General health news

...now browsing by category

 

Have We Stopped the AIDS Virus in Its Tracks?

Thursday, June 21st, 2012

Although we haven’t heard as much about the AIDS virus lately, that doesn’t mean it has stopped its deadly spread.  Researchers have been working feverishly for years now to come up with a cure or a treatment that could stop the virus and save lives.  For some, expensive treatments seemed to work, keeping the virus at bay for years, but for those living in poverty, treatments like that were only a dream.  Now though, new antiretroviral treatment has been developed at a price that will make it available to even low income people with HIV.

Currently, there are 56,000 Americans infected with AIDS every year and more than 30 million living with it worldwide.  In Africa, where poverty and AIDS are prevalent, a study of 500 HIV-infected women found that Nevapirine, a new and much cheaper treatment, was just as effective at slowing the virus as more expensive medicines like  Lopinavir and Ritonavir.  However, the newer, less expensive drug had 14% of its users stop treatment because of adverse side effects and toxicity.  Also, there was more drug resistance with Nevapirine compared to the more expensive medications.  With that said, nevaprine is an effective, affordable first-line alternative for the treatment of HIV. There are now even more drugs reaching the final testing stages and getting FDA approval that are effective enough to decrease the levels of the AIDS virus to undetectable levels in about 80% of their trial participants.  Recent discoveries of the delta-32 mutation to the gene that encodes CCR5 were found to block HIV receptors, rendering it incapable of multiplying.  Researchers have now found a way to mimic this mutation and, in a sense, cure patients with the use of their small molecule drug called Maraviroc.  Maraviroc (brand name, Selzentry) was approved in 2007 as an antiretroviral drug in the CCR5 receptor antagonist class used in the treatment of HIV infection and is now being tested for its safety and efficacy. More and more drugs are being developed with this break-through in mind.  Once each one has been approved for public consumption, many others will be able to create even less expensive options and get the drugs to the areas where they are needed most.

This flurry of discovery, innovation, and resourcefulness has made the AIDS epidemic suddenly much more manageable.  Although we haven’t quite taken the last step to stop all 2 million AIDS deaths each year, it seems we are on the cusp of putting this virus behind us.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Get inside Women’s Issues Live Every Thursday

Monday, June 11th, 2012

Since becoming a physician, I have felt the increasing urge to educate women concerning the issues they face every day, whether in regards to their health, raising children, or even trying to balance a successful career with everything else women face today.  It started with my book, The Ditchdigger’s Daughters, in which I shared my experiences growing up in a family headed by a determined father who encouraged his daughters to be ambitious and independent, despite the racial prejudices of the times.  I then went on to publish two more books, Inside Information for Women and Something to Prove, hoping to help women understand just how much they can do and to inspire them to persevere.

Finding great satisfaction in writing those books, I decided to continue writing for women through this blog, Paging Dr. Thornton.  Still feeling that I had more to share though, I decided to get even more personal by creating my own radio show.  Like the book, my radio show, Inside Information for Women, will address issues that affect women and their loved ones.  At 1pm ET every Thursday, I will speak live, that’s right live, to discuss women’s health and other topics.  I will even get the chance to respond directly to audience questions when they call in during the live show at 1-800-962-1160.  Of course, if you miss it, you can still go to my On the Air page on my website where the most recent installment will be available for playback.

I am excited to find yet another medium to share my knowledge and experiences both as a physician and as a wife and mother.  I’m particularly excited to start a conversation with my audience to address issues they feel are immediately important to them.  Please join me this Thursday at 1pm ET for the next installment of Inside Information for Women.  I look forward to speaking with you soon.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

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.

Women Are Enduring More and So Are Their Hearts

Thursday, May 3rd, 2012

There was a time, when women stayed home to care for the children, did not vote, and did not make money of their own.  Luckily, we’ve since achieved a sense of equality as citizens.  Unfortunately, that equality has not come without a price.  As modern day women, we work just as hard as men, but on average, still earn less.  We parent just as much as men, and often as not, more because it is ingrained in us to try and be that Hallmark mom, but still must bear the burden of pregnancy.  We deal with the emotional, physical, and economic stresses just as much as men, but now, studies show that our hearts do not get as much help during these stressful times.

