December 7th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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Not as often as you think, even though Medicare may be willing to pay for it every two years. Via Science Daily:
Now a new study led by Margaret L. Gourlay, MD, MPH of the University of North Carolina at Chapel Hill School of Medicine finds that women aged 67 years and older with normal bone mineral density scores may not need screening again for 10 years.
“If a woman’s bone density at age 67 is very good, then she doesn’t need to be re-screened in two years or three years, because we’re not likely to see much change,” Gourlay said. “Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it’s great news for this group of women,” Gourlay said.
The researchers suggest that for T scores > -1.5, repeat testing needn’t be done for 10 years. Women with T scores between -1.5 and -2.0 can be re-screened in 5 years, and those with T scores below -2.0 can have every other year testing as is done now.
To be honest, I’ve been spacing out bone density testing in woman with good baseline scores for some time, but not knowing how long I can go. This is great information for me and for my patients.
*This blog post was originally published at tbtam*
November 16th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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A new analysis of long-term data from the Women’s Health Initiative confirms what we already knew the first time around: Use of combination hormone replacement (HRT*) is associated with a small, but real, risk of breast cancer. This new 11-year followup data carries that knowledge out to its not unexpected conclusion — namely, that some (although not most) breast cancers can be fatal, and therefore the the use of HRT can increase breast cancer mortality.
While it may seem a bit of a “duh,” this study was, in fact, necessary to quell the WHI critics who continued to argue that the breast cancers caused by HRT were somehow less aggressive than those occurring off HRT (which they are not.) It was also a wake-up call for many women who were continuing to use HRT and thinking that somehow its risks did not apply to them. A fair number of these women appear to be coming off of HRT, at least in my practice. Others are staying the course and accepting the risks as they have been defined. Either of which is fine with me.
The spin going on around this study — both for and against HRT use — is tremendous and ultimately confusing to women. The pro-HRT crowd (some of whom have relationships to Pharma) is using language like: “The increased risk from using HRT for five years is the same as if your menopause occurred five years later,” which is technically true, but so what? The bioidentical hormone crowd (usually also selling the same) are using the study to further hype how their regimens are safer than the evil Big Pharma products — based on no data. Which leaves the rest of us to try to find ways to help our patients understand the risks, place them into perspective for themselves, and make a decision about how and if to treat their menopausal symptoms. Read more »
*This blog post was originally published at tbtam*
September 12th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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This is a thoughtful “sounding board” piece in the New England Journal of Medicine this week: Lessons from the Mammography Wars.
It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
August 21st, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Book Reviews, Health Tips, Humor, Opinion, True Stories
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I really didn’t expect to like Eat, Pray, Love. In fact, since its publication in 2006, I’d been avoiding it like the plague. “Typical new-agey, Oprah-y, girly-book,” I thought. Nothing in it to speak to me.
Then I saw the trailer for the movie, and I was hooked –- probably because I, like mostly everyone, love Julia Roberts. I immediately downloaded the book on my iPhone using the Kindle App and began to read.
First, let me say that Elizabeth Gilbert writes exceptionally well, and the book is actually a joy to read. I, of course, loved the Italy eating part. But more surprising to me, I wasn’t turned off by the whole yoga, Guru, find-yourself stuff. This is because Gilbert writes it all with a reporter’s curiosity and a skeptic’s eye, and frames it not as a belief system, but as a tool for self-discovery and peace. (Plus, I’m really good at skimming if I get bored.)
Too bad Gilbert’s curiosity and skepticism does not extend to the healthcare she receives while in Bali. She accepts the curative powers of a warm leaf placed on an oozing, infected cut without even wondering what leaf it might be or how it might have worked. Was it the heat (most likely) or something else (possibly)? I was dying to know.
She Xeroxes pages and pages of traditional medical treatments without sharing a single one with us in any meaningful way. While I’m pretty sure 99 percent of what was in there was bunk, there might be a few gems that would serve medical science. Unless Lizzie made a second copy, we’ll never know, will we?
But it was the UTI that really got to me. Read more »
*This blog post was originally published at tbtam*
June 24th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, Opinion, Research
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I seem to be asked more often these days if I do vulva reduction surgery. I’ve even been asked if I “refresh” vaginas (in which I refer them to their gynecologist.) I’m happy it’s a extremely small part of my practice.
I’m also happy to see that the current issue of Reproductive Health Matters is taking a close look at cosmetic surgery, especially female cosmetic genital surgery. Read more »
*This blog post was originally published at Suture for a Living*
