May, 2012

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Sleep Yourself Thin

Thursday, May 31st, 2012

When you are a parent, you do not always get a lot of opportunity for sleeping.  You do not get a lot of time for yourself in general really.  You have work to take care of, children to manage, and somewhere in there, a body to consider.  The fact is though, with our busy American lifestyles, the health of our bodies simply seems to take a back seat.  Unfortunately, this has caused many of us to become overweight, or even worse, obese and diabetic.  A recent study shows though, that if we could all just find enough regular time to sleep, we might be able to stay slimmer and healthier in general.

Right now, nearly two-thirds of Americans are overweight or obese.  Even more concerning is how many of these people are progressing into diabetes.  The CDC cites diabetes as a health issue for 8.3% of Americans and a whopping 79 million show signs of prediabetes.  While poor diet and little to no exercise are obvious causes for such an epidemic, stress and sleep schedules also play a role.   A recent study by researchers at the Brigham and Women’s Hospital and the Harvard Medical School in Boston found that “lack of sleep or disrupted sleep patterns…may lead to an increased risk of diabetes and obesity.”  The study involved tracking the effects of disrupted sleep routines in participants by shifting their sleeping time from 10 hours a night, to just 5.6 hours per 24 hour period.  This sleep restriction and pattern disruption caused 32% of participants to have decreased insulin secretion when they ate and lower metabolic rates, which led to high blood sugar levels bordering on pre-diabetic.  If they had continued the study for a year, they estimated that these levels could have caused them to gain about 12.5 additional pounds of body weight in one year.  When you add these conclusions to the hectic lifestyle of working American parents, it is no wonder so many are struggling with their weight.

When we are young, we spend a lot of time fighting our parents over daily naps and early bed times, but once we grow up, we find it even harder to put ourselves to bed.  Perhaps this study will help us hardworking adults realize that it is no use staying up all night stressing about our busy lives, if it only gives us fewer nights to live.

 

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Parenting, Women's health issues, Women's health news | No Responses »
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Just Because You’re On the Pill, Doesn’t Mean You Won’t Get Pregnant

Monday, May 28th, 2012

With contraception so much in the news lately, it seems that we have heard all there is to say about it.  A recent study regarding birth control though, has something quite different to say that definitely deserves our attention.  It’s evident from the attention that political contraceptive debates received that there are a lot of women in the US who take the pill or some other form of birth control.  According to the American Journal of Obstetrics and Gynecology though, many of those women wrongly assume that their contraception is infallible.

According to the Guttmacher Institute, 99% of women of reproductive age who have had sex use contraception.  That’s a lot of women, but Researchers at Washington University in St. Louis found that a shocking 45% of those women believe that contraception can prevent pregnancy 100% of the time.  With so many people taking birth control under this false assumption, it’s obvious there’s a need for education and media exposure.  While the pill, which is the most popular form of contraception, is mostly successful at preventing pregnancy, it can indeed fail between 2%-9% of the time.  And that’s the failure rate if you remember to take it every single day.  The failure rate can increase when women miss pills, are in their first month of taking the pill, switching dosages, or taking medications like antibiotics, migraine medications, or antidepressants.  Condoms have an even bigger failure rate of 15%-24%. This is why it’s so important for women to discuss their birth control options with their physician, and that discussion should include how effective each option is.  The rates of contraception failure with respect to perfect use and average use are outlined in my health book, Inside Information for Women.  Hopefully, that chapter will give you a better understanding of the types of contraception offered, their effectiveness and their applicability to your lifestyle.

This information shouldn’t make anyone panic, because as a whole, birth control is fairly effective, especially when compared to not using any contraception at all, which has a failure rate is 85%! However, knowing more about failure rates should make people aware of the actual risk involved in being sexually active, even while taking birth control.  This information probably won’t cause people to think again before having sex, and it may not prevent unintended pregnancies.  At the very least though, it gives parents like me yet another reason to teach our children that sexual activity does have consequences and is better saved for a time in our lives when we are ready to be responsible for our actions.

 

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Contraception (birth control), Fertility & Infertility, Pregnancy | No Responses »
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Exercise Beats Cancer

Thursday, May 24th, 2012

With more than 40% of Americans diagnosed with cancer in their lifetimes, it’s highly likely that you or someone you know has experienced cancer.  For this reason, we have put a lot of effort into finding cures and treatments for this devastating disease, and now, we are finally seeing some glimmer of hope in the statistics, especially in terms of prevention.  It seems that an active lifestyle, a healthy weight, and a smart diet can do a lot to reduce the risk of cancer.

