So, especially around the New Year, I get a lot of questions related to weight loss and looking for tips on dieting.  Honestly, I am not much of a dieter myself, I work out and I do eat pretty healthy.  Don’t get my wrong, I strap on a feedbag every now and again…BUT I use my workouts as my evening keel.  So, I know a lot of people will say ” Oh, I will have dessert tonight and just work out really hard tomorrow.”  What do I do?  I allow myself treats AFTER a hard workout, it is my own form of positive reinforcement for a job well done!  I hate going into my workout knowing that I have to workout extra because I went batty with the food the night before….you are setting yourself up for failure.  How do we not set ourselves up for failure?  Read on….

The cardinal rules of weight loss:
1. If you are into weighing yourself (I am not a big fan and I usually encourage people not to, but I know that some people hop on 10 times a day!!) only weight yourself ONCE A WEEK!!  Weight yourself at the same time (usually morning after you have pooped/peed and feel skinniest) and ensure that you only weight yourself weekly…ladies please take into account your cycle and you may be retaining water!

2. Shoot for a weight loss goal of 2lbs per week; anything more than that and you will have trouble keeping it off.

3.  Eating foods that are high in fiber will fill you up and be colon friendly!  I totally understand that during the winter you will want more yummy warm foods, but instead of a high fat, meaty stew, try a black bean stew or instead of regular pasta use spaghetti squash as the “pasta.”

4.  Try to limit sodas and take in around 2 Liters of water and/or coconut water a day.  It will help to flush out  toxins from your body and keep you feeling full.

5.  Keep your fat intake to less than 25% of your total daily caloric intake.

6. Hold yourself to your workout goals of working out 3-5 times a week (whatever works for you) and if you have trouble doing that, then work out with a friend, group classes, OR hire a personal trainer…it will hold you accountable for work out and/or weight loss goals.

7. Make plans with your friends that also want to lose weight so that you will do something active and watch what you eat!

8. Lay off the alcohol for a while…if you are trying to be really active and watch what you eat, one hangover day will make you not only feel like crap because you are hungover but will make you feel super guilty about “cheating” on your diet, and that mental downer will make it much harder to get back into gear.

9. Allow yourself a “cheat day” each week. Give yourself a day where you don’t go crazy, but if you want pizza (for example) go and have some, but just try not to eat the whole pie!  Or allow yourself some ice cream- whatever it is you are craving, allow yourself to have it, and do so completely guilt-free!

10.  Don’t STARVE yourself!  If you allow yourself to get so hungry that by the time you see food, you eat everything in front of you…not a good plan! I find that the best tip is to go and eat 6 small meals (snacks a day). Eating small one serving size snacks every 6 hours will keep your metabolism revved and you will never feel hungry.

11. Get sleep!  If you are exhausted, you will be less likely to make your own food, and your cortisol levels will be up due to stress and make you crave carbs/high fat foods.  So, make sure that you are getting adequate sleep, and making time for relaxation before bed…so that you can wind down before hitting the pillow.

12. Don’t set goals that are outrageous!  I have friends that say “I just want to lose 10 lbs” when losing 10 lbs would A) make them look anorexic and B) never be attained.  Every body is different and not everyone can look like a super model…but you can be healthy and shapely!

13. Start your day with a smoothie full of fiber and fresh fruits!  It will fill you up and keep your glucose levels maintained so you won’t be starving and you will be full of healthy vitamins and minerals to start off the day!!

I hope that some of these tips help you out.  Basically, you need to make lifestyle changes…and keep at them.  If you make changes and lose weight, going back to your old ways will just allow the lbs to pack back on.  So make a commitment to yourself and your decision to become healthier, and have people join you on your path to a healthier you, I promise, it will be so much easier!

Yours in Good Health
B

Lactose intolerance is technically a lactase deficiency…you can’t digest the sugar found in milk. There are easy treatments that you can implement into your diet so that you can eat lactose without any of the side effects.  Some people tend to think they have an intolerance when they really don’t, just a dislike for milk!

