Thank you, Susan B. Anthony

Written by yvonnethornton on August 18th, 2010

It’s difficult to imagine a time when women weren’t allowed to vote, especially now when the Supreme Court of the United States has, for the first time ever, three sitting women justices.

But it was just 90 years ago that the Susan B. Anthony Amendment was ratified, 14 years after her death, upon being passed by Tennessee on August 18, 1920, the last of the 36 states that were required to affirm it before it could become a part of the U.S. constitution.

The 19th was a simple amendment, the key part of which read:

“The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of sex.”

Women’s full equality has taken a bit longer to achieve. But we never would have gotten this far, this soon, if suffragist, civil rights activist, and labor reformer Susan B. Anthony hadn’t first convinced a congressman to propose the amendment, giving women the right to vote, back in 1878.

So, here’s to you, Susan B. Anthony, and here’s to all the women who have followed their dreams, and succeeded in ways that might not have been possible without you. We’ve come a long way.

– Yvonne S. Thornton, MD MPH

 

The new, several-mornings-after pill

Written by yvonnethornton on August 16th, 2010

The FDA has just approved an emergency contraceptive that can prevent pregnancy if taken up to five days after intercourse.

The new drug, ulipristal acetate (ella), will be available by prescription only, unlike the so-called “morning-after pill,” levonorgestrel, which can be bought over-the-counter.

While ella is not the first emergency contraceptive to be approved, it gives women a wider window of opportunity to prevent pregnancy than previous emergency contraceptives such as levonorgestrel, which must be taken within 72 hours to be effective.

Although it’s been used in Europe for the past year, ella won’t be available here in the U.S. for another two to three months. And there are still risks and side-effects associated with it, as with all drugs. Still, the introduction of a new emergency alternative is good news for women and their doctors, in preventing unintended pregnancy.

– Yvonne S. Thornton, MD. MPH

 

Obesity and early puberty

Written by yvonnethornton on July 31st, 2010

A new study confirms what earlier studies have found: girls who are obese begin puberty earlier.

With childhood obesity approaching an epidemic, early puberty is becoming more common. There appears to be a critical weight for girls, above which the body starts its journey to womanhood with thelarche (breast buds), pubarche (pubic and axillary hair) and finally, menarche (onset of menses).   So, in general, the heavier a young girl is, the earlier the onset of her secondary sexual characteristics.

While we don’t know all the possible consequences of early puberty, we know that puberty is a time of emotional turmoil. For a younger child, that’s going to be more difficult.

We also know that youngsters have a great need to feel like they fit in and the combination of obesity and early puberty can punch a hole in a young girl’s self-esteem.

So, watch the eating habits of your whole family, and help your children make good choices –  just as you make healthier choices for yourself. As I’ve said before, when it comes to battling the bulge, I’ve been there, so I know it’s a struggle. But maintaining a healthy weight is essential, for everyone.

– Yvonne S. Thornton, MD, MPH

 

Dance Your Way to Fitness?

Written by yvonnethornton on July 22nd, 2010

I read a press release the other day from the University of Illinois at Chicago where researcher David Marquez is conducting a study. He plans to get older Latinos out on the dance floor to determine whether doing the mambo, merengue and cha-cha-cha will help them stay fit, and perhaps avoid obesity, diabetes and other ills of a sedentary lifestyle.

While the results won’t yet be in for a while, I whole-heartedly endorse the premise. A number of years ago, I had gained a lot of weight, was overworked and was getting little exercise. Then I signed up for ballroom dancing classes. Not only did I have a blast (winning a dance contest along the way), but I whittled down my waistline while doing it.  Other studies have shown that ballroom dancing can also benefit your mental fitness and decrease your risk of developing Alzheimer’s disease.

So, if you’re bored with exercise machines, and if jogging just isn’t your thing, put on your dancing shoes and go. Unless your doctor advises against physically challenging activity, I can’t think of a better, more fun-filled fitness routine.

