Archive for the ‘Hormone Physician’ Category

MedicalResearch.com Interview with:

Dr. Richard Birtwhistle, ProfessorDepartments of Family Medicine and Community Health and EpidemiologyDirector of the Centre for Studies, Primary Care, Department of Family MedicineQueens University

MedicalResearch.com: What is the background for this study?

Response: Testing for thyroid dysfunction is a commonly done by primary care practitioners. While the Thyroid stimulating hormone (TSH) test is an easy blood test to perform results outside the normal range are often found and will revert to normal over time without treatment in patients without symptoms.

We wanted to see if there was any clinical benefit to patients by screening for thyroid dysfunction.

MedicalResearch.com: What are the main findings? What are the potential harms of over-testing for thyroid dysfunction?

Response: We did a systematic review of studies related to screening for thyroid dysfunction. We found no trials of screening for thyroid dysfunction. We analyzed studies (19 randomized trials and 3 cohort studies) of treatment of apparently screen detected patients. We looked for differences in mortality (total and cardiovascular), cardiovascular events (fatal and nonfatal MI, atrial fibrillation), fractures, thyroid specific quality of life, cognitive function and some intermediate outcomes such as blood pressure and cholesterol. Overall, the studies found no differences in these outcomes.

The potential harms of screening for thyroid dysfunction are related to the need for patients to have repeated followup blood tests, medical appointments and potentially unnecessary lifelong treatment. These potential harms can result in unnecessary worry for the patient, and use of resources (time and money) for both patients and the single payer health system.

We did not do any formal assessment of cost benefit because there appears to be no clinical benefit to patients.

MedicalResearch.com: What should readers take away from your report?

Response: We found several gaps in knowledge.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The task force uses the GRADE approach to assessing the evidence and making recommendations. No members of the working group had competing interests and one member of the task force reported developing an educational video on thyroid dysfunction but did not vote on the

Citation:

Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care

Richard Birtwhistle,Kate Morissette,James A. Dickinson,Donna L. Reynolds,Marc T. Avey,Francesca Reyes Domingo,Rachel RodinandBrett D. Thombs;for the Canadian Task Force on Preventive Health Care

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Last Modified: Nov 18, 2019 @ 5:54 pm

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Is There A Clinical Benefit To Asymptomatic Thyroid Function Screening? - MedicalResearch.com

If you happen to follow any of Texas' Republican leadership on Twitter and God bless you if you do you've likely encountered the state GOP's latest causeclbre: a child-custody dispute in Dallas County between a mom who says that one of her two 7-year-old twins is a trans girl and a dad who insists that the child chooses to dress and live as a boy when they're at the father's house.

A family court jury in the case initially awarded sole custody to the child's mother,Anne Georgulas, in late October before a state district judge overruled their decision and gave Georgulas and the child's father, Jeffrey Younger, joint custody, including joint responsibility over medical decisions affecting the child.

In the wake of the judge and jury's decisions, conservative media outlets like the Washington Examiner, The Texan and The Daily Wirepounced on the story, suggesting that Georgulas' and Younger's child might be "chemically castrated" or "mutilated" if left in Georgulas' care.

Politicians like Sen. Ted Cruz and Gov. Greg Abbott hopped on the bandwagon.

Comments like Cruz's are representative of the backlash against Georgulas. They're also screaming to be corrected.

Georgulas does not, as her representatives are careful to point out, intend to have her child placed on hormone blockers. Seven-year-olds don't go on hormone blockers, because they don't have sex hormones to block unless they're going through premature puberty, a condition for which doctors commonly prescribe hormone blockers.

"There are no medical interventions for prepubescent gender diverse children. The only thing to do at this stage is love and support your child,"Dr. Jack Turban, resident physician in psychiatry at Massachusetts General Hospital, where he researches the mental health of transgender youth, told the Observervia email.

Even for pubescent kids who do take hormone blockers, the drugs' effects can hardly be described as a medical transition. The drugs have been used for decades, according to Turban, and are safe.

"The risks associated with dysphoria toward puberty are typically much higher," he says.

If a kid elects to go off the blockers, they simply go through puberty.

"The only significant side effect is that the adolescent may fall behind on bone density. For this reason, doctors will regularly check bone density while the patient is on the medication," Turban wrote in an article published by Vox in October 2018. "If the medication is stopped, bone density catches up to normal after a few years as the child goes through the puberty of their gender assigned at birth."

Sex hormones if they are administered to teenagers at all are rarely started before a patient is 16, Turban says.

"Endocrine Society guidelines recommend age 16. In some instances where the gender history is very clear, estrogen or testosterone may be started as early as age 14," Turban says.

The only irreversible effects of sex hormone therapy, for teenagers or anyone else, are cosmetic changes like body fat redistribution and changes in body hair, Turban says.

"The greatest predictor of these kids doing well is when their parents love and accept them. Support your child and do not try to change them," Turban says. "If your child has questions about gender-affirming medical interventions, take them to a doctor who is knowledgeable about these options. Do not rely on information online, as much of it is misinformation."

Stephen Young has written about Dallas news for the Observer since 2014. He's a Dallas native and a graduate of the University of North Texas.

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Everything You've Heard About Viral Texas Custody Case Is Wrong - Dallas Observer

- Reflects company values and commitment to patients living with hypoparathyroidism -

- Top-line data from expanded PaTH Forward Trial expected in first quarter of 2020 -

- Company expects to exceed targeted enrollment of 40 subjects -

COPENHAGEN, Denmark, Nov. 14, 2019 (GLOBE NEWSWIRE) -- Ascendis Pharma A/S (ASND), a biopharmaceutical company that utilizes its innovative TransCon technology to address unmet medical needs, today announced a protocol addendum designed to facilitate enrollment of subjects previously treated with NATPARA (parathyroid hormone) for Injection in the United States (US) in PaTH Forward, a global phase 2 trial evaluating the safety, tolerability and efficacy of TransCon PTH in adult subjects with hypoparathyroidism (HP). TransCon PTH is an investigational long-acting prodrug of parathyroid hormone (PTH) in development as a potential once-daily replacement therapy for HP.

Previously, patients treated with NATPARA were required to undergo a long washout period prior to entering screening in PaTH Forward. In response to the recent recall of NATPARA in the US, Ascendis has been evaluating pathways to help enroll patients affected by the recall. Under the protocol addendum, patients previously treated with NATPARA in the US will now have an expedited pathway to enroll in PaTH Forward. As a result, the company expects to exceed targeted enrollment of 40 subjects in the trial.

This has been one of the most challenging times in the history of the hypoparathyroidism community, as we have navigated both the emotional and physical impact of the only PTH replacement therapy available being recalled in the US, said Deb Murphy, President and Vice Chair of the Board of Trustees of the HypoPARAthyroidism Association, Inc. We are grateful and very excited about Ascendis Pharmas efforts to expedite participation in the PaTH Forward Trial for additional patients.

Patients interested in participating in PaTH Forward in the US should discuss it with their physician, or visit pathforwardtrial.com, where they may contact a clinical representative who will refer them to a participating clinical investigator.

The unexpected recall of NATPARA in the US has had a major impact on my patients who have not been optimally controlled on standard of care with vitamin D and calcium supplements, said Mishaela Rubin, M.D., a PaTH Forward investigator. Patients living with hypoparathyroidism have an acute need to manage both their short-term symptoms and reduce risk of long-term complications. The PaTH Forward Trial is an opportunity for patients to participate in evaluation of a new potential treatment option for this debilitating disease.

PaTH Forward is a global, phase 2, randomized, double-blind, placebo-controlled, parallel group trial that will evaluate safety and efficacy of three fixed doses of TransCon PTH. The goal of PaTH Forward is to evaluate TransCon PTH control of serum and urinary calcium, and identify a titration regimen for complete withdrawal of standard of care (i.e., active vitamin D and calcium supplements). The trial will include adult subjects with HP who are currently receiving standard of care or were previously treated with parathyroid hormone therapies at up to 40 sites worldwide. The PaTH Forward Trial will introduce a ready-to-use pre-filled pen device and assess disease-specific patient-reported outcomes. After four weeks of dosing, all subjects may enter an open-label extension period with the opportunity to receive TransCon PTH to evaluate long-term safety and efficacy.

About TransCon Technology

TransCon refers to transient conjugation. The proprietary TransCon platform is an innovative technology to create new therapies that optimize therapeutic effect, including efficacy, safety and dosing frequency. TransCon molecules have three components: an unmodified parent drug, an inert carrier that protects it, and a linker that temporarily binds the two. When bound, the carrier inactivates and shields the parent drug from clearance. When injected into the body, physiologic pH and temperature conditions initiate the release of the active, unmodified parent drug in a predictable release manner. Because the parent drug is unmodified, its original mode of action is expected to be maintained. TransCon technology can be applied broadly to a protein, peptide or small molecule in multiple therapeutic areas, and can be used systemically or locally.

Story continues

About Hypoparathyroidism (HP)

Hypoparathyroidism (HP) is a rare endocrine disorder characterized by insufficient levels of parathyroid hormone (PTH), resulting in low calcium and elevated phosphate levels in the blood. HP affects approximately 80,000 patients in the United States, the majority of whom develop the condition following damage or accidental removal of the parathyroid glands during thyroid surgery. Patients often experience decreased quality of life. In the short term, symptoms include weakness, severe muscle cramps (tetany), abnormal sensations such as tingling, burning and numbness (paresthesia), memory loss, impaired judgment and headache. Over the long term, this complex disorder can increase risk of major complications, such as extraskeletal calcium depositions occurring within the brain, lens of the eye, and kidneys, which can lead to impaired renal function.

Until recently, HP remained among the few hormonal insufficiency states not treated by replacement of the missing hormone. Standard of care with active vitamin D analogs and calcium supplementation do not fully control the disease and may contribute to risk of renal disease. As a result, patients with HP have an estimated 4-fold to 8-fold greater risk of renal disease compared to healthy controls.

About Ascendis Pharma A/S

Ascendis Pharmais applying its innovative platform technology to build a leading, fully integrated biopharma company focused on making a meaningful difference in patients lives. Guided by its core values of patients, science and passion, the company utilizes its TransCon technologies to create new and potentially best-in-class therapies.

Ascendis Pharma currently has a pipeline of three independent endocrinology rare disease product candidates in clinical development and has established oncology as its second therapeutic area of focus. Additionally,Ascendis Pharma has multi-product collaborations withSanofiin diabetes and Genentech in the field of ophthalmology and continues to expand into additional therapeutic areas for both internal and external development.

Ascendis is headquartered in Copenhagen, Denmark, with offices in Heidelberg, Germany and Palo Alto, California.

For more information, please visit http://www.ascendispharma.com.

Forward-Looking Statements

This press release contains forward-looking statements that involve substantial risks and uncertainties. All statements, other than statements of historical facts, included in this press release regarding our future operations, plans and objectives of management are forward-looking statements. Examples of such statements include, but are not limited to, statements relating to (i) the timing of the topline data from the PaTH Forward Trial, (ii) our ability to apply our platform technology to build a leading, fully integrated biopharma company, (iii) our expectations regarding our ability to create new and potentially best-in-class therapies and (iv) our product pipeline. We may not actually achieve the plans, carry out the intentions or meet the expectations or projections disclosed in the forward-looking statements and you should not place undue reliance on these forward-looking statements. Actual results or events could differ materially from the plans, intentions, expectations and projections disclosed in the forward-looking statements. Various important factors could cause actual results or events to differ materially from the forward-looking statements that we make, including the following: unforeseen safety or efficacy results in our TransCon hGH, TransCon PTH and TransCon CNP or other development programs; unforeseen expenses related to the development and potential commercialization of TransCon hGH, TransCon PTH and TransCon CNP or other development programs, general and administrative expenses, other research and development expenses and our business generally; delays in the development of TransCon hGH, TransCon PTH and TransCon CNP or other development programs related to manufacturing, regulatory requirements, speed of patient recruitment or other unforeseen delays; dependence on third party manufacturers to supply study drug for planned clinical studies and potential commercial sale, if approved; and our ability to obtain additional funding, if needed, to support our business activities. For a further description of the risks and uncertainties that could cause actual results to differ from those expressed in these forward-looking statements, as well as risks relating to our business in general, see our current and future reports filed with, or submitted to, theU.S. Securities and Exchange Commission(SEC), including our Annual Report on Form 20-F for the year endedDecember 31, 2018, which we filed with theSEConApril 3, 2019. Forward-looking statements do not reflect the potential impact of any future in-licensing, collaborations, acquisitions, mergers, dispositions, joint ventures, or investments we may enter into or make. We do not assume any obligation to update any forward-looking statements, except as required by law.

Ascendis, Ascendis Pharma, the Ascendis Pharma logo, the company logo and TransCon are trademarks owned by the Ascendis Pharma group.November 2019 Ascendis Pharma A/S.

Internal contact: Scott T. Smith Chief Financial Officer (650) 352-8389ir@ascendispharma.com

Media contact:Ami KnoeflerHead of Global Communications(650) 739-9952 ack@ascendispharma.com

Investor contact:Patti BankWestwicke Partners(415) 513-1284patti.bank@westwicke.com

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Ascendis Pharma Expands TransCon PTH Phase 2 PaTH Forward Clinical Trial to Expedite Enrollment of Subjects Previously Treated with NATPARA in the...

What to anticipate from Intercourse After Having A Baby

Pregnancy and distribution modification great deal regarding the human anatomy, along with your sex-life.

Postdelivery hormone changes will make tissue that is vaginal and much more sensitive and painful. Your vagina, womb, and cervix have actually to return to size that is normal too. And when youre nursing, that may reduce libido.

Theres no timeline that is definitive says just how long you really need to wait to possess intercourse after having a baby. Nonetheless, many health practitioners suggest ladies wait 4 to 6 months carrying out a genital distribution.

After your medical professional has provided you the all clear to resume intimate tasks, you might still have to take things gradually. Keep in mind: as well as recovery that is physical youll also be adjusting up to a brand new member of the family, less rest, and a modification of your regular routine.

Its also possible to need certainly to wait much longer when you yourself have a perineal episiotomy or tear. An episiotomy is really a medical cut to widen the canal that is vaginal. Going back to intercourse too quickly may raise your chance of problems, such as for example postpartum hemorrhage and uterine infection.

Keep reading to find more info on the results of being pregnant and distribution on intercourse, and just how to possess a healthy, satisfying sex life after infant.

Intercourse after distribution shall feel various. One study that is small 2005 discovered that 83 % of females skilled sexual dilemmas in the 1st 90 days after their very very first distribution.

Nonetheless, that quantity will continue to fall due to the fact months that are post-pregnancy.

Hormones perform a large role in postdelivery data recovery and a come back to normal sexual intercourse.

When you look at the days childbirth that is immediately following estrogen falls to pre-pregnancy amounts. If nursing, estrogen levels might sink below pre-pregnancy levels. Estrogen helps provide natural lubrication that is vaginal therefore lower levels associated with hormone raise the probability of vaginal dryness.

Dry muscle can cause discomfort, also bleeding, while having sex. This increases your chance of illness.

Genital delivery can temporarily extend the muscle tissue associated with the canal that is vaginal. These muscles require time and energy to recover their stability and strength.

You may have a longer recovery if you had a perineal tear or episiotomy during vaginal birth. Making love too early can boost your threat of an infection.

