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expert advice

Smiling woman undergoing mammography
 by Victoria Santalesa

Guidelines For Female Mammography

You’re a big girl now. You pick out your own clothes in the morning, you make your own lunch, you go to sleep when you want to, and you book your own doctor’s appointments – but that’s not to say you have no questions about them. If you’re nearing the age of 40, you’re probably wondering if you should be booking your first mammogram, and with the conflicting information from medical groups, you may wish that someone would make the decision for you. If you’re nearing 40 and are a little confused about the issue of when to get your first mammogram, here are some guidelines that may provide some clarity.

When Should I Start Getting Mammograms?

The best course of action in deciding whether or not to get a mammogram is to check with a doctor. He will take your age, family, and other things into account to determine whether a mammogram is something you need to have done sooner rather than later.

The Conflict

If you look at the advice from medical groups, you will find a lot of conflicting information. While the American Cancer Society has been urging women for years to start having mammograms at 40, it is now recommending women to starts at 45, or 40 if the patient prefers. The American College of  Obstetricians and Gynecologist are holding fast at 40, while the US Preventative Services Task Force are saying women can put mammograms off until 50.

Who’s Right?

Therese Bevers, MD says there are pros and cons to starting early and upsides and downsides to waiting a few years. Here are some of the things you may want to consider in determining when to get your first mammogram.

False positives

A false positive means that a mammogram shows something that looks suspicious, but turns out to be harmless. This is more likely to happen in younger women. Premenopausal women tend to have dense breasts which can make mammograms difficult to read, and getting called back for another mammogram can be very stressful.

Earlier testing also means more cancers can be found. Although that may seem like a good thing, some cancers grow so slowly that there unlikely to affect you, however, doctors may not be able to tell which ones will turn to be problematic, and which will not. This can result in women seeking and receiving cancer treatment they really don’t need.

Early Detection

The biggest upside of starting your mammographies at 40 is that you are less likely to die of breast cancer, which is why Beavers still urges women to start at 40 and get checked on a yearly basis.

Weighing the Pros And Cons

In trying to decide whether or not to start your breast examinations at 40, ask yourself how you would feel if you got a false positive. One survey found that one-third of women would be willing to deal with false positives if it meant avoiding breast cancer.

Also, consider how you would feel if you ended up receiving cancer treatment you didn’t need. One study showed that as many as ten women may be getting over diagnosed for each avoided death.

You also may want to take into account whether or not there is a family history of breast cancer. If breast cancer is common in your family, you may want to start having the checks even earlier than 40.

However, even if breast cancer is not a genetic concern for you, it is still important to have mammograms done. Cancer doctor Dennis Citrin, MB, Ph.D. says, “Eighty-five percent of all breast cancers are not related to a specific gene mutation,” and adds that women who get mammograms regularly are 20% less likely to die from breast cancer.

What do you think? Should you start getting mammograms at 40, or is it better to wait?

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Unhappy woman taking pills
 by Victoria Santalesa

Antibiotics May Be Linked To Miscarriage

According to the March of Dimes, up to 10% of expecting moms will get a urinary tract infection or UTI, during their pregnancies. Of these, about 25%, if left untreated, can develop into kidney infection, which can life-threatening for both mother and child. However, the good news is that as long as a UTI is caught early enough, it can be easily treated with antibiotics, right? Well, yes and no. While antibiotics can be a safe and effective treatment for UTIs, there are some new revealing studies that pregnant women will want to know about before taking them.

Antibiotics and Miscarriage
A recent study published in the Canadian Medical Association Journal has found some eye opening links between antibiotics and miscarriage in pregnant women. The prevalence of UTIs in pregnant women and their likelihood to be treated with antibiotics make this an issue of concern. A study done by researchers at the Universite de Montreal collected data from 182,369 pregnant women in Quebec between the years of 1998 and 2009, 8,702 of which ended in miscarriage before the 20th week of pregnancy. Of these, 16 percent occurred after the women took antibiotics.

