Free Educational Seminar
Join us on September 4, October 2 or November 6 at 7 p.m. at our office in North Scottsdale to find out if you're a candidate for minimally invasive laparoscopic procedures. Call 480.391.3638 to reserve a seat at our free educational seminar.
Well, our transition from an Obstetrics and Gynecology office to a Gynecology office is complete. Dr. Wilson's last baby was delivered by cesarean section on June 30. For the patients who are planning a pregnancy or are pregnant, we have a referral list available in the office. The list includes the finest Obstetricians in the area, and the feedback we have been getting is positive.
We have painted the walls, taken down the bulletin boards with the hundreds of baby pictures, put up new artwork, and spread out into what feels like lots of space. Dr. Wilson is taking new Gynecology patients again, as are our three highly skilled Nurse Practitioners.
We are purchasing state-of-the-art equipment such as a new 3-dimensional ultrasound machine and a bone density DEXA unit. Both of these pieces of equipment will aid us in our quest to offer the best Gynecologic care available.
Feel free to send your friends, we welcome both our new and our old patients to our Gynecology practice.
| Office Update |
Dr. Wilson, 3 of her staff members, and 2 of her children travelled with a group of 50 medical volunteers to Matagalpa, Nicaragua in July. The group was able to perform 120 surgical procedures and see over 1000 patients in the clinics.
Matagalpa is located in Northern Nicaragua, a very poor area which depended on coffee production to support its inhabitants. Now that coffee prices have dropped considerably, many people are out of work or collecting such a low wage that they cannot support their families. Specifically, flooding the market with sun-grown coffee from Vietnam has had a devastating effect on the prices of the primarily shade-grown coffee from Nicaragua.
The Gynecology team performed 45 major gynecologic procedures, including hysterectomies and extensive prolapse repair. Nicaraguan women tend to have large families and poor nutrition, the combination of which causes severe pelvic floor prolapse. Some women are unable to function due to the degree of prolapse they have.
Every member of the team should be commended on their hard work, stoic attitude in the face of difficult circumstances, and their commitment to seriously underprivileged people. We weathered an emergency landing in Phoenix, a 24-hour delay in getting to Nicaragua, a burning bus, an extremely primitive hospital, constant rains, severe gastrointestinal distress, and a few frightening encounters. In spite of all of this, the volunteers were generous, caring, and uncomplaining. Thank you to all, especially Shannon Anderson, Bea Elmer, and Peggy DeCarolis.
Thank you to all of our generous patients and friends who contributed finances, stuffed animals, and T-shirts. The financial assistance allowed us to purchase the necessary drugs and supplies we needed. The stuffed animals provided comfort for the children facing an extremely frightening situation, and the T-shirts served as hospital gowns.
The Wall Street Journal recently ran an article entitled: "Five Tests Worth Paying For; Health Insurance Usually Won't Cover Them But They Could Save Your Life." The first test listed was transvaginal ultrasound. Why? Because transvaginal ultrasound is the best method we have of picking up on early, assymptomatic ovarian cancer.
Many of our patients who have a family history of ovarian cancer or are simply concerned about the disease come in for periodic elective transvaginal ultrasounds. While it is certainly not foolproof, it is probably the best method we have of detecting ovarian and uterine abnormalities. A blood test called Ca-125 has received more press as a test which will detect ovarian cancer, and it certainly can be valuable in this regard. There are two problems with the test, however. The first problem is that other conditions can cause Ca-125 to be elevated. Endometriosis, fibroids, and infection are the most common. Some of the highest Ca-125 levels I have ever seen have been in patients with endometriosis. The second problem is that Ca-125 is only elevated in a few types of ovarian cancer. These types happen to be the most common, but there are cancers that could be missed if we were depending on Ca-125 exclusively to detect ovarian cancer.
Ultrasound will detect ovarian cysts and masses, which could be pre-cancer or cancer. Most of the time they are not, but the awareness that an abnormality exists allows us to follow it appropriately. How we follow up on an ovarian abnormality depends on the patient's age and the appearance of the abnormality.
Ovarian cysts are extremely common and generally disappear on their own. For this reason, if we see a simple appearing cyst, we will generally repeat the ultrasound a few weeks later. If it was a simple cyst, most likely it will be gone by the time the patient returns.
If the ovarian abnormality is more complex and has a worrisome appearance, we will order a Ca-125 along with some other related blood tests. We may repeat the ultrasound sooner than 6 weeks. If the abnormality is still present or larger on repeat ultrasound, we recommend laparoscopic surgery to remove the portion of the ovary that is abnormal or in some cases of highly suspicious findings, the whole ovary. If the Ca-125 level is elevated without another explanation, surgery is recommended.
In order to help us determine the nature of an ovarian abnormality, we may order a CT scan or an MRI. These diagnostic tests give us different information than the ultrasound, and again, help us make a decision regarding the necessity of surgery.
If an ovarian abnormality is highly suspicious, we will recommend a consult with a Gynecologic Oncologist, a specialist in gynecologic cancer. Gynecologic Oncologists have done specialized training in cancers of the reproductive organs, and can perform the advanced types of surgical procedures necessary in these circumstances.
It is true that most of the time when we operate on a patient for an ovarian abnormality, it turns out to be benign. But the few patients who have had early ovarian malignancies detected by ultrasound and have undergone life-saving surgery make it all worthwhile in my mind.
