Women's Health Newsletters 1/07/01 - 2/4/01
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****** Woman's Diagnostic Cyber Newsletter *******
January 7, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
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1. Allergies during the winter
2. Pelvic reconstructive surgery complications
3. Reader submitted Q&A - Hair loss with BCPs
4. Sleep disorders with weight loss or gain
5. Controlling dust mites
6. Health tip to share - Cherries relieve gout
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. Allergies during the winter
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Those who live where there are 4 distinct seasons
often find relief from seasonal allergies during
the winter months. Since many seasonal allergies
are due to pollen and molds in the air, winter may
very well make the allergies go dormant too.
Sometimes, however, the allergic symptoms can be
as bad or worse during winter season.
Other common allergy causes are animal hairs and
dust mites. People with these allergies can worsen
in winter as the cold weather confines one to
inside the house more. Bedrooms can be the worst
source of dust mites. Special dust covers for
pillows and mattresses may help. Smoking or even
second-hand smoke is taboo for those with
allergies. It often worsens breathing problems as
much as a cold can do.
Antihistamines are the mainstay of treatment
although during the day, non sedating ones need to
be used. Prevention by avoiding the triggers of
allergy is essential to the degree that it can be
done.
Allergies in the winter
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2. Pelvic reconstructive surgery complications
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Pelvic reconstructive surgery refers to
gynecologic surgery that fixes uterine or vaginal
prolapse, cystocele, rectocele, enterocele, stress
incontinence or other pelvic support defects.
Compared to hysterectomy, these surgeries have
higher complication rates.
A recent study from Johns Hopkins indicated that
there may be as high as a 47% complication rate
and a 15% hospital readmission rate following
pelvic reconstructive surgery. This includes
readmission for recurrence of the the same or
another prolapse problem. Patients who had had
previous surgical reconstructive procedures or
those who had moderate amount of blood loss were
the ones who had more complications.
Pelvic reconstructive surgery can fix a long term
disabling problem but it should not be undertaken
lightly. Be sure to ask your doctor about what
complications are possible and how frequently they
occur.
Pelvic reconstructive surgery complications
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3. Reader submitted Q&A - Hair loss with BCPs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 25 and have had severe alopecia areata since
I was about 4 years old. In July, I started taking
Mircette birth control pills. Would my taking
these pills have anything to do with the recent
worsening of the alopecia?" M.
Yes and no. Birth control pills can stimulate hair
growth while changing the normal growth cycle
duration of hairs. The net result in some women is
a generlized loss of hair about 3-4 months after
starting the pills. This loss should be general,
all over the scalp and not patchy like alopecia
areata. It goes away on its own after 2-3 months.
To see how hormones can effect hair growth and
other causes of hair loss, see our article at:
Hair loss with birth control pills
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4. Sleep disorders with weight loss or gain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sleep apnea, a condition where breathing stops for
10 seconds or more during sleep, is more common
among males who are overweight and snore. More and
more, however, women are also being diagnosed with
sleep apnea. Any woman who has poor sleep should
be checked for this. Weight changes can
significantly affect the incidence of sleep
problems.
During sleep apnea, oxygen levels decline and
finally the sufferer awakens. This gives a very
disturbed sleep causing multiple awakening
episodes as well as night sweats, daytime fatigue
and sleepiness as well as irritability.
A recent study tracked almost 700 men and women
over 4 years to see how weight gain or weight loss
affected sleep apnea. They found that relative to
stable weight, a 10% weight gain was associated
with a 32% increase in the apnea index. A weight
loss of 10% was associated with a 26% decrease in
the apnea index.
Sleep disorders and weight change
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Controlling dust mites
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dust mites are a common cause of allergies. They
rank second behind pollen in the cause of
allergies. Mites are invisible to the naked eye
and are related to ticks and spiders rather than
insects. They often feed on the shed skin
particles of humans. Their own shed skin and feces
are the substances that cause allergic reactions.
Since mites tend to live in mattresses, pillows,
bed clothes and favorite sofas and chairs, those
are the places that need cleaning and sealing.
Control measures may include:
Enclose mattresses, box springs and pillows in
zippered allergen- and dust-proof covers.
Wash all bedding materials including blankets and
mattress pads every other week in hot water (130
deg F).
Avoid using any cloth window dressings or cloth or
pendants on walls.
Remove carpeting from the bedroom of the allergic
person and replace it with tile or wooden floors.
Replace upholstered furniture with wooden or
plastic furniture.
