Wellcast

Within the past year, a newer type of screening method has been used for women with dense breasts. This test is molecular breast imaging, otherwise known as “Breast Specific Gamma Imaging” (BSGI).
Researchers screened 940 women with both BSGI and mammography. All of these patients were diagnosed as high risk for breast cancer and had a breast density >50%. The investigators found 13 tumors in 12 patients, with BSGI finding 10 tumors and mammography only 3. Molecular breast imaging was more sensitive than mammography (75% vs. 25%) and more specific (93% vs. 91%).

Even though this test has an important role in finding cancers that are stealth to mammography, investigators are not advocating replacing mammography with BSGI. About 10-15% of breast tumors are missed on mammography for women with dense breast tissue. This is a common phenomenon in alot of women, especially those in their 40’s.

The goal is to use this tool as a low cost alternative to breast MRI which runs around $3500.00. Ouch! Molecular breast imaging in my town runs around $800.00. Radiologists find this test appropriate for women with extremely dense breasts and strong family history of breast cancer, and those with abnormal mammograms to determine whether biopsy is necessary. BSGI is a good adjunct screening tool in addition to mammography.

This is a test that can be individualized for women at high risk for breast cancer. It is my hope that we can personalize medicine better with these type of tests for certain populations. We need to get away from one size-fits-all in terms of screening approaches and direct certain tests for an individual women based on her risk and the characteristics of her breast tissue.

Reference: Hruska CB. HemOnc Today. “2008 Breast Cancer Symposium- Washington, Sept. 5-7. Molecular breast imaging found more tumors in dense breasts”, 2008.

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It’s hard to miss the headlines in the news concerning the economic turmoil in this country; only weeks away from what may be the most important presidential election in history. There are many important issues in this election, healthcare being one that is on the top of my list.

Peoples’ lives have changed, that has left them confused, frustrated and hopeless. We feel out of control, disempowered. It’s a vicious cycle that we’ve fallen into: Job loss leads to loss of health insurance. Health insurance costs have have gone up dramatically and most cannot afford it on their own. People looking for other work have found that they are not qualified, can’t afford to go back to school, or that companies are not willing (due to time and money) to train new people. Some people have settled to be on a “temp” list in which the hours (and paychecks) are unpredictable and again is not supplemented with health benefits. Many of these individuals are helping out their elderly parents with medical bills and other expenses and now need help themselves to pay for food, mortgage and other bills. This vicious cycle is going on all over America. Where did this land of hope and opportunity go?

I think it’s still here, deep within all of us. The paradigm has shifted from one of dependence on government subsidies to one of self- responsibility. Lets face it…I’m not counting on a social security check in the future, are you?
One thing I have always encouraged my patients to do is to help them find their own answers. Each one of us needs to participate in our own health care, and that starts with prevention. We have to take care of ourselves and not depend on others to “bail” us out. We can’t depend on our government or politicians to “fix” it for us. We ned to pick ourselves up and not fall victim to what’s happening around us. Is it affecting us? Absolutely! But we need to get through each day and take charge of our health, our money, our planet and our future.
Empower Thyself!

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Watch out for that slow, creeping weight gain that can take us by surprise as we get older. It is a common frustration I see when counseling women at mid-life. How and why does this happen?

So much of this is related to what we eat and our activity level. We may have been able to get away with eating refined sugars in the past, but as we keep consuming foods that contain white flour, white sugar and rich fatty ingredients, our pancreas starts to get overstimulated with all the work it needs to do in trying to get glucose in the cell. The pancreas must secrete insulin to get glucose into the cell to be used for fuel and energy. Instead of secreting insulin just when it sees food (as it should), the pancreas now secretes insulin ALL the time…even when we are sleeping. It now takes even MORE insulin to escort glucose into the cell because the receptors outside the cell have become dysfunctional and resistant. Hence the term, “insulin resistance”. If glucose cannot get into the cell, then it gets stored as fat in our adipose tissue (mainly the abdomen) and in coronary arteries, which leads to high cholesterol, high blood pressure, heart disease and diabetes.

But that’s not all…
Our thyroid and adrenal glands are also involved. Our adrenal hormones (glands that sit on top of our kidneys) are responsible for helping us adapt to stress, both emotional/psychological and physiologically. Lets face it, we are all under a tremendous amount of stress these days. When women are starting to go through peri-menopause and rocky hormone levels, their adrenals are also being used to cope with this changing internal environment as well as external stressors.

Some adrenal hormones assist in the conversion of thyroid hormones, T-4 to T-3. Some researchers believe that the entrance of thyroid hormone into our cells is under the influence of adrenal hormones. So if we have adrenal fatigue, which most of us do to some degree, then the way we utilize food for fuel will be compromised. This is where low thyroid function comes in. Symptoms of adrenal fatigue and hypothyroidism are sometimes indistinguishable. We start to put on weight, feel exhausted, have foggy thinking, more constipated, craving sugar, lack of libido, allergies, dark circles under the eyes, muscle and joint pain, dizziness, low blood pressure, low blood sugar, poor sleep, dry skin, cystic breasts, difficulty recovering from stresses like colds or jet lag, no stamina or motivation to do things, tendency to startle easily, lowered immune function, anxiety, depression, and premature aging.

