Women's Health Newsletters 9/23/01 - 12/2/01
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****** Woman's Diagnostic Cyber Newsletter *******
September 23, 2001
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Every two weeks from Woman's Diagnostic Cyber
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1. When to worry about an anxiety disorder
2. Living with lupus
3. Reader submitted Q&A - Irritable bowel syndrome
4. Different forms of osteoporosis
5. Insomnia among cancer patients
6. Health tip to share - Thyroid replacement on HRT
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. When to worry about an anxiety disorder
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Some amount of stress or tension is beneficial. It
stimulates us to complete necessary tasks. It may
play a role in pushing us to better jobs or living
situations. But when stress becomes excessive and
our minds can no longer handle it, anxiety takes
over control. Whenever anxiety affects our ability
to work or carry out daily living activities, it
becomes an anxiety disorder.
Anxiety disorders are one of the most common
emotional health problems. There are several
different types:
panic disorder (recurrent panic attacks)
obsessive-compulsive disorder (uncontrollable,
repetitive behaviors or thoughts)
post-traumatic stress disorder (recurrent,
distressing dreams and flashbacks after an
accident or violence such as rape)
generalized anxiety disorder (persistent worry
about everyday life events such as finances or
health)
phobias (specific phobias such as fear of heights
or social phobias, also called social anxiety
disorder)
The above problems should be treated with
counselling or drugs, both of which seem to be
equally effective treatments. Many insurance plans
do not cover psychologic counselling but they do
cover anti-anxiety drugs. The real problem is that
women with anxiety disorders have a tendency
become addicted to alcohol or drugs, therefore as
soon as you are identified as having an anxiety
disorder, it is time to start addressing it,
rather than all of the other stressful influences.
You need to tackle it so you do not become
addicted.
Ultimately, someone who suffers from anxiety
disorder needs to regain control over their mind
and body's handling of stress. Medications can be
helpful in starting to overcome anxiety disorders
but they are never a good long term solution.
People who use only medications to reduce anxiety
and never learn to gain mind control over stress
carry the anxiety disorder into their senior
years. They have trouble ever finding peace of
mind.
If your doctor suggests an anti-anxiety drug, ask
about other solutions.
When to worry about an anxiety disorder
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2. Living with lupus
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Systemic lupus erythematosus (SLE) is a strange
disease. No one quite knows what causes it but it
is classified as an auto immune disease. One's
body becomes allergic to its own organs. The
immune system can attack the skin, the joints, the
kidneys, the blood cells, the heart or blood
vessel system, the muscles, the liver or any part
of the body.
With skin, lupus causes disfiguring scars and hair
loss; with the joints it produces arthritis;
attacking the kidneys produces renal failure;
blood cell involvement causes anemia; the heart
being affected may cause heart failure; blood
vessel immune changes cause hypertension and
Raynaud's disease; muscle involvement results in
inflammation called myositis; liver lupus is a
type of hepatitis.
The first symptoms of lupus can be quite variable
all the way from fever and muscle aches to sudden
kidney failure. In fact one of the most serious
manifestations of lupus is kidney failure. When
it happens, dialysis several times a week or even
a kidney transplant may be needed. That alters
one's life.
As you can see, living with lupus can present
challenges.
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3. Reader submitted Q&A - Irritable bowel syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"What causes irritable bowel syndrome and how can
you treat it? "
"I am 47, menopausal, taking Prempro(R) 0.625
mg,and have a high stress job and life." - Arlene
Irritable bowel syndrome (IBS) is similar to a
baby's colic except it occurs in adults. It hurts
and it is associated with abnormal frequency of
bowel movements; either constipation or loose,
frequent stools. The abdominal and pelvic pain
that accompanies IBS characteristically get worse
or improves significantly with bowel movements.
While no one knows the specific cause of IBS,
whatever it is involves the nerve and muscle
control of the large colon. There are two
components, abnormal muscle contractions of the
colon (too fast or too slow) and an increased pain
sensitivity to the distension of the colon from
bowel contents.
Treatment is both general, to reduce or eliminate
anything that affects bowel motility and
distension, and specific, aimed at the predominant
symptom of pain, diarrhea, or constipation.
Dietary change is a mainstay of treatment to
restore the normal bowel motility. High fiber and
higher carbohydrate diet is used if constipation
is a major problem. High protein diet with
elimination of bowel muscle stimulants is used if
diarrhea (3 stools per day or more) is the major
symptom.
Bowel stimulants that may need to be eliminated
from the diet are:
caffeine
dairy products in lactose intolerant individuals
artificial sweeteners
alcohol
gas forming vegetables (beans)
spicy foods especially hot peppers
When pain is a predominant symptom, gas forming
foods as well as bowel stimulants should be
avoided.
Medications are used as treatment after dietary
change stabilizes symptoms as much as possible.
Again, the medical management depends upon what
symptoms are the worst, although sometimes
symptoms of constipation and diarrhea can be
alternating.
Constipation - osmotic laxatives such as
lactulose, polyethylene glycol solution
(Miralax(R))
Diarrhea - anti diarrheal agents such as
loperamide {Imodium(R)), diphenoxylate/atropine
(Lomotil(R)), cholestyramine resin (Prevalite(R))
Pain - anticholinergic agents such as dicyclomine,
hyoscyamine (Donnatal(R), Levsin(R)), anti anxiety
agents, non steroidal anti inflammatory drugs
(NSAIDs), occasionally other pain meds
Finally, stress reduction should be attempted. No
one denies that stress plays a role and yet there
is not a quick, easy treatment of excessive
stress. When it is affecting the health of the
body though, attention must be paid to stress
reduction techniques and activities otherwise the
health problem produced or aggravated by stress
will persist and worsen.
See our instruction sheet on coping with IBS:
Coping with Irritable Bowel Syndrome
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4. Different forms of osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know there are different types of
osteoporosis? I didn't. Much medical science
involves lumping and splitting and this proposed
categorization makes some sense clinically.
