Paging Dr. Thornton

Teachers Required to Give Students False Information

Written by yvonnethornton on August 12th, 2013

In a prime example of why parents must stay informed about their children’s school curriculum, North Carolina governor Pat McCrory signed a bill in July requiring that middle school students must be taught that abortion is a preventable cause of preterm births. Incidentally, this comes after McCrory’s promise not to sign any bills regarding abortion, period. But McCrory did not act alone; 73 state senators agreed that it was okay to give students erroneous information in the classroom.

I realize that this is a hot button issue for many, but let’s focus on the real issue here: middle school teachers required by law to lie to students. Is lie too strong a word? Absolutely not, and here’s why: There is no scientific evidence that abortions cause preterm labor. Let me say that again. There is no scientific evidence to support the idea that abortion causes preterm labor. This seems to be just another thinly disguised attempt to limit women’s ability to make choices for their own lives.

Proponents of the bill point to recent studies that show a limited risk of preterm births following abortions, but these studies and the recommendations made based on them are flawed. For one, they did not distinguish between successful medical abortions and those requiring surgery. In addition, they did not distinguish between induced and spontaneous abortions. Furthermore, legislators ignore the fact that the studies showed no increase at all in preterm births after abortions from 2000 onward, a fact probably contributable to modernized abortion methods.

In fact, David Grimes, a North Carolina professor of obstetrics and gynecology, called the bill “state sponsored ideology,” and pointed out that “the World Health Organization, the CDC, the American College of Obstetrics and Gynecologists, the American Academy of Pediatrics… and the American Public Health Association have all concluded that abortion does not cause prematurity.”

So why would these legislators support this bill? Do they have their own agendas, or do they just not understand the facts? Who knows – just do your part by staying informed, thinking for yourself, and getting your facts from the experts, not the politicians. Have a conversation with your middle school kids about this and other sex education topics. Don’t leave it to the schools.

To close, let me be crystal clear on this. This issue has nothing to do with how anyone may feel about abortion. It has only to do with the integrity of our schools’ curriculum being compromised by untruth. Be the voice of accuracy at home. Teach your kids how to find reliable information. You are free to teach your children about your moral beliefs. But at least tell the truth about the facts so that they are free to develop their own morals and form their own conclusions based in reality, not folklore.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Contraception (birth control), Women's health issues | 1 Response »
Tags: abstinence, birth control, health education, sex education, women’s health education

Your Shoes Could Be Hurting Your Health

Written by yvonnethornton on August 8th, 2013

It’s no secret by now that high heels are harmful to your health. You are probably aware that wearing high heels can increase your risk of falling or developing foot, leg, or back problems due to the pressure exerted on various parts of the foot and the misalignment of your ankles, hips, and spine. You probably already know that you should limit high heels to no more than two inches and avoid tight, pointy-toed shoes.

But did you know that your beloved flip-flops are just as bad?

Flip-flops literally expose your feet to a whole host of potential problems. From relatively benign issues like cold feet or stubbed toes to more serious injuries like cuts or broken bones, there are many problems which are completely avoidable by wearing protective and supportive shoes.

As if the potential for injury weren’t enough, researchers now suspect that flip-flops may prevent you from being as fit as you could be. When you wear flip-flops, you are forced to bunch your toes up to hold them on your feet. This prevents your arch from flexing naturally, which alters the way you walk. Think of this as a ripple effect, where you grip your shoes with your toes, which prevents you from flexing your arch, which prevents you from “pushing off” from each step strongly enough, which forces you to compensate with your hips, which puts more stress on your knees. The result is an unnatural gait that does not fully engage all the muscles in your legs and backside that walking should engage.

So think twice before wearing those flip-flops out to run errands or to the office (if you are lucky enough to work in that kind of office!). Flip-flops are great for occasional wear – to the pool or the beach – but not for hours on end, day after day. Your day-to-day shoes should be supportive and ergonomically correct. If you want to wear an open shoe like a sandal, at least make sure it has a strap that wraps around your ankle so that you aren’t tensing those toes up to hold the shoe on.

