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Archive for the ‘Hormone Physician’ Category

Mac and cheese products contain harmful chemicals, study finds – The Pike County Courier

Scientists say there are no known safe levels of phthalates for pregnant women and young children

Published Jul 30, 2017 at 11:13 am (Updated Jul 28, 2017)

For the study, the coalition contracted with an independent laboratory experienced in the testing of phthalates in food to test 30 cheese products purchased at retail grocery stores in the United States and shipped to the lab, unopened, in their original packaging. Findings revealed:Phthalates in nearly every cheese product tested (29 of 30 samples), with 10 different phthalates identified and up to six found in a single product.Phthalates in eight of the nine Kraft cheese product samples tested.Toxic chemical phthalates at levels on average more than four times higher in macaroni and cheese powder than in hard cheese blocks and other natural cheese.DEHP, the most widely banned phthalate around the world, in all 10 macaroni and cheese powders. DEHP accounted for nearly 60 percent of all phthalates found in the cheese product samples that were tested.

The cheese powers in ten varieties of macaroni and cheese products tested all contain toxic industrial chemicals (known as phthalates), according to the Coalition for Safer Food Processing and Packaging, a national alliance of leading public health and food safety groups.

Phthalates (THAL-eights) are hormone-disrupting chemicals that can lower testosterone, the male sex hormone, and alter thyroid function. Scientists have linked exposure to some phthalates, during pregnancy and early childhood, to changes in the developing brain that may result in kids who grow up struggling to succeed in school, at work, and in life.

Serving up one of Americas favorite comfort foods shouldnt mean exposing your children and family to harmful chemicals, said Mike Belliveau, executive director of the Environmental Health Strategy Center, a coalition member.

Two million boxes of macaroni and cheese are sold every day in the United States.

An 'indirect' food additiveScientists say there are no known safe levels of phthalates for vulnerable populations, such as pregnant women and young children," said Charlotte Brody, RN, national director of Healthy Babies Bright Futures, a coalition member.

Federal scientists reported this year that up to 725,000 American women of childbearing age may be exposed daily to phthalates at levels that threaten the healthy development of their babies, should they become pregnant.

Scientists agree that for most people, the greatest exposure to phthalates comes from the food we eat.

Phthalates are not intentionally added to food, but are classified as indirect food additives by government agencies. Industrial chemicals commonly added to plastics, rubber, adhesives, inks, and coatings, phthalates have been shown to migrate into food products during food processing, packaging, and preparation.

Source: Center for Food Safety:



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Mac and cheese products contain harmful chemicals, study finds - The Pike County Courier

Pediatricians must address adverse outcomes with compassion, resolve – American Medical Association (blog)

Despite best efforts to do no harm, clinicians should be prepared to respond to patients who experience adverse outcomes even if everything is done right. Often thought to refer only to medical error, the term iatrogenesischaracterizes a wider range of possible health care outcomes that are, as the Greek etymology suggests,physician-generated. Iatrogenic outcomes are particularly fraught in pediatrics, due to childrens inherent vulnerability as patients who typically lack decision-making authority.

This months issue of theAMA Journal of Ethicsgrapples with neglected clinical and ethical questions about pediatric iatrogenesis, including how clinicians communicate iatrogenic risks to patients parents or guardians, how clinicians manage therapies with inevitable iatrogenic harms, as well as how clinicians might consider, respond to, and mitigate iatrogenic consequences of their practices.

Take a moment to consider this question: A 12-year-old girl identifies as a boy, has been diagnosed with gender dysphoria (GD), and wants to begin gender transitioning with prepuberty hormone therapy. Her physician worries about the long-term iatrogenic risks of therapy. How should the physician respond?

Give your answer and find responses to this question in theAugust issueof theAMA Journal of Ethics,which features numerous perspectives on ethical questions related to pediatric iatrogenesis.

Articles include:

Should Clinicians Medicate Against Structural Violence? Potential Iatrogenic Risks and the Need for Social Interventions.Physicians should weigh not only the iatrogenic risks of off-label antipsychotic medications but also the possible consequences of failing to treat related, complicating social factors. Advocates must address structural violence and failures of imagination in their efforts to improve mental-health equity among vulnerable youth.

How Should Physicians Help Gender-Transitioning Adolescents Consider Potential Iatrogenic Harms of Hormone Therapy?Counseling and treatment of transgender youth can be challenging for mental-health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. In cases involving adolescents, it is critical that clinicians communicate appropriate expectations about the effectiveness and limitations of hormone therapy, as well as the risks of psychological and physical iatrogenic effects.

Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries?Physicians should, in certain cases, be held accountable by patients and their families for harm caused by successful genital surgeries performed for social and aesthetic reasons.It is important for physicians not just to know when and why to perform genital surgery, but also to understand how their patients might react to wrongful performance of these procedures, and to respond to their own blameworthiness in socially productive and morally restorative ways.

Clowning as a Complementary Approach for Reducing Iatrogenic Effects in Pediatrics.Hospitalized children who undergo painful procedures are more susceptible than others to experiencing iatrogenic effects, such as anxiety, pain and stress. Clowns in the clinical setting have been found to be effective in reducing childrens experiences of these effects during hospitalization and before procedures.

The AMACode of Medical Ethics Opinions Related to Iatrogenesis in Pediatrics. Although any patient can experience an iatrogenic outcome, pediatric patients are the most vulnerable to life-threatening complications. The AMACode of Medical Ethicsdoes not have any opinions that address iatrogenesis in pediatrics specifically, but it does offer guidance on pediatric decision making, preventing error and harm, and disclosing errors.

In the journals August podcast, Robert Nelson, MD, PhD, MDiv, a senior pediatric ethicist with the Food and Drug Administration, discusses strategies for communicating about iatrogenic outcomes with the parents and guardians of pediatric patients. Later in the episode, Gigi McMillan, the mother of a pediatric brain-tumor survivor, discusses how networks of peer mentors can help families navigate these painful situations.

The journals editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians.Submit a manuscriptfor publication. The journal alsoinvitesoriginal photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The journal is accepting applications from medical students, residents and fellows (MDs or DOs) in U.S.-based programs to serve as theme issue editors for monthly issues to be published from November 2018 through October 2019. Learn more.

Upcoming issues of theAMA Journal of Ethicswill focus on incarceration and correctional health care as well as clean-water access and the roles of clinicians.Sign upto receive email alerts when new issues are published.

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Pediatricians must address adverse outcomes with compassion, resolve - American Medical Association (blog)

Global Lyme Diagnostics Welcomes Dr. Mark Filidei and Dr. Jodie A. Dashore To Scientific Advisory Board – PR Web (press release)

Map A: Distribution by county of recorded presence of Lyme carrying ticks across the US between 19071996 (from Dennis et al. 1998). Map B: between 19072015 (from Eisen et al. 2016)

Research Triangle Park, NC (PRWEB) August 03, 2017

Global Lyme Diagnostics has announced that Dr. Mark Filidei, and Dr. Jodie Dashore have joined GLD's Scientific Advisory Board.

Dr. Filidei is an Internal Medicine physician and is the Director of Integrative/Functional Medicine for the Amen Clinics. Dr. Filidei is highly experienced in integrative/functional medicine modalities as well as conventional medicine and sees patients in person at the Amen Clinics Southern California. He was previously the medical director of the Whitaker Wellness Institute, the largest Integrative Medicine clinic in the United States where he spent over a decade treating thousands of patients for multiple complex medical issues. Dr. Filidei is an ILADS trained physician, which is the largest group of Lyme literate doctors in the world. He also has a special interest in diagnosing and treating CIRS (chronic inflammatory response syndrome) which is caused by toxic mold exposure. Dr Filidei lectures nationally on topics including the integrative approach to mental health, hormone replacement therapy, brain health, memory loss and Alzheimers disease, and mold and Lyme disease related issues.

Dr. Filidei correctly diagnosed Kris Kristofferson with Lyme Disease, after Kristofferson was misdiagnosed numerous times, with maladies ranging from Alzheimer's to fibromyalgia. The story was covered by news organizations such as CBS and was posted on the CMT website on July 8, 2016.

Dr. Jodie A. Dashore - Dr. Dashore has been a Lyme Literate Clinical practitioner since 2010. She specializes in an Integrative, alternative and plant-based medicine approach to Tick Borne Diseases and has been helping patients with Tick borne Infections from 11 countries around the globe. Dr. Dashore has given numerous national and international lectures on an integrative approach to Tick Borne infections. She is internationally recognized as a pioneering scientist and researcher who has coined the term "Complex Autism" (TM) to include Autism complicated with Tick Borne infections and other comorbid conditions.

Global Lyme Diagnostics has developed a breakthrough diagnostic solution specific to Lyme Disease that is grounded in science. The GLD test, developed by Dr. Marconi, is designed to significantly decrease the number of patients being misdiagnosed.

Dr. Marconis research has led to a novel breakthrough called chimeritopes which increase sensitivity by eliminating proteins that are not relevant to a Lyme infection (non-OsPC targets) and can further reduce false negatives by targeting Lyme causing bacteria variants across the North American spectrum. After licensing this technology platform and related intellectual property developed in Dr. Marconis lab at Virginia Commonwealth University, GLD focused on creating a highly accurate and reproducible solution.

"We are very pleased to have Dr. Filidei and Dr. Dashore join our Scientific Advisory Board. Their clinical advice will be extremely valuable in furthering GLDs science to help the global Lyme community, " stated Mickey Ramchandani, CEO of Global Lyme Diagnostics. "Misdiagnosis is a core issue, as Lyme Disease can masquerade as many things - juvenile arthritis, fibromyalgia, chronic fatigue syndrome, multiple sclerosis and a host of other diseases. We are passionate about providing a diagnostic solution that decreases the misdiagnosis of Lyme Disease."

After years of research GLD has also just launched the GLD test, specific to Lyme Disease, which can be requested by clinicians at physician kit request. Patients that would like to request a kit to take to their clinicians can do so here. Note: The GLD Test is not yet available for CA, FL, or NY residents.

More information about GLD, including the science behind the new test and the Global Lyme Diagnostics team is available at the website at

About Global Lyme Diagnostics:

GLD was formed with the sole purpose of providing a solution to the Lyme community including, physicians, clinicians, patients, advocates and families. Its initial focus is to develop and launch a test that is grounded in science and provides an answer to the challenges related to tests on the market. In addition to launching of their new test, GLD is working with the Lyme community and physicians to develop screening opportunities for worried individuals in Lyme endemic areas to help reduce long term complications. GLD is also researching methods to detect co-infections, as well as, assays that could differentiate early stage versus late stage infections for clinicians to better manage their patients.

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Global Lyme Diagnostics Welcomes Dr. Mark Filidei and Dr. Jodie A. Dashore To Scientific Advisory Board - PR Web (press release)

More clues link immune system imbalance with chronic fatigue syndrome – Science Magazine

Jennifer Brea, who has Chronic fatigue syndrome/myalgic encephalomyelitis,reveals her story in her film, Unrest.

By Giorgia GuglielmiJul. 31, 2017 , 3:00 PM

After a 5-month road trip across Asia in 2010, 22-year-old college graduate Matthew Lazell-Fairman started feeling constantly tired, his muscles sore and head aching. A doctor recommended getting a gym membership, but after the first training session, Lazell-Fairmans body crashed: He was so exhausted he couldnt go to work as a paralegal for the Federal Trade Commission in Washington, D.C., for days. Lazell-Fairman has never fully recovered. He can now do a few hours of light activitycooking, for exampleper day but has to spend the rest of his time lying flat in bed.

Lazell-Fairman is among the estimated 17 million people worldwide with chronic fatigue syndrome (CFS), a disease whose trigger is unknown and for which there are neither standard diagnostic tools nor effective treatments. In the largest study of its kind, researchers have now found that the blood levels of immune molecules that cause flulike symptoms such as fever and fatigue track the severity of symptoms in people who have received a diagnosis of CFS. The results may provide insight into the cause of the mysterious illness, or at least provide a way of gauging its progress and evaluating treatments.