According to the American Institute for Cancer Research, 1/3 of cancers can actually be prevented if Americans were to commit to being physically active every day for at least 30 minutes, if they were to maintain a healthy weight throughout their lives, and if their diet would include mostly plant foods, limited red meat, and as little processed meat as possible.  If that’s not enough motivation to live a healthy, balanced lifestyle, I don’t know what is!  Unfortunately, the American diet is packed with processed meats and other unhealthy foods and our culture is getting less active by the generation.  Hopefully, these statistics are enough to create a paradigm shift and force Americans to look at the long-term effects of their choices.

For those of us in our middle-aged years already, much of the damage has already been done, but that doesn’t mean we can’t turn it around.  In fact, a recent study in the Journal of the National Cancer Institute revealed that physical activity was linked to lower rates of breast and colon cancer deaths.  They found that cancer survivors, particularly breast cancer survivors, enjoyed longer lives when they exercised regularly, as compared to those who did not.  Exercise was also found to prevent reoccurring cancers. They believe the results stem from the way regular exercise effects insulin levels, inflammation, and immunity, but more studies are planned to better understand these recent results.

Between our American lifestyle, family histories, and the sheer prevalence of the disease, our risk factors for cancer only seem to be going up.  Now that we know that simply being healthy is just one way to reduce our risk though, maybe we can finally commit to getting out there and getting active.  How many more reasons do we need to take care of ourselves.

– Yvonne S. Thornton, M. D., M. P. H.

 

 

Posted in Women's health issues | No Responses »
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A Family History of Heart Disease Doesn’t Have to Be Your Future

Monday, May 21st, 2012

Heart disease is a growing problem in America.  It is the leading cause of death in both men and women, and is even more of a problem for African Americans.  For many Americans the tendency towards heart disease runs in the family, and with their fast food addiction and sedentary lifestyles, the risk only increases.  Just because you may have a history of heart disease in your family though, doesn’t mean it’s a fate you have to suffer.

Jennifer Sedbrook, an OSF Cardiovascular Service Line Leader, says that “We can control all but two of the factors that affect heart disease; family history and age.”  OSF (Order of St. Francis) Healthcare is a nonprofit Catholic health care corporation that operates a medical group, hospital system, health plan, and other health care facilities in Illinois and Michigan.  According to OSF, There are other important factors which can also increase our risk though, and those include our BMI, or body mass index, blood pressure, cholesterol, and weight.  It’s important to be aware of your body and to know each of these numbers, so that if there is a change, you can alert your doctor.  Additionally, if you know your body mass index and, consequently, weight are not where they should be, you can be proactive.  By eating healthy and committing to a regular exercise routine, you can drastically reduce your risk of heart disease.  This, along with controlling the amount of stress in your life, will decrease your cholesterol and blood pressure.

Ann Ripsom, one woman in a family of 7 siblings, has lowered her own risk factors by quitting smoking, joining Weight Watchers, and getting regular check-ups with her doctor.  She decided to get involved with the OSF Women’s Heart Ambassadors after losing three of her brothers to heart disease.  Three of her other siblings have also suffered from major heart issues.  Despite such an intense family history of heart problems, Ann does not show signs of the disease and is working to help others decrease their factors too.  She says that the most important thing to do is to take control of your risk factors and do not ignore signs your body may be giving you. In addition, people need to know the various symptoms of a heart attack, which can include chest pain, jaw pain, pain in either arm, nausea, sweating, disorientation, and fatigue.

More than 616,000 people died of heart disease in 2008 alone.  That accounted for 25% of the deaths in America that year.  By becoming educated about your risk factors, these kinds of deaths can be prevented.  Knowing this information and taking steps toward prevention is the most important thing you can do.  So find out what your numbers are, start eating healthy, and above all, get active.  Don’t let your family’s history determine your future.

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Posted in Women's health issues | No Responses »
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Jobs Should Provide Health Insurance, Not Moral Judgment

Thursday, May 17th, 2012

The debate over health insurance has certainly been heated over the past few years, and most of those arguments stemmed from concerns over financing and constitutional rights.  More recently though, it seems they have decided to narrow their focus to something a little more personal for women, and that’s contraception.  Although employers rarely want to know what you’re using your health insurance for due to privacy concerns, some would like to prevent their female employees from using their insurance for birth control.

