Osteoporosis - What You Need to Know

Maintaining bone health is an important part of a healthy lifestyle. As we age, our bone loses density and quality. Over time, this can lead to an increased risk for fracture (broken bones), chronic pain, decreased mobility, height loss & skeletal deformity (eg. Dowager’s hump of the back), and poor nutrition.

Your doctor may order a special bone density test called a DEXA scan which measures the density of your bone to determine your risk for fracture and other disabling consequences. A small amount of bone loss is called osteopenia and further loss may lead to osteoporosis. Your doctor may prescribe special medications that may help to strengthen bone and decrease your risk for fracture if you are found to have bone loss.

Certain lifestyle practices are imperative to maintain bone health. Make sure to include enough calcium in your diet. If you are still menstruating, you need approximately three servings of calcium-rich foods per day, or 800-1000 mg of calcium. If you are post-menopausal, you need 4-5 servings, or 1200-1500 mg of calcium. If you are pregnant, you need 4 servings, 1200 mg of calcium. Most multivitamins have 200 mg of calcium per pill. Examples of calcium-rich foods include; dairy products, green leafy vegetables, and calcium-fortified orange juice. Vitamin D is also an important component of the diet. Your doctor may want to check your blood levels to see if you are deficient. A normal maintenance dose is vitamin D3 1000 IU/day but if found to be deficient, you may require more. You also absorb vitamin D through the skin via exposure to sunlight but absorption varies with skin tone. Darker skin will not absorb as much. Sunscreen also blocks absorption. Fifteen minutes a day of sunlight exposure is recommended.

It is also important to get weight bearing exercise. This includes any type of activity that places weight on your bones like walking or lifting weights. It does not include exercises such as swimming or bicycling.

There are certain habits to avoid that increase bone destruction. This includes smoking and consuming large amounts soft drinks.

If you'd like additional information about osteoporosis or other GYN topics, please check out our website at www.mtauburnobgyn.com or call our office at:  513.241.4774.  

source:  oasis.oasisob.com

Pre-Term Labor Drops to 15 Year Low

The United States’ preterm birth rate dropped for the sixth consecutive year in 2012 to 11.5 percent, a 15-year low.

Six states – Alaska, California, Maine, New Hampshire, Oregon and Vermont – earned an “A” on the March of Dimes 2013 Premature Birth Report Card as their preterm birth rates met the March of Dimes 9.6% goal. The US preterm birth rate improved to the lowest rate in 15 years, but the change wasn’t enough to earn it a better grade. The nation again earned a “C” on the Report Card.

The March of Dimes estimates that, since 2006, about 176,000 fewer babies have been born too soon because of improvement in the preterm birth rate, potentially saving about $9 billion in health and societal costs.

“Although we have made great progress in reducing our nation’s preterm birth rate from historic highs, the US still has the highest rate of preterm birth of any industrialized country. We must continue to invest in preterm birth prevention because every baby deserves a healthy start in life,” says March of Dimes President Dr. Jennifer L. Howse. “A premature birth costs businesses about 12 times as much as uncomplicated healthy birth. As a result, premature birth is a major driver of health insurance costs not only for employers.”

The national preterm birth rate peaked in 2006 at 12.8% after rising steadily for more than two decades, according to the National Center for Health Statistics. The 2012 rate is a 10% improvement since the 2006 peak and the best rate since 1998. When compared to 2006, almost all states had lower preterm birth rates in 2012.

Want to see how your state measured up? The Report Card information for the U.S. and states are available online at: marchofdimes.com/reportcard.

Source:  March of Dimes Blog, 11/4/13

Women with Breast Cancer May Overestimate Secondary Risks

Young women with breast cancer often overestimate both their chance of developing cancer in the other breast and how much removal of that breast is likely to protect them, a new U.S. study suggests.  

In a survey of women diagnosed with cancer in one breast between ages 26 and 40 who chose to have a double mastectomy, almost all said a desire to extend their life was a very important part of the decision.  However, evidence shows removing the cancer-free breast does not improve survival rates, the study's lead author said. "For some women it might be the right decision, but you want to make sure they're making the decision based on the correct information," Shoshana M. Rosenberg, from the Susan F. Smith Center for Women's Cancers at the Dana-Farber Cancer Institute in Boston, said.

