The Risk of Cellulitis and Infections After Hysterectomies

Written by yvonnethornton on June 3rd, 2013

There is no doubt that a hysterectomy can be a traumatic experience for women. In fact, it is one of the most invasive surgeries that most women will face over the course of their lives. The immediate effects of a hysterectomy are far reaching.  The psychological effects of a hysterectomy can be devastating. Even women who do not plan on having any more children may experience difficulty coping with this kind of surgery.

Unfortunately, there are other risks associated with hysterectomies, and these risks can make it even more frightening for some women who are facing the surgery. Cellulitis and SSIs (surgical site infections), can cause complications after surgery for women. These issues can delay healing time, and can lead to other psychological effects as women cope with the cellulitis or SSI in addition to the effects of the surgery.

Many women may want to know if they are at risk for these kinds of issues after surgery. There are in fact multiple risk factors, as this study shows, which can include pulmonary disease, obesity, and even the lack of private insurance.  This may be concerning for some women as they go into their surgery.  Even the operating room environment in this study played a major role in whether a patient develops cellulitis (inflammation just below the skin) and a wound infection in the hospital (nosocomial).  One of my pet peeves is the wearing of O. R. scrubs as a fashion statement.  O. R. scrub attire was designed to decrease the possibility of outside contamination and not bringing it into the Operating Room.  Yet, today, you see doctors and O. R. personnel  (as well as the housekeeping personnel) wearing their “scrubs” to the food trucks outside of the hospital, wearing them home, walking and running in the street, sleeping in them.  All the while knowing that these filthy O. R. scrubs are vectors for disease and infection.  But, because everyone today is more casual, the patient has to suffer with a nosocomial infection (an infection contracted from the hospital) and needs to be treated with antibiotics or in some instances pay the ultimate price of an overwhelming, untreatable infection (such as MRSA) because someone was too lazy to change their O. R. scrubs before leaving the hospital.  Dr. Oz and other TV reality show doctors have set this unfortunate precedent by wearing their scrubs on TV, as if to make a statement that they are “real” doctors.  “Real” surgeons do not wear their scrub attire outside of the operating room, unless they are covered up with a buttoned, long, white coat.  So, the next time you see your doctor wearing scrubs outside of the Operating Room, you should call them on it.

Fortunately, the study also shows that certain precautions, such as pre-operative showers, antibiotic prophylaxis and better surgical techniques and a better operating room environment (personnel and instrumentation) can help prevent SSIs and cellulitis. It is important to figure out new ways to speed up the healing process in order to help women who have had these surgeries move on as quickly as possible—for many women, this will be one of the most traumatic experiences that they will ever go through.

– Yvonne S. Thornton, M. D., M. P. H.

 

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Better Knowledge of Symptoms Leads Gynecological Cancer Survivors to Seek Treatment

Written by yvonnethornton on May 30th, 2013

Though your doctor can provide much in the way of education about your health, the burden of determining whether or not a symptom is in need of treatment or diagnosis can fall into the hands of the patient. However, this can be a catch-22—self-diagnosis via Internet message boards and medical sites can be just as detrimental to a woman’s health as ignoring her symptoms completely, especially if she makes her own decisions about her care or treatment without consulting with her doctor. This leads to a problem that many doctors are finding it difficult to solve.

We want patients to be informed about their bodies and their health; however, we don’t want our patients to think that self-diagnosis is the way to go when it comes to caring for their bodies long-term. It is important to consider how women use message boards and medical websites to supplement their own understanding about their health. One study done on women in Japan showed that gynecological cancer survivors were more likely to seek treatment after searching online and connecting with others who had those same symptoms.

This proves that the Internet can be a great tool for assessing whether or not a symptom is normal—after all, it can be easy to dismiss something as natural without taking into account that it very well may not be. What seems to be a minor issue can easily be a symptom of something much greater. When women use the technology at their disposal to educate themselves about their health and use that education to open a dialogue with their doctor about whether or not they are in need of diagnostics or treatment, they are taking a proactive step toward bettering their health. Every woman should be aware of the importance of educating themselves about their bodies—but it is just as important that women realize self-diagnosis can be dangerous. Part of educating yourself is understanding that you are learning to communicate with your doctor, and aren’t trying to play “doctor” yourself.

– Yvonne S. Thornton, M. D., M. P. H.

 

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Even External Products Can Pose Risk to Expectant Mothers

Written by yvonnethornton on May 27th, 2013

As an expectant mother, women will hear any number of dos and don’ts. Being pregnant forces women to learn an entirely new way to treat their body, as certain chemicals can cause a great deal of harm to developing fetuses. It is likely that almost all pregnant women know the risks of drugs, alcohol, and tobacco, and a great deal will choose not to drink heavily sugary or caffeinated drinks for the duration of their pregnancies in order to prevent potential damage due to changes in their bodies from these products.

However, many patients still do not understand the importance of monitoring the products that they use externally. Chemicals can just as easily be absorbed through the skin, and can cause as much damage as if they were ingested. This is why women who are pregnant are asked not to dye their hair or to expose themselves to other chemicals until their child is born. For evidence of how easily chemicals can enter into the body, look at this case study in which a pregnant woman was found to be host to considerable amounts of mercury due to a face cream she had purchased in Mexico.

Though that list of dos and don’ts can seem pretty exhausting, there is one easy rule-of-thumb that expectant mother’s can use when it comes to the products that they choose to use during their pregnancy. When it doubt, it is always better to be safe than sorry. Put that food or that product aside if you are uncertain about it and talk to your doctor. He or she will be more than happy to help you decide whether or not the product that you are using is safe for you and your baby. The harmful effects of some chemicals to the body far outweigh the benefits of soft skin or the perfect hair color.

– Yvonne S. Thornton, M. D., M. P. H.

 

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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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