In the article below, bone mass deficits are
classified into 3 different groups based on
theories of bone modelling we know from
experimental studies:
1) less than normal bone mass but no tendency
toward fractures unless there are falls, injuries
or trauma that cause them. This equally affects
men, women and children.
2) low bone mass in which there is chronic bone
pain, mainly in the lumbar spine and spontaneous
fractures from normal physical activities of daily
living, not injuries. This is more common in women
than men and rare in children.
3) low bone mass from lack of muscle strength.
Fractures can be spontaneous or trauma induced but
muscle strengthening helps bone strengthening to
prevent spontaneous fractures.
This would explain why some women with low bone
density have moderate bone pain and others do not;
why some women increase bone density significantly
with weight training and weight bearing exercise
and others do not.
Different forms of osteoporosis
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5. Insomnia among cancer patients
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Everyone would expect that newly diagnosed cancer
patients might have trouble sleeping. And indeed
30-50% of cancer patients have insomnia within
their first several months after diagnosis.
Unfortunately, insomnia often persists in those
diagnosed with cancer for a long time. From 23-44%
describe insomnia symptoms 2-5 years after
treatment.
Patients rarely complain of sleep difficulties;
presumably because it seems like a small problem
next to the fear of cancer and side effects of
treatment. For this reason it is very much an
under appreciated problem. Other problems of
nausea, pain and depression receive first concern.
Insomnia can strongly affect health. It worsens
the anxiety, fatigue and depression that already
plagues cancer patients. There is some suggestion,
but not definite proof, that insomnia may increase
the death rate from cancer. It needs to be
recognized early and treated if possible.
The medical treatment for a cancer patient with
insomnia consists mostly of medications to control
pain or depression. After those are treated,
behavioral strategies to treat insomnia rather
than sleeping drugs, can be integrated into the
cancer care routine. Relaxation techniques are
helpful as well as making sure one does not get
too much sleep one night and too little the next.
Sleep may need to be slightly restricted to
facilitate falling asleep. Attention also needs to
be paid to a good sleep environment. Finally, if
any automatic thoughts or fears creep into the
mind at night, counselling may be indicated just
like with any anxiety disorder.
For a good overview of this problem, see the
article at Breastlink.com
Insomnia among cancer patients
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6. Health tip to share - Thyroid replacement on HRT
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you have hypothyroidism and take thyroid
replacement, when you are first placed on
menopausal hormone replacement therapy you may
need to have your dose of thyroid raised. There is
a fall in serum thyroxine in women with
hypothyroidism starting on HRT. Women without
hypothyroidism do not have a fall in serum
thyroxine levels when they start HRT. - FRJ
Increased Need for Thyroxine
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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The Hikers
One day, Joe, Bob and Dave were hiking in a
wilderness area when they came upon a large,
raging, violent river. They needed to get to the
other side, but had no idea of how to do so.
Joe prayed to G-d, saying, "Please G-d, give me
the strength to cross this river."
Poof! G-d gave him big arms and strong legs, and
he was able to swim across the river in about two
hours, although he almost drowned a couple of
times.
Seeing this, Dave prayed to G-d, saying,
"Please G-d, give me the strength and the tools to
cross this river."
Poof! G-d gave him a rowboat and he was able to
row across the river in about an hour, after
almost capsizing the boat a couple of times.
Bob had seen how this worked out for the other
two, so he also prayed to G-d saying,
"Please G-d, give me the strength and the tools,
and the intelligence to cross this river."
Poof! G-d turned him into a woman.
She looked at the map, hiked upstream a couple of
hundred yards, and then walked across the bridge.
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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 *******
October 7, 2001
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This Biweek from Woman's Diagnostic Cyber
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1. Mad cow disease testing and transmission
2. Post traumatic stress disorder
3. Reader submitted Q&A - complications of surgery
4. The G-spot, is it a myth?
5. Mycoplasma and ureaplasma genital infections
6. Health tip to share - Perineal care
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. Mad cow disease testing and transmission
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Mad cow disease is more properly called bovine
spongiform enchephalopathy (BSE). It has been a
problem in England and Europe where cows were fed
brain and spinal cord containing meats and bone
meal from sheep who had a similar disease to BSE
called "scrapie". There is good evidence that when
people eat meat from the central nervous system in
cows with BSE, this can produce a degenerative
brain disease in humans which is called a variant
Creutzfeldt-Jakob Disease or vCJD. To date no
cases of vCJD have been found in the U.S. that I
could find
Our FDA department has stated that they feel
confident that U.S. beef is "clean" due primarily
to early slaughter of animals, within 1 1/2 years
of maturation. They reported none of these young
animals have tested positive for BSE. As of this
writing, there have been a some positive tests in
sheep, goats and elk and deer in the U.S..
Our readers ask this -- "couldn't a virus lay
dormant, undetected during certain stages of
development? And why don't they sample cattle by
allowing them to mature to 2, 3 and 4 years of age
and then test? "
The answer is in two parts:
1) this disease is much differently transmitted
than any viral or bacterial diseases with which we
are familiar
2) there is still much we do not know about the
transmission of this condition
The disease seems to be transmitted by eating a
protein called a prion that is abnormally shaped.
This abnormally shaped protein causes other
proteins in the central nervous system (spinal
cord and brain) to become abnormally shaped also.
When enough abnormal proteins are produced, brain
and nervous symptoms develop in the animal or in a
human. Testing is performed in animals by killing
them and examining the protein tissue for these
abnormal prions. Unfortunately there is not a
blood test for this. The tests can pick up an
affected animal before symptoms are apparent but
because the induction of abnormal proteins is a
slow process, testing cows before 30 months of age
does not produce any positive tests.
The disease does not seem to be transmitted
according to classic viral transmission at all; it
is transmitted just by ingesting the abnormal meat
protein as far as we know. For example, infected
cows do not transmit the disease to their calves
by their milk or even just by the birth process.
