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Women's Health Newsletters 1/07/01 - 2/4/01

 

 

 

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****** Woman's Diagnostic Cyber Newsletter *******
                January 7, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Allergies during the winter
2. Pelvic reconstructive surgery complications
3. Reader submitted Q&A - Hair loss with BCPs
4. Sleep disorders with weight loss or gain
5. Controlling dust mites
6. Health tip to share - Cherries relieve gout
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. Allergies during the winter
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Those who live where there are 4 distinct seasons 
often find relief from seasonal allergies during 
the winter months. Since many seasonal allergies 
are due to pollen and molds in the air, winter may 
very well make the allergies go dormant too. 
Sometimes, however, the allergic symptoms can be 
as bad or worse during winter season. 

Other common allergy causes are animal hairs and 
dust mites. People with these allergies can worsen 
in winter as the cold weather confines one to 
inside the house more. Bedrooms can be the worst 
source of dust mites. Special dust covers for 
pillows and mattresses may help. Smoking or even 
second-hand smoke is taboo for those with 
allergies. It often worsens breathing problems as 
much as a cold can do. 

Antihistamines are the mainstay of treatment 
although during the day, non sedating ones need to 
be used. Prevention by avoiding the triggers of 
allergy is essential to the degree that it can be 
done. 

Allergies in the winter

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Pelvic reconstructive surgery complications
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Pelvic reconstructive surgery refers to 
gynecologic surgery that fixes uterine or vaginal 
prolapse, cystocele, rectocele, enterocele, stress 
incontinence or other pelvic support defects. 
Compared to hysterectomy, these surgeries have 
higher complication rates. 

A recent study from Johns Hopkins indicated that 
there may be as high as a 47% complication rate 
and a 15% hospital readmission rate following 
pelvic reconstructive surgery. This includes 
readmission for recurrence of the the same or 
another prolapse problem. Patients who had had 
previous surgical reconstructive procedures or 
those who had moderate amount of blood loss were 
the ones who had more complications. 

Pelvic reconstructive surgery can fix a long term 
disabling problem but it should not be undertaken 
lightly. Be sure to ask your doctor about what 
complications are possible and how frequently they 
occur. 

Pelvic reconstructive surgery complications

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Hair loss with BCPs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 25 and have had severe alopecia areata since 
I was about 4 years old. In July, I started taking 
Mircette birth control pills. Would my taking 
these pills have anything to do with the recent 
worsening of the alopecia?" M. 

Yes and no. Birth control pills can stimulate hair 
growth while changing the normal growth cycle 
duration of hairs. The net result in some women is 
a generlized loss of hair about 3-4 months after 
starting the pills. This loss should be general, 
all over the scalp and not patchy like alopecia 
areata. It goes away on its own after 2-3 months. 

To see how hormones can effect hair growth and 
other causes of hair loss, see our article at: 

Hair loss with birth control pills

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Sleep disorders with weight loss or gain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sleep apnea, a condition where breathing stops for 
10 seconds or more during sleep, is more common 
among males who are overweight and snore. More and 
more, however, women are also being diagnosed with 
sleep apnea. Any woman who has poor sleep should 
be checked for this. Weight changes can 
significantly affect the incidence of sleep 
problems. 

During sleep apnea, oxygen levels decline and 
finally the sufferer awakens. This gives a very 
disturbed sleep causing multiple awakening 
episodes as well as night sweats, daytime fatigue 
and sleepiness as well as irritability. 

A recent study tracked almost 700 men and women 
over 4 years to see how weight gain or weight loss 
affected sleep apnea. They found that relative to 
stable weight, a 10% weight gain was associated 
with a 32% increase in the apnea index. A weight 
loss of 10% was associated with a 26% decrease in 
the apnea index. 

Sleep disorders and weight change

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Controlling dust mites
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dust mites are a common cause of allergies. They 
rank second behind pollen in the cause of 
allergies. Mites are invisible to the naked eye 
and are related to ticks and spiders rather than 
insects. They often feed on the shed skin 
particles of humans. Their own shed skin and feces 
are the substances that cause allergic reactions. 

Since mites tend to live in mattresses, pillows, 
bed clothes and favorite sofas and chairs, those 
are the places that need cleaning and sealing. 
Control measures may include: 

Enclose mattresses, box springs and pillows in 
zippered allergen- and dust-proof covers. 
 
Wash all bedding materials including blankets and 
mattress pads every other week in hot water (130 
deg F). 

Avoid using any cloth window dressings or cloth or 
pendants on walls. 

Remove carpeting from the bedroom of the allergic 
person and replace it with tile or wooden floors. 

Replace upholstered furniture with wooden or 
plastic furniture. 

