Womens Health

Women's Health Newsletters 6/2/02 - 8/11/02



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****** Woman's Health Newsletter *******
             June  2,  2002
Biweekly from BackupMD on the Net
1. Supplements for a healthy heart
2. Body weight and birth control pill failure
3. Reader submitted Q&A - Continuous OCPs for cramps
4. Herbal safety news
5. Health tip to share - NSAID pain meds need more lead time
6. Humor is healthy

1. Supplements for a healthy heart
Vitamin and other nutritional supplementation has 
been promoted for many reasons but a common use is 
to prevent heart disease and cancer. The data for 
any benefit of heart disease prevention is 
somewhat doubtful. Vitamin E, vitamin C, beta 
carotene and coenzyme Q-10 are antioxidants that 
have been touted at various times as useful in the 
prevention of heart disease.  By blocking a 
chemical reaction (oxidation) that is necessary 
for the arteries to absorb LDL cholesterol (the 
"bad" cholesterol), fatty plaques in the arteries 
are lessened or prevented - at least so the theory 

Studies using vitamin E have had some success in 
showing a lower rate of heart disease but these 
were balanced by other scientifically valid 
studies showing no heart disease prevention. Right 
now there are no recommendations for vitamin E 
supplements to be used for heart problem 
prevention. Vitamin C, beta carotene and coenzyme-
Q are in the same state. Dietary studies suggested 
that people who had higher intake of those 
compounds had lower rates of heart disease but 
when studies were performed giving supplements to 
people, there did not appear to be any reduction 
in heart problems. 

The only nutritional supplement I know of that has 
shown promise in preventing the new occurrence of 
heart disease is fish oil -- omega-3 fatty acids 
or long-chain n-3 polyunsaturated fatty acids. 
When these have been given as dietary supplements 
there has been a lower incidence of adverse 
cardiac events. They help just minimally thin the 
blood, provide some protection from rhythm 
abnormalities and lower cholesterol. While the 
best source is from cold water fish such as tuna, 
salmon or halibut, other foods such as canola oil, 
flaxseed, flaxseed oil, walnuts, and leafy green 
vegetables all have some omega-3 fatty acids. 
Supplements in pill form rather than foods can be 
obtained at almost any health food store if 
dietary sources are not consistent for you. 

2.  Body weight and birth control pill failure
Other than forgetting to take the birth control 
pills (BCPs) or starting them too late in a cycle, 
there are not too many things known to reduce 
their efficacy. One question has always been, 
however, that women who weight more, may require 
higher dose oral contraceptives. This is 
especially true as the doses of estrogens in pills 
have gone from 35 mcg down to 20 mcg. 

Other medicines have their doses often calculated 
according to how much the patient weighs so it 
would make sense that BCPs might need to be 
adjusted by weight. The study cited below from 
Seattle, Washington looked at over 2800 women and 
found that the failure rate, i.e., unintended 
pregnancies, from birth control pills overall was 
3.8 per 100 women on the pill for one year. This 
is consistent with many other studies that the 
failure rate of BCPs is about 3%. 

They then looked the specific dose (estrogen 
component) of the birth control pill each woman 
was taking and segmented the failure rate by 
weight categories. They found that the women in 
the highest weight categories had an over 4 times 
increased pregnancy rate on the lowest dose pills 
(20 mcg of estrogen) as compared to women in the 
lowest weight categories. These results are not 
surprising but we have not previously had the data 
about the lower dose pills and failure rate.

There are some new contraceptives being marketed 
and one of them is a weekly skin patch (Evra(R) by 
Ortho-McNeil Pharmaceutical) which delivers 20 mcg 
of estrogen. In their literature they note that in 
women of 200 pounds weight or more, the failure 
rate was slightly higher. 

These studies would suggest to me that women who 
weigh 200 lbs or more should not use a 20 
microgram, low dose birth control pill, but rather 
they should consider using a 30 or 35 microgram 

Body weight and birth control pill failure

3. Reader submitted Q&A - Continuous OCPs for cramps
"My daughter just turned 17. About 1 1/2 years ago 
we put her on the pill to help the incredible pain 
she goes through every month with her period. It 
helped for about 4 months and that's all. We have 
continually asked her Gyn if there is anything 
stronger than Vicodin (already prescribed) and 
Naproxen (doesn't work either)....all they say is 
that they can put her on the pill continuously 
without the break, so she just won't get her 
period. This CANNOT be healthy! What about all the 
OTHER side effects of the pill? It doesn't seem 
they are taking those into consideration!" - JG 

Your doctor is treating your daughter under the 
diagnosis of primary dysmenorrhea or "painful 
menses". Intrauterine pressure generated with some 
menstrual cramps have been measured as high as 300 
mm Hg. A uterine contraction during labor only 
gets as high as about 80 mm Hg so you can see that 
a bad menstrual cramp can easily be 4 times as 
painful as laboring with a baby. 

Before we go on to address treatment, however, 
endometriosis is often reported in adolescents and 
if the pain just seems to persist too strong too 
long, you may need to ask your doctor about 
diagnostic laparoscopy to see if any endometriosis 
is present and also to dilate the cervix at the 
same time. While continuous oral contraceptive 
pill regimens can treat endometriosis, there are 
other therapies that might be used if there was a 
certain knowledge (not just guessing) that 
endometriosis was present. 

As far as pain medicines for dysmenorrhea, the non 
steroidal anti inflammatory drugs (NSAIDs) are the 
best because they block the formation of 
prostaglandin which causes the severe uterine 
contractions. They have to be taken on a regular 
basis during menses, however, not just when your 
daughter can't stand the pain. See our discussion 
in this newsletter about NSAIDs. 

A common problem with medications that doctors see 
is that an adolescent (or even an adult) looking 
for instant relief, waits until the pain builds up 
and then decides a pain medicine is needed. When 
she then takes an NSAID like Aleve(R) (she should 
take 2 or 3 at once, not just one like the bottle 
says) the onset of blocking the cause of the pain 
does not take place for several hours. So by that 
time she has concluded the pain medicine does not 
work. Instead, she should take two tablets 
regularly twice a day as soon as she senses that 
the cramps are going to start. The expectations 
should not be for total pain relief, but merely to 
lower the magnitude to the point where she can 
cope with the cramps until the period is over. 
Vicodin (R) and other narcotic pain medicines are 
not very effective at all for menstrual cramps. 

