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'Minor & James' posts

Should I consider hearing aids if I have hearing loss?

Persons with mild hearing loss often begin thinking about the possibility of seeking help from hearing aids. But they may do so grudgingly because they have heard stories from friends suggesting that hearing aids are never without complications. And it is true. Hearing aids always bring with them a set of advantages and disadvantages. And the degree to which a person will accept and enjoy their hearing aids depends a great deal upon how much the hearing loss is impinging on their enjoyment of life.

If you have been noticing ....

Eating for Two? Nutrition in Pregnancy

You may have many questions when you find out that you are pregnant, but some of the most common concerns revolve around nutrition and food safety. These are some basic guidelines from the American College of Obstetricians and Gynecologists to get you started. As always, your situation may be different and so always discuss specifics with your provider.

How much weight should I gain?

This depends on your pre-pregnancy BMI (body mass index - a calculation from your height and weight). In general, however, if your pre-pregnancy weight is normal you should gain between 25 to 35 pounds. Most women stay within this goal with an increase of only 300 extra calories a day (equal to about 2 tablespoons of peanut butter and one slice of whole wheat bread). If you are underweight, however, you may need to gain more weight, and if you are overweight, less. Your doctor can help you to come up with a specific weight goal.

What foods can't I eat?

Alcohol, of course, is not recommended in pregnancy, but there are other restrictions. Other foods can put you at risk for listeriosis, a bacterial infection that causes miscarriage and stillbirth. Unpasteurized milk and cheese can put you at risk, as can raw or undercooked shellfish, meat, or poultry. Deli meats and hotdogs are okay if they are heated until they are steaming hot.

What about fish?

That depends on the fish! Certain large fish may contain too much mercury to be safely eaten in pregnancy. High levels of mercury exposure in pregnancy may lead to nervous system damage in the unborn child. If you are pregnant you should avoid eating Shark, Tilefish, Swordfish, and King Mackerel and limit your intake of albacore tuna to 6 ounces a week.

You may eat fish and shellfish that are lower in mercury, but no more than 12 ounces a week. If you want to eat fish caught by family or friends from local waterways check for local advisories first, and do not eat more than 6 ounces.

Do I need to take extra vitamins or supplements?

It is important to take ...

Hormone therapy

Symptoms associated with menopause have been treated with estrogen and progesterone for many years. When I went into private practice in 1986, we had been taught that hormones given to postmenopausal women were protective. We prescribed them widely, like they were vitamins. If menses stopped, the next thing to do was to take hormone replacement therapy. We asked patients to let us know when their menses stopped so that we could administer hormone therapy promptly.

Today we have concerns about hormone therapy. The Women’s Health Initiative was a large study that collected data on the incidence of heart disease, stroke, cancer and bone fracture in women taking hormones as compared with women who did not take hormones in menopause. In 2002, a large portion of the study was discontinued because it appeared that women taking estrogen and progesterone were at increased risk for heart disease, stroke and breast cancer.

In 2002 many women went off of hormone therapy and many physicians stopped prescribing it. In the months that followed, many women found that they had symptoms of menopause that interfered with their lives. The consumer media began reporting on natural and bio-identical hormones. Claims surfaced of superior safety.

What are natural hormones?

Are You Up to Date on Your Pap Smear?

Recent changes to Pap guidelines may have you wondering when exactly you need to have a pap smear and in turn, how often you really need an annual exam with your gynecologist. Here I’m going to review the new pap guidelines so you can determine if you are up to date! Of course, every patient should check with their physician about what they recommend regarding the timing of cervical cancer screening because some specific populations may have different recommendations. These are just the general guidelines.

Pap smears are a screening test for cervical cancer. They have helped decrease the incidence of cervical cancer by more than 50% in the last 30 years. Over the last decade we’ve also begun testing for HPV (or Human Papillomavirus) which is by far the most common cause of abnormal pap smears and cervical cancer. It is an incredibly common sexually transmitted virus that can be spread by genital to genital contact but also oral to genital and manual to genital contact. It has been estimated that 75 to 80 percent of sexually active adults will acquire a genital tract HPV infection before the age of 50. Luckily, most HPV-infected women, especially younger women, will mount an effective immune response to the virus and will never develop dysplasia or cancer.

HPV is not like herpes —YOU CAN GET RID OF IT! The amount of time it takes to get rid of the virus varies but most experts think it takes an average of 8-24 months. Women with persistent HPV infections are more likely to get dysplasia and if it goes undetected or untreated, over time it can develop into cancer. HPV infections of the cervix do not cause symptoms and can only be detected by pap screening. Unfortunately we don’t have a cure for HPV, but vaccinations are available and FDA approved for girls and now boys ages 9-26. More on HPV is sure to show up in future blog posts, so stay tuned!

The American College of Obstetrics and Gynecology (ACOG) recommends starting pap screening ....

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