July, 2012

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What’s Making Depressed Mom’s Deliver Early?

Monday, July 30th, 2012

Nothing messes with our hormone’s more than pregnancy, which is why we feel so emotional during that time.  These emotions can certainly run the gamut, but when a tearful moment turns into weeks of depression, it’s time to call your physician.  There are studies pointing to depression as a factor when it comes to some premature births.  Besides that, it is simply a dangerous state in general for a pregnant or new mom to be in.

Researchers for the North Shore University Health System at the University of Chicago studied 14,000 pregnant women.  Their results showed that among the women who were clinically depressed, 14% delivered before their due date.  In women who were not depressed, preterm births were only at 10%.  Although 4% may not seem like much, when you’re talking about the health of your newborn, 4% is a big increase in odds.  The study did include socioeconomic factors as well, but did not study some other confounding variables.  Despite those flaws, the study found depression to be the common thread in many of the preterm births.

However, this doesn’t mean that being depressed will definitely lead an early delivery.  The way people handle depression can also affect their health and the health of their unborn baby.  Women using antidepressants, eating more comfort foods, drinking or using drugs could all be increasing these odds by not taking care of their depression properly.  Fewer than half of pregnant women in the U.S. are screened for depression. It’s always a good idea to seek out the advice of a physician before self-medicating, whether you are pregnant or not.  A good physician will try to determine the underlying cause of your depression instead of simply treating it.  Also, while it hasn’t been proven that antidepressants themselves may be linked to preterm births absolutely, there are studies suggesting a correlation.  Upon speaking with your physician, they may be able to offer alternative therapies for treating your depression rather than trying to prescribe medication to stop preterm birth——because that medication usually is ineffective with potentially harmful side-effects.

This information isn’t really surprising, as stress has long been known to have negative effects on pregnancy.  With depression being yet another source of stress for soon-to-be mom’s, and a medically-diagnosed one at that, you would be wise to take note of your mood.  It probably won’t stop swinging, but at least that’s better than slipping into long-term sadness.

– Yvonne S. Thornton, M. D., M. P. H.


Pregnancy and Power? It’s About Time!

Thursday, July 26th, 2012

Although many of us have gone through a pregnancy and maintained a rigorous career at the same time, it’s not something you often see when it comes to Fortune 500 positions.  Really, you don’t see many women in Fortune 500 leadership positions at all.  With Yahoo’s hiring of Marissa Mayer as their new CEO though, they now have both and she’s getting a lot of media attention as a result.

When Yahoo made the controversial move to snag Mayer away from Google, it wasn’t her intelligence and obvious experience that made the media pounce on the story.  Instead, it was her pregnancy.  People just couldn’t understand why Yahoo would take on a pregnant woman to save their downward sliding company.  Obviously, their process for selection has been long and they’ve done their research regarding who has the ideas and skills necessary to turn their company around.  When their first pick got caught lying on his resume, they didn’t take long to convince Mayer to leave Google, their main competitor.

Some say that Mayer will not be able to devote the kind of time and energy needed to revive the company as she gets further into her pregnancy and especially during maternity leave.  It seems that these people have never met a modern woman.  Most American mom’s work 40 hour plus weeks and take care of two or three kids, all while performing well at their positions.  In fact, according to the Bureau of Labor Statistics, seventy percent of American women with children under the age of eighteen are earning a paycheck while raising their children.  It’s shocking to realize that Mayer is the first pregnant Fortune 500 CEO ever.  Why can’t a woman use her uterus and her brain at the same time?  Has it really taken us this long to get over female stereotypes, particularly those concerning pregnancy?  This is the ultimate in multi-tasking. I know for a fact that both career and family can be balanced in a successful way.  In fact, I feel that it is my family who gave me the strength to achieve success in the first place.  My second memoir, Something to Prove, chronicles that journey.  I’m sure the arrival of Mayer’s baby will only drive her even harder to realize her career goals and those of Yahoo as well.  As far as seeing a pregnant woman in such a powerful position, I’d say it’s about time!


– Yvonne S. Thornton, M. D., M. P. H.

Yet Another Risky Pill for Weight Loss

Monday, July 23rd, 2012

Are you ready for a miraculous weight loss pill?  Aren’t we all?  As much as we’d all love to believe that they finally came up with a pill that will melt away the pounds, most of us are also worrying about the side effects, and rightly so.  The FDA just approved yet another wonder drug, but it will still be up to the public to find out just how safe it is.

