Women's Health Newsletters 12/03/00 - 12/31/00
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****** Woman's Diagnostic Cyber Newsletter *******
December 3, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
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1. Acne in adults
2. Thyroid cysts
3. Reader submitted Q&A - Different BCP Effects
4. Vulvar cancer
5. Kidney stones
6. Health tip to share - Caffeine limits
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. Acne in adults
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women often wonder why acne can flare in the adult
years. Often it is related to too much
testosterone (male hormone) that comes from
medicines, e.g., certain progestins in oral
contraceptives, DHEA supplements, or from the
ovaries such as that seen with polycystic ovarian
disease. When testosterone is elevated, sebum skin
oil production and skin cell sloughing goes up and
this tends to clog hair follicle and sweat gland
pores.
Another cause, however is a decrease in estrogen
such as that seen around the menopause. When
estrogen decreases, sex hormone binding globulin
goes down and more testosterone is released into
the circulating system thus stimulating acne
development. If estrogen is adequately replaced at
the menopause, the acne (and increased facial hair
growth by the way) problem is not as bad although
it may not entirely go away.
Other measures of facial cleanliness, topical
cleansing compounds and general skin care must be
resumed just as it must with a teenager. To
understand how acne forms and how to care for it,
you might want to read this section at
innerself.com:
Acne
See also our patient instruction sheet on acne at:
Acne Prevention Skin Care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Thyroid lumps
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you tilt your head and chin up and put your
neck muscles on stretch while looking at your neck
in the mirror, you can sometimes see the outline
of your thyroid gland lying on both sides of your
windpipe (trachea). Usually the gland is not well
seen unless your neck is quite thin. If it is
easily seen, there may be diffuse enlargement
called a goiter.
The gland looks like an "H" shape with the
crossbar of the "H" lying about an inch or two
below the "Adam's apple". If you swallow while
your neck is on stretch, you can see the gland
move sometimes, but more importantly, you can see
if there is an asymmetry on the right and left
side of the trachea. This would indicate a nodule
or cyst in the thyroid gland.
In general women do not have symptoms from these
cysts (fluid filled) or nodules (a solid growth).
Usually the doctor picks up a possible lump and
then an ultrasound is ordered. A cyst will be
obvious on ultrasound but if it is a solid mass, a
needle biopsy will need to be performed because
solid thyroid nodules may be malignant whereas
fluid filled cysts are almost never cancerous.
If you think you might have a prominent thyroid
gland or a lump on one side or the other of your
neck, see your doctor to confirm whether or not
there is reason for concern. You may also want to
look at this page at the endocrineweb.com:
Thyroid nodules
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Different BCP effects
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 25 years old. I haven't had a period in
about 6 months but I don't want to get pregnant
now. I'm overweight and can't lose any, I am
always tired, have acne that I can't clear up, and
I have excess body hair. I have been put on birth
control pills but they haven't helped. What would
be the best brand of pills for me to be on for my
problem? Also, my pills cost $30.00 a month. Are
there any sources for free pills?" - Anonymous
Birth control pills (BCPs) have different doses of
estrogens and different doses of progestins. In
addition, the different progestins used in BCPs
range in their potencies from weak to strong in
their ability to affect a change in the lining of
the uterus. The progestins also have weak to
strong effects that simulate male hormones like
testosterone. Some progestins worsen acne and male
pattern hair growth while higher doses of estrogen
decrease acne and hair growth.
When your doctor changes you to a different BCP
because of a problem such as acne, break through
bleeding, absent or light menses, depression,
moodiness, weigh gain or other annoying side
effects, the decision is based upon the progestin
potency, androgenicity and estrogen dose of other
pills. Have you ever wondered why they change
women to the pills they do? See our article at:
Which Oral Contraceptive Pill is Best
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Vulvar cancer - the different types
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Vulvar cancer is most often found in women over 50
and peaks in incidence in the 60's and 70's.
Symptoms of vulvar cancer include only itching
that has persisted over a long time or lesions of
the vulva like moles, ulcers or just skin rashes.
