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Dubai: As Dubai marks World Diabetes Day on November 14, parents of children diagnosed with Type I diabetes called for greater inclusion of these young patients in schools across the UAE.

Discussing the challenges they face in helping their children manage the disease, they said lack of awareness about the condition among the general public is the main reason why children with Type 1 Diabetes feel isolated.

What is Type I diabetes?

It is an auto immune disorder affecting young children whose body makes little or no insulin. Insulin is a hormone that helps the body use sugar for energy. It is produced by the pancreas, which is an organ located behind the stomach. In Type 1 diabetes, the childs immune system becomes faulty and destroys the cells in the pancreas that makes insulin (beta cells ). As a result, children with Type 1 diabetes need to take insulin to stay healthy. The condition can be life-threatening if it is not diagnosed early. It is different from Type II diabetes which is triggered by poor nutrition, sedentary lifestyles and obesity, resulting in insulin resistance.

Individual challenges

Pained by the lack of awareness surrounding Type 1 diabetes, Dubai-based Pamela Durant, whose son was diagnosed with diabetes at 20 months, gave up her highly successful career in health care management to start her own diabetes awareness company Diapoint to educate the community. Bringing up her son, now 11, she has been a hands on mother volunteering to accompany the school on field trips to keep an eye on her child, but she says not all kids are fortunate enough to get this inclusion.

Children with Type I diabetes require to have their blood sugar monitored regularly to avoid high or low blood sugar episodes. Sometimes, a school understands the severity of what could happen, or the care required, it may be frightening for them, or may seem like too much of a liability. There are cases of children who have been turned away from schools or left out of school activities for this reason - which is heart-breaking. In other cases, some schools have asked parents if they could provide a private nurse for their child at school. Not only is this a financial burden for the family, but it affects the child socially. It adds to the social stigma of having diabetes.

In another case, Nathalie, who arrived in the UAE with her husband last year, was heartbroken when her four-and-a-half-year-old daughter was given admission to a prestigious school in Abu Dhabi only to be declined when she disclosed her condition. My daughter was diagnosed with Type 1 diabetes when she was three-and-a-half. No kid should be treated differently because of their medical condition. They are already going through a lot each and every day and do not deserve to be treated that way, especially in a place where they are supposed to learn values, respect and equality, she remarked.

Elsewhere, Louis Kiernander, a mother of two, recently faced a terrible dilemma when her 11-year-old son had to go on a school trip in a new secondary school he had recently shifted to. Kiernander said: In the primary school my son attended, he was well supported by the school staff and nurses and was never excluded from school trips or sports or treated differently. However, in the new school, there are 11 diabetics in the secondary section and my son is the youngest. While the school tries to be supportive, challenges remain. As per law, only a certified nurse is allowed to give a life-saving injection in case of hypoglycaemia. So my son was asked not to go on the regular school trip and instead go on another where the nurse could accompany him. He was segregated and felt ostracised. All they had to do is send the nurse on the regular trip and I do pay a handsome amount as school fees. I was asked to sign a form saying that if my son faced an emergency in those three days, no one would be giving him a life-saving injection. It was a horrible situation and felt like signing a death warrant.

Right to a normal life

Dr Amani Osman, paediatric endocrinologist with Imperial College of London Diabetes Centre at Al Ain, who handles several cases remarked that every child had a right to be treated well in school. This is a psychosocial element and I constantly advise parents and schools that one must not set boundaries for a child because of his diabetes. No child should be denied the right to live a normal life, play sports and go on field trips or be treated any differently because of their condition.

Dr Osman added: Children with Type I diabetes spend a considerable number of their active hours at school and it is important to have a proper diabetes management plan in place. This can be possible with proper awareness, education and communication between parents, school nurses and the childs private physician.

Diabetes Management: What parents and schools can do

Parents should be honest and not conceal a childs condition from the school and friends so that he can get help in time. Children are afraid to be different, but in this case full disclosure can be life-saving.

Once the condition is known, parents need to supply glucose testing kits, insulin vials, syringes to the school. Usually, children have automatic glucose pumps attached and only a test in presence of the nurse is required to determine the bolus (unit quantity of insulin ) required to delivered mechanically. In other cases, a certified nurse can administer an insulin shot at the school clinic.

A child with diabetes requires insulin three times a day with three major meals. Children usually have breakfast at home and have their first insulin shot at home, the second one is in school during lunch hour and the child needs to go to the nurse and check his blood sugar levels before the meal to decide on the dose he needs two hours after the meal. Usually this is the only meal a child has at school. Any snack that has less than 50 gms of carbohydrates does not require the child to take insulin.

Hypoglycaemia: Anything below 70 milligrammes per deca litre (mgdl) is low blood sugar and once detected, parents usually pack orange juice as an emergency meal. The rule is 15 gms of carbohydrates which amounts to half a glass of orange juice or a glucose gel tablet that can be given orally and 15 minutes later blood needs to be tested.

There are cases where the blood sugar could get low enough for the child to lose consciousness. Sometimes, children take insulin and in their excitement to participate in some event, say a sport, overlook eating a proper meal. In such cases, the sugar could get very low. Nurses are trained to administer an intra muscular glucagon injection to reverse the action of insulin.

Hyperglycaemia: This is blood sugar above 200 mgdl two hours after a meal. Diabetic children must check their blood sugar in school before meals and two hours after meal and have their insulin dose adjusted as per the reading, something which the school nurse can help them with. A child who has high blood sugar must not be allowed to do a sport activity as he can easily go into diabetes ketoacidosis which is a stage where the body has not enough insulin and begins to produce blood acids and burn fat as fuel. In both cases of high or low blood sugar, the nurse can intervene and advise the child. Nowadays most children carry continuous glucose monitoring devices and it is not difficult to know what a childs blood sugar levels are.

Children with Type I diabetes usually must maintain higher levels of hygiene. In case of diabetic children, it is absolutely necessary to keep them at home as their blood sugar levels can dangerously fluctuate when they are ill.

It is also advisable that Type I diabetics get seasonal flu vaccines to keep any infections at bay as more complications would mean difficulty in managing their condition.

Mothers must pay attention to meal qualities providing nutritionally balanced meals with dense carbohydrates and whole foods and discourage any processed and sugary foods that could spike blood sugar.

It is important for schools to have regular physical activity and sports and encourage every child to be active. Obesity and over-weight issues are resulting in occurrence of Type II diabetes in children as young as six.

In case of adolescent children with Type I diabetes, the school must be sensitive to not discriminate against them as these can have long term impact on their self esteem and trigger depression.

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Call for greater inclusion of kids with Type 1 diabetes - Gulf News

In a world of hurt. Its a figure of speech not meant to be taken literally. But its a real place to those who inhabit the world of persistent pain, one whose moment-by-moment ramifications can upend and redefine life.

Theres a continuum in this world of hurt: Pain is variable and many manage it themselves without going to the doctor. They can hold jobs and function, albeit through varying levels of pain. For others, severe chronic pain can mean an inability to sit comfortably, or far worse, to fall off to sleep at night, day in and day out. For some, pain brings an inability to work, to get out and see friends, to travel or to take in a movie. And, with those compounding, cascading inabilities, an ever-shrinking solitary world because of hurt.

The threat of even more hurt must be defended against. When you have chronic pain, says 27-year-old Erika Delgado of South San Francisco, who has suffered with it her whole life, its like constantly being in flight mode. You constantly feel that youre in danger.

Often patients are reluctant to talk about pain that may send them to one doctor or therapist after another. Or pain that doesnt have a clear diagnosis, or pain that doesnt look obvious. They go stoic. You adapt, says David, a 68-year-old former executive who has been dealing with the after-effects of a sports injury and two back surgeries for two decades. At some point, youve got to say that what youve got is what youve got.

Despite the constant burning sensation in his back, the healthy appearing Redwood City resident tries to cope with his chronic pain quietly and, as much as possible, anonymously. Nobody wants to acknowledge their disability, says David, who nonetheless manages two contradictory things: an active schedule as a community volunteer and usually only two hours of sleep a night.

Except for those born with a rare congenital insensitivity which makes them literally feel no pain, everyone experiences it. A 2018 report for the U.S. Centers for Disease Control and Prevention estimated that 50 million Americans suffer from some form of chronic pain, and of that number, 19.6 million have pain severe enough that it frequently limits life or work activities. The economic toll is an estimated $560 billion in medical care, lost productivity and disability programs. The prevalence of pain, not surprisingly, goes up with age.

Pain, however, is actually beneficial, warning of danger so people can respond, for example, by pulling a hand away from a hot surface. Episodes of acute pain go with the territory for stubbed toes and broken bones, but the symptoms usually resolve as the tissue heals or bones mend. Persistent, or chronic pain, on the other hand, can become a disease in its own right, as the nervous system over time becomes rewired, even spreading pain beyond the original area. Thats one of the reasons why it can be so challenging to treat and so frustrating to those who live with it.

If theres good news in all of this for Peninsula residents, its that advances are being made in better understanding the causes and effective treatments for pain, and with that the ability to offer more personalized approaches for targeting individual patients. Whether high-technology brain imaging, or no-tech therapies like breathing exercises and yoga, there are more alternatives available than just going home with a prescription for pain pills something the nations opioid crisis has elevated as an urgent concern.

Dr. Sean Mackey is chief of the division of pain medicine and director of neuroscience and the pain lab at Stanford University. He leads a multidisciplinary team which brings academic research findings into a clinical setting to help patients alleviate longstanding pain and even to prevent pain, notably following surgery, from transitioning from acute to chronic. Our message, Mackey says, is that you dont have to suffer in silence, that there are approaches that can help.

Stanford Health Cares Pain Management Center at 500 Broadway in Redwood City is one of the largest, most comprehensive pain centers in the United States, if not the world, according to Mackey, and has twice been designated a Center of Excellence by the American Pain Society. Physicians from multiple disciplines including psychiatrists, physical therapists, nutritionists and others get involved treating patients.

One of the things that I think is unique to the Stanford program is that we integrate our research and clinical missions very tightly, he adds. Clinical knowledge can feed researchers with questions to go after, and research discoveries are translated into safe, effective therapies. One example of something that is being tested is transcranial magnetic stimulation brain zapping using something like a coil placed on top of the patients head. It doesnt hurt, Mackey says. Theres no pain and you can induce a current through it that generates a magnetic field that can activate different brain centers, and we can turn on and off the brain systems that are associated with pain. And weve had some really good results with it.

Stanford has been recruiting volunteers for further study of the efficacy of TMS for two kinds of pain, one of several studies that are planned. Another one is seeking evidence of the benefits of acupuncture for low back pain.

The Stanford scientists also study novel applications for medications, according to Mackey, as an example, repurposing naltrexone, which was originally used to treat drug and alcohol addiction. But at much lower doses, like one tenth of the usual dose, it has a completely different action, he says. It blocks nerve inflammation so its been very useful with fibromyalgia, which predominately affects women in their 30s, 40s and 50s, as well as some other chronic painful conditions.

Among the other new alternatives, Stanford is also using implanted devices that can override pain signals to a specific nerve and provide relief.

If the body had only a single pain center, obviously treating pain would be much simpler, but many parts of the brain and neural pathways are involved in the pain experience. One of the problems when pain becomes chronic is that it can alter both the peripheral nervous systems and the brain and spinal cord so that it amplifies the experience of pain and that magnifies it, according to Mackey. When that occurs, someone who has come through an injury or surgery may no longer need the original signals to keep on feeling pain.

What is experienced as pain relies on many sensory cues, among them emotions, beliefs, thoughts and expectations, and one of the factors that can feed into chronic pain is known as catastrophizing. The big word can apply to anything. Bills. The job. The country. But with pain, rumination, hopelessness and a feeling that the condition will never get better can trap the brain in an endless loop that is very difficult to break out of.

But the pain is still real. Unfortunately, in part because its invisible, patients commonly report feeling they are being blamed for their pain, according to Stanford associate professor Dr. BethDarnall, who has a doctorate in clinical psychology and is a pain scientist. (Its) a misperception that somehow people are saying pain is all in your head. Youre making it up. Its not real. Theres not a medical basis for your pain, therefore there must be something wrong with you (But) all pain is real. I always say that at the outset. All pain is real.

One of her primary interests is in developing low-cost, accessible treatments that empower patients so they can begin participating in managing their symptoms rather than feeling at the mercy of them among them cycles of poor sleep, persistent worry and feeling helpless.Darnall, who teaches a class on this at Stanfords Redwood City clinic four times a year, says studies demonstrate that in two months or so of cognitive behavioral therapy, improvement can be shown. They have evidenced substantial volumetric increases in the regions of the brain associated with brain control so literally increasing the brain matter in those regions that associate better regulation of pain.

Its long been established that cognitive and behavioral therapies are important in addressing chronic pain. Whats different is that were now focusing more and getting people better access to what works, she says. Rapid access to relief is kind of where the rubber hits the road.

Pain physician and professor Dr. Ming-Chih Kao is chief of Stanfords network of pain clinics (including the one in Redwood City), which is expanding geographically: Patients who are already in pain benefit because they dont have to drive so far for treatments and can come in more often.

Kao started his career in internal medicine, intending to focus on cancer as his specialty, but decided to switch to pain management in part because of how common pain complaints are, headaches and back pain topping the list. In the primary clinic that I saw about 20 to 30 percent of my patients could benefit from a pain specialist, he says. But the diagnosis and treatment of pain, he also saw, is very complicated and requires a team approach.

When he started at Stanford as a fellow, patients routinely were coming in who had been prescribed very high dosages of opiates. Primary care doctors, he says, were trying to do the right thing to reduce pain but the nature of opiate medications is that patients get used to it very quickly. They develop tolerance. They had to escalate the dose again and again and again. And pretty soon, some patients are finding themselves taking astronomical doses. And still not getting pain relief.

The issue has taken on new urgency as a result of the nations opioid crisis, which is commanding more public and regulatory attention. From a period when the drugs were overpromoted and the risks minimized, the pendulum has swung the other way, and in 2016 the Centers for Disease Control and Prevention recommended against opioids as a first-line treatment for chronic pain. There has been pushback from patients and physicians alike that things have gone too far the other way. (Both Mackey andDarnallhave spoken out against forced tapering of opioids.)

Fortunately, Kao notes, there are new medications available that can be used safely to treat chronic pain, and many patients on large-dose opiates have been switching over successfully. There are 200-plus medications for pain management; 20 are opioids.

With most patients who develop chronic pain, Kao observes, usually theres not just one cause. It may start out with a herniated disk, nerve impingement, joint inflammation or a muscle or tendon issue. If pain persists and reaches a high level, secondary injuries from disuse or being bedbound can set in too.

Sofor us, a patient coming in with back pain or a headache, weve got to figure out what parts of the pain cycle are important contributors to the chronic pain and then we try to tackle them one by one, Kao says, not just with the doctors but with the rest of our team.

Lifestyle changes can make a big difference. Oftentimes patients find themselves essentially in a feedback loop where they become less and less active to avoid pain, Kao says, but unfortunately inactivity over long periods of time weakens muscles and that can cause secondarily more pain. So thats actually the cycle were trying to break for a lot of patients. The therapeutic prescription might include swimming, yoga, Nordic walking using poles, biofeedback and meditation and psychological counseling to improve coping skills and the ability to commit to a treatment program.

San Mateo Medical Center the countys safety net hospital offers a multidisciplinary pain clinic that includes similar therapies including meditation, physical therapy, yoga and art, as well as classes to help patients understand the physiology of pain. The program draws heavily on the work of Australian neuroscientist Dr. Lorimer Moseley, whose poplar and entertaining talks on You Tube help as the title of one of his books puts it Explain Pain.

Clinic patient Douglas has the autoimmune disease fibromyalgia, which makes people hypersensitive to pain. Since she enrolled in the hospitals program early this year, she feels better and has gained a new perspective about how the mind and the body are linked. This class reminds us were not crazy, she says. Our pain is real.

It would be hard to find a more enthusiastic graduate than San Bruno resident JohnAcayan, aback painsufferer who says the pain clinic has helped him get past being depressed about things he can no longer do and instead look forward to what he can do. One of the things the pain management clinic has done for me is help me to realize that (if) youre injured, perhaps youre not going to be 100 percent the same, youre not going to be able to do everything that you used to. But you can be happy. You can do other things.

He even tried acupuncture, and despite a fear of needles, It was fantastic. I couldnt believe it. It made everything go away. Ill say literally the rest of that day was so tranquil. Absolutely no pain. Zero. That night, I slept fantastic. The next morning was great, but after a few days the pain came back. He tries not to think about pain so much. At one time, in fact, he thought his medication needed to be stronger. He was taking 600 milligrams of tramadol a day and is now down to 50. The clinic team guided him to the realization that he didnt need that much. I could take a pill and be happy and lightheaded, he says, but that isnt the way I want to feel. I want to feel normal. I dont want to feel loopy.

This summer,Acayangot to try out something fairly new in the hospitals treatment toolbox virtual reality. Patients put on goggles and operate controls to throw things at friendly sea otters on a video screen and become completely engrossed. Another version has a biofeedback component that gives viewers some control as their heart rate changes.

