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Women's Health
Breast Cancer - Treatment & Options!

Treat yourself! As diseases have advanced over the years so have the treatments. With a case like cancer, what once was thought to be incurable; today has more treatments than ever before! With so many options available, the best thing YOU can do would be to learn as much as possible about what’s out there. Whether you have been diagnosed with breast cancer or at risk, secure your future by understanding the breast cancer treatment options and how each will affect you. Ultimately, the goal of each treatment is to get rid of the cancer cells in the body and prevent them from coming back. Before you start receiving treatment, your doctor will need to analyze a few things first: 1. The type of breast cancer. 2. The size of the tumor. 3. The degree of spread in the body. 4. If the tumor has “receptors” for estrogen, progesterone, HER2 protein, or other specific features. 5. Your age. 6. Whether or not you’ve gone through menopause. 7. Other health issues you may have. 8. Your personal preferences for treatment. Breast Cancer Treatment Types:  Surgery – The two main types of breast surgeries are called mastectomy and lumpectomy which have their own respective types. A mastectomy involves removing the entire breast while a lumpectomy extracts only the tumor and tissues around it. Radiation Therapy – This uses high-energy waves to kill off the cancer cells. Chemotherapy – This method uses medicinal drugs to kill cancer cells, however, come with a number of side effects such as fatigue, hot flashes, early menopause, hair loss and nausea. Hormone Therapy – As the name suggests, this treatment typically uses medicines that prevent hormones, most especially estrogen, from speeding the growth of breast cancer cells. In some cases, this therapy works by preventing the ovaries from producing hormones, either through medication or surgery. This method also comes with a number of side effects such as vaginal dryness and hot flashes. The types of medications given depend on whether you have already gone through menopause. Targeted Therapy – This method also uses medicine but instead of directly targeting cancer, it prompts the body’s immune system instead to target and destroy the cancer cells. This is done by detecting a protein called HER2 which is highly prominent in breast cancer cells. Making the Decision:  With all these options, depending on your diagnosis, you may have to have some combined to make sure that all the cancer cells are removed. Talk things through with your doctor about the pros and cons of each treatment and how each will affect your lifestyle. Try meeting other women who are or have gone through breast cancer treatment. They can share with you, their experiences and give you the advice to understand and decide on what’s best for you. You could also ask your doctor if you could join a clinical trial wherein a research study is currently testing new treatments before they are made available to everyone. Regardless of what you choose, stay strong! Are you a breast cancer survivor? Care to share your story about breast cancer treatment? Please let us know down in the comments section!

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February 05, 2019
Lifeline Hospital
Admin
Women's Health
How Diabetes Can Affect Your Pregnancy

Having a baby is one of the greatest journeys a woman can go through in her lifetime. But just like everything dubbed as great, comes with its challenges. Anything could happen before, during or even after you’ve given birth. There are so many factors to consider and it’s so easy to feel overwhelmed. This is the case especially if you have underlying conditions, like diabetes that would put you and your future baby at risk. What is Diabetes? Diabetes happens to be a very common condition that affects millions of people worldwide. This is where your body is unable to convert carbohydrates (sugars and starches) from food to create energy. Therefore, all that extra sugar gets stored in your blood and can lead to heart, eye, and kidney damage. If ever you become pregnant, the extra sugar will increase the risk of problems for your child which includes birth defects. Whether it is type 1 or type 2, you need to plan your pregnancy and control your blood sugar. You can still have a healthy baby! Risks of Uncontrolled Diabetes While Pregnant: Serious Birth Defects (brain, spine, and heart) Increases chances of stillbirth or miscarriage Premature birth A newborn might have breathing problems, vision problems, intestinal problems, heart problems, bleeding into the brain Baby can grow very large and lead to delivery complications (injure shoulder nerves, break the collarbone, brain damage from lack of oxygen), and in turn force, you to have a caesarian section which has a longer healing time after birth. Newborn’s blood sugar to rapidly change from low to high. You can develop preeclampsia (protein in your urine and high blood pressure) which may lead you to have seizures or stroke and cause premature labor. Increase the chances of your child growing up to become overweight and develop diabetes What You Can Do? Talk to Your Doctor: Plan your pregnancy carefully. Get a checkup and discuss with your doctor whether or not it’s safe for you to become pregnant. What kind of preparations do you need to do for your body? What to do to keep your blood sugar under tight control? Discuss everything and anything that may occur. Prep Your Body: Depending on your current fitness, you may or may not need to take certain medications or supplements to get your baby ready. Be sure to eat as healthy as possible and exercise regularly. If you need help, you can always consult with a dietitian to develop a meal plan. Monitor: Your blood sugar, blood pressure, weight, etc. If you notice anything wrong inform your doctor ASAP! Controlling your diabetes before and during your pregnancy will greatly prevent issues such as miscarriage, stillbirth, prematurity, birth defects and anything else mentioned above. But if you happen to be already pregnant, take those steps now to get yourself under control. Make sure to see your doctor and monitor yourself regularly. Remember to eat healthy, stay active and take care of yourself! Even if you suffer from an underlying condition like diabetes & are planning to have a baby, you can still have a happy and healthy baby with the right advice & care from preconception check-ups to post-delivery care.

