Blog Archives - Page 6 of 7 - Women's Health of Augusta

Men and Women are different

Men and women are different. I realize this may not be a ground breaking revelation but aside from certain anatomical variations, the differences are not always noticeable.

https://youtu.be/gWt6DW8I4Ao

Women certainly have a different hormonal milieu than men, and some of the internal variations can be directly attributed to such; however, laying everything at the feet of the hormonal hooligans is both simplistic and unfounded. In other words, men and women are not solely their hormones, but a complex interaction of gender specific, unique physiology. Let’s look at some examples.

Women are at a greater risk of developing problems from alcohol use than men. This applies to simple health risks as well as severe consequences. The National Institutes of Health state that, based on current research, female alcoholics have death rates 50 to 100 percent higher than those of male alcoholics, including deaths from suicides, alcohol-related accidents, heart disease and stroke, and liver cirrhosis. Even though there are more male alcoholics than female, the women fare worse overall. This is related to how alcohol is metabolized in the female system. Women are more likely to develop liver damage from excessive alcohol consumption even when compared to similar intake for males. In addition, having more than 2 drinks a day can increase the risk for breast cancer for a woman. Why do these differences exist? In general women have less body water than men of similar body weight, so that women achieve higher concentrations of alcohol in the blood after drinking equivalent amounts of alcohol. In addition, women have smaller quantities of the enzyme dehydrogenase that breaks down alcohol in the stomach. A woman will absorb about 30% more alcohol into her bloodstream than a man of the same weight who has consumed an equal amount. There is a push by many organizations, especially on college campuses to educate women as to these differences. The consequences later in life can be substantial.

For years medical research on heart disease and risk factors was done exclusively on men. The vast majority of major work done in the earlier decades purposely excluded women for reasons ranging from potential pregnancy to volunteer recruitment. What resulted is a plethora of data that is extremely useful, but biased. Only with the advent of multiple studies including women have researchers realized that heart disease risk factors, occurrence, and prognosis are different for men and women. Heart disease has taken a back seat to breast cancer, for example, largely due to media attention and breast cancer awareness programs; however, heart disease is the leading cause of death in women over 50. A woman is more than ten times as likely to die of cardiovascular disease as she is to die of breast cancer. This is partly due to the fact that the survival rate for breast cancer is quite high, whereas over 40% of women do not survive their first heart attack. Women’s hearts are anatomically different from men, and they also function differently. A woman’s heart on average is smaller than a man’s, and it also tends to have smaller blood vessels supplying it. Researchers from Columbia University and New York Presbyterian Hospital believe that women also have a different rhythmicity to the pacemaker of their hearts, which causes them to beat faster. These same researchers believe that it may take a woman’s heart longer to relax after each beat. Some surgeons also hypothesize that the fact that women have a 50 % greater chance of dying during heart surgery than men could be related to some fundamental difference in the way women’s hearts work. These differences have led to a bias in how physicians viewed heart symptoms in women. Several studies indicated that if a woman and a man presented to an emergency room with identical symptoms, the man would be more likely to be evaluated for heart problems than the woman. Luckily with the new data, this trend is reversing and early disease is being suspected and detected in women, hopefully reducing both death and disability.

Most would agree that men and women think differently. This may have a physiologic basis as research indicates that men’s and women’s brains are structurally different. There are variations in grey and white matter, which leads to differences in things such as verbal abilities and connectivity between the two sides of the brain. These anatomical peculiarities can lead to a number of behavioral differences once thought to be social or environmental.

It’s important to understand there is no advantage or disadvantage with these variations, it’s just that being aware of the differences may help in promoting each individual’s health.

Brain Food

“I’m not kidding; it’s Miracle-Gro for the brain!” The statement reminded me of some ridiculous infomercial infecting late night TV. In this case however, it was generated from the mouth of a world class neurobiologist, so I took notice. He was speaking of a substance called Brain Derived Neurotrophic Factor (BDNF). What immediately intrigued me was he claimed that BDNF was the link between exercise and improved brain function. For years I had read articles in both the medical and running journals touting the psychological benefits of fitness, yet here was proof that fit folks were happier folks. Dr.John Ratey, a clinical professor of psychiatry at Harvard, outlined in his amazing book “Spark: The Revolutionary New Science of Exercise and the Brain” how exercise increased the production of BDNF which in turn stimulated nerve cells to grow and connect in the Hippocampus, a tiny area in the brain responsible for a number of high level functions. This growth of new cells actually translated into better memory and quicker learning. He went on to claim that certain other chemicals were released by exercising muscles that improved functioning in the amygdala, the emotional center of the brain. The implications of this and other research are monumental.