Vacuum often with a vacuum cleaner provided with a 
high efficiency purifying air (HEPA) filtration 
system. 

Filters on the air ducts do not help with mites 
because they cannot live in air ducts or anywhere 
away from moisture and food in bed, carpet or 
cloth fibers. 

Controlling dust mites

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Cherries relieve gout
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I've proven this theory which I read in the 
Prevention (magazine) Encyclopedia, published 
about 23 years ago. My husband had severe gout in 
his big toe when we married.  His Dr. had given 
him a medication which was not relieving it much.  
I had already begun my trek into natural 
alternatives to man-made drug remedies and had 
purchased the Prevention Encyclopedia. 

The remedy for gout is as follows: 
10 black cherries a day (when in season) until 
gout disappears.   When not in season, drink 8-10 
oz. of black cherry juice per day (may be found in 
health food stores and some supermarkets). 

I know this works, because we tried it twice.  
Since the second administration of treatment,the 
gout has never returned.  And, my husband no 
longer has a diet high in fat. 

C.H.

[editor note - Low protein diet, normal weight 
maintenance and no alcohol are also mainstays of 
gout prevention] 

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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Picture of Health
-=-=-=-=-=-=-=-=-=-

A woman walked up to a little old man rocking in a 
chair on his porch. 

"I couldn't help noticing how happy you look," she 
said. "What's your secret for a long happy life?" 

"I smoke three packs of cigarettes a day," he 
said. "I also drink a case of whiskey a week, eat 
fatty foods, and never exercise!" 

"That's amazing," the woman said. "How old are 
you?' 

He thought for a moment, and replied, "Twenty-six." 


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 *******
                January 14, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Self-help for a cold
2. Dry eye syndrome
3. Reader submitted Q&A - Menopause and sleep
4. Mood side effects from different progestins
5. Frostbite is a serious problem
6. Health tip to share - Low carbs make difference
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. Self-help for a cold
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The common cold is amazingly not yet curable. Its 
symptoms of a runny nose with clear mucous, 
sneezing, sore throat, a dry cough, and a slight 
fever (but not usually higher than 101 F), last 
about 3-7 days. 

Cold are contracted in two major ways: 

1) from other people who may sneeze or cough 
around you and their aerosol droplets containing 
virus are inhaled into your lungs 

2) or from contact with those viral droplets on 
objects  that have been touched by people with 
colds such as door knobs, money, towels, drinking 
glasses, and then your "contaminated" hands come 
in contact with your nose or mouth where the virus 
is inhaled or put into the mouth. 

Some people are more immune than others to these 
viruses and it takes a larger total number of 
viruses in the droplets of moisture to infect them 
with a cold. Others, whose immune system is 
compromised, catch a cold with fewer amounts of 
virus. 

It follows then that to prevent colds, you should: 

Wash hands frequently and always before eating 
Do not share eating and drinking items with others 

Keep your immune system in good shape: 
  Get plenty of sleep. 
  Eat a well balanced diet. 
  Get plenty of exercise. 
  And perhaps use Vitamin C supplements which may 
increase your resistance or decrease cold symptom 
severity 

It is also not out of line to ask closely located 
co-workers (school mates) who come to work with a 
cold to wear a mask if they insist on working and 
coughing near you. 

During this winter season, you may wish to look at 
the self-care tips and reasons for when to see the 
doctor in this article from the University of 
Missouri-Rolla Student Health Service. 

Self-help for a cold

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Dry eye syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The most common cause of dry eyes that a 
gynecologist sees is menopause. With falling 
estrogen levels, tears change in their composition 
and amount. Even with adequate hormonal 
replacement therapy, the eyes may still be dry. 

Many women, more so than men, have dry eye 
syndrome for reasons other than menopause. Certain 
prescribed medications such as anti bowel or 
bladder spasm meds, thyroid conditions, vitamin A 
deficiency, and diseases such as Parkinson's and 
Sjogren's Syndrome can also cause dryness. House 
or environmental conditions that are hot, dry or 
windy can produce dry eyes. Cigarette smoke can 
irritate the eyes and just working long hours in 
front of a computer can dry your eyes if you do 
not blink enough. 

Tears are not just water. they are actually 
composed of mucous, water with some salts and 
protein, and oil which helps keep the tear 
adherent to the surface of the eye. As people age, 
less oil is produced in the tear. 

The solution to dry eyes often includes the use of 
preservative-free, artificial tear solutions if 
the primary dry eye cause can not be totally 
reversed. If you have any problem or concerns 
about dry eyes, you may wish to review the subject 
at St. Luke's Cataract & Laser Institute web site: 

Dry eye syndrome

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Menopause and sleep
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 53 and having a terrible time falling 
asleep.  My doctor has prescribed Ambien® and 
it is working.  I would love to just be able to 
sleep on a regular basis.  Can I take this 
medicine for a long period of time?  Can I take it 
on a regular basis?  I have a great doctor, but he 
is not one who wants to write prescriptions and 
told me to check this information about sleep out 
for myself." 

