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****** Woman's Health Newsletter *******
October 19, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Rosacea
2. Deciding on repeat C-section or trial of labor
3. Reader submitted Q&A - Post op fatigue
4. Lifetime risk for diabetes
5. Health tip to share - Pap smear frequency
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Rosacea
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Rosacea is an inflammatory skin condition of the
face which can range from a mild redness in the
cheeks like blushing, to a constant redness and
acne-like rash. It can be mistaken for acne, the
facial rash of lupus erythematosis, an allergic
reaction to a soap or cosmetic or even a sunburn.
Blushing more easily can be an early sign of
rosacea. It can also cause a burning and gritty
sensation in the eyes if the skin around the eye
and on the inside of the eyelids is affected.
This condition is found in adults aged 30-60 and
in women more often than men. It is not a serious
life-threatening condition but it significantly
affects your appearance. The cause is still
unknown but scientists think it is a combination
of genetic and environmental factors. Triggers
that make it worse seem to be sun exposure,
stress, spicy foods, exercise, cold wind, hot
foods, and hot baths. Alcohol does not cause this
although it can make it worse in appearance
because alcohol dilates blood vessels of the face.
Self-care includes:
Use sunscreen (SPF of 15 or higher)
Protect your face from windburn
Do not touch (irritate) your facial skin too much
Avoid facial products with alcohol
Apply any moisturizer after the topical antibiotic
has dried
Use products labeled noncomedogenic (won't clog
pores)
If wearing makeup, use green-tinted pre-foundation
creams to counter skin redness
Treatments for rosacea include topical antibiotics
as well as antibiotics by mouth. Sometimes
Accutane(R) (isotretinoin), which is used for
severe acne, can be used to treat rosacea. Laser
therapy has also been used to reduce the
visibility of small blood vessels which accompany
rosacea.
Rosacea
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Deciding on repeat C-section or trial of labor
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you have previously had a Caesarean section and
become pregnant again, you may need to decide if
you wish to have a routinely scheduled repeat C-
section for delivery or whether you wish to have a
trial of labor. Surgery encompasses more risks
than a vaginal delivery but with a trial of labor,
there is also the chance (quite small) that the
previous uterine incision at time of C-section may
rupture and cause complications for both mother
and baby.
Doctors used to say that "once a C-section, always
a C-section." Then, because of increased surgical
complications compared with vaginal deliveries,
they began to recommend a trial of labor because
about 2/3's of women can deliver vaginally even
though they had a previous C-section. Recently the
pendulum has flipped and the risk of uterine
rupture with a trial of vaginal birth after C-
section (VBAC) has become of greater concern.
A recent study looked at the risks associated with
both repeat C-section and VBAC to see if there was
a way doctors and mothers could best decide which
choice to make in order to minimize the risks of
either strategy. Investigators found that if a
trial of labor has a 50% chance or greater of
success and if the chance of wanting a future
pregnancy after cesarean section is 20% or above,
then a women should choose a trial of labor to
minimize her risk. This strategy is best because
the risk of significant problems increases with
more and more consecutive Caesarean sections.
Deciding on repeat C-section or trial of labor
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Post op fatigue
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am a 37 yr. old wife and mother of two sons. I
had an abdominal hysterectomy 3 1/2 months ago.
While I only had my uterus removed and do not take
any medications and I thought my recovery was
going well, these last 3 weeks have been terrible.
I'm almost always exhausted, everywhere I sit, I
drift off to sleep. I'm sweating a lot at night
and have abdominal pain sometimes. I know that it
takes a while to heal, but is this normal after a
hysterectomy to be happening so late in the
healing process? Also, I am still numb in the
abdominal area. When does that leave? How can I
lose this pouch that I now carry? (my tummy that
is?" - G.P.
At 3 months post op from a hysterectomy you should
have recovered pretty much to your preoperative
energy levels. The abdominal numbness around the
incision, however, is common and may take as much
as a year to year and a half to go away as the
nerves slowly recover from having been cut in the
skin.
The fatigue and sleepiness sound as if they are
new symptoms and probably not related to the
surgery unless your ovaries have stopped
functioning and you are becoming menopausal. If
that is true, that may explain the hot flashes,
and sleep disturbances causing daytime sleepiness.
Age 37 is somewhat early for menopause but you can
never tell. Sometimes the surgery can shock the
ovaries and cause a premature menopause. Just ask
the doctor to run a menopause test (FSH blood
test) to see if that is the problem. If not, you
may need to look for another cause. Rarely
infection/abscess of the ovary can present at 3
months after hysterectomy but the doctor should be
able to tell that on exam. I would suggest seeing
the doctor again because of the pain, sweats and
hot flashes and ask for the FSH blood test.
As far as the abdominal pouching goes, the only
cure is abdominal muscle exercises and dieting.
The inactivity after surgery leads to increased
fat depositing in the lower abdomen as well as
weakness in the abdominal rectus muscles that go
from the ribs to the pelvic bone in the midline.
You will have to work hard on that to get rid of
the tummy!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Lifetime risk for diabetes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
How likely is it that you might develop diabetes
at sometime in your life? Those numbers have not
readily been available until now. Medical
scientists from the Center for Disease Control and
Prevention have calculated the odds of different
people developing diabetes at sometime in their
life. This is independent as to whether you have a
history of diabetes in your family.
They found that the estimated lifetime risk of
developing diabetes for individuals "born in 2000
is 32.8% for males and 38.5% for females. Females
have higher residual lifetime risks at all ages.
The highest estimated lifetime risk for diabetes
is among Hispanics (males, 45.4% and females,
52.5%)." Anyone who is diagnosed with diabetes has
a fairly large reduction in their life expectancy.
