4 Quick Zika Virus Facts – Treatment, Testing, How It Spreads, and Prevention

Zika VirusLet’s look at some Zika virus facts:

1. Treatment

At the moment, there are no approved drugs or vaccines for the Zika infection, but scientists are working on a vaccine.  Since the infection itself seems to be mild and short-lived, fluids and Tylenol are mostly recommended.

2. Testing

Testing to determine if you have had the virus is mainly confined to pregnant women and symptomatic travelers who have visited the areas where the virus has spread.  At this time, testing is done at only a state or federal lab and getting results can take weeks.

3. How It Spreads

The Zika virus is spread by the Aedes aegypti mosquito and through sex with an infected partner.  It is important for pregnant women to know the travel history of their sexual partners.

4. Prevention

Preventing mosquito bites is the best way to protect yourself from this virus.  Use the time-tested methods of bug sprays and cover-ups, and eliminate any standing water where mosquitoes can lay eggs.  You should check your window screens and keep the air conditioners on if possible because mosquitoes hate the cold.

-Dr. P

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Where Did This Mysterious Zika Virus Come From?

definition of zikaToday, the Zika virus is on the mind of almost everyone; pictures of the children affected by the virus are seen constantly in the news.  Beginning today, I will try to keep us up to date on the latest information available.

The virus is named after the Zika Forest in Uganda, Africa, where it was first discovered in the late 1940s.  Since then it was not considered to be a major problem because it usually caused mild flu symptoms, which soon passed rather quickly.  Then last year’s reports came from Brazil about a major invasion of the virus.  There were pictures of the many affected newborns that had been infected, and the resulting congenital microcephaly was seen everywhere.

Why is this virus now causing all these problems?  Where has it been the last 60-70 years?  Some experts believe the virus has mutated, and some think it has always been there, but was quietly going unnoticed.

As the summer approaches and the mosquitoes return, the Zika virus will certainly be a concern in the mainland of our country.  Puerto Rico already reported about a 1000 confirmed cases, including approximately 100 pregnant women.  With the travel season upon us, the numbers of our family and friends who will be exposed to the virus is staggering, so being aware of the latest information is paramount in our quest to be safe.

-Dr. P

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What Factors Lead You to Vaginitis?

Vaginitis - Printed Diagnosis with Blurred Text. On Background of Medicaments Composition - Red Pills, Injections and Syringe.

Let us continue our update and review of vaginitis from my last post about this topic.

To better understand why vaginitis occurs, let us look at the vaginal environment.  The lining of the vagina is made of squamous epithelial cells.  These are flat and stratified, which means that there are multiple layers of these calls.  These cells are rich in glycogen – a storage form of glucose.  Remember, glucose is the most important simple sugar, and it is used as a source of energy for all human functions.

The squamous cells are continuously being shed from the lining and the glycogen in these becomes the energy for the lactobacilli that are naturally found in the vagina.  These bacteria convert the glucose into lactic acid, which keeps the vaginal environment in an acidic state, helping to maintain the normal vaginal bacterial flora plus preventing abnormal organisms from growing.

Microscopic view of Trichomonas vaginalis
Trichomonas vaginalis

If you disrupt the normal community of organisms, vaginitis can occur.  There are many factors that can affect this natural environment:

  • Pregnancy
  • Estrogen levels, for example, a menopausal state where estrogen levels are decreased
  • Different phases of the menstrual cycle
  • Sexual activity
  • Sexually transmitted diseases
  • Different medications such as oral contraceptives and antibiotics

-Dr. P

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How to Exercise When Your Routine Is Being Snowed On

HowExSnow57039413 2If you are on a regular walking program as part of your exercise plan, the recent snowstorms may hold you back for a while.  It may be time to revisit your stairs at home or at work to continue staying in shape.

Try to vary your ascent by speed and the number of steps taken.  Before you begin each climb at home, you may want to add stretching and doing a plank or push-ups.  Before your descent, consider 10 jumping jacks.  Also, always remember to speak to your health care provider before beginning any exercise program!

-Dr. P

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What I Learn from the Anti-Aging Medicine Conferences

Last week, Mary Ann and I attended the World Congress on Anti-Aging Medicine in Las Vegas.  This is a meeting we attend annually, and each year we return with new and exciting information.

My focus was again on bio-identical hormone replacement therapy and I am never disappointed with my time spent with the world leaders in this field.  The overall philosophy of this branch of medicine is to help our patients prevent disease and to maintain function throughout their lives, long into old age.

-Dr. P

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What Are the New Breast Cancer Screening Guidelines for Average-Risk Women?

