Risk Factors For Urinary Incontinence

Written by yvonnethornton on May 23rd, 2013

There can be a lot of embarrassment associated with urinary stress incontinence, and a lot of women may feel like they can’t talk about it with anybody—even their doctor. However, those women should know that there is nothing to be ashamed of. It’s a fact of life that many women will have to deal with throughout their lives, whether it is after pregnancy, the result of aging, or due to any other number of causes.  In fact, with this study you can see just how many risk factors there are for UI. Moreover, UI (urinary incontinence) is not something to be ashamed of because it is the particular structure of women’s bodies that causes it to be so prevalent in the female gender.  It is also not related to the mode of delivery, i.e., cesarean vs. vaginal delivery.  Nuns have the same prevalence of urinary incontinence as mothers.

UI doesn’t necessarily mean you can’t hold it in at all—it simply means that there may be times or situations where women experience a little leakage, or there may be times when they are unable to “hold it” completely until they reach a restroom. Women may experience UI when they laugh or sneeze, or they might simply find the need to wear a panty liner throughout the day. It is a myth that there is nothing that can be done for UI.

The first and most important step in dealing with this issue is to speak with your doctor and specifically a urogynecologist. This is absolutely necessary, as there may be medical causes for sudden UI. If there are no medical causes, there might be other causes for UI, such as smoking.  If the cause is something like obesity, simply losing some excess weight can help. Your doctor can also recommend exercises that can help strengthen the pelvic wall and reduce UI. In extreme cases, your doctor may even recommend surgery to treat urinary incontinence. However, nothing can be done if patients are unwilling to speak to their doctor about the problem. Communication is always the first step in treating any issue.

- Yvonne S. Thornton, M. D., M. P. H.

 

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Technology in Medicine: Robotic Assistance in Surgeries

Written by yvonnethornton on May 20th, 2013

“Robots” are being used to assist in surgeries throughout the world. It sounds like something out of a movie, doesn’t it? The use of this kind of technology in medicine is raising a lot of questions for patients. Some may believe that the more technology that is used during their surgery, the better—others may have problems with the idea of a “machine” doing a lot of the work during a surgery. Doctors and surgeons are divided in much the same way, which is why studies are currently being done to assess the differences between robotic-assisted surgeries and traditional surgery methods.

In one study, women who were scheduled to receive hysterectomies were divided into two groups. One group received robotic assistance during surgery and the other did not. Researchers found that there were no significant differences in the outcomes of the surgeries—however, the robotic-assisted surgeries did take longer to complete. It may not seem like much of a finding, especially for patients, but studies like these may help ease the mind of individuals who worry about advances in medicine and whether or not they will be safe during their own surgeries or medical procedures.

Surgery—especially gynecological surgery—is becoming increasingly sophisticated, and that is good news for patients. Procedures that were once much more invasive can now be performed via laparoscopic methods, with only a few small incisions. While the outcomes at present are still very much the same for surgeries that do and do not use robotic assistance, there is a strong likelihood that in the future, as the technology advances, robotic-assisted surgeries could actually be much more advanced, and have much better postoperative outcomes compared to traditional surgical methods.

On the other hand, robotic surgery is very expensive (The DaVinci system costs 1.3 million dollars) and is labor-intensive (increased operating time), which means the patient is under anesthesia for a longer period of time, which may have serious sequelae.  All this has to be factored into the equation.  As a surgeon myself, the only advantage I see is that the surgeon gets to sit down during the entire procedure.  As a Catch-22, using robotic technology also reduces the training of young surgeons in the traditional approaches to operations, and thus the skill and “tried and true” surgical techniques are lost because they are no longer taught and performed on a daily basis.  The robot may have to be the wave of the future, by default, because surgical residents will no longer be taught how to do surgery the traditional way, and thereby fulfilling the prophesy.

The reason I find this so important to point out is to ease the minds of patients who worry about new methodologies in medicine—the simple fact is that even though surgery is growing more complex, it is also constantly improving in its ability to treat patients with a wide range of problems. While some of the newest trends in medicine may seem like science fiction more than anything else, our surgeons need to know and to be comfortable with both forms of surgery in order to have outcomes most advantageous for the patient.

- Yvonne S. Thornton, M. D., M. P. H.

 

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Ease of Use Most Important Factor in Contraceptive Method

Written by yvonnethornton on May 16th, 2013

A wide variety of women use contraception in the modern day, whether they are simply putting off having a child for the time being or they have decided not to have a child at all. The type of contraception that a woman chooses can have a big impact on her life, and is one of the most important decisions that she can make. One study examined the contraception methods used by a variety of women, across both age and social lines, to determine what factors were most important in determining the type of contraception used.