Chief Medical Information Officer Dr. MichaelAratowsays virtual reality can calm people down in high-anxiety areas like emergency rooms. He brought the idea to Dr. MelissaFledderjohann, a licensed clinical psychologist who directs the pain management clinic, and she readily agreed to offer it in her program. Most patients get a reduced pain sensation while theyre using VR, according toFledderjohann. We know that during and right after it, they definitely feel a decrease,Aratowsays. The question is does that decrease persist until next time? The jurys still out on that one.

SaysFledderjohann: It helps reinforce the concepts in our classes, saying There are tools you can do to manage your pain, reduce your pain. Its not just an external thing thats coming at you. You yourself can do your own pain management. And this would be a good example. By going though VR, you saw your pain reduced.

SimonKoytiger, a physical therapist who manages Vibrant Care Rehabilitation in San Carlos, is also a proponent of a comprehensive and holistic approach to treating pain, which he views a symptom, not the root of the problem. Especially in the fast-paced Bay Area, lifestyle issues including lack of exercise, working long hours, stress, poor diet and anxiety can show up as back or knee problems, andKoytigertries to help patients develop healthier habits. We have this chronic pain issue, he says. Lifestyle is never going to show up on an MRI.

Exercise, he points out, helps reduce pain many ways, first by making people stronger and less fragile and improving the capacity of all tissues in the body. Exercise also has endocrine effects, releasing the happy hormones serotonin and dopamine and reducing the production of the stress hormone cortisol.

I talk to patients about these three pillars very frequently: Its physical exercise, its diet and nutrition and its mental health,Koytigeradds. AndactuallyIm a bit of a believer, even though Im a physical therapist, that the primary pillar is mental health. Because who is the one whos choosing to eat well? Who is the one whos deciding to exercise that day or not? We make those decisions and if we are at ease and we have more peace and calmness in our minds, we are going to naturally do those things that are right for our body. If we are suffering with depression and anxiety and stress, its going to be much more challenging to balance those two domains.

Coming back from chronic pain can be a long haul.

Woodside resident Brad Dary, 65, counts himself fortunate that he came out the other side of years of chronic pain, which began in 1995 with a laminectomy followed by fusion surgery for a vertebra five years later.

For the first year after the surgery, I felt like I was cut in half, he says. I moved home with my parents. I was literally in bed for a year after that operation. It would take me about a half an hour to get from the bed to the bathroom. You cant do anything without your back being involved. I used a walker. He had to take morphine for the pain but hated having a foggy brain and couldnt wait to get off of it.

He tried acupuncture once but thought it was silly. But Dary, who is a videographer, says through a slow progression of pushing himself to do exercise and the healing process, he finally recovered. You just fight it out, he says. My biggest thing was doing exercise and trying to build my muscles as best I could Everyones situation is different. I had a lot of time to heal. It was 10 years. Today he jogs three times a weekand works out with weights. He thinks having to work so hard to get where he is challenges him to be more alive.

Rose who did not want to be identified by her real name for this story has made a remarkable comeback too from barely being able to get out of a hospital bed using a walker. The southern San Mateo County resident disciplines herself to walk two miles, three times a week and has worked up to doing 15 minutes on an exercise bike at the gym. Shes arrived at this point 15 years after a series of back surgeries over four years, the first to address stenosis and then two more that turned out to be needed because of damaged disks.

When it all began, she had a job, but she had to give up working long ago.

Patients tend not to do their physical therapy if its too painful, and she was prescribed fentanyl and vicodin to help her be better able to do the therapy she would need, which it did. They put me on heavy opioids because they knew to get through years of it would be so painful because all of these core muscles were, waist to pelvis front and back, cut three times through three surgeries, Rose explains. So that is a huge amount of healing.

Fifteen years ago, her first pain management doctor assured her that it would easy to get off the opioids when the time came. Its no problem, Rose clearly recalls him saying. Literally, he told me No problem. You just gradually step off the opioids.

But when she had been on them for six years and was ready to start declining, she learned otherwise. It took three years of tapering to get off opioids, drugs so powerful that she had to cut back milligram by milligram, for a month perhaps and then wait two months to cut back again. Each time, she had to deal anew with increased pain, plus the jittery withdrawal symptoms. Her skin felt like it was crawling and she had no idea what it was until someone she knows who works with people in addiction explained it to her.

Id never done drugs, she says. I didnt know. Im such an innocent Girl Scout.

She methodically tracked her dosage on an Excel spreadsheet. With such a plodding pace, it helped to be able to look back and confirm that she really was taking less. Rose says her current pain specialist is a Kaiser Permanente doctor who has been with her every step of the way and is her cheerleader. He emphasizes the importance to her of pacing activities, not overdoing and causing more pain that will trigger a desire for more opioids. Though she was already slender, when one of Roses physicians told her that losing five pounds would reduce the pain, she lost ten. In my case, she says, it makes a huge difference.

More than anything, what has really gotten her through it all, says Rose, is her support system of her husband and friends and her Christian faith. A Bible study group from church met in her house when she could not get out, and it helped to know that they were praying for her. Prayer is meditation, she observes, and the Bible study group was group therapy.

Roses advice to others with chronic pain? From my experience, really slow is what does it, she responds with a laugh, like the old Aesops fable, the tortoise always wins.

This story was originally published in the November print edition of Climate Magazine.

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Stanford's new, innovative tools to address chronic pain - Climate Online

AMA recently published a detailed study of over 180+ pages in its repository on Endometriosis Therapies market covering interesting aspects of market with supporting development scenario till 2025. The study provides market size break-up by revenue and volume* for emerging countries and important business segments along with commentary on trending factors, growth drivers. Profiled players in study from the coverage used under bottom-up approach are AbbVie Inc. (United States),Eli Lilly and Company (United States),AstraZeneca (United Kingdom),Bayer AG (Germany),Astellas Pharma, Inc. (Japan),Pfizer, Inc. (United States),Takeda Pharmaceutical Company Limited (Japan),Myovant Sciences (United Kingdom)

According to the endometriosis.org, the disorder, Endometriosis affects approximately one in 10 women during their reproductive years, estimating around 176 million women in the world. Endometriosis is a painful disorder in which the layer of tissue that normally surfaces inside the uterus, starts growing outside the uterus. This mainly occurs on the fallopian tubes, ovaries, and tissue around the uterus; however, in exceptional cases, it may occur in other parts of the body. Hormone therapies may be used as a treatment for mild endometriosis or as combined therapy, either before, or after surgery, for moderate to severe endometriosis. Further, High investment made by the Government in the R&D of endometriosis disorder and increasing female population of reproductive age is driving the Global Endometriosis Therapies market

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Market Segmentation:by Type (Hormonal Therapy (Oral Contraceptive Pills, Progestins), Hormone Replacement Therapy (GnRH Agonists, Luteinizing-hormone-releasing hormone receptor antagonist, etc.), AromataseInhibitors, Thermal Endometrial Ablation Devices), Application (Hospital, Clinic, Other), Drug Type (Oral Contraceptives, Progestins, NSAIDs, GnRH Analogues, LNR-IUDs, Others), Synthetic Hormone (Danazol, Gestrinone), Distribution Channel (Hospital Pharmacies, Retail Pharmacies, Drug Stores, E-commerce), Surgery (Laparoscopy, Hysterectomy, Laparotomy), Treatment Type (Pain Management, Hormone Therapy)

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Whats Trending in Market: Availability of a Large Number of Branded as Well As Generic Products

Major Players in the Market Involved In Clinical Trials

Growth Drivers:

Increasing Female Population of the Reproductive Age

Availability of Various Treatment Options

Rising Prevalence of Endometriosis in Young Adults

Restraints:

High Cost of Advanced Therapeutic Drugs

Less Number of Studies On the Disease

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Country level Break-up includes:North America (United States, Canada and Mexico)Europe (Germany, France, United Kingdom, Spain, Italy, Netherlands, Switzerland, Nordic, Others)Asia-Pacific (Japan, China, Australia, India, Taiwan, South Korea, Middle East & Africa, Others)

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Strategic Points Covered in Table of Content of Global Endometriosis Therapies Market:

Chapter 1: Introduction, market driving force product Objective of Study and Research Scope the Endometriosis Therapies market

Chapter 2: Exclusive Summary the basic information of the Endometriosis Therapies Market.

Chapter 3: Displaying the Market Dynamics- Drivers, Trends and Challenges of the Comptroller Software

Chapter 4: Presenting the Endometriosis Therapies Market Factor Analysis Porters Five Forces, Supply/Value Chain, PESTEL analysis, Market Entropy, Patent/Trademark Analysis.

Chapter 5: Displaying the by Type, End User and Region 2013-2018

Chapter 6: Evaluating the leading manufacturers of the Endometriosis Therapies market which consists of its Competitive Landscape, Peer Group Analysis, BCG Matrix & Company Profile

Chapter 7: To evaluate the market by segments, by countries and by manufacturers with revenue share and sales by key countries in these various regions.

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Is Endometriosis Therapies Market Trapped Between Growth Expectations and Uncertainty? - Industry News Stock

It was like an out of body experience when Charlotte Evans was told she had breast cancer at the age of 23.

In a state of shock, the young woman started laughing uncontrollably as doctors explained the devastating news.

Charlotte, now 25, had been aware of breast cancer ever since her mum was diagnosed with the disease 12 years ago.

When she found a lump in her own breast in April 2017, Charlotte initially assumed it was hormone related and felt reassured when her doctor turned her away because of how young she was.

But when she noticed changes to the lump, she booked another appointment with her GP and took her mum along.

Shortly afterwards, Charlotte set off on a romantic break with her boyfriend Adam, and when they returned Charlotte went to the clinic for her test results.

They sat me down and said you have breast cancer and because of the shock I just started laughing uncontrollably," says Charlotte.

"It was an out of body experience and I dont think I took any of what they were saying in.

"I just remember my mum grabbing my leg and letting out a horrified gasp.

"It didnt register with me for months to be honest. I just said I cannot lose my hair.

In the months that followed Charlotte underwent chemotherapy, a double mastectomy, breast reconstruction and a course of radiotherapy.

She opted for 'cold cap' treatment so she didn't lose her hair.

Charlotte's treatment also forced a discussion about her fertility much sooner than she and Adam had planned.

"I started IVF just before my chemotherapy began and I remember going to the hospital with Adam thinking it was a joke that we had to think about this at our age," she explains.

"It felt as though we were in a parallel universe. I knew one day I wanted to have a family but going through IVF treatment at 23 felt so premature.

"Adam was 24 and he hadnt signed up for this; fertility treatment, hospital appointments, bathing me when I didnt have the energy.

"But he took it all in his stride and I cant thank him and our families enough for all that they have done for me.

"Now I can see how important it was for me to take those precautionary steps for our future together.

Charlotte, who works as cabin crew for easyJet, is sharing her story as part of the Life-saving Journeys partnership, which sees charities Breast Cancer Now and Prostate Cancer UK join forces with her employer.

She says being diagnosed with cancer at such a young age forced her to grow up quickly.

She finished radiotherapy a year ago and is now back at work after 16 months off.

There are no words, youll never think it will happen to you," she explains.

"I had to grow up so quickly and it was hard but I always tried to stay positive.

"I would go to my chemo appointments wearing the clothes and make-up that made me feel good, and I would just deal with it.

"A diagnosis of breast cancer is life-changing, but it makes you appreciate everything so much more. As a teenager, it was really tough seeing my mum go through breast cancer, but it made our family closer.

"When I turned 22 I had a thought one day, just out of the blue, about whether or not I would be diagnosed at some stage in my life. I didnt think it would be at 23, but youre never too young."

Charlotte is sharing her story as part of the Life-saving Journeys partnership, which sees charities Breast Cancer Now and Prostate Cancer UK join forces with her employer.

The six-week collaboration, which last year raised more than 430,000 for cutting-edge research, hopes to raise even more money through its on-board collections this Autumn.

Charlotte says: "It feels really special knowing that money raised by easyJet passengers and crew during this campaign will be supporting Breast Cancer Now and Prostate Cancer UK.

"As well my own diagnosis of breast cancer, and my mums, my grandad was diagnosed with prostate cancer in2014 and has since made a full recovery, so both organisations are close to my heart."

She added: "Going back to work after 16 months off was tough, but easyJet were hugely understanding and supportive and Im so pleased to be back at work in a job I love. I want to thank all of our passengers for their donations, this money will provide hope for so many by helping to fund vital research into these horrible diseases.

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"When they told me I had breast cancer at 23 I started to laugh" - Manchester Evening News

'Women know nothing about menopause, then it hits them over the head like a ton of bricks'

BelfastTelegraph.co.uk

Not only do we not talk nearly enough about menopause - something that affects half the people on the planet, with menopausal women the fastest growing demographic section in the world - but most of the conversations we do have, are misplaced. We spend too much time talking about HRT versus no HRT, about breast cancer risks, even debating whether or not menopause is a 'thing'.

https://www.belfasttelegraph.co.uk/life/health/women-know-nothing-about-menopause-then-it-hits-them-over-the-head-like-a-ton-of-bricks-38682571.html

https://www.belfasttelegraph.co.uk/life/features/article38682570.ece/6fd38/AUTOCROP/h342/2019-11-12_lif_54832131_I5.JPG

Not only do we not talk nearly enough about menopause - something that affects half the people on the planet, with menopausal women the fastest growing demographic section in the world - but most of the conversations we do have, are misplaced. We spend too much time talking about HRT versus no HRT, about breast cancer risks, even debating whether or not menopause is a 'thing'.

In fact, we should be talking about heart health, osteoporosis, and Alzheimer's. We should be talking, at a most fundamental level, about what is a significant health occurrence, one that now, because of rising life-expectancy, comes roughly midway through a woman's life, and that will have a considerable impact on physical and mental wellbeing.

The conversation we need to be having isn't the slightly judgemental one around women's 'choices', it is around the health impact of the menopause and what to do about it.

At its simplest, menopause marks the end of a woman's reproductive phase. The ovaries no longer release an egg every month and menstruation stops. Production of oestrogen diminishes gradually in the years before menopause, accelerating in the last year or two.

This is the point at which women will generally begin to notice symptoms - there is a check-list of over 40 possible, from the well-known (hot flushes, night sweats, insomnia), to the less recognised: panic attacks, painful joints, dry eyes. Some are life-threatening, and some are life-limiting.

Obviously the different reactions of women are dictated by the severity of symptoms - and every woman is different, every woman will have a different menopause, just as we all had different experiences of puberty and hormonal cycles.

However, symptomatic responses aside, the fundamental reality of menopause is that depleted oestrogen has consequences for the whole of a woman's health, no matter how well she is managing her symptoms, and it is this that needs to be talked about, and understood.

"The problem is, women know nothing," says Barbara Taylor MD (menopausetaylor.me), who was an obstetrician and gynaecologist at the Texas Medical Centre, before she retired due to severe arthritis and threw herself into educating women about menopause.

"They don't know what menopause is, when it hits them over the head like a ton of bricks. They go through years of seeing doctors for all these different things. They see one person for their joint pain, someone else for their insomnia, they don't realise it's all one thing, that losing your oestrogen involves a whole list symptoms that make you miserable.

"It's not even about the symptoms, it's about the fact that when you lose your oestrogen, you are at higher risk of heart attack, osteoporosis and Alzheimer's, simply by virtue of losing something your body needed to function.

"It's a deficiency state. If you lose your insulin, you have 20 symptoms that make you miserable, and if you don't do something about it, you die. If you lose your thyroid hormones, ditto. So why do we not respond when we lose our oestrogen? Your body is trying to tell you something. And if you don't listen to it, it's going to get worse."

Barbara's mission is education. "I help women manage their menopause whatever way they want. I have no agenda, no product. This is a purely educational resource for women, on all of their options - diet, lifestyle, vitamins, minerals, herbs, hormonal medications, non-hormonal medications, acupuncture... All I do is teach."

Barbara emphasises the importance of understanding personal risk factors. "For example, one glass of red wine is good for reducing your risk of heart attack. But that same glass of red wine increases your risk of breast cancer. So you need to understand - what are your personal risk factors? Are you more at risk of breast cancer? Of stroke? Of heart attack? And act accordingly."

She emphasises that "one in every two deaths of post-menopausal women in America is from heart disease" - low levels of oestrogen pose a significant risk of developing disease in smaller blood vessels - "compared with 1 in 29 from breast cancer. And yet we talk far more about the breast cancer risk. We're looking the wrong way."

Women, she says, consult with her from all over the world, and the two biggest complaints are: "One, their vaginas are on fire - vaginal irritation is the biggest, most bothersome symptom - and they won't talk about it. They will talk about hot flushes, but not vaginal discomfort. Two, is insomnia, because when you don't get sleep, everything else is off track and awful. Those are the two biggest and most obvious complaints. But, once they get some information, what they want to know is, 'How can we be at such huge risk of heart attack, Alzheimer's and osteoporosis, and not know it'?"

Many women come to Barbara determined against HRT, and many of those reconsider in the light of the information.

"I see more converting to HRT than anything," she says. But the endgame is not conversion - to anything - it's education.

"Each woman has a journey, finding what works best for her. When they do find it, they are so shocked at how different their lives can be."

Most women who come to see Nigel Denby, dietitian and nutritionist at the Hormone Health clinic, come because of the weight.

Nigel explains: "They find this extra stone, stone-and-a-half, all in the mid-section. Often, they aren't eating more, they haven't stopped exercising, so why is this happening? Oestrogen levels are falling and the way your body lays down its fat changes. This is a symptom of menopause." Here, Nigel gives some advice to women going through 'the change'.

