Category Archives: Better Health Through Science

History of Birth Control in the US

Part Two

 NOW

Ultraconservative legislators in Texas and other states have defunded Planned Parenthood. More than fifty years after the epic moment in 1960 making birth control pills available, women are fighting the same old battle, the right to self-determination and contraception.

Some legislators at the national level have vowed to defund Planned Parenthood clinics across the United States. Those who fight to defund the clinics and legislate reduced contraceptive availability are antiabortionists. They vehemently attack clinics that provide abortions, leading to violence and terroristic murder of healthcare personnel. Planned Parenthood provides healthcare to both men and women, education, contraceptives, treatment of sexually transmitted diseases, and they offer fertility consultation. https://www.plannedparenthood.org/

Comprehensive sex education and free contraceptives reduce unplanned pregnancies and abortions. Why would those against abortion defund Planned Parenthood clinics limiting access to education and birth control, thus increasing the need for abortions?

Abortions have been a legal right under U.S. law since the Roe v. Wade Supreme Court decision in 1973. That decision deemed abortion a fundamental right under the U.S. Constitution. Roe, a single pregnant woman brought a class action suit against the constitutionality of the Texas laws that made abortion a crime except to save the life of the mother. District Attorney Wade was the defendant. The historic decision overturned the Texas law and held that a woman and her doctor could choose abortion in earlier months of pregnancy without legal restriction, and with restrictions in later months based on right to privacy.

Any adult has the right to make personal decisions based on their religious views. However, our founding principle of separation of church and state in the U.S. means no one as the right to impose their religious views on others.

Broad availability of birth control education and contraception has been shown to reduce unplanned pregnancies and reduce the need for abortions.

I wrote Modern Birth Control because of the potential loss of healthcare services to men modern-birth-control-kindle-coverand women. The small booklet provides up-to-date information on aspects of health related to contraception, sexually transmitted diseases, treatment, and avoidance of sexual assault. Many references are included. The 44 page book is available on Amazon. Paperback  – http://tinyurl.com/ModernBC E-book – http://tinyurl.com/ModernBC-Kindle

Betty Kuffel, MD

Improve Your Health

Springtime Weight Loss & Health Goals

KONICA MINOLTA DIGITAL CAMERAThe doldrums of winter have passed. With shorter nights and warmer days, the grass is greener, flowers are blooming and the birds are singing. It’s spring!

If you are an outdoor winter sports enthusiast, you may be fit and at your ideal weight. But, if icy weather kept you indoors and sedentary, you may have added a pound or two. If so, this is the time to get started on a healthy routine. Forget spring cleaning, instead, dust off your shoes and take a walk.

Before you begin, hop on the scale and record your weight. Use the baseline to track your progress to better health. According to the National Institutes of Health, excess weight can put you at risk for a multitude of health problems. Cardiovascular problems are at the top of the list, including heart attacks, strokes and high blood pressure. Close behind are: Type 2 diabetes, unhealthy pregnancies, sleep apnea and even some types of cancer.

Now that you have your weight, you need see where you are based on accepted parameters using the Body Mass Index (BMI) categories of weight:
• Normal = 18.5-24.9Scale, Tennis Shoes, Calculator
• Overweight = 25-29.9
• Obesity = 30 or higher

So, how do we measure BMI? The easiest way is to go to: BMI Calculator
Input your numbers and the internet program will give you the value.

If you like math and you’d rather calculate your BMI, you need your weight, height, a metric conversion multiplier and a calculator to square your answer and divide. It’s Easy – follow the steps below:

1. Multiply your weight in pounds by 0.45. Ex: 125 pounds x .45 = 56.25 kg

2. Multiply your height in inches by 0.025. Ex: 63” x .025 = 1.575 m

3. Square the answer from step 2. Example: 1.575 x 1.575 = 2.4806

4. Divide Step 1 answer by Step 3 answer. Example:56.25 divided by 2.480625 = 22.7 BMI

• If your BMI is normal, exercise is still important.
• If the BMI is elevated, get started on the Mediterranean 5/2 eating plan combined with walking at least 30 minutes a day plan to drop the unwanted pounds.

