Women's Health Newsletters 3/14/99 - 4/18/99
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***** Woman's Diagnostic Cyber Newsletter *****
March 21, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Anesthesia for outpatient surgery
2. Foot care for aerobics and other sports
3. Common types of female sexual dysfunction
4. Seeking dermatology advice on the internet
5. What is AIDs/HIV?
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Anesthesia for outpatient surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In the rush of being told you may need outpatient
surgery for a laparoscopy, cone biopsy, D&C or
other procedure, one of the last things you may
inquire about are questions about the anesthesia
process. This site below may be a last minute
resource if you forget to ask about:
What is ambulatory anesthesia?
How will I meet my anesthesiologist?
What types of anesthesia are available?
Preoperative Reminders
What about eating or drinking before my anesthesia?
Will I need someone to take me home?
Should I take my usual medicines?
What should I wear?
Day of Surgery
What happens before my surgery?
What happens during my surgery?
Recovery in the Surgical Facility
What can I expect after the operation until I go home?
Will I have any side effects?
When will I be able to go home?
What instructions will I receive?
Recovery at home
What can I expect?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Foot care for aerobics and other sports
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We are told to have an aerobic workout at least
three times a week but very often we attack it
unprepared to prevent muscle or foot injury. With
foot impact, leaping, jumping, side movements and
other insults to your feet, the old sneakers in
your closet are probably not proper shoes for
aerobics. The American Podiatric Medical
Association has a very helpful sports-related foot
care brochure series covering foot care and
prevention of injury in over 10 different sports
and fitness exercises. Are you aware of common
aerobic foot injuries such as:
Plantar fasciitis (arch pain)
Heel spurs
Sesamoiditis
Shin splints
Achilles tendon and calf pain
Stress fractures
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Common types of female sexual dysfunction
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Are the causes for decreased sexual desire
psychological or physical? What about the woman
who is adverse to sexual relations? Is that the
same as a woman who is just not interested? See
our weekly news article for the six most common
categories of female sexual dysfunction including:
Hypoactive sexual desire disorder (HSDD)
Sexual aversion disorder (SAD)
Female sexual arousal disorder (FSAD)
Female orgasmic disorder (FOD)
Dyspareunia
Vaginismus
Female sexual dysfunction
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Seeking dermatology advice on the internet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In an interesting article in the Archives of
Dermatology, investigators analyzed 209
unsolicited e-mails mostly sent to physicians by
individuals seeking teleadvice. They found that:
81% had a chronic disease and seek a second
opinion
17% were frustrated about previous, live physician
visits
40% of e-mails could have been answered by a
librarian
28% of all e-mails were suitable to be answered by
a physician via e-mail alone
27% of the cases any kind of consultation would
not have been possible without seeing the patient
2-3% of patients were only attempting self-
diagnosis
These numbers sound believable. The authors
concluded that teleadvice might be overused by
chronically ill and frustrated patients looking
desperately for additional information. I'm not
sure "overused" is the correct view.
Patients Looking for Information on the Internet and Seeking Teleadvice
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. What is AIDs/HIV?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Every once in awhile a family member or a good
friend or possibly even yourself has questions
about what the symptoms of AIDS are or how can it
really be transmitted. If so, you may want to look
at this fact sheet at AEGIS.COM
An introduction to HIV and AIDS
If you or a friend has been newly diagnosed, they
have a section called The Basics for someone newly
infected which is a must view as soon as a
positive test is found:
Day one starter kit (written by someone with AIDs)
What AIDs is
The science of HIV
Opportunistic Infections (preventing them)
HIV type 2
HIV statistics
Newly infected with HIV
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6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
How to talk about men and still be politically
correct
He does not have a beer gut,
He has developed a Liquid Grain Storage Facility.
He is not quiet,
He is a Conversational Minimalist.
He is not stupid,
He suffers from Minimal Cranial Development.
He does not get lost all the time,
He discovers Alternative Destinations.
He is not balding,
He is in Follicle Regression.
He is not a cradle robber,
He prefers Generationally Differential
Relationships.
He does not get falling-down drunk,
He becomes Accidentally Horizontal.
He does not have his head up his ass,
He suffers from Rectal-Cranial Inversion.
He is not short,
He is Anatomically Compact.
He does not have a rich daddy,
He is a Recipient of Parental Asset Infusion.
He does not constantly talk about cars,
He has a Vehicular Addiction.
He does not have a hot body,
He is Physically Combustible.
He is not unsophisticated,
He is Socially Challenged.
He does not eat like a pig,
He suffers from Reverse Anorexia.
He is not a bad dancer,
He is Overly Caucasian.