Signs and symptoms after ingesting milk:
Bloating
Gas
Nausea
Diarrhea
Stomach cramps

Are there causes?
Some people are just born with a lactose intolerance, they don’t produce the enzyme to break down lactose.  But, lactase levels decline with age, so it is part of the aging process that it becomes harder to digest milk products.  When we are young we have high levels and as we get older they diminish (makes eating that block of cheese more of a pickle).  As well, sometimes after surgery, specifically to the small intestine, people can have difficulties breaking down lactose due to the physical changes of their anatomy.  Also, with people that may have an underlying disease such as Crohn’s or a random gastroenteritis, taking care of the symptoms of the disease/virus will allow the stomach to get back to its normal ability to process lactose.

Does anything increase my risk of becoming lactose intolerant?
Increasing age
Radiation to the abdomen: for cancer treatments
Premature birth: the body may not make that enzyme due to changes at birth
Ethnicity: Indian Americans, Black, Asian, and Hispanic populations have higher rates of lactose intolerance
Surgery to the small intestine
Diseases of the small intestine: Clostridium Dificle (overgrowth of bacteria), Crohn’s disease, and celiac sprue.

Diagnosis:
So there are a couple of tests that actually diagnose a lactose intolerance, instead of you just deciding that you have one!  A lactose tolerance test is when your HCP gives you a liquid to drink with high levels of lactose, then check your blood glucose levels after two hours, if your blood glucose levels don’t rise, you are not absorbing the high lactose drink they gave you. There is a similar test where they give you a similar drink but test your exhalation for hydrogen, if you have high levels, then you are not absorbing the lactose.

Alternative treatments and Lifestyle changes:
You can use over the counter lactose enzyme pills before eating lactose, they do help with absorption.  Also, because of the active enzymes in yogurt, eating a yogurt before dairy prevents many of the signs and symptoms of lactose intolerance.  You can also try to drink raw milk, as there are active enzymes and bacteria present there too!  Try experimenting with different forms of lactose; some cheeses have different levels than others, as do milks (i.e. goat vs. cow).  Also studies have shown that ingesting lactose containing products with other foods slows absorption times and allows for less discomfort when eating lactose.  Ingesting probiotics can help you to absorb lactose without any of the bad side effects.

So, if you have difficulties tolerating lactose, go talk to your HCP to get tested for a true diagnosis (you could have something else) and try different changes to your diet, ingest smaller amounts at a time, eat lactose with meals, and try adding probiotics and enzymes to your diet.  Plus, there are tons of products on the market that are dairy without lactose!  Give these tips a go, and let me know if you become more tolerant!! 😉

Yours in Good Health
B

There are tons of companies out there selling products that contain synthetic pheromones and claim to help you to attract the opposite sex, but do we know how it works?  If it works?  And I want to explain what pheromones are and how they work on the human brain. There IS a reason that you are attracted to the people that you are attracted to, and it is a little more than skin deep!

What are Pheromones?
Pheromones are chemicals excreted that triggers a response in members of the same species.  There are pheromones that alert as a danger alarm, territorial, food, aggression, informational, trail, and sex and they can only be sensed within the same species.  For example, to keep certain animals out of your garden, you can use pheromones to send the “danger” message and keep them out.  You can also use pheromones to help trap insects and prevent them from laying eggs.  And, in theory it works on humans….right?

Do pheromones work on humans?
 It was first studied in the 1890’s in Germany and determined that your skin and hair follicles combined help to make your own signature scent, which therein lies your pheromones! The best example is of women who spend a lot of time together; subconsciously their bodies sync and they begin to have their menstrual cycles at the same time….and that is just from getting a slight whiff of some perspiration! So, pheromones do have an active role between humans, but will they help you land Mr./Ms. Right?