Diet won't "give you a 'natural HRT'. It just won't. Let's lay that to rest".

In terms of diet and lifestyle, you need to "take care of your bones, look after your heart, and sort out this menopausal midriff weight gain".

"The second your oestrogen starts falling, your risk of a heart attack goes up to the same as a man's. You've had protection all your life, until now. This is the biggest killer in the UK and the second biggest in Ireland, and nobody talks about that."

Essentially, you may need to learn to eat and exercise differently.

"What you're trying to do is wind back time," he says. "Your body is ageing. You're losing muscle tissue, laying fat down in a different way. You need to reverse that. And you're not going to do it by a couple of gym classes a week. It has to be every single day. It's hard work.

"First, get yourself active. Look at your day-to-day stuff. Are you getting your 10,000 steps in? If not, nothing you do in the gym is going to make a difference. Combine it with resistance exercise, focusing on thighs, gluts, abs, upper body and arms. wDo squats, abdominal curls, box press-ups, 4x10 reps every day. Work until your muscles are tired. That's going to generate muscle tissue that is going to speed up your metabolic rate."

As for diet: "If you are going to lose weight, you've got to cut out about 300-500 calories a day. Start with a food and activity diary.

"For most people, the extra calories come from booze and large portion sizes; most of us are eating way too much."

But, he emphasises: "All of that needs to happen while taking care of your bones and your heart health. You need two to three servings of dairy and consider supplementing with vitamin D. Try and eat more fruit and veg, more oily fish and soluble fibre."

Remember that: "You have another four decades in front of you, and the quality of those decades is down to you.

"If a woman focuses on the facts and not the hype, she can give herself the best years of health ahead of her."

And, he adds: "I love this work, because women at this phase of their lives are the most motivated women I work with."

The bad news is that there is no one test you can do to show you where you are in your fertility lifespan. GPs will do a blood test to establish your levels of follicle-stimulating hormone (FSH) and to rule out other possible causes, such as thyroid issues or vitamin deficiencies.

If your FSH blood levels are 30 mIU/mL or higher, together with absence of periods for 12 months, that suggests you have reached menopause.

However, testing during the years before menopause (known as peri-menopause), when FSH may be within normal range but oestrogen is dwindling, is more a question of symptom-checking, as blood tests are unreliable: hormone levels fluctuate constantly, so a blood test is a snapshot of a particular moment, rather than an overall picture.

Instead, it's a question of a balanced assessment of a woman's age, her symptoms, including changes to the menstrual cycle, and how she feels, after having ruled out other possible causes.

Belfast Telegraph

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'Women know nothing about menopause, then it hits them over the head like a ton of bricks' - Belfast Telegraph

Patients

Between Jun 11, 2012, and May 272,016, 228 Chinese women underwent vaginal repair for CSD at Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine. These women all had prolonged postmenstrual spotting and underwent treatment in our hospital. The research protocol was approved by the relevant Institutional Review Board before the study began. This study was approved by the Ethics Committee of Shanghai First Maternity and Infant Hospital, affiliated with Tongji University (KS1512), and was conducted in accordance with the Declaration of Helsinki.

We reviewed and collected the patients medical records and follow-up data after they provided informed consent. All participants gave written informed consent before the study began. The author(s) agreed to provide copies of the appropriate documentation if requested. Baseline clinicopathologic data, including delivery times, menstrual cycle, age, gravidity, parity, age at first C-section, number of C-sections, hemoglobin (Hb) and data from MRI imaging, were also recorded before surgery. Laboratory analysis of Hb was conducted via a regular blood test within 3days of surgery.

Patients treated by vaginal surgery were included in the study with the following criteria: 1) clinical features, such as longer menstruation after C-section and no significant change in the menstrual cycle; 2) history of C-section; and 3) CSD detected by MRI. Exclusion criteria included uterine pathologies, such as adenomyosis, leiomyoma and other conditions [21].

Each patient received continuous epidural anesthesia while in the lithotomy position. At a distance of 0.5cm below the site of the reflexed vesicocervical area,an anterior incision was made from the 3 oclock position to the 9 oclock position using an electric knife. The bladder was carefully dissected away from the uterus with sharp dissection scissors toward the abdominal cavity until the peritoneum was reached. Once the abdominal cavity was entered and the cervical and lower uterine segments were exposed. The CSD tissue was cut to the normal healthy muscle. The incision was closed with a double layer of 10 absorbable interrupted sutures. After adequate hemostasis, the peritoneum and bilateral bladder column were sutured, followed by the incision in the cervical vaginal area.

Patients included in the study had follow-up clinic visits to record their menstruation at 1, 3 and more than 6months after the procedure and measure the CSD scar site by MRI at more than 6months after the procedure. According to the previous study, patients menstruation would likely plateau at follow-up visits more than 3months after surgery [21]. The data from MRI were evaluated at the same center by an experienced radiologist. The data after surgery mainly included the number of menstruation days and the depth, length, width, and thickness of the remaining muscular layer (TRM) as well as the depth/ TRM ratio based on contrast-enhanced MRI [21](Fig. 1). Primary outcomes were the number of postmenstrual spotting days and depth/ TRM ratio. All events and any modifications that occurred during follow-up were recorded.

We defined the Class-A healing group as CSD patients who had menstruation duration of no more than 7days and a thickness of the remaining muscular layer of no less than 5.8mm after vaginal repair, and all other patients were included in the non-class-A healing group [28].

Patient characteristics and preoperative factors were analyzed using students t test and chi-square tests. Ages are given as the medians with ranges, others variables are expressed as meanSD. Multivariate logistic regression models were used to assess risk factors associated with non-class-A healing of CSD. Regression coefficients were used to generate prognostic nomograms. Model discrimination was measured quantitatively with the concordance index. Internal validation was performed using 1000 bootstrap resampling to quantify the overfitting of our modeling strategy and predict future performance of the model.

We incorporated both the depth/TRM ratio measured by MRI and clinical factors into a personalized nomogram for facilitating preoperative prediction of non-class-A healing in CSD patients. Multimarker analyses have been used in recent years for incorporating individual factors into marker panels [29].

All statistical analyses were performed by R software (version 3.3.2). The statistical significance levels were two-sided, with a P value of .05 or less.

Multivariable logistic regression analysis was used to assess the individualized prediction model with the following clinical candidate factors taken before surgery: the depth/ TRM ratio via MRI, number of menstruation days after C-section, WBC and fibrinogen. We built the final nomogram based on logistic regression analysis in the training cohort.

A calibration curve was plotted to evaluate the calibration of the nomogram using the Hosmer-Lemeshow test. A significant test statistic indicated that the prediction model did not calibrate perfectly [30]. Harrells C-index was computed to quantify the performance of the nomogram.

Internal validation was carried out using data from 167 patients.

Decision curve analysis was performed to determine the clinical usefulness of the nomogram by quantifying the net benefits at different threshold probabilities.

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Development and internal validation of a Nomogram for preoperative prediction of surgical treatment effect on cesarean section diverticulum - BMC...

For those who want to match their physical gender with what they feel is their true gender, Thailand is the place for Sex Reassignment Surgery (SRS) also known as Gender Reassignment Surgery, Sex Change Operation, and MtF Surgery, to name a few. So, what makes Thailand such an attractive destination for this type of procedure? In short, its because patients can get the most out of such surgeries in Thailand thanks to the number of highly trained surgeons, low-cost and quality health care, and decades of knowledge and experience in perfecting this procedure.

If youre considering SRS in Thailand, or you have a family member, a partner, or a friend who is wondering what is involved in the procedure, this guide should help to paint a clearer picture.

To undergo SRS is a huge, life-changing decision that should not be made lightly. It is a lengthy process that requires a lot of resilience and patience. Before the actual surgery, you will first need to live as a woman for at least a year and undertake hormone treatment to help reshape your body contour and stimulate the growth of a labia majora.

Heres a list of the required prerequisites that all surgeons will insist upon before considering your case:

The actual process usually involves a few procedures:

You may also choose other surgical procedures, such as a Tracheal Shave to remove your Adams apple, or a Buttock Augmentation to increase the volume of the buttocks. Since every patient is unique, the procedures involved in SRS can be performed based on your needs and budget.

The most important part of male-to-female surgery is the creation of the vagina. There are numerous surgical techniques to do this based on your preference. You can discuss with your surgeon which one is best for you. The other popular techniques are as follows:

1. SRS without vaginal depth

2. SRS with Penile Skin Inversion

3. SRS with Scrotal Skin Graft

4. SRS with Sigmoid Colon by Laparoscopic Technique

Caitlyn Jenner, Possibly the Most Famous Transgender Person Ever

Recovery after surgery will be a long and painful process. It will also require several follow up procedures as well as constant monitoring so you will have to stay a little bit longer at the hospital until you are fully ready to be discharged. Generally, allow for a minimum of 3 weeks stay in Thailand or the country of your choice area after your surgery. Most people are able to return to work in about 4-6 weeks after a sex change operation. Furthermore, you can resume strenuous work and exercise in about 6-8 weeks. It is vital that you strictly follow all medication instructions during your recovery period.

Social support is very important before and after the surgery, especially the support that comes from your family and loved ones. You have to be socially and emotionally stable before you undergo the operation. This is why it is required that you have proper counseling to help you with your emotional wellbeing. You have to prepare yourself mentally, before, during and after transition because it can be quite overwhelming and stressful.

It is also important that you maintain regular check-ups with your local Doctor to monitor the progress of your healing and avoid such complications.

The success rate for a sex change is very high, given our technological advancements. Gender reassignment surgery from male to female has a higher success rate than female to male; this is why more male transgender opts for a sex change.

However, given the nature and complexities of this type of surgery, you also have to be aware of its complications:

Possible side effects may also include:

SRS can be very expensive, especially since it is difficult to get this type of surgery in many countries. One reason why Thailand is popular with those who want to change their sexual identity is that the country offers more affordable fees. Many patients come from the United States because the US has the most expensive male-to-female SRS prices in the world.

The prices range from $25,000 to $30,000 for just the reconstruction of the genitals alone. If you want to add breast augmentation and voice feminisation surgery, you can expect to pay more than $50,000. Additionally, some clinics in the US dont include consultation fees in their prices, so you need to pay at least $50-100 for every consultation.

In general, SRS in Thailand costs around a third to half of what it can cost in the United States. For the reconstruction of the genitals in Thailand, you can expect to pay between $8,400 to $13,700 depending on which technique you choose.

Breast augmentation costs approximately $4,100 to $6,170 and Voice Feminisation Surgery costs between $3,590 to $7,180. In total, you will need to pay around $16,090 to $27,050 in Thailand for the complete procedure. These prices can also include packages, such as hospitalization accommodation, post-operative care, consultation fee, post-operative care, medications, and transportation.

The low-cost healthcare in Thailand does not mean low-quality treatment. In fact, Thailand is extremely popular among medical tourists because the country is known to have high-quality healthcare. Numerous medical centers in Thailand are accredited by prestigious international organizations, such as the Joint Commission International (JCI). The country has come a long way since its first Sex Reassignment Surgery in 1975, with many surgeons specialising in SRS for years, some even have over 20 years of experience. With their skills and experience, the surgeons and clinics can give patients the proper care they need and guarantee the best possible result.

Since there are many medical centres in the country that offer Male to Female SRS, it is understandable that some will better than others. To avoid disappointment, do your research, read reviews, find out about the clinics accreditation, and ask for your surgeons certifications. Better still, seek out the services of a dedicated Medical Tourism Facilitator like MyMediTravel who will guide you through the whole process and find you the best possible surgeon/clinic/hospital available and within your budget.

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Chinese Medical Tourists visiting Thailand set to exceed 1 million by 2020 - The Thaiger

Addison disease occurs due to the injury of the adrenal cortex which causes insufficient generation of the hormone aldosterone and cortisol.Indications of Addisons disease are known as primary adrenal insufficiency, resulting from insufficient production of two hormones cortisol and aldosterone.

Treatment options for Addisons disease include many medications, usually in the form of tablets, depending on the specific hormones that the body is missing.

The drugs required to effectively treat Addisons depends on the hormones that are no longer being effectively produced in the adrenal glands.

Access Report Details at: https://www.themarketreports.com/report/global-addison-disease-testing-market-research-report

The global Addison Disease Testing market is valued at xx million US$ in 2018 is expected to reach xx million US$ by the end of 2025, growing at a CAGR of xx% during 2019-2025.

This report focuses on Addison Disease Testing volume and value at global level, regional level and company level. From a global perspective, this report represents overall Addison Disease Testing market size by analyzing historical data and future prospect. Regionally, this report focuses on several key regions: North America, Europe, China and Japan.

Key companies profiled in Addison Disease Testing Market report are Nhs.Uk, Mayo Clinic, Vca Animal Hospital, Niddk, Cleveland Clinic, Webmd, Bmj Best Practice, National Organization For Rare Disorders, Core Diagnostics Private Limited, Laboratory Corporation Of America Holdings, Sonora Quest Laboratoriesand more in term of company basic information, Product Introduction, Application, Specification, Production, Revenue, Price and Gross Margin (2014-2019), etc.

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Table of Content

1 Addison Disease Testing Market Overview

2 Global Addison Disease Testing Market Competition by Manufacturers

3 Global Addison Disease Testing Production Market Share by Regions

4 Global Addison Disease Testing Consumption by Regions

5 Global Addison Disease Testing Production, Revenue, Price Trend by Type

6 Global Addison Disease Testing Market Analysis by Applications

7 Company Profiles and Key Figures in Addison Disease Testing Business

8 Addison Disease Testing Manufacturing Cost Analysis

9 Marketing Channel, Distributors and Customers

10 Market Dynamics

11 Global Addison Disease Testing Market Forecast

12 Research Findings and Conclusion

13 Methodology and Data Source

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Global Addison Disease Testing Market: What it got next? Find out with the latest research available at 'The Market Reports' - Market Research...

MetroHealth is opening a permanent clinic Tuesday at the LGBT Community Center of Greater Cleveland specifically to treat LGBTQ patients.

Greater Cleveland LGBT center, MetroHealth partner on clinic

MetroHealths Pride Network has operated clinics -- geared to LGBTQ patients -- within its existing facilities since 2007. Now, the hospital system is opening a clinic inside the community center for both well visits and specialized care, such as hormone therapy and HIV prevention. Daniel Hamilton is the community centers operations manager.

Its not just about testing. Its about preventative medication that will help people to make better health choices and reduce the risk of HIV when engaging in safer sex practices.

Hamilton also says he hopes having the clinic inside of the center will make getting care more convenient -- and less stigmatized -- for people who might otherwise delay treatment or ignore lingering illnesses.

The endorsement from the LGBT center, having the clinic here, and being able to make direct referral to a place thats already a place theyve come to feeling its a safe outreach: its a great way to get someone directly into service that may or may not make the call.

The new clinic at the community center will be open on Tuesdays.

Continue reading here:
MetroHealth, LGBT Center of Greater Cleveland Partner On New Clinic Opening Tuesday - WKSU News

Written by Allison Aubrey Nov. 11, 2019

There's new evidence that mind-body interventions can help reduce pain in people who have been taking prescription opioids and lead to reductions in the drug's dose.

In a study published this month in JAMA Internal Medicine, researchers reviewed evidence from 60 studies that included about 6,400 participants. They evaluated a range of strategies, including meditation, guided imagery, hypnosis and cognitive behavioral therapy.

"Mindfulness, cognitive behavioral therapy and clinical hypnosis appear to be the most useful for reducing pain," says study author Eric Garland, a professor at the University of Utah. The reductions in dose were modest overall, he says, but the study is a signal that this approach is beneficial.

And Pamela Bobb, who lives in Fairfield Glade, Tenn., can attest to the benefits. She's 56 and has endured decades of pain. "Oh, I had been suffering terribly for years," Bobb tells us.

She was born with a malformation in her pelvis that led to pain. Over the span of two decades, she underwent more than a dozen major surgeries, yet none of them gave her relief; each procedure left more scar tissue and nerve damage.

"I felt desperate, " Bobb says. "I didn't feel like I had any control."

She couldn't do basic things such as cook or take care of her family.

"I was completely debilitated," Bobb says. "And when you get to that point, you can't see beyond the pain you're just surviving."

She was put on high doses of opioids to ease the constant pain, but then a few years ago she thought, "There just has to be a better way." Ultimately, she found help at a clinic that specializes in complementary and alternative medicine.

"We offer a variety of things, explains Wayne Jonas, a physician who treated Bobb at the Fort Belvoir Community Hospital Pain Clinic in Fairfax County, Va.

"We offer physical therapy, behavioral medicine, acupuncture, yoga and mind body practices," Jonas says. None of these is a cure-all, he adds, but the idea is that there are lots of tools in the toolkit for people to try.

Jonas is a longtime proponent of an integrated, mind-body approach to treating pain and the author of How Healing Works, a book that describes the science behind these approaches.

He says that when someone is in severe pain, their body's normal defenses are down.

"It bumps up a variety of dysfunctions," Jonas says. Pain increases levels of the stress hormone cortisol and increases inflammatory processes in the body, too. "This starts a continual negative feedback loop that produces more pain," Jonas explains.

It's not a surprise, he says, that techniques such as meditation or yoga can be helpful. "If you engage in a deep mindfulness and relaxation it will counter those stress responses," Jonas says.