He is not a sex machine,
He is Romantically Automated.
He does not hog the blankets,
He is Thermally Unappreciative.
He is not a male chauvinist pig,
He has Swine Empathy.
He does not undress you with his eyes,
He has an Introspective Pornographic Moment.
He is not afraid of commitment,
He is Monogamously Challenged.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
March 28, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Diagnosis of fainting (syncope)
2. How do you know if you are perimenopausal?
3. Musculoskeletal causes of pelvic pain
4. Discount BCPs, estrogens and other meds
5. How to manage sources of stress
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Diagnosis of fainting (syncope)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Fainting can be an infrequent and benign occurrence
or it can be chronic, recurrent and serious in its
cause. Heart rhythm abnormalities are the most
serious problems, but fainting due to stress,
standing up too fast, being in a hot room, and
neurological problems can confuse the diagnosis.
Physicians may order an EKG but often the rhythm
abnormality, a slow heartbeat producing lack of
blood flow and oxygen to the brain, is undetected
because it does not occur very often. Then, longer
monitoring for 24 - 48 hours or even a month or
more is needed to make a proper diagnosis of
unexplained, recurrent fainting. Special monitors
are needed for this longer term monitoring. If
fainting is a problem, you may want to look at:
Fainting
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2. How do you know if you are perimenopausal?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women mistake perimenopause for menopause.
Because of the changes in the hormonal cycle,
symptoms such as hot flushes, fatigue, insomnia,
worsening premenstrual syndrome (PMS),
irritability, depression, headaches, and
forgetfulness can occur before menopause just as
they can after. Womens-health.com has a handy
self-assessment about perimenopause in their
Midlife Health Center. Each question has a short
fact sheet about why that question is being asked.
Perimenopausal assessment
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3. Musculoskeletal causes of pelvic pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that problems of abnormal curvature
of the spine and abdominal muscle abnormalities
can be the cause of pain which you perceive as
being uterine or ovarian in origin? Not often, but
sometimes pelvic pain can be sucessfully treated
with physical therapy and exercises if it is a
certain type of pain. See the article about pelvic
pain having origins in the muscles and ligaments
of the back and abdominal wall at:
Myofascial causes of pelvic pain
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4. Discount BCPs, estrogens and other meds
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
More and more pharmacies and drugstores are coming
online. There are opportunities to save some money
on prescriptions you may need. One firm called
Femscript.com has some discounts on birth control
pills, estrogen replacement and fertility drugs.
Some charges I noticed are:
Mircette, TriNorinyl, Norinyl 1/35, 1/50, Demulen
1/35, 1/50 all at $18 per cycle and Desogen at $14
per cycle. Ogen 0.625 (30 tablets) at $14 and
Alora patches at $17 for the 0.05 dose, 8 patches.
You may want to browse to see if you can beat some
of your local prices.
Discounts on birth control pills and other prescriptions
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. How to manage sources of stress
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From the Self-help & Psychology Magazine comes an
informative article by Edward A. Dreyfus, Ph.D. on
how to manage different sources of stress. The
majority of stress comes from our expectations of
how we ourselves should behave or how our
partners, family members or coworkers should act.
When they do not act in accordance with our
standards, we become agitated. Until you recognize
the source of the stress, you cannot quickly deal
with it. This article gives you some tips for
gaining a perspective on situations to reduce the
impact and hence the stress.
Managing sources of stress
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6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subject: "IF AIRLINES SOLD PAINT"
From: Robert G. Eisenhardt
Buying paint from a hardware store...
Customer: Hi, how much is your paint?
Clerk: We have regular quality for $12 a gallon
and premium for $18. How many gallons would you
like?
Customer: Five gallons of regular quality, please.
Clerk: Great. that will be $60 plus tax.
BUT......
Buying paint from an AIRLINE...
Customer: Hi, How much is your paint?
Clerk: Well, Sir that all depends.
Customer: Depends on what?
Clerk: Actually, a lot of things.
Customer: How about giving me an average price?
Clerk: Wow, that's too hard a question. The lowest
price is $9 a gallon, and we have 150 different
prices up to $200 a gallon.
Customer: What's the difference in the paint?
Clerk: Oh, there isn't any difference, it's all
the same paint.
Customer: Well, then, I'd like some of that $9 paint.
Clerk: Well, First I need to ask you a few
questions. When do you intend to use it?
Customer: I want to paint tomorrow, on my day off.
Clerk: Sir, the paint for tomorrow is $200 paint.
Customer: What? when would I have to paint in
order to get $9 paint?
Clerk: That would be in three weeks, but you will
also have to agree to start painting before Friday
of that week and continue painting until at least
Sunday.