How do they work in sexual attraction?
Numerous studies have been performed that show that heterosexual women and homosexual men react the same way to male pheromones in sweat.  Male sweat contains androstadienone, which is easily detected by your olfactory sense (sense of smell).  Also, it was shown that homosexual women did not respond to the sweat with androstadienone but responded appropriately to sweat with higher cortisone levels (i.e. female sweat/pheromones).  MRI’s were done of subjects brains whilst exposed to pheromones and it was found that they olfactory portion of the brain was stimulated along with the right hypothalamus (contains olffactory senses and stimulates your nerves…i.e. gets you really jazzed up!), right fusiform cortex (allows for face and body recognition), and the right orbitofrontal cortex (which aides in decision-making).  Basically, all of the parts of your brain that make you feel those wonderful tingly, attraction feelings!  So, there is a reason that you are attracted to the ones you love, and while it sounds pretty gross, you don’t mind smelling their sweaty bodies after a workout…and why doing active things together will actually keep you attracted to each other long term!!

psyweb.com

Do synthetic pheromones work?
There are tons of companies that sell colognes/perfumes with pheromones in them, and they claim that it will make you more attractive to the opposite sex.  Sadly, there is absolutely no research to support that synthetic pheromones work; it is only the real deal pheromones that work.  They have been studied extensively and there is nothing that shows they work like straight animal sweat!  Good smelling perfume/cologne can mix well with your natural pheromones to enhance them; which is why some colognes smell great on certain people and not so great on others.

So, skip the expensive synthetic pheromones and go sniff some armpits at the gym if you want to find your mate!! Pheromones are something that go to work without you even realizing it, but it makes sense why you are super attracted to certain people, and not others, it isn’t all looks when it comes to physical attraction…it can be sweat too!!

Yours in Good Health
B

Asparagus has been long known as a low calorie food that is high in potassium, folate, Vitamin C, and fiber (green asparagus), and high in antioxidants, as well as delicious.  Historically, not only was it eaten as a vegetable (apparently the Egyptians were big fans) but it was used as medicine because it has a diuretic property (meaning it makes you pee).  Why am I talking about this particular subject?  I served asparagus the other night and it became quite the topic of conversation between a few nurses…and everyone had a different theory, and some claimed that their pee didn’t smell, so I decided to delve deeper, and I must say, I just proved my theory wrong!!  I have to give kudos to a friend that doesn’t know a lick about geography, but knows about asparagus pee!!

Back to asparagus…along with making you pee, because of the compounds present in asparagus as it is metabolized in the body, some of the compounds are sulfur related (sulfur usually gives that rotten egg smell).  What are the exact derivatives making some of the pee flowery and some of it nasty resulting in that very specific asparagus scent?  methanethiol, dimethyl sulfide, dimethyl disulfide, bis methane, dimethyl sulfoxide, and dimethyl sulfone.  The first two tend to smell more pungent and the last two more sweet…and that’s how you get the ever-dreaded asparagus pee!!  (At least I dread it, but always forget about it until it happens!)

Apparently the smell is strongest after eating younger/fresh asparagus…so if you eat it and you don’t get super smelly pee, you can tell your host that their asparagus wasn’t fresh!  Also, it starts within 15-30 minutes of ingestion, which is super fast!

In the 1980’s there were three studies in France, China, and Israel that showed that it is a direct human trait to have asparagus smelling pee after they eat it. I had learned years ago that some people had an enzyme in their bladder that negated the smell, so some people didn’t have the smelly pee, and that was the info I had been living off of my whole life…turns out that that theory was disproved by the Israeli study that showed that 22% of the worlds population simply has an autosomal gene (meaning that it affects one of the 22 non-sex chromosome of the 24 that you get from your parents in your DNA) that allows them to detect the smell in the urine.  So, whilst everyone excretes the smell, not everyone can smell it, weird right?  They also found that the people who claim that their urine doesn’t smell (because they can’t smell it) are able to have the scent detected by other people with the gene!  I try not to go around smelling peoples pee, but I may have to prove this one out, seeing as I am the only person in my family who has asparagus pee (or so they claim!!!)

