Sticks and Stones Break Bones, So Does the Silent Disease Osteoporosis

The World Osteoporosis Day (WOD) 2018 campaign calls for global action to improve bone health and prevent fractures due to osteoporosis, including vertebral (spine) fractures — which often remain undiagnosed and untreated.  The public, healthcare professionals and organizations worldwide are joining together to raise awareness of bone health and call for action on osteoporosis and fracture prevention in their communities.

Facts About Osteoporosis

  • Osteoporosis is ahidden, underlying cause of painful, debilitating and life-threatening fractures
  • The most common of osteoporotic fractures are spine (vertebral) fractures, a major cause of pain, disability and loss of quality of life
  • Up to 70% of spine fractures remain undiagnosed, leaving sufferers unprotected against the high risk of more fractures
  • Back pain, height-loss and stooped back are all possible signs of spine fractures – ask for testing and treatment!
  • A family history of osteoporosis and broken bones is a sign that you too may be at higher risk
  • Osteoporosis is a growing global problem that respects no boundaries: worldwide, fractures affect one in three women and one in five men over the age of 50.

What is Osteoporosis

Osteoporosis causes bones to become weak and brittle — so brittle a fall or even mild stresses, such as bending over or coughing, can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone.

Osteoporosis affects men and women of all races. But white and Asian women — especially older women who are past menopause — are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

What are the symptoms of Osteoporosis

There typically are no symptoms in the initial stages of bone loss. But once your bones have been weakened by osteoporosis, you may have signs and symptoms that include:

  • Back pain, caused by a fractured or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone fracture that occurs much more easily than expected

What causes Osteoporosis

Osteoporosis weakens bone.  Your bones are in a constant state of renewal — new bone is made, and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone and your bone mass increases. Most people reach their peak bone mass by their early 20s. As people age, bone mass is lost faster than it’s created.

How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

What are the risk factors of Osteoporosis?

A number of factors can increase the likelihood that you’ll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.

Unchangeable risks

Some risk factors for osteoporosis are out of your control, including:

  • Your sex. Women are much more likely to develop osteoporosis than are men.
  • Age. The older you get, the greater your risk of osteoporosis.
  • Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
  • Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father experienced a hip fracture.
  • Body frame size. Men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.
  • Hormone levels

Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:

  • Sex hormones. Lowered sex hormone levels tend to weaken bone. The reduction of estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Men experience a gradual reduction in testosterone levels as they age. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen levels in women are likely to accelerate bone loss.
  • Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
  • Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.
  • Dietary factors

Osteoporosis is more likely to occur in people who have:

  • Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women.
  • Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium.
  • Steroids and other medications

Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent:

  • Seizures
  • Gastric reflux
  • Cancer
  • Transplant rejection
  • Medical conditions

The risk of osteoporosis is higher in people who have certain medical problems, including:

  • Celiac disease
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Cancer
  • Lupus
  • Multiple myeloma
  • Rheumatoid arthritis
  • Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

  • Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful.
  • Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.
  • Tobacco use. The exact role tobacco plays in osteoporosis isn’t clearly understood, but it has been shown that tobacco use contributes to weak bones.

How does osteoporosis cause vertebrae to crumple and collapse?

Bone fractures, particularly in the spine or hip, are the most serious complication of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.

In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrae) can weaken to the point that they may crumple, which can result in back pain, lost height and a hunched forward posture.

How can you prevent Osteoporosis?

Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life.

Protein

Protein is one of the building blocks of bone. And while most people get plenty of protein in their diets, some do not. Vegetarians and vegans can get enough protein in the diet if they intentionally seek suitable sources, such as soy, nuts, legumes, and dairy and eggs if allowed. Older adults may also eat less protein for assorted reasons. Protein supplementation is an option.

Body weight

Being underweight increases the chance of bone loss and fractures. Excess weight is now known to increase the risk of fractures in your arm and wrist. As such, maintaining an appropriate body weight is good for bones just as it is for health in general.

Calcium

Men and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70. Reliable sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, such as tofu
  • Calcium-fortified cereals and orange juice

If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium has been linked to kidney stones. Although yet unclear, some experts suggest that too much calcium especially in supplements can increase the risk of heart disease. The Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.

Vitamin D

Vitamin D improves your body’s ability to absorb calcium and improves bone health in other ways. People can get adequate amounts of vitamin D from sunlight, but this may not be a reliable source if you live in a high latitude, if you’re housebound, or if you regularly use sunscreen or avoid the sun entirely because of the risk of skin cancer.

Scientists don’t yet know the optimal daily dose of vitamin D for each person. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. For people without other sources of vitamin D and especially with limited sun exposure, a supplement may be needed. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.

Exercise

Exercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you’ll gain the most benefits if you start exercising regularly when you’re young and continue to exercise throughout your life.

Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine, and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older.

Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but they’re not as helpful for improving bone health.

When to see a doctor

You may want to talk to your doctor about osteoporosis if you went through early menopause or took corticosteroids for several months at a time, or if either of your parents had hip fractures.

You’ll probably first bring your symptoms to the attention of your family doctor, who may refer you to a rheumatologist — a doctor specializing in the treatment of diseases of the joints, muscles and bone. To get the right help, find a rheumatologist or other physician who knows how hard it is to endure bone deteriation.  Go to HealthLynked.com today to build a Free patient profile and begin communicating there with those who will collaborate on your wellness.

To find a health professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store your health information.

What Are the Signs and Symptoms of Ovarian Cancer?

Each year, the first Friday in September is designated as Wear Teal Day.  On this day, organizations unite in an effort to encourage you to dress in teal and educate yourself and those around you about the symptoms and risk factors of Ovarian Cancer.

What is Ovarian Cancer?

Ovarian cancer is a disease in which, depending on the type and stage, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

Cancer Basics

Cancer develops when abnormal cells in a part of the body (in this case, the ovary) begin to grow uncontrollably. This abnormal cell growth is common among all cancer types.

Normally, cells in your body divide and form new cells to replace worn out or dying cells, and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to create new abnormal cells, forming a tumor. Tumors can put pressure on other organs near the ovaries.

Cancer cells can sometimes travel to other parts of the body, where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells move into the bloodstream or lymph system of the body. Cancer cells that spread from other organ sites (such as breast or colon) to the ovary are not considered ovarian cancer. Cancer type is determined by the original site of the malignancy.

What is the general outlook for women diagnosed with ovarian cancer?

In women ages 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime. The American Cancer Society estimates that there will be over 22,280 new cases of ovarian cancer diagnosed this year and that more than 14,240 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is over 90 percent. Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, about 20 percent of all cases are found early, meaning in stage I or II.

If caught in stage III or higher, the survival rate can be as low as 28 percent. Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis. With almost 80% of women diagnosed in advanced stages of ovarian cancer, when prognosis is poor, we know that more needs to be done to spread awareness of this horrible disease that will take the lives of more than 14,000 women this year.

What are the Signs & Symptoms of Ovarian Cancer?

Ovarian cancer is difficult to detect, especially in the early stages. This is partly due to the fact that the ovaries – two small, almond-shaped organs on either side of the uterus – are deep within the abdominal cavity. The following are often identified by women as some of the signs and symptoms of ovarian cancer:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected.

Persistence of Symptoms

When the symptoms are persistent, when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest) it is imperative for a woman to see her doctor. Persistence of symptoms is key. Because these signs and symptoms of ovarian cancer have been described as vague or silent, only approximately 19 percent of ovarian cancer is diagnosed in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

Treatment Options

Surgery

Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.

Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals.

Chemotherapy

Before treatment begins, it is important to understand how chemotherapy works. Chemotherapy is the treatment of cancer using chemicals designed to destroy cancer cells or stop them from growing. The goal of chemotherapy is to cure cancer, shrink tumors prior to surgery or radiation therapy, destroy cells that might have spread, or control tumor growth.

Radiation

Radiation therapy uses high-­energy X­-rays to kill cancer cells and shrink tumors. Please note that this therapy is rarely used in the treatment of ovarian cancer in the United States. It is more often used in other parts of the body where cancer has spread.

Complementary Therapies

Some women with ovarian cancer turn toward the whole ­body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and lessen side effects, such as fatigue, pain, and nausea.

Complementary therapies are diverse practices and products that are used along with conventional medicine. Many women have tried and benefited from the complementary therapies listed below. Speaking with other women, in addition to the healthcare team, can suggest the therapies that may be most helpful and appropriate for each woman’s lifestyle.

Clinical Trials

Clinical trials are research studies designed to find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. Many women undergoing treatment for ovarian cancer choose to participate in clinical trials. Through participation in these trials, patients may receive access to new therapy options that are not available to women outside the clinical trial setting.

How am I Diagnosed with Ovarian Cancer?

Most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III or IV). This is because the symptoms of ovarian cancer, particularly in its early stages, often are not acute or intense, and present vaguely. In most cases, ovarian cancer is not detected during routine pelvic exams, unless the doctor notes that the ovary is enlarged. The sooner ovarian cancer is found and treated, the better a woman’s chance for survival. It is important to know that early stage symptoms can be difficult to detect, though are not always silent. As a result, it is important that women listen to their bodies and watch for early symptoms that may present.

Did You Know?

The Pap test does not detect ovarian cancer. It aids in evaluating cells for the detection of cervical cancer.

