Posts Tagged ‘Murray Fox, MD’

When to go to the gynecologist for the first time is a question that women have been asking for years. Once upon a time the answer to this question was around 21. But because women are becoming sexually active at progressively younger ages this question does not have a definitive answer. According to the gynecologists that make up the Plano, Texas based Women’s Specialists of Plano, “The most important concept to remember is that once you become sexually active, at whatever age, it is important to begin receiving regular pap smears. A pap smear test is the only way to be sure that you are free of STDs, ovarian, cervical or uterine cancer, or any other issues or underlying conditions that may occur with the reproductive organs.”

Your first OB appt and first Pap smear test is a common fear for every young woman. Oftentimes, the fear and anxiety can be so great that young women will purposely put off making that very first appointment.  Most women are anxious about exposing their most intimate parts to a stranger and are also afraid that there may be an amount of pain associated with the checkup. Both of these fears are normal thoughts.

Drs. Murray Fox, Daryl Greebon, Jules Monier, Dennis Eisenberg and Jennifer Newton (Plano, Texas gynecologists) answered several questions for this Q and A designed to help you decide when the best time is to visit an OBGYN for the first time.

Q. First OB appt:  When should I go to the gynecologist for the first time?

A. You should see your gynecologist for the first time upon becoming sexually active. Other reasons to visits the gynecologist would be:

• Abnormal bleeding outside of your normal menstrual cycle
• Menstrual periods become longer
• Menstrual periods become heavier and more painful
• An overall change or disruption in your menstrual period
• Severe pelvic cramps outside of your normal menstrual cycle
• Infections such as a bacterial infection or yeast infection that would cause itching, redness, burning or unusual discharge

Q. At what age should I have my first pap smear test?

A. The recommended age for a woman to receive her first pap smear is at age 21. Keep in mind that this age applies to a woman who is not sexually active, and has had regular, similar periods since the beginning of her menstruation.

Q. Why is it important to get annual pap smears?

A. It is important to return to your gynecologist annually because there are complications that arise without symptoms. This means that something could be wrong with your reproductive organs though you have no symptoms and no reason to believe so. The early stages of ovarian and cervical cancer will cause your pap smear to test abnormally; through a routine pelvic exam which is usually also included in these annual appointments, such abnormalities as tumors and cysts can also be diagnosed. Annual pap smears and pelvic exams allow your doctor to catch specific conditions at early stages so that proper treatment can be implemented and fertility can remain healthy. In addition, your gynecologist will check your breasts for any abnormal lumps during each annual visit. This is important because most women do not begin receiving regular mammograms until they are in their forties. Your gynecologist may be able to help you detect breast cancer in its early stages at your annual.

Q. Does it hurt to have a pap smear?

A. No, pap smears do not hurt.  There will be a mild discomfort during the exam and for most women the first check-up will be uncomfortable. However, the majority of the discomfort is the result of the unknown. There should be no pain associated with your pap smear and all future visits will become easier each and every time.

Q. What does the gynecologist do during a pap smear?

A. Before the check-up a nurse will bring you a sheet and ask you to undress waist down. As your doctor comes into the room you will be asked to lie down and place your feet in stirrups which will keep your feet in place during the exam. Your doctor will then use a lubricated speculum to gently open your vagina. It is important to relax and take deep breaths during this part. The more relaxed you are the less uncomfortable you are likely to be. Your doctor will then use a long q-tip to swab the inside of your vagina. This swab is what is tested to determine if the cells are healthy, or abnormal. After your doctor swabs you using the speculum, the tool is removed and the exam will be finished.

Most women find that their anxiety about their first pap smear test disappears just as quickly as the actually procedure. But for some the anxiety returns every year when they go back for their annual. It is important to remember that your health should be rated much higher than your fear.