Vacuum often with a vacuum cleaner provided with a
high efficiency purifying air (HEPA) filtration
system.
Filters on the air ducts do not help with mites
because they cannot live in air ducts or anywhere
away from moisture and food in bed, carpet or
cloth fibers.
Controlling dust mites
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6. Health tip to share - Cherries relieve gout
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I've proven this theory which I read in the
Prevention (magazine) Encyclopedia, published
about 23 years ago. My husband had severe gout in
his big toe when we married. His Dr. had given
him a medication which was not relieving it much.
I had already begun my trek into natural
alternatives to man-made drug remedies and had
purchased the Prevention Encyclopedia.
The remedy for gout is as follows:
10 black cherries a day (when in season) until
gout disappears. When not in season, drink 8-10
oz. of black cherry juice per day (may be found in
health food stores and some supermarkets).
I know this works, because we tried it twice.
Since the second administration of treatment,the
gout has never returned. And, my husband no
longer has a diet high in fat.
C.H.
[editor note - Low protein diet, normal weight
maintenance and no alcohol are also mainstays of
gout prevention]
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
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Picture of Health
-=-=-=-=-=-=-=-=-=-
A woman walked up to a little old man rocking in a
chair on his porch.
"I couldn't help noticing how happy you look," she
said. "What's your secret for a long happy life?"
"I smoke three packs of cigarettes a day," he
said. "I also drink a case of whiskey a week, eat
fatty foods, and never exercise!"
"That's amazing," the woman said. "How old are
you?'
He thought for a moment, and replied, "Twenty-six."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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****** Woman's Diagnostic Cyber Newsletter *******
January 14, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Self-help for a cold
2. Dry eye syndrome
3. Reader submitted Q&A - Menopause and sleep
4. Mood side effects from different progestins
5. Frostbite is a serious problem
6. Health tip to share - Low carbs make difference
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. Self-help for a cold
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The common cold is amazingly not yet curable. Its
symptoms of a runny nose with clear mucous,
sneezing, sore throat, a dry cough, and a slight
fever (but not usually higher than 101 F), last
about 3-7 days.
Cold are contracted in two major ways:
1) from other people who may sneeze or cough
around you and their aerosol droplets containing
virus are inhaled into your lungs
2) or from contact with those viral droplets on
objects that have been touched by people with
colds such as door knobs, money, towels, drinking
glasses, and then your "contaminated" hands come
in contact with your nose or mouth where the virus
is inhaled or put into the mouth.
Some people are more immune than others to these
viruses and it takes a larger total number of
viruses in the droplets of moisture to infect them
with a cold. Others, whose immune system is
compromised, catch a cold with fewer amounts of
virus.
It follows then that to prevent colds, you should:
Wash hands frequently and always before eating
Do not share eating and drinking items with others
Keep your immune system in good shape:
Get plenty of sleep.
Eat a well balanced diet.
Get plenty of exercise.
And perhaps use Vitamin C supplements which may
increase your resistance or decrease cold symptom
severity
It is also not out of line to ask closely located
co-workers (school mates) who come to work with a
cold to wear a mask if they insist on working and
coughing near you.
During this winter season, you may wish to look at
the self-care tips and reasons for when to see the
doctor in this article from the University of
Missouri-Rolla Student Health Service.
Self-help for a cold
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2. Dry eye syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The most common cause of dry eyes that a
gynecologist sees is menopause. With falling
estrogen levels, tears change in their composition
and amount. Even with adequate hormonal
replacement therapy, the eyes may still be dry.
Many women, more so than men, have dry eye
syndrome for reasons other than menopause. Certain
prescribed medications such as anti bowel or
bladder spasm meds, thyroid conditions, vitamin A
deficiency, and diseases such as Parkinson's and
Sjogren's Syndrome can also cause dryness. House
or environmental conditions that are hot, dry or
windy can produce dry eyes. Cigarette smoke can
irritate the eyes and just working long hours in
front of a computer can dry your eyes if you do
not blink enough.
Tears are not just water. they are actually
composed of mucous, water with some salts and
protein, and oil which helps keep the tear
adherent to the surface of the eye. As people age,
less oil is produced in the tear.