Oral contraceptive pills (OCPs) can be quite 
useful in treating menstrual cramps because they 
decrease the amount of menstrual tissue formed and 
lower the pain level (amplitude) of the uterine 
contractions probably due to their progestin 
effect. When given in a continuous fashion, i.e., 
no week of placebo pills to allow an artificial 
menstrual period, they can further reduce the 
level of pain because most of the time menstrual 
periods are blocked completely. There still may be 
some irregular spotting with cramps but generally 
they are of much lower severity and less 
interruptive of everyday activities. 

You have concerns about long term side effects or 
complications of continuous birth control pills. 
It would be helpful to know which concerns you 
have in mind because the television and newsprint 
media often exaggerate reported studies or experts 
comments out of proportion; otherwise they would 
have "ho-hum" news. You may need a personal 
medical educational consult to answer a specific 

In general, physicians do not have evidence of 
significant long term problems from either normal 
withdrawal oral contraceptive regimens or 
continuous oral contraceptives as used for 
endometriosis or severe menstrual cramps.  OCPs 
are associated with a much lower incidence of 
ovarian cancer and endometrial cancer. In fact 
they are one of the very few medicines known to 
actually prevent any cancers. Cervical cancer is 
slightly higher on the pills and breast cancer is 
essentially unchanged. As far as cervical cancer 
goes, the pills are not thought to have a chemical 
effect on it but rather they allow the behavior, 
intercourse with multiple partners, that has been 
also associated with increased cervical cancer. 
Long term use of OCPs are not known to affect 
future fertility one way or the other so this 
treatment now should not affect her ability to 
have a pregnancy in the future. 

The main deleterious effect of OCPs is the 
formation of blood clots in the veins and 
arterial thrombosis. The increased incidence is 
real but very small, on the level of two times 
increased over not taking the pills - 3 per 10,000 
women. The risk can go higher in women who are 
over 35 years of age and smoke or who have 
hypertension but it is highly unlikely your 17 
year old will have a problem with this. The small 
increase in risk does have to be weighed against 
the possible benefits, however. 

All in all, I would be comfortable prescribing the 
continuous pill regimen for this purpose. If she 
does not have significantly less days of severe 
pain after a 3 month course of continuous pills, 
then I would strongly consider a diagnostic 
laparoscopy to look for endometriosis. 
Endometriosis is the one thing that if not 
diagnosed early, can cause impaired fertility in 
the long run. 

4. Herbal safety news	
Herbal remedies for medical problems or disease 
prevention are popular because they are "natural 
approaches" to a healthier body. Unfortunately 
herbal formulations are not very much regulated 
for safety by governments, especially as compared 
to prescription medications. As a result, many 
unsubstantiated claims are made for various 
formulations and manufacturers of these products 
may intentionally or by accident adulterate the 
herbal mixture with pharmaceutical grade products 
or other herbal components that are misidentified. 

In the UK, the government has started an on-line 
herbal safety news site to let consumers be aware 
of problems they have found in various herbal 
formulations. That way you can look up ingredients 
in any herbal products you are using or even 
sometimes the name of the product to see if any 
reports have been made that would affect the 
safety of taking those supplements. 

Problems that have been identified include: 

content including plant substances that are known 
   to produce liver toxicity 
contamination with blood thinners such as coumadin 
contamination with a benzodiazepine that is a 
   strong, addicting anti-anxiety drug 
illegal adulteration of products with 
   fenfluramine, a diet substance taken off of the 
   market for complications 
illegal adulteration of products with sildenafil 
   citrate (Viagra(R)) 
inclusion in Chinese herbal remedies of plants 
   containing aristolochic acids which have been 
   associated with toxic kidney effects and cancer 
inclusion of prescription grade steroids in 
   topical creams 

Herbal remedies need to be treated with the same 
respect that prescription grade drugs are. After 
all, many pharmaceuticals were originally 
identified from and manufactured using the 
"natural sources" where the active ingredient was 
found. These remedies may also have interactions 
with other drugs you are taking. Do not take any 
herbal preparations in which the ingredients are 
not clearly listed in terms you understand. 
Finally, you may want to check out this site 
periodically if you take a herbal preparation on a 
regular basis or if you want to start a new one. 

Herbal safety news

5. Health tip to share - NSAID pain meds need more lead time
The class of pain medications called non steroidal 
anti inflammatory drugs (NSAIDs) work better as 
pain meds when the source of the pain is due to 
inflammation and swelling. While they reduce 
current pain somewhat, their most frequent use is 
to prevent future pain. They prevent the formation 
of an enzyme used to produce prostaglandin which 
is a pain and inflammation producing substance. 
They work best with pain due to muscle, ligament 
or bone inflammation. 

NSAIDs should be taken with the first sign of 
pain, but then they should be continued on a 
regular basis for several doses or several days 
even though the pain has been reduced. In this way 
they help prevent recurrence of the pain due to 
continued inflammation. A common mistake is to 
take something like naproxen (Aleve(R)) or 
ibuprofen (MotrinR)) and when they do not reduce 
the pain within 15 minutes, a person concludes 
they do not work and no further NSAID is taken. 
Then the pain persists when in fact taking the 
NSAID regularly could have significantly reduced 
that future pain. 

Over-the-counter NSAIDs include:

ibuprofen (Advil(R), Motrin(R), others) 
ketoprofen (Actron(R), Orudis(R)) 
naproxen sodium (Aleve(R)) 

NSAIDs available only by prescription include:

diclofenac sodium (Voltaren(R)) 
etodolac (Lodine(R)) 
fenoprofen (Nalfon(R)) 
flurbiprofen (Ansaid(R)) 
indomethacin (Indocin(R)) 
ketorolac (Torado(R)) 
nabumetone (Relafen(R)) 
oxaprozin (Daypro(R)) 
piroxicam (Feldene(R)) 
sulindac (Clinoril(R)) 

If you have a chronic pain that requires these 
medications on a regular basis, be sure to check 
with your doctor to see which one may be the best 
for you. They all have different side effects and 
tolerances and if one does not work, another might 
still be very effective. 

If after a trial of several of these different 
NSAIDs you find that your stomach is too irritated 
when taking them, there is a different class of 
anti-inflammatory drugs called Cox enzyme 
inhibitors such as Vioxx(R) or Celebrex(R) that 
may work for you. Ask your doctor about them. 