Think of meditation as a form of mental exercise.

"It's almost like weightlifting for your brain," says Garland. Just as curling a dumbbell strengthens the bicep, he says, "meditation is almost a way of, sort of curling the dumbbell of the mind to strengthen the mind's self control."

And this can change the way the brain perceives the input from the body. "If you can change the way the brain perceives signals from the body you can actually change the experience of pain," Garland says.

But there's a trick here: Learning to meditate takes time, effort and some training. It's more complicated than swallowing a pill. Pamela Bobb has stuck with it. She has tried a bunch of these alternative mind-body strategies, including acupuncture and biofeedback, and now starts every morning with a meditation practice.

"It's 4:45 in the morning and I've just awakened," she says in a recording she made of her practice, so I could listen in. She sounds centered, and calm. "I'm allowing my body to feel as relaxed as it possibly can."

Bobb has also overhauled her diet, now eating a lot more greens, fruits and vegetables and herbs and spices with anti-inflammatory properties. On the day we talk, she's making a spinach saute with ginger, mint and rosemary.

"I swear you can smell each of those spices. They smell so good!" she says.

Bobb is so at ease now that, just hanging out with her, you'd never guess all that she has endured. And she feels so much better, she says.

"It's empowering to [have] come all this way," Bobb says. She says she's made a fundamental transition in her mind: Instead of waiting for doctors to heal her with surgeries or injections, she now realizes that many of these alternative therapies have empowered her to help herself.

"So much of it does lie within me," she says.

Bobb accepts that she may never be completely pain-free, but now feels she has control over the discomfort.

She has reduced her opioid dose by 75%. She says she still benefits from a small maintenance dose of the medication. And her doctors say that for her, the benefits of the medicine outweigh potential harms.

In the midst of an opioid epidemic, Bobb's story may seem unlikely. But many people who have taken opioids for a prolonged period have similar stories. And last month, the Department of Health and Human Services released new guidelines urging doctors to take a deliberate approach to lowering doses of opioids for chronic pain patients.

The guidelines point to the potential harms of forcing patients off the medications.

"The goal is not necessarily to get off of all opioids but to reduce it to a dose [that is] safe," Adm. Brett P. Giroir, a physician and assistant secretary for health at HHS, told NPR. We asked him about Bobb's case. He is not her doctor, but after hearing her story he said, "The fact that she's been able to reduce her opioids substantially is a success story."

Giroir says this kind of comprehensive approach that includes alternative therapies "could be a model for what we want to do nationwide." He points out that earlier this year, the Centers for Medicare & Medicaid Services proposed covering acupuncture for Medicare patients who have chronic lower back pain.

As the evidence accumulates, Giroir says, there will be more attention placed on covering alternative therapies.

A 2017 Gallup Poll found that 78% of people would prefer to try other ways to address their physical pain before they take pain medication.

And doctors groups such as the American College of Physicians recommend that doctors offer more nonpharmacological treatments to pain patients, such as those who have chronic lower back pain.

Yet, a paper published last year finds that most insurers have not adopted policies that are consistent with these guidelines, and many don't pay for coverage of these services. An accompanying editorial argues that it's time for that to change.

It's clear that when it comes to tackling pain, it takes all of the tools in the toolkit. And when it comes to opioids, the approach needn't be all or nothing. Bobb says she has learned that, for her, the combination of medicine plus mind-body therapies works best.

Continued here:
Meditation Reduced The Opioid Dose She Needs To Ease Chronic Pain By 75% | Morning Edition - KCRW

Around age 3, Luna Younger started asking to wear dresses. Since the age of 5, she has insisted she is a girl. Now Luna is 7, and during court hearings, physicians, school staff, and family members have all testified that Luna has consistently, persistently identified as a girl.

While Lunas mother respects her daughters gender identity letting her wear what she chooses, whether its nail polish, dresses, or longer hair Lunas father does not. He insists Luna is not transgender. These polarizing differences over how to raise and treat a child are why trans families and advocates, as well as conservatives, have been closely watching the custody battle over the Coppell, Texas, trans girl.

After 15 months in court, on October 22, the jury awarded Lunas mother, Anne Georgulas, full conservatorship of her daughter. It was a decision that brought relief to the trans community and outraged conservatives who believe supporting a trans childs gender identity is tantamount to child abuse.

People were so riled up online, some sent threats to Georgulas; she was viciously attacked and threatened by complete strangers, her attorneys told the Daily Caller. Several prominent Texas officials even added to the fray, including Republican Gov. Greg Abbott, who promised to order the states child protective services to investigate Georgulas. State Rep. Steve Toth said he would propose a bill to add Transitioning of a Minor as Child Abuse.

Two days after the debate boiled over online, Judge Kim Cooks decided to vacate the jury decision. Instead, she granted the parents joint managing conservatorship, which is the equivalent of joint custody in Texas. (Cooks has maintained that she did not make her decision based on any government officials opinion; she has not responded to Voxs request for comment.) While Georgulas, a pediatrician, had requested that the court order Lunas father, Jeffrey Younger, to respect their daughters gender identity, Cooks said that the Court finds that the State of Texas has no compelling interest to justify such interference.

The ruling has brought more questions than answers: When one parent honors her childs gender identity and the other does not, what does that mean for the child? More specifically, what will it mean for her socialization, her mental well-being, and who shes allowed to be?

Trans advocates say Cookss decision is a dangerous misstep. Transgender children are among the most vulnerable members of the next generation, Gillian Branstetter, media relations manager at the National Center for Transgender Equality, told Vox. We know they experience any variety of godawful barriers to their own success, including bullying and harassment, including psychological distress, often resulting from such harassment, [and] family rejection. It does a serious disservice to those kids to give any incentive for a parent to reject their child for who they are.

On Tuesday, Georgulas filed to appeal the judges ruling, according to a press release from a family representative. The mother is asking Cooks to recuse herself after allegedly posting about the case on her personal Facebook while deliberations were ongoing. This is after the judge had placed a gag order on Georgulas and Younger from commenting about the case, acknowledging that the publicity from it was affecting Lunas and her twin brothers privacy and well-being. (Georgulas and Younger are still currently under gag order; Youngers attorney did not return Voxs request for comment.)

Since the verdict, a representative for Georgulas, Karen Hirsch, said that a rock was thrown through a window at Georgulass house while the children were sleeping and that Georgulas has been forced to close her pediatric practice after dead animals and graffiti were left outside the door. Meanwhile, parents in Lunas neighborhood are afraid to send their children to class after Younger had named the school online they feel their children could be in danger from those trying to attack Luna.

The case has hit a boiling point where lives feel threatened and trans families inside and outside of Texas feel unsafe all over whether a child should be allowed to wear a dress and be called she and her.

The legal battle over Luna and, ultimately, how she is allowed to identify reached a tipping point in August 2018 when Georgulas filed for a restraining order against Younger, specifically seeking to prevent him from entering Lunas school and telling people that the gender of Luna is different than a girl named Luna.

In response, Younger petitioned for full conservatorship that same month. Up until this point, he had been allowed to see his kids once a week for two hours and on the first, third, and fifth weekends of each month since 2017, though court testimony indicates he frequently skipped his visitation days. He also launched a social media campaign to save his child from the supposed harm of transitioning. For a child of Lunas age, this is solely social and consists of keeping her hair long, choosing her own clothing, and using a feminine name and pronouns.

However, the conservative campaign spread incorrect fears that Georgulas was seeking to immediately chemically castrate the child a misinformed, scary-sounding reference to hormone medications that would suppress Lunas testosterone production and replace it with estrogen, which would typically be years in Lunas future, according to standard medical guidelines. The only plans Georgulas had, according to court transcripts, was to take Luna to a Childrens Health clinic for transgender kids in Dallas. There, they would discuss a plan for potentially starting her on puberty blockers, which are reversible, in the next few years if Lunas gender dysphoria persists. (The clinic did not return Voxs requests for comment.)

Seizing on Youngers narrative of Georgulas manipulating her child, right-wing media outlets like LifeSiteNews and the Daily Wire also accused Georgulas of forcing Luna to be transgender because she wanted a girl. But that claim seems rather flimsy because Georgulas has two older daughters from a prior marriage.

In court testimony, Georgulas said that she would prefer if Luna were not transgender, but she supports her childs gender identity regardless of her own feelings. From my knowledge as a pediatrician and also from the research Ive done, it is better to affirm for the psychological well-being of the child [doctors recommended] that we affirm the childs choices, whatever those choices are, she said.

Meanwhile, Younger made the conservative media circuit rounds, insisting it was Georgulas who was forcing Luna to present as a girl. Luna presents as a boy with me and [she] presents as a girl with his mom, Younger told LifeSiteNews, a conservative Christian website, in September. [She] gets dressed as a boy at [her] mothers home and [she] comes out to me as a boy. That means that [shes] comfortable as a boy at [her] mothers home. Georgulas and others who have testified have disputed this latter part, saying it was Younger forcing Luna to present as a boy.

Maternal blame appears to be common when it comes to trans children of estranged couples. While data on the number of trans children involved in custody disputes doesnt yet exist, a Family Court Review study released earlier this year examined the cases of 10 divorced mothers who affirm their childs trans- and gender non-conforming identities. In each of the 10 cases, the childs father blamed the affirming mother for causing the child to be trans, and courts gave a favorable ruling to the father in four of those cases. However, parents probably have little or no influence on the childs core feelings that define him or her as gender typical or gender variant, the study said.

Overall, conservative media has used the custody case to not only bash transgender people (When they come for your kid blared a headline in the American Conservative, which was followed by a roundup of disinformation), but to demonize a mother and small child. It has resulted in threats, harassment, and even vandalism of my clients property, attorneys for Georgulas told the Daily Caller in a statement.

Despite how the far right has painted Georgulas, it is Youngers character that has come under legal scrutiny. According to court documents of the annulment of his and Georgulass marriage, the court found that Younger lied about multiple aspects of his life: his career, his previous marriages, his income, his education, and even his military service. It was enough for a Texas court to annul their six-year marriage because it was entered into under fraudulent terms.

Judge Cooks also called out Younger for profiting off a violation of his familys privacy. The father finds comfort in public controversy and attention surrounded by his use of unfounded facts and is thus motivated by financial gain of approximately $139,000 which he has received at the cost of the protection and privacy of his children, she wrote in her judgment, referring to a crowdfunding and merchandising scheme launched last year by Younger.

Even conservative pundit Glenn Beck expressed concern over Youngers past. On his radio show, he read the courts findings of fact showing that Younger acted aggressively toward Georgulass older daughters, withholding their possessions, locking them in their rooms, and forcing them to do plank push-ups until they agreed to follow house rules.

That aggressiveness was also directed at Luna, according to Georgulass attorney Kim Meaders. [Luna] has said to CPS that she is afraid of her father, she said in her opening statement. Her brother has said that she is sad and her father makes her sad. By making her dress in boys clothes, that makes Luna sad.

Perhaps the greatest falsehood of all, according to official court records, is that Luna hasnt been clear about how she identifies.

According to a transcript of a July 10, 2018, hearing in the case, Lunas twin brother, a CPS worker, a therapist, and a pediatrician all attest to Lunas gender identity as a girl. The medical professionals who have seen Luna have recommended she be affirmed and treated as a girl, and its Younger who refuses to accept his childs gender identity.

In April 2017, Luna asked to be referred to by the name Luna. At age 5, Luna was diagnosed by a qualified professional therapist as having gender dysphoria, distress stemming from a mismatch between her birth sex and her gender identity. Her pediatrician noted that at both her 5-year and 6-year checkups, Luna presented as a girl and has been persistent in her gender identity throughout her childhood.

The father doesnt follow the recommendations of the counselor or the pediatrician, and he shames her to try to make her feel bad for wanting to dress as a girl, Meaders, Georgulass attorney, told the court. Even though the father knows she wants super-long hair, he shaves her head when he has the opportunity and leaves the other twin boys hair long, referring to her twin brother Jude.

It is the hair-shaving detail that stands out as especially cruel to trans people and advocates. Lunas father has been very insistent on cutting her hair extremely short, and that is like one of my daughters biggest dysphoric points, Jane, a Dallas-area mother of a trans kid who knows Luna (and whose name has been changed for this story) told Vox. For her, all of this is about the fact that Luna is being forced to have short hair. She doesnt understand all the other ramifications.

Lunas hair figures so prominently in this case because at age 7, hair is often the only differentiating physical indicator of a childs gender. Clothed, boys and girls bodies at that age are essentially the same, having not yet undergone any effects from puberty. A trans child at age 7 does not make permanent changes to their body, despite what Younger claims Georgulas wants to do.

Ultimately, the dispute at this current stage and several years into the future is over Lunas social transition: how she wears her hair, what clothes she wears, her name, and pronouns.

There is no medical intervention of any sort prior to someone hitting puberty, Dr. Joshua Safer, executive director at the Center for Transgender Medicine and Surgery at Mount Sinai and president of the United States Professional Association for Transgender Health, told Vox. So small children do not get medicines and small children do not get surgeries, for sure.

The standard approach when kids are gender expansive when they say theyre transgender, when they think theyre transgender, whatever that might happen, to get a clue that this might be going on is pretty much to listen to the kid and to kind of follow their guidance in terms of what they want to do, what the child wants to do, he added.

Safer says its important to develop an individualized plan for mental and physical health for gender dysphoric kids and adolescents. Varying degrees of family support for transition means coexisting mental health issues are important to examine for any trans child; theres no one-size-fits-all solution for all kids. Most of all, the child must feel comfortable with the plan.

Genecis, the Childrens Health clinic where Georgulas wanted to Luna to receive care, makes it clear on its website that it does not perform gender-related surgeries. In providing comprehensive, age-appropriate mental health and hormonal care for trans youth and adolescents, it follows established guidelines from major medical associations in its treatment. The jurys decision, before it was overruled by the judge, would have allowed her to Luna to receive care at the clinic without Youngers approval. Now she wont be able to.

According to court transcripts, Younger had missed several appointments with medical professionals who have worked with Luna, claiming to want opinions from other providers. However, at the time, he hadnt followed through on those requests.

Boiling under the surface of the custody battle is a medical dispute over how best to treat and support children with gender dysphoria. Younger claimed in court that he supports the watchful waiting approach to dysphoric youth. Watchful waiting wasnt given its name until 2012, but its based on an older approach developed by Dutch and Canadian clinicians in the mid-to-late aughts that suggests that parents must ensure their children perform the role of their assigned sex at birth.

Under watchful waiting, a prepubescent trans girl like Luna would be forced to maintain short hair, wear stereotypical boy clothes, form friendships with boys her age, maintain her birth name and pronouns under the belief that its statistically likely that her dysphoria will desist by the time puberty begins. If Lunas dysphoria does persist, only then would she be given puberty blockers, so she can mature before making a more permanent decision on hormone treatment.

Political forces opposed to social transitions for children are fond of saying let kids be kids but watchful waiting seems counterintuitive to that goal.

Watchful waiting is a deceptive term, said Kelley Winters, a writer and consultant on issues of gender diversity in medical and public policy, told Vox. Theres nothing neutral. Its meant to sound effectively neutral, and theres nothing neutral about forcing trans kids to spend their childhoods in the closet and grow up with absolutely no memories of being authentically present in their entire childhood.

The approach is based on older statistics that as many as 80 percent of children with gender dysphoria will eventually desist and grow into cisgender adults. But those numbers, according to Safer, are flawed.

In terms of that desistance 80 percent comment, thats an old Dutch study where they didnt ask the blunt question about your gender identity to these kids, he said. They kind of danced around the topic with a bunch of other questions and kind of assumed they knew the gender identities, but I dont know that it shows much of anything. It just shows that 80 percent of kids who answer questions in a stereotypical way, that you think might be associated with gender identity, end up not being transgender. But theres a lot of bias in the questions.

At issue is the fact that when the Dutch and Canadian studies were conducted, the official diagnosis for gender-variant kids was gender identity disorder. In order to be diagnosed with GID, a child merely had to display cross-gender dress or behavior, regardless of whether they declared themselves to actually be a member of the opposite sex. The effect of this diagnosis is that cisgender gay and lesbian children, who also frequently display cross-gender preferences without declaring themselves to be the opposite gender before puberty, were caught up in the clinicians studies and so of course they would desist later on.

Even Thomas Steensma, a researcher and clinician at the Center of Expertise on Gender Dysphoria in Amsterdam and a proponent for watchful waiting, has noted the earlier samples may have included milder cases that are hard to compare with the clinical samples we see now in our clinics, in an interview with KQED last year. But he still urged caution with social transitioning of prepubescent children. With certain steps like a name change or a pronoun change, with a result that maybe others will only perceive you as a girl thats somewhere where we say, Okay, maybe you should explore things without taking steps that are hard to reverse. (Steensma hasnt returned Voxs request for comment.)

In 2012, gender identity disorder was changed to the less stigmatizing term gender dysphoria, distress resulting from a mismatch between the childs natal gender and their internal sense of their gender identity. Nowadays, in order to qualify for a gender dysphoria diagnosis, the child must be persistent, insistent, and consistent in their gender identity over a long period of time, criteria that didnt exist under the older diagnosis.

