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Obstetrics & Gynecology in Augusta, GA
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1303 D'Antignac St, Suite 2500
Augusta, Ga. 30901
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Human Body

Be Thankful and Be Amazed

body   

We take a lot for granted.  In these months devoted to celebrations and new beginnings, take a moment and ponder your own amazing human body.  Now many of you may wish you had a sturdier chassis, a bigger motor, a smaller bumper, or a flashier exterior, but the reality is that the model you operate within is nothing short of extraordinary.  Consider the following:

  • The average human brain has about 100 billion nerve cells.
  • Nerve impulses to and from the brain travel as fast as 170 miles per hour.
  • Your stomach needs to produce a new layer of mucus every two weeks or it would digest itself.
  • It takes the interaction of 72 different muscles to produce human speech.
  • The average life of a taste bud is 10 days.
  • The average cough comes out of your mouth at 60 miles per hour.
  • Relative to size, the strongest muscle in the body is the tongue.
  • Human thigh bones are stronger than concrete.
  • Our eyes are always the same size from birth, but our nose and ears never stop
  • growing.
  • The average human blinks their eyes 6,205,000 times each year.
  • Your skull is made up of 29 different bones.
  • The average surface of the human intestine is 656 square feet .
  • 15 million blood cells are destroyed in the human body every second.
  • The average human will shed 40 pounds of skin in a lifetime.
  • Every year about 98% of the atoms in your body are replaced.
  • Every human spent about half an hour as a single cell.
  • There are 45 miles of nerves in the skin of a human being.
  • The average human heart will beat 3,000 million times in its lifetime and pump 48
  • million gallons of blood.
  • During a 24-hour period, the average human will breathe 23,040 times.

As a physician I am perpetually in awe of our incredible body.  Even when it doesn’t function well, such as in disease, it has an uncanny ability to attempt to rectify the malady.  While the rest of the universe spirals away towards increasing chaos and entropy, the human body strives for homeostasis.   Modern medical and scientific research has explained many of the previously unknown mechanisms driving this tendency towards self preservation; however, there is still a vast depository of components and interactions that are still wrapped in a cloak of mystery.  Even knowing how something works on a cellular level, like the immune system or the blood clotting cascade, can only give one pause to contemplate the precision and perfection it embodies.

Understanding the physical properties and dynamic interaction of our body is only a small part of what makes us human.  We are so much more than our physical beings.  The mind and spirit of each person is so amazingly unique and pervasively interactive that they have to be praised and acknowledged along side the biochemistry.  Ever since man could ponder he has speculated about this interaction between mind, body, and spirit and those much wiser than I conclude that this triumvirate so intertwined as to be enmeshed.   The only logical conclusion is that true health is a balance of these three entities.  You can be physically fit but emotionally tattered, or you can be a spiritual giant and physically decrepit.  To fulfill the miracle that is your health, a balance must be achieved.

The ancient Greeks knew that balance was the ideal.  Socrates, prior to his Hemlock cocktail, said, “Everything in moderation,  nothing in excess.”  This advice is often overlooked in our contemporary society where we are often defined by our excesses.  Get more bling – run farther – close more deals – take more vitamins – all promulgating the idea that more is better.  It’s not, especially when it comes to your health.  For example, eating balanced meals of moderate calorie intake is more healthy than either eating too much, too little, or too restrictively.  It is hard for me to accept, but even exercising to an extreme can have some negative consequences.  Severe emotional extremes, high highs and low lows, is actually a psychological disorder. Embracing balance is the best way to allow mind, body, and spirit to flourish.

Let me give you a personal example to illustrate this point. I like to run marathons and, in the midst of training, inevitably I will come down with a cold.  This happens almost always after a long training run when my body hasn’t had a chance to recover and it’s resources are devoted to damage control instead of immune surveillance.  A healthier approach would be to take the necessary rest days between long training runs to allow my body to compensate.  Sometimes taking my own advice is akin to getting a root canal with pliers!

For many, good health is a choice.  Choose wisely.