This work is another strong piece of evidence that there is a biologic dysfunction at the root of the disease, says Mady Hornig, a physician scientist at Columbia University whose research has also identified potential biomarkers for CFS.

People with CFSmany patients and advocates prefer to call the condition myalgic encephalomyelitis (ME) because of the complex set of symptoms that are not limited to fatigueexperience prolonged, extreme exhaustion that doesnt improve with rest. The fatigue may worsen with physical or mental activity and often comes with brain fog, a feeling of mental clouding, and sensitivity to noise, light, or other stimuli like taste and smell. Patients may also have memory impairment, muscle pain, and gut problems such as diarrhea, bloating, and nausea.

For years, CFS had been dismissed as a psychological disorder, and some physicians advocated treating it primarily with psychotherapy or a gradual increase in physical activity. But many researchers, and funding agencies such as the National Institutes of Health, increasingly view it as a physiological problem. Its a medical mystery, says Mark Davis, an immunologist at Stanford University in Palo Alto, California.

For this reason, Davis, together with Stanford immunologist Jose Montoya and their teams, recently evaluated whether an imbalance of the immune system may trigger CFS/ME, as previous studies have suggested. By analyzing the blood of 192 people who had met one of the established criteria for CFS/ME diagnosis and 392 healthy individuals, the team found that the levels of 17 cytokines, substances produced by immune cells in response to infection, correlated with disease severity. They were higher in patients with the severest symptoms than in patients with milder symptoms or healthy people. In patients with the mildest symptoms, the levels of those same cytokines were lower than in healthy people, and in patients with moderate symptoms they were comparable to individuals with no disease. Of these 17 immune molecules, the vast majority is known to stimulate inflammation and produce flulike symptoms, the researchers report today in the Proceedings of the National Academy of Sciences.

I found surprising that so many cytokines are altered in the patients, Davis says. It seems like the disease is leaving no cytokine untouched. The work adds to our understanding that there are complex alterations of the immune system, Hornig says.

A few immune molecules drew particular attention because their levels didnt correlate with disease severity. The researchers have found that the blood level of TGF-, a cytokine that is involved in myriad biological processes, such as inflammation and cancer, was higher in CFS/ME patients, regardless of the severity of their symptoms, than in healthy people. And the blood levels of resistin, a hormone produced by immune cells, were lower in patients compared with individuals with no disease.

These molecules might drive the disorder, scientists speculate, but they could also simply reflect the patients immune system fighting back against an inflammation of different origin. These are deliberately agnostic assays, Davis says. First you look for correlation and then you try to understand why these things correlate with the disease.

Nonetheless, the new study is a tremendous step forward, says Gordon Broderick, a systems biologist at Rochester General Hospital in New York. Being able to examine so many CFS/ME patients and identify which immune molecules are associated with more intense symptoms is a big deal, he says.

Although it is important to rule out that altered levels of cytokines arent linked to factors such as allergies or sex hormones, which can also influence the immune system, the large number of patients showing an imbalance in these immune molecules suggests that it is either a cause or result of CFS/ME, Broderick says.

In the future, the scientists hope to use these immune molecules as diagnostic tools for the puzzling condition, and also figure out the role of cytokines and the immune system in the disease. I hope to see more research along those lines, Hornig says. Theres a lot of patients waiting for some answers.

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More clues link immune system imbalance with chronic fatigue syndrome - Science Magazine

Health Matters: Detecting and Treating Endometrial Cancer – NBC2 News

Its the fourth most common cancer for women in the U.S., but doctors say 80 percent of the time endometrial cancer is caught in stage one.

Dr. Fadi Abu Shahin, a gynecologic oncologist on the medical staff of Lee Health, says endometrial cancer can be caused by age, genetics, or medication. Endometrial cancer is cancer of the endometrium, which is the lining of the uterus on the inside. The most common is what we call unopposed estrogen where the womans body is producing estrogen only and not producing progesterone to counter act the effects of estrogen in the uterus.

That can lead to overgrowth of the lining of the uterus and can become cancerous over time. Women who are at risk for endometrial cancer may have a genetic predisposition or polycystic ovarian syndrome, where they dont ovulate regularly. In both cases doctors may prescribe birth control or hormone therapy as a preventative. The best treatment for those women is to put them on birth control pills or some form of hormonal therapy to prevent and protect the uterus from exposure to estrogen, said Dr. Abu Shahin.

Theres no regular screening for endometrial cancer, but doctors say if women experience symptoms they need to call their physician. In women after menopause any bleeding is abnormal. In women before menopause any irregularity in their periods or bleeding outside their period is abnormal, said Dr. Abu Shahin.

Endometrial cancer is the most common gynecologic cancer in women. If women are at risk, doctors may use genetic screening, biopsies, or ultrasounds to look for precancerous changes in the uterus. 70 to 80 percent of all women with endometrial cancer are diagnosed at stage one, which means the cancer was contained to the uterus, which means its highly curable, said Dr. Abu Shahin.

Patients may undergo a hysterectomy or choose to have only the high risk lymph nodes removed in a shorter, less invasive procedure.

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Health Matters: Detecting and Treating Endometrial Cancer - NBC2 News

More research needed to determine cardiovascular effects of long-term hormone therapy for transgender adults – 2 Minute Medicine

1. Cross-sex hormone therapy (CSHT) may be associated with worsening cardiovascular risk factors in transgender men.

2. CSHT may not result in increases in cardiovascular morbidity or mortality.

Evidence Rating Level: 2 (Good)

Study Rundown: Understanding the unique health care needs of the transgender population is highly important; approximately 1.4 million persons identify as transgender in the United States. One important area of study involves the role of sex hormonesincluding hormone blockers and cross-sex hormone therapyand cardiovascular disease (CVD). Sex hormones may be used to help transgender persons fully realize their gender identity. Despite the importance of this area of research, one of the barriers to providing appropriate care to transgender persons is the lack of physician training and clinical guidelines within this area. Additionally, there is limited health care research within this population. The authors of this study, therefore, conducted a systematic review that highlights research on the association between hormone therapy and CVD in cisgender adults, in addition to summarizing the association between CSHT and CVD in transgender adults. This study has several limitations. First, many studies included in this review focus on younger persons, limiting the generalizability of CSHT in older transgender adults. Additionally, there are few randomized controlled trials with respect to CSHT, which limits knowledge of any associations between CSHT and CVD.

Click to read the study, published in the Annals of Internal Medicine

Relevant Reading: Hormone therapy for transgender patients

In-Depth [narrative review]: The authors of this study systematically searched PubMed and EMBASE databases, of which 13 met inclusion and exclusion criteria. Of the articles, 3 reported findings only in transgender women, 3 only in transgender men, and 7 looked at both populations. Based on the articles reviewed, the authors observed that CSHT is associated with improved psychological functioning of transgender persons. While studies looking at CSHT and cardiovascular risk factors in transgender men are limited, several studies, including an early prospective study and an observational longitudinal study, suggest that CSHT increases CVD risk factors. These risk factors include blood pressure values, lipid levels, and insulin resistance. Furthermore, in transgender women, CSHT may increase thromboembolic risk. However, due to the lack of randomized controlled trials and prospective cohort studies found in this review, it is clear that further research is required to determine the cardiovascular effects of long-term CSHT for transgender adults.

Image: PD

20172 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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More research needed to determine cardiovascular effects of long-term hormone therapy for transgender adults - 2 Minute Medicine

Toothpaste Pregnancy Tests Are a Thing — but Do They Work? – The Stir

There's no shortage of weird tips and tricks on the Internet for everything from making your kids eat vegetables to getting your newborn to stop crying,but the latest trend in DIY is truly something else. Apparently, women are putting urine in toothpaste based on claims in a viral YouTube video that you can use this "natural" method as an alternative way to tell if you're pregnant.

The toothpaste pregnancy test works like this: First, you squeeze a small amount of plain white toothpaste into a cup, then you add a few drops of urine, mix it up, and wait three minutes. If the toothpaste starts to froth or turn a bluish color, that means the "test" is positive.

More from CafeMom: If You're Pregnant & Your Toilet Seat Turned Blue, You Are Not Alone

The video has more than 2 million views and Us Weekly notes it's a mainstay on Google Trends. As the explains, the toothpaste pregnancy test came about "decades ago when pregnancy tests weren't easily found in stores, especially for women living in rural settings." Now, they're mostly used as a cheap alternative to store-bought pregnancy tests.

Of course, not everyone is sold. The comments on YouTube range from grateful and enthusiastic to people saying this is total BS to men claiming they tried it and got a positive result (LOL).

So, is the toothpaste pregnancy test legit?

Sort of, says Dr. Napoleon Maminta, a primary care physician at Naptown Priority Healthin Indiana. If done correctly, this test may give a woman "reason to believe that she is pregnant," he says. But that positive result is not a guarantee.

More from CafeMom:How This Weird Purple Line on Your Booty Might Reveal When Your Baby's Coming

"While over-the-counter tests are difficult to compromise and taint, this homemade option can be easier to compromise if a person fails to take certain precautions," Dr. Maminta tells CafeMom.

If you're just seeing this for the first time and simplyhave to try it, Dr. Maminta offered some tips to get the best results.First, he says, it's vital to use clean cups so that no contaminants come into contact with the toothpaste. Second, women should use their first morning urine rather than using urine later in the day.

"First morning urine in pregnant women has higher concentrations of the pregnancy hormone hCG, which reacts with the chemicals in the paste to cause a color change," he explains.

Lastly, the toothpaste used must be naturally white and not one that is striped or artificially colored. "The natural white paste has the correct chemical composition to react with the hCG in the urine to cause a change in the paste's color and structure," Dr. Maminta explains. "Paste that is dyed will not react in the right way to give enough of a reading for a woman to know if she could be pregnant."

Even with all the precautions in place, Dr. Maminta still cautions that this should be viewed as an "initial test" and pregnancy should be confirmed via traditional, well-tested methods.

Long story short? Toothpaste pregnancy tests are not the most reliable method of finding out if you're pregnant. But, if you're trying to conceive and looking for some preliminary results before you shell out for another test? It might be worth a shot. As with all things related to pregnancy and our bodies, take the "alternative method" with a grain of salt -- and make sure you see a doctor!

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Toothpaste Pregnancy Tests Are a Thing -- but Do They Work? - The Stir

Clomid cycle day 22 – Metformin and clomid success stories 2014 – Van Wert independent

Submitted information

LIMA Employers in the greater West Central Ohio region will collect $33 million in rebates from the Ohio Bureau of Workers Compensation in checks that will be mailed beginning next week.

BWC Administrator/CEO Sarah Morrison, in Lima to present a ceremonial check to local business leaders, said employers are free to spend their rebates as they wish, but she hopes they will consider investing in workplace safety.

We work with employers all over Ohio to prevent injuries and illness in the workplace, and they will tell you that investing in safety is a wise business decision, said Morrison, speaking at a press conference at the Lima/Allen County Chamber of Commerce. Safe workplaces mean fewer injuries, fewer medical claims and a stable workforce, all of which leads to a healthy bottom line for a business.

Morrison was joined by chamber President/CEO Jed Metzger and Tony Daley of Limas Spallinger Millwright Services Inc. Metzger and Daley accepted the check on behalf of employers in the entire region, which includes Allen, Auglaize, Shelby, Hancock, Putnam, and Van Wert counties.

Ohio Gov. John Kasich proposed the rebate in March. Its the third such rebate in the last four years, made possible by an improving safety climate, prudent fiscal management and strong investment returns. The plan to distribute rebates to more than 200,000 Ohio employers during the month of July was approved by BWCs Board of Directors in April. Visitbwc.ohio.govfor more details and eligibility requirements.

The plan also includes a $44 million investment innew health and safety initiativesto promote a healthy workforce and a culture of safety in every Ohio workplace. This includes a new wellness program for small employers, funding for programs to help firefighters and those who work with children and adults with disabilities, and an education campaign to address common injuries at work and in the home.