Most viral infections in which the virus itself is
the transmissible agent would transmit to a fetus
or newborn by birth or lactation. Cooking the
meat thoroughly would prevent virus transmission
but it does not destroy this abnormal protein and
therefore is not protective.
This new and probably rare mode of disease
transmission is very important for medical science
but also extremely difficult to study. We do not
know if it takes ingestion of a microgram, a
milligram, a gram (1/30th of an ounce). 100 grams
or more of abnormal protein. Normally, meat from
the brain or central nervous system of beef cattle
would not knowingly be purchased by most
consumers. Unfortunately some butchers included
these parts in ground beef and beef sausage which
was the likely way the protein was consumed by
humans. Even steaks and roasts and other solid
beef muscle were banned in Europe for awhile
because of the fear that cutting across the spinal
cord could contaminate steaks. While this was a
theoretical concern, most experts now feel this is
not a mode of transmission and solid cuts of beef
are still consumed up to their normal levels in
Europe. Concern was raised about cow brain
products in some nutritional supplements but so
far this has again been a theoretical concern and
no cases have been traced to this source that I
could find.
These are some of the reasons why the Food and
Drug Administration in the U.S. does not think we
do not have Mad Cow disease in our American beef
cattle. There have been no cases of vCJD in the
U.S. and our cattle are killed and marketed at a
young age before any volume of abnormal protein
could form even if they were "infected".
The truth is they do not know for sure if the
disease is prevalent in our beef herds. I like the
idea to allow some cattle to mature to 3 or more
years and then test them, but I suspect the
prospect of culling out 10's of thousands of cows,
raising them for another couple of years, and then
slaughtering them for testing alone is one of
those projects that is difficult to get funded
until we do have a human case of variant
Creutzfeld-Jakob disease. There have been some
U.S. quarantines of suspected sheep herds as you
may know but no positive cow cases.
Mad cow disease testing and transmission
Q and A about BSE
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2. Post traumatic stress disorder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Post traumatic stress disorder (PTSD) is a series
of recurrent high anxiety states which are due to
a past event that caused a severe emotional
trauma. Something like a rape, a motor vehicle
accident, a physical assault or even an event like
the World Trade Center attack can precipitate
recurrent stress.
The symptoms often start about 3 months after the
causative event and can include:
flashbacks or nightmares
distancing oneself emotionally from others
withdrawal from work or family responsibilities
sleeping difficulty
anger control problems
exaggerated startle response
It is normal to have many of these reactions right
after a traumatic event, but the usual course of
things should be for the stressful reactions to
gradually lessen over time. If they persist beyond
several months or they don't seem to start until
several months after the event then PTSD should be
suspected. If this happens to you, be sure to see
your doctor, Zoloft(R) (sertraline) and other
selective serotonin re-uptake inhibitors (SSRIs)
have been an effective treatment for PTDS.
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3. Reader submitted Q&A - Complications of surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is it normal for sutures to dissolve two hours
after having uterus removed vaginally causing
internal bleeding and a second surgery to stop
bleeding causing the loss of healthy ovaries and
puncture to bladder." - Anonymous
I don't know of sutures dissolving within two
hours of surgery but certainly sutures can come
off of a blood vessel. The vessel just breaks off
where the suture was tied. Also vessels that did
not bleed at the time of surgery, perhaps because
of vessel spasm, can start bleeding right after
surgery. The most common bleeding complication
after vaginal hysterectomy occurs within the first
two hours following surgery. It happens about 1-2%
of the time.
If you had bleeding that continued, surgery had to
be performed to stop it. If the bleeding was in
the area of the ovary, sometimes the ovary has to
be removed to stop the bleeding. When suturing the
bleeding around the ovary, the blood supply to the
ovary may become injured and the ovary would
become gangrenous if left. In that case it would
need to be removed. To have to remove both ovaries
due to bleeding is unusual but it can happen.
Bladder injury can also occur while trying to stop
the bleeding. This does seem like too many
complications but the anatomy gets quite distorted
right after surgery especially with active
bleeding taking place. I assume the bladder injury
was recognized and repaired at the time of the 2nd
surgery.
I am sure you are concerned as to whether this
bleeding complication and injury to the bladder
would be due to negligence on the part of the
doctor. No one can say for sure without being
present at the surgery but these are complications
that are recognized as possible and most of the
time they would not be due negligence but rather
just bad luck. If the complications were taken
care of and you have no long term injury then
there is no grounds for malpractice. You can
always claim mental anguish as injury but most
lawyers would not take the case with just mental
anguish for injury.
Perhaps there is more to the story than you
related above. You may want to get a second
medical opinion or even an interview with a
reputable malpractice lawyer.
FAQs about Hysterectomy
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4. The G-spot, is it a myth?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The G-spot refers to a a small, but allegedly
highly sensitive area on the upper (anterior) wall
of the vagina just below the bladder. This spot
was proposed in 1982 to be a highly erogenous spot
whose stimulation can lead to a female vaginal
ejaculation or a stronger, deeper orgasm.
It appears from the review below that there is
very little scientific evidence that such a spot
exists. In fact almost any gentle manual
stimulation of any point inside the vagina can be
sexually arousing to the point of orgasm.
Apparently the existence of a G-spot rests only on
one paper in which 5 of 12 women were thought to
have one sensitive area on the anterior vaginal
wall.
This lack of evidence does not mean that such a
spot does NOT exist. It just means that it is
still questionable. If a woman cannot find her "G-
spot", she should not be concerned. If she does
not "ejaculate" with orgasm there also should not
be any concern. Female ejaculation from the
Skene's glands of the urethra is also an unproven
and unlikely event.
