Fibroids typically affect women in their 30s and 40s with as many as 20 to 40 percent of women older than 35 having some fibroids. For some reason, African American women are especially prone to fibroids with nearly 50 percent having fibroids of significant size.

Diagnosing Fibroids

Fibroids are generally diagnosed during a woman’s routine gynecological exam. Imaging studies like CT and MRI can be used to confirm the diagnosis.

If you are having these symptoms, you should talk to your doctor about whether you might have fibroids:

• Heavy, prolonged menstrual periods
• Unusual monthly bleeding with clots
• Pelvic pain, including pain during intercourse
• Pain in the back or legs
• Bladder pressure that makes you feel like you need to urinate
• Problems with constipation or bloating associated with pressure on the bowel
• Abnormally enlarged abdomen

Treatment Options

For some women with mild or no symptoms, the best treatment is called “watchful waiting” where the fibroids are monitored during regular checkups. If the fibroids are causing some of the problems listed above, your doctor may try medications including non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, birth control pills or hormone therapy. Medication therapy often is the first line of treatment for problem fibroids.

If medications don’t work, then there are other options. Surgery to remove the fibroids (myomectomy) may be an option. Generally myomectomy helps control symptoms and is about 80 percent effective. However, studies have shown that about 10 to 30 percent of the fibroids grow back after several years. The procedure can be done in several ways with recovery time varying from two to six weeks.

Hysterectomy, either open or laparoscopic, is commonly used for fibroids. About one-third of all hysterectomies in the U.S. are due to fibroids. However, hysterectomies are major surgical procedures and remove the entire uterus. A 3-4 day hospital stay is required and recovery time is about six weeks.

A minimally invasive approach

Another treatment option called uterine fibroid embolization works to get at the underlying cause of the problem fibroids. An interventional radiologist uses a catheter to access the blood supply to the fibroid and cut off the supply of blood. By depriving the fibroid of blood, the fibroid shrinks.

Uterine fibroid embolization uses minimally invasive techniques that may help reduce recovery time and leaves the uterus intact. In this procedure, the doctor makes a small cut in the skin in the groin and threads a catheter (a small, flexible tube) into the femoral artery up to the artery supplying the fibroid. A special X-ray helps guide the doctor in correctly placing the catheter. Once the catheter is in place, tiny plastic particles are injected into order to block the blood to the fibroid.

Embolization requires an overnight stay in the hospital. Medications to control pain and swelling are prescribed. Women may experience cramps, pain and fever following the procedure. Other rare side effects include infection and injury to the uterus that may result in a hysterectomy. A few women in their mid-40s or older (less than 2 percent) have begun menopause after UFE.

After a few days, you can resume light activities and generally can resume normal activities within a week to 10 days. The majority of women treated with embolization (85 to 90 percent) have significant reduction in the heavy bleeding and pain associated with fibroids. Only in rare cases do the treated fibroids return.

In some cases, women who have been treated with UFE have been able to become pregnant. However, the studies on fertility have not been confirmed as yet.

What treatment is right for me?

You and your doctor should discuss all available treatment options along with their associated benefits and risks. If you’d like to learn more about uterine fibroid embolization at North Fulton Regional Hospital, please call 770-751-2660.

1. Call 1-800-MEDICARE any time, day or night to get answers to any questions you may have. Calls should take, on average, 10 to 15 minutes.

2. When you call, you should:

• Tell us your zip code so we can tell us how to get drug savings at pharmacies near your home.

• Tell us what medicines you take and their dosages so that we can tell you which cards could save you the most on your medicines.

• Tell us if you like a particular pharmacy in your neighborhood, or prefer a drug card with an annual fee lower than $30, or if you want to hear more about a particular Medicare-approved card.

• Tell us if you have a limited income because you may qualify for even more help. If your income is below $1,405 a month if you are married or around $1,047 if you are single, you can get a $600 credit on your drug card toward the cost of your drugs this year, and another $600 for next year. Some drug makers are giving additional discounts. If your income is higher than this, we can give you information on state programs and drug maker programs that can provide additional help.

• Tell us if you want to learn how to save even more on your drug costs, like using generic drugs or mail-order pharmacies. Generic drugs work in exactly the same way as brand-name drugs, but they typically cost 70% less, and large discounts are available on generics through the Medicare-approved cards.

3. When you call, we will answer any other questions you may have. We will mail you a personalized booklet showing you how you can get the most help to lower your drug costs, including what you would pay for your drugs on the cards that best fit your needs.

4. We also will send you a standard enrollment form you can use to sign up for any card, along with specific instructions and where to go if you have more questions. We also will send you a form so you can apply for the $600 credit. Once you’ve decided which card is best for you, just fill out the form, send it in with your fee, and you’ll get the card in about a week.

5. You can sign up for a card any time this year. If you wish to change cards in 2005, you have from mid-November until the end of December. You don’t need to sign up right away, but if you sign up for the card by the end of May 2004, you can get full benefits from the discounts and the $600 credit, both of which start June 1, 2004.

The Medicare-approved drug discount card is a voluntary new program that you can use to get additional savings on drugs.

This information was provided by the Georgia Hospital Association.

To get more information on the program, go to the Medicare website by clicking here.

Some women who have certain medical conditions may have to take special precautions during pregnancy, so check with your doctor about your exercise routine. Even if you didn’t have an exercise routine before getting pregnant, this could be a great time to start on an exercise plan that will keep you healthier even after your baby is born.

How Exercise Helps

Exercise during your pregnancy has many benefits such as helping your body get ready for labor and childbirth. You can increase your energy and build up good muscle tone. Having a baby takes a lot of stamina, so being in good shape can really help.

Regular exercise also may help you in the following ways:

• Reduce backaches, constipation, bloating and swelling
• May help prevent or treat gestational diabetes
• Increase energy levels
• Improve mood
• Improve posture
• Promotes good muscle tone, strength and endurance
• Helps you sleep better

Weight gain comes with any pregnancy. In general, you can expect to gain 25 to 30 pounds. Your heart will have to pump more blood, and you’ll use about 20 percent more oxygen when you rest and even more when you exercise. Regular exercise can help your body meet these new demands.