A healthy economy depends on a strong and healthy workforce, Morrison continued. And when the economy is healthy, we all benefit.

Rebate checks will be mailed in phases starting July 10.

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Clomid cycle day 22 - Metformin and clomid success stories 2014 - Van Wert independent

Waking Often To Use The Bathroom May Signal Health Issues – Jamestown Post Journal

Frequent trips to the bathroom are keeping someone from sleeping through the night could be a sign of nocturia, which is a common cause of sleep loss, especially among older adults.

Were not talking about waking up once during the night, every few nights, said Dr. Richard Vienne, Univera Healthcare vice president and chief medical officer. Adults suffering from nocturia may awaken with the need to use the bathroom two to six times a night, every night.

Nearly two-thirds (65 percent) of those responding to a National Sleep Foundation poll of adults between the ages of 55 and 84 reported waking to use the bathroom at least a few nights per week. According to the foundation, most adults get seven to nine hours of sleep a night.

Waking two times a night to use the bathroom disrupts sleep patterns which can result in daytime sleepiness, a condition that affects an estimated 20 percent of the population. Persons with excessive daytime sleepiness are at risk of motor vehicle and work-related incidents, and have poorer health than adults who are well-rested.

Frequent trips to the bathroom at night could be a sign of a chronic disease, including heart disease, vascular disorders, diabetes, high blood pressure, restless leg syndrome, Parkinsons disease, multiple sclerosis, or sleep apnea, said Vienne. Nocturia is more common among older adults because their bodies produce less of an anti-diuretic hormone that enables their bodies to retain fluid by producing more urine at night. Another reason for nocturia among the elderly is that the bladder tends to lose holding capacity as we age.

The National Sleep Foundation offers these tips for those with symptoms of nocturia:

Drink a normal amount of liquid, but do so earlier in the day.

Cut down on any drinks in the last two hours before bed, especially alcohol, coffee or tea as these stimulate urine production.

Keep a diary of how much a person drinks, what they drink and when. Such information may be helpful in identifying situations which may make the nocturia worse.

Include in that diary a record of sleep habits as well as any daytime fatigue someone may be experiencing.

Vienne advises anyone experiencing symptoms of nocturia to consult with his or her physician. A doctor can assess for the possible cause of nocturia and order appropriate tests, referrals or treatments.

The Audubon Community Nature Center has received $24,921 to eradicate water chestnut and and reeds from its lands. ...

Southwestern High School officials recently released the schools honor and merit rolls for the fourth quarter of ...

The descendents of Elder John White, founder of Hartford, Conn., and Giles and Sarah Dodd White will meet Sunday, ...

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Waking Often To Use The Bathroom May Signal Health Issues - Jamestown Post Journal

Who stole my fertility? –

According to medical history, during the lifetime of Greek physician Hippocrates in 460-375 BC, a fibroid was known as a uterine stone.

The first surgery for fibroid was done for the late American president Abraham Lincolns cousin in 1809. The term fibroid was introduced in 1860.

Many women are diagnosed with uterine fibroids. For some, the fibroid is not medically impactful, while for others, it can cause infertility.

What is a uterine fibroid?

A womans womb or uterus is made up of muscles known as myometrium. This myometrium is composed of many strands of muscle fibres.

Fibroids arise from genetic alterations in a single muscle fibre. This causes the fibres to overgrow and form a fibroid.

The circulating female hormone called oestrogen can cause growth of the fibroid.

However, fibroids can also grow in a low oestrogen environment, possibly due to conversion of the male hormone called androgen into oestrogen. Yes, women have male hormones too!

Many women may have fibroids without ever realising it. This is because not all fibroids cause symptoms. Whether the fibroid causes a problem or not depends on the size and location of the fibroid.

General problems with fibroids

These can include:

Heavy period flow Generally, a fibroid that is located close to the inner layer of the womb (endometrium), and which distorts or displaces the womb cavity, may cause heavy periods.

If untreated, this can lead to anaemia.

Pelvic pain Larger fibroids (more than 4-5cm) may also cause pain.

Sometimes, the core of the fibroid can become soft, leading to severe pain. This is called red degeneration of the fibroid.

A large fibroid can also lead to compression of the urinary bladder and bowel, which leads to difficulty in passing out urine or faeces.

How does a fibroid affect fertility?

A fibroid can adversely affect fertility through:

Cervical displacement After sexual intercourse, sperm is deposited in the vagina. It will find its way through the neck of the womb (cervix) into the womb. Large fibroids can displace the cervix and reduce womb exposure to sperm.

Interfering with sperm migration The sperm that enter the womb need to swim a long distance to meet the female egg. A fibroid that distorts the womb cavity can interfere with sperm migration.

Obstruction of the Fallopian tube Once the sperm swims through the entire length of the womb, it needs to enter the Fallopian tube. This is where the sperm will finally meet the egg.

A fibroid that is located close to the entrance of the tube can obstruct it.

Interfering with egg uptake after ovulation The egg, on the other hand, once released from the ovary, will be picked up by the Fallopian tube. A fibroid located close to the tube can actually change the anatomical relationship between the ovary and the Fallopian tube. This can interfere with the uptake of the egg into the tube.

Affecting the implantation of the embryo An embryo is formed after a sperm manages to fertilise an egg. The embryo will then have to swim back into the womb cavity.

A fibroid located close to the endometrial lining of the womb can distort the lining, so that when the embryo finally reaches its destination, it may be difficult to get implanted in the womb cavity.

So, even after the embryo is formed successfully, the woman is not pregnant until the embryo implants.

Treatment options

Generally, treatment will depend on the symptoms, size and location of the fibroid.

Options include:

Doing nothing Even if you have been diagnosed to have a fibroid, it does not always mean that you need treatment.

So, do not be surprised if your doctor tells you to just wait and see. Fibroids that are small and do not cause any symptoms can be left alone.

Non-surgical treatment There are several options available.

Fibroid growth is dependent on the female hormones oestrogen and progesterone.

The production of these hormones from the ovary is controlled by Gonadotropin Releasing Hormone (GnRH). A synthetic form of GnRH can be used to stop the production of natural GnRH, which stops the production of oestrogen and fibroid growth.

This medication has been shown to reduce the size of a fibroid by up to 50%.

This is a temporary solution and it comes with side effects. GnRH makes a woman menopausal as long as she uses it. If used for more than six months, it can cause bone loss.

For this reason, the use of GnRH is limited to about six months, or as a preoperative measure to shrink the fibroid prior to surgery.

Ullipristal acetate is an oral tablet that has been used to control heavy menstrual bleeding due to a fibroid. It is as efficacious as GnRH and belongs to a group of medicines known as Selective Progesterone Receptor Modulator (SPRM). However, just like GnRH , it is not used as a long term solution.

Magnetic resonance imaging (MRI)-guided focused ultrasound is a treatment option where the fibroid is slowly killed by heating it using pulsed ultrasonic waves. This will cause cell death.

It is done with the help of an MRI to help the doctor see the fibroid in 3D.

Throughout the procedure, you are awake but painkillers will be given to keep you relaxed. The procedure generally takes about few hours.

Surgical treatment In the case of surgery, there are also several options available.

Sometimes, a fibroid can be removed vaginally via hysteroscopy (a telescope introduced vaginally into the uterus).

This method is best suited for fibroids that are located within the uterine lining (submucous fibroid).

A hysteroscope is used to see the fibroid under direct vision and the fibroid is cut using electricity. This method is also known as transcervical resection of fibroid.

Large fibroids generally need to be removed via a myomectomy.

The surgeon has two options on how to do the procedure.

The traditional way is called a laparotomy (open surgery), which involves a Caesarean-like abdominal cut.

The fibroid is removed abdominally and the uterine defect is sutured.

Generally, this method is associated with more pain after surgery and a longer recovery time.

Nowadays, more surgeons perform myomectomy laparoscopically.

In this technique, up to four small holes are made on the abdomen and laparoscopic instruments are introduced via the holes to perform the surgery.

Surgeons use a special instrument to cut the fibroids into small pieces before removing it.

For a woman who does not intend to become pregnant, a hysterectomy is sometimes needed, especially with multiple uterine fibroids.

This can be done by the traditional laparotomy or by laparoscopy (key hole) surgery.

However, hysterectomy is a big no-no if you are trying to conceive.

If you have a fibroid and have difficulty conceiving, visit your fertility specialist to determine if the fibroid needs to be removed.

Dr Agilan Arjunan is an obstetrician and gynaecologist, and fertility specialist. For more information, e-mail The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the readers own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Who stole my fertility? -

How High-Cholesterol Foods Can Ruin Your Sex Life – AlterNet

Photo Credit: Lightspring/Shutterstock

Two of possibly the greatest joys in life are food and sex. You can enjoy both separately or together, by yourself or with a partner (or group) and in general, each tends to complement the other rather well. That is, until one day they dont. The reason? Put simply, it comes down to that dreaded C-word.

Cholesterol: adversary to your arteries, the harbinger of heart-attacks, and you may be surprised to learn, an eradicator of erections. Before we get to that, though, lets start with what this accursed stuff actually is.

Cholesterol, explains Boston Medical Group, is a waxy, fat-like substance that travels around the body in blood particles called lipoproteins. There are two versions of cholesterol, the good kind and the bad. The first one, known as HDL, travels in the blood directly to the liver where it is broken down and used by the body. The bad one, LDL, travels through our arteries leaving a trail of plaque that damages, and ultimately blocks blood flow. This condition is called atherosclerosis, and is a precursor to heart attacks, strokes and, yep, you guessed it, erectile dysfunction.

An excess of cholesterol can lead to a complete blockage of the coronary artery, which will trigger a heart attack. Too much bad cholesterol (also known as LDL) in the bloodstream creates arterial plaque that damages and blocks blood flow. These blockages will result in inadequate circulation of blood throughout the body, which includes your nether regions.

So, what exactly does that imply for your sex life? Time for a little human biology lesson.

During the act of sexual stimulation, Boston Medical Group explains, the body releases chemicals that cause the penile arteries (corpora cavernosa) to relax. Basically, in the heat of the moment, your arteries relax allowing for better blood flow and, of course, the more visible physical attributes associated with having an erection.

By now you should be starting to connect the dots. The long and the, er, short of it is that reduced blood flow caused by the high presence of LDL cholesterol is directly linked to sexual disorders such as erectile dysfunction.

Dr. Michael Krychman, the executive director of the Southern California Center for Sexual Health and Survivorship, told Fox News that "as soon as a man presents with erectile dysfunction, we begin measuring cholesterol and blood pressure." Krychman added that furthermore, the same mechanisms through which men may suffer from sexual disorders caused by high cholesterol, hold similar effects for women.

"In the past we used to think if a woman is having sexual problems, shes frigid, and she needs to go home and have a glass of wine and relax," Krychman said. "However, there is emerging data associating underlying medical causes with female sexual dysfunction." In the case of women, Krychman explained, the fatty deposits caused by high cholesterol affects lubrication and libido.

Beyond blockages, LDL cholesterol also inhibits the production of nitric oxide, the artery-relaxing hormone required to produce an erection. LDL does this by reducing the arterys response to the hormone, which in turn decreases blood flow. And thats not the only hormone affected by high cholesterol. Production of testosteronewhich helps stimulate sexual drive in menis also limited by high cholesterol-caused lowered blood flow to the testicles, where the hormone is produced.

Now that weve covered the problem, lets look at ways to go about finding the solution. For starters, Krychman said, if you believe your high cholesterol is affecting your sex life you should consult a physician. In an article on Healthcentral, the author reiterates Krychmans point noting that men who develop erectile dysfunction without an obvious cause, such as from medication or physical injury, may have a 25% increased risk of cardiovascular disease over the next 5 years.

There are generally three basic ways to go about combating high cholesterol: diet, exercise, and medication.