A cesarean distribution also can impact sensation that is vaginal your brides website. Equivalent hormone problems could make the cells for the vagina dry and thin, perhaps resulting in painful intercourse.

Plus, youll be coping with stomach surgery, therefore youll desire to ensure that the incision web site has precisely healed before resuming intercourse.

You may get expecting interestingly quickly after delivering an infant. One research discovered the first ovulation for women that werent nursing is about six days. Some females ovulated even early in the day.

If youre nursing, the hormonal advantages of medical can behave as a natural type of contraceptive when it comes to first 4 to 6 months after distribution.

But, no more than 1 in 4 ladies who utilize this lactational amenorrhea method (LAM), or nursing as birth prevention, do therefore properly. That increases their danger for maternity.

If youre going to possess intercourse after pregnancy but dont want to risk another child therefore soon, intend to make use of a dependable approach to birth control.

A barrier technique, such as for instance a condom, might be good to use in the beginning. An implant or IUD can be used also. But, hormone choices may impact nursing and that can additionally have particular dangers, such as for example an increased danger for bloodstream clots.

Consult with your medical professional concerning the right selection for you.

Getting pregnant too rapidly after one maternity can place you at an elevated danger for premature birth or delivery defects.

Healthcare experts encourage ladies to place their pregnancies. Any office of Womens wellness suggests waiting at the least one year between each maternity. In addition to March of Dimes suggests waiting eighteen months.

If youre reasoning about another child, speak to your medical care pro. Theyll certainly be many acquainted with your wellbeing history and provide more recommendations that are personalized.

Some regular bleeding as your uterus heals in the weeks immediately following childbirth, youll likely experience. Intercourse could potentially cause some blood loss that is additional.

Likewise, your vagina may be drier and more sensitive and painful in the early days after childbirth. This is why the muscle tissue slimmer, that may lead to tearing or damage. The vagina may also become inflamed and swollen. During these cases, bleeding is not uncommon.

In the event that bleeding during intercourse does stop within four nt to six months or it worsens, see your medical practitioner. Youve probably an irritation or tear that needs treatment before starting having sex once again.

The hormones estrogen and progesterone are necessary to your babys development that is healthy maternity. Additionally they are actually crucial to your sexual interest.

Quantities of these hormones are extremely high during maternity. When the child is born, they decrease considerably, back again to levels that are pre-pregnancy.

Which means you might not feel any desire that is sexual a couple of months. However you ought to be waiting 4 to 6 months anyhow, as the human body recovers.

After your medical professional has offered you the all clear to resume activities that are sexual you may possibly opt to wait much longer before reigniting your sex-life. One research unearthed that 89 per cent of females had resumed sexual intercourse within 6 months of pregnancy.

If youre nursing, it may simply simply take additional time for the libido to go back than it might for females whom arent nursing. Thats because nursing keeps estrogen levels low.

Estrogen supplements are discouraged if youre nursing as it may affect milk manufacturing.

You and your partner may not feel like intimacy is even on the books when you couple changes in hormones with the fatigue of being a parent to a newborn.

As the human body adjusts to its brand brand new normal or once you stop breastfeeding, the hormones will start working once again, along with your libido should get back.

Pregnancy contributes to large amount of real modifications to your system. Thats why it is crucial to offer your self 4 to 6 days after distribution just before have sexual intercourse once again.

Throughout your recovery duration, the womb will shrink, hormones will come back to pre-pregnancy amounts, and muscle tissue will regain power and security.

Once youve been because of the go-ahead by the medical practitioner, be sure to simply take returning to intercourse to your time.

If any pain is experienced by you or symptoms that persist, consult with your physician. Painful intercourse may be an indicator of other conditions unrelated to pregnancy data data recovery.

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What to anticipate from Intercourse After Having A Baby - ESPBR

SPOKANE A federal judge in Spokane today ruled that the White House Administrations conscience rule is unlawful, granting summary judgment in Attorney General Bob Fergusons legal challenge. The rule would have given health care professionals broad discretion to refuse lawful and medically necessary care to patients for religious or moral reasons, even when the patients life is at risk.

This case represents the Washington Attorney Generals 25th consecutive legal victory against the Administration.

The court agreed that all Washingtonians deserve to receive the full range of health care services, Ferguson said. This rule would have disproportionately harmed rural and working poor Washington families, who have no alternatives to their local health care providers, as well as LGBTQ individuals, who already face discrimination when they seek medical care.

The lawsuit, filed in U.S. District Court for the Eastern District of Washington, argued that the rule would jeopardize access to reproductive health care, particularly for low-income, rural and working poor patients and allow providers to discriminate against LGBTQ individuals.

The conscience rule would have allowed health care workers to deny a patient access to medical care and services including reproductive care, end-of-life decisions, and care for transgender patients for moral or religious reasons, with no exception for medical emergencies. Under the rule, if the federal government believed Washington, its health care institutions, or other recipients of federal health care funds violated the rule, the federal government would be allowed to cut off all health care funding to the state more than $10 billion per year.

Ferguson filed the lawsuit in federal court in Spokane because rural communities, including those in Eastern Washington, have fewer health care providers and would be more likely to be harmed by the rule.

On Nov. 6, a federal judge in New York found the rule was unlawful and struck it down nationwide. Todays ruling provides an extra layer of protection against appeal by the Administration.

The conscience rule

The rule would have significantly expanded the number of individuals eligible to make refusals based on religious or moral beliefs. The rule applies to any employee providing any service to any patient, from ambulance drivers to receptionists to customer service representatives at insurance companies.

Some examples of potential impacts under the rule:

-A woman experiencing a life-threatening miscarriage calls an ambulance to her home. The EMT or paramedic who arrives could refuse to transport her to the hospital because they may terminate the pregnancy, despite the risk to the health of the mother and the fact that the pregnancy is not viable.

-A patient in need of an IUD to treat a condition such as endometriosis could be denied coverage by her insurance company on moral grounds because an IUD is also birth control. The patient would be responsible for the entire cost of her treatment.

-A patient who suffers debilitating pain with menstruation, or constant menstruation, could be cured with a surgery to remove her uterus. Her doctor could refuse to tell her about that option if he or she personally opposed sterilization.

-An employer could offer unmarried employees only health coverage that does not cover birth control, or choose to provide only plans that do not cover birth control at all.

-A receptionist, citing religious or moral objections, could refuse to schedule an appointment for an LGBTQ patient.

-A pharmacist could refuse to fill a prescription for hormone therapy for a transgender person.

-If a doctor who objects to physician-assisted suicide on religious grounds treats a patient with a painful, terminal disease who wants to use Washingtons Death with Dignity Act, the doctor may refuse to transfer that patients medical records to a participating provider.

Impacts on Washington

The rule threatened severe sanctions on states that do not comply. Any failure or apparent failure to follow the rule would jeopardize all federal health care funding, which states rely on to provide critical and often life-saving care.

Washington receives $8.2 billion annually for its Medicaid and Childrens Health Insurance programs, and more than $10.5 billion every year in federal funding from the U.S. Department of Health and Human Services. Washington relies on those funds for essential public health programs, including the Childrens Health Insurance Program, HIV/AIDS and STD prevention and education, and substance abuse and mental health treatment.

The rule provided no information on how the federal government will determine the rule has been violated.

The rule would have substantially increased the risk of discrimination against patients on the basis of sex, sexual orientation or gender identity. Transgender patients already face discrimination in the health care industry, including denial of routine medical care, like physicals, diabetes treatments and flu shots. The rule would give providers more leeway to refuse to provide care to transgender patients and discriminate based on gender identity.

Washington has a network of laws that balances patients right to health care treatment with respect for personal conscience. These laws allow medical professionals to refuse to provide certain services based on conscience, except in an emergency to save a human life. They also require health care institutions and providers to ensure that no one is denied information about or timely access to health care, by, for example, advising patients of all options required by todays medical standards.

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'Conscience rule' that puts providers' personal beliefs ahead of patient's emergency needs deemed unlawful - Northern Kittitas County Tribune

Theres new evidence that mind-body interventions can help reduce pain in people who have been taking prescription opioids and lead to reductions in the drugs dose.

In a study published this month in JAMA Internal Medicine, researchers reviewed evidence from 60 studies that included about 6,400 participants. They evaluated a range of strategies, including meditation, guided imagery, hypnosis and cognitive behavioral therapy.

Mindfulness, cognitive behavioral therapy and clinical hypnosis appear to be the most useful for reducing pain, says study author Eric Garland, a professor at the University of Utah. The reductions in dose were modest overall, he says, but the study is a signal that this approach is beneficial.

And Pamela Bobb, who lives in Fairfield Glade, Tenn., can attest to the benefits. Shes 56 and has endured decades of pain. Oh, I had been suffering terribly for years, Bobb tells us.

She was born with a malformation in her pelvis that led to pain. Over the span of two decades, she underwent more than a dozen major surgeries, yet none of them gave her relief; each procedure left more scar tissue and nerve damage.

I felt desperate, Bobb says. I didnt feel like I had any control.

She couldnt do basic things such as cook or take care of her family.

I was completely debilitated, Bobb says. And when you get to that point, you cant see beyond the pain youre just surviving.

She was put on high doses of opioids to ease the constant pain, but then a few years ago she thought, There just has to be a better way. Ultimately, she found help at a clinic that specializes in complementary and alternative medicine.

We offer a variety of things, explains Wayne Jonas, a physician who treated Bobb at the Fort Belvoir Community Hospital Pain Clinic in Fairfax County, Va.

We offer physical therapy, behavioral medicine, acupuncture, yoga and mind body practices, Jonas says. None of these is a cure-all, he adds, but the idea is that there are lots of tools in the toolkit for people to try.

Jonas is a longtime proponent of an integrated, mind-body approach to treating pain and the author of How Healing Works, a book that describes the science behind these approaches.

He says that when someone is in severe pain, their bodys normal defenses are down.

It bumps up a variety of dysfunctions, Jonas says. Pain increases levels of the stress hormone cortisol and increases inflammatory processes in the body, too. This starts a continual negative feedback loop that produces more pain, Jonas explains.

Its not a surprise, he says, that techniques such as meditation or yoga can be helpful. If you engage in a deep mindfulness and relaxation it will counter those stress responses, Jonas says.

Think of meditation as a form of mental exercise.

Its almost like weightlifting for your brain, says Garland. Just as curling a dumbbell strengthens the bicep, he says, meditation is almost a way of, sort of curling the dumbbell of the mind to strengthen the minds self control.

And this can change the way the brain perceives the input from the body. If you can change the way the brain perceives signals from the body you can actually change the experience of pain, Garland says.

But theres a trick here: Learning to meditate takes time, effort and some training. Its more complicated than swallowing a pill. Pamela Bobb has stuck with it. She has tried a bunch of these alternative mind-body strategies, including acupuncture and biofeedback, and now starts every morning with a meditation practice.

Its 4:45 in the morning and Ive just awakened, she says in a recording she made of her practice, so I could listen in. She sounds centered, and calm. Im allowing my body to feel as relaxed as it possibly can.

Bobb has also overhauled her diet, now eating a lot more greens, fruits and vegetables and herbs and spices with anti-inflammatory properties. On the day we talk, shes making a spinach saute with ginger, mint and rosemary.

I swear you can smell each of those spices. They smell so good! she says.

Bobb is so at ease now that, just hanging out with her, youd never guess all that she has endured. And she feels so much better, she says.

Its empowering to [have] come all this way, Bobb says. She says shes made a fundamental transition in her mind: Instead of waiting for doctors to heal her with surgeries or injections, she now realizes that many of these alternative therapies have empowered her to help herself.

So much of it does lie within me, she says.

Bobb accepts that she may never be completely pain-free, but now feels she has control over the discomfort.

She has reduced her opioid dose by 75%. She says she still benefits from a small maintenance dose of the medication. And her doctors say that for her, the benefits of the medicine outweigh potential harms.

In the midst of an opioid epidemic, Bobbs story may seem unlikely. But many people who have taken opioids for a prolonged period have similar stories. And last month, the Department of Health and Human Services released new guidelines urging doctors to take a deliberate approach to lowering doses of opioids for chronic pain patients.

The guidelines point to the potential harms of forcing patients off the medications.

The goal is not necessarily to get off of all opioids but to reduce it to a dose [that is] safe, Adm. Brett P. Giroir, a physician and assistant secretary for health at HHS, told NPR. We asked him about Bobbs case. He is not her doctor, but after hearing her story he said, The fact that shes been able to reduce her opioids substantially is a success story.

Giroir says this kind of comprehensive approach that includes alternative therapies could be a model for what we want to do nationwide. He points out that earlier this year, the Centers for Medicare & Medicaid Services proposed covering acupuncture for Medicare patients who have chronic lower back pain.

As the evidence accumulates, Giroir says, there will be more attention placed on covering alternative therapies.

A 2017 Gallup Poll found that 78% of people would prefer to try other ways to address their physical pain before they take pain medication.

And doctors groups such as the American College of Physicians recommend that doctors offer more nonpharmacological treatments to pain patients, such as those who have chronic lower back pain.

Yet, a paper published last year finds that most insurers have not adopted policies that are consistent with these guidelines, and many dont pay for coverage of these services. An accompanying editorial argues that its time for that to change.

Its clear that when it comes to tackling pain, it takes all of the tools in the toolkit. And when it comes to opioids, the approach neednt be all or nothing. Bobb says she has learned that, for her, the combination of medicine plus mind-body therapies works best.

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Meditation Reduced The Opioid Dose She Needs To Ease Chronic Pain By 75% - WABE 90.1 FM

Endocrine Testing Market Outlook provides thoughtful analysis of current issues facing the industry, along with current facts and statistics about the production and application in Endocrine Testing Market..

The Global Endocrine Testing Market is poised to grow strong during the forecast period 2017 to 2027. Endocrine Testing market is the definitive study of the global Endocrine Testing industry. The report content includes technology, industry drivers, geographic trends, market statistics, market forecasts, producers, and raw material/equipment suppliers.

Read Report Details at https://www.proaxivereports.com/7626

The Endocrine Testing industry study concludes with a list of leading companies/suppliers operating in this industry at different stages of the value chain.

List of key players profiled in the report:

Abbott Laboratories, AdnaGen, Beckman Coulter/Danaher, Biomedical Diagnostics, BioMerieux, Bio-Rad, Dako, DiaSorin, Eiken, Fujirebio, Instrumentation Laboratory, Kyowa Medex, Matritech, Ortho-Clinical Diagnostics, Roche, Siemens, Sysmex, Thermo Fisher, Tosoh, Wako, Wallac/PE,

By TestEstradiol (E2) Test, Follicle Stimulating Hormone (FSH) Test, Human Chorionic Gonadotropin (hCG) Test, Luteinizing Hormone (LH) Test, Dehydroepiandrosterone sulfate (DHEAS) Test, Progesterone Test, Testosterone Test, Thyroid Stimulating Hormone (TSH) Test, Others (Gastrin, Thymosin, Secretin, etc.)