Twenty-five years ago when I was in medical school we were taught that we were born with a set number of neurons (brain cells) and there were no more to be made…period. I remember joking in college about taking another late night excursion to the disco (yes, I am that old!) to “kill some brain cells” with Singapore Slings and Jack and Coke. We didn’t fret about the wholesale slaughter of brain cells as we all knew from biology class that we only used 20% of our brain anyway. In our way of thinking, that gave us a pretty good cushion! It was the unlucky folks born with fewer brain cells, and we all knew a few of those, who had the most to fear. We were wrong on all accounts. Now research is proving that new brain cells can be created, and formed in areas that have a major effect on cognition and emotions. Don’t take this as permission to guiltlessly get plastered; I don’t need to tell you of the disastrous effects of that, but it does open the door for medical miracles. The study of such alphabet soup as BDNF, IGF-1, and VGEF and other neuropeptides has given hope to developing successful treatments for senile dementia, Alzheimer’s and Parkinsonism. Medicine is not there yet, but we can conclude that getting fit by exercising regularly can reduce the incidence of these diseases as well as certain cancers and diabetes.

The great news is that you don’t have to train for a marathon to reap the benefits of fitness. The studies indicate that a brisk walk for 45 minutes three to four times a week can elicit these life enhancing outcomes.

One of the most exciting applications of this knowledge is illustrated by the Naperville school district. A middle class suburb south of Chicago, Naperville has been the focus of a real-life experiment documenting the benefits of fitness in kids. It is no surprise that kids who are active are more physically fit than their sedentary counterparts, but what has been found in Naperville is that these fit kids are also smarter! Over the past seventeen years the school district, consisting of 11 elementary schools, five junior high schools and two high schools, has made physical education an integral part of the school day (unlike the national average where only 6% of high schools have a daily PE program). Their gym class is not your typical dodge ball, basketball, softball curriculum (the average student in the typical hour long PE class spends 16 minutes actively moving). It is a program that promotes and measures fitness, not competition, and grades based on effort, not ability. They regularly run or ride bikes using donated treadmills and stationary bikes measuring effort by heart rate monitors. And they do it at a lower cost per student than comparable school systems! The results have been amazing. In 2002, 97% of entering freshmen were at a healthy body mass index (BMI) as compared to the national average of 65% and most striking was the impact that fitness had in the classroom. In that same year 96% of the eighth graders took the Trends in International Math and Science Test, an instrument designed to compare student’s knowledge level in different countries around the world. On the science part of the test the Naperville students scored the highest…in the world! Through a strict and comprehensive analysis it was shown that regular physical activity and fitness level correlated with the academic success of the Naperville students!

The message is clear. For adults and kids alike, regular aerobic exercise is not only good for the body, but it is great for the mind.

Ovarian Cancer

For women, ovarian cancer is a frightening malady because of its insidious nature. It’s been called a silent killer because once symptoms appear, the disease is often widespread. The key to overcoming this fear is understanding the reality of the disease and dispelling myths.

The American Cancer Society states, “Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 75. Her lifetime chance of dying from ovarian cancer is about 1 in 100.” Juxtapose this with the most common cancer in women, breast cancer, where a woman’s lifetime risk is 1 out of 8. Even when you consider total cancer deaths, ovarian ranks low compared to breast, lung, and colorectal. So indeed ovarian cancer is a fierce adversary, but realistically there is a much lower incidence of this type of cancer than many others.

One reason ovarian cancer is so feared is its delayed presentation of symptoms. Unlike many illnesses which telegraph their appearance early with notable symptoms, ovarian cancer often doesn’t produce noticeable problems until relatively late in its development. And when it does, the symptoms are nebulous and rarely initially recognizable as ovarian in nature. For example, a common symptom of ovarian cancer is abdominal bloating. Unfortunately, this same symptom can be associated with everything from bad sushi to irritable bowel syndrome. Common symptoms associated with ovarian cancer include:

Fatigue.