Getting Started

The first step before beginning any exercise program is to check with your doctor. Even if you participated in a regular exercise program or sports before you got pregnant, talk with your doctor to make certain that the program is still appropriate for your new status. You may need to make modifications to your existing program.

Your goal should be to exercise three or four times a week for at least 20 minutes per session. Start slowly and work up to your goal over three to four weeks.

Walking is an excellent exercise for nearly everyone. It gives you a moderate aerobic workout while putting less stress on your joints than some other forms of exercise such as jogging or high impact aerobics. Best of all, you’ll just need a good pair of well-fitting walking shoes, comfortable clothing, and a safe place to walk.

Prenatal Exercise and Prenatal Yoga Classes

North Fulton Regional Hospital offers prenatal exercise classes and prenatal yoga classes. These classes are taught by instructors who are experienced in working with women during their pregnancies. You’ll need a waiver signed by your doctor or midwife in order to participate in either class.

The prenatal exercise class is taught by a registered nurse who is certified in aerobic and prenatal exercise. The exercise routine is modified based on your stage of pregnancy. You’ll pay only for the classes you attend.

Prenatal yoga is taught by an experienced prenatal yoga instructor. You don’t need to have prior yoga experience to join the class. You can repeat the series of classes as often as you want, but registration is required for each series. Yoga can help you retain strength, tone and flexibility during your pregnancy. It also helps with posture and promotes relaxation and a feeling of well-being.

These classes fill up quickly, so early registration is recommended. Call 770-751-2687 to register or for more information.

Colds and flu are both highly contagious and have many symptoms in common, but the flu is a serious illness that may have life-threatening complications.

• Fever: Rare in adults and older children. Can be as high as 102ºF in infants and small children.
• Headache: Rare
• Muscle Aches: Mild
• Tiredness & Weakness: Mild
• Extreme Exhaustion: Never
• Runny Nose: Often
• Sneezing: Often
• Sore Throat: Often
• Cough: Mild hacking cough

• Fever: Usually 102ºF, but can go to 104ºF. Fever lasts 3-4 days.
• Headache: Sudden onset and can be severe.
• Muscle Aches: Usual, often severe.
• Tiredness & Weakness: Often extreme. Can last 2 or more weeks.
• Extreme Exhaustion: Sudden onset, can be severe.
• Runny Nose: Sometimes
• Sneezing: Sometimes
• Sore Throat: Sometimes
• Cough: Usual, can become severe.

The flu may be far more dangerous than a cold and may lead to pneumonia. Both are caused by viruses, but not the same ones.

Cold symptoms appear within one to three days of being exposed to the cold virus. Flu symptoms come on abruptly and may be quite severe including high fever, cough, headache, and muscle and body aches. Gastro-intestinal symptoms such as nausea, vomiting and diarrhea are more common in children than adults.

Influenza viruses spread through the air when a person with the flu coughs, sneezes or speaks. Other people then inhale the viruses. Once the virus enters the nose, throat or lungs, they start to multiply and symptoms of the flu appear. You also may be exposed to flu viruses by touching a surface such as a door handle or telephone and then touching your mouth or nose.

You may be contagious and able to spread the flu virus even before you start showing symptoms. Adults can transmit the flu virus one day before showing symptoms and up to seven days after getting sick. Children may be contagious for a longer period of time.

The best prevention is to get a flu shot in the fall. If you didn’t get your flu shot this year, there are still steps you can take.

• Avoid coming in contact with people who are sick.
• Stay home if you are sick, if possible.
• Cover your mouth and nose with a tissue when you cough or sneeze. Don’t use your hands since you will just transmit the virus to what you touch. If necessary, use your forearm or sleeve when coughing and sneezing.
• Wash your hands. Frequent hand washing using soap and water remains one of the best ways to keep from picking up viruses and from spreading them to others.
• Avoid touching your eyes, nose and mouth with your hands since this can spread viruses you’ve picked up from surfaces around you.

If you do get the flu, the best advice is to get plenty of rest, drink lots of liquid and avoid using alcohol and tobacco. You can take over-the-counter medicines to relieve symptoms of the flu.

CAUTION: Do NOT give aspirin to children or teenagers who have flu-like symptoms, especially a fever. In some cases, this has caused a serious complication known as Reye’s syndrome.

Some people are more at risk of developing complications of the flu. These include young children and people older than 50. Other at-risk groups include:

• Residents of nursing homes or chronic care facilities
• People with chronic disorders such as diabetes, heart, lung or kidney disorders
• People with a weakened immune system including those with HIV, leukemia or taking medications following an organ transplant
• Women who are pregnant and in their second or third trimester
• People who work in a healthcare facility

If you fall into one of these groups and develop symptoms of the flu, call your doctor immediately.

If you develop complications including trouble breathing, a very high fever, a severe sore throat, a cough that produces a lot of green or yellow mucus, or you feel faint, call your doctor.

There are some medications that may help shorten the flu’s duration and intensity. These include neuramidase, rimantadine and amantadine. Some of these medications only work with certain types of influenza viruses. To be effective, these need to be taken no later than 24 to 48 hours after you first develop symptoms.

Preconception Planning

There are steps you can take even before you get pregnant that may help ensure a healthy baby. You’ll want to start with scheduling a preconception appointment with your doctor. This visit will give your doctor an overview of your current health status plus your medical and family history.

Your doctor will want to know is whether you’re immune to certain infections such as rubella. If you aren’t immune, your doctor may recommend that you get the rubella vaccine at least three months before you become pregnant. During the fall, you should talk to your doctor about a flu shot.

Your current health status including conditions such as diabetes, high blood pressure, asthma and lupus, will play a part in your pregnancy. You and your doctor should take steps to make sure these conditions are under control before you become pregnant.