The G-spot: A modern gynecologic myth
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Mycoplasma and ureaplasma genital infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Mycoplasma and ureaplasma are two bacteria that
are often associated with genital track infections
in the same sites as the sexually transmitted
disease called chlamydia. In fact if a good
scientific does a thorough job of culturing all
bacteria present, they often find substantial
(30-50%) positive cultures for ureaplasma and a
fair number (10-20%) of positive cultures for
mycoplasma when examining women with urinary tract
infection symptoms, pregnancy vaginitis symptoms
or women with infertility.
The high incidence of positive cultures for these
bacteria is tempered only by the fact that genital
tract infections with pure ureaplasma or pure
mycoplasma are not commonly found. This throws
suspicion upon whether these bacteria even need
treatment as causative agents, i.e., they may
always be just opportunistic agents that occur
primarily with other bacteria which are the ones
needing the antibiotic treatment. On the other
hand, such a high incidence of positive cultures
makes many doctors think that these bacteria need
treatment.
To find out if these bacteria may be present,
special, non routine cultures need to be
performed. If you have:
1) recurrent urinary tract infection symptoms but
the urine cultures return negative
2) unexplained infertility
3) chronic pelvic pain
then you may want to ask the doctor to perform the
special cultures to see if mycoplasma or
ureaplasma are present. If they are present, you
and the doctor will then need to determine if
antibiotic treatment is likely to be helpful. Both
organisms seem to be very sensitive to both
erythromycin and to tetracycline. If the cultures
are not available, doctors sometimes just
prescribe empirical treatment with tetracycline
for some of the above conditions.
Mycoplasma and ureaplasma causing genital problems
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6. Health tip to share - Perineal care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"To 'control' smell in the outside vaginal area, I
use my grandmother's method: after a bath or a
good wash, mix a cup of water with 2 spoons of
good old apple cider vinegar and do a 'last' wash
and air dry the area with a hair drier in warm to
cool air. Keep a bottle handy of the apple cider
vinegar in the bathroom and a cup. I transfer the
vinegar to a nice plastic and pretty bottle that
goes with my bathroom. use it as frequently as
you can. like before going to bed and in the
morning. soon will be a nice 'habit'. If no time
to use the hair drier, spend some time with 'for
your use only towel' and do a nice dry. Daily
cotton undies are a must. Save the non-cotton cute
and expensive panties for a prelude of a wild
night only."
If you have a genital herpes condition use
Listerine(R) -- yes, that's right, Listerine(R) to
wash the affected area and use the hair drier in
the hottest you can take. The lesions will last
only a day or two the most. If you are home all
day (during the outbreaks) try to do this as
frequent as possible, like every hour. idea: drink
plenty of fluids that way you urinate a lot and
you have an excuse to do it. idea: cover the
vulvar area with a towel so you don't burn a
sensitive area. Lots of luck from an ex-sufferer"
- Marian
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"You Know It's Time To Diet When...."
You dance and it makes the band skip.
You are diagnosed with the flesh eating virus, and
the doctor gives you 22 more years to live.
You put mayonnaise on an aspirin.
You go to the zoo and the elephants throw you
peanuts.
Your driver's license says, "Picture continued on
other side."
You ran away and they had to use all four sides of
the milk carton for your picture.
You learn you were born with a silver shovel in
your mouth.
You could sell shade.
Your blood type is Ragu.
You need an appointment to attend an 'open house'.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 *******
October 21, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Uterine anomalies in recurrent miscarriage
2. Birth control during perimenopause
3. Reader submitted Q&A - HRT side effects
4. High energy drinks are deceptive
5. Progesterone to treat PMS brings up a point
6. Health tip to share - mouth sores
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.
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Uterine anomalies and recurrent miscarriage
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
One of the causes of recurrent miscarriage is when
the cavity of the uterus is deformed from its
normal pear-shaped contour. These deformities can
be acquired (impingement on the cavity by
fibroids, polyps, scarring) or congenital from
birth (indented, partially divided, divided).
Regular ultrasound of the pelvis often picks these
deformities up but it may miss as many as a third
of them. Saline sonohysterography, which involves
injecting saline in the cavity of the uterus can
give a better view of the cavity shape but it
sometimes causes uterine cramps and requires a
physician to do the injection. A new imaging
modality called 3-D ultrasound holds promise to be
much better at picking up these uterine cavity
deformities.
In this study below, 3-D ultrasound imaging was
used to identify uterine cavity shape
abnormalities in 503 women with recurrent
miscarriage and 3228 low risk women without
infertility or recurrent miscarriage. They found
that 21% of the women with recurrent miscarriage
had uterine cavity shape abnormalities. This was
significantly more than in the low risk women.
The bottom line is that women with a history of
recurrent miscarriage need to have a thorough
assessment of the inside of the uterus.
Uterine anomalies and recurrent miscarriage
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Birth control during perimenopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The perimenopause is the time before menopause
when ovarian function, normal hormonal cyclicity
and the ability to conceive all decline. Abnormal
bleeding, hot flashes and mood changes may occur
during this time, usually in the decade of the
40's. By age 40, 33% of couples are infertile and
at age 45, 87% of couples cannot conceive even if
they try very hard. Those who do get pregnant, run
a fairly high risk of having an infant with a
congenital anomaly.
Any woman who does not want to get pregnant during
perimenopause cannot just rely on age changes
alone for protection. Some women can still get
pregnant and there is no way to know who can and
who cannot unless no birth control is used. This
type of "fertility roulette" is unacceptable for
most women so the practical solution is to use
some type of birth control.
About 50% of women depend upon tubal sterilization
for birth control and 20% depend upon male
sterilization by vasectomy. This still leaves 30%
of women who may want to use either oral
contraceptives (if they do not smoke),
intrauterine contraceptive devices (IUCDs), or
barrier methods such as condoms or diaphragm.
If you are in the perimenopause and you or your
partner have not had a sterilization procedure, be
sure to discuss with your physician suitable
methods of birth control.
