Pain-free hands

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Q. Glen, I have soreness in my hands ! Do you have any suggestions?


A. Many of us take our hands for granted — until pain or loss of function transform even a simple task into a painful ordeal. Arthritis can make it difficult to button a shirt or carry a shopping bag. Carpal tunnel syndrome can interfere with work or hobbies. Hand or finger deformities can make basic self-care routines such as getting dressed or brushing teeth difficult.

Hands are highly visible, so hand pain, swollen joints or finger deformities can cause embarrassment and feelings of helplessness. Problems of the hand range from the mechanical to the neurological. Two leading causes of pain are arthritis and carpal tunnel syndrome, but lupus, gout, cysts, tendonitis, and other injuries can also impair hand function.

Today, nearly one in three adults has arthritis or other chronic joint problems. The key symptoms of arthritis of the hands are stiffness, swelling, pain, and loss of motion and function, making it the leading cause of disability among Americans.

Although there are more than 100 different types of arthritis, the most common by far is osteoarthritis, sometimes called degenerative joint disease. An estimated 21 million Americans, mostly middle-aged and older, have osteoarthritis. In addition to the hands, osteoarthritis typically strikes the knees, hips, feet, and back. Many factors can increase the likelihood of developing osteoarthritis.

Muscle weakness and a history of joint injuries caused by sports or accidents may also make a person more prone to a type of osteoarthritis known as traumatic arthritis. Ordinary, repetitive activities such as typing or playing a musical instrument may worsen arthritis symptoms, but they do not cause osteoarthritis of the hands.

Carpal tunnel syndrome is another cause of hand pain. It affects nearly 2% to 3% of all Americans and is more prevalent among women, affecting nearly twice as many women as men. The classic symptoms are pain, weakness, and tingling in the thumb, index finger, middle finger, and half of the ring finger. Often, these symptoms occur at night and awaken you from sleep. Sleeping with the wrists flexed — a common habit — can contribute to the nighttime symptoms. After you awaken, you may need to shake your hand to restore normal feeling. Some people say their hands feel swollen and useless, even though their hands don’t appear swollen. As the condition progresses, you may start feeling tingling during the day, and the pain may radiate up your arm. It may become difficult to make a tight fist, grasp small objects, or do other things with your hands. In severe, chronic cases, the muscles at the base of the thumb weaken. You may even lose the ability to distinguish between hot and cold by touch. A procedure to ease this nerve disorder is one of the most common surgeries done in the United States, with more than 200,000 procedures performed each year.

Tips for pain-free hands at work

It’s a good idea to have an ergonomic evaluation of your workspace to avoid repetitive strain injuries. If that’s not possible, the following tips may help:

• Keep your wrists in a neutral position, not flexed downward or extended upward, when using your computer. To check, place your wrist, palm facing down, on a flat, hard surface. Put a Band-Aid lengthwise over the top of your wrist, and then move to your keyboard and type. If the Band-Aid stretches or goes slack, your wrists aren’t in a neutral position.
• Get up from your desk and stretch at least once every hour. In between, take shorter breaks to rest your hands, palms up, on your lap or on a wrist rest. You can install software on your computer that reminds you to take micropauses or rest breaks and restricts your daily time on the computer.
• Be skeptical about new keyboard configurations (such as split keyboards) or mouse designs claiming to be ergonomic. It will take many years of study to learn whether such changes translate into fewer work-related upper-extremity musculoskeletal disorders.

I suffer from severe hand pain as well as hand muscle atrophy




Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

My mission is to provide you with "Trusted Advice for a Healthier Life."

Yours in good health

Any questions?

Ask Glen!

The Benefits of Vitamin C

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Q. Glen, What can vitamin C do for your health?


A.Vitamin C is one of the safest and most effective nutrients, experts say. It may not be the cure for the common cold (though it's thought to help prevent more serious complications). But the benefits of vitamin C may include protection against immune system deficiencies, cardiovascular disease, prenatal health problems, eye disease, and even skin wrinkling.

A recent study published in Seminars in Preventive and Alternative Medicine that looked at over 100 studies over 10 years revealed a growing list of benefits of vitamin C.

"Vitamin C has received a great deal of attention, and with good reason. Higher blood levels of vitamin C may be the ideal nutrition marker for overall health," says study researcher Mark Moyad, MD, MPH, of the University of Michigan. "The more we study vitamin C, the better our understanding of how diverse it is in protecting our health, from cardiovascular, cancer, stroke, eye health [and] immunity to living longer."

"But," Moyad notes, "the ideal dosage may be higher than the recommended dietary allowance."

How Much Vitamin C Is Enough?

Most of the studies Moyad and his colleagues examined used 500 daily milligrams of vitamin C to achieve health results. That's much higher than the RDA of 75-90 milligrams a day for adults. So unless you can eat plenty of fruits and vegetables, you may need to take a dietary supplement of vitamin C to gain all the benefits, Moyad says. He suggests taking 500 milligrams a day, in addition to eating five servings of fruits and vegetables.

"It is just not practical for most people to consume the required servings of fruits and vegetables needed on a consistent basis, whereas taking a once-daily supplement is safe, effective, and easy to do," Moyad says. He also notes that only 10% to 20% of adults get the recommended nine servings of fruits and vegetables daily.

Moyad says there is no real downside to taking a 500-milligram supplement, except that some types may irritate the stomach. That's why he recommends taking a non-acidic, buffered form of the vitamin. "The safe upper limit for vitamin C is 2,000 milligrams a day, and there is a great track record with strong evidence that taking 500 milligrams daily is safe," he says.

Still, American Dietetic Association spokeswoman Dee Sandquist, RD, suggests doing your best to work more fruits and vegetables into your diet before taking supplements.

"Strive to eat nine servings of fruits and vegetables daily, because you will get a healthy dose of vitamin C along with an abundance of other vitamins, minerals, and phytochemicals that are good for disease prevention and overall health," she says.

While a cup of orange juice or a half-cup of red pepper would be enough to meet your RDA for Vitamin C, here are all the foods and beverages you'd need to consume to reach 500 milligrams (mg):

• Cantaloupe, 1 cup: 59 mg Vitamin C
• Orange juice, 1 cup: 97 mg
• Broccoli, cooked, 1 cup: 74 mg
• Red cabbage, 1/2 cup: 40 mg
• Green pepper, 1/2 cup, 60 mg
• Red pepper, 1/2 cup, 95 mg
• Kiwi, 1 medium: 70 mg
• Tomato juice, 1 cup: 45 mg

The Health Benefits of Vitamin C

According to recent research, vitamin C may offer health benefits in these areas:

1.Stress. "A recent meta-analysis showed vitamin C was beneficial to individuals whose immune system was weakened due to stress -- a condition which is very common in our society," says Moyad. And, he adds, "because vitamin C is one of the nutrients sensitive to stress, and [is] the first nutrient to be depleted in alcoholics, smokers, and obese individuals, it makes it an ideal marker for overall health."

2. Colds. When it comes to the common cold, vitamin C may not be a cure. But studies show that it can help prevent more serious complications. "There is good evidence taking vitamin C for colds and flu can reduce the risk of developing further complications, such as pneumonia and lung infections," says Moyad.

3. Stroke. A recent study in the American Journal of Clinical Nutrition found that those with the highest concentrations of vitamin C in their blood were associated with 42% lower stroke risk than those with the lowest concentrations. The reasons for this are not completely clear. But what is clear is that people who eat plenty of fruits and vegetables have higher blood levels of vitamin C.