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February 05, 2019
Lifeline Hospital
Health & Wellness Partner
Body
Effective treatment of Musculoskeletal pain

Have you ever lifted a heavy bag too quickly and hurt your back? Or gone for a run and twisted your ankle? If so, you will know the lingering pain that such injuries can inflict – and also that feeling of reluctance to seek medical treatment. Because they often occur in mundane, everyday circumstances, we tend to dismiss joint and muscle injuries as minor and don’t want to trouble anybody with having to treat them. The rest, it seems, just grit their teeth. But pain is your body’s natural warning system. Disregard it at your peril. Early treatment will not only curtail your suffering, but it can also prevent chronic symptoms from setting in. Physical therapy applied early on can make investigations, surgery, pain medications, injections and additional medical appointments at a later date all less necessary. The message is clear: where joint and muscle pain are concerned, it pays to be proactive. Have I got musculoskeletal pain? Musculoskeletal pain is any pain that affects the muscles, bones, ligaments, tendons, and nerves. It is commonly – but not always – caused by physical injury. A recent study in Korea suggests that a person’s risk of muscle and joint injury can be increased by normal daily activities, including prolonged sitting, holding an awkward posture or reaching overhead. Overuse of specific muscles or joints can also lead to a type of musculoskeletal pain known as repetitive strain injury (RSI). Often seen in athletes, manual workers and others with jobs and hobbies that require the same movement to be made over and over again, RSI is caused by microscopic tissue damage that worsens with repeated movement. Age is another risk factor for musculoskeletal pain. Osteoarthritis, for example, is a painful degenerative joint condition that’s caused by the wearing away of protective cartilage where two bones meet to create a joint. Because cartilage wear and tear happens every time we move, by the time we reach later life, many of us have completely worn through the cartilage in commonly used joints like the hip and knee. Osteoarthritis is the most common cause of disability in older adults, affecting 10% to 15% of those over the age of 60. Musculoskeletal pain as a symptom of illness A case in point is fibromyalgia, a condition whereby sufferers experience chronic body pain lasting for months on end. The pain is often widespread throughout the body and accompanied by unexplained tiredness. According to research, it affects 3-6% of the world’s population and, while there is currently no known cure, early diagnosis allows patients to make lifestyle changes that can make the condition easier to live with. Moreover, research suggests that early treatment can prevent short-term pain from becoming chronic. According to a 2012 review in the US, failure to correctly treat pain from injury early on can lead to chronic symptoms because persistent pain signals can alter the way the nervous system responds to pain. Therefore, while pinpointing and self-treating pain from injury or overuse is often straightforward, it’s always worth seeking medical advice for musculoskeletal pain. According to a 2012 review in the US, failure to correctly treat pain from injury early on can lead to chronic symptoms because persistent pain signals can alter the way the nervous system responds to pain. Effective treatment of musculoskeletal pain While painkillers are often the first resort for the treatment of musculoskeletal pain, effective pain management goes a lot further than popping pills. True, an acute injury like a muscle strain can be effectively treated with rest and anti-inflammatory painkillers, but in many cases, there is more intervention required, and chronic pain requires