August, 2012

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Inside Information for Women – Todd Aiken? What Does He Know.

Friday, August 31st, 2012

Senator Todd Aiken – Is there a man in America who has unleashed such fury among women in the recent past? The words “legitimate” and “rape” should never even appear in close proximity to one another, let alone in the same sentence, connected to one another. The fact that he is still running in his election only proves how uneducated and behind-the-times he is. The sad thing about this is, regardless of his uneducated statements, there are still MANY people that will try to take a woman’s decision to choose away from her. We live in this country because we want the right to choose and the freedom of religion. That freedom to practice your own religion and choices means that you cannot force your opinions on others.

My most recent radio show speaks to this entire subject. Please listen and enjoy. I look forward to your comments.

 

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

INSIDE INFORMATION FOR WOMEN 8-30-12

Chocolate is the Caffeine of Choice for Moms to Be

Thursday, August 30th, 2012

When you get pregnant, you want to do everything you can to ensure the safety of your developing baby.  For this reason, most moms cut out foods, drinks, and chemicals that might have adverse effects on their baby.  Caffeine is just one thing they often give up, which means no more tall daily lattes or espressos.  Although high levels of caffeine can be dangerous, small amounts are fine, and one study found that the levels of caffeine found in chocolate are safe for moms and their unborn babies.

Many experts agree that moms should avoid taking in any more than 200 mg of caffeine per day.  This allows for a small cup of coffee, but most women still choose to avoid it altogether, which is probably a good idea, unless you need it as a stimulant for bowel regularity.  You never know how much caffeine a particular brew of coffee might hold, and it’s always better to be safe than sorry. When pregnancy has you craving something sweet though, you might forget that chocolate too contains caffeine.

Fetal heart rate reactivity is a medical term that describes how reactive the baby’s heart rate is when it is moving around in utero.  With fetal movement, the fetal heart rate accelerates about 15 beats per minute and is a sign of fetal well-being.  Fetal reactivity assessment is used as a surveillance tool when we are worried about the baby in a Mom who may have hypertension or diabetes (known as a nonstress test or NST).  The more “reactive” the fetal heart rate is, the better.   A study published in the Journal of Maternal-Fetal and Neonatal Medicine determined that eating chocolate can make the fetal heart rate more reactive .  This increased heart rate did not appear to be from the caffeine in chocolate, but rather from the theobromine, which dilates blood vessels and decreases blood pressure.  In order to make up for this physiologic change, your heart and also your baby’s heart have to pick up the pace in order to maintain adequate blood circulation, resulting in a more reactive fetal heart rate pattern, which is a good thing.

However, as with any chemical, food or supplement that alters your body function, it should be taken in moderation.  In other words, don’t go overboard, but don’t feel the need to pass up on a “chocolate moment” to satisfy those cravings once in a while either.

 

– Yvonne S. Thornton, M. D., M. P. H.

Don’t Rush Your Delivery

Monday, August 27th, 2012

While being pregnant is a blessing, how you feel while pregnant is hardly ever comfortable or convenient.  As your delivery date approaches, this will become even more true.  That doesn’t mean it’s a good idea to rush your delivery though.  In fact, rushing your delivery could lead to serious problems that would make life after your pregnancy even more inconvenient.  Let me clarify the definition of a full-term pregnancy.  A full-term pregnancy is between 38 weeks, 0 days and 42 weeks, 6 days.  Yes, four weeks!  Mother Nature gives the baby four weeks to make up its mind to exit the padded “condo”.  With that said, recent neonatal literature (http://journals.lww.com/greenjournal/Abstract/2011/11000/Neonatal_Outcomes_After_Implementation_of.12.aspx) has concluded that babies who are delivered before the 39th week of gestation are significantly at risk for neurological deficits and respiratory problems.

Unfortunately, we have become a society of convenience.  Consequently, there has been an increase in the number of births by early induction of labor lately.  While it’s true that if there is medical reason to induce labor early, it can be a necessity, that does not mean it is safe or recommended for everyone.  In some cases, couples decide that they would like their baby to be born on a special date for future birthdays.  For others, it is because a father might be leaving for a while and would otherwise miss the birth of his child.  In still other cases, doctors actually recommend early induction simply because they are hoping to have the holiday off or don’t want to be called away from their vacation should delivery come later than the expected due date.  A study by the Agency for Healthcare Research and Quality concerning the results of elective induction once again confirm the dangers involved.  Inducing labor before your baby is ready, can cause serious problems that could harm his or her physical and mental development.  Those developmental issues could affect them for the rest of their life.  Also, babies born too early often have to stay in the hospital longer and sometimes must spend that time in intensive care.  The March of Dimes has supported this study and is now strongly opposing early elective delivery before 39 weeks.