Customer: You've got to be kidding!
Clerk: Sir, we don't kid around here. Of course,
I'll have to check to see if we have any of that
paint available before I can sell it to you.
Customer: What do you mean check to see if you can
sell it to me? You have shelves full of that
stuff; I can see it right there.
Clerk: Just because you can see it doesn't mean
that we have it. It may be the same paint, but we
sell only a certain number of gallons on any given
weekend. Oh, and by the way, the price just went
up to $12.
Customer: You mean the price went up while we were
talking?
Clerk: Yes sir. You see, we change prices and
rules thousands of times a day, and since you
haven't actually walked out of the store with your
paint yet, we just decided to change. Unless you
want the same thing to happen again, I would
suggest you get on with your purchase. How many
gallons do you want?
Customer: I don't know exactly. Maybe five
gallons. Maybe I should buy six gallons just to
make sure I have enough.
Clerk: Oh, no sir, you can't do that. If you buy
the paint and then don't use it, you will be
liable for penalties and possible confiscation of
the paint you already have.
Customer: What?
Clerk: That's right. We can sell you enough paint
to do your kitchen, bathroom, hall and north
bedroom, but if you stop painting before you do
the other bedroom, you will be in violation of our
tariffs.
Customer: But what does it matter to you whether I
use all the paint? I already paid you for it!
Clerk: Sir, there's no point in getting upset;
that's just the way it is. We make plans based
upon the idea that you will use all the paint, and
when you don't, it just causes us all sorts of
problems.
Customer: This is crazy! I suppose something
terrible will happen if I don't keep painting
until Sunday night?
Clerk: Yes sir, it will.
Customer: Well, that does it! I am going somewhere
else to buy paint!
Clerk: That won't do you any good, sir. We all
have the same rules. You might as well just buy it
here, while the price is now $13.50 Thanks for
flying - I mean painting - with our airline.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you think you have a good doctor, be sure to
share that doctor with other women looking for
one.
/mdfind.htm
MD share program
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***** Woman's Diagnostic Cyber Newsletter *****
April 4, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Trying to get pregnant - An online book
2. Chronic cough - its most common causes
3. Screening for colon and rectal cancer
4. Urinary incontinence guidelines
5. Should you get a flu shot?
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Trying to get pregnant - An online book
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many of our message board participants are TTC
(trying to conceive). If so, you may find this
online book handy from a Dr. Malpani. It is even
searchable online to look up different topics.
Among the 44 online chapters are:
Getting pregnant basics, when to start worrying,
ovulation, semen analysis, polycystic ovarian
syndrome and advanced reproductive technologies.
The chapter on basics is even worthwhile for a
woman trying to prevent pregnancy at the current
time.
Online Trying to Get Pregnant Book
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Chronic cough - its most common causes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
What do you think would be the most common causes
for which someone with a chronic cough would be
referred to a pulmonary specialist? The three most
common causes are postnasal drip, asthma and
gastroesophageal reflux. These are not exactly the
what I would have guessed, especially the
gastroesophageal reflux. At an article by W. ROSS
LAWLER, M.D., An Office Approach to the Diagnosis
of Chronic Cough, these three causes are
discussed. Most acute coughs are due to acute
colds, sinusitis or bronchitis but go
away within less than 3 weeks. It may take up to 7
weeks for bronchial airway hyperreactivity to
return to normal following a simple viral upper
respiratory infection. So the definition of
chronic cough is lasting 8 weeks or greater.
Postinfectious bronchial inflammation is also a
common cause for referral but that usually takes
place when a cough has not gone away in 3 or more
weeks.
Chronic Cough
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3. Screening for colon and rectal cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Would it surprise you that colon cancer is 5 times
more common than ovarian cancer? It is and like
ovarian cancer it has a rising incidence over the
age of 50. What is the best strategy to detect
changes early (adenomatous polyps) before they
become cancerous? Screening tests and frequencies
for both women of average colorectal cancer risk,
and also for women at higher risk for colorectal
are discussed in this week's article at:
Colorectal cancer screening
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Urinary incontinence guidelines
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Urinary leakage is not uncommon in women and
fairly frequent in occurrence after the menopause.
The following site has a set of guidelines,
Treating Women's Incontinence: A Review of the
Literature and Recommendations for Practice by
Christine Bradway, MSN, RN, CS,
I especially like the review of the literature
about non-surgical treatments of incontinence such
as pelvic muscle exercises (Kegel's), biofeedback,
bladder retraining, vaginal weights, electrical
stimulation, and medical therapy.
