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***** Woman's Diagnostic Cyber Newsletter *****
June 18, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Your community's environmental pollutants
2. Dipstrip testing for UTI not always accurate
3. Reader submitted Q&A - Perimenopausal bleeding
4. The first menstrual period
5. Sleep apnea symptoms and treatment
6. Health tip to share - Icing an amputated thumb tip
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Your community's environmental pollutants
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Environmental Defense has a database at
scorecard.org which lists community pollutants as
reported by businesses and governmental agencies.
You can enter your zip code and see which
businesses are releasing large quantities of
potentially polluting compounds into the air, soil
and streams.
You can find out where in the U.S. or for your
community area, there are:
potential land contamination sites
chemical air pollutants
criteria (gases) air pollutants
animal waste from farms
manufacturing chemical releases
There is also a section on the health effects of
the different chemicals. Lead exposure can produce
menstrual disorders and infertility. Carbon
disulfide, mercury and PCBs (polychlorinated
biphenyls) also can cause menstrual
irregularities. You may want to know what
chemicals are possible problems where you live.
See:
Environmental pollution maps and info
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2. Dipstrip testing for UTI not always accurate
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are several ways in which urine is tested to
see if there is a urinary tract infection (UTI).
The gold standard test is a urine culture but
because of expense we often try to shortcut by
looking at the urine microscopically, doing a gram
stain for bacteria or now, dipstrip testing of the
urine looking at nitrites and leukocyte esterase.
In pregnancy there is dilatation of the urinary
tract which makes women more susceptible to
urinary infections so that testing for bacteria in
the urine is almost routine to prevent more
serious kidney infections. This study in the
American Journal of Gynecology looked at the
different methods of UTI diagnosis in pregnancy.
They found that the dipstip test (nitrites and
leukocyte esterase), which is the most commonly
used test in doctor's offices, picks up about 50%
of infections but if it is combined with a
microscopic urinalysis, then it picks up about 80%
of infections. The study recommends always doing a
urine culture to diagnose infection.
Conversely, if a woman suspects she has a urine
infection, a negative result on a dipstrip of the
urine should not mean that no treatment is given.
Urine testing on pregnancy for UTI
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Perimenopausal bleeding
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been having a menstrual cycle for the past
month and had one last August too. Any
information??? Still ongoing and today with clots
passing and great rushes of discharge."
"I am 46 and my menses were normal until about 10
months ago. "
Sara
Perimenopausal bleeding is often due to
anovulation problems that occur as the ovaries
become depleted of eggs. Because the chance of
endometrial cancer starts rising above 1% in women
over 40, investigations must be undertaken to rule
out precancerous or cancerous changes before
instituting any hormonal therapy.
Diagnostic procedures may involve ultrasounds,
endometrial biopsies or even hysteroscopy and D&C.
Treatments for bleeding not due to anatomical
lesions can include injectable or oral progestins,
oral contraceptives, or even danazol. Vitamin
supplements may also play a role in reducing
prolonged bleeding.
See our article at:
Prolonged perimenopausal bleeding
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. The first menstrual period
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concern and even fear about that first menstrual
period that a young girl will have, needs some
practical answers. At Redspot, there is a great
section on beginning menses that would be
appropriate to direct a daughter or friend to.
I like the first section on fast facts. It has
brief answers to many questions such as when will
I start?, how much blood will there be?, is it
really blood?, Will my period hurt?, will I get
cramps?, does menstrual fluid really smell bad?,
what if I am caught by surprise?, how long will it
last?, what is a normal period?, how do you count
your cycle?, will I have periods the rest of my
life? and many other questions that mentors might
fail to address.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Sleep apnea symptoms and treatment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Do you tend to fall asleep at boring meetings, in
the late afternoon or in early evening? That may
be normal or it may be the results of sleep
deprivation from episodes of apnea (stopping
breathing) during nighttime sleep. When you fall
asleep on the phone or are unable to drive more
than 30-60 minutes in a car without stopping and
doing something to try to "wake up", then you may
well have sleep apnea.
It can be associated with hypertension and even
heart failure or heart arrhythmias. Mostly though,
it affects your work and social relationships.
Treatment varies as to whether the cause is an
obstructive airway problem, a central brain
problem or a mixture of both. Sometimes positive
pressure masks will help or dental appliances that
help hold the tongue forward. Occasionally laser
surgery in which part of the soft palate is
removed can also improve the frequency of apnea
episodes. This is a treatment that is used for
loud snoring also. All persons (2% of women and 4%
of men) with sleep apnea snore. But not all
snorers have sleep apnea.
For a very good overview of symptoms, treatment
and prognosis of sleep apnea, see:
SLEEP APNEA Society of Alberta
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Icing an amputated thumb tip
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I recently sliced off about 1/4 the width of my
right thumb (outer side). I knew about putting
severed parts/pieces on ice and taking it to the
emergency dept. When I started to do this, I
thought about the ice being "old" for such a use,
so I put the piece into a "snack-size" zip-lock
bag, zipped it up, and placed this into a larger
bag which contained the ice, along with some
water, to promote an even cooling process. It
turned out that they could not have used the piece
of thumb if it had been placed directly in the ice
water, it would have been dehydrated, possibly
contaminated. The piece was sewn back on,
fingernail and all and on the 16th day, the
hardened outer piece came off and, although the
piece is numb but "tingley", it's going to look
just fine. The only other alternative would have
been to amputate enough of the tip of my thumb to
gain enough skin to pull over the end and suture
in place. This is information that a person would
have to know at the time of the accident, there's
not much time to spare."