If a woman has regular pelvic exams, vulvar cancer
can be found early.
There are several different types of vulvar cancer
that women can have.
squamous cell cancer (the most common)
vulvar melanoma
Bartholin gland carcinoma
Padget's disease
verrucous (wart-like) carcinoma
The only way to diagnose vulvar cancer is to take
a biopsy. While no one wants a biopsy in a
sensitive area like the vulva, it is important not
to let a vulvar irritation or ulcerous area exist
a long time without having such a biopsy to
confirm or deny a cancer.
Treatment of a vulvar cancer depends on the stage
of the cancer, i.e., how big it is, how deep into
the skin is goes and whether it has spread to
lymph nodes. Excision of the lesion and most of
the vulva can be performed for lesions that are
not too big. Sometimes radiation therapy is needed
to treat more advanced cancers.
The American Cancer Society has some valuable resource
pages on vulvar cancer.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Kidney stones and calcium oxalate
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Kidney stones develop from crystals that
precipitate out of solution in the urine and build
up on the inside of the kidney collecting system.
The urine naturally contains chemicals that
prevent or inhibit the crystals from forming.
These inhibitors do not seem to work for everyone,
however, and some people form stones.
A common type of crystal is calcium oxalate.
Sometimes on a urinalysis, oxalate crystals are
seen. While they are not significant in the
absence of symptoms, they may indicate that the
person is a stone former or has a tendency to form
kidney stones. Less common types of stones include
uric acid stones, cystine stones, or struvite
(infection) stones.
If a woman forms calcium oxalate stones then she
should eliminate calcium supplements and reduce
foods containing high levels of oxalates.
Chocolate. colas and coffee are high in calcium
and oxalates. For a longer list of food high in
calcium and oxalates and a more extensive
discussion of kidney stones, see this article at
Medemall.
Kidney stones
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Caffeine limits
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Caffeine in a diet is ok as long as it is not
excessive. More than 4 coffee servings per day
(500 mg or more caffeine) is associated with an
increased risk of heart attacks since caffeine is
a stimulant. Women with fibrocystic breast
conditions or a history of calcium oxalate stone
formation benefit from a zero caffeine intake per
day. Caffeine content of various products:
brewed (drip-method) coffee.....110-150mg
instant coffee.....40-108mg
brewed tea.....20-100mg
cola drink.....30-46mg
(other drinks mg of caffeine - Jolt 100.0, Afri-
Cola 100.0, Mountain Dew 55.0 (note - in Canada,
Mountain Dew has no caffeine), Diet Mountain Dew
55.0, Mello Yellow 52.8, Tab 46.8, Coca-Cola 45.6,
Diet Cola 45.6, Mr. Pibb 40.8, Dr. Pepper 39.6,
Pepsi Cola 37.2)
dark chocolate 1oz.....5-35mg
milk chocolate 1oz.....1-15mg
Excedrin.....130mg
Midol, Anacin.....65mg
aspirin, plain.....0mg
Dexatrim(weight control product).....280mg
No Doz.....100mg
To be safe, keep it under 300 mg of caffeine per day.
FRJ
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
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7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Top 10 Reasons Eve was Created"
10. Lord worried that Adam would frequently
become lost in the garden because he would not ask
for directions.
9. Lord knew that Adam would one day require
someone to locate and hand him the TV remote.
8. Lord knew that Adam would never go out and get
himself a new fig leaf when his seat wore out and
would therefore need Eve to get one for him.
7. Lord knew that Adam would never be able to
make a doctor's, dentist or haircut appointment
for himself.
6. Lord knew that Adam would never be able to
remember which night to put the garbage on the
curb.
5. Lord knew that if the world was to be
populated, men would never be able to handle the
pain and discomfort of childbearing.
4. As Keeper of the Garden, Adam would never
remember where he left his tools.
3. Apparently, Adam needed someone to blame his
troubles on when Lord caught him hiding in the
garden.
2. As the Bible says, it is not good for man to
be alone!