Because of the high amounts of potassium, if you have renal failure or insufficiency, you should be careful of your intake.  But, to everyone else, eat up!  It is great for pregnant women due to the high amounts of fiber AND folate (to prevent neural tube defects in your little growing ones).  And no longer feel the need to be embarrassed about asparagus pee, apparently it happens to us all, just feel empowered that you are one of the 22% that has super smelling powers!

Yours in Good Health
B

There are three main forms of Arthritis: Rheumatoid arthritis is a chronic inflammation disorder that usually affects the small joints in hands and feet, Gout which is a build up of uric acid in the small joints (usually in feet) and is preventable and reversible, and Osteoarthritis (OA) is the most common, which is a degenerative joint disease that occurs when the cartilage between bones wears down, the bones rub and cause significant pain. It is caused by the normal wear and tear of the body and repetitive motions, the aging process, obesity and extra stress on the joints, heredity, and muscle weakness.   There is no cure but there are plenty of ways to live a healthy active life with it, and many treatments both modern and alternative medical treatments.

Where does it most likely occur?
Hands
Hips
Knees
Neck
Lower back

What are the symptoms?
They are gradual and develop over time, so they may be difficult to notice at first.
Pain: after using the joint
Tenderness: When you put light pressure on the joint
Stiffness: When you first wake up in the morning or after long periods of inactivity
Loss of Flexibility: you may notice that you don’t have full range of motion, or are unable to move your joints the way that you could.
Grating sensation: You may hear or feel a grating sensation when you use the joint, you can sometimes feel the bone grating on bone
Bone spurs: sometimes extra bits of bone will form around and in the joint and make it feel/appear misshapen.

What are some Risk Factors?
Age: Older than 40 years old is when the signs of OA usually start to occur.
Sex: Women are more likely to develop OA than men
Bone Deformities/Injuries: Sometimes people are born with malformed joints at birth or have had joint injuries due to sports, etc., and those joints are more likely to have OA.
Obesity: Being overweight puts more stress on the joints and increases your risk of OA.
Occupation: As repetitive motions can cause the cartilage to wear down, any job with repetitive motions.  For example, Nurses have a high rate of OA in their hand joints from using their hands to manipulate IV tubing and doing other fine motor movements with their hands.
Genetics: Having Gout or Rheumatoid Arthritis (RA) increases your risk of developing OA.

Complications?
The main complication is that it is a degenerative disease that doesn’t stop, and it can be very painful for people and make it difficult to get through your day, so it can make your life harder.  You don’t realize how much you use your joints and how easy life is when they don’t cause you any pain!  So, learning to live with the disease is the main complication.

How am I diagnosed?
Usually you are diagnosed by your reported joint pain to your HCP, then through the use of X-Ray and MRI (Magnetic Resonance Imaging).  Your HCP may draw some fluid out of the joint to test that the pain isn’t due to infection.

What are some medical treatments?
Medications: Acetaminophen (Tylenol) can help with moderate pain but you need to limit intake if you drink alcohol, Ibuprofen (Advil/Motrin) Naproxen (Aleve) will help with moderate pain and diminish and swelling that might occur but you need to be careful to eat when you take ti to prevent ulcers and also you cannot take these medications if you have a history of bleeding ulcers or renal disfunction.  Tramadol (Ultram) is a prescription analgesic that takes care of moderate to severe pain but should only be used short-term to prevent wide effects of constipation and nausea. Other stronger prescription pan medications (oxycodone) can be used but there is the risk of addiction and side effects of drowsiness and inability to drive or perform other daily tasks.  Finally, for extreme pain, your HCP may opt to administer cortisone shots directly into the joint and the pain is most often completely relieved for up to 6 weeks BUT too many injections can caused added joint destruction so they may only be administered when absolutely necessary.

