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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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706.733.4427
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Too Pooped to Play

“I’m sick and tired of being sick and tired!” 

“I just have no energy.”

     One of the most common problems of the 21st century woman is fatigue.  I am not exaggerating by stating that well over 40% of women I see in my office complain at some stage of their life of excessive tiredness.  Lack of energy is not a local phenomenon either (in spite of the claims of one woman who was sure that SRS had something to do with her low energy level.  Of course this was the same gal who had been nabbed by aliens and forced to watch reruns of “Geraldo”).  National statistics are equally as impressive.  One study even went as far to claim that 30.3 % of adolescents experienced excessive fatigue (PEDIATRICS Vol. 119 No. 3 March 2007, pp. e603-e609) 

   The classification of fatigue runs the gamut from a transient mild tiredness to a debilitating lack of energy.  One of the inherent problems in studying a condition such as this is the subjectivity of the diagnosis.  Those who suffer with chronic fatigue are often perceived as malingerers and patronizingly dismissed.  There is still reluctance on the part of many medical practitioners to legitimize chronic fatigue syndrome, the most extreme form of tiredness, as a genuine entity; however, this appears to be an area where the science is finally catching up with the clinical observation.  As with any medical problem that is poorly understood, the treatment of excessive fatigue is varied, sometimes unconventional, and often unsuccessful.  It is important to distinguish chronic fatigue syndrome from “garden variety” tiredness as they differ in numbers of symptoms and degree of disability.  For many sufferers it comes down to how much the lack of energy interferes with normal day to day activities.  The Center for Disease Control in Atlanta has set down certain criteria for physicians and researchers to use in making the diagnosis of chronic fatigue syndrome.  A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

  • cognitive dysfunction, including impaired memory or concentration
  • exhaustion and increased symptoms for more than 24 hours following physical or mental exercise
  • unrefreshing sleep
  • joint pain (without redness or swelling)
  • persistent muscle pain
  • headaches of a new type or severity
  • tender lymph nodes
  • sore throat

  You can see from these symptoms that there is tremendous overlap with other common problems.  We all may experience some of these problems some of the time. The key is the persistence and intensity of the problem and, importantly, no other medical or emotional troubles that serve as a cause.

   There is hope!  Since becoming a more universally defined syndrome, additional research has been done on ways to thwart this bothersome illness.  Many of these treatments and suggestions also apply to the woman who has only mild symptoms.  So whether you are unable to get out of the bed or just collapse at the end of a busy day, these pointers may be worthwhile pursuing.

     First and foremost, get a good checkup by your doctor.  Many medical conditions such as hypothyroidism, menopause, Lupus, depression, anemia, and sleep apnea have fatigue as a primary symptom.  If you check out well with your doc, consider the following:

1.  Check your sleep habits.  We are a culture of sleep deprivation.  It makes logical sense that if we don’t sleep restfully we will be tired the next day.  I am amazed at the number of folks that forget this simple connection.  Improve your sleep and your energy will rebound.

2.  Force yourself to get off the couch.  Multiple studies show the positive effect of exercise on energy level.  You may be saying, “I would exercise if I wasn’t so darn tired!” It is tough, but forcing yourself to do something, even a good walk, will, over time, improve your energy level.

3.  Garbage in equals energy gone.  We are what we eat, and this applies to energy level.  In fact, energy derives from the body’s ability to metabolize food.  If we put molasses in our car’s gas tank, it won’t go far.  If we put junk in our gas tank, we won’t go far!

4. Reduce stress.  Stress magnifies everything!  The more stress, the more your lack of energy.  It’s as if the body tries to shut down to save itself from the stress. The more you can minimize stress, the more energy you will have.

  I realize this is a very superficial treatment of very complex solutions, but maybe it can stimulate you to investigate these approaches on your own. 

   

Menopause or mental pause?

     Aileen blew into my office like a Summer storm.  “Help me, I’m a poster child for Hormones from Hell!”  After catching my breath, I assured her that there were many ways of dealing with the ravages of hot flashes, dry skin, mood changes and forgetfulness.  I started by reinforcing that menopause is not a disease. Inaccurately and unfortunately there is a pervasive sense that menopause is the “ultimate and inevitable bad experience” for aging women.  I jokingly explained that women were not designed to self-destruct at fifty!   

     Menopause is a normal, natural transition, and it is vital for women to view it with a positive perspective.  That simple understanding is the conerstone in building a plan to thwart the symptoms of “the change.”  But it is equally important to realize that not everyone has a problem with menopause.

      As a physician, my experience treating menopausal women is that there are some universal similarities in women’s experiences, but because of every person’s unique physiology and life journey, this time in a woman’s life is very individualized.

