Urinary
Tract Infections UTI's are Common and Preventable There
are simple, non-toxic alternatives.
"UTI's
are usually easy to prevent through simple lifestyle changes.
Your doctor will tell you to drink
lots of water to flush any bad bacteria from the
urinary tract. That goes hand in hand with another piece of
key advice: Pee when you need to and pee after sex. Holding
in your urine makes you more susceptible to UTIs, and peeing
after sex helps you expel any harmful bacteria that may have
entered your urinary tract during intercourse. You also should
take special care to keep your vulva (the outer vagina) clean
and dry -- one way of doing that is to always wipe front to
back. Cranberry juice or cranberry juice supplements may help
ward off infection. If you are susceptible to UTIs, your doctor
will probably advise you to avoid sex play that may result in
bacteria being placed in proximity to your urethra." -- Dr. Vanessa Cullins, vice president for medical affairs at
the Planned Parenthood Federation of America.
Chronic
Urinary Tract Infections are common among many women, with
some men affected as well. In fact, 80 to 90 percent of all
bladder infections (cystitis) can be attributed to a type
of E. Coli entering the urinary tract, a problem 50 times
more common in women and girls than in men. Find out what
simple, alternative, and non-toxic steps you can take to prevent
it. Click
here to find the cause, effective treatment
and preventative for this disorder. Also see BroadPoints.com.
Five
Operations You Don't Want to Get What To Do Instead
By CURT PESMEN,
HEALTH MAGAZINE, CNN
Maybe
I'm the wrong ex-patient to be telling you this: Experimental
surgery erased Stage III colon cancer from my shell-shocked
body six years ago. But even I've got to admit that all is
not well in America's operating rooms: At least 12,000 Americans
die each year from unnecessary surgery, according to a Journal
of the American Medical Association report. And tens of thousands
more suffer complications.
The fact is, no matter how talented the surgeon, the body
doesn't much care about the doc's credentials. Surgery is
a trauma, and the body responds as such -- with major blood
loss and swelling, and all manner of nerve and pain signals
that can stick around sometimes for months.
Those are but a few reasons to try to minimize elective surgery.
And I found even more after talking with more than 25 experts
involved in various aspects of surgery and surgical care,
and after reviewing a half-dozen governmental and medical
think tank reports on surgery in the United States. Here's
what you need to know about five surgeries that are overused
and alternative solutions that may be worth a look.
Hysterectomy
There's long been a concern, at least among
many women, about the high rates of hysterectomy (a procedure
to remove the uterus) in the United States. American women
undergo twice as many hysterectomies per capita as British
women and four times as many as Swedish women.
The surgery is commonly used to treat persistent vaginal bleeding
or to remove benign fibroids and painful endometriosis tissue.
If both the uterus and ovaries are removed, it takes away
sources of estrogen and testosterone. Without these hormones,
the risk of heart disease and osteoporosis rises markedly.
There are also potential side effects: pelvic problems, lower
sexual desire and reduced pleasure. Hysterectomies got more
negative press after a landmark 2005 University of California,
Los Angeles study revealed that, unless a woman is at very
high risk of ovarian cancer, removing her ovaries during hysterectomy
actually raised her health risks.
So why are doctors still performing the double-whammy surgery?
"Our profession is entrenched in terms of doing hysterectomies,"
says Ernst Bartsich, M.D., a gynecological surgeon at Weill-Cornell
Medical Center in New York. "I'm not proud of that. It
may be an acceptable procedure, but it isn't necessary in
so many cases." In fact, he adds, of the 617,000 hysterectomies
performed annually, "from 76 to 85 percent" may
be unnecessary.
Although hysterectomy should be considered for uterine cancer,
some 90 percent of procedures in the United States today are
performed for reasons other than treating cancer, according
to William H. Parker, M.D., clinical professor of gynecology
at UCLA and author of the '05 study. The bottom line, he says:
If a hysterectomy is recommended, get a second opinion and
consider the alternatives.
What
to Do Instead
Go Knife-Free. Endometrial ablation, a nonsurgical
procedure that targets the uterine lining, is another fix
for persistent vaginal bleeding.
You've been waiting at the doctor's office for over an hour
past your appointment. Sound familiar? Pick up on the signs
that it's time to dismiss your doctor so that you can start
getting the care you deserve.