a completely different approach altogether – one that tackles physical, psychological and social factors. What we’re talking about here is a multidisciplinary team that works under one roof that might consist of health professionals such as manual therapy or physical therapy experts, osteopaths, chiropractors, anesthesiologists who specialize in pain management, naturopathic medicine practitioners, nurses, psychologists, social workers, and home care nurses. As always, the best first step is an early assessment by your primary physician. Once he or she has diagnosed the most likely cause of your pain, you can then be referred to other specialists for appropriate care or further investigation. Remember that pain is sometimes a sign of another condition and, therefore, it is not uncommon for what seems like a simple injury to require input from specialists, such as rheumatologists, endocrinologists or orthopaedic surgeons. If there is no identifiable cause and a chronic pain syndrome is suspected, it is likely that you will undergo several tests. Remember that pain is sometimes a sign of another condition and, therefore, it is not uncommon for what seems like a simple injury to require input from specialists, such as rheumatologists, endocrinologists or orthopaedic surgeons. You may find yourself having to undergo a ‘diagnosis of exclusion’ – whereby, in the absence of objective proof, the most likely cause of your pain is diagnosed by ruling out all provable explanations for your symptoms. Chronic pain conditions like fibromyalgia are called ‘diagnoses of exclusion’. Doctors will often run many tests (including blood tests and imaging) before giving you a chronic pain syndrome diagnosis. It sounds alarming but even if you do fall into the category of having a chronic pain syndrome, this need not consign you to a lifetime of discomfort. There is a wide variety of medications available (including muscle relaxants and stronger painkillers), as well as physical therapy and electrical nerve stimulators that are all effective tools for managing long-term pain. Recent studies also suggest that more innovative therapies like injecting injured joints with numbing medicine under precise ultrasound guidance or with a natural blood component, called platelet-rich plasma (PRP), or with stem cells derived from fat from your own body may have a role to play in treating acute or chronic musculoskeletal pain without resorting to surgery. Do not ignore the pain US Government statistics from 2015 show that musculoskeletal complaints accounted for nearly one-third of all days absent from work. This figure could be greatly reduced if people were more inclined to seek treatment for what they perceive as a ‘normal’ ailment. Rather than hobbling along and hoping the pain will go away, there is plenty you can do to keep the debilitating effects of musculoskeletal pain to a minimum. Rather than hobbling along and hoping the pain will go away, there is plenty you can do to keep the debilitating effects of musculoskeletal pain to a minimum. If the cause of your pain is an injury, you can treat it at home with painkillers, ice, rest and elevation, but take the precaution of seeking medical help. What seems like a straightforward injury could well be the symptom of a more serious condition and early intervention is the secret to preventing a straightforward injury from developing into a long-term problem. As with any warning system, once you know the cause of the alarm you can take the appropriate course of action. But put up resilience to pain before you know where it’s coming from and you run the risk of it becoming a nagging feature for life.

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February 05, 2019
Novomed Integrative Medicine
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Women's Health
Menopause & CHD - How they're connected!