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

6. Humor is healthy

"Games For Hospital Waiting Rooms"

Surgery: Operation, Life

Neurology: Concentration, Boggle

Mental Health: Crazy Eights, Solitaire, Outburst

Gastroenterology: Chutes and Ladders, Go Fish, 
Poker, Dungeons and Dragons, Lincoln Logs 

Administration: Trivial Pursuit, Monopoly

Eating Disorders: Hungry Hungry Hippos

Finance: Trouble

Diabetes Center: Candyland

Plastic Surgery: Mr. Potato Head

Payroll: Payday

Rehab: Twister

Parkinson's Center: Jenga

Travel Clinic: Ants in the Pants

Infectious Disease: Cooties, Risk

Geriatric Medicine: Bingo

Gene Therapy: Barrel of Monkeys

Urology: Upwards

Cardiology: Hearts

Orthopedics: Pinball

Cafeteria: Mousetrap

Pediatrics: Tic Tac Toe

Hospital Patient Relations: Sorry

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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****** Woman's Health Newsletter *******
           June 16, 2002
Biweekly from BackupMD on the Net

1. How allergies work
2. Tanning salons associated with increased skin cancer 
3. Reader submitted Q&A - Finding a cause for hair loss
4. Compulsive gambling is an illness
5. Health tip to share -  Perineal clipping to reduce odor
6. Humor is healthy

1. How allergies work

When your nose is runny and eyes are itchy you 
probably are just interested in relief; not in why 
this reaction is happening. Sometimes though, it 
is helpful to know the detail of how a medical 
condition is produced especially when it is one 
that is chronic and going to afflict you the rest 
of your life. Allergy is one such condition. 
People with allergies have genes that make them 
more likely to develop a bodily reaction to 
various substances they are exposed to. 

The body's immune system is the main protective 
mechanism to maintain health. It identifies and 
fights off bacteria, viruses, parasites, cancer 
cells, food and any foreign protein substance.  
Lymphocytes are one type of white cell in your 
blood and they are a major component of the immune 
system. As soon as a foreign protein enters the 
body, the lymphocytes identify the protein, 
fingerprint it and determine if it belongs to this 
body or not. "Lymphocytes act like traveling 
customs agents. Everywhere they go, they are busy 
checking the passports of every cell they 
encounter. Whenever they discover a cell that 
seems threatening, they immediately begin 
countermeasures against it. The biochemical 
process behind these countermeasures is amazing! " 

Allergies result when this immune system is 
hypersensitive, overreactive. When the system 
misidentifies harmless proteins as serious enemies 
and then reacts out of proportion to the threat, 
you get symptoms from this major bodily battle. 
Those symptoms may be mildly annoying or a major 
illness.  Usually for your immune system to 
overreact like this you must have a genetic 
tendency for it. 

After the lymphocyte identifies the foreign 
protein (antigen) it goes back to a lymph node 
where it changes into a different type of white 
blood cell (mast cell). The mast cell manufactures 
a chemical called an immunoglobulin that is 
exactly configured like a laser ray to destroy the 
specific protein that the lymphocyte identified in 
the first place. Of the different immunoglobulins 
(IgA, IgD, IgE, IgG, IgM), Ig E is the class that 
forms an allergic reaction. They attach to other 
white blood cells in what is called the 
sensitizing exposure, 

When the protein comes into the body again, at 
least 7-10 days after the sensitizing reaction, 
the IgE primed mast cells release many chemicals 
including  histamine that try to destroy the 
"invading" protein. Histamine lowers the local 
blood pressure and causes itching and swelling . 
It can also cause wheezing, an itchy, runny nose, 
nausea, vomiting or diarrhea. That is why "anti-
histamine" drugs are used to treat allergies. 

Specific allergies can be identified either by a 
blood test for IgE or by a scratch test in which 
the suspected allergen is "scratched" into the 
skin to see if the body reacts to it with redness 
and swelling. A problem with specific 
identification of allergies, however is what is 
called cross-reactivity. Sometimes proteins of 
different but similar substances, e.g., shrimp and 
crab meat, can both cause an allergic response 
even though the body had previously been exposed 
to only one of them. Even so, allergen 
identification is very important so that you can 
avoid the offending allergen in the first place. 

Now why is it important to know the mechanism of 
action for allergies? If there is a genetic 
disposition for your body to form allergic 
responses, there is not much you can do - correct? 
No. You basically have two practical choices for 
self-care. Identify the causative agents so you 
absolutely avoid them and treat with anti-
histamines for mild but annoying allergic 
reactions. Unfortunately there is only one self 
home test for food allergies that I know of, 

Food allergy test kit

and none for other plant/mold fungus allergies. 
For those tests you will have to have a doctor's 
order and have a blood drawn and sent to a special 
laboratory. If you are having serious reactions, 
see an allergist for allergen identification and 

One last tip. The gold standard for diagnosing 
allergies are the scratch test sets applied in the 
allergist's office. Many times, however, you may 
not want to suffer the reactions you get during 
testing or you may fear causing a new allergy by 
sensitizing through your skin to a new substance 
you are not already allergic to. The allergy 
doctor may prefer the scratch tests because they 
are more accurate but you can ask to have the 
blood test done instead, with subsequent scratch 
testing if needed,  to narrow down the specific 
allergen from a general group of substances. 

How allergies work

2.  Tanning salons associated with increased skin cancer 
It should come as no surprise that those who use 
tanning salons are at twice the risk of developing 
non melanotic skin cancer as those who do not. At 
least that is what a recent study suggests. 
Repetitive doses of the ultraviolet wavelength of 
light can,  over time, stimulate the growth of a 
skin cancer. The study in the Journal of the 
National Cancer Institute (J Natl Cancer Inst 2002 
Feb 6;94(3):224-6) even corrected for those who 
previously had bad burns and excessive sun 
exposure in the past. There still was an increased 
risk in those individuals who used indoor tanning 

There are basically three types of skin cancer: 

basal cell skin cancer - starts from the bottom of 
the outer skin layer, most common form of skin 

squamous cell skin cancer - arises from the middle 
layer of skin cells and occurs mostly in areas 
exposed to the sun/tanning rays 

melanoma - from middle skin layers and contains 
very much pigment (dark like a mole) and dangerous 
because it spreads easily to other areas of the 

Even though this study looked at the non melanoma 
types of skin cancer, all types of skin cancer are 
known to increase in frequency with repeated sun 
exposure, What can you do to avoid this known 
risk? Self tanning lotions are safe to use and can 
give you that suntanned look. Avoid any burning of 
the skin by using 15 SPF sunscreen or higher when 

You also need to know that the indoor tanning 
industry representatives claim that newer 
equipment is less cancer producing and produces 
ultraviolet rays that are not "as harmful". 
However there really is no evidence yet that the 
newer equipment makes a difference and until that 
time it would be safer to assume that any 
repetitive ultraviolet light exposure can increase 
your risk for skin cancer. 

