The following are 5 important questions about Intrauterine Device – IUD’s. This type of contraception is used by millions of women. Initial questions are usually easy to find. These questions really help understand what we can expect and it helps answers concerns we might have.

1.)  What kinds of IUD or Intrauterine Devices are there?

2 main types.

1.)   Non-hormonal Copper IUD  (ParaGard)

2.)   Hormonal IUD  (Mirena)

Copper IUD is a copper wire that wraps around the T shape device.

Hormonal IUD releases a hormone Levonorgestrel. The Copper IUD is good for 10 years while the Hormonal IUD is good for 5 years.

2.)  Can an IUD be used during breastfeeding?

Yes. Neither will result in side effects or are harmful to the infant. The quality or quantity of the breast milk is not affected.

3.)  Should I use another form of contraception during the first month of an IUD?

For the copper IUD – it is effective the moment it is placed.  In some cases, it can be effective within the first 5 days after intercourse. This would be considered as Emergency Contraceptive and would be more effective than oral pills.

For the Hormonal IUD – Immediately effective if placed within 7 days after you started your period. Otherwise, used alternative contraception for the first 7 days.

4.)  Will an IUD affect my period?

Copper IUD – may cause irregular menstrual periods. Your periods might become heavier and last longer than you are used to. Cramping can be seen. Complete absence of a period is unlikely.

Hormonal IUD – Irregular menstrual periods are possible. Decrease in duration and intensity of your period is often seen. You may experience less cramping. Complete absence of a period is likely but doesn’t occur in all cases.

*** Sometimes heavy menstrual periods or very painful menstrual periods are the primary reasons to get a hormonal IUD.

5.)  Can I get pregnant while I have an IUD

Yes. Although this rarely happens. It is possible. If you think that you could be, meet with your provider immediately.

They may want to ensure you don’t have an ectopic pregnancy. Ultrasound, exam, blood work, and other evaluations may occur.

If you have a normal pregnancy – you can than choose whether to continue the pregnancy.

If you choose to continue with the pregnancy – the IUD will be removed immediately. If you keep the IUD during pregnancy – you will risk your health and your baby’s health.

There is a risk of miscarriage when removing the IUD.

If the IUD can’t be removed – you will be monitored closely during pregnancy.

Learn more specifics about the IUD or Intrauterine Device – Here

Take a look at our most recent medical question sent in.  It isn’t for everyone – but it’s some useful information.

Our child recent underwent surgery for Pyloric Stenosis. We were shocked by the news that our baby was sick. We are hopeful that this will help. Can you please get out the news.

Pyloric Stenosis is an interesting and well understood condition. It affects boys much more than girls. In fact, it often affects the first born males almost 4 times more than others. I am not sure if that is the case from our email reader. But it something to think about.

When you have your well child check ups – this is something that is often looked for. It “develops” in the first six weeks of life. Sometimes it can be seen in older children, but this is unlikely. The presenting symptoms is often projectile vomiting. Of course, projectile vomiting can happen in several other diseases – but this needs to be considered each time.

An exam will happen and a mass can be felt in the abdomen in most cases. The word “mass” is often never a good sign. In this case, the mass comes from the functional problem of this condition.  Stenosis means narrowing and Pyloric often refers to the stomach and means gate. In this case therefore – a narrowing of the gate is occurring.  The location is near the end of the stomach and the Small Intestines.

Food enters the stomach and gets broken down. Some digesting of the food happens in the stomach, but more digesting happens in the intestines. In infants with pyloric stenosis – the food can’t pass from the stomach to the intestines and it therefore is vomited back out the mouth.  It needs to go somewhere.

A muscle that helps with the closing of the Stomach when empty becomes quite enlarged. This muscle does not allow for the complete opening of the stomach into the intestines. This portion of the intestines is known as the duodenum. AS the muscle thickens – the opening becomes smaller and smaller.