In terms of diet, most physicians will generally suggest cutting out saturated fats. This Alternet article, for instance, suggests nine ways you can increase the presence of good cholesterol (HDL) in your diet. By enjoying a low carb diet, avoiding trans fats, and doing regular exercise, explains the author, a person can greatly reduce their risk of heart disease, and in turn, reduce the effects that cause erectile dysfunction. For more diet tips, heres a list of 14 other foods that help with circulation.

This 2013 study, published in the journal Medline, looked at erectile function in relation to mens weight loss. Drawing on data from 145 sexually active overweight/obese men, the study found that dysfunction level improved with a small weight loss - even for men who did not have clinical dysfunction, co-author Clare Collins, a professor of nutrition and dietetics at the University of Newcastle, told Alternet via email. The study further found that overweight men were more likely to suffer from erectile dysfunction.

The main message is that improving your eating habits so that you drop a small amount of weight can improve your sex life, said Collins, adding the important reminder: talk to your doctor if youre experiencing erectile dysfunction.

The main reason for this last bit of advice comes down to medication. Suzy Cohen, a pharmacist writing for Lifescript, points out that high cholesterol and erectile dysfunctionwhich are often experienced togetherremain two separate conditions requiring different treatment. If you have ED, Cohen notes, assume (until proven otherwise) that you have mild heart disease or pre-diabetes. As such, she continues, simply taking lipid lowering medications that bring down your cholesterol levels may still hold negative effects for erectile function, due to a lack of hormones.

Enter statins.

Statins are a type of medication known for lowering cholesterol, and through that process helping to reduce heart disease. According to the findings of a 2014 study published by the Journal of Sexual Medicine, statins might also help benefit men with erectile dysfunction.

In the past, research had shown that statins had a negative effect on testosterone levels. This meant that many physicians questioned the efficacy of cholesterol-lowering medication when it came to improving sexual health. But a 2014 study by researchers from the cardiovascular research department at Rutgers Universitys Robert Wood Johnson Medical School proved differently.

For the study, researchers conducted a meta-analysis of previous studies on erectile dysfunction and statins. 11 trials that measured erectile function using the International Index of Erectile Function (IIEF) were identified for analysis following a systematic search of MEDLINE, Web of Knowledge, the Cochrane Database, and

Whats the IIEF? The IIEF, taken from self-administered survey results, are a set of five questions, scored on a five-point scale that when totalled either indicates a low number, indicating poor sexual function, or the opposite.

Overall, the analysis revealed that their was statistically significant proof that statins caused a clinically relevant improvement of erectile function as measured by the five-item version of the IIEF in men who had both high cholesterol and ED. Specifically, the study found that, overall, IIEF scores rose by 3.4 points in men who took statins compared to the control, which represents a 24.3 per cent improvement.

The increase in erectile function scores with statins was approximately one-third to one-half of what has been reported with drugs like Viagra, Cialis or Levitra, Dr John Kostis, the director of Rutger Universitys Cardiovascular Institute who lead the study, said in an article in the Daily Mail. It was larger than the reported effect of lifestyle modification. For men with erectile dysfunction who need statins to control cholesterol, this may be an extra benefit.

Kostis went on to explain the teams understanding of their findings to the Daily Mail. They believe that the statins help to improve erectile function by assisting with blood vessel dilation, which in turn improves vascular blood flow to the penis.

Ultimately, a healthy lifestyle is the best method to prevent disease, including erectile dysfunction," said Kostis, adding that although statin therapy may only help some people suffering from ED, in the long-run it has been proven to reduce your chances of experiencing cardiovascular disease.

Rather than preventing the possibility of a heart attack in the future, he said, the more immediate benefit of improving erectile function might improve adherence to statin therapy.

So, at its worst statin therapy will only help high cholesterol sufferers with their hearts and at its best, it could also improve their situation in the bedroom. Kostis was sure to add that statins should not be recommended as a primary form of treatment for ED, if patients have healthy cholesterol levels. He added that in order to more fully investigate the link between statin therapy and ED would require a larger trial.

In the end, like most issues pertaining to your health, the best solution requires a holistic approach. If you find yourself with high cholesterol and erectile dysfunction, its time to change your ways. Remember, step one: consult your physician. From there, with the right combination of diet, exercise and medication you could keep enjoying those great fruits of life, long into your years.

Robin Scher is a freelance writer from South Africa currently based in New York. He tweets infrequently @RobScherHimself.

How High-Cholesterol Foods Can Ruin Your Sex Life - AlterNet

8 Health Issues You Had No Idea Transgender and Gender-Diverse People Are Dealing With – Women’s Health

Women's Health
8 Health Issues You Had No Idea Transgender and Gender-Diverse People Are Dealing With
Women's Health
Physician assistant Diane Bruessow, who works for the private medical office Healthy Transitions, says that doctors who don't work with transitions don't necessarily know the details of working with hormone therapy. That's why Alex Keuroghlian, M.D., M ...

and more »

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8 Health Issues You Had No Idea Transgender and Gender-Diverse People Are Dealing With - Women's Health

Concussions tied to menstrual problems in young women – WHTC

Thursday, July 06, 2017 3:51 p.m. EDT

By Andrew M. Seaman

(Reuters Health) - Young women who suffer a concussion may be at increased risk of menstrual irregularities, at least for a few months, suggests a new U.S. study.

Researchers found that young women were nearly six times more likely to have irregular menstrual cycles after a concussion, compared to young women who were treated for non-head-related injuries.

After a concussion, women should talk to their healthcare providers about the increased risk, said senior author Anthony Kontos, of the University of Pittsburgh Medical Center Sports Medicine Concussion Program. It's important, he added, "for care providers to be concerned about menstrual patterns and encouraging women to track that after their injury."

Irregular menstrual cycles may disrupt the body's hormones and lead to delayed body development in young women, Kontos told Reuters Health. Hormone disruption can also lead to poor bone health.

Concussions result from a hit or blow to the head that causes the brain to move back and forth or twist inside a person's skull, according to the Centers for Disease Control and Prevention.

A study last year by the Seattle Sports Concussion Research Collaborative estimated that up to 1.9 million children in the U.S. experience a sports-related concussion each year. Girls are also known to have a more difficult concussion recovery than buys, Kontos and his colleagues write in JAMA Pediatrics.

Hormone disorders are known to occur after traumatic brain injuries, they add. Some research has suggested menstrual disorders are more common after those types of injuries, too.

For the new study, the researchers recruited 68 girls and women, ages 12 to 21, who were recovering from concussions. The participants received a text message every Sunday night for about four months linking to a survey that asked about their menstrual cycle. They were asked about bleeding, new injuries, possibly pregnancies and birth control.

Sixty-one young women with non-head-related injuries were also surveyed every week.

About 24 percent of concussion patients had at least two abnormal menstrual cycles during follow-up, compared to 5 percent of patients with other types of injuries.

Kontos said concussions might increase the risk of irregular menstrual cycles by disrupting the hypothalamic-pituitary-ovarian axis, a group of hormone-emitting glands that often act in concert.

Dr. Jeffrey Bazarian, an emergency physician and brain injury expert at the University of Rochester Medical Center in New York, told Reuters Health a concussion could interfere with the pituitary gland in the center of the brain.

"Its possible that this also happens to males and the question is how does it effect them," said Bazarian, who was not involved in the new study.

The researchers can't yet explain their findings, however. Nor can the study prove concussions actually cause abnormal menstruation.

Kontos also said it's unclear whether the increased risk of abnormal menstrual patterns lasts beyond four months.

"We dont know beyond that," he said. "Its one of the studies wed like to do."

SOURCE: JAMA Pediatrics, online July 3, 2017.

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Concussions tied to menstrual problems in young women - WHTC

Local doctor wants to save kids from hot cars – The Northwest Florida Daily News

JENNIE McKEON @JennieMnwfdn

MARY ESTHER The tragic death of a 7-week-old child left in a van earlier this week is a reminder of how dangerous Florida heat can be.

Okaloosa County sheriff's deputies were called to a home in Mary Esther about 9:30 p.m. Sunday, where they found infant dead inside a van. A family member was not aware that the child's mother had placed the baby in the rear-facing car seat inside the van after church about 12:45 p.m.

Investigators are still waiting for results of the autopsy from the Medical Examiner's Office, sheriff's office spokeswoman Michele Nicholson said.

"This is a tragic event that we are continuing to investigate, and will provide more information when the evidence, facts and interviews are concluded and reviewed," she added in an email statement.

According to the website, an average of 37 children in the United States die from heat-related deaths after being left inside vehicles. Since 1990, about 800 children have died of vehicular heat strokes.

Niceville physician Wayne Justice has made it a personal mission to help save families from experiencing those tragedies after reading about one in the summer of 2013.

"I know how busy life can be. I have two kids who were 7 and 4 at the time," Justice said. "I started to think ... when doctors put patients on ventilators we have sensors to measure carbon dioxide. I'd love to see some kind of device in cars that monitors temperature and carbon dioxide."

Justice enlisted friends Dr. Kit Kuss and engineer Mark Denney to come up with a prototype. In January 2016 they received a patent on the XTRAS (Extreme Temperature Rescue Alarm System). He sees the device being installed in the dome light or TV monitors in cars that could sense motion, CO2 levels and temperature.

"The device would alarm parents by phone or call 911," he said. "Maybe even crank up the car and turn the AC on. It could also save pets."

As a father and a doctor, Justice said he would like to see his prototype developed into a life-saving device. He's hoping to work with, (KAC), which works to raise awareness about the dangers inherent to children in or around motor vehicles, and the National Highway Traffic Safety Administration to do more testing and get the finished device in cars.

"I see it as a baby shower gift," he said. "You give monitors and the XTRAS."

According to KAC, in more than half of the cases in which a child is left in a hot car, the person responsible for the child left them unknowingly. Neuroscientists say brains can go on "auto pilot" and go through the day's schedule without noticing changes in the routine.

Justice also points out children can get accidentally locked in cars with the child safety lock features.

"It's horrible and devastating," he said. "I would love to see this implemented in cars and save lives."

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Local doctor wants to save kids from hot cars - The Northwest Florida Daily News

WFAN voice breaks through media’s wall of Tiger protection – New York Post

Either the 22-year news embargo has been lifted or the Broadcasting Thought Police havent yet arrested WFANs Richard Neer for media malfeasance in the first degree. What he said on the air Monday morning, after all, previously was an act of sedition.

Neer cast some practical doubt on a fellow who for years was presented to Americans not only as the greatest in his sport (which was true for a while), but also as the worlds greatest son, husband, father and human: Tiger Woods. Yet Neers still at large, not yet in custody.

Neer noted that Woods, that morning, had tweeted he was out of drug rehab, although not quite. Drug and rehabilitation didnt make the cut. The message read: I recently completed an out of state private intensive program. I will continue to tackle this going forward with my doctors, family and friends.

Whatever this is.

Neer said this strikes him as one of those dubious two-week miracle cures, thus hes not convinced Woods is properly dealing with an addiction for which he might need intensive treatment.

Neer might have added that this tweet, in the month following Woods 3 a.m., lost-in-space, DUI arrest, carried the stink of a Team Tiger public relations ploy, as it was sent in the midst of the July Fourth holiday. Public relations folks often have high-profile clients choose to release statements that dont reflect particularly well on them at times that make the least possible news.

But what, other than Woods ability to shoot lower than everyone else, has not been accompanied by the doubtful, followed by media-excused absences of common sense?

He tweeted that after an intensive program he was working with my doctors.

In 2009, with the finest doctors in this country to select from, Woods and company chose Canadian Anthony Galea, who was flown to Florida a reported 14 times to treat Woods knee.

Two years later, Galea pled guilty to smuggling illegal drugs and human growth hormone into the United States.

Woods and Galea claimed the doctor administered no illegal treatments. So then why would Woods fly him in from Toronto? He couldnt have been similarly, legally treated by a U.S.-accredited physician?

