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Discusses Women's Health

I have on-going discussions with patients who have been on hormone therapy for more than five years as to whether they should continue or stop. There is a valid concern about a potential increase in risk of breast cancer with long term estrogen and progestin therapy. (The use of estrogen only in women who have…

As I was glancing through the monthly Journal Menopause I came upon an interesting article that had cosmetic implications. The authors looked at the potential adverse skin effects subsequent to the removal of the ovaries during hysterectomy in premenopausal women who had surgery for benign conditions. The study included 135 premenopausal women between 40 and…

I try to record the network shows I want to see. Usually, I am not in front of my TV at the right time or cannot stay up late enough to watch a live broadcast. I also want to bypass those drug, car and insurance ads. As I speed my DVR through the commercials to…

Stem cell therapy is widely considered the future for treatment of disease. The media (and the medical articles they quote) have made stem cell – based technologies seem like the cure-all for every ailment, ache and pain. We wish it were so and stem cell clinics thrive on that wish… In a recent perspective in…

Many of my friends and patients have asked me about my opinion of the video that showed a  Planed Parenthood employee discussing reimbursement for recovery of fetal tissue. I tried to explain the fact that the video was misleading and was edited in order to make Planned Parenthood seem as if it was conducting callous…

The end of the personal belief exemption for vaccinations of children in California has been celebrated in a “front page” article in the August 27th issue of the New England Journal of Medicine. Here is a synopsis of what the authors from the Stanford University School of Medicine and Law School wrote. “The new law…

I have always thought that there was too much concern about GMO’s (genetically modified organisms) and that genetic engineering of our food sources might be the way to prevent future starvation in our overpopulated world. After all, genetically engineered crops are touted as a way to increase yields, allow plants to thrive when irrigated less…

Happy birthday to our public health insurance programs! A recent article in JAMA reported some impressive statistics about them that I thought were worth sharing … Medicare and Medicaid serve 111 million beneficiaries and account for $1 trillion in total spending. They generate 43% of hospital revenue and represent 39% of national health spending. One…

I just passed my Cologuard test. No, there’s no grade it’s just a result that’s negative or positive and thankfully my test was negative. I have discussed this colorectal cancer test in a previous article, but to review…It is a stool test that can ascertain the presence of abnormal DNA due to advanced adenomas (considered…

We are dying from too much sun. I’m not talking about global warming, although our fossil fuel consumption does have an impact on the ozone layer… Melanoma rates in the United States have doubled between 1982 and 2011. According to data from the CDC the incidence of melanoma increased from 11.2 cases per 100,000 population…

As some of you may have heard in the news, an advisory panel to the FDA recommended approval of a new drug called flibanserin for the treatment of hypoactive sexual desire disorder or HSDD. (Yes we have to give a medical name and call something a disorder in order to treat it; “diminished or absent…

Most women over a certain age (OK usually over 40) will look in the mirror and closely survey those facial wrinkles, folds and lines that inexorably appear with age. And that’s when they (we) bless the fact that cosmetic fillers are readily available to address these unwanted linear indentations at the local dermatologist’s office. So,…

There is an ongoing controversy as to whether hormone therapy is protective of coronary heart disease. If so, whether this makes a difference to coronary protection if the hormone therapy is started in early menopause, begun years after the menopausal transition, or continued for many years. This is an extraordinarily important issue…Coronary heart disease (CHD)…

Last week I was walking on the boardwalk in Venice with my daughter and soon to be son-in-law and we passed a large green and white sign with a picture of a cannabis plant. Several, young people dressed in green scrubs were handing out flyers proclaiming that the doctor was in the “office” situated between…

My daughter is getting married this weekend at my home so I didn’t have a chance to write my blog post. I will renew my medical vows to you next week.