The arguments behind this have been few.  Some claim that cutting birth control out of their health insurance plans would save money.  While this is somewhat true, in the grand scheme of things, it’s a bit ridiculous.  Birth control is easy to produce and access, and with so many competing contraception options and companies, the price is affordable.  Additionally, when female employees take birth control, they prevent pregnancies, which are much more costly for health insurance plans in the way of prenatal check-ups, hospital stays, maternity leave, and eventually, another family member to add to the plan.  In the long run, employers would actually save money by giving their employees access to contraception.

Money isn’t the only argument though.  There are religious organizations that don’t want to provide birth control to their employees out of religious, or moral, concerns.  Although the foundation of their organization stems from a particular religion, they employ people who are not necessarily a part of that faith.  There are religious hospitals, private schools, and nonprofit organizations for example, who have hundreds of staff members from all walks of life.  They feel that they have a right to impose their moral judgment on all of their employees. If they must abide by the same antidiscrimination laws that prevent them from firing someone because of their religion, race, or sexual orientation, then why should they be allowed to discriminate when it comes to health insurance?

Obviously, as a physician, I believe that the gift of life is precious.  That’s also why I believe though, that women need to be ready to receive that gift.  It takes a huge commitment to raise a child, and even more to develop that child into an intelligent, caring, and well-balanced person.  Our jobs are there to give us the opportunity to provide for our families, both in terms of money and health insurance and in terms of allowing a woman, mother or not, to feel as if she is self-sufficient, contributing and using the talents that she has developed over a lifetime. Mothers especially need an outlet other than their children.  Our jobs have no right to decide when we start that family though and by no means do they have the authority to judge the morality of our decisions.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Contraception (birth control), Parenting, Pregnancy, Women's health news | No Responses »
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Don’t Want Kids? Why Haven’t You Told Your OB/GYN?

Monday, May 14th, 2012

Back in my mother’s day, women were expected to grow up and raise a family.  Nowadays though, modern women view having kids as more of an option.  In fact, more and more often women are choosing to forgo the family experience in exchange for a demanding or prestigious career.  There is no longer a societal stigma for not having children.  It is truly a choice.  Oprah Winfrey, two recently-appointed female Supreme Court Justices, Condolezza Rice, and even our Surgeon General are childless.  While I can say firsthand that it is possible to have both a career and children, I can certainly relate to the ambitious young women out there who want different achievements than those of their mothers’ generation.  While these young women may have decided beyond a doubt that they don’t want children, for some reason, they’re not sharing this information with their OB/GYNs.

Many people see OB/GYNs as physicians who perform annual exams or take care of matters concerning pregnancy.  While these are important parts of our job, they’re not the sole aspects.  We are here to provide support and advice when it comes to a variety of women’s health issues.  Just because you’ve decided not to have kids, doesn’t mean we don’t have anything more to tell you.  In fact, OB/GYNs can give you valuable information concerning your permanent birth control options.  Although so many women are opting out of pregnancy, they continue to use contraception methods that are temporary, not always effective, and sometimes, risky to their health.  With average use, condoms have a failure rate of 17.4 percent and the pill has an 8.7 percent failure rate.  In addition to the pregnancy risk, hormonal birth control increases a woman’s risk for blood clots, strokes and heart attacks.  Yet, those who don’t want kids or those who don’t want any more kids, continue to take the risk.

As stated in my women’s health book, “Inside Information for Women”, the most common form of contraception among couples is sterilization.  While most have heard about invasive procedures like vasectomies and tubal ligations, only 12 percent were aware that other options existed.  Because, in the final analysis, whoever carries the child is the one who is going to be the one most concerned about birth control, it is more usually the female partner rather than her mate who elects sterilization. There is more than one type of sterilization for women though, including sealing fallopian tubes using an instrument with an electrical current, closing them with clips, clamps, or rings.  A new method of sterilization (Essure®) involves inserting spring-like coils into the tubes through the cervix around which tissue grows to block the tubes.  President of AAGL and practicing OB/GYN, Dr. Linda Bradley believes that more women would choose a permanent method if they were simply more educated on the matter.  She cites the insert procedure (Essure®) as being 99.8 percent effective and a lot less invasive than a tubal ligation.  She notes the insert method, for instance, as being a “non-surgical permanent birth control procedure [that] offers women the option of no incisions, no hormones, no general anesthesia and no slowing down to recover.”  It’s a fairly new procedure, just ten years old, but it is gaining in popularity among those who have learned about it.