The real concern of this condition is malnutrition and dehydration. As both consequences advance, serious complications can be seen by the infant.  Loss of weight, abdominal pain, food hungers, crying can be seen.

The treatment of this condition is Surgery. A 3-4 cm incision used to be the treatment of choice. Now, laproscopy is the preferred treatment. IV fluids will often be given prior to and after surgery. A child may remain in the hospital for 1-2 days – more if a complication is experienced. Recovery is often seen.

The main question about this condition is cause. Functionally – an enlarged muscle is the answer. But, an exact cause is often unknown. Genetics is a likely cause and some see Erythomycin given in the first month of life as another cause possibility. It is believed that a baby is not born with the condition but develops it early in life.

Learn more about Pyloric Stenosis here:

I recently received an email asking about Addison Crisis.

It reads:  My sister-in law just was sent to the hospital and came back with a Diagnosis of Addison Disease and was told she had a crisis. What does this mean?

The answer is interesting.

The first thing to understand is about Addison’s Disease:

In this condition, the the Adrenal Gland does not produce enough steroid hormones. (Glucocorticoids as well as mineralocorticoids)

It is a rare condition that affects the Endocrine System. This condition can also be called:  Chronic Adrenal Insufficiency. 70-80% of the time, there is an insufficiency of the adrenal hormone called Cortisol.

Often the cause is damage from one’s own Immune System. This can be referred to as Primary Adrenal Insufficiency. Tumors can be seen, but this is a rare cause agent.

****  Addison’s disease is named after Dr. Thomas Addison, the British physician who first described the condition in 1849

Now, onto Addison Crisis!!

It is really called an Addisonian Crisis. This occurs possibly as the result of an undiagnosed condition or a serious change in adrenal function. This is a medical emergency and potentially life-threatening situation. Hospitalization is often necessary part of this disease.

Symptoms of this are:

1.)    Sudden pain in legs, lower back, or abdomen
2.)    Severe vomiting and diarrhea
3.)    Dehydration
4.)    Low blood pressure
5.)    Syncope – Loss of consciousness or ability to stand
6.)    Hypoglycemia [Low blood sugar]
7.)    Fevers
8.)    Confusion
9.)     Psychosis
10.)    Slurred Speech
11.)     Lethargy
12.)     Convulsions

Treatment for Crisis

Standard therapy involves injections of hormones. Large volumes of IV fluid including Dextrose. Fluid by mouth is the next treatment when patient becomes more stable.

Take a look at this to get a better understanding:

Click on the picture to get a better view!

This question has been asked of me several times now. It is an interesting question, wouldn’t you say? The reason it is so intriguing is that it happens to almost all of us.

Therefore, one would think, it would be a genetic thing. And the answer is yes and no.

The estimate is that a normal person (whatever that really means anyways) has around 100,000 – 150,000 strands of hair on your head. That doesn’t take into account arm, back, leg, or genital hairs. The numbers could be twice that amount or more.

Hair cells, divide so often, that they can duplicate themselves in a few short hours. Some divide faster, that is why some hair grows quicker. As we get older, the cell division, for the most part, slows down. Only the cells of bone marrow grow quicker.

Hair is actually white – pigments change the color.  There are two types of pigments – Dark (eumelanin) and light (phaeomelanin)  These two pigments will blend together and create the individual hair color.

On a Genetic Level

Our genes are the basic code that determines our hair color. We will discuss a chemical – called melanin that is closely related to hair color. But our genes are equally as important. Our genes from our parents – give us our hair color. There are many aspects of genes involved – that is why shades of color are important.

There isn’t a single gene for blond – if so…that would mean only a few basic hair colors.

That would be so boring!!

Cell Growth of Hair

At the base of each hair is a hair follicle. This is the pigment of cells responsible for hair growth. Pigment cells are also what are responsible for the color of the hair.  A chemical is produced called melanin. This substance is what is responsible for our hair color – red, black, blond, brown or another combination.

The amount, type, and mixture of melanin will lead to hair color.