By TechnologyTandem Mass spectrometry, Immunoassay (Enzyme immunoassays, Radioimmunoassays (RIA)) Technologies, Monoclonal and Polyclonal Antibody Technologies, Sensor (Electrochemical, Biosensors, etc.) Technologies, Clinical Chemistry Technologies, Others (Liquid Chromatography + Mass Spectrometry (LC-MS),

By End UserHospitals, Commercial Laboratories, Ambulatory Care Centers, Home Based Tests, Physician Offices

By

By

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The Endocrine Testing market research report provides a concise and clear overview of this complex and often dynamic industry. The report dives into the trends in the specialty Endocrine Testing industry by looking at the market from a regional perspective, application perspective, and materials point of view. As a market with significant growth potential, we look not only at the market today, but also at how it will develop over the next three years and the trends and developments that will drive growth.

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Global and Regional Endocrine Testing Industry Production, Sales and Consumption Status and Prospects Professional Market Research Report 2019-2024 -...

Jim Gaffigan, comedian, writer and actor, worries about his health. "I want to lose weight. I figure ... [+] I have a good seven to ten years of performing at the present level." (Photo by Chris Pizzello/Invision/AP)

Okay, I confess. I went for a provocative title. Are comics infected with the bubonic plague? Nope. Are they dropping like flies? Of course not. However, it may be tempting to think this way because a tragically large number of beloved comedic talents have died suddenly and prematurely: John Candy, Bill Hicks, Freddy Prinze, Patrice ONeal and many others.

After interviewing several stand-up comics, comedic actors and writers during the New York Comedy Festival (which wrapped up November 10, 2019), I have a better understanding of the highly atypical lifestyle led by these immensely talented individuals, the wide range of health issues they face, and the role of medical professionals in addressing their medical and mental health concerns.

There is a thin line that separates laughter and pain, comedy and tragedy, humor and hurt.

The plethora of headlines reporting yet another comedians death at the hands of drugs or suicide tempts us to believe that addiction and mental illness are epidemics within the comedy world. Lenny Bruce, Jim Belushi, Chris Farley, Greg Giraldo, Mitch Hedberg and Robin Williams are just a few in a long list of funny folks who have all sadly succumbed to drug overdose, depression and suicide. In fact, the high number of premature deaths prompted the Laugh Factory in Hollywood to hire an on-site psychologist. To get more clarity on this issue, I posed a series of questions to several comedians.

Why do so many comedians experience addiction and mental illness?

This is nothing new, according to comic superstar Jim Gaffigan. There is nothing normal about going onstage and making a crowd of strangers laugh. The Pale Tourist comic compared comedy to addiction: Stand-up is an endorphin rush probably similar to a drug. Its also a strange combination of control (you have a mic) and no control (the reaction of the audience).

Comedian and breast cancer survivor Jenny Saldana.

Stand-up comedian Jenny Saldana: Its really hard to be ON all the time. The breast cancer survivor and patient advocate explained, We struggle with our onstage persona and our personal lives. Combine these issues with access to drugs in the late-night scene, says Saldana, and addiction lurks around the corner.

According to comedian Jim Mendrinos, there are plenty of risk factors: Isolation, long periods of traveling without a support system, and crazy-easy access to drugs and booze. The Gotham TV Writing instructor added, As with all true artists, we feel too much. Most comics I know suffer from some type of depression.

Comedian Jim Mendrinos has experienced multiple health issues including concussions and facial ... [+] surgery.

If youve experienced addiction or mental illness, what kind of treatment did you receive? How did you achieve recovery? If you havent, how did you avoid both conditions?

Pakistani-American comedian Mona Shaikh is well aware of the connection between trauma and addiction. The comedy community has a lot of trauma and pain. A survivor of significant verbal and physical abuse that led to suicidal thoughts, Ms. Shaikh is crystal clear about her recovery: Therapy singlehandedly saved my life. She also finds comedythe love of my lifevery empowering as it allows her to share her pain and trauma.

Comedian and event emcee Mona Shaikh speaks at the Women's March, San Francisco. Abused by her ... [+] father, brother and ex-husband, Shaikh uses comedy to share her trauma, pain and resilience. (Photo by Kelly Sullivan/Getty Images)

Therapy was a recurring theme. According to Gaffigan, therapy helped a lot. Comedians, like most humans, have demons. He added, my wife [and writing partner, Jeannie Gaffigan] has been invaluable in keeping me grounded.

The tragedy of life is what dies inside a man while he lives.

Comedy Cellar regular, Ian Fidance, credits medications and counseling to his long-term recovery from alcohol use disorder. Naltrexone saved my life. He also praised the Greenwich House for providing him with much-needed care. Fidancelike many people with addictionfaced tremendous stigma: I had to divorce myself from the moral-failing paradigm.

Stand-up comic Ian Fidance takes part in SiriusXM host Ron Bennington's annual Thanksgiving Special ... [+] at the Hard Rock Cafe in New York City. (Photo by Cindy Ord/Getty Images for SiriusXM)

What health issues do comedians worry about?

Alas, comedians are people, too. And just like all of us, they experience a wide range of health issues beyond anxiety and drugs.

Jeannie Gaffigan, writer and executive producer of The Jim Gaffigan Show, cited poor diet and lack of sleep affecting her husband. For an internationally touring comedian, waking up at the same time every morning is impossible. As a television writer, she would be awake until 3 a.m., order Indian food. Then during the day, the mother of five young children would receive calls from school about a childs strep throat. Its a manic existence.

Ms. Gaffigan, author of the recently released memoir, When Life Gives You Pears: The Healing Power of Family, Faith, and Funny People, shared her life-altering journey with a pear-size brain tumor, followed by intubations, infections and vocal cord dysfunction. So how, if at all, did this major neurosurgical health problem impact her life, including comedy writing? It made me bolder. She publicly discusses J-tubes, PEG tubes, colonoscopies and other humiliating topics that arent exactly dinner conversation. The comedic power couple documented their post-hospitalization dietary ritual in a very funny and candid YouTube series, Feeding Frenzy.

NEW YORK, NY: Jeannie Gaffigan and Jim Gaffigan visit SiriusXM Townhall at SiriusXM Studio on June ... [+] 28, 2016, in New York City. (Photo by Robin Marchant/Getty Images)

Many other health issues impact comedians. Stacy Kendro worries about back and neck pain as well as migraines. But lack of health coverage can be a barrier. Im mostly part-time with comedy and need to pay cash out of pocket. Ms. Saldana agreed: Most comedians dont access health care and go a long time without seeing a medical professional.

What would you like medical professionals to know? How can we better serve the comedy community?

Ms. Kendro: I would go to a therapist if I could afford one. Health insurance needs to be accessible to performers, especially those in the trenches, on the road, working clubs.

Mr. Mendrinos: Artists need help. We often dont have access to health insurance. I know five comics who have died by suicide. We tend to self-medicate with drugs and comedy.

Ms. Gaffigan: Doctors need to be creative in their advice. Tailor it to the comedians late-night work hours and travel schedule.

Ms. Saldana: I guarantee that if doctors started a free clinic at a comedy club, offering flu shots, STD screening and basic counseling, theyd be overbooked in minutes.

Comedian Stacy Kendro feels that "real comedy comes from pain." The funniest people she's ever known ... [+] "were the most emotionally fraught."

******************

Personally, I always found laughter to be therapeuticwell before I became a physician. From a young age, I gravitated toward funny films and television sitcoms. I cherishedin fact, enviedmy friends who had a natural ability to make others laugh. Years later, I became an avid fan of stand-up comedy. To this day, I have tremendous admiration for any person who courageously stands alone on stage and makes complete strangers laugh. A unique skill set I will never possess.

It turns out that comedians provide a genuinely therapeutic skilla reality that Im sure many comics discovered at least intuitively at a young age. Evidence shows that laughter has many short- and long-term health benefits. According to the Mayo Clinic, laughter acutely stimulates our heart, lungs and other organs by increasing oxygen intake; it also activates the brain to release endorphins (the happy hormone); and relieves tension by relaxing our muscles. In the long term, laughter can improve our immune system, which fights infections and illnesses; reduce pain; and improve mood.

Women enjoy a laughter yoga session at a laughing club in Kolkata, India. Laughter yoga helps to ... [+] increase happiness, but it also strengthens the immune system, reduces pain and lowers stress. (Photo by Avijit Ghosh/SOPA Images/LightRocket via Getty Images)

Substance abuse and mental illness are clearly underaddressed in the comedy community, not unlike the general population. The way to tackle this? I will reiterate Mr. Fidances remark: We need to reduce the stigma faced by people with addiction and mental illness. Globally, both remain THE most stigmatized social problems, according to the World Health Organization. A key way to decrease stigma is through widespread education. Addiction and mental illness are chronic illnesses of the brain, NOT signs of moral weakness or failure. Treatment like medications and behavioral therapies existand work! But health care access needs to be widely accessible. Perhaps comedians should have a union, as suggested by Ms. Kendro. Maybe comedy clubs could partner with local hospitals or clinics and offer basic health services. We need to be innovative.

The comedy and addiction medicine worlds taught me a key lesson: the importance of community. A common mantra in my line of work is The opposite of addiction isnt sobriety, its connection. The Gaffigans feeding tube videos led to an outpouring of stories. Pain and suffering are universal. People connect with openness and authenticity. On that note, I am deeply grateful to the comedians who have generously shared their stories. To every comedian out thereamateur and professionalyour humor is truly healing!

Read more:
If Laughter Is The Best Medicine, Why Are So Many Comedians In Poor Health? - Forbes

Docs who give sufferers with incurable breast most cancers a survival prediction are flawed virtually 80 per cent of the time, analysis reveals.

Main GPs are calling for victims to be given greatest and worst-case time frames to color a extra correct image of their future.

Nearly all of sufferers given a lethal prognosis need to know the way lengthy theyve left to dwell, based on Dr Belinda Kiely, an oncologist on the College of Sydney.

That is often in order that they know whether or not they need to cease working or promote their house, or if theyll attend a liked ones wedding ceremony, she claims.

However the GP mentioned the common life expectancy theyre given is barely correct 20 to 30 per cent of the time.

Docs within the UK and US, much like Australia, use their expertise to foretell how lengthy sufferers will survive. There is not one set mannequin.

Docs who give sufferers with incurable breast most cancers a mean survival time are flawed virtually 80 per cent of the time, analysis reveals

They think about affected person age, bodily situation and the way aggressive their most cancers is earlier than cross-referencing it with common survival occasions and adjusting.

The issue with common survival occasions is that theres a 50 per cent likelihood the affected person outlives this, based on Dr Kiely.

Talking on the Superior Breast Most cancers Fifth Worldwide Consensus Convention in Lisbon, she mentioned: Each week in my clinic, I meet ladies of all ages with superior breast most cancers.

They steadily ask, How long have I got? Theyve very sensible considerations and questions that they need assist with.

For instance, they may need to know whether or not they need to cancel a deliberate vacation, whether or not theyll be capable of attend their daughters wedding ceremony, or whether or not they need to cease working or promote their home.

Nevertheless, oncologists are generally uncertain about easy methods to assist.They might fear whether or not it is attainable to present correct data and the way greatest to speak about this with out destroying hope.

Dr Kielys analysis has proven that its higher to supply estimates for the best-case, worst-case and typical survival occasions.She mentioned this was extra correct and useful to sufferers.

It includes docs estimating the anticipated survival time for a affected person, dividing it by 4 to get the worst-case state of affairs and multiplying it by three to get the best-case end result.

The everyday life expectancy for superior breast most cancers sufferers is between a half and two occasions the docs estimate.

Dr Kiely informed the convention: If we inform a affected person that her estimated median survival time is six months, that conveys no hope of a attainable longer survival, regardless that she has a 50 per cent likelihood of dwelling longer.

Then again, offering three eventualities helps sufferers put together for the attainable worst-case and, on the similar time, hope for the attainable best-case.

That is extra useful for sufferers planning and selections for the long run.

Dr Kiely and her colleagues performed a trial with 33 oncologists who between them spoke to 146 sufferers with superior most cancers about their anticipated survival occasions.

Every affected person was supplied with a printed one-page abstract of their particular person best-case, typical and worst-case eventualities.

Ninety-one per cent of the sufferers mentioned they discovered the printed data useful, 88 per cent mentioned it helped them to make plans and 88 per cent mentioned it improved their understanding.

Seventy-seven per cent of sufferers mentioned the eventualities had been the identical or higher than theyd anticipated.

Primarily based on their findings, Dr Kiely and her colleagues at the moment are selling the three-scenario method with oncologists in Australia. They hope to encourage docs around the globe to do the identical.

Chair of the convention, Dr Fatima Cardoso, director of the breast unit of the Champalimaud Medical Centre in Lisbon, Portugal, endorsed the method.

Main GPs are calling for victims to be given best-case and worst-case time frames to color a extra correct image of their future

The physician,who was not concerned with the analysis, mentioned: This software for calculating and sharing the three eventualities provides docs the assistance they should talk with sufferers in a sensible and useful method.

Analysis reveals that sufferers who talk about these points with their physician have higher high quality of life, are much less more likely to bear aggressive end-of-life resuscitation and are much less more likely to die within the hospital.

However in the meanwhile, we additionally know that many sufferers will not be having these conversations.

Most sufferers with superior most cancers need some details about how lengthy theyre more likely to dwell, though many say they discover it tough to ask this query.

One in eight ladies within the UK and US will develop breast most cancers sooner or later of their lives, Most cancers Analysis UK statistics present.

Within the UK, triple unfavourable breast most cancers makes up 15 per cent of circumstances of the illness round 7,500 individuals annually.

And within the US, its chargeable for 10-to-20 per cent of breast cancers, based on Breastcancer.org

The probabilities of long-term survival are higher the sooner the most cancers is identified.

Round 9 out of 10 of girls dwell past 5 years if theyre identified with stage one breast most cancers.

Stage one describes a tumour lower than 2cm in size and most cancers that has not unfold across the physique.

However five-year survival charges plummet to at least one in 10 for these identified with stage 4 breast most cancers when most cancers has unfold to different organs across the physique.

Breast most cancers is without doubt one of the most typical cancers on the earth. Every year within the UK there are greater than 55,000 new circumstances, and the illness claims the lives of 11,500 ladies. Within the US, it strikes 266,000 annually and kills 40,000.However what causes it and the way can or not its handled?

Whats breast most cancers?

Breast most cancers develops from a cancerous cell which develops within the lining of a duct or lobule in one of many breasts.

When the breast most cancers has unfold into surrounding breast tissue its known as an invasive breast most cancers. Some individuals are identified with carcinoma in situ, the place no most cancers cells have grown past the duct or lobule.

Most circumstances develop in ladies over the age of 50 however youthful ladies are generally affected. Breast most cancers can develop in males although that is uncommon.

The cancerous cells are graded from stage one, which suggests a gradual progress, as much as stage 4, which is probably the most aggressive.

What causes breast most cancers?

A cancerous tumour begins from one irregular cell. The precise cause why a cell turns into cancerous is unclear. Its thought that one thing damages or alters sure genes within the cell. This makes the cell irregular and multiply uncontrolled.

Though breast most cancers can develop for no obvious cause, there are some threat elements that may improve the possibility of creating breast most cancers, similar to genetics.

What are the signs of breast most cancers?

The same old first symptom is a painless lump within the breast, though most breast lumps will not be cancerous and are fluid crammed cysts, that are benign.

The primary place that breast most cancers often spreads to is the lymph nodes within the armpit. If this happens youll develop a swelling or lump in an armpit.

How is breast most cancers identified?

In case you are confirmed to have breast most cancers, additional checks could also be wanted to evaluate if it has unfold. For instance, blood checks, an ultrasound scan of the liver or a chest x-ray.