Wherever you are in your reproductive plans, it’s important to share them with your OB/GYN.  They can give you information you may not have considered, guide you in your decision making, and help you make the healthiest and most informed choice regarding your reproductive health.  The next time you and your loved one debate over who should get that permanent birth control procedure, include your OB/GYN in the conversation.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Contraception (birth control), Fertility & Infertility, Women's health issues | No Responses »
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Happy Mother’s Day!

Sunday, May 13th, 2012

 

Itasker F. Thornton 1915-1977

I want to take this opportunity to wish all the Moms and the Moms-to-be a very Happy Mother’s Day.  I have delivered 5,542 babies as an obstetrician over the past 40 years and I can’t imagine a better specialty in medicine to practice.  My life has been to share the joy of so many couples who have started a new chapter in their lives by starting a family.

My mother, Itasker Frances Edmonds Thornton, died in 1977 at 61 years of age.  She was too young to die, but she raised five daughters (with the addition of our foster sister, Betty) and encouraged us to be the best.  We started out living in the housing projects of New Jersey. However, my Dad built our home in Long Branch, New Jersey with my Mom serving as his hod carrier in order for me and my sisters to go to a better school and have a chance at succeeding in life.  As teenagers, our mom was the bass player in our all-girl family R&B band known as “The Thornton Sisters”.  We went on to win six consecutive weeks in the Amateur Night contest held at the famed Apollo Theatre, recorded for Atlantic Records and performed at the Brooklyn Fox with Murray the K and his Swingin’ Soireé.   Watch Your Step

My Mom: Top Row - third from the left next to me with the sax

My mom had three years of college at Bluefield State Teachers College back in the 1940s, but the credits were not accepted in the northern colleges when she left West Virginia to come to New York City.  My mother always regretted not getting her college diploma and, I believe, she was the true driving force behind all of her daughters excelling in academics.

Although she had to leave college without a diploma, working with the West Virginia Higher Education Policy Commission, I secured her that elusive “sheepskin” and, in 2005, she was posthumously awarded a Doctorate of Humanities from Bluefield State College.  On her diploma it states: “She dared to dream great things and, through those whose lives she touched, great things were achieved.”

Her daughters, with her love and guidance, became successful, independent and accomplished women: an obstetrician, a psychiatrist, a prosthodontic oral surgeon, a Ph. D. and an attorney.  Mom, all I can say is “thank you” for your love and your vision.  I wouldn’t be where I am and who I am if it weren’t for you.  May you rest in peace.  I love you.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Parenting | No Responses »
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WHAT’S WRONG WITH THIS PICTURE?

Friday, May 11th, 2012

2012 -- The All-Male Leadership of ACOG

I just returned from the 60th Annual Clinical meeting of ACOG (Women’s Health Physicians).  I can’t explain it, but after being a member for over 30 years, it bothered me to no end to see ALL men on the dais as representatives of women’s health as if women couldn’t make policy about their own health.  When I was a resident, 95% of obstetricians were male.  Now, women comprise over 46% of practicing obstetricians and almost 80% of the OB/GYN resident physicians, YET all you see in the  governing body and officers (who set policy for the care of women) are 12 elderly Caucasian males.   Their very presence as leaders do not reflect the diversity of the ACOG membership today, yet there they are. No Blacks, No women, No minorities.  It’s as if ACOG were stuck in a time warp of 60 years ago!!  Since 1951, there have been only two female Presidents of the College and the last one was almost twenty years ago!  It seems so anachronistic and so wrong.

The male obstetricians have had the power to dictate and oversee women’s health for decades and it appears that they are NOT relinquishing it to any female any time soon; even if it pertains to women’s health!! It is a shame that in the 21st century, no one at ACOG (American College of Obstetricians and Gynecologists) is reaching out for inclusion of women and minorities in its upper echelons.  A picture is worth a thousand words.

– Yvonne S. Thornton, M. D., M. P. H.

Introduction of ACOG’s leadership

Posted in Health care policy, Women's health issues | No Responses »
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Are Cesareans the Lazy Way Out?

Thursday, May 10th, 2012

The process of giving birth has certainly evolved over the years.  Women can now opt for an assortment of painkillers, choose to do a home birth, and even substitute doctors for midwives.  The most recent trend though, seems to be cesarean deliveries.  Instead of enduring hours of labor, being coached by the doctor, and toughing out a natural, vaginal birth, babies are getting the quick way out.  Is this increase because of concerns for the mother’s or child’s health, or simply because obstetricians are looking for the lazy way out?