The solution to dry eyes often includes the use of
preservative-free, artificial tear solutions if
the primary dry eye cause can not be totally
reversed. If you have any problem or concerns
about dry eyes, you may wish to review the subject
at St. Luke's Cataract & Laser Institute web site:
Dry eye syndrome
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3. Reader submitted Q&A - Menopause and sleep
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 53 and having a terrible time falling
asleep. My doctor has prescribed Ambien® and
it is working. I would love to just be able to
sleep on a regular basis. Can I take this
medicine for a long period of time? Can I take it
on a regular basis? I have a great doctor, but he
is not one who wants to write prescriptions and
told me to check this information about sleep out
for myself."
"I do all the regular type of things to help i.e.
no exercise late, no caffeine, good sleep setting,
etc. I am on HRT also. None of these things seem
to work. I really think this is all menopause
related. I hate not sleeping. It makes life very
difficult. I still have children at home and
cannot just nap when I feel like it. Please help
me on this. Thank you." - Roxie
Sleep problems are more frequent as women (and
men) age. Menopause can worsen sleep problems if
estrogen is not adequately replaced. There are
two main categories of difficulties, insomnia and
sleep disorders.
For a discussion of these and what you can do to
improve sleeping, see our article at:
Sleep Problems, Menopause and Melatonin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Mood side effects from different progestins
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Practioners have often noticed that women have
more adverse mood symptoms (irritability,
depression, feel lousy) and physical symptoms
(abdominal bloating, achiness) according to the
amount and type of progesterone or progestin they
are taking when using either oral contraceptives
or menopausal hormone replacement therapy (HRT).
Finally we have a scientific study that looks at
this factor. Investigators looked at 51 menopausal
women who were taking hormone replacement. They
all received the same estrogen compound and dose
and about half received medroxyprogesterone
acetate (equivalent to Provera(R)) while the other
half received norethindrone acetate (equivalent to
Aygestin (R) and also in Activella(R), FemHRT(R),
and BCPs Estrostep(R) and LoEstrin(R)).
The study found that women who had a history of
PMS responded strongly (negatively) to both
progestins. In women without a history of PMS,
medroxyprogesterone acetate produced less negative
mood symptoms but more negative physical symptoms
than norethindrone acetate.
This information will be helpful to women who are
having side effects such as mood problems or
bloating with oral contraceptives or HRT. It also
reaffirms that PMS symptoms are more likely due to
progesterone secretion in the 2nd two weeks of the
menstrual cycle. Women who have PMS symptoms while
taking birth control pills may want to ask their
physician to change them to a pill with a
different progestin.
Mood side effects from different progestins
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Frostbite is a serious problem
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Frostbite can be serious. It may result in damage
like a third degree burn or even cause loss of a
limb. With winter sports activities or even just
becoming unexpectedly stuck in the snow, you may
need to worry about the danger of cold exposure.
Frostbite can be divided into:
first degree - burning, stinging, aching,
throbbing of the skin that appears reddened and
swollen with possible peeling of skin about a week
later like a sunburn.
second degree - numbness and heaviness of the
affected area that appears as significant
swelling, blisters, black scabs.
third degree - Loss of sensation, area feels like
"woody" with purplish, blood-filled blisters
followed by dark skin discoloration and
subsequently death of the skin.
fourth degree - because of complete freezing of
skin, fat, muscle, and bone, the area is initially
quite red, and then becomes black before it needs
to be amputated.
Only when you are safely out of the cold should
you attempt treatment for frostbite. It is safest
to do this in the hospital. The affected area is
rapidly thawed in a water bath for 15-30 minutes.
Clear blisters are opened and topical treatment
using antibiotics and aloe vera (70%) are used.
Pain meds are given as well as a tetanus shot.
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6. Health tip to share - Low carbs make a difference
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have found that a low carbohydrate diet
virtually relieves all my aliments including gout,
bursitis, back pain, allergies, high blood
pressure etc. I have these problems only when
consuming too many carbohydrates which for me is
anything more than regular green, non-starch
vegetables." Theresa Ross
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A woman and a man are involved in a car accident;
it's a bad one. Both of their cars are totally
demolished but amazingly neither of them are hurt.
After they crawl out of their cars, the woman
says, "So you're a man, that's interesting. I'm a
woman.
Wow, just look at our cars! There's nothing left,
but fortunately we are unhurt. This must be a sign
that we should meet and be friends and live
together in peace for the rest of our days."
The man replied, "I agree with you completely.
This must be a sign!"
The woman continued, "And look at this, here's
another miracle. My car is completely demolished
but this bottle of wine didn't break. Surely God
wants us to drink this wine and celebrate our good
fortune."