And finally, the number ONE reason that Lord
created Eve...
1. When Lord finished the creation of Adam, she
stepped back, scratched her head and said,
"Hmmm... I can do better than that."
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That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter *******
December 10, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Prevention of stroke
2. Pressure plus heat or cold helps headaches
3. Reader submitted Q&A - Constant bleeding
4. Toxic shock syndrome and tampon use
5. Laryngitis - How to care for it
6. Health tip to share - More caffeine
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. Prevention of stroke
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Stroke is the number two cause of death in the
world right behind ischemic heart disease (heart
attacks). Treating high blood pressure is the best
way to prevent a first stroke but after a person
has had one stroke, it is not clear at what level
that blood pressure treatment will prevent a
secondary stroke.
Lowering blood cholesterol concentration is
another way to prevent some strokes, so be sure to
have your cholesterol checked and treated if it is
elevated. A low fat diet rich in fresh fruits and
vegetables along with exercise and smoking
avoidance are also preventative for stroke. Once
you have had a stroke, however, it is not clear
that diet and exercise will prevent another
stroke.
Blood thinners such as aspirin (a baby aspirin a
day) can also help prevent strokes but only in
those who either have had a previous stroke or who
have high risk factors for a stroke. If you are at
low risk for stroke, aspirin therapy daily is NOT
beneficial and may even raise the incidence of
hemorrhagic stroke.
Stroke prevention
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2. Pressure plus heat or cold helps headaches
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Headaches have been a pain since the beginning of
time. Home remedies have often included applying
some sort of pressure to the head or putting a
tight band around the head. Hot and cold
compresses have also been used. This recent study
tested how heat and cold and pressure relieved or
lessened headache pain.
Fifteen headache patients were given headbands
that would contain a frozen (cold) or microwaved
(hot) gel pack and the band could be tightened by
pulling a tension strap. They recorded the pain and
duration of several headaches and then used the
bands with their choice of either hot or cold gel
packs for the next several headaches.
The pressure bands were rated as optimally
effective by 87% of the participants. The duration
of headaches without the headband but with a
patient's usual medication ranged from 2 to 8
hours. Headache duration while using the band
ranged from 0.67 to 2.83 hours, a definite
improvement.
Pressure, Heat, and Cold Relieve Headaches
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Constant bleeding
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have had my period almost constantly for the
last 13 months. I've gone to 2 doctors and they
both seem to agree that I am too young to have a
hysterectomy. I am 50 years old. I have always had
a heavy period. In addition to the constant period
I also have a prolapsed uterus and I have problems
with my bladder sticking out slightly. I have a
little pain (It would have to incapacitate me
before I would complain). I have had back problems
on and off for most of my adult life (the last 10
years being the worst). Another major problem is
anemia caused by the constant loss of blood. I had
a D&C 2 months ago. My period started
approximately one month later and I've had it ever
since (this past week it is almost back to normal
(meaning heavy at times). I started PremPro® when
my period started after the D&C. I thought the
PremPro® was suppose to stabilize the period. I
have approximately 1 week of pills left. How long
should I wait before I tell the doctor that a
hysterectomy is warranted? I was thinking that if
I still have a constant period for the next
several months would a hysterectomy be reasonable?
At present I am using a pessary which is helping
with the bladder/uterus problem. I am taking iron
pills and vitamin B-12. " - Lyn
Age 50 is not too young for a hysterectomy but you
do have several options. The bleeding problems can
be controlled with hormonal therapy or even
endometrial ablation. The prolapse of the uterus
and bladder can be helped by a pessary like you
are using or it may be improved by surgery. The
hysterectomy is only an incidental part of that
surgery.
With both a bleeding problem and the pelvic organ
prolapse problem, surgery including a hysterectomy
may be the most practical choice for you but you
might want to look at our article below to see the
options.