K.R.
[Editor note] Here is thanks for a previous tip:
"I just wanted to say 'Thank You' to the woman who
submitted the health tip regarding heavy menses
and taking vitamin C. Timing was perfect. I had a
regular appointment with my gyn doctor and ran it
by her, and I then tried it, and it worked. Thanks
again.
M.R.
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7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medical Shorts
Sign in the obstetrics ward of a hospital:
"Research shows that the first five minutes of
life can be most risky."
Underneath someone had scrawled:
"The last five minutes aren't so great either."
M Kushnir, MD 4/8/99
What do you get when a patient upon examination
presents with signs of insomnia, dyslexia, and
agnosticism? A patient who stays up all night
wondering if there is really a DOG!!!
Dr. Schlesinger 2/18/99
In the course of a visit for another problem, my
patient referred to the herbal remedy she had
recently taken for her cold symptoms. "I sure felt
better after taking 'euthanasia'(echinacea)!"
Bryan Cummings, MD 2/12/99
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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***** Woman's Diagnostic Cyber Newsletter *****
June 25, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Miscarriage rate rises significantly with age
2. Colorectal cancer facts
3. Reader submitted Q&A - Post hysterectomy probs
4. Brain attacks - TIA to strokes
5. Recommendations for thyroid screening
6. Health tip to share - Chronic yeast infections
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Miscarriage rate rises significantly with age
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We have known for many years that the chance of
losing a pregnancy due to miscarriage, stillborn
or ectopic pregnancy rises quite a bit with age.
How much it rises has been somewhat difficult to
quantify.
The following article in the British Medical
Journal looked at over 1.2 million births in
Denmark and measured the loss rates. They found
the following miscarriage rate (spontaneous
abortion) by age.
Age Rate
12-19 13.3%;
20-24, 11.1%;
25-29, 11.9%;
30-34, 15.0%;
35-39, 24.6%;
40-44, 51.0%;
over45 93.4%.
Maternal age and fetal loss
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2. Colorectal cancer facts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In the case of the colon, most malignant tumors
develop from benign polyps. This is not true in
the uterus or cervix however. Endometrial polyps
and endocervical polyps infrequently become
malignant but this is not true in the
gastrointestinal tract.
Cancer of the colon and rectum is the third
leading cause of cancer deaths behind lung and
breast. It causes about 3% of the annual deaths in
the U.S. Colonoscopy is the best screening test
although checking the stool for occult blood is
the easiest but with a lot of false positives.
This site on colorectal cancer at cancerfacts.com
has some good anatomical drawings that help
explain where the colon is in the body. It also
has a listing of symptoms to look for such as:
a prolonged change in bowel habits
narrowing of the stool
a feeling of fullness after bowel movements
crampy abdominal pain
blood in the stool
Colorectal cancer
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3. Reader submitted Q&A - Post hysterectomy probs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Since my hysterectomy 4 1/2 months ago, I
experience bleeding after intercourse. Is this
normal? It is a small amount of fresh blood,
bright red. Is it possible that I have not healed
internally yet? "
I am age 45. My menstrual history was normal and
the hysterectomy was performed because of a large
rapidly growing fibroid tumor." - S.B.
Why don't doctors tell you all the things that can
happen after hysterectomy? Because there are
actually quite a few symptoms that are normal but
disappear with time and a large list of rare but
possible complications that might turn you off.
You need to know about all of them, however.
For a discussion of what to expect, see our
article at:
Expectations of post hysterectomy recovery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Brain attacks - TIA to strokes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is it possible for a stroke to last only 5-20
minutes. Yes. There is a type of mini-stroke
called transient ischemic attacks - TIAs. Any lack
of oxygen to the brain can cause similar symptoms.
If the cause is temporary, the symptoms may be
temporary. If there is a permanent loss of blood
supply such as a blood vessel that clots off or
hemorrhages in the brain, the symptoms are either
permanent or last until any healing takes place.
Symptoms can be:
blindness in only one eye
arm/leg weakness, numbness, or paralysis
confusion or loss of balance
speaking or understanding difficulty
facial paralysis or numbness
sudden severe dizziness
There are some treatments that can help minimize
the effects of strokes or possibly prevent them
once you have the problem. Therefore it is
important to recognize the symptoms and see a
doctor right away if you suspect a problem.
Brain attacks
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5. Recommendations for thyroid screening
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The American Thyroid Association has come out with
recommendations for screening for thyroid
dysfunction.
Basically they recommend that adults begin having
thyroid screening using a blood thyrotropin
hormone test (serum TSH) at age 35 and every 5
years after. It is more important for women to
have this because they have a higher incidence of
thyroid diseases, but this testing can even be
justified in men.
This is a NEW recommendation so be sure to let
your doctor know if it is five years since your
last thyroid checkup.
Guidelines for Detection of Thyroid Dysfunction
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6. Health tip to share - Chronic yeast infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I was once plagued by chronic yeast infections.