Researchers at Penn State conducted a study to find out how the heart and blood pressure of men and women differed when presented with mental stress.  All subjects were given the same problems and were monitored carefully to see how they dealt with the pressure.  The hearts of both men and women started working harder as the stress mounted, as was expected.  The amount of blood flow to the heart increased in men in order to make up for the extra work, but it did not increase in women.  This was a surprising discovery.  Professor Chester Ray, who led the study, believes this “shows women may be more susceptible to experiencing a cardiac event with mental stress compared to men.”  With heart attacks being much more common in women than in men, their results are helping doctors understand why.  Hopefully, these findings will encourage more women to seek a doctor’s advice when they feel stress that seems to be affecting their heart.

What does this boil down to? It boils down to the fact that women need to begin to realize that they need to demand the help that they deserve and need. We simply cannot be everything to everyone all of the time. We need to set priorities, and stick to them. My new memoir, “Something to Prove” chronicles my life as a woman who balances career, home and family; hopefully serving as a roadmap for other adventurous women.  Different times in our lives call for different priorities. Being a harried mother may be just as stressful as meeting an office deadline or being the sole caretaker of infirm parents or performing difficult surgery.  We are not superwomen, though if you look at what a majority of women accomplish on a day-to-day basis, we might as well be; even without the additional pressure that put on ourselves trying to “do it all”. All women who have children have one job, if she works outside the home, then she has two jobs, and if you are also cook, cleaner, and overall the “go-to” person, you might just have three jobs. And this is considered normal… It’s no wonder women are stressed.   

Although psychological studies have shown that women feel they are “expected to possess many diverse traits and behaviors, such as being both competitive and nurturing, compliant and assertive, and to appear in control without any signs of vulnerability,” they need to realize these expectations contradict themselves and are simply not realistic.  If your lifestyle has caused you to deal with inordinate amounts of stress, your mental, emotional, and physical health will suffer if you don’t make a change.  A study at the Chinese University of Hong Kong found that women who had more satisfying jobs and home lives were less likely to develop as much mental stress, even though they had the same amount of responsibilities as others.  I love ballroom dancing and I twirl around the dance floor each week with a cha-cha or tango in order to de-stress and have a creative outlet.  In other words, find something that you love doing and it won’t take quite as much of a toll on your health.  With this in mind, you can still be a modern day woman and take on numerous responsibilities, but you shouldn’t be afraid to ask for help when you need it.  As a physician, author, wife, and mother, I know that finding this balance can be difficult, but your heart is worth it.

— Yvonne S. Thornton, M. D., M. P. H.

Childhood Obesity Speeds the Onset of Puberty in Girls

Tuesday, April 24th, 2012

When I was young, even though my Dad wanted to “plump up” me and my sisters so that we would be less attractive to boys, for the most part, sitting down at the family table meant eating a well-balanced meal and reconnecting with each other after a busy day.  This time wasn’t just important for the bonding opportunity it provided, but for the proper nutrition it allowed my sisters and I to receive.  It was there that we learned what a balanced diet was and to appreciate the food we had.  Snacking throughout the day was a privilege and eating snacks between meals was a luxury a poor person could ill afford. Unfortunately now days, it seems that many parents don’t have time for traditional dinners or are unwilling to make time for time them.  Snacks are cheap, ubiquitous and filled with carbohydrates. With so many people reaching for the quickest, easiest foods, families are moving to a culture of convenience and their kids are paying the price.