Right now, one out of every three births happens through cesarean.  In 1965, only 4.5% of births were cesareans.  Why the big increase?  Unfortunately, it’s not a result of medical need.  Instead, 29% of Obstetricians polled in a survey said, “they were performing more Caesareans because they feared lawsuits.”  (Some other physicians, myself included, happen to be of the mindset that it is more about convenience, on both the parent and physician side, than anything else. It takes serious stamina to stand by and coach a woman through thirty hours of difficult labor. And I do it because I love my job. I am a warhorse, and I am there for my patients.) Because they’re concerned about being held responsible for potential harm to the baby from vaginal labor and deliveries, they would rather opt for cesarean deliveries.  While this kind of labor may be quicker, it is by no means safer.  A cesarean is an invasive surgery that is actually more likely than a vaginal birth to pose a risk for complications that might, “put the mother back in the hospital and the infant in an intensive-care unit.”  Some hospitals are not giving moms all the information.  Instead, they offer the cesarean as a casual choice in order to skip providing long-term labor support, to get through the labor as quickly as possible, and to avoid malpractice claims.  Cesareans are also much more expensive, consequently, making hospitals more money.  While there are women who do need cesareans for valid medical reasons such as breech for first-time Mom’s, high-order multiple births in one delivery, cephalopelvic disproportion (the baby’s too large for Mom’s pelvis) or eminent danger to the mother (such as hemorrhage) or fetus (sudden abnormal heart rate), these do not make up nearly enough of the more than 30% cesarean rate.  That means that the majority of cesareans are happening because obstetricians are choosing them, not mothers.  If Mother Nature wanted our babes to be born by Cesarean, she would have put a zipper on our abdomens.  The consequence of this increase in Cesarean births (some by maternal request) is the increase in maternal death and Cesarean hysterectomies in subsequent pregnancies due to hemorrhage caused by abnormal placental location and uterine rupture.

This is why it’s so important to become as informed as possible about child birth before making any decisions.  Make sure you have a caring, ethical obstetrician who is willing to give you all the information you need to make the safest choice for you and your child.  If they recommend a cesarean, ask them about their reasons and whether or not it is medically necessary.  Remember, it is your body, your baby, and your choice.

— Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Women's health issues | No Responses »
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Early Menopause is Bad News for Women and Their Bones

Monday, May 7th, 2012

Let’s face it.  None of us looks forward to getting old, but we try to do it with as much grace as possible.  For some women though, menopause, a hormonal change that should come later in life, comes sooner than expected.  Instead of dealing with hot flashes, night sweats, mood swings and all the other symptoms of menopause in their 50s, they’re facing it in their 40s or even younger.  And as if early menopause isn’t bad enough, studies now show that it increases their risk for osteoporosis and even shortens their life expectancy.

Swedish researchers from Skane University Hospital in Malmo conducted a study of almost 400 women over the course of just under 30 years.  They found that of the women who started menopause before the age of 47, 56 percent developed osteoporosis compared to just 30 percent in the women who started menopause later in life.  Women suffering from osteoporosis are at greater risk for bone fractures, bone pain, and loss of height due to bone loss.  Their findings also showed that women who had undergone early menopause had a greater risk of fragility fracture and death with a rate 17 percent higher than the women with later menopause.  The rate of fractures in women with early menopause was 44% compared to 31% in those women who entered menopause later.

The cause of early menopause is not yet clear, though there seems to be a link between it and premature ovarian failure, hysterectomies, chemotherapy, and possibly even stress.  Premature ovarian failure has been associated with Fragile X syndrome, so there may be a genetic link. Unfortunately, preventing and reversing early menopause is not yet possible, but there are ways to decrease your risk of osteoporosis.  The bone masses of most women peaks in their 20s.  You can increase yours by getting plenty of calcium, vitamin D and exercise.  A balanced diet and thirty minutes of weight training or other moderate exercise every day can make big difference when it comes to your bone health.

The association found between early menopause, osteoporosis, and death is causing some to call for more studies to determine a more definite correlation. The higher mortality rate in women with early menopause does need further study in order to address the confounding variables, such lifestyle, medications and smoking.  In the meantime, we should take the results as a warning to take care of our bodies, particularly our bones, as early as possible.

— Yvonne S. Thornton, M. D., M. P. H.

Posted in Fertility & Infertility, Hormone replacement therapy, Menstruation, Women's health issues, Women's health news | No Responses »
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