The Cure? Taking 350 mg of Acidophilus 3 times
every day. It worked for me. I haven't had one
since.
anonymous
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
/healthtip.htm
Health tip suggestion form
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7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
HOW TO KEEP A HEALTHY LEVEL OF INSANITY
1) At lunch time, sit in your parked car and point
a hair dryer at passing cars to see if they slow
down.
2) Put your garbage can on your desk and label it
"IN."
3) Put decaf in the coffee maker for 3 weeks. Once
everyone has gotten over their caffeine
addictions, switch to espresso.
4) In the memo field of all your checks, write
'for sexual favors.'
5) As often as possible, skip rather than walk.
6) Sing Along at the opera.
7) Go to a poetry recital and ask why the poems
don't rhyme.
8) Find out where your boss shops and buy exactly
the same outfits. Wear them one day after your
boss does. (This is especially effective if your
boss is the opposite gender.)
9) Call the psychic hotline and just say, "Guess"
10) When the money comes out of the ATM, scream
"I Won!", "I Won!" "3rd time this week!!!"
11) When leaving the Zoo, start running towards
the parking lot, yelling "Run for your lives,
they're loose!"
12) Every time you see a broom yell "Honey, your
mother is here"
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That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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***** Woman's Diagnostic Cyber Newsletter *****
July 2, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Colas associated with teen bone fractures
2. Accutane for acne and birth defects
3. Reader submitted Q&A - Constipation
4. Trichomonas profile
5. Health related hoaxes and rumors
6. Health tip to share - Vitamin B2 for migraines
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Colas associated with teen bone fractures
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Physically active teen girls who consume colas and
other non-cola carbonated beverages have over 3
times the risk of having a bone fracture than
physically active girls who do not drink colas.
This is according to an article in the Archives of
Pediatrics and Adolescent Medicine.
The authors do not know why this relationship
holds. They speculate that since "teens have
doubled or tripled their consumption of soft
drinks and they have cut their consumption of milk
by more than 40%" that they may not be getting
enough calcium and therefore have brittle bones
more susceptible to breaking. I'm not so sure it
isn't due to a caffeine-induced over activity but
then who knows. Again,epidemiological studies do
not address cause and effect but rather identify
associations we must learn from.
Teenaged Girls, Colas and Bone Fractures
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Accutane for acne and birth defects
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Retinoic acid is an analog of vitamin A marketed
under the trade name Accutane [R] for nodular
acne, a very severe form. It has been known for
many years to cause major birth defects and
spontaneous miscarriages. In fact women who are
prescribed Accutane are supposed to be on
effective contraception.
Years ago a registry was created for reproductive
aged women who had the potential to become
pregnant while taking the Accutane. 454,273 women
enrolled in the registry from 1989 to October 1999
and approximately 900 women became pregnant. Many
of these women had spontaneous miscarriages or
babies with major birth defects if they did not
choose to have the pregnancy terminated. The main
reason for this article however, was to examine
why a focus group of these women who had been
warned about the consequences of Accutane and
pregnancy still got pregnant.
Major associations were:
1) over half had an episode of intercourse without
being on contraception and 93% were not using 2
methods of contraception as they were supposed to
by the protocol.
2) 20% had negative pregnancy tests before
starting but still became pregnant before actually
beginning the prescription.
3) about 15% got pregnant while using pills from a
leftover previous prescription.
4) some purchased the drug in Mexico, bypassing
the usual physician instruction safeguards.
In the focus group of 14 women who became pregnant
while using Accutane, 5 had induced abortions, 4
had spontaneous miscarriages, 4 had normal infants
and 1 had a baby with major birth defects.
Accutane and pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Constipation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"What causes a ripple in the colon? I have a
problem trying to have a normal bowel movement.
My doctor claims the rippling effect is causing
blockage so the stool cannot come out. Is there
anything that can be done for this problem?"
"I am age 69, with Non-Hodgkins Lymphoma (in
remission), taking Estrace ® for hot flashes.
" - Lorrie
Constipation is a symptom that may have many
different causes. Although most of the time
dietary and general living habits are responsible
for constipation, sometimes there can be an
inherent defect in the rippling motion of the
colon muscle that produces constipation.
Another cause may be a weakness of the rectum
(rectocele) or an involuntary spasm of the anal
sphincter muscle. For these and dietary discussion
about different constipation causes, see our
article at:
Constipation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Trichomonas profile
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With many sexually transmitted diseases, the
question often comes up as to whether it is
possible to contract the disease, such as
trichomonas, HPV or bacterial vaginosis, by
methods other than intravaginal intercourse. In
other words can a woman get a trichomonas
infection from a moist toilet seat, hot tub or
swimming pool.
The answer is that it is possible. One study
showed trichomonads can survive up to 3 hours in
water with varying concentration of minerals. And
yet many women do not ever contract trichomonas in
this way.
It is probably best to consider trichomonas
vaginitis as 98-99% a sexually transmitted
disease. Look at our disease profile on
trichomonas:
Trichomonas disease profile
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5. Health related hoaxes and rumors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The governmental unit called the Center for
Disease Control (CDC) based in Atlanta, Georgia,
USA has the charge to monitor and investigate
instances of any small or large epidemics of
contagious or communicable diseases. Their web
site is a very rich source for recommendations
about causes and treatments of bacterial, viral
and parasite diseases.
