community pollutants as reported by businesses and governmental agencies. You can enter your zip code and see which businesses are releasing large quantities of potentially polluting compounds into the air, soil and streams. You can find out where in the U.S. or for your community area, there are: potential land contamination sites chemical air pollutants criteria (gases) air pollutants animal waste from farms manufacturing chemical releases There is also a section on the health effects of the different chemicals. Lead exposure can produce menstrual disorders and infertility. Carbon disulfide, mercury and PCBs (polychlorinated biphenyls) also can cause menstrual irregularities. You may want to know what chemicals are possible problems where you live. See: Environmental pollution maps and info ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Dipstrip testing for UTI not always accurate ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ There are several ways in which urine is tested to see if there is a urinary tract infection (UTI). The gold standard test is a urine culture but because of expense we often try to shortcut by looking at the urine microscopically, doing a gram stain for bacteria or now, dipstrip testing of the urine looking at nitrites and leukocyte esterase. In pregnancy there is dilatation of the urinary tract which makes women more susceptible to urinary infections so that testing for bacteria in the urine is almost routine to prevent more serious kidney infections. This study in the American Journal of Gynecology looked at the different methods of UTI diagnosis in pregnancy. They found that the dipstip test (nitrites and leukocyte esterase), which is the most commonly used test in doctor's offices, picks up about 50% of infections but if it is combined with a microscopic urinalysis, then it picks up about 80% of infections. The study recommends always doing a urine culture to diagnose infection. Conversely, if a woman suspects she has a urine infection, a negative result on a dipstrip of the urine should not mean that no treatment is given. Urine testing on pregnancy for UTI ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Perimenopausal bleeding ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "I have been having a menstrual cycle for the past month and had one last August too. Any information??? Still ongoing and today with clots passing and great rushes of discharge." "I am 46 and my menses were normal until about 10 months ago. " Sara Perimenopausal bleeding is often due to anovulation problems that occur as the ovaries become depleted of eggs. Because the chance of endometrial cancer starts rising above 1% in women over 40, investigations must be undertaken to rule out precancerous or cancerous changes before instituting any hormonal therapy. Diagnostic procedures may involve ultrasounds, endometrial biopsies or even hysteroscopy and D&C. Treatments for bleeding not due to anatomical lesions can include injectable or oral progestins, oral contraceptives, or even danazol. Vitamin supplements may also play a role in reducing prolonged bleeding. See our article at: Prolonged perimenopausal bleeding ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. The first menstrual period ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Concern and even fear about that first menstrual period that a young girl will have, needs some practical answers. At Redspot, there is a great section on beginning menses that would be appropriate to direct a daughter or friend to. I like the first section on fast facts. It has brief answers to many questions such as when will I start?, how much blood will there be?, is it really blood?, Will my period hurt?, will I get cramps?, does menstrual fluid really smell bad?, what if I am caught by surprise?, how long will it last?, what is a normal period?, how do you count your cycle?, will I have periods the rest of my life? and many other questions that mentors might fail to address. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Sleep apnea symptoms and treatment ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Do you tend to fall asleep at boring meetings, in the late afternoon or in early evening? That may be normal or it may be the results of sleep deprivation from episodes of apnea (stopping breathing) during nighttime sleep. When you fall asleep on the phone or are unable to drive more than 30-60 minutes in a car without stopping and doing something to try to "wake up", then you may well have sleep apnea. It can be associated with hypertension and even heart failure or heart arrhythmias. Mostly though, it affects your work and social relationships. Treatment varies as to whether the cause is an obstructive airway problem, a central brain problem or a mixture of both. Sometimes positive pressure masks will help or dental appliances that help hold the tongue forward. Occasionally laser surgery in which part of the soft palate is removed can also improve the frequency of apnea episodes. This is a treatment that is used for loud snoring also. All persons (2% of women and 4% of men) with sleep apnea snore. But not all snorers have sleep apnea. For a very good overview of symptoms, treatment and prognosis of sleep apnea, see: SLEEP APNEA Society of Alberta ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - Icing an amputated thumb tip ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "I recently sliced off about 1/4 the width of my right thumb (outer side). I knew about putting severed parts/pieces on ice and taking it to the emergency dept. When I started to do this, I thought about the ice being "old" for such a use, so I put the piece into a "snack-size" zip-lock bag, zipped it up, and placed this into a larger bag which contained the ice, along with some water, to promote an even cooling process. It turned out that they could not have used the piece of thumb if it had been placed directly in the ice water, it would have been dehydrated, possibly contaminated. The piece was sewn back on, fingernail and all and on the 16th day, the hardened outer piece came off and, although the piece is numb but "tingley", it's going to look just fine. The only other alternative would have been to amputate enough of the tip of my thumb to gain enough skin to pull over the end and suture in place. This is information that a person would have to know at the time of the accident, there's not much time to spare." K.R. [Editor note] Here is thanks for a previous tip: "I just wanted to say 'Thank You' to the woman who submitted the health tip regarding heavy menses and taking vitamin C. Timing was perfect. I had a regular appointment with my gyn doctor and ran it by her, and I then tried it, and it worked. Thanks again. M.R. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Medical Shorts Sign in the obstetrics ward of a hospital: "Research shows that the first five minutes of life can be most risky." Underneath someone had scrawled: "The last five minutes aren't so great either." M Kushnir, MD 4/8/99 What do you get when a patient upon examination presents with signs of insomnia, dyslexia, and agnosticism? A patient who stays up all night wondering if there is really a DOG!!! Dr. Schlesinger 2/18/99 In the course of a visit for another problem, my patient referred to the herbal remedy she had recently taken for her cold symptoms. "I sure felt better after taking 'euthanasia'(echinacea)!" Bryan Cummings, MD 2/12/99 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** June 25, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Miscarriage rate rises significantly with age 2. Colorectal cancer facts 3. Reader submitted Q&A - Post hysterectomy probs 4. Brain attacks - TIA to strokes 5. Recommendations for thyroid screening 6. Health tip to share - Chronic yeast infections 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. Miscarriage rate rises significantly with age ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ We have known for many years that the chance of losing a pregnancy due to miscarriage, stillborn or ectopic pregnancy rises quite a bit with age. How much it rises has been somewhat difficult to quantify. The following article in the British Medical Journal looked at over 1.2 million births in Denmark and measured the loss rates. They found the following miscarriage rate (spontaneous abortion) by age. Age Rate 12-19 13.3%; 20-24, 11.1%; 25-29, 11.9%; 30-34, 15.0%; 35-39, 24.6%; 40-44, 51.0%; over45 93.4%. Maternal age and fetal loss ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Colorectal cancer facts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In the case of the colon, most malignant tumors develop from benign polyps. This is not true in the uterus or cervix however. Endometrial polyps and endocervical polyps infrequently become malignant but this is not true in the gastrointestinal tract. Cancer of the colon and rectum is the third leading cause of cancer deaths behind lung and breast. It causes about 3% of the annual deaths in the U.S. Colonoscopy is the best screening test although checking the stool for occult blood is the easiest but with a lot of false positives. This site on colorectal cancer at cancerfacts.com has some good anatomical drawings that help explain where the colon is in the body. It also has a listing of symptoms to look for such as: a prolonged change in bowel habits narrowing of the stool a feeling of fullness after bowel movements crampy abdominal pain blood in the stool Colorectal cancer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Post hysterectomy probs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Since my hysterectomy 4 1/2 months ago, I experience bleeding after intercourse. Is this normal? It is a small amount of fresh blood, bright red. Is it possible that I have not healed internally yet? " I am age 45. My menstrual history was normal and the hysterectomy was performed because of a large rapidly growing fibroid tumor." - S.B. Why don't doctors tell you all the things that can happen after hysterectomy? Because there are actually quite a few symptoms that are normal but disappear with time and a large list of rare but possible complications that might turn you off. You need to know about all of them, however. For a discussion of what to expect, see our article at: Expectations of post hysterectomy recovery ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Brain attacks - TIA to strokes ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is it possible for a stroke to last only 5-20 minutes. Yes. There is a type of mini-stroke called transient ischemic attacks - TIAs. Any lack of oxygen to the brain can cause similar symptoms. If the cause is temporary, the symptoms may be temporary. If there is a permanent loss of blood supply such as a blood vessel that clots off or hemorrhages in the brain, the symptoms are either permanent or last until any healing takes place. Symptoms can be: blindness in only one eye arm/leg weakness, numbness, or paralysis confusion or loss of balance speaking or understanding difficulty facial paralysis or numbness sudden severe dizziness There are some treatments that can help minimize the effects of strokes or possibly prevent them once you have the problem. Therefore it is important to recognize the symptoms and see a doctor right away if you suspect a problem. Brain attacks ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Recommendations for thyroid screening ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The American Thyroid Association has come out with recommendations for screening for thyroid dysfunction. Basically they recommend that adults begin having thyroid screening using a blood thyrotropin hormone test (serum TSH) at age 35 and every 5 years after. It is more important for women to have this because they have a higher incidence of thyroid diseases, but this testing can even be justified in men. This is a NEW recommendation so be sure to let your doctor know if it is five years since your last thyroid checkup. Guidelines for Detection of Thyroid Dysfunction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - Chronic yeast infections ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I was once plagued by chronic yeast infections. The Cure? Taking 350 mg of Acidophilus 3 times every day. It worked for me. I haven't had one since. anonymous If you have discovered ways of coping with a disease or condition and it works for you, please share it with us: /healthtip.htm Health tip suggestion form ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ HOW TO KEEP A HEALTHY LEVEL OF INSANITY 1) At lunch time, sit in your parked car and point a hair dryer at passing cars to see if they slow down. 2) Put your garbage can on your desk and label it "IN." 3) Put decaf in the coffee maker for 3 weeks. Once everyone has gotten over their caffeine addictions, switch to espresso. 