Go to: Your Heart, our other blog, to find details regarding both Mediterranean food choices and guideline for the plan of eating two low calorie days per week – allowing easy weight reduction.
Losing just 5 to 10 percent of your body weight may lower your chances of developing heart disease? If you weigh 200 pounds, this means losing as little as 10 pounds could prolong your life. Weight loss benefits include:
• Improved energy, sleep, sex life and self-image
• Lower blood pressure, lower cholesterol and lowered risk of heart attack
• Reduced cancer risk
• Fewer aches and pains
• Reduced risk of dementia
Spring Forward. Put on your tennis shoes and start walking. Listen for the sweet sounds of returning birds. Watch for spring flowers and pussy willow buds. Take a dog for a walk. Ask a friend to join you.

Lift your spirits and improve your health.

Betty Kuffel MD and Bev EricksonTall Grass

Lipstick Logic

Your Heart Book Cover- Final FINALMore information about heart health and losing weight can be found in our book: YOUR HEART

ESTROGEN IS BACK IN THE NEWS

Estrogen Supplements May Reduce Dementia Risks

Two recent studies show a possible benefit of estrogen supplements in menopausal women to reduce dementia risk. These studies are very important because women are living longer and any improvement in mental function or delay in the onset of dementia could provide great benefit for women.

Loss of ovarian hormone production following menopause or surgical ovarian removal, results in important changes throughout the body. Bone density decreases, osteoporosis develops and more fractures occur. Hot flashes, mucus membrane dryness, reduced libido, hair loss, skin wrinkling, all become issues. The list goes on. Some problems related to estrogen loss seem minor, but decreasing risks for heart disease, osteoporosis and dementia are major considerations for long term health.

In the past, physicians provided prescriptions for hormone replacement therapy (HRT) for women following menopause. In the summer of 2002, physicians stopped prescribing hormone replacement therapy after the Women’s Health Initiative (WHI) concluded the risks of estrogen treatment far outweighed its benefits. The large WHI study also reported the combination of estrogen plus progestin not only increased the risk of both breast cancer and heart disease, but women had an increased risk for dementia.

The following studies suggest estrogen alone (without progestin) may be beneficial for the brain and memory and not detrimental as the WHI study reported:

+ Neurobiology of Aging published a Norwegian study where researchers studied MRI scans of women taking estrogen. They found an important area for memory, the hippocampus, showed preserved brain volume in women who started taking estrogen supplements before or at the beginning of menopause and continued for a number of years. Since the hippocampus is the area affected in the progression of Alzheimer’s disease, the findings in the Norwegian study are hopeful.

+ The National Proceedings of Science reported that a team of scientists at Guelph University in Ontario studied the effect of estrogen on synapses in mouse brains, the location where brain cells communicate. Within minutes of an estrogen injection, a large increase in synapse activity occurred in the hippocampus. Boosting estrogen levels may help strengthen brain connections and result in improved learning and memory. Human studies are needed to validate their findings and any long term benefit.

WHI conclusions are being revisited by practicing physicians and research groups. Estrogen replacement in women may once again be prescribed as an anti-dementia aid. However, if a woman has had clots, strokes or cancer, estrogen is not appropriate.

For additional information on benefits of estrogen from new studies see our blog at:Your Heart Book Cover- Final FINAL
www.yourheartbook.com

http://tinyurl.com/mvpm2y9

The Benefits of Daily Exercise after Menopause

20151020_152306

Women experience menopause with lost ovarian function due to aging or surgical removal. Loss of estrogen in the postmenopausal state affects the body in both obvious and subtle ways. Obvious effects are hot flushes, thinning hair and skin wrinkling, but there are many more silent harmful effects.

Early menopause contributes to osteoporosis. Gradual weakening of bones occurs without the estrogen stimulus to calcium metabolism and bone strength. Further bone loss may evolve to fractures and disability.

We also know the effectiveness of high-density-lipoprotein (HDL), the “good” blood fat, is reduced without estrogen effect. This transporter molecule is responsible for removing cholesterol buildup in arteries. HDL particles without the effect of estrogen are less efficient and the risk for heart attacks increases in women following menopause. Postmenopausal women can offset some of this effect by eating healthy and staying active. Statin medication to modify abnormal blood lipids may also be needed.