Ten Commandments of Good Health


Many years ago a desert dweller climbed a mountain and talked to a bush on fire.  What resulted was a set of laws that was to revolutionize mankind’s behavior.  These were not ten suggestions formulated by a long range planning committee nor were they ten proposals put forth by a strategic consultant, they were commandments from a Holy God.  These laws have become almost universally accepted, even by divergent religions, as wise and worthy of adopting. 

     With all humility and a sincere desire to be unpretentious (I am not even worthy enough to scrape the grasshoppers from Moses’ designer goat skin sandals), I propose the Ten Commandments of good health to serve as a lamppost for your journey down fitness lane.  It seems unfair to hurry through these guidelines, so I will opine in both this month’s and next month’s column to cover them all.

                                                      Commandment One

You Shall Exercise:

Live Longer, Reduce Stress, and Grow Your Brain

     Exercise is the elusive fountain of youth.  If you are heavy, harried or hormonal, moving with purpose is a critical part of the solution. Everyone knows exercise is good for you, but few of us follow through. Exercise begins above the neck with a commitment to self and family.  Part of this motivation lies in the hidden benefits of exercise that are not common knowledge such as the prevention of breast and prostate cancer,  reduction in the onset and progression of Alzheimer’s disease, and as a cure for clinical depression.  Start with a simple walking program and free yourself from the “couch of doom”.

Commandment Two      

You Shall Rest:

A Nap a Day May Keep the Doctor Away

     We live in a hurry-up culture where “Just Do It” supplants “Let It Be”. Busyness has be­come a virtue that is without merit.  Idle hands are the devil’s playthings only in those who haven’t learned the discipline of relaxation.  Certainly there is a place for goal setting and industrious behavior, but there is also a purpose in rest and play. Relaxing on purpose is healthier than just doing something aimlessly. A major area of our lives that is most affected by this culture of chaos is sleep. The average adult requires eight hours of restful sleep a night to function best the next day.  The average adult actually gets around six hours of sleep a night.  This obvious disconnect leads to chronic fatigue and foggy thinking.  40% of Americans (100 million people) are moderately to severely sleep-deprived!

Commandment Three     

You Shall Not Worry:

Make Stress Work For You

     Stress is the little yapping dog biting at the heels of our health.  It is generally an annoyance, but, if it goes on long enough, can become a festering wound.  There are a number of books and counselors that provide a wealth of guidance on effective stress management in a world that oozes anxiety.   Studies indicate that up to 75% of visits to doctors are related to anxiety.  Stress is simply a perception of an internal or external event and thereby can be influenced by our thoughts.  One person’s stress is another person’s opportunity.  You will never be without stress, but you can control and minimize the adverse effects. 

Commandment Four 

You Shall Get Checkups:

                                          Prevention Pays Lifelong Dividends

     A healthy mind and body is dependent on action and education, not passivity and ignorance.  You must be an advocate for you and your family’s well-being by embracing prevention.  Men are especially negligent in this arena, and often decisions regarding family health are delegated (by default) to women in the household.  Seventy percent of health decisions involving the family are made by mom, which includes checkups, vaccines, nutrition, and screening tests.  Most importantly, the woman, by her actions and decisions, sets the tone for current and future health decisions.  A major health care crisis today is not cancer, AIDs, or heart disease, but people not making healthy, proactive lifestyle decisions.  We have to transform a system based on sick care to one that truly embraces well care, and that can only be achieved by practicing individual, responsible prevention.

Commandment Five

You Shall Not Be Gluttonous:

Eat Your Way to Good Health

     

     We are often called a society of consumption.  The talking heads are referring to consumerism; however, the real consumption issue is what we eat.  Our diet has more of an impact on our health and longevity than almost any other activity.  Content and quantity are the evil twins of gluttony.  There are four simple guidelines that, if followed consistently, will provide a foundation of healthy nutrition that will build a legacy of wellness.  Simply stated, eat balanced, low fat, low sugar, and high fiber meals. It is possible to alter the health inheritance of our kids and grandkids by changing how we think about food.  You can spring the family from the prison of poor nutrition and not be held captive by your genetics through a simple and doable eating plan.  We truly are what we eat. 

Next month…what else but six through ten!

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.

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.