Nurse Assisting Patient Undergoing MammogramThe American Cancer Society (ACS) recently updated their breast cancer screening guidelines for women who are at an average risk of developing the disease.  It was published in the October 20, 2015 issue of JAMA (Journal of the American Medical Society).

Here are the recommendations:

  • Women with an average risk of breast cancer should undergo regular screening mammograms starting at age 45
  • Starting at 40, have annual screenings if the woman desires
  • For women aged 45 to 54, the screenings must be annual
  • For women over 55, mammograms every 2 years or annually if the women desires
  • Screen as long as the overall health of the women is good or if her life expectancy is 10 years or greater
  • For average-risk women at any age, ACS does not recommend clinical breast exams for breast cancer screening

These recommendations have refueled the debate over what are the best guidelines, and these differ from the other major health organizations.  It can be confusing, but I think it opens more discussions between women and their health care providers concerning the best way to screen for breast cancer for each individual.  Please continue to speak to your health care provider about your breast health and come up with a plan best suited for you.

-Dr. P

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New Hope for Women with Ovarian Cancer

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A recent medical article reviewed that the ten year survival rate of patients who were treated for ovarian cancer has been increasing and now may be approaching 30%.  This is an exciting report, and it suggests that the current medical and surgical treatments are starting to have a positive effect on survival rates.

Early diagnosis is still most important when dealing with any cancer and especially ovarian cancer.  Remember to visit your health care provider if you are experiencing increased gastrointestinal bloating or if your “stomach” is just not right.

-Dr. P

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What Could Your Frequent Hot Flashes Indicate?

Mature Woman Experiencing Hot Flush From Menopause
Frequent hot flashes may indicate an increased risk of developing heart disease.

A recent small study of menopausal women with frequent hot flashes may show a relationship between these flashes and an increased chance of developing heart disease. Frequent hot flashes meant that the women experienced these flashes 5-6 times per day.

In the study, changes were seen in the vessels of the cardiovascular system.  This again points to the importance of menopausal women having regular visits with their health care professionals to assess their cardiovascular health!

-Dr. P

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These Missed Signs Could Be Why Women Are More Likely to Die of Heart Disease

Electrocardiogram - Concept of healthcare, heartbeat shown on monitor - pink

The risk of suffering from a heart attack increases for women after going through menopause.  It seems that estrogen is heart protective, and after the menses stops, estrogen production greatly decreases.  Therefore, heart problems become more of a concern.

It is important to remember that more women die of heart disease each year than men.  This may be attributed to the fact that women do not seek medical attention as quickly as men when possible heart concerns develop.  When suffering a heart attack, most men will describe crushing or squeezing chest pain while women will have no chest pain or simply a fullness feeling in the chest.  Many women during a heart attack may complain of dizziness, shortness of breath, nausea, and weakness.woman hugging her husband

Please be alert for a woman’s special signs of a heart attack, and do not delay a trip to the ER.  Your family and close ones need you!

-Dr. P

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Why Are Colonoscopies Crucial for You and When?

I would like to introduce you to my son, Dr. Michael Polcino III!  He is a board certified colorectal surgeon and surgical oncologist.  Today, he is discussing colorectal cancer and indications for a colonoscopy.  Colorectal cancer is the third most commonly diagnosed cancer for both men and women and is the second leading cause of cancer deaths in the U.S.  My son’s website is: colorectalsurgeryoflongisland.com  His blog: colorectalsurgeryoflongisland.com/blog

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Which Medications Should You Avoid During Pregnancy?

medications-342461_640If you are considering pregnancy or are already pregnant, here are a few of the medications you should not be taking:

  • Benzodiazepine sedatives: these are medications used to help anxiety and insomnia; Xanax and Ativan are two of this class
  • Statins: used to decrease cholesterol; Lipitor and Crestor are in this class
  • Non-contraceptive estrogens
  • Warfarin derivatives: anticoagulants (blood thinners)
  • Iodinated glycerol: an expectorant
  • Vitamin A preparations
  • Misoprostol: used to decrease the chance of ulcers when using nonsteroidal anti-inflammatory medications
  • Isotretinoin: for acne; Acutane is in this class

Of course this is not the complete list of medications you should not be taking when you are pregnant or considering a pregnancy.  Always remember to review all of your medications with your health care provider when pregnancy is part of your plans.  If a medication is needed, the safest medication or other form of treatment will be part of that discussion.

-Dr. P

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Why Testing for Thrombophilia Before Using Birth Control Is Important

Raquel Goldstein, RPA-C, MS, is a physician assistant at Dr. Polcino’s office. Today she speaks about thrombophilia’s effect on a woman using birth control. Since about 10% of women will carry thrombophilia, it is important to be informed about this genetic trait and what is recommended if it is identified.