Although you and your doctor might be itching to get that baby out and into the world, that is no reason to induce labor.  If it becomes medically necessary to do so, then it can be done safely, but the risks are still increased.  If your doctor urges you to induce labor without a medical reason, seek a second opinion.  If it’s just your impatience pulling you in that direction, be patient.  You’ll have plenty of time with your little one soon enough, and by waiting for your baby’s natural delivery date, the time you get with them will be of a much better quality.

 

– Yvonne S. Thornton, M. D., M. P. H.

West Nile Virus Without the Bite

Thursday, August 23rd, 2012

Another West Nile Virus scare is sweeping the nation.  In fact, many regions have declared states of emergency due to the number of infected people in their area.  This has led to more spraying and other strategies meant to kill mosquitos carrying the virus and to prevent them from breeding further this year.  It’s not just the bite of those mosquitos that can transmit the virus though, which is making some mothers nervous.

Approximately, two weeks after being bitten by a mosquito carrying the West Nile, the virus finishes its incubation period and the infected person may start noticing symptoms.  Although they cannot transmit the disease through any sort of casual contact, there are a few ways someone could accidentally pass the illness on to someone else.  This can occur as a result of blood transfusions and organ transplants, telling us that the blood plays a major role in transmission.  That also means that mothers can pass the virus from their blood to their unborn babies or even to a baby they are breastfeeding.  This is not common, as least as far as documentation shows, but it is possible.  If you are pregnant or breastfeeding and have begun to feel ill after being bitten by a mosquito in the past couple of weeks, you may want to speak to your physician just to make sure it is not West Nile.  While some people never develop symptoms, those with compromised or delicate immune systems, such as the elderly, babies, and pregnant women, could contract more severe cases with symptoms like swollen lymph nodes, rashes, fever, aches, and nausea.  In a small percentage of cases, the virus is fatal, but this is rare when it is caught and treated early.

For the most part, this West Nile scare is exactly that- a scare.  In truth, more people die every year from the common flu than from any outbreak of West Nile thus far.  However, that doesn’t mean you should ignore any symptoms if you suspect you may have it, especially if you are pregnant.  In the meantime, get rid of standing water near your home, stay inside during dusk and dawn hours, and wear a safe repellent if you think you will likely be around mosquitos.  When you’re carrying or caring for your baby, it’s always better to be safe than sorry.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Is Your Blood Type Bad for Your Heart?

Monday, August 20th, 2012

You probably already lament any risks for illness you inherited from your family’s gene pool, but unfortunately, there is now yet another concern to consider.  Your blood type may determine your risk for heart disease, which means yet another aspect of your life that you can’t control but that impacts your health.

Researchers at Harvard Medical School and the Harvard School of Public Health combined and analyzed information from two large and long-term studies.  These studies involved more than 90,000 people and at least two decades.  After taking into account age, gender, as well as other important factors, they found that people with Type O blood seemed to be at much less of a risk for heart disease than those with other blood types.  To be exact, their findings showed that people with Type B blood are 11% more likely to develop heart disease than those with Type O.  Type As had a 5% higher risk, and Type ABs were at the highest risk, being 23% more likely to suffer from a heart disease.  Their results are yet to be confirmed or explained, but some theories suggest it could have to do with varying levels of LDL and inflammation linked to certain blood types.

Unfortunately, we cannot change our blood type, so if you are in the higher risk categories, this study may cause some concern.  However, these results do not prove that you will definitely have heart disease if you have Type AB blood.  It only shows that you are more likely to suffer from it.  You can still control other factors such as your weight, exercise, and nutrition, which can do a lot towards preventing heart issues. Forewarned is forearmed.  So, if your blood type is one that places you at higher risk for heart disease, you will simply need to work harder to keep heart disease at bay.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Estrogen and Anxiety

Thursday, August 16th, 2012

While some men may believe that fear and anxiety in women comes down to all that estrogen, it’s actually quite the opposite.  It is low estrogen that is more likely to make an anxious woman according new research from Harvard.

During your menstrual cycle, your estrogen levels tend to ebb and flow (no pun intended), and your mood and mental state are then prone to these fluctuations.  Extremely high estrogen levels seem to protect women from emotional disturbance, and low levels make them more vulnerable to trauma.  This knowledge isn’t being limited to PMS and birth control though, they are also considering a much more widespread use.  Researchers believe that they can create a pill that will influence estrogen levels, much like birth control does, but to prevent post-traumatic stress disorder.  Their research shows that women who experienced traumatic events while their estrogen was low suffered emotional trauma for a much longer period.  Before heading into perilous situations or even right after, an estrogen pill could protect their mental states.  Even in men this tactic could be used.  Men’s testosterone is converted to estrogen in the brain, so even though they are less likely to suffer from depression and anxiety disorders as a whole, they still use estrogen to remain stable.

