5 Health Questions To Ask Your Mom

Sunday was Mother’s Day and many were celebrating with cards, calls, flowers and brunch to honor the women in their lives.  Yet, how many know the full health history of their mom, grandmother and aunts?  This information could prove to be critical when it comes to your own health therefore these are 5 questions to ask the female family in your life.

1.       How was menopause?  This question is important as women tend to follow them other women in their family when it comes to peri-menopause and menopausal changes.  Do the hot flashes and night sweats start in the 40’s or 50’s?  How long did it take?  Was it rough?  Was it easy?  How did she treat it?  Any complications? 

2.       Who has had cancer in the family?  And at what age?  This applies to both the men and women however mom tends to know this information.  If grandma and the aunts had breast cancer at a younger age, this is more concerning than finding out grandma had it later in life.  Has anyone had thyroid cancer? Prostate cancer? Ovarian, cervical or uterine cancer? Skin cancer?  Know your family’s cancer history.

3.       What are the family trends?  If all the women eventually develop thyroid disease and go on thyroid medication, this helps both you and your health care provider to be extra diligent and pro-active.  Does heart disease run in the family?  What about obesity?  Fertility problems?  Endometriosis?  Osteoporosis?  Do the women tend to lose their hair as they age?  Everyone have their gallbladder?  What about digestive or food allergy problems?  All of this information is critical for future planning and may shed light into current symptoms.

4.       Any outliers in the family?  The 2^nd cousin with celiac’s disease may not strike you as important however as your gas and bloating worsens, it could be a direct link.  The weird uncle whose mood alternates from really happy and hyper to down and depressed may be suffering from undiagnosed bi-polar.  This can be genetically linked as can depression in the family.  If just grandma had aches and pains it could have been undiagnosed fibromyalgia or a certain type of arthritis – how is your pain?

5.       What about your siblings?  Not all brothers and sisters are close therefore they may not inform each other about different health issues, concerns, scares and symptoms but mom usually knows.  Ask her if your symptoms sound like anyone in the family or periodically check in on the health of the rest of the family.  You may find out that your older sister has been having problems getting pregnant too or that your brother experiences the same types of migraines that you do and the same medications are not working.

While some people may prefer to keep some of their health history private, the more you know the more you (and your family) can be pro-active and prevent when possible.  Let your health care provider know of any changes as well to routinely keep your chart up-to-date and help them provide the best care possible for you.

 

Learn more on the women's health website, Emowher!

References:

1.       Segurado, R., Deterawadleigh, S., Levinson, D., Lewis, C., Gill, M., Nurnbergerjr, J., Craddock, N. Depaulo, J.  (2003). "Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part III: Bipolar Disorder". Am J Human Genetics 73 (1): 49–62.

2.       Steiner, A., Baird, D., Kesner, J.  (2008). Mother’s Menopausal Age is Associated with her Daughter’s Early Follicular Phase Urinary, Follicle Stimulating Hormone Level.  Menopause. 15(5): 940–944.

How Much Alcohol do you Drink?

Alcohol consumption is a large part of the American culture in that it is used in celebration, toasts, as a form of bonding, at sporting events, after bad days and during the holidays.  It is advised that men not drink more than 2 drinks per day, and women keep it to 1 drink per day however recent research in the February 2013 Journal of the Academy of Nutrition and Dietetics found that 18 percent of men and 11 percent of women are drinking above and beyond this recommendation. 

In a given week, how many alcoholic beverages do you drink?  Wine with dinner? Cocktails with the girls? A beer to relax?  While moderation is important and the occasional drink may be okay, remember that alcohol has other implications that may get in the way of your health.  First, alcohol increases the risk of certain cancers, particularly breast, liver, mouth, colorectal, and throat.   Second, alcohol requires a lot of processing by the liver which can interfere with the processing of other important substances such as medications, chemicals, and hormones.  Third, liver processing, especially at night, can lead to insomnia or 3am wake-ups.  Fourth, alcohol is not calorie free therefore it can cause weight gain and (depending what your drink of choice is) increases in blood sugar levels.  Fifth, ongoing alcohol consumption can further depress mood disorders, lead to a decreased memory and worsen psoriasis and other skin disorders.

Alcohol addiction is an important health concern to recognize in both yourself and the people you love.  Many choose alcohol as their coping mechanism when times are stressful or things are tough however other healthier options are available.  Even though the current recommendation for women is 7 drinks per week, remember that a drink is typically considered 5 ounces of wine, 1.5 ounces of hard liquor or 12 ounces of beer and 7 drinks may be too many for you and your health goals.  With that said, how many drinks do you really have? 

References:

1.       Grens, K.  Too Many Americans still Drink too Much: Study. Web.  25 February, 2013

http://www.nlm.nih.gov/medlineplus/news/fullstory_134308.html

2.       Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V.,   Scotti, L., M., Jenab, Turati, F., Pasquali, E.,  Pelucchi, C., Bellocco, R.,  Negri, E., Corrao, G., Rehm, J., Boffetta, P., and  La Vecchia, C. Light Alcohol Drinking and Cancer.  Web. 25 February, 2013.         http://www.medscape.com/viewarticle/778949

3.       Kazakevich, N., Moody, M., Landau, J., and Goldberg, L.  Alcohol and Skin Disorders.  Web.  25 February, 2013.

http://www.medscape.com/viewarticle/742538

New Vitamin D Guidelines - Update or Bogus?

In the October 2012 issue of the science journal PLOS ONE, researchers determined that the appropriate level of Vitamin D for the average American is above 20 ng/ml which is 10 points lower than the original cut-off of 30ng/ml.  These new lab values have been picked up and supported by the Institute of Medicine and subsequently several insurance companies however other groups, such as the Endocrine Society, maintains 30 ng/ml and above is adequate.