Therapy: The use of physical therapy can aid in keeping functionality and range of motion of the joint. Some orthotics/shoe inserts can decrease stress on your joints and help to relieve pain. As well, group therapy with other people that have OA can discuss ways that they live with their disease and support each other.

Surgical/Invasive procedures: Viscospplementation is when substances similar to the fluids that are normally in your joints (which comes from rooster combs) is put into your joint and adds cushioning to the joint and can diminish pain, currently only approved for OA of the knee but is being studied in other joints.  Joint replacement therapy is when the damaged portions of your joint are removed and a plastic and metal prothesis is put back in its place that lasts up to 20 years and you can have basically ANY joint replaced (even in small hand joints) but there is a small risk of bleeding and infection along with the surgery.  Another surgical procedure is called bone realigning, and it is when you cannot get a joint replacement, part of the bone is removed to allow for decreased pressure on the joint (usually performed for knee OA).  And bone fusion can also be done surgically which increases stability and decreases the pain, so an ankle that becomes fused will have no pain with full weight bearing, but you will no longer have your full range of motion.

Alternative Therapies:
Acupuncture can assist in decreasing your pain by inserting needles directly into certain pressure points (please read my acupuncture blog from last week).
Ginger can assist in decreasing OA pain, and can be ingested candied, cooked, as tea BUT it can interact with blood thinning medications, so you need to discuss with your HCP.
Glucosamine and Chondroitin have mixed studies (please see my earlier blog) but some people report feeling better with their use.  Just be aware that they can also interact with blood thinners.
Avocado-soybean unsaponifiables (ASUs) are newly being studied but have shown that the oils from both when taken together decrease the degeneration of the cartilage and can assist in cartilage repair in hips and knees.  I really have high hopes that this will be a great treatment for people with OA!!
Tai Chi/Yoga help with OA because of the easy moving and stretching and as people learn to breathe and feel their bodies it aides in de-stressing and studies have found that people report a decrease in OA pain.  It allows for range of motion without heavy stress on the joints.

How do I live with OA?
You need to keep your joints warm and moving, the pain occurs mostly in the morning or when you don’t use your joints a lot, but if you have swelling and perform repetitive motions, try to rest your joint to decrease the swelling and try not to do repetitive motions (as much as possible- I know, easier said than done!) Light exercise that has low impact, such as tai chi, yoga, and swimming can help with joint pain because it decreases the stress on the joints but allows you to keep them moving.  If you re overweight, try to lose weight as it will significantly decrease the stress on primarily your hip and knee joints. Also, some over the counter pain relief creams gels can really help, such as icy hot, etc.  One cream that I am a huge advocate of is called Sombra cream and it is amazing at relieving joint pain, I sometimes slap some on my knees before going for a long run, if they are sore, and they feel great (I’m trying to find research on Sombra…I may have to do my own to show how great it is!!)  And, if your joint pain is really severe and makes it difficult to go through the day, you can go see an occupational therapist (with referral from your HCP) and you can get assistive devices to help you get through your day (such as grabbers, stability devices, walking aides, etc.)

OA can be difficult to live with but there are numerous ways to live with it, and even adding yoga to your exercise routine might help to prevent it (studies are still being done).  As well, I really have high hopes that the ASUs that will help to stave off cartilage degeneration and prevent the pain of OA, and I will update you all with the research as it comes out.  I hope that some of these treatments, whichever way you choose to go with your OA works for you, and if there are any treatments/alternative therapies that I am missing I would love to hear them!!

Yours in Good Health
B

Goji berries are also known as wolf berries from a plant primarily grown in southeastern Europe and Asia.  That are claimed to have some pretty decent healing powers such as anti-aging, and are claimed to be the healthiest food source in the world; being jam packed with vitamins, minerals, and antioxidants.  Each company that sells its Goji products claims that they have “scientific research” to back up their claims of this amazing berry and the numerous health benefits, but it is impossible to find said research.