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Are You Prepared for This Summer’s Tiniest Villains?

I was working in my garden, and guess what I discovered yesterday, once again?  I spotted another tick on myself!  Because of this, I thought it would be a great time to discuss ticks all over again – what they do, what you should do if you find one on yourself, and all about Lyme disease.

Are You Prepared for This Summer’s Tiniest Villains-742474_1280Over 30,000 new cases of Lyme disease are diagnosed each summer, and 90% occur in 10 states.  New York is one of those states.  This disease is an infection caused by the bacteria called Borrelia burgdorferi, which enters the body from an infected deer tick’s bite.

While the tick is attached, it begins to suck blood from the victim, and at this time, it regurgitates the bacteria back into the person’s system.  Most of the infections in humans are caused from the bites of immature ticks called nymphs, which are the size of poppy seeds.  The disease can also be transmitted from the bite of an adult deer tick, but because they are larger, they are more likely to be discovered before having time to transmit the disease.

The Infectious Disease Society of America does not recommend antibiotics for everyone who has been bitten by a tick.  If the rash of Lyme disease develops, then antibiotics are advised.

The rash is the easily noticed circular “bull’s eye” target-like rash.  This rash can begin anywhere from 1 to 4 weeks after the bite.  It starts out being the size of a quarter and can widen to 6 to 9 inches as the bacteria spread out.  If your anxiety of developing the disease is great, many doctors will treat you with doxycycline if you do not have an allergy to the medication.

You Found a Tick on Yourself – What Are the Next Steps?

Once you have discovered that a tick is on your body, you remove it with tweezers.  Try to detach it at the base of the tick’s attachment.  If it is removed within 24 to 48 hours, it is unlikely that it has infected you withTick Removal Display Image Lyme disease.  Also, it is important to remember that only 1 in 20 people bitten with an infected tick will develop the disease.  Not every deer tick carries the Borrelia burgdorferi bacteria, with usually 1 in 5 being carriers in high risk areas.

An Alternate Way to Remove Those Ticks!

I recently learned about a different way to help remove a tick.  Take a cotton ball and put liquid soap on it.  Cover the discovered tick with the cotton ball and rub the soap on the tick for a few seconds.  Usually the tick will dislodge on its own and be stuck to the cotton ball as you take it away.  Hopefully you will not need to try this method but keep it in the back of your mind.

What Is Most Likely to Happen if You Are Diagnosed with Lyme Disease?

When Lyme disease has been diagnosed because you have the “bull’s eye” rash from a tick bite or a positive blood test, your medical team will usually prescribe an antibiotic regimen.  Depending upon your history of allergies, two of the most common treatments are amoxicillin (500 mg three times a day for 14 to 21 days) or doxycycline (100 mg twice a day for 14 to 21 days).

Bull's Eye Rash (Tick)

Intravenous antibiotic treatments are not often needed, but they are needed when the Lyme infections are more serious.  These would include infections around the brain and spinal cord (meningitis) or heart (carditis).

I would like to leave you with two interesting facts about Lyme disease.  If for some reason you get the infection and do not obtain treatment with an antibiotic, you have about a 10-15% risk of developing Lyme arthritis, and this needs to be treated with a different antibiotic plan.

Even after treating Lyme disease and having no blood tests pointing to an active disease, about 10-20% of people will not feel well for months, having complaints of being exhausted and joint pain.  Antibiotics do not seem to be the answer for this frustrating condition.  The passage of time is the ultimate treatment.

Enjoy your summer and always check your clothes and body for ticks after working or playing outdoors in a grassy area.  Then take a shower, which removes the ticks off your body and prevents those troublesome bites!

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-Dr. P

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When Should Young Women Start Getting Pap Smears?

5461276006_df3a5a44b8_zCervical cancer was once the number one cancer killer, but with the introduction of the Pap smear almost 60 years ago, this cancer has become increasingly rare.  The guidelines for cervical cancer screening are always evolving, and the American Society for Colposcopy and Cervical Pathology (ASCCP) has been at the forefront of these changes.

The relationship between high-risk HPV (human papillomavirus) and the development of pre-cervical and cervical cancer has been well established.  Thankfully, most HPV infections are short-lived and not detected within 1-2 years.  Only a small percentage of infected women will go on to develop a high-grade cervical abnormality or cervical cancer.

More than 80% of all women will develop a genital HPV infection by the time they reach the age of 50.  HPV infections are the most common in young women, and again, these infections are cleared by most young women in less than two years.

