Wednesday, October 12, 2016

Friday, April 29, 2016

April is Alcohol Awareness Month, Guys!

by Dr. Margaret Aranda


Hey, guys, we're starting off serious here:
* In 1987, AZT was first used to treat AIDS. That was a HUGE advancement in medicine, as HIV protesters filled the sidewalks and entrances of USA government buildings, picketing for better health care and specialty clinics devoted just for AIDS

* The top selling car was the Ford Escort, at $ 6,895. 
* The Ford Mustang (my personal FAV) sold for $ 9,209. 
* The USA stock market crashed in October, & other world stock markets crashed ( Reference ). 

Everyone around me seemed quiet and reflective, but I was busy studying as a pre-med undergraduate student.  So my own head was filled with Inorganic Chemistry, Chicano Studies, Intermediate Expository Writing, and Independent Study where I went room-to-room teaching about the genetics of either Tay-Sachs or Sickle Cell Disease. That was my introduction to medicine, as I lived in a bubble. 

Today,  The National Council on Alcoholism and Drug Dependence  wants to rid society of the "stigma" associated with #alcoholism, hoping to concentrate on getting the diagnosis, receiving therapy, heading toward recovery, and living with Quality of Life. 

Especially at home. Especially in front of children and spouses. Life is too short to live poisoned by ugly, abusive, self-inflicted, #alcoholism.

So let us join you in encouragement! Please DO GO DRY! We are behind you! Your money can go to better things than self-destruction - to good causes! #alcohol kills, so give ....give ....give to your own children, or to orphans who are starving and dying. For real. Because According to the CDC today, there is an alcohol-related death every 51 minutes

You know what I'm talking about. So #alcohol? Get that away from you. You do not need it unless it's a special occasion and you are staying at home, you know? That's my opinion, and I'm sticking to it. 

Did you know: #Alcohol Awareness Month began in 1987 ? 
Where were you? 



Image 1 1987 Ford Mustang. Awesome muscle car, yeah?
 Take care of your car, of course. 


But take care of yourself and your family and your children's memories and generations of alcoholism, by GOING DRY and being that example that YOU NEVER HAD. C'MON!

I KNOW YOU CAN DO IT!

Saturday, April 18, 2015

What do the Ovaries Mean to a Man? Uhhhhmmm....

by Margaret Aranda, MD, Ph.D.

Men don't usually think of a woman's ovaries too often, unless there is a reason to, such as when their wife of 30 years develops ovarian cancer. Otherwise, the ovaries secrete eggs once a month, and when not impregnated by a sperm, the uterine lining sheds, causing the menstrual period.

Of course it's not all that easy, because a woman's ovaries secrete estrogen, progesterone, and testosterone in different amounts, at different times through the ovarian cycle, so well, Uhhhhmmm... there is the explanation you've been waiting for, regarding her cycles, her period, her Pre-menstrual Syndrome (PMS), Post-Traumatic Stress Disorder (PTSD), irritability, sadness, as well as physical cramping and torture that may lead some to consider suicide.

The women that have virtually no symptoms of belly ache or headache or migraines? We go on, then we go off, and WaLa! No big deal (but don't tell those other women, because they will hate us).


So there are a few things every man should know about his woman's ovaries:

1. She is born with two; one on each side of the uterus. I have detailed this out for you, including hormone production of the hormones, quite thoroughly: Ovaries For Babies

2. After menopause, the ovaries can still work for up to 15 years in some women, so don't let her just rush out to the nearest drive-through Hysterectomy Site and get her uterus out (and what about the ovaries?). With heart disease being the #1 cause of death in women, Uhhhhmmm....we have a choice....a) take a 1:70 chance of getting ovarian cancer, or 2) keep up the monitoring for uterine cancer with a simple blood test called a CA-125. Many have argued: Men get their PSA tested, so why shouldn't women get their CA-125 tested? When I was in medical school, ovarian cancer was a death sentence. Today, things are better although mortality is still considerable. So at some point, men, your wife has to decide and/or some doctor is going to insist that she get a hysterectomy (uterus out) plus oopherectomy (ovaries out, too), and you can't just stare into the wall.

3. For hysterectomy, considerations of whether or not the ovaries should be taken out are spelled out for you roughly here, here, but don't be deceived. There are charges that the whole thing is a racket, and it is a fact that women are dying earlier than they ever have, while men are living longer. Could that be the effect of ovary removal? So yes, many women have 'ok' experiences with their hysterectomy and oophorectomy that it hardly phases them. In fact, some ladies at the office brag about it until every single woman has had one. Guess what? There won't be any grandchildren for you, and you will spend some nights crying. Because you should have been more involved. But now you are being proactive, right? So let's get prepared and realize that not all women have a good outcome.