Then she hands the bottle to the man. The man nods
his head in agreement, opens it and drinks half
the bottle and then hands it back to the woman.
The woman takes the bottle, immediately puts the
cap back on, and hands it back to the man.
The man asks, "Aren't you having any?"
The woman replies, "No. I think I'll just wait for
the police."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter *******
January 21, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Preventing medical errors
2. Acute macular degeneration of the eye
3. Reader submitted Q&A - My breast cancer risk?
4. Ovarian cysts
5. A child's response when a parent is sick
6. Health tip to share - Lysine for fever blisters
7. Humor is healthy
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1. Preventing medical errors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We have heard much about medical errors recently
and how they can affect your health care. If you
are concerned about finding a competent doctor,
you will also want to know what you should do to
take an active role in avoiding any mistakes in
the care you receive.
"Twenty Tips to Prevent Medical Errors" has some
helpful suggestions to make all members of your
health care team vigilant in avoiding mistakes.
Some of the highlights of the list include:
be an active member of your own care - know what
is going on
make sure you can read your doctor's prescription
and know what it says
ask for information about your medicine in terms
you can understand
in the hospital, make sure health care workers who
come in direct contact with you wash their hands.
more is not always better, you may be better off
without certain treatments or tests
The essence is to take an active role and know
what is being decided about your health care and
why it is being decided. Do not be afraid to ask
questions to clarify what was said or why
something was ordered. If laboratory tests were
ordered, find out the results. Don't assume that
no news means the results are normal.
Preventing medical errors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Acute macular degeneration of the eye
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The macula is the area of the eye on the retina
that is responsible for clear central vision. In
the next line, focus on the I in the center and
notice how the beginning "3" and the ending "2"
are out of focus.
3--------------------------I---------------------------2
With macular degeneration, focusing directly on
the "I" does not make it clear. It becomes cloudy
also and even wavy and can affect one or both
eyes.
The progressive loss of vision usually takes place
over a long time. There are two types, a dry type
and a wet type . The wet type has some hemorrhage
(blood) behind the macula while the dry type just
has loss of retinal cells.
The cause is not known other than aging although
there may be some genetic tendency toward the
degeneration of retinal cells. Women who take
estrogen replacement tend to have a lower
incidence of acute macular degeneration by about
50%.
Laser therapy can sometimes help the wet type but
for the most part there is not a known treatment.
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3. Reader submitted Q&A - My breast cancer risk?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Should I be worried about breast cancer? I am 26
and my maternal aunt died of breast cancer at the
age of 46. I have fibrocystic breast and I am
taking Loestrin(R) 1.5/30 birth control pills?"
- Joy
We are barraged with claims that some factor has
now been found to be a risk factor for breast
cancer. Whether it is dietary fat, alcohol use,
fibrocystic breast disease, estrogen use, birth
control pill use, or even working the evening
shift, it becomes very confusing how much each of
these conditions actually increase risk.
An accurate risk prediction calculator called the
Gail Model has been developed and it does not
include many of the factors that you might think
put a woman at risk. This is because when the
important risks such as age, family history of
cancer and previous biopsies etc., have been
accounted for, these other conditions do not
change your risk.
For a discussion of what risk factors you should
be concerned with, see:
Should I be worried about breast cancer?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Ovarian cysts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With the benefits of technology come the hazards.
Doctors order pelvic ultrasound studies for many
reasons and our current ultrasound machines can
find small follicle cysts that are actually normal
eggs developing in the ovary. The radiologist may
report these as "cysts" -- implying an abnormal
finding -- when in fact they are totally normal
structures expected to be present.
In fact any simple cyst in the ovary measuring 2.5
cm (one inch) or less is most likely to be a
normal egg follicle. After eggs are released
(ovulated), a corpus luteum gland (which looks
like a cyst on ultrasound) is formed. It may range
normally from about 2.5 cm up to 5 cm).
When an ultrasound study reports an ovarian cyst,
what does it mean? There can be non physiologic
cysts like endometriosis or benign neoplasms of
the ovary that measure 5 cm or less but since most
physiologic cysts are that size, the usual
treatment is to wait and see if the cyst goes away
or gets smaller over time. This is determined by
repeating the ultrasound study in approximately 6
weeks. If the cyst is not smaller or gone in that
time. Further therapy may be needed.