Childhood obesity is on the rise and it’s having effects in some unexpected areas.  Studies are now suggesting that girls who are overweight start menstruation at much younger ages.  The average age of onset of menstruation (menarche) in the late 20th century was between 12.6 to 12.8 years.  Recently, that age has decreased to 12.43 years.   It has been argued that girls need to reach a critical weight (47.8 Kg) to initiate pubertal changes; it is more likely that what is needed is a shift of body composition, with an increase in the percentage of body fat. The percentage of body fat in children (16%) needs to rise to 23.5% to initiate puberty.  A 2011 study found that each 1 kg/m2 increase in childhood body-mass index (BMI) can be expected to result in a 6.5% higher absolute risk of early menarche (before age 12 years).

Normally, once a young woman reaches a particular body mass index, that tells her body she is of childbearing weight.  This starts the menstruation cycle.  If a young girl, say of about eight or nine, is overweight, she will reach this body mass index much sooner, triggering her body to go into early puberty.  While early childhood obesity is itself a problem, early puberty can also lead to a shortened growth span.  Most girls stop growing a few years after starting menstruation.  If they start this too soon, they will also stop growing much earlier than normal.  If childhood obesity continues to increase, the rise in early maturation is likely to follow.  In 1965, about 5% of kids were considered obese in the US.  Obesity in children has increased three-fold over the past 30 years.  In 1980 obesity in children, ages 6-11, was a mere 6.5% but by 2008 it increased to 19.6%.

Today, about 25 million children are either overweight or obese.  Researchers are finding that increases in the number of girls hitting puberty early seems to be in keeping with these obesity statistics.  The First Lady is even promoting a change in our habits that affect childhood obesity.

Although convenient, fattening foods have flooded the markets; there are still plenty of healthy foods out there.  Parents cannot expect their kids to make smart choices about their diets, especially at such young ages.  It’s up to them to teach their children how to eat, so they can grow up to make good choices for themselves and their own families.  There’s something to be said for those traditional sit-down dinners, because they truly benefit the health of our children in more ways than one.

— Yvonne S. Thornton, M. D., M. P. H.

Sources:

http://children.webmd.com/features/obesity

http://www.helium.com/items/1249193-delayed-puberty

 

 

 

No Breastfeeding; No Guilt

Thursday, April 19th, 2012

I was raised in an era when children were fed Karo Syrup and evaporated milk, and nobody gave my mother a guilt-trip for doing so.  As with many low-income families, she spent much of her time working to provide for our family and would not have been able to stay home to breastfeed.  Somehow though, we all grew up to be healthy, happy adults.  In fact, two of my sisters are doctors and the other is a lawyer and Ph. D., so I’d say we turned out pretty well.  The American Academy of Pediatrics (AAP) though, would like moms to believe otherwise.

When an organization like the AAP recommends breastfeeding, new moms are likely to trust in their expertise and follow suit, assuming the organization has conducted years of research and found conclusive results in favor of breastfeeding.  Unfortunately, that just isn’t the case.  That hasn’t stopped them from publishing an executive summary of their recommendations though.

In their most recent Executive Summary on Breastfeeding and the Use of Human Milk, the AAP cited, “a variety of government data sets, including the Centers for Disease Control and Prevention (CDC) National Immunization Survey, the NHANES, and Maternity Practices in Infant Nutrition and Care.”  These studies merely show how many people are breastfeeding in developed countries, not whether or not this has been beneficial for the children involved.

In fact, there has so far only been one scientific study performed and this is where all of their data is coming from.  Also, the study itself admits that, “Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings.”  In other words, they gathered their information from other reports and performed a scientific analysis, but did not do any controlled experiments themselves, so they can’t be certain that the relationship between the health of children and the rate of breastfeeding are actually related.  Even more shocking is the AAP’s blatant disregard for some of the findings in the study.  The AAP Summary reports that, “Adjusted outcomes for intelligence scores and teacher’s ratings are significantly greater in breastfed infants.”  While the study they are citing actually says, “There was no relationship between breastfeeding in term infants and cognitive performance.”  Human breast milk is deficient in iron and Vitamin D; yet, those deficiencies are rarely mentioned when it comes to comparing breastfeeding and formula feeding.  Moreover, the touted immunity conferred to the newborn from breastfeeding has not resulted in better outcomes for breastfed infants.