Birth control during perimenopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - HRT side effects
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is Natural HRT better than synthetic? If so/not
why? I'm searching for a natural HRT, because of
side effects of synthetic HRT." - vj
This is a tough question to answer. Even the
concept of "natural" is not clear. The naturally
occurring estrogens are estradiol (E2, biest),
estrone (E1) and in pregnancy, estriol (E3,
triest). None of them occur in nature other than
in animals or humans. Therefore for pharmaceutical
doses they are made synthetically from a chemical
process. This is also true for progesterone. It is
made synthetically.
There are some naturally occurring substances with
estrogen effect such as conjugated equine
estrogens from pregnant horses and plant
substances called phytoestrogens from soy, red
clover and other plants. These are not
synthetically made, just extracted and purified
from their source.
Conjugated estrogens have many different
estrogenic compounds in them but the majority by
volume is pure estrone, the same chemical compound
that occurs in women. Phytoestrogens are not as
potent as estradiol and estrone. They also have
slightly different effects in women. They may help
with osteoporosis and to some degree with hot
flashes but they do not stimulate the vaginal skin
to prevent dryness.
Side effects are determined not so much by whether
the estrogens are made synthetically or extracted
from natural sources. They depend upon the
specific type of estrogenic compound and your
body's specific response to it.
What side effects are bothering you? Bleeding
problems vary by the dose, route of
administration (pill, patch, topical, shot), by
your body size and by how far past menopause you
are. Hot flashes vary by the dose, the specific
compound and how well the estrogens are absorbed
from the stomach or skin. Mood symptoms such as
irritability or depression are often determined by
the progesterone or progestin rather than the
estrogen part of HRT.
Difficulties with side effects from hormone
replacement therapy are some of the most
challenging problems gynecologists face. You will
need to work closely with your doctor to try
different forms of HRT estrogen and progesterone
and different doses and routes of administration.
You may need blood levels drawn to see how well
you are absorbing the medication and changes based
upon whatever specific side effects you have. This
is one health problem that might be too difficult
treat on your own.
For more explanation, see our past article:
What is Natural About Natural Hormone Therapy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. High energy drinks are deceptive
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
High energy drinks have made substantial sales
gains in the last several years. Beverages like
Red Bull, Sobe Adrenaline Rush, Whoopass, Hype,
180 and others came on our market and promise a
quick energy boost. Students use them to cram for
exams, salesmen to get going, exercisers to
increase their workouts and bar patrons to be able
to drink more.
These beverages basically contain caffeine, sugar,
amino acids and sometimes vitamins. It is hard to
find exact counts on caffeine content but most
have in the range of 100 mg or about that of a cup
of drip coffee, about twice as much as a Coke or 3
times that of a Pepsi. The sugar and calorie
amount ranges about as much as a Pepsi or Coke
also. Taurine, an amino acid, is often an
ingredient and one manufacturer claims it is added
to speed up the effect of the caffeine.
Herbal products are also in the mix. Guarana, from
seeds of an Amazon plant, is used and has caffeine
in it separate from the caffeine added to the
drink and listed on the ingredients. Ginseng is
often added and occasionally ephedra appears in
the ingredients such as in the diet drink Metab-O-
Lite. Most experts consider the combination of
caffeine and ephedra dangerous to anyone with high
blood pressure or heart disease and they feel this
combination can lead to heart attacks or strokes.
While these high energy drinks are probably no
worse than a cup of coffee and a Coke together,
more than one or two can lead to caffeine toxicity
and cause heart palpitations and nausea.
Definitely avoid the ones containing ephedra and
don't make a habit of mixing them with alcohol. If
you have a problem with palpitations, avoid these
high energy drinks altogether. If others call them
"health drinks", at least you will know what they
are.
High energy drinks are deceptive
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Progesterone to treat PMS brings up a point
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Some years back, pure progesterone or synthetic
progestins were used in an attempt to treat
premenstrual syndrome, PMS. Most doctors are not
currently using progesterone as treatment because
randomized studies show no benefit. This review
below in the British Medical Journal (BMJ)
reaffirms that progesterone is not effective after
analyzing scientific clinical trials treating PMS.
So what's the news? Some disagreeing responses to
this article caught my attention and point out
that there is still confusion as to what
premenstrual syndrome actually is. The BMJ accepts
email responses to their articles and posts them.
One nurse midwife from the U.S. indicated
confusion as to how progesterone was not effective
in these studies when in fact she has successfully
used topical progesterone cream for cyclic breast
soreness (mastalgia). She is equating cyclic
breast soreness with PMS.
Another woman responded that the studies must not
have administered the progesterone "in sync" with
a woman's menstrual cycle because when she did
use the progesterone "in sync", her headaches
were immediately controlled. Thus she equated
cyclical headaches with PMS.
Many women have physical symptoms or conditions
that vary with menses and worsen in the 2nd half
of the cycle. Lower abdominal bloating, breast
tenderness, swelling of the legs, menstrual cramps
and headaches are commonly cited. But without mood
symptoms that accompany the physical symptoms,
most doctors would not consider a diagnosis of
PMS. The definition commonly used is:
Premenstrual Syndrome ("PMS") is a combination of
"physical" and "emotional" (or behavioral)
symptoms that occurs premenstrual and is absent
the rest of the cycle; the symptoms are severe
enough to significantly interfere with work or
home activities.
PMS is not just one specific physical symptom or a
collection of them and it is not just a specific
or collection of psychological, mood symptoms. It
is the COMBINATION of both physical and mood
symptoms. Also there has to be an interval during
the menstrual cycle in which the symptoms are
totally absent. Otherwise what you have is really
just a menstrual exacerbation of an underlying
chronic physical or mood problem.
This may seem to be "playing with words" but it is
an important conceptual difference when conducting
scientific studies and testing any type of
pharmaceutical intervention. Topical progesterone
cream may well decrease cyclic breast pain but it
does not help the mood symptoms of PMS.