Coronary heart disease (CHD), the number one killer worldwide, is commonly regarded as something that afflicts men rather than women. But it would be a mistake to assume, as a woman, that you are not susceptible to CHD, especially if you are about to enter, or already going through menopause. CHD may occur later in women than in men on average but it remains the biggest killer of women worldwide. As with any disease, awareness of your own susceptibility is your first layer of protection. As a gynaecologist who sees female patients at all stages of their lives, I am particularly interested in a growing body of research that indicates an increase in the risk of CHD among women after the menopause. True, age is a factor in the probability of developing CHD but numerous studies have revealed aspects of the menopause that are all linked to other proven CHD risk factors, such as blood pressure and cholesterol. An Indian study involving 237 pre- and postmenopausal women (and 263 men) found that women who had gone through the menopause had higher blood pressure, heart rate, and cholesterol levels than men of the same age, or women who were yet to go through menopause. The inference is that it’s the hormonal changes associated with menopause that increase the risk. This may sound frightening if this time of life is fast approaching for you, but there’s no need to panic. My interest lies in helping women reduce their risk of developing CHD, which you can do by making some simple lifestyle choices. The good news is that there’s a lot you can do to keep your heart healthy before, during and after menopause. The links between menopause and heart disease It’s important not to see menopause as an affliction. It’s a natural phase of every woman’s life, the time when the finite number of ovarian follicles (from which an egg is released each month) runs out, and it occurs typically around the age of 50 to 52 years old. Rather like puberty, it brings lots of hormonal changes, notably a fall in the level of estrogen – the ‘sex hormone’ that regulates the release of eggs. Let’s look at these various changes in a bit more detail. Estrogen levels: Estrogen has another role, unrelated to reproduction. Researchers have found that estrogen causes the inner layer of artery walls (the endothelium) to relax, which in turn keeps blood vessels flexible. This is significant because thickened and stiff blood vessels are associated with many types of cardiovascular diseases (CVDs), including coronary artery disease (CAD) and heart attacks. One study found that women with low estrogen levels had a seven-fold higher risk of CAD than women with normal estrogen levels. Researchers have found that estrogen causes the inner layer of artery walls (the endothelium) to relax, which in turn keeps blood vessels flexible. Body fat: Another consequence of the fall in estrogen is the redistribution of body fat. During menopause the classic female body fat profile – around the hips and thighs – shifts to around the abdomen. This type of fat distribution is known to increase a person’s risk of all types of CVDs because abdominal fat sits inside the body and stops vital organs from working properly. Studies specifically assessing Middle Eastern populations have shown that fat around the tummy can increase CVD risk by 16% to 21%. Cholesterol: Blood cholesterol levels, another long known risk factor for CVD, have also been shown to change as a result of hormonal changes during menopause. High levels of ‘bad’ cholesterol can cause plaque build-up in your arteries, resulting in the dangerous thickening of blood vessel walls. In contrast, ‘good’ cholesterol helps to flush ‘bad’ cholesterol from the body and thus high levels of ‘good’ cholesterol can reduce your risk of CHD and stroke. Studies dating as far back as the 1980s have shown that menopause lowers ‘good’ cholesterol levels and raises the level of ‘bad’ cholesterol. Glucose tolerance: Another role of estrogen is to act on the cells of the pancreas that secrete insulin in response to glucose in the blood. Falling estrogen levels mean a fall in insulin and a reduction in glucose tolerance, another known risk factor for CVD. Blood pressure: Similarly, blood pressure levels have also been found to rise in menopausal women due to increased sympathetic tone. One landmark study, which involved close to 7,000 participants, demonstrated that such increases in blood pressure can raise the risk of CVD among women by 2.5 times. According to Dutch scientists, blood pressure rises steeply after menopause because the drop in estrogen level triggers an increase in the activity of the blood enzyme renin, which helps to control blood pressure.  How to build up your resistance to heart disease: These are just a few examples of known CHD risk factors that have been shown to be affected by the decline in estrogen during menopause. Other chronic factors, such as poor diet and lifestyle, also contribute to your risk of declining heart health. I’m aware that this may create the impression that your life is being threatened on numerous fronts. As if going through the menopause isn’t enough. Other chronic factors, such as poor diet and lifestyle, also contribute to your risk of declining heart health. But there is plenty you can do to fight back, so let’s get started.  