Ultraviolet Rays, Tanning Salons, And Risks for Cancer 

3. Reader submitted Q&A - Finding a cause for hair loss

"How can one investigate the cause of hair loss 
beyond the expected thinning at the onset of 
menopause. I took phentermine for a while but the 
hair loss continued after stopping. I did lose 30 
pounds in just a few months, but the hair loss 
continues. Are there tests for deficiencies or 
other possible causes?" 

"I am 53 and have been 1 1/2 years without a 
period." - E.S. 

Hair loss can have many different causes from 
local agents such as the chemicals in hair 
products, to body wide substances that we ingest 
or are deficient in from our diets, to natural 
hormonal changes such as pregnancy or menopause, 
to disease states that affect the skin and hair as 
an organ. Ingested causes can be toxic substances 
from our water or food as well as medical 
prescription drugs or over-the-counter drugs. 

In your case the menopause with its decreased 
estrogen levels and the dieting are the most 
likely culprits in explaining your hair loss. You 
did not mention if you were taking any estrogen 
supplements for hormone replacement or vitamin and 
mineral supplements while dieting but these would 
be important to prevent hair loss if you are not 
taking them. As far as I know, the phentermine is 
not thought to be a drug that causes hair loss 
although there are many drugs that can cause it. 

Hair cycle growth goes through different phases. 
Agents that cause hair sloughing, called 
effluvium, can be active in those different 
phases. Anagen phase is the growth phase that a 
hair goes through and it generally lasts about 6-
10 years for each individual, randomly growing 
hair. Catagen phase is a very short deactivation 
phase where the hair follicle prepares to go 
inactive. Catagen phase lasts only about 2-3 
weeks. Telogen phase is the final resting phase of 
a hair follicle and it lasts about 30- 90 days. At 
any one time, about 90% of hair is in the anagen 
growth phase and about 10% is in the resting 
telogen phase. When you brush your hair and it 
comes out in the brush, that is removing resting 
phase (telogen) hair shafts. After resting, a hair 
follicle sloughs its shaft becomes active again, 
growing a new hair shaft as long as the follicle 
itself has not been damaged. 

If a disease or substance affects the growing 
(anagen) phase of hair, hair loss is massive and a 
person can actually lose most (90%) of her hair. 
If the disease or substance affects only the 
resting (telogen) phase. only about 10% of hair is 
lost (although that seems like a massive amount 
also) and the loss only lasts for about 3-4 
months. Post partum effluvium and hair loss 
associated with menopause is mainly due to the 
lower estrogen levels put more hair into the 
resting phase all at once and then in 1-3 months 
there is a significant  hair loss - "gobs of 
hair".  Hair growth will resume as soon as the 
hormones are back to normal level. 

From www.keratin.com, we can get some lists of the 
different causes of hair shedding or "effluviums".  
In addition to withdrawal of estrogen hormone, 
telogen effluvium can be caused by: 

diet deficiencies, particularly lack of iron 
crash dieting 
ultra violet (UV) radiation
acute blood loss 
hyperthyroidism or hypothyroidism 
extreme physical stress such as surgery 
emotional stress  
severe illness
drugs such as:
  cholesterol-lowering drugs, clofibrate, 
  anti-histamines/ulcer drugs, cimetidine, 
ranitidine, famotidine 
  anti-coagulant drugs, dicumarol, heparin, 
coumarin, warfarin 
  anti-convulsant drugs, ethotoin, phenytoin, 
mephenytoin, trimethadione, paramethodione, 
valproate sodium 
  anti-thyroid drugs, carbimazole, methimazole, 
itraconazole, thiouracil 
  beta blockers/high blood pressure drugs, 
acebutolol, diazoxide, nadolol, atenolol, 
pindolol, labetalol, metoprolol, propranolol, 
  non steroidal anti-inflammatory drugs, aspirin, 
fenoprofen, meclomen, ibuprofen, naproxen, 
indomethacine, piroxicam, ketoprofen, sulindac 
  arthritis drugs, penicillamine, auranofin, 
indomethacin, naproxen, methotrexate 
  tricyclic anti-depressant drugs, amitriptyline, 
imipramine, amoxapine, nortriptyline, desipramine, 
protriptyline, doxepin, trimpramine 
  vitamin A and derivative drugs, retinoids, 
retinol, acitretin , isotretinoin, etretinate,   
  miscellaneous drugs, allopurinol, aminodarone, azothioprine, azulfidine, bromocriptine, carbamazepine, choramphenicol, clomiphene, clonidine, colchicine, dixyrazine, ethambutol, ethionamide, etretianate, gentamycin, haloperidol, hydantoin, levodopa, interferon-alpha, methyldopa, methysergide, metapyranone, nifrofurantoin, para-amino-salicylic acid, prazosin, probenecid, pyridostigmine bromide, sulphasalazine, terfenadine 
  toxic chemicals containing:
     monomeric/dimeric chloroprene (rubber 
manufacturing), potassium bismuth (cosmetic 
formulations with "pearlescence"), lithium salts, 
iodine, iron, lead, gold, aluminum,  arsenic, 
boric acid, borates, mercury, selenium, thallium, 

Many of the same triggers that cause hair loss in 
the resting phase can also cause hair loss in the 
actively growing anagen phase. Since so many hair 
follicles (about 90%) are in the growth phase at 
any one time, this can result in massive amounts 
of hair falling out at once. Causes of anagen 
effluvium include: 

genetic hereditary disease 

defective hormone production other than estrogens 
nutrient deficiencies such as copper, iron, zinc, 
  biotin, essential fatty acids, or vitamin C  
cancer treatments 
excessive X rays or X ray therapy
toxic agents such as thallium, arsenic, lead, 
  bismuth, vitamin A and derivatives 
Therefore to get back to your question of how you 
can go about determining the cause of the hair 
loss, be sure that you are on estrogen replacement 
and a multivitamin/mineral supplement as you diet. 
If you are already on those and are still having 
hair loss, see your doctor and ask for the 

1. Check the list of any prescription medicines or 
over-the counter medicines that you take on a 
regular basis to see if any of them cause hair 

2. Check a complete blood count (CBC) and serum 
iron looking for anemia or iron deficiency/excess 

3. Check a TSH,  thyroid function study

4. Check a screen for toxic metals and mineral 
There are at home thyroid tests (TSH) and  mineral 
screens you can order on the internet but of 
course insurance does not cover the tests unless 
your doctor orders them. 

