Archive for the ‘Women’s Health’ Category

Athlete drink

I’m often asked by patients how much water they need to drink each day. The Institute of Medicine has calculated that men need about 13 cups or three quarts of liquids and women need about nine cups or two quarts of liquids daily. We also ingest approximately 2 ½ cups, or 20 percent of our daily intake of liquids from food, especially fruits and vegetables. In addition, beverages that we commonly drink such as coffee, juice, milk and soda are composed mostly of water.

Water makes up 60 percent of our body weight. Every cell and system of our body depends on water. Lack of water causes dehydration, a condition that occurs when the body receives an inadequate amount of fluids, which in turn slows down and eventually shuts down vital bodily functions.

Our bodies constantly lose water from perspiring, breathing, urinating and having bowel movements.

Various factors determine just how much more water we may need to drink, such as:

– Environment — Hot weather, especially with high humidity, increases perspiration. Even in frigid weather, water is lost from our bodies when breathing during activities such as skiing or hiking.

– Exercise —Also increases perspiration. The more prolonged and intense the exercising, the greater the fluid loss is.

– Illness — Intense or prolonged vomiting and/or diarrhea can lead to life-threatening dehydration. This is an unfortunate cause of death in many developing countries.

– Pregnancy and breast feeding — Increases women’s fluids needs.

After hours of prolonged exercise with heavy sweating we lose electrolytes, especially salt. This is when drinking a sports drink is recommended because it will not only replace the lost water but also the depleted electrolytes. Electrolytes lost through sweat from mild to moderate exercise, can be replaced from the food we eat.

Some liquids can act as a diuretic, which means they cause you to urinate more liquid than you’ve taken in. Caffeine is often implicated, but is really a weak diuretic. Alcoholic beverages on the other hand, especially at higher quantities, can be very potent diuretics causing dehydration which is a major cause of a hangover.

A rough guide as to whether or not you are consuming enough water is to check your urine color. If it appears light yellow, like lemonade, you’re probably well-hydrated but if it is very dark yellow, like apple juice, you need to drink more water.

To keep your body healthy:

– Drink a glass of water or other low or non-calorie beverage with each meal and between each meal.

– Drink water before, during and after exercise.

Bottoms up!

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Doctor 3

Women’s health just took a leap forward with the passage of California Senate Bill 1538, authored by former state Senator Joe Simitian, which requires that women with dense breast tissue as determined by a mammogram be informed that they have the condition.

Women with dense breast tissue will be made aware of the fact that a tumor may not be seen on the mammogram, that they are at a higher risk for breast cancer, and that they should talk to a doctor about the condition. They will also be informed about other breast screening options.

This law came about as a suggestion to Mr. Simitian from a local Santa Cruz woman, Amy Colton, who has dense breast tissue and developed breast cancer in spite of having had routine mammograms. Kudos to Amy for championing this issue.

About 40 percent of all women have dense breast tissue, and many are unaware of their condition. Well over half of the cases of breast cancer in these women were missed with only routine mammography.

After skin cancer, breast cancer is the most common cancer in women in the U.S. Although, we usually associate breast cancer in women, it does occasionally occur in men.

The most common symptoms of breast cancer are:

– A breast lump

– Any change in the nipple, especially discharge or bleeding

– A change to the breast skin, such as the appearance of a dimple or pitting of the skin

– A change in size or shape of the breast

It is not clear why some women get breast cancer and some don’t.

It would seem that breast cancer is caused by an interaction between one’s genetic make-up and/or one’s environment. About 10 percent of breast cancer can be linked to inherited defective genes passed down through generations of a family. Blood tests are available to determine who may have these genes.

Known risk factors for breast cancer are:

– Increasing age — it’s more common in women older than 55

– A family or personal history of breast cancer

– Inherited genes

– Beginning your period at a young age or beginning menopause at an older age

– Post-menopausal hormone therapy, using a combination of estrogen and progesterone

– Drinking alcohol

Tests and procedures to detect breast cancer include:

– Breast exam, including self-exams as well as routine exams from a doctor

– Mammograms

– Breast ultrasounds

– Using a needle for a biopsy (removing a specimen of the suspected tissue for examination)

Current treatment guidelines for breast cancer are too large of a topic for this report.

Let me just say that tremendous strides are being made in the successful treatment of this disease.

Fortunately, the majority of breast changes do not turn out to be cancerous. Even if you have had a recent normal mammogram, see your doctor if you find any changes in your breasts, and work with your doctor to have routine breast exams and testing.