For a discussion about ovarian cysts, see this
page at ppphealthcare.co.uk :
Ovarian cysts
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5. A child's response when a parent is sick
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you or your spouse have to go to the hospital,
what does your child think? What should you tell
the child? A child under the age of 8-10 may too
selfish or irrational to just accept that dad or
especially mom won't be there for awhile to take
care of them. They may even resent the lack of
attention.
If you come down with an illness or have to have a
hospitalization, do not just tell the child
"everything is going to be ok." They can see that
it is not ok or that you are quite worried and
preoccupied. They imagine a sudden loss of love or
even a total loss of the sick parent and fear
abandonment.
It is best to very concrete with a young child.
Tell them you will need to be in bed for x days to
rest so that you will be able to take care of
them. If you have to go to the hospital give a
careful explanation of how long it will be and
what is happening. Accept all the help that is
offered to you in terms of child care. The least
you change a child's routine, the more accepting
they are of the unknown situation.
You may want to check out this site at
Indiaparenting.com
When a parent is sick
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6. Health tip to share - Lysine for fever blisters
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"If you are troubled with fever blisters. The
remedy is simple. Take a L-Lysine tablet every
day. I once had real bad fever blisters and since
doing this I have not had a single one." Marian
[editor note - There are several positive studies
showing 1000 - 1200 mg/day of L-lysine is
effective in reducing both oral (cold sores) and
genital herpes. There have been a few negative
clinical trials also, so it may not work for
everyone.]
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Anxious to comply
When Joe was seated in the doctor's waiting room
and anxious to get his visit over, he said to the
person seated next to him "May I see the doctor
first, I think rigor mortis is setting in."
When he got in to see the doctor, the doctor asked
him if he had been staying on his low cholesterol
diet. Joe quipped that his wife had been feeding
him so many vegetables that yesterday he was
sitting on the back porch and his body started
leaning toward the sun.
When he came home from the doctor looking very
worried. his wife said, "What's the problem?"
Joe said, "The doctor told me I have to take a
pill every day for the rest of my life."
She said, "So what? Lots of people have to take a
pill every day their whole lives."
He said, "I know, but he only gave me four pills!"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter *******
January 28, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Pain in the ball of your foot
2. ASCUS Pap smears over age 50
3. Reader submitted Q&A - Hemorrhoid care
4. PMS treatment
5. Exercise and stress
6. Health tip to share - Calcium for sleep loss
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. Pain in the ball of your foot
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chronic pain in the ball of the foot is called
metatarsalgia because it is at the base of the
metatarsal bones of the foot where they connect to
the toes. The most common cause is poor fitting
shoes, especially women's dress shoes and other
shoes that are too tight across the ball of the
foot.
The cause of the pain is inflammation of the
tendons and muscles around the bones. While anti-
inflammatory medicines like ibuprofen (Advil(R) or
naproxen (Alleve(R)) help immediately, the
treatment is to get foot ware that fits better.
Shoes that have a wider toe box and rocker bottom
soles that will take the pressure off the balls of
the feet are the solution.
There are also different orthotic foot products
that can help this problem. Be sure to seek help
if you are having this painful problem.
Metatarsalgia - Pain in the ball of the foot
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. ASCUS Pap smears over age 50
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Atypical squamous cells of undetermined
significance (ASCUS) on a Pap smear is a
disconcerting pain in the neck. It almost always
represents just normal cellular repair on a
slightly irritated cervix and mostly goes away
given time. When ASCUS Pap smears occur after
menopause it is often associated with low estrogen
levels. The Pap smear seems to improve after
estrogen is given.
This study looked at how often an ASCUS Pap smear
goes on to become worse and get classified as a
dysplasia as time goes on. They looked at the Pap
smears of 150 women over the age of 50 and an
equal number of matched control Pap smears from
women under the age of 50.
Subsequent Pap smears were followed to see how
many went on to indicate cervical dysplasia. In
the women under age 50, dysplasia occurred in
almost 30% of subsequent Paps. In the menopausal
women, subsequent dysplasia occurred only about
13% of the time. Thus an ASCUS Pap smear after the
menopause is somewhat less worrisome than in
premenopausal women.
ASCUS Pap smears after 50
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Hemorrhoid care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have avoided going to the doctor for my
hemorrhoids by using over the counter remedies,
but it is becoming unbearable. I eat a high-fiber
diet but that has not helped either. Is there
anything else I can do before I make that
embarrassing doctor's appointment?" rf
It depends upon what you have already done and
what are your risk factors for the hemorrhoids. Do
you have a constantly sitting job or a heavy
lifting one? Are you often constipated? Do you
have medical problems such as obesity or chronic
lung disease?