Focus on Fibroids. Fibroids are a problem for 20 to 25 percent
of women, but there are several specific routes to relief
that aren't nearly as drastic as hysterectomy. For instance,
myomectomy, which removes just the fibroids and not the uterus,
is becoming increasingly popular. And there are other less-invasive
treatments out there, too.
In France in the early 1990s, a doctor who was prepping women
for fibroid surgery -- by blocking, or embolizing, the arteries
that supplied blood to the fibroids in the uterus -- noticed
a number of the benign tumors either soon shrank or disappeared,
and, voila, Jacques Ravina, M.D,. had discovered uterine fibroid
embolization.
Since then, interventional radiologists in the United States
have expanded their use of UFE (typically a one- to three-hour
procedure), using injectable pellets that shrink and "starve"
fibroids into submission. Based on research from David Siegel,
M.D., chief of vascular and interventional radiology at Long
Island Jewish Medical Center, New Hyde Park, New York, 15,000
to 18,000 UFEs are performed here each year, and up to 80
percent of women with fibroids are candidates for it.
Another new fibroid treatment is high-intensity focused ultrasound,
or HIFU. This even less invasive, more forgiving new procedure
treats and shrinks fibroids. It's what's called a no-scalpel
surgery that combines MRI (an imaging machine) mapping followed
by powerful sound-wave "shaving" of tumor tissue.
Episiotomy
It can sound so simple and efficient when an
OB-GYN lays out all the reasons why she performs episiotomy
before delivery. After all, it's logical that cutting or extending
the vaginal opening along the perineum (between the vagina
and anus) would reduce the risk of pelvic-tissue tears and
ease childbirth. But studies show that severing muscles in
and around the lower vaginal wall (it's more than just skin)
causes as many or more problems than it prevents. Pain, irritation,
muscle tears, and incontinence are all common aftereffects
of episiotomy.
Last year the American College of Obstetricians and Gynecologists
released new guidelines that said that episiotomy should no
longer be performed routinely -- and the numbers have dropped.
Many doctors now reserve episiotomy for cases when the baby
is in distress. But the rates (about 25 percent in the United
States) are still much too high, experts say, and some worry
that it's because women aren't aware that they can decline
the surgery.
"We asked women who'd delivered vaginally with episiotomy
in 2005 whether they had a choice," says Eugene Declercq,
Ph.D., main author of the leading national survey of childbirth
in America, "Listening to Mothers II," and professor
of maternal and child health at the Boston University School
of Public Health. "We found that only 18 percent said
they had a choice, while 73 percent said they didn't."
In other words, about three of four women in childbirth were
not asked about the surgery they would soon face in an urgent
situation. "Women often were told, 'I can get the baby
out quicker,'" Declercq says, as opposed to doctors actually
asking them, 'Would you like an episiotomy?'"
What to Do Instead
Communicate. The time to prevent an unnecessary
episiotomy is well before labor, experts agree. When choosing
an OB-GYN practice, ask for its rate of episiotomy. And when
you get pregnant, have your preference to avoid the surgery
written on your chart.
Get Ready With Kegels. Working with a nurse or midwife may
reduce the chance of such surgery, experts say; she can teach
Kegel exercises for stronger vaginal muscles, or perform perineal
and pelvic-floor massage before and during labor.
Angioplasty
Every year in the United States, surgeons perform 1.2 million
angioplasties, during which a cardiologist uses tiny balloons
and implanted wire cages known as stents to unclog arteries.
This Roto-Rooter-type approach is less invasive and has a
shorter recovery period than bypass, which is open-heart surgery.
The problem: A groundbreaking study of more than 2,000 heart
patients indicated that a completely nonsurgical method --
heart medication -- was just as beneficial as angioplasty
and stents in keeping arteries open in many patients.
The bottom line: Angioplasty did not appear to prevent heart
attacks or save lives among nonemergency heart subjects in
the study.
What to Do Instead
Take the Right Meds. If the study is right, medications may
be as strong as steel. "If you have chest pain and are
stable, you can take medicines that do the job of angioplasty,"
says William Boden, M.D., of the University of Buffalo School
of Medicine, Buffalo, New York, and an author of the study.
Medicines used in the study included aspirin, and blood pressure
and cholesterol drugs -- and they were taken along with exercise
and diet changes.
"If those don't work, then you can have angioplasty,"
Boden says. "Now we can unequivocally say that."
Of course, what's right for you depends on the severity of
your atherosclerosis risks (blood pressure, cholesterol, triglycerides)
along with any heart-related pain. The onus is also on the
patient to treat a doc's lifestyle recommendations -- diet
and exercise guidelines -- just as seriously as if they were
prescription medicines.