It is estimated that a man diagnosed with diabetes
at age 40 will lose 11.6 years of life and a woman
diagnosed at age 40 will lose 14.3 years of life.
These premature deaths are due to the
complications of diabetes as well as the worsening
effect it has on other conditions such as high
blood pressure, heart disease, smoking etc.
The bottom line is that we should make every
effort we can to prevent diabetes by maintaining a
healthy diet, lifestyle and weight throughout our
lives. Also, we should pay more attention to early
diagnosis of diabetes. Perhaps we have been
underestimating it as a common health problem.
Lifetime risk for diabetes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Pap smear frequency
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you have not previously had abnormal Pap smears
and have had several normal (negative) Pap smears
recently, it is now recommended that you only need
to have a Pap test every 3 years. The risk of
getting invasive cancer of the cervix with this
strategy is less than 2/100,000
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Now that they are retired, my mother and
father are discussing all aspects of their
future. "What will you do if I die before you
do?" Dad asked Mom.
After some thought, she said that she'd
probably look for a house-sharing situation
with three other single or widowed women
who might be a little younger than herself,
since she is so active for her age.
Then Mom asked Dad, "What will you do if
I die first?"
He replied, "Probably the same thing."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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****** Woman's Health Newsletter *******
November 2, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Colon polyps
2. Psycho social factors and high blood pressure
3. Reader submitted Q&A - Gastric reflux disease
4. Recurrent yeast infection from skin sources
5. Health tip to share - Endometriosis
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Colon polyps
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many people die each year as a result of colon
cancer and yet it is a very preventable disease.
Most colon cancer arises in skin tags on the
inside of the large bowel (colon) called polyps.
They go through a phase in which they just have
"glandular" growth before becoming an invasive
malignant growth.
When polyps are present, they may bleed so that
minute amounts of blood are measurable in the
stool. In this phase they can be detected by
testing your stool for hidden (occult) blood.
However if blood is present in the stool, it does
not necessarily mean cancer or even polyps. It may
just be due to bleeding from hemorrhoids or even
blood from red meat like hamburger or steak in
your diet. If the test for blood in the stool is
positive even after going without eating red meat
for several days, then you will need to have a
diagnostic procedure performed like a colonoscopy
or flexible sigmoidoscopy. This is an office study
while you are sedated (but not put asleep) in
which a telescopic instrument is placed in the
rectum to visually look for polyps.
The American Cancer Society recommends yearly
stool tests to check for microscopic bleeding
starting at age 40. They also recommend a flexible
sigmoidoscopy every three to five years for people
aged 50 or older or even more often if you have a
history of colon cancer or colon polyps in your
family. When polyps are found in these early
stages even before they cause bleeding, they
usually can easily be removed by biopsy at the
time of sigmoidoscopy or colonoscopy. It is felt
that removal of all polyps prevents a person from
developing most forms of colon cancer.
Colon polyps
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2. Psycho social factors and high blood pressure
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The association between a "Type A personality"
(competitive, aggressive) and high blood pressure
has been known for a long time. However it is not
clear whether just plain anxiousness, depression
or anger/hostility are causes also.
A recent study looked prospectively at the
development of hypertension and measured several
personality traits at the start and end to see if
they had an effect on development of high blood
pressure. The investigators examined the role of
psycho social factors of time urgency/impatience
(TUI), achievement striving/competitiveness (ASC),
hostility, depression, and anxiety on the long-
term (5 year) risk of hypertension.
They found that only two of the factors were
significantly associated with developing high
blood pressure: time urgency/impatience and
hostility. It was surprising that
Striving/competitiveness was not actually
predictive of blood pressure elevation. Thus it
appears that the real elements of a "Type A
personality" that are associated with high blood
pressure are impatience and anger. Striving to get
ahead or competing in the workplace do not cause
high blood pressure unless you get angry about it
or impatient with the process.
Psycho social factors and high blood pressure
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Gastric reflux disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been suffering form gastroesophageal
reflux disease (GERD) for the last 5 months.
Suggested remedy includes change in life style.
Exactly what changes will minimize the symptoms? I
am a house wife with 2 children. I recently had a
laparoscopic hysterectomy done. I have recovered
well. Is it true that GERD leads to esophageal
cancer? how can it be prevented?" - C.R.
When acid secretions from the stomach escape
upward into the throat (esophagus) where they are
not supposed to be, they cause chronic ulcerative
damage to the inside skin lining. Any chronic
irritation of skin can predispose a person to
developing cancer in that area. For that reason,
the acid reflux needs to be treated not only to
give relief from short term symptoms of heartburn,
difficulty swallowing and chest discomfort, but
also to minimize any long term effect (20-30
years) that might induce an esophageal cancer.
While sometimes a bacterial infection of the
stomach called heliobacter pylori can contribute
to GERD, the predominant causes are habits and
conditions of our daily life which we should have
control to change on our own. These are labeled
lifestyle factors. They include:
smoking
alcohol ingestion
excessive caffeine
eating too fast (10 versus 30 minutes for a meal)
eating too many spicy hot, peppery foods
low fruit and vegetable consumption
excessive nitrite intake (from preserved meats)
lying down too soon after eating
obesity (increases stomach pressure to cause reflux)
Doctors often prescribe proton pump inhibitor
medications which decrease the production of
stomach acid as treatment for GERD. These
prescriptions might include omeprazole
(Prilosec[R]), lansoprazole (Prevacid [R]),
rabeprazole (Aciphex[R]), or pantoprazole
(Protonix[R]). However these meds just provide
temporary relief and you must change the
"lifestyle" habits which are contributing to the
problem; otherwise you will be taking those
medicines forever.