Treatment of Constant Vaginal Menopausal Bleeding
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Toxic shock syndrome and tampon use
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sometimes the question comes up about using
tampons for vaginal discharge and how long can
they be left in before being at risk for toxic
shock syndrome. Toxic shock syndrome is rare
occurring in 1-2/10000 women or less. It is
primarily due to an infection with staphylococcus
although sometimes a streptococcus can be
associated.
Toxic shock syndrome is also associated with high
absorbency tampons. The manufacturers suggest you
use the lowest absorbency possible. Choose one
that is fully absorbed (no white fiber showing) at
about 4 hours. If it is fully absorbed before 4
hours you should consider one with higher
absorbency. If there is still an area of white
showing at 4 hours, you might try a lower
absorbency tampon.
Some manufacturers recommend alternating tampons
with pads so a tampon is not always being used.
This is a safe recommendation but no one knows if
it is really necessary. The essence is not to
leave a tampon in so long that it erodes the
vaginal skin lining allowing any bacterial toxins
into the blood stream. Tampons can be left in over
night for 8 hours but should be immediately
changes upon rising.
All of these above rules apply to tampons and
menses. While you can use them for blocking a
vaginal discharge that irritates the vulvar
region, there is a greater chance with a discharge
that a bacterial infection is present so I think
it would be much safer not to use a tampon
repetitively without a break of several hours using
a pad if necessary.
Using tampons
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Laryngitis - How to care for it
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Laryngitis is most often due to a viral infection
although occasionally it can be due to a bacterial
infection requiring antibiotics. It can cause
voice loss for several days. Most people spend
those days seeking relief from the throat
tickling, scratchiness, and rawness they feel.
In addition to avoiding irritants such as tobacco
smoke or alcohol, there are measures you can try
for relief:
herbal teas such as slippery elm or licorice
zinc lozenges
vitamins C and B complex
herbal gargles
If its really bad though, ask the doctor for a
steroid inhaler.
Caring for laryngitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - More caffeine
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In our last tip about caffeine excess (500 mg or
more/day is an overdose), it was pointed out that
we neglected to include mochas and lattes in the
caffeine limits health tip - "...espresso is
America's latest and greatest legalized
trafficking..."
Caffeine in various coffee preparations (mg)
Expresso 1.5 to 2 oz.....100 mg
Peet's Latte 8 oz.....96 mg
Starbucks Mocha 8 oz.....63 mg
Spinelli Espresso 2 oz.....108 mg
Starbucks regular drip 8 oz.....233 mg,
Spinelli regular drip 8 oz.....217 mg
Peet's regular drip 8 oz.....192 mg
Caffeine content
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women's Bumper Stickers
-=-=-=-=-=-=-=-=-=-
Here are some of the latest in bumper stickers for
women!
- So Many Men, So Few Who Can Afford Me.
- God Made Us Sisters, Prozac Made Us Friends.
- If They Don't Have Chocolate In Heaven, I Ain't
Going.
- My Mother Is A Travel Agent For Guilt Trips.
- Princess, Having Had Sufficient Experience With
Princes, Seeks Frog.
- Coffee, Chocolate, Men ... Some Things Are Just
Better Rich.
- Don't Treat Me Any Differently Than You Would
The Queen
- If You Want Breakfast In Bed, Sleep In The
Kitchen.
- Dinner Is Ready When The Smoke Alarm Goes Off.
- I'm Out Of Estrogen - And I Have A Gun.
- Warning: 6 Minutes Til Next Mood Swing.
- And Your Point Is?
- I resemble that comment!
- Warning: I Have An Attitude And I Know How To
Use It.
- Of Course I Don't Look Busy...I Did It Right The
First Time.
- Do Not Start With Me. You Will Not Win.
- You Have The Right To Remain Silent, So Please
Shut Up.
- All Stressed Out And No One To Choke.
- I'm One Of Those Bad Things That Happen To Good
People
- How Can I Miss You If You Won't Go Away?
- Sorry If I Looked Interested. I'm Not.
- If We Are What We Eat, I'm Fast, Cheap And Easy.
- Don't Upset Me! I'm Running Out Of Places To
Hide The Bodies.