Screening Tests

Although there is no consistently-reliable screening test to detect ovarian cancer, the following tests are available and should be offered to women, especially those women at high risk for the disease:

  • Pelvic Exam: Women age 18 and older should have a mandatory annual vaginal exam. Women age 35 and older should receive an annual rectovaginal exam (physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness).
  • Transvaginal Sonography: This ultrasound, performed with a small instrument placed in the vagina, is appropriate, especially for women at high risk for ovarian cancer, or for those with an abnormal pelvic exam.
  • CA-125 Test: This blood test determines if the level of CA-125, a protein produced by ovarian cancer cells, has increased in the blood of a woman at high risk for ovarian cancer, or a woman with an abnormal pelvic examination.

While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at average risk for ovarian cancer.

Positive Tests

If any of these tests are positive, a woman should consult with a gynecologic oncologist, who may conduct a CT scan and evaluate the test results. However, the only way to more accurately confirm an ovarian cancer diagnosis is with a biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

Research into new ovarian cancer screening tests is ongoing, and new diagnostic tests may be on the horizon. The National Ovarian Cancer Coalition monitors the latest scientific developments. Please visit their Research page for additional information.

Getting Help

To locate a physician in your area who can help with the symptoms you are suffering and aid in treatment, if necessary, please find one today using HealthLynked.com.  We are the first of its kind social ecosystem designed to connect physicians and patients for the efficient exchange of information in a secure platform designed for communication and collaboration.

Ready to get Lynked?  Go to HealthLynked.com, right now, to start getting the help you need, for free.

Source:

Ovarian.org

A Woman’s Story of Overcoming PCOS | 20 (plus) things you Need to Know

If you are looking for the stuff you “need to know” from the title, it’s further on down in the article.  In observance of PCOS Awareness Month, we thought we would share the true story of a young woman living with polycystic ovary syndrome (PCOS).  I know her well but interviewed her for the article anyway.  She’s my super cool middle, Delaney.

Delaney grew up a very active, wonderfully gregarious kid who moved around a few times with the Navy until we exited and settled in SoCar – that’s South Carolina, for those who don’t know.  A natural athlete, fast, nimble and taller than her peers, she quickly found herself to be a standout soccer player.  She didn’t know she couldn’t score every time she had the ball at her feet, and so she did.  Because she was quick and had incredible endurance, she also was recruited by the track coach to run the varsity 800m in seventh grade, along with a teammate who was her opposite on the field.

But soccer was her thing, and she eventually dropped the spikes to focus solely on futbol.  Running upwards of 8 miles every day in practice – anywhere from trotting to full Sprint, even backwards and sideways as an outside midfielder, she was fit in all the ways a peak performing Athlete would be.  To fuel it all, she would eat FOUR big meals every day – each bigger than those her 220 lbs weight Training father would consume.  She ate it and burned it with a ferocity on the Field we all admired.

Attack, fight, victory was her personal motto, in everything and in all ways.  Then came college.  She decided to focus on her studies and didn’t go out for the team.  In fact, just about every bit of working out came to a screeching halt.  And then, her period stopped….for a full year.

She had gained the average “freshman fifteen”, which wasn’t surprising when considering her eating habits, if anything, were filling her with added calories, and she had stopped using those calories on the field.  So, if she had always had her period as an athlete and now had even more body fat, why was she experiencing amenorrhea  (the technical term for missing your period)?   Stress?  All the life changes in general?  Purely hormonal?

Poly cystic ovarian syndrome is, at its most basic level, a hormonal imbalance, where too much of the “male” hormones are produced in a female.  While the only apparent symptom she displayed at the time was amenorrhea, her ever diligent homeopathic healer in residence, aka, her mom, was convinced she had PCOS.

First stop, her old pediatrician, who told her everything was normal; but she could go on birth control to start her period again.  After all, having one is important for so many other things in a young woman’s life, like the other hormones it generates that aid in creating increased bone density.

Not enough info, so on to an Ob/Gyn.  There, the feedback was little more along the lines of what her mom had already assumed, but they were even skeptical.  “So, let’s get an ultrasound,” my wife suggested.  The physician said you couldn’t see PCOS on an ultrasound.  As a DMS, my wife knew better.

On ultrasound, it was clear her ovaries were encased in cysts.  They were covered in follicles too numerous to count – today, 20 on an ovary will typically be used as a clear diagnosis.

Diagnosis in hand, the physician gave her the long list of troubles she was set to endure in her life – infertility, type II diabetes, a constant struggle with weight gain, hirsutism, and skin issues to name a few.  And, as if on queue, while the lack of period was the only thing she went to the physician for, she began to experience all of the negative symptoms save diabetes.

“I started to use PCOS as an excuse to eat whatever I wanted,” she says today.  “I just stopped caring about what I put in my body,” and she may have even begun to somewhat celebrate the new-found freedom from lack of discipline around diet.  Pictures of food became the standard in her social feed, and she did start to suffer the weight gain her MD predicted.  Along with that came the added pain of body image issues.

She started taking birth control to manage her cycle, and it worked.  At least, it did ensure she became regular; but deep down inside, she knew it wasn’t fixing the problem.  “I knew it was a bandaid put on to cover what was really wrong, so I quit after a year.  It wasn’t really doing anything.  It definitely was not helping fix whatever was at the root,” she said to me this Labor Day morning.

She finished college as a star student, winning all but one of the math awards given out by the University of South Carolina.  I guess I forgot to mention, she’s also brilliant, and I am very proud, of her and all of our kids.  On to New York City!

Always called to serve, Delaney decided to teach in the high schools of the Bronx.  She was not sure if it was the added stress or the increased disregard for dietary discipline, but she added even more weight with the move, though she began to workout more than before.  And, the skin issues and extra hair growth kicked in….

“I began to understand I had to do something.  Thankfully, Mom has always been a huge proponent of natural healing, so I started a few different regiments of eating more mindfully and living more intentionally,” Delaney says now.  She went through a few rounds of Whole 30, and really started to stop eating when full.  “I used to empty my plate, no matter what;… but now come home with leftovers routinely,” she says.  “If I want to have pizza, I still have pizza.  I just don’t eat a WHOLE pizza.”

The changes in diet and exercise, along with a few other healthy changes in her life, over a two-year period, have restored this vivacious young lady to the same level of health she had when she entered college in 2011.  She would say her PCOS is in remission.

“I still wonder, on occasion, about my ability to have a family; but, since my cycle is normal, naturally, I am ovulating, and my health is optimized, I think that won’t be a problem, either.”  We hope not!  We love grandkids!

Delaney would tell anyone asking her results may not be normal.  She would encourage you to seek to control PCOS in the most natural ways possible – through diet, exercise and healthy living – but she also acknowledges those methods may not be for everyone.  Definitely seek medical counsel.

So, What Is PCOS, Really?

Polycystic ovary syndrome is a hormonal condition. Hormones are substances your body makes to help make different processes happen. Some are related to your ability to have a baby, and also affect your menstrual cycle. Those that are involved in PCOS include.

  • Androgens: Often called “male” hormones, women have them, too. Those with PCOS tend to have higher levels, which can cause symptoms like hair loss, hair in places you don’t want it (such as on your face), and trouble getting pregnant.
  • Insulin: This hormone manages your blood sugar. If you have PCOS, your body might not react to insulin the way that it should.
  • Progesterone: With PCOS, your body may not have enough of this hormone. That can make you to miss your periods for a long time, or to have periods that are hard to predict.

With PCOS, your reproductive hormones are out of balance. This can lead to problems with your ovaries, such as not having your period on time, or missing it entirely.  In women who have it, it can:

  • Affect your ability to have a child (fertility)
  • Make your periods stop or become difficult to predict
  • Cause acneand unwanted hair
  • Raise your chances for other health problems, including diabetesand high blood pressure

There are treatments for the symptoms, and if you want to get pregnant, that’s still possible, though you may need to try different methods.  Many women who have PCOS don’t have cysts on their ovaries, so “polycystic” can be misleading. You might have cysts, and you might not.

What Are the Symptoms of PCOS?

If you have things such as oily skin, missed periods, or trouble losing weight, you may think those issues are just a normal part of your life. But those frustrations could actually be signs that you have polycystic ovary (or ovarian) syndrome, also known as PCOS.

The condition has many symptoms, and you may not have all of them. It’s pretty common for it to take women a while – even years – to find out they have this condition.

Things You Might Notice

You might be most bothered by some of the PCOS symptoms that other people can notice. These include:

  • Hair growth in unwanted areas. Your doctor may call this “hirsutism” (pronounced HUR-soo-tiz-uhm). You might have unwanted hair growing in places such as on your face or chin, breasts, stomach, or thumbs and toes.
  • Hair loss. Women with PCOS might see thinning hair on their head, which could worsen in middle age.
  • Weight problems. About half of women with PCOS struggle with weight gain or have a tough time losing weight.
  • Acne or oily skin. Because of hormone changes related to PCOS, you might develop pimples and oily skin. (You can have these  PCOS, of course).
  • Problems sleeping, feeling tired all the time. You could have trouble falling asleep. Or you might have a disorder known as sleep apnea. This means that even when you do sleep, you do not feel well-rested after you wake up.
  • Headaches. This is because of hormone changes with PCOS.
  • Trouble getting pregnant. PCOS is one of the leading causes of infertility.
  • Period problems. You could have irregular periods. Or you might not have a period for several months. Or you might have very heavy bleeding during your period.

How Do I Know If I Have PCOS?

There’s no single test that, by itself, shows whether you have polycystic ovary syndrome, or PCOS. Your doctor will ask you about your symptoms and give you a physical exam and blood tests to help find out if you have this condition.

PCOS is a common hormone disorder that can cause problems with your period, fertility, weight, and skin. It can also put you at risk for other conditions, such as type 2 diabetes. If you have it, the sooner you find out, the sooner you can start treatment.

