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***** Woman's Diagnostic Cyber Newsletter *****
June 6, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Herpes simplex infections of the skin
2. Dietary fiber decreases heart disease in women
3. Pap smear after hysterectomy
4. Understanding osteoporosis
5. Premenstrual Syndrome
6. Humor is healthy
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1. Herpes simplex infections of the skin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The Department of Dermatology at Waikato Hospital
in Hamilton New Zealand has a site describing
herpes simplex infections, both type I and type
II. I like the part that explains how, With each
attack of herpes simplex, the virus grows down the
nerves and out into the skin or mucous membranes
where it multiplies, causing the clinical lesion.
After each attack it "dies back" up the nerve
fiber and enters the resting state again.
Herpes simplex infection
See also the support site at AOL for herpes
sufferers. The section on how often herpes is
transmitted is excellent. The annual risk of
transmission averages 5 to 10% per year for those
abstaining from sex during outbreaks. The risk of
acquisition is much higher (16.9%) for women, but
somewhat lower for those who already had HSV-1.
People who have HSV-1 seem to be more resistant to
the HSV-2; not that this is an immunity but rather
it is a higher resistance factor.
Herpes site at AOL
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2. Dietary fiber decreases heart disease in women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We have known for awhile that increased dietary
fiber lowers heart disease in men. Now a study in
Journal of the American Medical Association (JAMA)
has looked at whether the same thing is true in
women. They found that women who had the highest
dietary intake of fiber, mostly from cereal
grains, had a reduced risk rate of coronary artery
events (77%) compared with women who took in the
lowest amount of fiber.
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3. Pap smear after hysterectomy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
How likely is it that a women over age 50 who has
had a hysterectomy will develop an abnormal Pap
smear? Actually it is quite a small chance on the
order of 2-4 per 1000 women. If the uterus is
still present, however, this rate of abnormal Paps
jumps to 10-15/1000, i.e., 1.0-1.5%. If a woman
has not had a history of an abnormal Pap and has
had several negative Paps in a row to eliminate
false negative tests, then a good case can be made
for either no further Paps or a Pap smear only
every 5 years. Yearly pelvic exams are still
recommended if the ovaries are in place, but a Pap
smear does not have to be done if the uterus is
gone.
Pap after hysterectomy
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4. Understanding osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you do not really understand osteoporosis or
perhaps you do not realize that bone loss in women
begins as early as age 35-40, then you might want
to check out this article on Thriveonline about
"What is osteoporosis?" Is has some pictures of
normal bone and osteoporotic bone as well as a
risk assessment tool to calculate your risk for
osteoporosis.
Osteoporosis
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5. Premenstrual Syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
At healthanswers.com there is a concise reference
section that gives an overview of Premenstrual
Syndrome including definition, cause, symptoms,
signs, treatment and expectations.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
TO: ALL EMPLOYEES
SUBJECT: SICK LEAVE POLICY
*SICKNESS
No excuse...We will no longer accept your doctor's
statement as proof. We believe that if you are
able to go to the doctor, you are able to come to
work.
*AN OPERATION:
We are no longer allowing this practice. We wish
to discourage any thoughts that you may need an
operation. We believe that as long as you are an
employee here, you will need all of whatever you
have and should not consider having anything
removed. We hired you as you are, and to have
anything removed would certainly make you less
than we bargained for.
DEATH:
*Other than your own.
This is no excuse for missing work. There is
nothing you can do for them, and we are sure that
someone else can attend to the arrangements.
However, if the funeral can be held in the late
afternoon, we will be glad to allow you to work
through your lunch hour and subsequently let you
leave 1 hour early, provided your share of the
work is ahead enough to keep the job going in your
absence.
*Your own:
This will be accepted as an excuse. However, we
require at least two weeks notice as we feel it is
your duty to train your replacement.
ALSO
Entirely too much time is being spent in the
restroom. In the future, we will follow the
practice of going in alphabetical order. For
instance, those whose names begin with "A" will go
from 8:00-8:15, and so on. If you're unable to go
at your time, it will be necessary to wait until
the next day when your time comes again.