"I do all the regular type of things to help i.e. 
no exercise late, no caffeine, good sleep setting, 
etc. I am on HRT also. None of these things seem 
to work.  I really think this is all menopause 
related.  I hate not sleeping.  It makes life very 
difficult. I still have children at home and 
cannot just nap when I feel like it.  Please help 
me on this.  Thank you." - Roxie 

Sleep problems are more frequent as women (and 
men) age. Menopause can worsen sleep problems if 
estrogen is not adequately replaced.  There are 
two main categories of difficulties, insomnia and 
sleep disorders. 

For a discussion of these and what you can do to 
improve sleeping, see our article at: 

Sleep Problems, Menopause and Melatonin

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Mood side effects from different progestins
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Practioners have often noticed that women have 
more adverse mood symptoms (irritability, 
depression, feel lousy) and physical symptoms 
(abdominal bloating, achiness) according to the 
amount and type of progesterone or progestin they 
are taking when using either oral contraceptives 
or menopausal hormone replacement therapy (HRT). 

Finally we have a scientific study that looks at 
this factor. Investigators looked at 51 menopausal 
women who were taking hormone replacement. They 
all received the same estrogen compound and dose 
and about half received medroxyprogesterone 
acetate (equivalent to Provera(R)) while the other 
half received norethindrone acetate (equivalent to 
Aygestin (R) and also in Activella(R), FemHRT(R), 
and BCPs Estrostep(R) and LoEstrin(R)). 

The study found that women who had a history of 
PMS responded strongly (negatively) to both 
progestins. In women without a history of PMS, 
medroxyprogesterone acetate produced less negative 
mood symptoms but more negative physical symptoms 
than norethindrone acetate. 

This information will be helpful to women who are 
having side effects such as mood problems or 
bloating with oral contraceptives or HRT. It also 
reaffirms that PMS symptoms are more likely due to 
progesterone secretion in the 2nd two weeks of the 
menstrual cycle. Women who have PMS symptoms while 
taking birth control pills may want to ask their 
physician to change them to a pill with a 
different progestin. 

Mood side effects from different progestins

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Frostbite is a serious problem
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Frostbite can be serious. It may result in damage 
like a third degree burn or even cause loss of a 
limb. With winter sports activities or even just 
becoming unexpectedly  stuck in the snow, you may 
need to worry about the danger of cold exposure. 

Frostbite can be divided into: 

first degree - burning, stinging, aching, 
throbbing of the skin that appears reddened and 
swollen with possible peeling of skin about a week 
later like a sunburn. 

second degree - numbness and heaviness of the 
affected area that appears as significant 
swelling, blisters, black scabs. 

third degree - Loss of sensation, area feels like 
"woody" with purplish, blood-filled blisters 
followed by dark skin discoloration and 
subsequently death of the skin. 

fourth degree - because of complete freezing of 
skin, fat, muscle, and bone, the area is initially 
quite red, and then becomes black before it needs 
to be amputated. 

Only when you are safely out of the cold should 
you attempt treatment for frostbite. It is safest 
to do this in the hospital. The affected area is 
rapidly thawed in a water bath for 15-30 minutes. 
Clear blisters are opened and topical treatment 
using antibiotics and aloe vera (70%) are used. 
Pain meds are given as well as a tetanus shot. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Low carbs make a difference
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have found that a low carbohydrate diet 
virtually relieves all my aliments including gout, 
bursitis, back pain, allergies, high blood 
pressure etc. I have these problems only when 
consuming too many carbohydrates which for me is 
anything more than regular green, non-starch 
vegetables."  Theresa Ross 

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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A woman and a man are involved in a car accident; 
it's a bad one. Both of  their cars are totally 
demolished but amazingly neither of them are hurt. 
 
After they crawl out of their cars, the woman 
says, "So you're a man, that's interesting. I'm a 
woman. 
 
Wow, just look at our cars! There's nothing left, 
but fortunately we are unhurt. This must be a sign 
that we should meet and be friends and live 
together in peace for the rest of our days." 
 
The man replied, "I agree with you completely. 
This must be a sign!" 
 
The woman continued, "And look at this, here's 
another miracle. My car is completely demolished 
but this bottle of wine didn't break. Surely God 
wants us to drink this wine and celebrate our good 
fortune." 
 
Then she hands the bottle to the man. The man nods 
his head in agreement, opens it and drinks half 
the bottle and then hands it back to the woman. 
 