You should be aware that, with their lack of arch support, ballet flats do not fare much better under scrutiny than flip-flops. Incidentally, research shows no additional benefit from wearing “toning” sneakers; regular walking or running shoes will do just fine for exercise, and any comfortable, well-fitting shoes with good arch support are fine for daily wear.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: bone health, injury prevention, women's health

High Rate of Smoking Relapse After Pregnancy and Delivery

Written by yvonnethornton on August 5th, 2013

It is no secret that smoking can have an incredibly harmful effect on a growing fetus. Smoking during pregnancy can lead to major problems, from fetal deformities to miscarriages and stillbirths. All women are encouraged to quit smoking well before conceiving, and those that do not are encouraged to quit smoking as quickly as possible after discovering that they are pregnant. There are many intervention programs in place to help women who smoke quit during pregnancy. However, there has been a lot of concern in recent years that smoking cessation during pregnancy is not permanent.

Studies have shown that upwards of 48 percent of women who do quit smoking during pregnancy will relapse afterwards, with a sharp increase in relapse occurring up to a point about six months after delivery. Traditional intervention programs designed to help women quit smoking during pregnancy have shown low success rates in helping a woman quit smoking overall.

This is important because the risks of second-hand smoke are still much higher than is safe, especially with the association of second-hand smoke and the development of childhood asthma. Women are encouraged to make every attempt to quit smoking, not only for their own health, but also for the health of their families.

It is becoming increasingly obvious that quitting during pregnancy—when there is a strong motivation to quit—does not have the lasting effects that could be hoped for. Additionally, the stressful time after delivery is often debilitating to a woman’s efforts to remain nicotine-free.

It is strongly suggested that women who quit smoking during pregnancy seek some sort of aid, counseling, or even medical intervention after delivery in order to prevent smoking relapse. There are a number of products and coping strategies available that can help. While it is admirable to want to quit, it may not be wise to attempt to go “cold turkey”, even for women who have gone without a cigarette for up to, or over, nine months.

Women should remember that their lives change in many ways after they deliver a child. The coping strategies a woman develops during pregnancy may not work in the postpartum period, especially without the motivation of being pregnant to prevent smoking relapse. As a woman’s Ob-Gyn will most likely be the doctor a woman sees the most during the postpartum period, they are an incredible resource for helping their patients stay off the cigarettes for good.

I have helped many women quit smoking in my years as a doctor, and with help a good number of those women never smoke again. Women need to take extra steps to quit smoking permanently to ensure both their health and that of their families.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Pregnancy | No Responses »
Tags: postpartum health, Pregnancy, smoking, smoking cessation

Teen Pregnancy May Be Associated With Obesity Risk in Later Life

Written by yvonnethornton on August 1st, 2013

Concern about the increased prevalence in teen pregnancies has raised a lot of questions societally as well as within the medical community. It is no secret that an event such as childbirth can play a large role in a woman’s health, and the potential changes that may take place are increased in a teenager, whose body is still growing and changing throughout adolescence. From very real concerns such as the potential for premature delivery to the psychological effects of becoming a mother at a very young age or giving a child up for adoption, there is much fodder for examination and research.

One study has even suggested that there is a potential association between adolescent pregnancy and obesity later in life. However, it is important to note that this association is still vague at best, and researchers have yet to uncover a cause for this heightened obesity risk. While it is possible that the associations between adolescent pregnancy and obesity is caused by the physiological changes that take place in the female body (and in particular the adolescent female body) during pregnancy, there are also many factors –primarily psychological and sociological—to take into consideration in order to determine the underlying cause of this association. I believe that these young women, obese or not obese, gain so much weight when they are pregnant that obesity is the result of the pregnancy and they cannot lose the weight postpartum, given the additional responsibilities of raising a child.

Demographically speaking, adolescent mothers are more likely to be from a racial minority, to have lived in poverty, or to have attained a lower educational level than many of their peers. Four out of five black women are either overweight or obese. It is highly likely that at least part of the association between adolescent pregnancy and weight gain is due to this “crossover”, as women of these demographics are also those most likely to be classed as overweight or obese. This is part of the difficulty in determining whether or not there are other physiological factors to take into account.