What Your Doctor Will ask

Your doctor will want to know about all the signs and symptoms you’ve noticed. This is an important step to help figure out whether you have PCOS, and to rule out other conditions that cause similar symptoms.

You’ll need to answer questions about your family’s medical history, including whether your mother or sister has PCOS or problems getting pregnant. This information is helpful — PCOS tends to run in families.

Be ready to discuss any period problems you’ve had, weight changes, and other concerns.

Your doctor may diagnose PCOS if you have at least two of these symptoms:

  • Irregular periods
  • Higher levels of androgen (male hormones) shown in blood tests or through symptoms like acne, male-pattern balding, or extra hair growth on your face, chin, or body
  • Cysts in your ovaries as shown in an ultrasound exam

What’s the Treatment for PCOS?

Treatments can help you manage the symptoms of polycystic ovary syndrome (PCOS) and lower your odds for long-term health problems such as diabetes and heart disease.

You and your doctor should talk about what your goals are, then you can come up with a treatment plan. For example, if you want to get pregnant and are having trouble, then your treatment would focus on helping you conceive. If you want to tame PCOS-related acne, your treatment would be geared toward skin problems.

Healthy Habits

  • One of the best ways to deal with PCOSis to eat well and exercise
  • Many women with PCOS are overweightor obese. Losing just 5% to 10% of your body weight may ease some symptoms and help make your periods more regular. It may also help manage problems with blood sugar levels and ovulation.
  • Since PCOS could lead to high blood sugar, your doctor may want you to limit starchy or sugary foods. Instead, eat foods and meals that have plenty of fiber, which raise your blood sugarlevel slowly.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.

Hormone Treatments and Medication

Birth control is the most common PCOS treatment for women who don’t want to get pregnant. Hormonal birth control — pills, a skin patch, vaginal ring, shots, or a hormonal IUD (intrauterine device) — can help restore regular periods. The hormones also treat acne and unwanted hair growth.

These birth control methods may also lower your chance of having endometrial cancer, in the inner lining of the uterus.

Taking just a hormone called progestin could help get your periods back on track. It doesn’t prevent pregnancies or treat unwanted hair growth and acne. But it can lower the chance of uterine cancer.

Metformin (Fortamet, Glucophage) lowers insulin levels. It can help with weight loss and may prevent you from getting type 2 diabetes. It may also make you more fertile.

If birth control doesn’t stop hair growth after 6 months, your doctor may prescribe spironolactone (Aldactone). It lowers the level of a type of sex hormone called androgens. But you shouldn’t take it if you’re pregnant or plan to become pregnant, because it can cause birth defects.

Weight Loss

When a healthy diet and regular exercise aren’t enough, medications can make losing weight easier. Different drugs work in different ways. For example, orlistat (Alli, Xenical) stops your body from digesting some of the fat in your food, so it may also improve your cholesterol levels. Lorcaserin (Belviq) makes you feel less hungry. Your doctor will prescribe the medication they think will be the most successful for you.

Weight loss surgery could help if you’re severely obese and other methods haven’t worked. The change in your weight afterward can regulate your menstrual cycle and hormones and cut your odds of having diabetes.

Hair Removal

Products called depilatories, including creams, gels, and lotions, break down the protein structure of hair so it falls out of the skin. Follow the directions on the package.

A process like electrolysis (a way to remove individual hairs by using an electric current to destroy the root) or laser therapy destroys hair follicles. You’ll need several sessions, and though some hair may come back, it should be finer and less noticeable.

Fertility

Your doctor may prescribe medication to help you get pregnant. Clomiphene and letrozole encourage steps in the process that trigger ovulation. If they don’t work, you can try shots of hormones called gonadotropins.

A surgery called ovarian drilling might make your ovaries work better when ovulation medications don’t, but it’s being done less often than it used to. The doctor makes a small cut in your belly and uses a tool called a laparoscope with a needle to poke your ovary and wreck a small part of it. The procedure changes your hormone levels and may make it easier for you to ovulate.

With in vitro fertilization, or IVF, your egg is fertilized outside of your body and then placed back inside your uterus. This may be the best way to get pregnant when you have PCOS, but it can be expensive.

What Are the Complications of PCOS?

If you have polycystic ovary syndrome, your ovaries may contain many tiny cysts that cause your body to produce too many hormones called androgens.

In men, androgens are made in the testes. They’re involved in the development of male sex organs and other male characteristics, like body hair. In women, androgens are made in the ovaries, but are later turned into estrogens. These are hormones that play a vital role in the reproductive system, as well as the health of your heart, arteries, skin, hair, brain, and other body parts and systems.

If you have PCOS and your androgen levels are too high, you have higher odds for a number of possible complications. (These may differ from woman to woman):

Trouble Getting Pregnant

  • Cysts in the ovaries can interfere with ovulation. That’s when one of your ovaries releases an egg each month. If a healthy egg isn’t available to be fertilized by a sperm, you can’t get pregnant.
  • You may still be able to get pregnant if you have PCOS. But you might have to take medicine and work with a fertility specialist to make it happen.

Insulin Issues

Doctors aren’t sure what causes PCOS. One theory is that insulin resistance may cause your body to make too many androgens.

Insulin is a hormone that helps the cells in your body absorb sugar (glucose) from your blood to be used as energy later. If you have insulin resistance, the cells in your muscles, organs, and other tissue don’t absorb blood sugar very well. As a result, you can have too much sugar moving through your bloodstream. This is called diabetes, and it can cause problems with your cardiovascular and nervous systems.

Other Possible Problems

You might have metabolic syndrome. This is a group of symptoms that raise the risk of cardiovascular disease, such as high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.  Other common complications of PCOS include:

  • Depression
  • Anxiety
  • Bleeding from the uterus and higher risk of uterine cancer
  • Sleep problems
  • Inflammation of the liver

Some complications of PCOS may not be serious threats to your health, but they can be unwanted and embarrassing:

  • Abnormal body or facial hair growth
  • Thinning hair on your head
  • Weight gain around your middle
  • Acne, dark patches, and other skin problems

Most women at some point have to contend with weight, but for women with polycystic ovary syndrome(PCOS), losing weight can become a constant struggle.

PCOS is the most common hormonal disorder in women of childbearing age and can lead to issues with fertility. Women who have PCOS have higher levels of male hormones and are also less sensitive to insulin or are “insulin-resistant.” Many are overweight or obese. As a result, these women can be at a higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.

If you have PCOS, certain lifestyle changes can help you shed pounds and reduce the disease’s severity.

Why does polycystic ovary syndrome cause weight gain?

PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition — called insulin resistance– can cause insulin and sugar — glucose — to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods — and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen. That is where men tend to carry weight. So, instead of having a pear shape, women with PCOS have more of an apple shape.

Abdominal fat is the most dangerous kind of fat. That’s because it is associated with an increased risk of heart disease and other health conditions.

What are the risks associated with PCOS-related weight gain?

No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

  • Type 2 diabetes
  • High cholesterol
  • High blood pressure
  • Sleep apnea
  • Infertility
  • Endometrial cancer

Many of these conditions can lead to heart disease. In fact, women with PCOS are four to seven times more likely to have a heart attack than women of the same age without the condition.

Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne.

What can I do to lose weight if I have polycystic ovary syndrome?

Losing weight not only cuts your risk for many diseases, it can also make you feel better. When you have PCOS, shedding just 10% of your body weight can bring your periods back to normal. It can also help relieve some of the symptoms of polycystic ovary syndrome.

Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications.

To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index. Body mass index is also called BMI, and it is the ratio of your height to your weight.

Your doctor may also prescribe medication. Several medications are approved for PCOS, including birth control pills and anti-androgen medications. The anti-androgen medications block the effects of male hormones. A few medications are used specifically to promote weight loss in women with PCOS. These include:

  • Metformin (Glucophage). Metformin is a diabetes drug that helps the body use insulin more efficiently. It also reduces testosterone production. Some research has found that it can help obese women with PCOS lose weight.
  • Thiazolidinediones. These should be used with contraception. The drugs pioglitazone (Actos) and rosiglitazone (Avandia) also help the body use insulin. In studies, these drugs improved insulin resistance. But their effect on body weight is unclear. All patients using Avandia must review and fully understand the cardiovascular risks. Research has found that Flutamide (Eulexin), an anti-androgen drug, helps obese women with PCOS lose weight. It also improves their blood sugar levels. The drug can be given alone or with metformin.

In addition to taking medication, adding healthy habits into your lifestyle can help you keep your weight under control:

  • Eat a high-fiber, low-sugar diet. Load up on fruits, vegetables, and whole grains. Avoid processed and fatty foods to keep your blood sugar levels in check. If you’re having trouble eating healthy on your own, talk to your doctor or a dietitian.
  • Eat four to six small meals throughout the day, rather than three large meals. This will help control your blood sugar levels.
  • Exercise for at least 30 minutes a day on most, if not all, days of the week.
  • Work with your doctor to track your cholesterol and blood pressure levels.
  • If you smoke, get involved in a program that can help you quit.

PCOS and Your Fertility — and What You Can Do About It

One of the most common reasons a woman has trouble getting pregnant is a condition called polycystic ovary syndrome (PCOS).  It’s a hormone problem that interferes with the reproductive system.   When you have PCOS, your ovaries are larger than normal. These bigger ovaries can have many tiny cysts that contain immature eggs.

Hormone Differences

PCOS causes a woman’s body to produce higher-than-normal levels of androgens. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgens than women.