The woman takes the bottle, immediately puts the 
cap back on, and hands it back to the man. 
 
The man asks, "Aren't you having any?" 
 
The woman replies, "No. I think I'll just wait for 
the police." 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 *******
                January 21, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Preventing medical errors
2. Acute macular degeneration of the eye
3. Reader submitted Q&A - My breast cancer risk?
4. Ovarian cysts
5. A child's response when a parent is sick
6. Health tip to share - Lysine for fever blisters
7. Humor is healthy

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Preventing medical errors
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We have heard much about medical errors recently 
and how they can affect your health care. If you 
are concerned about finding a competent doctor, 
you will also want to know what you should do to 
take an active role in avoiding any mistakes in 
the care you receive. 

"Twenty Tips to Prevent Medical Errors" has some 
helpful suggestions to make all members of your 
health care team vigilant in avoiding mistakes. 
Some of the highlights of the list include: 

be an active member of your own care - know what 
is going on 

make sure you can read your doctor's prescription 
and know what it says 

ask for information about your medicine in terms 
you can understand 

in the hospital, make sure health care workers who 
come in direct contact with you wash their hands. 

more is not always better, you may be better off 
without certain treatments or tests 
  
The essence is to take an active role and know 
what is being decided about your health care and 
why it is being decided. Do not be afraid to ask 
questions to clarify what was said or why 
something was ordered. If laboratory tests were 
ordered, find out the results. Don't assume that 
no news means the results are normal. 

Preventing medical errors

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Acute macular degeneration of the eye
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The macula is the area of the eye on the retina 
that is responsible for clear central vision. In 
the next line, focus on the I in the center and 
notice how the beginning  "3" and the ending "2" 
are out of focus. 

3--------------------------I---------------------------2

With macular degeneration, focusing directly on 
the "I" does not make it clear. It becomes cloudy 
also and even wavy and can affect one or both 
eyes. 

The progressive loss of vision usually takes place 
over a long time. There are two types, a dry type 
and a wet type . The wet type has some hemorrhage 
(blood) behind the macula while the dry type just 
has loss of retinal cells. 

The cause is not known other than aging although 
there may be some genetic tendency toward the 
degeneration of retinal cells. Women who take 
estrogen replacement tend to have a lower 
incidence of acute macular degeneration by about 
50%. 

Laser therapy can sometimes help the wet type but 
for the most part there is not a known treatment. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - My breast cancer risk?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Should I be worried about breast cancer?  I am 26 
and my maternal aunt died of breast cancer at the 
age of 46.  I have fibrocystic breast and I am 
taking Loestrin(R) 1.5/30 birth control pills?" 
- Joy 

We are barraged with claims that some factor has 
now been found to be a risk factor for breast 
cancer. Whether it is dietary fat, alcohol use, 
fibrocystic breast disease, estrogen use, birth 
control pill use, or even working the evening 
shift, it becomes very confusing how much each of 
these conditions actually increase risk. 

An accurate risk prediction calculator called the 
Gail Model has been developed and it does not 
include many of the factors that you might think 
put a woman at risk. This is because when the 
important risks such as age, family history of 
cancer and previous biopsies etc., have been 
accounted for, these other conditions do not 
change your risk. 

For a discussion of what risk factors you should 
be concerned with, see: 

Should I be worried about breast cancer?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Ovarian cysts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With the benefits of technology come the hazards. 
Doctors order pelvic ultrasound studies for many 
reasons and our current ultrasound machines can 
find small follicle cysts that are actually normal 
eggs developing in the ovary. The radiologist may 
report these as "cysts" -- implying an abnormal 
finding -- when in fact they are totally normal 
structures expected to be present. 
                                            
In fact any simple cyst in the ovary measuring 2.5 
cm (one inch) or less is most likely to be a 
normal egg follicle. After eggs are released 
(ovulated), a corpus luteum gland (which looks 
like a cyst on ultrasound) is formed. It may range 
normally from about 2.5 cm up to 5 cm). 

When an ultrasound study reports an ovarian cyst, 
what does it mean? There can be non physiologic 
cysts like endometriosis or benign neoplasms of 
the ovary that measure 5 cm or less but since most 
physiologic cysts are that size, the usual 
treatment is to wait and see if the cyst goes away 
or gets smaller  over time. This is determined by 
repeating the ultrasound study in approximately 6 
weeks. If the cyst is not smaller or gone in that 
time. Further therapy may be needed. 

For a discussion about ovarian cysts, see this 
page at ppphealthcare.co.uk : 

Ovarian cysts

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. A child's response when a parent is sick
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you or your spouse have to go to the hospital, 
what does your child think? What should you tell 
the child? A child under the age of 8-10 may too 
selfish or irrational to just accept that dad or 
especially mom won't be there for awhile to take 
care of them. They may even resent the lack of 
attention. 