"People who consume more fruit and vegetables will not only have higher [blood] levels of vitamin C, but higher intake of other nutrients potentially beneficial to health, such as fiber and other vitamins and minerals," study researcher Phyo K. Myint said in an email interview.

4. Skin Aging. Vitamin C affects cells on the inside and outside of the body. A study published in the American Journal of Clinical Nutrition examined links between nutrient intakes and skin aging in 4,025 women aged 40-74. It found that higher vitamin C intakes were associated with a lower likelihood of a wrinkled appearance, dryness of the skin, and a better skin-aging appearance.

Other studies have suggested that vitamin C may also:

• Improve macular degeneration.
• Reduce inflammation.
• Reduce the risk of cancer and cardiovascular disease.

Vitamin C's Role in the Body

Vitamin C, also known as ascorbic acid, is necessary for the growth, development and repair of all body tissues. It's involved in many body functions, including formation of collagen, absorption of iron, the immune system, wound healing, and the maintenance of cartilage, bones, and teeth.

Vitamin C is one of many antioxidants that can protect against damage caused by harmful molecules called free radicals, as well as toxic chemicals and pollutants like cigarette smoke. Free radicals can build up and contribute to the development of health conditions such as cancer, heart disease, and arthritis.

Vitamin C is not stored in the body (excess amounts are excreted), so overdose is not a concern. But it's still important not to exceed the safe upper limit of 2,000 milligrams a day to avoid stomach upset and diarrhea.

Water-soluble vitamins must be continuously supplied in the diet to maintain healthy levels. Eat vitamin-C-rich fruits and vegetables raw, or cook them with minimal water so you don't lose some of the water-soluble vitamin in the cooking water.

Vitamin C is easily absorbed both in food and in pill form, and it can enhance the absorption of iron when the two are eaten together.

Deficiency of vitamin C is relatively rare, and primarily seen in malnourished adults. In extreme cases, it can lead to scurvy -- characterized by weakness, anemia, bruising, bleeding, and loose teeth.

How to Get More Vitamin C in Your Diet

This antioxidant super-nutrient is found in a variety of fruits and vegetables. Yet, according to dietary intake data and the 2005 U.S. Dietary Guidelines, most adults don't get enough vitamin C in their diets. This is especially true of smokers and non-Hispanic black males, according to research done by Jeff Hampl, PhD, RD, and colleagues at the University of Arizona.

The foods richest in vitamin C are citrus fruits, green peppers, strawberries, tomatoes, broccoli, white potatoes, and sweet potatoes. Other good sources include dark leafy greens, cantaloupe, papaya, mango, watermelon, brussels sprouts, cauliflower, cabbage, red peppers, raspberries, blueberries, winter squash, and pineapples.

Here are eight easy ways to work more fruits and veggies into your diet each day:

1. Add pureed or grated fruits and veggies to recipes for muffins, meatloaf, and soups.
2. Keep cut-up fruits and veggies on hand so they are ready for a quick snack.
3. Frozen fruit slices make a cool summer treat.
4. Include dark lettuce, tomatoes, and shredded broccoli slaw on all your sandwiches and wraps.
5. Eat raw veggies with hummus, low-fat dips, and salsas.
6. Add fresh or frozen berries to muffins, pancakes, cereal, and salads.
7. Throw a handful of dried fruit on top of your cereal or in a baggie with nuts for an easy snack.
8. Enjoy a glass of vegetable juice as a filling and low-calorie mid-afternoon snack,

The bottom line? "There is no one silver bullet vitamin, mineral, or nutrient," says Sandquist. "It is all about the big picture. And eating a varied diet rich in all the nutrients is the best strategy for good health."

Her advice: Take a daily multivitamin, because most people don't get enough of several nutrients. And if you want to combat colds and flu, wash your hands more often.

Reference:

Mark Moyad, MD, MPH, of the University of Michigan

Dee Sandquist, RD

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !



My mission is to provide you with "Trusted Advice for a Healthier Life."


Yours in good health

Any questions?

Ask Glen!

How to Conquer a Cold

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Q. Glen, Is there any Remedy's For the Common Cold


A.There is no cure for the common cold, but you can get relief from your cold symptoms by:

• Resting in bed
• Drinking plenty of fluids
• Gargling with warm salt water or using throat sprays or lozenges for a scratchy or sore throat
• Using petroleum jelly for a raw nose
• Taking aspirin or acetaminophen, Tylenol, for example, for headache or fever

A word of caution: Several studies have linked aspirin use to the development of Reye's syndrome in children recovering from flu or chickenpox. Reye's syndrome is a rare but serious illness that usually occurs in children between the ages of 3 and 12 years. It can affect all organs of the body but most often the brain and liver. While most children who survive an episode of Reye's syndrome do not suffer any lasting consequences, the illness can lead to permanent brain damage or death. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or medicine containing aspirin when they have any viral illness such as the common cold.

Over-the-counter cold medicines
Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some of your cold symptoms but will not prevent or even shorten the length of your cold. Moreover, because most of these medicines have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, you should take them with care.

Over-the-counter-antihistamines
Nonprescription antihistamines may give you some relief from symptoms such as runny nose and watery eyes which are commonly associated with colds.

Antibiotics
Never take antibiotics to treat a cold because antibiotics do not kill viruses. You should use these prescription medicines only if you have a rare bacterial complication, such as sinusitis or ear infections. In addition, you should not use antibiotics "just in case" because they will not prevent bacterial infections.

Steam
Although inhaling steam may temporarily relieve symptoms of congestion, health experts have found that this approach is not an effective treatment.

Reference: Web MD

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

My mission is to provide you with "Trusted Advice for a Healthier Life."


Yours in good health

Any questions?

Ask Glen!

Stress and the Spread of Cancer

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Q. Glen, Can stress cause cancer?

A. Though it's clearly not a simple matter of cause and effect, the theory that stress is somehow related to cancer is a persistent one. There have been several long-range research studies that investigated a possible connection, but results were contradictory. However, a lab study from cancer biologists at Wake Forest University School of Medicine in Winston-Salem, North Carolina, recently found new evidence on the impact of the stress hormone epinephrine on cancers of the breast and prostate. Now we may be on the way to understanding this complex relationship better, and learning whether stress may actually cause cancer... or just causes the body to lose its ability to fight it.

STRESS LETS BAD CELLS TAKE CHARGE

The adrenal glands, which sit on the kidneys, produce epinephrine, also known as adrenaline. The body uses this hormone like a power tool at times of stress, but when stress is prolonged, the adrenals continue to pump out the hormone and levels remain elevated. Wondering how the excess epinephrine affects cancer cells, and by what process, researchers exposed breast and prostate cancer cells to the hormone in the lab. What's supposed to happen in the body, normally, is that a protein with the peculiar name of "BAD" helps trigger naturally occurring cell death, called apoptosis -- but when epinephrine comes into contact with BAD, as the researchers discovered, it activates enzymes that inactivate BAD and the cells continue to grow.

This might be one way high stress connects to cancer... unchecked by BAD, the cancerous cells continue on their destructive path. This discovery could help explain a previous Canadian study's finding that men who had taken beta blocker drugs for hypertension for at least four years had an 18% lower risk of developing prostate cancer... since beta blockers block the effects of epinephrine. Also, even more recently, another study published in the Journal of Psychosomatic Research, demonstrated that in patients with metastatic breast cancer, stressful or traumatic life events reduced the "median disease-free interval" to 30 months from 62.