You and your partner will also need to discuss any inherited conditions such as sickle cell anemia, cystic fibrosis and muscular dystrophy. Genetic counseling may be recommended for certain ethnic groups and others with inherited disorders in their family history.

Lifestyle Changes

There are changes you can make to your lifestyle before you become pregnant to make certain you are as healthy as possible. Some of the changes to consider are:

• Stop smoking. Smoking decreases a woman’s chance of getting pregnant, and may reduce a man’s sperm count. Smoking during pregnancy may result in a lower birth weight for the baby. Women who smoke have a higher incidence of miscarriages and stillbirths.

• Reduce or eliminate alcohol consumption. Babies who are exposed to alcohol before birth may have mental retardation, learning disabilities and behavioral problems. Like smoking, alcohol consumption may reduce your ability to conceive and may affect both the quality and quantity of a man’s sperm.

• Eat Healthy and Exercise. Adopting healthy eating habits and exercising can help you get in shape for your pregnancy. If you are overweight, your doctor may want you to lose weight before you become pregnant. Women who are thinking about getting pregnant should start taking folic acid supplements that help protect the baby against neural tube defects such as spina bifida. Talk to your doctor about how much folic acid you should be taking.

To learn more, plan to attend our “Maybe Baby?” seminar.

Some women who have certain medical conditions may have to take special precautions during pregnancy, so check with your doctor about your exercise routine. Even if you didn’t have an exercise routine before getting pregnant, this could be a great time to start on an exercise plan that will keep you healthier even after your baby is born.

How Exercise Helps

Exercise during your pregnancy has many benefits such as helping your body get ready for labor and childbirth. You can increase your energy and build up good muscle tone. Having a baby takes a lot of stamina, so being in good shape can really help.

Regular exercise also may help you in the following ways:

• Reduce backaches, constipation, bloating and swelling
• May help prevent or treat gestational diabetes
• Increase energy levels
• Improve mood
• Improve posture
• Promotes good muscle tone, strength and endurance
• Helps you sleep better

Weight gain comes with any pregnancy. In general, you can expect to gain 25 to 30 pounds. Your heart will have to pump more blood, and you’ll use about 20 percent more oxygen when you rest and even more when you exercise. Regular exercise can help your body meet these new demands.

Getting Started

The first step before beginning any exercise program is to check with your doctor. Even if you participated in a regular exercise program or sports before you got pregnant, talk with your doctor to make certain that the program is still appropriate for your new status. You may need to make modifications to your existing program.

Your goal should be to exercise three or four times a week for at least 20 minutes per session. Start slowly and work up to your goal over three to four weeks.

Walking is an excellent exercise for nearly everyone. It gives you a moderate aerobic workout while putting less stress on your joints than some other forms of exercise such as jogging or high impact aerobics. Best of all, you’ll just need a good pair of well-fitting walking shoes, comfortable clothing, and a safe place to walk.

Prenatal Exercise and Prenatal Yoga Classes

North Fulton Regional Hospital offers prenatal exercise classes and prenatal yoga classes. These classes are taught by instructors who are experienced in working with women during their pregnancies. You’ll need a waiver signed by your doctor or midwife in order to participate in either class.

The prenatal exercise class is taught by a registered nurse who is certified in aerobic and prenatal exercise. The exercise routine is modified based on your stage of pregnancy. You’ll pay only for the classes you attend.

Prenatal yoga is taught by an experienced prenatal yoga instructor. You don’t need to have prior yoga experience to join the class. You can repeat the series of classes as often as you want, but registration is required for each series. Yoga can help you retain strength, tone and flexibility during your pregnancy. It also helps with posture and promotes relaxation and a feeling of well-being.

These classes fill up quickly, so early registration is recommended. Call 770-751-2687 to register or for more information.

However, women who postpone childbearing may face some special risks.  Generally, women have decreased fertility starting in their early thirties and it’s not unusual for a woman in her mid-thirties to take longer to conceive than a younger woman.

A decrease in ovulation can be the result of less frequent ovulation, or to problems such as endometriosis, in which tissue similar to that lining the uterus attaches to the ovaries or fallopian tubes and interferes with conception.

Other problems may accumulate with age.  Conditions such as diabetes and high blood pressure are more common in older women and may endanger a pregnant woman and her developing baby.  She may also face a higher risk of placental and bleeding problems during pregnancy, as well as risk of cardiovascular problems.

Risk of Miscarriage

Most miscarriages occur in the first trimester of pregnancy.  According to the March of Dimes, rate of miscarriage in older women in significantly greater than that of young women.  Studies show that this risk is about nine percent for women in their twenties.  It rises to about 20 percent at ages 35 – 39 and rises to more than 50 percent by age 42.  The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage.

Risk of Birth Defects

The risk of certain chromosomal disorders increases as a woman ages.  The most common of these is Down syndrome, a combination of mental retardation and physical abnormalities caused by the presence of an extra chromosome 21.  At age twenty-five a woman has a 1-in-1250 chance of having a baby with Down syndrome.  At age 35, the chance increases to 1-in-400 and at age 40 it’s 1-in-100.

Many women who are 35 or older have prenatal testing, such as amniocentesis or chorionic villus samples, to rule out Down syndrome and other chromosomal abnormalities.  If prenatal testing rules out any defects and the mother is healthy, the baby is likely at no greater risk of birth defects than if the mother were in her twenties.

First-time mothers over 30 are also more likely than women in their early twenties to have difficulty during labor.  This may account for an increased rate of cesarean sections among women over 30. 

The good news is that advances in medical care have made late-age pregnancy safer.  And there are steps a pregnant woman can do to reduce her risks.  These include:

• Consume 400 micrograms (0.4 milligram) of the B vitamin folic acid daily before and during pregnancy (this applies to all women of childbearing age).
• Have a pre-pregnancy medical check-up and obtain early and regular prenatal care during pregnancy.
• Eat a variety of nutritious foods and achieve proper weight for height before conception.
• Don’t drink alcoholic beverages during pregnancy.
• Don’t smoke during pregnancy.
• Don’t use any drug, even over-the-counter medications, unless recommended by a health care provider who knows you are pregnant.