Professor of Psychology Larry Carhill says that, “The single biggest bias in neuroscience research is the belief that sex differences are insignificant or small,” but the truth is there are many differences and learning them could be the key to treating clinical disorders in the future.  As with any good treatment plan, it is best to treat the individual as a whole person, and not just as a statistic.  That means understanding what makes their systems work, even when it comes to gender differences, so we can restore both men and women to good health.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

PTSD from Infertility?

Monday, August 13th, 2012

Normally, when you think of post-traumatic stress disorder, you think of soldiers returning from battles with a foreign enemy, not women battling infertility.  Surprisingly though, researchers have found that women undergoing fertility treatments are highly likely to develop PTSD and are calling for a change in the definition of the disorder.

Based on a survey conducted by Allyson Bradow who is the Director of Psychological Services at Home of the Innocents, 50% of women who went through fertility treatments met the criteria for PTSD.  As a result of their stressful experiences, infertile women are 6 times more likely to suffer from PTSD than the general population.  This has led some to believe that perhaps the definition for PTSD needs to be expanded.  Currently, its definition limits its diagnosis to those who have “experienced or witnessed a life-threatening event or [an] event that could cause serious injury.”

Bradow believes that it should also be diagnosed for those who have experienced trauma due to the failure to meet expectations for life.

The ability to procreate is believed to be a fundamental life process.  Trauma is defined as a wound or injury.  The word origin of injury comes from the Latin “injuria”  (in = not + jus =  right) and its definition is to cause one to suffer hardship and loss undeservedly and unexpectedly.  Therefore, if one loses his/her ability to procreate, this satisfies the definition of trauma.  It is not uncommon for couples struggling with infertility to suffer from anxiety, depression, and other related symptoms.  Any time a person’s heart is set on something, particularly a life accomplishment like procreation, they are bound to react extremely emotionally to a negative outcome.  Some find procreation so important, that they feel they have not lived up to the expectations of life when they cannot conceive and are severely traumatized by it.  Whether or not this stress can be considered PTSD or not is yet undecided.  What is clear though is that infertility physicians and clinics need to ramp up their counseling services.  If infertility is an unfixable issue, then couples need help finding a way to be content with it, so they can live emotionally- and mentally-healthy lives.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Scalp-Cooling Cap Freezes Chemo Hair Loss

Thursday, August 9th, 2012

Breast cancer, or any kind of cancer for that matter, is scary and stressful, and it doesn’t help that the treatment can cause hair loss.  Then, not only must you brave the disease, but also the beacon that your bald head becomes, proclaiming to everyone that you have cancer.  Recent experiments though show that a hat could stop or slow hair loss due to chemotherapy.

When you go through chemotherapy, its intent is to attack the rapidly dividing cancer cells.  Unfortunately, the drugs can’t always tell which rapidly-dividing cells are harmless.  Because your hair follicles divide quickly too, they often get attacked by the drugs.  These effects vary depending on the type of chemotherapy drugs you’re using, the regimen you’re on, and of course, the rate at which your hair follicle cells divide.  That’s why some people do not experience hair loss, while others experience it temporarily or even permanently.  Researchers at Laval University in Quebec sought a way to prevent or slow hair loss during chemotherapy.  They found, that by using a scalp-cooling cap, they could constrict the blood vessels around the follicles, preventing some of the chemotherapy drugs from giving their full dose to those areas.  When tested on a small, preliminary group, they found that the cap did show promise.  The cap was used for 20 minutes before the treatment and for an hour or more after the treatment.  Overall, their results showed 69% of women who tried it saw hair loss at the “not at all,” “a little,” or “moderate” levels.

If further trials test the cap and find it successful, it may be another option to add to your chemo treatment down the road.  That could mean a lot longer stays at the clinic, but it could also make for a slightly less stressful road to recovery in the end.  A scalp-cooling cap that freezes chemo hair loss in its tracks could be one more thing breast cancer survivors have to be thankful for.

 

– Yvonne S. Thornton, M. D., M. P. H.

Don’t Forget to Ask

Monday, August 6th, 2012

When you are pregnant, there are a lot of things running through your mind at once, most of them being questions.  As the date of delivery approaches, those questions become all the more important and all the more difficult to remember to ask.  Here are a few important ones that you should add to your list.