Going Grey

This can occur at any age. Part of this may have to do with genetics. If your Dad or Mom went gray at twenty – you are at risk of doing the same thing. Gray can come immediately or over time. Genetics and some other things play a role in this. Probably the most important role is genetics.

Your risk of going grey – on average – increase around 10-20% for every decade of life after 30.

Death of the Follicle

Over time, as we age, the pigment aspect of the follicle starts to die. It may not be all at once – or all the follicles at once. This turns the color – or the hair loses color. The result may be grey, white, silver, or some combination.

Other causes of a Grey color

Since Genes aren’t the only issue – what are other things to consider. Well, where you live can play a huge role. A very dry climate can be harsh on the hair. It can lead or be a risk factor to  color change. Just as when you were a kid, and played at the beach, and your color lightened – a similar thing can happened.

Next, things like toxins, chemical exposure and pollutants all can affect hair color. These aren’t necessarily a short term thing. But for long exposure can be the culprit.

Stress, Children, and Medical Issues

There are many who would argue – despite chemical changes – stress and children can lead to grey hair.

Truthfully, the jury is still out on this. Obviously there are people we’ve seen that have dramatically changed their hair color – no of their own choosing.

But we can’t be certain – it wouldn’t have happened otherwise.

I see the proof in some photos of those who’ve had a difficult time.  Some – but not all have had dramatic changes.

Therefore – stress has to be at least a consideration.

Gardasil is one of the few available vaccines for HPV.  Human Papillomavirus or more commonly known as HPV is a virus that is sexually transmitted. It has several types, but only a few types have been directly linked to cervical cancer.

Recently the The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted and approved the use of Cervarix for girls 11 and 12.

Gardasil has been approved for use since 2006.

Cervarix was approved by the Food and Drug Administration on October 16th

The panel also voted to approved the use of Gardasil to males between the age of 9 through 26.

The dosing for Gardasil and Cervarix will be approved and allowed in the Government’s Vaccines for Children program

This program will provide immunizations free for uninsured and under-insured children.

Dosing for both will be given in 3 doses

-    1st shot:
-    2nd shot:   1-2 months following the 1st shot
-    3rd shot:   6 months following 1st shot

Gardasil is made by Merck & Co
Cervarix is made by GlaxoSmithKline

Will Boys choose to have Vaccine?

This appears one of the main questions.   Since men don’t get cervical cancer they may not feel the responsibility.   Although the vaccination does not  just cover cervical cancer but covers genital warts as well.

It is believed that only 1% of sexually active males in the U.S. develop genital warts.   Genital warts are not life threatening.

The true benefit would return back to the female.

Some argue to require or mandate a vaccination and prompt health insures to pay for this vaccination.

Currently no mandate has been put into place but the CDC will begin debating this argument in the next few weeks.

A Harvard University study recently placed in the British Medical Journal this mouth found no cost benefit by vaccinating boys. Consideration for the benefit that women would gain was added into this study, though it didn’t change the outcome.   However, Mereck did their own study and found the results were different from the study done at Harvard University.

“It may seem unfair:   Should this burden be borne by only girls and women?” asked Nancy Berlinger of the Hastings Center, a nonprofit bioethics research institute.

http://online.wsj.com/article/SB125572545935790741

Check out the blog article entitled:  HPV Vaccine may do more than prevent Cervical Cancer, it may cause girls to be more cautious about sexual activity

Recently I spoke with a women who was not very far along in her pregnancy.  We discussed several issues such as:  how long she had been trying, what she was giving up, her “planned pregnancy“,  her worries, her symptoms, and other concerns.   Then she threw me for a loop by saying that she was planning on having a C-section rather than vaginal delivery because she didn’t want to go through the pains of childbirth.

I wasn’t even sure that was an option.  Is elective C-section so planned that one may decide to have a C-section for non medical reasons?  A very interesting concept and can be a great argument starter at family parties.  My personal jury is still out deciding on a verdict…. but what do you think?