My take on the conclusions of this study and the entire situation of pregnant adolescents and future obesity is that these young women are looking for acceptance and have very low self-esteem. Their feelings are exploited by their male counterparts, who have a biological imperative to be intimate and not be rebuffed. Consequently, sexual intercourse is a form of being “accepted” and “loved”, only to find out later that the girl is pregnant, has gained excessive weight during the pregnancy and is now alone being responsible for a new life. Her old habits (no exercise and cheap fast food) with a low or nonexistent income lead to her obesity and that of her child. Then, it becomes a vicious cycle.

Regardless of the reasons for the prevalence of overweight and obese women among those who were pregnant as teenagers, studies like these highlight the importance of increased contraceptive aid and sexual education among female adolescents. At present, it seems that the primary association between these two groups of women, i.e., those who become pregnant as teenagers and those who are classed as overweight or obese in adulthood, is a lack of education or awareness about their bodies.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Pregnancy | No Responses »
Tags: obesity, Pregnancy, teen pregnancy, women's health

Researchers Suggesting There is No “One-Size-Fits-All” Approach to Breast Screenings

Written by yvonnethornton on July 29th, 2013

Mammograms are universally accepted as the most effective way of screening for breast cancer; however, is this really true? Many women may be surprised to learn that there is more than one method for detecting potentially life-threatening masses in the breasts, and these varying procedures are being used in an increasing number of women in the population. This is not to say that mammograms are not important or valuable as a detection tool in screening for breast cancers – however, in many cases it may not be effective when used alone, and as new screening technologies are developed and become more widespread an increasing number of women will need to work with their doctors to develop a more personalized approach to breast screenings.

According to a new report in the June issue of the American Journal of Medicine, for many years, mammography has been the sole imaging test recommended for breast cancer screening, and remains the only test proven to reduce breast cancer-related mortality. However, the widespread application of mammography in population-based screening remains controversial, owing to decreased sensitivity in women with dense breast tissue, radiation concerns, and a high rate of false-positive studies, leading to excessive breast biopsies. Those who image the breasts are adapting to these challenges with the development of new technologies. Low-dose mammography can reduce radiation risk to the breast. Contrast-enhanced mammography can evaluate blood flow in the breast, similar to MRI. Tomosynthesis produces multiple mammographic slices through the breast, similar to computerized tomography (CT scan), and has significant potential to lower recall rates and increase specificity.

The article goes on to say that both whole-breast ultrasound and MRI have been shown to detect additional cancers in certain high-risk populations and will likely be increasingly used in screening women with dense breasts. MRI studies are very expensive and have a high false positive rate, i.e., they have difficulty in identifying a negative on the image as a true negative (without disease) in the patient. However, a decrease in mortality has not been proven using these modalities. Molecular imaging in the form of BSGI and PEM of the breast is widely available. Positron emission mammography (PEM) and breast-specific gamma imaging (BSGI) use molecular imaging to increase specificity in cancer detection by demonstrating increased metabolic activity. However, due to relatively large whole-body radiation doses (equivalent to 20-30 mammograms), they are not currently suitable for annual screening.

The reason that the same method will not work with every woman is because every woman’s body is different. Variations in the structure of a woman’s breast, the density of her breast tissue, or even the existence of implants may affect the ability of the standard mammogram to fully detect any underlying lumps or irregularities in her breast tissue. Simply put, every woman’s breasts are different, and so too must the screening for every woman be different.

While these advances are encouraging, it is improbable that any of the new technologies will replace mammography for population-based screening programs, because all have significant limitations. Furthermore, given the heterogeneity of the human population, a “perfect” imaging technology for breast cancer screening will likely never be found. However, women who feel as if they have different needs should consult with their doctor and ask whether or not there may be special considerations they should make as a part of screening for cancers. However, ultimately the main thing that older women should do is to continue receiving their mammograms regularly as well as younger women (less than 35 years of age) conducting breast self-examinations on a regular basis within the comfort of their own home. In coming years it is likely that the plan of action for women will begin to change depending on individual women’s needs, but the existence of different technologies is still no substitute for the screening methods that are commonly accepted and readily available.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: Breast cancer, breast cancer screening, breast imaging, mammography, women's health