How is breast most cancers handled?

Remedy choices which can be thought of embrace surgical procedure, chemotherapy, radiotherapy and hormone remedy. Typically a mix of two or extra of those remedies are used.

How profitable is remedy?

The outlook is greatest in those that are identified when the most cancers remains to be small, and has not unfold. Surgical removing of a tumour in an early stage might then give a superb likelihood of treatment.

The routine mammography provided to ladies between the ages of 50 and 70 imply extra breast cancers are being identified and handled at an early stage.

For extra data go to breastcancercare.org.uk or http://www.cancerhelp.org.uk

Read more from the original source:
Doctors who give advanced breast cancer patients an average survival time 'wrong 80% of the time' - Herald Publicist

Editor's note: The following is Patch Field Editor Russ Crespolini's, hopefully, weekly column. It is reflective of his opinion alone.

"One slip, and you're toast."

A doctor said this to describe a test my endocrinologist said I needed to get more answers about my brain tumor.

For those of you who have been following along at home, I have been documenting in my column my ongoing medical issue that included a myriad of tests all leading to the conclusion that I have a pair of tumors. One in my brain, attached to my pituitary gland and one somewhere else in the body, most likely in my lungs.

It, or they, are causing a biochemical imbalance known as cushing syndrome or disease.

The next step for me is an inferior petrosal sinus sampling (IPSS). The IPSS is an invasive procedure in which adrenocorticotropic hormone (ACTH) levels are sampled from the veins that drain the pituitary gland. This is done through what is apparently a really painful catheterization process. So, good times. They send the probes up into the brain through the groin to grab the samples.

They then compare the ACTH levels in the peripheral blood to determine whether the pituitary tumor is causing my issues. If it is NOT the culprit and it is an incidental finding, then we begin a hunt for an ectopic (mostly benign) tumor...or a malignancy.

In the interim, I went to my primary care physician for a physical and they suggested that I get a second opinion. So I went to see a second endocrinologist who reviewed my results, and described the IPSS test to me and followed it up by telling me that the test is dangerous because one slip and I am toast.

As in dead.

Cool.

He said it with no malice, he was just trying to make a point of the seriousness of what I was facing. Which I appreciate. But what he didn't appreciate was one of the things that had kept me sane over the past few weeks was the thought I was heading towards some kind of consensus and some kind of a resolution. Having that questioned left me feeling more lost and hopeless than I can remember feeling in a very long time.

Because now I was being torn between two completely different schools of thought. One was saying I needed to undergo this test, which came with risks and the other was that I just needed to keep repeating more conservatives tests every month.

In neither plan, was a path to treating my symptoms.

So I spent the weekend trying to figure out what to do next. My first endocrinologist was trying to find me a place to get the IPSS and the second doctor had me second-guessing the wisdom of that decision. And not matter how hard I tried to rationalize and explain it away, "one slip and you're toast" still kept repeating over in my internal monologue.

And then I made an accidental discovery. One of my earlier columns, a couple in fact, had been picked up by the an organization called the Pituitary Network Association. The PNA is an international non-profit organization for patients with pituitary tumors and disorders, their families, loved ones, and the physicians and health care providers who treat them.

PNA was founded in 1992 by a group of acromegalic patients in order to communicate and share their experiences and concerns. PNA has rapidly grown to become the world's largest and fastest growing patient advocacy organization devoted to the treatment and cure of pituitary disorders. This was a nice discovery because my thoughts were being shared with other people who were going through something similar. It also showed me the power of this Patch network. But I also discovered that their network included experts.

I reached out to them and immediately got a response back that walked me through why I needed to find a specialist in this area and then gave me the name of one at Sloan Kettering in New York. The next morning, my doctor messaged me to tell me she found a specialist that can help me with this test and what comes after.

It was the same name.

So now I know where I am headed next. Sure, one slip and I might be toast. But I need to trust that these specialists won't slip.

Russ Crespolini is a Field Editor for Patch Media, adjunct professor and college newspaper advisor. His columns have won awards from the National Newspaper Association and the New Jersey Press Association.

He writes them in hopes of connecting with readers and engaging with them. And because it is cheaper than therapy. He can be reached at russ.crespolini@patch.com

More:
Russs Ravings: One Slip, And Youre Toast - Westfield, NJ Patch

Feeling a little heated? Its typically nothing to worry about especially if youre sick. However, other issues can cause your temperature to rise.

A normal body temp is typically around 98.6 degrees Fahrenheit (37 degrees Celsius) but can vary slightly for each individual, and even fluctuate depending on the time of day.

It can be lower in the morning and higher in the late afternoon and evening, said Michael Hall, a physician based in Miami. But when your temperature gets to 100.4 degrees Fahrenheit or higher, and lasts more than a few hours, youre getting into fever territory something that can be caused by a number of conditions.

Most of my patients understand that a fever is a common symptom of cold and flu, said Christopher Dietz, an area medical director at MedExpress Urgent Care. However, what some people might not realize is that a fever isnt always just a sign that youre coming down with something.

Heres what could also be at play, according to medical experts:

PhotoAlto/Frederic Cirou via Getty Images

Infections

If you are looking for the reason behind your elevated temperature, start here. Experts note that infections are commonly associated with a fever.

When the immune system detects a threat such as bacteria or virus, a substance known as pyrogens is released into the bloodstream to reach the hypothalamus, which regulates body temperature, said Diana Gall, a general practitioner with Doctor4U in the U.K. When the hypothalamus detects pyrogens, it raises body temperature and causes fever in an attempt to kill off bacteria and viruses.

She noted that a high fever is one of the ways your body is responding and fighting the infection but a body temperature that is too high can also be dangerous.

If the fever is persistent and isnt coming down with home remedies, you should see a doctor, particularly if the fever is accompanied by a severe headache, difficulty breathing, blood in your urine or stool, redness of the skin or rash, or vomiting, etc. The infection may be serious and your body temperature may not reduce without medical treatment, she said.

Overexerting yourself outdoors

Hot outdoor temperatures and internal heat generation from exercise and mechanical movement of the body can heat you up, said Phil Mitchell, national medical director at DispatchHealth.

Under normal circumstances, your body will function well enough to cool you down through sweating and dilation of blood vessels. But if these basic systems are overcome and you cannot cool down, your body will continue to increase in temperature.

This typically does not happen from exercise alone, but exertion in a hot environment can cause this under the right circumstances, Mitchell said. He noted that you should immediately remove yourself from the heat and try other methods to cool your body down if this is the case.

Heatstroke can occur if heat exhaustion is not treated promptly. You need immediate medical attention if you become confused, lose consciousness or if you have an elevated temperature in this situation, said Steven Reisman, a cardiologist and director of New York Cardiac Diagnostic Center.

Vaccinations

Vaccines to prevent a bacterial or viral infection prepare your body to come in contact with that infection later, said Erik A. Larsen, assistant director of EMS and emergency preparedness at White Plains Hospital in New Yorks Westchester County.

So when you get the vaccine, your bodys immune response is stimulated and the body says, Whoa, what is this? It then mounts a fever, he said.

Larsen added that when you get a vaccine, youre not really invaded by an active infection, but it tips your body off that sometime in the future you may come across this.

tommaso79 via Getty Images

Alcohol withdrawal

Low-grade fevers can occur during the first few days of alcohol withdrawal as the central nervous system, which has been suppressed by alcohol, readjusts, said Holly Phillips, a board-certified general internist in New York and a medical expert for RxSaver.

Alcohol withdrawal also causes tremors, which can affect your heat, Larsen said.

The body is reacting to the loss of not receiving alcohol, which creates muscle contractions. This makes the body shake like a tremor, and it raises the bodys temperature, he said.

Inflammatory conditions

Certain inflammatory conditions, like rheumatoid arthritis and lupus, can cause fevers, said Lisa Alex, a physician at Medical Offices of Manhattan. This also occurs because the body is producing pyrogens, which raises your temperature. So if you have underlying inflammatory conditions and have a flare-up of any sort, the result may be a fever.

Certain medications

Many medications like antibiotics [and] antimalarials can also cause drug-induced fever. Anticonvulsants and some herbal medications can also do the trick, said Soma Mandal, a New Jersey-based physician.

You should monitor your bodys reaction when taking any new medication.

Look for a fever that starts a week after starting a new medication and goes away once you stop taking the drug, said J. David Gatz, an assistant medical director of the emergency department at the University of Maryland Medical Center.

Blood clots

Blood clots are an under-discussed source of fevers, according to Nate Favini, medical lead at preventative primary care service Forward.

If youre experiencing fever along with pain, swelling and redness in your leg or shortness of breath, that could be a sign of a blood clot, he said.

Endometriosis

While rare, several of my patients have had fever and flu-like symptoms every month at the start of their periods, likely due to severe pelvic inflammation caused by chronic bleeding into the stomach from wide-spread endometriosis, said Kenneth Ward, director of Predictive Laboratories and a scientific advisor for Predictive Technology Group in Salt Lake City.

If you experience this, Ward suggested making an appointment with your physician to get screened for the condition. Additional symptoms can include debilitating cramps during your period or pain with sex, urination or bowel movements.

Recent surgery

If youve recently gone under the knife, especially for a chest or abdominal procedure, you may experience an elevation in temperature in the days to follow, known as postoperative fever.

The body produces inflammatory proteins in response to the trauma surgery ... This causes fever as a reaction for the first few days post-operatively, said Laurence Gerlis, CEO and lead clinician at SameDayDoctor in London.

Studies show that this is a common side effect from surgeries, with up to 90% of patients reporting elevated temperature after the fact. In most cases, this resolves on its own.

Fevers could also be a side effect to anesthesia, although thats more rare, said Erin Nance, an orthopedic surgeon and hand and upper extremity specialist in New York. This is called malignant hyperthermia.

When this happens, according to Nance, its because of your bodys response to common anesthetic agents used during surgery. This can present as a high fever, muscle rigidity and rapid heart rate. The condition can be fatal and is treated with a medication called Dantrolene and ice packs.

If you have a family history of malignant hyperthermia, it is critical to tell your anesthesiologist before proceeding with surgery, she said.

STIs

Rina Allawh, a board-certified dermatologist with Montgomery Dermatology LLC in Pennsylvania, said that certain sexually transmitted infections may cause a higher-than-normal temperature.

Initially, syphilis presents with a non-tender chancre (i.e. an ulcer). However, if left untreated, may result in high fevers, joint pain, lymph node enlargement and fatigue, he said.

Gonorrhea, if left untreated, may result in high fevers associated with a rash, Allawh said. To prevent life-threatening consequences, prompt recognition and treatment of the condition is essential, he said. Additionally, practicing safe sexual practices and sexual-transmitted disease testing is equally as important.

Traveling to another country

Depending on the area of travel, a rise in body temperature can often be attributed to tropical bacteria and protozoa not often seen in developed countries, said Amna Husain, a board certified pediatrician and founder of Pure Direct Pediatric in New Jersey.

For this reason, I recommend travelers consult with their physicians and refer to the (Centers for Disease Control) guidelines for safe food and water recommendations, she said.

laflor via Getty Images

Hormone disorders or changes

Hyperthyroidism itself does not cause a fever, but we can see a very dangerous and fatal disorder associated with a large influx of thyroid hormone into the body called a thyroid storm, which does have fever, along with rapid heartbeat, fluctuations in blood pressure, and tremors associated with it, Husain said.

She noted that thyroid storm can occur because of a major stressor such as trauma, heart attack, delivery of a baby or because of an infection in people with uncontrolled hyperthyroidism.

In rare cases, it can be caused by treatment of hyperthyroidism with radioactive iodine therapy for Graves disease, she said.

Hormonal changes that occur during menopause can also cause you to feel warmer than normal, which are typically known as hot flashes.

Cancer

Keep in mind that a fever isnt necessarily the first sign or a major sign of cancer. However, it could be one of many symptoms.

Several cancers are associated with fever, which are most commonly leukemias and lymphomas, although other cancers can cause this as well, said Timothy S. Pardee, chief medical officer at Rafael Pharmaceuticals and an oncologist and director of Leukemia Translational Research at Wake Forest Baptist Health in North Carolina.

Pardee said this occurs because, in some cases, cancer cells create an inflammatory response, which then causes the body to respond with a fever. In other cases, the cancer cells themselves secrete cytokines or substances in the body that can cause a fever. And, according to Pardee, cancers like leukemia can impair your bodys ability to fight off infections resulting in prolonged illnesses and fevers.

Additional symptoms to look for are unintended weight loss and drenching night sweats (where you have to change your shirt or sheets when you wake up). These symptoms should prompt a call to your doctor for further evaluation, he added.

When you should be concerned about a fever

A fever may not be cause for alarm, unless there are some specific situations, said David Cutler, a family medicine physician at Providence Saint Johns Health Center in Santa Monica, California.

He added that medication to reduce fever when there is an infection like a cold, flu or pneumonia can help minimize bothersome symptoms like headache, body aches and dehydration from excessive sweating.

But if the fever is caused by hormonal effects, such as menopausal hot flashes or muscular activity like strenuous exercise, these medications will not be effective. In these instances, Cutler said to use measures like cooling fans to lower the bodys temperature.

According to Amesh A. Adalja, senior scholar at Johns Hopkins Center for Health Security in Maryland, a person should be concerned for fever above 101 degrees Fahrenheit (38.3 degrees Celsius) when it is unremitting, when it is associated with other symptoms such as dehydration, extreme fatigue, shortness of breath and severe rash.

Additionally, someone suffering who has a compromised immune system should have a low threshold for seeking medical attention. Same goes for those who are pregnant, have heart or lung disease, or who are very young, he said.

That said, if youre ever concerned about a fever, its always worth it to call your doctor. Thats what theyre there for, after all.

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13 Unexpected Reasons Why You Might Have A Fever - HuffPost

November is National Diabetes Month.

Diabetes is a serious condition that happens when your body cannot make enough of a hormone called insulin or cannot properly use the insulin it has. Insulin helps your body digest sugars that come from what you eat and drink. Without enough insulin, sugar builds up in your blood. Over time, having too much sugar or glucose in your blood can cause health problems.

More than 30.3 million Americans have diabetes, or about 9.4 percent of the population. About 1 in 4 people with diabetes do not know they have the disease. Another 84.1 million have pre-diabetes, a condition in which a persons blood sugar is high, but not high enough to trigger diabetes.

According to the National Heart, Lung and Blood Institute, adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes. This is because over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart. The good news is that steps taken to manage diabetes can also help lower the risk of having heart disease or a stroke.

Manage your A1C, blood pressure and cholesterol levels. Ask your health care team what your goals should be.

Develop or maintain healthy lifestyle habits. Follow a healthy eating plan and make physical activity part of your routine. To reduce stress, try gardening, taking a walk or listening to favorite music.

Stop smoking or using other tobacco products. If you have diabetes and use tobacco, your risk of heart problems is even greater. Both tobacco use and diabetes narrow blood vessels, so your heart has to work harder.

Take medicine as directed. It is important that those with diabetes take any medicine as prescribed by a physician. Talk with your doctor if you have questions about your medicines and do not stop taking them without checking with your doctor first.

Skillet Zucchini and Mushrooms

In a large skillet, heat oil. Saut green pepper and onion. Add zucchini and cook, covered until tender. Add mushrooms and heat through.

