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Site FeedbackWH - A Guide to Women's Health
Hints on Head Lice
Anyone can get head lice, but children ages 3 to 12 are the most vulnerable due to their higher rates of exposure. If you suspect that the reddish-brown, wingless insects have found a home in your child's hair, take the following precautions:
- Check family members for lice once a week. Don't confuse the white, oval-shaped nits (lice eggs) with dandruff. Nits will be firmly attached to the hair shaft.
- Treat only those who are infested. Consult your pharmacist or doctor beforehand if the person who needs to be treated has allergies or epilepsy, or is pregnant or nursing.
- Apply lice medicine, available over the counter, according to label instructions. Repeat treatment as directed.
- Every two to three days after treatment, wet the hair and carefully comb with a nit comb, removing any nits or lice. Continue for 10 to 14 days.
- Machine wash bedding and recently worn clothing in hot water and dry on high heat.
- Avoid lice sprays. Vacuuming is the safest bet for removing lice from upholstered furniture and the floor.
[back to top]Choosing an Obstetrics Caregiver
You've just found out you're pregnant, and you're ready to choose your physician caregiver. Here are some options to consider and Web sites to explore.
- OB/GYN (www.acog.org): Doctors who specialize in obstetrics and gynecology provide prenatal care and deliver babies. They are trained to handle all phases of pregnancy, from preconception planning to postpartum recovery.
- Perinatologist (www.perinatology.com): These maternal-fetal medicine specialists concentrate exclusively on the most severe complications that arise, such as heart disease, kidney disease, recurrent pregnancy losses, a complicated family medical history, severe genetic conditions, and/or a baby who has been diagnosed before birth with a medical condition.
New Cath Lab's Advanced Technology
John Muir Medical Center, Concord Campus, recently introduced a state-of-the-art cardiac catheterization laboratory with flat detector biplane technology—the first of its kind in Northern California.
This advanced imaging system enables doctors to view detailed, 3-D images of a patient's heart and facilitates faster and more accurate diagnosis and treatment of cardiac disease. The digital flat detector provides outstanding image quality, with less distortion than older, more cumbersome X-ray-tube technologies, and exposes patients to less radiation during actual procedures than other systems, according to cardiologists Ayman Hosny, M.D., and Gus Argenal, M.D., who are on staff at John Muir Health and perform interventional cardiac procedures.
"The biplane technology allows us to look at the heart in two views. We can get an excellent study quicker," says Dr. Hosny. "We can cut the procedure time in half, compared to single-plane equipment. Physicians doing the study get accurate information and see things you would not appreciate with average equipment. That's extremely helpful in the split-second decisions we make in the cath lab."
Dr. Argenal also applauds the system's advanced capabilities and its added safety benefits. "It's a real plus in terms of taking care of sick patients," he says, "especially those with renal disease or diabetes, because we don't need to use as much contrast— the dye that allows us to take pictures of coronary arteries."
The new system will be used for diagnostic and therapeutic catheterizations, including angiography, angioplasty and stent placement. "This equipment is the gold standard, both to visualize and to intervene," says Dr. Argenal. "It's good for physicians, good for the hospital and good for the community."
Cardiac Education SeriesThis free, monthly course, available at John Muir Medical Center, Walnut Creek Campus and Concord, addresses coronary artery disease treatment and risk factor modification. It's designed for patients who have the condition and their family members. For class schedule, call (925) 674-2200 or (925) 941-7900, then press option 3. |
A Woman's Guide To Diabetes
From infants to seniors, U.S. women face increasing risks for diabetes. Here's information you need to know about this disease— including vital tips on prevention.
Source: Diabetes and Women's Health Across the Life Stages, Centers for Disease Control, 2001
Diabetes has become big news. A case in point: In January, The New York Times ran a major frontpage series about the disease's epidemic proportions and its looming threat to public health. More recently, the new inhalable insulin captured headlines when it became the first product of its kind to receive U.S. Food and Drug Administration approval.There's good reason for all the interest in—and growing concern about—diabetes. According to the Centers for Disease Control and Prevention (CDC), nearly 21 million Americans live with this debilitating medical condition, and its incidence has been rising rapidly. Among women ages 30-39, for example, diabetes rates increased 70 percent from 1990 to 1998.
Given these worrisome developments, diabetes clearly is a topic that merits everyone's attention. The following overview highlights key facts about the disease and offers valuable insights from medical experts on staff at John Muir Diabetes Centers in Walnut Creek and Concord.
The Big Picture
- According to CDC data, about 90 to 95 percent of women with diabetes have type 2, which typically develops after age 40. Type 2 is linked to overweight, weight gain and physical inactivity.
- Prevalence of type 2 diabetes is at least two to four times higher among black, Hispanic, American Indian and Asian Pacific Islander women than among white women.
An Expert's Perspective
Type 2 diabetes, once known as adultonset
diabetes, is sparked by resistance
of the body's cells to insulin, a hormone
secreted by the pancreas, explains Douglas
Zlock, M.D., an endocrinologist and medical
director of the John Muir Diabetes
Center - Walnut Creek. Insulin resistance
is a big problem because insulin allows
glucose (sugar) to enter the cells and
be converted to energy. (Note: Insulin
resistance is also at work in gestational
diabetes, which strikes women during
pregnancy. Type 1 diabetes, once known
as juvenile-onset diabetes, occurs when
the pancreas makes little or no insulin.)