See you on the dance floor.

– Yvonne S. Thornton, MD, MPH

 

Overweight or Obese? Don’t Count On Your Birth Control Pills.

Written by yvonnethornton on July 14th, 2010

Since the pill first appeared on the scene, about 50 years ago, women have felt secure knowing that they had an almost foolproof way to avoid unwanted pregnancies. And that’s been mostly true.

But maybe not for all women.

If you’re overweight or obese, recent studies suggest that birth control pills might not be as effective for you as they are for more slender women:

“In one study of oral contraceptive pills, women with a body mass index (BMI) in the overweight range (a BMI of 25 or more) had a higher risk of pregnancy that those in the normal weight range. In another study of contraceptive skin patches, higher body weight — not higher BMI — was associated with higher risks of pregnancy.”

In addition to the sobering news about the lessened effectiveness of hormonal birth control, these birth control methods are thought to slightly increase a woman’s risks of heart disease, high blood pressure and other conditions. When you consider that overweight and obese women are already at increased risk of heart disease, diabetes and other ills, and that pregnancy is a riskier venture, overall, for obese women and their babies, you have a new incentive for getting your weight down.

I know it isn’t easy. I’ve struggled with weight myself and can attest to the fact that it’s a constant battle. But it’s a battle we must fight – and win. And now, we have one more reason to do it.

– Yvonne S. Thornton, MD, MPH

 

Pre-existing condition? No longer a problem.

Written by yvonnethornton on July 9th, 2010

After all the hoopla, once healthcare reform was signed into law earlier this year, it didn’t immediately seem like much had changed. Most of the provisions of the new healthcare bill aren’t slated to take effect for a few years yet.

But there’s one provision, an all-important one for people who have been denied health insurance in the past, that could be a lifesaver.

And it takes effect this summer.

You can now get health insurance – good comprehensive coverage – if you’ve previously been turned down due to a pre-existing condition. Your new insurance will cover that pre-existing condition along with your other medical needs. Perhaps best of all, according to law, the premiums for this insurance must be affordable. You should pay about what anyone else your age pays, regardless of health.

Depending on the state where you live, the insurance plan will either be run by the state or federal government. Go here to find out about how to apply in your state.

So, if you have been denied insurance, or denied insurance for your pre-existing condition, and have been without any health insurance for six months or more, this is for you.

Take advantage. And here’s to your good health.

– Yvonne S. Thornton, MD, MPH

 

The Ditchdigger’s Daughters on BET on July 11

Written by yvonnethornton on July 9th, 2010

The Ditchdigger’s Daughters movie is scheduled to be re-broadcast this Sunday, July 11th at 5:30 pm (EDT), on BET.  Get your TIVO out, if you haven’t seen it before.

– Yvonne S. Thornton, MD, MPH

 

Ready to Deliver and Morbidly Obese: One of My Most Challenging Cases

Written by yvonnethornton on June 23rd, 2010

A recent article in The New York Times talked about how the obesity epidemic is affecting pregnant women and their babies:

About one in five women are obese when they become pregnant, meaning they have a body mass index of at least 30, as would a 5-foot-5 woman weighing 180 pounds, according to researchers with the federal Centers for Disease Control and Prevention. And medical evidence suggests that obesity might be contributing to record-high rates of Caesarean sections and leading to more birth defects and deaths for mothers and babies.

New York City’s health department reported last Friday that half of the 161 women who died because of a problem with their pregnancy between 2001 and 2005 were obese. Black women were hit hardest, with a mortality rate seven times that of white women. While deaths are extremely rare in pregnancy, the city’s rate of 23.1 per every 100,000 births is twice the national average.

My new book, SOMETHING TO PROVE, is a personal memoir first, but because I’m a maternal-fetal medicine specialist and a surgeon, it also details a number of gripping moments in the operating room.