Not surprisingly, one of the most important factors used by women in determining their method of birth control is its ease of use. The birth control pill can be notoriously difficult for some women to keep track of. It must be administered at the same time, every day, to be effective. That is why an increasing number of women are turning to other contraceptive methods, such as IUDs, to prevent pregnancy.

However, as a doctor I feel it’s my duty to urge women to think a little bit more about what contraception is best for them. There are a number of other factors besides ease of use to consider when choosing a method of birth control, from the permanence of the method you want to use to biological issues which may play a huge role in determining the efficacy of your chosen method. For example, an IUD may be best suited for a woman who has already had children and is looking for a more long-term solution to prevent pregnancy. Before making a decision about your birth control, be certain you engage in a dialogue with your doctor to determine what solution is best for you. There are so many options out there that it is easy in this day and age to find something tailored to your individual needs.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Do We Need to Talk More About Mammograms?

Written by yvonnethornton on May 13th, 2013

It seems like a no-brainer that women should receive screening for breast cancer with a mammogram. It is recommended by most doctors that women, starting between the ages of thirty and forty, begin to schedule their mammograms every two years. It is at about this time that breast cancer becomes a serious risk to most women, and it will remain a risk to most women until well after menopause. However, as serious as this issue is, there are still a lot of women who decide not to get mammograms. Why is that?

For patients, there is a real fear associated with mammograms. They can be uncomfortable, and there are always stories getting out about false diagnoses of breast cancer being made. In fact, it is likely that a lot of women will need to undergo a biopsy to determine whether a spot found in a mammogram is cancerous or not—however, the benefits of a potential diagnosis early on, before cancer has a chance to grow and spread, far outweighs the potential downside of having to undergo a biopsy when no cancer is present.

In addition, there are unfortunately still many women out there who treat the age of 70 as a magical cut-off point when they no longer need breast cancer screenings. However, most women who get breast cancer are over 50, and a large number of these are over 70. Senior women are not being told how important it is to receive a regular mammogram, as this study indicates.  A large number of younger women are also unaware of the importance of checking their breasts regularly with home examinations. It is important for women of all ages to be aware of the fact that they are at risk, no matter what their age, background, or current health.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Studies Provide Shocking Postpartum Depression Statistics

Written by yvonnethornton on May 9th, 2013

Becoming a new mother should be the happiest time in the lives of most women—at least, that is what society tells us. But every year, thousands of women across the country who have recently given birth, or who are about to give birth, report experiencing depression and postpartum depression. This issue only came to light in the past few decades, as an increasing number of women overcome the “shame” associated with mental illness to talk about and raise awareness of their experiences. Increased awareness of postpartum depression means that fewer women feel the need to hide their problems, and more women will seek help earlier in the onset of postpartum depression when it can be more easily treatable.

However, there are still a lot of problems when it comes to awareness. One of those issues is the fact that the segment of the population that is most likely to be diagnosed with it is the segment least likely to be knowledgeable about the subject. In this study, which identified women positively diagnosed with postpartum depression as well as the demographics of affected women, it was revealed that women positive with a diagnosis were more likely to be younger, African American, and to be in a lower income bracket.

In addition, most of the women who were found to have postpartum depression were also found to have a comorbid generalized anxiety disorder. That means that many instances of depression may also dismissed as common anxiety, or the typical concerns of a new mother. It is important to correctly identify depression, as it can have an immense effect on both mother and baby in the period after birth. In fact, many women will suffer depression for years afterward. In this study alone, 14 percent of the women in the study were positively diagnosed.

Women should be informed about postpartum depression and its effects, and they should know that it is a common problem after pregnancy. Of course, postpartum depression is just one of the many issues that a woman might face regarding pregnancy and childbirth—my mission in life is to inform women of all ages and races of what is going on with their bodies, and in my book, “Inside Information for Women”, I discuss pregnancy and childbirth in detail, in the hopes that more women will go through the process with the knowledge that they need to remain safe, healthy, and happy throughout their pregnancy and well afterwards.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Preserving Fertility for Cancer Survivors

Written by yvonnethornton on May 6th, 2013

Cancer is a devastating diagnosis for a woman of any age, but for a young woman who is hoping to eventually start a family, there can be a host of other problems associated with this disease. No matter what type of cancer a woman faces, it can have severely damaging effects on her reproductive health. Radiation therapy and chemotherapy can cause major problems with a woman’s eggs, and can even make them not viable for future reproduction. Women who suffer from ovarian and cervical cancers may even be forced to undergo a full or partial hysterectomy.