We now have a good understanding of the natural history of HPV infections and the development of cervical cancer and the pre-cancers.  ASCCP’s guidelines advise that cervical cancer screening should begin at age 21 regardless of the age of sexual initiation.  Since most of the infections in the young will regress, starting a screening program at an earlier age may result in many unnecessary treatment interventions.

Remember to always discuss your particular concerns and develop your individual screening program with your healthcare professional.

-Dr. P

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What Could Happen if You Smoke During Pregnancy?

We all know that cigarette smoking is a health hazard.  In pregnancy, smoking spreads that hazard to the baby as well as the mom.  The CDC (Centers for Disease Control and Prevention) provides us with the following information:

  • It is reported that 10% of women smoke during the last 3 months of pregnancy
  • 50% of women who smoke before a pregnancy will quit during the pregnancy
  • 50% of women who stopped smoking during a pregnancy will go back to smoking after their baby is born
  • Smoking increases the difficulty to become pregnant
  • Smoking increases the risk of spontaneous miscarriages
  • Smoking also increases the risk of a premature birth
  • This action increases nicotine and decreases oxygen to the developing fetus
  • The baby’s placenta may not work as well in mothers who smoke
  • Smoking increases the risk of certain birth defects, including cleft lip and cleft palate

If you smoke, please try to stop for your health and the health of your baby.

Cigarette Blog

-Dr. P

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How Probiotics Can Be an Enormous Benefit to Your Health

The business associated with the use of probiotics is huge around the world.  It promises to use live and good bacteria to decrease/replace the bad bacteria that can build up in the colon.  Probiotics are live bacteria that are mostly found in foods and supplements.  They have the potential to provide beneficial health effects for the person ingesting the bacteria.

probiotics-4

The human gastrointestinal tract, especially the colon, is populated by a large amount and assortment of bacteria, called the intestinal flora.  This flora develops over the first two years of life and evolves over time based on health, diet, genetics, and many other factors.  This good natural bacteria and added probiotics seem to work in a variety of ways:

  • Natural good bacteria and probiotics prevent the growth of bad bacteria by not allowing a place for it to grow and competing for the nutrients.
  • They lower the acidity of the intestine, creating an unwelcome environment for the bad bacteria.
  • They increase the production of mucin.  Mucins are the proteins that bind to form the gel-like mucous, made by the epithelial cells that line the intestines.  This produces a chemical barrier which limits the damage of inflammation.

You should open a discussion with your health care provider about the benefits of probiotics, especially the next time an antibiotic is needed.  Antibiotics can affect the natural flora of the intestine so a probiotic review may be perfect.

Probiotics 2

-Dr. P

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How Can Uterine Fibroids Affect Your Pregnancy?

How Can Uterine Fibroids Affect Your PregnancyAbout 5% of all women have a uterine fibroid and this is the most common of the noncancerous gynecological tumors.  Since fibroids can increase risks during a pregnancy, the health care provider follows a pregnant woman with fibroids carefully.

One of the complications can be that the baby is in a position other than head-down near the time of delivery.  This can affect the type of delivery advised.  Other possible complications associated with fibroids and pregnancy can be pain, preterm delivery, premature rupture of the membranes, and other difficulties.

Because of the great hormonal changes during pregnancy, fibroids can shrink or grow at this time.  The changes occur mostly in the first 3 months of the pregnancy.  More pregnancy complications have been found when a fibroid is larger than 10 cm.

If you have fibroids and are pregnant, start early discussions with your health care providers about the risks to be concerned about and how is the best way to be followed during your pregnancy.

-Dr. P

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What Are the Risks of Delaying Childbirth?

Over the past 50 years, more women are delaying childbirth for many reasons.  Now obstetrical teams are seeing an increase in first births for woSmiling young doctor holding a beautiful newborn baby.men aged 40 to 44.  Pregnancies can progress beautifully with these women but increased risks have been associated with later motherhood.  Some of these risks include:

  • Abnormal fetal chromosomes
  • Diabetes during the pregnancy
  • High blood pressure before and during the pregnancy
  • Preterm labor and delivery
  • Increased chance of twins

The age of the father is also of concern here.  Advanced paternal age is often thought of as being 40 or older at the time of conception.  There are studies suggesting that advanced paternal age can be associated with a higher risk for autism spectrum disorders and some gene abnormalities.

If you or your partner is in this age group and are considering a pregnancy, begin a discussion with your health care provider.