Among women with early-stage breast cancer who do not have genetic mutations that increase their risk, past research has found the chance of developing cancer in the second breast to be between 2 and 4 percent over five years.  Although mastectomy does reduce the chance of a second cancer in the breast, a much bigger concern is the risk of developing metastatic disease as a result of the original cancer, Rosenberg said.  Removing the second breast does not affect the risk of the original cancer spreading elsewhere in the body, she added, and thus isn't likely to prolong a woman's life.

More and more women with breast cancer are having both breasts removed, Rosenberg noted, and the trend is most pronounced in young women. To see why that might be, she and her colleagues sent surveys to 123 young women who had opted for double mastectomy, an average of two years after their surgery.  Of those women, 94 percent said the desire to extend the length of life was a "very" or "extremely" important factor in their decision to have both breasts removed.

Women without the BRCA1 or BRCA2 genetic mutations believed about 10 percent of women in their situation would develop a second breast cancer over 5 years.  Survey participants "vastly overestimated their risk," according to Rosenberg.  Still, the majority of them answered correctly that most women with early-stage breast cancer will die of something else. And less than one in five believed women with breast cancer who have both breasts removed live longer than those who don't, the study team reported in the Annals of Internal Medicine. "Obviously, when they're making this decision it's a very anxious time, especially in younger women," Rosenberg said.

About one in eight U.S. women will be diagnosed with breast cancer during her lifetime. According to a recent study, one in 173 will get the disease before age 40.

Rosenberg said many women who have a double mastectomy undergo breast reconstruction, which can involve extensive surgery and long recovery times and carries a risk of complications.  "The complications are almost never life-threatening, but they can certainly compromise a patient's health," Dr. Todd Tuttle, a surgical oncologist at the University of Minnesota Medical Center's Breast Center in Minneapolis, said. For example, some women get infections, or have wounds that don't heal.  Tuttle, who wrote a commentary published with the new study, said mastectomy and reconstruction also "may potentially delay any other therapies that are recommended to treat their original breast cancer."  He said that "hyperawareness" about breast cancer in the U.S. may contribute to women overestimating their cancer-related risks and the benefits of a double mastectomy. In Europe, he said, there has not been the same increase in rates of normal-breast mastectomy among women with cancer.

Tuttle agreed with Rosenberg that some women may have good reasons for wanting both breasts removed, but that they should be fully informed before making that decision.  "Physicians need to take the time to talk to their patients about what their risk of getting cancer is in that opposite breast," he said. "Having that normal breast removed will not improve their survival."

source: http://www.foxnews.com/health/2013/09/17/women-with-breast-cancer-may-overestimate-secondary-risks/

10 Ways to Deal with Stress Without Smoking

Dealing with stress is a key part of quitting smoking for many women.  Many smokers who went back to smoking did so because of stress & negative moods. You may have learned to deal with stress by smoking. So, it's important to find ways to handle stress without smoking.

Here are some tips that women have found helpful:

1. Take a Break  - Even if it just for a few minutes, find a way to step back from what is happening.  This might mean doing something that is relaxing, actually getting away from it for awhile or taking a "mini-vacation" in your head by imagining you are somewhere else.
2. Deep Breathing - Take a few slow, deep breaths.  For an extra benefit, breathe in through your nose and out through your mouth.  You will feel your body relax.
3. Visualize - Close your eyes and imagine you are in a place where you feel safe, comfortable, and relaxed.  It can be a real place or something you make up.  Picture it as clearly as you can, including imagining what you would feel, hear, and maybe even smell if you were truly there.  Let yourself enjoy being there for a few minutes.
4. Exercise - When your body is active, it sends out natural chemicals that help your mood and reduce your stress.  Walking is one of the easiest exercises for most people.  Even a short walk every day will help reduce your stress and improve your health.  And...it's free!
5. Talk to Someone for Support - Sharing your feelings and being involved with other people is a great way to help reduce stress.
6. Focus on the Here and Now - Many of us spend a lot of energy worrying about things that may go wrong in the future and how bad they might be.  Instead, try focusing just on what in happening now, not on what you might have to deal with in the future.
7. Accept That Stress Happens - Life is full of twists and turns.  You will always have some level of stress in your life.  It is often helpful to accept that there will be good days and bad days and not to worry too much about the bad days.  Tomorrow will be a new day!
8. Take Care of Yourself - Especially right after quitting smoking, you should make extra efforts to take care of yourself.  This includes basic things like eating a balanced diet, drinking lots of water, and getting enough sleep.
9. Cut Out Caffeine - Caffeine helps keep you awake when you are tired, but it can also make you feel tense, jittery, worried, and stressed.  So, if you are feeling stressed, drinking caffeinated coffee, tea, or soda is like adding stress on top of the stress you already have!  This is especially true as you are quitting smoking.  Cutting back, or even eliminating caffeine can help reduce your feeling of stress. 
10. Face the Problem - A lot of stress is caused by things that are happening in your life.  Stop and think about what makes you stressed.  Is there something you could be doing to fix the problem?  It can be helpful to talk with others about what is happening and  see if there are ways to make it better.