Background

Giving birth by Cesarean section or also called Caesarean section and C-section can be a difficult choice.  For many it becomes a life saving measure during an emergency while giving birth.  It is another option other than vaginal delivery

The raise in number of C-sections is astounding.  Consider that in 1970 only 6 percent of all births were by C-section.  Back in 2005 that number had increased 5 times to over 30% of pregnancies.

C-section is a abdominal surgery then through the uterus to allow for the birth of a child. It is often considered riskier than vaginal birth but both procedures cause a risk for  mortality of both the baby and the mother.

The following are several reasons to have a C-section planned:

1.)  A previous C-section – although not must – having a previous C-section does not prohibit you from ever having a vaginal delivery again

2.)  Your baby is breech   [Bottom first]

3.)  Your baby is transverse  [sideways]

4.)  More than one baby – C-section may be an option

5.)  You develop a conditon known as Placenta previa

6.)  Mother having HIV and a high viral load    [HIV isn't passed through the placenta but can be transferred
during vaginal delivery

7.)  Complication to baby that otherwise would worsen with vaginal delivery

8.)  A very large baby

9.)  Others

Unplanned C-sections

1.)  Difficulty during birth

2.)  Distress of baby during birth

3.)  Umbilical cord concerns

4.)  Placenta abruption  [when the placenta unattaches from uterine wall - loss of oxygen to baby]

5.)  Others
*** – remember that over 90% of preterm deliveries are done by C-section   http://www.marchofdimes.com/aboutus/22684_30185.asp

Elective C-section

-       Some doctors endorse c-sections for medical reasons

-       Some OBGYN clinics in Italy have a 80-90% C-section rate to prevent lawsuits

-       In Brazil  -  hospitals are allowing 80% of births to be done by C-section

-       Increase number of C-sections are being done for non medical reasons

My recent conversation isn’t unheard of and is increasing in value for many women.  Some women report watching family members with difficult deliveries and others want an uncomplicated delivery.  A reported increase in the number of women waiting to become pregnant until later in their lives may also be a factor. This is just one of many areas that women and physicians alike have drawn lines and have begun to debate the idea of non medical elective C-sections.

Q:    What is the Swine Flu?

The  Swine Flu is a type of Influenza Virus, it is also referred to as H1N1. Several other types of virus can transmit from animal to humans when mutated.  Such as avian, horse, dog, and pig.

It was first found in Mexico in April of 2009.       This type of virus from a class of viruses called Orthomyxoviruses

There are 5 main types of this virus and the swine influenza is a subtype of one of the 5.   Influenza A is the major player in many flu symptoms and epidemics each year and the Swine flu is a type of Influenza A

Q:     I recently heard that washing your hands won’t help with the Swine Flu? I don’t see how that is possible!!!

This is a great question. I am completely positive that washing your hands helps with most viral and bacterial infections. At least helps prevent. And typically passing soap over your hands and scrubbing can be quite effective in the prevention of passing microbes from person to person.

When it comes to the swine flu however, contributing factors to the passage of infection such as restroom use, touching a door knob, covering your mouth when coughing, passing money and others can not be compensated by washing hands alone.

Recent Studies point to the passage of Swine flu through breathing and inhaling the microscopic particles that are already in the air. This is the main action or transmission of this virus. Sneezing into your hands may not even be a great way passage of the virus is seen. However, droplets from sneezing are airborn and breathed into the lungs causing the infection. This may also be why some believe that you can get the swine flu even after the person sick has left the room. The virus is still in the air and you breath it in.

 Q:    Why is the Swine Flu a Pandemic?

The U.N. Health Officials met in Geneva on Thursday June 11th, 2009 to discuss the H1N1 virus the World Health Organization (WHO) officially declared a 2009 Swine flu pandemic. This is the first such update in over 41 years. . The severity of the virus world wide is rather moderate but the reason for the classification to pandemic is related to how quickly the virus has spread. 