If you have cut down your intake of fruits and
acid foods like tomatoes because they worsen your
symptoms, there is an over-the-counter food
supplement called Prelief[R] that lowers the acid
content of foods so that you can eat small amounts
of them. But remember again, that this is just a
temporary fix to the problem.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Recurrent yeast infection from skin sources
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women feel they suffer from Chronic,
recurrent yeast vaginitis caused by candida yeast
species. However we know that 50% of the time,
episodes of suspected yeast vaginitis or vulvitis
are not really caused by yeast. At least yeast
cultures are negative when they are checked. The
other 50% of the time, yeast is the culprit and
women who have this suffer moderately.
A recent study looked at how often women who had
recurrent yeast infections had evidence of yeast
growth from sites other than the vagina such as
the mouth, rectum, perianal skin, and urine. They
postulated that the other sites might be the
source of the yeast causing a vaginal infection.
They also looked at habits such as oral sex,
wearing tight fitting pants or non-cotton
underwear to see if these made a difference in the
frequency of culture positive candida infection.
The investigators confirmed previous studies by
finding that only 50% of the suspected episodes of
recurrent yeast vaginitis were culture positive
for yeast in the vagina. However, of the 50% of
women who did have positive vaginal yeast
cultures, yeast could also be cultured from other
sites a significant percent of the time:
mouth 17%
rectum 52%
perianal skin 74%
urine 35%
When yeast was cultured from these other sites,
the species of yeast was often different than the
typical candida albicans that is most often
associated with vaginal infection. These findings
would indicate that the source of yeast
reinfection may often be from other skin sites and
that treatment needs to be directed against non
candida albicans species.
The investigators also found NO correlation
between oral sex, tight fitting pants or use of
non cotton underwear as causes of recurrent yeast
infection. This is contrary to what many doctors
have said.
Recurrent yeast infection from skin sources
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Endometriosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have lived with the pain of endometriosis and
have had two laparotomy surgeries to treat it, the
second surgery did not relieve my pain. My gyne
physician ordered Lupron(R) (for two years), which
did relieve the pain, but the Lupron(R) caused
osteoporosis. I stopped taking Lupron one year ago
and my endometriosis pain came back. My primary
care physician recommended that I increase my
Caltrate(R) dose (calcium carbonate) from 600
mg/day to 1200 mg/day to treat my osteoporosis.
Within two months of the increased dose, my
endometriosis pain is so much less!! We found a
good treatment by accident!" - KMS
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Eternal Truths"
Remember, once you get over the hill, you'll begin
to pick up speed.
I love cooking with wine. Sometimes I even put it
in the food.
If it weren't for STRESS I'd have no energy at
all.
Whatever hits the fan will not be evenly
distributed.
Everyone has a photographic memory. Some just
don't have any film.
Dogs have owners. Cats have staff.
If the shoe fits......buy a pair in every color.
Never be too open minded, your brains could fall
out.
If you look like your passport picture, you
probably need the trip.
Bills travel through the mail at twice the speed
of checks.
Some days are a total waste of makeup.
Men are from earth. Women are from earth. Deal
with it.
A balanced diet is a cookie in each hand.
Middle age is when broadness of the mind and
narrowness of the waist change places.
Opportunities always look bigger going than
coming.
Junk is something you've kept for years and throw
away three weeks before you need it.
Experience is a wonderful thing. It enables you to
recognize a mistake when you make it again.
By the time you can make ends meet, they move the
ends.
Learn from the mistakes of others. Trust me...you
can't live long enough to make them all yourself.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
November 16, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Laser skin resurfacing
2. Pelvic muscle exercise to reduce incontinence
3. Reader submitted Q&A - Measuring estrogen
4. Uterine artery embolization
5. Health tip to share - Excessive weight and depression
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Laser skin resurfacing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You may have heard of dermabrasion or chemical
peel as methods to treat your skin to remove
wrinkles, scars and pigmented areas. Recently,
dermatologists and plastic surgeons have been
using lasers to vaporize those outer skin layers
containing the defects you do not want. This is
called laser skin resurfacing (LSR) or "laser
peel," A carbon dioxide (CO2) laser is used to
remove areas of damaged or wrinkled skin, layer by
layer. The procedure is most commonly used to
minimize the appearance of fine lines, especially
around the mouth and the eyes. However, it is also
effective in treating facial scars due to acne or
areas of uneven pigmentation.
Many physicians feel this technique is better than
the chemical peels or dermabrasion because the
depth of skin layer can be much better controlled.
Thus there is less deep skin damage, bleeding and
quicker recovery. Only recently have studies been
performed to see how patients tolerate laser
resurfacing in the long run.
Investigators followed 27 patients who underwent
laser resurfacing for acne scarring or skin
photodamage. They interviewed them at
postoperative days 1 and 3, within 1 week, at 3
weeks, 6 weeks, 3 months, and 30 months and asked
standardized questions.
They found that on the first postoperative day 37%
were concerned about the outcome, one in nine
patients considered it a "terrible" experience. At
3.7 days after the procedure, 89% would have the
procedure again. At 3 months post LSR, the
patients' mean rating of appearance was 2.3 (0-3
scale), and all 27 (100%) felt that their
appearance had been improved by LSR.
Long term after 30 months:
75% would recommend the procedure,
71% would have LSR again
88% felt that their appearance was improved,
final appearance was rated 1.8 (0-3 scale)
Patients undergoing LSR to treat acne scarring
were as satisfied as patients treated for
photodamage.
Hopefully this give you an idea of what to expect
as far as satisfaction from a laser resurfacing
procedure.
Laser skin resurfacing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Pelvic muscle exercise to reduce incontinence
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dr. Arnold Kegel in the late 1940's began
publishing about the benefits of pelvic exercises
for female urinary incontinence. his particular
brand of exercises, Kegel's exercises, have come
to be a standard non surgical treatment to improve
urinary continence. Actually Dr. Kegel was much
more successful than we are today in using the
pelvic muscle exercises to improve this problem.