Stress is a part of life - you can't avoid it, but you can learn better ways to deal with it than smoking.  Some of the ideas on this list may be perfect for you, others may not be your style.  Some take practice, some work right away.  Try them out!  If something works for you, great!  If not, no big deal!  Simply try another one.  You are the only person who knows what works best for you and what doesn't.  Keep looking for ways to make quitting, and your day, easier.  

Mt. Auburn OBGYN Associates
Cincinnati, Ohio  |  513-241-4774

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source:  http://women.smokefree.gov/ 

Caffeine and It's Effects on Low Birth Weight

A recent study published this year in the journal BMC Medicine concerning caffeine intake during pregnancy, indicates it might be linked to low birth weight, but not with pre-maturity. Some mothers are breathing a sigh of relief while others are tossing their coffees in the trash. We've had the caffeine debate for what seems like forever, with the pro-versus-no arguments ranging from theories that it might cause fetal cardiac problems to miscarriages and premature labor.  After studying these theories thoroughly, experts eventually agreed that a cup of coffee probably doesn't do any harm; yet, a gallon of coffee doesn't do anyone any good either!

The caffeine study was done in Norway and looked at 59,000 pregnant women who self-reported their caffeine intake at 17, 22, and 30 weeks. While the conclusion that caffeine consumption is linked with low birth weight babies is statistically significant, its important to look at the details. When >200 mg/day of caffeine was consumed it was associated with a decrease of 2.2 ounces from an expected birth weight and when the consumption was 100 mg/day the decrease birth weight was 0.98 ounces. Yipes! That's pretty small.

So the important thing to remember - in the US, the recommended dose of caffeine per day is less than 200 mg/day. If your pregnancy is low risk, stick to the recommended dose.  If your pregnancy becomes high risk because of the possibility your baby may be small, then cutting the caffeine might be a good idea.

I definitely agree that "a cup of coffee proably doesn't do anybody any harm and a gallon of coffee doesn't do anyone any good."

Dr. Emily Wiebracht, Mt Auburn OBGYN in Cincinnati, OH

Pink or Blue? Find out sooner than you think.

Leave yourself plenty of time to shop for pink...or blue! We're excited to offer our patients a "baby preview" ultrasound as early as 16 weeks of pregnancy to determine your baby's gender. These scans are available at our Mason and Mt. Auburn offices.  Here are the details:

• cost of the preview scan is $75
• $25 of this cost can be applied towards a 4-D ultrasound at a later date
• the scan takes approximately 15 minutes
• you'll receive 2-3 photos to take home and share
• if sex cannot be determined, $50 will be refunded 
• there is a 100% money back guarantee if the gender identification is incorrect

Call the office to schedule your appointment: 513.241.4774.

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Welcome to the Mt. Auburn OBGYN Blog!

Mt. Auburn OBGYN is excited to launch our new blog.  Check back with us for practice updates, tips from your doctor, comments on the latest trends in women's health, and information on community events.  You can also find us, follow us, and friend us on the following social media outlets:  

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All the best!
The Physicians and Staff at Mt. Auburn OBGYN