4) In the memo field of all your checks, write 'for sexual favors.' 5) As often as possible, skip rather than walk. 6) Sing Along at the opera. 7) Go to a poetry recital and ask why the poems don't rhyme. 8) Find out where your boss shops and buy exactly the same outfits. Wear them one day after your boss does. (This is especially effective if your boss is the opposite gender.) 9) Call the psychic hotline and just say, "Guess" 10) When the money comes out of the ATM, scream "I Won!", "I Won!" "3rd time this week!!!" 11) When leaving the Zoo, start running towards the parking lot, yelling "Run for your lives, they're loose!" 12) Every time you see a broom yell "Honey, your mother is here" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 2, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Colas associated with teen bone fractures 2. Accutane for acne and birth defects 3. Reader submitted Q&A - Constipation 4. Trichomonas profile 5. Health related hoaxes and rumors 6. Health tip to share - Vitamin B2 for migraines 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. Colas associated with teen bone fractures ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Physically active teen girls who consume colas and other non-cola carbonated beverages have over 3 times the risk of having a bone fracture than physically active girls who do not drink colas. This is according to an article in the Archives of Pediatrics and Adolescent Medicine. The authors do not know why this relationship holds. They speculate that since "teens have doubled or tripled their consumption of soft drinks and they have cut their consumption of milk by more than 40%" that they may not be getting enough calcium and therefore have brittle bones more susceptible to breaking. I'm not so sure it isn't due to a caffeine-induced over activity but then who knows. Again,epidemiological studies do not address cause and effect but rather identify associations we must learn from. Teenaged Girls, Colas and Bone Fractures ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Accutane for acne and birth defects ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Retinoic acid is an analog of vitamin A marketed under the trade name Accutane [R] for nodular acne, a very severe form. It has been known for many years to cause major birth defects and spontaneous miscarriages. In fact women who are prescribed Accutane are supposed to be on effective contraception. Years ago a registry was created for reproductive aged women who had the potential to become pregnant while taking the Accutane. 454,273 women enrolled in the registry from 1989 to October 1999 and approximately 900 women became pregnant. Many of these women had spontaneous miscarriages or babies with major birth defects if they did not choose to have the pregnancy terminated. The main reason for this article however, was to examine why a focus group of these women who had been warned about the consequences of Accutane and pregnancy still got pregnant. Major associations were: 1) over half had an episode of intercourse without being on contraception and 93% were not using 2 methods of contraception as they were supposed to by the protocol. 2) 20% had negative pregnancy tests before starting but still became pregnant before actually beginning the prescription. 3) about 15% got pregnant while using pills from a leftover previous prescription. 4) some purchased the drug in Mexico, bypassing the usual physician instruction safeguards. In the focus group of 14 women who became pregnant while using Accutane, 5 had induced abortions, 4 had spontaneous miscarriages, 4 had normal infants and 1 had a baby with major birth defects. Accutane and pregnancy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Constipation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "What causes a ripple in the colon? I have a problem trying to have a normal bowel movement. My doctor claims the rippling effect is causing blockage so the stool cannot come out. Is there anything that can be done for this problem?" "I am age 69, with Non-Hodgkins Lymphoma (in remission), taking Estrace ® for hot flashes. " - Lorrie Constipation is a symptom that may have many different causes. Although most of the time dietary and general living habits are responsible for constipation, sometimes there can be an inherent defect in the rippling motion of the colon muscle that produces constipation. Another cause may be a weakness of the rectum (rectocele) or an involuntary spasm of the anal sphincter muscle. For these and dietary discussion about different constipation causes, see our article at: Constipation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Trichomonas profile ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ With many sexually transmitted diseases, the question often comes up as to whether it is possible to contract the disease, such as trichomonas, HPV or bacterial vaginosis, by methods other than intravaginal intercourse. In other words can a woman get a trichomonas infection from a moist toilet seat, hot tub or swimming pool. The answer is that it is possible. One study showed trichomonads can survive up to 3 hours in water with varying concentration of minerals. And yet many women do not ever contract trichomonas in this way. It is probably best to consider trichomonas vaginitis as 98-99% a sexually transmitted disease. Look at our disease profile on trichomonas: Trichomonas disease profile ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Health related hoaxes and rumors ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The governmental unit called the Center for Disease Control (CDC) based in Atlanta, Georgia, USA has the charge to monitor and investigate instances of any small or large epidemics of contagious or communicable diseases. Their web site is a very rich source for recommendations about causes and treatments of bacterial, viral and parasite diseases. One of the interesting features on their site is a section called Current Health Related Hoaxes and Rumors. In it they comment about what investigation has actually been done about conditions or contagious "scares" that you may hear about and wonder what substance there is to them. Current examples are statements about: Does HIV Cause AIDS? (what ways can HIV be transmitted?) False Email Report: Hantavirus Spread by Contact With Soda Cans or Grocery Packages (a false rumor) False Email Report: Klingerman Virus (no such virus) False Internet Report: Bananas (no basis as far as CDC can tell) Needle Stick Hoaxes (one episode was documented but no subsequent instances) CDC's Health related hoaxes and rumors ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - Vitamin B2 for migraines ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I am an Ob-Gyn outside of Philadelphia. My wife has been a migraineur all her life and even though she has been on over 50 different meds including experimental ones, she was getting headaches every 7-10 days even on the SSRI's. I read an article last year about a small study in which migraine patients placed on 400 mg of vitamin B2 (Riboflavin) had a significant success rate in markedly reducing the frequency and severity of migraine. It took about 2 months to kick in. Well, in Feb of this year she decided to try it and after about 6 weeks, she suddenly went 5 weeks without a headache and the one she did get at that point was much less severe. I am happy to report hat since Feb, she has had a total of 3 or 4, all of which have been mild. So far no toxic effects have been observed. She is considering stopping the SSRI's to see if this continues. I need not tell you how exciting this discovery has been to us and I wanted to share this with other migraine sufferers! Louis E. Criden, M.D. [editor note - Here is a study I found supporting the above concept. I was not previously aware of it.] Vitamin B2 study on migraines 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ When Life Really Begins A geneticist, a lawyer, and a family counselor meet over lunch to decide once and for all when life really begins. The geneticist spoke first. "I've done many, many tests, and have come to the conclusion that life begins once the sperm and the egg unite." The lawyer spoke next. "I am a person who interprets the written law, and, therefore, I believe that life begins at different times depending on what state one lives in." "Well, I'm afraid that I must disagree with both of you," responds the family counselor. "Over the years, I've met with thousands of parents and attended dozens of workshops. I have come to the conclusion that you start living once your youngest child goes off to college and your dog dies." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 9, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Can testosterone really help women? 2 What is sarcoidosis? 3. Reader submitted Q&A - Kegel's for incontinence 4. Inverted nipples 5. Health tip to share - Ingrown toenails 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. Can testosterone really help women? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Women's Health Information Center at JAMA (Journal of the American Medical Association) has an article about the role of the male hormone, testosterone, in how women feel at all ages. We know that with surgical removal of the ovaries premenopausally there is a very sudden drop of testosterone and that may explain post op fatigue, lack of energy and libido problems, but the role of testosterone throughout a woman's life is not clear. Normal ranges for testosterone levels in women have been determined but very rarely do doctors measure these levels in looking for a deficiency state. Most insurance companies do not recognize deficiency states of testosterone in women and thus the cost of lab tests may not be covered. With scientific trials of a testosterone patch for women currently underway, this investigator feels that a testosterone deficiency state can explain the fatigue, loss of energy and decreased libido of many menopausal women. If you are interested in this topic, you may also want to reread our previous article on this subject. Will testosterone help menopausal symptoms? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. What is sarcoidosis? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sarcoidosis is a condition occurring more often in African-American women ages 20-40 in which small granulomas or lumps of inflammatory tissue grow in different areas of the body. No one knows the cause. These growths can alter the normal function of an organ like the lung or lymph nodes if there are too many of them growing in one place. The most common areas affected are the: lungs - causing shortness of breath or cough skin - raised, red bumps under the skin and near shins eye - causing teariness and redness lymph nodes - causing pain behind chest bone, fatigue joints - causing arthritis symptoms It is commonly suspected by an abnormal chest x-ray showing spots like old tuberculosis or other xrays like CAT scans showing lymph node swelling. Diagnosis is confirmed by a biopsy of a granuloma and its appearance under the microscope. About 50% of the time these granulomas clear on their own. In mild cases no treatment is needed. Sometimes, however, steroid treatment or other chemotherapy is needed. What is sarcoidosis? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Kegel's for incontinence ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Are the Kegel exercise devices found in many "home health" catalogs of any help in doing the exercises? " Evelyn Kegel exercises involve contracting the muscle at the opening of the vagina called the bulbocavernosus muscle. This helps strengthen the external urethral sphincter muscle which, in turn, helps to prevent loss of urine with straining, coughing or sneezing. The muscle exercises have been well described and are mostly taught now as isometric repetitive contractions without any devices. Devices have been used for many years to aid in this process and to help women identify the proper muscle to contract. Vaginal weighted cones have been successful and the devices placed in the vagina to provide resistance to contractions also probably help identify the correct muscle. Devices placed between the legs to contract with the thigh and buttock muscles are not likely to be helpful. For a discussion of Kegel's exercises, devices and an instruction sheet, see our article at: Kegel exercises and devices ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Inverted nipples ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Having breast nipples that are flat or inverted and don't come out is not as uncommon among women as you would think. When a woman has them all of her life, they are due to a congenital shortening of the ducts of the