On Tuesday, the US Food and Drug Administration allowed another weight loss pill to be put on the market.  It’s called Qsymia, and though it does have risky side effects, they believe the benefits outweigh the dangers.  Dr. Janet Woodcock, Director of FDA’s research department said that “Obesity threatens the overall wellbeing of patients and is a major public health concern.”  Because obesity impacts two-thirds of Americans, it does indeed seem like a major issue, but taking care of that problem with a pill is quite another matter.  Some past weight loss drugs approved by the FDA were found to have very dangerous side effects that cost people their lives.  You might remember the rise and fall of the popular diet pill Fen-Phen for example.  Even after years of testing in the lab, some drugs can prove to have side effects that either weren’t observed in the controlled tests or were ignored as minor drawbacks.

Qysymia is a combination for stimulants and anti-seizure drugs and is one of the first new diet pills to become FDA approved in 13 years.  Its side effects and risks include a fast heart rate, metabolic acidosis, birth defects, and heart damage.  It is only approved for those considered obese, which is a BMI of 30 or more, and those with a BMI of 27 or more and who have a weight-related medical condition.  The two experts on the FDA panel who voted against the approval of Qsymia worry that it will have “severe, even fatal, consequences.”  Dr. Woodcock, however, believes that if it’s used properly and in combination with a healthy diet and regular exercise, it could be just the thing we need to halt the obesity epidemic.

I don’t know about other physicians, but I plan to stick to the less-miraculous prescription for a health weight- eating right and staying active.  There just can’t be a pill for everything!


– Yvonne S. Thornton, M. D., M. P. H.



Fertility Financing Becomes a Popular Option

Thursday, July 19th, 2012

How much is a baby worth to a couple trying to get pregnant?  It’s likely priceless, but to the lending industry, it’s worth millions.  Apparently, because of the steep cost of fertility treatments, some couples are turning to financing to get enough money to improve their odds of having a child.

One couple in Rockville, Md, Jill and Tom Clinton, tried desperately to get pregnant, but after a heartbreaking miscarriage, they decided to try a fertility clinic.  Unfortunately, the cost of the average in-vitro fertilization cycle is about $12,000 and their insurance wouldn’t cover any of it.  Additionally, it often takes several cycles to get good enough odds for a successful pregnancy.  In order to make it happen, they drained their savings and were happy to receive a baby boy from that investment.  When they wanted a second child though, there was no money left for fertility treatments, so their doctor told them about the possibility of getting financing.  After more research, they found that fertility financing companies are being created around the country and the industry is growing fast.  It’s so popular in fact, that Capex MD, the company the Clintons decided to use, funds a whopping one million dollars in fertility loans each month and that number is rising steadily.

It appears unclear as to why this new industry is growing so fast.  Some speculate that more couples are trying to get pregnant later in life and so are more likely to need fertility treatments, while others believe it’s simply the new option that is giving rise to the results.  Couples who previously couldn’t afford in vitro fertilization now have the option to get financing and so they do.  Either way, it is causing concern among medical ethics committees like the one at Langone Medical Center.  They wonder if lending companies aren’t taking advantage of the desperate nature of couples in this situation, seemingly holding a miracle right in from of them.  Arthur Caplan, head of the Langone Medical Center Ethics Division worries that couples are “not going to hear the failure and success rate, the interest rate, and what the risks are of the treatments.” Instead, couples may only pay attention to the idea that there is one more opportunity to allow them to give pregnancy another try.

– Yvonne S. Thornton, M. D., M. P. H.

Osteoporosis and Alcohol

Monday, July 16th, 2012

Like any reputable physician, I don’t condone heavy drinking, but that doesn’t mean I don’t necessarily partake in a glass of my favorite wine every now and then.  The truth is, a little alcohol once in a while never hurt anyone.  While recent studies suggest that a little bit of drinking may actually help our bones, my personal opinion is that one might be jumping the gun a bit.  Nevertheless, in the “spirit” of being complete and open, I wanted you to know about the recent research that has been covered by the media.

As odd as the connection may seem, a study by the College of Public Health and Human Sciences at Oregon State University found that even small amounts of alcohol have an impact on bone metabolism.  Their study of 40 postmenopausal women who drank moderately did show some benefit.  In fact, according to the principal investigator, “moderate alcohol [use] may slow bone loss by lowering bone turnover.”  That can help to reduce a woman’s risk for osteoporosis later in life.  Urzula Iwaniec, associate professor at OSU, explained that bones are living tissue with old bones constantly being replaced by new bone.  This is why increasing the metabolism of bones helps to stimulate the growth of new bone and keep older, thinning bones at bay.  One of the problems I had with this study is the sample size.  The number of patients studied was way too small to arrive at such a conclusion.  The three main mechanisms by which osteoporosis develops are an inadequate peak bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption, and inadequate formation of new bone during remodeling. An interplay of these three mechanisms underlies the development of fragile bone tissue.  This study only addresses one aspect of osteoporosis and fails to investigate the other possibilities.