Similarly, watchful waiting as a concept has been pushed to the fringes in American medicine as of late, as it is seen as needlessly punitive to the child. Instead, whats more commonly recommended is the affirming method, which allows gender-expansive children to more freely experiment with their gender expression, trying on new names or pronouns as needed. Its an individualized approach without permanent outcomes. Rather than attempting to fix a prepubescent childs perceived gender-related disorder, the affirming approach, which recommends social transitioning if the child wants it, seeks to lessen the actual dysphoria experienced by the child without medical treatment.

The affirming model has been recommended by nearly every major American medical association, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, the American College of Obstetricians and Gynecologists, and many others. What is most important is for a parent to listen, respect and support their childs self-expressed identity. This encourages open conversations that may be difficult but key to the childs mental health and the familys resilience and wellbeing, wrote Jason Rafferty, a doctor at Hasbro Childrens Hospital in Providence, Rhode Island, and a professor at Brown University, in a key AAP statement on affirming the gender identities of trans youth released last October.

The kid isnt going to brainwash him or herself into being transgender [if their gender identity is affirmed], Safer said. Theyre going to say how they feel and you can pretty much be respectful and they wont be railroaded into anything, which I think is the anxiety that people still have, and there was some anxiety in the past in the medical establishment, but I think the medical establishment is getting more and more comfortable that that does not seem like a likely event.

Critics of the affirming model fret that cisgender kids may unknowingly get caught up in a gender transition that they will later come to regret, but according to Safer, the key is to be cautious and keep communication open with kids. The ones who are sure of themselves will continuously tell you so.

Safer has said that within his previous practice in Boston and his current one in New York City, hes seen less than 1 percent of his own patients, among several hundred cases, end up desisting. We certainly dont want to be taking transgender kids and not treating them because we know were not perfect in our understanding, he said. There are opportunities, again, to go slow and theres a real range. The kids who are certain of their gender identity, those are not the kids who come back 10 years later and say that it was wrong to do the treatment.

According to a 2016 University of Washington study of 73 children with gender dysphoria, trans kids who are affirmed in their gender identity showed typical rates of depression and only slightly elevated rates of anxiety compared to their non-transgender peer groups. These findings suggest that familial support in general, or specifically via the decision to allow their children to socially transition, may be associated with better mental health outcomes among transgender children, the study said.

Meanwhile, a 2018 study shows that using a trans childs chosen name and pronouns significantly reduces suicide risk.

By the time Luna persists to the stage where her family would need to consider puberty blockers, which according to Georgulass testimony is sometime between the ages of 9 and 11, she would have been persistent, insistent, and consistent in her gender identity for at least six years, with another two or so years to go before having to make a decision about whether to pursue puberty as a girl through the use of cross-sex hormones.

While puberty blockers merely act as a pause on an adolescents natal puberty, cross-sex hormones would be used to initiate the puberty of the opposite sex if the teens dysphoria still persists. Blockers are a tool to keep permanent changes from natal puberty from taking place so that adolescents age 9 to 14 can be more mentally mature before deciding on the course of their permanent treatment when the time comes, according to Safer. Cross-sex hormones would mean testosterone injections for trans boys and a combination of a testosterone blocker in addition to estrogen for trans girls. Safer says its a careful and cautious system that also respects the autonomy young trans people should have over their own lives and bodies.

However, ultra-conservatives and trans-exclusionary radical feminists, along with some extreme sexologists, have other ideas for those childrens futures, lobbying to ban puberty blockers and cross-sex hormones for all minors. While theyve tried to appropriate the watchful waiting description, their approach is more traditionally known as the reparative method, a form of conversion therapy. They appeal to the fallacy that natal puberty is natural and therefore necessary for all kids.

But this approach would force trans girls into male puberty and trans boys into female puberty without their consent, and brings along its own permanent changes, which could only partially be reversed through painful and expensive medical treatments in adulthood. Trans women forced through male puberty would then have to undergo painful and expensive electrolysis to remove facial hair and may be left with a body frame (shoulder and hip width) that would be unchangeable by any surgeries. Trans men would have to have surgery to remove their breasts and, like their trans female counterparts, be forced to live in an unwanted body frame for their entire lives.

Then there are the repercussions of depriving adolescents of social transitioning. Forcing trans people to wait until adulthood deprives them of a childhood where they can be their full selves. Gendered socialization is also missed, dumping adult trans people into a new gender role without the experience to handle delicate gendered social situations such as dating or employment. Trans women are often perceived as too aggressive after transitioning in the workplace, thanks to sexist gender expectations. Allowing for an earlier social transition would let trans adolescents learn how to handle these situations on the same time scale as their cisgender peers.

However, those most invested in maintaining a strict gender dichotomy are the same crowd thats ardently opposed to the existence of trans people, especially trans kids.

Beyond the larger questions over how to treat gender expansive and dysphoric children, the Luna Younger case serves as yet another battleground in the conservative war against the transgender community at large. What concerns Jane, the Dallas-area parent of a trans child, though, is how powerful state and federal officials have taken aim at individual trans children in order to push their political agenda.

Im really concerned about what this looks like moving forward in politics that our politicians here in Texas, our legislators that are supposed to be protecting all children, are explicitly targeting a 7-year-old for their own political gain, she said. Thats really frightening that theyre stooping to those levels.

In addition to Governor Abbott, Texas Sen. Ted Cruz and the presidents son, Donald Trump Jr., a frequent commenter on trans issues, also chimed in on the case, both calling Lunas transition child abuse.

Riding the wave of conservative outrage, Texas legislator Matt Krause has floated the idea of banning the use of puberty blockers in gender dysphoric children in the state, a move which, if replicated in other states, could rip thousands of adolescents off of gender-affirming treatment and force trans girls like Luna to develop facial and body hair in addition to stereotypically male secondary sex characteristics without her consent. Or it could force her to travel hundreds of miles out of state to seek the same treatment.

Fellow Republican legislator Steve Toth promised on Twitter that the first bill in the next legislative session in 2021 would aim at designating affirming a trans childs gender identity as child abuse under state law. This would mean the state would legislate the clothes, name, and hair of a child.

The movement against trans kids has also spread beyond Texas state lines. Early last week, Georgia Republican state Rep. Ginny Ehrhart proposed the Vulnerable Child Protection Act, which would make it illegal for medical providers to consider any treatment which would result in sterilization, mastectomy, vasectomy, castration and other forms of genital mutilation, many of which are not treatments considered for trans adolescents. However, Ehrharts bill would also ban puberty blockers and cross-sex hormones for every individual under the age of 18. A similar bill has also been floated by a Kentucky state lawmaker following the Younger case.

Among the disinformation tossed around by conservative media recently was a report that the puberty-blocking drug Lupron was responsible for the death of thousands of people. However, an NBC News report on the controversy found that the drugs primary usage is to treat hormone-dependent cancers such as terminal prostate cancer and the drug was used as part of treatment and was not the cause of death in those cases.

Branstetter said that the Younger case in particular is dangerous because its so personal for one family. This has been a constant disinformation war amongst a legion of conservative media sites that has sought to disparage transgender people and to fear-monger about our health care, she said. To play into those hands, as the governor has done in this case, its exploitative. It is using a family and a child as a means to score political points and youre doing so without their consent.

Jane said the attention to the case has given her serious doubts about her public advocacy as a parent of a trans child in Texas. She has hired IT professionals to monitor her familys tech and installed additional security cameras around her house. Its been really, really stressful, intense, she said. And lots of tears, lots of sleepless nights. And lots of phone calls from other people figuring out how they can support this family.

Already, the attention from state and national conservative politicians has had a chilling effect on trans-supportive parents. Several Texas-based parents of trans kids declined to speak with Vox for this story because they were specifically afraid of the governor calling CPS on them. Branstetter notes that many parents of trans kids keep whats called a safe book, which documents every instance of observable gender dysphoria and every medical and psychological appointment because strangers who disagree with allowing children to socially transition often call CPS with accusations of child abuse. One clinician who was approached for an interview for this story had been told by their institution not to comment for a piece that mentioned ongoing litigation.

While Texas families with trans kids fear official government retaliation for supporting their childrens transitions, the family at the center of the case is left to deal with the fallout. Lost in the media frenzy and the court dispute has been Lunas own voice on the matter. In her young mind, what this boils down to is she thinks that all of this court stuff is so she doesnt have to cut her hair anymore, Karen Hirsch, a family friend of Georgulas who is acting as a media contact, told Vox. Thats what it comes down to for her. She just wants to be a girl. She doesnt want all of [this] conflict.

As of last week, Judge Cooks granted Younger an extra school day of custody a week. Hirsch said that Younger dressed Luna as a boy and sent her off to class on Tuesday. When she arrived, the teacher had extra clothes and said that if you want to change, you may change, Hirsch said.

And when mom and dad werent around and couldnt influence Luna one way or the other, what did she choose to do?

Hirsch said Luna chose to wear the dress.

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The battle over Luna Younger, a 7-year-old trans girl in Texas, explained - Vox.com

Even if youve taken the abortion pill, you can still change your mind, proclaims the website of a group called Alternatives Pregnancy Center.

The center offers what it calls abortion pill reversal, a treatment it claims can stop a medication abortion thats already been started. Many organizations around the country are beginning to offer the procedure, and a growing number of states require that patients seeking abortions be told about it.

But theres a problem. All of the evidence that we have so far indicates that this treatment is not effective, Daniel Grossman, an OB-GYN and the director of Advancing New Standards in Reproductive Health, a research group at the University of California San Francisco, told Vox.

Pioneered by an anti-abortion doctor in California, abortion reversal involves taking the hormone progesterone after the first dose of abortion medication. However, reproductive health experts, including the American Congress of Obstetricians and Gynecologists, say theres no evidence the procedure actually works to stop an abortion from happening. And, they warn, no one knows what the side effects might be of taking progesterone in an effort to reverse abortion medication.

But Republican-controlled state legislatures are increasingly passing bills requiring doctors to tell patients about the possibility of abortion reversal. The latest is Ohio, where the state Senate passed such a bill last week; the legislation now goes to the state House for consideration.

Anti-abortion groups argue that progesterone is safe and the laws are just a way to make sure patients are aware of their options. But reproductive health advocates say pregnant people around the country are essentially becoming test subjects in an unscientific and unethical experiment.

Its one thing when states were forcing abortion providers to give information that was inaccurate about the risks associated with abortion, Grossman said. This takes it to a whole new level.

Typically, a medication abortion works like this: The pregnant patient takes a pill, called mifepristone, meant to stop the pregnancy from progressing. Then, up to 48 hours later, the patient takes a second pill, misoprostol, that induces contractions and causes the uterus to empty. Mifepristone has been FDA-approved since 2000, and the procedure works to end a pregnancy about 95-99 percent of the time.

But in 2012, Dr. George Delgado, a family medicine physician in San Diego who identifies as pro-life, announced that he had developed a method to reverse the process, according to NPR. If patients changed their minds about the abortion after taking mifepristone but before taking misoprostol, he said, taking progesterone could help the pregnancy continue.

In a paper published that year, he said that of six patients who had received progesterone injections after taking mifepristone, four were able to continue their pregnancies.

When his research came to the attention of anti-abortion advocates, states around the country started passing laws requiring doctors to tell patients that medication abortions could be reversed. The first, Arkansas, passed its law in 2015, and such laws are now on the books in at least eight states, though courts have blocked enforcement in some. Five states including Arkansas, which expanded its requirements have passed laws this year alone, according to HuffPost.

Ohio could become the sixth the bill passed the state Senate last Wednesday and now heads to the House, where Republicans have a majority. The states Republican governor, Mike DeWine, has signed abortion restrictions in the past, including a ban on the procedure after about six weeks gestation, which has been blocked in court.

Abortion opponents and groups identifying as pro-life argue that abortion reversal laws are necessary to make patients aware of their options.

Women should be given full, informed consent when they are considering an abortion, Ingrid Skop, the chairman-elect of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), told Vox.

Because the abortion pill regimen can be reversed, she said, they should be given that information.

But many medical experts say theres no evidence that progesterone does anything to reverse abortion. In a 2017 statement, the American Congress of Obstetricians and Gynecologists said that Delgados 2012 paper, involving just a handful of patients, was not scientific evidence that progesterone resulted in the continuation of those pregnancies.

As the group noted, mifepristone on its own does not always work to end a pregnancy, with up to half of patients who take mifepristone alone remaining pregnant. Thats why mifepristone is prescribed with misoprostol to complete an abortion. So its possible that Delgados patients who remained pregnant would have done so regardless of whether they received progesterone.

In 2018, Delgado published another paper, this time looking at the effect of progesterone on 547 patients who took it after taking mifepristone. He found that in 48 percent of cases, the patient went on to have a live birth, with the rate going up to 64 percent if the progesterone was administered by injection.

Critics, however, point out that this paper was not published in a mainstream scientific journal but rather in Issues in Law and Medicine, a journal that has featured anti-abortion legal analysis as well as articles promoting the debunked theory of a link between vaccines and autism, as Rewire.News reports.

And according to Grossman, the design of the research may have inflated the success rate of the treatment. Some providers involved only prescribed progesterone after an ultrasound confirmed that the pregnancy was continuing, meaning that people for whom mifepristone didnt work well to begin with may be overrepresented in the data.

In addition, Grossman said, its not clear from the paper whether patients were informed that the treatment was experimental. Delgado has not responded to Voxs request for comment, but he told NPR that before his 2018 paper, he told patients that abortion reversal was a novel treatment. Now, he says, we have a substantial amount of data. There is no alternative. And its been proven to be safe, so, why not give it a chance?

Progesterone is sometimes prescribed during pregnancy for other reasons, like to prevent premature labor in the second and third trimesters, Grossman said. But theres no data on whether its safe to give after mifepristone or to take throughout pregnancy, as reversal patients are sometimes advised to do.

The impact on patients of mifepristone combined with high doses of progesterone is virtually unstudied, Kathryn Eggleston, medical director of the sole abortion clinic in North Dakota, wrote in an affidavit obtained by HuffPost. Researchers do not know, she said, whether the combination could cause birth defects, for example.

Moreover, as Grossman noted, the prescription of an unproven treatment to pregnant women has disturbing echoes in Americas past. We know that abortion patients are more likely to be women of color and low-income women, he said, and these are populations that have had research performed on them that was clearly unethical. For example, in the 19th century, Dr. J. Marion Sims conducted gynecological research, including operations without anesthesia, on enslaved women.

However, there are researchers working on a study of abortion reversal designed to meet ethical and scientific standards. Mitchell Creinin, an OB-GYN and professor at the University of California Davis, is conducting a controlled study of progesterone treatment that has been approved by an institutional review board, according to NPR. The results should be available next year.

For now, though, abortion providers say laws like the one proposed in Ohio will hamper their ability to ethically care for pregnant people.

Abortion reversal is unproven, unscientific, and potentially unsafe, Tam Nickerson-Scott, clinic operations director at Preterm, Ohios largest abortion provider, told Vox. We certainly dont want to give out false information to our patients.

Its not clear how many people are currently being prescribed abortion reversal in the United States. But Skop, the AAPLOG chair, believes it is very common and says that most pregnancy resource centers facilities that offer counseling with an anti-abortion bent, also called crisis pregnancy centers offer the procedure. Obria, an anti-abortion group with facilities around the country that recently received a federal family planning grant from the Trump administration, advertises the procedure on its website.

Its also not clear how patients who do get progesterone treatment pay for the medication. Unproven treatments are typically not covered by insurance, Grossman noted. Skop said that patients sometimes pay for progesterone out of pocket and that sometimes pregnancy centers may cover the cost.

Meanwhile, one of the biggest questions around abortion reversal is how many people really want to undo their abortions once theyve started. Some say the number is significant. Women do regret their abortions, said Skop. Ive been practicing for 23 years, and Im also the board chairman of a pregnancy resource center, and we see it frequently.

However, research shows that most patients are actually quite sure about their decisions to have an abortion. One recent study found that, on average, abortion patients were as or more sure of their decision to have an abortion than people facing other medical procedures, such as knee surgery. Another found that 95 percent of abortion patients did not regret the procedure.

But its possible that abortion reversal laws could actually lead to more regretted abortions. In her affidavit, Eggleston, the North Dakota provider, wrote that abortion reversal laws could encourage people to get medication abortions before they are ready to do so, by giving them the mistaken impression that the procedure can be easily reversed if they change their mind.

For Nickerson-Scott, meanwhile, the Ohio bill just causes more hurdles in a state where patients already have to go through a 24-hour waiting period and a total of three doctors appointments to complete a medication abortion. Instead, Ohio patients deserve autonomy over their bodies, she said. We have to trust people that they are the expert of their lives.

I have never heard anyone who has come through our doors and who has told me that they have regretted their abortion, Nickerson-Scott said. What I do hear is, Thank you for being here.

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Abortion pill reversal: an unproven treatment offered by crisis pregnancy centers - Vox.com

Eight years of work and some well-timed coincidences led Donald McDonnell and his lab to a discovery that could change the lives of breast cancer patients.

McDonnell, chair of the department of pharmacology and cancer biology, researches a type of breast cancer called estrogen-receptor positive cancera type in which tumor cells grow in response to the hormone estrogen. He said ER-positive breast cancer makes up about 75% of cases of the disease.

Doctors can treat this kind of cancer with endocrine therapy, which uses anti-estrogen hormones to stop tumors from growing, according to the Mayo Clinic. However, McDonnell said that some cancers are resistant to this treatment, which leaves traditional chemotherapy as the only option.