Spoon into a 2-quart baking dish. Sprinkle with cheese. Cover and let stand for 5 minutes or until cheese is melted. Serve hot.

Makes 6 servings.

Nutrition information per serving: 70 calories, 4g fat, 60 mg sodium, 5 g carbohydrates 1 g fiber.

Cami Wells is an Extension Educator for Nebraska Extension in Hall County. Contact her at (308) 385-5088 or at cwells2@unl.edu. Visit the Hall County website at http://www.hall.unl.edu

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Nutrition Break: Take diabetes to heart | Advice - Grand Island Independent

AUGUSTA As Maine compiles thousands of test results for soil and water contamination from an emerging class of toxic substances, consumers need look no further than their own homes for the most immediate and persistent exposure to these forever chemicals.

You wont find them listed on many labels, but the chemicals known as PFAS are literally everywhere in the modern household.

From the moment that we wake up in the morning to the moment we go to bed, we are encountering products that contain these chemicals, said Mike Schade, who tracks PFAS and other chemicals in consumer products for the nonprofit Safer Chemicals, Healthy Families Mind the Store campaign.

They are in cosmetics, shampoos and dental floss. Grabbing pizza, a burger or hot-and-ready dinner from a grocery store? Your food may come with a side order of PFAS-laced packaging.

From the Gore-Tex jacket or boots that keep you cozy in winter, to the stain-resistant couches and nonstick cookware that make life less messy, many of the modern products so common in American households are made with a diverse class of chemical now at the center of a growing health concern.

Studies have linked two specific types of the chemical PFOA and PFOS to cancer, kidney disease and other serious aliments. But while the chemical industry says newer varieties are safer, medical and public health experts say the developing science strongly suggests otherwise.

These are serious concerns about human health across the population, said Dr. Leonardo Trasande, director of New York University School of Medicines environmental pediatrics program and author of the book Sicker Fatter Poorer on hormone-disrupting chemicals. The reality is we always have gaps in our understanding, but at the same time there is enough data for us to take action.

WHAT ARE PFAS?

The term PFAS refers generally to a broad category of synthetic chemicals, per- and polyfluoroalkyl substances, the first of which were developed in the 1940s by companies such as Dupont and 3M.

The chemicals helped usher in a new era of consumer convenience, perhaps best illustrated by the revolutionary nonstick cookware coated by Teflon. Dubbed the slickest substance known to man, the key chemical component in Teflon, polytetrafluoroethylene or PTFE, and another chemical PFOA work by essentially preventing water and water-based substances from penetrating.

Those hydrophobic qualities have made the two chemicals and thousands of subsequent varieties extremely popular with manufacturers. In addition to creating nonstick surfaces on frying pans, types of PFAS make ski jackets water-repellent, help prevent spilled wine from immediately staining carpet or upholstery, and keep fast food wrappers or takeout containers from becoming soggy, greasy messes before you can finish the food.

But their function goes beyond consumer convenience. These chemicals also serve lifesaving roles.

A type of PFAS is the critical ingredient in the foam that airport and military firefighters use and are required by the Federal Aviation Administration to keep in supply to smother the ferociously hot fires created by burning jet fuel. Dozens of municipal fire departments in Maine as well as petroleum companies also keep PFAS foam on hand.

Fluoropolymers that are part of the PFAS family are also commonly used in lifesaving medical devices such as stents and pacemakers as well as some brands of dental floss.

EMERGING HEALTH CONCERNS

The complex and hardy chemical compounds that make PFAS so useful in consumer products also mean, however, that the chemicals do not easily break down in the environment or the body. Some compounds are believed to linger for decades centuries, even in soils and take years to exit the body after exposure, hence the nickname forever chemicals.

Concerns over the health effects of PFOA began surfacing in the 1980s among workers at a DuPont factory in West Virginia that produced Teflon products. But the company kept quiet about the growing evidence of PFOAs toxicity even after workers began being diagnosed with higher rates of leukemia and kidney cancer, as well as birth defects among the children of female workers.

Then in 1998, a neighboring farmer whose livestock were mysteriously dying sued the company in a landmark environmental lawsuit that showed DuPont knew for years about the health risks of the chemical. The farmer won that lawsuit, and a subsequent class-action case targeted the company for contaminating local drinking water.

Both PFOA and another toxic chemical cousin, PFOS, are no longer allowed to be manufactured in the U.S., Europe or Japan or used in products made here, although the compounds are still reportedly used in some foreign manufacturing.

The primary manufacturers of PFAS in the U.S. 3M, DuPont and its spinoff, Chemours are also facing dozens of lawsuits filed by plaintiffs claiming the chemicals have caused cancer or other health problems.

CHEMICAL WHACK-A-MOLE

Chemical companies have since switched to differently structured forms of PFAS (chemically speaking, six-chain compounds versus the eight-chain versions in PFOS and PFOA) that manufacturers say break down faster and avoid the toxicity problems of their predecessors.

The body of evidence reviewed shows they are not carcinogenic, they do not have developmental or reproductive concerns, the toxicity is much approved over the toxicity of PFOA and PFOS that weve spent a lot of time talking about, Renee Lani of FluoroCouncil told members of Maines PFAS task force in September. The dont bioaccumulate and an evidence analysis that was just published last year demonstrates that they are not an endocrine disruptor.

Environmental health groups and medical professionals strongly dispute industry claims that the next-generation, short-chain PFAS compounds are less problematic. And they point to the widespread development and use of new PFAS varieties as evidence of a federal regulatory system that they say is ill-equipped to keep up with industry and failing to protect public health.

This is chemical whack-a-mole in action, said Trasande, who is vice chairman for research in the NYU School of Medicines Pediatric Department. Just because the chemical has a short half-life, that helps if the exposure is a single point in time. But these are ongoing chemicals with consistent, ongoing exposure.

Trasande, who specializes in endocrine-disrupting chemicals in children, said evidence suggests that the newer, shorter-chain PFAS compounds stay in the body long enough to have health impacts. Laboratory animal studies have shown potential liver and kidney toxicity from some of the newer generation of compounds.

And he said there are serious gaps in our knowledge and toxicology in figuring out how PFAS interact with the hundreds of hormones in the body, particularly among children and adolescents.

There is what we know and what we havent studied, Trasande told Maine lawmakers in March during an appearance before the Legislatures Environment and Natural Resources Committee.

Industry representatives have urged Maine lawmakers as well as members of Congress not to group-label all PFAS as potentially hazardous substances. Companies that make PFAS say the newer, most common types of chemicals are safer and less forever than the now-banned versions definitely linked to cancer, kidney disease and other ailments.

My fear is that an overgeneralization is leading to a lot of misinformation, a lot of fear and a lot of confusion over a chemistry that is not even being used anymore, Brady Pitts, an application chemist for PFAS manufacturer Daikin America, told Maine lawmakers at the same March hearing.

And then there is the potential health threat posed by contamination from the legacy, now-banned versions.

Dr. Abby Fleisch, an attending physician in pediatric endocrinology and diabetes at Maine Medical Center, recently received a five-year, $2.2 million federal grant to study whether childhood or pre-birth exposure to PFAS can contribute to development of diabetes or lower bone densities.

Fleisch and her team is still in the earlier stages of that research, but initial findings suggest that children between the ages of 6 and 10 who had higher PFAS levels in the blood also had lower bone density. That is important because adolescence is peak bone-formation time, and low bone mineral density during teenage years may predispose those individuals to osteoporosis later in life, Fleisch said.

The research team also plans to follow up on earlier work examining the same group of women and children that suggested girls exposed to higher PFAS levels in utero could be predisposed to childhood obesity.

Research suggests that PFAS exposure may impact multiple health outcomes, Fleisch said in an interview. However, we dont have all of the answers and I believe it is important to continue exploring these fields.

REGULATORY ACTION AND INACTION

Theres been a flurry of activity at the state and federal level in recent years, spurred initially by the discovery of PFAS hotspots around military bases.

In Maine, high levels of PFAS have been found at the former Brunswick Naval Air Station, former Loring Air Force Base and around the Maine Air National Guard base at Bangor International Airport. But the chemicals have also turned up on an Arundel dairy farm, at former tanneries, near landfills and other industrial sites in Maine.

Congress and the federal government are exploring a variety of actions, ranging from adopting tighter health standards for contamination to adding PFAS to the list of chemicals eligible for federal cleanup under the Superfund program. There is also an effort to add at least some forms of PFAS to the list of chemicals that companies are required to report emitting or discharging under the federal Toxics Release Inventory.

Maines PFAS task force is expected to recommend a host of legislative or administrative actions. Those potential actions include expanded statewide tests for contamination, required reporting whenever a fire department uses PFAS-laden foam and mandatory screening for PFAS among all public water systems.

The Maine Department of Environmental Protection, meanwhile, is seeking legislative authority to order companies to clean up PFAS-contaminated sites, something it currently lacks because the federal government doesnt list PFAS as a hazardous material.

Maine is among the handful of states including Washington, Massachusetts, New Hampshire and Michigan that are leading the regulatory charge on PFAS. For instance, Maine lawmakers passed the nations first phase-out of PFAS in food packaging earlier this year, although the law only takes effect when safer alternatives are available.

We dont anticipate a lot of progress in Washington regulating PFAS in food packaging so it is really up to the states to step up, said Schade, of the Safer Chemicals, Healthy Families nonprofit.

THE CUSTOMER IS ALWAYS RIGHT

Schade is also a firm believer in the power of the consumer. And he says recent decisions by retailers to act on PFAS before the federal government is proof of that power.

Through its Mind the Store campaign, Safer Chemicals, Healthy Families, and like-minded organizations nationwide have tested consumer products and food packaging for the presence of PFAS. They then used those results to attempt to pressure manufacturers or retailers to remove PFAS from products.

For instance, a 2018 report from Mind the Store and the group Toxic-Free Future showed likely PFAS ingredients in many store-brand products and packaging from the major grocery store chains Ahold Delhaize, Whole Foods, Albertsons and Kroger.

Immediately after the report, Whole Foods announced plans to stop using takeout food packaging that contains PFAS. And in September of this year, the owner of Hannaford and Stop & Shop supermarket chains, Ahold Delhaize, announced that it plans to begin removing PFAS from packaging for grocery items, baby products and personal care products.

Both the Lowes and Home Depot home improvement chains also recently announced that they would stop selling carpeting and rugs that contain PFAS. And two weeks ago, Staples announced that it would work with suppliers to begin transitioning to safer alternatives to PFAS and other chemicals in products.

Additionally, the maker of the water-repellent fabric Gore-Tex has committed to eliminate PFAS varieties of environmental concern from 85 percent of its consumer products by the end of next year and from the remaining products by 2023.

So this is really a growing sustainability trend among major retailers and businesses, Schade said. At the same time, we have seen leadership from states such as Maine and Washington in recent years.

PROTECTING YOURSELF

According to the Agency for Toxic Substances and Disease Registry within the U.S. Centers for Disease Control and Prevention, exposure to PFOA and PFOS from todays consumer products is usually low, especially when compared to exposures to contaminated drinking water.

But PFAS awareness advocates say there are steps that consumers can take to educate and potentially protect themselves from exposure. They include:

Organizations such the Environmental Working Group, Safer Chemicals, Healthy Families and Toxic-Free Future recommend avoiding nonstick cookware altogether. Thats because even newer versions marketed as PFOA-free could contain the shorter-chain chemical cousins that they maintain have not been proved safe.

Many of those organizations recommend using cast-iron or stainless steel. But advice to consumers on such topics as nonstick cookware can be contradictory and confusing.

In a 2016 fact sheet on PFOA, the American Cancer Society stated: Other than the possible risk of flu-like symptoms from breathing in fumes from an overheated Teflon-coated pan, there are no known risks to humans from using Teflon-coated cookware. While PFOA is used in making Teflon, it is not present (or is present in extremely small amounts) in Teflon-coated products.

Finding out whether a product was made with PFAS is difficult. But Schade with the Mind the Store campaign said consumers should ask manufacturers or retailers such questions, in part to educate themselves and in part to send a message to businesses.

Consumers really need to be savvy and aware, but at the same time none of us should need to have a Ph.D. in chemistry, which is why we need governments to act, he said.

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Households are awash in 'forever chemicals' - Press Herald

COLUMBUS, Ohio The Ohio Senate Nov. 6 passed a bill that would require a child born alive following an abortion receives the same medical care accorded any newborn at the same gestational age.

A second measure OKd the same day would mandate that abortion facilities inform women that chemical abortions can possibly be reversed to save their unborn childs life.

The Born-Alive Infant Protection Act, or S.B. 208, passed with a 24-9 vote, and the Abortion Pill Reversal Act, or S.B. 155, passed with a 23-10 vote.

Called life-affirming by the Catholic Conference of Ohio, the public policy arm of the states Catholic bishops, the two bills will now be taken up by the Ohio House of Representatives. The conference commended the bills sponsors, Republican Sens. Terry Johnson and Peggy Lehner, respectively. Lehner also was a co-sponsor of the Born-Alive bill.

This legislation acknowledges, promotes and preserves the dignity of human life, Johnson said in a statement. Every new born infant deserves our compassion and care, no matter where we stand in the broader abortion debate.

In addition to the medical care provisions, this legislation creates reporting requirements and penalties for the attending physician who fails to report a born-alive baby. While individual cases will remain confidential, the Ohios Department of Health will publish annually the number of babies who survive abortions.

Current federal law recognizes that all infants born at any stage of development, regardless of the circumstances surrounding the birth, are persons. However, supporters of this legislation believe this recognition alone is insufficient to provide protections for infants born alive following an attempted abortion, said a news release from Johnsons office.

The Born-Alive Infant Protection Act is a vital protection of defenseless babies that survive failed abortions, said a statement from Stephanie Ranade Krider, vice president of Ohio Right to Life. This bill would stand ready to protect these helpless infants and require they are given proper medical attention at their most critical moment.

She added, These babies deserve protection under law like infants born under any other circumstance.

Regarding S.B. 155, Lehner said in a statement: Women who decide to take their babies to term should be celebrated and supported. This bill simply gives women more information about the option for a second chance to make an extremely emotional and difficult decision.

The bill would require doctors prescribing abortion-inducing drugs to also provide written information informing the patient of the possibility of reversing the effects of an abortion in the event she changes her mind within the first two days.

According to a news release from Lehners office, the Mifeprex chemical abortion procedure is a two-day regimen used to terminate early pregnancies by blocking the hormone progesterone needed to sustain pregnancy. A second drug, Misoprostol, stimulates uterine contraction to expel the dead baby.

Women who choose a chemical abortion and regret it within the first two days of taking the first drug have a chance to save their baby, as long as they have not taken the second drug, it said.

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Ohio Senate bills will 'give more babies a second chance,' say supporters - The Dialog

Close to half of New Jersey's adult population either has diabetes or is one step away from the irreversible diagnosis.

And most of these folks don't even know it.

According to 2019 figures from the American Diabetes Association, approximately 862,000 people in New Jersey have the chronic disease, which affects a body's ability to produce or use the hormone insulin. More than 2.4 million other Garden State residents, meanwhile, have prediabetes blood glucose levels are higher than normal, but not yet high enough to be counted as a full-blown diabetes diagnosis.

It's believed that a little more than a quarter of diabetic adults are not aware of their condition, along with 90% of folks living with prediabetes.