The National Diabetes Information Clearinghouse (NDIC), a division of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), has several suggestions for maintaining the diabetic body, from the head down to the feet.  Specifically, there are steps to caring for the eyes, teeth, heart, kidneys, feet and nerves.

The NDIC recommends the following:

Eye Care:

Help prevent diabetic retinopathy ( blood vessel damage), cataracts (clouding of the lens) and glaucoma (increased fluid pressure) by getting a dilated eye examination at least once per year.

Teeth & Gum Care:

Brush and floss every day, especially after meals and snacks, keep dentures clean and see a dentist at least twice every year to keep teeth and gums healthy.  This may help to prevent or slow down gum disease, periodontis (gums pulling away from the teeth), loose or sensitive teeth and changes in bite.

Heart Care:

Help prevent damage to the heart and blood vessels by keeping blood pressure, cholesterol and fats within a range that your physician has determined is right for you.  Take any medications at the same time every day and ask your physician about adding aspirin if it is not already being taken.  Maintain a healthy weight by eating right and getting physical activity for at least 30 minutes each day.  If a smoker, create a plan to quit.  This will help minimize your risks for chest pain, heart attack, cardiomyopathy (narrowing of the vessels) and stroke.

Kidney Care:

Help prevent diabetic nephropathy (kidney problems), such as proteinuria (leakage of protein from the kidneys) and kidney failure, by keeping your blood pressure under 130/85, eating a healthy diet, treating kidney or bladder infections immediately and getting your urine checked once or twice per year for protein.

Foot Care:

Keep the feet clean and dry, wear properly fitting shoes with socks at all times and keep dry or cracked skin moisturized.  This will help to keep foot problems such as corns, calluses, blisters , warts, athlete’s foot or ingrown toenails from becoming infected and turning into more serious conditions.  When seeing your physician for your annual check-up, ask to have your circulation and nerve responses evaluated.

Nerve Care:

Diabetic neuropathy (nerve damage) can occur when there is damage to the blood vessels that supply the nerves with oxygen or there is damage to the nerve covering.  This can cause nerves to stop sending messages, cause them to send the wrong messages or cause them to send messages too slowly.  This means that if nerve damage is present, feeling may not be as good.  Without proper inspection and care for the body, an infection may go unnoticed and become something more serious.

It is clear that diabetes is a whole body disease.  Keeping your blood sugar levels within the proper range is the best defense against any of the above complications.  Talking regularly with your physician and caring for your entire body will help ensure better health from your head bone all the way down to your foot bone.

For more information on care for the diabetic body, contact the National Institute of Diabetes and Digestive and Kidney Diseases at www.niddk.nih.gov.

However, women who postpone childbearing may face some special risks.  Generally, women have decreased fertility starting in their early thirties and it’s not unusual for a woman in her mid-thirties to take longer to conceive than a younger woman.

A decrease in ovulation can be the result of less frequent ovulation, or to problems such as endometriosis, in which tissue similar to that lining the uterus attaches to the ovaries or fallopian tubes and interferes with conception.

Other problems may accumulate with age.  Conditions such as diabetes and high blood pressure are more common in older women and may endanger a pregnant woman and her developing baby.  She may also face a higher risk of placental and bleeding problems during pregnancy, as well as risk of cardiovascular problems.

Risk of Miscarriage

Most miscarriages occur in the first trimester of pregnancy.  According to the March of Dimes, rate of miscarriage in older women in significantly greater than that of young women.  Studies show that this risk is about nine percent for women in their twenties.  It rises to about 20 percent at ages 35 – 39 and rises to more than 50 percent by age 42.  The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage.

Risk of Birth Defects

The risk of certain chromosomal disorders increases as a woman ages.  The most common of these is Down syndrome, a combination of mental retardation and physical abnormalities caused by the presence of an extra chromosome 21.  At age twenty-five a woman has a 1-in-1250 chance of having a baby with Down syndrome.  At age 35, the chance increases to 1-in-400 and at age 40 it’s 1-in-100.

Many women who are 35 or older have prenatal testing, such as amniocentesis or chorionic villus samples, to rule out Down syndrome and other chromosomal abnormalities.  If prenatal testing rules out any defects and the mother is healthy, the baby is likely at no greater risk of birth defects than if the mother were in her twenties.

First-time mothers over 30 are also more likely than women in their early twenties to have difficulty during labor.  This may account for an increased rate of cesarean sections among women over 30. 

The good news is that advances in medical care have made late-age pregnancy safer.  And there are steps a pregnant woman can do to reduce her risks.  These include:

• Consume 400 micrograms (0.4 milligram) of the B vitamin folic acid daily before and during pregnancy (this applies to all women of childbearing age).
• Have a pre-pregnancy medical check-up and obtain early and regular prenatal care during pregnancy.
• Eat a variety of nutritious foods and achieve proper weight for height before conception.
• Don’t drink alcoholic beverages during pregnancy.
• Don’t smoke during pregnancy.
• Don’t use any drug, even over-the-counter medications, unless recommended by a health care provider who knows you are pregnant.

The National Diabetes Information Clearinghouse (NDIC), a division of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), has several suggestions for maintaining the diabetic body, from the head down to the feet.  Specifically, there are steps to caring for the eyes, teeth, heart, kidneys, feet and nerves.

The NDIC recommends the following:

Eye Care:

Help prevent diabetic retinopathy ( blood vessel damage), cataracts (clouding of the lens) and glaucoma (increased fluid pressure) by getting a dilated eye examination at least once per year.

Teeth & Gum Care:

Brush and floss every day, especially after meals and snacks, keep dentures clean and see a dentist at least twice every year to keep teeth and gums healthy.  This may help to prevent or slow down gum disease, periodontis (gums pulling away from the teeth), loose or sensitive teeth and changes in bite.