Talking About Depression With Your Ob-Gyn

Written by yvonnethornton on July 25th, 2013

Depression is one of the most serious and prevalent disorders affecting women in the present day. It is also one of the most underreported disorders affecting women, and the number of those affected by it is increasing every year. Depression affects women of all age ranges and social statuses, and it affects those in poor health as well as those who are seemingly in perfect condition. With depression being so common, and affecting so many, it would seem that Ob-Gyn’s regularly diagnosis this problem in women. However, studies are suggesting that doctors miss a diagnosis of depression in as much as sixty percent of their patients.

Whether the women had a preexisting diagnosis of depression, reported suffering from psychological distress, or simply felt as if they might be depressed, their depression consistently went undiagnosed throughout visits with their Ob-Gyn. The most common signs recognized by doctors included physical manifestations of the disorder, such as weight gains and losses as well as reported insomnia.

Those that did receive a diagnosis were primarily women who were under twelve months postpartum, those under thirty-five years of age, and women who were seeing their Ob-Gyn either to discuss their depression symptoms or as part of a regular checkup. The most common visits in which the depression went unnoticed were visits in which the woman had scheduled an appointment to discuss an existing complaint.

This raises the all-important question—why do so many doctors miss depression diagnoses? There are likely a number of factors, ranging from the feeling of suffers that they are not in need of help to a reluctance to discuss any issues that are not “medical” with a medical practitioner. However, it is important for women to realize that depression is a medical issue, and it is one that can severely impact them throughout their lives—and it can even impact their health directly. Recognize that your mental state is just as important to report as your physical state and, most importantly, persistent feelings of sadness, loneliness, and lack of interest in one’s life are not feelings that must simply be “dealt with”. Your doctor can help.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: depression, postpartum depression, psychology, women's health

Use of Decongestants During Pregnancy May Be Linked to Birth Defects

Written by yvonnethornton on July 22nd, 2013

Women have a long checklist list of products to avoid during pregnancy, from alcohol and caffeine to more serious chemicals that can seriously affect fetal development. However, the effects of certain medicines and other products have largely been unknown. One of the more common medications that women ask if they can use during pregnancy is the simple decongestant—something which most people take for granted. For a woman who is already suffering the discomfort of pregnancy, the idea of asking her to shoulder the burden of a stuffy nose and sinus pressure may seem a little harsh. However, new studies are suggesting that decongestants taken in the first-trimest of pregnancy may be a major item on the “to avoid” checklist, as they have been linked to birth defects.

The decongestants that researchers focused on in the study included both oral and nasal remedies. While the correlations between certain types of decongestants and potential birth defects still requires further investigation, this finding presents and opportunity to discuss one of the more important aspects of obstetric medicine. The simple fact of the matter is that there is no way to know all of the potential risks a woman faces during pregnancy. Some women may not even know they are pregnant when taking these over-the-counter decongestants. Therefore, any woman in the childbearing years who is not using effective contraception should think twice about relieving symptoms of an annoying stuffy nose as a trade-off for increasing the risk of a child with birth defects.

While research has come a long way in identifying major risk factors, a number of other risk factors are still unknowns. This is even more so the case as new products are released into the market, new chemicals make their way onto store shelves, and ultimately pregnant women are exposed to an increasingly wider range of products during pregnancy. It is also a good reminder of the importance a woman should place on responsible behaviors during pregnancy, which include rethinking her normal habits and routines and consulting with a medical professional before taking any medication—even ones that seem fairly mild or harmless.