One of my most challenging cases involved a pregnant patient transferred to my care. When I walked into my new patient’s hospital room, I discovered she weighed more than 500 pounds and her baby was showing signs of distress on the fetal monitor.  The patient needed to be delivered. Let me give you a sense of the challenge with a brief excerpt:

…Many surgeons would begin their cut above her navel in an attempt to avoid that enormous layer of fat, while trying to find the uterus to get the baby out. …The area above the pubis, even in a morbidly obese woman, is usually flat and firm. Instead of a vertical incision from the navel down, I’d lift up the apron of fat and do a horizontal incision just above the pubis. That would allow me to get into the uterus and get the baby out. …We taped her massive belly to her chest, swabbed her with an antiseptic solution, and I went in. I was able to perform the cesarean quickly, without incident or excessive bleeding, and delivered the baby in only a few minutes.

The surgeon who handled the case recounted in The New York Times decided to cut through all the mother’s layers of fat, rather than using my technique of retracting and taping the massive layers of fat, which a colleague dubbed the “Thornton suspenders.” While there might have been excellent reasons for the physician’s decision, I hope more obstetricians learn to use the “Thornton suspenders” for such difficult deliveries in obese moms. Because, as the Times article explains:

… where every minute counted, it took four or five minutes, rather than the usual one or two, to pull out a 1-pound 11-ounce baby boy.

– Yvonne S. Thornton, MD, MPH

 

My New Memoir – “Something To Prove” – Is Now Listed On Amazon.com

Written by yvonnethornton on June 15th, 2010

It will still be several months before SOMETHING TO PROVE: A Daughter’s Journey to Fulfill a Father’s Legacy (Kaplan 2010), is on the bookstore shelves. My publisher plans a launch in late December. But, I’m thrilled to say that Amazon.com already has it listed in the “Books” section.

Writing this new book was a response, in a way, to the thousand or more letters, emails, and phone calls, I’ve gotten from readers – women and men, grade schoolers and grandparents – who wanted me to know how much THE DITCHDIGGER’S DAUGHTERS inspired them. You asked to know what had occurred after that book ended. The answers are in SOMETHING TO PROVE, which, as the Amazon description says, picks up where THE DITCHDIGGER’S DAUGHTERS left off.

Most important, SOMETHING TO PROVE shows that what was true as I was growing up is still true today: despite bias, despite setbacks, with hard work and determination, we can accomplish whatever we set out to do.

I can’t wait for you to read it (although you will have to wait, for a little while longer, at least). And I look forward to reading your letters and emails after you’ve turned the last page.

– Yvonne S. Thornton, MD, MPH

 

Promising Advances In Treating Breast Cancer

Written by yvonnethornton on June 9th, 2010

As many as 12.7 percent of American women will be diagnosed with breast cancer at some point in their lives, according to the National Cancer Institute. The disease, if caught early, is very survivable. The big questions about treatment have included how aggressively to attack the tumors to keep cancer from recurring.

Two new studies, reported in The New York Times, suggest that a woman’s long-term survival doesn’t necessarily hinge on choosing the most aggressive treatment. And, if that conclusion is confirmed by further studies, it’s very good news, because treatment can come with significant side-effects.


“A new study has found that for certain women getting a lumpectomy, the standard treatment — an operation to remove underarm lymph nodes that can leave them with painfully swollen arms — may not be necessary. Compared with not removing the nodes, the surgery did not prolong survival or prevent recurrence of the cancer.

“And a second study found that a single dose of radiation, delivered directly to the site of the tumor right after a woman has a lumpectomy, was as effective as the six or so weeks of daily radiation treatments that most women now endure.”

Two notes of caution, however. The study on lumpectomy followed patients for five years; the study on radiation followed patients for four years. Breast cancer can recur after five years so we won’t know for sure that less aggressive treatment makes sense unless a longer term follow-up yields similarly promising results. But each study is cause for hope if not yet celebration.

– Yvonne S. Thornton, MD, MPH