INSIGHTS FROM THE RESEARCH TEAM

George Kulik, PhD, was one of the study's lead authors. When I called him he told me that not all types of cancer cells respond this way to stress hormones, so one priority is identifying which ones do. One reason past studies on stress and cancer have not been able to show a relationship could be because not all cancers are shown to react to epinephrine and Dr. Kulik suspects only 5% to 10% may be affected by the hormone. Dr. Kulik explained that in a large population study, these would be "washed out" in the overall findings. But once researchers know which cancer cells respond, they will have the opportunity to study them more closely.

WHAT CAUSES WHAT?

In some ways it almost seems like a bad joke -- a cancer diagnosis is highly stressful for anyone to have and obviously a time that stress hormones are likely to soar. It's not known whether epinephrine has an impact on the development of cancerous cells but, according to Dr. Kulik, the presence of stress hormones might interfere with cancer care because treatment is designed to trigger apoptosis of the diseased cells. Dr. Kulik and his colleagues are now working to learn more about the impact of stress hormones on individual patients, which he says will be aided by the fact that it is already possible to identify the level of stress hormones people have.

His team has now moved from experiments in the lab to doing them with mice. However, there is no reason to wait to develop better awareness of personal stress levels and to build an arsenal of tools to handle stress more successfully. Immediate responses to the acute stress of, say, receiving disappointing news or being anxious about a big event should include deep breathing, quiet music and other practices that are instantly soothing. For longer-term stress, such as day-to-day parenting challenges, a difficult job situation, or, for that matter, a cancer diagnosis, it is useful to develop stress management skills, which may include meditation, self-hypnosis, exercise and other techniques that calm the mind and the body. You can learn these in formal classes frequently found at community centers, YMCAs and the like, but there are also many books and CDs that are extremely helpful in practicing these techniques at home. Since stress has certainly been linked to other diseases as well, you can't lose by focusing on managing your stress.

Source(s):

George Kulik, PhD, assistant professor of cancer biology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

My mission is to provide you with "Trusted Advice for a Healthier Life."

Yours in good health

Any questions?

Ask Glen!

Low Back Pain: Treatment and Prevention

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Q. Glen! I am a men that suffers from Lower Back Pain, Are there any treatments available?

A. About three of every four men have endured a bout of low back pain, and many have had repeated episodes. The pain may begin gradually or suddenly; it may be mild or severe. In most cases, doctors cannot pinpoint the cause of the pain, and in most cases x-rays and blood tests are useless. In fact, even advanced imaging techniques such as MRIs and CTs are not recommended for typical patients.

Most people with low back pain can handle the problem themselves, sometimes with the aid of a phone call or visit to their doctor and the short-term use of simple medications. But there are exceptions; the list below details situations that call for prompt medical attention.

Warning signs: When to worry about your back First episode before age 20 or after 55 Recent major trauma, including motor vehicle accidents, falls, and severe sports injuries Radiation of pain down a leg, particularly if accompanied by: Numbness or loss of sensation Weakness or loss of muscular strength Impaired bowel or bladder control Constant pain that is not affected by motion Pain in the upper back or chest Pain that increases at night or when lying down Unexplained weight loss of 10 pounds or more Unexplained fever A previous diagnosis of cancer Use of corticosteroids or other immunosuppressive drugs History of drug abuse History of a major chronic medical illness

If you have one of the warning symptoms in the list, consult your doctor. But if you have garden-variety pain, you may well be able to take care of it yourself — and you certainly should take steps to keep your back in shape.

What to do

Until recently, doctors recommended elaborate programs of bed rest, traction, or therapeutic exercises for acute low back pain. Not anymore. Careful studies show that none of these programs help. The best plan is to return to normal activities as soon as you can. Don’t try to do special back exercises while you are in the throes of pain, but don’t stay in bed any longer than you have to either. In fact, gentle activity can help you walk away from pain. Above all, use common sense. Avoid prolonged sitting, heavy lifting, and repetitive bending and twisting motions. Be as active as your pain will allow, but don’t push too hard; you may not need strict bed rest, but you certainly won’t benefit from forcing yourself to be up and around in the face of pain. When you rest, lie on a firm surface such as a good mattress, a mattress with a bedboard under it, or the floor. When you sit, select a chair with good low back support. As you improve, spend less time resting, more time standing and walking.

Many people with acute back pain find ice packs helpful, at least during the first two or three days. Use a gel pack that you chill in your freezer or simply put some ice cubes in a plastic bag surrounded by a thin towel. Apply cold to the spots that hurt most for 10–20 minutes three to four times a day. After a few days, switch to a hot pack or heating pad on a similar schedule. But don’t be dogmatic; there is no firm scientific evidence favoring heat or cold, so do what feels best to you or do nothing at all.

Expect to recover, but expect it to take some time, and be prepared to accept some ups and downs as you get better. And along with the pain, expect to endure endless doses of well-intended advice. Nearly everyone has had back pain, and nearly everyone “knows” something that worked wonders. Listen politely, but don’t try anything radical.

Demystifying the scans In an ordinary x-ray, a stationary generating tube beams x-rays through the patient; body tissues that are dense (such as vertebral bodies) impede the passage of x-rays, while tissues that are less dense (such as the disks between the vertebrae) allow them to pass through the body to a sheet of film behind the patient. Like ordinary photos, the film is developed to produce a negative that is placed on a lighted screen for viewing; dense tissues appear white. A typical series of lower spine x-rays takes about 20 minutes, and exposes the patient to 1,200 millirem of radiation, about four times the amount of radiation people get from natural sources each year. Computed tomography (CT scanning) is an imaging technique that also relies on radiation. The x-ray generating tube rotates around the patient, beaming x-rays through the body. The x-rays that pass through are collected by detectors that produce an electrical signal that is channeled into a computer. CT scans provide much more detailed information than ordinary x-rays, and it is displayed in panels that depict very thin cross-sectional “slices” of the body’s anatomy. A CT scan of the lumbar spine takes 10–15 minutes and exposes the patient to 4,000 millirem of radiation. Magnetic resonance imaging (MRI) does not expose the patient to radiation. Instead, it applies an intense magnetic field and pulses of radio waves to the body. In response, radio signals are emitted from hydrogen atoms in the body (mostly in the body’s water). These signals are captured by detectors and analyzed by a computer to produce images of unsurpassed clarity and detail. An MRI of the spine takes about 45 minutes. MRIs and CT scans are expensive, and charges and reimbursements vary widely around the country.

Medication

In our medicated society, there is a pill for nearly everything — and in the case of back pain, there are lots of pills. None of them will actually speed your recovery, much less prevent recurrences. Still, medication can reduce pain and hasten your return to normal activity.

Use only what’s necessary. Government guidelines suggest starting with a simple pain reliever like acetaminophen (Tylenol and other brands). It may be less potent than other medications, but it has fewer side effects; use high doses, but don’t exceed 1,000 mg four times a day.

Most doctors recommend a nonsteroidal anti-inflammatory medication (NSAID) as the basic treatment. You can try a nonprescription product such as aspirin, ibuprofen (Motrin, Advil, and other brands), or naproxen (Aleve and other brands), or you can ask for one of the many prescription NSAIDs. Older people and those with gastritis or gastric bleeding problems might be better off with the selective COX-2 inhibitor celecoxib (Celebrex) — but patients with cardiovascular risk factors should use it with great caution, if at all. Stronger prescription painkillers and narcotics are rarely needed.

If you have intense muscle spasms, your doctor may prescribe a muscle relaxant such as diazepam (Valium), cyclobenzaprine (Flexeril), carisoprodol (Soma), or methocarbamol (Robaxin). These prescription drugs are of uncertain benefit and are usually recommended for short-term use. Finally, an antiseizure medication such as gabapentin (Neurontin) appears to help relieve the nerve pain from sciatica; doctors may prescribe it for this purpose even though the FDA has not approved it for this use.