What if My Doctor’s Unavailable?

Although your physician may have set a due date, that is only a best guess as to when you will actually deliver.  Normally, your doctor will try to be available for a delivery in the week before and after that date.  However, extenuating circumstances or a very early delivery could cause them to be unavailable when you need them.  Instead of panicking when the time comes and taking whoever happens to be available, plan for this situation ahead of time.  Speak with your doctor about potential back-ups.  Ask who they recommend and if you can get their numbers for your on-call list.  It might also be a good idea to meet them, so if they do end up delivering your baby, you will have already established a relationship with them, making for a more comfortable experience.

 Who Can Come with Me?

Back in the day, women would bear their pain alone but for the doctors and nurses in the delivery room, but now, most moms want to bring in the father, or at least some trusted family member or friend.  For a standard delivery, this shouldn’t be a problem, but if there are complications, they may be asked to leave so that doctors have more room to work.  Normally, they will ask you to restrict access to the delivery room to one or two people and with all the chaos birth can bring, you’ll appreciate not having too many people around.  If you will be having a C-Section surgery though, having someone in the delivery room may or may not be possible.  Be sure to ask before promising access to anyone.

 Will Someone Be There to Show Me?

Some women panic a bit after going through delivery and finally getting the chance to be alone with their new baby.  They suddenly realize that they don’t know how to change a diaper or that breastfeeding is harder than it looks.  Luckily, there are people on staff at the hospital who can guide you through your first attempts at these tasks.  They can give you tips to help you get your baby to latch for breastfeeding and show you the proper way to take care of their sanitary needs as well.  Ask your chosen hospital about who they have available to go through these questions with you once you have delivered.

If you have more questions, be sure to join me for my live webcast, Inside Information for Women, every Thursday at 1pm Eastern.  I can take your call and do my best to answer any burning questions you might have regarding your pregnancy, delivery, or women’s health in general.  In the meantime, if your due date is approaching, be sure to write down the questions you have, so you will remember to ask each one at your next pregnancy check-up.  That way, when your baby and body are ready to deliver, your mind will be ready too.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

It’s Called an Annual for a Reason

Thursday, August 2nd, 2012

It’s not news to OB/GYNs that women don’t exactly look forward to their annual exam.  We understand that it may feel more like a chore than a checkup when you’ve been told you have to do it every year.  Some experts though, have new recommendations, saying most women don’t need yearly cervical cancer screenings.  Before you start celebrating though, you may want to consider the many long-term benefits annuals have on your health.  As I have mentioned many, many times on this blog, ”A PAP SMEAR IS NOT A PELVIC EXAM.”

The new recommendations by the U. S. Preventive Services Task Force and the American Cancer Society were released March 15, 2012.   They recommend:

  • Women between ages 21 and 65 without risk factors (such as DES exposure or immunodeficiency) should undergo cytologic screening (a Pap smear) every 3 years.
  • Those aged 30 to 65 wishing to extend the screening interval could undergo screening with both cytologic exam and human papillomavirus (HPV) testing every 5 years.
  • Women younger than 21 should not be screened.
  • Women older than 65 who have been adequately screened previously should not be screened.

 The above recommendations may cause women to shirk going to their OB/GYNs for that dreaded pelvic examination because they are not having an annual Pap smear.

However, as we age, there’s no doubt our bodies change.  For the most part, those changes are normal.  Sometimes though, medical issues can develop.  Every time you go to an annual exam, you are getting checked to make sure everything is in healthy working order.  If you catch issues before they get too big, treatment and even cures can be more effective.  With the rise in so many types of cancer, you’ll want a professional checking to make sure there are no signs of tumors.  That is why pelvic exams, mammograms and cervical screenings are so important.  If you were to wait two or three years, it may be too late.  My health book, Inside Information for Women will explain all the aspects of a pelvic exam and an annual gynecologic examination.

You also have the chance during your visit with an OB/GYN to discuss your health and how it’s affecting your life, or how your life is affecting your health as the case may be, and that can bring up symptoms that you didn’t even realize were connected.  It can also provide you with valuable advice that will help you take care of your body.  With all the change people go through in a single year, it’s nice to know that someone with knowledge and compassion is there to make sure you remain in good health for many years to come.

The fact is women are such multi-taskers trained to take care of everyone that we forget to take care of ourselves. The point is, if we don’t take care of ourselves, we won’t be there to take care of others. Don’t have time for your annual checkup? It’s time that you find the time.

 

– Yvonne S. Thornton, M. D., M. P. H.