Upset stomach.

Back pain.

Pain during sex.

Constipation.

Menstrual changes.

Abdominal swelling with weight loss

As you can see, virtually all women will experience at least one of these symptoms intermittently. The distinguishing factor often is a persistence or continual worsening of symptoms.

Unlike the Pap smear for cervical cancer, there are no good screening tests for ovarian cancer. There is some evidence that a combination of various blood tests and a pelvic ultrasound may suggest an early ovarian cancer, yet these have not yet been shown to be useful enough in a low risk population to be promoted as a screen for everyone. Certainly these tests (and others like a CT scan) can help steer the diagnosis in someone with unexplained symptoms, but we are still woefully lacking in a universal screening test for ovarian cancer.

There are some folks who are at a higher risk for this disease and therefore warrant closer monitoring. Risk factors for ovarian cancer include a family history, menstruating at an early age (before 12), having not given birth to any children, a first child after 30, menopause after 50, and having never taken oral contraceptives (taking birth control pills actually reduces the risk of ovarian cancer). Of special interest is the genetic relationship between various female cancers like breast and ovarian. About 10 to 15 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. The most significant risk factor for ovarian cancer is an inherited genetic mutation in one of two genes: breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2). These genes are responsible for about 5 to 10 percent of all ovarian cancers. Eastern European women and women of Ashkenazi Jewish descent are at a higher risk of carrying BRCA1 and BRCA2 mutations. Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer have an increased risk of ovarian cancer. These can be detected with a blood test and many insurances will cover this in high risk women. There is an ethical debate regarding someone who tests positive for these mutations. Do you prophylactically remove the ovaries as a preventative tool? There are no clear cut answers at this stage as not everyone who has these mutations will develop cancer. The utility in this knowledge allows the individual to make a rational decision based on a variety of factors.

Treatment of ovarian cancer is often a combination of surgery and chemotherapy. Much of the treatment depends on the extent of the disease noted during the surgical removal of the cancerous tissue. This cancer tends to spread both by local growth in the pelvis and through the bloodstream and lymphatics, so it can metastasize or reoccur in distant parts of the body. There have been advances in treatment, especially in chemotherapeutic agents, and one of the most exciting ares of research is in various immunological techniques. These approaches literally label the cancer cells with tags that allow a chemotherapeutic agent to selectively attack the bad cells while leaving the good cells alone. Many women are successfully propelled into remission with these and other techniques, so there is expanding hope as research develops.

Ovarian cancer is a serious and scary disease, but it is not the death sentence it once was.

Teens…When to see a gynecologist

I am convinced most women view visiting their gynecologist somewhat like having a root canal…with no clothes on! This is a completely rational reaction as no “normal” woman relishes the necessary but unappreciated ritual. You arrive on time and two hours later Nurse Ratchet puts you in a room cold enough to hang meat and then tells you to disrobe and put on a napkin. By the time the doctor arrives you are so cold your skin has changed to an eerie shade of light blue: you look like a Smurf in a togo. The doc asks you to scoot down…then scoot down some more and well, you know the rest. Actually the whole thing takes only a few minutes and is not as bad as, say, an
IRS audit, but I am a male so what do I know! I understand it is different on your side of the speculum.

So given this exam is something you relish passing on to your beloved daughters, much as you would Malaria or Scabies, when should a young woman be exposed to this sisterhood right of passage? The American College of Obstetricians and Gynecologists recommends a young woman’s first visit to the gynecologist be between the ages of 13-15. Before you and she run screaming from the room, let me reassure you that those guidelines are rarely followed and, in my opinion, somewhat misguided. I understand that Ivory Tower practitioners denote this visit as a “preventive” ,but I don’t know many 13 year olds who are comfortable talking herpes and contraception. The College clarifies that no exam is needed at this impressionable age, but that then raises the question of its true necessity. Unfortunately there are those folks who need a thorough and graphic discussion of various reproductive health topics at this age, as 14% of 15- year olds and 75% of 19- year olds admit to having at least one episode of intercourse.