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As we begin a new year, I’d like to share with you a selection of highlights from some of my columns this past year:

Antibiotics:Antibiotics are useful for bacterial infections only, and not for viral infections, such as the common cold, bronchitis and sore throats.

Strokes:If you are having any symptoms that you think might be caused by a stroke, do not hesitate — seek help immediately from the nearest emergency room.

Insomnia:Remedies for sleep problems include lifestyle and behavioral therapies, alternative medicine and prescription medication.

Sleep apnea:This condition needs to be treated, as it leads to a greater risk of heart attacks.

Depression:This is a true medical illness treated with therapy or medication, sometimes in combination.

Asthma:Although it can be deadly, asthma is easily treated with proper medication and close follow-up with a doctor.

Sun exposure:Take the harmful effects of the sun seriously and use sunscreen liberally and frequently. Cover up as much as possible when in the sun.

Cholesterol:To help prevent heart attacks and strokes, keep cholesterol at a normal level.

Coffee:On the whole, coffee is much more beneficial than harmful to your health.

Backpacks for students:Lighten them up. Heavy packs cause neck and back problems for kids.

Influenza vaccine:Flu shots are useful to prevent influenza and can be given from fall to spring. It’s still not too late.

Head injuries:Concussions should be taken very seriously, as they can be deadly and can lead to long-term brain disability.

Calling in sick:Staying home when ill not only helps you recover quicker, but also prevents spreading the illness to your co-workers or fellow students.

Stress:Dealing with stress can help prevent poor health.

The full columns and all others I have written can be found here on my blog at https://valleydoctor.wordpress.com.

Have a very healthy and happy new year.

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2011 Highlights

As I begin my fifth year writing this column, I’d like to thank my readers for the encouraging feedback I’ve received from so many of you.

Today I’d like to share with you what I consider the highlights from some of my columns this past year.

– Diabetes: Adult-onset diabetes can be prevented by exercise, diet and weight control.

– Sugar: Sugar comes in a variety of forms and in and of itself is not unhealthy, but excessive intake of sugar leads to obesity, which contributes to poor health.

– Smoking: Smoking causes one out of five deaths each year in the United States and damages almost every organ in the body.

– Deep-vein thrombosis (blood clots): If you have had recent surgery or prolonged bed rest, recently traveled or are pregnant and you have pain or swelling in a lower leg, you might have a blood clot and need immediate medical attention.

– Senior moments: We all have “senior moments” from time to time, with occasional memory loss, but if these moments persist, worsen or interfere with daily activity, medical attention is needed.

– Radiation: We are exposed daily to radiation both natural and manmade. The more we can prevent such exposure by limiting excessive medical and dental x-rays and checking our homes for radon, the healthier we will be.

– Dizziness: This is a common condition but usually not serious. However, if symptoms are persistent or troublesome, a medical evaluation is necessary.

– Colon cancer: This cancer, if found early, has a very favorable cure rate — so talk to your doctor if you are 50 years or older, have a family history of colon cancer, or have rectal bleeding or any change of bowel habits.

– Bedbugs: When arriving home from a stay in a hotel, unpack your suitcase as far away from your bed as possible.

– Meningitis: Common symptoms include bad headache, stiff neck, nausea and vomiting; this is a serious infection, which can occasionally be deadly.

– Treatment of upper respiratory symptoms in children: Avoid over-the-counter cold and flu medications for children younger than 4 years of age, except for acetaminophen (Tylenol) and ibuprofen (Advil). Both of these medications can be used in the proper dose for treating fever or pain.

– Non-physician health care providers: Nurse practitioners and physician assistants are very well trained to care for most patients’ needs when working with their supervising physician partners.

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Good news has just come from the California Department of Public Health, which recently reported that the state’s adult smoking rate has hit a record low. Last year, 11.9 percent of the state’s adults smoked, down from 13.1 percent in 2009. By comparison, in 1984, 26 percent of our state’s adults smoked.

This is a very encouraging trend.

Tobacco use causes a greatly increased risk of death. More deaths are caused by tobacco use (mostly in the form of cigarette smoking), than by HIV infection, illegal drug use, alcohol use, motor vehicle injuries, suicide and murder combined.

Cigarette smoking causes one in five deaths in the U.S. each year, with about 400,000 deaths from direct smoking and 50,000 deaths from indirect smoke. On average, adults who smoke die 14 years sooner than nonsmokers. Between the years 1960 and 1990, deaths from lung cancer in women increased more than 500 percent.

