Category Archives: Uncategorized

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 The-Surpreme-Court.jpgdecision 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

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Motherhood and Apple Pie

k9293041Motherhood and Apple Pie is an idiom used to express a wholesome concept of traditional life in the United States. Unfortunately, times have changed so much over the past 50 years the intended meaning no longer applies. If we look at motherhood and child health over the past 25 years, the US has failed. Maternal deaths are at an all time high. Even with a decline in infant mortality between 1990 and 2010, US infant deaths surpass those of other industrialized countries.
International comparisons of infant mortality show the United States has more infant deaths than most European countries, Japan, Hong Kong, South Korea, Iceland, Israel, Cuba and Canada. Monaco and Japan have the lowest infant death rates in the world.
How can so many mothers and babies be dying in the United States – a country that touts itself as having the best healthcare in the world? Let’s look at some of the reasons.

Cardiovascular disease and infection are the most common causes of maternal death. Because many US women have delayed pregnancy until they are older, they are more apt to have developed chronic diseases including obesity, heart disease, high blood pressure and diabetes prior to their first delivery. All of these common medical problems place additional health risk on both mother and infant.
Medical costs for pre-natal care, delivery and post partum care are high. Choosing to avoid these high costs by delivering at home also places the mother and child at increased risk, especially if urgent interventions for complications become necessary for a safe birth. On the other hand, technology in medical centers has improved treatments to mitigate life-threatening complications such as hemorrhage and obstructed labor requiring C-sections. Going forward, the Affordable Care Act will help participants obtain easier and more affordable access to both maternal and child healthcare.

In reality, the safe, heartwarming values associated with Motherhood and Apple Pie didn’t apply to all mothers even in years past. As recently as the 50’s and 60’s, unmarried girls and women suffered terribly at the hands of society. Young unwed mothers were often whisked off to maternity receiving-homes by their mortified families who wanted to hide the shameful pregnancy. The babies of these young women were typically removed from them in emotionally devastating ways, often not allowing the young mother to even see the infant before the child was placed for adoption. Mothers mourned the loss of their babies. Treatment of many women in that era is found in The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Rove v. Wade, written by Ann Fessler.

According to the data presented in Fessler’s book, inhumane practices during labor and delivery were common. Treatment by medical practitioners, nurses and child welfare services often left the mother with physical and emotional scars that never healed.
Today, many unmarried women are giving birth. Most of them choose to keep their children. In fact, more than half of US births are to unmarried women. These births are often to couples living together. From the National Center of Health Statistics, in 2009, 41% of children were born outside of marriage and 53% of children were born to women under 30, but not all of these pregnancies were unplanned. The stigma of being a single parent has decreased and many women elect to raise a child alone. However, few women disagree that a two parent household is advantageous.

Parenting is supremely important for the emotional, social and intellectual development of a child. Today, more and more grandmothers are filling this important role in childcare by helping to contribute to the care and emotional stability of their grandchildren.
Single low income women with children are at a huge disadvantage in our society. If they can find work, their incomes are often too low to provide adequate housing and appropriate childcare. Sharing households and receiving support from family members who help single parents support their efforts toward the American Dream is helpful, but even with support, the dream has become harder and harder to reach.

motherhood-guruAdults provide the role model for children. Raising children with self esteem and confidence contributes to their successes as an adult. Children tend to mirror their parent’s and caregiver’s behaviors so adequate childcare is essential for single parenting to be successful. Encouragement, respect and love can also be provided by extended family members and baby sitters. Studies show even severely abused and neglected children can be nurtured into confident adults by a caring supportive mother figure.
Today, motherhood has huge challenges and little apple pie. With over 8 million single mothers providing sole support for their children, their options to find good paying jobs are few. Single mothers can be just as successful in child rearing as married mothers, but they may need a little help from their friends.
On this Mother’s Day, please honor women and remember the poem written by William Ross Wallace (1819-1881) The Hand That Rocks the Cradle Rules the World.

(Last verse)

Blessings on the hand of women!
Fathers, sons, and daughters cry,
And the sacred song is mingled
With the worship in the sky—
Mingles where no tempest darkens,
Rainbows evermore are hurled;
For the hand that rocks the cradle
Is the hand that rules the world.

References:
Statistical data source: http://www.geoba.se/index.php
Poem of the Week http://www.potw.org

Betty Kuffel, MD
Lipsticklogic.com

Cardiovascular Disease – Leading Cause of Death related to Childbirth

Heart Disease in Young Women

 Statistics from the state of California confirmed the leading cause of death related to childbirth is cardiovascular disease:

                ♥1/4 of women who died had some form of cardiovascular disease

                ♥2/3 of the deaths were related to cardiomyopathy (heart muscle weakness)

ct-x-heart-pregnancy-0220-em.jpg-20130218Only 6% of these women had been diagnosed with a heart problem prior to pregnancy. (American Heart Association Scientific Session report)

We think of pregnant women as healthy vibrant individuals who do well and have healthy babies. But, pregnancy is a high risk condition for many reasons. Pregnancy places a large cardiovascular load on a woman’s body.