If you come down with an illness or have to have a 
hospitalization, do not just tell the child 
"everything is going to be ok." They can see that 
it is not ok or that you are quite worried and 
preoccupied. They imagine a sudden loss of love or 
even a total loss of the sick parent and fear 
abandonment. 

It is best to very concrete with a young child. 
Tell them you will need to be in bed for x days to 
rest so that you will be able to take care of 
them. If you have to go to the hospital give a 
careful explanation of how long it will be and 
what is happening. Accept all the help that is 
offered to you in terms of child care. The least 
you change a child's routine, the more accepting 
they are of the unknown situation. 

You may want to check out this site at 
Indiaparenting.com 

When a parent is sick

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Lysine for fever blisters
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"If you are troubled with fever blisters. The 
remedy is simple. Take a L-Lysine tablet every 
day. I once had real bad fever blisters and since 
doing this I have not had a single one." Marian 

[editor note - There are several positive studies 
showing  1000 - 1200 mg/day of L-lysine is 
effective in reducing both oral (cold sores) and 
genital herpes. There have been a few negative 
clinical trials also, so it may not work for 
everyone.] 

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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Anxious to comply

When Joe was seated in the doctor's waiting room 
and anxious to get his visit over, he said to the 
person seated next to him "May I see the doctor 
first, I think rigor mortis is setting in." 

When he got in to see the doctor, the doctor asked 
him if he had been staying on his low cholesterol 
diet. Joe quipped that his wife had been feeding 
him so many vegetables that yesterday he was 
sitting on the back porch and his body started 
leaning toward the sun. 

When he came home from the doctor looking very 
worried. his wife said, "What's the problem?" 

Joe said, "The doctor told me I have to take a 
pill every day for the rest of my life." 

She said, "So what? Lots of people have to take a 
pill every day their whole lives." 

He said, "I know, but he only gave me four pills!" 


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 *******
                January 28, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Pain in the ball of your foot
2. ASCUS Pap smears over age 50
3. Reader submitted Q&A - Hemorrhoid care
4. PMS treatment
5. Exercise and stress
6. Health tip to share - Calcium for sleep loss
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. Pain in the ball of your foot
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chronic pain in the ball of the foot is called 
metatarsalgia because it is at the base of the 
metatarsal bones of the foot where they connect to 
the toes. The most common cause is poor fitting 
shoes, especially women's dress shoes and other 
shoes that are too tight across the ball of the 
foot. 

The cause of the pain is inflammation of the 
tendons and muscles around the bones. While anti-
inflammatory medicines like ibuprofen (Advil(R) or 
naproxen (Alleve(R)) help immediately, the 
treatment is to get foot ware that fits better. 
Shoes that have a wider toe box and rocker bottom 
soles that will take the pressure off the balls of 
the feet are the solution. 

There are also different orthotic foot products 
that can help this problem. Be sure to seek help 
if you are having this painful problem. 

Metatarsalgia - Pain in the ball of the foot

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. ASCUS Pap smears over age 50
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Atypical squamous cells of undetermined 
significance (ASCUS) on a Pap smear is a 
disconcerting pain in the neck. It almost always 
represents just normal cellular repair on a 
slightly irritated cervix and mostly goes away 
given time. When ASCUS Pap smears occur after 
menopause it is often associated with low estrogen 
levels. The Pap smear seems to improve after 
estrogen is given. 

This study looked at how often an ASCUS Pap smear 
goes on to become worse and get classified as a 
dysplasia as time goes on. They looked at the Pap 
smears of 150 women over the age of 50 and an 
equal number of matched control Pap smears from 
women under the age of 50. 

Subsequent Pap smears were followed to see how 
many went on to indicate cervical dysplasia. In 
the women under age 50, dysplasia occurred in 
almost 30% of subsequent Paps. In the menopausal 
women, subsequent dysplasia occurred only about 
13% of the time. Thus an ASCUS Pap smear after the 
menopause is somewhat less worrisome than in 
premenopausal women. 

ASCUS Pap smears after 50

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Hemorrhoid care
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have avoided going to the doctor for my 
hemorrhoids by using over the counter remedies, 
but it is becoming unbearable. I eat a high-fiber 
diet but that has not helped either. Is there 
anything else I can do before I make that 
embarrassing doctor's appointment?" rf 

It depends upon what you have already done and 
what are your risk factors for the hemorrhoids. Do 
you have a constantly sitting job or a heavy 
lifting one? Are you often constipated? Do you 
have medical problems such as obesity or chronic 
lung disease? 