breast. Sometimes upon stimulation, the nipples can evert but again, it depends upon the degree of shortening of the ducts. Plastic surgeons can fix this problem but the surgery costs about $2000 a breast. This can also be a problem with breast feeding but usually it is overcome with practice and effort. Breast feeding with flat or inverted nipples ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Health tip to share - Ingrown toenails ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "For temporary (sometimes longer) relief of ingrown toenails, take a warm bath to soften nails, dry your feet and trim toenails. Then take the bar of soap and gently scrape it from the edge of the nail toward the foot at the corners of the nail. This causes a soft soap pacing to collect under the nail and it lifts the painful corners to give you relief. I usually do this before bed but I also do it during the day. It really gives me relief and I haven't had to see a doctor about it yet." DMG ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subject: Women's Dictionary Argument (ar*gyou*ment) n. -- A discussion that occurs when you're right, but he just hasn't realized it yet. Airhead (er*hed) n. -- What a woman intentionally becomes when pulled over by a policeman. Bar-be-que (bar*bi*q) n. -- You bought the groceries, washed the lettuce, chopped the tomatoes, diced the onions, marinated the meat, and cleaned everything up, but he "made the dinner". Cantaloupe (kant*e*lope) n. -- Gotta get married in a church. Childbirth (child*brth) n. -- You get to go through 36 hours of contractions; he gets to hold your hand and say "focus... breathe.... push...." Clothes dryer (kloze dri*yer) n. -- An appliance designed to eat socks. Diet Soda (dy*it so*da) n. -- A drink you buy at a convenience store to go with a half pound bag of peanut M&M's. Eternity (e*ter*ni*tee) n. -- The last two minutes of a football game. Exercise (ex*er*siz) v. -- To walk up and down a mall, occasionally resting to make a purchase. Grocery list (grow*ser*ee list) n. -- What you spend half an hour writing, then forget to take with you to the store. Hair Dresser (hare dres*er) n. -- Someone who is able to create a style you will never be able to duplicate again. See "Magician". Hardware Store (hard*war stor) n. -- Similar to a black hole in space: if he goes in, he isn't coming out anytime soon. Lipstick (lip*stik) n. -- On your lips, coloring to enhance the beauty of your mouth. On his collar, coloring only a tramp would wear. Park (park) v./n. -- Before children, a verb meaning "to go somewhere and neck." After children, a noun meaning a place with a swing set and slide. Patience (pa*shens) n. -- The most important ingredient for dating, marriage, and children. See also "tranquilizers". Valentine's Day (val*en*tinez dae) n. -- A day when you have dreams of a candlelight dinner, diamonds, and romance, but consider yourself lucky to get a card. Waterproof Mascara (wah*tr*pruf mas*kar*ah) n. -- Comes off if you cry, shower, or swim, but will not come off if you try to remove it. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 16, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Dry eye syndrome - Be aware of the causes 2. Vulvar pain (vulvodynia) vs vestibulitis 3. Reader submitted Q&A - 4. Bunion Background 5. Selecting exercise and sport shoes 6. Health tip to share - Recurrent yeast infections 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. Dry eye syndrome - Be aware of the causes ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dry eyes can occur from so many causes that there is actually an entity called dry eye syndrome. Gritty, red watery eyes are the main symptoms and many people are amazed that something can actually be done about them. Women may have dry eyes due to hormonal changes associated with pregnancy, lactation, oral contraceptives, menstruation, and post menopause. While no one knows for sure, it is probably a low estrogen state or one with an increased progesterone/estrogen ratio that makes eyes dry. Other causes are from the diseases of rheumatoid arthritis, diabetes, thyroid abnormalities, asthma, cataracts, glaucoma, lupus. Medications such as antidepressants, decongestants, antihistamines, antihypertensives, birth control pills, diuretics, ulcer medication, and tranquilizers can also cause eye dryness. The treatment is basically conserving a person's natural tears or adding artificial tears. If the condition is temporary then artificial tears may be the best treatment. The tear duct which drains away normal eye tearing can be plugged with a small device (punctum plug) and this may be a better long term treatment for some people with a chronic problem. If you are on birth control pills, you might ask your doctor to switch you to a pill with a lower progestin potency and a higher estrogen dose. The same is true of hormonal replacement therapy after the menopause. Raising the estrogen level and decreasing or changing the progestin may help. Dry eye awareness ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Vulvar pain (vulvodynia) vs vestibulitis ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Pain on the outside of the vagina (vulva) can be due to many causes. As a symptom, it is called vulvodynia. Sometimes you hear about a disease or condition called vulvar vestibulitis. You may wonder when a painful, sometimes burning vulva is vulvar vestibulitis and when is it just a symptom of some other condition. This FAQ page below gives an excellent history and differentiation of vulvar pain conditions. In vulvar vestibulitis, which is an inflammatory condition of the glands of the vestibule, the skin between the vulva and the hymen on the lower part of the vaginal opening usually presents with redness of the vulvar vestibule, especially with small red spots; pain with intercourse or tampon insertion and a stinging pain when urine touches the skin in that area. A second type of vulvodynia, similar to but different from vestibulitis, is like a constant irritation of the skin nerve endings (neuralgia). It presents with tingling and itching ranging from mild to severe and often involves the entire vulva. Its pain sensation does not require something to touch it to produce the pain. Finally, there are a host of other causes of vulvar pain and irritation such as candida vaginitis, genital herpes infections, vaginismus (spasm of the vaginal opening muscle), allergic or irritant reactions and many other less frequent but possible causes. Another very comprehensive links page about vulvar pain can be found at: Vulvar pain links ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Vitamin supplementation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Is 10,000 mg of Vitamin A too much to take per day? I am 69, happy and healthy and exercise 1 hour daily." - Evelyn The recommended daily allowances (RDA) of most vitamins and minerals are set at minimum amounts to prevent deficiency states. We have learned, however, that supplements of vitamins and minerals can help prevent certain diseases or even treat them just as prescription medicines can. If you are interested in what levels of vitamins are safe to take, please look at our article: Vitamin Intake - How Much is Too Much? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Bunion Background ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A bunion is a bone deformity of the great toe. Women are more susceptible to them because of wearing pointed shoes. As a woman gets older, arthritis can also cause this defect where the toe tip is deviated and pointing toward the other toes and the great toe base sticks out to the side making the foot wider with a painful compression of the toe base by any shoes. The American Society of Foot and Ankle Surgeons (podiatric physicians) has a very good fact sheet about bunions, what they are and how they are treated. There can be an hereditary predisposition to bunions so if your parents had them you may also develop them at sometime in your life. Treatments vary whether the deformity is mild or severe. Padding, inserts and medication may help, but sometimes surgery is need to really get the great toe back in line. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Selecting exercise and sport shoes ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ As long as we are on the subject of foot problems, and also to give the medical foot specialists (orthopedists) equal time, there is a very good review of how to go about selecting sports shoes for different activities. The American Orthopaedic Foot and Ankle Society produced this guide to help you find the best shoe to help you enjoy exercise and sports and lessen your chance of injury. For example, joggers need overall cushioning and heel control walkers need heel cushioning and rocker bottom design aerobics requires lightweight shoes with ball cushioning tennis requires side stability with inner/outer supports They also give some tips on buying: Don't go just by size. Have your feet measured Visit the shoe store at the end of a workout when your feet are largest Wear the sock you normally wear when working out Fit the shoe to the largest foot Finally, there are some suggestions about when certain painful foot conditions may benefit from a heel cup, an arch support or a metatarsal pad. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - recurrent yeast infections ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "I suffered from recurrent vaginal yeast infections, each month, for three years. I was tested for diabetes, and it was ruled out. I went to a surgeon that was going to be uplifting my bladder, and I mentioned to him about my fungus on my toenail and the yeast infections, as I was at wits end. He told me about his own toe/fungus and how he treated it. He prescribed Diflucan (R) one pill per week for one year. That was the end of the problematic yeast infections and the fungus toenail. This was five years ago, and have only had one yeast infection in all this time." DN ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Good Old Fred Fred had been faithful to his religion but was now in the hospital, near death. The family called their pastor to stand with them. As the pastor stood next to the bed, Fred's condition appeared to deteriorate and he motioned frantically for something to write on. The pastor lovingly handed him a pen and a piece of paper, and Ol' Fred used his last bit of energy to scribble a note, then he died. The religious leader thought it best not to look at the note at that time, so he placed it in his jacket pocket. At the funeral, as he was finishing the message, he realized that he was wearing the same jacket that he was wearing when Ol' Fred died. He said, "You know, Ol' Fred handed me a note just before he died. I haven't looked at it, but knowing Fred, I'm sure there's a word of inspiration there for us all." He opened the note, and read, "Hey, you're standing on my oxygen tube!" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** July 23, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Fitness routines - the ultimate workout 2. Facelift nips and tucks 3. Reader submitted Q&A - DES exposure liability 4. Toxic shock syndrome 5. A brief history of childbirth 6. Health tip to share - Cooling down a sunburn 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. You can now access our web site from most search engines or by just typing in your browser URL window - BACKUPMD or backupmd Browsers and search engines using Realnames will find us. This will not work for AOL users. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Fitness routines - the ultimate workout ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In fitness workouts, most women know about how to calculate their maximum heart rate (220 minus age) and then to monitor your exercise workout so that the heart rate is at about 75-85% of the maximum rate. But this does not tell you what type of workout to use. There are several to choose from. Interval training - varies the intensity up to high intensity with periods of low and medium intensity. Strength training - needs to include upper body pushing and pulling, knee straightening and bending, low back straightening and abdominal exercises. Muscular failure - repetitions of one movement until muscle exhaustion followed by another movement cycle of a rested muscle. Supersetting - alternate contraction and stretching of opposing (antagonist) muscles. Pre-exhaustion - paired exercises of large and small muscles of the same regional group. Stretching - between exercises helps flexibility and reduces soreness. Circuit training - fast repetitions of whole body exercises. Priority system weight training - entire muscle groups have a workout with rests in between to prevent exhaustion. Weight training alternating with aerobic training - bursts