A study reported at the North American Menopause Society stated women after menopausal tend to weigh more, have larger waist lines, and a higher percentage of body fat than younger more active premenopausal women. Sedentary behavior correlated with a larger waist size – no surprise. But their findings showed regular exercise brought benefit to both pre- and post-menopausal women. When women increased their daily exercise – energy, mobility, and bone density all improved, along with reduction in waist size. Increased activity and weight control can also reduce the risk of developing Type 2 diabetes.

Last year, a journal of the American Association for Cancer Research reported a four year study examining women who walked the equivalent of thirty minutes per day had a lower risk of invasive breast cancer. The exact mechanism is unknown, but we do know exercise carries many positive benefits. Researchers stressed the benefit of lowered risk of invasive breast cancer was lost when exercise stopped — so daily exercise is key.

Walking daily can become a positive routine and is as important to overall health as brushing your teeth. Dogs love to walk. Our dogs provide encouragement to take a hike even in the rain. If you don’t have a dog, find a friend to join you. Exercise and social relationships correlate with happiness and longer life. Find a route that makes you smile and take a daily walk.

Some good advice from Dr. Seuss:
You have brains in your head.
You have feet in your shoes.
You can steer yourself in any direction you choose.

20151018_142608Betty and Bev

Alcohol, Women and the Economy

Alcohol abuse has ruined many lives and relationships. There are few families without these problems. Child abuse, partner abuse and self-abuse are all intertwined when it comes to the use of mind-changing substances. Some people are successful occasional users, many are not.

Recent research articles and experiences with alcoholic friends stimulated this series of blogs on the topic. This will be our last one for now, but I wanted to end with recent information on the topic to help you analyze your own behavior and possibly intervene when you see dangerous behavior occurring.
Microbreweries and small distilleries have become popular everywhere. Tasting a “flight” of either beer or hard liquor samples may put you over the safe driving blood alcohol limit of .08. A designated driver is essential. One in ten deaths among working-age Americans between the ages of 20-64 is caused by excessive alcohol. Drunk driving kills.

Two days ago, a report from the Centers for Disease Control and Prevention (CDC) released a study showing alcohol consumption and costs have accelerated. The economic costs are due to reduced work productivity, the cost of treating people for health problems related to alcohol, and crime. These statistics did not examine the pain and suffering from alcoholic behaviors.
We all understand why pregnant women must be wary of alcohol and its harm to an unborn child. Fetal Alcohol Syndrome, also called Fetal Alcohol Spectrum Disorder (FASD) is a constant reminder that mental and physical changes are attributable to a mother’s behavior while pregnant. There is no amount of alcohol consumed while pregnant that has been proven safe. The primary concern is that small amounts of alcohol could negatively affect the developing fetal brain. Each woman has to decide. Our advice to pregnant women is to wait and have a glass champagne to celebrate after the birth of your child.

Many have a glass of wine for social reasons. Others drink to get drunk, or are addicted and don’t stop until their blood alcohol level causes them to pass out. Tragedies happen every day due to alcohol. Think twice before you drink, and never drive after drinking.

Betty and Bev

I’ll Drink to That!

Some water flowing in high mountain streams is pristine enough to drink without the need of additives to kill or filter out disease-causing microbes. But, in many places on planet earth, water clean enough for consumption is in short supply. In California and other drought-ridden locations, plants and animals are dying due to insufficient water. In many areas around the world, dysentery from drinking contaminated water is prevalent and life-threatening.

We take water purity for granted in the US where chlorinated water pours from our taps. But, during much of the past 10,000 years, before the availability of pure water, the only safe liquid to drink contained alcohol. Today, we see alcohol through many lenses, with both good and bad views.

Alcohol is the metabolic byproduct of the natural process of fermentation that occurs when yeasts metabolize sugars. In the Middle Ages, alcohol was called “the water of life,” aqua vitae. They learned to make wine from grapes, and beer from fermented grain. People of all ages, including children, drank alcoholic beverages as their primary consumable liquid. The alcohol destroyed many microbes causing disease and made it safer to drink than water. The processes for making wine and beer are simple. Today, many people make them for fun. Microbreweries have sprung up everywhere. There are many suppliers, even health food stores carry the products.

All alcohols are not consumable. Some can cause blindness and death. Disinfectant alcohol is applied to surfaces of the body prior to medical procedures, and is the primary ingredient in liquid hand purifiers. Windshield cleaners spew various colored fluids containing alcohol. There are many industrial uses.