-Dr. P

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A Simple Exercise That Burns More Calories Than Walking

Young women in the officeI have always advised my patients that walking is a great exercise.  A pair of sneakers and comfortable clothes is all you need to get started.  Taking the stairs instead of the elevator has been another of my common suggestions, and as the colder weather quickly approaches, maybe we should consider starting a stair climbing program.

Most of us have access to stairs, either at home, work, or the mall.  A great way to begin is climbing the stairs one at a time at your own pace, either holding on to the rail or keeping your hands free.  You are using more muscles and burning more calories than walking.  It is a vertical exercise, so it is good for muscle strengthening, cardiovascular work, and weight loss.  Once you are up the stairs, you must come back down since the descent also has great benefits.

As always, do not start an exercise program unless you have discussed it with your health care provider.  Stair climbing can be an easy addition to your exercise program and who knows where it will take you!

-Dr. P

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A Tool to Measure Your Risk of Developing Breast Cancer

A Tool to Measure Your Risk of Developing Breast CancerMany women who are at an increased risk of developing breast cancer are not aware of their risk.  If you are at an increased risk, a pharmacologic preventive therapy (chemoprevention) is a consideration you should discuss with your health care provider.  It has been reported that the agents used can reduce the risk by 50%.

The Gail Breast Cancer Risk Assessment Tool is one of the models that has been developed to quantify a woman’s risk of developing breast cancer.  By answering a series of questions about lifestyle, obstetric and gynecological history, and family history, a 5 year and lifetime risk can be calculated.  If there is a moderate to high risk, lifestyle and pharmacologic interventions should be considered.

Tamoxifen (Nolvadex) and Raloxifene (Evista) are two agents that may be discussed to help in the reduction in breast cancer.  There are risks and benefits to both medications, which need to be considered.

-Dr. P

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Don’t Only Be Aware in October

As October quickly comes to a close, the breast cancer awareness campaign will also come to an end.  It is imperative that our fight against breast cancer should not be at the forefront of our minds only in October but be there day by day, all year long.  All of us have someone close who has suffered with this cancer, so all of us must encourage the women in our lives to pursue proper breast health.  Don’t hold back today; speak to someone dear to you about breast cancer and you may save a loved one’s life!Mother and Daughter Face To Face

-Dr. P

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A Healthy Exercise for Beautiful Autumn

The fall season is full of pumpkins, mums, scary costumes, and beautiful crisp clean air!  It is a perfect time to get started on an outdoor walking program.  Join a friend or relative and begin your walking exploration of your neighborhood and make this fall the getting in shape season for you.Autumn Leaves, Berries and Pinecones

-Dr. P

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The Vegetable from the Fountain of Youth

“If you’re looking for the Fountain of Youth, kale may just be it!” Tom Gatto, a registered dietician, updates us on the nutritional powerhouse called kale. His discussion includes nutrient density, how to prepare it, and which vitamins, minerals, and antioxidants it contains and how they enhance our health.

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What Makes You at Risk for Hepatitis C?

…..Recently, the newspapers have been full of articles concerning the hepatitis C virus (HCV) and a new medication that reportedly cures people with the chronic type of the disease.  It is a very expensive drug, but the results have been wonderful; so I think it is time to give a little review of this disease.Hepatitis C Risk Factors 2

…..Hepatitis C is a contagious disease that is usually transmitted through blood contact with an infected person.  When first getting the disease (acute HCV), there may be no symptoms or only mild flu-like symptoms.  Most people do not even know that they have the disease, and most will go on to develop the chronic HCV, which is a long-term illness.

…..Of those with the chronic illness, about 25% will develop a severe liver disease such as cirrhosis or cancer.  At this time, baby boomers seem to be at the highest risk for the chronic version of this disease.  This will include the population born between 1945 and 1965.

…..The risk factors include:

  • Having a blood transfusion before 1992
  • Being on kidney dialysis
  • Sexual contact with an infected partner
  • Obtaining a tattoo or body piercing with an unclean instrument
  • Being exposed as a health care worker
  • Injecting drugs

…..Since baby boomers are many times more likely to have chronic HCV than other age populations, a screening blood test should be considered for this age group.  Feeling tired seems to be the most common symptom of the disease, so talk to your health care professional to see if a test should be considered for you!

-Dr. P

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An Alternate Way to Remove Those Ticks!

…..Last weekend, I was reminded that we are deep into another summer that is full of the problems with ticks.  At the end of a great summer day, I watched as my daughter checked her little ones for ticks.  She keeps them away from the bushy areas, but at bath time the checking takes place.

…..I recently learned about a different way to help remove a Ticks 4 Green Cotton Ballstick.  Take a cotton ball and put liquid soap on it.  Cover the discovered tick with the cotton ball and rub the soap on the tick for a few seconds.  Usually the tick will dislodge on its own and be stuck to the cotton ball as you take it away.