Perhaps his success was based upon excellent
patient compliance in religiously performing the
isometric muscle contractions several times a day
for months at a time.
A recent study in Hong Kong looked at many
factors such as age, mode of delivery, menopausal
status, history of pelvic surgery, duration of
incontinence, and how well the women adhered
(compliance) to the muscle exercise regimen.
Basically they found that almost totally, the best
predictor of reducing incontinence was the
compliance rather than any other factor. In other
words postmenopausal women did as well as
premenopausal women in reducing urine leakage as
long as they did their exercises as they were
supposed to.
The pelvic muscle training program appears to be
able to reduce urinary incontinence episodes by
85%. Although women who had more numerous wetting
episodes did not become totally dry, those who
were more compliant with the exercises had a
greater reduction in leakage episodes.
This finding is a recurrent theme in the
literature, i.e., that simple muscle exercises can
be as effective as surgery if a person is really
disciplined to carry out the exercises.
Pelvic muscle exercise to reduce incontinence
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Measuring estrogen
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am a 70 year old woman and want before starting
HRT to check my hormone levels. What is better, a
vaginal smear, blood or urine test? May be
something else? The doctor recommended
hysterectomy because of pelvic prolapse." - J.
Starting hormone replacement therapy at age 70 if
you have not been taking it before, is somewhat
late and questionably beneficial. Usually women
take hormone replacement to prevent hot flashes,
vaginal dryness and bone thinning. If you have not
had those problems up until now or if you have
overcome or survived them, then you should not
need any replacement therapy. After a hysterectomy
you can take only estrogen therapy as your hormone
replacement rather than both estrogen and
progesterone (HRT), but if you have not taken it
since menopause in your 50's then the major
benefits have been lost. To get any of the long
term benefits of estrogen including the maximum
protection against rapid bone loss, the therapy
needs to be started within 5 years of menopause.
To directly address your question about measuring
estrogen levels, I would have to say that a blood
estrogen level (estradiol) is probably the most
accurate, instantaneous measurement of how much
estrogen your body is producing. This is true even
though your ovaries stopped working years ago.
Estrogen can be made from other body hormones and
converted to natural estrogen in the skin and fat
cells.
Urine estrogen measurement does not have well
established norms as to what level a
postmenopausal women should be at. You can also
measure salivary estrogens with home hormone test
kits. The salivary estrogens measure the average
levels that were present in your body over the
last 48 hours. Again the normal ranges for a
menopausal woman not to have symptoms or to
prevent osteoporosis are more difficult to come
by.
Estrogen levels as measured by a maturation index
of vaginal cells that have been collected like a
Pap smear, are a very good indication of whether
any estrogen is actually getting to the lining of
the vaginal wall. It is more useful when taking
oral estrogens to see if they are absorbed enough
to prevent vaginal dryness.It is not a
particularly good way to measure if the estrogens
are high enough to prevent hot flashes, for
example.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Uterine artery embolization
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Uterine artery embolization (UAE) is a medical x-
ray procedure to block the blood supply to uterine
fibroids so that they will shrink up and cause
less symptoms such as pain or abnormal menstrual
bleeding. It still is in a relatively experimental
state but UAE has had enough successes that women
should be aware of it as an alternative to
surgical treatment of fibroids such as
hysterectomy or myomectomy (removal of individual
fibroids without removing the uterus.)
The procedure of uterine artery embolization is
carried out by making a small incision in the
groin and inserting a catheter in the main artery
to the leg, the femoral artery. The catheter is
then advanced to the uterine artery under x-ray
control and a substance called polyvinyl alcohol
is injected to block the small branches of the
uterine artery. These in turn cut off the blood
supply to the fibroids.
There can be complications of this procedure just
like any procedure:
infection requiring hysterectomy
embolization of other organs such as the ovary
causing menopause
infertility
loss of ability to have orgasm
failure of the fibroids to be ablated
chronic pain
blood clot in the groin
bleeding from the incision site
bleeding or foul discharge from the vagina
and even death
Of course these are all complications (except
continued growth or regrowth of the fibroids) that
one can have from hysterectomy. Since the
procedure is still somewhat new, we do not have
good statistics on how often to expect these
complications compared to hysterectomy or
myomectomy.
Uterine artery embolization
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Excessive weight and depression
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No one really knows whether depression is a cause
of overeating and excessive weight or whether the
excessive weight itself (and body image) causes
depression. For the most part we just say they are
associated. But when women have surgical treatment
of extreme obesity, they have a lower likelihood
of depression after recovering from the surgery.
In effect it does not matter whether obesity is a
cause or effect of depression; losing weight helps
lessen depression.
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Another Child"
When Diane found out she was pregnant, she told
the good news to anyone who would listen. But her
4-year-old son overheard some of her parents'
private conversations. One day when Diane and her
4-year-old were shopping a woman asked the little
boy if he was excited about the new baby.
"Yes!" the 4-year-old said, "and I know what we
are going to name it, too. If it's a girl we're
going to call her Christina, and if it's another
boy we're going to call it quits!"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
November 30, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Allergies and allergens
2. Toxoplasmosis infection
3. Reader submitted Q&A - Breast reduction and lactation
4. Grief and the holidays
5. Health tip to share - Yogurt for yeast infections
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Allergies and allergens
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Allergies are rising in frequency and it is not
only allergic asthma and sinusitis/rhinitis that
are the problems. Allergic skin reactions called
atopic eczema are becoming more frequent both
among children and adults. This is characterized
by redness and peeling of the skin especially on
the hands but it can be anywhere on the body.