      I am a “recovering traditionalist”.  I was trained in the old school approach to menopause (which means drugs, and if that didn’t work, more drugs). In almost twenty years of practice I have found that many women are not satisfied with their options and many discover that their “treatments” are worse than their symptoms.  Especially in this age of “estrogen panic” where the media (and many physicians) has touted misleading and confusing advice on hormones, many women are looking towards alternative treatments for their symptoms. One woman put it well.  She said, “Physicians have a duty to give a woman the best care they can provide, especially their options.  However each person is ultimately responsible for his or her own health.  We, the patients, need help, guidance, and a listening ear.” Those were powerful and challenging words.

   The general dissatisfaction among women is amplified by the observation that only 17% of eligible women in the US are taking some type of hormone replacement and up to 80% of women who start on hormones stop them after two years!  The needs of women are not being met!  This problem with compliance is due to poor communication and fear.  After all, treatment of symptoms is not limited to simply taking a drug.  Successfully navigating the potentially turbulent waters of menopause requires a more comprehensive approach.

Herbs, complimentary teachings, diet, and exercise all should be discussed along with hormones.  The main caveat surrounding these modalities is that they must be held to the same standard and scrutiny that safeguards traditional hormone replacement.

The major problem in meshing the traditional and complimentary approaches to health is a mistaken perception of mutual exclusivity.  These treatments can coexist and be complimentary.

  I am saying that choice and personal responsibility are keys to unlock a joyous menopause.

      This is an opportunity to live with passion and fulfill your life mission. This is a time to take stock of the past and choose your path for the future. The choice is yours. It is a choice that is difficult if not impossible to make wisely without sound information and guidance.

THE 4 “A”s

    Many of the lifestyle choices you make, such as diet and exercise, can dramatically affect your menopausal experience. It is not a time to be complacent or anxious.  It is a time- a season- to rejoice and celebrate the joy of living. 

Following the four “A”s,   Attitude, Action, Aptitude and Apothecary, can be the prescription for menopausal merriment.     Attitude– what we believe is our reality, what we know is our truth.  Belief plays a major role in the symptoms of menopause.  Our thoughts become our actions, our actions become our deeds, our deeds become our habits, our habits become our character, and our character becomes our legacy.  In many instances, if you anticipate a horrible experience, you will be right!

Action– this involves two levels.  First, acting on your knowing.  The key to any successful person, whether it’s in business, raising a family, or celebrating menopause is taking action. There is nothing more sad than a good idea that dies from loneliness or lack of attention.  Whether that’s using hormones, herbs, massage therapy or exercise, you have to take action to achieve results.

       The second part of action is exercise.  It is the fountain of youth and can help in reducing both weight and hot flashes! 

Aptitude– educate yourself, learn your options.  Ask questions, talk to others, and take responsibility. Through knowledge about menopause, you eliminate fear and create opportunities.  M.D. does not mean menopause director!  Learn so you can be a partner in your health care.

Apothecary– We have a plethora of medicines and natural substances to treat the symptoms of menopause.  These are merely tools; however, they cannot stand alone. 

Explore your options and live joyously and healthy.

Healthy Tips

A celebration is often the result of an accomplishment, a special event , or honoring memories.  These are good things, but do we really need the “special” to warrant a celebration? Wouldn’t it be great to be able to delight in the relatively mundane?  Some of the happiest folks I know are those who relish just being able to get out of bed in the morning.  We can celebrate our health, good or bad, by reflecting on what a true miracle it is that all these billions of cells are working in concert to allow us to walk, run, think, eat, love, write, and even occasionally complain.  In celebration of simply being alive, I have compiled a list of healthy tips (or rambling recommendations) collected over the years to promote, extend, repair and rekindle your health.  Let the celebration begin!

   

People who rarely spend time outside (elderly, housebound) are at a greater risk for osteoporosis due to a lack of vitamin D, which is increased in sun exposure.  400 IU a day in supplement form can help prevent brittle bones.

Taking 400 micrograms of folic acid a day before getting pregnant can reduce the likelihood of neural tube defects in the baby (spina bifida, etc.)

Exercise 30 minutes every day.  The more and bigger the muscles used, the less time needed to achieve fitness (cross country skiing best, walking is good, using the channel changer is bad.)

The more colorful your meals the better. Bright colored fruits and veggies contain greater anti oxidants and other protective substances.

Use herbs (Black Cohosh) and vitamins (E) to control mild menopausal symptoms.  Many are scientifically valid and may work for you.

It’s not brain surgery; to eat healthy go low fat, low sugar, high fiber and balanced.

Eliminate soft drinks.  An extra can of soda a day can add 15 pounds in a year.

Almost half of all doctor visits are stress related.  A great tool for stress management is regular, aerobic exercise.

The solution to permanent weight loss is not dieting, it is getting fit.  Only muscles burn fat, and only muscles that are used!

If you are pressed for time, three ten minute exercise sessions can be as helpful as a single thirty minute segment.

Most women over twenty need to take some extra calcium (500mg) The better the bones before menopause, the better they are afterwards.

Eating habits are formed at an early age.  Teach children as early as two to be aware of good and bad food choices.

Don’t focus on weight.  Your per cent body fat and/or your Body Mass Index (BMI) are better measures of health.  Throw away the traditional scales and get a device that calculates body fat and BMI.  They are reasonably priced and accurate.