We appreciate your cooperation,
THE MANAGEMENT
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
P.S. Let us know what you think of the newsletter
Feedback and suggestions
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
June 13, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Warm up for summer exercise
2. Early breast cancer and alternative medicine use
3. Cellulite - What do we really know?
4. Skin basics
5. Vitamin deficiencies and excess
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. Warm up for summer exercise
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The Adventure Network has a section on Health and
Safety Tips that is very handy for women involved
in outdoors activities this summer. I like the
section on fitness that has good advice for
different activities you might want to start. Did
you know that bouncing during a stretch is the
wrong thing to do? Or during walking and hiking,
to prevent upper body and neck aches, you should
keep your chin up and eyes looking straight ahead
down the trail? Your neck should be relaxed and
your head centered between your shoulders. Keep
your shoulders relaxed by lifting your chest--as
if you are trying to fill your lungs with more
air.
Among the fitness tips are:
Getting in Shape for Summer Walks
A Healthy Back
Exercise Safety Checklist
Heart Rate Primer
Why Stretch?
Exercising During Pregnancy
Exercising in the Heat: Humidity is Hell
Fitness tips
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2. Early breast cancer and alternative medicine use
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A recent article in the New England Journal of
Medicine about 480 women with newly diagnosed
breast cancer reminds us of how science has the
potential to be misleading. This study looked at
the use of alternative medical therapies by these
women which increased from 10.6% before diagnosis
to 38.7% after diagnosis, i.e., a new use rate of
28.1%. The authors found that "Women who initiated
the use of alternative medicine after surgery
reported a worse quality of life than women who
never used alternative medicine."
They concluded "new use of alternative medicine
was a marker of greater psychosocial distress and
worse quality of life. "
The big factor that was not well accounted for was
that women with breast cancer often are placed on
tamoxifen which is an antiestrogen and makes
menopausal symptoms worse, i.e., life "is
miserable". There are no ideal "medical therapies"
that help the low estrogen state and many women
turn to "alternative medical therapy" such as oil
of evening primrose, St Johns's Wort, ginseng etc.
Perhaps this study was not about alternative
medicine seekers because of "cancer distress" as
is was about menopausal distress.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Cellulite - What do we really know?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Do we actually know what cellulite is? Are women
more prone to it than men? This week's educational
article looks at the existent, but very limited,
medical studies that have examined Cellulite">cellulite as a
form of body fat deposition.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Skin basics
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The site at Ask Noah about Dermatology is a
tremendous resource about many skin conditions.
There is a basic section about skin that is worth
reading even if you do not have problems at the
present time. It contains:
Black Skin, Hair and Nails
Hyperhidrosis (Excessive Sweating)
Itching (Pruritis)
Spider Veins
Mature Skin
Dry Skin (Mature)
Skin Lesions (Mature)
Skin Diseases in Maturity
Symptoms to Watch for with Mature Skin
Scars
Can You Make a Scar Less Noticeable?
Methods of Scar Treatment
Scar Treatment Methods - Additional
What Can and Cannot Be Done for Scars
Skin Anatomy
The Structure of the Skin
The Epidermis
The Dermis
The Subcutaneous Tissue
The Structure of the Skin for Kids
Skin Cancer
Skin basics
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5. Vitamin deficiencies and excesses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Among the many claims for cures by vitamin and
supplement therapy have you ever wondered what the
known effects of too little or too much of certain
vitamins are acording to most scientists. The
signs of vitamin deficiencies or excesses are
listed at:
Vitamin deficiencies and excesses
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6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Deep within a forest a little turtle began to
climb a tree. After hours of effort he reached the
top, jumped into the air waving his front legs and
crashed to the ground. After recovering, he slowly
climbed the tree again, jumped, and fell to the
ground.
The turtle tried again and again while a couple of
birds sitting on a branch watched his sad efforts.
Finally, the female bird turned to her mate.
"Dear," she chirped, "I think it's time to tell
him he's adopted."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
June 20, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Pregnancy implantation is later than we think
2. Depression in 36-44 year old women
3. Progesterone - its uses and effects
4. Health care fraud
5. Does coffee prevent gallstones?
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. Pregnancy implantation is later than we think
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A recent study in the New England Journal of
Medicine looked at the time of implantation of
pregnancy in 221 women who had stopped
contraception and were trying to conceive. They
used a very sensitive pregnancy test and collected
daily urine samples. Although they did not use LH
testing to determine ovulation (they used an
estrogen to progesterone ratio), they determined
that in all patients, implantation occurred 6-12
days after ovulation. In 84% of women,
implantation occurred on days 8-10 and when it
occurred later, the miscarriage rate increased. On
day 10, 11 and greater than 11, the pregnancy loss
rates were 26%, 52% and 82% respectively. If
implantation occurred on day 9 or before, the
early loss rate was 13%. Overall in the study the
pregnancy loss rate was 25% but you have to
remember these are chemical pregnancies, not
recognized clinical pregnancies, i.e., some of the
losses occurred before a conventional, home pregnancy
test would be positive.