So why are they so adamant about it?  It turns out; they have spent the past several years urging the Senate to carry out a $15 million campaign to promote breastfeeding at maternity care practices, community-based organizations, and hospitals.  In other words, wherever mothers might be giving birth or receiving pediatric care, their physicians are flooded with propaganda pushing the importance of breastfeeding.  This has led to a lot of pressure on moms who have chosen not to breastfeed, and consequently, a lot of unnecessary guilt.  Mothers have the right to choose the method they feel most comfortable with, and shouldn’t have to feel guilty for that choice.

— Yvonne S. Thornton, M. D., M. P. H.

Sources:

http://www2.aap.org/breastfeeding/files/pdf/Breastfeeding2012ExecSum.pdf

http://www.usbreastfeeding.org/Portals/0/Letters-Comments/2011-03-07-Joint-Letter-BF-Approp.pdf

 

Great Scores Don’t Necessarily Mean Great Doctors

Monday, April 16th, 2012

If you’re planning to go into the medical field like I did, then you’re probably aware of the strict application process most medical schools will put you through.  If you don’t have the right grades or MCAT scores, you might not get into the school of your choice, no matter how badly you want to help people.  Unfortunately, this means top medical schools are letting in bright students who are great test takers, but who can’t take care of patients.

Being a physician is about much more than memorizing information from medical encyclopedias and science classes.  I’ve found that a strong sense of empathy and compassion for others, as well as a generosity of spirit has been crucial to my success in medicine.  It allows me to put myself in my patients’ shoes, which in turn gives me a better sense of what to ask and what to look for.

Many aspiring doctors don’t have the grades to get them into the top schools, but they may have more emotional intelligence than the students who beat them out for those spots.  Eventually, the positions of physicians are filled with very smart people who just don’t seem to take the time or care patients need.  It takes patience to listen to everything a patient has to say and then to dig even deeper.  It’s not about solving a puzzle as fast as possible.  It’s about understanding underlying issues that may not be obvious at first glance and knowing how to uncover them tactfully. It all goes back to bedside manner, which seems to have disappeared in an absurd dichotomy of doctors having the attitude “I know it all and you know nothing”. Doctors must listen to patients. Our patients know their bodies better than their doctors do. After all, patients live in their bodies. We only visit those bodies.

Luckily, after three years of study, the American Medical Association has realized this and is encouraging medical schools to look deeper into their potential students than just their test scores.  As a result, many are adding comprehensive interviews that attempt to find out who the applicant is as a person, not just as a student.  The Association of American Medical Colleges has also announced that it will be changing the scope of the MCAT exam to include more emphasis on psychology, sociology, and biology.  President of the AAMC, Darrell Kirch, said about the changes, “Being a good doctor is about more than scientific knowledge.  It also requires an understanding of people.”  I couldn’t agree more, and I hope this changing philosophy will help bring patients more compassionate and effective doctors.

— Yvonne S. Thornton, M. D., M. P. H.

In came Beyoncé and the security guards. Out went the hospital’s common sense—and common decency.

Friday, January 13th, 2012

As an OB-GYN who has delivered thousands of babies—including several with rich and famous parents—I’m scratching my head over the insanity at Lenox Hill Hospital in New York City surrounding the birth of Beyoncé’s baby.

Here’s a sampling of what went on, according to The New York Times:

The familiar area outside the neonatal unit had been transformed: partitions had been put up, the maternity ward windows were completely covered, and even the hospitals’ security cameras had been taped over with paper. Guards with Secret Service-style earpieces roamed the floor.

“We were told we could walk no further,” Ms. Nash-Coulon said Monday. And when she and her husband, Neil, demanded an explanation, she added, the guard claimed, unconvincingly, “ ‘Well, they’re handling hazardous materials,’ ” even as a large group of people screened from view were passing through the main hallway he had declared off-limits.

Let me make this perfectly clear: The hospital had no right to bar other patients from having free access to their babies.  Worse, from a safety perspective, doctors were prevented from visiting their own patients on rounds, because of this so-called “security.”