One of the interesting features on their site is a
section called Current Health Related Hoaxes and
Rumors. In it they comment about what
investigation has actually been done about
conditions or contagious "scares" that you may
hear about and wonder what substance there is to
them. Current examples are statements about:
Does HIV Cause AIDS?
(what ways can HIV be transmitted?)
False Email Report: Hantavirus Spread by Contact
With Soda Cans or Grocery Packages
(a false rumor)
False Email Report: Klingerman Virus
(no such virus)
False Internet Report: Bananas
(no basis as far as CDC can tell)
Needle Stick Hoaxes
(one episode was documented but no subsequent
instances)
CDC's Health related hoaxes and rumors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Vitamin B2 for migraines
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I am an Ob-Gyn outside of Philadelphia. My wife
has been a migraineur all her life and even though
she has been on over 50 different meds including
experimental ones, she was getting headaches every
7-10 days even on the SSRI's. I read an article
last year about a small study in which migraine
patients placed on 400 mg of vitamin B2
(Riboflavin) had a significant success rate in
markedly reducing the frequency and severity of
migraine. It took about 2 months to kick in.
Well, in Feb of this year she decided to try it
and after about 6 weeks, she suddenly went 5 weeks
without a headache and the one she did get at that
point was much less severe. I am happy to report
hat since Feb, she has had a total of 3 or 4, all
of which have been mild. So far no toxic effects
have been observed. She is considering stopping
the SSRI's to see if this continues. I need not
tell you how exciting this discovery has been to
us and I wanted to share this with other migraine
sufferers!
Louis E. Criden, M.D.
[editor note - Here is a study I found supporting
the above concept. I was not previously aware of
it.]
Vitamin B2 study on migraines
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When Life Really Begins
A geneticist, a lawyer, and a family counselor
meet over lunch to decide once and for all when
life really begins.
The geneticist spoke first. "I've done many, many
tests, and have come to the conclusion that life
begins once the sperm and the egg unite."
The lawyer spoke next. "I am a person who
interprets the written law, and, therefore, I
believe that life begins at different times
depending on what state one lives in."
"Well, I'm afraid that I must disagree with both
of you," responds the family counselor.
"Over the years, I've met with thousands of
parents and attended dozens of workshops. I have
come to the conclusion that you start living once
your youngest child goes off to college and your
dog dies."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
***** Woman's Diagnostic Cyber Newsletter *****
July 9, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Can testosterone really help women?
2 What is sarcoidosis?
3. Reader submitted Q&A - Kegel's for incontinence
4. Inverted nipples
5. Health tip to share - Ingrown toenails
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. Can testosterone really help women?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The Women's Health Information Center at JAMA
(Journal of the American Medical Association) has
an article about the role of the male hormone,
testosterone, in how women feel at all ages. We
know that with surgical removal of the ovaries
premenopausally there is a very sudden drop of
testosterone and that may explain post op fatigue,
lack of energy and libido problems, but the role
of testosterone throughout a woman's life is not
clear.
Normal ranges for testosterone levels in women
have been determined but very rarely do doctors
measure these levels in looking for a deficiency
state. Most insurance companies do not recognize
deficiency states of testosterone in women and
thus the cost of lab tests may not be covered.
With scientific trials of a testosterone patch for
women currently underway, this investigator feels
that a testosterone deficiency state can explain
the fatigue, loss of energy and decreased libido
of many menopausal women.
If you are interested in this topic, you may also
want to reread our previous article on this
subject.
Will testosterone help menopausal symptoms?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. What is sarcoidosis?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sarcoidosis is a condition occurring more often in
African-American women ages 20-40 in which small
granulomas or lumps of inflammatory tissue grow in
different areas of the body. No one knows the
cause. These growths can alter the normal function
of an organ like the lung or lymph nodes if there
are too many of them growing in one place.
The most common areas affected are the:
lungs - causing shortness of breath or cough
skin - raised, red bumps under the skin and near
shins
eye - causing teariness and redness
lymph nodes - causing pain behind chest bone, fatigue
joints - causing arthritis symptoms
It is commonly suspected by an abnormal chest x-ray
showing spots like old tuberculosis or other xrays
like CAT scans showing lymph node swelling.
Diagnosis is confirmed by a biopsy of a granuloma
and its appearance under the microscope.
About 50% of the time these granulomas clear on
their own. In mild cases no treatment is needed.
Sometimes, however, steroid treatment or other
chemotherapy is needed.
What is sarcoidosis?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Kegel's for incontinence
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Are the Kegel exercise devices found in many
"home health" catalogs of any help in doing the
exercises? "
Evelyn
Kegel exercises involve contracting the muscle at
the opening of the vagina called the
bulbocavernosus muscle. This helps strengthen the
external urethral sphincter muscle which, in turn,
helps to prevent loss of urine with straining,
coughing or sneezing. The muscle exercises have
been well described and are mostly taught now as
isometric repetitive contractions without any
devices.
Devices have been used for many years to aid in
this process and to help women identify the proper
muscle to contract. Vaginal weighted cones have
been successful and the devices placed in the
vagina to provide resistance to contractions also
probably help identify the correct muscle. Devices
placed between the legs to contract with the thigh
and buttock muscles are not likely to be helpful.