Any condition that predisposes to hemorrhoids
should be changed or brought under control as much
as possible. Then dietary change that makes the
stool lubricated and soft as well as promoting a
bowel movement every day or every other day, is
the next step. Topical creams and ointments may
need to be used to provide relief until the
predisposing factors can be corrected and the
body heals the dilated veins on its own.
Taking care of hemorrhoids
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. PMS treatment with Chasteberry extract
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chasteberry extract is from the plant vitex or
Agnus castus. As far back as Roman times,
Chasteberry was thought to suppress sexual desire.
Young girls wore the blossoms to show they were
remaining chaste.
More recently it has been used to treat breast
pain called mastalgia and PMS. Up until now there
have not been any randomized clinical trials
comparing this extract with placebo. Now there
have been reported two studies that are
randomized, double blind placebo controlled
trials. Both show clinical effectiveness of the
Chasteberry extract when used to treat PMS.
This extract does not have plant estrogenic or
progesterone properties like soy or red clover.
Instead, it has a mechanism of action that lowers
serum prolactin by preventing pituitary prolactin
release.
The doses used in the two studies below were 20 mg
tablets daily of a special extract, Ze 440,
manufactured in Germany.
PMS treatment with agnus castus fruit extract (BMJ)
PMS treatment with agnus castus fruit extract (Arch Gynecol Obstet )
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Exercise and stress
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Exercise always seems to lower stress. How does it
do that? The traditional teaching is that it helps
the physiological signs of stress such as heart
rate or blood pressure. It does do that. When
stress raises heart rate and blood pressure, these
physiological signs tend to stay elevated and
prolong the feeling of stress.
After exercise, the body naturally resumes a lower
baseline blood pressure and heart rate because the
"fight or flight" hormones, epinephrine and
norepinephrine are depleted from the exercise. The
physiological feeling of stress disappears after
exercise and cannot resume for a certain amount of
recovery time.
There is another field of thought about stress and
exercise. The major reduction of stress may be
more psychological than physical. In other words
by choosing to exercise on a regular basis, you
take more control over your life. Stress results
from our feeling of loss of control of events in
our lives. When we take control the stress gets
better or goes away.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Calcium for sleep loss
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Regarding your comments on loss of sleep due to
HRT/menopause. I was having the same
problems/symptoms due to a recent hysterectomy. I
am 38, and my 46 yr. old sister who is in
menopause was having the same problem. She
suggested taking your daily calcium in liquid
form, found at the local health food store, in a
little bit of warm milk before bed. Worked great
for her and has for a year. Unfortunately, my
store was out so I started chewing my Viativ (R)
nightly with a cup of sleepy time tea. I can now
profess to a wonderful 7-8 hours of sleep per
night with no nap during the day........since I
have a 2 yr., this has been a miracle cure for
me!!" - katie
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
What A Man Really Means When He Says...
--submitted by Barb (Celina, OH)
"I can't find it."
MEANS
'It didn't fall into my outstretched hands, so I'm
completely clueless.'
"That's women's work."
MEANS
"It's dirty, difficult and thankless."
"Will you marry me?"
MEANS
"Both of my roommates have moved out, I can't find
the washer, and there is no more peanut butter."
"It's a guy thing."
MEANS
"There is no rational thought pattern connected
with it, and you have no chance at all of making
it logical."
"Can I help with dinner?"
MEANS
"Why isn't it already on the table?"
"It would take too long to explain."
MEANS
"I have no idea how it works."
"I'm getting more exercise lately."
MEANS
"The batteries in the remote are dead."
"We're going to be late."
MEANS
"Now I have a legitimate excuse to drive like a
maniac."
"Take a break, honey, you're working too hard."
MEANS
"I can't hear the game over the vacuum cleaner."
That's interesting, dear.
MEANS
"Are you still talking?"
"Honey, we don't need material things to prove our
love."
MEANS
"I forgot our anniversary -- again."
"You expect too much of me."
MEANS
"You want me to stay awake."
"It's really a good movie."
MEANS
"It's got guns, knives, fast cars and naked
women."
"You know how bad my memory is."
MEANS
"I remember the words to the theme song of
'F-Troop,' the address of the first girl I kissed,
the Vehicle Identification number of every car
I've ever owned, but I forgot your birthday."
I was just thinking about you, and got you these
roses."