Transvaginal ultrasound can also detect uterine abnormalities such as fibroids, adenomyosis, endometrial polyps, endometrial hyperplasia, and endometrial cancer. These types of uterine abnormalities need to be followed or treated as well.
Our office offers transvaginal ultrasound presently, and we plan on updating our ultrasound equipment shortly to provide our patients with the newest and most advanced technology available. We are purchasing an ultrasound machine with 3 dimensional capacity, which will allow us to more accurately define fibroids, polyps, and many other abnormalities.
Julie Hodge, our ultrasound technician, is extremely capable and well trained. She will discuss her findings with you at the time, so you don't have to wait days for a phone call from the doctor. Of course, you will receive a phone call after I have reviewed your ultrasound, but you will walk out of the office with a good idea of what was found.
The fact of the matter is, even though many women choose to pay for their transvaginal ultrasound simply as a screening test, most insurance companies end up paying for the test once it is submitted. All in all, there is very little to lose by scheduling a transvaginal ultrasound. And it could save your life.
In the United States, the prevalence of obesity and diabetes is climbing steadily. Obesity significantly increases the likelihood of developing diabetes, high blood pressure, high cholesterol, asthma, arthritis, and general poor health status. Increasing physical activity, improving diet, then sustaining these lifestyle changes can reduce both body weight and risk of associated diseases. At least 25% of adults engage in no leisure-time physical activity at all.
Consuming nuts can help prevent adult onset diabetes. In an analysis of the Nurses Health Study, women who consumed more nuts (unsaturated fat) than meats and cheese (saturated fat) had a significantly lower risk of developing diabetes, and did not gain as much weight. Consumption of nuts also has a positive effect on lipids and coronary artery disease. It is generally true that the type of fat a person consumes is just as important as how much fat. Avoidance of animal-derived foods is a healthier way to eat.
I have always been involved in cat and dog rescue, but lately I have expanded my interests and my passion to parrot rescue. I grew up with an Amazon parrot, and have always wanted parrot companions, but needed to wait until my life was less complicated. I purchased a senegal parrot in February when I began to decrease my deliveries, and went on to adopt a 6 year old Blue and Gold Macaw named Larry. I am Larry's 6th owner. Larry has developed some bad habits like biting and screaming, and apparently no one could change these patterns. Since that time, I have adopted 2 more older blue and gold macaws, 3 cockatoos, 2 african greys, 2 hyacinth macaws, an amazon, and 3 more senegals.
The unwanted parrot problem is enormous in the United States and abroad. People buy a parrot in a pet store because it is cute and pretty, but they generally have no idea what it will take to care for the parrot. They also never consider that the parrot can live from 30 to 70 years!
Parrots are very intelligent creatures and require stimulation in the form of human and/or parrot interaction, toys, and varying surroundings. In the wild, they fly great distances, interact with their flock, and constantly forage for food. Putting a parrot in a small cage with no toys and no other parrots is cruel and neglectful, but this is the way many of them are kept, particularly after the owner tires of them. Eventually, bad behaviors develop out of boredom and frustration, and the owner either puts an ad in the paper or moves the parrot into a spare room or garage where the bird will not annoy anyone. In extreme circumstances, the parrot is euthanized because the biting and screaming has gone too far and the parrot is unadoptable.
For this reason, a number of parrot sanctuaries have sprung up across the country. These sanctuaries take unwanted birds and let them live out their lives with other birds of their species in large flight cages. Tuscon Avian Rescue, Oasis Sanctuary, and The Gabriel Foundation are a few examples of wonderful sanctuaries run primarily by volunteers and exist on donated money.
The sad thing is that most of the negative behavior parrots develop can be altered with time and effort on the part of the human caregiver. Biting, screaming, and feather picking are the most common problems encountered. These and other undesirable habits are addressed in 2 books by Sally Blanchard; The Companion Parrot Handbook and The Beak Book. Sally also publishes the Companion Parrot Quarterly and a set of Parrot Training videotapes. These are all available along with many good articles and links at www.companionparrot.com.
What can you do to help alleviate this problem? If you are going to buy a parrot, consider adopting a previously owned bird. Even a 20 year old macaw will probably live another 30 years. Many of these birds are fabulous pets, but the owner may have found themselves in circumstances that make it impossible for he or she to keep their beloved bird. Two of my birds were adopted under these circumstances. Look in the paper or contact one of the sanctuaries. If you are going to adopt a bird, please take it seriously and educate yourself before you adopt. Be prepared to spend lots of money on a cage, a few perches, toys, food, and a carrier. Be prepared to devote time and attention to your bird. Know also that parrots do scream, and generally the bigger the bird the louder the scream. Your neighbors may not appreciate your new addition.
Finally, discourage PETsMART and other large pet stores from selling parrots as pets. Most of these stores do not sell puppies and kittens and are proud of their philosophical stand on this issue. But they are not beyond selling a parrot that can live for 70 years! If you must have a baby parrot, buy from a reputable breeder who does not mass-produce parrots for financial gain. Companion Parrot Quarterly contains a list of excellent breeders.
In conclusion, parrots are wonderful, cuddly, intelligent, and loyal companions. I recommend them as pets, however, to only a few people who are truly prepared to devote and time and energy and money it takes to do them justice.
P.S. You can meet Jesse, a 10 year old cockatoo, at Dr. Wilson's office. He loves attention; stop in for a cuddle.
Copyright ©2003 Dr. Deborah Wilson, eNews Design ©2003 The Rogers Group, Inc.