Urinary incontinence guidelines
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Should you get a flu shot?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The study below in the Journal of the American
Medical Association (JAMA) looks at what is the
excess risk of hospitalization and death from
influenza in women of various risk and disease
conditions. Among women with no identified high-
risk conditions, estimated annual excess
hospitalizations and deaths were 4 and 6 per
10,000 in women aged 15 to 44 and 45 to 64 years,
respectively. These are very low numbers and must
be weighed against the potential of rare but
serious, adverse effects from any vaccination such
as a neurological (Guillain-Barre syndrome) or
autoimmune (Thrombotic thrombocytopenic purpura)
complication.
This would imply that women under 65 do not
necessarily need to take flu vaccination unless
they have some sort of a chronic medical problem.
To be more direct, in my opinion, I do not
recommend flu shots for women who are not at high
risk.
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6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From: Phyllis B., San Antonio, TX
Nothing Up His Sleeve...
The baby was just born. He had all his pieces and
looked quite normal, except that he was laughing
like crazy. I mean laughing real hard.
All the doctors and nurses were examining the
little newborn in front of the worried parents,
but he kept laughing. He laughed, hands in tight
fists, until tears were rolling down his cheeks.
During the initial exam, the obstetrician slowly
unfolded the tiny fingers to check if the hand was
all right. Nobody in the room believed what was
found in the baby's hand.
A birth control pill!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
April 11, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Heavy menses - its causes and treatments
2. Organic solvent exposure causes birth defects
3. Lifestyle choices and infertility
4. Allergic rhinitis
5. Melatonin promotes sleep but overdose can occur
6. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Heavy menses - its causes and treatments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Heavy menses is an aggravating problem that rears
up in the decade of the 40's before menopause. It
is often difficult to explain why menses get so
heavy. There are some known causes but many times
we are not so sure of the exact mechanism of heavy
bleeding.
This is a classic article from 1996 in the Medical
Journal of Australia. Its definitions and methods
for diagnosis are very understandable. It
thoroughly covers medical therapy as well as
surgical therapy other than hysterectomy such as
endometrial ablation and myomectomy. If you've
entered the decade of the 40's and menses are
getting heavier each cycle, this article is a
great educational resource that you may want to
read.
Menorrhagia - heavy menses
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2. Organic solvent exposure causes birth defects
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women are exposed to organic solvents in
their workplace such a toluene, ethylene and
others. This is especially true of women working
in a laboratory technician capacity.
A recent Journal of the American Medical
Association article found a greatly increased
incidence of birth defects (13 to 1) in women
exposed to such solvents. There was also and
increased rate of miscarriage (46.2% vs 19.2%).
Toluene has previously been associated with birth
defects in "glue sniffers" but this is the first
good report that confirms a problem with
occupational exposure.
Pregnancy outcome after exposure to organic solvents
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Lifestyle choices and infertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Certain diseases and conditions can cause
infertility but those are things we do not seem to
have control over. Many women are unaware how
everyday habits that can be changed play a role in
interfering with attempts to conceive. Just how
much of a role does smoking, caffeine, alcohol,
increased weight, decreased weight STDs or delayed
childbearing play. These factors are discussed at:
Infertility and lifestyle changes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Allergic rhinitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Spring is finally coming but it often brings
allergies. If you have ever had a runny nose and
eyes in the Spring and have struggled with
different meds that sometimes sedate you and at
other times hype you up, you may want to look at
this article on allergic rhinitis. I especially
liked the extensive discussion of the different
medications both by prescription and over-the-
counter, and their strong points and side effects.
Allergic rhinitis at Dr John's Med World
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Melatonin promotes sleep but overdose can occur
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Melatonin is sold as a dietary supplement than can
be used to promote sleep, reduce stress and combat
jet lag. Effectiveness in sleep promotion has been
shown in some studies but the doses and
interactions with other relaxants and sleep meds
are not clear. The article below, published in the
Southern Medical Journal points out an instance of
overdose of melatonin in an elderly man already
taking melatonin regularly.
Melatonin overdose
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From: "Joe Lex"
Subject: Y0K
Message from: Rome
April 10, 1 B.C.
Dear Cassius,
Are you still working on the Y zero K problem?
This change from BC to AD is giving us a lot of
headaches and we haven't much time left. I don't
know how people will cope with working the wrong
way around. Having been working happily downwards
forever, now we have to start thinking upwards.
You would think that someone would have thought of
it earlier and not left it to us to sort out at
the last minute.
I spoke to Caesar the other evening. He was livid
that Julius hadn't done something about it when he
was sorting out the calendar. He said he could see
why Brutus turned nasty. We called in the
consulting astrologers, but they simply said that
continuing downwards using minus BC won't work. As
usual, the consultants charged a fortune for doing
nothing useful. As for myself, I just can't see
the sand in an hourglass flowing upwards.