Alternative therapy

Your doctor can’t do much to speed your recovery from ordinary mechanical low back pain. In most cases, he simply makes sure that you are not one of the few back patients with a serious problem, provides the medications you need for short-term pain relief, and encourages a common-sense return to normal activities instead of bed rest. But if physicians are of limited value for the average patient with acute back pain, can other practitioners do any better?

In a few cases, perhaps. Small studies have suggested that patients who receive spinal manipulation from chiropractors or osteopaths require less medication and are more satisfied with their care than people who receive standard treatment. It’s not clear if this benefit is due to the adjustment therapy itself or is the result of the extra time, hands-on care, and encouragement that patients receive. However, the differences are slight — which is no surprise, since the vast majority of patients recover with any form of intervention or with no treatment at all.

Although physical therapy and back exercises may help patients with chronic back pain, they are not effective for acute episodes. Massage therapy appears to help people feel better, but its advantage over standard care is small, and studies that demonstrate a benefit have been questioned on technical grounds. Although acupuncture can help with various types of pain, acupuncture and acupressure have had mixed success with back pain; some studies show modest benefit, others none.

Unsuccessful therapies

It’s a long list. Bed rest is the biggest surprise and the greatest disappointment; long the mainstay of treatment, it actually makes things worse. Traction, back braces and belts, lumbar supports, back school, transcutaneous electrical nerve stimulation, and antidepressants have all been flops.

Other treatments

Most acute low back pain will resolve with a simple, conservative, self-directed program. Even so, some men require additional treatment, as do many patients with chronic or recurrent pain. A physical therapy rehabilitation program can be very helpful. It typically involves an exercise program to improve posture, body mechanics, flexibility, and strength, and it may add modalities such as heat or cold treatments and ultrasound. If physical therapy doesn’t do the trick, doctors may treat selected patients by injecting steroids into the painful area. Preliminary studies suggest that injections of botulinum toxin (Botox) may relieve painful muscle spasms. Surgery is also available. It may be mandatory, even urgent, in cases of complicated back pain, but it should be the last resort for uncomplicated pain. If a herniated lumbar disc is responsible, a lumbar discectomy with magnified vision is usually the preferred approach. Laser surgery and endoscopic procedures are being studied but are still experimental. Needless to say, different surgical approaches may be required to treat other problems.

Keep your back in shape

The back exercises, posture tips, and instructions for lifting shown below may help. A good mattress and supportive chairs also make sense. But the best way to prevent back pain is to keep the rest of your body healthy. Aerobic conditioning is paramount; active, fit men have less back pain than sedentary, out-of-shape guys. Swimming, walking, and biking are particularly desirable for men who have had back pain in the past. A good diet will also help — not by nourishing bones and joints, but by preventing obesity. The old-time docs had it right when they said you could never be too thin for your back.

Hints for a happy back

Stand with your head up, your chin in, your back flattened, and your pelvis straight.

Sleep on a firm mattress. If you lie on your back, place a thin pillow under your knees.

Bend from your hips and knees, not your back.

Hold heavy objects close to your body when you lift or carry.

Sit as close to the pedals as you can without compromising air-bag safety or good driving. Consider a firm backrest if your seat is soft.

Select a firm chair with a straight back and use a footrest for prolonged sitting.

Sit up straight; when you lean forward, bend from your hips instead of slouching.

Exercises for a healthy back Use these exercises to help prevent back pain; if you’ve had pain, wait until you are pain-free to begin. Lie on a firm mat or carpeted floor. Begin slowly, build up gradually, and back off if you experience pain. Hold each position for a count of 10; then exhale and relax. Repeat each exercise 3 times at first; then build to 8–10 repetitions. Do your exercises 3–4 times per week. Consult a physical therapist or physician if you have chronic or recurrent back pain.
Hamstring stretch	Alternate hamstring stretch
Sitting back bend
Half sit-up
Knee-to-chest raise
Pelvic tilt
Elbow prop-up
Press-up
Hip hyperextension

Back to basics

Because it’s so common, back pain is the subject of intense discussion, both among health care professionals and the general public. Everyone with a back, it seems, is an expert; programs for prevention spark debate, theories about causation ignite controversy, and treatment plans start wars. If you’ve found a way to live with your back, stick with it. If you need more help, listen to the options; then decide what’s best for you. For most men, a conservative, self-directed program will control acute low back pain. But whether you treat yourself or get professional help, you should always listen to your body, staying alert for the signals that could indicate serious trouble. Fortunately, such warnings are uncommon. For most men, basic care will banish backaches.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

My mission is to provide you with "Trusted Advice for a Healthier Life."

Yours in good health

Any questions?

Ask Glen!

Your Guide to the Male Reproductive System

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Q. Glen, What is the purpose of the male organ ( penis ) ?


A. The purpose of the organs of the male reproductive system is to perform the following functions:

• To produce, maintain and transport sperm (the male reproductive cells) and protective fluid (semen)
• To discharge sperm within the female reproductive tract during sex
• To produce and secrete male sex hormones responsible for maintaining the male reproductive system

Unlike the female reproductive system, most of the male reproductive system is located outside of the body. These external structures include the penis, scrotum, and testicles.

• Penis: This is the male organ used in sexual intercourse. It has 3 parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans, which is the cone-shaped part at the end of the penis. The glans, also called the head of the penis, is covered with a loose layer of skin called foreskin. (This skin is sometimes removed in a procedure called circumcision.) The opening of the urethra, the tube that transports semen and urine, is at the tip of the penis. The penis also contains a number of sensitive nerve endings.

  The body of the penis is cylindrical in shape and consists of 3 circular shaped chambers. These chambers are made up of special, sponge-like tissue. This tissue contains thousands of large spaces that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.

  Semen, which contains sperm (reproductive cells), is expelled (ejaculated) through the end of the penis when the man reaches sexual climax (orgasm). When the penis is erect, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.

• Scrotum: This is the loose pouch-like sac of skin that hangs behind the penis. It contains the testicles (also called testes), as well as many nerves and blood vessels. The scrotum acts as a "climate control system" for the testes. For normal sperm development, the testes must be at a temperature slightly cooler than body temperature. Special muscles in the wall of the scrotum allow it to contract and relax, moving the testicles closer to the body for warmth or farther away from the body to cool the temperature.

• Testicles (testes): These are oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for generating sperm. Within the testes are coiled masses of tubes called seminiferous tubules. These tubes are responsible for producing sperm cells.

The internal organs of the male reproductive system, also called accessory organs, include the following:

• Epididymis: The epididymis is a long, coiled tube that rests on the backside of each testicle. It transports and stores sperm cells that are produced in the testes. It also is the job of the epididymis to bring the sperm to maturity, since the sperm that emerge from the testes are immature and incapable of fertilization. During sexual arousal, contractions force the sperm into the vas deferens.

• Vas deferens: The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens transports mature sperm to the urethra, the tube that carries urine or sperm to outside of the body, in preparation for ejaculation.

• Ejaculatory ducts: These are formed by the fusion of the vas deferens and the seminal vesicles (see below). The ejaculatory ducts empty into the urethra.

• Urethra: The urethra is the tube that carries urine from the bladder to outside of the body. In males, it has the additional function of ejaculating semen when the man reaches orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.

• Seminal vesicles: The seminal vesicles are sac-like pouches that attach to the vas deferens near the base of the bladder. The seminal vesicles produce a sugar-rich fluid (fructose) that provides sperm with a source of energy to help them move. The fluid of the seminal vesicles makes up most of the volume of a man's ejaculatory fluid, or ejaculate.