Sound familiar?

The point is…this doesn’t just happen when you hit a certain age. It’s been happening for many years. It’s that your body now has a hard time compensating with keeping everything in check, so these symptoms start emerging and we call it “aging”. I just call it frustrating, but there is something you can do.

See a practitioner that can test your thyroid and adrenal function. Talk to a good clinical nutritionist who is familiar with insulin resistance and can also rule out food allergies. Gluten allergy has been well researched in its association with malabsorption, blood sugar imbalances, adrenal fatigue and thyroid dysfunction. The main emphasis is on increasing whole grains and dietary fiber along with essential fatty acids, healthy proteins and quality fats. Eat frequently, several small snacks a day instead of 3 larger meals a day and exercise. Exercise has been shown to decrease insulin resistance, lower blood pressure and high cholesterol, reduce stress and help weight loss.

Supplements to consider are chromium picolinate, alpha lipoic acid, selenium, and cinnamon.

You can reverse these symptoms and the time to start is NOW.

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Tags: Health, weight gain, Wellness

John McCain seemed to favor embryonic stem cell research more than the other members of his Republican party; at least that’s what he said in 2007. Now, he’s taking a different stance. Now, he claims it “a federal crime for researchers to use cells or fetal tissue from an embryo created for research purposes.” Sounds like a pretty clear “flip-flop” to me.

Read more

Although presidential candidate John McCain has reaffirmed support for federal funding of embryonic stem cell research, scientists fear that his actual policies would criminalize their work.

Read the rest of this post from Wired: Med-Tech

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There have been some mixed reviews about Black Cohosh (Cimicifuga racemosa) and its use in preventing menopausal symptoms. Clinically, women that I see have improved greatly when using this herb for symptoms such as night sweats, hot flushes, fatigue and mood. Now, a study at the First Hospital of Peking University in Beijing, published the first major trial looking at the effect of Black Cohosh vs a pharmaceutical drug for menopausal women.

The study randomized 244 Chinese women aged 40-60 to either daily treatment with 40 mg of a standardized Black Cohosh known as Remifemin or 2.5 mg of Tibolone which is a synthetic steroid whose hormonal effects are said to be “tissue-specific” primarily with estrogen. It is used in Europe and Asia as an alternative to hormone replacement for menopausal symptoms and is said to have fewer side effects than traditional hormone treatments. Tibolone effects estrogen, progesterone and testosterone activity.
After 12 weeks, both treatment groups had significant improvement in symptoms including hot flushes, insomnia, depression, weakness and fatigue, joint pain, headaches and palpitations. WOW!!

In terms of safety and side effect profiles, Remifemin was the clear winner. None of the women in this group had vaginal bleeding, while 17 in the Tibolone group had abnormal bleeding. This is a common reason why women stop their hormone replacement therapy. The Tibolone group also had breast and abdominal pain while the Black Cohosh group had none of these symptoms.

This is one of the few studies comparing an herb head-to-head with a pharmaceutical drug for women in menopause (it’s about time!). I recommend Remifemin frequently for my patients with mild to moderate symptoms and see very few side effects.

Reference: Hudson, T. Holistic Primary Care. “Black Cohosh Compares Favorably With Drug Therapy for Menopausal Symptoms”. Fall 2008, p. 14.

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Here we go again!
Safety studies have shown ill effects of the product bisphenol A, or BPA commonly found in baby bottles, plastic drink containers and in the lining of food cans. Most studies have been done in animals. Now, this chemical has been studied for the first time in humans and has demonstrated similar effects in people. This research found that people with the highest levels of bisphenol A in their bodies were more than twice as likely to develop heart disease and/or diabetes.

BPA is a chemical used to make polycarbonate plastics. It is found in resistant durable plastic containers and bottles, and is also used to make durable epoxy resins used as the coating in most food and beverage cans and in dental fillings. It may also disrupt hormones, primarily estrogen, especially when hot foods are cooked in this plastic as it leaches this chemical and puts women at risk for estrogen dominant health conditions such as uterine fibroids, endometriosis and breast cancer.

The FDA recently reported this chemical as being safe, however, a panel of outside experts will hear testimony on health effects from BPA again.

Read the rest of this post from CNN.com - Health

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Don’t be surprised if your doctor recommends a cholesterol screening test for your 2 year old. Yes, what once was a common screening test for those over 35, is now becoming a way of detecting early risks for heart disease.

The research has shown through autopsy data that atherosclerosis begins in childhood and that elevated cholesterol levels in childhood is associated with an increased risk of cardiovascular disease in adulthood. Lipid levels rise rapidly in our earlier years and stabilize by age 5 to those similar to adolescents. Currently 35-45% of children are screened for cholesterol levels due to a positive family history of cardiovascular disease (Bauchner, H. Journal Watch Pediatrics and Adolescent Medicine, Vol.7, Number 9, 2008, p.68).