We have heard that there are 3 wise guys in the
east working on the problem, but unfortunately
they won't arrive till it's all over. Some say the
world will cease to exist at the moment of
transition. Anyway we are continuing to work on
this blasted Y zero K problem and I will send you
a parchment if anything further develops.
Plutonius.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
April 18, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Visible embryo
2. Ovarian cancer screening may increase survival
3. Malignant melanoma in women
4. Oral contraceptive use and strokes
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Visible embryo
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you would like to see pictures of what the
embryo in a developing pregnancy looks like in the
first 10 weeks of pregnancy, take a look at the
site by Mouse Works and sponsored by The National
Institutes of Child Health and Human Development
at:
Visible embryo
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Ovarian cancer screening may increase survival
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Screening for ovarian cancer using a CA-125 blood
test and vaginal ultrasound has received negative
recommendations over the past decade in the
American medical literature because of the large
cost to pick up an unsuspected case of ovarian
cancer (about 2/1000 women screened), the false
positive rate of about 10:1 in postmenopausal
women (all these 10 women may need to undergo
surgery and its risks to find one ovarian cancer),
and finally, the concern that even if a cancer is
discovered, is it early enough to make a
difference in survival.
Those of you who are interested in this topic may
enjoy the summary in the British Medical Journal
about a Lancet article in which over 20,000 women
over 45 years of age were screened and 6 ovarian
cancers were found. In those with ovarian cancer,
survival was 73 months in the screened group and
42 months in the control group. This data may help
change the establishment's adversity to screening
for this occult growing cancer.
Ovarian cancer screening
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Malignant melanoma in women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that the most common cancer in women
25-29 years of age is malignant melanoma of the
skin? Many women are aware that sun and tanning
bed exposure increases the incidence of skin
cancers but the pigmented skin cancers called
melanoma can often be fatal if they are at all
advanced when diagnosed. Since pregnancy,
menopause and birth control hormones (mostly the
estrogen) tend to darken moles and freckles and
even cause facial blotching (melasma), the
question becomes do they increase the incidence or
severity of melanoma. Probably not, but the woman
who notices increased size and darkening of moles
in pregnancy, needs to be check more frequently.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Oral contraceptive use and strokes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Recent teaching has said that current low dose (35
micrograms or less of ethinyl estradiol) birth
control pills does not increase brain strokes in
women under 35 years of age but increases risk for
thrombotic (clotting) strokes and hemorrhagic
(bleeding) strokes in women over 35 who also
smoke. A recent study in the Journal of the
American Medical Association reconfirms that, in
general, strokes are not increased in young women
using oral contraceptive pills (OCPs). For some
reason, they also FAILED to find a relationship of
OCPs and strokes in women who smoked and were over
age 35. There was an increase in risk (2 times),
however, in women who have a history of migraine
headaches.
This is not enough evidence to run out and restart
smoking if you are on the pill, but it reminds us
that we have to be careful to individualize to
each woman's situation, the pros and cons of
different life strategies.
OCPs and strokes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The Top Signs You've Joined a Cheap HMO
"Pre-natal vitamin" prescription is a box of Tic-
Tacs.
Even your paper robe is recycled.
Plan covers only "group" gynecological exams.
Preprinted prescription pads that say "Walk it
off, wimp."
Their newest revenue stream: Video of your recent
colonoscopy goes up for sale on the Internet.
You ask for Viagra. You get a Popsicle stick and
duct tape.
You can get your flu shot as soon as "the"
hypodermic needle is dry.
Your primary care physician has a Burger King
badge poking out underneath his coat.
"If you'd just stop screaming and sign the check,
we'll sew you back up!"
"Patient responsible for 200% of out-of-network
charges" is not a typo.
24-hour claims line is 1 800 TUF LUCK
Despite what your doctor says, you don't remember
hearing anything about the benefits of pre-
moistened tongue depressors.
EKG monitor is an Etch-A-Sketch
Instead of a surgical glove, they use pink
dishwashing ones.
Physician in charge of Suicide Prevention Hotline
is Dr. Kevorkian.
The only expense covered 100% is embalming.
Use of antibiotics deemed an "unauthorized
experimental procedure."
"Chemotherapy" machine looks suspiciously like a
tanning bed.
You swear you saw salad tongs and a crab fork on
the instrument tray just before the anesthesia
kicked in.
Tight budget prevents acquisition of separate
rectal thermometers.
Tongue depressors taste faintly of Fudgesicle.
This list copyright 1999 by Chris White
http://www.topfive.com
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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