WHO chief Dr. Margaret Chan said “The World is moving into the early days of its first influenza pandemic in the 21st century“.

Q:    Is there a Vaccine for the Swine Flu in 2009 and 2010?

Yes,  the CDC has helped to provide a vaccine that is available for the public.   The Virus in question has been isolated and several companies have worked hard to find a workable vaccine.

Q:    Who should get the vaccine?

According to the Advisory Committee set up by the CDC, several groups are recommended to get the vaccine:

1.)    Pregnant Women
2.)    Caregivers
3.)    Healthcare professionals
4.)    All individuals 6 months to 24 years of age
5.)    Those from age 25 to 64 who are at risk and have other health coniditons

Q:    Does it protect against the seasonal flu?

No, for protection against both the seasonal flu and the Swine Flu then you will need both vaccines

Q:    How should I decide who gets the Swine Flu Vaccine?

Follow the guidelines or otherwise speak to your health care professional

Q:    Does a product like Lysol help kill Influenza?

It appears so, Lysol Disinfectant spray, wipes and cleaners are reported to be successful in killing the virus

Blogs related to the Swine Flu:

H1N1 Plateau and MutationsNational Emergency – The Swine FluSwine Flu – Heating Up or Exploding??

Let Human Testing Begin!!!

Swine Flu Vaccine Awarded First Contract

Pandemic WHO – Updated with new related deaths

Pandemic WHO

What is more important:

To breathe OXYGEN or to release CARBON DIOXIDE?                What do you think??

Welcome to InterActive Health!

This is a chance for you to ask a medical question

We would love to hear from you!!

Why does hair turn Grey?

The estimate is that a normal person has around 100,000 – 150,000 strands of hair on your head. That doesn’t take into account arm, back, leg, or genital hairs. The numbers could be twice that amount or more.

Hair is actually white – pigments change the color.  There are two types of pigments – Dark (eumelanin) and light (phaeomelanin)  These two pigments will blend together and create the individual hair color.

This can occur at any age. Part of this may have to do with genetics. If your Dad or Mom went gray at twenty – you are at risk of doing the same thing.

Over time, as we age, the pigment aspect of the follicle starts to die. It may not be all at once – or all the follicles at once. This turns the color – or the hair loses color. The result may be grey, white, silver, or some combination.

Learn more here:  Why in the World does your Hair turn Grey?

Should all women get a Mammogram?

Age and relevance continues to dominate the argument of mammography.  Mammograms are a key way to diagnosis breast cancer.   The essential “facts about Breast Cancer” always include mammograms.     Mammograms have been an important theme and has been promoted during Breast Cancer Awareness Month.

But for many women both young and old,the question regarding the importance of mammograms continues to be dusted off.

Mammograms are a specialized X-rays that looks at breast tissue.   Can be done as a routine screening or following a breast exam finding a concerning nodule.

So the answer is Yes

Learn more here – The Mammogram Debate – What should you choose?

Should boys and girls be given a vaccination for HPV?

Gardasil is one of the few available vaccines for HPV.  Human Papillomavirus or more commonly known as HPV is a virus that is sexually transmitted. It has several types, but only a few types have been directly linked to cervical cancer.

Recently the The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted and approved the use of Cervarix for girls 11 and 12.

Gardasil has been approved for use since 2006.

Cervarix was approved by the Food and Drug Administration on October 16th

Learn more here – Should Gardasil be a Required Vaccination for Boys?

Should I choose to have a C-Section?

Recently I spoke with a women who was not very far along in her pregnancy.  We discussed several issues such as:  how long she had been trying, what she was giving up, her “planned pregnancy“,  her worries, her symptoms, and other concerns.   Then she threw me for a loop by saying that she was planning on having a C-section rather than vaginal delivery because she didn’t want to go through the pains of childbirth childbirth.

Learn more here -  To have a C-Section or not to have a C-Section?