For a discussion of Kegel's exercises, devices and
an instruction sheet, see our article at:
Kegel exercises and devices
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Inverted nipples
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Having breast nipples that are flat or inverted
and don't come out is not as uncommon among women
as you would think. When a woman has them all of
her life, they are due to a congenital shortening
of the ducts of the breast. Sometimes upon
stimulation, the nipples can evert but again, it
depends upon the degree of shortening of the
ducts.
Plastic surgeons can fix this problem but the
surgery costs about $2000 a breast.
This can also be a problem with breast feeding but
usually it is overcome with practice and effort.
Breast feeding with flat or inverted nipples
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Ingrown toenails
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"For temporary (sometimes longer) relief of ingrown
toenails, take a warm bath to soften nails, dry
your feet and trim toenails. Then take the bar of
soap and gently scrape it from the edge of the
nail toward the foot at the corners of the nail.
This causes a soft soap pacing to collect under
the nail and it lifts the painful corners to give
you relief. I usually do this before bed but I
also do it during the day. It really gives me
relief and I haven't had to see a doctor about it
yet."
DMG
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subject: Women's Dictionary
Argument (ar*gyou*ment) n. -- A discussion that
occurs when you're right, but he just hasn't
realized it yet.
Airhead (er*hed) n. -- What a woman intentionally
becomes when pulled over by a policeman.
Bar-be-que (bar*bi*q) n. -- You bought the
groceries, washed the lettuce, chopped the
tomatoes, diced the onions, marinated the meat,
and cleaned everything up, but he "made the
dinner".
Cantaloupe (kant*e*lope) n. -- Gotta get married
in a church.
Childbirth (child*brth) n. -- You get to go
through 36 hours of contractions; he gets to hold
your hand and say "focus... breathe.... push...."
Clothes dryer (kloze dri*yer) n. -- An appliance
designed to eat socks.
Diet Soda (dy*it so*da) n. -- A drink you buy at a
convenience store to go with a half pound bag of
peanut M&M's.
Eternity (e*ter*ni*tee) n. -- The last two minutes
of a football game.
Exercise (ex*er*siz) v. -- To walk up and down a
mall, occasionally resting to make a purchase.
Grocery list (grow*ser*ee list) n. -- What you
spend half an hour writing, then forget to take
with you to the store.
Hair Dresser (hare dres*er) n. -- Someone who is
able to create a style you will never be able to
duplicate again. See "Magician".
Hardware Store (hard*war stor) n. -- Similar to a
black hole in space: if he goes in, he isn't
coming out anytime soon.
Lipstick (lip*stik) n. -- On your lips, coloring
to enhance the beauty of your mouth. On his
collar, coloring only a tramp would wear.
Park (park) v./n. -- Before children, a verb
meaning "to go somewhere and neck." After
children, a noun meaning a place with a swing set
and slide.
Patience (pa*shens) n. -- The most important
ingredient for dating, marriage, and children.
See also "tranquilizers".
Valentine's Day (val*en*tinez dae) n. -- A day
when you have dreams of a candlelight dinner,
diamonds, and romance, but consider yourself lucky
to get a card.
Waterproof Mascara (wah*tr*pruf mas*kar*ah) n. --
Comes off if you cry, shower, or swim, but will
not come off if you try to remove it.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
***** Woman's Diagnostic Cyber Newsletter *****
July 16, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Dry eye syndrome - Be aware of the causes
2. Vulvar pain (vulvodynia) vs vestibulitis
3. Reader submitted Q&A -
4. Bunion Background
5. Selecting exercise and sport shoes
6. Health tip to share - Recurrent yeast infections
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Dry eye syndrome - Be aware of the causes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dry eyes can occur from so many causes that there
is actually an entity called dry eye syndrome.
Gritty, red watery eyes are the main symptoms and
many people are amazed that something can actually
be done about them.
Women may have dry eyes due to hormonal changes
associated with pregnancy, lactation, oral
contraceptives, menstruation, and post menopause.
While no one knows for sure, it is probably a low
estrogen state or one with an increased
progesterone/estrogen ratio that makes eyes dry.
Other causes are from the diseases of rheumatoid
arthritis, diabetes, thyroid abnormalities,
asthma, cataracts, glaucoma, lupus. Medications
such as antidepressants, decongestants,
antihistamines, antihypertensives, birth control
pills, diuretics, ulcer medication, and
tranquilizers can also cause eye dryness.
The treatment is basically conserving a person's
natural tears or adding artificial tears. If the
condition is temporary then artificial tears may be
the best treatment. The tear duct which drains
away normal eye tearing can be plugged with a
small device (punctum plug) and this may be a
better long term treatment for some people with a
chronic problem.
If you are on birth control pills, you might ask
your doctor to switch you to a pill with a lower
progestin potency and a higher estrogen dose. The
same is true of hormonal replacement therapy after
the menopause. Raising the estrogen level and
decreasing or changing the progestin may help.
Dry eye awareness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Vulvar pain (vulvodynia) vs vestibulitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Pain on the outside of the vagina (vulva) can be
due to many causes. As a symptom, it is called
vulvodynia. Sometimes you hear about a disease or
condition called vulvar vestibulitis. You may
wonder when a painful, sometimes burning vulva is
vulvar vestibulitis and when is it just a symptom
of some other condition.