…..Hopefully you will not need to try this method but keep it in the back of your mind.  Enjoy the summer!

concept

…..For my instructions on removing a tick with tweezers: You Found a Tick on Yourself – What Are the Next Steps?

-Dr. P

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Concerned About Mercury Consumption During Pregnancy? The FDA Has Relaxed Its Stance

Two fresh sea bream on wooden board with herbs and lemonThe Food and Drug Administration of the United States has recently drafted new guidelines, reassuring pregnant women and nursing mothers that they should include more seafood in their diets.  This is because the health benefits far outweigh the risk of the mercury content.

The new suggestions advise eating 8 to 12 ounces of seafood a week, which means 2 to 3 meals per week.  The FDA also suggests that young children should also be eating fish 2 to 3 times per week in portions that are appropriate for their age.

Some important facts:

  • Fish are loaded with the types of omega-3 fatty acids that are high in DHA, which is important in brain and eye development.
  • The FDA suggests that women and children should consume fish low in mercury.  These include canned light tuna, salmon, tilapia, catfish, cod, shrimp, and pollock.
  • Four fish to avoid because of their high levels of mercury include shark, swordfish, tilefish from the Gulf of Mexico, and king mackerel.
  • Almost all fish contain trace amounts of mercury.  Mercury in high amounts can harm the brain and nervous system.

-Dr. P

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Polycystic Ovary Syndrome in Young Women – Signs You May Have It

…..P??????????????????olycystic ovary syndrome (PCOS) is a common endocrine problem in young women, and it often goes undiagnosed in the adolescent population.  The patients are frequently presented with menstrual irregularity and signs of androgen excess, which includes unwanted excess hair growth and acne.  These are the symptoms that usually lead the patients to visit their health care professional.  The weight of the young women can range from normal to elevated, and with obesity, the androgen affects can be more advanced.

…..To make the diagnosis of PCOS, certain criteria need to be met.  The most common guideline requires 2 of the following characteristics:

  • Signs of androgen excess
  • Irregular menses (probably secondary to problems with ovulation)
  • On a sonogram exam of the pelvis, the ovaries are found to have many small cysts (polycystic ovaries)

…..PCOS can have metabolic consequences with major effects on the glucose metabolism, affecting up to 25% of these young women.  There are different ways to screen for this abnormality, from obtaining fasting levels of glucose and insulin to a full glucose tolerance test.  Elevated weight levels, monitored by determining the BMI, increases the risk of developing these metabolic problems.

…..Next time we will review management for the young PCOS patients.

-Dr. P

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A Vitamin That May Reduce the Risk of Uterine Fibroids

…..It seems that every day there is a study revealing the importance of having a normal level of vitamin D.  A new report even points to an association between fibroids and vitamin D.  Uterine fibroids are benign tumors of the uterine smooth muscle, and this affects approximately 30 to 40% of all women.  It is one of the leading causes for a hysterectomy in the United States.  In the laboratory it has been shown that an active metabolite of vitamin D can inhibit the growth of fibroid tissue.

…..AA Vitamin That May Reduce the Risk of Uterine Fibroidspproximately 1000 women ages 35 to 49 years old were enrolled in a study where the vitamin D level was obtained, and the fibroid status was determined by ultrasound screenings of these premenopausal women.  The group with normal vitamin D levels had a 30% lower risk of fibroids as compared to those with vitamin D insufficiency.

…..More research needs to be done to confirm these findings but it seems that sufficient vitamin D may be associated with a reduced risk of uterine fibroids.  As always, speak to your health care provider before beginning any new vitamin supplement program.

-Dr. P

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Some Solutions to Your Recurrent Yeast Infections

Yeast CellsRecurrent vaginal yeast infections (Candida vulvovaginitis) is a common problem for many women, leading to frequent visits to their health care providers.  By definition, four or more occurrences of this vulvovaginitis within 12 months indicate a recurrent infection, which can lead to much frustration for the suffering patient.

Candida is a microorganism that is normally found in the vagina along with bacteria.  There is usually a natural balanced mix of yeast and bacteria in the vagina.  When the balance is disrupted, there can be an overgrowth of yeast, which is the infection.  Vaginal cultures can be obtained in these patients to check for certain species of yeast that can be resistant to standard treatments.

Fluconazole (brand name Diflucan) is used in one of the advised treatment regimens.  This is an antifungal agent that is generally well tolerated but can be associated with headaches, nausea, and abdominal discomfort.

