Colleague's email address:
Your email address:
Subject:	A colleague recommends WH - A Guide to Women's Health: June 2008
Message:

• WH - A Guide to Women's Health
• June 2008
• Healthy You
• Being a Mom
• At the Doctor's

WH - A Guide to Women's Health

Pregnancy with a Chronic Health Condition

If you have a chronic health condition, there's a lot to think about when considering pregnancy. A preconception appointment with your doctor can help pinpoint the best choices for you and your baby. Some questions to ask at that important meeting:

• Will it be difficult to conceive? What are the risks?
• How will being pregnant affect my condition?
• How should I prepare for pregnancy?
• Will my treatment change during pregnancy?
• What about medication?
• How can I improve my odds of having a healthy baby?
• Is breastfeeding an option?

If you decide to become pregnant, your healthcare provider will closely monitor your underlying condition and quickly identify any problems. Regular prenatal care throughout your pregnancy will be the best safeguard for health—yours and your baby's.

Source: www.mayoclinic.com

[back to top]

Cold Medicine Is a Hot Topic

Medical experts are challenging the safety and effectiveness of over-the-counter (OTC) cough and cold medicines for infants and young children. Here's the scoop:

Recently, the U.S. Food and Drug Administration issued a public health advisory against the use of OTC cough and cold medicines for any child under 2 years of age. Those medicines, the FDA warned, can cause harmful side effects and overdoses can be deadly.

In testimony before the FDA, the American Academy of Pediatrics also cited studies that found that "these medications, either singly or in combination, do not work to relieve cough and cold symptoms" in children under 6 years of age.

The upshot? The FDA advisory led many retailers to pull the targeted OTC products off their shelves. What's more, the FDA says it will review use of OTC cough and cold medicines for children between ages 2 and 11.

In the meantime, parents should remember that the typical cold can go away by itself. To relieve symptoms, a child's doctor may suggest various remedies, including fluids to loosen congestion, fever reducers, salt-water gargle, humidified air and plenty of rest.

[back to top]

Understanding MRSA Infections

If you've noticed all the recent news about methicillin-resistant Staphylococcus aureus (MRSA), you may have wondered exactly what MRSA is, how it causes infections and how you can help to prevent its spread.

Here's some background: The usually harmless germs that commonly live on the skin and in the nose are called staphylococcus or "staph" bacteria. Sometimes, though, they enter the body through a break in the skin and cause an infection, which is then usually treated with antibiotics. When common antibiotics don't kill the staph bacteria, it means the bacteria have become resistant to those antibiotics. This type of staph is called MRSA.

The truth is, anyone can get MRSA. You can get MRSA the same way you catch a cold, or by touching someone or something that had the bacteria on it and then touching your eyes or nose. Infections range from mild to very serious, even life threatening, if left untreated. When a person is a carrier for MRSA and experiences small cuts or abrasions to the skin, MRSA may flourish. That's why MRSA tends to break out in clusters where people have close contact, like school teams, college dorms and gyms.

What does MRSA look like? It generally appears as skin infections, often in otherwise healthy people. The outbreaks may look like pimples, boils or blisters, which can be swollen and painful and have draining pus. MRSA can also infect other areas of the body, such as blood, lungs, eyes and urine. These types of infections are less common, although often more serious.

MRSA infections should always be treated by a healthcare provider. If you have an active MRSA infection, your provider may drain the lesion, give antibiotics, reduce the amount of bacteria on your skin, or combine two or more treatments.

Hand washing and excellent hygiene practices are the first line of defense against MRSA transmission. Another key safeguard is avoiding direct contact with skin, clothing and any items that become contaminated with MRSA.

[back to top]

Is Weight Loss Surgery For You?

When diets fail those who are significantly overweight, weight loss surgery may be an option

One-third of Americans are now obese, often despite repeated efforts to slim down. Many have tried nearly every diet imaginable. Some have even succeeded in shedding the extra pounds, only to regain the weight—and then some.

To compound the frustration, medical experts now know that obesity is a serious health issue. It actually boosts the risk of developing a host of chronic conditions, including high blood pressure, diabetes, heart disease, sleep apnea and arthritis.

Surgical Options

For those who are significantly overweight and have not had success with diets or other nonsurgical methods, John Muir Health offers bariatric (weight loss) surgery. Bariatric surgery helps patients slim down for good by reducing the size of the stomach, and some procedures also impair the absorption of calories through the intestine. As does all surgery, bariatric procedures have risks, which are thoroughly discussed with patients beforehand.