It is important to receive your checkup annually. But it is important to call your gynecologist sooner if:

• Your periods become irregular or cease
• Your periods become heavy
• You experience odor and/or discomfort
• If intercourse becomes painful
• If you think you may be pregnant

When the examination portion of your appointment is complete, your gynecologist will most likely meet with you and discuss a health follow-up with you and answer any questions you may have about such topics as birth control, etc. Finding the right OBGYN is just as important as going every year. Some women see the same doctor through their twenties, the birth of their children and into their mid-life years.  If the time is now for you to find and visit an OBGYN, ask around to friends and family for a solid recommendation and make the appointment sooner than later.

Women’s Specialists of Plano Drs. Dennis Eisenberg and Murray Fox Perform First Robotic Hysterectomy on New DaVinci Si Machine with 8mm Camera at Medical Center Plano

Dr. Dennis Eisenberg of Plano, Texas, a pioneer in the use of the robotic hysterectomy surgical technique, recently completed his first hysterectomy surgery at Medical Center Plano using the new DaVinci Si machine. Dr. Eisenberg was assisted on this procedure by fellow surgeon Dr. Murray Fox of Plano, TX.

Plano, TX, August 23, 2011 –(PR.com)– Dr. Dennis Eisenberg of Plano, Texas, a pioneer in the use of the robotic hysterectomy surgical technique, recently completed Medical Center Plano’s first hysterectomy surgery using the new DaVinci Si machine. Dr. Eisenberg was assisted on this surgery by fellow robotic surgeon Dr. Murray Fox.

The DaVinci Si machine has an 8mm camera, the smallest camera that has ever been used for a robotic hysterectomy. The benefit for patients of the smaller camera offered by the new machine at Medical Center Plano is that it requires a smaller incision. This makes robotic hysterectomies performed with DaVinci Si machine even less invasive than the procedure already is.

The Women’s Specialists of Plano (972.379.2416, http://obgynplano.com) specializes in pelvic floor dysfunction and vaginal prolapse. When Jean, a 74-year old resident of Plano, Texas, began having unusual and at times frightening symptoms during bowel movements, she decided to make an appointment with the Women’s Specialists of Plano.  “What should have been an everyday normal bodily function for anyone, created stress and anxiety for me because every time I attempted to take a bowel movement, I felt as if my internal organs were coming out—and in most cases, they were,” said Jean.

Jean’s OBGYN, Dr. Murray Fox, diagnosed her condition as pelvic floor dysfunction, or in her case, a vaginal prolapse. It is a common disorder seen by the entire group of doctors at WSOP including Drs. Jules Monier, Dennis Eisenberg, Daryl Greebon and Jennifer Newton.

Pelvic floor dysfunction is a condition in which the muscles that uphold the reproductive and digestive organs of a female weaken, and fail to work properly. The immediate result of this muscle failure is “falling of the female organs”, or, a sensation of pelvic pressure or an actual falling of the organs dropping through the vagina. Difficulty passing stools and urinary incontinence are the most common immediate symptoms eventually causing pain, and even more alarming symptoms such as what Jean was experiencing.  With the insertion of a vaginal pessary, Jean’s symptoms went away and she was able to resume life as normal.

During the early stages of pelvic floor dysfunction, it may be possible to re-strengthen the pelvic muscles through physical therapy and repair the damage before the dysfunction progresses. But due to the nature of the symptoms, it is commonly missed at an early stage, and the dysfunction becomes much worse.

When pelvic floor dysfunction is not treated properly or immediately it can cause problems of much larger proportions such as:

• Cystocele-The protrusion of the bladder into, and at times through the vagina.
• Rectocele-The protrusion of the rectum into, and at times through the vagina.
• Enterocele-The protrusion of the bowel into, and at times through the vagina.
• Urethrocele-The protrusion of the urethra into, and at times through the vagina.
• Vaginal Prolapse-The protrusion of the top of the vagina into the lower portion of the vagina completely inverting it. (This is most common in post-hysterectomy patients.)