I know if I had told my daughters at thirteen they were headed to the gynecologist, they would have booked a slow boat to Australia. Now, to be certain, anytime a young woman is having issues with her period, needs contraception, or specifically has questions about her health she should have unlimited access to a compassionate, non intimidating physician, but for most that will come a bit later. The same national organization recommends starting Pap smears and exams at 21, and I think this is more realistic. I certainly am not naive enough to assume women under the age of 21 are not having reproductive or gynecological issues, witness the unplanned pregnancy rate in this country, yet if a young woman is not sexually active, has no period issues, and has no specific gynecological concerns, I think 21 is a reasonable time to initiate gyn visits.

Much of the anxiety in both mothers and daughters regarding gynecological health revolves around knowing what is normal and what is not. There are definitely genetic predispositions that would make mom’s and daughter’s experiences somewhat similar, but that is not necessarily the case. For example, the median age for the onset of menses is 12.4. That means there will be plenty of young women who start cycles at 11 and also some who don’t start until 14. In general, a girl needs to be evaluated if she has not begun developing breast buds by age 13 or hasn’t started her cycle by age 15. The average time between cycles for young women is 32 days, but that can vary wildly, especially in the first few years of menstruation. A flow lasting longer than seven days or requiring more than 3-6 pads or tampons a day is considered excessive. You can see this is somewhat subjective, so each woman’s situation should be individually assessed and analyzed.

There a number of common scenarios that change both the cycle amount and regularity, especially during the teen years. Two frequent influences are stress and weight change. Worrying about midterms, making cheerleading, or the soccer playoffs can wreak havoc on cycle regularity. Any change in weight (usually by at least 5-10 lbs) can also affect regularity and amount. Vigorous exercise (take note you cross country runners, gymnasts, and swimmers) can cause what is known as exercise induced amenorrhea, or lack of cycles. Many a pregnancy test has anxiously been checked by those whose unending athleticism led to missing a period. The good news is that most of these irregularities resolve with stabilization in weight or a reduction in stress. A more rare but serious cause of irregular cycles is eating disorders like anorexia and bulimia.

The goal of an effective young women’s health program is to provide education, advice, counseling, and compassionate care. The age at which you begin your interaction with the system is largely dependent on your individual needs and health history.

Vitamins and Women’s Health

Americans have the most expensive urine in the world! Let me explain.

We are massive consumers of vitamins in this country, and unfortunately, much of the good stuff is eliminated from our body before it has any beneficial effect. That is not to say that vitamin supplements are a waste, in fact, we strongly recommend that patients use certain vitamins and minerals. Yet in a billion-dollar industry like the vitamin market, you must be a discerning consumer. If you are going to take vitamins (and many of you should), you must first know your individual needs, and second, choose an appropriate dosage and quality.

In general, most women in the country conform to the SAD diet (Standard American Diet), which leaves them short on some essential nutrients. Vitamin supplements are used to either meet basic nutritional needs or to treat a particular problem such as anemia or hot flashes. For most folks, the best way to make your body happy on a day-to-day basis is to eat balanced whole foods; but if you don’t (let’s be real here!), a basic multivitamin that contains Vitamins C, E, A, D, and the B series is essential. Many will also contain important minerals for women including iron, calcium, magnesium, boron and potassium. In spite of the many advertising claims otherwise, there is very little real difference among quality multivitamins. We suggest doing your homework (a good place to start is www.ConsumerLab.com ) and get comfortable with a particular brand and then stick with it. Your pharmacist or health food store may also be a great source of information. Don’t walk into a discount warehouse or a grocery store and buy the first bottle you see.

Two vitally important caveats go with any vitamin or supplement. First you must take an appropriate dose, and second, you must take the supplement for an appropriate time frame. Herein lie many of the problems with vitamin use. Dosage is important! That sounds simple, but consider what would happen if you took a tenth of an aspirin for a headache. Probably nothing! And it would be absurd to then conclude that aspirin doesn’t help headaches. However, that is what happens all the time with vitamins and herbs. The scientific studies that show beneficial effects of supplements are always performed with specific dosages, and it is essential to know what amounts are proven to be effective. There are many reference books that list evidence based dosages from various studies.