MEANS:
"The girl selling them on the corner was a real
babe, wearing a thong bikini."
"Oh, don't fuss. I just cut myself. It's no big
deal."
MEANS
"I have actually severed a limb, but will bleed to
death before I admit I'm hurt."
"I do help around the house."
MEANS
"I once threw a dirty towel near the laundry
basket."
"Hey, I've got reasons for what I'm doing."
MEANS
"And I sure hope I think of some pretty soon."
"What did I do this time?"
MEANS
"What did you catch me at?"
"She's one of the rabid feminists."
MEANS
"She refused to make my coffee."
"I heard you."
MEANS
"I haven't the foggiest clue what you just said,
and am hoping desperately that I can fake it well
enough so that you don't spend the next 3 days
yelling at me."
"You know I could never love anyone else."
MEANS
"I am used to the way you yell at me, and realize
it could be worse."
"You really look terrific in that outfit."
MEANS
"Please don't try on one more outfit. I'm
starving."
"I brought you a present."
MEANS
"It was free ice scraper night at the game."
"I missed you."
MEANS
"I can't find my sock drawer, the kids are hungry
and we are out of toilet paper."
"I'm not lost, I know exactly where we are."
MEANS
"No one will ever see us alive again."
"This relationship is getting too serious."
MEANS
"I like you almost as much as I like my truck."
"I don't need to read the instructions."
MEANS
"I am perfectly capable of screwing it up without
printed help."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
****** Woman's Diagnostic Cyber Newsletter *******
February 4, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. In mild hypertension, headaches not sign of high BP
2. Glucosamine sulfate for osteoarthritis
3. Reader submitted Q&A - Rapid heart rate
4. Polycystic ovarian disease and pregnancy
5. Diverticular disease of the colon
6. Health tip to share - Getting to sleep
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. In mild hypertension headaches not a high BP sign
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most people assume that headaches are a sign that
blood pressure is elevated in someone who has mild
hypertension. Actually this is not borne out in
studies that have looked at a person's blood
pressure at the time a headache is present. They
do not find a blood pressure elevation during the
headache.
The argument among experts has been that perhaps
the blood pressure increase preceded the headache
and thus it is missed by the time a headache is
noticed and the blood pressure recorded. This
study, reported in the Archives of Internal
Medicine, used 24 hour ambulatory blood pressure
monitoring in 76 patients with mild hypertension.
They found that 33% of the patients had headaches
during the monitoring period. Their average 24
hour blood pressures were not different from the
patients who did not have headaches. Also, the
blood pressures before and after the headaches
were not changed at all.
The significance of this study is that the absence
or presence of a headache cannot be used as a sign
that the blood pressure is or is not in control.
Headaches in mild hypertension
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Glucosamine sulfate for osteoarthritis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Both chondroiten sulfate and glucosamine sulfate
have been advocated for a while as nutritional
supplements for osteoarthritis. A recent study in
Lancet using 1500 mg of glucosamine sulfate a day
for 3 years shows that progressive loss of joint
space did not take place in subjects who took
glucosamine whereas it significantly took place in
those who took placebo.
Joint space, which shows up as distance between the
bones on xray, is occupied by cartilage. Cartilage
provides the cushion between the bones and is worn
away in the case of osteoarthritis. This
scientific confirmation of the effectiveness of
glucosamine will benefit many older women who are
plagued with the pain of osteoarthritis.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Rapid heart rate
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been to the doctor and have my pulse
checked. My resting pulse is 96. The doctor
takes it again, and it is the same. He looks
puzzled, but doesn't say what it is or if it is
bad. Sometimes while laying down I can feel
different pulses feel like they are going to jump
out of wherever they are pounding. What to do?
I'm 47 and am Synthroid tablets. I thought I was
going through menopause last year, but that
straightened itself out." - Brenda
The normal resting heart rate is between 60 and
100. Yes, some women naturally have higher heart
rates without any disease process. The fact that
your pulses feel pounding, however, suggests it is
not normal for you.
Common causes of elevated heart rate include:
too much thyroid medication, hyperthyroidism,
anxiety, cardiac arrhymias (especially premature
ventricular contractions - PVCs), and
deconditioning.
Deconditioning refers to having a chronic lack of
any aerobic physical activity, i.e., being quite
far "out of shape".
