Needless suffering!

Everytime I see a new patient for HRT (Hormone Replacement Therapy) I am amazed at how much women are suffering with menopause and how few people are aware that there are alternatives.
A patient I saw today looked so unhappy I wanted to just reach out and tell her "It will be OK". Despair was written all over her face.
She must have felt my empathy because after the consultation she surprised me when she said
"at least someone cares!".

As strange as it may seem I am so used to being a woman's last resort, they come in devasted by how they feel and how difficult it is to find help.

It just boggles my mind that in 2009 the medical profession still refuses to acknowledge menopause for what it is : a syndrome that often requires treatment. No snide comments or knowing winks 'you know she is going through the change' or 'its a natural process suck it up' and do we really care who's mother went through menopause without so much as a hot flash? This is 2009 and we are baby boomers, working and juggling, stressed to the max, already out of balance before menopause deals us the final blow.

It occurred to me today where a large part of the problem lies: With us the doctors!
In medical school menopause is barely mentioned and then in passing with a reference to the bad health conditions that occur after it but not as a medical entity that itself should be taken seriously.
Until the medical establishment and then the public at large takes it seriously, patients will not feel comfortable discussing the full extent of their complaints.
I have said ad nauseum: there is more to menopause than hot flashes, there is more to a woman than a uterus! And not only can hot flashes be debilitating, menopause is a syndrome not a symptom. It is a constellation of symptoms affecting almost every organ in the body. It is a bona fide condition which should be handled as such and considered worthy of treatment. Women should not be made to feel apologetic because they 'can't handle it' nor should they randomly be given medications for sleep, depression and anxiety without having the benefit of a full evaluation and treatment of the underlying cause.

IT IS TIME TO START A CONVERSATION about those issues that affect the quality of the lives of women - Menopause can adversely impact the lives of those closest to us and it is time we gave this syndrome the public attention it deserves. The Public Health impact affects not only women but families and friends, workmates and relationships.
If you know someone who is suffering needlessly with menopausal symptoms please spread the word and let them know there are treatments available that will restore their quality of life.

Add life to your years and years to your life

Dr Tuakli

Vitamin and supplement testing

Oftentimes people ask me ''what would be a good vitamin regimen for me?" as if there is a fixed regimen that works for everyone and all I need to do is tell them what it is.
Unfortunately it is not quite that simple but the answer is important none-the-less. Vitamin and supplement deficiency cause a lot of symptoms ranging from deafness and macular degeneration to dizziness and hair loss. One of the commonest deficiency symptoms is fatigue, unfortunately this can be caused by iron deficiency, vitamin D deficiency, deficiency of zinc iron, iodine and thyroid, vitamin B12 deficiency, inadequate anti-oxidants, different hormone deficiencies and on and on!
As with all good medical care it is better if the regimen is tailored to the individual patient rather than a one size fits all approach.
Fortunately this question can be answered with a simple blood test, check out a list of some of the deficiencies that can be tested for on the Weight Control page of my website. That test, plus an evaluation of your hormone and iodine levels can be the key to a whole new quality of life.

Its your health, take control !

Have a great week

Helping you to add life to your years and years to your life....

Dr Tuakli

BOTOX and FILLERS in time for Easter!

We will be having a special day to get ready for spring. Botox and Fillers on sale April 4th at our Columbia office.
If you used to think smoothing out wrinkles and looking bright is only for the rich and famous, think again. Its really not as major as other 'cosmetic procedures' and takes only about 30 minutes. Make a subtle yet noticeable difference.
See you there!

The WISDOM study waiting for spring!

Hi welcome back.
Got the winter blues? Let's talk about the symptoms of menopause.

This week I want to mention a study that many in this country are not aware of regarding HRT. Most people know about the Women's health Initiative study (WHI) which was stopped at the NIH after the results of women taking Prempro and Premarin did not look good.
However it seems that when some positive studies come out there is not as much publicity.

The most recent large scale Hormone Replacement study published is the WISDOM study taken from a trial of 5000 women in the UK, Australia and New Zealand.
WISDOM stands for Women's International Studyof long Duration on Oestrogen after Menopause.
This study was actually going on at the same time as the WHI but the investigators decided not to stop it when the WHI study stopped.
You can read the full study in the British Medical Journal, part of it was discussed in May 2008
and part in the August 21 2008 edition (BMJ 2008:337 a 1190).

The May edition discusses the fact that there is much less risk of venous thrombosis (blood clots in the veins) especially in the first year when it is usually higher if the (O)estrogen is not taken by mouth.
The August article dwells on quality of life issues, something which is, to my mind at least, just as important as keeping people physically healthy.

The study essentially shows that hormone replacement improves the physical and emotional well being of menopausal women (big surprise!).

There was SIGNIFICANT improvement in 'vasomotor' symptoms (i.e hot flashes, night sweats etc), sexual functioning, sleep problems and aching joints and muscles (now that IS a surprise!).

I have to admit that does pretty much sum up my clinical experience over the past 2 decades.
The VAST majority of women who come in for hormone replacement are complaining of:
Hot flashes, zero sex drive, anxiety/depression, sleep disturbances and general malaise.
The unfortunate thing about the study is that they used the Premarin (yep, the horses urine) and Provera (yes, the one that can increase the incidence of breast cancer).

So what's the bottom line?

You CAN treat Menopause and feel better, you just have to do it safely. Every woman should choose what's RIGHT for her, no two women are the same. Stay away from things that are not natural to the HUMAN female and keep reading and educating yourself about your choices.
Remember:YOU CAN FEEL BETTER!!!! Yeah!

Have a good week, add years to your life and life to your years!

Dr Tuakli

Welcome to our blog!

Hi everyone,

We have a new website and blog and I am excited about having a forum to provide valuable information about your health. In the coming weeks I will be discussing the benefits of Hormone Replacement Therapy (HRT), Cosmetic treatments, Weight-Control treatments, and interesting case studies of health topics that interest our community of bloggers.

In our office patients who are interested in HRT fill out a symptom monitor questionaire at their initial visit to measure their symptoms of hormone imbalance from 1-10, with 10 being the worst. This week I had a lady in her early forties who had a 10 out of 10 on 13 out of 15 symptom categories such as depression, estrogen dominance, sleeplessness, irritability, and low libido. Her symptoms imply that she has a severe hormonal imbalance which means that we need to conduct tests so that we can ascertain the cause of her problems. We sent her for saliva testing, urine iodine testing, blood work, and vitamin screening. We will follow her case on future blogs to track her treatment and results.

This weekend we Spring Forward an hour! Remember to set your clocks as we move towards Springtime.

As always, our goal is to add years to your life and life to your years,

Dr. Tuakli