But to even hint that this made less sense than it did nonsense went widely ignored. Woods was entitled to escape such logical doubt while his career has been laced with the stench of fraud.

His closely followed, far-flung and expensive amateur career surely was financed by his father after the monolithic rep firm, IMG, hired Earl Woods as a talent scout, as if Dad scouted other talent. Tiger then belonged to IMG the instant he turned pro, thus Team Tiger thumbed its nose at USGA rules prohibiting amateurs from having agents.

His come-out, attitude-enriched Nike commercial had Woods, who previously had insisted that he didnt want to be known for his race, saying, There are still courses in the United States that I am not allowed to play because of the color of my skin.

But as the most celebrated amateur since Bobby Jones, no such thing, as a Nike rep later admitted, was true. Woods, however, often played and practiced at a course in Houston that excluded women.

In 1997, when Woods skipped a PGA event in the U.S. to play a tournament in Thailand, the media reported Team Tigers claim: he was playing in Thailand to honor his mothers heritage. What a son!

That $500,000 appearance fee to play in Thailand? Shhh. Dont ruin it! After all, that weeks PGA Tour winner won only $270,000.

But Woods has always been guarded and enabled by fractional truths, if not lies, blissfully indulged or advanced by media.

Of course, no one rolled over and played dead for Woods more often than TV, its golf voices allowing him to be the only player entitled to act like a foul-mouthed spoiled brat, even into his late 30s, without a discouraging word about what was impossible for viewers to not hear or see.

During the 2010 Ryder Cup, as Woods and Steve Stricker were losing their second team match, NBCs Johnny Miller identified the problem: Stricker. It was his fault.

Yet it was clear to even miniature golfers that Stricker was playing better than Woods.

Into NBCs booth entered Colin Montgomerie, guest commentator. Apparently unfamiliar with the rules of Tiger Woods American TV coverage, the Scotsman volunteered that Woods was playing poorly.

He has hardly hit a fairway or green in regulation, Montgomerie said.

OMG! Awkward silence. Montgomerie had no idea that no matter how conspicuous the truth, youre not supposed to say that, not about Tiger Woods.

And so despite the rank pandering and Woods continuing free fall, the media have done Woods no favors.

FOX Sports boss and former ESPN shot-caller Jamie Horowitz, this week was fired for alleged sexual misconduct. Employees must attend seminars to deter sexual harassment, yet its their bosses who are fired for it.

Its odd, too, how defense lawyers make public declarations of hard facts without possibly knowing them. Horowitzs attorney, Patricia Glaser, immediately knew that FOX, not Horowitz, was the guilty party:

The way Jamie has been treated by FOX is appalling, she said. At no point in his tenure was there any mention from his superiors or human resources of any misconduct or an inability to adhere to professional conduct.

Does that mean FOX owed Horowitz a warning to cut it out?

Glaser continued: Jamie was hired by FOX to do a job that until today he has performed in an exemplary fashion.

How does she know? Did she shadow Horowitz at work?

Finally, she said, Any slanderous accusations to the contrary will be vigorously defended.

So how can she be sure shes not slandering those who fired him?

Many high-powered attorneys are like Mike Francesa. They can publicly claim anything about anything and anyone as fact without knowing if its true, never to be held accountable.

Game 5 of the 1956 World Series, and we can hear John Sterling: Casey Stengel has seen enough, Suzyn. He has brought in eighth-inning man Dellin Betances. That closes the book on Don Larsen: Seven innings, no runs, no hits, no walks.

FOXs commercials for Tuesdays All-Star Game are off by at least a half-hour. The game will not begin at 7:30 p.m., but sometime after 8 p.m.

Damien Wilson, the Cowboys linebacker who was arrested Tuesday on two counts of aggravated assault with a deadly weapon a car and a rifle is a University of Minnesota man.

After Joey Chestnut again won the 2017 Nathans Hot Dog Eating competition on July 4, reader Mark Woloshyn was disappointed that ESPN didnt post Chestnuts postgame exit velocity.

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WFAN voice breaks through media's wall of Tiger protection - New York Post

Anti tb drugs side effects pdf – Antioch Herald

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A copy of the Declaration of Independence.

Following is the text of the Declaration of Independence in celebration of Independence Day, July 4th, 2017:

IN CONGRESS, July 4, 1776.

The unanimous Declaration of the thirteen united States of America,

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Natures God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

He has refused his Assent to Laws, the most wholesome and necessary for the public good.

He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.

He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.

He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures.

He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.

He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.

He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.

He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.

He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.

He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance.

He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures.

He has affected to render the Military independent of and superior to the Civil power.

He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:

For Quartering large bodies of armed troops among us:

For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States:

For cutting off our Trade with all parts of the world:

For imposing Taxes on us without our Consent:

For depriving us in many cases, of the benefits of Trial by Jury:

For transporting us beyond Seas to be tried for pretended offences

For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:

For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:

For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.

He has abdicated Government here, by declaring us out of his Protection and waging War against us.

He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people.

He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation. He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands. He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people.

Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.

We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.

The 56 signatures on the Declaration appear in the positions indicated:

Column 1


Button Gwinnett

Lyman Hall

George Walton

Column 2

North Carolina:

William Hooper

Joseph Hewes

John Penn

South Carolina:

Edward Rutledge

Thomas Heyward, Jr.

Thomas Lynch, Jr.

Arthur Middleton

Column 3


John Hancock


Samuel Chase

William Paca

Thomas Stone

Charles Carroll of Carrollton


George Wythe

Richard Henry Lee

Thomas Jefferson

Benjamin Harrison

Thomas Nelson, Jr.

Francis Lightfoot Lee

Carter Braxton

Column 4

Pennsylvania: Robert Morris

Benjamin Rush

Benjamin Franklin

John Morton

George Clymer

James Smith

George Taylor

James Wilson

George Ross

Delaware: Caesar Rodney

George Read

Thomas McKean

Column 5

New York:

William Floyd

Philip Livingston

Francis Lewis

Lewis Morris

New Jersey:

Richard Stockton

John Witherspoon

Francis Hopkinson

John Hart

Abraham Clark

Column 6

New Hampshire:

Josiah Bartlett

William Whipple


Samuel Adams

John Adams

Robert Treat Paine

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Anti tb drugs side effects pdf - Antioch Herald

Only read this if you’re stressed – Meridian Star

Stress. Lets face it. We all have it. The people who dont read this article are simply in denial or arent ready to face it. Stress is the kudzu that looks pretty benign at first, but then takes over everything. It grows out of control. This can lead to adrenal fatigue, which well get into through a future column. We need to figure out how to become more aware of it in order to address it head on.

Stress comes in many forms be prepared, Im about to mention some examples. If they hit home with you, then that feeling you get deep in your chest as I mention them, is the stress response! Ever cram for a final test Stay up all night with a fussy child? Late for work? Have a big presentation to give? Need to get four kids to seven different places after school in traffic (I raised my hand on this one!)? Been diagnosed with an illness? Cancer?Facing a move? Retiring? And the list goes on. And heres the thing depending on how you mentally respond, any situation could or could not be stressful.

Stress disrupts sleep and eating habits, alters hormones, increases risk of illness and accelerates aging just to name a few. Its like a bridle to a horse it has the ability to influence everything else in our lives. Tired all the time Its probably stress causing that or could at least be a significant factor. Heres a good way to test if stress is built into your daily routine are you reactive or proactive most of the day? Do you just put out small fire after small fire answering your phone every time in dings? Responding to email every 5 minutes? Starting several tasks but not completing any before something else pulls you away? If your response is yes, then youre reactive. This is the opposite of proactive, which is the key to carrying around less stress. Proactive is planning and then having a good idea of how your day/week/month/year will unfold. In a life where reactive is the norm, stress is the norm.

As I eluded to above, many times stress is a decision we make in our minds. I have a wonderful friend who, God bless her, turns everything, even a decision about whether or not to put sugar in her tea, into a live or die, extreme stress and life altering decision. She lives in this uber-stress zone that I dont even have enough mental capacity or energy to fathom! This is just cruising for an early heart attack!

Another part of moving towards minimizing stress is that its counter cultural. Just watch a few commercials the American culture is all about being driven, doing more, having more, never settling, and on and on. Dont get me wrong, there are some good caveats to American culture, but the undue stress it put on us through, most times, unachievable expectations is not one of them. Its the perpetual drive for more that breaks us eventually. Sometimes we just need to have an awareness of the moment we are in and be content in that. I think it would lead to less stress not to mention likely freeing our time up more for ourselves, our families, sleep, and whatever else we wanted to do that felt less stressful and more rewarding.

Ever had someone sneak up and scare you?! Ill admit, Im that dad who does it to his kids! That feeling you get is adrenaline from your adrenal glands. How about long term stress, like having a weekly office meeting where you have to present accomplishments? Cortisol is the longer-term hormone released from the adrenals to adjust to stress. How about when that runs out? Like when youre a mother of an infant and you get up with them 2-5 times (yes, that many times for those of you who havent had children yet!) per night for up to a year?! Thats when cortisol reserves are depleted and you move towards burnout or adrenal fatigue. Stress tells your body through all these phases to release fancy things like interleukin-6 and C-reactive protein which cause inflammation. Inflammation is the gateway to almost all the long term issue related to stress like heart disease, high blood pressure, lowered immunity (i.e you get sick more often), poor wound healing, weight gain, insomnia, fatigue and memory impairment.

Well, if I left you there, it would be depressing and add to your stress. Heres a list of just a few simple things you can do to lower your stress level and get back to what normal should feel like:

1. Get more sleep. Just turn the TV off sooner or put your phone down and do it. Youll feel better.

2. Wake up 5 minutes earlier and use that time for quiet reflection and/or to plan your day youd be amazed what a difference this makes!

3. Turn you phone off for part of the day. Heresy, I know! But 20 years ago, if you were driving somewhere for an hour and a half, nobody could reach you and the world didnt end, did it?

4. Schedule your priorities dont prioritize your schedule. Cheesy I knowbut catchy!

5. Get bored. Spend some time doing absolutely nothing ironically, youll get something out of it!

6. Prepare and cook a meal with a significant other. Its therapeutic and will enhance your relationship.

Thats just a few things. There are thousands of other applications. The challenge for you today is to be aware of stress in your life and pick 1-2 things to do to address it. Trust me, itll put a smile on your face!

Dr. Thomas is a board-certified physician who operates Complete Health Integrative Wellness Clinic and Thomas Urology Clinic in Starkville.

This newspaper column is for informational purposes only and is, under no circumstances, intended to constitute medical advice or to create or continue a physician-patient relationship. If you have a medical emergency, you should immediately seek care from your nearest emergency room, and if you have specific health questions, you should consult your own physician.

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Only read this if you're stressed - Meridian Star

Carol Renke, MD Top Doctors 2017 – Palm Springs Life

Dr. Carol Renke and her family practice exudes a familial atmosphere and thats exactly how she likes it. Her husband, Robert Renke, serves as practice manager; much of her staff has been with her for many years; and Renke gets to care for multiple generations of patients, ranging from adolescents to the elderly.

Ive gotten to see patients through different phases of life and I love getting to know them as people, not just their medical histories, she says. I make sure Im spending a little more time with my patients than I think most people are doing these days.

Her two staff physician assistants keep appointments open daily so sick patients can get same-day appointments rather than having to wait. Even with last-minute scheduling, Renke oversees the cases. I review everything. All the blood tests, all the X-rays, she says. And in the style of old-fashioned medicine, Renke insists on following up with a letter or a call after every test. Theres no, Oh if you dont hear from us, everythings fine, she explains. If you do a test, you want the results.

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Carol Renke, MD Top Doctors 2017 - Palm Springs Life

It’s time for baseball to allow the use of PEDs – Fort Worth Star Telegram (blog)

Fort Worth Star Telegram (blog)
It's time for baseball to allow the use of PEDs
Fort Worth Star Telegram (blog)
A former Major League Baseball trainer is fairly certain that ballplayers are using steroids again. That's if they ever really stopped, the trainer, who worked for more than 10 seasons with a big league ballclub, recently told me. It wouldn't ...