Heartburn Surgery
A whopping 60 million Americans experience heartburn at least
once a month; 16 million deal with it daily. It's no wonder
that after suffering nasty symptoms (intense stomach-acid
backup or near-instant burning in the throat and chest after
just a few bites), patients badly want to believe surgery
can provide a quick fix. And, for some, it does.
A procedure called nissen fundoplication can help control
acid reflux and its painful symptoms by restoring the open-and-close
valve function of the esophagus. But Jose Remes-Troche, M.D.,
of the Institute of Science, Medicine, and Nutrition in Mexico,
reported in The American Journal of Surgery that symptoms
don't always go away after the popular procedure, which involves
wrapping a part of the stomach around the weak part of the
esophagus.
"That may be because surgery doesn't directly affect
healing capacity or dietary or lifestyle choices, which in
turn can lead to recurrence in a hurry," he says.
The surgery can come undone, and side effects may include
bloating and trouble swallowing. Remes-Troche believes it's
best for very serious cases of long-standing gastroesophageal
reflux disease, or GERD, or for those at risk of Barrett's
esophagus, a disease of the upper gastrointestinal tract that
follows years of heartburn affliction and can be a precursor
to esophageal cancer.
What to Do Instead
Make Lifestyle Changes. A combination of diet, exercise, and
acid-reducing medication may help sufferers beat the burn
without going under the knife. But it's a treatment that requires
perseverance.
"It took me four years of appointments, diets, drugs,
sleeping on slant beds -- and even yoga -- to keep my heartburn
manageable," says Debbie Bunten, 44, a Silicon Valley
business-development manager for a software firm, who was
eager to avoid surgery. "But I did it, and am glad I
did."
Another technological development can make a heartburn diagnosis
easier to swallow -- a tiny camera pill that beams pictures
of your esophagus (14 shots per second) through your neck
to a receiver or computer in the doctor's office; it passes
harmlessly out of your system four to six hours later. The
device can be used instead of standard endoscopy to screen
chronic-heartburn sufferers for various esophageal complaints,
including GERD, which can develop into the potentially precancerous
Barrett's esophagus. Unlike an endoscopy, in which you're
sedated and a lighted tube is snaked down your throat, a capsule
camera leaves you wide awake and is finished within 20 minutes,
says Pillcam guru David Fleischer, M.D., a staff physician
in gastroenterology and hepatology, and professor of medicine
at Mayo Clinic College of Medicine. If anesthesia makes you
sick, the capsule camera may be for you.
Lower-Back
Surgery
Since the 1980s, operations for lower-back pain and sciatica
have increased roughly 50 percent, from approximately 200,000
to more than 300,000 surgeries annually in the United States.
That rise is largely due to minimally invasive advances that
include endoscopic keyhole tools used in tandem with magnified
video output.
To its credit, surgery (endoscopic or the traditional lumbar-disc
repair) does relieve lower-back pain in 85 to 90 percent of
cases, docs say. "Yet the relief is sometimes temporary,"
says Christopher Centeno, M.D., director of the brand new
Centeno-Schultz Pain Clinic near Denver, Colorado. And that
adds up to tens of thousands of frustrated patients who find
the promise of surgery was overwrought or short-lived.
What to Do Instead
Try Painkillers and Exercise. Despite the relentless nature
of lower-back pain, the most common cause is a relatively
minor problem -- muscle strain -- not disc irritation, disc
rupture, or even a bone problem, experts say. Despite its
severity, this type of spine pain most often subsides within
a month or two. That's why surgery, or any other invasive
test or treatment beyond light exercise or painkillers, is
rarely justified within the first month of a complaint. Even
pain caused by a bulging or herniated disc "resolves
on its own within a year in some 60 percent of cases,"
orthopedists claim.
"Seventy to eighty percent of the time we can get to
a concrete diagnosis, find a way to manage pain, and get patients
off the drugs without surgery," Centeno says. "Or,
more appropriately, never start the drugs."
"We used to prescribe 30 days bed rest for patients with
herniated discs, but that was 15 to 20 years ago," says
Venu Akuthota, M.D., medical director of the Spine Center
at University of Colorado Hospital and associate professor
of medicine at the University of Colorado School of Medicine.
"Actually, movement is very helpful for treating back
conditions. Nowadays, we prescribe moderate, low-impact exercise,
like walking, or working out on an elliptical trainer or treadmill."
