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Pap Examination
Pap Smears Can Save Your Life
No cancer screening test in medical history is as effective for early detection of cancer as the Pap examination. Sadly, 80 percent of women who die of cervical cancer have not had a Pap examination in five years or more.
A Pap examination is a simple procedure in which your physician painlessly obtains cells from the surface of your cervix, often using a special brush to sample the area where most cancers begin to develop. The cells are placed on a glass slide, which is sent to a laboratory. At the laboratory, the cells are stained and then examined under a microscope by specially trained cytotechnologists. If an abnormality is found, a pathologist, a physician who specializes in laboratory medicine, studies the cells and makes the final interpretation.
Its primary purpose is to detect early cervical cancer and pre–cancerous conditions. An abnormal Pap smear often means pre–cancer, a change that can lead to cervical cancer if left untreated. If cancerous or pre–cancerous cells are found, the next step is a more thorough examination of your cervix, during which your physician will obtain tissue biopsies for a pathologist to study.
Sometimes, an abnormal Pap smear means there are uncertain cell changes that could be pre–cancerous or could be entirely benign, needing no further investigation. A Pap examination also may detect infections such as bacteria, yeast or viruses. One kind of sexually transmitted virus is important to detect because of its link to cervical cancer. This virus is human papillomavirus (HPV), sometimes called “Condyloma” or genital warts.
Every woman should have an annual Pap examination when she becomes sexually active or turns 18 years old–whichever comes first. Regular Pap examinations should continue after menopause and after a hysterectomy (removal of the uterus) To ensure that the cells your physician obtains during the exam are adequate for evaluation, you should abstain from sexual activity and avoid using vaginal douches or lubricants for 48 hours before the examination. Pathologists recommends that you have yearly Pap and pelvic examinations. Cervical cancer takes time to develop into a deadly disease. The pelvic exam is added insurance, it can help detect signs of cancer in female organs other than the cervix. Any woman can develop cancer of the cervix, but you are at a higher risk if. You have had multiple sex partners or a male partner who has had multiple female partners. If your partner has had sex with other women, you are at high risk even if you have had only one partner.
Osteoporosis in Women
Osteoporosis is a condition of weakened bone sometimes called brittle bone disease. The bone that is present is biologically normal, but there is a deficiency on the amount of bone substance. There are other very rare conditions where the bone is not normal, and may or may not be mechanically weaker.
These fractures come about from the loss of bone substance, most of which is lost after menopause. Men and other women are more protected, but from time to time can also have osteoporosis. There is a close relationship between the strength of the bone supporting the joint prosthesis and the long–term success of the implant. We are only now realizing how important the surrounding bone is in protecting the joint implant from loosening and other damage.
Typically bone loss starts after menopause, and progresses over time. All bone loss is bad, but as bone loss progresses complications can arise, such as fractures, curvature of the spine, and back pain. While some risk factors for osteoporosis and not under our control, like our age and gender, our ancestry, and our family health history, other risk factors can be affected by our behavior. These include smoking, excessive alcohol consumption, lack of exercise, and avoidance of calcium rich foods. If you have suffered a bone fracture, especially of the hip, wrist or spine, bones that are most frequently involved with osteoporosis, you probably already have some osteoporosis. In this circumstance, treatment for bone weakness is justified and is very important.
Treatment for osteoporosis
- Synthetic estrogen or progestin therapy or both for postmenopausal women
- Intake of calcium and other nutrients
- Weight–bearing exercise
- Drugs such as calcitonin and alendronate sodium, a no hormonal treatment for osteoporosis.
An 8 oz. Glass of milk has 300 mg of calcium. Along with calcium, it is important to take at least 400 units of vitamin D, found in all over–the–counter multivitamins. Another simple measure is to get daily weight–bearing exercise, such as a walking program.
Newer drugs which are not hormones can be used when hormone replacement is too risky, associated with too many side effects or is not working to maintain bone strength. After treatment is started, a bone density test should be repeated every 2 years. If drugs are necessary for bone maintenance, they may be necessary for a lifetime, although this has not yet been decided.
Diet
- Goal: 1200 mg of Calcium Milk, 8 oz 300 mg Cheese 1 oz, 200 mg Calcium pills (Calcium carbonate, calcium citrate, 1200 mg/day)
- Goal: 400 to 800 units per day Vitamin D Yogurt 8 oz 400 mg Calcium fortified orange juice Multivitamins, 400 units/tablet, Fortified milk, 400 units/quart
- Avoid smoking
- Walking, Nordic Track, treadmill
- Avoid sudden rapid movement, heavy lifting
- Limit alcohol
- Aquatic program
- Low–impact, weight bearing best
- Hormone (Estrogen) Replacement Therapy (HRT) should be considered by all post menopausal women
- Protective for heart disease, bladder problems,
- Dementia
- Side–effects, vaginal bleeding,
- Breast tenderness,
- Venous thrombosis (blood clots),
- Gall bladder problems
If cannot take HRT Side–effects, precipitate hot flashes, same venous Thrombosis risk of estrogen Benefits of estrogen without stimulation of uterine or Breast tissue.
Hot or Cold compression for joints? Do you ever wonder?
Cold reduces blood to the area it is applied to and heat brings more blood to the area it is applied to. Heat reduces muscle spasm and therefore is useful in situations where muscles are tight such as a stiff neck or back. Muscle ache after exercise. During excessive exercise beyond what one is accustomed to comfortably do, muscles can get sore. If the exercise is very intense, there may not be enough blood flow to eliminate all the chemicals produced as side products, these are needed to be eliminated. It is these accumulated chemicals that cause this type of muscle ache. Over the next few hours these chemicals are gradually eliminated through the blood and the muscles are no longer sore. Since it is blood supply that helps eliminate the chemicals that cause the pain, it makes sense to use heat to help sore muscles after exercise. Add to that the effect heat has in relaxing tight muscles and a hot bath (or any form of heat) makes great sense here. In fact it is from this use of heat that heat became so popular.
When an injury occurs, tissues are damaged and bleeding occurs. Here, heat would increase blood flow and increase the bleeding. Instead cold will reduce blood flow to the area and therefore reduce bleeding which is good. Also as you recall, cold numbs the area it is applied to which in the case of an injury is an added benefit.
Inflammation (tendonitis, bursitis, etc.) means that more blood is going to an area as a reaction to some problem there. That is why an inflamed area of skin is red and painful. Applying heat to an inflamed area will send more blood to the area making it even more inflamed. Cold on the other hand will reduce the blood and numb the pain. In the case of inflammation, cold is the right choice. People so frequently misuse one or the other that I thought it would be helpful to explain what each does and when it is best to use one or the other and even situations when both may work.