A good doctor will always encourage and support getting a second opinion…so in important decisions, do just that.

Don’t limit yourself by thinking that health is strictly physical.  Wellness is a balance of mind, body, and spirit.

Don’t skimp on preventive care.  The Pap test and mammogram have saved millions of lives.

If you have a strong family history of ovarian cancer (in mother or sister) demand a yearly sonogram and CA-125 blood test to check your ovaries.  It is far from a perfect screen, but it is the best available so far.

Young women (ages 9-26) who are not yet sexually active should strongly consider getting vaccinated against the Human Papilloma Virus (HPV). It is the single biggest cause of pre-cancer and cancerous changes in the cervix.

Acupressure has been effective for the nausea associated with early pregnancies. The most common device used is “Sea Bands”, an elastic band that applies pressure to a point on the wrist.

Caffeine consumption is one of the leading causes of bladder problems in women.  Eliminating caffeine from the diet may reverse symptoms of incontinence, frequency, and urgency.

Some women in the menopause need testosterone supplementation along with estrogen and progesterone to help with a lagging sex drive.

Many herbal medicines and treatments can interact with prescription drugs.  When getting your yearly checkup, don’t forget to tell your doctor about any supplements or herbs you take on a regular basis.

Before any surgery, always stop taking Ginkgo, Ginseng, Garlic, or vitamin E.  They can increase bleeding and lead to problems with the surgery.

Always bring two things to every doctor’s visit: a written set of questions and a list of your current medications.

20 percent of cancer deaths are related to obesity.  Maintaining a healthy weight may be your best guard against developing cancer.

Aerobic exercise might be better for your brain than your body.  Early studies show that exercise can cause damaged brain cells to regenerate, possibly thwarting diseases like Alzheimer’s.

The average person makes about 250 decisions about food every day and most people don’t have a clue as to what influences their choices. Consciously think about what you are eating and you will generally eat less.

A massage once a week can not only reduce muscle fatigue and soreness, but it can be just as good for stress management as a session with a counselor.

The quickest way to get fit with exercise is to WALC.  Wind sprints (just periodically increase the intensity of the exercise) Aerobic (this type of exercise burns fat) Lift (lifting weights builds muscle, which in turn increases metabolism) Cross train (vary your exercise regimen and you will get fit faster).

We hope you’ll find these healthy tips useful!

Menopause or Mental Pause?

     Aileen blew into my office like a Summer storm.  “Help me, I’m a poster child for Hormones from Hell!”  After catching my breath, I assured her that there were many ways of dealing with the ravages of hot flashes, dry skin, mood changes and forgetfulness.  I started by reinforcing that menopause is not a disease. Inaccurately and unfortunately there is a pervasive sense that menopause is the “ultimate and inevitable bad experience” for aging women.  I jokingly explained that women were not designed to self-destruct at fifty!   

     Menopause is a normal, natural transition, and it is vital for women to view it with a positive perspective.  That simple understanding is the cornerstone in building a plan to thwart the symptoms of “the change.”  But it is equally important to realize that not everyone has a problem with menopause.

      As a physician, my experience treating menopausal women is that there are some universal similarities in women’s experiences, but because of every person’s unique physiology and life journey, this time in a woman’s life is very individualized.

      I am a “recovering traditionalist”.  I was trained in the old school approach to menopause (which means drugs, and if that didn’t work, more drugs). In almost thirty years of practice I have found that many women are not satisfied with their options and many discover that their “treatments” are worse than their symptoms.  Especially in this age of “estrogen panic” where the media (and many physicians) has touted misleading and confusing advice on hormones, many women are looking towards alternative treatments for their symptoms. One woman put it well.  She said, “Physicians have a duty to give a woman the best care they can provide, especially their options.  However each person is ultimately responsible for his or her own health.  We, the patients, need help, guidance, and a listening ear.” Those were powerful and challenging words.

   The general dissatisfaction among women is amplified by the observation that only 17% of eligible women in the US are taking some type of hormone replacement and up to 80% of women who start on hormones stop them after two years!  The needs of women are not being met!  This problem with compliance is due to poor communication and fear.  After all, treatment of symptoms is not limited to simply taking a drug.  Successfully navigating the potentially turbulent waters of menopause requires a more comprehensive approach.

Herbs, complimentary teachings, diet, and exercise all should be discussed along with hormones.  The main caveat surrounding these modalities is that they must be held to the same standard and scrutiny that safeguards traditional hormone replacement.

The major problem in meshing the traditional and complimentary approaches to health is a mistaken perception of mutual exclusivity.  These treatments can coexist and be complimentary.

  I am saying that choice and personal responsibility are keys to unlock a joyous menopause.

      This is an opportunity to live with passion and fulfill your life mission. This is a time to take stock of the past and choose your path for the future. The choice is yours. It is a choice that is difficult if not impossible to make wisely without sound information and guidance