Don’t forget that most vitamins and supplements don’t work overnight. Many may take up to four to six weeks of continual use to achieve any benefits. Some, like the antioxidants, need to be used on a regular basis to exert their action.

Certain individual vitamins have been shown to help specific problems. Below is a list of common problems and their vitamin remedies that have at least one good study to compliment their use:

Hot Flashes, Breast tenderness, Vitamin E (d-alpha-tocopherol) 800IU /day

Antioxidant, immune enhancement Vitamin C (1-3 grams a day)

PMS Vitamin B6 (50mg twice a day)

Anemia Vitamin B12 (100 micrograms a day)

Vision Vitamin A (2,500 IU a day)

Cold sores Zinc 50 mg/ day

Bone health Calcium 500-600 mg /day

Magnesium 200-400mg/day

Boron 3-5 mg / day

As with all vitamins and supplements, always tell your doctor what you are taking, as there can be interaction between these substances and prescription medicines.

A Merry Heart Does Good Like a Medicine

Norman Cousins, while struggling with a severe neuromuscular disease, said, “Laughter is like internal jogging. Ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.” Those of you who regularly scan Reader’s Digest remember a column titled, “Laughter is the best medicine”. Indeed it is, and sometimes we forget that. So here is my prescription for surviving everyday stress…laugh three times a day! Some of the most effective laughter is that which we do at ourselves. The less serious we take ourselves, the less burdensome everyday stresses and strains. For example, I recently attended a local high school football game and quickly lapsed into a flashback when the bands took the field for the halftime entertainment. No, I wasn’t in the band in high school. The idea of walking backwards in circles while reading music was a bit overwhelming, but my mother was convinced that I had the potential to be the next John Philip Souza. She felt that one way to navigate the treacherous waters of a new high school was to join their celebrated band. I had just been uprooted from a comfortable middle school existence in Memphis to the mountains of East Tennessee , replete with orange painted outhouses, to begin my high school years. I was the size of a Hobbit, and about as good-looking, so my social integration options were vastly limited. I certainly was not a candidate for football (a religion in Knoxville) although; in retrospect, I would have made a wonderful tackling dummy. Track was not an option as I had the speed of an anemic sloth. Basket ball…well let’s just say dribbling at the level of other’s knees didn’t fare well for a stellar career. So maybe the band was a way that I could find my niche in an otherwise niche-less existence. At least my mother thought so. So the first day a school she set up an appointment with the band director to discuss my future musical career. Unfortunately, she made me come along. Once we arrived in the hallowed sanctuary known as the “band room” , Mr.Jenkins, the band teacher, granted us an audience.

“Now exactly what instrument does your boy play?”, he asked condescendingly. I felt this was a rather appropriate question and a reasonable place to start the discussion until it dawned on me that I didn’t play an instrument. I suspected that my mother also knew this as she had not seen or heard me with anything other than a kazoo since kindergarten, but she was not fazed by the inquiry.

“He doesn’t…yet”, she confidently replied. This obviously was not the response Mr. Jenkins was expecting as he stared at her with a look that said, “Well what in the name of Beethoven are you doing here then?” Mom, ever the perceptive sort, picked up on his incredulity and explained that before we invested in lessons or instruments, she wanted to get his impression as to which instrument I was best suited to play. At this point I was busily plotting both my escape and my plan for putting mom on medication. I had read of studies that looked at a person’s likelihood of being a criminal based on their physical traits, you know, beady eyes, big forehead etc, but I had yet to see any research correlating a person’s physical appearance and their ability to master a band instrument. I felt myself slowly sinking into “Music Man” hell. Mr. Jenkins composed himself, obviously trying to pacify the crazy woman sitting before him, and shot a glance at my face, as if to say, “Is she serious?” I cocked my head, subtly conveying the dual message that yes, she is serious and she may be armed, so do what she asks. He then proceeded to survey my mouth, fingers, eyes and anything else he could possibly think of that would indicate the ideal instrument for me. It was like being scrutinized for lice after being accused of infecting the whole school.