Like their male counterparts, women with diabetes are at increased risk for a laundry list of complications, some of which are life-threatening. The disease can lead to serious damage to many parts of the body, including the heart, eyes, kidneys, blood vessels, nerves, teeth, gums, feet and legs. "Diabetes is a 'silent' disease," says Dr. Zlock. "Most people don't have any symptoms, so they don't pay much attention to it until they've developed chronic complications."
Once a diabetes diagnosis is confirmed, the main focus of treatment is keeping blood sugar in a normal range. Typical treatments include careful meal planning, regular exercise, home blood glucose testing, and in some cases, oral medication and/or insulin.
Childhood and Adolescence
- Most children and adolescents ages 10-19 with diabetes have type 1. But according to the CDC, the incidence of type 2 diabetes is on the rise among both girls and boys, particularly within certain racial and ethnic groups. The 1990s saw a 10-fold hike in type 2 diabetes among adolescents.
An Expert's Perspective
"We're all worried about type 2 diabetes
occurring at a younger age," says Dr. Zlock.
"Sedentary lifestyles and poor nutrition
lead to obesity and diabetes. Children
spend hours in front of computers and TVs.
Many families eat at fast food restaurants
because fast food is cheaper and more
convenient than eating healthier foods."
The Reproductive Years
- Up to 4 percent of U.S. women develop gestational diabetes during pregnancy.
- Although gestational diabetes typically ends after the baby's birth, women with the condition have up to a 45 percent risk of recurrence with the next pregnancy and up to a 63 percent risk of developing type 2 diabetes later in life.
"Counseling and education about proper diet—especially controlling the intake of carbohydrates—are very important components of our program," says Anna Chang, M.D., an endocrinologist who works with Sweet Success, a multidisciplinary program at John Muir Diabetes Center - Concord, for pregnant women with gestational or pre-existing diabetes. (Its counterpart at the Walnut Creek Campus is the Diabetes in Pregnancy Program.)
The major risk for pregnant women with poorly controlled diabetes, Dr. Chang adds, "is giving birth to a large baby (who weighs more than nine pounds), which can lead to birth injury. Other risks include low blood sugars and breathing problems in the newborn, as well as increased risk of obesity in childhood." Women with pre-existing diabetes have added risks of complications and abnormalities, so preconception planning is vital. Observes Dr. Zlock, "We strongly encourage women of childbearing age to have their blood sugar in control before they conceive a child."
Midlife
- The risk of heart disease, the most common complication of diabetes, is more serious among women than men, according to a CDC report on diabetes and women's health. After a heart attack, women with diabetes have lower survival rates and a poorer quality of life than men.
"It may be that we just haven't focused on women and the likelihood that they'll have a heart attack," says Dr. Zlock. "About 30 percent of people with diabetes who have heart attacks don't have typical symptoms, such as crushing chest pain. People with diabetes may need screening stress tests."
Resources at John Muir HealthJohn Muir Health offers comprehensive inpatient and outpatient care for individuals with diabetes, including support groups, exercise classes and community health education programs on diabetes care and management, insulin pumps, intensive insulin therapy, diabetes in pregnancy, and more. The programs are offered through the John Muir Diabetes Centers in Concord and Walnut Creek.
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Senior Years
- In this country, elderly women with diabetes outnumber elderly male diabetics. (The underlying math: Because females live an average of seven years longer than males, there are nearly twice as many elderly women as elderly men.)
"People put money in the bank to save for retirement but I tell my patients that if they're making changes in diet and exercising, they're actually banking their good health," says Sharon Paulucci, clinical manager of the John Muir Diabetes Center - Walnut Creek, which offers an array of care, classes and support groups. The staff includes registered nurses and dietitians, all of whom are certified diabetes educators. "What we're trying to do is help people manage their diabetes rather than having diabetes run their life."
About Prevention
- An estimated 41 million people in the U.S. have "prediabetes," a relatively new term used to describe blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. > Studies show that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes.
Medical researchers have identified effective steps to forestall type 2 diabetes, says Carolyn Cox, R.D., program manager at the John Muir Diabetes Center - Concord. In the landmark Diabetes Prevention Program (DPP), she explains, researchers demonstrated that even modest lifestyle changes can prevent or delay the onset of type 2 diabetes. A 5 percent to 10 percent weight loss, coupled with just 30 minutes of daily exercise, produced a whopping 58 percent reduction in diabetes rates.
With all the concern about prediabetes, experts advise people to get tested for diabetes if they're overweight and over 45, or if they are at risk. People at risk include those who have high blood pressure, low HDL cholesterol, high triglycerides or a family history of diabetes; minority group members; and women who had gestational diabetes or who gave birth to a large baby (more than 9 pounds). Emphasizes Cox: "We especially want to encourage those who don't have diabetes yet to decrease the risk factors that they have control over with diet and exercise."