TSH at Home Test

Mineral Check Home Mineral Analysis

4. Compulsive gambling is an illness
Most people place wagers or bets at sometime in 
their lives but they don't get carried away. There 
is quite a difference between buying 1 or 2 
tickets on the state lottery and spending 5-10% or 
more of your take home wages on bets in the hopes 
of "striking it rich". At some point the 
compulsive gambler loses control of the betting 
process and risks financial ruin to support an 
addiction to placing bets. 

Almost 3% of adults in the U.S. are considered 
compulsive or "problem" gamblers. From the Mayo 
Clinic web site we get the following signs and 
symptoms of gambling addiction: 

You take time from work and family life to gamble. 

You secretly gamble. 

You feel remorse after gambling and repeatedly vow 
to quit. You may even quit for a while and then 
start again. 

You don't plan to gamble. You just "end up" 
gambling. And you gamble until your last dollar is 

You gamble with money you need to pay bills or 
solve financial problems. You lie, steal, borrow 
or sell things to get gambling money. 

When you lose, you gamble to win back your losses. 
When you win, you gamble to win more. You dream of 
the "big win" and what it will buy. 

You gamble when you feel "down" or when you feel 
like celebrating. 

Many physicians feel that a behavior addiction 
like compulsive gambling is a disease due to 
imbalances of certain chemicals in the brain. At 
least the condition which psychiatrists would 
classify as an impulse-control disorder, responds 
to many of the psychotropic drugs used for such 
conditions. Psychotherapy and referral to 
organizations such as the 12 step program of 
Gamblers Anonymous are also mainstays of treatment 
for this condition. 

If you know of anyone who  seems to be preoccupied 
with gambling, help them seek medical attention 
for this. 

What Is Compulsive Gambling?

5. Health tip to share - Perineal clipping to reduce odor
"One thing that I have figured out that helps 
eliminate odors caused by sweating in the vaginal 
area is to simply keep the hair closely trimmed as 
close to the skin as possible to combat an over 
abundance of bacteria growth between the hair 
where heat and sweat are trapped. It does not get 
rid of the problem, but is sure helps." -  

[editor note - If you suffer from vulvar burning 
and itching or irritant vulvitis, shaving the hair 
is not a good idea since it protects the skin from 

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

6. Humor is healthy
"Learn Life From A Dog"

1. Never pass up the opportunity to go for a joy 

2. Allow the experience of fresh air and the wind 
in your face to be pure ecstasy. 

3. When loved ones come home, always run to greet 

4. When it's in your best interest, always 
practice obedience. 

5. Enjoy it when someone wants to rub your tummy. 

6. Take naps and always stretch before rising. 

7. Run, romp, and play daily. 

8. Eat with gusto and enthusiasm. 

9. Be loyal.

10. Never pretend to be something you're not. 

11. If what you want lies buried, dig until you 
find it. 

12. When someone is having a bad day, be silent, 
sit close by and nuzzle them gently. 

13. Delight in the simple joy of a long walk. 

14. Thrive on attention and let people touch you. 

15. Avoid biting when a simple growl will do. 

16. On hot days, drink lots of water and lie under 
a shady tree. 

17. When you are happy, dance around and wag your 
entire body. 

18. No matter how often you are criticized, don't 
buy into the guilt thing and pout. Run right back 
and make friends. 

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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****** Woman's Health Newsletter *******
            June 30,  2002
Biweekly from BackupMD on the Net

1. Continuous BCPs to reduce unwanted symptoms
2. Panic disorder - What is it and can it be treated?
3. Reader submitted Q&A - Uterine lining thickness
4. Psoriasis - a common chronic condition
5. Health tip to share - How much water to drink?
6. Humor is healthy

The next newsletter will be in two weeks.

1. Continuous BCPs to reduce unwanted symptoms
For almost 40 years, the most frequent method of 
taking oral contraceptive pills has been the 
standard 21 days of active  hormonal pills and 7 
days of  taking "placebo" pills or being off of 
the active pills. This allows the menses to take 
place but still prevents pregnancy. We have 
discussed alterations of this pill regimen to 
treat endometriosis or to minimize menstrual 
problems but there has not been extensive 
experience in reporting how well this regimen 

The following study describes the experience of 
one Ob-Gyn, Dr. Patricia Sulak, in using an 
altered regimen over the years 1993-2000. The most 
common regimen used was to take the pills 
continuously for 12 weeks (4 pill cycles of active 
pills) and then being off for one week before 
repeating the regimen. The regimen was varied 
however, from commonly 9 weeks of active pills to 
over a years worth of active pills before taking a 
7 day break and having a menses. 

The purpose in using this extended regimen was to 
reduce symptoms of symptoms of headache in 35%, 
painful menstrual cramps in 21%, heavy or 
prolonged menses in 19%, and premenstrual symptoms 
in 13%. The remaining 12% of patients used the 
regimen because of convenience, endometriosis, and 
other reasons such as menstrual-associated acne. 

About 90% of the women who were counseled on this 
continuous regimen chose to use it. The ones who 
did not use it did so because they did not feel 
their symptoms were bad enough or they just felt 
better having a monthly menses. Of the women who 
started this extended regimen, 21% discontinued 
birth control pills altogether and 14% returned to 
a standard monthly regimen. The rest continued on 
with the extended regimen. 

Basically this report indicates that this is an 
acceptable alternative form of taking oral 
contraceptive pills to minimize any menstrual-
related symptoms. 

Taking birth control pills without withdrawal

2. Panic disorder - What is it and can it be treated?

Panic disorder affects over 1% of the population 
at sometime in their lives. There may be a family 
inheritance factor involved and women are twice as 
frequent as men to have panic disorder. The 
"attack" is not just a stressed feeling but an 
overwhelming fear that comes on without any 
warning whatsoever. The sense of fear induces a 
strong bodily reaction because of an outpouring of 
epinephrine and norepinephrine. Reactions include: 

racing heartbeat 
difficulty breathing, feeling as though you 'can't 
   get enough air' 
terror that is almost paralyzing 
dizziness, lightheadedness or nausea 
trembling, sweating, shaking 
choking, chest pains 
hot flashes, or sudden chills 
tingling in fingers or toes ('pins and needles') 
fear that you're going to go crazy or are about to 

It is amazing how symptoms like these can just 
arise out of the blue with no immediate events 
preceding them or an event that would not 
ordinarily evoke such a strong reaction. The 
reaction itself only lasts several minutes but 
repeated attacks can occur for several hours. 

Probably many people experience one or two such 
panic attacks at sometime in their lives. What 
makes it a disorder needing treatment, is when you 
live in fear of a possible future panic attack. 
Usually this takes four or more attacks to really 
condition you to fear additional attacks. 
Caffeine, exercise and certain medications can act 
as triggers for the attacks. Often a person will 
develop a phobia based on something that has 
triggered an attack in the past. 