• Prostate gland: The prostate gland is a walnut-sized structure that is located below the urinary bladder in front of the rectum. The prostate gland contributes additional fluid to the ejaculate. Prostate fluids also help to nourish the sperm. The urethra, which carries the ejaculate to be expelled during orgasm, runs through the center of the prostate gland.

• Bulbourethral glands: Also called Cowper's glands, these are pea-sized structures located on the sides of the urethra just below the prostate gland. These glands produce a clear, slippery fluid that empties directly into the urethra. This fluid serves to lubricate the urethra and to neutralize any acidity that may be present due to residual drops of urine in the urethra.

How Does the Male Reproductive System Function?

The entire male reproductive system is dependent on hormones, which are chemicals that regulate the activity of many different types of cells or organs. The primary hormones involved in the male reproductive system are follicle-stimulating hormone, luteinizing hormone, and testosterone.

Follicle-stimulating hormone is necessary for sperm production (spermatogenesis) and luteinizing hormone stimulates the production of testosterone, which is also needed to make sperm. Testosterone is responsible for the development of male characteristics, including muscle mass and strength, fat distribution, bone mass, facial hair growth, voice change and sex drive.

Reviewed by the doctors at:

The Cleveland Clinic Urological Institute.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

Any questions? Ask Glen

Your Guide to the Female Reproductive System

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Q. Glen, Can you explain the female reproduction system?

A.The female reproductive system is designed to carry out several functions. It produces the female egg cells necessary for reproduction, called the ova or oocytes. The system is designed to transport the ova to the site of fertilization. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The next step for the fertilized egg is to implant into the walls of the uterus, beginning the initial stages of pregnancy. If fertilization and/or implantation does not take place, the system is designed to menstruate (the monthly shedding of the uterine lining). In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.

What Parts Make-up the Female Anatomy?

The female reproductive anatomy includes internal and external structures.

The function of the external female reproductive structures (the genitals) is twofold: To enable sperm to enter the body and to protect the internal genital organs from infectious organisms. The main external structures of the female reproductive system include:

• Labia majora: The labia majora enclose and protect the other external reproductive organs. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males. The labia majora contain sweat and oil-secreting glands. After puberty, the labia majora are covered with hair.
• Labia minora: Literally translated as "small lips," the labia minora can be very small or up to 2 inches wide. They lie just inside the labia majora, and surround the openings to the vagina (the canal that joins the lower part of the uterus to the outside of the body) and urethra (the tube that carries urine from the bladder to the outside of the body).
• Bartholin's glands: These glands are located beside the vaginal opening and produce a fluid (mucus) secretion.
• Clitoris: The two labia minora meet at the clitoris, a small, sensitive protrusion that is comparable to the penis in males. The clitoris is covered by a fold of skin, called the prepuce, which is similar to the foreskin at the end of the penis. Like the penis, the clitoris is very sensitive to stimulation and can become erect.

The internal reproductive organs in the female include:

• Vagina: The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal.
• Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus. The uterus is divided into two parts: the cervix, which is the lower part that opens into the vagina, and the main body of the uterus, called the corpus. The corpus can easily expand to hold a developing baby. A channel through the cervix allows sperm to enter and menstrual blood to exit.
• Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the uterus. The ovaries produce eggs and hormones.
• Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.

What Happens During the Menstrual Cycle?

Females of reproductive age experience cycles of hormonal activity that repeat at about one-month intervals.(Menstru means "monthly"; hence the term menstrual cycle.) With every cycle, a woman's body prepares for a potential pregnancy, whether or not that is the woman's intention. The term menstruation refers to the periodic shedding of the uterine lining.

The average menstrual cycle takes about 28 days and occurs in phases: the follicular phase, the ovulatory phase (ovulation), and the luteal phase.

There are four major hormones (chemicals that stimulate or regulate the activity of cells or organs) involved in the menstrual cycle: follicle-stimulating hormone, luteinizing hormone, estrogen and progesterone.

Follicular Phase

This phase starts on the first day of your period. During the follicular phase of the menstrual cycle, the following events occur:

• Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH) are released from the brain and travel in the blood to the ovaries.
• The hormones stimulate the growth of about 15-20 eggs in the ovaries each in its own "shell," called a follicle.
• These hormones (FSH and LH) also trigger an increase in the production of the female hormone estrogen.
• As estrogen levels rise, like a switch, it turns off the production of follicle-stimulating hormone. This careful balance of hormones allows the body to limit the number of follicles that complete maturation, or growth.
• As the follicular phase progresses, one follicle in one ovary becomes dominant and continues to mature. This dominant follicle suppresses all of the other follicles in the group. As a result, they stop growing and die. The dominant follicle continues to produce estrogen.

Ovulatory Phase

The ovulatory phase, or ovulation, starts about 14 days after the follicular phase started. The ovulatory phase is the midpoint of the menstrual cycle, with the next menstrual period starting about 2 weeks later. During this phase, the following events occur:

• The rise in estrogen from the dominant follicle triggers a surge in the amount of luteinizing hormone that is produced by the brain.
• This causes the dominant follicle to release its egg from the ovary.
• As the egg is released (a process called ovulation) it is captured by finger-like projections on the end of the fallopian tubes (fimbriae). The fimbriae sweep the egg into the tube.
• Also during this phase, there is an increase in the amount and thickness of mucous produced by the cervix (lower part of the uterus.) If a woman were to have intercourse during this time, the thick mucus captures the man's sperm, nourishes it, and helps it to move towards the egg for fertilization.

Luteal Phase

The luteal phase begins right after ovulation and involves the following processes:

• Once it releases its egg, the empty follicle develops into a new structure called the corpus luteum.
• The corpus luteum secretes the hormone progesterone. Progesterone prepares the uterus for a fertilized egg to implant.
• If intercourse has taken place and a man's sperm has fertilized the egg (a process called conception), the fertilized egg (embryo) will travel through the fallopian tube to implant in the uterus. The woman is now considered pregnant.
• If the egg is not fertilized, it passes through the uterus. Not needed to support a pregnancy, the lining of the uterus breaks down and sheds, and the next menstrual period begins.

How Many Eggs Does a Woman Have?

During fetal life, there are about 6 million to 7 million eggs in the female ovaries. From this time, no new eggs are produced.

The vast majority of the eggs within the ovaries steadily die, until they are depleted at menopause. At birth, there are approximately 1 million eggs; and by the time of puberty, only about 300,000 remain. Of these, 300 to 400 will be ovulated during a woman's reproductive lifetime. The eggs continue to degenerate during pregnancy, with the use of birth control pills, and in the presence or absence of regular menstrual cycles.

Reviewed by the doctors at:

The Cleveland Clinic Department of Obstetrics and Gynecology.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

Any questions? Ask Glen

Less Sleep May Lower Testosterone

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Q. Glen. I am a man up in my age. I do not get enough sleep and my sex drive is declining, is there a link?

A. Yes, Poor Sleep Tied to Declining Testosterone Levels Among Older Men

April 2, 2007 -- Less sleep may be linked to lower testosterone among older men, according to a new study.

Men’s testosterone levels typically decline with age, and in some men that drop in male hormones can lead to a lack of energy or libido as well as an increased risk of falls with broken bones.

But researchers say some men in their 80s manage to maintain testosterone levels usually seen in young men. The reasons behind the large variation in testosterone levels aren’t understood, and researchers say their findings suggest sleep may play a role.

"The results of the study raise the possibility that older men who obtain less actual sleep during the night have lower blood testosterone levels in the morning," says researcher Plamen Penev, MD, PhD of the University of Chicago, in a news release.