Statistics suggest that 40% of women between 60-80 years of age will experience some degree of pelvic floor dysfunction or vaginal prolapse. At this age the dysfunction is the resort of multiple things including age, gravity, number of children, constipation, childbirth etc. However, it is important to note that 1 of every 3 women of 25 and up will suffer from the dysfunction as well. The most common causes being pregnancy, obesity, vaginal delivery, and menopause.

If you begin to notice symptoms that lead you to believe that you may be suffering from any degree of pelvic floor dysfunction, consult with your physician as soon as possible. Pelvic floor dysfunction is diagnosed through a series of testing. Your doctor will begin their testing with a careful study of your medical history, symptoms, and physically or emotionally traumatic experiences that could be contributing to the physical and emotional pain of this disorder. Specific tests will be administered to determine which muscles are not properly performing their job.

Pelvic floor dysfunction may be treated with specialized physical therapy known as biofeedback if the dysfunction is found at an early stage. With biofeedback, a person may be able to strengthen the pelvic floor muscles and remind the body to perform these tasks as it should. Approximately 75% of individuals with pelvic floor dysfunction experience significant improvement with biofeedback.

Many times, pelvic floor dysfunction patients and those suffering from vaginal prolapse will need corrective surgery.  Using a vaginal pessary or a mesh device is often effective for curing the problem. A vaginal pessary can be inserted into the vagina to support the prolapsed organs. Meshes to secure organs into place are also commonly used. Using sutures, a mesh is used to help keep the bladder, uterus or other pelvic organs secure.  Using a pessary or a mesh will commonly alleviate symptoms.

If you are experiencing unusual symptoms that you believe may be associated with pelvic floor dysfunction, consult with your doctor and learn about the treatment options that are available to help you with your specific situation.

An estimated 17 million women in the U.S. will cope with female bladder problems and urinary incontinence each year. According to the Women’s Specialists of Plano, TX, (972.379.2416, http://obgynplano.com), a large majority of these women do not discuss the symptoms associated with their incontinence with their family doctors and in many cases, the condition is left untreated.

Urinary incontinence is the medical term used to describe the loss of urine control. It can happen when you cough, sneeze, exercise or do any other type of activity that may put stress on the bladder. Urinary incontinence can exist where a woman might experience episodes of a slight dribble of urine, to the inability to hold urine all together; it can also be temporary or permanent depending on the underlying cause. While it is not a serious health concern, it can lead to anxiety, stress and embarrassment for sufferers.

Causes of Female Urinary Incontinence

Female urinary incontinence is usually caused by weakened or damaged pelvic muscles that prevent the urethra from closing tight enough to hold urine in the bladder. Many women will experience incontinence after giving childbirth where exceptional strain is put on the pelvic region. For many, this condition will go away, while for others, it will continue to worsen before female incontinence treatment is sought. Other causes of female urinary incontinence include:

• Childbirth
• The aging process
• Traumatic injury
• Weight gain
• Smoking
• Neurological disorders (spinal cord/head injuries)
• Infections (urinary tract, bladder infections, etc.)
• Certain diseases (such as Multiple Sclerosis)
• Medications, prescription drugs

Types of Female Urinary Incontinence

Drs. Daryl Greebon, Jules Monier, Murray Fox, Dennis Eisenberg and Jennifer Newton are Plano, Texas gynecologists that make up the Women’s Specialists of Plano. They offer female incontinence treatment and see various types of female urinary incontinence from patients that enter their office doors.

There are five basic types of urinary incontinence. Stress incontinence occurs when you leak urine during a physical activity such as lifting, jumping, exercising, sneezing and coughing. It is typically a result of both hypermobility (which occurs when the urethra and bladder neck shift from their normal positions) and an Intrinsic Sphincter Deficiency, which occurs when the urethral sphincter is unable to close tightly enough to hold urine in the bladder during physical exertion.

Urge incontinence is described as over-activity of the detrusor muscle, which is the smooth muscle that surrounds the bladder. It typically relaxes to allow the bladder to fill, then contracts to squeeze out urine when a woman goes to the toilet. During urge incontinence, the bladder will contract frequently creating an overwhelming need to urinate even if you just went. This condition is often referred to as “overactive bladder” and makes it difficult to hold your urine long enough to reach a toilet.