Learn About Stem Cells. I've seen the future of back surgery
firsthand. And it looked to me, from behind my surgical mask,
as if a woman's bare behind was doing much of the work. Up
close, huddled inside the Centeno-Schultz Pain Center, I joined
a team of M.Ds., a Ph.D., and two nurses to witness orthopedic
history in vivo: an adult stem cell transplant to help bones
and joints grow anew.
In the midst of the huddle, Centeno, the back-and neck-pain
specialist, is plunging a needle that looks big enough to
use on a horse deep into the hip bone of a 54-year-old weekend
athlete and skier who's been forced to the sidelines by injury
and long-term lower-back pain. The patient is tired of pain
pills but wary of major surgery. Instead she's undergoing
one of the first ASC orthopedic transplants in the nation.
The harvested stem cells will be used to grow millions of
new ones that will be implanted in her back to spur and regenerate
more youthful, healthy joint tissue -- if all goes as planned
in this part of an ongoing study approved by a medical research
institutional review board, that is. So far, at least, it
has. Early MRI pictures of related procedures have shown impressive
growth of regenerative tissue. And there's even better news:
By using the patient's own stem cells, the surgical team avoids
the ethical debate over using embryonic tissue for research
purposes. See BroadPoints.com. --
WASHINGTON October 8 – Some scientists think they
have figured out the real job of the troublesome and seemingly
useless appendix: It produces and protects good germs
for your gut.
That's the theory from surgeons and immunologists at Duke
University Medical School, published online in a scientific
journal this week.
For generations the appendix has been dismissed as superfluous.
Doctors figured it had no function. Surgeons removed them
routinely. People live fine without them.
And when infected the appendix can turn deadly. It gets
inflamed quickly and some people die if it isn't removed
in time. Two years ago, 321,000 Americans were hospitalized
with appendicitis, according to the Centers for Disease
Control and Prevention.
The function of the appendix seems related to the massive
amount of bacteria populating the human digestive system,
according to the study in the Journal of Theoretical Biology.
There are more bacteria than human cells in the typical
body. Most of it is good and helps digest food. SeeI Do Not Eat Dead Animals.
But sometimes the flora of bacteria in the intestines
die or are purged. Diseases such as cholera or amoebic
dysentery would clear the gut of useful bacteria. The
appendix's job is to reboot the digestive system in that
case.
The appendix "acts as a good safe house for bacteria,"
said Duke surgery professor Bill Parker, a study co-author.
The location of the appendix -- just below the normal
one-way flow of food and germs in the large intestine
in a sort of gut cul-de-sac -- helps support the theory,
he said.
Also, the worm-shaped organ outgrowth acts like a bacteria
factory, cultivating the good germs, Parker said.
That use is not needed in a modern industrialized society,
Parker said. If a person's gut flora dies, they can usually
repopulate it easily with germs they pick up from other
people, he said. But before dense populations in modern
times and during epidemics of cholera that affected a
whole region, it wasn't as easy to grow back that bacteria
and the appendix came in handy.
In less developed countries, where the appendix may be
still useful, the rate of appendicitis is lower than in
the U.S., other studies have shown, Parker said.
The appendix, which is about two to four inches long,
may be another case of an overly hygienic society triggering
an overreaction by the body's immune system, he said.
Even though the appendix seems to have a function, people
should still have them removed when they are inflamed
because it could turn deadly, Parker said. About 300 to
400 Americans die of appendicitis each year, according
to the CDC.
Five scientists not connected with the research said that
the Duke theory makes sense and raises interesting questions.
The idea "seems by far the most likely" explanation
for the function of the appendix, said Brandeis University
biochemistry professor Douglas Theobald. "It makes
evolutionary sense."
The theory led Gary Huffnagle, a University of Michigan
internal medicine and microbiology professor, to wonder
about the value of another body part that is often yanked:
"I'll bet eventually we'll find the same sort of
thing with the tonsils." -- See BroadPoints.com.
*Consultation
with a health care professional should occur before applying
adjustments or treatments to the body, consuming medications
or nutritional supplements and before dieting, fasting or exercising.
None of these activities are herein presented as substitutes
for competent medical treatment. See
Disclaimer.
EqualsHappiness.com
*Consultation
with a health care professional should occur before applying
adjustments or treatments to the body, consuming medications
or nutritional supplements and before dieting, fasting or exercising.
None of these activities are herein presented as substitutes
for competent medical treatment.