I hesitate to call women who take these products irresponsible or negligent—after all, not everyone is a doctor and not everybody has the access to medical information that can tell her at a glance what is and is not safe. That is why part of a responsible pregnancy is not only knowing to avoid certain products and materials, but is developing a good relationship with the medical professional in charge of one’s healthcare during pregnancy.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy | No Responses »
Tags: birth defects, medication, obstetrics, Pregnancy

Sleep Disruption in Postmenopausal Women

Written by yvonnethornton on July 18th, 2013

Do you experience difficulty sleeping? If so, then you are not alone. More than a third of individuals report that they face some difficulty sleeping that leaves them tired throughout the day, whether that is insomnia, discomfort during sleep, or patterns of sleeping and waking in the middle of the night. An individual might have difficulty sleeping for any number of reasons, whether it is simply the fact that they are too busy to get the rest that they need or whether it is the result of some more severe issue related to emotional distress or anxiety. However, a new study suggests that sleep difficulties might be heightened in postmenopausal women. A person should receive between 7^1/2and 8 hours of uninterrupted sleep a day.

In this study, both premenopausal women and postmenopausal women were asked to keep a diary tracking their typical sleep patterns across a two-week period. The results showed that postmenopausal women did show a lessened ability to get the recommended amount of sleep throughout the night. When compared to these women’s workday and leisure day schedules, it also showed that postmenopausal women were more likely to lose sleep related to the stresses of their workday. Consequently, postmenopausal women had less than 7 hours of sleep compared to their premenopausal counterparts who slept about seven and one-half hours.

It can be easy to brush off studies like these, or to think that you’ll simply make up the sleep later if you are one of those that regularly experiences sleep problems. However, there is more than enough evidence available to suggest that losing sleep could lead toward much bigger problems down the line. Despite the potential risks of going without sleep, insomnia and related issues are still one of the most underreported medical problems that many people, and especially women, face. Be sure that if you are experiencing sleep difficulties, you speak to your doctor about them—especially if these sleep difficulties are concurrent with any other life changes, whether they are medical or emotional.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Hormone replacement therapy, Menopause | No Responses »
Tags: insomnia, Menopause, Sleep, women's health

Preterm Delivery May Help Identify Risks for Cardiovascular Health

Written by yvonnethornton on July 15th, 2013

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, General health news | No Responses »
Tags: insomnia, Menopause, Sleep, women's health

Further Proof that What You Drink Can Affect Your Urinary Health

Written by yvonnethornton on July 11th, 2013

Urinary health is a bit of a tricky subject for some women to discuss, but it can be one of the biggest issues that many women face throughout their lives. Most women will endure issues such as Urinary Tract Infections (UTIs) or urinary incontinence at some point during their lives, and it is important for women to have a healthy dialogue with their doctor about the ways that they can prevent and treat problems such as UTIs when they occur.

There has long been a consensus among doctors that the amount of fluid intake that a woman has day-to-day, can affect the healthy of her bladder, kidneys, and urinary tract. One of the most important things that a woman can do to maintain her health is to be certain that she is drinking the recommended amount of water throughout the day. However, a new study is showing that the types of fluids a woman takes into her body plays as important of a role in preventing and treating UTIs as the amount of fluid that she drinks.

Caffeine and drinks high in sugar such as sodas are one of the biggest risk factors for both men and women for experiencing urgency symptoms and UTI symptoms. This is in addition to the elevated risks of obesity and diabetes that come with drinking sugary sodas. On the other hand, certain types of fruit juices such as orange and grapefruit may reduce the symptoms of UTIs. In this observational study, the ingestion of citrus juices had a weak link for significance regarding an actual improvement in lower urinary tract infections or the prevention of a urinary tract infections. Citrus juice ingestion showed more promise in men compared to women. Recent studies have also debunked the idea of drinking cranberry juice to prevent urinary tract infections. The best way to reduce the risk of urinary tract infections is to drink more water and refrain from sexual intercourse. Simple advice, but difficult to follow.

None of this is surprising news for doctors, many of whom have been recommending that women with a history of UTIs avoid caffeinated drinks and sodas, while increasing their water intake, for years. What is probably more surprising is the number of women who still do not know about the effects that caffeine and sugar consumption can have not just on their weight, but on other aspects of their health. This is a clear indicator that more women need to be open about any UTI problems that they may be experiencing so that they can have an open and honest discussion with their doctor about their urinary health. There is nothing to be shy about in this case, especially when such simple measures can be taken to ensure your health.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: obesity, urinary health, UTIs, women's health