Today's weight loss surgery is usually done laparoscopically, through tiny incisions, requiring just one or two days in the hospital. "Surgery supersedes the success of any conservative weight loss by diet," says Fernando Otero, M.D., a general and vascular surgeon on staff at the John Muir Weight Loss Surgery Center, on the John Muir Medical Center - Concord Campus. "In our weight loss surgery program, the long-term success rate is over 80 percent of patients losing the majority of their excess body weight and keeping it off."

The Weight Loss Surgery Center offers various types of weight loss surgery. Two procedures work by reducing the stomach capacity to make the person feel full quickly, thereby restricting the amount of food he or she can eat. In sleeve gastrectomy, a newer procedure, the surgeon removes about 80 percent of the stomach to create a sleeve-shaped stomach to restrict food intake. In Lap-Band® surgery, the surgeon places an adjustable band around the top part of the stomach to reduce the size of the upper stomach.

Two other procedures shrink the size of the stomach and also reduce the amount of calories absorbed from the food that is eaten. Roux-en-Y gastric bypass is a laparoscopic procedure that reduces the stomach to a small pouch and also causes food to bypass a section of the small intestine, reducing calories absorbed. The duodenal switch procedure removes about 75 percent of the stomach and then rearranges the small intestine so food enters it very far downstream, decreasing absorption of fat and calories.

A Road to Better Health

Despite the number of surgical options available, weight loss surgery isn't for everyone. Only those who are at least 80 pounds overweight, or whose body mass index is 40 or more, are candidates. (Body mass index is a calculation based on a person's height and weight.) Those who have a body mass index of 35 or more and have health conditions that are directly related to being overweight may also qualify.

Help for Diabetes

For those who do undergo bariatric surgery, the benefits can be significant. "Patients typically lose half of their excess body weight within 12 to 18 months after gastric bypass, which is our most common operation," Dr. Otero says. "And the surgery itself is actually very effective in reducing or correcting medical illnesses associated with obesity."

In fact, the Journal of the American Medical Association recently published a study of people with type II diabetes that showed 73 percent of those who had bariatric surgery had complete remission of their diabetes, compared with just 13 percent of those who'd received medical and behavioral care. "For a lot of patients, the improvement happens so quickly— even before all of the weight drops off—that there may be some process in the gastrointestinal tract that causes the improvement of the diabetes," Dr. Otero theorizes. Weight loss surgery has also been shown to improve or resolve high blood pressure, cardiac risk, sleep apnea, and chronic joint and back pain.

Getting Needed Support

Experts encourage those who are considering bariatric surgery to do their homework before making a decision. "We recommend that they go to our support group, which is for people who have already had the surgery as well as new people who are coming in," Dr. Otero explains. "Those who've already had the surgery talk about their experience, so it can be a great source of information."

The John Muir Weight Loss Surgery Center is unique because it offers multidisciplinary treatment in a centralized, fully staffed program, located within John Muir Medical Center, to ensure patients receive the best possible care and advice before, during and after surgery. "In most other centers, the bariatric program is run from the surgeon's own office," Dr. Otero observes. "But with our program, the patient has the advantage of the full spectrum of services at John Muir Medical Center."

All prospective surgery patients, for example, meet with bariatric nurse manager Anne Timberlake, R.N.; a clinical dietician; and a psychologist before meeting with the bariatric surgeon to be evaluated for surgery. And if a patient needs additional services—such as cardiology, pulmonary or gastrointestinal evaluation—they're all available at the medical center as well.

Even with the availability of top-notch specialists and services, weight loss surgery isn't a magic bullet, Timberlake emphasizes. It's simply a tool that can give patients a fresh start, but they need to commit to making important lifestyle changes. "We teach patients how to develop 'success habits' so they can be successful after surgery," Timberlake says. "That includes eating a protein- focused diet, eating slowly, stopping when they feel full, exercising regularly, and taking vitamin and mineral supplements."

The John Muir staff closely monitors patients during the period of rapid weight loss and are also accessible by telephone or e-mail to respond to any concerns. Meanwhile, the patient's family members are encouraged to attend any doctor appointments, as well as the support group, so they can learn about life after surgery. "I try to get to know each patient and their family," Timberlake says. "The patient is improving his or her eating habits and exercising regularly, so the health of the entire family often improves."

Most patients are able to maintain their weight loss. However, the Weight Loss Surgery Center provides ongoing guidance and support to help patients lose—and keep off—any regained pounds. Following surgery, Dr. Otero says, it's gratifying to watch patients' lives transform. "They change not only physically," he says, "but also emotionally and psychologically."

"Patients are finally able to engage in activities they couldn't before," Timberlake adds. "They become more physically active and, as a result, are able to lead a fuller life."

[back to top]