Your doctor will want to recheck your thyroid
function (serum TSH) to make sure you are not
getting too much Synthroid [R] medication. He may
also want to have you do a 24 hour heart monitor
to check for heart arrhythmias. You should be able
to tell if anxiety or deconditioning are playing a
role. There are some other more rare causes of
increased heart rate so be sure to keep working
with your physician until you have a cause.
Heartbeat sensations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Polycystic ovarian disease and pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Not much is known about the obstetric outcome of
women who have polycystic ovarian syndrome (PCOS)
and finally become pregnant. The main concern is
that women with PCOS have increased insulin
resistance and thus may have more gestational
diabetes. They may also have more preeclampsia or
other pregnancy problems.
This study looked at 99 patients with PCOS who got
pregnant and what their outcomes were. There was a
higher percentage of twin pregnancies (9.9% vs
1.1%) in women with PCOS versus controls.
Presumably this was because of fertility pills and
shots used to induce ovulation. There were also
more women with first pregnancies (nulligravid)
among the women with PCOS. All of the data was
corrected for these differences.
The investigators found that there was a higher
incidence of gestational diabetes in the group
with PCOS (20% vs 9%). There was no higher chance
of preeclampsia or premature labor when taking
into account the difference in multiple
pregnancies and first babies.
Therefore, the main unique obstetric risk factor
for women with PCOS is a higher incidence of
gestational diabetes; most other major pregnancy
risks are similar to the general female
population.
PCOD and subsequent pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Diverticular disease of the colon
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Diverticula occur as we get older -- usually after
age 50. They are sac-like protrusions that form
along the length of the colon that may look like
multiple appendices. If they do not get inflamed,
there are usually no symptoms although sometimes
even without inflammation they can give symptoms
of diarrhea or constipation and cramps like
irritable bowel syndrome.
When diverticula become inflamed it is called
diverticulitis. This infection can present like an
appendicitis with fever, chills, nausea and pain.
The main difference from appendicitis is that the
pain presents predominantly in the left lower
abdomen rather than on the right.
Treatment for acute diverticulitis is
hospitalization with intravenous fluids and
antibiotic therapy. Surgery may have to be
performed if medical treatment does not resolve
the inflammation in three or four days or if there
is evidence of bowel perforation or abscess
formation.
If you get irritable bowel symptoms after age 50,
be sure not to miss your periodic screening
sigmoidoscopy or colonoscopy that will not only
check for colon polyps, but also can check for
diverticula.
Diverticular disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Getting to sleep
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If I am stressed out, I have a difficult time
trying to get to sleep at night. I have tried
this routine, and it works great!
1) Take a nice warm mineral bath with an soothing
aromatherapy candle
2) Make yourself some SleepyTime(r) tea
3) Rub Sleepwell(tm)on the back of your neck and
shoulders(www.thymes.com)
4) Turn off the TV and get into bed with a good
book.
You'll sleep like a baby! Do this every night, not
just when you are stressed-out! Pleasant
dreams...zzzzzzzzzzzzzzzzzzzzzzz
Suzanne
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are several men sitting around in the locker
room of a private club after exercising. Suddenly
a cell phone on one of the benches rings.
One of the men picks it up, and the following
conversation ensues:
"Hello?"
"Honey, it's me. Are you at the club?"
"Yes."
"Great! I am at the mall two blocks from where you
are. I just saw a beautiful mink coat. It's
absolutely gorgeous!! Can I buy it?"
"What's the price?"
"Only $1,500.00."
"Well, OK, go ahead and get it, if you like it
that much..."
"Ahhh, and I also stopped by the Mercedes
dealership and saw the new models. I saw one I
really liked. I spoke with the salesman, and he
gave me a really good price...and since we need to
exchange the BMW that we bought last year..."
"What price did he quote you?"
"Only $60,000..."
"OK, but for that price I want it with all the
options."
"Great! But before we hang up, something else..."
"What?"
"It might look like a lot, but I was reconciling
your bank account and...I stopped by the real
estate agent this morning and saw the house we had
looked at last year. It's on sale!! Remember? The
one with a pool, English Garden, acre of park
area, beach front property..."
"How much are they asking?"
"Only $450,000 -- a magnificent price...and I see
that we have that much in the bank to cover..."
"Well, then go ahead and buy it, but just bid
$420,000. OK?"
"OK, sweetie ... Thanks! I'll see you later!! I
love you!!!"
"Bye...I do too..."
The man hangs up, closes the phone's flap, and
raises his hand while holding the phone and asks
to all those present,
"Does anyone know who this phone belongs to?"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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