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Information on emergency birth control

Anita Tourigny, ARNP

Anita Tourigny, ARNP
Nurse Practitioner, Minor & James OB/GYN

Oops, the condom fell off or broke. Oops, you went away for the weekend and your birth control pills stayed home. In the past, women ran the risk of an unintended pregnancy when birth control was not used or failed.
 
Emergency birth control has been available for many years, starting with medicine approaches that were not approved by the Food and Drug Administration. In 1999, Plan B, levonorgestrel pills taken by mouth, was approved for use by prescription and in 2006 was approved without prescription for women 18 years old and over. It was approved for those 17 and older in 2009 without prescription. In late February, 2014, FDA approved over the counter sales of generic emergency contraceptives without proof of age.
 
Another  ...

How to get the most out of your OB/GYN appointment

Emma Grabinski
Unless you are having a baby, seeing an OB/GYN often makes women feel very nervous.  This can lead to forgetting questions, forgetting important information about your condition and leaving feeling dissatisfied.

In order to get the most out of your appointment here are some simple tips:

1. Come prepared!
  • Bring a list of your medications; this can help us be sure that anything we prescribe will be safe for you.  Your problem may also be related to your medication – for example, blood thinners can cause heavy periods.
  • Know your family history. Things that are important for OB/GYNs to know include family member with blood clots, recurrent (more than 3) miscarriages, family members with cancer of the breast, ovary, uterus or colon (bowel.)  It is also helpful to know the age they were diagnosed.
  • Bring a list of questions! The more you ask, the more you’ll know.  We want our patients to be well informed so that we can help you make the right treatment plan for you. Also, there may not be time to go over everything in one appointment so make sure you start with what is important to you.
2. Check your inhibitions at the door!
  • Trust me, we have seen and heard everything and there is very little than can shock us! It is important that you are open and honest so that we can make sure we understand exactly what is going on to come up with the right diagnosis. 
  • It is likely that ...

New nutrition labels, same healthy eating advice

Dinesh Thekke-Karumathil, MD

Dinesh Thekke-Karumathil, MD
Pediatric Hospitalist

We all know that as a nation, we are getting bigger and heavier. Worse still, our future - our children- are becoming obese and unhealthy at increasingly younger ages. For decades, the scourge of obesity was blamed on a high calorie, high fat diet. Turns out, we have probably been doing it wrong all these years and our bulging waistline attests to this colossal failure. Research and the medical community now have increasing evidence that the real villain of the story is a very sweet little molecule called fructose. Fructose is what gives us the sweetness in table sugar (sucrose)…also in brown sugar, honey, agave, and of course, high fructose corn syrup. Call it by any name, but sugars are dangerous to our health. Fructose is addictive, much in the same way as alcohol and illicit drugs are. In fact, sugar (fructose) metabolism closely replicates alcohol metabolism except for the acute effects on brain. Sugar has been likened to alcohol without the buzz!

You may already have heard about First Lady Michelle Obama’s work with the FDA which has led to newly proposed changes to nutrition labels on packaged foods. The amount of sugars, specifically, “added sugars” will be part of that new label. I am not implying that a zero added sugar diet will be the panacea for the pandemic of obesity and ill health. We still need to eat healthy and exercise right. There is no magic pill, no startling new advice. Remember what our grandmothers used to say:
 

Nutrition spotlight on quinoa

Sarah Lawson, RD

Sarah Lawson, RD
Registered Dietitian

This week the Registered Dietitians and Diet Technicians offered up a unique spin on quinoa for National Nutrition Month. Many of you reported you have had it as a side dish at dinner or in a salad for lunch. However on Wednesday, we served quinoa for breakfast! Spiced up with cinnamon, cloves, ginger, and cardamom, the sky is the limit for extra add-ins to further boost the nutrition of your morning meal.

Additional Flavor Ideas to Mix and Match:
  • Chopped nuts (walnuts, pecans, hazelnuts, almonds, etc)
  • Diced apple or pear
  • Banana slices
  • Mixed berries
  • Dried fruit (raisins, dried cranberries, prunes)
  • Almond or peanut butter
  • A tablespoon of flax seed or chia for healthy essential fatty acids
  • Honey, maple syrup, or agave nectar for sweetness
  • Scrambled egg for protein
Technically considered a seed (not a grain), quinoa is gluten-free and a complete source of protein. A serving provides a good source of dietary fiber, iron, magnesium, phosphorus, and zinc. Quinoa is also packed with B-Vitamins including folate, thiamin, riboflavin, and B6. Try substituting quinoa for pasta or rice at meals to change things up and increase the nutrition ..

To Mammogram or Not to Mammogram? A note on recent studies

Mary Kelly, MD

A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.

Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.

There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.

Secondly ...

Weak link between epsilon toxin and MS

James D. Bowen, MD

A recent article has been published suggesting that MS may be caused by a bacterial toxin. The bacteria is Clostridium Perfringens, a common bacteria found in soil and a cause of food poisoning. This bacteria can produce a number of toxins, one of which is the epsilon toxin.

This study found that about 10% of people with multiple sclerosis (MS) had antibodies to the epsilon toxin, compared to 1% of people without MS. In pathology specimens from mice, the epsilon toxin was found to bind to blood vessels in the retina of the eye, and to myelin in the brain. The authors also reported a single case of a woman with MS who was infected with Clostridium Perfringens and that was producing the epsilon toxin.

Though this study has been widely discussed online, I think that it is unlikely that this will be the answer to the MS problem. This study was primarily in pathology tissue, which found that the toxin was able to bind to myelin. Many more studies will be needed to determine whether this toxin is capable of causing damage to myelin of the type that is seen in MS. There are many other known toxins to myelin, but so far none seem to be the cause of MS.

They tried to show that ..

Adding kale to your repertoire

Sarah Lawson, RD

Sarah Lawson, RD
Registered Dietitian

Thank you to everyone who stopped by for the first week of National Nutrition Month yesterday! It was a big success and you made it possible! The overall feedback we received was very positive for the Kale salad we shared, even those who thought they didn’t enjoy kale! This proves a great example of exploring new, nutritious foods to add to your current diet that you might not have tried (or liked) before.

For those who found the below recipe too salty, you can reduce the sea salt to 1/2 teaspoon and add just ¼ cup of gorgonzola cheese. The sea salt is pertinent to “massage” the kale which helps tenderize the leaves. You may also substitute gorgonzola cheese for a reduced-sodium goat cheese or feta instead. Enjoy!

Massaged Kale Salad


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