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It's time for baseball to allow the use of PEDs - Fort Worth Star Telegram (blog)

The Science Behind the Abortion Pill – Smithsonian

The "abortion pill" (actually two separate medications) can be taken up to 10 weeks after pregnancy, according to the FDA.

Roe v. Wade may have legalized abortion in America 45 years ago, but the fight it ignited is far from over. While abortion is still legal, many states have since passed laws that restrict access to abortion to varying degreesmaking it more expensive, difficult or even illegal in specific circumstancesto terminate a pregnancy. Todayabortion clinics are disappearing at a record pace,andMedicaid payouts to Planned Parenthood are in jeopardy.

As a result, many women do not have access to a safe clinical abortion.

The fact that a clinic exists in her state doesnt help a woman who lives far away from that clinic and has no way to get there, says Susan Yanow, a reproductive health consultant for the international nonprofit Women Help Women(WHW). Seven statesKentucky, North Dakota, South Dakota, Missouri, Mississippi, Wyoming and West Virginiacurrently haveonly one abortion provider, and Kentuckymay soon bethe only state with none.

Now some women are once again taking the procedure outside the doctor's office, outside the law, and into their own hands. While the days of the infamous wire coat hanger aren't quiteover, many women are turning to asafer method made possible by modern medicine: the abortion pill.

For those with access to a clinic, the abortion pill has become anincreasingly popular wayto legally terminate an early pregnancy. The Food and Drug Administration mandatesthat medication can only be prescribed by a healthcare provider "who meets certain qualifications";19 statesalso require that a physician be there physically to supervise the procedure.

Anti-abortion activists argue against the safety of using this method outsidea doctor's office, and have even argued that states should require stricter medical supervision for abortion medication. These drugs are dangerous. They are deadly. If they are mishandled, they result in serious injury, Kristi Hamrick, spokeswoman for the antiabortion groupAmericans United for Life, recently told The Washington Post.(Hamrick is not a physician.)

Butwomen who can't get the medication legally can and dobuy it illegally, either online or in Mexico. In fact, thisis fast becoming the primary option for womenwho lack others: In 2015, more than 700,000 Google users in the U.S. typed in queries about self-induced abortions, includingbuy abortion pills online and free abortion pills,according to theNew York Times. In May 2016,Glamourmagazine chronicled the stories of women seeking these pills inThe Rise of the DIY Abortion.

Thats why, in April, WHW launched its first website to assist American women undergoing medical abortions on their own. The new Trump administration and anti-abortion legislatures in many states are moving swiftly to push abortion out of reach, said Kinga Jelinska, the groups executive director, ina statementannouncing the move. The new website,, provides women with confidential, one-on-one counseling on how to safely use theirabortion medicationregardless of where they may have obtained it.

It isn'tclear just how many women are seeking abortion medication outside of a clinic. To protect its clients, WHW does not disclose how many inquiries its trained counselors receive. But in the past several years,manywomenhave been charged for buying or taking it illegally, with several facing felony charges andjail time. As use of the abortion pill spreads outside the doctors office and into murky legal waters, we asked: How does this procedure work? And how safe is it?


While it's used by many abortion clinics, the name abortion pill is a bit misleading. Medical clinics actually administer two different types of medication: one mifepristone pill(which goes by the brand name Mifeprex), and four misoprostol tablets.

How does it work? The first dosea 200 mg mifepristone pillbegins the process by blocking the bodys progesterone, a hormone that is needed to continue a pregnancy in its early stages. Whenever a woman has a period, part of what stimulates that period is the withdrawal of progesterone, saysDr. Lauren Thaxton, an obstetrician-gynecologist in Albuquerque, New Mexico who has been performing abortions for six years

By blocking this hormone, the first pill helps break down the uterine lining that a woman normally sheds during her period, so that the embryo can detach from the uterine wall. After that happens (generally one to two days after taking the first mifepristone pill),a woman dissolves four 200 mcg misoprostol tablets in her mouth. This second medication, which is also used to induce labor, helps expel the detached embryo.

Misoprostol is in a class of medications called prostaglandins, saysobstetrician-gynecologist Dr. Daniel Grossman, who isthe director of Advancing New Standards in Reproductive Health and co-author of a recent paper exploring the possibility of moving early abortion medication over the counter. One of the effects of prostaglandins [is] that they cause whats called cervical ripeningmeaning causing the cervix to soften, open up, and become thinner. And it also causes the uterus to contract.

Misoprostol was first developed in the U.S. in 1973 to treat peptic ulcers,which it did by preventing harsh gastric secretions. But it had known,major side-effectson a pregnant uterus. In the 1980s, French researchers developed mifepristone,also known as RU-486, a pill that could be taken in sequence with misoprostol to induce an abortion. France legalized this regimen in 1988, andChina,Great Britain and Swedensoon followed suit.

In the U.S., reproductive rights activists hoped the FDA would adopt the method in the '90s, but anti-abortion activists helped delay its approval until 2000. When the U.S. first legalized abortion medication, it was available up to seven weeks after pregnancy. Women receiving it had to visit a clinic three timesonce to take the mifepristone, a second time to take the misoprostol, and a third time for a follow-up.

In 2016, the FDAextended the pregnancy period to 10 weeks and reduced the number of required visits to two, meaning that women could now take the misoprostol at home (though some states have restricted that as well). Today there are even clinicsthat aim tode-stigmatize the processby offering a "spa-like experience,"like a Maryland Carafem health center that offers hot tea and robes to women seeking medical abortions.

One to two weeks after taking the medication, the woman returns to the clinic to make sure the pregnancy has passed. When taken between nine and 10 weeks into a pregnancy, mifepristone and misoprostol are 93 percent effective at inducing an abortion, according to Planned Parenthood. The earlier they are taken, the more effective they are.

In 2014, almost half of U.S. hospital and clinical abortions performed before nine weeks were medication abortions, according to estimates from the Guttmacher Institute, a research and policy organization for reproductive rights. But if WHWs new counseling services, Google queries and the increase in articles on DIY abortionsare any indication, many moremedical abortions may be happening outside the clinic.



Cara Harshman, a freelance writer and marketer in San Francisco, had her (legal) medication abortion in January. In an interview, she said that her symptoms of cramps, bleedingand nausea lasted for about five days after taking the misoprostol. By the time she had her follow-up appointment, she was stable and feeling healthy. She wrote about her experience on the Facebook group Pantsuit Nationin an essay she thenre-published on Medium and Shout Your Abortion.

The only health issue that came up during Harshmans abortion was a blood test showing she was Rh negative, a rare blood type, meaning she had to receive a shot of the medication RhoGAM after taking the misoprostol. According to Thaxton, most women are Rh positive. But if a woman is Rh neg, pregnant and having bleeding, she needs to receive RhoGAM to prevent alloimmunization in future pregnancies, which is a condition wherein the mother develops an immune response to fetal red blood cells, Thaxton wrote in an email.

Overall [a medicationabortion]is extremely safe, says Thaxton, who is also a member ofPhysicians for Reproductive Health.Common symptoms include nausea, cramping and heavy bleeding, similar to what women experience during a miscarriage. Thaxton generally tells her patients that if they soak through four maxi pads in two hours, that's too much bleeding, and they should consult their physician. Theres a rare risk of [too much] bleedingsometimes bleeding requiring a blood transfusionand that can be related to the risk that the pregnancy has incompletely passed, she says.

To prevent this, abortion providers will counsel women about whether they have a history of bleeding disorders before prescribing this method. Theres also a small risk of infections like endometritis(inflammation of the uterine lining)or the contraction of the bacterium Clostridium Sordellii, both of which can also occur after childbirth. However, Thaxton said that the instances of infections after medication abortions are extremely, extremely rare.

Women are always screened for health conditions that might make a surgical abortion a safer option than the abortion pill, Thaxton wrote in an email. But for the vast majority of women, the abortion pill is a safe, private, effective way to have an abortion."


Both mifepristone and misoprostol are available to purchaseonline without a prescription, even though doing so isillegal under federal law (laws regarding inducing an abortion vary by state). Many women who have to resort to this method use only misoprostol, because itis easier to get on its ownand is available over (or under) the counterin many Latin American countries.

Texas women have been getting misoprostol at Mexican pharmacies for years, The New York Timesreported in 2013; whileabortion in Mexico is legally restricted, the medication is sold over the counter for ulcers.

Research has found that a larger amount of misoprostol is needed to induce an abortion on its own, and its usually less effective than the combined method. During the first 12 weeks of pregnancy, a woman who takes three 800 mcg doses of misoprostol orally at least three hours apart has an 85 percent chance of having a complete abortion, according toa 2007 study in theInternational Journal of Gynecology and Obstetrics.

Yet somestudies suggest that inducing an abortion using misoprostol alone is no less safe than the combined method. The World Health Organizationrecommends misoprostolas a safe alternative when mifepristone isn't available, andGrossman says he would use the misoprostol-only method if he didn't have access to mifepristone as well.

Over-the-counter abortion medication may sound pretty far-fetched in a country like the U.S., where even standard birth control requires a prescription in almost every state. Yet the fact that women are already managing their medication abortions on their own has led some to wonder: Could the abortion pill(s) ever be sold over-the-counter, asGrossman's study explored?

In a recent Guardian op-ed, he writesthat limited research suggests women who take abortion medication on their own are doing so safely, adding that there is no question that use of these medications has contributed to a reduction in abortion-related mortality worldwide. Abortion medication, he argues, could one day meet the FDAs requirements for over-the-counter drugs. In fact, the research group Gynuity Health Projects is already conducting an FDA-approved research project calledTelAbortion to test the safety of women using mail-order medication and online consultation to perform their abortions at home.

Of course, future research willbe needed to test these hypotheses. But even if the pill's at-home safety is confirmed,if history tells us anything, it's that efforts to make abortion more accessible will be fought every step of the way.

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The Science Behind the Abortion Pill - Smithsonian

Ask the Doctor: Earaches, getting shorter with age, temperature regulation – WNDU-TV

Each Tuesday, Doctor Rob Riley joins us on NewsCenter 16 at Noon to answer viewers' medical questions. Here are the questions he addressed on June 20.

Why do I get an earache when I sleep? It goes away once I'm up."

Dr. Riley: Several possibilities here. Some ear infections hurt more at night, perhaps due to fluid shifts that occur with lying flat. Sometimes dental problems can do this. If you're a mouth breather, drying out the throat at night can cause irritation to the bottom of the Eustachian tubes which we can perceive as ear pain. And it can be as simple as sleep position. If you're putting pressure on a nerve that goes to the ear as you sleep, that will get better when you get up and the pressure is relieved. In any event, if this problem persists, it's definitely worth a visit to your physician who can examine your ear canals, look at the middle ear spaces, look at your inside of your mouth and throat and see if there's something there that requires treatment.

"I know as we age we get a bit shorter. I've shrunk three inches and now my belly is getting bigger. I tell people that as I got shorter, my innards had to go somewhere. Is this explanation anywhere near the truth?"

Dr. Riley: Well, maybe. It's true that we all tend to lose a little height as we get older. The little shock absorbers between the bones of our spine tend to get a little flatter over time and it adds up. Losing three inches is a lot, though, and suggests some of the height loss may be due to compression of the bones themselves. So it may be a good idea for our viewer to be checked for osteoporosis as we have some treatments for that that may reduce the risk of bone fractures later in life. In terms of tummies pooching out, I suppose a shorter spinal column might contribute some, but it's more likely to be due to increased belly fat that's pretty common as we age.

Why does the inside of my body feel cold but my skin is burning hot?"