Many medical scientists blame the rising incidence
of atopic eczema on the number of chemical
products that we have been increasingly exposed to
over the last 40 years. Soaps, detergents, bubble-
baths, gels, cleaning products and even baby wipes
containing perfume and alcohol are products
containing many new chemicals that can potentially
cause an allergic reaction in our skin.
House dust mites are also a very common allergen
that not only causes inhalational problems, but
also can produce skin eczema reactions. Did you
know that:
1 in 3 adults now actively suffer from an allergy
4 in 10 school children have an allergic condition
Allergic disease is growing 5% per year
Over 65% of people reported reacting to chemicals
and perfumes
Asthma, rhinitis and eczema often caused by house
dust mite have increased threefold in the last 20
years
There are 28,000 house dust mites in an ounce of
dust
House dust mite droppings enter the body through
the nose, linings of the eyes and linings in the
airways of the lungs
Sitting on a bed or sofa disturbs the house dust
mite dropping which then stay airborne for at
least 30 minutes
The average bed contains more than 10,000 dust
mites and over 2 million droppings
The average pillow doubles in weight in six months
due to the droppings of the house dust mite
While you cannot totally avoid exposure to
chemicals that your skin comes in contact with or
avoid house dust mites altogether, it is worth the
effort to try to reduce the quantity of your
exposure. Just lessen your exposure to different
chemicals and lower your exposure to house dust
mites as much as you can.
Allergies and allergens
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Toxoplasmosis infection
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Toxoplasmosis is a parasite infection that is
common, but generally unrecognized because it
causes very few symptoms. Cats can be carriers of
this infection as well as raw meat from animals
such as deer (venison), sheep (lamb) and pigs
(pork). When cats become infected, their feces
contain the parasites and can be infective at that
time. Handling cat litter pans or any contact with
cat feces itself can cause an infection in humans.
Eating or handling raw meat as listed above or
even from the knives, cutting boards or cooking
utensils that come in contact the meat can be
contagious.
The typical infection produces either no symptoms
at all or flu-like feelings "with swollen lymph
glands, or muscle aches and pains that last for a
month or more. Rarely, a person with a 'normal'
immune system may develop eye damage from
toxoplasmosis. However, most people who become
infected with toxoplasmosis do not know it."
Severe infections tend to occur only in
individuals with compromised immune systems such
as those on chemotherapy, HIV positive or having
had a recent organ transplant. Newborn infants can
be infected from the mother who has been exposed
shortly before or during early pregnancy. If the
baby has a congenital infection, it can have eye
damage including blindness as well as mental
retardation. This makes it especially important
for women who are trying to conceive to avoid
contact with potential sources of toxoplasmosis.
Preventative steps include:
Wear gloves when you garden
Wash your hands well after outdoor activities
wash hands before you eat or prepare any food
Wash any cutting boards, sinks, knives, etc. that
have touched raw meat.
Cook all meat to an internal temperature of 160° F
Diagnosis of toxoplasmosis is by blood tests that
measure antibodies against the organism. You can
get those blood tests at most public health
departments in your community or ask your doctor
to order the tests if you have any symptoms such
as lymph node swelling, muscle aches lasting more
than a few days or any flu-like symptoms that seem
to last longer than 4-5 days.
Once your body has been exposed to toxoplasmosis,
it becomes immune to further symptoms or to being
contagious to others. Mot of the time no treatment
is needed unless the infection is severe.
Toxoplasmosis infection
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Breast reduction and lactation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"How safe is Breast Reduction? Will I still be
able to breast feed when I get pregnant and have
babies?"
I am a 21 year old, healthy, normal menstruation,
on no medication. I am not overweight. My
breasts are extremely large. I do a lot of
running and due to the large size of my breasts, I
often return with an extreme backache. I have
tried wearing sports bras, but they don't seem to
alleviate the pain. I am so unhappy with the size
of my breasts - I sometimes feel very depressed."
R.G.
Breast size reduction is called reduction
mammoplasty and is indicated anytime a woman is
having physical symptoms because of the breast
size and weight. Macromastia is distinguished from
large, normal breasts by the presence of
persistent, painful symptoms such as upper
backache or neck pain associated with standing,
sitting or running. Also there can be physical
signs such as arm nerve numbness, marked breast
size differences, shoulder grooving and skin
breakdown/inflammation underneath the breasts.
There can be complications from the surgery. These
include numbness of the breast or nipple,
persistent pain where the breast skin has been
sutured, Poor appearance of the skin scars,
infection, bleeding and even blood clots. Rarely
(less than 1%), there can be loss of the nipple
due to blood supply that has been cut off and
there can be an inability to breast feed.
While having the surgery does not mean you cannot
breast feed, women who have the reduction
mammoplasty tend not to breast feed as often or as
long as women who have not had the procedure. We
do not know the reasons for this but one study of
women who started out breast feeding found:
Still any breast feeding at
1 month 6 month 12 months
with surgery 58% 16% 10%
no surgery 94% 58% 42%
For women with breast reduction surgery, the
median duration of exclusive and any breast feeding
was 5 days and 2 months, respectively, and 3
months and 6 months for controls without the
breast reduction mammoplasty. The results of this
study suggest that breast reduction surgery has a
negative impact on breast feeding continuance
although there are undoubtedly many different
reasons for this.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Grief and the holidays
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
While holidays are usually a time of enjoyment and
celebration, they can be reminders of loved ones
who are no longer with you. Sadness or grief over
a person who has died can easily be brought on by
celebrations, gatherings, meals, and even recipes
and songs. This is common for many people as the
reminders trigger thoughts you had suppressed
during the rest of the year. However, for most
people, there is not a dread of the holidays
because of these reminders.