The use of progesterone to treat PMS
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - mouth sores
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"This is to respond to the lady who was
complaining of mouth sores. I used to also suffer
from this ailment and have found that since I
began brushing my teeth with a baking soda based
toothpaste, that the ulcers and sores have
disappeared. I don't know if this will work for
you, but it's worth a try. It's also a whole lot
cheaper than medication or an extra visit to the
dentist!" - Anonymous
Mouth sores
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Cat Laws"
Law of Cat Inertia
A cat at rest will tend to remain at rest, unless
acted upon by some outside force - such as the
opening of cat food, or a nearby scurrying mouse.
Law of Cat Motion
A cat will move in a straight line, unless there
is a really good reason to change direction.
Law of Cat Magnetism
All blue blazers and black sweaters attract cat
hair in direct proportion to the darkness of the
fabric.
Law of Cat Thermodynamics
Heat flows from a warmer to a cooler body, except
in the case of a cat, in which case all heat flows
to the cat.
Law of Cat Stretching
A cat will stretch to a distance proportional to
the length of the nap just taken.
Law of Cat Sleeping
All cats must sleep with people whenever possible,
in a position as uncomfortable for the people
involved, and as comfortable as possible for the
cat.
Law of Cat Elongation
A cat can make her body long enough to reach just
about any counter top that has anything remotely
interesting on it.
Law of Cat Obstruction
A cat must lay on the floor in such a position to
obstruct the maximum amount of human foot traffic.
Law of Cat Acceleration
A cat will accelerate at a constant rate, until he
gets good and ready to stop.
Law of Dinner Table Attendance
Cats must attend all meals when anything good is
served.
Law of Rug Configuration
No rug may remain in its naturally flat state for
very long.
Law of Obedience Resistance
A cat's resistance varies in proportion to a
human's desire for her to do something.
First Law of Energy Conservation
Cats know that energy can neither be created nor
destroyed and will, therefore, use as little
energy as possible.
Second Law of Energy Conservation
Cats also know that energy can only be stored by a
lot of napping.
Law of Refrigerator Observation
If a cat watches a refrigerator long enough,
someone will come along and take out something
good to eat.
Law of Electric Blanket Attraction
Turn on an electric blanket and a cat will jump
into bed at the speed of light.
Law of Random Comfort Seeking
A cat will always seek, and usually take over, the
most comfortable spot in any given room.
Law of Bag/Box Occupancy
All bags and boxes in a given room must contain a
cat within the earliest possible nanosecond.
Law of Cat Embarrassment
A cat's irritation rises in direct proportion to
her embarrassment times the amount of human
laughter.
Law of Milk Consumption
A cat will drink his weight in milk, squared, just
to show you he can.
Law of Furniture Replacement
A cat's desire to scratch furniture is directly
proportional to the cost of the furniture.
Law of Cat Landing
A cat will always land in the softest place
possible; often the midsection of an unsuspecting,
reclining human.
Law of Fluid Displacement
A cat immersed in milk will displace her own
volume, minus the amount of milk consumed.
Law of Cat Disinterest
A cat's interest level will vary in inverse
proportion to the amount of effort a human expends
in trying to interest him.
Law of Pill Rejection
Any pill given to a cat has the potential energy
to reach escape velocity.
Law of Cat Composition
A cat is composed of Matter + Antimatter = It
Doesn't Matter
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
November 4, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Beating cancer with humor
2. Food additives - why are they used?
3. Reader submitted Q&A - What is diverticulitis?
4. The natural limits of pregnancy testing
5. Diarrhea and E.coli food poisoning
6. Health tip to share - Exercise for low back pain
7. Humor is healthy
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Beating cancer with humor
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Would anything about breast cancer be humorous?
You would think not, and yet after the initial
shock of any medical condition, humor is known to
reduce stress, lift a veil of depression, improve
outlook, and even stimulate the immune system to
help fight most diseases. Many doctors believe
laughter can be as healing as the medicines
prescribed.
The article below chronicles the response of one
woman, a breast cancer survivor, who has found how
humor helps her cope with her feelings. She
creates cartoons about cancer, its treatment and
all of the surrounding events. She feels the humor
made her treatments less harsh. she slept better
and was more motivated to exercise. Most of all it
helped her connect with the people around her and
changed their interactions to be more positive and
upbeat with her.
Most of our readers are aware of our slight
attempts to interject a little humor by way of
jokes. (Yes, I heard you thinking "very little"!)
I realize not all of them are funny but what is
really interesting is how there is always someone
who is "offended" by any given joke. It is this
degree of emotional response with "being
offended" that I think needs comment.
We get feedback from different newsletter readers
who write in about how they were offended at us
making fun of: age, weight loss difficulties,
men, menopause, PMS, mental conditions,
"dumbness", body parts, or whatever. I appreciate
the feedback and welcome these comments. But
sometimes I feel sorry that the person who is so
offended is taking a subject so seriously. I hope
it is just a time in their life and not a long
term reaction to the topic.
I think finding a joke or any humor attempt
offensive is much different from finding it not
funny. People who are offended by a particular
joke may often have a problem with their emotional
thought processes. Whether it is unresolved anger
over a disease or condition out of our control or
whether it is an obsessive long term concern, it
is harmful to one's health. I say "try to get over
it".
Now before someone jumps on this attitude as just
politically incorrect or insensitive to the
feelings of others, let me say that it doesn't
mean you have to laugh about cancer right after a
doctor tells you you have it. But eventually you
should be able find the humor in the events
surrounding this or any condition. It is part of
the healthy adjustment process and the lack of it
may make the condition worse. Depression and
stress definitely suppress your own body's health
defense mechanisms. Humor is healthy; its a
philosphy of life.
I guess the bottom line is if you find yourself
"offended" by a joke or humorous attempt, examine
your own though process to see if there is a
chance it is your problem, not theirs.