Other forms of female urinary incontinence include overflow incontinence where the bladder never completely empties causing urine to leak, and functional incontinence where a physical limitation or immobility may exist making it impossible for a person to reach the toilet in time.

Female Incontinence Treatment

There are solutions for female urinary incontinence and female bladder problems that have been proven to bring them a sense of normalcy. Every woman should discuss their symptoms with their physician so that the correct solution can be found.  For mild incontinence, Kegal exercises are usually effective; behavior therapies and small lifestyle changes such as decreasing the amount of fluids taken in or scheduling bladder elimination can also help.

For women who experience moderate incontinence, medications, protective undergarments and bulking injections such as collagen may be used. Some women find that their female bladder problems go away with the use of a pessary device. A pessary device is a stiff ring that is inserted into the vagina where it places pressure against the wall of the vagina and urethra. This pressure helps control leakage because it repositions the urethra.

For many women, surgery becomes the answer in order to get their incontinence under control. Retropubic suspensions are used to treat hypermobility. These suspensions elevate and restore the bladder neck and urethra back to their natural anatomical positions.  This procedure is often referred to as the Burch procedure.

A variety of slings are also available to help restore normal bladder function. Slings can be inserted via a minimally-invasive surgical technique to help support the bladder and urethra. Some slings use self-fixating anchors while others use sutures.  All are used to provide relief of the sensations and symptoms associated with urinary incontinence and most provide good results.

If you suffer from incontinence, make an appointment with your gynecologist to talk about your symptoms and options for a permanent solution so that your quality of life can be restored and the stress and anxiety from female urinary incontinence eliminated.

Every woman will go through menopause and will experience different symptoms. There is help that can be offered to treat these symptoms. Talk to your gynecologist today.

When I interviewed some of the physicians at the Women’s Specialist of Plano, Texas (http://obgynplano.com, 972.379.2416) for a women’s health feature on the topic of menopause, I assumed they would tell me the obvious: that menopause is simply a phase all women go through that causes unwanted symptoms and an end to all menstrual periods.

I was right, they did. But I also learned a lot more during my discussion with Drs. Murray Fox, Daryl Greebon, Jules Monier, Dennis Eisenburg and Jennifer Newton—all skilled and experienced gynecologists with WSOP—that really made me think differently about the “change of life.”

Menopause symptoms and treatments are different for every woman and there is a range of options for each specific case.  As a 37-year old female, I thought I still had a long time until I had to deal with the side effects of menopause. I distinctly remember my mom going through it at age 50 when she had a serious hot flash during the middle of my engagement party.

The truth—is that what I saw in her, were symptoms she had been dealing with for several years.

What Is Menopause?

Every woman is born with a certain number of eggs. These eggs are stored in the ovaries and it is in the ovaries that the hormones estrogen and progesterone are produced, which regulate ovulation and menstruation. Menopause occurs when the ovaries no longer produce an egg every month and menstruation stops. Natural menopause is a normal condition that occurs in all women between the ages of 40-58. Natural, meaning that menopause occurs without the side effects of any medical treatment such as a hysterectomy or chemotherapy. All women will experience some of the same symptoms from menopause as they age, but all will experience one common characteristic: their reproductive period will come to an end.

While the end to a menstrual cycle is a welcomed part of menopause, there are a number of unwelcome symptoms associated with this change. They include: irregular periods, missed periods, fatigue, mood swings and irritability, insomnia, depression, headaches, muscle aches and pains, bone loss (osteoporosis), incontinence and changes in sex drive (libido) as well as a decrease in vaginal lubrication.  In additions, many women will experience hot flashes and night sweats. Fortunately, many of the symptoms associated with menopause are temporary and will eventually disappear once menopause ends.