Someone in the hospital decided that the celebrity of a hip-hop artist was sufficient to ignore medical necessity and common decency. Not a good message to send to sick people.

Beyond that, I’m alarmed to learn that the baby was born by Cesarean, as so many celebrity babies are today. I could be mistaken, but I doubt that Beyoncé’s OB-GYN warned her of the risks before treating little Blue Ivy’s birth like just another item on the to-do list. The risks are real: a dramatic increase in maternal deaths due to hemorrhage and infection; more babies ending up in the neonatal intensive care units after Cesarean births because of respiratory distress.

If she’d been my patient, I’d have told her what I tell other mothers-to-be: if God wanted women to have Cesareans, he would have put a zipper in the pubic area.

– Yvonne S. Thornton, MD, MPH

Baby’s tastebuds mirror Mom’s food choices?

Wednesday, November 30th, 2011

You’ve probably heard the claim that exposing a baby in the womb to Mozart will increase his or her IQ. Despite the hype, the research doesn’t support major leaps in smarts (but, if nothing else, it might improve your child’s musical taste, later on).

Now, there’s some evidence showing that you may be able to shape a yet-to-be-born child’s taste in food.

“The flavor and odors of what mothers eat show up in the amniotic fluid, which is swallowed by the fetus, and in breast milk. There is evidence that fetal taste buds are mature in utero by 13 to 15 weeks, with taste receptor cells appearing at 16 weeks, according to researchers.

“’With flavor learning, you can train a baby’s palate with repetitive exposure,” said Kim Trout, director of the nurse midwifery/women’s health nurse practitioner program at Georgetown University.

“Trout recently co-authored a paper that reviews the evidence on prenatal flavor learning and its implications for controlling childhood obesity and diabetes, among the country’s most pressing health problems…”

 

Although I’m just as skeptical of this claim as I am about the one for baby-and-Mozart, I see real benefit in giving this a try, whether it makes your baby want broccoli or not. That’s because, in my practice, I see too many women gaining too much weight during pregnancy, which can not only cause complications for mother and baby, but can be almost impossible to shed once your baby is born.

So, bring on the Brussels sprouts, and eschew the Twinkies. Pass by the apple pie and bite into a nice juicy apple instead. Whether it does a thing to change your baby’s mind about what tastes good later in life, it will do a world of good for you both right now.

– Yvonne S. Thornton, MD, MPH

Should you be worried about the blot clot risk with newer birth control pills?

Monday, November 21st, 2011

You might have read the news that YAZ and Yasmin, two newer birth control pills, are riskier to take than older contraceptives due to higher potential for blood clot formation.

But it’s important to put this into perspective. No matter what birth control pill you use, blood clots are a possibility, if an uncommon one. What you might not know is that blood clots are even more common in pregnancy. Fortunately, the vast majority of the millions of women who get pregnant and give birth each year don’t suffer blood clots. Just as millions of women take birth control pills with no such side effects.

So, is there a unique problem with YAZ? Yes, but not the one identified in the headlines. The problem is in the marketing.

YAZ was promoted to women as a pill for bloating and acne in addition to its contraceptive effects. While that might be a good marketing strategy, it’s not a good medical one. Contraceptives are for birth control, and the best one for you, based on your medical history, might have nothing to do with acne. People shouldn’t pick their birth control the way they pick their toothpaste—on the basis of consumer advertising. You should consult your doctor who will look at your history and decide what form of contraception meets your needs. If your family has a history of strokes, blood clots, or thrombophlebitis (a blood clot that causes swelling in a vein), your doctor will almost certainly order advanced testing due to the possibility that any birth control pill—YAZ, Yasmin, or older medicines—might be inappropriate for your condition.

But if your doctor has already determined that YAZ or Yasmin is a safe bet, and you’re on one of these now? Keep taking it unless your doctor says otherwise. The alternative could be unintended pregnancy. And pregnancy, ironically enough, is more likely to cause a blood clot than your birth control pills.

– Yvonne S. Thornton, MD, MPH