Antibiotics to Avoid
Although all of this may be enough to scare you off antibiotics during pregnancy entirely, you should know that there are some medications which are higher risk than others. The most dangerous drug classes are tetracyclines, which is used as a treatment for acne, and quinolones, which can be used on a variety of infections, and was a common culprit in causing miscarriage, increasing its likelihood by three times. Clarithromycin, prescribed for pneumonia and bronchitis multiplies the risk by two. Azithromycin, used for infections of the respiratory system and some STIs, increased the of miscarriage risk by 60%, while metronidazole, used to treat bacterial vaginosis, increased the chances by 70%. Trimethoprim and sulfamethoxazole upped the risk by 25%.

Expert Advice
While it may seem as if there are no safe alternatives, Sherry Ross ob-gyn at Providence Saint John’s Health Center has some insight on the subject: If you notice symptoms of UTI, you definitely want to inform your doctor; if left untreated they can lead to preterm birth, kidney infection, and preeclampsia. Your doctor should recommend going with safer antibiotics, such as nitrofurantion, cephalosporin, penicillin, and erythromycin. All of these are safe antibiotics with a broad range of uses. Ross says, “Most important is to make sure you discuss the pros and cons of UTI options with your obstetrician and ways to avoid recurrent infections during the rest of the pregnancy, If you are trying to conceive and are unsure of your pregnancy status, you would want to make sure you are taking the antibiotics not associated with an increase in miscarriage risk.”

Have you experience UTI during pregnancy? How did you handle it? What’s your expert advice? Let us know!

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Woman with lower back pain
 by Victoria Santalesa

Embrace Massage For Lower Back Aches and Pain

According to the principles of yoga, the inner spirit, or kundalini, is symbolized as a coiled snake at the back of the spine. When it is awakened, the snake moves upward and a burning flame shoots through your chakra. Thus, if you practice holistic healing, lower back pain may be an indication that your root chakra is ungrounded. If you don’t subscribe to this philosophy, however, you may just think that your lower back really hurts.

Either way you look at it, a lot of people suffer from lower back pain and most can agree that massage is a good way to relieve it. But, how does the medical world weigh in on the possibility of massage as a real world treatment for chronic back pain? Read on to find out.

Benefits of Massage for Chronic Lower Back Pain
William Elder is the principle investigator of a recent study on the benefits of massage therapy for lower back pain. He says, ” Current medical guidelines actually recommend massage therapy prior to the use of opioid medications for lower back pain.Yet, even with those guidelines, physicians and nurse practitioners are not recommending massage therapy.”

Lower back pain is a common problem, but it usually goes away relatively quickly, However, for about 15 percent of sufferers, it can be a more long term problem. For long term sufferers, treatments generally include prescription opioid painkillers, exercise, behavioral changes, steroid injections, acupuncture, and surgery. Recently researchers have begun to explore massage as another possibility.

Woman having a massage

The study included over 100 volunteers paired with approved massage therapist who expertly assessed the patient’s problem and created a suitable treatment plan. The participants received ten treatments and were reevaluated after 12 weeks. Findings showed more than half of the volunteers had less pain after 12 weeks and continued to report a reduction in pain over the following three months. Said Elder, “The results are exciting because it shows that most doctors can refer their patients for massage as a treatment. It’s applicable in the real world.”

The Medical World
Dr Anders Cohen also believes in the possibility of massage as a solution for lower back pain. The neurosurgery chief at the Brooklyn Hospital recommends massage therapy to his patients as a part of his comprehensive treatment plan. “Massage is a great way to break up adhesions and is great for soft tissue, If the back pain is a soft tissue issue, such as muscles and ligaments, it works great. Plus there is the bonus of a therapeutic touch,” he says.

Tips for Effective Treatment
Study co-author Niki Munk give some advice for those seeking massage treatment for lower back pain. She advises that massage needs to occur regularly until a level of general comfort is achieved, and then patients can manage their back pain on a schedule that suits their needs. Munk recommends finding a therapist that you can develop a good relationship with. ” Chronic low back pain is a complex issue that can’t be cured from just a one-hour massage. Find a therapeutic massage clinic and asks questions about the therapist, such as their initial training and continuing education. Also, make sure the therapist sets up a treatment plan that works for you.”