If the anticipation of grief precedes the holiday
by weeks or months of if the loss of the loved one
is recent producing raw hurt feelings, then you
have to adopt some methods of coping with the
problem so it does not ruin the holiday for
others. Coping depends upon whether you are alone
with those grief feelings or whether you will be
in the presence of others who share or know of
your grief.
If you are alone with your grief, you may need to
"cancel" the holidays by embarking upon a trip
away from home or participate in a new event that
that is unlikely to have the same reminder
triggers. Volunteerism is another activity that
does not necessarily avoid the holiday but it puts
you in a different setting that may help you avoid
severe pain and sadness. Volunteering for work in
shelters, prisons, libraries, hospitals or many
other places can serve as a healthy distraction
from the grief and pain in your own life.
If you are not alone in your feelings but are
going to be in the presence of others who can
understand how you feel, it may be best to talk
about your feelings for a little bit just to let
it not "bottle up". You may want to change some of
the family traditions to new ones. Sometimes you
may have to have an escape plan if it becomes too
intense. The important thing to remember is that
the grief feelings should get better over time.
The second holiday after losing a loved one can be
worse than the first one when you had more
emotional support and were with the logistics of
settling an estate. After that, each holiday
should gradually become less painful. If it does
not, then you seek professional help.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Yogurt for yeast infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"After having several recurrent yeast infections
and not getting much (or any) relief from oral
medications or over-the-counter creams, I decided
to take matters into my own hands and did a little
research. I found a site that suggested eating 8
ounces of yogurt everyday to combat this. I
started doing that and it really worked for me.
Since then, I have not had a single yeast
infection. It couldn't hurt to try, if nothing
else, you will be getting added calcium in your
diet!" - Doris
[editor note - Many yogurt brands and some milk
brands now have lactobacillus acidophillus
cultures in them. These are the protective
bacteria for the gastrointestinal tract and
genital tract. You can also get lactobacillus
acidophilus in the health food stores in pill form
if you want to avoid the added calories - 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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Dreaded Old Age"
I have always dreaded old age. I cannot imagine
anything worse than being old. How awful it must
be to have nothing to do all day long but stare at
the walls or watch TV? So last week, when the
President suggested we all celebrate Senior Citizen
Week by cheering up a senior citizen, I decided to do
just that. I would call on my new neighbor, an elderly
retired gentleman, recently widowed, and who, I
presumed, had moved in with his married daughter
because he was too old to take care of himself. I baked
a batch of cookies, and, without bothering to call (some
old people cannot hear the phone), I went off to brighten
this old guy's day.
When I rang the doorbell this "old guy" came to
the door dressed in tennis shorts and a polo
shirt, looking about as ancient and decrepit as
Donny Osmond.
"I'm sorry I can't invite you in," he said when I
introduced myself, "but I'm due at the Racquet
Club at two. I'm playing in the semifinals today."
"Oh that's all right," I said. "I baked you some
cookies..."
"Great!" he interrupted, snatching the box. "Just
what I need for bridge club tomorrow! Thanks so
much!"
I continued, "...and just thought we'd visit a
while. But that's okay! I'll just trot across the
street and call on Granny Grady."
"Don't bother," he said. "Gran's not home; I know.
I just called to remind her of our date to go
dancing tonight. She may be at the beauty shop.
She mentioned at breakfast (at which house?) that
she had an appointment for a tint job."
So I went home and called my Mother's cousin (age
83); she was in the hospital ... ... working in
the gift shop. . ....
I called my aunt (age 74);
she was on vacation in China. .
I called my husband's uncle (age 79).
I forgot; ...... he was on his honeymoon. ....
I still dread old age, now more than ever.
I just don't think I'm up to it.
Author Unknown
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
December 14, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Sick building syndrome
2. Dyslexia
3. Reader submitted Q&A - Cholesterol levels
4. Obesity and insulin resistance
5. Health tip to share - Cinnamon
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Sick building syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most of us are familiar with situations in which
people working in a specific building or area
within a building develop health symptoms which
they attribute to air contaminants or other
environmental factors. When the symptoms are
diagnosed as recognized diseases or as due to
identifiable airborne contaminants, this is called
"building related illness".
When the symptoms or complaints are vague and no
specific causes such as molds, viruses, bacteria
or airborne toxins can be identified, this is
called "sick building syndrome".
For example, in "sick building syndrome" symptoms
might include headaches; eye, nose, or throat
irritation; dry cough; dry or itchy skin;
dizziness and nausea; difficulty in concentrating;
fatigue; and sensitivity to odors. These are
symptoms that are difficult to pin down as to what
specifically is causing this. Typically, those who
have symptoms report relief as soon as they leave
the building.
With building related illnesses, symptoms are more
likely to include complaints such as cough, chest
tightness, fever, chills and muscle aches.
Recovery time after leaving the building may be
more prolonged.
Contributing factors to sick building syndrome are
thought to be primarily inadequate ventilation, or
chemical or biological air contaminants from
indoor or outdoor sources. Those contaminants can
be things like smoke, carbon monoxide, nitrogen
dioxide, and volatile fumes from things like
adhesives, carpeting, upholstery, manufactured
wood products, copy machines, pesticides, and
cleaning agents. They can also be biological
contaminants such as bacteria, molds, pollen, and
viruses that breed in stagnant water that has
accumulated in ducts, humidifiers and drain pans,
or where water has collected on ceiling tiles,
carpeting, or insulation.
If you suspect a problem in a building
environment, you should first report it to the
owner of the building or your employer if it is a
place of work. If the problem does not seem to be
easily solved, and in most cases the cause is not
easily identified, either your employer or you can
write to the National Institute of Occupational
Safety and Health (NIOSH) to ask for their help in
investigation. They have the authority following a
written request from employees, authorized
representative of employees, or employers, to
determine whether any substance normally found in
the place of employment has potentially toxic
effects in such concentrations as used or found.