Help for Menopause

For women who choose to discuss menopause symptoms and treatments with their physicians, it is reassuring to know that there are many natural and home remedy steps one can take to help decrease and prevent some of the symptoms such as exercise, yoga, eating a healthy diet and getting plenty of rest.  Many women learn how to cool a hot flash by learning what triggers them. This helps them limit when hot flashes will occur and control them when they start.

For women that need additional help during menopause, there are medications that can be taken to help minimize the symptoms such as antidepressants, bone loss medications, Clonidine (a high blood pressure medication that helps ease hot flashes), vaginal estrogen creams and Progestin pills which help with irregular periods before menopause occurs.

Hormal Replacment Therapy:  Is It Right For You?

The onset of menopausal symptoms occur when the body stops producing estrogens. There are three types of estrogen produced in the human body and all three of these occur in balanced proportions, and although they are closely related, each has its own special function:

• Estradiol is the primary estrogen hormone and in nature it comprises 80% of the estrogen a woman’s body makes.
• Estrone is the least prevalent of the normal estrogens in women.  It increases significantly during pregnancy, but is a bit weaker than estradiol in its effect.
• Estriol is the third natural estrogen, and is also less potent in estrogen effect than estradiol.

Menopause symptoms and treatments will vary for each woman. For many women, hormone replacement therapy is used in the post-menopausal patient to minimize symptoms caused by the lack of a predictable estrogen-progesterone production. While hormone replacement is not for everyone, it has made a difference in millions of women’s lives. Patients are generally divided into two groups: those with a uterus and those without.  Patients without a uterus are usually treated with estrogen alone (estrogen replacement therapy – ERT); while those with a uterus are treated with estrogen and progesterone (hormone replacement therapy – HRT).

Likewise, hormone medications are also divided into groups: natural (made from soy, yam or other roots), bio-identical (compounded by a pharmacy) and synthetic (manufactured by pharmaceutical companies). In a woman who still has her uterus, ANY form of estrogen can stimulate the uterine lining and cause bleeding issues and the risk of endometrial cancer. The key in preventing this problem when estrogen replacement therapy is needed is to use progesterone with it in an adequate amount to protect the endometrium. For women who do not have a uterus, the endometrium is gone, and there is no need for progesterone, which can make estrogen therapy easier whether it is a cream, pill, or patch.

HRT and ERT:  Pill or Cream?

Is it better to take a pill, or use topical therapy?  This too has been debated for years.  Not all people respond equally well to the same product, so one woman may find it easier in her routine of life to take a pill.  Another may not react well with the pill, or may have trouble remembering to take a pill regularly and may be a better candidate for the patch, vaginal ring or for estrogen cream.  Each method works the same and it is important for a woman to find the best match for her and for her current lifestyle.

Hormone Replacement Therapy and Breast Cancer

The link between estrogen and breast cancer has been a highly discussed topic over the last decade.  According to Dr. Murray Fox, “Much of the data that has been reported in the media regarding the link between estrogen and breast cancer has been vastly misrepresented.  The media touts that 30% or 40% of women develop breast cancer while taking estrogen.  Those numbers are distorted. In recent tests that included several groups of 10,000 women, out of those who had no hormone treatment, 28 developed breast cancer; those with hormone treatment resulted in 36 women who developed breast cancer.  In a similar group of women who took estrogen alone, without any progesterone (because they had had hysterectomies), there were 7 fewer cases of breast cancer, suggesting that it is not primarily estrogen that causes the problem, but is the combination of estrogen and progesterone.”

Dr. Daryl Greebon agrees, “It is important for women to understand that estrogen poses greater risks for other medical issues than cancer. The primary risk of estrogen is blood clots (phlebitis); this can include blood clots in the leg, pulmonary embolus, or stroke. These risks exist with any estrogen replacement therapy whether oral or topical, and whether compounded or not.”

Dr. Jules Monier and the other physicians at the Women’s Specialist in Plano, Texas recommend their patients who are on estrogen replacement therapy use the lowest dose of estrogen possible for the shortest time possible, preferably no more than 5 years.  “However, quality of life is an important consideration, and as with all medical treatments one must weigh the benefits and the risks. For women who have incapacitating symptoms it may be worth the risks to have a better life style, this is an individual choice, “ says Dr. Monier.