Less Sleep, Lower Testosterone

In the study researchers measured morning testosterone levels in 12 healthy men between ages 64 and 74. Their sleep was also monitored over the course of about a week.

The results showed that the amount of sleep the men got was a significantly related to the amount of testosterone in morning blood samples. The more sleep the men got, the higher their testosterone level, and those with less sleep had lower testosterone levels (the range of sleep was four hours to eight hours with an average of six hours).

"Although the findings suggest that how long a person sleeps may be an indicator of age-related changes in important hormone signals in the body, future studies are needed to determine the importance of these relationships for the health of older adults," says Penev.

Sleep experts recommend that adults get between seven and eight hours of sleep per night to maintain optimum health.

This finding appears in the April issue of Sleep.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

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Female Infertility

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Q. Glen, What is Female Infertility?

A. For a man and a woman who are having frequent intercourse without using any birth control, the average amount of time that it takes to conceive is six months. Most couples are able to achieve a pregnancy within one year if they have intercourse frequently (twice per week or more often). Between 10% and 15% of couples will continue to have difficulty conceiving after one year of trying. When pregnancy is this slow to occur, the man and woman are diagnosed as infertile.

Infertility can be caused by health problems in the man, the woman or both partners. In some infertile couples, no cause can be found to explain the problem. In approximately 20% of couples, more than one cause of the infertility is found. The cause of infertility occurs about as often in men as in women.

Normal aging reduces a woman's ability to become pregnant. Ovulation, the process of forming and releasing an egg, becomes slower and less effective. Aging begins to reduce fertility as early as age 30, and pregnancy rates are very low after age 44, even when fertility medications are used. Even though fertility is less reliable for women of older ages, approximately 20% of women in the United States have their first child at or after age 35.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

Any questions? Ask Glen

Female Infertility Symtoms

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Q. Glen, What are the symptoms of Infertility?

A. The primary symptom of infertility is difficulty getting pregnant. Various causes of infertility may result in additional symptoms. Any of the following problems may cause infertility:

• Infrequent ovulation (egg release from the ovary) accounts for 20% of female infertility problems. If your ovulation is infrequent, your periods will be spaced apart by longer than a month, or they will be absent. Common causes of infrequent ovulation include body stresses such as eating disorders, unusually ambitious exercise training, rapid weight loss, low body weight and obesity. Some hormonal abnormalities such as thyroid problems, pituitary-gland problems, adrenal-gland problems and polycystic ovary syndrome can delay or prevent the ovaries from releasing an egg. Some symptoms that might suggest a hormone abnormality include unexpected weight loss or gain, fatigue, excessive hair growth or hair loss, acne and ovarian cysts. Cysts in the ovary can cause pelvic pain and also can interfere with the normal process of ovulation.

• Scarring in the fallopian tubes can prevent pregnancy because it stops the egg from traveling into the uterus. Fallopian-tube problems are the cause in approximately 30% of female infertility problems. Damage can be from a previous surgery, a previous ectopic (tubal) pregnancy, tubal scarring from endometriosis or from pelvic inflammatory disease. Pelvic inflammatory disease is a bacterial infection in the pelvis, caused by sexually transmitted bacteria such as gonorrhea or chlamydia. It often scars, damages or blocks the fallopian tubes. A history of pelvic pain, with or without fever, may suggest a diagnosis of endometriosis or pelvic infection.

• Abnormalities in the shape or lining of the uterus account for almost 20% of female infertility problems. Fibroid tumors or uterine polyps sometimes result in heavy menstrual bleeding, pelvic pain or enlargement of the uterus. Scar tissue can develop within the uterine cavity as a complication of uterine infections, miscarriages, abortions, or surgical procedures such as a dilation and curettage (D&C). Such scar tissue can lead to infrequent periods or minimal menstrual flow.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!


Any questions? Ask Glen

Female Infertility Treatment

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Q. Glen, Are there any treatments for Infertility?

A. Treatment depends on the results of your infertility evaluation. Some causes of infertility have a specific treatment, such as surgery to remove a fibroid tumor or medicines to treat a thyroid problem.

Infertility associated with infrequent or absent ovulation often can be treated with hormone medications called fertility drugs. All fertility medications have potential side effects, and can cause twins or even more than two babies in one pregnancy. Most fertility treatments require the supervision of a fertility specialist. Examples of fertility medicines include:

• Clomiphene citrate (Clomid, Milophene, Serophene) is a medicine that stimulates the ovary to release one or more eggs. This medicine works indirectly by adjusting levels of your natural hormones.

• Injected forms of luteinizing hormone and follicle-stimulating hormone may be used when supervised by an infertility specialist. These medications encourage the ovaries to release more than one egg at a time. This is known as superovulation, or ovulation induction. These medicines are sometimes given after a course of treatment by another hormone medicine, known as a GnRH analogue, that quiets down all natural hormone stimulation to the ovary in preparation for a precisely timed cycle of ovulation.

After fertility drug treatment, the eggs that mature in your ovary can be allowed to travel naturally into the uterus if the fallopian tubes are healthy. Sometimes surgery is used to harvest the eggs that mature after fertility drug treatment, so they can be fertilized with greater certainty and placed into the uterus. Procedures that can help you to start a pregnancy include:

• Intrauterine insemination is a procedure in which sperm are inserted into the uterus directly. Semen is collected by the man, usually after he stimulates himself to ejaculate, and is inserted into the uterus using a special catheter or a syringe.

• In vitro fertilization (commonly called IVF, and known in the early days of the procedure as "test tube baby") combines egg and sperm in a laboratory dish. Surgery is required to collect the eggs that your ovary has been stimulated to release. The eggs and sperm are combined in the laboratory, and the embryos are inserted into your uterus. Multiple embryos may be placed inside the uterus, but IVF does not guarantee that a pregnancy will result. Sometimes, more than one embryo implants itself in the uterus, which can result in twins, triplets or higher-order multiple pregnancies. This procedure requires treatment with hormones beforehand.

• Zygote intrafallopian transfer (ZIFT) and gamete intrafallopian transfer (GIFT) are variations of the surgical IVF procedure and require the presence of at least one healthy fallopian tube. In ZIFT, eggs are removed from the ovary by surgery and are combined with sperm in a laboratory. The resulting embryos are placed in the fallopian tube. GIFT is when eggs and sperm are placed in the fallopian tube before the sperm and egg have fertilized together, allowing the eggs and sperm to fertilize inside the woman. As with IVF, these procedures require hormone pretreatment.

It is important for you to get counseling about all options for parenthood, including procedures for adoption. Some health insurance plans do not pay for infertility treatment.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!


Any questions? Ask Glen

Is It a Heart Attack?

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Q. Glen, How do I know if I am having a Heart Attack

A.If you go to the emergency room with symptoms like chest pain, you'll probably be given tests to rule out other problems that could be causing the pain.

Physicians or emergency room staff must first determine whether you are having a heart attack, an episode of angina, or something completely unrelated to the heart (see Diagnosing Heart Disease). The American College of Cardiology recommends that a diagnosis of heart attack be made when two of the following three criteria are met:

• compatible symptoms (see Common Symptoms of a Heart Attack )
• suggestive EKG abnormalities
• blood tests that reveal elevated levels of the blood chemicals creatine kinase-MB or troponin (see "Blood Tests" below).

Because heart attacks are sometimes hard to distinguish from other causes of chest pain, your physician may also order additional tests, such as echocardiography, nuclear scans, and cardiac catheterization, before making a diagnosis.