Sick building syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Dyslexia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dyslexia is the most common learning disability in
children. It results from a difficulty in the
brain's ability to translate written images or
letters into their meaning in the brain. These
children have normal vision and intelligence but
the inability to recognize the meaning of letters
or words creates moderate reading and writing
difficulties. It can also affect math abilities.
Signs of possible dyslexia in a pre-schooler may
be starting to talk late, difficulty in adding new
words to the vocabulary or difficulty in rhyming.
By first or second grade the difficulty in reading
and writing becomes more apparent and the child
usually falls behind the expected level of
accomplishment for his/her age. The hallmark is
the inability to recognize written words on a
printed page.
While there is no single test to diagnose
dyslexia, the child may need to be referred to a
specialist who administers educational tests
focusing on reading and writing skills. Most
schools are aware of who those specialists are
even though there may not be one in your immediate
locale.
If the dyslexia is mild, you may be able to help
the child at home by reading to him or her often
and helping the child pronounce letters and spell
out words. If the dyslexia is more severe, the
child will need special help in school with
individual or small group sessions and may even
need to train for a vocation that does not rely as
much on reading and writing skills.
Dyslexia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Cholesterol levels
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Three months ago I was told by doctor and shown
my medical report checked on cholesterol is as
high as 215 mg/dl. This cholesterol check was done
on the spot without fasting a night before. I was
told to go back for review two months later with a
fast a night before - I believe this is a more
thorough and detailed check. During these two
weeks I was having my jogging and swimming daily
and took instant oats every morning as breakfast
with controlling of my diets."
"Report shows after two weeks:
Total cholesterol drop to 203 mg/dl (5.21mmol/L);
Triglycerides: 51 mg/dl (0.58 mmol/L);
HDL: 80 mg/dl (2.06 mmol/L);
LDL: 113 mg/dl (2.89 mmol/L);
Total Cholesterol / HDL Ratio: 2.5"
"From the above report, do you think my
cholesterol is still high? Please explain my
situation in respect of my cholesterol standard.
And if I am pregnant during this period (during
the two months) will the above results been
affected? Such like why my HDL is so high?"
"Why is it the total of the three elements (HDL.
LDL. And Triglycerides) do not equal to 203 mg/dl
as showed in my medical report? What is the right
way to calculate the total cholesterol?" - ML
Actually your blood cholesterol values look very
good to me. It is true that the National
Cholesterol Education Program wants you to have a
total cholesterol value lower than 200 but your
value is only slightly above that (203) and it is
above that primarily because of a high value of
the good cholesterol (HDL value of 80). The HDL
value is the single most important cholesterol
level for women. As long as their value is above
45 mg/dl, women are at lower risk for
arteriosclerotic changes.
I do not know why your HDL/good cholesterol level
is high but that is certainly they way you want it
to be. Estrogens, wine/alcohol and a healthy diet
are known to raise HDL levels as well as
medications including nicotinic acid and some of
the statin drugs. Pregnancy usually raises
cholesterol levels but it is mostly because of the
HDL levels that are increased due to high estrogen
levels. If you were pregnant when these above
values were drawn, you would still have good
cholesterol levels in my opinion.
The HDL and LDL levels do not add up to the total
cholesterol because there is a another component
called VLDL (very low density lipoproteins that
should add in there to make up the difference.
They are not generally thought to be good or bad.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Obesity and insulin resistance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Insulin resistance is a condition often considered
to be a precursor to diabetes. With increasing
resistance of the body to normal, circulating
insulin levels, blood sugars become higher and
higher. The insulin secretion works overtime to
keep up with the higher glucose levels and when it
finally lowers the glucose level, it depresses the
glucose too low resulting in hypoglycemic hunger.
The hunger in turn makes you eat more and become
obese. Since being overweight is common and
insulin resistance is more common in overweight
individuals and is associated with an increased
risk for type 2 diabetes mellitus and
cardiovascular disease, it follows that we need
some screening tests to determine which overweight
people are insulin resistant.
A recent study from Stanford, California looked at
what metabolic markers could be used to identify
overweight individuals who are insulin resistant.
They found that there are three measurements that
are fairly equivalent in helping to identify
overweight individuals who may be insulin
resistant. Those measurements are:
plasma triglyceride level (fasting) greater than
130 mg/dL (1.47 mmol/L)
triglyceride-high-density lipoprotein cholesterol
ratio of 3 or more (1.8 in SI units)
fasting insulin level of greater than 15uU/ml (109
pmol/L)
You can get the first two measurements from a
lipid profile test. These are available for home
testing. The fasting insulin level would need to
be ordered by your doctor. If any of the above
values are abnormal, it is very important to your
health to begin a weight reduction diet. You may
prevent the early onset of diabetes or heart
disease or both.
Obesity and insulin resistance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Cinnamon
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I skipped a period one month then had one the
next month, and 17 days later started another
period of heavy bleeding with lots of clots, this
lasted over 3 weeks, I used cinnamon 1/4 tsp in
eggnog, on toast and drank cinnamon tea, the
bleeding stopped in two days." - fm
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"The Rules of Chocolate"
If you've got melted chocolate all over your
hands, you're eating it too slowly.
Chocolate covered raisins, cherries, orange slices
and strawberries all count as fruit, so eat as
many as you want.
The problem: How to get 2 pounds of chocolate home
from the store in hot car. The solution: Eat it in
the parking lot.
Diet tip: Eat a chocolate bar before each meal.
It'll take the edge off your appetite and you'll
eat less.
A nice box of chocolates can provide your total
daily intake of calories in one place. Isn't that
handy?