4. The rest of the women wish they were never born, practically. They suffer severe depression, womb emptiness, and constantly cry. So men, learn about this stuff. Take some time off work to delve into it as if it was your most important "job project" that could make your life either a living hell or a blissful heaven. Because unless you do so, this author thinks you are sitting in the back seat reading the newspaper while your wife is about to morph into another being, and you don't give a crap.

5. So get up and read. Go to her appointments. Act like you're interested. Because who is going to wipe your butt when you get old? Do You have a Long-Term Care Policy in place? Geez. You have a lot of work to do, but just take baby steps, one at a time.


Archives of the Vagina: A Journey through Time
by Dr. Margaret Aranda
ISBN: 978-1-62854-116-8    

Friday, April 17, 2015

What Happens When a Physician Turns into a Patient?


by Margaret Aranda, MD, PhD.

Written from hospital bed to hospital bed as I learned how to read and write again, speak and process brain information. Traumatic brain injury (TBI) is sometimes followed by a more rare condition, diabetes insipidus (DI) that has nothing to do with blood sugar. 

DI occurs because the posterior pituitary gland, that hangs from the brain like a dangling apple, gets smashed on its back, onto the skull. A hormone (i.e. DDAVP, or vasopressin, or anti-diuretic hormone) gets "knocked out," so a 'higher' hormone completely loses communication with it. 

What happens next is that this 'higher' hormone, located in the hypothalamus of the brain, speaks and speaks and speaks and speaks and speaks to the pituitary gland (not knowing it is "broken" or "severed")...and the body pees itself to death. Because the pituitary gland is missing "anti-diuretic" hormone, there is nothing any more to tell the hypothalamus "We're in the desert. Stop Peeing!" 

So most people with TBI die of DI via dehydration and kidney failure, perhaps mostly in their sleep. They are thirsty, thirsty, thirsty, yet keep peeing, peeing, peeing. They don't know that they can NEVER catch up in the drinking. I have had it twice now, and it is no fun. Titrating salt and water, water weight and Na levels ~ That's because the DDAVP is gone. Treatment? DDAVP or vasopressin, or Anti-diuretic hormone. No one wants to be on this drug regimen to "fake" an illness, as I was accused of doing. The unneeded drug will kill a person. Anyway, that's your pathophysiology lesson for today. 

Pituitary gland representation.PNG
Pituitary gland. Posterior pituitary is in blue. Pars nervosa and infundibular stalk are not labeled, but pars nervosa is at bottom and infundibular stalk is at top.)
Image 1. The Posterior Pituitary Gland.  It receives signals from the hypothalamus, to determine total body water (TBW) an prevent either hyponatremia or hypernatremia (both lead to death; the first by turning into a water balloon and having water toxicity; the second leads to death by kidney failure). Resource: Wikipedia

That is just one bit of the scientific, historic, humanistic, philosophical aspects which this book covers. If you or a loved one have suffered a TBI or ANY chronic illness due to accident or misadventure (i.e., Lyme's disease), then this book is for you AND your family AND your doctor AND the caregivers. No one else can "tell it like it is" the way that someone who has "been through it" has. And I have.

Dedication: Even if life is difficult, I learned at an early age that one has some control over one's destiny. Thank you, Dad, for teaching me from a young age that I can strive to achieve and never give up. 
   This book is dedicated to Dr. David S. Cannom and Los Angeles Cardiology Associates, which he founded in 1985. It is also dedicated to Keck School of Medicine at USC, Dean Tranquata, Good Samaritan Hospital of Los Angeles, and their cardiology department with Dr. Cannom. 
   I appreciate all the efforts turing the Tilt Table Test as wee as the special care you gave me on the cardiology floor. (Being the only patient without gray hair was iconic) Thank you for all your nursing, administrative, and physician efforts on my behalf. It is a great pleasure to donate a portion of the proceeds of this book to Good Samaritan's Campaign for Cardiology.
   Had it not been for Stanford's University of School of Medicine and the departments of anesthesiology and critical care, I never would have learned how to argue my own medical cases using concepts such as orthostatic hypotension, mean arterial pressure, orthostatics, ataxia, and the relevance of ataxia on the vertebral artery for balance. That little thing called, "balance" that we use when we get up to walk? Most of you take it for granted. We stand up and faint, as the blood pools in our legs and leaves our heads. For this reason, I give with great pleasure some proceeds of this book to Ronald G. Pearl, MD, Ph.D., Chairperson of the Anesthesiology and Pain Management Department, to put it towards his chosen effort. 