20150626_195841The drinkable form is ethyl alcohol. It is used in celebratory toasts, paired with elegant dining, and has been shown to contribute to cardiovascular health. Undisciplined drinking carries health risks and tragedy. Alcohol is a sedative drug and a toxin. Excessive consumption contributes to loss of mental function, also causing addiction and liver failure. Alcohol has become a common social drink and a problem for many who drink to excess.

Our next blog will review a new powdered alcohol product called palcohol. Additional blogs will provide information on health and social issues related to alcohol consumption, common early signs of problematic drinking, and will discuss blood alcohol determinations.

Here’s to safe drinking, designated drivers, and moderation in all things.

Betty and Bev

INFLUENZA UPDATE

Influenza is a respiratory illness caused by a virus.

In 1918 a deadly outbreak of influenza known as Spanish Flu occurred. The disease killed about 50 million people around the world. Recent research done on preserved lung tissue from people who died showed the lung damage seen with bacterial infections, not viral. Researchers concluded the Spanish Flu virus caused a severe respiratory illness, complicated by bacterial infection before effective antibiotics were available.

Seasonal flu remains a serious health problem carrying the greatest risk in older people and those with lung conditions such as asthma and chronic lung disease. Ninety percent of deaths occur in people over the age of sixty-five. A bacterial pneumonia is a common occurrence with influenza. The “pneumonia shot” only prevents one type of bacterial pneumonia, pneumococcal, and is recommended for adults 65 and older.

Today, each year in the US more than 36,000 people die and 200,000 are hospitalized with the flu. Anti-viral drugs are available and shorten symptomatic periods by a couple of days. Antibiotics reduce fatalities from complicated pneumonias that often follow influenza. Getting a “pneumonia shot” only prevents pneumococcal pneumonia.

Each year the flu vaccine is formulated to stimulate immunity to the influenza viruses most likely to be present in the upcoming season. The vaccine usually covers 3-4 different viruses. While the Centers of Disease Control and Prevention (CDC) researchers do their best to match the annual vaccine with the anticipated viruses, the vaccine may not prevent all influenza illnesses because the viruses mutate and change each year.

“The CDC notes that around 70% of this season’s H3N2 viruses have been identified as “drift variants” – viruses that possess antigenic or genetic changes that make them different from the virus included in this season’s flu vaccine, meaning the vaccine’s effectiveness is reduced.”

 “… the CDC estimates that the flu vaccine has reduced an individual’s risk of visiting a doctor due to flu by 23%. This result remained after accounting for patients’ age, sex, race/ethnicity, self-reported health and the number of days between illness onset and study enrollment.”

The best way to prevent the flu is to get your immunization every year. Once you have been immunized it takes about two weeks for the body to generate a response to prevent the disease.

“Despite the low effectiveness of the 2014-15 flu vaccine, the CDC continues to recommend that all people aged 6 months and older receive the vaccine, as it may still prevent infections from some circulating influenza A H3N2 viruses and reduce severe flu-related complications.”

What to do: To protect yourself from influenza, avoid people with respiratory illnesses, avoid hand shaking, use good hand washing technique and utilize alcohol hand purifiers. Early symptoms are typically muscle aching (myalgias), fever and worsening respiratory symptoms. Isolate yourself if you develop the symptoms. Antiviral drugs must be started within 48 hours of onset of symptoms to have benefit. Call you physician for advice if you are not improving or develop shortness of breath.

Best wishes for health and avoidance of influenza.

Betty Kuffel, MD

Broken Heart Syndrome

Takotsubo Cardiomyopathy

Losing a loved one, the sudden stress of receiving bad news, intense fear or domestic violence can break your heart. But this isn’t in the emotional sense we usually think about. There is an acute heart problem seen primarily in women of menopausal age in which the heart weakens in the face of sudden stress. The main pumping chamber of the heart balloons instead of contracts. Resulting chest pain and shortness of breath are symptoms indistinguishable from a heart attack.

The electrocardiogram shows classic ST segment elevation found in heart attacks. In addition, there is often a small sharp rise in troponin, a heart injury blood marker. In a typical heart attack caused by a blocked coronary artery, the damaged heart muscle cells leak troponin, but usually in larger amounts.