The American Academy of Pediatrics (AAP) has released new guidelines due to the rising incidence of obesity and type 2 diabetes in U.S. children. Besides the standard advice of restricting cholesterol and saturated fats and exercise, the new guidelines calls for wider screening, and cholesterol-lowering drugs to be considered in children.

There are several concerns with using these drugs (statins) in children.

First, we don’t know the long-term risks or benefits of these drugs (statins) in children.
Second, there may be concerns about aggressive cholesterol lowering. A recent study analyzing the aggressive lowering of blood sugar in type 2 diabetes was associated with increased mortality. Lets not experiment on our kids!

Last, if a child is treated with a drug, does it not “label” that child as having high cholesterol, which could have long-term implications and possibly raise a red flag for health insurers to deny coverage for a pre-existing condition.

I believe each practitioner needs to consider the concerns and preferences of patients and families when making decisions about the use of statins in children.

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The answer: they all prevent heart disease. With over 700 different bacteria in your mouth, its no wonder that many say the mouth is the dirtiest place in the human body.

So it makes sense that if there is a portal of entry via a tiny blood vessel in the gums, this bug may slip into the central blood system and cause ill effects. These bacteria can bind to sticky platelets and adhere to blood vessel walls and cause heart disease. Read more about the importance of good dental care.

Another good reason to get regular dental check-ups and keep up on brushing and flossing.

AFP - Here’s another reason to brush your teeth: poor dental hygiene boosts the risk of heart attacks and strokes, a pair of studies reported this week.

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Read the rest of this post from Yahoo! News: Most Emailed - Health

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There has been alot in the news comparing the 2 procedures used to treat coronary artery disease. That is: angioplasty vs bypass surgery.

An angioplasty is a non-surgical procedure where a catheter is thread into the artery that is partially blocked and a balloon is used to flatten the blockage. A stent is left in to prop the artery open. On the other hand, bypass surgery reroutes blood vessels around the blockage so that blood and oxygen can still be delivered to the heart muscle.

European doctors recently studied over 3000 patients in Europe and the U.S., who had coronary artery disease with single or multiple heart blockages. The results indicated that in patients who had an angioplasty, “nearly 14 percent needed another procedure after a year, compared with about 6 percent of surgery patients”. Also, surgery patients had a lower death rate.

But surgeries don’t come without their risks…patients who had surgery had about a 2 percent stroke risk versus nearly zero risk for patients who had an angioplasty. So what’s the best thing to do?

First, prevention is best. Eat well, exercise, get yearly check-ups.

Second, medical therapy is the next step. Treat high blood pressure and high lipids if you have these conditions and do step 1.

If you have been diagnosed with having more than one blocked coronary artery, consider surgery. It is better than getting multiple angioplasty procedures. If you have stable angina or early coronary artery disease with only one blocked vessel, then angioplasty and stent placement may be best. Of coarse, talk to your doctor about the options.

AP - For heart patients with clogged arteries, the choice between bypass surgery or an angioplasty may come down to one question: How many procedures would you like to have?…

Read the rest of this post from Yahoo! News: Most Emailed - Health

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Earwax is more than a jellybean flavor found in the infamous Harry Potter films. It really has a purpose in our ears. Clinically known as cerumen, it acts as a cleaning agent that lubricates and protects the ear from bacteria and debris.

The problem with some people is that they make too much of this “good stuff” which can lead to symptoms. Symptoms of too much ear wax can be pain, hearing loss, itching of the ear and tinnitus (ringing of the ears).

We see quite a few patients in the clinic with impacted ear wax. Many of these adults have used ear candles in the past to help draw out their ear wax. This works for many people. The main caution is for those that use this device and develop ear pain because their problem was NOT ear wax. So do not use ear candling unless you are sure you have wax in the ear.

We usually irrigate the ear gently with normal saline or water, letting water wash out excess wax. Some times I will use an ear “pick” to remove wax but please “don’t try this at home”. While we’re on the subject, do not put Q-tips or anything else in your ear to remove wax.

If you have a history of having to go to your doctor’s ofice to get wax removed, try irrigating and loosening the wax yourself before it starts to build up. You can use about a capful of olive oil, or any cooking oil in your kitchen, or a small amount of hydrogen peroxide (it will fizzle in your ear) in the effected ear. Keep your head tilted to allow the liquid to stay in thr ear for a few minutes. Then irrigate the ear with a bulb syringe (that you can find at the drug store) using warm tap water. It may take a day or two to flush most of the wax out.

So if you tend to have symptoms of too much ear wax every 6 months, then attempt to irrgate the ears every 3-4 months. See your clinician if you have problems removing it on your own.

Anyone with hearing aids needs to get checked more regularly for wax build-up. Waiting too long reduces hearing and can damage the hearing aid. So if you notice some ear wax naturally after showering or cleaning your ears, remove what you see, but know that it serves a purpose. But if too much of a good thing leaves you with ear symptoms, then there are some things you can do about it.

Earwax provides benefits to the body, helping to clean and lubricate the ear canal, but too much can cause problems. New guidelines strongly advise doctors to clean out excess earwax and check people with hearing aids every three months….

Read the rest of this post from WebMD Health

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