Heart Care:

Help prevent damage to the heart and blood vessels by keeping blood pressure, cholesterol and fats within a range that your physician has determined is right for you.  Take any medications at the same time every day and ask your physician about adding aspirin if it is not already being taken.  Maintain a healthy weight by eating right and getting physical activity for at least 30 minutes each day.  If a smoker, create a plan to quit.  This will help minimize your risks for chest pain, heart attack, cardiomyopathy (narrowing of the vessels) and stroke.

Kidney Care:

Help prevent diabetic nephropathy (kidney problems), such as proteinuria (leakage of protein from the kidneys) and kidney failure, by keeping your blood pressure under 130/85, eating a healthy diet, treating kidney or bladder infections immediately and getting your urine checked once or twice per year for protein.

Foot Care:

Keep the feet clean and dry, wear properly fitting shoes with socks at all times and keep dry or cracked skin moisturized.  This will help to keep foot problems such as corns, calluses, blisters , warts, athlete’s foot or ingrown toenails from becoming infected and turning into more serious conditions.  When seeing your physician for your annual check-up, ask to have your circulation and nerve responses evaluated.

Nerve Care:

Diabetic neuropathy (nerve damage) can occur when there is damage to the blood vessels that supply the nerves with oxygen or there is damage to the nerve covering.  This can cause nerves to stop sending messages, cause them to send the wrong messages or cause them to send messages too slowly.  This means that if nerve damage is present, feeling may not be as good.  Without proper inspection and care for the body, an infection may go unnoticed and become something more serious.

It is clear that diabetes is a whole body disease.  Keeping your blood sugar levels within the proper range is the best defense against any of the above complications.  Talking regularly with your physician and caring for your entire body will help ensure better health from your head bone all the way down to your foot bone.

For more information on care for the diabetic body, contact the National Institute of Diabetes and Digestive and Kidney Diseases at www.niddk.nih.gov.

Pregnancy is a magical time.  Women in their thirties may feel they might have missed out on some of that magic.  This is not completely true according to the March of Dimes.  Many women over age 35 have healthy pregnancies and healthy babies, and the rate of pregnancies for women of these ages continues to rise.

However, women who postpone childbearing may face some special risks.  Generally, women have decreased fertility starting in their early thirties and it’s not unusual for a woman in her mid-thirties to take longer to conceive than a younger woman.

A decrease in ovulation can be the result of less frequent ovulation, or to problems such as endometriosis, in which tissue similar to that lining the uterus attaches to the ovaries or fallopian tubes and interferes with conception.

Other problems may accumulate with age.  Conditions such as diabetes and high blood pressure are more common in older women and may endanger a pregnant woman and her developing baby.  She may also face a higher risk of placental and bleeding problems during pregnancy, as well as risk of cardiovascular problems.

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Risk of Miscarriage
Most miscarriages occur in the first trimester of pregnancy.  According to the March of Dimes, rate of miscarriage in older women in significantly greater than that of young women.  Studies show that this risk is about nine percent for women in their twenties.  It rises to about 20 percent at ages 35 – 39 and rises to more than 50 percent by age 42.  The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage.

top of page

Risk of Birth Defects
The risk of certain chromosomal disorders increases as a woman ages.  The most common of these is Down syndrome, a combination of mental retardation and physical abnormalities caused by the presence of an extra chromosome 21.  At age twenty-five a woman has a 1-in-1250 chance of having a baby with Down syndrome.  At age 35, the chance increases to 1-in-400 and at age 40 it’s 1-in-100.

Many women who are 35 or older have prenatal testing, such as amniocentesis or chorionic villus samples, to rule out Down syndrome and other chromosomal abnormalities. 

First-time mothers over 30 are also more likely than women in their early twenties to have difficulty during labor.  This may account for an increased rate of cesarean sections among women over 30.

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Reducing Your Risk
The good news is that advances in medical care have made late-age pregnancy safer.  And there are steps a pregnant woman can do to reduce her risks.  These include:

• Consume 400 micrograms (0.4 milligram) of the B vitamin folic acid daily before and during pregnancy (this applies to all women of childbearing age).
• Have a pre-pregnancy medical check-up and obtain early and regular prenatal care during pregnancy.
• Eat a variety of nutritious foods and achieve proper weight for height before conception.
• Don’t drink alcoholic beverages during pregnancy.
• Don’t smoke during pregnancy.
• Don’t use any drug, even over-the-counter medications, unless recommended by a health care provider who knows you are pregnant.

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The flu, short for influenza, is caused by viruses that infect the respiratory tract and causes a more severe illness than the common cold.  Common signs of the flu include a fever, dry cough, sore throat, nasal congestion, headaches and body aches, and fatigue.

Most people who get the flu recover completely in one to two weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia.  Every year there are an average of 36,000 deaths and 114,000 hospitalizations nationwide due to influenza. That's why we try to combat the influenza early with a vaccination.

Since influenza viruses continually change over time, people are susceptible to the virus infection throughout their lives.  That means that just because you had a shot last year doesn't mean you'll be protected this year.  Each year the vaccine is updated to include the most current influenza virus strains.

A lot of folks bypass the flu shot, believing that the vaccine will actually give them the flu.  That's not true.  The fact is that the vaccine causes no side effects in most people. 

A small number of people may get mild side effects, including a low-grade fever for about day or a headache.  The most serious side effect is an allergic reaction in people who have a severe allergy to eggs, since the viruses used in the vaccine are grown in hen's eggs.  For that reason, people who have an allergy to eggs should not get a flu shot.

The bottom line is that, for many people, a flu shot is the best defense against this often-debilitating illness.  It's especially important for any person who's at increased risk for complications from the illness, including

• Persons aged 50 or older;
• Residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic medical conditions;
• Adults and children aged 8 months and older who have chronic disorders of the pulmonary or cardiovascular systems, including children with asthma;
• Adults and children aged 8 months and older who require regular medical care or had to be hospitalized because of chronic metabolic diseases (like diabetes), chronic kidney disease or weakened immune system;
• Children and teenagers (aged 6 months to 18 years) who are receiving long-term aspirin therapy; and
• Women who will be in the second or third trimester of pregnancy during the flu season.