Androgens are important in the development of male sex organs and other male traits.  In women, androgens are usually converted into the hormone estrogen.

Ovulation Problems

Elevated levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation.

If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. PCOS can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies.

Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production.

If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.

You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.

Medicines to Help You Ovulate

You won’t be able to get pregnant while you’re taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines may help:

  • Clomiphene is an anti-estrogen drug that you take at the beginning of your cycle.
  • If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin.
  • If clomiphene and metformin don’t work, your doctor may prescribe a medication containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You get this medicine in a shot.
  • One other drug that helps with ovulation is letrozole. It’s sometimes used when other medications aren’t effective.

If you have PCOS and you want to get pregnant, you should work with a doctor who is a specialist in reproductive medicine. This type of doctor is also known as a fertility specialist.

A specialist will help make sure you get the right dose of medicines, help with any problems you have, and schedule regular checkups and ultrasounds to see how you’re doing. (An ultrasound is a machine that uses sound waves to create images of the inside of your body. It’s a painless procedure that can track the growth and development of your baby).

Lifestyle Changes

For some women, gaining a lot of weight can affect their hormones. In turn, losing weight, if you’re obese or overweight, may help get your hormones back to normal levels. Losing 10% of your body weight may help your menstrual cycle become more predictable. This should help you get pregnant.

In general, living a healthier lifestyle with a better diet, regular exercise, no smoking, less stress, and control of diabetes and other medical conditions should improve your fertility odds.

Remember, if your period isn’t happening when it should, or you’ve already been diagnosed with PCOS, work closely with your doctor to help get it under control. And if you want to get pregnant, talk with a fertility specialist.

Getting Help  

If you’re having irregular periods or are unable to get pregnant, see your doctor. The same holds for:

  • Mood changes
  • Unexplained weight gain
  • Changes in your hair or skin

These symptoms may might not be caused by PCOS but could signal other serious health issues.

If anything is this article sounds like something you are dealing with, get connected with a doctor in your area who can help. To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from – WebMd

The Benefits of Breastfeeding for Both Mother and Baby | WebMD


In honor of Breastfeeding Awareness Month, we will be sharing a series of articles promoting breastfeeding.  This next one is about the “ABC’s” of breastfeeding – a brief overview of the basics you should know, republished in full from WebMD.


Breastfeeding Overview

Making the decision to breastfeed is a personal matter. It’s also one that’s likely to draw strong opinions from friends and family.

Many medical experts, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. And breastfeeding for a year at least with other foods which should be started at 6 months of age, such as vegetables, grains, fruits, proteins.

But you and your baby are unique, and the decision is up to you. This overview of breastfeeding can help you decide.

What Are the Benefits of Breastfeeding for Your Baby?

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat — everything your baby needs to grow. And it’s all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding lowers your baby’s risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.

Breastfeeding has been linked to higher IQ scores in later childhood in some studies. What’s more, the physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children. The AAP says breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome). It’s been thought to lower the risk of diabetes, obesity, and certain cancers as well, but more research is needed.

Are There Breastfeeding Benefits for the Mother?

Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster. It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding also lowers your risk of breast and ovarian cancer. It may lower your risk of osteoporosis, too.

Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, it saves you time and money. It also gives you regular time to relax quietly with your newborn as you bond.

Will I Make Enough Milk to Breastfeed?

The first few days after birth, your breasts make an ideal “first milk.” It’s called colostrum. Colostrum is thick, yellowish, and scant, but there’s plenty to meet your baby’s nutritional needs. Colostrum helps a newborn’s digestive tract develop and prepare itself to digest breast milk.

Most babies lose a small amount of weight in the first 3 to 5 days after birth. This is unrelated to breastfeeding.

As your baby needs more milk and nurses more, your breasts respond by making more milk. Experts recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. If you supplement with formula, your breasts might make less milk.

Even if you breastfeed less than the recommended 6 months, it’s better to breastfeed for a short time than no time at all. You can add solid food at 6 months but also continue to breastfeed if you want to keep producing milk.

What’s the Best Position for Breastfeeding?

The best position for you is the one where you and your baby are both comfortable and relaxed, and you don’t have to strain to hold the position or keep nursing. Here are some common positions for breastfeeding your baby:

  • Cradle position. Rest the side of your baby’s head in the crook of your elbow with his whole body facing you. Position your baby’s belly against your body so he feels fully supported. Your other, “free” arm can wrap around to support your baby’s head and neck — or reach through your baby’s legs to support the lower back.
  • Football position. Line your baby’s back along your forearm to hold your baby like a football, supporting his head and neck in your palm. This works best with newborns and small babies. It’s also a good position if you’re recovering from a cesarean birth and need to protect your belly from the pressure or weight of your baby.
  • Side-lying position. This position is great for night feedings in bed. Side-lying also works well if you’re recovering from an episiotomy, an incision to widen the vaginal opening during delivery. Use pillows under your head to get comfortable. Then snuggle close to your baby and use your free hand to lift your breast and nipple into your baby’s mouth. Once your baby is correctly “latched on,” support your baby’s head and neck with your free hand so there’s no twisting or straining to keep nursing.

How Do I Get My Baby to ‘Latch on’ During Breastfeeding?

Position your baby facing you, so your baby is comfortable and doesn’t have to twist his neck to feed. With one hand, cup your breast and gently stroke your baby’s lower lip with your nipple. Your baby’s instinctive reflex will be to open the mouth wide. With your hand supporting your baby’s neck, bring your baby’s mouth closer around your nipple, trying to center your nipple in the baby’s mouth above the tongue.

You’ll know your baby is “latched on” correctly when both lips are pursed outward around your nipple. Your infant should have all of your nipple and most of the areola, which is the darker skin around your nipple, in his mouth. While you may feel a slight tingling or tugging, breastfeeding should not be painful. If your baby isn’t latched on correctly and nursing with a smooth, comfortable rhythm, gently nudge your pinky between your baby’s gums to break the suction, remove your nipple, and try again. Good “latching on” helps prevent sore nipples.

What Are the ABCs of Breastfeeding?

  • A = Awareness. Watch for your baby’s signs of hunger, and breastfeed whenever your baby is hungry. This is called “on demand” feeding. The first few weeks, you may be nursing eight to 12 times every 24 hours. Hungry infants move their hands toward their mouths, make sucking noises or mouth movements, or move toward your breast. Don’t wait for your baby to cry. That’s a sign he’s too hungry.
  • B = Be patient. Breastfeed as long as your baby wants to nurse each time. Don’t hurry your infant through feedings. Infants typically breastfeed for 10 to 20 minutes on each breast.
  • C = Comfort. This is key. Relax while breastfeeding, and your milk is more likely to “let down” and flow. Get yourself comfortable with pillows as needed to support your arms, head, and neck, and a footrest to support your feet and legs before you begin to breastfeed.

Are There Medical Considerations With Breastfeeding?

In a few situations, breastfeeding could cause a baby harm. You should not breastfeed if:

  • You are HIV positive. You can pass the HIV virus to your infant through breast milk.
  • You have active, untreated tuberculosis.
  • You’re receiving chemotherapy for cancer.
  • You’re using an illegal drug, such as cocaine or marijuana.
  • Your baby has a rare condition called galactosemia and cannot tolerate the natural sugar, called galactose, in breast milk.
  • You’re taking certain prescription medications, such as some drugs for migraine headaches, Parkinson’s disease, or arthritis.

Talk with your doctor before starting to breastfeed if you’re taking prescription drugs of any kind. Your doctor can help you make an informed decision based on your particular medication.

Having a cold or flu should not prevent you from breastfeeding. Breast milk won’t give your baby the illness and may even give antibodies to your baby to help fight off the illness.

Also, the AAP suggests that — starting at 4 months of age — exclusively breastfed infants, and infants who are partially breastfed and receive more than one-half of their daily feedings as human milk, should be supplemented with oral iron. This should continue until foods with iron, such as iron-fortified cereals, are introduced in the diet. The AAP recommends checking iron levels in all children at age 1.

Discuss supplementation of both iron and vitamin D with your pediatrician Your doctor can guide you on recommendations about the proper amounts for both your baby and you, when to start, and how often the supplements should be taken.

Why Do Some Women Choose Not to Breastfeed?

  • Some women don’t want to breastfeed in public.
  • Some prefer the flexibility of knowing that a father or any caregiver can bottle-feed the baby any time.
  • Babies tend to digest formula more slowly than breast milk, so bottle feedings may not be as frequent as breastfeeding sessions.

The time commitment, and being “on-call” for feedings every few hours of a newborn’s life, isn’t feasible for every woman. Some women fear that breastfeeding will ruin the appearance of their breasts. But most breast surgeons would argue that age, gravity, genetics, and lifestyle factors like smoking all change the shape of a woman’s breasts more than breastfeeding does.

What Are Some Common Challenges With Breastfeeding?