EKG Patterns
Emergency room staff often do an immediate EKG; sometimes this is even done in the ambulance during the ride to the hospital. The EKG helps, in many cases (but not all), to determine whether you are having a heart attack, and if so what type of heart attack.

One type is a full-thickness heart attack, also known as a transmural heart attack. When such heart attacks follow the rules, they produce an injury current that shows up on an EKG as an ST segment elevation (see Types of Heart Attacks ). Cardiologists call this kind of heart attack an ST-elevation myocardial infarction, or STEMI.

A partial-thickness heart attack, or non-ST-elevation myocardial infarction, produces different EKG changes — or at least, it should. Instead of becoming elevated, the ST segment is depressed, or lowered.

To complicate matters, angina often produces exactly the same changes as a partial-thickness (non-STEMI) heart attack, and it can sometimes mimic a full-thickness (STEMI) heart attack. More often, the EKG abnormalities that accompany a heart attack are atypical, subtle, or even absent. That’s why doctors always use blood tests to diagnose heart attacks.

Blood tests
When heart cells die, they release enzymes, the chemicals that trigger vital tissue functions. Some of these enzymes are specific to the heart and aren’t produced in any other tissue in large quantities. Doctors measure the blood levels of these enzymes at intervals over time.

Because dying heart cells release different enzymes at different rates, the blood tests can help pinpoint the time the heart attack occurred — information that is particularly useful when symptoms are vague. In addition, the more cells that die, the higher the blood levels of these different enzymes. Doctors can use this information to estimate the amount of heart tissue that has been destroyed.

If doctors suspect that you are having a heart attack, they usually test the blood, either for a specific form of the enzyme creatine kinase (known as creatine kinase-MB) or for two forms of a chemical called troponin (troponin-T and troponin-I). The level of creatine kinase-MB goes up when there has been damage to heart tissue. It rises within 6 hours of a heart attack, reaches peak levels at about 18 hours, and returns to normal within 2–3 days. Testing for this enzyme is useful for the many people who arrive at the hospital several hours after the onset of a heart attack. Abnormally high levels of troponins are also evidence of a heart attack because these proteins begin to rise within minutes to hours after a heart attack. Troponin levels usually increase sharply about 4–6 hours after heart muscle has been damaged, reach peak levels in 10–24 hours, and return to normal 10–14 days later.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

Any questions? Ask Glen

Electrocardiogram (EKG)

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Q. Glen, What is a EKG?

A. An electrocardiogram (EKG) is a painless process that records the heart's electrical activity. Small metal electrodes are placed on the person's wrists, ankles and chest. The electrical signals travel from the electrodes through wires to the EKG machine, which transforms the signals into patterns or waves. Different waves represent different areas of your heart through which electrical currents flow. The electrical currents stimulate the heart muscles to contract and relax. The P wave represents the current in the upper chambers of the heart (atria); the QRS complex represents current in the lower heart chambers (ventricles); and the T wave

represents the heart's brief "rest period" as it recharges electrically (repolarizes) between heartbeats.

EKG waves are recorded on paper as they move through the EKG machine, showing the heart rate and heart rhythm. The appearance of the wave patterns can give important clues about damage to the heart muscle or irritation of the membrane around the heart (pericardium).

In most cases, a basic EKG takes about 5 to 10 minutes. It can be done in a doctor's office, in a laboratory or in a hospital.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

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Why Some Women are More Likely To Get Cervical Cancer Than Other Women

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Q. Glen, what are the risk factors of cervical cancer?

A.While it's impossible to predict which women will get cervical cancer and which won't, we do have something to help us understand whose cervical cancer risk is higher. We know that women who have certain risk factors face an increased risk of getting cervical cancer, and although several factors play a role in determining cervical cancer risk, just one factor – having the human papillomavirus or HPV - significantly increases an individual woman’s risk for cervical cancer.

HPV is the single most significant risk factor for development of cervical cancer. Virtually all women who develop cervical cancer also have HPV. However, not all women who have HPV develop cervical cancer. There are several types of HPV and only a few types increase cervical cancer risk. In fact, HPV is so common that almost everyone is infected at some point in their lives.
Physicians often screen women for HPV, even when there are no obvious symptoms present.

Fact: The National Cancer Institute expects over 11,000 women to develop cervical cancer in 2007. Sadly, 3,670 women will die in 2007 from cervical cancer.

Factors That May Influence the Development of Cervical Cancer

1. Failure to have annual gynecology exams with Pap tests.
   Screening for cervical cancer is part of the annual gynecology exam that should begin by the time a woman is 21 or three years after sexual activity begins for women under 21. The Pap test, which is part of the gynecology exam, screens for cellular changes that can lead to cervical cancer, if left untreated. Fortunately, there are several techniques such as the LEEP procedure and the CONE biopsy, among others that can stop cellular changes before cervical cancer develops. The truth is that cervical cancer is far more likely to occur in women who fail to schedule annual gynecology exams, than in women who see their gynecologists regularly.

   See: What Happens During Your Gynecology Exam

2. Having a weakened immune system.
   Women who have HIV, the virus that causes AIDS, often take drugs that weaken the body’s natural immunity or its ability to fight off disease. These women also have an increased risk for cervical cancer and should be closely monitored by their gynecologist for the development of precancerous changes to the cervix.

3. Age.
   Cervical cancer occurs significantly more often in women over 40.

4. Previous Sexual History.
   Women who have had a large number of sexual partners are more likely to develop cervical cancer. Even if you have not had many sexual partners, if your male sex partner has had many previous partners, your risk for cervical cancer could be higher due to the increased risk of having contracted HPV.

5. Smoking.
   Having HPV and smoking cigarettes increases the risk of cervical cancer.

   See: Smoking – The Women’s Health Perspective

6. Long-term Oral Contraceptive Use.
   Women who have used the Pill to prevent pregnancy for five years or longer, and who also have HPV, may have an increased risk for cervical cancer.

7. Having multiple children.
   Some studies have suggested that women with HPV who also have several children may have an increased risk for cervical cancer.

   A rare form of cervical cancer may develop in women whose mothers were prescribed diethylstilbestrol, commonly referred to as DES, during pregnancy to prevent miscarriage. Although this drug is no longer prescribed, if you were born from 1940 to 1971, you may be at risk of developing this rare form of cervical cancer. Discuss you concerns with your health-care provider if you believe you may be at risk.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

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The Cervix?

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Q. Glen,What is the Cervix?

A.The cervix is a conical shaped passageway that connects the uterus to the vagina. Two types of cells cover the cervix, columnar and squamous. The cervix is about 1 inch long.

What is the Function of the Cervix?
The cervix allows the passage of a baby from the uterus to the vagina during childbirth. The cervical opening widens, called dilation.

Terms to Know
You may hear these terms during exams, Pap smears, or colposcopies:

transformation zone: an area inside the endocervical canal that is a common place for dysplasia to occur in women.

• The transformation zone is commonly called the "TZ" by doctors and on medical charts.
  
  
• os: The os is a small opening in the cervix that opens to allow the passage of menstrual fluids or the passage of a baby during childbirth.
  
  
• endocervical canal: The endocervical canal is passageway from the opening of the cervix to uterus. During a colposcopy, a doctor may scrape the endocervical canal to collect cells for examination. This is called an endocervical canal curettage, or ECC.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

Any questions? Ask Glen

Lybrel - The Continuous Birth Control Pill

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Q. Glen, What s Lybrel?