Contributed by: Nick, Chuck and Ross
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter *******
December 17, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Is snacking all that bad?
2. Thinking of getting breast implants?
3. Reader submitted Q&A - Abnormal Pap HGSIL
4. Skin care with incontinence
5. What is sciatica?
6. Health tip to share - Peanut butter benefits
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. Is snacking all that bad?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you are a compulsive overeater, snacking can be
harmful but it also has a role in a healthy
balanced diet. If the snack calories are part of
the overall daily calorie allowance and not extra
calories, they can actually help lower blood sugar
and insulin levels because of the smaller calorie
load at each feeding.
Of course it does depend upon what the snack foods
are. Certain snack foods can help provide added
vitamins and minerals. Nuts, sunflower seeds and
some dried fruits are helpful to boost iron
intakes. Fruits are rich in vitamin C and
fortified fruit juices can help increase iron
absorption by the body. Vegetable juices such as
the V8 Brand, carrot-juice based medley of drinks
contain beta-carotene and lycopene. Even tea and
hot chocolate drinks can provide antioxidant
flavonoids.
Cavities can be worsened if the snacks are all
carbohydrate based because mouth bacteria thrive
on carbohydrates and produce acid which dissolves
enamel and causes tooth decay. This can be a
downside of snacking. You can get around it by
chewing sugar free gum after any food. This
increases the flow of saliva in the mouth and
helps to neutralize acids. The xylitol in the gum
actually inhibits growth of the oral bacterium
Streptococcus mutans.
Snacking plays a role in helping athletes or any
adults who are exercising have improved physical
performance. Elderly people who may have
difficulty with large meals can benefit from
snacking and small meals to get the nutrients they
still need. So snacking itself is not always bad,
only if its quality and quantity are not
controlled.
The role of snacks
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2. Thinking of getting breast implants?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you are considering having breast implants but
you are not sure how likely they are to cause or
have complications, you may want to read this
Institute of Medicine (IOM) 1999 study of
silicone breast implant safety. They actually
found that the only complications of breast
implants were local complications and not systemic
diseases that were originally alleged to be a
problem.
Aside from normal surgical complications such as
infection, swelling, redness, bleeding and any
anesthetic problems, there are some unique local
problems that breast implants can be associated
with.
Scar tissue contraction in the capsule around the
implant can tighten and squeeze the implant and
form a very hard shell around the implant.
An implant can rupture and if it is silicone
filled, the silicone can escape and form nodules
and lumpiness around the breast. If the implant is
saline filled, the saline can also leak out but it
is resorbed in the body so the net result is a
deflation of the implant.
Other complications of the implants can also
sometimes occur:
pain
dissatisfaction with cosmetic results
infection
hematoma/seroma
changes in nipple and breast sensation
calcium deposits in tissue around implant
delayed wound healing
extrusion
necrosis
tissue atrophy/chest wall deformity
interference with mammography
unexpected milk production and leakage
As usual, when the list of possible complications
from any surgical procedure is written down, they
look so ominous that most people would say "no
way!" And yet many women have these transplants
and do not have problems. Read about these
possible complications but do not get too
discouraged if you are really interested.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Abnormal Pap HGSIL
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have had my first abnormal pap smear. It showed
'high grade epithelial lesions'. The ob/gyn said
that the LEEP is the next step, after my
colposcopy results are revealed. Does this mean
that I have just cervical dysplasia, or is it
really cervical cancer. I am scared, although I
have a family background of various types of
cancers on both sides of my family. " - Carol
A Pap smear that returns as a high grade squamous
intraepithelial lesion (HGSIL) is very unlikely to
be an invasive cancer of the cervix. But it is
possible, so a biopsy must be performed to see
what changes are actually present in the tissue.
Usually the biopsy returns with an indication of
either moderate or severe dysplasia of the cervix.