After what seemed like hours, he stopped, grunted, and said “trumpet…yes, trumpet”. A huge grin crossed mom’s face as this seemed to validate her quest. All I could think of was Dizzy Gillespie, that huge, old guy who puffed out his cheeks to the size of a steroid laced chipmunk whenever he played his horn. I didn’t want to walk around school with the cheeks of a bloated rodent, so I instantly expressed my apprehension. Of course, my protest fell on deaf ears as mom was already negotiating horn rentals and lesson fees.

How was I supposed to get the girls playing something you have to clear spit out of every few minutes? Neil Diamond never wooed a woman with his classic marching tunes! As I walked out of the room, visions of chapped lips and elastic cheeks dancing in my head, I realized that maybe I needed to find a better way to fit in. I wonder if girls dig science projects?

Dr.Ron Eaker

Eat For Life!

The one question we are asked in the office most often, other than how to improve libido, is how to eat healthy. Since 45 million people in this country are overweight, it is no wonder that this is on everyone’s mind. Simple is better, so here are some simple guidelines for eating healthy.

Rule number one: Eat balanced meals. What your mother always taught you is true. There is no one super food, in spite of what the algae lovers claim, and there is likewise no naturally evil food (well, maybe Spam qualifies as evil). We were created to survive on a variety of nutrients and no one food can provide everything you need, so mix it up to guarantee proper health. Balance proteins, carbohydrates, and fats by selecting a wide variety of foods. Spice up your life! Get crazy and try foods that are different from burgers, bacon, and barbecue! Travel the world by making one night a week “ethnic night” and sample various foreign cuisine. There are three sub rules in this category: eat whole foods whenever possible, mainly plants, and prepare them in as close to the natural state as you can. In other words don’t fry, fritter, and fracture your food! And one final caveat, don’t overdo it. One given in proper weight management is watching total calorie intake. How much you eat is just as important as the mix.

Rule number two: Eat low fat meals. This is not to demonize fat but to remind you that too much of some stuff is just not healthy. In spite of the cacophony of nutritional advice out there, there is not a reliable expert around who tells you to eat more lard. Some fat is necessary but we should all limit saturated and trans fats. These include margarine, salad dressings, processed cakes, chips,cookies, and gobs of other nasties. Become a label reader. It’s right there in black and white. If the serving size contains more than 5 grams of saturated fat, put the item down and run away screaming. Total fat in your diet shouldn’t exceed 25% of total calories. There are a number of fat counters available in Apps and online so it is relatively easy to calculate how much of the grease is sliding down your gullet. Don’t forget there are some good fats. For example, the omega 3 fatty acids found in abundance in some plants (flaxseed) and cold water fish (tuna, halibut) are critical in assuring good health and are essential for their anti-inflammatory actions.

Rule number three: Eat low sugar. The average person will consume 160 pounds of sugar a year! Most sodas will contain 40g of sugar in each can! Sugar, or glucose in fancy doctor talk, is necessary for energy, yet most of us eat enough sugar to power a high school soccer team. The low carb craze of recent vintage did make us aware of the evils of consuming to much sugar (carbohydrates=sugar); and the data supports that a low carb lifestyle is healthy. Keep in mind that your need for sugar and energy is directly proportional to your activity level. Marathoners need more carbohydrates than chess masters.

Rule number four: Eat more fiber. This rule may be a bit of a surprise because it doesn’t get the airplay that the other rules seem to enjoy; however, fiber, both soluble and insoluble, is a key component of a healthy diet. These are things that aren’t actually metabolized in the system put serve a variety of vital functions such as binding excess cholesterol, promoting bowel health, and regulating hormone levels. The American Heart Association has stated that consuming 28 grams of fiber a day can reduce your risk of heart disease, the number one killer of both men and women. Fiber is abundant in fruits and vegetables, grains, nuts, legumes, and tree bark. (Just seeing if you were paying attention). Choosing foods high in fiber not only fulfills the need for roughage, but these foods also tend to be low in calories and filling.

It’s All in Your Head!

“The doctor who fails to have a placebo effect on his patients should become a pathologist”

J.N. Blau, M.D.