This FAQ page below gives an excellent history and
differentiation of vulvar pain conditions. In
vulvar vestibulitis, which is an inflammatory
condition of the glands of the vestibule, the skin
between the vulva and the hymen on the lower part
of the vaginal opening usually presents with
redness of the vulvar vestibule, especially with
small red spots; pain with intercourse or tampon
insertion and a stinging pain when urine touches
the skin in that area.
A second type of vulvodynia, similar to but
different from vestibulitis, is like a constant
irritation of the skin nerve endings (neuralgia).
It presents with tingling and itching ranging from
mild to severe and often involves the entire
vulva. Its pain sensation does not require
something to touch it to produce the pain.
Finally, there are a host of other causes of
vulvar pain and irritation such as candida
vaginitis, genital herpes infections, vaginismus
(spasm of the vaginal opening muscle), allergic or
irritant reactions and many other less frequent
but possible causes.
Another very comprehensive links page about vulvar
pain can be found at:
Vulvar pain links
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Vitamin supplementation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is 10,000 mg of Vitamin A too much to take per
day? I am 69, happy and healthy and exercise 1
hour daily." - Evelyn
The recommended daily allowances (RDA) of most
vitamins and minerals are set at minimum amounts
to prevent deficiency states. We have learned,
however, that supplements of vitamins and minerals
can help prevent certain diseases or even treat
them just as prescription medicines can.
If you are interested in what levels of vitamins
are safe to take, please look at our article:
Vitamin Intake - How Much is Too Much?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Bunion Background
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A bunion is a bone deformity of the great toe.
Women are more susceptible to them because of
wearing pointed shoes. As a woman gets older,
arthritis can also cause this defect where the toe
tip is deviated and pointing toward the other toes
and the great toe base sticks out to the side
making the foot wider with a painful compression
of the toe base by any shoes.
The American Society of Foot and Ankle Surgeons
(podiatric physicians) has a very good fact sheet
about bunions, what they are and how they are
treated. There can be an hereditary predisposition
to bunions so if your parents had them you may
also develop them at sometime in your life.
Treatments vary whether the deformity is mild or
severe. Padding, inserts and medication may help,
but sometimes surgery is need to really get the
great toe back in line.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Selecting exercise and sport shoes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As long as we are on the subject of foot problems,
and also to give the medical foot specialists
(orthopedists) equal time, there is a very good
review of how to go about selecting sports shoes
for different activities.
The American Orthopaedic Foot and Ankle Society produced this guide to help
you find the best shoe to help you enjoy exercise
and sports and lessen your chance of injury.
For example, joggers need overall cushioning and heel control
walkers need heel cushioning and rocker bottom design
aerobics requires lightweight shoes with ball cushioning
tennis requires side stability with inner/outer supports
They also give some tips on buying:
Don't go just by size. Have your feet measured
Visit the shoe store at the end of a workout when
your feet are largest
Wear the sock you normally wear when working out
Fit the shoe to the largest foot
Finally, there are some suggestions about when
certain painful foot conditions may benefit from a
heel cup, an arch support or a metatarsal pad.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - recurrent yeast infections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I suffered from recurrent vaginal yeast
infections, each month, for three years. I was
tested for diabetes, and it was ruled out. I went
to a surgeon that was going to be uplifting my
bladder, and I mentioned to him about my fungus on
my toenail and the yeast infections, as I was at
wits end. He told me about his own toe/fungus
and how he treated it. He prescribed Diflucan (R)
one pill per week for one year. That was the end
of the problematic yeast infections and the fungus
toenail. This was five years ago, and have only
had one yeast infection in all this time."
DN
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Good Old Fred
Fred had been faithful to his religion but was now
in the hospital, near death. The family called
their pastor to stand with them.
As the pastor stood next to the bed, Fred's
condition appeared to deteriorate and he motioned
frantically for something to write on.
The pastor lovingly handed him a pen and a piece
of paper, and Ol' Fred used his last bit of energy
to scribble a note, then he died.
The religious leader thought it best not to look
at the note at that time, so he placed it in his
jacket pocket.
At the funeral, as he was finishing the message,
he realized that he was wearing the same jacket
that he was wearing when Ol' Fred died. He said,
"You know, Ol' Fred handed me a note just before
he died. I haven't looked at it, but knowing Fred,
I'm sure there's a word of inspiration there for
us all."
He opened the note, and read, "Hey, you're
standing on my oxygen tube!"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
***** Woman's Diagnostic Cyber Newsletter *****
July 23, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Fitness routines - the ultimate workout
2. Facelift nips and tucks
3. Reader submitted Q&A - DES exposure liability
4. Toxic shock syndrome
5. A brief history of childbirth
6. Health tip to share - Cooling down a sunburn
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
You can now access our web site from most search
engines or by just typing in your browser URL
window - BACKUPMD or backupmd
Browsers and search engines using Realnames will
find us. This will not work for AOL users.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Fitness routines - the ultimate workout
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In fitness workouts, most women know about how to
calculate their maximum heart rate (220 minus age)
and then to monitor your exercise workout so that
the heart rate is at about 75-85% of the maximum
rate.
But this does not tell you what type of workout to
use. There are several to choose from.
Interval training - varies the intensity up to
high intensity with periods of low and medium
intensity.
Strength training - needs to include upper body
pushing and pulling, knee straightening and
bending, low back straightening and abdominal
exercises.
Muscular failure - repetitions of one movement
until muscle exhaustion followed by another
movement cycle of a rested muscle.