Menopause symptoms and treatments and the best solution to handle the “change of life” can be a complex issue for many women. Each woman should discuss the options that are available with their doctor. The choice of using HRT or ERT should be made based on a balance of risks and benefits.  While there are risks to consider, for those women who suffer severely from menopausal symptoms, hormone replacement therapy and estrogen replacement therapy can make a major difference in their life.

About the writer:  Kristy Theis is the content editor for EmedicalMedia.  The physicians that make up the Women’s Specialists of Plano, Texas were interviewed for this article.

The article below was written by Kristy Theis, Medical Content Editor for eMedical Media in Dallas, TX.  It was featured on Hubpages May 12, 2010 and written on behalf of the Women’s Specialists of Plano.

“I Have Uterine Fibroids.  Should I be concerned?”

The doctors that make up the Women’s Specialists of Plano (972.379.2416) see their fair share of uterine fibroids weekly at their North Texas OBGYN office. Uterine fibroid tumors are one of the most common gynecological conditions affecting American women today—in fact, this year alone, almost 1 in 4 will be diagnosed with these benign uterine tumors.  While the majority of uterine fibroid tumors are non-cancerous, there is the incidence of malignancy (cancer) in about 1 in 10,000—making fibroids a worrisome diagnosis for thousands of women.

Not too long ago, most American women were sent down the road of having a hysterectomy when diagnosed with uterine fibroids.  I recently interviewed a group of Plano, Texas-based gynecologists—as well as some of their patients—and was pleasantly surprised to learn that there are in fact several options for patients suffering from uterine fibroids.

Fibroids are tumors that develop in the uterus, most often, affecting women over the age of 30 and still in childbearing years. They can be very small, exist as one or in groupings, can be slow or fast growing, and for many, symptoms will be almost non-existent. For many women, on-going and at times continuous cramping, bloating, constipation, heavy bleeding and a feeling of pressure and pain in the uterus can exist.  For women with a personal or family history of cancer, knowing that these tumors exist within the uterus can be troublesome making the treatment of uterine cysts a very important decision for them.

When I met with Patricia, a patient of Dr. Murray Fox, a physician with the Women’s Specialists of Plano practice, she described symptoms that sounded more like a pregnancy than a uterine fibroid.  Her non-cancerous uterine tumors presented themselves years earlier and over time began to grow until the end result was a cantaloupe size tumor.  With a growth so large, she decided to have a full hysterectomy because once the tumor was removed, much of her uterus would have to be removed with it. Since Patricia was past her child-bearing years, a hysterectomy was an acceptable route to take.

According to Dr. Jules Monier, a gynecologist with Women’s Specialists, most women will be diagnosed in the earlier stages through routine pelvic exams.

“We are able to diagnose uterine fibroids early on in most cases and monitor them with each patient.  During this time, conservative treatment of uterine cysts can be provided.  It’s important for women to be cognitive of their symptoms and pay attention to what their body is telling them so that a more aggressive treatment option can be considered if necessary.  No woman should be expected to endure the harsher symptoms that can come along with uterine fibroids.”

The exact causes of fibroid tumors are unknown. The Women’s Specialists of Plano experts agree that treatment of uterine cysts is not necessary with uterine fibroids unless at least one of the following conditions are occurring:

• The uterine fibroid is greater in size than a 12-week pregnancy
• The uterine fibroid(s) is growing
• The uterine fibroid(s) is causing bleeding
• The uterine fibroid(s) is causing pain
• The uterine fibroid(s) is associated with pregnancy loss

Treatment options available today are vastly different than years ago.  “Before our patients have to consider a hysterectomy for their uterine fibroids, they do have other treatment options, that in most cases, are successful.  Uterine artery embolization and myomectomy procedures are highly effective treatment options and are generally recommended before a hysterectomy,” Says Dr. Daryl Greebon, a Plano, Texas-based OBGYN.