The most optimal time for implantation is probably
days 7-9 with the majority of successful
pregnancies occurring on days 8 and 9, not day 7 as
is traditionally thought.
Further implication of this study (my
conclusion) is that many cases of failure to
conceive may be due to slow transit time through
the faloppian tubes rather than a host of other
problems such as sperm antibodies, cervical mucous
problems etc.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Depression in 36-44 year old women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many studies about depression stem from patients
who present to a medical office for one reason or
another. It is difficult sometimes to determine
how frequent a condition such as depression is in
the general community because many who are
affected do not seek any treatment.
In this community-based study in Boston, women aged
36-44, 22.4% scored as moderately depressed and
8.6% had testing scores consistent with severe
depression. Women who were widowed, divorced or
separated were twice as likely as married women to
have depression as were women who smoked.
Depression in late PREmenopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Progesterone - its uses and effects
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Estrogens and even female use of testosterone has
been extensively discussed and written about in
magazines and the news. But what about
progesterone? What is its effect? Is it a wonder
drug as some authors and promoters would have you
think? This week's article discusses the:
differences between natural and synthetic progesterone
the different forms of progesterone available
effects of too much or too little progesterone
regulation of abnormal bleeding with progesterone
does progesterone block estrogen's beneficial effects?
does progesterone cause mood changes
Progesterone and progestogens
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Health care fraud
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Health care fraud has always been with us but the
worldwide web allows us to be gullible quicker and
more frequently. There are various sites that try
to monitor some of this and since our readers are
very interested in health, you may want to become
active with these groups.
One group is The National Council Against Health
Fraud. They have some position papers you may want
to read if you are interested in any of the
following:
Acupuncture
Chiropractic
Colonic Irrigation
Diet and Criminal Behavior
Diploma Mills
Homeopathy
Health Care Fraud
Also, if you know of any instances of deceptive
healthcare practices or have questions about
something that might be fraudulent, contact
Quackwatch. You may be interested in some of their
general observations about Quackery:
How Should It Be Defined?
How It Harms
How It Sells
25 Ways to Spot It
More Ploys That May Fool You
Common Misconceptions
Ten Ways to Avoid Being Quacked
Signs of a "Quacky" Web Site
Pro-Quackery Legislation
Why Bogus Therapies Often Seem to Work
Fifteen Ways to Spot an Internet Bandit
Dr Stephen Barrett's Quackwatch
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Does coffee prevent gallstones?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This study in men says - YES. Drinking 2-3 cups of
coffee per day reduces the risk of gallstones by
40% (risk ratio .6). It is nice to hear some of our
vices are useful. There is no reason to think the
same relationship does not hold true in women
also.
The moral of the story -- if you take estrogens
(increases gallbladder disease including
gallstones), drink coffee!
Coffee drinking and gallstones
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Signs that you MIGHT be experiencing menopause:
1. You sell your home heating system at a yard
sale. (Hot flashes)
2. The person you sleep with complains about snow
piling up on the bed. (Nightsweats)
3. Your husband jokes that instead of buying a
wood stove, he is using you to heat the family
room this winter. Rather than just saying you are
not amused, you shoot him. (Mood swings)
4. You write post-it notes with your kid's names
on them. (Memory Loss)
5. Your husband chirps, "Hi honey, I'm home." and
you reply, "Well, if it isn't Ozzie f---------ing
Nelson". (Irritability)
6. The phenobarbitol dose that wiped out the
Heaven's Gate Cult gives you 4 hours of decent
rest. (Sleeplessness)
7. You find guacamole in your hair after a Mexican
dinner. (Fatigue)
8. You change your underwear after every sneeze.
(Mild incontinence)
9. You need Jaws Of Life to help you out of your
car after returning home from an Italian
restaurant. (Sudden weight gain)
10. You ask Jiffy Lube to put you up on a hoist.
Dryness)
11. You take a sudden interest in "Wrestlemania".
(Female hormone deficiency)
12. You're on so much estrogen that you take your
Brownie troop on a field trip to Chippendales.