The product of eight years of research conducted in McDonnells lab, recently published in Cell Reports, could change that. Researchers discovered a way to stop tumors from growing by using antibodies to target two proteins found in endocrine-therapy-resistant cancer cells.

This would likely be another relatively benign, in terms of side effects, therapy, so that it potentially could extend the life of patients who have late-stage disease, McDonnell said.

Instead of trying to prevent cells from becoming resistant, the researchers in McDonnells lab explored ways to exploit the differences between resistant and non-resistant cells, creating treatments that would be uniquely effective in cells that do not respond to traditional therapy.

Researchers identified two proteins, AGR2 and LYPD3, present in therapy-resistant cancers. The proteins interact with each other, and the researchers thought that they might be able to prevent tumor growth by targeting them with a drug.

McDonnell said that he was presenting these results at a Duke Cancer Institute research meeting when Jim Abbruzzese, D.C.I. professor of medical oncology at Duke, told him about research that identified LYPD3 in pancreatic cancer cells. Moreover, Abbruzzese said that a researcher at the MD Anderson Cancer Center had developed antibodies that neutralized the protein.

Interested, McDonnell went to Texas.

Charles Logsdon, professor and chair of cancer biology at MD Anderson, had created antibodies to both proteins and licensed them to a company called Viba Therapeutics. Viba, a company in which McDonnell owns stock, provided the antibodies to researchers in McDonnells lab, who injected them into mice with endocrine-resistant breast cancer.

The results were striking: The tumors stopped growing.

I think a lot of basic science is kind of putting pieces together until you make that connection, said Kimberly Darlington, a former M.D.-Ph.D. student and researcher in McDonnells lab, of the discoveries that led to the teams breakthrough.

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McDonnells team submitted their findings for publication, he said, but the reviewers wanted more from them. Animal models were one thing, but were the proteins found in human breast cancer as well?

Answering that question took more collaboration. McDonnell turned to Mitch Dowsett, a professor of biochemical endocrinology at the Royal Marsden Hospital in London who oversees large collections of data on tumors in humans.

McDonnells team worked with tissue samples that Dowsett had gathered. Their findings matched what they had seen so far: AGR2 and LYPD3 were highly prevalent in cells from tumors that were resistant to traditional therapy.

My goal in starting this project was to understand the process and trials and tribulations of drug discovery, and I feel like weve sort of gone through the gamut, Darlington said, from working with cells to performing mouse studies to finding evidence that their treatment could work in humans.

Today, McDonnell runs a lab on the second floor of Dukes Levine Science Research Center that manages to be both spacious and, in some places, cluttered. Researchers peer into microscopes, machinery covers the countertops and shelves feature an array of bottles and boxes.

This is not where McDonnell thought he would end up, he said. He grew up in Limerick, Ireland, and he earned a scholarship to study marine biology at the National University of Ireland, Galway. That plan changed when he met Mary Downes at a community dance, whose mother had been diagnosed with breast cancer earlier that day.

McDonnell and Downes started dating, and Downes mother would have him go to the library to research her disease. That research inspired McDonnell to go to the group that had given him the scholarship and ask to use the money to study breast cancer.

The guy who was the head of the scholarship committee said, You know, my daughter or my wife may get breast cancer some day. Take your scholarship and go and study breast cancer, McDonnell said.

McDonnell studied metabolism and immunology at NUI Galway, graduating in 1983. By then, he and Downes had married and the couple moved to Houston so that McDonnell could pursue a Ph.D. at Baylor.

McDonnell is now 58, and he said he has had an amazing career in breast cancer research.

I would have been cold, poor and wet for the rest of my life, as a marine biologist on the west coast of Ireland, he said, laughing.

Today, McDonnells lab is working with Viba to develop versions of their antibodies that work in humans. McDonnell said that he is hopeful about the results, and a drug could be on the market soon.

Originally posted here:
Years of work lead Duke researcher to clues behind treating breast cancer - Duke Chronicle

Q: How common is breast cancer in men?

A: Men do get breast cancer, but at much lower numbers than women.

About 2,200 American men are diagnosed with breast cancer each year, compared with about 245,000 women, according to the Centers for Disease Control and Prevention. About 460 men die from the disease annually, compared to 41,000 women who die.

The risk of a man developing breast cancer is low, but men are more likely to die from breast cancer than their female counterparts, according to a Vanderbilt University study recently published in JAMA Oncology.

Breast cancer isnt just a disease for females, Dr. Xiao-ou Shu, senior author of the Vanderbilt study, told the online publication STAT. Men diagnosed with breast cancer have a worse survival rate, and we dont understand the exact reason for the disparity.

Men, just like women, are encouraged to do self-breast exams. The National Comprehensive Cancer Network recommends men who are 35 or older and at higher risk for breast cancer have an annual clinical breast exam.

Mathew Knowles, father and former manager of Beyonc and Solange, put male breast cancer in the spotlight by speaking publicly about his diagnosis. A mammogram showed he had stage 1A breast cancer, and he had a mastectomy in July, according to the New York Times.

Testing revealed that Knowles had the BRCA2 gene mutation, an inheritable trait that increases the risk of some cancers.

Knowles found his cancer at an early stage, but most men are diagnosed when the cancer is more advanced, said Dr. Halle Moore, an oncologist at the Cleveland Clinic.

People might have a problem and dont come forward, Moore said. Theres not as much awareness as there could be.

Men with breast cancer often feel isolated and invisible, said Betsy Kohn, chief program officer for The Gathering Place, which offers free programs to help people and families coping with cancer.

When they tell others about their diagnosis, they are often met with disbelief. Doctor offices decorated in pink send a message that men are interlopers in an all-female space.

They dont have a lot of people to talk to, Kohn said. She counsels men with breast cancer to find a support group where they can share feelings, and be willing to ask for help.

Men with breast cancer have similar treatment options as women, including surgery, radiation, chemotherapy and hormone therapy. Targeted therapy, which are drugs that target cell changes in tumors, are also an option.

Here is more information about breast cancer in men, from the American Cancer Society.

Risk factors:

Symptoms:

Women have similar breast cancer symptoms.

Resources for more information:

American Cancer Society in Ohio

A Gathering Place

Male Breast Cancer Coalition

HIS Breast Cancer Awareness

If you are a man who has had breast cancer, contact patient advocacy writer Julie Washington for a future story. Include your name and city where you live; your comments may be published.

In her Health Matters column, Washington will answer readers questions about navigating health-care systems. (She will not address individual treatments.) Your comments may be published in a future story. Send questions and comments for publication including your name, city and daytime phone number to jwashington@plaind.com. You can also find Julie on Twitter @JulieEWash.

Link:
Mens risk of breast cancer is low, but mortality is high: Health Matters - cleveland.com

The worldwide market for Thyroid Hormone Disorder Drug is expected to grow at a CAGR of roughly over the next five years, will reach million US$ in 2024, from million US$ in 2019.

Access Report Details at: https://www.themarketreports.com/report/global-thyroid-hormone-disorder-drug-market-by-manufacturers-regions-type-and-application-forecast

Market share of global Thyroid Hormone Disorder Drug industry is dominate by companies like Novo Nordisk, Sanofi, Merck, Eli Lilly, AstraZeneca, AbbVie and others which are profiled in this report as well in terms of Sales, Price, Revenue, Gross Margin and Market Share (2017-2018).

With the help of 15 chapters spread over 100 pages this report describe Thyroid Hormone Disorder Drug Introduction, product scope, market overview, market opportunities, market risk, and market driving force. Later it provide top manufacturers sales, revenue, and price of Thyroid Hormone Disorder Drug, in 2017 and 2018 followed by regional and country wise analysis of sales, revenue and market share. Added to above, the important forecasting information by regions, type and application, with sales and revenue from 2019 to 2024 is provided in this research report. At last information about Thyroid Hormone Disorder Drug sales channel, distributors, traders, dealers, and research findings completes the global Thyroid Hormone Disorder Drug market research report.

Market Segment by Regions, regional analysis covers:

North America (USA, Canada and Mexico)

Europe (Germany, France, UK, Russia and Italy)

Asia-Pacific (China, Japan, Korea, India and Southeast Asia)

South America (Brazil, Argentina, Columbia, etc.)

Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

Market Segment by Type, covers:

Injection

Oral

Others

Market Segment by Applications, can be divided into

Hospital

Clinic

Medical Center

Others

Purchase this premium research report at: https://www.themarketreports.com/report/buy-now/1488400

Table of Contents

1 Market Overview

2 Manufacturers Profiles

3 Global Thyroid Hormone Disorder Drug Market Competitions, by Manufacturer

4 Global Thyroid Hormone Disorder Drug Market Analysis by Regions

5 North America Thyroid Hormone Disorder Drug by Countries

6 Europe Thyroid Hormone Disorder Drug by Countries

7 Asia-Pacific Thyroid Hormone Disorder Drug by Countries

8 South America Thyroid Hormone Disorder Drug by Countries

9 Middle East and Africa Thyroid Hormone Disorder Drug by Countries

10 Global Thyroid Hormone Disorder Drug Market Segment by Type

11 Global Thyroid Hormone Disorder Drug Market Segment by Application

12 Thyroid Hormone Disorder Drug Market Forecast (2019-2024)

13 Sales Channel, Distributors, Traders and Dealers

14 Research Findings and Conclusion

15 Appendix

Ask your report related queries at: https://www.themarketreports.com/report/ask-your-query/1488400

Continued here:
Global Thyroid Hormone Disorder Drug Industry: Sales, Revenue, Market Share and Competition by Manufacturer Covered in a Latest Research - Market...

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On-demand video consultations with doctors have proven popular healthtech startup apps like Kry and Babylon have been downloaded more than 1.2m times in Europe as patients show that theyre keen for flexible checkups.

Now it turns out that people want on-demand video consultations for their pets, too.

FirstVet is a three-year-old Swedish startup that puts pet owners in touch with vets via an app. Its expanded into neighbouring Norway, Denmark and Finland, as well as the UK and has clocked up more than 200,000 registered users.

One Trustpilot reviewer said its great for emergencies that probably arent emergencies. Other reviewers were pleased that FirstVet saved them a trip to a clinic and a hefty bill.

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Like many doctor apps FirstVet has built partnerships with several insurance companies, including Bought By Many in the UK, making the service free for some users. For other UK customers it costs 20-30 per consultation.

Dogs are the most commonly treated pet, followed by cats. Horses account for 4% of consultations, while perhaps the most unusual treatment FirstVet has assisted with was organising an x-ray for a goldfish.

With its latest injection of funding an 18.5m Series B led by London-based fund OMERS Ventures, with participation from Creandum FirstVet plans to launch in other markets, such as France, Germany and the US. Theres big money to be made heading to North America: the US veterinary care market was worth $70bn in 2017, compared with only 9bn in Germany.

FirstVet currently has a team of 35 and works with 150 vets.

Pharma giant Bayers venture capital arm, Leaps by Bayer, led a $25m round of investment into UK medtech startup Medopad.

Its not the only big firm keen on the company; Medopad also works with Johnson & Johnson, GlaxoSmithKline (GSK) and Chinese internet giant Tencent, amongst others.

Medopad, founded in London in 2011, builds and tracks digital biomarkers (i.e. indicators of illness or disease picked up by apps and wearables). These help doctors monitor patients conditions via an app.

Its also integrated several other healthtech companies within its platform, such as medical equipment firm Medtronic and heart rhythm monitor FibriCheck. This means clinicians (and patients) can use Medopad to track several conditions rather than using a separate app for each.

Many healthtech startups are making a platform play: from Berlin-based digital diagnosis app Ada to Paris-based health insurance provider Alan all aspire to be a one-stop-shop for patients health needs.

Few European healthtech businesses have landed as many corporate and hospital partnerships as Medopad, however. Earlier this year, it began a clinical trial with Tencent to test the use of artificial intelligenceto diagnose patients with Parkinsons disease. It also signed a three-year contract with one UK hospital, The Royal Wolverhampton NHS Trust, to offer remote support to patients living with heart problems and diabetes. Medopad has also begun acquiring competitors; last September it bought US rival Sherbit.

Inne is far from the only fertility and contraception startup in Europe. There are now quite a few, including Natural Cycles, a birth control app, Moody Month, an app which helps women track their hormones and Clue, which helps women track their periods. Many of these aim to help women return to their natural cycle and move away from hormone-control pills.

Berlin-based Inne has developed a saliva biosensor device to help women work out when theyll be most fertile. The product, which can be used to get pregnant or avoid getting pregnant, will launch later this year.

London venture capital firm Blossom Capital led the round, with prominent angel investors Taavet Hinrikus and Tom Stafford also participating.

Inne joins the booming world of European femtech from digital doctors specifically catering to womento menopause tech.

See the original post:
FirstVet raises 18.5m and other European healthtech news - Sifted

Teens and young adults with anorexia are at risk of life-threatening illness even if their weight falls within a "normal" range.

That's the conclusion of a new study that looked at "atypical anorexia," or cases in which patients show all the symptoms of anorexia with the exception of low body weight. In the past, these cases were considered less severe than typical anorexia cases, but the new study found that both types show the same signs of severe malnutrition. "Patients with atypical anorexia are just as sick, medically but they may be even sicker, psychologically," said Dr. Neville Golden, a professor of pediatrics at the Stanford School of Medicine and co-author of the new study. Although recognized in the diagnostic manual for mental health disorders, the DSM-5, atypical anorexia may remain underdiagnosed, Golden said.

"The assumption is that doctors in the community are not recognizing it," he said. The oversight may place patients at risk of cardiac arrest, bone degradation and even death, Golden and his colleagues found.

The new study, published Nov. 5 in the journal Pediatrics, shows that there's no connection between an anorexic patient's weight and the actual severity of their condition. In the end, the number on the scale matters far less than the sheer amount of weight patients lose over the course of their illness both normal-weight and underweight patients fare worse the more weight they drop.

Related: Understanding Weight: BMI & Body Fat

"There's no weight or BMI that equals [an] eating disorder," said Dr. Casey Cottrill, the medical director of the eating disorders program at Nationwide Children's Hospital in Columbus, Ohio, who was not involved with the study. Over the last five to 10 years, the number of normal-weight people hospitalized for anorexia treatment has spiked, she said. Recent studies estimate that one-third of patients admitted to hospitals for anorexia treatment are of normal weight. In both atypical and typical cases, the signs of malnutrition appear the same, but patients of normal or above-average weight may suffer longer before being noticed.

In light of this, doctors must watch for signs of disordered eating and malnutrition in all patients, regardless of size, Cottrill said.

Although atypical anorexia has gained recognition, still, "when one thinks of malnutrition, one thinks of low weight," Golden said. To learn whether low-weight anorexic patients actually fare worse in clinic, Golden and his colleagues organized the largest, most comprehensive assessment of normal-weight adolescents with anorexia to date.

The study compared 50 teens and young adults with atypical anorexia with 66 patients who met the traditional diagnostic criteria, meaning their weight fell below 85% of what would be expected for their height and age. The participants ranged in age from 12 to 24 years old and received treatment for their disorders during the study. More than 90% of participants were female. (Anorexia is about 3 times more common in females compared with males, according to the National Eating Disorders Association (NEDA).)

The authors compared the patients' current weights, histories of weight loss and vital signs; and found that regardless of participants' weight at admission, those with more dramatic weight losses appeared more severely ill.

Patients who lost a large amount of weight, fast, displayed the lowest heart rates among those in the study. In fact, for every 2% increase in the rate of weight loss per month, patients' heart rates measured 1 beat per minute slower in the hospital. A dangerously low heart rate points to a larger problem: poor nutrition leaves the heart with too little fuel to pump properly while also forcing the body to break down heart tissue for much-needed energy, according to NEDA. Clinicians usually hospitalize patients whose heart rates clock below 50 beats per minute, as their condition can quickly deteriorate into complete heart failure, Cottrill said.

Related: What Is Mental Health?

Patients with atypical and typical anorexia showed similar dips in other critical measures of health. Both groups had dangerously low blood pressure and became dizzy when moving from lying down to sitting up or standing. Both groups showed deficiencies in key electrolytes such as potassium, phosphorus and magnesium nutrients that help vital organs like the heart running smoothly. The patients who lost the most weight, or had been losing weight for an extended period, had the lowest electrolyte levels.

All female patients who had begun menstruating stopped having regular periods, meaning their bodies were no longer producing enough estrogen to maintain their normal cycles. Without estrogen, the growing patients' bones could not absorb calcium as they should during puberty, Cottrill said.

Overall, both groups of patients appeared similar on all counts except one. Those with atypical anorexia actually ranked worse on a questionnaire designed to measure the severity of their eating disorder psychopathology. The poor scores suggest that those with atypical anorexia may be more fixated on losing weight, restricting their food intake and burning off calories than those with typical anorexia. Anecdotally, the patients seemed "very fearful of getting back to their [original] weight," Golden said.

Future research should investigate the best treatment for cases of atypical anorexia, particularly cases in which patients are overweight or obese, since very little data exists in this area, Cottrill said. Weight gain normally comes along with both the physical and psychological treatment of anorexia, but with overweight patients, it's difficult to gauge how much weight they need to regain. More research must be done on how different bodies react to malnutrition and how best to treat patients of different sizes, Cottrill said.