During a uterine artery embolization procedure, physicians use an x-ray camera to inject small particles through a catheter directly aimed at the fibroid. These particles block the arteries that provide blood flow and essentially cause the fibroids to shrink.

A myomectomy is a surgical procedure where the fibroid tumors are surgically removed.  This procedure can be done with an open incision or using a more minimally-invasive technique such as the robotic myomectomy. The robotic method reduces the side effects of the surgery and overall recovery.  A myomectomy, in general, is considered one of the only surgical treatment options that preserve fertility.

In the procedures mentioned above, a large majority of women experience relief with their symptoms.

Robin is another patient of Women’s Specialists I interviewed and one who had a dramatically different outcome than my earlier subject.  She also battled uterine fibroid tumors since she was in her late 20’s and because she still desired to have children, she opted to have a robotic myomectomy. Dr. Dennis Eisenberg performed the surgery robotically and today, she remains symptom free from her fibroid tumors.  Although the risk of them returning does exist; she has not had any real significant growths or reoccurrences.

Dr. Murray Fox explains, “Uterine fibroid tumors can affect the quality of life.  I have had young women who are afraid to go to their places of business for fear they will soak through their clothes due to heavy bleeding caused by fibroids, and others who have experienced weight gain in the abdominal area because of fast growing and oversized tumors. The question I go over with my patients first is should the fibroid tumors be treated?  If the answer is yes, we discuss how.”

It is extremely important to talk to your gynecologist, get all of the facts revolving around your specific uterine fibroid tumors and review all of your options to help you decide the best outcome for your particular situation, future desires and current lifestyle.

About the writer:

Kristy Theis is the Medical Content Editor for eMedical Media and is a Dallas-based freelance communications writer.

The gynecologists and patients of the Women’s Specialists of Plano contributed to this article.Visit them on the web at www.obgynplano.com.

Dr. Murray Fox, a Plano gynecologist, and Dr. Daryl Greebon, a Plano OBGYN, of Women’s Specialists of Plano have joined the Faith in Practice medical mission team currently in Guatemala. Dr. Fox and Dr. Greebon are medical mission veterans and find the experience incredibly rewarding. Dr. Murray Fox and Dr. Daryl Greebon will volunteer their surgical expertise to poor Guatemalan women in need of gynecologic surgery. The surgeries they perform will include removal of uterine fibroids, hysterectomy and vaginal reconstruction.

Faith in Practice’s mission is to improve the physical, spiritual, and economic conditions of Guatemalan’s poor through short-term surgical, medical and dental mission trips and health-related educational programs

The large FIP team of surgeons, anesthesiologists, nurses, administrators, clergy, translators, oral surgeons, dental hygienists, and a photojournalist will travel to Reutealeahu, Guatemala from February 26, 2010 through March 7, 2010. The team will provide short-term surgical, medical and dental care. Prior to the mission, the team gathers all the supplies that will be required for performing surgery and post-operative care. Each team member typically brings 2 trunks of medical supplies. In total, 86 trunks arrived in Guatemala for this mission.

At the beginning of the trip, the FIP team will assess all surgery candidates and prepare a surgical schedule. The remainder of the week will be spent in surgery and providing after care.

To follow Dr. Fox and Dr. Greebon while they are on their medical mission, a Facebook Fan Page has been set up, Faith In Practice-Greebon Team 244.

Bone and Calcium Metabolism: Prevention of Osteoporosis

Author: Dr Murray Fox

Bone metabolism in the human body is a very dynamic process. There is a constant lying down of bone by cells called oste

oblasts and resorbtion of bone by cells called osteoclasts. Initially the osteoblasts work much harder and faster that the osteoclasts and bone is laid down to facilitate growth.

