November 16th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Research
No Comments »
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*
October 24th, 2010 by admin in Better Health Network, True Stories
No Comments »
She’s tweeting her medical mission in Haiti. So tragic are the unmet medical needs of these people. From Doc Gurley:
Saw an alone 9-month-pregnant 19 yr old. No birth kit, no string for the cord, no plan for who would be with her. Gave supplies+discussed how to ask helper to wash hands. Nothing sharp&clean for cord so gave scalpel. Acted out birth, w/handwashing.
Also saw woman with overwhelming postpartum uterus infection. Someone used hands at delivery to pull out pieces of placenta.
Saw 14yrold girl w/months of excruciating pain, mass in her lower belly, wasting. Ruptured appy? Tumor? Left her w/ narcotics, antibiotics.
Also, women do not have menstrual protection supplies:
I’ve been asked, if there are no pads, what do women use? In the cases I saw, one used a page of a magazine & another a dinner napkin.
God bless you, Doc Gurley, and the members of your team for all you’re doing. What can we do to help?
*This blog post was originally published at tbtam*
January 22nd, 2009 by Dr. Val Jones in Medblogger Shout Outs
No Comments »
My friend and fellow medblogger Peggy Polaneczky, MD had this to say after returning from a medical conference in Salzburg:
We had lots of conversations about healthcare in our respective countries. And all I can say is, despite all the issues we have in the United States, I wouldn’t want to be practicing medicine anywhere else but here. Not when I hear tale of docs whose only way of surviving financially is to take tips from patients who pay to squeeze into the surgical schedule ahead of the cue. Or of abdominal emergencies handled in hospitals that don’t have a CT scanner. And not a single fellow has a microscope in their office, forcing them to rely on gram stain only for management of vaginitis. (A poor substitute for an in office wet prep in my opinion.)
Most of these docs would give their eye teeth to spend some time learning medicine in the United Sates, be it something as simple as an observership or as complex as a second residency. Unfortunately, visa regulations in their countries and ours make this extremely difficult. But all of them will be offered observerships in Vienna and in Germany at the Institute’s expense.