In addition, when treating obesity, doctors must learn how to help people lose weight sustainably, without resorting to drastic measures, Golden said. By monitoring patients more closely, perhaps physicians can catch poor habits before they fester into a full-fledged eating disorder, he suggested. The first step, of course, is to raise awareness of what disordered eating looks like.

"I think there's a lack of awareness of atypical anorexia nervosa, even among clinicians," said Dr. Avinash Boddapati, a child and adolescent psychiatrist in the Northwell Health network, who was not involved with the study. As a psychiatrist, Boddapati said he can address the underlying emotional distress and harmful coping mechanisms that lead to disordered eating. But to tackle the problem head-on, pediatricians and parental guardians need to work together to monitor signs of atypical anorexia.

"The big take home message is to focus, not just on the weight, but on the rate of weight loss," he said.

Psychiatrists can also screen for rapid and extensive weight loss in their patients, "even kids [who fall] within a normal weight range," said Dr. Peng Pang, an adolescent psychiatrist at Staten Island University Hospital in New York. First, mental health professionals should ensure that their patients are physically stable, and refer them to a hospital if their health may be compromised, said Pang, who wasn't involved with the study. Then, once the patient's vital signs are restored, psychiatrists can work with patients to find new, sustainable coping mechanisms.

"Regardless of the body weight, I think the message is that you have to intervene, immediately and aggressively," Pang said.

Originally published on Live Science.

Read more here:
Teens with Anorexia May Be 'Dangerously Ill' Even if They Are Not Underweight - Livescience.com

Addison disease occurs due to the injury of the adrenal cortex which causes insufficient generation of the hormone aldosterone and cortisol.Indications of Addisons disease are known as primary adrenal insufficiency, resulting from insufficient production of two hormones cortisol and aldosterone.

Access Report Details at: https://www.themarketreports.com/report/global-addison-disease-testing-market-by-manufacturers-regions-type-and-application-forecast

Market share of global Addison Disease Testing industry is dominate by companies like NHS.UK, Mayo Clinic, VCA Animal Hospital, NIDDK, Cleveland Clinic, WebMD, BMJ Best Practice, National Organization for Rare Disorders, Core Diagnostics Private Limited, Laboratory Corporation of America Holdings, Sonora Quest Laboratories and others which are profiled in this report as well in terms of Sales, Price, Revenue, Gross Margin and Market Share (2017-2018).

With the help of 15 chapters spread over 100 pages this report describe Addison Disease Testing Introduction, product scope, market overview, market opportunities, market risk, and market driving force. Later it provide top manufacturers sales, revenue, and price of Addison Disease Testing, in 2017 and 2018 followed by regional and country wise analysis of sales, revenue and market share. Added to above, the important forecasting information by regions, type and application, with sales and revenue from 2019 to 2024 is provided in this research report. At last information about Addison Disease Testing sales channel, distributors, traders, dealers, and research findings completes the global Addison Disease Testing market research report.

Market Segment by Regions, regional analysis covers:

North America (USA, Canada and Mexico)

Europe (Germany, France, UK, Russia and Italy)

Asia-Pacific (China, Japan, Korea, India and Southeast Asia)

South America (Brazil, Argentina, Columbia, etc.)

Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

Market Segment by Type, covers:

Laboratory testing

Imaging studies

Market Segment by Applications, can be divided into

Clinics

Hospitals

Diagnostics laboratories

Purchase this premium research report at: https://www.themarketreports.com/report/buy-now/1499860

Table of Contents

1 Market Overview

2 Manufacturers Profiles

3 Global Addison Disease Testing Market Competitions, by Manufacturer

4 Global Addison Disease Testing Market Analysis by Regions

5 North America Addison Disease Testing by Countries

6 Europe Addison Disease Testing by Countries

7 Asia-Pacific Addison Disease Testing by Countries

8 South America Addison Disease Testing by Countries

9 Middle East and Africa Addison Disease Testing by Countries

10 Global Addison Disease Testing Market Segment by Type

11 Global Addison Disease Testing Market Segment by Application

12 Addison Disease Testing Market Forecast (2019-2024)

13 Sales Channel, Distributors, Traders and Dealers

14 Research Findings and Conclusion

15 Appendix

Ask your report related queries at: https://www.themarketreports.com/report/ask-your-query/1499860

More:
Global Addison Disease Testing Market Forecast to 2024 by Types, Application and by Regions - Market Research Newspaper

LOS ANGELES: Wellness brand HUM Nutrition, the leader in the beauty vitamin and supplement category, launches its latest revolutionary product, MIGHTY NIGHT, to boost skin cell renewal during sleep.

Mighty Night uses clean, clinically proven ingredients in effective dosages that work while you sleep resulting in a fresh complexion each morning. The proprietary formula boosts overnight renewal by supporting skin cell turnover, scavenging free radicals, promoting optimal sleep and improving skin texture.

During sleep, the body produces more collagen and melatonin both known to reduce fine lines and wrinkles. Levels of the stress hormone cortisol fall during sleep, which helps skin to repair daytime damage. And, the human growth hormone, responsible for accelerating skin's repair and cell regeneration, is released during sleep.

Mighty Night ingredients include Ubiquinol, the most absorbable form of CoQ10 which protects the skin cell's membrane and supports overall renewal; Ceramides to lock in moisture and boost elasticity; Ferulic Acid proven to scavenge free radicals; and, a clinically studied combination of Valerian Root, Hops and Passion Flower that helps to promote optimal sleep.

Sleep is when your skin repairs itself, grows new cells and fortifies against moisture loss and free radical damage. Valerian Root and Hops are two herbs I recommend for better sleep quality, which is critical for overnight recovery, says Dr. Breus PHD, aka The Sleep Doctor.

Dermatologist Dr. Julie Russak of the Russak Dermatology Clinic in New York says Ferulic acid and ceramides offer skin benefits while you sleep by improving the protective barrier of skin and strengthening it. When our skin barrier is at its optimal state, we appear healthier. HUM's Mighty Night is a responsibly sourced, multi-beneficial supplement I trust and recommend to my patients.

Mighty Night is available at http://www.humnutrition.com and http://www.sephora.com beginning October 18th. It retails for $40 for a 30-day supply (60 capsules) and is vegan, vegetarian, Non-GMO, gluten-free and sustainably sourced.

Take 2 at bedtime and expect results in 4 to 6 weeks.Here's to a peaceful beauty rest, Sleeping Beauty.

Read more here:
HUM Nutrition Launches Mighty Night to optimize beauty sleep from within, United States News#244481 - New Kerala

The Fulton County Health Department has scheduled the following health clinics and services.

CANTON The Fulton County Health Department has scheduled the following health clinics and services. Please call the number listed with each service for an appointment or more information.

All offices of the Fulton County Health Department will be closed Monday, Nov. 11, 2019 in observance of Veterans Day.

Maternal child health: Health screenings, WIC nutrition education and supplemental food coupons for women, infants and children. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria clinic appointments call 329-2922.

Canton - WIC Nutrition Education - Tuesday, Nov. 12 - 8-4 - Appt needed

Astoria - Clinic, WIC Nutrition Educ. - Wednesday, Nov. 13 - 9-3 - Appt needed

Canton - Clinic - Thursday, Nov. 14 - 8-4 - Appt needed

Adult Health Immunizations: Various vaccines are available. There is a fee for immunization administration. Medicaid cards are accepted. To make an appointment or for more information call 647-1134 (ext. 254).

Canton - Immunizations - Tuesday, Nov 5 - 4-7 - Appt needed

Canton - Immunizations - Wednesday, Nov 6 - 8-4 - Appt needed

Other times available by special arrangement at Canton, Cuba and Astoria.

Blood Lead Screening: Blood lead screenings are available for children ages one to six years. A fee is based on income. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria appointments call 329-2922.

Family Planning: Confidential family planning services are available by appointment at the Canton office for families and males of child-bearing age. Services provided include physical exams, pap smears, sexually transmitted disease testing, contraceptive methods, pregnancy testing, education and counseling. Services are available to individuals of all income levels. Fees are based on a sliding fee scale with services provided at no charge to many clients. Medicaid and many insurances are accepted. After hours appointments are available. To make an appointment or for more information call the 647-1134 (ext. 244). *Program funding includes a grant from the US DHHS Title X.

Pregnancy testing: Confidential urine pregnancy testing is available at the Canton and Astoria offices. This service is available to females of all income levels. A nominal fee is charged. No appointment is needed. A first morning urine specimen should be collected for optimal testing and brought to the health department. Services are provided on a walk-in basis on the following days each week:

Canton: Every Wednesday & Thursday, 8-3:30 (for more information call 647-1134 ext. 244)

Astoria: Every Wednesday, 9-2:30 (for more information call 329-2922)

Womens Health: A womens clinic for pap tests, clinical breast examinations and vaginal examinations is available by appointment. There is a nominal fee for this service. Medicaid cards are accepted. Financial assistance is available for a mammogram. Cardiovascular screenings may be available to age and income eligible women. To make an appointment or for more information call 647-1134 (ext. 244).

Mammograms: Age and income eligible women may receive mammograms at no charge. Speakers are available to provide information to clubs and organizations. For more information or to apply for financial assistance, call 647-1134 (ext. 254).

Mens Health: Prostate specific antigen (PSA) blood tests are available for men for a fee. To make an appointment or for more information call 647-1134 (ext. 224).

Sexually Transmitted Disease (STD) Clinic: Confidential STD and HIV testing services are available by appointment to males and females at the Canton office. Services include physical exams to identify STDs, a variety of STD testing, HIV testing, education, counseling, medications and condoms. There is a nominal fee for services. Services are available to individuals of all income levels. Medicaid cards are accepted. To make an appointment or for more information call 746-1134 (ext. 224).

HIV Testing and Counseling: Confidential HIV testing and counseling services are available by appointment through the sexually transmitted disease (STD) clinic at the Canton office. To make an appointment or for more information call 647-1134 (ext. 224).

Tuberculosis (TB) Testing: TB skin tests are available at no charge by appointment. To make an appointment or for more information call 647-1134 (ext. 254).

Blood Pressure Screenings: The Fulton County Health Department provides blood pressure screenings at no charge on a walk-in basis during the following times:

Astoria - Screening - Wednesday, Nov. 13 - 9-12 - Walk in

Health Watch Wellness Program: The Health Watch Program provides low cost lab services. Through this program adults can obtain venous blood draws for a variety of blood tests. Blood tests offered without a doctors order Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), Lipid Panel, Prostate Specific Antigen (PSA) test, Hepatitis C test, and Thyroid Stimulating Hormone (TSH). A wide variety of blood tests are also available with a doctors order. There is a charge at the time of service. To make an appointment or for more information call 647-1134 (ext. 254).

Dental Services: The Dental Center offers a variety of basic dental services to children and adults. An appointment is needed. Medicaid and Kid Care cards are accepted. To make an appointment or for more information call 647-1134 (ext. 292).

See the original post here:
Health Department announces services for the week of Nov 11 - Canton Daily Ledger

(Picture Credit: JOHANNES EISELE/AFP via Getty Images)

Its no surprise that dogs can soothe us when we feel troubled. But research shows bonding with dogs has positive benefits even on a biological level.

Dogs elevate levels of the hormone oxytocin in our bodies, which promotes feelings of trust and well being. Oxytocin also heightens our ability to interpret facial expressions, helps us overcome paranoia, and has positive effects on our social interactions.

These benefits are, in many ways, directly opposite of many of the symptoms returning military veterans experience when they suffer from PTSD.A pet is a medication without side effects that has so many benefits, saysMayo Clinic oncologist Dr. Edward Creagan.

Symptoms of post-traumatic stress disorder, commonly known as PTSD, can appear right away or take years to surface.

Returning soldiers often experience it because they faced danger to their lives or the lives of their fellow soldiers, and they had no control over the situation. They witnessed injuries or death, or they themselves also suffered physical harm.

The shell shock and combat stress symptoms common among those suffering from PTSD are varied; however, many experience suicidal thoughts, recurring memories and nightmares, sleeplessness, a loss of interest in life or feeling numb, anger, irritation, and fear. PTSD can thus impact their everyday life.

A trained PTSD service dog can provide a sense of security and have a calming effect on veterans, help with episodes of depression, anxiety, and PTSD, and they can also be loving companions.

These dogs can sense mood and will know when its a difficult day. Additionally, organizations train them to respond to PTSD episodes and help bring their humans back to a relaxed state.

Furthermore, they give companionship without judgment, bringing joy into lives as they help heal emotional wounds.

As a wonderful bonus, its often a new lease on life for the dogs, as well.

Many service dogs trained to help those suffering from PTSD have been on a difficult journey of their own and are rescues who were mistreated or abandoned, living in shelters.

Organizations train these dogs to alert veterans to potential PTSD triggers and to help them ease their anxieties. Its a win-win situation when a dog is rescued and gains a secure home and purpose, and the veteran gets a companion to help diminish the emotionally destructive feeling of isolation.

If you are a veteran or know one who could benefit from a trained service dog, there are dozens of organizations who can help.

DogTime interviewed K9s For Warriors, an organization that trains service dogs and provides them to veterans free of charge.

Here are a few other organizations that can help veterans find companion animals and service dogs:

As we approach Veterans Day and honor those whove valiantly served and sacrificed for our country, its also a good time to spread the word about the many organizations and non-profits that it possible for veterans with PTSD to be matched with canine companions.

There are many fabulous organizations in cities and towns throughout the countrydedicated to helping returning military rebuild their lives with help from an assistance dog.

Additionally, more information and PTSD resources are available through the US Department of Veterans Affairs website.

You can also help by reaching out to these organizations, donating and volunteering. They need lots of help, and most have a variety of volunteer positions available. Its a beautiful way to show your gratitude to those whove served.

Do you think dogs can help veterans with PTSD return to civilian life? Let us know in the comments below!

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Dogs Help Veterans With PTSD Heal And Live Their Lives, And You Can Help, Too! - DogTime

When youre ready for an intrauterine device, or IUD, it can feel like an exciting and empowering contraceptive commitment, right? But while youre dreaming of your new life with an IUD (hello, whole entire years of pregnancy prevention), you also have at least one other major choice to make: copper vs. hormonal IUD.

IUDs are small devices inserted into your uterus, and theyre one of the most reliable forms of long-lasting birth control available. And there are two very different kinds. You could opt for a hormonal IUD like Mirena, Skyla, Liletta, or Kyleena, which all use progestin to thin your uterine lining and thicken your cervical mucus so its more difficult for sperm to reach an egg. Or you could go with the copper IUD, manufactured under the name Paragard, instead, which seems a little more mysterious than other forms of birth control. Heres what you need to know about the copper IUD.

It sounds like magic, but its just science. So, how does the copper IUD work, exactly? Paragard is a plastic, T-shaped device that, like other IUDs, fits snugly inside your uterus. The difference is that while hormonal IUDs emit progestin, Paragard has copper wire coiled around it. That copper produces an inflammatory reaction that interferes with sperm movement, thus preventing pregnancy, according to the Mayo Clinic. You can think of it kind of like a long-lasting spermicide, Brett Worly, M.D., an ob/gyn at the Ohio State University Wexner Medical Center, tells SELF.

In terms of longevity, the copper IUD is the epitome of this set it and forget it form of birth control, offering a full decade of pregnancy protection.

By comparison, hormonal IUDs Mirena and Kyleena are recommended for up to five years, Liletta is also recommended for up to five years, and Skyla is recommended for up to three years.

The copper IUD is over 99 percent effective at preventing pregnancy. A 2017 literature review published in Perspectives on Sexual and Reproductive Health looked at birth control failure rates between 2006-2010 and found that IUDs, both hormonal and non-hormonal, have the lowest failure rate of all contraceptive methods. Additionally, earlier research from 2011 shows that the copper IUD fails (meaning people get pregnant while using it) just 0.8 percent of the time. That boils down to fewer than one out of 100 women getting pregnant in the first year of using the copper IUD, which is a pretty excellent success rate.

It makes sense when you think about it. Unlike birth control methods like the pill, you dont actually have to do anything with your copper IUD besides getting it inserted (and then removed when you should), so the opportunities for user error go way down.

When it comes to birth control, only internal and external condoms can prevent the spread of sexually transmitted infections. So, if youre using the copper IUD and are at risk for STIs (like if you have partners whose STI status you dont know), youll still need to use some form of protection like condoms or dental dams. You should also get tested regularly. In fact, the CDC has recommendations for your STI screening schedule depending on your circumstances.

Depending on your insurance provider, the out-of-pocket copper IUD costs can be up to $1,300, which includes the fees for the device itself and any costs associated with insertion (like that of your visit).

Luckily, many insurance companies currently cover these costs in full, though that may change in the future. Call your insurer or discuss the potential costs with your doctors office to be sure.

Some people arent the best candidates for the copper IUD. Those include people who have uterine issues, like large fibroids, that might affect the IUDs placement. Having an infection like pelvic inflammatory disease (a condition in which sexually transmitted bacteria infects the reproductive organs) is also a contraindication, as is abnormal vaginal bleeding that hasnt been diagnosed, along with a few other issues. If you have concerns about how the copper IUD might work with your existing medical condition, be honest about it with your doctor. Theyll either be able to reassure you that it should be just fine or help you find a different birth control method that makes more sense for your situation.