What nutrients do Goji berries contain?
Low amounts of calcium
Potassium
Iron
Zinc
Selenium
Vitamin B12
Vitamin C

Health Benefits?
There was one weak study in the Journal of Alternative and Complementary Medicine that showed no health benefits between the Goji berries and the placebo, but they claimed that it could be helpful and needed further studying. All of the claims that were made on one particular infomercial stating that Sloan Kettering in NY found that Goji helped to cure breast cancer were false claims and it has never even been studied in that hospital.  Basically every study claim related to Goji’s in advertisements are false or not reproducible.

Any bad side effects?
There have been two reported cases of older adults had serious medical complications after using Goji products because it interacts with the blood thinner coumadin (warfarin) by increasing the effects allowing for increased bleeding times.  This can easily put people at harm and lead to certain death, because the interaction is not completely understood, therefore it will make it very difficult for medical professionals to treat and reverse the effects and increased bleeding times.

This is an unregulated product, just like many other health supplements.  The FDA has put a few companies that made claims of healing on warning, as it is not a medication regulated by the FDA and companies cannot claim that is it used as a treatment or cure, as well there has been a class action suit against one certain Goji product company due to false claims and misinterpretations of their products, and results from clients.   It is a fruit with various vitamins and minerals that you body can use an absorb.  Is it the healthiest thing that will every cross your lips?  Probably not, but it isn’t the worst either.  Based on the lack of ability to prove the benefits of this fruit in research, and the cost of buying Gojis (not to mention the taste- I dubbed them “poop berries” in my house”- yuck) it is not worth it.  But, if you do choose to add Goji to your diet, just make sure to talk to your HCP if you are on and medications before you start the regimen, and stop if you notice any symptoms that are uncomfortable and tell your HCP so that you can be worked up for a possible interaction, and ensure your health and safety.

Yours in Good Health

So many of us that grow up on Western medicine think that acupuncture is a ridiculous idea, and others, who have tried the traditionally Eastern medicine since the mid 20th century in this area of the world, have long benefitted from the bodies response to the long thread-like needles inserted into our meridians and realigning our Qi.  These needles are inserted at certain specific points and depths along the meridians that, according to traditional Chinese medicine, contain vital levels of your Qi.  Just to clarify, qi is your circulating life energy.  I totally understand how people can easily scoff at what they don’t understand, it is even a really difficult practice to study because you really can’t use a placebo.

According to the World Health Organization (WHO), acupuncture is considered medically appropriate to treat around 40 different medical problems, and there are numerous other problems that acupuncture provides therapeutic effects.  A study from a major university in Germany that people with tension headaches and migraines had significantly decreased symptoms (to no symptoms) with use of acupuncture as treatment.  As well, a study at M.D. Anderson in Texas showed that neck cancer patients, who have a side effect with treatment of severe dry mouth, had a significant improvement of symptoms with acupuncture when added to their treatment regimen. Most commonly acupuncture is used to treat: migraines/headaches, stress, infertility, PMS, depression, allergies, addictions, hypertension, GI disorders, menopause, the symptoms related to cancer treatments, osteoarthritis, and many other ailments.

How are treatments performed?
It usually involves several weekly or biweekly treatments, as you are treating your whole body, which involves an exam, a past medical health questionnaire, insertion of needles, and a consultation for advice and follow-up.  Usually the treatment sessions can last from 30-60 minutes.  Make sure that your acupuncturist is using single use, disposable needles, an when they are inserted the the correct depth, you may feel an aching sensation, they will stay there for 20 minutes, then be removed.  Most people feel immediately better, despite the need to have multiple treatments.