What do you think of massage as a way of treating lower back pain? Let us know how powerful you think the power of massage can be.

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Woman checking pills
 by Victoria Santalesa

A List Of Items To Toss From Your Medicine Cabinet ASAP

Humorist and author Erma Bombeck once famously wrote, “My theory on housework is, if the item doesn’t multiply, smell, catch fire, or block the refrigerator door, let it be.” Operating on this logic, one could make a case for neglecting to clean out the medicine cabinet. After all, it’s highly unlikely you’ll find your antibiotics overrun with germs, right? Although there may be some attractive qualities to this theory, there may be some detriments to leaving your medicine cabinet unexamined for too long. The AMA recommends that you clean out your medicine cabinet once a year, and with spring cleaning upon us, this may be an ideal time. Here are some guidelines on doing just that.

What to Discard
Sara Bingel, PharmD, clinical pharmacist at Mount Sinai Hospital says, “In general, I would say many oral medications are safe to take a year or two beyond their marked expiration date.”

Items to save after expiration include pain relievers, allergy medications, like Benadryl, aspirins, stomach medications, like Tums, headache pills, and cold and flu pills.

Items to toss include itroglycerine for chest pain, life saving medications, antibiotics, liquid/suspension medications, and children’s meds.

Life-saving Drugs
When it comes to lifesaving drugs, it is crucial to heed expiration dates. The FDA requires medication manufacturers to find out how long it takes for drugs to reach a potency of 95%; after that, it is expired. That means that, when it comes to life saving meds, it’s all about getting the right amount into your body. Says Michael J. Negrete, PharmD., “I might be willing to roll the dice with cough syrup. It’s no big deal if the potency is down and it doesn’t help my cough. But imagine, with an Epi-pen, which keeps people from going into anaphylactic shock, not working.”

Woman at medicine cabinet

Store Meds Well
Expiration dates operate on the assumption that the unopened package is being kept in a cool, dry, dark place. While an untampered with package of Benedryl stored in a dark drawer in dry conditions is likely to be effective for years after its expiration date, one stored in a humid bathroom may be a very different story.

Take Visual Cues
When it comes to determining what to throw out of your medicine cabinet, there are some things you can judge for yourself. You don’t want to take a pill that crumbles in your hand and ineffective aspirin tends to smell like vinegar. Negrete advises that you, “Be suspicious of anything that looks out of the ordinary.”

Hold On To Solids, Lose the Liquids
Liquids, gels, and suspensions (in which the active ingredients is suspended in a liquid) tend to lose their potency more easily than pills and are also at risk of bacteria contamination, Bingel says, “Think rancid milk.”

Toss Children’s Meds
Paul Langevin, MD., director of cardiac anesthesiology at Waterbury Hospital comments, “Because children are smaller and their metabolic systems aren’t fully developed, I wouldn’t hang on to kids’ meds past the expiration date. Plus, a lot of medications for children are prepared in suspensions so the kids will take them and those flavored liquids can decompose and acquire bacterial growth.”

Are you cleaning out your medicine cabinet once a year? When the last time you went through your meds was.

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Woman reading bedtime story to child in bed
 by Victoria Santalesa

Improve The Bond With Your Children By Reading Them A Bedtime Story

“A person’s a person, no matter how small.” What a lovely thought for a child to contemplate. This is a quote f5om Dr. Suess’s “Horton Hears A Who!” If you’ve ever read to your children, you do not need to be told that it is the right thing to do. Reading to your children is an act as natural as breathing. It becomes obvious with each question they ask and each phrase they memorize. However, if just the act in itself isn’t enough to convince you, here are some more scientific examples of how your relationship with your child is enriched by sharing bedtime stories.

The Research
According to the Reid Lyon, the behavior branch chief of the National Institute of Child Health and Human Development, “Neural research shows that when parents and caregivers interact verbally with children–which includes reading to them–kids learn a great deal more than we ever thought possible.” Reading to a child can help the child develop morals and creativity, and children are never too young to start.