Top up your estrogen levels: Firstly, you can minimize the hormonal changes by topping up your estrogen levels with hormone replacement therapy (HRT). There are two types: estrogen only and combined HRT, which contains estrogen and another hormone called progestogen. As highlighted in one report, combined HRT is recommended for most women because taking estrogen on its own can increase the risk of developing womb cancer. Adding progestogen to estrogen minimizes this risk. Combined HRT is not without its own risks, including blood clots in the legs and breast cancer. However, the risk of these events is usually very small. Nonetheless, it is best to speak with your primary physician before starting HRT, and take the time to discuss bioidenticals – a new form of hormone replacement made with exactly the same chemical make-up as natural hormones and, therefore, in theory, more predictable with fewer side effects than traditional HRT.  A key element in making estrogen replacement safer is the evaluation of estrogen metabolism. Approximately 10% of patients should not take these estrogens as their bodies turn them into carcinogenic hormones, so a round of tests will determine your complete hormone panel and make sure your liver can safely handle the added estrogen before a treatment plan is chosen.  Eat a heart-friendly diet: With menopause bringing a rise in ‘bad’ cholesterol and fall in ‘good’ cholesterol, you can tip the scales back in your favor by adjusting your diet. Cholesterol-friendly chemicals called plant sterols and stanols are naturally found in many foods, including nuts, seeds, oily fish, fruits, and vegetables. Adding heart-friendly foods to your diet is one side of the bargain; the other is removing those foods that encourage weight gain or an increase in cholesterol, specifically high-calorie sugary processed foods and saturated fats. Drinking alcohol and smoking are also proven contributory factors in the risk of developing CVD, so cut down on your alcohol intake and ditch the cigarettes as part of your heart healthy lifestyle. Adding heart-friendly foods to your diet is one side of the bargain; the other is removing those foods that encourage weight gain or an increase in cholesterol, specifically high-calorie sugary processed foods and saturated fats. Break a sweat: Taking regular physical exercise is one of the best things you can do to reduce your risk of heart disease, at any age. Menopausal women can burn off abdominal fat and lower their blood pressure by exercising regularly. A typical recommended exercise regime is the American Heart Association’s ‘40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week’.  Supplement your diet: There are many minerals and vitamins the body needs to compensate for menopausal changes, but the two key supplements where heart health is concerned are vitamin D and omega 3 oils. Studies have found that supplementing with vitamin D can reduce high blood pressure, and vitamin D deficiency has also been linked to other CVD risk factors, including diabetes, and cardiovascular events, such as heart attacks and strokes. This suggests a need for supplementation if you are deficient in vitamin D – and you may well be, because recent research has demonstrated that more than 50% of UAE nationals have insufficient levels of vitamin D because of cultural dress customs and avoidance of the sun, which is needed by the body to produce the vitamin. Your doctor can recommend the best for your individual needs, based on your nutrigenomics profile (how your genes interact with nutrition). Omega 3 supplements, meanwhile, have been found by numerous studies, including a large review involving 39,044 patients, to significantly reduce cardiovascular events and deaths. But remember to see your primary physician before starting any course of supplements.  Take charge of your own menopausal health:  The link between the menopause and heart disease is clear, due to the effects of falling estrogen, but that doesn’t mean it’s inevitable. Far from it. Exercise regularly, keep your weight down, eat a nutritious diet that’s high in unsaturated oils, fruits, and vegetables, and avoid unhealthy habits like smoking and eating junk food. Most importantly, don’t worry! Consider stress reduction techniques like acupuncture, yoga, and meditation and use this knowledge as an opportunity to make the lifestyle changes needed to keep heart disease at bay. That way you should emerge from the menopause in better shape than you went in.

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February 05, 2019
Novomed Integrative Medicine
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Women's Health
How Thyroid Treatment can change your life!

The thyroid gland plays a vital role in your body’s functionality, helping to regulate your metabolism and thereby affecting a wide range of functions, including breathing, sleep, mood, energy, weight, and digestion. It’s estimated that 200 million people worldwide have a dysfunctional thyroid and that one in eight women will contract a thyroid disease in their lifetime. Thyroid disease is particularly common in the Middle East, affecting up to 47% of the population in some countries. The good news is that most thyroid conditions can be corrected, either by lifestyle changes such as diet or through hormone replacement therapy (HRT). Why your thyroid is important: As a doctor focusing on women’s health, I have come across many cases of thyroid disease. In general, one of three things occurs: the thyroid becomes overactive, underactive or grows abnormally. Overactivity: When thyroid overactivity (hyperthyroidism) occurs, too much T4 and T3 is produced, which speeds up the body’s processes, causing nervousness, anxiety, rapid heartbeat, shakes, sweating, weight loss and sleep disruption. It