If you can't eat all your chocolate, it will keep
in the freezer. But if you can't eat all your
chocolate, what's wrong with you?
If calories are an issue, store your chocolate on
top of the fridge. Calories are afraid of heights,
and they will jump out of the chocolate to protect
themselves.
If you eat equal amounts of dark chocolate and
white chocolate, is that a balanced diet? Don't
they actually counteract each other?
Money talks. Chocolate sings.
Chocolate has many preservatives. Preservatives
make you look younger.
Q. Why is there no such organization as Chocoholics
Anonymous?
A. Because no one wants to quit.
If not for chocolate, there would be no need for
control top pantyhose. An entire garment industry
would be devastated.
Put "eat chocolate" at the top of your list of
things to do today. That way, at least you'll get
one thing done.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
December 28, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Flu FAQs
2. Echinacea not effective for kids colds
3. Reader submitted Q&A - Psoriasis
4. Polycystic ovarian syndrome
5. Health tip to share - Urinary frequency and milk
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Flu FAQs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The particular strain of flu that is most active
is called the Fujian strain. Even though this year
there is a mismatch between the vaccine flu strain
(not the Fujian strain) and the most commonly
occurring Fujian strain of flu virus, there is
still some cross protection against contracting
flu. Also, the Fujian strain only accounts for
about 70-80% of the episodes of flu. The other 20-
30% are covered by the flu vaccine.
People who are recommended to receive the flu-shot
are:
Children age 6 months to 23 months
People over the age of 65
Anybody with a chronic medical condition
Women in the second or third trimester of pregnancy
Those people who are the next highest priority for
vaccination are:
Anybody who shares a home with an
immunocompromised person
Health care workers
There is a flu immunization that is administered
through a nasal spray rather than a shot. It is
called Flu-Mist. It contains a live virus so that
sometimes the nasal immunization produces more
symptoms, such as a runny nose, sore throat,
headache, or cough, than the shot vaccination. It
is not recommended for those with a chronic
medical condition or who are on immunosupressive
therapy.
This year's flu strain seems to be hitting
children unusually hard. Children who have not
been vaccinated before are recommended to have two
doses of the flu shot since they often do not
develop a high enough antibody level the first
time. After a child is vaccinated for one season,
he or she only needs to get one dose a year in
succeeding years.
What should you do if you are not immunized
against the flu this year and are either exposed
to someone who has the flu or start developing flu
signs such as fever, muscle aches or extreme
fatigue? If you are in a high risk group such as
those mentioned above, then see your doctor who
may decide to try to lessen your symptoms by using
one of the antiviral medications such as
Flumadine, Tamiflu, and others. If you are not in
a high risk group you may just as well try to ride
it out without any medication. Watch out for any
post-flu problems, however. If you do not recover
within 5-7 days after symptoms start or you
develop a persistent fever or productive cough,
see your doctor. A post-flu pneumonia can be a
serious problem.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Echinacea not effective for kids colds
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Echinacea is used as a herbal preparation from the
Purple Cone flower that grows in North America. It
has been touted as useful to prevent and treat
upper respiratory tract infections such as colds.
The evidence has not been very good that it
actually works to prevent colds but there is some
indication that perhaps it can shorten the
duration of cold symptoms.
A recent study from the University of Washington
reported in the Journal of the American Medical
Association (JAMA) administered echinacea to
children between the ages of 2-11 each time they
developed any cold symptoms. Half of the children
received a placebo while the other half were given
an echinacea supplement. The investigators
measured the duration and severity of symptoms as
well as the number of days of fever or time to
peak severity of symptoms.
Less than 20% of children made it through the 4
month study period without developing any colds.
The remainder of the children developed one or
more colds and received either placebo or
echinacea. Of the children who developed colds,
the median duration was 9 days of symptoms in that
4 month period.
The investigators found no difference in the
length or severity of upper respiratory tract
symptoms between the children who received
echinacea and those who did not. Also, there was
no difference in the rate of adverse events
reported in the 2 treatment groups; however, a
rash occurred during 7.1% of the colds treated
with echinacea and only 2.7% of those treated with
placebo. Therefore in view of the ineffectiveness
of echinacea in shortening cold symptom duration
in children and the increased rate of skin rashes,
it does not seem wise to use it for that purpose.
Echinacea for use with colds
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Psoriasis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Despite a great diet and following advice of many
sources, I still have psoriasis and it is
spreading from knuckles to elbows, etc. Where
does it come from? What can I do?" - AAC
The cause of psoriasis is still a mystery. We do
not know where it "comes from". We know that
psoriasis involves an immune reaction in which
white blood cells called T cells are put into
action in large quantities by some unknown
stimulus. These T cells are supposed to help the
body fight infection but in this case their
massive numbers just cause inflammation of the
skin and a high turnover of skin cells which
produces the flaky, reddened lesion of psoriasis.
Conditions that may cause flare ups of psoriasis
include infections, stress, and climate changes
that dry the skin. Sometimes certain medicines
such as lithium for depression or beta-blockers
prescribed for high blood pressure, may trigger an
outbreak or worsen the disease. Any toxin (eg.
metals such as mercury) or allergy to foods or
herbal supplements that produce eczema (atopic
dermatitis) will worsen or flare psoriasis.
You sound like you have done the things
recommended by doctors for the psoriasis and most
of the doctors will probably tell you that there
is nothing else you can do such as dietary change
or skin exposure change to lessen psoriasis
flares. I think, however, that if I had psoriasis,
I would be sure I did not have any food allergies
or exposure to heavy metals or toxins by using
some of the home test kits that check for these
things. Then if any of them were positive, I would
seek medical confirmation of those allergies or
exposures and take action to avoid eating or
contact with substances that might be producing a
skin reaction of any type.