Women who are postmenopausal are normally most at risk for bone thinning because of their reduced estrogen.  With that said, researchers did warn against drinking by young adult women, whose bones are still building and that excessive drinking is not a healthy idea for anyone.  However, even the lead author concluded that “the study doesn’t prove that moderate alcohol consumption wards off osteoporosis; it merely shows an association between the two.”  Those who drank one or two alcoholic beverages per day showed increased bone metabolism, and when they stopped drinking for two weeks, the risks for osteoporosis immediately began to show in their blood.  When they resumed drinking again, researchers were amazed to see their bone marker turnover rate return to previous levels.  Unfortunately, the researchers did not test any other hypothesis or mechanism for this change. They believe the reason for this effect is the ability for alcohol to act like estrogen, but it may not be due to this mechanism with respect to bone turnover.

We once thought that calcium and Vitamin D supplementation should be taken to prevent bone fractures.  However, the United States Preventive Services Task Force, an independent panel of experts in prevention and primary care, recently issued a draft statement in June, 2012 recommending that healthy postmenopausal women should not take low doses of calcium or vitamin D supplements to prevent fractures.  Why?  Because the supplements were found not to prevent fractures and only increased the risk of other problems, such as kidney stones.   So the risk outweighed the benefit and taking these supplements may actually be harming you.

While this seminal study about imbibing alcohol doesn’t give us an excuse to throw our healthy calcium- and vitamin D-rich diets out the window, it may be another factor to consider when it comes to our bones.  We already know that red wine may help prevent heart disease, so perhaps, in time, larger studies may support the conclusions of this research and that we may pour ourselves a drink and raise a glass to women’s health.

– Yvonne S. Thornton, M. D., M. P. H.

Reversing the Biological Clock with Someone Else’s

Thursday, July 12th, 2012

Because so many women hold giving birth as one of their ultimate lifetime experiences, they don’t want to miss out on it because of infertility or the aging process.  Unfortunately though, as women get older, their ability to reproduce decreases.  With so many American women waiting until later in life to start their families, these upwardly mobile women are finding problems with fertility issues to be more common than they had expected.  For this reason, doctors have been working on adding to their various fertility treatments to help these older women give birth.  In vitro fertilization is one method that has gained a new strategy that seems to be reversing the biological clock of women over 40 years of age.

For women who are 43 years or older, the likelihood of getting pregnant, even with the help of three cycles of in vitro fertilization, is only 10 percent.  This is because a woman is born with all the eggs she will ever have and over time, the number of eggs of a woman significantly decreases from 1 million at her birth down to 34,000 at 36 years of age.  Not only are there less in numbers but the likelihood of the remaining eggs to function normally in the reproductive process becomes less.  However, researchers have found that when one uses a “donor” egg, i.e.,  when a young woman’s eggs are donated and in vitro fertilization is used in combination with these younger eggs, the chances of pregnancy increase to 60 or even 80%.   Nearly 250,000 women participated in this reproductive study by researchers at the Baylor College of Medicine and what they found was quite promising.  Even infertile, older women using donated eggs and in vitro fertilization had the same chances of getting pregnant as fertile young women using natural means.

Although these findings are exciting for those desperate to have a baby later in life, the process is not as easy as it sounds.  It is an expensive, unpleasant process, and not without its drawbacks.  It’s important to remember that the baby is not genetically related to the mother.  Some women find that less appealing (to be carrying a child that does not have her DNA).  Moreover, sometimes infertility is a sign of other reproductive problems that can cause issues during a pregnancy and long-term concerns for a child born in this manner.  For this reason, it is extremely important to consult with your OB/GYN before proceeding with such a program.  Many “older” celebrities have become mothers in this fashion.  But, keep in mind, healthy babies come from healthy mothers, so one should consider all other options before traveling down this path to motherhood.

You can read more about infertility in the chapter, “I’m not pregnant—and I want to be” in my health book, “INSIDE INFORMATION FOR WOMEN”.


– Yvonne S. Thornton, M. D., M. P. H.


Lung Cancer in Women is on the Rise in the South

Monday, July 9th, 2012

Have you seen an anti-smoking ad recently?  Odds are, you probably have not, and if you have seen them, there most likely haven’t been many.  About twenty years ago, anti-smoking campaigns were extremely prevalent due to the high numbers of lung cancer deaths related to the habit.  As a result, both smoking and lung cancer have declined significantly.  At least, they’ve declined in most places around the US.  Unfortunately, statistics are now showing that in the south and some parts of the Midwest, lung cancer among women is once again on the rise.