"The key to really being able to prevent or manage diabetes is understanding your risk," said Lauren Grosz, executive director of the association's New Jersey and New York City markets. "If people are at high risk, we encourage them to see their doctor and get a blood test."

Every year in New Jersey, the association said, an estimated 39,000 people are diagnosed with diabetes.

With the diagnosis, individuals are at greater risk for other serious complications such as heart disease, stroke, end-stage kidney disease and blindness.

As part of American Diabetes Month, the association launched a campaign called Count Me In, which encourages those impacted by the disease to "get involved in the fight" by volunteering, becoming advocates and donating to the cause, and urges those who may be at risk to speak with their physician.

People with diabetes incur medical expenses more than two times higher than those who do not have diabetes, the association said. In New Jersey, total direct medical costs related to diagnosed diabetes were estimated at $6.7 billion in 2017.

Affordability is the biggest barrier to care for suffering individuals who do not have health insurance, according to the Diabetes Foundation. And whether or not someone has insurance, the foundation said, insulin is expensive.

"Depending on the type of insulin, the costs could be overwhelming," said Ginine Cilente, executive director of the Hackensack-based foundation, which helps people manage the disease and provides short-term medication for those who can't afford it.

The foundation's youngest participant last year was 3 years old. The oldest was 95.

"Diabetes is hard, and we think getting help shouldn't be," Cilente said. "We have come across a lot of people who say they are rationing their insulin."

Diabetes is the eighth leading cause of death in the Garden State, and the rate of new adult cases is increasing, according to the Department of Health.

The state says it is making progress in reducing the diabetes death rate, and increasing the percentage of diabetic adults who get an A1C test at least twice a year.

More from New Jersey 101.5:

Contact reporter Dino Flammia at dino.flammia@townsquaremedia.com.

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39,000 people in NJ are diagnosed with diabetes every year - New Jersey 101.5 FM Radio

She did so a safe distance from her homeland, where LGBTIQ+ (Lesbian, Gay, Bisexual, Transgender/Transsexual, Intersex and Queer/Questioning) people regularly face persecution that is actively encouraged by political and religious leaders.

Just last month, a gender nonconforming LGBTIQ+ activist was brutally murdered in his own home. Hacked in the head with a gardening tool, according to Sexual Minorities Uganda.

Negesa is not exaggerating when she says: I cant go back home. I may lose my life.

So, the 27-year-old has become an asylum seeker, applying for indefinite leave to remain in Germany. She has been housed in a LGBTIQ+-friendly shelter while her case is considered. A decision is expected on Friday.

It has been several weeks since she said goodbye to her family and headed to Berlin. If her application is granted, there is no telling when she will see them again. They are missing me a lot, she says of those for whom her athletics career had been a route out of poverty. When they call me, they are asking when Im coming back.

But Negesa is defiant about her decision to end seven years of silence about how she was told just weeks before the London Olympics that she produced too much testosterone to compete fairly as a woman, how she found herself with one option for reducing it, how what she thought would be a simple procedure resulted in her internal testes being cut out, and how she felt so unwell afterwards that she feared she would die.

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Exclusive interview: DSD athlete Annet Negesa - 'My family miss me, but if I go back to Uganda I may lose my life' - The Telegraph

Homelessness is a prominent concern among LGBT+ people, particularly the transgender community. Nearly one-third of the respondents who completed the 2015 U.S. Transgender Survey reported homelessness at some point in their lives, with even higher rates (74%) among individuals whose families had rejected them. Additionally, at the time the survey data was collected, the number of respondents who were concurrently homeless (0.53%) was three times that of the general U.S. adult population (0.18% according to the Department of Housing and Urban Development). This prevalence demonstrates the pervasiveness of home insecurity in the transgender community, which is partially caused by the transphobic socioeconomic discrimination mentioned in the first part of this series.

Homelessness can create a multitude of risks that directly cause health problems, exacerbate existing illness and make conditions more difficult to treat or manage. Therefore, housing insecurity may create complicated clinical scenarios that cannot be readily resolved by our standard health care system. As stated by the National Health Care for the Homeless Council (NHCHC) in the Homelessness & Health Fact Sheet, The best, most coordinated, medical services are not very effective if the patients health is continually compromised by street and shelter conditions. Even inpatient hospitalization, or residential drug treatment and mental health care (when available), do not have lasting impacts if a client has to return to the streets upon discharge.

Transgender individuals health may be more severely impacted by homelessness because of the decreased availability of supportive public services. In Transitioning Our Shelters: A Guide to Making Homeless Shelters Safe for Transgender People, the National Gay and Lesbian Task Force and the National Coalition for the Homeless assert that transgender people have a greater need for shelter and other social services because of lack of education, discrimination, increased ejection from homes, inability to access quality health care and inability to pay for transgender-specific health services such as hormones, counseling and gender-affirming procedures. Lifelong, systemic discrimination against transgender individuals can cause them to have an increased need for institutional support while also denying them access to such assistance.

Services available to cisgender individuals are also not always accessible to transgender persons. Homeless shelters are often thought of as a step towards escaping homelessness, but shelters can be especially unsafe for this patient subset. In the 2015 U.S. Transgender Survey, 26% of respondents who were homeless in the past year avoided shelters for fear of maltreatment. Of those who did stay in a shelter, 70% experienced this identity-based mistreatment. Both staff members and residents were responsible for the discrimination. Shelter staff ejected some respondents (9%) after they became aware of the participants identity and forced even more (14%) to present as the wrong gender. Transphobia from shelter staff also prevented some individuals (4%) from being initially approved as residents. Forty-four percent of the respondents who lived at a shelter eventually left because of poor treatment or unsafe conditions.

A 2016 telephone test conducted by the Center for American Progress (CAP) and Equal Rights Center also illustrates the prevalence of discrimination from shelter staff. Only 30% of the shelters contacted by the study indicated that were willing to accommodate transgender women, with 13% stating that the resident must be placed in isolation or with men and 21% refusing shelter entirely. Instances of discrimination from shelter staff in this test and other surveys by CAP were not localized to a specific area, but were reported across the country. Rather than being a site of stability, homeless shelters are a place of targeted harassment and anxiety for transgender residents. By increasing their experiences of discrimination and hostility, shelters might contribute to transgender individuals negative health outcomes and decreased health service utilization. However, avoiding or not being able to access a shelter may also cause transgender individuals to face unsafe conditions on the streets. If providers are not aware of specific programs policies towards transgender people, they may risk recommending unaccepting housing rehabilitation or shelter programs to their homeless transgender patients.

A new proposal from the Department of Housing and Urban Development (HUD) would risk making this patient subgroup even more susceptible to discrimination when seeking shelter services. The proposal would allow for HUD-funded shelters to refuse admission based on factors such as religious beliefs. Religious freedom has frequently been cited as a tactic to avoid providing services to LGBT+ individuals, including health care services. Sasha Buchert, a senior attorney with Lambda Legal, said of the proposal, This would be absolutely devastating in the sense that it would send a message to shelter providers that they can turn away trans people with impunity. Theyre wrong. The law is the law and the federal housing Title VII [of The Civil Rights Act] prohibits discrimination based on sex and that would encompass gender identity.

However, Bucherts statement does not take into account the difficulties that rejected applicants would have in filing such discrimination claims and the current federal deliberations on whether laws prohibiting discrimination on the basis of sex apply in cases of transphobia. Allowing for refusal of shelter admission may further reduce the small number of services transgender people can and are willing to access, and sets a precedent for discrimination from shelter and governmental staff. Both results will cause homeless transgender individuals to experience more shelter-based and street-based instances of discrimination and violence. Such experiences can contribute to diminished physical and emotional wellness among this population. Additionally, homeless transgender people may avoid other organizations that they perceive to be discriminative or religiously intolerant, such as religiously-affiliated hospitals.

The HUDs proposal would also federally define an individuals sex as the sex listed in their governmental documents. This definition of sex specifically targets the transgender community by invalidating their gender. Although some states allow for a person to change the sex listed on their governmental documents, many transgender individuals are unable to update their gender marker because of legal, cost and time restraints. Additionally, altering legal documents may necessitate listing a location of residence, a catch-22 for homeless transgender individuals. This definition of sex may force transgender individuals to misgender themselves, unwillingly disclose their transgender identity to shelter staff or reside at sex-specific shelters that do not match their gender. These actions of misgendering may lead to diminished self-esteem and make transgender individuals more susceptible to discrimination, judgment and violence at shelter facilities.

In a statement on the proposal, Mara Kiesling, the executive director for the National Center for Transgender Equality, stated that, The programs impacted by this rule are life-saving for transgender people, particularly youth rejected by their families, and a lack of stable housing fuels the violence and abuse that takes the lives of many transgender people of color across the country. The press release further details that transgender people who have experienced homelessness are more likely to face physical and sexual violence than those who have not. By denying homeless transgender individuals the opportunity to escape unsafe environments, the HUDs proposal may increase homeless transgender peoples need for supportive services while causing them to be more fearful of seeking assistance. To prevent harm to patients and avoidance of care, physicians must address the impacts of proposals such as this, even though they may seem outside the realm of the medical community. Without being aware of current policies, physicians will continue to create treatment plans that are impossible for patients to follow or will inadequately address their needs.

Although changing homeless services may seem outside the realm of physician practice, the authors of Transitioning Our Shelters have previously made several recommendations on how health care practitioners could make clinical decisions that would improve transgender patients experiences in shelters. Transgender people need advocates for their continued access to hormone treatments while in shelters because of the undesirable mental and physical effects that cessation can have on their bodies. Therefore, transgender shelter residents may need protection from shelters syringe bans so that they can continue their hormonal injections. Without defending these needs, transgender individuals mental and physical health could worsen despite the best clinical visits. Physicians could provide statements asserting the medical necessity of gender-affirming medications and further work with transgender individuals in their community to dismantle the existing barriers at shelters. To truly care for vulnerable patients, physicians must be willing to partner with them to think of innovative ways to counteract cisnormative and transphobic practices.

If physicians advocate for transgender patients right to access medical services, such as hormone treatments in homeless shelters, they could also challenge the dehumanization and discrimination that these individuals face. With the societal and scientific authority granted to physicians for their title and training, they could lend validity to transgender individuals existing acts of advocacy through partnerships with transgender advocates and patients. Such efforts could help bridge the divide between health care providers and transgender individuals and improve societal acceptance of transgender people. By addressing larger political, social and economic barriers to health for oppressed patients and by partnering with them, physicians could prevent harm altogether and avoid searching for a cure to complex social problems during their brief clinical visits.

Image Credit: Trans Solidarity Rally and March 55401(CC BY-SA 2.0)bytedeytan

Writer-in-Training

University of South Carolina School of Medicine - Columbia

Lexi Dickson is a second year medical student at the University of South Carolina School of Medicine in Columbia, South Carolina class of 2022. In 2018, she graduated from the University of South Carolina Honors College with a Bachelor of Science in biochemistry and molecular biology. She enjoys trying new restaurants, dancing, and traveling in her free time. Lexi is undecided on what specialty she would like to pursue after graduating medical school, but is interested in emergency medicine.

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Continuing Medical Education on Trans Health: Addressing the HUD's Proposed Rule (Part 2 of 2) - Pager Publications, Inc.

Im going to start this postthe same way Ill end it reminding you that each persons cancer journey isjust that their own journey. Its unique to each individual there is noright or wrong way to get through a cancer diagnosis. Trust me on this one.

So why are we talking aboutcancer today? Because Ive been asked a lot lately about why I chose to avoidchemo and radiation. Especially working in the health care industry, I thinkpeople expected me to take a more traditional route. But instead, I opted totake a naturopathic approach WITH some traditional methods.

This is where it starts gettingheated. As soon as I say naturopathic, I start getting slammed forperpetuating myths or not admitting to the truth, or my personal favoritebeing a hippy-dippy Indian. True statement, I am a bit of a hippy dippyNative American I mean, I live in nature, I believe Mother Nature and all ofthe elements help us in the various facets of our lives and I do believe the wereturn to the earth from which we live on. But Im not sure thats what thesepeople mean when they say that.

Having two kinds of cancer is acomplete double whammy!

Before I go too far down thispath though, I want to acknowledge that this journey is mine and mine alone.And that although many of you know that when I say #effcancer it usually refersto my breast cancer, but what a lot of you dont know is that late last year Iwas told I have early stage cervical cancer. It was a shock. A hit to the gut or lower as the case may be. And Im not afraid to talk about it, though I dontexactly love having my vajay-jay be the topic of public fodder, it was more menot sharing because when I did tell those closest to me, I saw the deep way itimpacted them. Hearing me say I have ANOTHER form of cancer was like twisting aknife. There were tears, there were swear words, there were gasps, there were are you fuc$king kidding memoments. So, I opted to process this one with those closest to me and now,after having had a couple of surgeries and having changed my naturopathicapproach again, Im ready to talk about it.

Now that Im ready to talkabout it, why am I talking about it here? Because Ive been sharing my methodswith people individually for a while now and frankly, Im getting a littletired of repeating my message each time when I could just put it all here andpoint people to it. So, Im going to share a bit about the approach I took andwhy.

So, what do I mean by anaturopathic approach that combines with traditional methods? I mean that forboth my breast and cervical cancer, I opted to have masses removed. I opted tohave the damaged and cancerous tissues surgically removed from my body but notto move into chemotherapy drugs or radiation as the next step. I didnt want topotentially damage healthy tissue just to combat damaged tissue. I consultedmany an osteopath, naturopath, traditional Chinese medicine practitioners, etc.I asked a lot of questions, talked to a lot of people who had chosen theseoptions and made a plan.

That plan is always evolving,optimizing, changing based on research and what seems to work for me. I stillsee my primary care physician (who is an amazingProvidenceSt. Joseph Health doc), I see a naturopath and I see my oncologistspecialist (also amazing PSJH docs), and we all work together. Its part of whyI love my traditional clinical experts, they know its my choice, they arewilling to answer my questions and work with my non-traditional docs. Side note if your doctor wont answer your questions, you need a new doctor.

Youre probably thinking were seven paragraphs in and I dont know what you mean by naturopathicapproach to cancer. So here goes this is what my journey consists of:

B12 injections can take a littlegetting used to

Full cocoon red light therapy feelsamazing!

There you have it, thats beenmy path as Ive gone on this journey. There are also a lot of naturopathicoptions Ive considered but havent tried yet. Mostly because I havent neededthem, but if youre doing the research, certainly take the time to look atchelation, regenerative peptide treatment, halo therapy, biomagnetic therapy,hyperbaric oxygen therapy and more.

With so many options toconsider, make your journey the one you want it to be. Because, as I said atthe beginning, each persons cancer journey is their own to determine how andwhat they make it. I wish you all the best of luck as you go on your personalpath.

Excerpt from:
Let's Talk Cancer and Controversy - Thrive Global

November is National Diabetes Awareness Month; therefore, I chose to focus on the nutritional aspect of this very serious, yet manageable disease.

When you have diabetes, your body cant use the food you eat in the proper way. Normally, when you eat food, namely carbohydrates, they are digested and changed into glucose, a sugar the body uses for fuel. The glucose is carried by the bloodstream, where it waits to be picked up by insulin to be taken to individual cells of the body. The pancreas is an organ in your body that houses the cells that make the hormone insulin. Insulin helps the glucose enter the cells of your body, much like the key that opens the door to let the blood sugar out so you can have energy to work and play.