How does it work?
In Traditional Chinese Medicine it is described that health is the result of a balance of   the yin and the yang (also known as yan) of the life force (Qi).  There are 350 acupuncture points in the body and all of these energy pathways need to be assessed and the ones with poor flow need treatment with acupuncture to allow for increased flow and personal balance.  If needles are inserted into the areas where there is illness or improper energy flow, the needles can help to change the balance and bring back the proper balance and energy flow.

Who should go?
The best part of acupuncture is that besides a few contraindications, mostly anyone can get treatment, even for just feeling like you have low energy.  Although many insurance companies are starting to cover part of the cost of acupuncture for certain medical diagnoses (check with your specific insurance company to find out if they cover and how much).   The only people that should be wary of treatment are people with bleeding or clotting disorders or if you are taking blood thinners, you are at a higher risk for bleeding at insertion sites or bruising; it should be discussed with your HCP before being treated.

The benefits?
It is safe, very few side effects, and it is a good alternative for some patients as adjunct to medications OR for people who do not wish to take medications.  And there are so many benefits, including reduced stress and overall feeling better.

Any Risks?
Besides the bleeding risks, as discussed above, there is a risk of the needle breaking or going into an internal organ and causing damage (which is extremely rare), and if unsterilized needles are used (which should NEVER be done) there is a risk of infection.

There is always a risk when using an unregulated alternative therapy that you are going to someone who doesn’t know what they are doing, and that they are not appropriately trained for what they are doing, so always talk to your HCP about acupounctire treatment before going, and get referred by them OR by a current client.  Meet the acupuncturist and if you feel uncomfortable at any point, just leave, and don’t be discouraged, just talk around and find one that is right for you. You can try looking online for acupuncturists, just beware and talk to current clients as references.  Also, don’t be discouraged if your HCP doesn’t “believe” in alternative therapies, it is your body and your treatment, happiness, and health is your decision and no one else’s.  So go out and get some needles stuck in you, and let me know how you feel!!

Yours in Good Health,
B

Apparently I am doing a bit of an “STD week” here, due to the rates of STD’s rising AND issues with long-term complications. One thing that people need to know more about is Pelvic Inflammatory Disease (PID).  PID is an infection of the uterus and fallopian tubes (the tubules that the eggs travel down to get fertilized).  The CDC estimates that 750,000 women get acute PID every year and because of this infection, 75,000 women become infertile every year.  With the rates of US infertility raising yearly, this is important to know about because it is a complication of STD’s, primarily Chlamydia and Gonorrhea, that goes unnoticed and can lead to severe long-term complications.

How do I get PID?
PID is a complication of STD’s, which is usually from unprotected sex.  If women have and STD that goes unnoticed and untreated for an extended period of time, and it is totally person dependent on that time period, the infection can spread up the uterus and into the fallopian tubes causing a wide spread infection.  The infection can lead to chronic uterine pain, abscesses in the uterus or fallopian tubes, and ectopic pregnancies (pregnancies in the fallopian tubes or in other places that where they should be).

What are risk factors?
Women who are sexually active, usually of childbearing years under the age of 25 are at highest risk of PID
People with prior PID infection
The higher the number of sexual partners, the higher your risk becomes
Using douche can increase your risk of PID by pushing bacteria higher up into your vagina, and causing an infection (such as PID)
IUD’s can increase the risk of PID UNLESS the women is tested before the IUD is placed and has concurrent STD testing.

What are the symptoms?
The scary thing is that you can have absolutely no symptoms or pretty severe symptoms.  Usually with Chlamydia, there are very very few symptoms, as most often the women don’t know they have an infection.  But, some of the noticeable symptoms are lower abdominal pain ( I know, who doesn’t get that on occasion?), fever, unusual discharge, painful sex, pain with peeing, and irregular menstrual bleeding.  One very rare but VERY serious complication is called Fitz-Hugh-Curtis syndrome which causes right upper quadrant pain (under the right side of the rib cage on your stomach); it causes your liver to adhere to lungs and can cause respiratory problems….there is no real treatment and no treatment unless is causes other issues.  Also, of note, the fevers and abdominal pain can mimic that of appendicitis/a ruptured appendix, so it can be an emergency and require emergent surgery and at least an overnight hospital stay.