According to the Journal of Clinical Oncology, the risk of dying from lung cancer was highest in women born in the 1930s, but that rate dropped in the following decades.  Among the baby boomer generation, that rate has dropped further or remained low, except for in southern and Midwestern states.  For example, in Alabama, lung cancer deaths increased from 6.9% to 10.7% as opposed to rates in California which fell from 6.1% to 2.8%.  These statistics came about after a 23 state comparison meant to find out the current rates of lung cancer in connection to smoking.  There is much speculation as to the causes of these differences which appear to be regional issues.  Some experts believe it is due to a letting up of anti-smoking campaigns and strategies like cigarette taxation.  Others though, feel that a study on the availability and cost of health care for lung cancer treatment in those areas is needed to determine if that may be the actual cause.

No matter the reason for these regional differences, there is obviously still a significant amount of the population who are smokers and who ignore the warnings about the harmful effects of such a habit.  It’s likely to take both an improvement in the medical care available in those areas as well as an anti-smoking campaign as aggressive as California’s to make any kind of difference.  In the meantime, it’s up to parents like us to continue to warn our children to stay away from tobacco products.


– Yvonne S. Thornton, M. D., M. P. H.



Stressing Out Trumps Family Nutrition

Thursday, July 5th, 2012

Let’s face it.  Whether you’ve been at work all day dealing with stress, or are like many who are stressed because of their daily unsuccessful job hunts, the last thing you want to do is come home and cook a big, balanced meal for your family.  Researchers have found that this is becoming more of a problem as more Americans are either out of work or feeling increased pressure from their jobs.  This means that the stress of parents is now affecting the nutrition and health of their children.

According to a study published in the Journal of Science and Medicine, parents with high stress levels were more likely to serve fast food, unbalanced meals, and less fruits and vegetables each day.  Although their study included people who were unemployed and had more time to cook for their families, stress still played a bigger role.  Whether parents were stressed out because of work or lack of it, their teens received less nutritional meals.  The study compared the meals of 3700 parents with teens in the Midwest, about half of which, were unemployed.  Professor of Nutrition Science and Policy at Tufts University in Boston, Dr. Alice Lichtenstein, says that “work stress can affect many areas of daily life, including meal times and quality.”  In most families, it was the mother who did most of the meal prep, despite employment.   Lichtenstein suggests helping each other to lighten the load by sharing kitchen and cooking duties with any able family member.  Perhaps this would help stressed out parents increase the amount of balanced family meals they provide each week from the average of 4 to 7.

When you are raising a family, there is certainly a lot of stress to deal with, and nobody should have to bare that burden alone.  Whether that means being open and honest about the family’s financial situation and day-to-day stresses or simply sharing chores around the home, the purpose of family is to share life, not to be the burden of it.  So if you know your partner could use some support, be sure to give it freely, and if you are the one taking on the majority of the work and stress load, don’t be afraid to ask for help.  Both your and your family’s nutrition and overall health could depend on it.


– Yvonne S. Thornton, M. D., M. P. H.



Congress Upholds the Health of Americans

Monday, July 2nd, 2012

When Obama was elected president, most of America was anticipating his universal healthcare plan.  When the actual implementation of that plan looked as though it would be blocked though, many worried that he would be unable to deliver on his promise.  Luckily, Congress decided to uphold most of what has become known as “Obamacare,” and Americans in desperate need of affordable healthcare are celebrating.

According to the US Census of 2010, 49.9 million Americans were without healthcare and that number was on the rise.  Experts say this is in part due to the rise in unemployment and poverty, but also the weak economy causing businesses to cut back on expenses.  By 2014 though, all that will change.  Because the Supreme Court decided that Obamacare is indeed constitutional, more than 300,000 children who have pre-existing conditions will now find health insurance coverage.  That means that being sick will no longer prevent them or anyone else from getting the care they need to treat their sickness.  Additionally, kids will be able to remain on their parent’s health insurance plan until they turn 26, saving families a lot more money in the long run since they won’t have to pay for separate care.  Preventative healthcare benefits like mammograms will also be covered without copays, hopefully encouraging more people to take these precautions to catch issues before they became bigger and more expensive health concerns.

Although some find these new requirements to be a problem for small and growing businesses, businesses with wages less than 50,000 a year will actually receive tax credits for providing coverage.  Otherwise, these benefits will be paid for by increased taxes on Medicare Payroll for couples making more than $250,000 a year, unearned income like capital gains, and added fees for insurance companies, pharmaceutical companies and medical device manufacturers to name a few.  And to prevent those companies from simply upping their premiums, they will need to be more transparent about their costs and justify any “unreasonably” large healthcare premium increases.

Obviously not everyone is happy about the recent ruling, but as healthcare improves, I think all Americans will appreciate the improved health of our nation in the coming years.  Personally, both as a mother and a physician, I am thankful that the Supreme Court has finally ruled on behalf of the people.


– Yvonne S. Thornton, M. D., M. P. H.