Dr. Riley: We don't know the age of our viewer, but temperature regulation issues are common as part of menopause. Classically, we think of women getting hot flashes, but temperature problems in general can accompany menopause. This time of year, a bad sunburn can cause people to get the chills. Another concern that comes to mind is thyroid disease. Thyroid hormone affects lots of body functions, including temperature regulation. Low levels of thyroid hormone can cause the person to feel cold when everyone else in the room is comfortable. This condition is much more common in women than in men and is diagnosed with a simple blood test. It's treated by giving people additional thyroid hormone that they can take in pill form. That often takes care of the problem.

Dr. Riley joins us from Memorial Family Medicine.

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Ask the Doctor: Earaches, getting shorter with age, temperature regulation - WNDU-TV

Weekend Doctor – The Courier

By DR. LORIE THOMAS As we age, there are many changes that take place in our bodies. One of these changes involves our bodies going through menopause. No one ever tells you that the aging process causes your skin to lose elasticity. For women, this may intensify many other changes that have already occurred with the effects of hormone changes and structural changes from pregnancy and childbirth. Elasticity is a result of the changes in collagen. Collagen is a structural protein found in skin that gives it strength, elasticity and replaces dead cells. Changes in collagen for a woman may lead to: Stress urinary incontinence, which happens when physical movement or activity puts pressure on your bladder Vaginal thinning, which reduces natural lubrication Vaginal dryness, leading to painful sex Many women find themselves embarrassed, frustrated, helpless and unlikely to ask a physician for help. Often, the standard medical recommendation of estrogen cannot be used for a woman due to a history of breast cancer, a blood-clotting disorder or heart risks. A woman may believe she has no options, but this may not be true as she could consider a laser procedure. This procedure helps rebuild the natural collagen of the vagina. A procedure called vaginal rejuvenation is a non-surgical treatment to restore a youthful state. Vaginal rejuvenation stimulates the regeneration of collagen and elastin. This procedure has a positive impact and improves urinary stress incontinence, vaginal tightness, vaginal dryness and the symptoms of postmenopausal atrophy. Vaginal rejuvenation is a 30-minute, noninvasive treatment where a specialized laser probe is inserted into your vagina to deliver light energy directly to your vaginal tissue to stimulate collagen production. Following your vaginal rejuvenation treatment, you can return to your normal daily activities immediately following treatment. However, you should avoid sexual intercourse for five days. Many individuals report that their vaginal rejuvenation procedure is more comfortable than having a Pap smear. Women wanting this procedure should consult with a physician to assure it is appropriate for them. Thomas is an obstetrician-gynecologist affiliated with Blanchard Valley Health System. Questions for Blanchard Valley Health System experts may be sent to: Weekend Doctor, The Courier, P.O. Box 609, Findlay 45839.


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Weekend Doctor - The Courier

Tips for easing hot flashes – FOX 5 Atlanta

ATLANTA - As an OBGYN with Piedmont Physicians in Newnan, Dr. Tia Guster gets asked a lot about what works for hot flashes.

"It's a little bit of trial and error," Dr. Guster says. "S you have to pack your patience hat on that one."

That's because the triggers are different for each woman, Guster says.

For some, drinking alcohol or caffeine can turn up the heat.

For others, stress, eating spicy food, just being in the heat can trigger that sweaty, flushed feeling.

So, Guster says, start by paying attention to what you're wearing.

"So keep it kind of loose, with flowing maxi-dresses, if you can, at all, wear that as a fashion trend," she says.

And try turning down the temperature at home.

For severe hot flashes, Dr. Guster says, ask your physician whether you're a candidate for hormone replacement therapy, also known asHRT, and what the risks and benefits are.

Your doctor may also prescribe non-hormonal medication to ease your symptoms.

And, Guster says, soy also works for some women.

"Legitimately, soy-based products are helpful, because they act essentially as estrogens in your body," she says. "And we've got those over-the-counter."

Steer clear of soy and soy products if you have a hormone-sensitive condition, like certain breast cancers.Guster says supplements like black cohosh, red clover and evening primrose oil may also help ease your symptoms.

"I think it's worth a try before you go to (prescription) medicine," she says. "But definitely bring all your stuff in and just have a conversation, like, 'Doc, I use this, and I use this. What do you think about this?'"

Finally, Guster says, exercise can be a huge help.

"It boosts your endorphins," she says. "It lowers your weight. It helps with your heart rate and your blood pressure. And all these things are excellent foundations for health."

You don't have to lift weights or run a marathon, Dr. Guster says.

"Just walk up and down your block for 30 minutes," she recommends. "It's also mind-clearing, which goes a long way."

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Tips for easing hot flashes - FOX 5 Atlanta

What My 90-Year-Old Mom Taught Me About The Future Of AI In Health Care – WBUR

wbur Commentary

June 16, 2017

By Dr. Isaac Kohane

Quick: What is the hilly profile in the red figure below?

No, its not my fitness trackers daily step count, but youre close.

Its a set of daily weights, as measured by an electronic scale over a period of several weeks. More specifically, the daily weights of my 90-year-old mother, who continues to live in her own apartment despite all my offers. "I outlived Hitler and Stalin, she says. I can take care of myself."

She can, in fact, take care of herself, but Ive found over recent months that she can take care of herself far better with some digital help. And that experience, though only a single case, persuades me that recent spectacular gains in artificial intelligence could bode far better for our health than studies to date suggest. But also that caring, common-sensical humans will not be replaced by AI any time soon.

My mother has moderate heart dysfunction, and her physician has her on all the right medications, including a daily dose of Lasix, a "water pill" that makes you urinate more and thereby eliminate some of the salt in your blood. Yet last year, over several weeks, her legs became increasingly swollen with fluid, to the point that it oozed out of her skin. Her shins looked as if they were covered withtears. She was also in quite a bit of discomfort.

Her physician sent her to the emergency room, where an ultrasound showed that her heart was enlarged and pumping less effectively than it should. She landed in the hospital for a week, where the most important treatment she received was intravenous Lasix, a far more potent form than her usual pills.

By the time she left the hospital, her legs had not returned to normal but were visibly thinner. As I would have said as a callous medical student, she had been effectively "dried out." She was also considerably weaker from spending a week in a hospital bed, but regained her strength with the help of a physical therapist.

Six months later, a similar scenario played out, but worse. This time, she had to go to a rehabilitation facility after her hospital stay because she was too weak to care for herself or even to walk without help. I suppose if you survive malaria, starvation and typhus as a child, you must be made of tough protoplasm. After two weeks of intensive rehab, she was back at her apartment again.

But two hospital staysin such a short period concerned me. So I decided to try something that in my day job as a researcher in biomedical informatics the use of computing to advance medicine --I knew had been tried before by many health systems with highly variable and often disappointing results.Nonetheless, I was determined to make it work.

The Plan

The plan was to have her watch her weight daily, and every time there was any sign of increased fluid, to recommend an extra dose an extra pill of Lasix, to restore her fluid balance.

This type of thinking has informed doctors for decades. Outside the hospital, it has worked well for some, but multiple trials, several involving computerized alerts every week to change water-pill dosage, have not conclusively shown benefit.

On the other hand, a friends father, a physician, had defied the odds and lived for decades with severe heart failure by weighing himself daily and adjusting his medications accordingly. That was not a trial, true, but it seemed remarkable, and I wanted to emulate it.

Before I go further, let me confess that when I tell this story to my colleagues, especially those trained in internal medicine or cardiology, their responses range from outright alarm to pursed-lip disapproval. It only gets worse when I remind them that I trained in pediatrics. So lets be clear: Don't try this at home, kids. And I would emphasize that I did not remove my mother from her regular internists care. He remained as a safety net, and I communicated with him copiously.

Back to my story: The challenge was to manage my mother within the constraints of my demanding schedule. I decided the first, most crucial task was to get accurate weights sent to me promptly so that I could act on them. I decided to purchase an internet-enabled scale from Fitbit that allowed me to check my mother's weight via Fitbit's web application.

I asked my mother to weigh herself every morning before eating. In the first few weeks, if she forgot to weigh herself I could see that and would call her to nudge her. Within a month, I never had to remind her anymore. Instead, shed call me to see what I thought of her weight.

Now for the easy part, how to control fluid balance. Heart physiology is complex, and many have tried with only partial success to devise computational models that can predict how it will change with perturbations from diet, medications, disease or exercise. But I boiled it down to one question: How to determine whether she should take an extra Lasixon a given day?

I'll call my plan an algorithm, so it will sound authoritative:

1. If her weight increases by more than 1 pound in one day, recommend one extra Lasix pill. 2. If her weight increases by only 1 pound, then wait to see if it increases by another pound in the following two days, in which case, recommend an extra Lasix pill. And if she took the extra pill, then: 3. If the weight does not return to normal by the second day after the extra dose, then give one additional dose the third day. If on the third day the weight has not returned to baseline, go visit her in her apartment and see if her legs are swollen or if her breathing has changed.

This third part of the algorithm I labeled "visiting nurse." If I saw anything that worried me swollen legs, faster breathing, poor skin color I would call her doctor and ask him to evaluate her. At this point, wed be back in the conventional medical management world, but Id have a lot more useful information to share with her doctor than I would otherwise.

The algorithm also included sleuthing out the cause of the weight gain. On the phone Id go over what she had eaten. Often the culprit was a source of additional salt. Only after reviewing a typical salad and pasta dinner would I learn that shed enjoyed a dozen delicious salt-loaded crackers.

Just having these "debugging" phone calls after a weight gain caused these diet-borne risks to be eliminated rapidly. They also provided my mother with a very concrete sense of which foods to avoid.

So What About AI?

Now back to the graph I shared above. It shows a few weeks of what has gone on for over a year. I managed each of those peaks according to the algorithm. Through the miracle of the internet and smartphones, I was able to run the algorithm even when I was in a distant part of the globe to give a talk or on a family vacation.

Best of all, my mother hasn't even come close to needing to go back to the hospital. Her legs remain completely unswollen. Also, I never called her doctor about persistent fluid gain because that part of the algorithm was never triggered.

Moreover, after a few months, my mother startedcallingme to let me know that she had already implemented the algorithm for that day, because shed gotten tired of waiting for me to call her with my recommendation.

So what about AI? If computers can now win Texas hold 'em poker with imperfect information and bluffing human beings, surely they can manage patients like my mother?

Im not so sure.

A frail, elderly patients health may be influenced by single or multiple perturbations that span the full spectrum of human experience: How much salt was in yesterdays food, the appearance of a skin infection on a leg, change in thyroid hormone levels, increased fluid loss due to apartment heat after an air conditioner failure, sad news causing mood changes causing decreased exercise.

That is only a partial list of the challenges that my mother has overcome in the past year.

And though it may seem straightforward, managing an outpatient with heart failure is far more difficult than the apparently more complex tasks that have been featured in the success of "deep learning": finding cancer cells in a pathology slide, or signs of diabetic disease in a photograph of a retina.

Even more challenging: How does a computer program obtain trust and persuasive powers so that skeptics like my mother will comply with recommendations? What discussions, diagrams, pressures or incentives will be sufficient to convince someone who may not be feeling well at all to change a behavior, a medication or diet?

These skills are hard to come by in humans, let alone computers.

So should we give up? On the contrary. Lets not fall into the trap of "the Superhuman Human Fallacy" the demand that computers perform better than even the best of humans. A more useful comparison is to the way humans actually perform.

Even with imperfect hardware and simplistic algorithms, my mother's doing better than before, when weeks would pass between physician visits and treatment adjustments. Im confident she and many other patients can do better still, but only if we shore up the two sides of the clinical compact.

On the one side, organized medicine has to change its practice so that it can ingest the day-to-day or even minute-to-minute measurements made of our fast-growing chronically ill and aging population, and transduce these data into timely treatment. But without thoughtful and broad application of AI techniques into the process of health care, our already struggling and stressed health care workforce will simply be not able to meet this challenge.

And on the other side, AI cannot replace family and friends as guardians of health not now and perhaps not ever.