Any condition that predisposes to hemorrhoids 
should be changed or brought under control as much 
as possible. Then dietary change that makes the 
stool lubricated and soft as well as promoting a 
bowel movement every day or every other day, is 
the next step. Topical creams and ointments  may 
need to be used to provide relief until the 
predisposing factors can be corrected and  the 
body heals the dilated veins on its own. 


Taking care of hemorrhoids

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. PMS treatment with Chasteberry extract
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chasteberry extract is from the plant vitex or 
Agnus castus. As far back as Roman times, 
Chasteberry was thought to suppress sexual desire. 
Young girls wore the blossoms to show they were 
remaining chaste. 

More recently it has been used to treat breast 
pain called mastalgia and PMS. Up until now there 
have not been any randomized clinical trials 
comparing this extract with placebo. Now there 
have been reported two studies that are 
randomized, double blind placebo controlled 
trials. Both show clinical effectiveness of the 
Chasteberry extract when used to treat PMS. 

This extract does not have plant estrogenic or 
progesterone properties like soy or red clover. 
Instead, it has a mechanism of action that lowers 
serum prolactin by preventing pituitary prolactin 
release. 

The doses used in the two studies below were 20 mg 
tablets daily of a special extract, Ze 440, 
manufactured in Germany. 

PMS treatment with agnus castus fruit extract (BMJ)

PMS treatment with agnus castus fruit extract (Arch Gynecol Obstet )

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Exercise and stress
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Exercise always seems to lower stress. How does it 
do that? The traditional teaching is that it helps 
the physiological signs of stress such as heart 
rate or blood pressure. It does do that. When 
stress raises heart rate and blood pressure, these 
physiological signs tend to stay elevated and 
prolong the feeling of stress. 

After exercise, the body naturally resumes a lower 
baseline blood pressure and heart rate because the 
"fight or flight" hormones, epinephrine and 
norepinephrine are depleted from the exercise. The 
physiological feeling of stress disappears after 
exercise and cannot resume for a certain amount of 
recovery time. 

There is another field of thought about stress and 
exercise. The major reduction of stress may be 
more psychological than physical. In other words 
by choosing to exercise on a regular basis, you 
take more control over your life. Stress results 
from our feeling of loss of control of events in 
our lives. When we take control the stress gets 
better or goes away. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Calcium for sleep loss
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Regarding your comments on loss of sleep due to 
HRT/menopause. I was having the same 
problems/symptoms due to a recent hysterectomy. I 
am 38, and my 46 yr. old sister who is in 
menopause was having the same problem.  She 
suggested taking your daily calcium in liquid 
form, found at the local health food store, in a 
little bit of warm milk before bed.  Worked great 
for her and has for a year. Unfortunately, my 
store was out so I started chewing my Viativ (R) 
nightly with a cup of sleepy time tea.  I can now 
profess to a wonderful 7-8 hours of sleep per 
night with no nap during the day........since I 
have a 2 yr., this has been a miracle cure for 
me!!" -   katie


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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
What A Man Really Means When He Says... 
  --submitted by Barb (Celina, OH)

"I can't find it."
MEANS 
'It didn't fall into my outstretched hands, so I'm 
completely clueless.' 

"That's women's work."
MEANS 
"It's dirty, difficult and thankless."

"Will you marry me?"
MEANS 
"Both of my roommates have moved out, I can't find 
the washer, and there is no more peanut butter." 

"It's a guy thing."
MEANS 
"There is no rational thought pattern connected 
with it, and you have no chance at all of making 
it logical." 

"Can I help with dinner?"
MEANS 
"Why isn't it already on the table?" 

"It would take too long to explain."
MEANS 
"I have no idea how it works." 

"I'm getting more exercise lately."
MEANS 
"The batteries in the remote are dead." 

"We're going to be late."
MEANS 
"Now I have a legitimate excuse to drive like a 
maniac." 

"Take a break, honey, you're working too hard." 
MEANS 
"I can't hear the game over the vacuum cleaner." 

That's interesting, dear. 
MEANS 
"Are you still talking?" 

"Honey, we don't need material things to prove our 
love." 
MEANS 
"I forgot our anniversary -- again." 

"You expect too much of me."
MEANS 
"You want me to stay awake."

"It's really a good movie."
MEANS 
"It's got guns, knives, fast cars and naked 
women." 

"You know how bad my memory is."
MEANS 
"I remember the words to the theme song of 
'F-Troop,' the address of the first girl I kissed, 
the Vehicle Identification number of  every car 
I've ever owned, but I forgot your birthday." 

I was just thinking about you, and got you these 
roses." 
MEANS: 
"The girl selling them on the corner was a real 
babe, wearing a thong bikini." 