The lines between the art and science of medicine are often blurred. Many years ago, when the earth was cooling and I was a medical student, I was assigned to shadow an older Ob/Gyn in private practice. The goal was to gives us young medical pups a sense of real world medicine. Dr.Koronik was a gifted clinician as well as a crafty student of human behavior. One afternoon we were speaking with a patient, a recently married young female, who was completing her yearly exam when she reported her libido, or sex drive, had driven off and she didn’t have the map! Dr. K had done a thorough physical exam and knew anatomically everything was intact, and so he talked with her at length about her life situation and decided to get some baseline blood work. She was to return when the blood work was back and review the results and discuss any treatment options. After she left, Dr. K pulled me aside and said he felt her problem was more from the neck up and not the waist down. He was not patronizing or minimizing her problem, it was just an honest assessment of what he surmised was the source of her lack of desire. Upon her return, they reviewed the blood work which supported the idea that all was well physiologically, and Dr.K had a long discussion about stress, relationships, and other important factors in sexual well being. At the conclusion he presented her with a bottle of tablets and told her that taking one on a daily basis may increase her libido. I was taken aback and after she left I questioned his prescribing of a medication for what he seemed to think was an emotional issue. He explained, in what was to be the first of many lessons in healing as opposed to curing, that the “medicine” was nothing more than sugar pills, and that he felt they would aid in minimizing her psychological issues with intimacy. There are a number of ethical and legal issues involved with this “treatment” but remember this was almost 30 years ago and in a small town in East Tennessee.

I didn’t see the young lady in follow up, but a few days later Dr.K reported a Ford 350 pickup truck backed up to the rear of his office around closing time. A burly, six foot something cowboy straight off a movie set ambled out of the truck cab and sauntered to the back door of the clinic.

“Hey doc,” he offered as he thrust his hand in greeting. “My wife came to see ya a few days ago about this…eh…problem she been havin’ ”. No doubt, this was the husband of the libido challenged patient.

“I just wanted to come shake your hand for them pills you gave her cause, let me tell ya, I don’t ever want to run out of them things! I brought my truck here to load up a batch!”

Say what you may but the placebo effect is a real and powerful scientifically validated phenomenon. There are some amazing studies done with PET scanners, machines that “light up” areas of the brain that are functioning in thoughts and emotions, that confirm that feelings can be translated into physical changes in the brain. When we feel happy or sad, specific areas of the brain are activated and in turn set off a cascade of hormones, neurotransmitters, and a cavalcade of substances that elicit amazing physical effects. There is a branch of science called psychoneuroimmunology that studies how our thoughts and emotions effect our immune system. For example, if you get int an argument with your spouse or yell at your kids getting dressed for school, not only do you feel stressed, but you are more susceptible to catching a cold! There is even some evidence that chronically stressed or angry individuals are more at risk for certain cancers because their emotional state impairs their immune system’s natural ability to eradicate early abnormal cells.

The Mayo Clinic issued a series of findings on research done on the reasons the placebo effect is genuine:

“A patient whose doctor is supportive and positive may benefit more from any treatment, active or placebo.

A patient who believes a treatment will work is more likely to experience the placebo effect than one who doubts it.

Some patients respond well to frequent and intensive medical attention, whether or not a drug or treatment is potent.”

Indeed, the placebo effect is “all in your head” but it is just as real and often as therapeutic as a drug.

Now if I could just find some of those “libido” pills!

Sleep problems? You’re not alone.

It is estimated that over 40 million Americans suffer from some sort of chronic sleep disorder and almost 90% of those are unidentified or undiagnosed! That’s a considerable number of folks exposing themselves to bad infomercials at 2 AM. I must admit that I traditionally related sleep disorders to older people and shift workers, but a recent study from the National Sleep Foundation indicates that almost 36% of 18-29 year olds have a sleep issue that disrupts their life. In a time of budgetary restraints and fiscal precariousness, sleep problems have been estimated to cause 16-20 billion dollars of economic losses to business and industry. We don’t often associate sleep problems with other major population health risks such as heart disease and diabetes, yet sleep disorders are every bit as important to the health of the nation as other maladies. Women are particularly hard hit as 79% report sleep disturbances during pregnancy, 36% report sleep problems in the peri-menopause and menopause time periods, and 24% say sleep problems interfere with them caring for their family.