The vaccine is also highly recommended for people who are in close or frequent contact with anyone in these high-risk groups, including health care personnel and volunteers who work with high-risk patients and people who live in a household with a high-risk person.

Keep in mind that because the viruses change often, not everyone will be completely covered by the vaccine.  But people who do get the flu after getting the vaccine may have a milder case than those who do not get vaccinated.

What can you do if you decide to skip a flu shot this year?  You may protect yourself by eating right, getting enough sleep, and watching carefully for any flu symptoms.  If the flu develops – and if it doesn’t get better in a couple of days – call your physician.  If you’re in a high-risk group and you get the flu, don’t wait.  Call your physician.

You want to be spending your time with friends and family -- not the doctor.  The flu is a serious illness.  Don't let it keep you down this season.

The head bone’s connected to the neck bone.  The neck bone’s connected to the shoulder bone.  The shoulder bone’s connected to the arm bone.  And so on.  When you have diabetes, taking care of your body can feel a lot like progressing through this song.  Diabetes is a whole body disease.  It just happens to be controlled by blood sugar.

The National Diabetes Information Clearinghouse (NDIC), a division of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), has several suggestions for maintaining the diabetic body, from the head down to the feet.  Specifically, there are steps to caring for the eyes, teeth, heart, kidneys, feet and nerves.
The NDIC recommends the following:
 
Eye Care:
• Help prevent diabetic retinopathy ( blood vessel damage), cataracts (clouding of the lens) and glaucoma (increased fluid pressure) by getting a dilated eye examination at least once per year.

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Teeth & Gum Care:
• Brush and floss every day, especially after meals and snacks, keep dentures clean and see a dentist at least twice every year to keep teeth and gums healthy.  This may help to prevent or slow down gum disease, periodontis (gums pulling away from the teeth), loose or sensitive teeth and changes in bite.

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Heart Care:
• Help prevent damage to the heart and blood vessels by keeping blood pressure, cholesterol and fats within a range that your physician has determined is right for you.  Take any medications at the same time every day and ask your physician about adding aspirin if it is not already being taken.  Maintain a healthy weight by eating right and getting physical activity for at least 30 minutes each day.  If a smoker, create a plan to quit.  This will help minimize your risks for chest pain, heart attack, cardiomyopathy (narrowing of the vessels) and stroke.

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Kidney Care:
• Help prevent diabetic nephropathy (kidney problems), such as proteinuria (leakage of protein from the kidneys) and kidney failure, by keeping your blood pressure under 130/85, eating a healthy diet, treating kidney or bladder infections immediately and getting your urine checked once or twice per year for protein.

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Foot Care:
• Keep the feet clean and dry, wear properly fitting shoes with socks at all times and keep dry or cracked skin moisturized.  This will help to keep foot problems such as corns, calluses, blisters , warts, athlete’s foot or ingrown toenails from becoming infected and turning into more serious conditions.  When seeing your physician for your annual check-up, ask to have your circulation and nerve responses evaluated.

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Nerve Care:
• Diabetic neuropathy (nerve damage) can occur when there is damage to the blood vessels that supply the nerves with oxygen or there is damage to the nerve covering.  This can cause nerves to stop sending messages, cause them to send the wrong messages or cause them to send messages too slowly.  This means that if nerve damage is present, feeling may not be as good.  Without proper inspection and care for the body, an infection may go unnoticed and become something more serious.

It is clear that diabetes is a whole body disease.  Keeping your blood sugar levels within the proper range is the best defense against any of the above complications.  Talking regularly with your physician and caring for your entire body will help ensure better health from your head bone all the way down to your foot bone.

For more information on care for the diabetic body, contact the National Institute of Diabetes and Digestive and Kidney Diseases at www.niddk.nih.gov.

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Since we still don't know just what causes breast cancer, for now a woman's best protection is early detection.  Following are the American Cancer Society's guidelines for the early detection of breast cancer:

Age 20 - 39

·        Have a clinical breast exam by a doctor or nurse every three years

·        Do a breast self-exam every month

Age 40 +

·        Have a mammogram every year (an annual mammogram often provides the first clue that a woman might have breast cancer)

·        Have a clinical breast exam by a doctor or nurse every year

·        Do a breast self-exam every month

Simply being a woman is the main risk factor for breast cancer.  Other risk factors include:

Age: The chance of getting breast cancer goes up as a woman gets older.

Genetics: About one in 10 cases of breast cancer is linked to changes (mutations) in certain genes.  If a woman has inherited a changed gene from either parent, she is more likely to get breast cancer.  About five women out of 10 with these gene changes will get breast cancer by the age of 70.

Family History: Breast cancer risk is higher among women whose close blood relatives have the disease.  The relatives can be from either the mother’s or father’s side.  Having a mother, sister or daughter with breast cancer almost doubles a woman’s risk.

Personal History: A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast.

Race: White women are slightly more likely to get breast cancer than are African-American women.  But African-American women are more likely to die of this cancer.  Asian, Hispanic and American Indian women have a lower risk.

History of Breast Biopsy: Certain types of abnormal breast biopsy results can be linked to a slightly higher risk of breast cancer.

History of Radiation Treatment: Women who have had chest area radiation treatment as a child or young woman have a greatly increased risk of breast cancer.

Menstrual Periods: Women who began having periods early (before 12 years of age) or who went through menopause after the age of 50 have a small increased risk of breast cancer.  The same is true for women who have not had children, or who had their first child after they were 30 years old.

For more information about the many factors affecting breast cancer risk, call the American Cancer Society at 1-800-ACS-2345 or visit their web site at http://www.cancer.org.