If an angiogram determines there is a blocked artery the cardiologist will likely place a stent. But in the broken heart syndrome known as Takotsubo Cardiomyopathy, instead of finding blockage, the coronary arteries are clear — the results indicate a failing heart with an odd shape. It looks like an octopus trap (a tako-tsubo).

 

The actual cause of this disorder is not known but is likely related to a surge of stress hormones that stun the heart and prevent normal muscle contraction. Takotsubo is usually seen in older estrogen-deficient menopausal women. However, younger women who lack estrogen because of surgical menopause from ovary removal are also at risk. Animal studies show estrogen appears to protect the heart in stress states.

There are no treatments shown to reverse Takotsubo. Doctors usually order common heart failure medications including beta blockers (to reduce heart rate and blood pressure), ACE inhibitors (to dilate arteries making it easier for the heart to pump) and diuretics (to remove excess fluid). It isn’t known if continuing the drugs can prevent a recurrence, but within two months, most patients fully recover. A few women are left with reduced heart function, and occasionally abnormal heart rhythms occur.

Women in this age group may also have underlying heart disease requiring medical management unrelated to the sudden stress state. Like men, women develop blockage of the major coronary arteries.

Another heart problem most often seen in women involves only small heart arteries. The large coronary arteries are clear but tiny arteriolar vessels are diseased. Microvascular disease is serious. It can lead to heart attacks and heart failure. A treadmill in combination with continuous monitoring, followed by echocardiogram to check heart function will show abnormalities. Microvascular disease is also treated medically.

Techniques used to help reduce stress hormone surges include: progressive muscle relaxation, exercise, yoga, avoiding alcohol and caffeine. Controlling anxiety is not easy and counseling may be necessary.

 

Lipstick Logic
Betty Kuffel, MD

Healthy Lifestyle – 2015

MAKING CHANGES IN THE NEW YEAR

Lifestyle means different things to different people. In the past, a healthy lifestyle for hardworking farmers meant getting up before dawn to first milk cows before spending a long day of heavy labor in the fields. A breakfast of fried pork chops and eggs accompanied by homemade bread slathered with butter commonly provided the first meal of the day. A hard working man needed those heavy calories for energy to perform his daily job.

Scan old photos and it’s unlikely you’ll find a fat farmer. They ate food laden with fat and calories but they worked it off. They earned their calories. My grandfather was a farmer. I saw what he ate. My family enjoyed amazing meals, especially during threshing when friends helped friends and families helped families. Eating well was their way of life. For most of us it’s the same today—except now, many people don’t earn their calories.

The body is an efficient metabolic machine. When you eat more calories than you burn your body stores the excess as fat. So lifestyle today is different from the lifestyle of the past, and practices of the past are unhealthy today.

Exercise is the single most important activity that correlates with a long and healthy life. A close second are: your food choices and the volume of food you eat. We need to eat to live, not live to eat.

A new twenty year-long study of 70,000 women confirmed a healthy lifestyle could prevent 75% of heart attacks in young women. Death rates from heart disease in the US have slowly dropped over the past four decades, but in women ages 35-44, this is not true. The study published in the American College of Cardiology reported health habits make the difference. Women with unhealthy lifestyle choices began showing increased heart risks by age 47.

Below are seven top ways to improve your lifestyle and reduce risks for heart disease:

• Don’t smoke
• Consume a maximum of one alcoholic drink/day
• Maintain a normal body mass index (BMI)
• Watch seven or fewer hours of TV per week
• Exercise at least 2.5 hours per week (35 minutes per day)
• Eat a quality diet based on Harvard’s School of Public Health healthy eating plate.
• Have an annual physical that includes a lipid panel

Smoking: Quit. Ask your doctor for assistance if you can’t do it on your own.
Alcohol: Wine: 5 ounces, Liquor: 1.5 ounces, Beer: 12 ounces
Plate and portions: Healthy Eating
BMI: At the link below you’ll find health information and a BMI calculator to check your current BMI. For the calculation you need to know your weight in pounds and height.
http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Make 2015 a healthy year for you and your family. Monitor your blood pressure, address your weight, add exercise every day and encourage others to do the same.