Sleep deprivation can lead to chronic tiredness, moodiness, frustration, difficulty in controlling emotions, inability to concentrate adequately, and problems with abstract thought. In other words, sleep deprived individuals are generally not happy folks! There is good evidence that a lack of adequate sleep can lead to an impairment in immune function, metabolic problems, weight gain, and hypertension. The National Highway Safety Administration has said, “Drowsiness has been the cause of 100,000 traffic crashes every year, killing more than 1500 Americans and injuring another 71,000.” Some physicians believe sleep disorders are the most unrecognized common malady we face today.

The average adult needs about 7 1/2 to 8 hours of sleep a day to feel rested and allow the body to rebuild, refresh, and rejuvenate. Obviously this number is a generalization as some individuals require less and some more, so it is vital to determine honestly your threshold. In general, older adults require a bit less sleep to avoid problems; however, it is not as dramatic difference as some would imagine. A common yet often missed cause of sleep problems are various medicines and drugs. Caffeine, alcohol, nicotine, steroids, decongestants, antidepressants, and blood pressure medicines are just a few of the ingested substances that can keep you awake.

Healthy sleeping habits for the family

Fix a bedtime and fix an awakening time
Avoid napping during the day
Avoid alcohol before bed
Avoid caffeine containing beverages 4 – 6 hours before bedtime
Avoid heavy, spicy, or sugary foods before bed
Regular exercise is good but not before bedtime
Comfortable bedding
Bedroom cool, dark, quiet
Bedroom reserved for sleep – NOT a work room
Go to bed only when sleepy
If unable to sleep, move to another room
Return to bed only when sleepy
Avoid a visible bedroom clock with a lighted dial
Don’t let yourself repeatedly check the time!
Turn the clock around or put it under the bed

There are a few herbal medicines that have been minimally helpful in promoting sleep for some people. These include Valerian root, Kava, Chamomile, and in older individuals-melatonin. The worst thing to do is nothing…sleep problems rarely spontaneously resolve. Don’t ignore the issue and take steps to a more restful sleep today.

Exercise During Pregnancy

The key to healthy exercise during pregnancy is to not wait until you are pregnant to establish a regular exercise program. Women who enter into pregnancy fit and exercising can, in most cases, continue their exercise regimens with certain common sense caveats. Begin from the perspective of what can I do instead of what are my restrictions. Every new mom’s situation is unique, so don’t do anything until you discuss it with your doctor, but it is a conversation you need to have. According to the America College of Obstetricians there are a few instances where you shouldn’t exercise:

Symptomatic heart disease
Restrictive lung disease (such as bad asthma)
Incompetent cervix/cerclage
Multiple gestation at risk for premature labor
Persistent second- or third-trimester bleeding
Placenta previa after 26 weeks of gestation
Premature labor during the current pregnancy
Ruptured membranes
Preeclampsia/pregnancy-induced hypertension

So what kind of exercise is best in pregnancy? The simple answer is that there is no best. Much of that depends on what you have been doing prior, or better yet, what you enjoy. I can hear you now, “I don’t enjoy any type of exercise!”. It’s time for a little attitude change because it’s not just about you anymore. You see, exercise not only helps you while carrying the little bambino, but also helps the bambino. Women who exercise in pregnancy have a lower incidence of gestational diabetes, hypertension, and excessive weight gain, all of which can lesson the problems for the baby.

There are a few common sense guidelines to follow with exercise in pregnancy:

After the first trimester, avoid exercises lying on your back
Start slowly and gradually build up to at least 30 minutes of exercise a day
Avoid brisk exercise in hot, humid weather or if you have a fever
Wear comfortable clothing to keep cool
Wear a bra that is comfortable and gives lots of support
Drink plenty of water to stay well hydrated at all times
Consume an appropriate diet to keep energy up

The rule of thumb for exercise in pregnancy is that it is generally good coupled with a dose of common sense. Most reputable doctors will tell you not to skydive or alligator wrestle whilst with child, even if an ancient Egyptian aristocrat invites you.

Find Us

Call Us

Hours

Category: Blog