Using this medication, there have been rare cases of serious liver reactions and low blood sugars.  This may happen in patients using medications to lower their blood sugar.  For the recurrent infections, one treatment plan is fluconazole 150 mg orally every 72 hours for 3 doses, followed by the medication once a week for 6 months.

If the cause of the recurrence is thought to be one of the more resistant species of Candida, intravaginal boric acid capsules taken once a day nightly for 14 days may be a consideration.

As always, this information should only be the start of your journey to treat this common problem.  You must have a good discussion with your health care provider concerning any medication and treatment regime that is being considered.

-Dr. P

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Osteoporosis – Are You at Risk and How Do You Treat It?

…..Many menopausal women suffer from osteoporosis.  Osteoporosis is the thinning of bones which causes them to become weak, brittle, and more susceptible to fractures.  Women have an increased risk of osteoporosis throughout their lifetime.  Risk factors include:

  • Low body weight
  • Smoking history
  • Fair skin
  • Menopausal state

…..There are various methods of prevention and treatment for osteoporosis.  There are medications such as the bisphosphonates (Fosamax) and selective estrogen receptor modulators (Evista).  Supplements such as calcium and Vitamin D are important additives.  Helpful lifestyle Osteoporosis Treatment Preventionchanges include the cessation of smoking, decreased alcohol use, and weight-bearing exercises.

…..Evista is a medication used to treat osteoporosis in the selective estrogen receptor modulator class.  It mimics the beneficial effects of estrogen by increasing bone density.  Many studies have also shown that Evista decreases the risk of certain types of breast cancer.  The side effects of Evista are hot flushes, leg cramps, and infrequent blood clots or strokes.

…..Speak to your health care provider to see if Evista can be of benefit for you to treat osteoporosis and prevent breast cancer.

-Dr. P

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These Signs May Imply You Have Hypothyroidism

The thyroid gland is one of the largest endocrine glands in the body and is located in the lower portion of the neck.  It is the site where the thyroid hormones are made, and these hormones have many significant functions.  Hypothyroidism (underactive thyroid function) is the most common of the possible thyroid problems and is seen more in women.  Some signs of this condition can be fatigue, cold intolerance, low heart rate, weight gain, dry skin, and coarse hair.

A boredomlow body temperature can be an early sign of a thyroid that is not producing a sufficient amount of hormones.  A person’s body temperature is a measure of the body’s ability to generate and eliminate excess heat.  The thyroid hormone has a direct effect on the basal metabolic rate, which can affect our body temperatures.  The average body temperature should be 98.6 F during the mid-afternoon.

If you are experiencing any of the above symptoms or if your mid-afternoon temperature is below average, then you should speak to your health care provider about the possibility of a thyroid condition.

-Dr. P

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Avoid the Metabolic and Reproductive Consequences of PCOS

Polycystic ovary syndrome (PCOS) is very common, but many times it is underdiagnosed and a misunderstood disorder in young women today.  Symptoms of PCOS may include irregular periods, increased facial and body hair, alopecia, acne, and multiple cysts of the ovaries.

IAvoid the Metabolic and Reproductive Consequences of PCOSt is important to diagnose PCOS due to its potential metabolic and reproductive consequences.  PCOS can increase the risk of heart disease, obesity, high blood pressure, diabetes, liver problems, and obstructive sleep apnea.  PCOS may also increase the risk of having difficulties conceiving.

There are various treatment modalities available for PCOS patients, so speak to your health care professional if you have any of these signs or symptoms.

-Dr. P

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Some Risks When You Use Oral Contraceptives

It has been a common thought that when using a medication for a particular problem, always try to use the lowest dose possible so potential side effects would be decreased. In terms of oral contraceptives, the dosage of these medications has been gradually reduced over the years in order to decrease the risks of abnormal blood clotting and breast concerns. Now the new very low dose oral contraceptive formulas are being reviewed due to their potential effects on long-term bone health when used in young women.

Oral Contraceptives RisksBone mass increases greatly in young women. It is an important buildup which can have great effects later on in life.

Osteoporosis is a common problem especially in older women, and it is a condition of low bone mass, increasing the possibility of fractures. Recent studies have indicated that young women who have been on the very low dose oral contraceptives may have a decrease in the buildup of their bone mass, setting them up for potential problems as they grow older.

As always, before beginning any medication, you must have a good discussion with your health care provider about that medication. When considering an oral contraceptive, ask questions about the various dosages available so the best choice can be made.

-Dr. P

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Urgent Gynecological Care

…..I am excited to tell you about a new service offered here at our practice.  We realize that women have become very busy with commitments to family, work, and community.  The pressures of career demands, managing a household, taking care of the children, and day-to-day responsibilities can make life hectic at times.  This can make scheduling urgent doctor’s visits a hassle.