ERs are equipped to handle most emergencies.  Patients usually arrive at the ER by ambulance or by a friend or family member.  Sometimes they may even drive themselves!  Patients who arrive by ambulance or are unconscious upon arrival are usually assigned a patient bed immediately.  If someone else brings you to the ER and you are not unconscious, you will first be brought to a waiting room, where your medical condition can be assessed.

It’s important to know that medical attention in the ER is usually based on severity of injury or illness.  Typical categories may include: immediately life-threatening, urgent but not immediately life-threatening and less urgent.  This categorization is usually conducted by a triage nurse and is necessary to ensure that the most severe patients are treated first.  The triage nurse is usually the first person you will see in the ER.  The nurse will check your vital signs (temperature, pulse, blood pressure, etc.) and will get a brief medical history, including information on current treatments or medications.

Once you see the triage nurse you will usually have to go through registration.  This is where you provide insurance information.  If your condition is life-threatening or if you arrive by ambulance, this step may be done later at the bedside.

Once an emergency physician is able to see you, you will be brought to an examination room.  Some emergency departments break out their examination rooms into various categories, including a trauma center for severely injured patients, a fast track for minor injuries or illnesses and an observation unit for patients who required prolonged treatment or several diagnostic tests.

The emergency physician will ask a lot of questions about the circumstances surrounding the injury or illness.  To help increase the possibility of correct diagnosis and treatment, you must be sure to be completely truthful about events and symptoms.  If you are critically ill, you may be admitted to the hospital.  If your injury or illness does not require hospitalization, the physician may place you in the observation unit or may prescribe a treatment plan and medications.

In addition to being familiar with how the ER works, you should be familiar with a few things before a visit, including:

• The fastest route to your local ER
• Emergency room procedures, including who to check in with and how to check a patient’s status
• Visiting procedures

Also, keep in mind that ERs can be very busy, with a lot of people – patients, nurses and physicians.  Remember to stay calm and to be polite, but assertive.

Joint replacement is surgery done to replace all or part of the diseased portions of the joint with an artificial device (prosthesis) to restore joint movement.  The most common reason why patients undergo hip or knee replacement is from the natural wearing down of the joint.  This is known as osteoarthritis.  For this reason, it’s logical to understand that most patients who have the surgery are older. The more the joints are used, the more they wear down.  Possible reasons for replacement of the hip or knee joint may include:

• Pain that has failed to respond to conservative therapy (medications, steroid injections, physical therapy, lifestyle and activity adjustments, rest)
• Osteoarthritis or arthritis confirmed by X-ray
• Inability to work, sleep or move because of pain
• Loose prosthesis
• Joint fractures, tumors or deformities

While joint replacement is ideal for some patients, it’s not for all.  Joint replacement surgery is not recommended for those with current joint infection, poor skin coverage around the joint, paralysis of the muscles surrounding the joint, severe vessel, nerve or physical disease or those who are morbidly obese (over 300 pounds). It is also not typically recommended for those who are young because of the strain that can be put on the prosthesis.

If you’re considering joint replacement, talk with your physician about seeing an orthopaedic surgeon for an evaluation. This evaluation usually consists of taking a medical history, doing a physical examination of the joint and surrounding areas and taking X-rays of the joint. Occasionally, blood tests, an MRI (Magnetic Resonance Imaging) or a bone scan may be done to assess the condition of the bone and tissues around the joint. In addition, the surgeon will ask about the patient’s expectations of the surgery and talk about the risks involved and the possible outcomes for recovery.

Rehabilitation is an important part of getting the maximum benefits out of joint replacement surgery. Typically, therapy begins the day after surgery. While the initial exercises are extremely basic, the goal is to get the joint moving. Physical therapy increases daily until the patient can perform daily care activities unassisted and is ready to be released from the hospital. Before going home, a patient should have a plan mapped out for aftercare: wound care, physical therapy and occupational therapy, if needed. The patient should also have a clear understanding of what can and cannot be done after surgery, in order to allow for proper healing and recovery.

It’s important to realize that joint replacement surgery is not a magical cure.  It may, however, help many of the patients who undergo the surgery to live in less pain with the ability to carry on with normal, daily activities that many take for granted – such as replacing items that are not part of the body, like tennis shoes and light bulbs.

We offer free seminars on hip and knee pain. To learn more visit our website under “Find an Event” or call us toll free at 1-888-TENET-4U (888-836-3848).

The rate of high blood pressure for African-Americans in the U.S. ranks among the highest in the world, according to the American Heart Association. More than 36% of African-American men have high blood pressure, compared to 25.2% for white men and 24.2% for Hispanic men.  The comparative rates for women are similar.

The result of this difference, according to the Heart Association, is that African-Americans are much more likely than whites and Hispanics to have a stroke or serious kidney disease, and to die from heart disease.

At the other end of the scale are Asian/Pacific Islanders, for whom the rates of high blood pressure are 9.7% for men and 8.4% for women.

Hispanic women are more likely and Hispanic men are less likely than whites to have high blood pressure.  Hispanics also are less likely than whites and African-Americans to be aware of their high blood pressure, to have it treated or to have it controlled.

African-Americans experience a correspondingly high rate of cardiovascular disease: 41% of men and 40% of women suffer from these illnesses.  Among whites, 30% of men and 24% of women have cardiovascular disease, while for Hispanics the figures are 29% for men and 27% for women.

High blood pressure can be a contributing factor in death rates from cardiovascular disease. Among the major racial groups in the U.S., white people have the highest death rates from cardiovascular disease.  It accounts for the deaths of 42.5% of white women and 38.6% of white men.  But African-Americans aren’t far behind.  Some 40.8% of African-American women and 33.8% of African-American men die of cardiovascular disease.

The cause of most cases of high blood pressure is not known, but doctors note that the disease is easily detected and usually controllable.  Knowing these different risk factors and possible steps you can take to reduce the risk may help you take steps to protect yourself and your family.