No More Tears: A Physician Turned Patient Inspires Recovery
Foreward
Acknowledgments
A Place with "No More Tears"
Introduction
Introduction to My Life
The Accident
Picking Garlic and Doctor Shopping
Before the Accident
Dysautonomia and Living with 'Brittle Dysautonomia'
Fifty Ways to Fall Out of Bed
The Gift of Prophecy
Prophecy during this Writing
Declined Memory
Traumatic Brain Injury (TBI)
News for the Family, Especially the Significant Other
All Men are Not Dogs
The Disabled: News for both Old and New Friends
The Status of the Disabled in My World


Chapters continue on a second blog, yet to come. 
The "Forward", written by Dr. S Cannom himself, will be included. www.drmargaretaranda.tateauthor.com/other-works/

Sunday, April 12, 2015

What Your Woman in Menopause is Going Through

 by Margaret Aranda, MD, Ph.D.


What are some important things that every husband should know about menopause and how it affects a woman? (Hint: it has to do with how a man is affected) Well, I think the most important thing is that it can cause vaginal dryness, which leads to pain on intercourse. Some women complain that having sex feels 'like a knife stabbing me'. Really. It HURTS, and that's no fun for either partner. And there are other issues, too. Besides the frustration, humiliation, and resentment, and rage that festers. This is discussed in more length in my newest book, out NOW and available on www.drmargaretaranda.tateauthor.com/other-works). Men, want to stop feeling like you work, take pre-teens driving as a carpool, pay for this and that, and your wife is sweating so much that she has to sleep on another bed? In another room? 

Menopause = 1) male manopause, after prostatectomy  +/- irradiation/chemotherapy/orchiectomy; 2) female menopause, after hysterectomy with uterus and ovaries removed (that's a whole different story); and 3) oophorectomy (ovaries removed due to ovarian cancer).

I have noticed, for example, that a postmenopausal woman can be talking to me at night, and indeed let's make that a ~ cool ~ night with a breeze.  Her upper lip and forehead are covered with sweat.  In fact, her upper eyebrows and neck glisten in the moonlight.  I innocently ask (during our conversation on menopause), "Do you get hot flashes?"


She says, "No, I never get hot flashes."


So I ask, "Do you have pain with intercourse?"  Well, no big response there.  I persist, "Do you enjoy sex?"  She scoffs, "I could take it or leave it." She practically explodes at me!" " I just have sex to make my husband happy, but if it was up to me, I wouldn't even have sex.  And I would not miss it."  She smiles ever so gently. "Ugh!"

So I back up again, "Well, why don't you enjoy it?"  
She thinks.  
She hesitates.  
I wait, patiently.  
"Well, I guess that it just doesn't feel good."  

Results are in from Menopause, The Blog, which you can Click Here to Read.  While millions of women in the USA may have vaginal atrophy from a decrease of estrogen production after menopause, only about an estimated 7% are getting treatment!  This is simply astounding to me!  If you are a husband and your wife is complaining that having sex hurts during menopause, then this affects you as a man.

Studies show that a woman is reluctant to discuss the situation with her doctor, and doctors are reluctant to discuss it with their patients. So what is a man to do?

Firstly, we are reminded once again that with education comes empowerment. Now that you know that your wife could be having this problem, it may be good to talk to her about it. It could be that a woman does not realize that she has vaginal dryness.  The change could have happened so gradually over the perimenopausal years, that she does not realize that she actually has pain on intercourse, or dyspareunia.   So let's just step back a moment and realize that vaginal dryness, vaginal atrophy, and pain on intercourse ~ all these things can happen.  It's ok.  It can happen overnight from surgery, or it can happen over 15 years of natural menopause, naturally, as the ovaries are still secreting hormones. This is when the woman is most likely to be unaware that she is even IN menopause!

Men and Women just need to realize, like the perspiring woman who says she does not get hot flashes, that a woman's body continues to change with time. Men need to continue to be attuned to their woman's body.  Why?  Because menopause can riddle a woman's life with insomnia, restlessness, agitation, depression, hot flashes by day, sweats by night, pain on intercourse, vaginal dryness, dry skin, and general irritability. To name a few. And does that affect a man's sex life? Uhh.

Women can spend fully one-third of their lives in menopause.  
That's a long time to suffer unnecessarily. 
I know it affects you, because it has to affect you.
So we'd better get 'good' at being IN menopause, yes?  
Let's do!