During your IUD insertion, your medical practitioner will insert a speculum into your vagina, clean your vagina and cervix, then place the IUD, according to the Mayo Clinic. They do this by putting the device into an applicator tube, pushing the tube into your vagina and through your cervix, then releasing the IUD into your uterus. Once the IUD is in there, its wings will extend so it can assume its T shape, and it will start its pregnancy-preventing ways. Like all IUDs, the copper version has little fishing wire-esque strings that hang down through your cervix.

People can experience a wide range of sensations during IUD insertion. Some have described the process as [a] few seconds of discomfort, others like sharp, intense, nausea-inducing pain. You can ask your doctor about which pain medication they recommend taking before and after the procedure, since you may experience some residual cramping. Your provider may also be able to offer medications to help your cervix open or to try to numb it instead, although getting those drugs doesnt necessarily mean youll completely bypass any pain or discomfort.

The removal process simply involves your medical practitioner grasping onto your IUDs strings with forceps, then pulling out the device. As the IUD leaves your body, its arms will fold in. You might experience some light bleeding and cramping during this process and afterward, according to the Mayo Clinic. Once the IUD is out, your fertility should get back to normal pretty much immediately, so if youre not ready to get pregnant, youll either need a new IUD or another form of birth control.

So, lets talk about possible copper IUD side effects. The copper IUD might increase your period pain and bleeding or cause bleeding between periods, the American College of Obstetricians and Gynecologists (ACOG) says. Thats why its not recommended for people with conditions like endometriosis that can already cause heavy and painful periods, Taraneh Shirazian, M.D., assistant professor in the department of obstetrics and gynecology at NYU Langone Medical Center, tells SELF.

Some methods of birth control only seem to make your period worse because theyre not improving it, but the copper IUD can actually drive up bleeding and pain in some people. This is because of the local inflammation it causes in your uterus, Dr. Shirazian says, which can lead to extra irritation and blood.

Everyone is different, and if you experience this copper IUD side effect, its hard to predict how long it will last. The good news is that for many people, this issue goes away or at least decreases after using the IUD for a year, ACOG says. If youre at all concerned about how your period might change with the copper IUD, this is definitely something to bring up with your doctor.

Since the copper IUD doesnt contain hormones, you can use it in situations where other kinds of birth control may not be a fit. For instance, it might be a good choice for [breastfeeding people], Dr. Shirazian says. This is because theres a slight chance that estrogen, which is in forms of combined hormonal birth control like the pill, patch, and ring, may impact your milk supply, according to the ACOG.

Due to its lack of estrogen, the copper IUD may also offer an advantage for some people who have health conditions that can get worse when exposed to this hormone, such as people with a history of blood clots, or high blood pressure (estrogen can raise it further), Dr. Shirazian says.

If youre not able to tolerate hormones for some reason, definitely mention that to your doctor when trying to find which type of IUD is right for you.

Usually your partner cannot feel the strings, Dr. Worly says. That doesnt mean this cant happen, though. Its also worth mentioning that, if your partner can feel your strings or they appear longer than usual, this could be a sign that your IUD has moved and needs to be adjusted, according to the Mayo Clinic. If your IUD is firmly in place, you can also talk to your medical practitioner about trimming the strings, Dr. Worly says.

IUDs come with a small risk of expulsion, which is when your body starts to push the IUD out of you. There isnt a ton of research on this out there, but the average expulsion incidence rate is between 2 to 10 percent of users, ACOG says. Risk factors include recently having had the IUD inserted, getting it placed right after childbirth, and history of heavy or prolonged periods, among others. Though you dont really need to stress about this possibility, if it were to happen to you, you might experience symptoms like bleeding and cramping, feel something hard coming from your cervix, or see the IUD somewhere outside of your body; however, it is possible to experience an expulsion without any major symptoms.

IUDs can also cause perforation, which is when the device pushes through the wall of your uterus. It sounds alarming, but again, the risk is really low. According to a 2015 study published in the journal Conception, out of 61,448 people who had an IUD, only 20 with the copper form experienced a perforation. In fact, perforation most often happens due to an error during placement. Much like with expulsion, this isnt something that needs to keep you up at night, but if you were dealing with perforation, you would potentially experience pelvic pain (which can be a symptom of a ton of things), though you might not experience any major symptoms at all.

If you can feel your strings protruding from your cervix, thats a pretty clear sign your IUD is where it should be. But if you cant, its not a reason to immediately assume youre dealing with an IUD complication like perforation or expulsion. Over time, the strings often soften and curl up around your cervix, so you might not be able to feel them. (This is another reason why your IUD may be a non-issue during sex.

Even if your ob/gyn doesnt see the strings when youre looking to remove your IUD, they can use tools like an ultrasound to find the device, so theyre able to take it out.

Many people dont realize this, but the copper IUD is an effective form of emergency contraception as long as its inserted within five days after unprotected sex, according to ACOG. A 2012 meta-analysis of published in the journal Human Reproduction looked at 42 studies and found that the copper IUD had a pregnancy rate of only 0.09 percent when it was used as a form of emergency contraception.

The copper IUD causes inflammation in the uterine lining and may prevent implantation of the developing embryo, Dr. Worly explains.

Of course, this isnt necessarily the most convenient form of emergency contraception. If you werent planning on getting an IUD, pill-based forms may make more sense for you depending on how easily youre able to access them vs. an intrauterine device.

It might feel like theres a lot of information to take in about the copper IUD, not to mention all the other [birth control](https://www.self.com/topic/birth-control options at your disposal. If your head is spinning, you dont have to go it alonethats what doctors are for. Or, if you have nary a question and are just really excited to get that thing in there, well, thats what doctors are for, too.

Related:

Originally Appeared on Self

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13 Things You Absolutely Should Know Before Getting the Paragard Copper IUD - Yahoo Lifestyle

Cleveland Browns safety Jermaine Whitehead, quickly realizing that keeping it real isnt actually applicable in the real world, was released from the team after, among other things, threatening to kill multiple Twitter users after the Browns loss to the Denver Broncos on Sunday. Comedian Tiffany Haddish, bringing an entirely new meaning to streaky shooter, said she once defecated in her boyfriends new Air Jordan shoes after the boyfriend allegedly cheated on Haddish on her birthday. Los Angeles Lakers forward Anthony Davis, who is as likely to leave Hollywood for Chicago as Kim Kardashian-West, said there is a possibility he could sign with his hometown Chicago Bulls this offseason after just one season with the Lakers. Miami Heat forward Jimmy Butler, creating a straw man out of a Texas Straw Hat, said he felt disrespected by the initial reaction to his free agency signing this summer because Mfs act like Im not a good basketball player.

The NBA, hoping fans will fiend so much for an Indiana Pacers-Toronto Raptors opening round playoff series that theyll be willing to pay extra for it, announced an over-the-top streaming subscription for the NBA TV television channel. Atlanta Hawks center John Collins, needing the extra room in his stomach for all the Gladys Knights Chicken & Waffles and Chick-fil-A in Atlanta, was suspended 25 games for testing positive for Growth Hormone Releasing Peptide-2 (GHRP-2), a growth hormone that possibly increases food appetite. Jacksonville Jaguars quarterback Gardner Minshew, who, no doubt in his mind, wouldve won the Super Bowl this season had head coach Doug Marrone kept him as the starter, was replaced by former starter Nick Foles after Foles missed the last eight games. A Washington-area brewery, hoping to get Washington Redskins fans as disoriented as a Gus Frerotte headbutt, is offering a new Sell the Team IPA in reference to Redskins owner Dan Snyder that contains 9.5 percent alcohol by volume.

Weekly water cooler fodder: The Week That Was NewsletterSubscribe

Southern Universitys Dancing Dolls: 50 years of grace, style and beautyRead nowA fear of flying wont stop Isaiah Stewarts dad from showing supportRead nowLike it or not, the Nationals knew what they were in for at the White HouseRead now

Cleveland Browns quarterback Baker Mayfield, who, using this logic, should be as hairless as a competitive swimmer based on how hes played all season, said he shaved off his handlebar mustache immediately following the teams 24-19 loss to the Denver Broncos on Sunday because I didnt deserve it. Chicago Bears quarterback Mitchell Trubisky, like if O.J. Simpson complained about a minimum speed limit being implemented on Southern California highways, said he wants the televisions turned off at the teams headquarters because youve got too many people talking on TV about us and what they think about us what we should do, what we are and what were not. The University of Alabama student government, backpedaling faster than a Crimson Tide defensive back in zone coverage, quickly reversed its warning to student groups that they would risk forfeiture of future home games if the groups demonstrated against President Donald Trump at Saturdays home game against LSU, releasing a statement clarifying that the government body strongly affirms its belief in free speech and the rights of all students to express their opinions.

Multiple NFL teams are reportedly interested in signing free-agent receiver Antonio Brown pending a resolution to the leagues investigation into accusations of Brown sexually assaulting multiple women, though the teams may become less interested if Brown expresses a desire to not stand for the national anthem. Georgia and Ohio State, which will need the financial windfall from this matchup for when they inevitably have to pay their players, scheduled a home-and-home football series for 2030 and 2031. Brown, the first black person in the history of America to actually play the race card, tweeted f the nfl, would never play for the league and accused it of treating black people the worse mere hours after it was reported the league would meet with Brown next week.

Illustrations by Nathan Gelgud.

Martenzie is an associate editor for The Undefeated. His favorite cinematic moment is when Django said "Y'all want to see somethin?"

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Antonio Brown said he will never play in the NFL again and other news of the week - The Undefeated

(Pregnancy Help News)Ivette had just taken the first dose of the chemical abortion pill protocol when she began to feel the pangs of regret. Sitting in the abortion facility, she felt emotion wash over her.

I knew it was wrong, and as soon and the doctor walked out, I started crying. I asked my boyfriend, Why are we doing this? and he just hugged me, she wrote in a reflection sent to Heartbeat International several months later.

The abortion facility hadnt let Ivette see her unborn baby on the ultrasound screen, but they estimated her child to be about four weeks old. Just a day before, the couple had believed abortion was their only way forward. With an almost-two-year-old daughter at home, they didnt believe that bringing another child into the world was financially feasible.

That belief was about to be challenged in a major way.

On the drive back home from the abortion facility, the full force of Ivettes regret came rushing through her.

I started arguing with my boyfriend, asking him why he had convinced me to do it. That I didnt want to, that I hated him, she wrote. And he was just looking at me, and I was crying and crying.

Struck by her words, her boyfriend pulled the car over.

He started telling me I was right, that he was dumb for even talking me into it, that we shouldve done the right thing, she recalled.

Thats when her boyfriend decided to take action. Grabbing his phone, he began searching the internet for a way to save their unborn baby. He came across Abortion Pill Rescue, a 24/7 helpline (877-558-0333) backed by a network of 800 medical professionals offering Abortion Pill Reversal.

Otherwise known as the abortion pill or RU-486, chemical abortions typically involve two drugs: mifepristone and misoprostol. Mifepristone, the first drug, destabilizes a pregnancy by blocking progesterone, the natural hormone needed to sustain a healthy pregnancy. To finish the abortion, misoprostol induces labor, forcing a womans body to deliver the baby.

The reversal protocol, which was developed by physicians George Delgado and Matt Harrison more than a decade ago, works by giving a woman extra progesterone up to 72 hours after she takes the first chemical abortion drug.

READ:Abortion pill reversal uses the same hormone used to halt miscarriages, so why do some oppose it?

Now operated by Heartbeat International, the Abortion Pill Rescue Network (APRN) has saved more than 900 babies to date.

Women who are facing the immediate regret of abortion call the APRN helpline every day seeking hope and options, said Christa Brown, director of Medical Impact for Heartbeat International. They dont give up the right to other choices when they seek an abortion and we are here to help.

For Brown, a womans courage to call the helpline and try to rescue her baby is nothing short of heroic.

One of APRNs main goals is to help ensure that women like Ivette have the opportunity to choose life for their children every step of the way, she said. We are so thankful for the courage and strength of our clients who choose life often under many pressures to continue the abortion. All of our 900 moms are true heroes.

Despite whatever glimmer of hope the helpline offered, Ivette was convinced it was too late for their baby.

I told (my boyfriend), Hang up. This is ridiculous. Theres nothing we can do. What is done is done, and took away his phone as we drove back home, she wrote. I felt sad. I felt mad. I hated myself. I couldnt stop thinking about my daughter I already had and what a beautiful blessing she was coming into our lives.

Tears overwhelmed Ivette for the rest of the day. She could hardly sleep that night. Early the next morning, she searched the internet once more for the Abortion Pill Rescue number.

A really nice nurse answered, Ivette wrote. I will never forget her. She started asking me questions and told me we were still in time to reverse the abortion.

The nurse connected Ivette to a local doctor who provides the Abortion Pill Reversal protocol and advised her not to take the rest of the chemical abortion regimen. The doctors office set Ivette up with an appointment immediately. Together, she and her boyfriend drove 45 minutes to the pro-life clinic.

I felt so much peace as I entered his clinic, Ivette wrote. It had a really big Virgin Mary and a little place for people to pray. I felt hope.

While waiting to be seen, she slipped into the bathroom. Her hope faltered as she saw how much she was bleeding.

I was bleeding so much, and I said to myself, Im losing the baby, she wrote.

But the doctor was still willing to fight for her and her unborn baby. He administered progesterone to her and prescribed more for her to take over the course of the next two weeks when she was to return to the clinic for a follow-up appointment.

READ:To date, Abortion Pill Reversal has helped save over 900 babies from abortion

Ivettes worries werent gone just yet. The same day she began the reversal treatment, she received a dire voicemail from the abortion facility she had visited. The staff reminded her to take the other four chemical abortion pills the facility had given her and warned that if she continued the pregnancy, her baby would be born with birth defects.

Once more, Ivette turned to the kind nurse from the Abortion Pill Rescue helpline for guidance. Using the research performed by physician George Delgado, the nurse assured her that her baby was at no greater risk of being born with a defect than any other baby.

As the days passed by, Ivette continued to bleed heavily. Nevertheless, she continued to take the progesterone, and after two weeks, she returned to the pro-life clinic.

Ivette nervously watched the screen as the doctor performed the ultrasound. Then, he gave her the news she was longing to hear.

He told me, Theres a heartbeat!!! she said. And there it was on the screen, a little flickering. We couldnt believe it. I looked over at my boyfriend as he smiled and said, We did the right thing.

Ivette continued to take progesterone for the rest of the first trimester. Then, late last year, she met the tiny baby she and her boyfriend rescued all those months ago.

I delivered my baby boy by c-section, and let me tell you, he is the cutest little guy, she wrote. I couldnt imagine my life without my daughter and my son. I love them so much and I know we did the right thing. Thank you, Abortion Pill Reversal, for this second chance.

Editors Note: This article was published at Pregnancy Help News and is reprinted here with permission.

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Parents choose abortion pill reversal, rescue baby: 'I know we did the right thing' - Live Action News

While patients still have to work hard to change their lifestyles, without the constant hormonally-induced cravings for food, attaining and sustaining substantial weight loss becomes a great deal easier.

LOS ANGELES (PRWEB) November 06, 2019

An October 21 article on Yahoo Lifestyle reported on a New York woman who was able to lose 185 pounds through weight loss surgery and who has been able to maintain that loss since 2005. The woman spoke about her past struggle with severe obesity, from experiencing knee pain when she walked to being too large to wear the dress shed always hoped to wear on her wedding day. Fourteen years later and several dress sizes smaller, the article reports that she is finally able to wear a dream dress as she prepares to renew her vows with her husband. Los Angeles-based weight loss surgery specialists Dr. Feiz & Associates notes that bariatric surgery is making these kinds of stories a great deal more common.

Dr. Feiz & Associates comments that, for those struggling with obesity, losing the weight is very hard but thats not the only problem. Its keeping the weight off and maintaining the new weight that is typically even far more challenging. The clinic explains that, while it is sometimes possible to slim down naturally through diet, exercise and strong self-discipline, success is short-lived in the large majority of cases. The clinic says that the body is wired to fight anything it deems a potential threat, including substantial weight loss which it takes as a sign of imminent famine. So, production of the hormone responsible for the nagging feelings of hunger that make weight loss so difficult already present in larger amounts in overweight and obese people goes into overdrive. Plagued by ever-increasing cravings which feel exactly like hunger, the clinic says that its no wonder why the vast majority of people who attempt to defeat obesity on their own eventually backslide and regain all of the weight that they have worked so to get rid of sometimes with a few extra pounds attached.

What a weight loss procedure such as a sleeve gastrectomy does is reduce the size of the stomach, says Dr. Feiz & Associates. By removing a significant portion of the stomach, individuals are discouraged from overeating as it becomes uncomfortable, decreasing their appetite but thats only part of the story. In the process of reducing the size of the stomach, production of the primary hormone associated with hunger, called ghrelin, is also reduced substantially. The clinic notes that patients still have to work hard to change their lifestyles but, without the constant hormonally-induced cravings for food, attaining and sustaining substantial weight loss becomes a great deal easier.

Interested readers who would like to know more about Dr. Feiz & Associates and weight loss offerings can call 310-855-8058 or visit the clinics website at https://www.drfeiz.com.

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Weight Loss Surgery and a Bride Who Can Finally Wear Her Dream Wedding Dress Highlight Long Term Benefits, says Dr. Feiz & Associates - PR Web