Supersetting - alternate contraction and
stretching of opposing (antagonist) muscles.
Pre-exhaustion - paired exercises of large and
small muscles of the same regional group.
Stretching - between exercises helps flexibility
and reduces soreness.
Circuit training - fast repetitions of whole body
exercises.
Priority system weight training - entire muscle
groups have a workout with rests in between to
prevent exhaustion.
Weight training alternating with aerobic training
- bursts of aerobic activity interspersed for 1-3
minutes in between strength exercises.
Remember that body fat is burned systemically, not
from the area that is being exercised. Sorry!
The ultimate fitness routine
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Facelift nips and tucks
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you ever worship the summer sun before you
found out that life's skin wrinkles are mostly a
result of long term sun damage? Ever think about a
facelift to get rid of those jaw or neck wrinkles?
Its possible to have a facelift at age 40 or 70
but having realistic expectations of what the
results will look like is key to procedure
success. Finding a good plastic surgeon is also
important because each face is different and
requires a "custom" procedure.
There are some common incisions, however, and
consistent postoperative bruising and puffiness.
You may not want to be seen in public for awhile.
Take a look at Mayohealth.org for an explanation
and pictures.
Facelifts - what to expect
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - DES exposure liability
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am a DES daughter, i.e., exposed in utero to a
nonsteriod estrogen that causes cellular and
formation defects in the reproductive system and
possibly autoimmune, bone, and other problems. I
have been told that the only successful lawsuits
involve infertility or cancer. I would like to
know why more cases are not settled in
relationship to other known problems this drug has
caused. My problems are related to a cellular
defect (adenosis) caused by this drug."
"The makers of DES claim adenosis has other
causes. How prevalent was adenosis before DES was
marketed, if the condition was known at all before
this time? What are the other known causes? I have
only heard of DES being the possible cause. I have
also been diagnosed with a deformity called a
hooded cervix which is also considered caused by
DES drugs. "
"Adenosis has caused continued periods AFTER a
hysterectomy and sapped much of my energy all my
life due to heavy irregular bleeding that caused
chronic anemia. Recent research has shown that
effects most likely can be passed down to future
generations also. I have 3 children. Two with
autoimmune problems and one with a gynecological
problem. I would like to take the drug companies
to court, but what are my chances? Is there any
justice for us?"
Actually there have been some lawsuits won against
the manufacturers of DES for just adenosis
problems and not cancer or infertility but awards
would be expected to be higher if cancer or
infertility are the injuries.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Toxic shock syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Except for the small increase in cases about 20
years ago when one type of super absorbent tampon
was associated with toxic shock syndrome, this is
actually a very rare disease. Anyone, even men and
children can get this disease. About half the
instances are from infections following burns,
boils, insect bites or surgery. The other half are
associated in women with tampon use.
It is caused by a toxin produced by a
staphlococcal infection of the vagina. Symptoms
include the very sudden onset of a high fever
(over 102 deg F), a sunburn like rash over the
face and upper trunk and extremities. Vomiting,
faintness, dizziness, diarrhea, and confusion are
also symptoms which indicate a generalized
systemic reaction to the toxin. It can lead in
some instances to death.
At the information site on Toxic Shock Syndrome in
the UK, the following tips for using tampons are
included:
wash your hands before and after inserting a
tampon
change tampons regularly, as often as directed
on the pack
never insert more than one tampon at a time
when using at night, insert a fresh tampon
before going to bed and remove it on waking
remove a tampon at the end of a period
It may also be a good idea to intersperse the use
of pads or liners in between tampon use.
Toxic shock syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. A brief history of childbirth
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We often forget how much the medical guidance of
childbirth has changed over the centuries. The
following brief medical history article by Dr. Ian
Carr at the University of Manitoba in Manitoba
Canada is very much worth reading.
It guides us from the first early Cesarean
sections in which women never survived, through
the use of obstetrical forceps and operative
maneuvers for obstructed labors.
Until the time that it was realized that sepsis
due to bacterial infection was the leading cause
of death in childbirth, there were very poor
survival statistics, at least as we currently
experience them.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - cooling down a sunburn
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When summer sun exposure gets too much and you
develop a stinging sunburn, several remedies may
help. Aspirin (if you are not allergic or on blood
thinners) is better than acetaminophen or
ibuprofen because it reduces the swelling and
inflammation along with pain relief. Cool soaks or
a cool bath as soon as coming out of the sun will
help. Low dose steroid ointments available over
the counter (with hydrocortisone for example) will
help you get sleep at night but remember that pain
from a burn is a signal not to go out in the sun
again and if the pain is eased by steroid
ointments, you still should not get more sun.
Remember that the major risk factors for skin
cancer (basal cell) include the lifetime number of
blistering sunburns, being red-headed, and having
blue, hazel or green eye color as opposed to
brown.
Ed.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Are men quick about vasectomies?
One day, after a man had his annual physical, the
doctor came out and said, "You had a great check-
up. Is there anything that you'd like to talk
about or ask me?"
"Well," he said, "I was thinking about getting a
vasectomy."
"That's a pretty big decision. Have you talked it
over with your family?" inquired the doctor.
"Yeah." said the man.
"Well, what did they have to say about it?" asked
the doctor.