Medical Disclaimer: Nothing on this website is meant to diagnose, treat, or practice medicine. You must be seen in person by a physician for appropriate and individual medical treatment. If you have an emergency, call 9-1-1 in the USA.

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Monday, October 7, 2013

Archives of the Vagina: A Journey through Time


by Dr. Margaret Aranda

For my Caring Friends, here's a preview of my newest book, written before the doctor dropped me on the floor in March, 2013. I wrote this book (many of you will understand) because I'm not sure if I'll live long enough to see my daughter live through all the stages of womanhood: the maiden, the mother, and the crone. It will be certain to help husbands understand their wives go through menopause, and help their daughters go through menstruation. Especially if both are happening at the same time.

                                   Book Cover Photo. Archives of the Vagina: A Journey through Time.

The book starts with my first period, and is very tongue-in-cheek humorous, because all girls know where they were when they started their first period. Then I go through history, sociology, anatomy, and the endocrinology of the ovaries.

I discuss what Aristotle thought of menstruation and menopause, how William T. Stead is a hero we never hear about for rescuing children out of prostitution in London's brothels. This book is filled with the sociology of menstruation, including whether women on their periods can fly a plane, and whether women who are camping on their periods attract bear attacks that lead to death.

One of the most surprising statistics that I learned in my research and interviews of women is that in the USA, in women over 45 years old, 40% have had a hysterectomy. Of these, nearly 50% have had normal ovaries removed without proper Informed Consent. I dedicate an entire chapter to "Ovarian Conservation" (i.e., keeping your ovaries), and give you all the risk factors you need to know so you can put yourself on the Chart to see if you are at risk for ovarian cancer, and hence should get them removed. So my next book will be Hysterectomy can be Hell. I hope to get an Army behind me on this one, because it will take a Movement to change our culture. And changing a culture always means that people won't like you. Believe me. I've been there before.

I discuss the HPV vaccination for girls aged 11-12, starting your period, how to put in a tampon, and introduce what most people don't know: the menstrual cup, and the nondisposable pad. I promote a certain program that helps girls in Africa obtain menstrual pads so they don't have to miss school, be drop-outs, get pregnant, contract HIV, attain a lower socioeconomic status, and die earlier than the girls that are more educated. So expect a Movement there, too.

I go through the Women's Health Initiative and basically tear it to shreds, because it had, in my opinion, no application to women in menopause suffering symptoms of vaginal dryness and hot flashes. I let you skip a very medical chapter if you would like, but I also put it in there for medical personnel to evaluate it for themselves. I dissect menopause and give the man's perspective, too, hopefully leading you to more self-discovery and compassionate understanding. Pretty funny stories there, too, my friend.

I have spoken to men who have had over 1,000 sexual partners and still do not know where the woman's urethra is. So I depict it for you explicitly, and explain why you should stay away from it so your woman does not get a urinary tract infection (UTI). Same thing for rectal sex; the rectum is filled with E.Coli bacteria and if you put the penis back into the vagina after rectal sex and it rubs onto the urethra (where the pee comes out), your woman can develop a whopping and bloody UTI. So, save the rectal sex for last. There's more, and it's all in this comprehensive Reference Book.

The last half of the book is dedicated to such things as Invisible Diseases, the Low Glycemic Diet, Immunonutrition and Fish Oil, Telemeres, Living for not only Health & Wellness but also for Quality of Life, Caregiving (and the effects on women, by ethnicity), Long-Term care, and death and dying. I empower you to ask questions, eat Spoon by Spoon, and Don't Fall when you are elderly. I tired of seeing women come into the Operating Room for hip fractures from a fall. You need to know your bone density, and take your Vitamin D or Calcium.

The role of an Endocrinologist in your care can not be underestimated. I also believe that Cenegenics has an excellent program for Concierge Medicine, private pay by cash, that is mostly utilized by Presidents and CEOs of companies. They are mostly men. This needs to change, because there are plenty of millionaire women out there (and wives of CEO men). And women need to stop spending all their time nurturing others, and start spending some time nurturing themselves. So I took all this knowledge in my head and told it to you before my traumatic brain injury and DI occurred; and I thank God that I did it.

There. I said it. My opinion rings throughout this book, and it is backed up by over 200 Stanford-quality references that are NIH-funded. I list them all for you, and many of them are dated in 2012 and 2013. Nothing but the best for you, my friends. Nothing but the best. Be prepared to learn, to grow, and to  ROCK your WORLD. You can ORDER the book at www.drmargaretaranda.tateauthor.com/other-works/

God Bless You in all that you do.