Young women without underlying heart disease are better prepared to tolerate the stress of pregnancy than older women. However many women are now delaying planned pregnancies until an older age when the potential for heart disease has increased.

Lifestyle, including food choices, alcohol consumption, and tobacco use all impact health during pregnancy. Obesity and Type 2 diabetes also increase risk to mother and infant. Cigarette smoking increases risk for sudden infant death and women who smoke are also more likely to suffer sudden death.

Two conditions often seen with pregnancy are: high blood pressure (pre-eclampsia) and diabetes (gestational diabetes). Both require careful monitoring and treatment Women with these problems during pregnancy are more likely to develop high blood pressure, diabetes and cardiovascular disease later in life.

Being overweight and pregnant places both mother and child at risk for cardiovascular disease and complications during delivery, including C-sections and anesthesia-related problems. Overweight pregnant women are more likely to have stillbirths, deliver prematurely and may have large infants making delivery difficult. Large babies are more likely to become obese in childhood.

Additional statistics: (From The American College of Obstetricians and Gynecologists)

  • Over one-third of women living in the US are obese
  • More than one-half of pregnant women are overweight or obese
  • 8% of reproductive-age women are extremely obese & at high risk for pregnancy complications

Guidelines for pregnancy weight gain are calculated based on the woman’s pre-pregnant BMI (Body Mass Index). Details are available on the American Congress of Obstetricians and Gynecologists website: www.acog.org  Search “Weight Gain During Pregnancy.”

 General guideline:

·         1.1 – 4.4 pounds in the first three months

·         1 pound/week during the last six months

·         The average total weight gain over all BMI ranges =  30 pounds

·         Low weight women: over 30 pounds may be acceptable

·         Obese women: gain only 11-20 pounds during the entire pregnancy

Nutrition counseling at all weights is very important to assure proper food choices and nutrition during pregnancy.

Before becoming pregnant, healthy choices, an active lifestyle (including daily exercise) and weight control are all important. Seek a full medical evaluation including laboratory studies before becoming pregnant. An exercise program and nutrition counseling will benefit mother and infant.

 

WOMEN’S HEART DISEASE

Front Page - Kindle- 6x9The first volume in our women’s health book series is in the final editing process. After many iterations, our cover has evolved to the attached image. We aren’t sure this will be the final but it’s close.

As many newly published e-book authors know, the old adage You can’t tell a book by its cover doesn’t hold true anymore.  The first glimpse at a book cover should be readable in postage stamp size. Subtitles can tell it all and many sources suggest using a subtitle to further identify your book contents to those people skimming titles on the many Internet sites available to all of us.

With expanding knowledge in the e-book, media and marketing world, it is difficult to keep up with the many options.

Blue Heron Loft has done a great job in creating this cover and my Eyes of a Pedophile cover.  http://www.blueheronloft.com

Your Heart is a complete handbook of the anatomy, physiology and dynamics of heart health. It provides detailed explanations of many types of heart disease, some specific to women, and choices you can make to maintain a healthy heart. By learning about a disease that impacts so many lives and then taking steps to improve your own cardiovascular health and the health of your family, who knows? – You may save your life or the life of someone you love.

Below is an excerpt from Your Heart: Prevent and Reverse Heart Disease:

DIFFERENCES IN THE FEMALE HEART

Early in life, male and female hearts look and act the same. With aging, gender differences in disease processes become apparent and often contribute to misdiagnosis in women. Men develop the usual type of arterial heart disease which narrows the large coronary arteries on the heart surface. Women often have narrowing of large coronary arteries like men, but females are also prone to developing coronary microvascular dysfunction (CMD) – a problem involving the small vessels called arterioles. In the face of inflammatory disorders that often affect women more than men, these tiny arterioles become stiff and unable to supply adequate oxygen to the heart muscle.

A number of health problems cause inflammatory changes: high blood-sugar, smoking and chronic infection. Additional factors like poorly controlled premenopausal hypertension, anemia and rheumatologic disorders also affect women and are thought to contribute to the development of CMD. However, the specific cause of CMD is still unknown and anyone can develop these changes. Coronary microvascular dysfunction cannot be treated with stents or bypass, but medications are beneficial and life prolonging.