For many young women, the second question they ask after determining their prognosis is what effect their cancer will have on their future ability to start a family. Fortunately, advances in science over the past few decades have made it entirely possible for a woman to preserve her fertility after a cancer diagnosis. There are many options available for women who want to start a family after they have recovered from their illness. However, it is important to note that many of these options must be pursued early on in a cancer diagnosis—especially if the woman is choosing to freeze her eggs for future in vitro fertilization use.

Many women may see egg freezing as their only choice, and will not want to pursue this avenue when undergoing cancer treatment—this may leave them feeling as if they might never have the chance to start a family. This study shows that most women believe egg and embryo banking is their only option. This is most certainly not the case. Women who are concerned about their potential for reproduction should talk with their doctors and learn all the options before they give it up for a lost cause. There are many mothers out there who have had their children after surviving this horrible disease. I invite people to read my book, “Inside Information For Women”, for more information on the effects of breast and other cancers on the female body.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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I Am Officially a Mother-In-Law

Written by yvonnethornton on May 3rd, 2013

The greatest happiness a mother can have in her life is seeing her children grow up healthy and happy.  I am so blessed to have been able to attend the wedding of my son to his beautiful bride! Although I’ve had many successes, and I have a lot of things in my life to be proud of, I can’t think of any moment in my life that made me more proud, or more successful, than welcoming my daughter-in-law into our family. She is a truly wonderful woman—the type that every mother dreams of her son someday marrying. Of course, I like to believe it’s my influence that made my son grow up to choose such a good woman, but I think that this time I will let him have all the credit.

My son and his beautiful bride

The wedding was an incredible event, and it was the perfect way to celebrate the union not just of my son and his bride, but also of our two families. I had a blast, and it is certainly an event that I will remember for the rest of my life.  I can’t wait to see what comes next for my son and my daughter-in-law. Marriage is a blessing, filled with a lot of hard work, obstacles, and joys, and I know that they will meet any and all challenges they face head-on.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Some Basic Stats on Weight Gain During Pregnancy

Written by yvonnethornton on May 2nd, 2013

I cannot believe my eyes every time I see the gossip magazines talking about some celebrity’s upcoming pregnancy. No matter how you feel about a woman, you should be happy for her and supportive when she’s facing the prospect of motherhood, especially when it’s her first baby that is on the way. But rather than talk about the positive aspects of parenthood, or even silly things like what baby clothes she’s buying, or the type of crib she’s going to put into her nursery, all the magazines can do is talk about the weight they’ve gained during their pregnancy.

This is simply astonishing to me. When did the most important part of a woman’s pregnancy become how much weight she is putting on? As if our society’s standards of beauty weren’t bad enough, now we have to go and turn those “skinny at all costs” ideas on expectant mothers? The simple fact is normal-sized women are supposed to put on weight during pregnancy. Obese women have other recommendations for pregnancy weight gain. Studies show that the average woman should gain at least 25 to 35 pounds while pregnant.  Actually, the ideal weight gain should be closer to 11 kg or about 22 pounds.  This obsession with weight has led to a condition known as “pregorexia”, which is a rare condition, but becoming more common, which pertains to a woman’s drive to control pregnancy weight gain through extreme dieting and exercise.  This is an eating disorder and it shouldn’t be when it comes to women who are pregnant.  It is an outgrowth of all of this idiotic media focus on appearance and body images that average women strive to resemble celebrities.

When our society starts shaming women for gaining weight during their pregnancy, or suggesting that women are unhappy because of a few extra pounds they’ve put on, it can do a lot of damage to mothers and children. Are we creating a culture of women who are asking their doctors no, “What can I do to keep my baby healthy?” but “How can I make sure I don’t gain too much weight while I’m pregnant?” I’ve already made it known what I think about our culture and its standards of beauty. The fact that people in our society would rather focus on thinness rather than on the health of expectant mothers and their children is unbelievable.  On the other hand, the guidelines for weight gain in the average women should not be ignored.  Women who gain 50-100 pounds during their pregnancy are also putting their pregnancy and unborn child at increased risk for preeclampsia, diabetes and caesarean birth.