Panic attacks can be treated but it takes a 
therapy combination to really escape the fears of 
a future attack. Psychologic counseling is needed 
to understand what is going on. Medications can 
help significantly as well as avoidance of any 
panic triggers. If you think panic disorder may be 
a problem, be sure to seek professional help to 
diagnose and treat this. 

Whether or not you think you may suffer from panic 
disorder, you are invited to take a survey to help 
determine background knowledge of this problem. In 
an effort to increase understanding on panic 
disorder and perimenopause in women, one of our 
readers, Pamela Balentine, a Ph.D. candidate, is 
conducting an Internet based research project and 
is seeking women between the ages of 40 to 60 to 
participate by taking the Perimenopause Panic 
Disorder Survey at: 

Perimenopause Panic Disorder Survey

Answers to questions about panic disorder

3. Reader submitted Q&A - Uterine lining thickness
"Had sonogram few days past and it showed the 
lining to be 0.86 cm (8.6mm) so now the Dr. wants 
to do a biopsy. He says lining should not be over 
0.8 (8 mm). Please explain where/what is problem." 

I am 58 and on HRT for 2 years, but had a full 
period 6 months ago and 4 months ago. I get 
spotting occasionally, sometimes bright blood, 
sometimes very dark. Started periods at age 10. No 
Meds, only vitamins. My Pap 6 months ago was 
normal." - anonymous 

The endometrial (lining on the inside of the 
uterus) thickness on pelvic ultrasound measurement 
is an often misunderstood indicator in making 
medical decisions about possible uterine 
(endometrial) cancer or other pathology. It was 
originally developed as a decision factor in women 
who are postmenopausal and also having bleeding. 
As you may know, uterine bleeding after a woman 
has permanently stopped her menses can be a sign 
of cancer. 

Our medical rule-of-thumb is that any woman who 
has postmenopausal bleeding should have a tissue 
biopsy of the endometrium or full dilatation and 
curettage (D&C) in order to make sure there is no 
uterine cancer present or any precancerous tissue 
inside the uterus. This is different than cancer 
of the cervix, the opening to the uterus (womb) 
which is screened for by Pap smear. About 5% of 
women with postmenopausal bleeding will have 
cancerous or precancerous tissue changes. The 
cause of the bleeding in the other 90% is hormone 
therapy side effects, a very thin (atrophic) 
lining that bleeds easily or simply unknown. 

Since over 95% of women with postmenopausal 
bleeding have no serious cause of the problem, 
pelvic ultrasound measurement of the uterine 
lining was investigated to see if its measured 
thickness could predict whether a woman was likely 
to have an abnormal tissue endometrial biopsy or 
D&C. Basically the studies found out that women 
who have less than 5 mm endometrial thickness very 
rarely turn out to have uterine cancer; at least 
much less than 1% of the time. 

Therefore, if the doctor ordered an ultrasound for 
a woman with abnormal or irregular postmenopausal 
bleeding or spotting, and the endometrial 
thickness is 4 mm or less, then a somewhat painful 
biopsy or D&C can be avoided. If the thickness is 
5 mm or more, then the recommendation is still to 
go ahead and do a biopsy or D&C. With all of this 
being said, there is one recent study that 
suggests ultrasound measurements would miss about 
4% of endometrial cancers which, if true, means 
that we still always need to do a biopsy anyway. 

The 8 mm measurement is a different rule. It 
actually comes from studies that show the normal 
endometrial thickness in asymptomatic postmenopausal 
women rarely exceeds 8 mm in  size. This means 
that if a postmenopausal woman DID NOT have any 
bleeding but was found on routine scan to have a 
lining 8 mm or more, then she should have an 
endometrial biopsy performed. In your case, since 
you are having abnormal bleeding, an value of 5 mm 
or more would result in the recommended 
endometrial tissue sampling. 

None of these endometrial thickness rules apply to 
women who are premenopausal. Premenopausal women 
can have an endometrial thickness up to 20-24 mm.

4.  Psoriasis - a common chronic condition

Psoriasis is a dull red skin rash with scaly 
raised patches or plaques. The scales have a 
silver sheen but they usually are not itchy. The 
rash characteristically appears first on the 
elbows, knees and scalp. From there, it can go to 
involve the fingers and toes. This is an inherited 
skin condition but it usually needs a trigger such 
as a medication, trauma, hormone changes or some 
major physiologic event to start it up.  

Since the disease is chronic, it really never goes 
away. Medications can help the flare-ups, however. 
About one fourth of the women who get psoriasis 
also develop arthritis, psoriatic arthritis. The 
mainstay treatments are ultraviolet lights, 
steroid creams and tar creams and shampoos. 
Occasionally, anti-cancer drugs like methotrexate 
are used to treat psoriasis especially if 
arthritis is present. 

Since the rashes are present in exposed skin areas 
that others can see, it is a disfiguring disease 
and can cause psychological or emotional 
reactions. That is where the term "the heartbreak 
of psoriasis" came from. It is not just a benign 
skin rash. In many, the lesions can cover the body 
from head to toe. About 75% of people with 
psoriasis feel that the disease has a moderate to 
severe impact on their daily lives. The number of 
people with psoriasis who have contemplated 
suicide at sometime in their lives may be as high 
as 25%. 


5. Health tip to share - How much water to drink?

"Water intake, in addition to the natural water 
content of food you eat each day, varies depending 
upon your exercise level and diet. The average 
woman needs about 9 cups (8 oz.) of water a day. 
The average diet provides about  3-4 cups of water 
a day. Therefore the daily water requirement for a 
woman who is not dieting and who is not sweating 
from exercise each day, is about 5-6 cups of 
liquids to keep from becoming dehydrated. This 
would be about four 12 oz glasses or three 16 oz 
drinks each day. If you drink 8 ounces of liquid 
with each meal, that means you would only need 
another 3 cups of liquid a day. Any exercise would 
require more water and if your urine is becoming a 
strong yellow color then you need more fluid. 
Actually many women take in too much fluid in a 
day and have urinary frequency and urgency 
problems because of it." - FRJ 

If you have discovered ways of coping with a 
disease or condition and it works for you, please 
share it with us: 

Health tip suggestion form

6. Humor is healthy
Thoughts for the day

1. There's always a lot to be thankful for if you 
take time to look for it. For example I am sitting 
here thinking how nice it is that wrinkles don't 

2. If you can't be kind, at least have the decency 
to be vague. 

3. Don't assume people are intentionally trying to 
hurt you when stupidity is probably the best 

4. The real art of conversation is not only to say 
the right thing at the right time, but also to 
leave unsaid the wrong thing at the tempting 

5. The older you get, the tougher it is to lose 
weight, because by then your body and your fat are 
really good friends. 