The Benefits

Woman reading to child

Develops Communication
Reading a story to your baby helps them to develop their listening, memory, and language recognition skills. It is also a good way to give them the chance to hear words they might not hear otherwise, especially ones which are less likely to come up in everyday speech. Bedtime stories can also improve a child’s memory. You will find that with repetition, children will begin to remember dialogues and story lines, and will often chime in with a spoiler or two.

Creates Routine
Children like to know what’s coming next. Reading a story is an assuring way of letting your child know its time for bed. Not only does the routine element keep stress levels down, the activity itself calms them and helps them sleep better at night.

Increase Imagination
Sometimes, it is hard to believe children’s imaginations need any stimulation, but listening to a story and looking at pictures gives them ideas and helps to motivate their creativity. Reading to children encourages them to question behaviors and develop comprehension skills and increase general cognition.

mother daughter

Stronger Bond
If you’re a parent you know that nothing is better than cuddling up with your child after a long day. Adding books to that experience can strengthen the bond between you by engaging in a shared activity.

Good Habits
When you read to your children, you are instilling them with a love of books. You are their greatest inspiration and the behavior you model is the behavior they’ll imitate. Although it may be hard for busy parents to carve out time to read to their children, bedtime can be a great opportunity to pass on an invaluable gift.

What are your children’s favorite bedtime tales? Let us know what you recommend for giving children the sweetest dreams.

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Woman sneezing into napkin
 by Victoria Santalesa

Living With Seasonal Allergic Rhinitis

Does this season have you doing the allergic salute? The allergic salute, also called the nasal salute, is defined as the gesture of wiping or rubbing the nose in an upward manner with the fingers, palm, or back of hand in and upward motion, and is a common telltale sign of allergic rhinitis.

Suffering with allergies is no fun, and while “saluting” can relieve the symptoms, it can also lead to the transfer of bacteria and germs, and, when done often enough, can result in a “transverse nasal crease,” (a crease running across the nose) which can become a permanent feature. But, worry not. Allergic seasonal rhinitis does not have to doom its sufferers to a life of inevitable unsightly scars. There are some ways to handle the condition salute free. Read on to find out how you can survive the season uncreased.

What Is Allergic Rhinitis?
More commonly referred to as allergies or hay fever, allergic rhinitis happens when your immune system has an extreme reaction to air particles that you breathe. Your immune system reacts by attacking these particles, also called allergens, which causes symptoms, like runny nose and sneezing.

Unfortunately, people with allergies can suffer from the symptoms for many years. They may occur at certain times during the year or at random times. Sinusitis and ear infections are other allergy related problems. Symptoms may become less severe over time and allergens may have less of an effect.

Symptoms
Some of the most common symptoms of allergic rhinitis are repeated sneezing, especially right after waking up in the morning and a runny nose with post-nasal drip. The nasal drainage is usually thin and clear, but may become thick, cloudy and yellowish if there is a sinus or nasal infection involved. Other signs of rhinitis are watery and itchy eyes and itchy ears, nose, and throat.

How Is It Caused?
Pollen from grasses, trees, and weeds is the biggest cause of allergic rhinitis. Dust mites, cockroaches, animal dander, and mold are also triggers, as are things in the workplace, such as chemicals, cereal grain, and wood dust.
If your allergies are due to pollen, your symptoms are more likely to occur when pollen levels are high. If you are affected by indoor allergens, such as dust mites, your symptoms may occur more frequently.

Treatment
While there is no cure for allergic rhinitis, avoiding the causes of your allergies can significantly reduce symptoms. This may require frequent house cleaning to eliminate animals dander, mold, and dust. You may also want to stay indoors when the pollen count is high.

Over the counter medicines are available, but you may want to talk to your doctor first is you have another existing health condition. or are pregnant or breastfeeding.
If allergies are severe, immunotherapy, such as allergy shots, is another option for prevention or reduction of symptoms.

How are you surviving this allergy season? Are you doing the nasal salute, or perhaps you are giving your allergies quite a different salute. Let us know what you do to cope.

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