Archive for the ‘Uncategorized’ Category

It’s an incredibly good time to avoid an unintended pregnancy

Monday, September 28th, 2009

UNINTENDED PREGNANCY AND FLU

One (1) million of the 10 million women who will have intercourse tonight  do NOT want to become pregnant BUT will use no contraceptive (10%).

 Approximately half of all unintended pregnancies are in women using no contraceptive at all.  All of the 1 million women who will have intercourse using no contracceptive at all tonight, but do not wish to become pregnant, have ffour readily available options: abstinence, outercourse, a condom or withdrawal.

Were a condom used correctly by a woman tonight her risk of pregnancy would be 1 in 4,000. Here is how that 1 in 4,000 risk is calculated:

  • The perfect user failure rate for using condoms is 2 pregnancies among 100 couples using condoms perfectly for a year PERFECTLY… no mistakes. Perfectly means using a condom every single time, placing the condom on the penis before there is any vaginal penetration and removing the penis from the vagina as soon as ejaculation occurs.
  • This means 2 pregnancies in 100 couples each having intercourse about 80 times a year or 4 pregnancies from 100 X 80 or 8,000 acts of intercourse.
  • 2/8,000 = 1/4,000. THIS  IS THE FAILURE RATE FOR A SINGLE ACT OF INTERCOURSE USING A CONDOM CORRECTLY.  NOT TOO SHABBY!

A couple using withdrawal perfectly ONCE has a risk of 1 in 2,000 of becoming pregnant.  Were withdrawal used correctly tonight by a woman and her partner, her risk of pregnancy from that one act of intercourse would be 1 in 2,000.  Here is how that 1 in 2,000 risk is calculated:

  • The perfect user failure rate for withdrawal is 4 pregnancies among 100 couples using withdrawal for a year PERFECTLY… no mistakes.
  • This means 4 pregnancies in 100 couples having intercourse about 80 times a year or 4 pregnancies from 100 X 80 in 8,000 acts of intercourse.
  • 4/8,000 = 1/2,000
  • A couple using withdrawal perfectly ONCE has a risk of 1 in 2,000 of becoming pregnant.

Couples who choose to use outercourse or abstinence tonight would have no risk for pregnancy at all.

Another day we will discuss IUDs, Implanon implants, male and female sterilization and several other effective contraceptives women wanting to avoid unwanted pregnancies can use.

Right now  is an incredible good time to avoid an unintended pregnancy.  It is flu season.  Both seasonal flu season and swine or H1N1 flu threaten pregnant women. Last year only only 15% of pregnant women were immunized against seasonal flu.  Public health officials are not expecting this percent to be much better this winter.  And they are estimating that only 5% of pregnant women will be immunized against the new H1N1 flu.  Miserably low numbers.

Since the swine flu has been upon us, 6% of deaths attributed to this virus have been pregnant women but only 1% of the population has been pregnant. So the H1N1 virus is dangerous for pregnant$$ women.  And the problem for the developing baby is that premature births are more likely if a woman has been infected with the H1N1 virus during pregnancy.  So there are problems for mother and child.

BOTTOM LINE: Unintended pregnancy is never desireable.  But with two flu epidemics about to descend upon us NOW is an incredibly good time to avoid an unintended pregnancy. 

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Stress is all about us… Everywhere!!

Sunday, September 27th, 2009

Stress is everywhere

Robert A. Hatcher MD, MPH     

September 27, 2009 

Stress is all about us.  It creeps into our lives like fog the day after a rainstorm.  Stress seems to taunt us with the refrain: “Stop me if you can.”  But sometimes it seems almost impossible to stop.  Sometimes it enters our lives from unexpected quarters. Sometimes we can see it a-coming and run from it! Sometimes we bring it on ourselves. Sometimes it happens in response to something completely beyond our control.

So where does all this leave us? Hopefully, it does not lead us to paralyzing uncertainty. Stress is undoubtedly a major cause of disease – a formidable foe for a person trying to be healthy! 

No one has written my destiny for me or your destiny for you. No one has written my plan for today for me or your plan for today for you. Each person’s response to the stress in her or his life is going to be an important determinant of his or her health.

What are the diseases linked to stress?

  • Heart disease
  • Hypertension
  • Ulcers
  • Cancer
  • Accidents
  • Depression
  • Suicide
  • Anxiety attacks
  • Eating disorders (too much and too little)
  • Some kinds of headaches
  • Failure of women to ovulate (and therefore infertility – more on this in an upcoming column)
  • Poor school and job performance

What are some ways to lower the stress level?

  • Deep breathing is a part of virtually every stress reduction program for the past several thousand years
  • Prayer and meditation
  • Exercise is important for health and some of the healthiest aspects of regular exercise are the benefits of exercise in terms of stress reduction
  • Carrying a book at all time so that frustration from delays while driving, waiting rooms, lines, broken appointments, and waiting for the completion of car repairs becomes a treat rather than an event that raises your blood pressure
  • Carrying a charged up cell phone may also let you make a call you have been wanting to make diminishing your frustration from a delay
  • Daily meditation
  • Counting to ten when beginning to become angry

 

The serenity prayer outlines the two approaches you and I can take in the face of each stressful event, experience or relationship we face today. This short prayer helps many millions of people every day by encouraging us to accept things we cannot change and to have the courage to change things we can change.