Betty Kuffel, MD and Bev Erickson

Lipstick Logic (TM)

LOVE YOUR HEART

Your Heart – Prevent and Reverse Heart Disease in Women, Men and Children

Kindle e-book $2.99   http://tinyurl.com/kindle-heart-sale          

Paperback $9.99  https://www.createspace.com/4330606

For the entire month of February, Your Heart is offered at sale rates.

American Heart Month is a perfect time to raise awareness and explore reversible risk factors for cardiovascular disease. Know your health history and address factors that can be modified to improve heart health:

♥ Tobacco use and cessation

♥ High blood pressure identification and treatment

♥ Cholesterol abnormalities paired with dietary modification and statin use when needed

♥ Obesity and diabetes with recommendations for normalizing weight and glucose

♥ Low activity levels counteracted with exercise prescriptions

♥ Alcohol consumption history and limitation of use

♥ Heredity factors and recommended interventions

Heart risk factors are within your ability to control. Make this the month you evaluate your personal risks and take action to reduce them. With the right knowledge and actions, the number one cause of death in women and men is preventable.

Book Excerpt:

Why is coronary artery disease the leading cause of death?

Atherosclerosis is a disease of affluence. In developed countries throughout the world where food is plentiful, coronary artery disease is the leading cause of death. We eat, not only because we feel hungry, we eat to pass time, we eat for enjoyment, and we munch mindlessly at social events. The fact is, we eat too much and it’s making us sick.

Coronary artery disease is tied to obesity. Food choices, portion sizes and exercise interplay, but the disease is more complex than any of these factors.

Statistics are boring to read and don’t mean much when they are without a face. But consider the fact that 50% of all people have high blood pressure, high cholesterol or smoke; all three factors cause heart disease. Many of us personally know someone with these problems. Is it you? A loved one? You have the ability to make healthy choices and improve your health by treating these factors.

Part of the high death rate from heart disease is due to a lack of education about the cause and what can be done to fight it. But even knowing sound health practices, many people do not follow them. In recent years, there has been a reduction in heart deaths through improved treatment, education and reduction of risk factors, but coronary artery disease still remains the leading cause of death.

Two programs to address education, diagnosis and treatment are: the Million Hearts initiative, developed by the Department of Health and Human Services, with a goal to prevent a million heart attacks and strokes by 2017; and the WISEWOMAN program, administered through the Centers for Disease Control and Prevention.

Heart disease is a huge problem in developed countries around the world, including the United States. The Million Hearts program joined with the US Centers for Disease Control and Prevention, the American Heart Association and other organizations. Together they share strategies to reduce heart risk factors and save lives. Information from these organizations is available for education programs to implement change.

At 21 US sites, the WISEWOMAN project provides a screening and evaluation program to help women obtain healthcare when they have little or no insurance. Examinations, laboratory tests and education to lower risks are included.

Diabetes, overweight, poor diet choices, low physical activity and excess alcohol are all issues placing people at risk. If any of these affect you, take control, read more, learn more and make heart healthy changes. Don’t become a statistic. Take action. Choose to reduce your personal risk factors.

According to the US Centers for Disease Control and Prevention, 50% of men and 64% of women who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.

Katie, a registered nurse who believed she was healthy, working full time in a hospital but having difficulty with an arthritic knee finally decided to see an orthopedist. He recommended a total knee replacement procedure. As part of her preoperative evaluation, her primary physician evaluated her and performed an electrocardiogram. The electrical tracing of her heart conduction and rhythm was abnormal, indicating ischemia. A special nuclear medicine test of her heart showed marked reduction of circulation in the heart muscle. Katie went directly to the heart cath lab where two main coronary arteries were found to be more than 90% blocked by cholesterol plaques. The cardiologist dilated and stented both arteries. The orthopedic surgery had to be placed on hold. — Katie denies ever having any symptoms related to her heart.

Many people are aware that high cholesterol is associated with heart attacks, yet have never had a cholesterol blood test done. Because they have no symptoms, they can’t believe they might be a candidate for a heart attack. The more you know how lifestyle, food choices and heredity factors impact heart health, the more equipped you will be to make healthy choices and obtain proper healthcare. This section provides more information on risk factors.

 Thanks for stopping by. We hope 2014 will be a healthy and happy year for you.

Betty and Bev