A.Lybrel is a brand new combination birth control pill that is the first extended-cycle oral contraceptive designed to supply an active dose of hormones every day. This pill will completely stop a woman's period for a full year. It contains 365 90 microgram levonorgestrel/20 microgram ethinyl estradiol tablets and is classified as a low dose, continuous, non-cyclic combination oral contarceptive. Lybrel was approved for use by the U.S. Food and Drug Administration on May 22, 2007 as the first, and only, birth control pill that is also designed to eliminate women's monthly periods.

How it works:

Lybrel will work just like other combination birth control pills by preventing ovulation from occuring. The difference is that it will supply a steady low dose of ethinyl estradiol and levonorgestrel to be taken 365 days of the year without a pill-free interval or placebo period. Lybrel will prevent menstruation as long as the pill is taken daily.

The most recent study of 187 women taking Lybrel found that 99 percent of the women began menstruation within 90 days (3 months) after discontinuing use. Additionally, 4 women became pregnant before their period returned, and 2 women reported a return to menses more than 90 days after the completion of the study.

The Debate Surrounding Lybrel:

Opponents claim that it is unnatural or harmful to manipulate a woman’s menstrual cycle by completely stopping her period. The reality, however, is that by using birth control pills, in and of itself, women are already manipulating their menstrual cycles. Given that few women naturally have a regular 28-day menstrual cycle, pill use automatically manipulates a woman’s cycle causing it to be a perfect 28-day cycle.

An important distinction that should be made is that women who take oral contraceptives do not have a “true” period; they actually experience what is known as withdrawal bleeding on the seven days they are off the active hormones. The bleeding tends to be shorter and lighter than a regular period because the uterine lining does not build up in women who use the pill, so there is less that needs to be shed. Basically, once the hormones are not taken (as during the fourth week of a pill cycle), the small buildup of the lining of the uterus is discarded. Women on Lybrel get continuous hormones (without days off the active pills), so they should have little or no uterine bleeding.

This so-called period that occurs during regular 21 or 28 day combination birth control packs really has no medical function other than reassuring a woman that she is not pregnant. In fact, according to Dr. Steven Goldstein, professor of OB-GYN at New York University School of Medicine, “scientists who invented birth control pills back in the ‘50s thought that women would be more likely to take them if they included a period week.”

Women have chosen to avoid their periods through manipulating their birth control pills due to physically demanding jobs, upcoming honeymoons or vacations, and/or severe period-related symptoms. For decades, medical professionals have been advising women on how to do this properly. Up until now, many pill users have chosen to avoid having a period by starting a new pill pack during the fourth week (when one’s period usually occurs).

Advantages and Benefits of Lybrel:

• The FDA approval of Lybrel is reflective of the wishes of the American public. A national poll found that 60 percent of women would appreciate not having a period every month and one-third would choose never to have one
  
  
• Gynecologist, Dr. Anita L. Nelson, professor of OB-GYN at the David Geffen School of Medicine at the University of California, Los Angeles, advises that all women using birth control can benefit from having more control over their bodies. She further claims, in regard to the withdrawal bleeding that occurs while using the pill, “women need to realize that there is no health benefit to this.”
  
  
• Medical authorities state that there are no health risks or medical reasons women need to have a monthly period
  
  
• Eliminating the menstrual week of a woman’s cycle (as Lybrel will do), will cause hormonal levels to stabilize which often leads to a reduction or complete elimination of the symptoms associated with this week such as: bloating, cramping, irritability, headaches, tender breasts, and other various aches and pains
  
  
• According to Wyeth Pharmaceuticals (the manufacturer of Lybrel), 59 percent of women taking Lybrel stopped bleeding after six months of use
  
  
• Eliminating periods through the use of continuous oral contraceptives has been shown to be an effective treatment for many health-related problems, such as endometriosis, anemia, and epilepsy
  
  
• The use of Lybrel will save women money because they would no longer have to buy feminine hygiene products and/or period-related medications to treat headaches and other PMS symptoms
  
  
• One study reported that after seven to 13 pill packs, women on Lybrel reported less nausea and breast pain than those on a 21-day birth control pill. Researchers found, in a different study, that three months of taking Lybrel reduced PMS and associated complaints in 114 women (Source: Planned Parenthood)
  
  
• Since Lybrel contains a lower daily dose of synthetic hormones than traditional combination pills, the cumulative monthly dose may actually be equal to or lower than some of the other brands women are currently taking

Potential Risks and Disadvantages:

• Many women welcome their monthly period as it provides reassurance about their continued fertility and femininity or lets them know they are not pregnant. In fact, according to research done by Wyeth, 50 percent of the women surveyed welcomed their periods as a sign that they were not pregnant and nearly 25 percent revealed that they felt their periods were a natural part of womanhood
  
  
• The continuous exposure to hormones associated with Lybrel has been a source of concern for some people. However, many health-care providers point out that seven additional days of low-dose hormone exposure per month are unlikely to significantly increase any risks beyond those faced by women taking other types of combination birth control pill
  
  
• The low doses of hormones used in Lybrel may cause breakthrough bleeding (unexpected spotting)
  
  
• One of the greatest concerns is that the long-term safety of continuous contraception remains unknown.

• There is some apprehension that continuous hormone treatments could increase the risk of breast cancer; however, there is no evidence to back this up
  
  
• Another concern about Lybrel: Since approximately 1 to 8 percent of oral contraceptive users become pregnant each year, young women who have never been pregnant and are taking Lybrel may not recognize pregnancy-related symptoms if they are indeed pregnant since they cannot rely on a missing period to indicate a pregnancy
  
  
• Lybrel has the same side effects as other hormonal methods

In general, serious complications do not occur very often with oral contraceptive use. Some women who use a combination pill (like Lybrel) may have a slightly greater chance of certain major disorders than nonusers, including (but not limited to) a slight increase a woman's chance of developing blood clots and stroke. Medical risks increase:

• In women who smoke
• In women age 35 and older (should be monitored while taking Lybrel)
• In women who are 35 or older and smoke
• In women who have conditions associated with a heart attack (such as, high cholesterol, high blood pressure, diabetes and conditions that increase the risk of blood clotting)
• More on: Women Who Should Not Use Hormonal Contraceptives

Effectiveness:

Health-care professionals and additional data reveal that Lybrel is just as safe as other combination birth control pills and preliminary research yields that the effectiveness of Lybrel is similar to that of oral contraceptives as well.

Findings presented at the 55th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists showed that when Lybrel was compared with a traditional 21-day combination oral contraceptive:

• Of the 323 women who took Lybrel, 0 became pregnant
• Of the 318 women who took a traditional 21-day oral contraceptive, three became pregnant

Most studies, however, indicate that Lybrel (just like combination oral contraceptives) is 92 to 99.7 percent effective. This means that with typical use, only 8 out of every 100 women will become pregnant during the first year of use. With perfect use, less than 1 will become pregnant during the first year of use.

How to Obtain Lybrel:

In order to obtain a prescription for the Lybrel, a woman has to have a medical evaluation, blood pressure check, and possibly a pelvic exam by a physician. Women can then have the prescription filled at a local pharmacy.

Costs:

Lybrel may be purchased at a drugstore or clinic as long as a woman has a valid prescription. A woman should check with her private health insurance policy as coverage for birth control varies. Medicaid may sometimes cover these costs. In general, the charges from family planning clinics will usually be less than private health-care providers.

In addition to the cost of the year supply of Lybrel, there is also the cost associated with the medical examination in order to obtain a prescription. At the time of the publishing of this article, Wyeth Pharmaceuticals has declined comment as what it would cost to purchase Lybel.

STD Protection:

Lybrel offers no protection against sexually transmitted infections.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Glen Edward Mitchell

Any questions? Ask Glen