  • Sore nipples. You can expect some soreness in the first weeks of breastfeeding. Make sure your baby latches on correctly, and use one finger to break the suction of your baby’s mouth after each feeding. That will help prevent sore nipples. If you still get sore, be sure you nurse with each breast fully enough to empty the milk ducts. If you don’t, your breasts can become engorged, swollen, and painful. Holding ice or a bag of frozen peas against sore nipples can temporarily ease discomfort. Keeping your nipples dry and letting them “air dry” between feedings helps, too. Your baby tends to suck more actively at the start. So begin feedings with the less-sore nipple.
  • Dry, cracked nipples. Avoid soaps, perfumed creams, or lotions with alcohol in them, which can make nipples even more dry and cracked. You can gently apply pure lanolin to your nipples after a feeding, but be sure you gently wash the lanolin off before breastfeeding again. Changing your bra pads often will help your nipples stay dry. And you should use only cotton bra pads.
  • Worries about producing enough milk.A general rule of thumb is that a baby who’s wetting six to eight diapers a day is most likely getting enough milk. Avoid supplementing your breast milk with formula, and never give your infant plain water. Your body needs the frequent, regular demand of your baby’s nursing to keep producing milk. Some women mistakenly think they can’t breastfeed if they have small breasts. But small-breasted women can make milk just as well as large-breasted women. Good nutrition, plenty of rest, and staying well hydrated all help, too.
  • Pumping and storing milk. You can get breast milk by hand or pump it with a breast pump. It may take a few days or weeks for your baby to get used to breast milk in a bottle. So begin practicing early if you’re going back to work. Breast milk can be safely used within 2 days if it’s stored in a refrigerator. You can freeze breast milk for up to 6 months. Don’t warm up or thaw frozen breast milk in a microwave. That will destroy some of its immune-boosting qualities, and

it can cause fatty portions of the breast milk to become super hot. Thaw breast milk in the refrigerator or in a bowl of warm water instead.

  • Inverted nipples. An inverted nipple doesn’t poke forward when you pinch the areola, the dark skin around the nipple. A lactation consultant — a specialist in breastfeeding education — can give simple tips that have allowed women with inverted nipples to breastfeed successfully.
  • Breast engorgement. Breast fullness is natural and healthy. It happens as your breasts become full of milk, staying soft and pliable. But breast engorgement means the blood vessels in your breast have become congested. This traps fluid in your breasts and makes them feel hard, painful, and swollen. Alternate heat and cold, for instance using ice packs and hot showers, to relieve mild symptoms. It can also help to release your milk by hand or use a breast pump.
  • Blocked ducts. A single sore spot on your breast, which may be red and hot, can signal a plugged milk duct. This can often be relieved by warm compresses and gentle massage over the area to release the blockage. More frequent nursing can also help.
  • Breast infection (mastitis). This occasionally results when bacteria enter the breast, often through a cracked nipple after breastfeeding. If you have a sore area on your breast along with flu-like symptoms, fever, and fatigue, call your doctor. Antibiotics are usually needed to clear up a breast infection, but you can most likely continue to breastfeed while you have the infection and take antibiotics. To relieve breast tenderness, apply moist heat to the sore area four times a day for 15 to 20 minutes each time.
  • Stress. Being overly anxious or stressed can interfere with your let-down reflex. That’s your body’s natural release of milk into the milk ducts. It’s triggered by hormones released when your baby nurses. It can also be triggered just by hearing your baby cry or thinking about your baby. Stay as relaxed and calm as possible before and during nursing — it can help your milk let down and flow more easily. That, in turn, can help calm and relax your infant.
  • Premature babies may not be able to breastfeed right away. In some cases, mothers can release breast milk and feed it through a bottle or feeding tube.
  • Warning signs. Breastfeeding is a natural, healthy process. But call your doctor if:
  • Your breasts become unusually red, swollen, hard, or sore.
  • You have unusual discharge or bleeding from your nipples.
  • You’re concerned your baby isn’t gaining weight or getting enough milk.

Where Can I Get Help With Breastfeeding?

Images of mothers breastfeeding their babies make it look simple — but most women need some help and coaching. It can come from a nurse, doctor, family member, or friend, and it helps mothers get over possible bumps in the road.

Reach out to friends, family, and your doctor with any questions you may have. Most likely, the women in your life have had those same questions.

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

SOURCE: WebMD Medical Reference Reviewed by Dan Brennan, MD on December 5, 2017

Sources

News release, American Academy of Pediatrics.

Baker, R. Pediatrics, November 2010.

American Academy of Pediatrics: “Policy Statement: Breastfeeding and the Use of Human Milk.”

American College of Obstetricians and Gynecologists: “Breastfeeding Your Baby.”

CDC: “Proper Handling and Storage of Human Milk.”

National Women’s Health Information Center: “Benefits of Breastfeeding.”

National Women’s Health Information Center: “Questions and Answers About Breastfeeding.”

National Women’s Health Information Center: “How Lifestyle Affects Breast Milk.”

La Leche League International: “How Do I Position My Baby to Breastfeed?”

American Academy of Family Physicians: “Breastfeeding: Hints To Help You Get Off to a Good Start.”

National Library of Medicine: “Overcoming Breastfeeding Problems.”

KidsHealth.org: “Feeding Your Newborn.”

American College of Nurse-Midwives, GotMom.org: “Breastfeeding with Confidence.”

© 2017 WebMD, LLC. All rights reserved.

Are We Infertile? Finding Help When Trying to Get Pregnant

Infertility happens when a couple cannot conceive after having regular unprotected sex.  It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Worldwide, 8 to 12 percent of couples experience fertility problems. Between 45 and 50 percent of cases are thought to stem from factors that affect the man.

Treatment is often available.

Causes in men

The following are common causes of infertility in men.

Semen and sperm

Semen is the milky fluid that a man’s penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.

The sperm is produced in the testicles.

When a man ejaculates and releases semen through the penis, the seminal fluid, or semen, helps transport the sperm toward the egg.

The following problems are possible:

  • Low sperm count: The man ejaculates a low number of sperm. A sperm count of under 15 million is considered low. Around one third of couples have difficulty conceiving due to a low sperm count.
  • Low sperm mobility (motility): The sperm cannot “swim” as well as they should to reach the egg.
  • Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. Up to 2 percent of men are thought to have suboptimal sperm.

Abnormal semen may not be able to carry the sperm effectively.

This can result from:

  • A medical condition: This could be a testicular infection, cancer, or surgery.
  • Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
  • Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder
  • Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency.

Other causes may include:

  • Genetic factors: A man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome, as in Klinefelter’s syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm.
  • Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production.
  • Hypospadias: The urethral opening is under the penis, instead of its tip. This abnormality is usually surgically corrected in infancy. If the correction is not done, it may be harder for the sperm to get to the female’s cervix. Hypospadias affects about 1 in every 500 newborn boys.
  • Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra.
  • Radiation therapy: This can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
  • Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

Some medications increase the risk of fertility problems in men.

  • Sulfasalazine: This anti-inflammatory drug can significantly lower a man’s sperm count. It is often prescribed for Crohn’s disease or rheumatoid arthritis. Sperm count often returns to normal after stopping the medication.
  • Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility.
  • Chemotherapy: Some types may significantly reduce sperm count.
  • Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count.
  • Age: Male fertility starts to fall after 40 years.
  • Exposure to chemicals: Pesticides, for example, may increase the risk.
  • Excess alcohol consumption: This may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count.
  • Overweight or obesity: This may reduce the chance of conceiving.
  • Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity.

Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. Women are advised not to use the drug for more than one day.

Causes in women

Infertility in women can also have a range of causes.

Risk factors

Risk factors that increase the risk include:

  • Age: The ability to conceive starts to fall around the age of 32 years.
  • Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
  • Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.
  • Being obese or overweight: This can increase the risk of infertility in women as well as men.
  • Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.
  • Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.
  • Exercise: Both too much and too little exercise can lead to fertility problems.
  • Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man’s scrotum. Some other STIs may also cause infertility.
  • Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.
  • Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Medical conditions

Some medical conditions can affect fertility.

Ovulation disorders appear to be the most common cause of infertility in women.

Ovulation is the monthly release of an egg. The eggs may never be released, or they may only be released in some cycles.

Ovulation disorders can be due to:

  • Premature ovarian failure: The ovaries stop working before the age of 40 years.
  • Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.
  • Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.
  • Chronic conditions: These include AIDS or cancer.

Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.

If the egg does not travel, it can be harder to conceive naturally.

Causes include:

  • Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.

Medications, treatments, and drugs

Some drugs can affect fertility in a woman.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.
  • Chemotherapy: Some chemotherapy drugs can result in ovarian failure. In some cases, this may be permanent.
  • Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems.
  • Illegal drugs: Some women who use marijuana or cocaine may have fertility problems.

Cholesterol

One study has found that high cholesterol levels may have an impact on fertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

However, a survey has suggested that the 3 days most likely to offer a fertile window are the 2 days before ovulation plus the 1 day of ovulation.

Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility.

  • Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.
  • Varicocele: Surgically removing a varicose vein in the scrotum may help.
  • Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
  • Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory.
  • Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked, sperm may not be ejaculated properly.

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

  • Clomiphene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • Metformin (Glucophage): If Clomiphene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
  • Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
  • Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Reducing the risk of multiple pregnancies

Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. The chance of a multiple birth is lower with an oral fertility drug.

Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed. Couples will have to consider the ethical and emotional aspects of this procedure.

Surgical procedures for women

If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

Endometriosis may be treated through laparoscopic surgery. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. It can also help if a man has severe erectile dysfunction.

In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use.

Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.

Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. Fertility treatment with donor eggs is usually done using IVF.

Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to implant into the uterine lining. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. In some women, and especially with age, the membrane becomes harder. This can make it difficult for the embryo to implant.

Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury.

Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

Most people will visit a physician if there is no pregnancy after 12 months of trying.

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.

A doctor can give advice and carry out some preliminary assessments. It is better for a couple to see the doctor together.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Infertility tests for men

The doctor will ask the man about his medical history, medications, and sexual habits and carry out a physical examination. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities.

  • Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Sperm counts can fluctuate, so that several samples may be necessary.
  • Blood test: The lab will test for levels of testosterone and other hormones.
  • Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation.
  • Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it.