There is a lot of research in general about Vitamin D.  It is touted as a vitamin (actually, it's a hormone) that helps with bone strength and support, muscles, mood (think seasonal depression in the cold winter months), autoimmune conditions (most all of them) and cancer protection/prevention.  The Institute of Medicine reports that the evidence is 'too conflicting' to really support a higher Vitamin D level in the blood yet reputed groups such as The Vitamin D Council and Life Extension coupled with the Endocrine Society think otherwise.

Does it matter?

I think so.  If research can point to higher levels of Vitamin D (as in the 50-100 ng/ml) range as even *possibly* helpful for bones, mood, autoimmune and cancer without side effects (assuming one does not overdose on Vitamin D), then let's support the *possibly* and take Vitamin D.  Anecdotally, patients often report just 'feeling better' at higher levels (as in above 20 ng/ml).

Either way, talk with your health care provider and request Vitamin D testing.  Vitamin D is a fat-soluble vitamin and does require other nutrients such as magnesium, zinc and Vitamin K, to work more effectively.    The Vitamin D3 form known as cholecalciferol, is the more appropriate form to take.

References:
Holly Kramer, Chris Sempos, Guichan Cao, Amy Luke, David Shoham, Richard Cooper, Ramon Durazo-Arvizu. Mortality Rates Across 25-Hydroxyvitamin D (25[OH]D) Levels among Adults with and without Estimated Glomerular Filtration Rate <60 .="." 7="7" font="font" nbsp="nbsp" one.="one." plos="plos">

Ovarian Cancer: Don’t Miss These Signs

Ovarian cancer is an elusive one because the signs and symptoms mimic other common complaints. Women often blow them off or chalk them up to everyday life before seeing a doctor. On the flip-side, healthcare practitioners might also view the vague complaints as dietary or stress related instead of getting a work-up.

There is no easy diagnosis for ovarian cancer. Breast cancer usually comes with a lump, change in skin, inverted nipples, or discharge. Endometrial cancer usually comes with post-menopausal bleeding/spotting or discharge. Ovarian cancer moves much more stealthily than that.

Here are some things to watch out for:
1)Chronic bloating that won’t go away no matter what you do. (It doesn’t generally come and go)
2)Abdominal swelling in the lower pelvic area. Makes it hard to button your pants.
3)Feeling full quickly when eating.
4)Urinary urgency – you have to go NOW!
5)Pelvic pain
6)Vague back pain not from sprain/strain, overuse or trauma.

Here are some risk factors for ovarian cancer:
1)Starting your period before 12years old. This causes more ovulations.
2)Never having been pregnant allows you to cycle and ovulate more.
3)Going into menopause later means you have more cycles.
4)Obesity
5)Having certain mutations of BRCA1 or BRCA2 gene

Please keep in mind that the symptoms are vague. You may have urinary urgency but yours could be due to the vaginal births you had not ovarian cancer. You may experience chronic bloating but you also eat cheese everyday and are intolerant to it. Is your low back pain from your desk job or 3-inch heels, or maybe from gardening all Saturday?

After examining these concerns with no relief from treatments, please talk with your healthcare practitioner about a pelvic ultrasound and possibly some blood-work. Ovarian cancer is often caught in the late-stage and survival isn’t that promising. If you recognize yourself in this article, please examine the possibilities and talk with your doctor.

Ovaries Removed? Let’s Look At The Cancer Risks.

Many women have had their ovaries removed for non-cancerous reasons. The procedure is called an oophorectomy and commonly occurs with a hysterectomy. Once the ovaries are removed, a huge portion of hormone production comes to a screeching halt. A recent study in the 2009 May issue of Obstetrics and Gynecology examined the long term consequences of an oophorectomy of both ovaries and cancer risk.

The great news is that your risk for breast and ovarian cancer goes down. The not-so-great news is that your risk for all-cause mortality such as coronary heart disease and lung cancer increases.

"Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced to prevent subsequent development of ovarian cancer," write William H. Parker, MD, from the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California, and colleagues. "Oophorectomy before menopause leads to an abrupt reduction in endogenous estrogen and androgen production....Later age of menopause has been associated with a reduced risk of death from coronary heart disease and stroke, and studies show that preserving ovarian function is associated with a lower risk of coronary heart disease."

Before having your ovaries removed for non-cancerous reasons, talk with your doctor about the risks and benefits especially if you have the opportunity to keep them during your hysterectomy.

Alcohol and Cancer: What’s the Risk?

“Don’t take away my wine!” was the cry of many a woman over the last few weeks when research reported one glass of alcohol per day increases the risk of cancer. As one of my post-menopausal patients so eloquently stated, “When they took me off HRT years ago due to the negative studies I turned to wine to relax and unwind. Now I’ve got nothing so I’m going to need a doctor’s note in case I hurt someone.”

Of course she was saying this in jest however the latest research caused quite a ruckus amongst the female health world. As part of my initial consultation we discuss alcohol consumption and more often than not I find many women drink at least 7 glasses of alcohol per week.

Although I am okay with drinking in moderation, I explain to women that alcohol raises estrogen and essentially clogs up the liver. It causes hypoglycemia at night which makes it difficult for women to fall asleep or stay asleep and is dehydrating to our bodies. Over the long-term, alcohol can deplete our B-vitamins which are so essential to health.

Due to its empty calories, alcohol can slowly pack on the pounds and may be a reason behind elevated blood pressure, triglycerides, and/or liver enzymes. And while I understand that nothing tastes better on a hot day than a cold beer or chilled chardonnay, it’s best done on a limited basis of 2-3 drinks per week.