Testing:
There are no precise tests for PID because it is a complication from other STD’s, so the best tests are getting regularly STD tested.  And it is also based upon the clinical findings of your HCP in your abdominal exam.  Also, an ultrasound may be performed to rule out abscesses or other problems that may mimic PID.

Are there any treatments?
Usually PID is treated with two antibiotics (orally) to ensure that the bacteria is being treated and preventing it from doing further damage to your reproductive system.  In cases where a women is pregnant, or having severe symptoms, they may be admitted to the hospital for IV antibiotics for treatment and for monitoring of the baby.  And, as stated above, the symptoms may mimic a ruptured appendix requiring emergent surgery, which is why any abdominal pain symptoms in a women require an abdominal exam in the Emergency Room.

How do I prevent PID?
Use protection with every sexual partner unless you are in a monogamous relationship and you are both getting tested.  Get tested regularly regardless of your use of protection or not, it is your body and you need to make sure that you are safe and healthy.  If you have ANY of the symptoms above, go get tested and talk to your HCP. Also, regular Gynecological exams are a way to prevent the infection from getting  to far and having your HCP notice any changes that you might have in your cervix that you did not know of.

So, please spread the word, be safe, get tested, and go talk to your HCP if you have any inkling that you might have PID.  Infertility is such a horrible price to pay for a mistake of having sex with the wrong person, getting an STD, and not getting it treated…there is no excuse these days with free/low cost STD clinics in every city!  (Go to your local Department of Public Healths website to find where the low cost/free clinics are)

Yours in Good Health
B

Syphilis infections are on the rise worldwide since 2000, especially in the population of men who have sex with men, young women, and African American populations, in the ages from 20-36.  HCP’s aren’t really sure why because there is SO much education on prevention of STD’s being done in the world.  So, the best way to ensure that you are safe and sound is to have the knowledge of the signs and symptoms and know how to prevent the infection.  Syphilis was a heavily studied disease back in the day, known as the Tuskegee Trials (and probably one of the most horrific studies done by the US Government) where from 1932-1972 they infected a bunch of African American men from Macon County Tennessee with Syphilis and watched how their bodies reacted from the disease in the short and long term.  This study lead to laws about ethical treatment of study patients and requirements for informed consent for biomedical studies.  And, actually, in 1767 syphilis was an issue, mostly due to a lack of contraception, but one of the first true surgeons, John Hunter, infected himself to learn more about the disease, and learn to treat it.  As it ends up, a quick shot of penicillin will do the trick, but what John Hunter learned is a fascinating part of the disease; you can get a couple of days of subtle signs of infection, then they go away and you can have no symptoms at all, but still transmit the disease and have long term complications.

What is Syphilis?
Syphilis is a bacterial infection (from the bacteria Treponema Pallidum) that is spread through unprotected sex and can cause a painless sore on the genitals, in your mouth, around the anus, or rectum and direct contact with the sore will lead to infection.  It is an infection that goes in stages and early on, it can be simply treated with antibiotics to prevent the infection from spreading, but if undiagnosed over the long term it can cause cardiac (heart) and neurological (brain/nerves) problems.

What are signs and symptoms of syphilis?
Primary Stage:
The round painless sore that occurs is called a chancre and it usually pops up 10-90 days after initial infection (average is 21 days after infection) and can be one sore or multiple sores and they appear where the syphilis entered the body (so if you had anal sex with an infected partner, it will show up around the anus, etc) and usually lasts 3-6 weeks then goes away on its own without treatment.  This DOES NOT mean that the infection is gone, it just progresses to the secondary stage.  As you can see from the pictures below, some of the chancre are things you cannot miss on yourself, an others might be easier to miss…

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