Infertility tests for women

A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits.

She will also undergo a gynecologic examination and a number of tests:

  • Blood test: This can assess hormone levels and whether a woman is ovulating.
  • Hysterosalpingography: Fluid is injected into the woman’s uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If a blockage is present, surgery may be necessary.
  • Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.

Other tests include:

  • ovarian reserve testing, to find out how effective the eggs are after ovulation
  • genetic testing, to see if a genetic abnormality is interfering with fertility
  • pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries
  • Chlamydia test, which may indicate the need for antibiotic treatment
  • thyroid function test, as this may affect the hormonal balance

Complications

Some complications can result from infertility and its treatment. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

Some physical effects may also result from treatment.

Ovarian hyperstimulation syndrome

The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops.

Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomiphene and gonadotrophins. It can also develop after IVF.

Symptoms include:

  • bloating
  • constipation
  • dark urine
  • diarrhea
  • nausea
  • abdominal pain
  • vomiting

They are usually mild and easy to treat.

Rarely, a blood clot may develop in an artery or vein, liver or kidney problems can arise, and respiratory distress may develop. In severe cases, OHSS can be fatal.

Ectopic pregnancy

This is when a fertilized egg implants outside the womb, usually in a fallopian tube. If it stays in there, complications can develop, such as the rupture of the fallopian tube. This pregnancy has no chance of continuing.

Immediate surgery is needed and, sadly, the tube on that side will be lost. However, future pregnancy is possible with the other ovary and tube.

Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.

Coping mentally

It is impossible to know how long treatment will go on for and how successful it will be. Coping and persevering can be stressful. The emotional toll on both partners can affect their relationship.

Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation.

It is important to tell a doctor if excessive mental and emotional stress develop. They can often recommend a counselor and others who can offer appropriate support. Online support from organizations such as Resolve can be helpful.

Outlook

For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before.

In 1978, the first baby was born as a result of IVF. By 2014, over 5 million people had been born after being conceived through IVF.

As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time.

Financing fertility treatment can also be costly, but there are programs that can help with this.

Finding Help

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Source:

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Infertility in men and women, Medical News Today, 4 January 2018

Wearing a Scoliosis Brace: Anna’s Experience – Pediatric Orthopedic Surgery

Treated with scoliosis bracing, Anna has successfully completed brace treatment. She describes her experience while wearing the brace and gives helpful advice to other patients requiring treatment for spinal curvature. To request an appointment, visit: http://www.mayoclinic.org/departments-centers/childrens-center/overview/appointments?mc_id=us&utm_source=youtube&utm_medium=sm&utm_content=video&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100504

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How to Measure Your Blood Sugar – Mayo Clinic Patient Education

In this short video, a Mayo Clinic Certified Diabetes Educator introduces us to the equipment and walks us through the process of checking blood sugar levels for people with diabetes.

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Upper Limb Amputation Patient Education Video

Patients have many questions when facing an upper limb amputation. Hear directly from patients about their prosthetics and how they’ve adjusted to every day life.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Will At Home Testing Improve Screening and Lower Cancer Rates?

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, report researchers at the University of North Carolina Comprehensive Cancer Center.

In collaboration with the Mecklenburg County Health Department in Charlotte, researchers with UNC Lineberger’s Carolina Cancer Screening Initiative examined the impact of targeted outreach to more than 2,100 people insured by Medicaid who were not up-to-date with colorectal cancer screening. The project resulted in a nearly 9 percentage point percent increase in screening rates for patients who received a screening kit in the mail compared with patients who just received a reminder, and it demonstrated that their method could serve as a model to improve screening on a larger scale. The findings were published in the journal Cancer.

The American Cancer Society estimates that more than 97,000 people will be diagnosed with colorectal cancer in the United States this year, and it will result in approximately 50,600 deaths. It is third most common type of cancer in the United States, and the second leading cause of cancer death.  Cancer, overall, is the second killer in the US, behind heart disease.

While colorectal cancer screening has proven effective in reducing cancer deaths, researchers report too few people are getting screened. Current guidelines from ACS recommend regular screening with either a high-sensitivity stool-based test or a structural (visual) exam for average-risk people aged 45 years and older, and that all positive results should be followed with colonoscopy.

Despite these recommendation, studies have identified notable gaps in screening rates, including by race, geographic region and other socioeconomic factors. Among patients who are insured, people with Medicaid have the lowest rates of colorectal cancer testing.

“There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease, but screening rates are only about 63 percent, and low-income, and otherwise vulnerable populations, tend to be screened at even lower rates,” said the study’s first author UNC Lineberger’s Alison Brenner, Ph.D., MPH, research assistant professor in the UNC School of Medicine Department of Internal Medicine.

For the project, researchers either mailed reminders about colorectal cancer screening and instructions on how to arrange one with the health department, or reminders plus a fecal immunochemical test, or FIT kit, which can detect blood in the stool—a symptom of colon cancer. The patient completes the test at home and returns it to a provider for analysis. Patients who have a positive FIT kit result will be scheduled for a colonoscopy.

The UNC Lineberger researchers worked with the Mecklenburg County Health Department staff, who coordinated the reminders and mailings and ran the test analyses. They also partnered with Medicaid care coordinators to provide patient navigation support to patients who had abnormal test results and required a colonoscopy.

Twenty-one percent of patients who received FIT kits in the mail completed the screening test, compared with 12 percent of patients who just received a reminder. Eighteen people who completed FIT tests had abnormal results, and 15 of those people were eligible for a colonoscopy. Of the 10 who completed the colonoscopy, one patient had an abnormal result.

“Preventive care amongst vulnerable populations rarely rises to the top of the mental queue of things that need to get done,” Brenner said. “In North Carolina, many Medicaid recipients are on disability. Making something like colorectal cancer screening as simple and seamless as possible is really important. If it’s right in front of someone, it’s more likely to get done, even if there are simple barriers in place.”

Brenner said the study shows the potential to harness resources like the county health department for health prevention services.

“This collaborative and pragmatic quality improvement effort demonstrates the feasibility, acceptability, and efficiency of using existing health services resources and infrastructure, including Medicaid-based navigation to colonoscopy to deliver timely cancer screening services to low income populations,” said UNC Lineberger’s Stephanie Wheeler, Ph.D., MPH, associate professor in the UNC Gillings School of Global Public Health and the study’s senior author.

She said researchers plan to move forward to study whether they can implement their approach on a larger scale, and to understand all of the cost implications.

“This is looking at expanding the medical neighborhood—to harness community resources to target patients and in this case, insured patients, who are maybe not getting this from a primary health care organization, and how to increase screening rates in these types of vulnerable populations,” Brenner said.


If you are looking for a doctor to discuss the need for colon cancer screening or your results, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Source:  originally printed, “By sending tests in the mail, researchers boost colorectal cancer screening.”  July 14, 2018 , UNC Lineberger Comprehensive Cancer Center

More information: Alison T. Brenner et al, Comparative effectiveness of mailed reminders with and without fecal immunochemical tests for Medicaid beneficiaries at a large county health department: A randomized controlled trial, Cancer (2018).  DOI: 10.1002/cncr.31566

Provided by: UNC Lineberger Comprehensive Cancer Center

Muscle Loss and Aging

Mayo Clinic Dr. Nathan LeBrasseur discusses muscle loss during the aging process and also looks at strategies and therapies to maintain muscle health.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Loneliness – A Gene Deep Epidemic that Raises Health Risks and Can Be Spread

A 2016 survey of more than 2,000 American adults found 72 percent report having felt a sense of loneliness, with nearly a third (31 percent) experiencing loneliness at least once a week. The survey was conducted online by Harris Poll on behalf of the American Osteopathic Association in September.

Isolation is often an underlying factor in many of the most common health conditions, including chronic pain, substance abuse and depression, according to osteopathic physicians.

Long working hours, increased use of social media—in many cases surpassing in-person interaction—and a mobile workforce traveling or living far from family contribute to the high rates of loneliness, noted Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine.

“Loneliness is an invisible epidemic masked by our online personas, which are rarely representative of our real emotions,” said Dr. Caudle. “It’s important for patients to understand how their mental and emotional well-being directly affects the body. By taking a whole-person approach to care, osteopathic physicians are trained to address these underlying issues that can quietly erode patients’ health.”

Damage to the Immune Response

Research links loneliness to a number of dysfunctional immune responses, suggesting that being lonely has the potential to harm overall health.

In one study, researchers found that people who were more lonely showed signs of elevated latent herpes virus reactivation and produced more inflammation-related proteins in response to acute stress than did people who felt more socially connected.

These proteins signal the presence of inflammation, and chronic inflammation is linked to numerous conditions, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer’s disease, as well as the frailty and functional decline that can accompany aging.

Reactivation of a latent herpes virus is known to be associated with stress, suggesting that loneliness functions as a chronic stressor that triggers a poorly controlled immune response.

“It is clear from previous research that poor-quality relationships are linked to a number of health problems, including premature mortality and all sorts of other very serious health conditions. And people who are lonely clearly feel like they are in poor-quality relationships,” said Lisa Jaremka, a postdoctoral fellow at the Institute for Behavioral Medicine Research at Ohio State University and lead author of the research.

“One reason this type of research is important is to understand how loneliness and relationships broadly affect health. The more we understand about the process, the more potential there is to counter those negative effects – to perhaps intervene. If we don’t know the physiological processes, what are we going to do to change them?”