I, like most physicians had to switch to EMR’s (electronic medical records) three years ago. It took months to train both my staff and myself. We had to scan all the charts and put them in a HIPAA protected cloud. There are numerous EMR’s out there and the problem is that they do not “talk”…

Over the counter, extremely sensitive pregnancy tests now allow a woman to find out that she is pregnant even before she has missed a period. And if she then gets a “late period”, she realizes it represents a failed early pregnancy. Miscarriage is extremely prevalent, occurring in up to 20% of clinically recognized pregnancies (and…

This definitely caught my attention: In the section titled, “News from the FDA” in this week’s edition of JAMA there was a short notification that the FDA had approved a drug to reduce double chins. The drug is called Kybella (I have no idea what the Latin root for chin is, or how they came…

Although I rarely write articles about pregnancy, I couldn’t pass on a study that appeared in the April issue of the American Journal of Obstetrics and Gynecology. The authors from McGill University tested Vitamin D levels in a group of pregnant women in Halfax, Nova Scotia and Quebec City (not sunny places).169 of these women…

Five days a week the American Congress of Obstetricians and Gynecologists ( ACOG) emails its fellows (yes I’m a Fellow) a summary of headlines that can impact our specialty. In Thursday’s section on women’s health and research, they highlighted a new study published in The Journal of Clinical Endocrinology and Metabolism. (There are so many…

For Mother’s Day, “Save the Children” released its report on The State of the World’s Mothers. This year they concentrated on The Urban Disadvantage. Every day, 17,000 children die before reaching their fifth birthday. Many of these preventable deaths occur in city slums where overcrowding and poor sanitation exists. Half the world’s population currently lives…

Next week after we celebrate Mother’s Day, I will report on the state of the world’s mothers from data that was just released by “Save the Children”. But this week, I thought I would be more uplifting and talk about the advances in freezing eggs which can allow women to become mothers when they otherwise…

As many of you know, I am on the board of trustees of Save the Children. I have received daily updates on the horrific consequences of the earthquake in Nepal. Save the Children has had programs in Nepal for decades and has a staff of 450 in the most rural areas of the country. Our…

Some of you may have noticed that I did not write my website article last week. Well, I was sick! I got that cold and cough that seems to be going around and stayed home for a week. It was clearly viral so there were no medications other than supportive ones, i.e. cough medicine and…

I am writing this after having hiked up a mountain, slow motioned through tai chi, attempted a “funky dance” class (no I did not do it in a white coat) and was balanced with BOSU sculpt. (Exercises are done on an unstable half ball called a BOSU. The word stands for” both sides up”… it’s…

Insurance companies, medical societies, the government, scientists, researchers and, yes, patients often look at the cost of medical disorders and problems as well as that of the therapy to treat or prevent them. Does a disease or troublesome symptoms cause a decrease in life span, health span or life quality? Does it impact a person’s…

Anywhere from 12 to 15% of early pregnancies which have been detected with pregnancy tests are lost. Perhaps more occur in women who simply think their periods were late and didn’t run tests to see if they were pregnant. Miscarriage rates also increase as couples get older. A delay in trying to get pregnant again…

This week every newspaper (that I read) featured an article that appeared in the March 17th JAMA issue. It raised questions about the reliability of breast biopsies and whether recommendations for therapy should be solely based on a single biopsy “reading”. As usual, after the attention grabbing headlines, certain details were missing (or discussed at…

A part of healthcare diligence is getting an eye examination. After the age of 40, many women are told by their friendly ophthalmologist “I see the beginning of cataracts”. Or worse, especially as we get older “You have cataracts.” That pronouncement does not equate with total loss of vision for most Americans who have access…

We all have had dense breasts (although a better word would be “firm”) from puberty into our early 40s. Most women know what I mean… perky comes to mind, and when we actually looked good in a T-shirt without a bra (when we did purchase a bra, we looked for one that was low cut…

As I sipped my afternoon cup of coffee, I came across an article in the journal Menopause that examined the association between caffeine and menopausal symptoms. How relevant I thought…after all 85% of the US population consumes some form of caffeine containing beverage daily. And 80% of women going through perimenopausal and menopause have vasomotor…

I used to say that home delivery was for pizza. It was a comment that was sort of cute, questionably appropriate, and currently considered “not-with-it” and even offensive. Historically, it was of course the norm. In 1940 (yes, before I was born) 44 % of births in the United States States occurred outside the hospital…