6. The easiest way to find something lost around 
the house is to buy a replacement. 

7. He who hesitates is probably right. 

8. If you think there is good in everybody, you 
haven't met everybody. 

9. If you can smile when things go wrong, you have 
someone in mind to blame. 

10. The sole purpose of a child's middle name is 
so he can tell when he's really in trouble. 

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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****** Woman's Health Newsletter *******
            July 14,  2002
Biweekly from BackupMD on the Net

1. Black raspberries as antioxidants
2. Knee replacement to relieve pain
3. Reader submitted Q&A - Urine overflow
4. Estrogen and progestin HRT 5 year outcomes
5. Health tip to share -  Frequent UTIs
6. Humor is healthy

1.  Black raspberries as antioxidants

All types of berries - strawberries, blueberries, 
blackberries, and raspberries, etc -  contain a 
good supply of antioxidants. These antioxidants 
have a preventative effect on both heart disease 
and cancer. Vitamins C and E are some of the best 
known antioxidants and black raspberries, which 
are different from blackberries, have the  very 
highest levels of vitamin C. 

In a recent animal study, black raspberries were 
fed to a strain of rats who had been injected with 
a cancer causing agent. The object of the study 
was to see if rats, who ate equivalent diets 
without the black raspberries, developed more 
cancer than those who ate black raspberries as 
about 5% of their daily diet. As it turned out, 
the animals on the black raspberry diet had 80% 
fewer cancers. These results were even 40% better 
than when the test was done with strawberries and 

This is an animal study and not a human study and 
none of us can eat as many black raspberries as 
needed to replicate these results, but the lesson 
here is to include varied, fresh unprocessed foods 
in our diet to remain as healthy as possible. At 
about 3/4-1 calorie a berry, fresh berries, 
especially black raspberries, can play a role in 
anyones diet. Also, it is extremely likely but not 
absolutely proven that the fresh food is better 
for you than taking a supplement, eg. vitamin C. 
Black raspberries also have in them acrocyanins 
(the black pigment), phenols, such as ellagic, 
coumaric and ferulic acid; calcium; as well as 
vitamins A, C, E and folic acid. All of these 
substances are known chemopreventive agents.

Black Raspberries a Potentially Powerful Preventive Agent

2.   Knee replacement to relieve pain

Chronic knee pain is a difficult health burden to 
bear. It can sideline you from any physical 
exercise at all. Arthritis roughens the smooth 
surfaces of the knee joint cartilage and is the 
dominant cause of chronic knee pain. 
Osteoarthritis is the most frequent form of 
cartilage destruction although rheumatoid 
arthritis and traumatic arthritis from a previous 
knee injury can also be the etiology. 

Normally the thigh bone (femur) glides smoothly 
over the shin bone (tibia) when you bend at the 
knee. The joint can even slide and rotate over the 
lubricated plastic-like cushion of cartilage. When 
the cushion becomes pitted or broken, the unusual 
friction causes pain. 

If the knee joint is painful due to arthritis, 
normal treatment includes physical therapy and 
strengthening of the muscles around the joint, 
anti-inflammatory pain medicines and the long term 
use of glucosamine and/or chondroitin sulfate. 
This nutrient supplement has been shown to thicken 
the knee cartilage over a year or more of taking 

When the normal treatment fails to relieve or 
significantly lessen the pain, your life may be 
affected enough to consider total replacement of 
the knee joint. If so, you may want to look at 
what is involved in joint replacement. It involves 
about 5 days in the hospital and a recovery time 
of about 3 months. Then you should be able to 
resume walking, dancing, swimming, golfing and 
cycling. There are some activities you will have 
to give up for the rest of your life, however: 
jogging, jumping, lifting over 40 pounds, or any 
activities that result in twisting or crawling. 
Even a new knee joint made out of synthetic 
materials cannot stand these types of abuses. 

3. Reader submitted Q&A - Urine overflow

"Can you explain what  "bladder overflow" is. Plus 
how it is treated and if it is dangerous." 

"I am 65 years old.  Have not had a menstrual 
period since I was  50 years old. Had a 
hysterectomy, but not for any ailment. Had bladder 
surgery. Gyn felt it was safer to perform 

"I am in very good health except for sudden 
bladder overflow. Have urine bag and catheter 
until the bladder shrinks back to size." - Sue 

Overflow urine incontinence is due to a bladder 
that has been over stretched and lost its ability 
to contract and fully empty all of the urine when 
you decide to void. The overstretching weakens the 
bladder detrusor muscle and voiding only occurs 
when the bladder reaches the limit of its 
stretching (about a quart of urine). the amount 
voided is only a small amount (less than a cup) 
compared to the total amount of urine inside. 

There are basically two causes of  bladder over 

obstructed outflow of urine from the bladder due 
   to urethral narrowing 

loss of  nerve supply to the bladder detrusor 
   muscle due to medical disease or medications 

I do not know which of the causes of an 
overstretched bladder you have but if you had 
recent bladder repair surgery, that can sometimes 
(about 2-5% of the time) obstruct the urethra, the 
outflow tube from the bladder. If the obstruction 
is due to surgery, it often will improve within 3-
6 months after the operation and you will just 
need to self-cath or use the Foley catheter until 
then. If the obstruction persists beyond 3-6 
months, you may need a second surgery to relieve 
the tightening of the urethra. 

The other main cause of overflow urine leakage is 
due to a very weak bladder muscle. This can be 
caused by a medical condition such as diabetes 
which deadens the nerves to the bladder. There are 
some other less common neurological and spinal 
cord diseases and surgical causes that can produce 
this but your doctor would likely be aware if 
those applied in your case. 

Medications can also cause the bladder to be weak. 
In fact most of the medicines we prescribe for 
overactive bladder or urine urgency intentionally 
cause the bladder to relax and get bigger. Certain 
anti-depressant medications can cause this as well 
as any medicine that has an "atropine-like" 
mechanism of action. Medicines used for irritable 
bowel syndrome would fall in this category for 

Treatment of bladder overflow due to muscle 
weakness includes discontinuing any medicines that 
may worsen it and a program of timed double 
voiding. This is a regimen in which you void a 
second time less than a minute after voiding the 
first time in order to more thoroughly empty the 
urine from the bladder. This starts out every hour 
during the day for a week and progresses each week 
to every 90 minutes, 120 minutes, 150 minutes and 
180 minutes (3 hours). Each time schedule is held 
for a week. You should not exceed 3 hours without 
voiding. This double timed voiding regimen is 
probably what the doctor will put you on after the 
catheter is removed. 