Hmm ...I wonder if the timing is getting better
for those anthrax jokes?...:)
Beating cancer with humor
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Food additives - why are they used?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that there are over 400 additives and
over 3000 flavorings that are added to foods on
our supermarket shelves today? Some additives
make the food more colorful, last longer before
spoiling, or make it more tasty. Sometimes they
are added just to be able to produce the food more
cheaply. In any case, the food industry tells us
that without these additives, our selection of
processed foods would be severely restricted
compared to what is available today.
It is estimated that less than 1% of additives
really help keep food safe from bacterial
poisoning and contamination. Most of them are used
just for cosmetic reasons to make the food appear
more appetizing. Even the term "natural" for an
additive may not necessarily mean beneficial.
Natural colors can still cause allergies and who
would expect "natural beet coloring" in a
strawberry product?
Additives fall into several different groups:
colors - artificial or natural to alter appearance
preservatives and antioxidants - prevent bacterial
growth or fat turning rancid
emulsifiers, stabilizers and thickeners - modify
texture, spreadability
processing aids - anti-caking, gelling or firming
agents
flavor enhancers - modify taste such as monsodium
glutamate
glazing agents - give a shining or polished
appearance
flour treatments, improvers and bleaching agents -
for processed bread
packing gases - inert gases, eg., nitrogen to keep
produce looking fresh longer
sweeteners - aspartame, saccharin, sorbitol,
isomalt
flavors - may replace the actual ingredient such
as lemon, beef, tomato
Are all of these safe? Probably not for everyone,
but there is no answer as to which ones are
harmful. Allergies or unusual reactions can occur
to any chemical. The additives are tested and
regulated to a certain degree by government
agencies but flavors are not.
For a list of which additives and flavors may
cause health problems, check out this article from
Great Britain at the surgerydoor.co.uk. It also
covers which additives need to be listed on
ingredient labels, and caveats about reading the
labels.
Food additives
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - What is diverticulitis?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
" What is diverticulitis, it's symptoms and
treatment? I'm 48 years old. My menstrual cycle
is pretty regular. Sometimes my insides hurt more
than usual, but not all the time. I'm going
through different tests right now because of
vomiting and nausea. So far diverticulitis and a
precancerous polyp have been diagnosed. Gall
bladder tests have been normal. " Brenda
First come the diverticula of the colon. They are
herniations of the bowel lining through the muscle
of the large colon. Diverticula are thought to be
caused by a chronic increase in intra-colon
pressure such as that caused by constipation.
Once diverticula form, only about 25% of the time
do they become symptomatic. Nausea, vomiting and
abdominal bloating along with constipation are
often symptoms. Diverticula can become more
symptomatic by developing bleeding or infection.
If infection takes place, it is called
diverticulitis. Diverticulitis often produces pain
especially in the left lower pelvic area. If you
were to develop fever and chills along with
abdominal pain, you should be sure to see your
doctor immediately. You are fortunate that the
doctors have already looked in the colon and
removed the precancerous polyp.
When diverticulitis flares, it is treated with
antibiotics and fluids. Sometimes you may have to
be hospitalized for an acute infection and if an
abscess forms outside the wall of the colon, you
may even need surgery including a surgical
resection of the segment of colon that has the
diverticulitis.
Dietary treatment with high fiber foods to prevent
constipation is the mainstay treatment. It is
hoped that reducing intra-colon pressure will
reduce the chance of a diverticula becoming
infected. Most prophylactic antibiotic regimens do
not prevent recurrences of acute inflammation
although there have been some trials with a drug
called rifaximin. Your doctor may be aware of
clinical trials involving other medications to
prevent recurrences.
See our disease profile below:
Diverticulosis and diverticulitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. The natural limits of pregnancy testing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you are trying to get pregnant, when is the
best time to begin testing? Most home pregnancy
test kits will say to start testing as early as
the first day of a missed period. Doctor's offices
also tend to say the same thing. Even for very
sensitive home pregnancy tests it is not wise to
start checking before day 12 after ovulation. All
of these recommendations presuppose that ovulation
for that cycle occurred about 14 days before the
day of the missed menses. However, ovulation can
be very variable and unless a woman is using
ovulation predictor tests to know for sure when
ovulation occurs, one can never be sure that the
period is really due on the day you think it is
due.
The hormone of pregnancy, HCG, is not measurable
in the blood or urine until the pregnancy
"implants" in the uterine lining. This takes place
anywhere from day 6-12 after ovulation but most
commonly on day 8. In a usual 28 day cycle,
ovulation occurs about day 14, so day 8 after
ovulation would be about day 22 after the last
menstrual period (LMP). However if ovulation that
cycle were delayed until day 23 for some reason,
then implantation would not occur until day 31 and
the pregnancy test would not be positive until
about day 34 or after. This would mean that if a
woman tested negative on day 29 after her LMP. she
could still be pregnant that cycle.
In the study below, very sensitive pregnancy tests
were used to determine when pregnancy occurred in
spontaneous cycles of 136 women trying to conceive
who knew when their next menstrual period was due.
They did not use any methods to detect ovulation.
The investigators found that 10% of the actual
pregnancies did not turn the test positive on the
first day of a missed, expected menses. In other
words the women actually became pregnant during
that cycle but ovulation (or implantation) must
have occurred later than expected.
This study shows the natural ovulation variability
that occurs even in a woman who considers herself
to be regular in her menstrual cycle.
The natural limits of pregnancy testing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Diarrhea and E.coli food poisoning
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Food poisoning from various bacteria is not
common, but when it happens, it usually affects a
large number of people at a time. In recent
decades, a syndrome of severe, watery diarrhea due
to food contaminated with a special strain of E.
Coli, strain O157:H7, has been recognized and has
been the cause of over 70,000 infections and 60
deaths each year in the U.S.