When the appropriate weight gain is achieved in the normal-sized patient, women  who are pregnant should not be ashamed of the weight they’ve gained—every pound that they put on should be worn as a badge of honor, as its proof that they are nourishing a happy and healthy infant with their bodies. When I see a woman who cares more about the health of her child than her dress size, I applaud them for having the courage to do what’s right and to stand up to the standards of our crazy society.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Can A Low-Dose Birth Control Help Control PMS?

Written by yvonnethornton on April 29th, 2013

Being a woman is tough, especially when you have to deal with the monthly effects of premenstrual syndrome. PMS can have a range of effects, as every woman knows, and while for some it may be nothing more than a minor annoyance, for others it can be pretty difficult to get up and go while they’re dealing with symptoms such as moodiness, aches, pains, and bloating. I understand that, and part of my job is making sure that women have all the resources they need so they can live healthy, comfortable lives, no matter what their bodies are putting them through.

While birth control and other drugs been used for years to deal with the more serious symptoms of more severe cases of PMS, or even premenstrual dysphoric disorder, (PMDD), both women and physicians hesitate to give full doses of birth control to women who don’t need or want it. The birth control pill comes with a lot of side effects, as any woman who has taken it knows, and this can cause a lot of concerns for women who are already dealing with the effects of PMS. Fortunately, low-dose birth control can do a lot to regulate your menstrual cycle, and it comes with far fewer side effects than its more estrogen-heavy counterpart. Studies show that it can also help to alleviate the symptoms of PMS, so it may be an option for women who are trying to deal with the worst symptoms of their oncoming menstrual cycle.

If you think your PMS symptoms are bad enough to warrant medical intervention, make sure you bring it up during your next appointment with your doctor. It’s important to have a dialogue with the person in charge of your health about what is going on with your body, and what can be done to make you more comfortable, and your life a little easier. It’s also important to trust your doctor’s judgment when it comes to low-dose birth control, or any other form of treatment. They will know what is best for your body, and can talk you through your options.

 

- Yvonne S. Thornton, M. D., M. P. H.

 

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Know the Facts When Making the Decision to Breastfeed

Written by yvonnethornton on April 25th, 2013

There is not a doctor out there who will deny there are some definite benefits to breastfeeding. Both mother and baby experience these benefits, which range from helping mom to lose some of her baby weight to helping your infant gain greater immunity to childhood diseases. But when my patients ask me whether or not they should breastfeed after they give birth, the last thing I want to do is bully them, or use scare tactics to pressure them into breastfeeding if they don’t think that it is the best option for them.

Perhaps it’s just me, but I think these decisions are best left to the mother. It is not my job as a doctor to make those decisions for you. However, it is my job to make sure that you have the facts, and all the facts, before you decide either way. A lot of women might not know just how many benefits there are to breastfeeding, but on the contrary, a lot of women may have heard information that is just plain false. For example, plenty of people trying to push breastfeeding on young mothers will tell them that mother’s milk can prevent obesity later in life, but studies show that this is not the case at all.

Why is this important to me? Because I don’t think that any woman should be shamed for making the decision not to breastfeed if she doesn’t think that option is right for her. And there are plenty of women who have good reasons not to, whether they produce low amounts of milk, they need to return to work or take care of the rest of the family, or the process is just too painful for them. This is an important choice to make—possibly the most important choice that new parents will make in the first months of their child’s life. I want people to be informed about every option that they have, and will always encourage those who are uncertain about that choice to know everything they can, and to get their information from a source that isn’t trying to push some sort of an agenda. Let’s face it—parenthood is hard. You need information to make the right decisions. And there is absolutely nothing wrong with formula feeding. Unlike the milk from breastfeeding, which is deficient in Vitamin D and iron, formula feeding has enhanced those vital nutrients and there is also a quantitative check on just how much your baby is receiving in milk.  There are NO randomized clinical studies or trials (Level I) that have compared exclusive breastfeeding with formula feeding.  Therefore, the recommendations made are not based on evidence-based medicine.  Breastfeeding sounds good, so it must be good and sound.  With breastfeeding, that may not be the case.  Each mother has to decide what is best for her family, her baby and her self.  A panel of “experts” cannot recommend a course of action based on what “sounds” good without definitive outcomes of the two modes of management.  This has not been done when it comes to comparing breastfeeding to formula feeding.  Only observational studies exist and they are not the appropriate study design upon which to make decisions about such an important aspect of infant nutrition. The goal is to give your child the nutrition that he or she needs in order to grow.

- Yvonne S. Thornton, M. D., M. P. H.

 

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