I spent many years in Israel and was used to seeing men in various venues smoking a hookah. I remember being at a home where the host brought out several hookahs and invited the guests to join in. I tried it for a minute and found it quite unpleasant, but then I don’t smoke cigarettes,…

With the advance of genomic medicine, a myriad of issues regarding discrimination in obtaining insurance and jobs has come to fore. It turns out that every one of us carries at least a few genetic variants that will influence, but in most cases not exclusively determine our health and lifespan. And as computers “spell out”…

I, like everyone else, have gone digital. I read several of my medical journals on my iPhone or iPad. Every time I see a patient, my nurse and I enter her vital signs, medications, allergies, smoking status, family history, environmental data and of course, medical complaints, physical exam, diagnosis, assessment and plan on her electronic…

This week’s JAMA has a viewpoint article titled “The implications of marijuana legalization in Colorado”. I expected to read about side effects (there are many medical societies that still have great doubts about the use of marijuana, at least recreationally) and just perhaps something positive. Initially the article traces the timeline of marijuana’s legalization: In…

I know I have discussed this subject in my books and previous website articles but in this last month’s issue of the journal Menopause there was section called NAMS (North American Menopause Society) Practice Pearl that dealt with this and I thought it was a good idea to go over their “Pearl”. The term “bio…

After I returned from my fabulous trip to Israel and Jordan (I also visited Petra), I caught up on my reading and in the January 6 issue of JAMA I found a review of travelers diarrhea. The authors searched multiple databases on the subject from the period between 2012 and 2014. There were 2676 articles……

When I’m here I can’t help but compare our US healthcare system to that of Israel. Members of my family have received phenomenal care here, but rather than take their word for it I logged on to the website of The Ministry of Foreign Affairs. I knew their report would laudatory but it is, after…

As I was about to leave for Israel for my daughter’s wedding, I couldn’t help but scan the article in JAMA with the title listed above: “Feeling Old vs Being Old” and the associations between self perceived age and mortality. (Nothing makes one feel older than having offspring old enough to get married, but then…

This time next week I’ll be in Tel Aviv. I’m going for my younger daughter’s wedding and I’m quite excited. As I tried to see as many patients as possible before the end of the year, I also quickly perused the current JAMA. As usual I found a relevant article that I think we all…

I rarely write website articles on prenatal issues, but I thought that the fish debate was one that would be interesting, not just to my patients who are considering getting or are already pregnant, but also to their mothers, mother-in-laws and the rest of the family and friends who eagerly offer advice as soon as…

I have become acutely aware of the nutritional intake of young children since my two grandchildren have moved to their new home nearby. We frequently get to share meals in my kitchen, restaurants or (most often) my daughters home; but the choice of “agreeable” foods is significantly restricted. So when I saw the CDC report…

There’s so much to be thankful for this holiday; our health, the well-being of our families and despite the results of the elections, the well-being of our country. There is also much that we can do for others. And now between Thanksgiving, Christmas and Hanukkah we have “give back Tuesday”. I kind of thought I…

I am writing this on a flight home to LA from New York. I went to the very cold east coast for a Save the Children board meeting and Gala. I participated in three days of nonstop discussions (and celebration) of the humanitarian efforts of this amazing NGO (non governmental organization) for which I have…

Smoking is the number one cause of lung cancer and lung cancer is the leading cause of cancer related deaths in the United States. (More than breast, colorectal and prostate cancer combined!) A proper medical history should always include a smoking history and medical care should include therapies (and ongoing encouragement) to stop if a…

We all know what comes with our 50th birthday… The advice by your physician to get colon cancer screening. And then comes the yuck factor; discussion of the ways to do a colon cleanse in order to be able to view the interior aspects of this very long digestive conduit with either a “true” or…

After the report that came out in 2002 from the Women’s Health Initiative (WHI) almost 80% of women who had been on Premarin and Provera stopped taking it. But as more and more women went through the menopausal change, had significant symptoms and the results of the WHI underwent interpretation and reanalysis, women and their…

Many of us have now assumed certain grandparenting duties with joy and pleasure, especially if we do can them without the duress of becoming the primary care giver … Apparently there have been very few studies on what this role does to our cognitive health. So I read with great interest the article that appeared…

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