"They're in favour, 15 to 2." replied the man.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Diagnostic Cyber Newsletter *******
July 30, 2000
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Multiple sclerosis facts
2. Growths on the vulva
3. Reader submitted Q&A - Can't void after surgery
4. Find a gynecologic cancer specialist
5. The music of healing
6. Health tip to share - Perineal odor
7. Humor is healthy
Spread the word! Send a copy of this newsletter
to someone you know.
Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Multiple sclerosis facts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Multiple sclerosis (MS) is a weird disease because
it causes episodic symptoms that seem to come and
go. It strikes between the ages of 30-50 more
often in women.
Symptoms may be mild or severe as the disease goes
through its exacerbations and remissions. While
fatigue is a common symptom, although nonspecific,
it is the loss of coordination, muscle weakness,
spastic muscle contractions, numbness, slurred
speech, and visual problems that finally bring a
person to a doctor.
Unfortunately, early in this disease, tests used
to diagnose multiple sclerosis such as magnetic
resonance imaging (MRI) may not yet be positive.
This may make you think the symptoms are
imaginary. It is not uncommon for symptoms to go
on for two years or more before the diagnosis of
MS is made.
Be sure to take a look at MSfacts.org for more
information about this difficult-to-diagnose
condition.
Multiple sclerosis fact sheet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Growths on the vulva
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We often get questions about a growth or sore area
on the vulva near the vaginal opening of "what can
it be?" It is very difficult to diagnose vulvar
lesions without looking at it so most of the time
the answer is to go see your doctor. Sometimes the
web has descriptions with images to match so you
can try to temporarily self diagnose.
On many occasions the concern is about the
possibility of genital warts or condyloma
accuminata, a fleshy-like skin growth caused by
the HPV virus. While many times a text description
is adequate, in this case photos are very helpful
in order to temporarily self-diagnose.
At Dr. Koop's encyclopedia, there is a good page
with images about condyloma accuminata.
Condyloma accuminata
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Can't void after surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Thirteen weeks ago I had a laparoscopic assisted
vaginal hysterectomy and a bladder suspension
using a sling. I have not been able to urinate
since; I've been doing clean intermittent
catheterization (CIC) to empty my bladder. The
doctors say to wait six months to see if I will
eventually urinate on my own. They believe my
bladder is weak from years of drinking too much
fluid and not urinating often enough. Are they
being realistic that six months will cure this? Or
should I save myself the trouble and have the
sutures removed now?"
"I am 43 years old and in good general health."
Diane
The inability to void urine after surgery can
happen with a hysterectomy but it is more common
after a procedure to correct urinary incontinence.
It seems to occur more often after a certain type
of anti-incontinence surgery called a sling
procedure, but it can happen with any of the other
procedures used.
For a discussion of why this happens and what to
expect about it clearing up with or without
additional surgery, see our article at:
Voiding difficulty after incontinence surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Find a gynecologic cancer specialist
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When a diagnosis of cancer comes, it comes
suddenly. Some early stages of cancer can be
treated by any gynecologic surgeon but if a cancer
has spread, sometimes a specialist surgeon will
make more effort to track down every possible
group of malignant cells.
At Women's Cancer Network there is a FIND A DOC
database that has the gynecologic oncologists,
women's cancer specialists, that you can look up
by state.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. The music of healing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Music therapy has a definite but under appreciated
role in healing. Music is known to lessen the
level of chronic pain and even improve or relieve
depression. People who have had strokes and cannot
talk have sometimes been to sing a favorite old
song.
Music certainly can relieve stress and its range
of healing powers are probably not yet fully
known. Be sure to include it in your daily life
more than just to soothe road rage in the daily
commute.
The music of healing
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Perineal odors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I've found that drinking pineapple juice decreases
perineal odors.
Anon
(Ed. note - please give us feedback on this one!)
If you have discovered ways of coping with a
disease or condition and it works for you,
please share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Catching The Virus"
The "I Love You" virus that infects users of
Microsoft's outlook has morphed. Watch for these
variations:
- The "I love you, too" virus:
Responds with an appropriate letter stating that
the user loves you as well. Spreads peace and
harmony throughout the corporate workplace,
causing lost productivity and chaos on Wall Street
as no one tries to screw anyone else out of a
deal.
- The "I'm looking for more of a commitment" virus
Receives the "I love you" virus email and
immediately schedules a recurring event called
"hold for my sweetie" for Friday and Saturdays
into your calendar and the calendar of the person
who sent the mail, registers you for a year of
pre-paid videos at Blockbuster.com, and deletes
any appointments called "Golf with the guys" or
"Night out with the Girls." It also erases the
phone number from the contact card for your 'ex',
and puts in a monthly reminder for the anniversary
of your first date.
- The "Let's just be friends" virus -
Immediately deletes the "I love you" virus, sends
a "Let's Just be friends" response, and books you
for a discount weekend at Hedonism at an online
travel site.
- The "Unsafe Sex" virus -
Spreads unprotected files to every other hard disk
on the net.
- The "Safe Sex" virus -
Wraps the "I Love You letter" in a container that
keeps it from spreading 99.45% of the time.
- The "Sexual Harassment Lawsuit" virus -
Forwards a copy of the "I Love You" virus to
Human Resources and to your lawyer with
threatening legal language attached.
Automatically accepts settlement offer e-mails
over $100k.
More variations are being discovered every day, so
make sure you update your virus protection.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
