Wednesday, July 16, 2014

Don't Fall Off of a Flat Planet!

Just a quick update on previous posts before moving on.
I opted for mammographic screenings for an apples-to-apples comparison with previous results. I'm comfortable with the risk/benefit ratio at this time. At one year post-surgery, all appears well. I am grateful. Should a concern come up, spiral MRI is an appealing choice, but I see no need for it yet. As for menopausal symptoms, I'm still sizing up my options. Quality of life is at stake here.


There. I'd like to move on now, back to wider topics on these pages. Such as:

Don't Fall Off of a Flat Planet!

 One or two studies (which may or not be accurate), given adequate media attention, can alter health care in general for decades, not always in a positive way. In fact, let's look at several medical myths that have no doubt left many patients (and their care providers) with regrets that the data that they trusted in changed, but they didn't "get the memo" until it was too late:

1. Saturated fat (eggs, butter, etc) causes heart disease.
2. Cholesterol in the body is a killer and is raised by eating foods high in cholesterol.
3. Artificial sweeteners are safe substitutes for sugar.
4. Grains should make up most of our diet.
5. Genetically engineered foods are safe and comparable to other foods.
6. Low-fat foods prevent heart disease.
7. The sun's rays are harmful.
8. Long periods of aerobic activity are healthy
9. Salt is bad for you.
10. All HRT is dangerous.

I haven't time to detail how science has now proven the error of every one of these statements (to differing degrees). Suffice it to say: science evolves, yet news of its evolution travels far, far too slowly.
The above statements have all been accepted as true for most persons most of the time or even all persons all of the time. And though science has discovered otherwise, these myths persist. And we suffer for it.


For example, let's take item 10.

The Women's Health Initiative (WHI) is a giant study done in the early 1990's. Information gained from it by 2002 or so caused us to suspect hormone replacement therapy of raising risk of certain diseases, including stroke and breast cancer. And at the time of the study, these concerns were valid, considering the compounds, form of delivery, and timing.

Back then, hormone therapy usually consisted of compounds which were like (but not enough like) hormones produced by the human body. They were administered orally and at intervals also unlike those of the human body. At that time, patients may have been well advised to stop their use.
But in the decade or so since, new hormone compounds have been developed which mimic human compounds much more closely. This has greatly reduced the elevated risk of breast cancer. Timing of delivery has also improved, and we are finding that because oral delivery of these medications is complicated by digestive functions, trans-dermal (through the skin) administration nearly eliminates elevated risks of stroke.

And one more thing worth mention: the patients studied in 1991 were not newly menopausal, active patients of normal body weight. The median was age 62, overweight, and sedentary (a good number even in nursing homes) already at elevated risk for disease. Studies since then have proven that when hrt is initiated within a certain window of time after menopause, safety is much, much better.

So it is clear that in 2014, hrt is nothing like it was in 1991. Health technology has advanced impressively across the board. Yet warnings and contraindications regarding hrt still abound. And a decade of women have missed out on solutions to their debilitating symptoms and possibly even prevention of disease for a longer, better life.There is an old saying that people "perish from lack of knowledge." -Never more true than here.
For those interested in study publications, one of the most comprehensive I've seen is this. It notes critical differences between P4 (progesterone) and synthetic progestins in breast cancer proliferation, and differences in oral and transdermal estrogen administration and differing risk of stroke and blood clotting.


Some people still eat margarine instead of butter, thinking it more safe. Some still avoid the sun like the plague, not just missing out on the benefits of its rays, but actually putting themselves at much higher risk of deadly diseases due to vitamin deficiencies that these rays could prevent. Some persons still trust in extended periods of aerobic activity for optimum health, unaware that this is not the optimum form of exercise, and may even be harmful to some in the long run (no pun). The world is not flat. But we need to know it!


We learn more every day. This is true in medical, political, and all other forms of science. As we learn, we need to be able to use this information as soon as possible. But our methods of getting the word out leave much to be desired. This is why we as patients must do the best we can to learn what we can for ourselves. Though they do their best (under sometimes dreadfully time-deficient circumstances) we mustn't trust others to do this critical work for us. Today, adequate information is available on almost any topic-instantaneously. The purpose of this message is that you avail yourself of it, and as a result, enjoy a much higher health level and quality of life. Search, learn, and then take what you've learned to your health providers. Draft a personal, individual health plan for yourself and thrive.
Blessings and health to you!