"Oh, don't fuss. I just cut myself. It's no big 
deal." 
MEANS 
"I have actually severed a limb, but will bleed to 
death before I admit I'm hurt." 

"I do help around the house."
MEANS 
"I once threw a dirty towel near the laundry 
basket." 

"Hey, I've got reasons for what I'm doing."
MEANS 
"And I sure hope I think of some pretty soon." 

"What did I do this time?"
MEANS 
"What did you catch me at?"

"She's one of the rabid feminists."
MEANS 
"She refused to make my coffee."

"I heard you."
MEANS 
"I haven't the foggiest clue what you just said, 
and am hoping desperately that I can fake it well 
enough so that you don't spend the next 3 days 
yelling at me." 

"You know I could never love anyone else."
MEANS 
"I am used to the way you yell at me, and realize 
it could be worse." 

"You really look terrific in that outfit."
MEANS 
"Please don't try on one more outfit. I'm 
starving." 

"I brought you a present."
MEANS 
"It was free ice scraper night at the game."

"I missed you."
MEANS 
"I can't find my sock drawer, the kids are hungry 
and we are out of toilet paper." 

"I'm not lost, I know exactly where we are."
MEANS 
"No one will ever see us alive again."

"This relationship is getting too serious."
MEANS 
"I like you almost as much as I like my truck." 

"I don't need to read the instructions."
MEANS 
"I am perfectly capable of screwing it up without 
printed help." 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 *******
                February 4, 2001
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. In mild hypertension, headaches not sign of high BP
2. Glucosamine sulfate for osteoarthritis 
3. Reader submitted Q&A - Rapid heart rate
4. Polycystic ovarian disease and pregnancy
5. Diverticular disease of the colon
6. Health tip to share -  Getting to sleep
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. In mild hypertension headaches not a high BP sign 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Most people assume that headaches are a sign that 
blood pressure is elevated in someone who has mild 
hypertension. Actually this is not borne out in 
studies that have looked at a person's blood 
pressure at the time a headache is present. They 
do not find a blood pressure elevation during the 
headache. 

The argument among experts has been that perhaps 
the blood pressure increase preceded the headache 
and thus it is missed by the time a headache is 
noticed and the blood pressure recorded. This 
study, reported in the Archives of Internal 
Medicine, used 24 hour ambulatory blood pressure 
monitoring in 76 patients with mild hypertension. 

They found that 33% of the patients had headaches 
during the monitoring period. Their average 24 
hour blood pressures were not different from the 
patients who did not have headaches. Also, the 
blood pressures before and after the headaches 
were not changed at all. 

The significance of this study is that the absence 
or presence of a headache cannot be used as a sign 
that the blood pressure is or is not in control. 

Headaches in mild hypertension

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Glucosamine sulfate for osteoarthritis 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Both chondroiten sulfate and glucosamine sulfate 
have been advocated for a while as nutritional 
supplements for osteoarthritis. A recent study in 
Lancet using 1500 mg of glucosamine sulfate a day 
for 3 years shows that progressive loss of joint 
space did not take place in subjects who took 
glucosamine whereas it significantly took place in 
those who took placebo. 

Joint space, which shows up as distance between the 
bones on xray, is occupied by cartilage. Cartilage 
provides the cushion between the bones and is worn 
away in the case of osteoarthritis. This 
scientific confirmation  of the effectiveness of 
glucosamine will benefit many older women who are 
plagued with the pain of osteoarthritis. 


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Rapid heart rate
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have been to the doctor and have my pulse 
checked.  My resting pulse is 96.  The doctor 
takes it again, and it is the same.  He looks 
puzzled, but doesn't say what it is or if it is 
bad.  Sometimes while laying down I can feel 
different pulses feel like they are going to jump 
out of wherever they are pounding.  What to do? 

I'm 47 and am Synthroid tablets.  I thought I was 
going through menopause last year, but that 
straightened itself out." - Brenda 

The normal resting heart rate is between 60 and 
100. Yes, some women naturally have higher heart 
rates without any disease process. The fact that 
your pulses feel pounding, however, suggests it is 
not normal for you. 

Common causes of elevated heart rate include: 

too much thyroid medication, hyperthyroidism, 
anxiety, cardiac arrhymias (especially premature 
ventricular contractions - PVCs), and 
deconditioning. 

Deconditioning refers to having a chronic lack of 
any aerobic physical activity, i.e., being quite 
far "out of shape". 

Your doctor will want to recheck your thyroid 
function (serum TSH) to make sure you are not 
getting too much Synthroid [R] medication. He may 
also want to have you do a 24 hour heart monitor 
to check for heart arrhythmias. You should be able 
to tell if anxiety or deconditioning are playing a 
role. There are some other more rare causes of 
increased heart rate so be sure to keep working 
with your physician until you have a cause. 