Treatment is recommended for advanced dysplasia
and often the treatment used is a LEEP procedure
in which the abnormal cervical tissue is removed
with an electrical wire cautery. For a discussion
of this, please see our article at:
HGSIL Lesion of the Cervix on Pap Smear
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4.Skin care with incontinence
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Patients who are bed-ridden often develop pressure
skin ulcers (bed sores, decubitus ulcers) from
skin break down brought on by incontinence of
urine or feces. We can learn from the principles
of skin care in these circumstances because many
cases of irritant vulvitis or painful vulva are due
to the same type of skin irritation before there
is a complete breakdown to an ulcerative
condition.
Water should be used to wash the area as soon
after any incontinence episode as possible.
Bacteria should not be allowed to remain in
contact with the skin for long periods of time.
The water should be warm but not hot. If any
cleanser is used, it should be one that does not
strip the skin of its normal oils and does not
need to be rinsed off. Normal soaps are
contraindicated; special no rinse, gentle
cleansers can be used. During cleansing, very
little force or friction should be applied to the
skin. Excessive rubbing can cause skin break down.
Finally some type of skin protector should be
applied which seals out further external bacteria
and moisture. Unscented petrolatum gel or non
mineral oils such as vegetable oil, olive oil or
other essential oils such as grape or jojoba may
be used to protect the skin until the next
cleansing.
Skin care with incontinence
You may also want to look at our patient
instruction sheet for chronic vulvar pain and
irritant vulvitis which incorporates these above
principles.
Tips for Chronic Vulvar Pain Management
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. What is sciatica?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sciatica refers to pain going down the sciatic
nerve. Often it is a shooting pain or a shock that
goes from the low back and hip down the back of
the thigh, down into the leg. It is often due to a
herniated disc although sometimes it is due to
muscle spasm compressing the sciatic nerve farther
from the spine.
An MRI is used to diagnose a disc problem. If it
does not show a herniated disk, the pain can be
caused by one of several other problems.
1. Sacroiliitis
2. Lumbar Facet Joint Syndrome
3. Piriformis Syndrome
4. Iliolumbar Syndrome
5. Lumbar Spinal Stenosis
For explanations of these above conditions, you
may want to visit spineuniverse.com
What is sciatica?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Peanut butter benefits
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Peanut butter frequently gets a bum rap as a food.
It contains many vitamins and minerals and its
protein content is 24%. While it is true that
peanut butter is 50% fat, it is mostly
monounsaturated, or the "good fat" that's also
found in olive oil and canola oil. In two
tablespoons, a normal serving, there is the
following content:
Nutrient Percent (amount)
Daily
Value
Calories 10% (190 calories)
Protein 13% (8g)
Fiber 8% (2g)
Total Fat 24% (16g)
unsaturated 29% (13g)
saturated 13% (3g)
Vitamin E 22% (2mg)
Niacin 24% (4mg)
Folate 7.5% (30mcg)
Vitamin B6 8% (0.15mg)
Thiamin (B1) 3% (0.04mg)
Magnesium 15% (52mg)
Phosphorus 13% (104mg)
Copper 9% (0.17mg)
Potassium 7% (244mg)
Iron 6% (0.62mg)
Zinc 6% (0.91mg)
Calcium 2% (13mg)
Peanut Butter Nutrient Analysis
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Mary was married to a male chauvinist. They both
worked full time, but he never did anything around
the house and certainly not any housework. That,
he declared, was woman's work!
But one evening Mary arrived home from work to
find the children bathed, a load of wash in the
washing machine and another in the dryer, dinner
on the stove and a beautifully set table, complete
with flowers. She was astonished, and she
immediately wanted to know what was going on.
It turned out that Charley, her husband, had read
a magazine article that suggested working wives
would be more romantically inclined if they
weren't so tired from having to do all the
housework, in addition to holding down a full-time
job.
The next day, she couldn't wait to tell her
girlfriends at the office. "How did it work out?"
they asked. Mary said. "Charley even cleaned up,
helped the kids with their homework, folded the
laundry and put everything away. I really enjoyed
my evening."
"But what about afterward?" her friends wanted to
know. "It didn't work out," Mary said. "Charley
was too tired."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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