But let us not give stress a 100% negative rating. It is certainly true that stress may have some beneficial motivating effects.  Stress can keep our nose to the grindstone if we are taking organic chemistry course, a tough math course or a daunting creative writing course. Stress can heighten our awareness in some dangerous situations where awareness is essential. Stress may cause us to eliminate procrastination. Stress may help us to visualize the best course of action for a given situation.

Stress can help a woman who is being beaten and sexually abused to see the wisdom of leaving that man. In Rabun County she should call FAITH. And stress can help a person prepare for a difficult speech (in most surveys found to be the most stressful experience a person can be faced with).

But for the most part stress is something I hope to minimize in my life today.

 

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Serenity Prayers Help!

Saturday, September 26th, 2009

Serenity Prayers Help!

Robert A. Hatcher MD, MPH

It’s amazing how often we find ourselves grasping at straws as we try to work through our approach to a difficult issue.  We may feel our heart pounding away down in our chest. Were we to take our pulse it might be frighteningly high.  Sometimes what helps so much is several deep breaths followed by the serenity prayer:

God grant me the serenity to accept the things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference.

Here’s a situation: A beloved person is dying of cancer.  She has come to the point when she, herself, her husband, her physicians and her minister have all decided that no more treatment is the best course. This is also what her children and her sister and brother reluctantly agree is now the right course of action.  So there is unanimous agreement with the decision that they must accept the reality that death is approaching sooner rather than later. Hospice is now involved and is helping so much.

All seem to agree that they must have the serenity to accept a reality they wish were not upon them. The question remains: what are the right steps they must have the courage to DO?   

In other words, what does the second half of the serenity prayer say to the family of this dying person?  They might conclude that what would help the most is simply for them to be there with her. To remain in relationship with her.  To pray with her. To express love and gratitude to her for her glorious life.  For all to have a sense of humor.  And sometimes it is the dying person who feels most comfortable injecting the humor. 

Diane Grant, over in Salem, South Carolina was at the bedside of her dying mother. They had been praying with her. She was eating almost nothing. She asked her mom if she was ready to die.  Her mom quipped back: “Can I finish my jello first?”

What often comes to my mind when involved in everyday decisions as well as difficult situations is that the serenity prayer could help me sort things out. Sometimes this helps me distinguish what I must have the serenity to accept and what I must have the courage to do.   

This prayer is on the lips of some people almost constantly. Each day, it seems, there are so many causes of stress in our lives.  Some days we work too many hours.  Sometimes we are too much into blaming. Sometimes we are afraid.  Sometimes we are in doubt.  Sometimes we don’t know how to help a loved one who is hurting.  The serenity prayer is remarkable.  Often it can  nudge us in the direction of a wise course of action.

Try it five times today!

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Are NuvaRings affected by vaginal medications?

Saturday, April 11th, 2009

Question: I just switched from the patch to NuvaRing. I have problems with recurrent yeast infections. To maintain vaginal pH, I have used intra-vaginal medications Fem PH or Relagard. Is it okay to use this medication with the NuvaRing or are the acids in it damaging to the ring?

Answer: NuvaRings are not affected by the vaginal meds you are currently using.

From the chapter on NuvaRings in Contraceptive Technology:

Vaginal symptoms. In clinical trials, the most common reason for discontinuation was vaginal symptoms or problems related to ring use, such as ring expulsion, foreign body sensation or coital problems, occurring in 1-2.6% of women. Other self-reported vaginal symptoms include vaginitis, leukorrhea, and vaginal discomfort. In a recent randomized comparative trial, however, the only vaginal symptom significantly associated with NuvaRing use was vaginal wetness; 63% of ring-users reported vaginal wetness compared with 43% of COC users. Microbiological evaluation showed ring use to be associated only with an increase in hydrogen peroxide producing Lactobacillus.

Vaginal symptoms

Advise women that they may perceive more vaginal discharge or wetness while using the ring, but that this does not signify infection. Counsel them that there is no increased risk of vaginal infection with     NuvaRing use. However, if a woman complains of vulvovaginal itching or a foul odor, she should be evaluated and treated as needed.

Low steady release of hormones: The ring has a steady release rate, providing a low and consistent release of hormones. Although the ring users have progestin levels similar to those of COC users, their EE levels are lower: two-fold lower than those in women taking 35 µmg EE COCs and three-fold lower than those in women wearing the patch. One recent study found that, in the first 3 months of use, fewer patients called about side effects from the NuvaRing than they did about the patch or COCs. Pharmacokinetic parameters are only surrogate endpoints, however, and may not necessarily reflect a decreased risk of estrogen-related side-effects or long-term risks.

Excellent cycle control: Compared with COCs, the ring is less likely to produce irregular bleeding, especially in the first few cycles. Most vaginal ring users experience withdrawal bleeding on schedule.

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