of aerobic activity interspersed for 1-3 minutes in between strength exercises. Remember that body fat is burned systemically, not from the area that is being exercised. Sorry! The ultimate fitness routine ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Facelift nips and tucks ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you ever worship the summer sun before you found out that life's skin wrinkles are mostly a result of long term sun damage? Ever think about a facelift to get rid of those jaw or neck wrinkles? Its possible to have a facelift at age 40 or 70 but having realistic expectations of what the results will look like is key to procedure success. Finding a good plastic surgeon is also important because each face is different and requires a "custom" procedure. There are some common incisions, however, and consistent postoperative bruising and puffiness. You may not want to be seen in public for awhile. Take a look at Mayohealth.org for an explanation and pictures. Facelifts - what to expect ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - DES exposure liability ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "I am a DES daughter, i.e., exposed in utero to a nonsteriod estrogen that causes cellular and formation defects in the reproductive system and possibly autoimmune, bone, and other problems. I have been told that the only successful lawsuits involve infertility or cancer. I would like to know why more cases are not settled in relationship to other known problems this drug has caused. My problems are related to a cellular defect (adenosis) caused by this drug." "The makers of DES claim adenosis has other causes. How prevalent was adenosis before DES was marketed, if the condition was known at all before this time? What are the other known causes? I have only heard of DES being the possible cause. I have also been diagnosed with a deformity called a hooded cervix which is also considered caused by DES drugs. " "Adenosis has caused continued periods AFTER a hysterectomy and sapped much of my energy all my life due to heavy irregular bleeding that caused chronic anemia. Recent research has shown that effects most likely can be passed down to future generations also. I have 3 children. Two with autoimmune problems and one with a gynecological problem. I would like to take the drug companies to court, but what are my chances? Is there any justice for us?" Actually there have been some lawsuits won against the manufacturers of DES for just adenosis problems and not cancer or infertility but awards would be expected to be higher if cancer or infertility are the injuries. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Toxic shock syndrome ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Except for the small increase in cases about 20 years ago when one type of super absorbent tampon was associated with toxic shock syndrome, this is actually a very rare disease. Anyone, even men and children can get this disease. About half the instances are from infections following burns, boils, insect bites or surgery. The other half are associated in women with tampon use. It is caused by a toxin produced by a staphlococcal infection of the vagina. Symptoms include the very sudden onset of a high fever (over 102 deg F), a sunburn like rash over the face and upper trunk and extremities. Vomiting, faintness, dizziness, diarrhea, and confusion are also symptoms which indicate a generalized systemic reaction to the toxin. It can lead in some instances to death. At the information site on Toxic Shock Syndrome in the UK, the following tips for using tampons are included: wash your hands before and after inserting a tampon change tampons regularly, as often as directed on the pack never insert more than one tampon at a time when using at night, insert a fresh tampon before going to bed and remove it on waking remove a tampon at the end of a period It may also be a good idea to intersperse the use of pads or liners in between tampon use. Toxic shock syndrome ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. A brief history of childbirth ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ We often forget how much the medical guidance of childbirth has changed over the centuries. The following brief medical history article by Dr. Ian Carr at the University of Manitoba in Manitoba Canada is very much worth reading. It guides us from the first early Cesarean sections in which women never survived, through the use of obstetrical forceps and operative maneuvers for obstructed labors. Until the time that it was realized that sepsis due to bacterial infection was the leading cause of death in childbirth, there were very poor survival statistics, at least as we currently experience them. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - cooling down a sunburn ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ When summer sun exposure gets too much and you develop a stinging sunburn, several remedies may help. Aspirin (if you are not allergic or on blood thinners) is better than acetaminophen or ibuprofen because it reduces the swelling and inflammation along with pain relief. Cool soaks or a cool bath as soon as coming out of the sun will help. Low dose steroid ointments available over the counter (with hydrocortisone for example) will help you get sleep at night but remember that pain from a burn is a signal not to go out in the sun again and if the pain is eased by steroid ointments, you still should not get more sun. Remember that the major risk factors for skin cancer (basal cell) include the lifetime number of blistering sunburns, being red-headed, and having blue, hazel or green eye color as opposed to brown. Ed. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are men quick about vasectomies? One day, after a man had his annual physical, the doctor came out and said, "You had a great check- up. Is there anything that you'd like to talk about or ask me?" "Well," he said, "I was thinking about getting a vasectomy." "That's a pretty big decision. Have you talked it over with your family?" inquired the doctor. "Yeah." said the man. "Well, what did they have to say about it?" asked the doctor. "They're in favour, 15 to 2." replied the man. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter ******* July 30, 2000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Multiple sclerosis facts 2. Growths on the vulva 3. Reader submitted Q&A - Can't void after surgery 4. Find a gynecologic cancer specialist 5. The music of healing 6. Health tip to share - Perineal odor 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. Multiple sclerosis facts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Multiple sclerosis (MS) is a weird disease because it causes episodic symptoms that seem to come and go. It strikes between the ages of 30-50 more often in women. Symptoms may be mild or severe as the disease goes through its exacerbations and remissions. While fatigue is a common symptom, although nonspecific, it is the loss of coordination, muscle weakness, spastic muscle contractions, numbness, slurred speech, and visual problems that finally bring a person to a doctor. Unfortunately, early in this disease, tests used to diagnose multiple sclerosis such as magnetic resonance imaging (MRI) may not yet be positive. This may make you think the symptoms are imaginary. It is not uncommon for symptoms to go on for two years or more before the diagnosis of MS is made. Be sure to take a look at MSfacts.org for more information about this difficult-to-diagnose condition. Multiple sclerosis fact sheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Growths on the vulva ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ We often get questions about a growth or sore area on the vulva near the vaginal opening of "what can it be?" It is very difficult to diagnose vulvar lesions without looking at it so most of the time the answer is to go see your doctor. Sometimes the web has descriptions with images to match so you can try to temporarily self diagnose. On many occasions the concern is about the possibility of genital warts or condyloma accuminata, a fleshy-like skin growth caused by the HPV virus. While many times a text description is adequate, in this case photos are very helpful in order to temporarily self-diagnose. At Dr. Koop's encyclopedia, there is a good page with images about condyloma accuminata. Condyloma accuminata ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Can't void after surgery ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Thirteen weeks ago I had a laparoscopic assisted vaginal hysterectomy and a bladder suspension using a sling. I have not been able to urinate since; I've been doing clean intermittent catheterization (CIC) to empty my bladder. The doctors say to wait six months to see if I will eventually urinate on my own. They believe my bladder is weak from years of drinking too much fluid and not urinating often enough. Are they being realistic that six months will cure this? Or should I save myself the trouble and have the sutures removed now?" "I am 43 years old and in good general health." Diane The inability to void urine after surgery can happen with a hysterectomy but it is more common after a procedure to correct urinary incontinence. It seems to occur more often after a certain type of anti-incontinence surgery called a sling procedure, but it can happen with any of the other procedures used. For a discussion of why this happens and what to expect about it clearing up with or without additional surgery, see our article at: Voiding difficulty after incontinence surgery ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Find a gynecologic cancer specialist ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ When a diagnosis of cancer comes, it comes suddenly. Some early stages of cancer can be treated by any gynecologic surgeon but if a cancer has spread, sometimes a specialist surgeon will make more effort to track down every possible group of malignant cells. At Women's Cancer Network there is a FIND A DOC database that has the gynecologic oncologists, women's cancer specialists, that you can look up by state. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. The music of healing ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Music therapy has a definite but under appreciated role in healing. Music is known to lessen the level of chronic pain and even improve or relieve depression. People who have had strokes and cannot talk have sometimes been to sing a favorite old song. Music certainly can relieve stress and its range of healing powers are probably not yet fully known. Be sure to include it in your daily life more than just to soothe road rage in the daily commute. The music of healing ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Health tip to share - Perineal odors ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I've found that drinking pineapple juice decreases perineal odors. Anon (Ed. note - please give us feedback on this one!) 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Catching The Virus" The "I Love You" virus that infects users of Microsoft's outlook has morphed. Watch for these variations: - The "I love you, too" virus: Responds with an appropriate letter stating that the user loves you as well. Spreads peace and harmony throughout the corporate workplace, causing lost productivity and chaos on Wall Street as no one tries to screw anyone else out of a deal. - The "I'm looking for more of a commitment" virus Receives the "I love you" virus email and immediately schedules a recurring event called "hold for my sweetie" for Friday and Saturdays into your calendar and the calendar of the person who sent the mail, registers you for a year of pre-paid videos at Blockbuster.com, and deletes any appointments called "Golf with the guys" or "Night out with the Girls." It also erases the phone number from the contact card for your 'ex', and puts in a monthly reminder for the anniversary of your first date. - The "Let's just be friends" virus - Immediately deletes the "I love you" virus, sends a "Let's Just be friends" response, and books you for a discount weekend at Hedonism at an online travel site. - The "Unsafe Sex" virus - Spreads unprotected files to every other hard disk on the net. - The "Safe Sex" virus - Wraps the "I Love You letter" in a container that keeps it from spreading 99.45% of the time. - The "Sexual Harassment Lawsuit" virus - Forwards a copy of the "I Love You" virus to Human Resources and to your lawyer with threatening legal language attached. Automatically accepts settlement offer e-mails over $100k. More variations are being discovered every day, so make sure you update your virus protection. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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