E. coli is a common human and animal bowel
bacteria of which there are over 100 different
strains. Most of the strains do not produce a
toxic human response; they are normal bowel
bacteria. Several toxic strains have been
identified, however, and they can produce a severe
dehydrating diarrhea and even a toxic response
that destroys red blood cells and may result in
complete kidney failure.
Since first identified in the early 1980s, E.
Coli O157:H7 has caused outbreaks in:
eating hamburger from a national fast food
franchise
sandwiches made and served at a nursing home
outbreak in a child care center
contaminated roast beef
contaminated salad bar
unpasteurized apple juice
contaminated commercial dry-cured salami product
contaminated swimming pool
While diarrhea can be a sign of a cold or flu,
signs of severe diarrhea that should alert you to
seeking medical attention include:
a temperature of more than 102 deg F, 38.9 deg C
bloody stools
a dry mouth or crying without tears (severe
dehydration)
unusual sleepiness, drowsiness or unresponsiveness
Steps that you may take to prevent illness from E.
coli contamination at home include:
have your water checked for E. coli counts
cook any ground meat to an internal temperature of
160 deg F, 71 deg C
cook any solid muscle meat cut (steak, roast) to
an internal temperature of 135 deg F, 57.2 deg C
wash produce before eating with just water,
chlorinated water or soap
wash counter tops, cutting boards, utensils after
working with raw meat just as you would with
chicken for salmonella
wash hands frequently when cooking or when
handling diapers, litter boxes or anything
coming in contact with or even close to stool.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Exercise for low back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"My first issue of your letter is dated 6/3/2001.
I didn't get to see it until we arrived home after
a four week trip up to the Northwest Territories.
When I downloaded the e-mail, I had forgotten I
had subscribed to your news letter and just when I
was about to "delete" it, the article on hip and
leg pain or the piriformis syndrome, caught my
eye. Before we left on this journey, I had been
seeing a chiropractor for my lower back and had
absolutely no help from him. while we were gone I
was in such misery I took too many Alleve and
ended up at a health clinic with my stomach in
near ulceration. My intention was to get a MRI
upon arriving home as I told my husband, I could
not live this way....I couldn't walk, sit or stand
for any length of time and sleeping was anything
but! I read the exercise to do for this problem
and I still cannot believe it! My pain was
alleviated so quickly I am still astounded. I have
given the site and a copy of the exercise to
several people and they too have seen terrific
results. I am still stunned that this simple
exercise is not standard procedure for every
health care professional treating someone with
symptoms such as mine. It was truly divine
intervention. Thank you for making my life pain
free again. If I have any tightness in my lower
back, I immediately do the exercise and I have
immediate relief. " - Joanne
(editor note - here is the exercise referred to
from About.com - Sports Medicine for stretching
the right piriformis muscle:
"lay on your back, bend your knees and cross your
right leg over your left so your right ankle rests
on your left knee in a figure four position. Bring
your left leg towards your chest by bending at the
hip. Reach through and grab your left thigh to
help pull things towards your chest. "
To stretch the left piriformis muscle just
substitute left for right and right for left in
the above exercise.)
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
HOW DOGS AND MEN ARE THE SAME:
1. Both take up too much space on the bed.
2. Both have irrational fears about vacuum
cleaning.
3. Both mark their territory.
4. Neither tells you what's bothering them.
5. The smaller ones tend to be more nervous.
6. Neither does any dishes.
7. Neither of them notice when you get your hair
cut.
8. Both like dominance games.
9. Both are suspicious of the postman.
10. Neither understands what you see in cats.
HOW DOGS ARE BETTER THAN MEN:
1. Dogs do not have problems expressing affection
in public.
2. Dogs miss you when you're gone.
3. Dogs feel guilty when they've done something
wrong.
4. Dogs admit when they're jealous.
5. Dogs do not play games with you-except fetch
(and they never laugh at how you throw.)
6. You can train a dog.
7. Dogs are easy to buy for.
8. The worst social disease you can get from dogs
is fleas.
9. Dogs understand what "no" means.
10. Dogs mean it when they kiss you.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
November 18, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Teens and cancer
2. Diagnosis of uterine fibroids
3. Reader submitted Q&A - Atherosclerosis plaque
4. Multiple Sclerosis - What is it?
5. Hemorrhoids - the symptoms and treatment
6. Health tip to share - Preventing overeating
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. Teens and cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Children may not understand a disease such as
cancer. Teens understand it but think they are
indestructible. If you tell a teen that sun
exposure can lead to skin cancers and melanoma
they either tune you out or just file it in a "not
applicable to me" mind folder. But more and more
teens are developing skin cancers. The clinics
that see and manage skin cancer including
melanomas note a rise in the number of younger
patients they are seeing.
One study showed that the percent of time that
teens routinely practiced sun-protection behaviors
on sunny days were:
wearing sunglasses (32%)
wearing long pants (21%)
staying in the shade (22%)
applying sunscreen (31%)
It is the sunburn part of skin sun exposure that
is the most damaging. Once skin damage occurs,
subsequent sun exposure can induce cancerous
change even without further burning.
If you have a teen, be sure to reinforce the
cancer hazards of ignoring sun protection
behavior. Also help them check the back of their
neck, their back and even the back of their legs
where they may not be able to see moles or
pigmented skin lesions that have enlarged or
darkened in color, or whose borders have become
irregular.
Teens and cancer
Sun protection behaviors in teens
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Diagnosis of uterine fibroids
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The tools used to diagnose uterine fibroids are
the pelvic exam, ultrasound imaging,
sonohysterography (injection of fluid into the
uterus), magnetic resonance imaging (MRI),
hysteroscopy (looking into the uterus with a
scope). and laparoscopy. The following site, All
About Myomectomy, contains some good explanations
of how the above tools are used to determine all
about fibroids; how many, how big they are, where
in the uterus they are located and how likely they
are to be producing the symptoms that are
bothering you.
This latter determination is important because as
many as 5-10% of women and possibly as high as 25%
of women have uterine fibroids
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