The results are based on a series of studies conducted with two populations: a healthy group of overweight middle-aged adults and a group of breast cancer survivors. The researchers measured loneliness in all studies using the UCLA Loneliness Scale, a questionnaire that assesses perceptions of social isolation and loneliness.

Jaremka presented the research at the Society for Personality and Social Psychology annual meeting in New Orleans.

The researchers first sought to obtain a snapshot of immune system behavior related to loneliness by gauging levels of antibodies in the blood that are produced when herpes viruses are reactivated.

Participants were 200 breast cancer survivors who were between two months and three years past completion of cancer treatment with an average age of 51 years. Their blood was analyzed for the presence of antibodies against Epstein-Barr virus and cytomegalovirus.

Both are herpes viruses that infect a majority of Americans. About half of infections do not produce illness, but once a person is infected, the viruses remain dormant in the body and can be reactivated, resulting in elevated antibody levels, or titers – again, often producing no symptoms but hinting at regulatory problems in the cellular immune system.

Lonelier participants had higher levels of antibodies against cytomegalovirus than did less lonely participants, and those higher antibody levels were related to more pain, depression and fatigue symptoms. No difference was seen in Epstein-Barr virus antibody levels, possibly because this reactivation is linked to age and many of these participants were somewhat older, meaning reactivation related to loneliness would be difficult to detect, Jaremka said.

Previous research has suggested that stress can promote reactivation of these viruses, also resulting in elevated antibody titers.

“The same processes involved in stress and reactivation of these viruses is probably also relevant to the loneliness findings,” Jaremka said. “Loneliness has been thought of in many ways as a chronic stressor – a socially painful situation that can last for quite a long time.”

In an additional set of studies, the scientists sought to determine how loneliness affected the production of proinflammatory proteins, or cytokines, in response to stress. These studies were conducted with 144 women from the same group of breast cancer survivors and a group of 134 overweight middle-aged and older adults with no major health problems.

Baseline blood samples were taken from all participants, who were then subjected to stress – they were asked to deliver an impromptu five-minute speech and perform a mental arithmetic task in front of a video camera and three panelists. Researchers followed by stimulating the participants’ immune systems with lipopolysaccharide, a compound found on bacterial cell walls that is known to trigger an immune response.

In both populations, those who were lonelier produced significantly higher levels of a cytokine called interleukin-6, or IL-6, in response to acute stress than did participants who were more socially connected. Levels of another cytokine, tumor necrosis factor-alpha, also rose more dramatically in lonelier participants than in less lonely participants, but the findings were significant by statistical standards in only one study group, the healthy adults.

In the study with breast cancer survivors, researchers also tested for levels of the cytokine interleukin 1-beta, which was produced at higher levels in lonelier participants.

When the scientists controlled for a number of factors, including sleep quality, age and general health measures, the results were the same.  “We saw consistency in the sense that more lonely people in both studies had more inflammation than less lonely people,” Jaremka said.

“It’s also important to remember the flip side, which is that people who feel very socially connected are experiencing more positive outcomes,” she said.

Loneliness Can Add 30 Points To Your Blood Pressure

In another study conducted at the Center for Cognitive and Social Neuroscience at the University of Chicago, researchers found that if you are over 50 and lonely, you could be adding 30 points to your blood pressure and raising significantly your chances of suffering from hypertension.   The increase in blood pressure due to loneliness was present after taking into account a person’s emotional state (how sad or stressed the person was).

The older the lonely person gets, the higher his/her blood pressure seems to get, said the researchers.   Lead researcher, Louise Hawkley, said “The take-home message is that feelings of loneliness are a health risk, in that the lonelier you are, the higher your blood pressure. And we know that high blood pressure has all kinds of negative consequences.”

229 people were monitored in this study, aged 50-68. The participants had to answer a questionnaire which determined each person’s level of loneliness.

Hawkley said it is not as simple as that. She said “Remember, people can feel lonely even if they are with a lot of people. You can think of Marilyn Monroe or Princess Diana – there was certainly nothing lacking in their social lives, yet they claimed to have felt intensely lonely. They may want to go out and make friends, and yet they have a nagging lack of trust with whomever they want to interact with, or they may feel hostile. So, they end up behaving in ways that force potential partners away.”

Loneliness Is Gene Deep

Loneliness has a molecular signature is reflected in the lonely person’s DNA. This was the conclusion of a new US study by scientists at the University of California Los Angeles (UCLA) and other US academic centers.

The study is published in an issue of the journal, Genome Biology.  The researchers discovered a distinct pattern of gene expression in immune cells of people who are chronically extremely lonely.

Study author Steve Cole, associate professor of medicine at the Division of Hematology and Oncology at the David Geffen School of Medicine at UCLA, member of the Cousins Center for Psychoneuroimmunology, and member of UCLA’s Jonsson Comprehensive Cancer Center said in a press release that:

“What this study shows is that the biological impact of social isolation reaches down into some of our most basic internal processes: the activity of our genes.”  Cole and colleagues suggest that feelings of isolation are linked to changes in gene expression that drive inflammation, one of the first responses of the immune system.  They hope the study gives a framework for understanding how social factors and increased risk of heart disease, viral infections and cancer are linked.

Scientists already know that social environments affect health. People who are lonely and socially isolated die earlier.  What they don’t know is if the higher rate of death among lonely people is because of reduced social resources or because of the effect of isolation on their bodily functions, or perhaps both.

However, Cole and the other researchers found that changes in the way immune cells express their genes were directly linked to the “subjective experience of social distance”.  The differences were independent of other known risk factors like health status, weight, age and use of medication, they said.  “The changes were even independent of the objective size of a person’s social network,” said Cole.

Cole and colleagues enrolled 14 participants from the Chicago Health, Aging, and Social Relations Study and scanned their DNA using a chip technology called DNA microarrays that allowed them to survey all known human genes in the samples.  6 of the participants scored in the top 15 per cent of a well known psychological test for loneliness that was developed in the 70s called the UCLA Loneliness Scale.  The remaining 8 participants scored in the bottom 15 per cent of the Loneliness Scale.

The DNA survey showed that 209 gene transcripts (where the gene gets its code ready to start making proteins) were expressed differently between the two groups. All the genes coded for leucocytes, agents of the immune system.  78 of the gene transcripts were “over expressed” (resulting in too much protein) and 131 were “under expressed” (not enough protein) in the lonely individuals compared to the others.

The over expressed genes included many that control immune system functions like inflammation.  However, it was also interesting that the under expressed genes were those involved in antiviral responses and production of antibodies.

“These data provide the first indication that human genome-wide transcriptional activity is altered in association with a social epidemiological risk factor. Impaired transcription of glucocorticoid response genes and increased activity of pro-inflammatory transcription control pathways provide a functional genomic explanation for elevated risk of inflammatory disease in individuals who experience chronically high levels of subjective social isolation.”

Distinguishing between the various aspects of loneliness that are closely linked to these changes in gene expression, the scientists discovered:  “What counts at the level of gene expression is not how many people you know, it’s how many you feel really close to over time,” said Cole.  He added that the findings could identify molecular targets for blocking the negative health impact of social isolation.

Loneliness Can Spread Through Social Networks

A US study of social networks found that a person’s loneliness can spread to others, in that when they become lonely they move to the edge of the network and transmit feelings of loneliness to their few remaining friends who also become lonely, leading to an effect that the researchers described as an unravelling at the edges of our social fabric.

The study, which was sponsored by the National Institute on Aging, is the work of John T Cacciopo of the University of Chicago, James H Fowler of the University of California, San Diego, and Nicholas A Christakis of Harvard University and is about to be published in the December issue of the Journal of Personality and Social Psychology.

Cacciopo, a social neuroscientist and lead investigator on the study, is Tiffany and Margaret Blake Distinguished Service Professor in Psychology at Chicago. He told the press that:

“We detected an extraordinary pattern of contagion that leads people to be moved to the edge of the social network when they become lonely.”

“On the periphery people have fewer friends, yet their loneliness leads them to losing the few ties they have left,” he added.

Loneliness is often associated with mental and physical diseases that can shorten life, said Cacioppo, so it is important for us to recognize it and help people reconnect with their social group before they move to the edges.

He and his co-authors wrote that while previous studies have already shown that a person’s loneliness and the number of people they are connected to in a network are linked, we don’t know much about “the placement of loneliness within, or the spread of loneliness through, social networks”.

Using longitudinal data from a large-scale study, they found that loneliness, like a bad cold, spreads in groups: people share their loneliness with others.

Cacioppo and colleagues used data on 5,124 people in the second generation of participants from the Framingham Heart Study, which has been tracking the health of individuals and their descendants for more than 60 years. The data set included information taken every two to four years on participants’ friends and social contacts.

For the study, Cacioppo and colleagues charted the friendship histories of participants and linked them to their reports of loneliness. This showed a pattern of loneliness that spread as people reported fewer close friends, and that lonely people appeared to transmit loneliness to others, and then moved to the edges of their social networks.

“Loneliness is disproportionately represented at the periphery of social networks and spreads through a contagious process,” wrote the researchers.

For example, one pattern might start when a participant reports one extra day a week of loneliness. This is followed by similar reports among his or her next-door neighbors who are also close friends. The pattern of loneliness then spreads as the neighbors spend less time together.

“These reinforcing effects mean that our social fabric can fray at the edges, like a yarn that comes loose at the end of a crocheted sweater,” explained Cacioppo.

The researchers also found that:

  • Women were more likely to report “catching loneliness from others” than men (perhaps reinforcing findings from studies that suggest women rely more on emotional support than men).
  • Loneliness occurred in clusters and extended up to three degrees of separation.
  • A person’s chances of reporting increased loneliness were more likely to be linked to changes in friendship networks than changes in family networks.

