Protecting ourselves from illness is a complex process: unfortunately, not just a shot: but nutrition, improvement of our immune system, exercise, hand washing, limiting exposure when possible all are an integral part of avoiding disease. Vaccinations are invaluable however, and I have always urged patients to take full advantage of them, and that means rechecking with your health care provider regularly. Vaccination has eradicated small pox, and hopefully polio will be the next to go. We have talked about eradicating cervical cancer, and sexual health has to be added to the list of behaviors that contribute to the eradication of cervical cancer! Flu shots are only about 62 % effective in the 2013 flu season in sophisticated viral studies, although improvements, mentioned below, are coming for 2014. The CDC has announced changes in the vaccination policy. For pregnant moms there is a policy change in what is called the Tdap vaccine. Tdap which stands for, the tetanus, diphtheria, acellular pertussis vaccine, comes on the heels of pertussis (whooping cough) outbreaks, including in our community in Illinois, as well as in other communities across the United States. The new recommendation is to vaccinate pregnant women in each and every pregnancy in the third trimester, preferably between 27 and 36 weeks. This includes pregnant women who have been vaccinated previously. Tdap vaccination according to the label is FDA approved for adults as single use only, so repeat maternal vaccination is considered an off-label use. Tdap booster is recommended universally for all adults, including those aged 65 years and older. There has been a change to the flu vaccine as well. Influenza vaccination is recommended for everyone, each year, over 6 months of age. That still stands, but there has been a name change. Instead of TIV, which stands for trivalent inactivated influenza vaccine, the new name is IIV -- inactivated influenza vaccine. There are situations where there is individual risk for vaccinations, and those should be determined by your own providers. For instance those who had Guillian-Barre syndrome within 6 weeks of a prior influenza vaccine might be told not to get the vaccination, and similarly some people with egg allergies cannot take live virus vaccines. Starting next year, many manufacturers will transition from a trivalent formulation that covers 2 strains of influenza A and 1 strain of influenza B to a quadrivalent formulation that doubles the coverage for these strains. For more complete information, speak with your own gyno, and additionally you can turn to the CDC website, the FDA website, or perhaps the Vaccine advisor.
Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...
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