Research has shown that through diet, weight loss, exercise and lifestyle changes, the risk of high blood pressure and heart disease may be reduced.  Doctors and other health professionals believe that following some simple guidelines may help improve your health:

·        Eat foods low in saturated fat and keep your overall fat intake to a minimum.

·        Eat plenty of fruits, vegetables and high-fiber foods.

·        Limit your sodium intake, both in the products you buy and the salt you add in cooking and at the table. Try to stay below 2,400 mgs per day (about a teaspoon).

·        Limit alcohol intake to no more than one drink a day for women and two drinks per day for men (or an ounce of alcohol overall).

·        Make sure your diet includes foods high in potassium and eat plenty of low-fat or non-fat dairy products.

·        Engage in physical activity at least 20-30 minutes a day 4-5 days a week.

·        Refrain from smoking.

If you have questions about high blood pressure, cardiovascular disease or possible treatments, you may want to consult your doctor or call 1-888-TENET-4U for a free, confidential physician referral.]]> North Fulton Hospital Fri, 23 Jan 2009 16:19:20 GMT http://www.nfultonhospital.com/en-US/aboutus/hospitalNews/newsandarticles/Pages/What’s Race Got to Do with High Blood Pressure.aspx http://www.nfultonhospital.com/en-US/aboutus/hospitalNews/newsandarticles/Pages/The Key to a Healthy Heart.aspx

The Centers for Disease Control says cardiovascular diseases, including heart disease and stroke, are among the leading cause of death in the United States. In fact, it accounts for 40 percent of all deaths. Yet many Americans don't pay attention to the risk factors of heart disease, which include high cholesterol, poor nutrition, smoking and obesity.

If you have these risk factors talk to a doctor. It’s important to be honest (even if you’re a little embarrassed about your smoking or overeating habits) so the doctors can assess your risk for heart disease as accurately as possible.  What goes on during a heart exam depends on the patient’s risk factors, history of heart problems, current symptoms and the doctor’s interpretation of the patient’s risk factors.

A doctor will usually perform a simple test first, such as a chest x-ray and EKG, to measure the electrical impulses in the heart. The doctor may then want to order an ejection fraction, a test that measures how much blood the left ventricle is pumping out of the heart with each contraction. The doctor may also order an echocardiography, an ultrasound test that uses sound waves to examine the heart’s structure and motion.

Other tests a doctor may order include a computed tomography scan or magnetic resonance imaging. These tests are noninvasive, or in other words they don’t involve using needles or tubes.

Other tests such as radionuclide ventriculography involve injecting a small amount of radioactive dye into a vein and then taking pictures as the heart pumps.

Of course, the best thing to do is to try to prevent your chances of getting heart disease.  What can you do to lower your risk?

·        Exercise and lose weight. Even low intensity activities when performed for at least 30 minutes can bring health benefits. This can include walking, gardening and even moderate housework.

·        If you smoke, this is another reason to quit.

·        Try to establish a balanced diet. This will help you get all the nutrients your body needs and may help reduce your cholesterol.

Keeping your heart healthy can help keep your body running in top condition. ]]> North Fulton Hospital Fri, 23 Jan 2009 16:19:14 GMT http://www.nfultonhospital.com/en-US/aboutus/hospitalNews/newsandarticles/Pages/The Key to a Healthy Heart.aspx http://www.nfultonhospital.com/en-US/aboutus/hospitalNews/newsandarticles/Pages/Cholesterol The Good Bad and Ugly.aspx With all of the advertisements in magazines and on television, you’ve probably seen at least one about cholesterol.  Chances are you’ve seen several.  Talk of LDL, HDL, cholesterol lowering medications, etc.  You probably find yourself wondering what all this means.  As confusing as it may seem, your cholesterol is something you need to understand.

Cholesterol is a soft, waxy substance found with the fats in your blood and in your body’s cells. And like a lot of things, a certain amount provides benefits while too much can cause damage.  For example, cholesterol is important because it helps form cell membranes, hormones and other functions.  But if cholesterol levels become too high, it can become a risk factor for coronary heart disease.   If your total cholesterol is less than 200 mg/dL, your heart attack risk is relatively low, unless you have other risk factors.

Since cholesterol and fats cannot be dissolved in the blood, they have to be transported from cell to cell by special carriers called lipoproteins.  This is where all of the talk about LDL and HDL comes in.  LDL stands for low-density lipoprotein and is the major transporter of cholesterol in the body.  If too much LDL cholesterol is present  (160mg/dL or higher) it can cause a build up of plaque in the arteries, which can then lead to a heart attack or stroke.  This is why LDL cholesterol is sometimes called the “bad” cholesterol.

HDL stands for high-density lipoprotein. HDL is responsible for carrying one-third to one-fourth of blood cholesterol.  HDL cholesterol is also called the “good” cholesterol.  This is because it’s believed that it carries cholesterol away from the arteries to the liver, where the body can then get rid of it.  It is also believed to slow down plaque formation. 

The American Heart Association (AHA) recommends that your daily cholesterol intake be less than 300mg.  If you have heart disease, your intake should be no more than 200mg.  One way of helping to limit cholesterol intake is by reducing foods high in saturated fat and cholesterol.  These are foods that typically come from animals: butter, cream, egg yolks, processed or fatty meats and fried foods.  Instead, your diet should be high in fruits and vegetables, whole grains, low-fat or fat free dairy products, lean meat and fish.

Another way to manage cholesterol is through exercise.  Exercise may increase HDL cholesterol in some people.  It also may help to control weight, diabetes and high blood pressure.  Physical inactivity is a major risk factor for developing heart disease.

Quitting smoking and monitoring alcohol consumption are two more ways to help manage your cholesterol.  According to the AHA, smoking helps to lower HDL cholesterol levels and is one of the major factors for heart disease that you can change. 

If following the above recommendations, along with the help of a physician, still doesn’t lower your cholesterol enough, there are medications available that may help. Talk to your physician to see if this might be beneficial to you.