Smoking damages nearly every organ in the human body. Here are some of the more common health problems caused by tobacco products:

– Cancer of the lung (23 times higher rate among smokers than nonsmokers)

– Cancers of the bladder, mouth, throat, vocal cords, esophagus, cervix, kidney, pancreas and stomach, and certain forms of leukemia

– Coronary heart disease, which usually leads to heart attacks

– Doubled risk of a stroke

– Blockage of blood flow to legs and feet, sometime leading to amputation

– Tenfold increase in likelihood of death from emphysema, a condition in which lung tissue is slowly destroyed by smoke

– Reproductive problems, such as infertility, early birth, stillbirth and impotency

– Decreased bone density in the elderly, leading to increased chance of fractures

It is estimated that more than 370 billion cigarettes are consumed by American smokers per year. In 2005, cigarette manufacturers spent more than $13 billion on advertising to lure people into smoking. What is the cost to our financially precarious health care system? It is estimated that cigarette smoking costs $96 billion yearly in health care expenditures and another nearly $100 billion in lost productivity.

I personally find all of this data shocking. We, in this society, must take a firmer stand against the use of all tobacco products. Every day, more than 1,000 American teenagers begin smoking. We need do a better job in preventing our youth from beginning to smoke and to get those, young and old, who are already addicted to tobacco to quit.

For those of you who wish to quit but have been unable to do it on your own, your doctor has various treatment options that could help you.

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For what seems to be a minor health problem, swimmer’s ear results in nearly 2.4 million doctor visits annually and costs our health care system $500 million a year. Swimmer’s ear is an inflammation of the ear canal, resulting from water entering the ear through swimming or bathing. This wet environment in the ear canal allows germs to multiply, thus leading to the painful infection. Warm temperatures, high humidity and more time spent in the water increase one’s risk of acquiring swimmer’s ear. That’s why this malady peaks during the summer swimming season, occurring more frequently in the months of June, July and August. Symptoms of swimmer’s ear include pain, tenderness, redness and swelling of the ear canal. Occasionally, there is a discharge from the ear. Though it’s a very painful condition, swimmer’s ear will almost always clear up completely, leaving no long-term pain or hearing loss. This infection is treated with a course of antibiotic ear drops for about a week. These are my recommendations to prevent swimmer’s ear:

    • Avoid cleaning the ear with cotton swabs, which can cause micro trauma to the ear canal, thus making it more susceptible to infection.
    • Dry the ears as thoroughly as possible after water exposure.
    • Commercial ear drops, available from pharmacies, can be bought to use in the ear after swimming to help prevent infection. As an alternative, a homemade solution can be used in place of the commercial one, by mixing equal parts rubbing alcohol and white vinegar and placing several drops in the ear canal after water exposure. The alcohol helps dry the ear, and the vinegar helps keep germs from growing. Those with ear tubes or a possible hole in the ear drum should not put any type of drops in their ears.

Have a safe and enjoyable summer.

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As we prepare to leave the old year behind and greet the New Year, I would like to propose the following health-related resolutions:

• If you smoke — quit.

• If you drink alcohol, do so in moderation.

• Develop a routine exercise program and stick with it.

• Improve your diet — increase fruits and vegetables and decrease fats and carbohydrates.

• Buckle up every time you enter your car.

• Don’t talk on your cell phone while driving. It’s not only very dangerous, but also now illegal.

• Get regular dental checkups and eye exams.

• If you are overweight, try to lose weight. If you can’t, at least remain physically fit.

• Use sunscreen when outside during the sunny months.

• Routinely examine your skin for any unusual changes.

• Keep your immunizations up to date — all the usual vaccinations that babies and children receive, as well as a diphtheria-tetanus booster every 10 years for adults and a yearly influenza vaccine.

• Have your blood pressure checked at every health care visit.

• Have a pap test for women beginning at age 20, continuing per doctor’s recommendation.

• Have a cholesterol level test starting at age 20.

• Have a clinical breast exam and mammogram for women beginning at age 40 per doctor’s recommendation.

• Have a blood sugar test starting at age 45.

• Have a colon screening (colonoscopy) beginning at age 50.

• Have a prostate exam for men starting at age 50.

• Do not climb ladders. (This is personal experience speaking.)

• See your doctor sooner rather than later if you have a strong family history of any significant medical problems, such as cancer, heart disease, diabetes, high blood pressure, etc.

• Avoid stress. Relax and honestly try to enjoy your life, whatever your circumstances.

After having practiced medicine for more than 37 years, I can assure you that following the above resolutions will very likely add years of healthy living to your life.

This month will mark the beginning of three years of writing this column. Reader feedback has been beyond expectations, for which I am very grateful. Please contact me if you have requests for medical topics that are important to you or that might have a broad reader appeal.

Happy healthy holidays!

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