In the case of diabetes, you may not be making any insulin at all, known as Type 1 diabetes. This type is typically seen in newborns up to young adults. The only way to manage this type is through insulin injections.

Type 2 diabetes is when the individual is still able to produce insulin, but not enough to manage a normal blood glucose level, or is unable to use the insulin he/she makes, called insulin resistance. This type generally occurs in adulthood, but is becoming more common in childhood. Treatment generally includes medication management along with lifestyle changes such as increased physical activity, weight loss and diet changes.

A meal plan should be designed to meet individual needs. It should consist of regular meals, with or without snacks to help control the amount of sugar (glucose) in your blood. A diabetics medical regimen may determine dietary modifications. In either case, the basic premise all foods can fit into a plan is taught. Some exceptions might include sugar-loaded beverages.

Learning how to carb count can make it easier to manipulate a diet plan. In order to master this, it will be helpful to have the education from a diabetes care and education specialist (DCES), formally known as a certified diabetes educator, who has had the training and passed the exam for the credentials. A physician referral is needed for this education.

A helpful tool to start using when first learning to count carbs is knowing the portion size of the food you are eating just as in weight management strategies. Make use of measuring cups and spoons for increasing awareness of the amount of food and beverage to be consumed.

Making use of the food labels is also helpful. Pay attention to the serving size listed along with the total grams of carbohydrate. This will make sense once a carbohydrate spending allowance is given. For instance, an average adult male might do well with 60 to 75 grams of carb per meal, while a female would do better with 30 to 45 grams per meal. An example of a 45-gram carb meal would be equivalent to a sandwich on two slices of bread and a fresh fruit. The carbohydrate spending allowance will be assigned based on the individuals needs using age, activity, height and weight.

Carbohydrate foods include natural sugars such as lactose, found in milk and yogurts; fructose, found in fruits; and starch, found in grains, potatoes, pastas, rice, etc. Sugar is a simple carb that is more readily broken down and can spike blood sugars. Its use should be minimized as possible.

Sugar alcohols such as mannitol, xylitol, sorbitol, isomalt, erythritol, isomalt and maltitol come from plant products such as fruits and berries. The carbohydrate in these plant products is altered through a chemical process. These sugar substitutes provide somewhat fewer calories than table sugar (sucrose), mainly because they are not well absorbed and may even have a small laxative effect. Therefore, they have little to no effect on raising blood glucose levels.

Artificial sweeteners are alternatives to giving sweetness to foods without adding calories and minimal to no added carbs. They include:

1. Saccharin: SweetN Low (pink packages)

2. Aspartame: Nutrasweet/Equal (blue packages)

3. Acesulfame-K: Sunett, Sweet One

4. Sucralose: Splenda (yellow packages)

5. Stevia: Sweet Leaf (green packages). This is the only all-natural, zero-calorie sweetener derived from a plant.

It is important to note that just because a food is listed as sugar-free does not make it carbohydrate-free, as it may contain other sources of carbs. You still need to check the labels and count the carbs.

Once carb counting is understood, it is important to learn to add protein (fish, skinless poultry, beef or pork), and heart healthy fats (olive oil, nuts) to meals and snacks to help balance out blood sugars. For example, when choosing to eat an apple, it may be beneficial to pair it with some peanut butter, nuts or cheese. Proteins and fats do not generally produce a glucose load. They can also help to provide satiety over a longer time frame.

Personal food preferences should be taken into account when planning meals. Here is an example of a generalized, healthy meal plan that we all can strive for, diabetic or not. It includes the Mediterranean style.

BREAKFAST

Greek-style yogurt mixed with walnuts and berries of choice

1 whole-grain slice of toast spread with avocado or nut butter

LUNCH

Tuna Salad on whole-grain bun or in mixed Lettuce greens; add almonds and toss with balsamic vinegar and olive oil

Orange slices and tomato and feta cheese marinated in olive oil

SNACK

Grapes and goat cheese

SUPPER

Broiled fish or skinless chicken or turkey

Brown rice, quinoa or sweet potato

Tossed greens with tomatoes, olives, avocado and olive oil-based dressing

SNACK

Mixed nuts and apple slices

Note: Beverages may include teas, coffee or other non-sugar drinks.

As with any upcoming holiday, please be mindful while you enjoy the family traditions you have.

Chris Willis is a clinical dietitian/certified diabetes educator at OSF HealthCare St. Mary Medical Center in Galesburg.

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Chris Willis: Diabetes and nutrition - Galesburg Register-Mail

Ivette had just taken the first dose of the chemical abortion pill protocol when she began to feel the pangs of regret. Sitting in the abortion facility, she felt emotion wash over her.

I knew it was wrong, and as soon and the doctor walked out, I started crying. I asked my boyfriend, Why are we doing this? and he just hugged me, she wrote in a reflection sent to Heartbeat International several months later.

The abortion facility hadnt let Ivette see her unborn baby on the ultrasound screen, but they estimated her child to be about four weeks old. Just a day before, the couple had believed abortion was their only way forward. With an almost-two-year-old daughter at home, they didnt believe that bringing another child into the world was financially feasible.

That belief was about to be challenged in a major way.

On the drive back home from the abortion facility, the full force of Ivettes regret came rushing through her.

I started arguing with my boyfriend, asking him why he had convinced me to do it. That I didnt want to, that I hated him, she wrote. And he was just looking at me, and I was crying and crying.

Struck by her words, her boyfriend pulled the car over.

He started telling me I was right, that he was dumb for even talking me into it, that we shouldve done the right thing, she recalled.

Thats when her boyfriend decided to take action. Grabbing his phone, he began searching the internet for a way to save their unborn baby. He came across Abortion Pill Rescue, a 24/7 helpline (877-558-0333) backed by a network of 800 medical professionals offering Abortion Pill Reversal.

Otherwise known as the abortion pill or RU-486, chemical abortions typically involve two drugs: mifepristone and misoprostol. Mifepristone, the first drug, destabilizes a pregnancy by blocking progesterone, the natural hormone needed to sustain a healthy pregnancy. To finish the abortion, misoprostol induces labor, forcing a womans body to deliver the baby.

The reversal protocol, which was developed by physicians George Delgado and Matt Harrison more than a decade ago, works by giving a woman extra progesterone up to 72 hours after she takes the first chemical abortion drug.

Now operated by Heartbeat International, the Abortion Pill Rescue Network (APRN) has saved more than 900 babies to date.

Women who are facing the immediate regret of abortion call the APRN helpline every day seeking hope and options, said Christa Brown, director of Medical Impact for Heartbeat International. They dont give up the right to other choices when they seek an abortion and we are here to help.

For Brown, a womans courage to call the helpline and try to rescue her baby is nothing short of heroic.

One of APRNs main goals is to help ensure that women like Ivette have the opportunity to choose life for their children every step of the way, she said. We are so thankful for the courage and strength of our clients who choose life often under many pressures to continue the abortion. All of our 900 moms are true heroes.

Despite whatever glimmer of hope the helpline offered, Ivette was convinced it was too late for their baby.

I told (my boyfriend), Hang up. This is ridiculous. Theres nothing we can do. What is done is done, and took away his phone as we drove back home, she wrote. I felt sad. I felt mad. I hated myself. I couldnt stop thinking about my daughter I already had and what a beautiful blessing she was coming into our lives.

Tears overwhelmed Ivette for the rest of the day. She could hardly sleep that night. Early the next morning, she searched the internet once more for the Abortion Pill Rescue number.

A really nice nurse answered, Ivette wrote. I will never forget her. She started asking me questions and told me we were still in time to reverse the abortion.

The nurse connected Ivette to a local doctor who provides the Abortion Pill Reversal protocol and advised her not to take the rest of the chemical abortion regimen. The doctors office set Ivette up with an appointment immediately. Together, she and her boyfriend drove 45 minutes to the pro-life clinic.

I felt so much peace as I entered his clinic, Ivette wrote. It had a really big Virgin Mary and a little place for people to pray. I felt hope.

While waiting to be seen, she slipped into the bathroom. Her hope faltered as she saw how much she was bleeding.

I was bleeding so much, and I said to myself, Im losing the baby, she wrote.

But the doctor was still willing to fight for her and her unborn baby. He administered progesterone to her and prescribed more for her to take over the course of the next two weeks when she was to return to the clinic for a follow-up appointment.

Ivettes worries werent gone just yet. The same day she began the reversal treatment, she received a dire voicemail from the abortion facility she had visited. The staff reminded her to take the other four chemical abortion pills the facility had given her and warned that if she continued the pregnancy, her baby would be born with birth defects.

Once more, Ivette turned to the kind nurse from the Abortion Pill Rescue helpline for guidance. Using the research performed by physician George Delgado, the nurse assured her that her baby was at no greater risk of being born with a defect than any other baby.

As the days passed by, Ivette continued to bleed heavily. Nevertheless, she continued to take the progesterone, and after two weeks, she returned to the pro-life clinic.

Ivette nervously watched the screen as the doctor performed the ultrasound. Then, he gave her the news she was longing to hear.

He told me, Theres a heartbeat!!! she said. And there it was on the screen, a little flickering. We couldnt believe it. I looked over at my boyfriend as he smiled and said, We did the right thing.

Ivette continued to take progesterone for the rest of the first trimester. Then, late last year, she met the tiny baby she and her boyfriend rescued all those months ago.

I delivered my baby boy by c-section, and let me tell you, he is the cutest little guy, she wrote. I couldnt imagine my life without my daughter and my son. I love them so much and I know we did the right thing. Thank you, Abortion Pill Reversal, for this second chance.

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I know we did the right thing - Mom and dad reverse chemical abortion, rescue their unborn baby - Pregnancy Help News

More than 20 million Americans have some form of thyroid disease, according to the American Thyroid Association, but up to 60 percent don't know it.

A simple blood test to check your thyroid's hormone levels is all that's needed to find out if you have this disease.

The thyroid is a butterfly-shaped gland in the neck that can have a dramatic impact on your body. It controls your metabolism, regulates your body temperature, keeps your heart pumping, and so much more.

So thyroid disease can occur in one of two ways: you can either have a high-functioning thyroid or hyperthyroidism, or you can have a slow-functioning thyroid or hypothyroidism, said Amistad Community Health Center internal medicine physician Dr. Jacqueline Phillips.

Dr. Phillips said more than 12 percent of Americans will develop an underactive thyroid or an overactive thyroid.

Symptoms you will have if you have hyperthyroid is a rapid weight loss; you will feel nervous, you will have palpitations, or you will feel your heart beating irregular," Dr. Phillips said. "You will also have some diarrhea, and be hot all the time.

"Hypothyroidism is when your thyroid is acting slow and will have opposite symptoms. So people with hypothyroidism will tend to gain weight, feel cold most of the time, you will have hair loss, dry skin, and you will just overall feel tired and fatigued."

People of all ages and races can get thyroid disease. However, women are five to eight times more likely than men to have thyroid problems. In fact, 1 in 8 women will develop thyroid problems during her lifetime.

Your doctor will check two labs, the first lab is TSH and the second lab is a free T4," Dr. Phillips said. "Based off your levels, you will either be diagnosed of having too much thyroid or too little thyroid. If you have too little thyroid (hypothyroidism), it is replaced with a small tablet that contains thyroid hormone. If you have too much thyroid (hyperthyroidism) then what you will need to do is take a medication that will help your thyroid stop making hormone, and then they will refer you to an endocrinologist for further treatment."

Thyroid disorders are fairly common in adults. Fortunately, nearly all thyroid problems can be managed successfully when identified early.

Prevention would be with regular screening, and especially if you are having any symptoms of either hyperthyroidism or hypothyroidism, that you talk to your doctor, and you get the appropriate blood work done, said Phillips.

Dr. Phillips says you should really see your doctor if you are having rapid weight gain or rapid weight loss.

Consider seeing your primary care provider if signs and symptoms of hypothyroidism or hyperthyroidism are present, or if a nodule is noted in the lower front sides of your neck. Your provider will perform a detailed medical history and physical exam.

Workup may include lab tests, X-rays and referral to an endocrinologist. If surgery is needed, you will be referred to an ear, nose and throat, or general, surgeon with expertise in performing thyroid procedures to evaluate and talk with you about your options.

The following are symptoms for hypothyroidism:

The following are symptoms for hyperthyroidism:

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Local News Blood tests are all that's needed to detect thyroid disease Roland Rodriguez 6:33 - KRIS Corpus Christi News

The population of women in Duluth over 45 is estimated by the U.S. Census Bureau at 28,000.

Women most affected by menopausal symptoms are between 45 and 64. My mother, aunts, and grandmother are all of this age and all have weathered their menopausal changes, some with the aid of prescription hormone replacement therapy.

A shared experience is of a healthy, shift-working woman, 45 years old, struggling with significant night sweats and insomnia for three months. She makes an appointment with her primary-care provider, who has been seeing her regularly for health care for the last few years, since after the birth of her daughter. She previously had regular care with her OB/GYN doctor but felt too old for her follow-up routine visits. So she transitioned to a local primary-care provider. At this visit, she hoped to receive some aid for her bothersome symptoms.

I dont have the luxury to be this tired all the time from not sleeping due to these horrible night sweats, she said to her doctor. I need to be efficient at work so I can provide for my family. Is there something I can take or do?

Her primary replied, I have to refer you to an OB/GYN, because I do not have the expertise to manage patients with hormone replacement therapy, which is a treatment that can help you.

She is frustrated because she took off work for this visit and now has to make another visit in the OB/GYN office in three weeks and has an additional drive of 35 minutes. But she complies.

At her next visit, she is struck with how old she feels, surrounded in the waiting room by young expecting mothers and their buzzing children. She meets with the OB/GYN provider, who spends a brief seven minutes with her, and she leaves feeling very comfortable with a new prescription of hormone replacement therapy.

The problem is this common treatment of hormone replacement therapy, or HRT, is not routinely instructed to primary-care providers in their mandatory continuing-education requirements, particularly in low-risk women. Primary-care providers are required to have continued education as part of their licensure to practice medicine.

These providers serving female patients include medical doctors, nurse practitioners, advanced-practice registered nurses, and physician assistants. This problem leads to increased costs and referrals for low-risk patients and a loss of revenue for providers who have the capacity to manage this highly effective and safe therapy for close to half of their patient population.

As a womens-health nurse practitioner, I have heard this common story from many female patients, and it is time for the health care system to listen. All primary-care providers need regular, mandatory continuing education on hormone replacement therapy treatments. This mandatory education should include the large body of evidence that supports the safe use of HRT in menopausal women and the important risk factors when HRT is not appropriate.

HRT can be counseled, prescribed, and managed in low-risk women by primary-care providers.

Regionally, the practice of managing HRT is diverse and is very typical practice in urban settings while much less common practice in rural areas where primary-care providers are pivotal.

My primary-care colleagues continue to ask how to treat female patients who have multiple high-risk factors and who shouldnt be on HRT. My rebuttal is that their keen knowledge is correct: HRT is likely not the treatment for these female patients. A referral to an expert in womens health is highly encouraged for high-risk women. The population of high-risk women is typically amongst younger ages or is found during pregnancy or through routine surveillance in all care settings.

With mandatory continuing education for primary-care providers in managing safe hormone replacement therapy for women, their confidence in the medications and the management of these low-risk women will increase, along with provider satisfaction from patients.