Urgent Gynecological Care

…..Therefore, I am happy to announce a new program called urgent gynecological care.  This means that immediate appointments are now available 6 days a week.  In gynecology offices, when a patient calls to make an appointment, many times she cannot see her OB/GYN for a few weeks or even months.  This can have a negative impact on her health if immediate attention is needed.

…..Call us and we will be happy to set up an appointment.  I am looking forward to caring for your special need.

-Dr. P

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Rejuvenate Your Life with This Simple Exercise

Everyone is always telling us to exercise, and we all know that the simplest program of all is walking.  There are many studies that confirm the substantial benefits of walking, and these include heart health, weight loss, stronger bones, and just feeling happier.  I have often advised my patients to try to walk about a half hour per day and explained that the distance at first is not important.

Young Woman Standing with Arms Stretched OutAs your conditioning improves, the distance over that time will increase and you will be surprised at how much better you feel.  Some helpful tips:

  • Start with a warm-up for the first few minutes to get the muscles going.
  • Like our mothers always told us, try to stand up straight and gently move those arms.
  • The proper shoes and socks are important.  I have always asked for the advice of the professionals at our local runner’s store.
  • Take those long steady steps so that the senior shuffle stays away from our door.

As always, if there are any questions about your health, speak to your health professional before beginning a program.  I am looking forward to saying hi as we pass on the streets of our neighborhood!

-Dr. P

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Should Pregnant Women Get the Flu Shot?

.Syringe….It is time to bring up the flu vaccine again!  October is the start of the flu season, and it can run all the way into the spring.  The flu vaccines are available now, and remember, it takes about two weeks to produce the protective antibodies after receiving the vaccine.

…..Pregnant women who get the flu have an increased risk to develop serious complications from the infection, resulting in hospitalizations.  Also, with the new moms’ vaccinations, protection is also increased for their infants who are susceptible to influenza-related respiratory illnesses.  Let us review a couple of points:

  • In the past there was concern about trace amounts of a preservative called thimerosal, which was in some flu vaccines.  There are thimerosal-free vaccines now, and the U.S. Centers for Disease Control and Prevention have concluded that the thimerosal used in the vaccine is safe.
  • Patients with egg allergies need to discuss this with their medical practitioner before receiving the vaccine.

…..Over the past few years, more pregnant women have received the flu vaccine, with the percentage reaching about 50%.  Let us try to raise that number this year and get better protection all around!

…..For more information, view two of my other posts about the flu: Why Should You Get a Flu Shot Each Year? and The Concern of Getting the Flu Shot During Pregnancy – FAQs Answered

-Dr. P

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Why Finding Out if You Have Cancer Genes Is Imperative

…..Breast cancer and Lynch syndrome genes are carried by over one million people in the United States, and these two conditions are associated with the most common hereditary gynecological cancers.  At present, only a very small percentage of the women who carry these genes have been identified.  Therefore, the protocols that can be used to decrease the risk of dying from the cancers that these genes can cause are not being instituted.

…..GenesOur family history will be the first indication that these genes may be a part of our genetic pool, and this can lead to testing for our carrier status.  If identified, the cancer screening tests start earlier for the individual carrier and for their relatives in future generations.

…..We must remember that, based on family history, about ten percent of women are at an increased risk for a gynecological cancer.  Due to the increased risk of breast, ovarian, colorectal, and prostate cancer, which is determined from the family history, a more intense and earlier testing program may be needed.

…..A woman with a first degree relative with breast cancer has an increased risk for developing that cancer, and it is greater if that cancer was found in that relative before the age of 50.  A first degree relative is a parent, brother, sister, or child.

-Dr. P

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An Important Action to Take to Prepare for Future Medical Conditions

…..Every day there is another story on the daily news about a genetic breakthrough concerning a medical condition.  Be it about an increased risk for developing a cancer or an inherited condition affected by a specific lifestyle, genetic technologies are advancing rapidly.  This will lead to a more personalized medical care based on an individual’s personal risk.Family Portrait

…..Before stepping into this new world of high-tech genetics, we must not forget about the low-tech importance of obtaining our family’s medical history.  Most of us feel that our family history is important but some studies have shown that only about 30% of us will actively collect information about family health conditions.  It is important to be armed with this information so when you visit your health professional, the best care can be obtained.

…..Therefore, at your next family party when you are having coffee with your great Aunt Mary, get her to tell some good family stories, and begin the collection process for your family’s medical history.

-Dr. P

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