Dont discount doing a pap smear

A patient said to me last week “I do believe you saved my life for the second time Dr. Tuakli” And I thought Wow! You know what, she is right. People thank me for saving their lives from time to time and not to sound cavalier but I often think that it is nice to hear but I was just doing my job. Any qualified physician could have been credited with doing the same thing. But this time was different and very stark. This 50 something year old lady has been in my practice for perhaps 3 or 4 years. She has a variety of medical issues that we have been working on and from time to time I would suggest she have a pap. She had told me previously that she had been told that she didn’t need one because she had had a hysterectomy. Interestingly enough whenever I probed further she never seemed sure about exactly what had been done. Was the uterus completely gone including the cervix? How about the ovaries? Why was the surgery done in the first place? It never ceases to amaze me how many times I ask those questions and the answer is “I don’t know”, particularly in over 40 year old women. I eventually convinced her that it would be a good idea to just do a routine check up even though she had no symptoms and so I did a pap. As soon as I started her pap I knew from the look of the lesion in her vagina that it was cancerous. Putting cells on a slide and sending it to the lab quite frankly was a formality and I had her schedule an appointment with a gynecology oncologist pending the results. She told me when she came in last week that the specialist walked into the room and the first thing he said to her was “What is a women your age doing still getting pap smears?!” (I wont be referring any more patients to him). The arrogance dissolved when he saw the cytology report and the patient has since had the appropriate surgery. So why do I tell this cautionary tale? Well, for one thing, the current guidelines imply that she did not need a pap smear, simply based on her age. Secondly, I think that many women are walking around thinking that because they have had a hysterectomy they are immune to genital cancers. Thirdly, standard recommendations are just that, written for the common good but not by someone who knows you. Do not take them as gospel. You could argue that this is the exception to the rule and that is probably true but it also means that someone’s mother and sister will still be alive 3 years from now and she also managed to avoid the trauma of cancer therapy that would have resulted had she found it later. In medicine it is not always easy to argue with “official recommendations” and specialists who don’t know the patients. I believe that I taught myself something with this case, not everything has to be rational, and care must be individualized regardless. I am a strong believer in learning from past experience even if its not written anywhere. I derive no satisfaction from my patient being diagnosed with cancer but I am sure glad I followed my gut. When in doubt get a pap, it sure beats the alternative!

New Look for the New Year, my Detox face!

Well here is my 2013 look, post detox! I got new photos done today and here is the big reveal! I thought it was time I got an update and the photographer agreed, he made me laugh talking about realtors who still use photographs from 30 years ago and how surprised people are when they actually meet the person. "No you don't understand" I told him, "my goal is to show people how well my face products and anti-aging program work! I'm really not trying to scare anyone when they meet the real me". After 30 plus years of practice I like to think I am doing something right. On a serious note, the more you read about detoxing the more you realize how critical it is to detox. The water, the food, the environment, chemicals. The EPA says that the indoor air is more polluted than the outdoor air! Toxins in today's world are unavoidable and there is absolutely no doubt in my mind that they are associated with the increase in certain diseases especially cancer. Since we can't live in a bubble let's do what is within our power to stay healthy. That's your goal and my goal, one of those goals that has to stay the same year after year. Please come back and read my blog often together we will make it work. I plan too keep sharing my 'secrets' until the whole world knows! Add life to your years and years to your life! Dr. Nadu Tuakli

Bioidentical Hormone Replacement a poem!

Here is a poem a patient of mine wrote about the way she felt before and after BHRT. She read it at the last seminar and hopes to make a You Tube video of it! Pre↓ vs. Post↑ Pre-HRT::: I did not care.... I could not...... get out of the bed......... my dreams laid on the coffee table......... waiting to be spoken............. I was sad a lot.......... but I faked a lot........... I was dry ............ and my scent disappeared............ I used to be horny at times......... and then, I never was.......... I could not remember the last time I wanted some......... I thought - "is this all there is to life?" .......... often........... waiting for someone.......... to come and turn on my life switch........... lonely was my new best friend........... my bed, was my lover.......... exercise, I forgot how............ tears, always close by............. skin, no moisture........... eyes, half shut.......... soul, dormant............. I did not know how bad I felt........... until I started feeling great again!....................................................................... Post-HRT::: I show up............... I care........... I care that I matter.............. I care about myself............. I care about my house........... I care about my body............ I care about my life............ I care about my soul.............. I care............. I care about what I let into my life............ and what I choose to keep out............. I care about what's going on in me; and outside of me............... my scent came back; my horny came back............. my moisture came back ................. fuzzy thinking left and my sleep came back............ more importantly, for real................. my smile came back............... my care came back............. I let God open my mind............. towards a solution – HRT!.............. what am I talking about?........... “hormone replacement therapy”.............. the bio-identical kind.............. and I began............... to feel better........... I regained the strength............... to turn my life switch back on............... I now care............... Because I now matter.................................. “Pleasant words are like a honeycomb, Sweetness to the soul and health to the bones.” – Proverbs 16:24........... Angela Riddick ........ * Poetic Mustard Seeds ........... * blacquepoet@comcast.net ALL RIGHTS RESERVED................. Dedicated to Dr. Nadu Tuakli because every day is a glorious day!