Each person has a genetically determined peak bone mass which is attained in their twenties. By age 17 ninety percent of the bone mass has been obtained. The consequence of bone loss is the development of very weak and fragile bones, a medical condition known as osteoporosis. Osteoporosis is associated with compression fracture of the bones of the spine called vertebra(ae) and fracture of the hip. While these fractures from osteoporosis may be painful and cause shortening of

stature, even difficulty breathing, the major consequence is complications and even death from surgical repair of the hip fracture.

Calcium and Vitamin D Play a Critical Role

Adequate calcium, exercise and vitamin D are required to attain and maintain bone mass. This is important in the prevention of osteoporosis. Current data indicates that the majority of children do not receive adequate amounts of calcium or vitamin D.
Recommended amount of calcium vary for individuals.

Below is a table of adequate intakes as outlined by the National Academy of Science.

Recommended Calcium Intakes

Ages Amount mg/day
Birth–6 months 210
6 months–1 year 270
1–3 500
4–8 800
9–13 1300
14–18 1300
19–30 1000
31–50 1000
51–70 1200
70 or older 1200
Pregnant & Lactating 1000
14–18 1300
19–50 1000

Role of Vitamin D

Vitamin D also plays an important role in healthy bone development. Vitamin D helps in the absorption of calcium (this is why milk is fortified with vitamin D). In the past many people depended on the sun’s effect on the skin to make vitamin D. Since more emphasis has been place on sunscreen, there is less sun effect and a greater need for vitamin D supplement. The exact amount of vitamin D required is being debated, but the consensus is that Americans are generally deficient in vitamin D and require greater amounts than originally thought. 800 international units to 1000 international units is the current recommendation for adults.

Certain medical conditions may limit the amount of calcium that may be ingested. As always, consulting your physician is suggested regarding your personal specific calcium needs.

Exercise is Necessary to Maintain Bone Health

Weight bearing exercise (walking, running, etc.) is an excellent stimulus for bone growth. Current recommendations are:

Adults: Engage in at least 30 minutes of moderate physical activity [on] most, preferably all, days of the week

Children: Engage in at least 60 minutes of moderate physical activity [on] most, preferably all, days of the week

Bone Mineral Density

The evaluation of bone strength, the about of calcium in the bone, is measured by a dual density densitometer. The purpose of this is to measure the exact bone mineral density of the spinal vertebrae, usually the four lumbar (lower back) vertebrae, and the femur, the large thigh bone that connects to the pelvis in the hip socket.

The bone mineral density (BMD) is usually expressed as a “T” score which is a comparison of the patients BMD to a young person. A “T” score that is – 1 or higher is considered normal. A “T” score of – 2.5 or lower is considered osteoporosis. A “T” score between – 1 and – 2.5 is called osteopenia – a softening of the bone.
Bone mineral density testing should be recommended to all postmenopausal women aged 65 years or older. Bone mineral density testing may be recommended to postmenopausal women younger than 65 years who have 1 or more risk factors for osteoporosis (See Below). Bone mineral density testing should be performed on all postmenopausal women with fractures to confirm the diagnosis of osteoporosis and determine disease severity.

Risk Factors for Osteoporotic Fracture in Postmenopausal Women

• History of prior fracture
• Family history of osteoporosis
• Caucasian race
• Dementia
• Poor nutrition
• Smoking
• Low weight and body mass index
• Estrogen deficiency*
o Early menopause (age younger than 45 years) or bilateral oophorectomy
o Prolonged premenopausal amenorrhea (>1 year)
• Long-term low calcium intake
• Alcoholism
• Impaired eyesight despite adequate correction
• History of falls
• Inadequate physical activity

About the Author:

Dr. Murray Fox is a board certified gynecologist with Women’s Specialist of Plano. Dr. Fox has over 30 years of practice and expertise in his field. His special areas of interest include preventative medicine, pelvic floor abnormalities, adolescent gynecology, and robotic surgery. http://www.obgynplano.com/womens-doctors-physicians/dr-murray-fox-md/

Article Source: ArticlesBase.com – Bone and Calcium Metabolism: Prevention of Osteoporosis