Special tests are required to diagnose CMD. Women may have advanced microvascular changes and be at risk for a heart attack, yet a coronary angiogram — the best diagnostic evaluation for large coronary arteries — may appear normal. When the angiogram is normal but clinical suspicion for heart disease is high, a “Stress-Echo” is recommended to evaluate for CMD. Diagnostic methods are discussed in SECTION 15.

 Heart risks increase in menopause

Menopause is the biological time period when ovary function ceases. Ovaries produce estrogen, progesterone and a small amount of the male hormone, testosterone. At menopause, ovarian production of these hormones stops and hastens the occurrence of changes in the female body.

Not only are there cardiac changes. Around age fifty, when ovarian function naturally fades, most women begin recognizing other bodily changes as well. Some of these are: mood disorder, reduced libido, and hot flushes. But unknown to them, many women also begin silent internal vascular changes leading to heart disease. When premenopausal women have their ovaries surgically removed, the changes of menopause begin abruptly. This is referred to as “surgical menopause.” Starting at a younger age, problems related to estrogen deficiency take a toll on bone health making osteoporosis more likely. In all women lacking estrogen, skin changes become evident with vaginal tissue dryness. Hair may become thinner and skin less resilient.

In the past, hormone replacement therapy (HRT) using estrogen, progesterone or a combination of the two, was recommended. However, based on information from the Women’s Health Initiative, as of May 2012, the U.S. Preventive Services Task Force recommended against HRT to prevent chronic diseases such as: heart disease and osteoporosis. This is based on longitudinal studies over many years, weighing risks and benefits of taking replacement hormones. Still, under some circumstances HRT may be appropriate. If you have concerns, discuss hormone replacement with your physician.

Coronary heart disease gradually increases in women after menopause but can affect younger women, too, including those who have functional ovaries and continue to menstruate. Women under age 55 may not recognize the symptoms of heart disease or don’t seek medical attention believing they are too young to have a heart attack. American Heart Association statistics show heart disease kills 16,000 young women between the ages of 30-55, each year.

Because heart disease in women is variable, women of all ages, not only post menopausal women, should pay attention to symptoms that could indicate heart trouble, such as: indigestion, unexplained dizziness or weakness, jaw aching, sweating and feeling short of breath.

Betty Kuffel MD

CUTTING HOLIDAY CALORIES LOGICALLY

Calories in/Calories out Weight control scale and tape

Each pound of body weight equals 3500 kcal (calories). To gain a pound, you simply eat 3500 calories more than you burn. To lose a pound, it’s the opposite and much more difficult to accomplish—you must eat less or burn more, to equal a deficit of 3500 calories.

For example, if you eat one banana per day (100 calories) more than you have burned, in one week you will have stored 700 extra calories. That makes 2800 calories in a month and in one year, about ten pounds of excess weight. One hundred calories doesn’t seem like much, but it adds up. It is just: one tablespoon of butter, a slice of bread (with a teaspoon of butter), an apple. It’s in the numbers.

Gelato DessertIf you are in the habit of eating ice cream at bedtime, one scoop contains about 400 calories. That adds up even faster. If you eat a scoop of ice cream even three nights a week without earning it by exercising 400 calories, in a year, you will be fifteen pounds heavier. But do you only eat one scoop, or do you eat more and with chocolate syrup?

So, what do you have to do to earn a 400 calorie treat? A 120 pound person jumping rope burns about 9 calories per minute. That means you have to jump rope for 43 minutes. Not many of us will do that even for ice cream. Hiking for 1.5 hours, the same weight person would burn off 400 calories. Or just walk 4 miles per day and you have earned your 400 calorie snack and won’t gain weight.

Losing weight is more difficult than quitting smoking because you must make thoughtful food choices everyday, many times a day, for life. Quitting smoking is quitting, no more choices. You don’t need tobacco to live but you do need food.

Motivation to lose weight must come from within. It takes dedication and a change in eating patterns.  It is life-changing and you can do it!  To be successful, some people need to change friends. Friends who tempt you with high calorie meals and don’t assist you in your plan are not friends. They are like people who offer liquor to alcoholics who have quit drinking.

There are no excuses. Being overweight and unhealthy is not purely genetic. It is about fifty percent environmental. Yes, body type such as the “apple shape,” those with a round belly and skinny legs, are familial and at high risk for heart disease and diabetes. But weight control, food choices and exercise, are healthy choices that can change all that. Identical twin studies show the twin adopted into a family of healthy-eating exercisers attains a thin body shape. The twin adopted into a family of snackers who are couch potatoes ends up overweight like the adoptive family.

Unfortunately, there is no magic to weight loss. Effective weight control or weight loss plans all include exercise. Exercise increases metabolism, improves fitness, burns calories, decreases depression, prolongs life—and it goes on and on. Try to make exercise a part of your day and your healthy weight plan. If you walk for thirty minutes, climb stairs for fifteen minutes or do general housework for twenty-five minutes, you will burn one hundred calories.