The authors concluded that the study helps us better understand the social forces that drive loneliness.

Society may benefit by “aggressively targeting the people in the periphery to help repair their social networks and to create a protective barrier against loneliness that can keep the whole network from unraveling,” they added.

Other studies suggest that as people become lonely they trust other people less and less, and this leads to a cycle of less trusting and more loneliness, which leads to less trusting, and so on, and as time goes by it becomes harder and harder to make friends.

Cacioppo said researchers have seen this social tendency reflected in monkey colonies that drive out members who have been removed and then reintroduced.  He said such a pattern makes it all the more important for us to recognize and offset loneliness before it spreads.

Overcoming Loneliness

The first step in addressing loneliness is to determine whether those feelings are caused by depression. A physician can diagnose any existing mental health conditions and suggest treatment options. To limit loneliness, physicians recommend some simple steps to help increase real social engagement:

  1. Consider a digital cleanse. Social networks can offer real connections, but the curated platforms may over-emphasize the success of others, which can lead to feelings of inadequacy. For more empowering activities, consider enrolling in a continuing education course or spending time enjoying nature.
  2. Exercise with others. Participating in a running club, group fitness course or team sport can have dual benefits, creating opportunities to meet new people while also improving physical health. Many sports stores, churches and community groups offer free weekly activities including fun runs and yoga.
  3. Buy local. Developing a routine that includes visiting a local shopkeeper, coffee shop, farmers’ market or gym builds roots in the community. Creating relationships with local vendors can lead to a sense of shared history and camaraderie.
  4. Step out of your comfort zone. Introducing yourself to nearby neighbors or engaging with people in the building elevator—while initially uncomfortable—can begin the process of developing community and has the added bonus of alleviating loneliness for others.
  5. Change jobs, schools or cities. This drastic option is not always possible, and certainly not easy, but it may have the most significant impact. Start by identifying the culture that would best fit your personality and work toward a transition.

“Face-to-face communication is critical for emotional and mental health,” Dr. Caudle added. “Seeking out meaningful human interactions makes patients happier and, ultimately, healthier overall.”

Conclusion

Loneliness has negative effects on your immune system, creates a genetic signature and can spread through social networks.  Our digital addictions seem to be contributing to our disconnectedness.  Additional studies indicate loneliness significantly shortens lives and can lead to or magnify dementia and Alzheimer’s.

Today is National Cheer up the Lonely Day.  Visit with the lonely and bring happy things to talk about. Keep the conversation upbeat, and lively. When you leave, give a big hug and let them know you enjoyed the stay. Sending cards or making a phone call is okay if they live too far away to visit, but what a lonely person really needs is face to face time with other people.

If you are feeling lonely, other studies indicate you are more likely to see a physician with increased frequency. To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

[1] Caldwell, Emily. The Immune System Taxed By Loneliness, Similar To The Effect Of Chronic Stress.  Medical News Today, Tuesday 22 January 2013

This work was supported by grants from the National Institutes of Health, the American Cancer Society Postdoctoral Fellowship and a Pelotonia Postdoctoral Fellowship from Ohio State’s Comprehensive Cancer Center.

Co-authors include Christopher Fagundes of the Institute for Behavioral Medicine Research (IBMR); Juan Peng of the College of Public Health; Jeanette Bennett of the Division of Oral Biology; Ronald Glaser of the Department of Molecular Virology, Immunology and Medical Genetics; William Malarkey of the Department of Internal Medicine; and Janice Kiecolt-Glaser of the Department of Psychiatry, all at Ohio State. Bennett, Glaser, Malarkey and Kiecolt-Glaser are also IBMR investigators.

[2] Lombardi, Yvonne. Loneliness Can Add 30 Points To Your Blood Pressure If You Are Over 50.  Medical News Today. Wednesday, 29 March 2006.

[3] Paddock, Catharine PhD.  Loneliness Is Gene Deep. Medical News Today. Friday, 14 September 2007

“Effects of loneliness on gene expression.”
Cole SW, Hawkley LC, Arevalo JM, Sung CY, Rose RM, Cacioppo JT.
Genome Biology 2007, 8:R189.
doi:10.1186/gb-2007-8-9-r189
Published online 13 September 2007 (provisional version).

[4]  Paddock, Catharine PhD.  Loneliness Can Spread Through Social Networks.  Medical News Today. Wednesday, 2 December 2009

“Alone in the Crowd: The Structure and Spread of Loneliness in a Large Social Network.”
John T Cacciopo, James H Fowler, Nicholas A Christakis.
Journal of Personality and Social Psychology, December 2009 (pre-publication proof).
DOI:10.1037/a0016076

[5] American Osteopathic Association.  Survey Finds Nearly Three-Quarters (72%) of Americans Feel Lonely: Osteopathic Physicians Say Silent ‘Loneliness Epidemic’ Contributes to Nation’s Health Woes. PRN. Oct 11, 2016.

 

The AntiBiotic Resistance Crisis and How the Platypus Might Save Us All

Although platypuses are deeply unusual animals, as researchers dig deeper into their biochemistry, it seems that they might hold the key to the growing problem of antibiotic resistance.

Antibiotic resistance is a topic that sits squarely in the center of medical researchers’ minds; it’s a huge concern.  In fact, many scientists consider it to be one of the “world’s most pressing public health problems.”

In a nutshell, antibiotic resistance occurs when a species of bacteria becomes immune to antibiotics.  Once bacteria have developed an ambivalence to these drugs, they are able to survive their onslaught and pass antibiotic-resistant genes onto the next generation.

But today, diseases that were once very easily treatable with antibiotics — such as pneumonia and tuberculosis — are becoming life-threatening.  The World Health Organization (WHO) pull no punches when they write, “Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill.”

As we use these drugs more and more, an increasing number are becoming ineffective.  On this dimly lit and deeply worrying backdrop, the platypus waddles into the spotlight. Can this reclusive, semi-aquatic weirdo lift this sense of impending doom?

The peculiar platypus

The platypus needs no introduction, but I’ll give you one anyway because they’re just so pleasing to consider.

Platypuses are monotremes — that is, a subgroup of mammals that comprises just five species (the platypus and four species of the hedgehog-like echidna). The former is one of the most iconic and baffling animals on the planet.

She’s hairy and warm-blooded, similar to standard mammals, yet she lays eggs. She has a duck-like bill and a beaver-like tail, and she is one of the very few venomous mammals.

The strangeness doesn’t stop there, however; the female has two ovaries — no surprise — but only the left one actually works. Also, baby platypuses are born with teeth, but, at an early age, they all fall out, leaving a horny plate.

So, how on earth could such a natural oddity help to save the human race from the horrors of antibiotic resistance? Well, the answer might lie in its milk.

According to an earlier study, platypus milk contains unique antibacterial properties. The authors report that proteins in their milk “were effective in killing a broad range of bacterial pathogens.”

Investigating platypus milk in detail

Recently, a team of researchers from Australia’s Commonwealth Scientific and Industrial Research Organization (CSIRO) combined forces with Deakin University in Victoria, also in Australia. They wanted to examine the almighty prowess of platypus milk and attempt to understand why it’s so potent. Their results were recently published in the journal Structural Biology Communications.

In the laboratory, the scientists replicated the platypus milk protein responsible for its antibacterial powers and gave it a long, hard inspection. As Dr. Julie Sharp, from Deakin University, states, “We were interested to examine the protein’s structure and characteristics to find out exactly what part of the protein was doing what.”

Recreating a protein in the laboratory sounds, at first reading, to be a relatively simple job — but it’s not. Achieving this feat took the combined might of the Synchrotron, a cyclic particle accelerator, and the CSIRO’s ultra-hi-tech Collaborative Crystallisation Centre.

The magical, bacteria-slaughtering capabilities of the milk protein might come from its unique 3-D folding. The protein has a ringlet-like formation, thus earning it the nickname Shirley Temple. The intriguing format of the protein has not been seen in nature before.

“Platypus[es] are such weird animals that it would make sense for them to have weird biochemistry.”

Lead study author Dr. Janet Newman

Why is the platypus’s milk so powerful?

The platypus is a conundrum of a creature with miraculous milk.  Unlike the vast majority of mammals, the platypus has no nipples (which is yet another reason why platypuses are considered one of planet Earth’s oddest residents). So, without nipples, the mother platypus secretes milk from a patch of skin.

As an aside, baby platypuses — rather boringly — are officially called “baby platypuses.” However, there are more pleasing, if unofficial, names, including puggles and platypups, so feel free to use whichever you deem cutest.

I’ll stick with baby platypuses for the sake of maintaining some degree of scientific integrity. But as I was saying, since there are no teets, the mother’s milk comes into contact with the outside world, and the baby platypus must lick the milk from the surrounding hair.

Of course, this opens the young animals up to an unholy array of bacteria and other nasties. This, perhaps, is the reason that platypus milk needs to be so profoundly antibacterial.

Shirley Temple may open the door to other fields of study, too; Dr. Newman says, “Although we’ve identified this highly unusual protein as only existing in monotremes, this discovery increases our knowledge of protein structures in general and will go on to inform other drug discovery work done at the Centre.”

For now, we will have to wait and see how this new protein might be unleashed in the war against antibiotic resistance. Hopefully, the wait will not be a long one. God bless the platypups!


To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Sources:

Newman, Tim. “Platypus milk: The key to preventing deadly infections?”, Medical News Today, Wednesday, 21 March 2018