AI may be good at chess and Go, and at developing expertise once reserved for doctors in arcane areas such as reading X-rays. But AI does not do well at understanding the wide world, at picking up mood or subtle signs of distress, at convincing a resistant human to listen to the doctor. We don't need AI for that; we need a caring village.

Dr. Isaac Kohane is the inaugural chair of the Department of Biomedical Informatics at Harvard Medical School.

Excerpt from:
What My 90-Year-Old Mom Taught Me About The Future Of AI In Health Care - WBUR

From Medical Pariah to Feminist Icon: The Story of the IUD – Smithsonian

In the past half-century, this tiny object has gone from feminist icon to dangerous villain to, incredibly, feminist icon once again. And no, we're not sure why the background is pink.

The IUD is a clever little T-shaped object that does a really good job of babyproofing your uterus. Its relatively safe, last up to 10 years, and is 20 times better at preventing pregnancy than birth control pills, the patch or the ring. Today the IUD, which stands for intrauterine device, has become so trendy that you can find it on necklaces and earrings on Etsy, and read upfront memoirs by women about their experiences. But it wasnt always this way.

In the 1960s and '70s, the device started hittingits stride as an icon of liberated feminism. But in the mid-'70s, disaster hit. For decades, the IUD was roundly shunned in the United States by women and doctors alike. Today it is by far the most-used reversible contraception method in the world, with 106 million women relying on it for long-term contraception. And yet its still relatively rare in the U.S., wherenearly half of all pregnancies are still unintended.

That may be changing. Directly after President Trump took office, news outlets reported on the rush for long-acting birth control, speculating that the new urgency was fueled byfears that the administration would slash Obamacare requirements forinsurers to cover intrauterine devices and other forms of contraception, as well as stop Medicaid reimbursements for Planned Parenthood.(Most forms of the IUD, it turns out, can outlast a presidential term.) Suddenly, it seemedthat the IUD was destined to become a symbol of modern feminism once again.

To which longtime IUD-users say: Duh. What took you so long? Lets go back to the beginning.

Two Strands of Coarse Silkworm Gut

In 1909, a German medical journal published a paper on a funny-sounding device meant to prevent pregnancy. The device, according to the article, consisted of two strands of coarse silkworm gut united by a thin bronze filament, which were inserted into the uterus using a female bladder catheter (ouch!). The idea behind this and other early IUDs was that putting foreign objects in the uterus tended to sparkan inflammatory response that made life tougher for sperm, says David Hubacher, an epidemiologist who studies contraception at FHI 360, a human development nonprofit.

Prior to this point, the main form of internal contraception was known as an interuterine device, a device made of metal or silkworm-and-glass that was originally used for "therapeutic purposes."This device had a major drawback: it crossed both the vagina and the uterus, thus connecting the uterus to the outside environment by way of the vagina. In a time when gonorrhea was more common and had no good cure, these devices resulted in a high rate of pelvic inflammatory disease.

The 1909 papers title, Ein Mittel zur Verhtung der Konzeption (a means of preventing conception), was no doubt shocking to readers at the time, for whom birth control was a taboo topic, according to acontemporary medical journal. That might explain why, although it was the first genuine IUD, it seems not to have been widely used. It wasn't until 1928 thata German physician named Ernest Grafenberg developed a variation on the silkworm gut IUD, made of metal filaments shaped into a ring, which became more well-known.

Still,regulation was poor. As IUDs increased in popularity, so didreports of cases of pelvic inflammatory disease associated with them. By the late 1940s, only a miniscule number of American women were using European IUD technology, says Hubacher,who haswrittenon thehistoryof the device.

The IUD's first heydaydovetailed with the liberated 1960s and '70s. They got another bump when, in the 1970s, Senate hearings featuring safety concerns over the birth control pill pushed many women toward the IUD. Soon the little device had become, in the words of one doctors 1982 history of the IUD, the unofficial status symbol for the liberated woman. IUDs were worn as earrings even as bras were being burned.

It seemed the IUD was finally destined to have its day. At one point in the '70s, nearly 10 percent of American women using contraception were choosing an IUD. But then, just as it had become the anti-pregnancy choice du jour amongliberated women, one popular model turned out to be deadly. Enter: Dalkon Shield.

An American Tragedy

Today just the name "Dalkon Shield" evokes collective wincingamong a certain generation.In the 1970s, this crab-shaped IUD model was beginning to be linked with reports major health problems including pelvic inflammatory disease, septic abortions, infertility and even death. In 1974, amid media reports, congressional hearings and falling sales, the devices manufacturer suspended sales. ByJuly 1975, there were 16 deaths linked to the device, according to the Chicago Tribune.

By 1987, the New York Times was reporting that as many as 200,000 American women have testified that they were injured by the device and have filed claims against the A.H. Robins Company, the one-time maker of Chapstick Lip Balm. (The Washington Post cited more than 300,000 victims.) The manufacturer filed for bankruptcy in 1985, and a $2.4 billion trust was established in the late 80s for women whod been affected. The failure of Dalkon Shield would have consequences for decades to come.

Between 1982 and 1988, the use of IUDs and other long-acting reversible contraceptives in the U.S.declined significantly. That year, updated devices came out that met new FDA safety and manufacturing requirements, but the damage had been done. The shadow of the Dalkon Shield hung over the entire market, dissuading American women from even considering IUDs even as their popularity in Europe grew.

Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, says that in the 80s, when she discussed contraceptive options with her patients, IUDs were not even considered as a remote possibility. There was no person who would have let me put one in, she says.

In 1996, The Washington Post ran a story about a family planner from New Jersey working with IUD-using populations in Senegal, Nigeria and Kenya who herself had trouble finding an American physician willing to give her one. (At that time, only 1.4 percent of American women using birth control were using an IUD.) A year later, a Virginia physician trying to test a new IUD for market reported that he couldnt give the device away for free.

The reasons for the Dalkon Shields problems are still a topic of debate. During the fallout of the devices problems, researchers reported that a major problem with the device was the particular design of the Dalkon Shields tail string, which is used bothto help women make sure the device is still in place, and to aid in its eventual removal. Unlike other IUDs at the time, the string on the Dalkon Shield was made not of one filament but of many tightly wound filaments.

According to expert testimony in legal cases and reporting from that time, the multifilament string acted as a wick, pulling bacteria and sexually transmitted viruses into the wombs of Shield wearers, as The New York Times put it in 1987.

But Hubacher and Minkin say it was never clear how much the devices tail string was at fault. Rather, says Minkin, who was an expert witness on behalf of a trust later established to pay out women hurt by the device, the objects pronged, crab-like shape made it difficult to insert. That, possibly combined with poor doctor training, meant that it probably wasnt being placed correctly, she says. As a result, some women got pregnant while wearing the devices, leading to septic abortions and, in some cases, death.

She and Hubacher add that another potential danger for women was the fact that screening for pre-existing STIs like chlamydia and gonorrhea wasnt as good in the 1970s as it is now. Inserting an IUD into a woman with an infection might have spread that infection, potentially leading to pelvic inflammatory disease, which can cause infertility.

What's certain, however, is that the Dalkon Shield's failure rippled out to Americans' perceptions of all IUDs.After the controversy, all but one were pulled from the market by 1986. Even today, says Megan Kavanaugh, a senior research scientist at the Guttmacher Institute, some young women she interviews say their mothers have told them to avoid the devices.

Contraception's Gold Standard

Over the last 15 years, cultural attitudes toward this maligned device have been warming. Ameican IUD use has been on the upward swingsince the early 2000s, and several new brands have hit the market featuring names like Skyla, Kyleena and Liletta(apparently theres a mandate that new IUDs sound like pop stars). In the years 2011 to 2013, around one in 10 American women aged 15 to 44 who relied on contraception usedan IUDa five-fold increase over the previous decade, according to data from the Centers for Disease Control.

A safe IUD is the answer to all birth control prayers, writes a woman on Huffington Post who put her two teenage daughters on the device. I switched over a year ago from the pill to an IUD, and it has made a world of difference, writes another, adding: "I am EXTREMELY forgetful, and it is how we ended up with my now-5-year-old!" A gynecologist who herself wears an IUD recently wrote about the advantages of using a form of birth control that youre supposed to forget.

Kavanaugh attributes the change in great part to a recognition within the scientific community that modern IUDs are extremely safe. It helps, she adds, that a younger generation of women and doctors dont have the strong negative associations as those who grew up during the time of the Dalkon Shield. The American College of Obstetricians and Gynecologists now recommends the IUD as the gold standard of birth control, calling them safe and appropriate... These contraceptives have the highest rates of satisfaction and continuation of all reversible contraceptives.

These days there are two major types of IUDs: hormonal and copper. The copper IUD, physicians believe, is toxic to sperm, slowing and damaging the little wrigglers as they swim toward the egg like heat-seeking missiles. The hormonal IUD releases progestinthe synthetic version of the naturally-produced hormone estrogen, and the same hormone found in the pillwhich makes cervical mucus thicker and more hostile to sperm. While the mechanisms are different, the result is the same: Never the twain shall meet.

Hubacher and Minkin attribute the safety of modern-day IUDs to a number of factors. First of all, screening for STIs is much better nowadays. In addition, because they use copper or hormones rather than merely plastic, modern-day IUDs aremore effective at preventing pregnancy. (That means that IUD users are less likely to get pregnant, which can lead to medical issues like ectopic pregnancy.) Moreover, if the multifilament string was ever at fault, modern-day IUDs use single filament strings, eliminating that potential cause of infection.

Many physicians now back the IUD so much that it's become something of a cause to champion. Kavanaugh points to an organization in Washington, D.C. and a task force in New York City that promote IUD use and offer insertion training to medical professionals. IUD advertising has increased, and magazines like Cosmopolitan and Elle are running stories singing the praises of these tiny objects. Rates of IUD use have been growing across many demographic groups, says Kavanaugh, and the pace is especially rapid among young women. Now, a woman who becomes sexually active at 17 but doesnt want a baby till shes in her late 20s might be a good candidate for an IUD that lasts years.

Anecdotally, gynecologists say theyre seeing a major increase in demand. About six months [ago], I was doing one to two IUD insertions a week and now Im doing one to two a day. It's a huge increase,"says Brandi Ring, an ob-gyn in Denver whos part of a new generation of doctors and patients embracing the IUD. As of 2012, 10.3 percent of women who use contraception were using an IUD slightly more than what it was before the Dalkon Shield fiasco. Of course, because the U.S. population has grown, that means more women in the United States are using an IUD than ever before, Hubacher says.

I break it down for my patients in terms of how often they have to remember or think about their birth control, says Ring. I start with the pill, and I say: In the next year you will have to think about your birth control 365 times. For your IUD, you have to think about it twice: once to tell me you want it, and once when I put it in. Even better, because the IUD gets inserted by the doctor and lasts for years, theres little opportunity for user error. It has a failure rate of about one percentcompared to condoms, which have a 13 percent failure rate over the course of a year, or the pill, at 7 percent.

That said, the IUD isnt perfect. Both formscan cause bleeding and cramping directly after insertion, and ParaGard (the copper version) is known in some cases to initially make periods heavier and cramping more intense. It is possible, while rare,that an IUD could perforate your uterus, particularly if you have never had children or have recently given birth; this serious riskusually happens during insertion. There is also small risk that your body willexpel the device.(Check here for morecommon side effects for each type of IUD.)

The financial downside to IUDs is that women need to pay a chunk of change upfront, depending on insurance coverage. The price ranges: Right now, Obamacare generally covers the bulk of the cost of getting an IUD, sometimes leaving women with a few hundred dollars. Meanwhile, the cost of getting one without any insurance could be upwards of $1000 dollars, according to Kavanaugh.But over the long-term, the IUD ranks among the most cost-effective of contraceptives once you factor in things like the cost of unintended pregnancy.

In the end, it's your body, your choice. But if you do go forth and get an IUD, know that the tiny device in your uterus comes with a long and tangled history.

See more here:
From Medical Pariah to Feminist Icon: The Story of the IUD - Smithsonian