Eliminating excess fat intake is the easiest way to cut calories. You would hardly miss a tablespoon of butter that contains one hundred calories. One tablespoon of oil is found in many creamy salad dressings, mayo and most gravy. Envision how much a tablespoon contains. It is a small amount, much less than the usual ladle commonly used to serve salad dressing. You can still use salad dressing; just don’t sabotage your plan. Or better yet, use low-calorie vinegar dressing instead.

Weight Watchers teaches people how to eat.  Healthy food choices become a part of every meal. They use a point system instead of calorie counting to make it simple and with this method you will learn how to eat. If you are not inclined to attend meetings you can join online or find a friend who has similar interests, learn to count calories, eat healthy and walk every day. If you have trouble walking, find an activity such as stationary bicycling or swimming that you and your physician believe is safe for you.

Set a goal. If you lose one pound a week, that is 52 pounds in a year. If you are significantly overweight and would like to lose that much, it is best to do it gradually with healthy choices and exercise. That way you are much more likely to keep it off and improve your health for life. The Mediterranean diet which consists primarily of fresh fruits, vegetables, nuts, and lean meat and fish, provides easy healthful food choices. You omit fried foods, caloric pastries and use mono-unsaturated fats such as olive oil sparingly.Vegetables

Some holiday thoughts regarding food choices:

  • Serve healthy low-calorie food options to your family and guests.
  • Keep candy and sweets out of view. Lower temptations to snack.
  • Don’t buy unhealthy snacks. Consider chips poison due to calories, fat and excess salt content.
  • Keep apples in view. It is a low calorie healthful snack.
  • Forget pies and ice cream. A slice of pie is about 400 calories a slice.
  • Go very light on pasta, gravies, creamy salad dressings, mayo and nuts.

Overview of a few calorie counts on common food choices:

  • 1 cup of oil roasted peanuts~900 calories
  • 20 almonds~150 calories
  • 1 cup plain pasta or 1 cup white rice or 1 cup mashed potatoes~ 220 calories
  • 2 slices white meat turkey~45 calories
  • 3 slices cooked bacon, fat drained~100 calories
  • 1 boiled egg~ 80 calories
  • 1 egg white~ 15 calories
  • 1 slice bread~70 calories
  • 1 peanut butter/butter/2 slices of bread sandwich~400 calories
  • 1 cup cooked green beans~45 calories
  • 1 medium apple~ 90 calories

ApplesCheck out www.WebMD.com (Living Healthy) for some heart healthy recipes, and www.Realage.com (and take the RealAge Test).

Make 2013 a healthier year for you and your family. In this chaotic world, there are many things out of our control, but inside your world, examine what you can control. Small changes in the right direction can make a huge difference in your health.

THE POWERS OF MISTLETOE


How did kissing beneath a sprig of parasitic poisonous plant to ward off evil spirits

and improve fertility come to be celebrated during modern holidays?

Through the ages, ancient Greeks and Celtic Druids bestowed magical powers on mistletoe. This attractive green leafy plant with white berries and strong roots grows through bark and sucks its nutrients from the mother-tree. Mistletoe can grow as a bush and it thrives in trees, but is rarely seen growing in oak trees. When found in an oak, Druid priests considered the parasitic plant a sex symbol and the soul of the tree.

Kissing under the mistletoe has so many powers; it is difficult to keep them all straight. In the Middle Ages, branches of mistletoe hung from ceilings to ward off evil spirits. Today, decorating homes with mistletoe at Christmastime survives from Druid and pre-Christian traditions. In European folklore, mistletoe was even considered an aphrodisiac that could bestow life and fertility on believers.

In Scandinavia, mistletoe was considered a peace-plant helping enemies solve differences and could help warring couples make up. If you attended a Christmastime Kissing Ball in 18th century England, you had to agree to be kissed under the mistletoe. The special kiss might bring romance, lasting friendship and goodwill but any un-kissed girl would certainly not marry in the coming year, so there was a scramble for that kiss.

Many mistletoe beliefs are a mesh of lore and modern-day fun. Kissing under the mistletoe has become a holiday tradition representing peace and love. Just remember, no matter how hungry you are—don’t eat the mistletoe!

Some mistletoe varieties are poisonous and must not be consumed in any fashion. Keep the plant away from children and pets. Plants that contain phoratoxin can cause a variety of symptoms from blurred vision to blood pressure changes and death. Call Poison Control and seek medical attention if any of the leaves or berries are eaten.

ASPCA Animal Poison Control Center hotline at (888) 426-4435

US POISON CONTROL CENTER 1-800-222-1222

Betty Kuffel, MD

A Logical Approach To Health

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