(Hormone therapy)
*author unknown
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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***** Woman's Diagnostic Cyber Newsletter *****
June 27, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Vulvar pain (vulvodynia)
2. Breast reduction surgery
3. Pelvic inflammatory disease and infertility
4. Eyestrain from computer use
5. Helping a friend with a chronic illness
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. Vulvar pain (vulvodynia)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
At Dr. Glazer's site, vulvodynia.com, there is an
extensive compilation of questions and answers
about vulvar pain - its many causes and
treatments.
Did you know there is a higher frequency of
associated pain problems with vulvodynia such as
fibromyalgia, interstitial cystitis, irritable
bowel syndrome, or autoimmune disorders?
Some women find propylene glycol (an ingredient in
many sexual lubricants!) to be a vulvar irritant
which can cause or worsen vulvodynia. You may want
to learn about oxalate sensitivity, a theory that
some women have pain because they have sensitivity
to plant oxalates, which form crystals and lodge
in the vulvar tissue following urination. This
theory is still controversial but it has some
rationale behind it. Low oxalate diets can
sometimes help vulvodynia.
In any case, vulvodynia is a complicated problem
and physician knowledge is sometimes limited. If
you have this problem of chronic vulvar pain, you
need to learn about it extensively so that you can
work together with your doctor to best determine
what may be causing the pain in your case and what
therapy methods may be best for you.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Breast reduction surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
While most women are familiar with requests for
plastic surgeons to increase breast size, there
are a fair number of women who desire surgical
reduction in breast size. Are you familiar with
which symptoms would suggest the need for a
reduction other than just a desire to look
different?
You might want to look at the site below if:
you have pain due to your breast size, usually
involving your back, neck, and/or your shoulders
you have shoulder grooving from your brassiere
straps
you have skin irritation beneath your breasts
there are restrictions in your activity due to
your breast size
you have pain from dense, fibrous breasts (even if
not extremely large breasted)
breast size varies significantly from side to side
Breast reduction surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Pelvic inflammatory disease and infertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Pelvic inflammatory disease can affect fertility
by damaging the faloppian tubes. If the infection
is confined to the tubes, the infection abscess is
called a pyosalpinx. If the abscess leaks out and
includes the ovary, it is called a tubo-ovarian
abscess. This is discussed at:
Tubo-ovarian abscesses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Eyestrain from computer use
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
At WebMD.com, they have licensed some self-care
advisor tips from the American Institute of
Preventive Medicine. I was especially interested
in the section on preventing eyestrain from
computer videoscreen use.
It makes sense that you should place the screen so
that your line of sight is 10 to 15 degrees (about
one-third of a 45-degree angle) below horizontal
but if you do not really think about it when
setting up your chair, desk and computer screen,
you may end up viewing your computer screen at an
angle that worsens eyestrain or neck and back
muscle strain. In other words, the monitor should
not be so high that if you look straight ahead
(zero degrees from horizontal), you see the
screen. Rather it should be positioned so that
with the screen two feet away from you, your eyes
should be looking down about 15 degrees from the
horizontal. Lower than that is not any better than
higher.
Eyestrain from computers
The American Institute of Preventive Medicine also
produces a Self Care Guide,
Self-care guide
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Helping a friend with a chronic illness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When a friend has surgery or an illness that will
be successfully treated. it is not difficult to
rally around with meals, flowers, visits and
gifts. If she has a chronic illness such as
fibromyalgia, chronic migraine headaches, multiple
sclerosis, or one of numerous other chronic
conditions, what do you say to her? What do you
do?
Should you tell her to get out there and push
herself through the pain? Do you encourage her to
remain hopeful? For answers, you may want to look
at an article at restministries.org that gives you
tips of what to do and what to say to a friend with a
chronic medical problem. You may also be
interested in other articles about:
When Friends Turn Away
When Your Spouse Doesn't Believe that You are Ill
Do you wonder why your doctor won't listen to the
newest research about treatment for your illness?
What to say to a friend with a chronic illness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
IS THERE A DOCTOR IN THE HOUSE?
It was a stifling hot day and a man fainted in the
middle of a busy intersection. Traffic quickly
piled up in all directions while a woman rushed to
help him. When she knelt down to loosen his
collar, a man emerged from the crowd, pushed her
aside, and said, "It's all right honey, I've had a
course in first aid."
The woman stood up and watched as he took the ill
man's pulse and prepared to administer artificial
respiration. At this point she tapped him on the
shoulder and said,
"When you get to the part about calling a doctor,
I'm already here."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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