is most commonly caused by an autoimmune condition called Graves’ disease, in which the immune system attacks the thyroid, causing it to release more hormone than needed. The cause of Graves’ disease is unknown, although, many factors, including genetics, gender, stress, and smoking play a role. Underactivity: A more common condition is underactive thyroid (hypothyroidism). Here the thyroid produces reduced levels of T4 and T3, resulting in symptoms such as fatigue, weakness, weight gain, depression, constipation, irritability, irregular periods, low libido, feeling cold, memory loss, hair loss, poor skin condition, and even infertility. A dysfunctional thyroid can make it hard to conceive because elevated or suppressed thyroid hormones shorten the menstrual cycle, affect the eggs and alter the production of hormones like prolactin and globulin, which are needed for normal ovulation. A dysfunctional thyroid can make it hard to conceive because elevated or suppressed thyroid hormones shorten the menstrual cycle, affect the eggs and alter the production of hormones like prolactin and globulin, which are needed for normal ovulation. In developing countries, this under-activity is commonly caused by iodine deficiency, but the most common cause is an autoimmune condition called Hashimoto’s thyroiditis, in which the body attacks the thyroid gland and makes it less efficient at producing hormones. Abnormal growth: Somewhere between 50% and 67% of people in the world also have abnormal lumps on their thyroid, called nodules, which become more common with age and are more prevalent in women. In most cases, these are fluid-filled cysts or pockets of extra thyroid tissue and are mostly harmless. But a small percentage – around 12% – can be cancerous. Because of the lack of publicity about thyroid disease, it is rarely detected early on. Affected patients tend to experience lots of seemingly unrelated symptoms and have no idea that they can all stem from the same source. A patient suffering from heart palpitations, feeling hot, shortness of breath, insomnia, diarrhea, irregular periods or a combination of these symptoms is unlikely to report to their doctor that their thyroid needs examining. Similarly, a patient who frequently feels cold, tired, constipated and depressed is more likely to assume the problem is sleep, diet or just their time of life. Affected patients tend to experience lots of seemingly unrelated symptoms and have no idea that they can all stem from the same source. Detecting and treating thyroid disorders: In most cases, a blood test to measure thyroid hormone levels is all that is needed. Patients with thyroid overactivity will usually have raised levels of T3 and T4, while those with an underactive thyroid will have reduced levels. Doctors also tend to measure levels of thyroid stimulating hormone (TSH), the substance that triggers thyroid hormone release. As thyroid disease often presents as a myriad of symptoms, doctors must also rule out other conditions when making a diagnosis. This includes testing for deficiency of other hormones such as cortisol, estrogen and progesterone; nutritional deficiencies, especially iron, vitamin D, iodine and selenium; and autoimmune disorders. The lifestyle factor: When lifestyle factors such as nutritional deficiencies are diagnosed, correcting these factors may be enough to correct the thyroid condition. Stress, smoking, and lack of nutrients such as calcium, iron, vitamin D, selenium and iodine, are all associated with an increased risk of developing thyroid disease. These nutrients can be replenished by following a controlled diet or a course of herbal remedies. Foods rich in the vitamins and minerals you need include eggs, oily fish, leafy green vegetables, beans, nuts, and seeds. In cases where these lifestyle changes are not enough to remedy the symptoms, medical intervention is readily available. Patients with an overactive thyroid can be prescribed medication that partially blocks the production of T3 and T4. An underactive thyroid can be treated with HRT to top up the levels of T3 and T4 and this treatment usually remains in place for life. Bioidentical hormone replacement therapy (BHRT) uses hormones that are identical to those produced naturally by the thyroid. These can be man-made or obtained from desiccated animal tissues. Popular man-made hormone replacements include Cytomel (T3) and Levothyroxine (T4), the latter being more commonly prescribed because T4 is the hormone that the thyroid naturally makes more of and it gets converted to T3 in the body. Before taking any hormone replacements, it’s essential that you undergo proper testing. Don’t be afraid to get diagnosed.  In most cases, thyroid disease is easily treated. The more we can share knowledge about this vital little gland, the more women we can help to lead a normal, healthy, energetic lifestyle. I will leave you with three simple facts to remember. Firstly, while genetics does influence your risk of developing the thyroid disease, a balanced diet and low-stress lifestyle help to minimize this risk. Secondly, if you experience any of the symptoms I’ve mentioned, see your doctor to check whether it could be thyroid disease. Finally, don’t worry. Thyroid disease is very common and very treatable, so if you’ve been recently diagnosed, start looking forward to feeling happier and healthier from now on.

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February 04, 2019
Novomed Integrative Medicine
Health & Wellness Partner
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