Heartbeat sensations

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Polycystic ovarian disease and pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Not much is known about the obstetric outcome of 
women who have polycystic ovarian syndrome (PCOS) 
and finally become pregnant. The main concern is 
that women with PCOS have increased insulin 
resistance and thus may have more gestational 
diabetes. They may also have more preeclampsia or 
other pregnancy problems. 

This study looked at 99 patients with PCOS who got 
pregnant and what their outcomes were. There was a 
higher percentage of twin pregnancies (9.9% vs 
1.1%) in women with PCOS versus controls. 
Presumably this was because of fertility pills and 
shots used to induce ovulation. There were also 
more women with first pregnancies (nulligravid)  
among the women with PCOS. All of the data was 
corrected for these differences. 

The investigators found that there was a higher 
incidence of gestational diabetes in the group 
with PCOS (20% vs 9%). There was no higher chance 
of preeclampsia or premature labor when taking 
into account the difference in multiple 
pregnancies and first babies. 

Therefore, the main unique obstetric risk factor 
for women with PCOS is a higher incidence of 
gestational diabetes; most other major pregnancy 
risks are similar to the general female 
population. 

PCOD and subsequent pregnancy

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Diverticular disease of the colon
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Diverticula occur as we get older -- usually after 
age 50. They are sac-like protrusions that form 
along the length of the colon that may look like 
multiple appendices. If they do not get inflamed, 
there are usually no symptoms although sometimes 
even without inflammation they can give symptoms 
of diarrhea or constipation and cramps like 
irritable bowel syndrome. 

When diverticula become inflamed it is called 
diverticulitis. This infection can present like an 
appendicitis with fever, chills, nausea and pain. 
The main difference from appendicitis is that the 
pain presents predominantly in the left lower 
abdomen rather than on the right. 

Treatment for acute diverticulitis is 
hospitalization with intravenous fluids and 
antibiotic therapy.  Surgery may have to be 
performed if medical treatment does not resolve 
the inflammation in three or four days or if there 
is evidence of bowel perforation  or abscess 
formation. 

If you get irritable bowel symptoms after age 50, 
be sure not to miss your periodic screening 
sigmoidoscopy or colonoscopy that will not only 
check for colon polyps, but also can check for 
diverticula. 

Diverticular disease

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Health tip to share - Getting to sleep
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If I am stressed out, I have a difficult time 
trying to get to sleep at night.  I have tried 
this routine, and it works great! 

1) Take a nice warm mineral bath with an soothing 
aromatherapy candle 

2) Make yourself some SleepyTime(r) tea 

3) Rub Sleepwell(tm)on the back of your neck and 
shoulders(www.thymes.com) 

4) Turn off the TV and get into bed with a good 
book. 

You'll sleep like a baby! Do this every night, not 
just when you are stressed-out!  Pleasant 
dreams...zzzzzzzzzzzzzzzzzzzzzzz  

Suzanne

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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are several men sitting around in the locker 
room of a private club after exercising. Suddenly 
a cell phone on one of the benches rings. 

One of the men picks it up, and the following 
conversation ensues: 

"Hello?"

"Honey, it's me. Are you at the club?"

"Yes."

"Great! I am at the mall two blocks from where you 
are. I just saw a beautiful mink coat. It's 
absolutely gorgeous!! Can I buy it?" 

"What's the price?"

"Only $1,500.00."

"Well, OK, go ahead and get it, if you like it 
that much..." 

"Ahhh, and I also stopped by the Mercedes 
dealership and saw the new models. I saw one I 
really liked. I spoke with the salesman, and he 
gave me a really good price...and since we need to 
exchange the BMW that we bought last year..." 

"What price did he quote you?" 

"Only $60,000..." 

"OK, but for that price I want it with all the 
options." 

"Great! But before we hang up, something else..." 

"What?"

"It might look like a lot, but I was reconciling 
your bank account and...I stopped by the real 
estate agent this morning and saw the house we had 
looked at last year. It's on sale!! Remember? The 
one with a pool, English Garden, acre of park 
area, beach front property..." 

"How much are they asking?" 

"Only $450,000 -- a magnificent price...and I see 
that we have that much in the bank to cover..." 

"Well, then go ahead and buy it, but just bid 
$420,000. OK?" 

"OK, sweetie ... Thanks! I'll see you later!! I 
love you!!!" 

"Bye...I do too..." 

The man hangs up, closes the phone's flap, and 
raises his hand while holding the phone and asks 
to all those present, 

"Does anyone know who this phone belongs to?" 

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





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