Overflow urine leakage is a serious and somewhat 
difficult problem to treat so you will have to 
work closely with your doctor to get over it. The 
doctor may want you to see a urologist or 
urogynecology specialist if it does not seem the 
problem is improving with treatment. 

4. Estrogen and progestin HRT 5 year outcomes

You may have heard of the Women's Health 
Initiative study which was stopped after and 
average of 5 years follow-up because of excess 
adverse events in the women who were using hormone 
replacement therapy (Prempro). I think it is 
helpful to look at the benefits and risks that the 
study found 

The study looked at over 16000 postmenopausal 
women aged 50-79 who had a uterus and were 
candidates for hormone replacement therapy (HRT) 
with estrogen and progestin. Half of the women 
took HRT and half had placebo. The main outcomes 
they looked for were cardiac problems and strokes 
but they also looked at new cancers that occurred 
even though those cancer probably had started 
before the study was ever begun. 

They found more of the following events for each 
10,000 women years of HRT use: 

7 more coronary heart disease events, 
8 more strokes, 
8 more pulmonary emboli, 
and 8 more invasive breast cancers

There were some benefits and they found the 
following LESS events  for each 10,000 women years 
of HRT use: 

6 fewer colorectal cancers 
and 5 fewer hip fractures.

There were no differences in the number of deaths 
in either group. 

Well what can we conclude about these results? 
They actually are not much different than other 
previous studies, i.e., there is a very small 
increase in the risk of breast cancer with HRT. 
Almost one extra woman will develop breast cancer 
for each 100 women using HRT for 10 years. This 
low incidence is offset by less women on HRT who 
develop colorectal cancer and hip fractures which 
are as serious as cancers since they can often 
result in death. 

An increase in heart disease and serious vascular 
problems (2.3 more per 100 women using HRT for 10 
years) over the first 5 years of HRT use is where 
the main disadvantage is. Even though these women 
did not have heart disease at the start of the 
study, this is similar to the HERs study which 
demonstrated an increase in vascular problems 
early in the study and a lowering later in the 
study. If estrogen has a preventative effect on 
the future development of heart disease, it is a 
long term effect and in the short run there 
appears to be a small adverse effect. 

Although most studies that have looked at long 
term HRT use conclude that the overall death rate 
is less with HRT therapy than without it, this 
study will not be able to confirm or refute that 
since it was stopped early. Also a woman needs to 
keep in mind that this study does not apply to 
those who are taking only estrogen therapy i.e., 
probably having had a previous hysterectomy. There 
is some suspicion that the progestin component of 
HRT (medroxyprogesterone acetate) may be the cause 
of cardiovascular problems. 

Overall the study results are not a reason for 
women to discontinue HRT but you certainly should 
talk over the pros and cons which might apply to 
your own specific health history and that of your 
close blood relatives. 

Risks and benefits of estrogen plus progestin in 
healthy postmenopausal women

5. Health tip to share - Frequent UTIs

"I suffer from frequent bladder/urinary tract 
infections. I remember my first one at 7 years 
old. Over the years I have seen many doctors about 
it and basically all I get is antibiotics when I 
have an infection. I have now found a way to keep 
the problem under control and get rid of it 
naturally if I do get an infection." 

"CranActin(cranberry extract pills) is known for 
discouraging bacteria from clinging to the walls 
of the urethra and thus is flushed out much easier 
when voiding. I take one cap in the morning, two 
at about 2 pm and another in the evening with a 
big glass of water. If I do wind up with an 
infection (usually just in the urethra) I double 
up on them and the pain is usually gone in one or 
two days." 

"I really have been to many doctors(specialists). 
Have had laparoscopies, bladder biopsy, 
cystoscopy."  -  Debbie 

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

6. Humor is healthy
"Hearing Problem"

A concerned husband went to a doctor to talk about 
his wife. He says to the doctor, "Doctor, I think 
my wife is deaf because she never hears me the 
first time and always asks me to repeat things." 

"Well," the doctor replied, "go home and tonight 
stand about 15 feet from her and say something to 
her. If she doesn't reply move about 5 feet close 
and say it again. Keep doing this so that we'll 
get an idea about the severity of her deafness." 

Sure enough, the husband goes home and does 
exactly as instructed. He starts off about 15 feet 
from his wife in the kitchen as she is chopping 
some vegetables and says, "Honey, what's for 
dinner?" He hears no response.  He moves about 5 
feet closer and asks again. No reply. He moves 5 
feet closer. Still no reply. He gets fed up and 
moves right behind her, about an inch away, and 
asks again, "Honey, what's for dinner?" 

She replies, 
"For the fourth time, vegetable stew!" 

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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****** Woman's Health Newsletter *******
            July 28,  2002
Biweekly from BackupMD on the Net

1. Aloe vera and its healing properties
2. Women and testosterone
3. Reader submitted Q&A -  Polyps on gyn exam
4. Persistence in taking cholesterol lowering drugs?
5. Health tip to share - Cranberry juice
6. Humor is healthy

1.  Aloe vera and its healing properties
Even though the cactus-like plant, aloe vera, has 
been used for generations to promote healing of 
wounds and relieve skin burning, we still do not 
know much about how it works. The active 
ingredients are probably in the gooey gel from 
inside the leaves because that is why you break 
open the leaf to get the thin, sticky gel and rub 
it on a skin cut, sore or burn. Wounds that take 3 
weeks to heal will often completely heal in 2 
weeks. It may be used as a skin soap on patients 
undergoing radiation therapy to delay or prevent 
some of the redness from the xray therapy. 
Patients with psoriasis also seem to benefit from 
it and aloe has also been shown to be helpful for 
constipation when used by mouth. 

Some investigators believe the healing properties 
are from the vitamins and other chemicals in the 
goo, while others believe the goo is simply acting 
as a moisturizer and barrier that promotes more 
rapid healing. Recent investigators found that the 
gel-like substance contains "pectin", the 
substance one uses to make jelly. The aloe vera 
pectin is made of different carbohydrates than the 
pectin used in cooking but it is similar in its 
"gooey ness" properties. 

With any plant product, a skin allergic response 
can develop or photosensitivity take place. With 
photosensitivity, the skin appears normal at first 
but as soon as sun shines on the skin, a redness 
quickly develops. So be careful. 

Aloe vera and its healing properties

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