Kelsey Thompson of Duluth is a womens-health nurse practitioner in Minneapolis. She received a bachelors degree in nursing from the College of St. Scholastica. She earned a masters in womens health and a doctorate in nursing from Duke University in North Carolina.

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Nurse's View Column: Health care system failing the women in our families - Duluth News Tribune

Though we associate chilly fall temperatures with flu season, the two are not mutually inclusive.The time in which the flu virus is most contagious is widely known as the "season," and though that time of year usually starts in October and peaks from December to February, flu deaths have already been reported in the United States. While it remains difficult to predict how severe this season will be, it's not too late to create a plan of attack.

Dr. Nodar James, medical director at Upper East Side Rehabilitation and Nursing Center, told Salon that because flu symptoms can develop days after the virus enters the body, it's possible to spread the flu to someone else before know you are sick, as well as while you are sick.

"The flu is spread in a few different ways.One way is through contact with bodily fluid, so if someone with the flu coughs or sneezes and doesn't cover their mouth or nose, anyone who comes in contact is at risk of getting sick," James explained."Most people are most contagious 34 days after the flu begins. However, in some cases you can also infect people even before symptoms begin."

Here are some tips on how to prepare for the flu season.

Get your flu vaccine.

The best way to protect against serious outcomes of the flu virus is to get vaccinated,according to nearly every medical professional or health care expert Salon spoke with for this article.

The effectiveness of the influenza vaccine, which combines four different inactive flu strains, varies from person to person. Recent studies show that flu vaccination reduces the risk of flu illness between 40% and 60% of people.

The flu vaccine is not perfect, mostly because of the number of strains of the virus that circulate, but it can provide some cover. Because flu virus strains evolve every year, medical experts recommend getting vaccinated annually.

Nasal spray is also an option for patients who are needle-averse. In previous years, the American Academy of Pediatrics recommended children be vaccinated with a shot, as some studies showed it was more effective. There is no such suggestion this year.

Wash your hands.

TheCenters for Disease Control and Prevention (CDC)recommends washing your hands frequently and for at least 20 seconds at a time (perhaps sing the "Happy Birthday" song from beginning to end.) When washing your hands, "be sure to lather the backs of your hands, between the fingers, and under your nails," the CDC notes.

"People are more germ-conscious these days so avoiding a handshake is not as rude as once thought, especially during flu season. If you must do it,washor sanitize with yourhands immediately,"Dr. Benjamin Barlow, chief medical officer of American Family Care, told Salon.

Keep your distance.

It's easy to spread germs whenliving in close quarters, especially during the winter months when more people tend to stay indoors. However, doctors recommend avoiding close contact and sharing during the season.

"Since viruses like the flu spread through droplets secreted through coughing, sneezing and breathing, spending hours in close proximity to a person who is sick, breathing in the droplets, is a sure-fire way to get sick,"Dr. Anna Cabeca, a physician and author of "The Hormone Fix" told Salon. "A good combo is to regularly wash your hands, carry a scarf when traveling and perhaps to wear a face mask, especially if you are susceptible, or if you're sick yourself and don't want to contaminate others."

Get enough sleep.

Sleep is critical to maintaining and strengthening our immune system, which is constantly working to quash various kinds of viruses and bacteria. During flu season, doctors advise making sleep a priority and trying to get the recommended 8 hours of sleep each night.

Reduce stress levels.

Relieving stress and anxiety levels is key to increasing your overall health and sense of well-being.Dr. Steve Silvestro, a pediatrician in the Washington, D.C., area and the host of The Child Repair Guide Podcast, said managing mental stress is "one of thebest ways to keep healthy during flu season."

"It has to do with the effects of cortisol on our immune system," he explained to Salon. "We know that a short burst of cortisol say, going on a short run can help the immune system by briefly decreasing inflammation. But when cortisol is chronically elevated, like when we are feeling stressed at work or home for long stretches of time, inflammation in our bodies increases, and our immune system has a harder time fighting off infection."

In that way, taking care of your metal health perhaps by doing something you love, such as spending time in nature can help your immune system stay strong.

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We asked experts how to dodge the flu this year - Salon

Can leftover spaghetti really kill you? Can you actually cough up a blood clot in the shape of your lung? In Yahoo Lifestyle Canadas newest series, What The Health?!, we ask doctors to weigh in on odd health news stories and set the record straight. Be sure to check back every Friday for the latest.

A Sudbury, Ont. woman who spent years in tears as her nose, chin, hands and feet gradually kept getting bigger was shocked to learn that changes to her physical features were caused by a brain tumour.

Rebecca Churan says she couldnt understand why she was inexplicably getting uglier as her jawline and chin continued to grow and her feet went from size 8.5 to 10.

ALSO SEE: Saskatchewan curler dies from rare childbirth condition: What is amniotic fluid embolism?

Over the span of at least a decade, doctors diagnosed the now 29-year-old with a range of conditions including borderline diabetes, polycystic ovary syndrome, anxiety and depression. As her body kept changing, Churan became increasingly desperate for help, visiting another physician earlier this year.

I told this doctor that my face was changing, and I was getting uglier, and that I didn't understand why I was gaining weight since I was barely eating, Churantoldthe Daily Mail. She issued me a blood test and then called me back in and told me I had a pituitary tumour based on the results of that test.

That test measured insulin-like growth factor, or IGF1, which controls tissue and bone growth. Depending on a persons age, a typical reading ranges from 97 to 297; Churans was 1015. Further examination found that she had a benign tumour in her brain on her pituitary gland, which releases hormones that control human growth.

It causedacromegaly, a rare condition in which the body produces excessive amounts of the growth hormone, causing body parts to become abnormally large. The condition gets its name from the Greek words for extremities and enlargement.

When acromegaly begins in childhood, it can lead to giantism, as seen in Andr the Giant and the late actor Richard Kiel, who played the steel-tooth villain Jaws in two James Bond films. When it develops after someone has reached their full height and their bones are already fused, different parts of the body will being to grow and tissue becomes thicker, says DrAli Imran, a professor of medicine in the division of endocrinology at Dalhousie University.

ALSO SEE: What The Health?! British teenager paralyzed after falling from his couch

Acromegaly affects approximately three to five people in a million, with about 2,000 Canadians living with the condition. However, those numbers are likely low.

Many people remain, unfortunately, undiagnosed forever, Imran tells Yahoo Canada. The actual prevalence of disease is much higher what is currently being reported.

The reason is that many of the features of acromegaly are very nonspecific, and others are slow to develop, he explains. For instance, one common feature is the hands and feet begin to enlarge and the facial features begin to enlarge, but the change is so subtle and so slow, it may take many years before somebody notices. If a doctor has not seen a patient for a number of years they can see the difference, but on a day to day level the difference is very hard to notice until it becomes really obvious. Many of the other features like excessive sweating, weight gain, aching joints, and sleep apnea are so common in the general population that most people wont put two and two together. As a result, diagnoses can be delayed from up to 10 years or even more.

ALSO SEE: What The Health?! Woman's ruptured brain cyst originally misdiagnosed as migraines

Other symptoms include skin tags, enlarged tongue, deepening of voice due to enlarged sinuses and vocal cords, headaches, impaired vision, decreased libido, abnormalities in menstrual cycle and erectile dysfunction.

Overgrowth of bone and cartilage can lead to arthritis, while thickening tissue can cause carpal tunnel syndrome. Even organs, including the heart, can enlarge.

Story continues

The most common treatment is surgery to remove the tumour, with the pituitary gland reached through an incision in the noise or upper lip. Sometimes, unfortunately, not all of the tumour can be excised; they can also recur. Radiation and medications are other options, though Imran notes that drugs are expensivein some cases, up to several thousands of dollars a month.

Churan had her tumour removed through her nose. Her hands, feet, and facial features shrunk down to a normal size within months.

Shes going public with her story to raise awareness of acromegaly and encourage people who may be having similar symptoms without explanation to seek medical help. The Canadian Pituitary Patient Association has marked November 1 asAcromegaly Awareness Day.

ALSO SEE: What the Health?! Can you really die from burning your throat on hot foods?

There really is no information other than extreme cases online, Churan said. There's barely any awareness or tools to help people recognize the signs, so many cases are diagnosed as hormonal disorders. I saw the scariest photos of Andr the Giant and others who had not been treated early on during the process. I was mortified, scared, and hopeless.

I had this tumour for over 15 years based on the photos I've looked back over, but I just thought it was the way I was ageing at the time, she said. You must stay positive and find hope in any way you can while fighting. I want people to understand that a simple blood test can often diagnose a pituitary tumour. Dont just accept any diagnosis without digging deeper and asking if something else could be causing it.

Besides the physical effects of the condition, theres the severe mental and emotional toll it can take.

Churan post surgery. Image via Facebook.

What is important is for people to understand is that these rare disorders can be devastating for the people who suffer from them, Imran says, urging people with acromegaly to seek specialist care, such as that available in Nova Scotia. Caregivers and the public need to know how these affect the lives of a small number of people in a very bad way. The major problem which we find is chronic pain, ongoing arthritis, and nerve problems. Even after treatment, many dont feel better.

The psychological impact is just immense, he adds. People who have gone through a lot of health issues end up very frustrated that they havent been able to find an answer and realize their condition was missed for 10 or 15 years and sadly they have to live with this for years. This is not an easy problem; theres no easy fix, but were fortunate to be living in a country where treatment is available.

Let us know what you think by commenting below and tweeting @YahooStyleCA! Follow us on Twitter and Instagram.

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What The Health? Brain tumour causes woman's nose, chin to grow - Yahoo News Canada

A committee for the US Food and Drug Administration now recommends that the approval of Makena, a drug used to reduce the risk of preterm births, should be withdrawn and some women who have used the medication are sounding the alarm.

The 9-7 vote, which took place at a meeting of the Bone, Reproductive and Urologic Drugs Advisory Committee on Tuesday, came in response to evidence suggesting that the drug was not effective.

The committee serves as an advisory group to the FDA and the voting results are not binding, said Dr. Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, who was not involved in the committee meeting.

Most of the time the FDA will make a decision that aligns with the committee, but not always, Gellad said.

One study showed FDA will go against the committee about 20% of the time. But the committee did vote that removal of the drug from the market was warranted, which is relevant for supporting any FDA decision about withdrawal, he said.

An FDA spokesperson confirmed in an email on Thursday that the committee voted 13-3 that there is not substantial evidence of effectiveness of Makena in reducing the risk of recurrent preterm birth, based on findings from two trials that were part of a study called PROLONG, published last week in the American Journal of Perinatology.

Nine members of the committee voted to pursue withdrawal of approval for Makena, and seven members voted to leave Makena on the market under accelerated approval and require a new confirmatory trial.

None voted to leave the drug on the market without requiring a new confirmatory trial.

Makena, sold by AMAG Pharmaceuticals, is a progestin hormone that gets delivered to a patient as an injection. In 2011, the FDA approved the medicine to reduce the risk of preterm birth in women who have a history of spontaneous preterm birth under the provisions of accelerated approval regulations.

Accelerated approval is a mechanism for drugs to be approved by FDA before they have proven benefit. They need to address a high need clinical condition for which there are no or few other therapies, like premature birth, and they have to show some effect on a surrogate outcome an outcome that is reasonably expected to be related to clinical benefit, Gellad said.

As a requirement for a drug that is approved through accelerated approval, the company must perform a confirmatory trial to show clinical benefit. In this case, it took eight years, and the confirmatory trial showed no benefit, he said, adding that many of the patients in the trial were not from the United States.

So one argument from the company is that the trial does not represent effectiveness in the US, and because there are no other drugs available, and a prior study showed effectiveness, and its recommended by various OB/GYN groups, that it should stay on the market and be evaluated in another trial, he said. The caveat is that this treatment existed even before accelerated approval because pharmacies could compound or make the therapy themselves so if the drug leaves the market, there is still an option to use the drug.

Current guidelines in the United States recommend the use of progesterone supplementation, such as Makena, in women with prior spontaneous preterm births.

Last week, when the results of the PROLONG study were published, the Society for Maternal-Fetal Medicine released updated clinical guidance for providers to discuss important factors with patients, including uncertainty regarding the benefit of the drug.

Meanwhile, the American College of Obstetricians and Gynecologists released a statement from its Vice President for Practice Activities, Dr. Christopher Zahn, indicating that ACOGs clinical guidance on the use of the medication will remain in effect.

ACOGs guidance is based on a review of the best available literature. As such, we will continue to monitor this topic, evaluate additional literature and any further analyses as published, and address findings as needed in relevant clinical guidance, Zahn said in the statement.

Danielle Boyce, a mother of four and research consultant based in Philadelphia, had significant preterm labor issues with her first two children, including her eldest son, Charlie. He was born preterm at 34 weeks, developed a seizure disorder as a baby and now has Lennox-Gastaut syndrome, severe intellectual disability and autism, Boyce said.

When Boyce became pregnant for a third time at age 42, she was very concerned about having another preterm birth and made the shared decision with her physician to start using Makena. Her third and fourth children came home from the hospital and did not require a NICU stay. They are both healthy and developing normally, Boyce said.

I am glad that I had the opportunity to use Makena while it was still available because it worked for me, Boyce said in an email on Thursday.

Boyce added that she respects the decision the members of the FDA panel made since it was based on evidence presented to them but noted that studies can be flawed.

As someone trained in epidemiology and statistics, as well as someone who has served on FDA panels myself, I can appreciate the difficult decision that the panel had to make given the evidence presented, Boyce said.

I agree that the study design could have been better and the statistical endpoints were not achieved, she said about the evidence. However, this is a rare case where the stakes are so high and the side effect profile is so low that an additional layer of scrutiny is warranted beyond the statistical evidence presented before a decision is made to pull this effective medication from the market.

Boyce said that she would ask the FDA panel to consider ACOGs judgment.

Meanwhile, there also have been calls for the FDA to ban Makena.

Earlier this month, the consumer advocacy nonprofit Public Citizen submitted a petition to request that the FDA immediately withdraw the approval of all medications containing hydroxyprogesterone caproate (Makena).

Meena Aladdin, a health researcher at Public Citizens Health Research Group, testified during the FDA committee on Tuesday, arguing that maintaining approval of Makena in the absence of any clinical benefits being demonstrated by Trial 002 or Trial 003 would make a mockery of the more than 50-year FDA legal standard requiring substantial evidence of a drugs effectiveness.

In response to the FDA vote, AMAG Pharmaceuticals Chief Medical Officer Dr. Julie Krop said in a statement that the company was disappointed.

We are committed to working with the FDA to identify feasible ways to generate additional efficacy data on Makena while retaining current access to the therapy for at-risk pregnant women, Krop said in the statement.

For more than a decade, health care providers have relied on hydroxyprogesterone caproate (Makena) to reduce preterm delivery in high-risk patients, which aligns with recently updated treatment recommendations of the American College of Obstetricians and Gynecologists, as well as the Society for Maternal-Fetal Medicine, she said.

The medication now remains in limbo until the FDA makes a final decision based on its committees new recommendations.

I predict FDA will remove the drug from the market, since the confirmatory trial showed no benefit, and removing the drug does not necessarily completely eliminate the opportunity for some women to receive the therapy, Gellad said. There is an 80% chance I will be right.

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FDA panel recommends withdrawing approval of Makena drug, used to prevent preterm births - KEYT