tag:blogger.com,1999:blog-87441406925953458832024-03-13T09:43:22.213-06:00Menopause MomentsMilk in the cupboard, cornflakes in the 'frig. Women of 'a certain age' find these moments infinitely amusing...and definitely scary. Are we overwhelmed, inattentive, or just moseying on down the road to dementia?<BR><BR>
I'm an aging female internist, and I invite you to share your own menopause moments, or just take a moment to read stories and information from my life, my practice, and the latest from the world of medical research.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.comBlogger124125tag:blogger.com,1999:blog-8744140692595345883.post-31814888412546627472021-08-10T17:25:00.002-06:002021-08-10T17:25:42.071-06:00<p> </p><p class="MsoNormal" style="margin-bottom: 0in;"><em><b><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Odoribacteraceae<o:p></o:p></span></b></em></p>
<p class="MsoNormal" style="margin-bottom: 0in;"><em><b><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></b></em></p>
<p align="right" class="MsoNormal" style="margin-bottom: 0in; text-align: right;"><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">“In people over
the age of 100, an enrichment <o:p></o:p></span></p>
<p align="right" class="MsoNormal" style="margin-bottom: 0in; text-align: right;"><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">in a distinct
set of gut microbes generate <o:p></o:p></span></p>
<p align="right" class="MsoNormal" style="margin-bottom: 0in; text-align: right;"><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">unique bile
acids.”<o:p></o:p></span></p>
<p align="right" class="MsoNormal" style="margin-bottom: 0in; text-align: right;"><i><span style="background: white; color: #424242; font-size: 12.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Professor Kenya
Honda<o:p></o:p></span></i></p>
<p align="right" class="MsoNormal" style="margin-bottom: 0in; text-align: right;"><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 12.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></em></p>
<p class="MsoNormal"><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">New research on the gut microbiome of old folks in Japan was
reported in the latest issue of </span></em><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nature Research</span></em><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">.</span></em><i><span style="background: white; color: #424242; font-family: "Source Serif Pro",serif; font-size: 15.0pt; line-height: 107%;"> </span></i><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">The scientists analyzed the </span><a href="https://www.studyfinds.org/tag/gut-health/" target="_blank"><span style="background: white; color: black; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext; text-decoration: none; text-underline: none;">gut bacteria</span></a><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> of more
than 300 adults in Japan, including 160 </span><a href="https://www.studyfinds.org/longer-life-humans-124-years-old/" target="_blank"><span style="background: white; color: black; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-color-alt: windowtext; text-decoration: none; text-underline: none;">over 100 years-old</span></a><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">, 112 between
85 and 89, and 47 under 55 years-old.<em><span style="font-family: "Calibri",sans-serif; font-style: normal; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Principal investigator Honda and colleagues
found that bacterial isolates in fecal samples from </span></em>centenarians were
often enriched with microbes capable of synthesizing potent bile acids that
were not present in the younger groups. <em><span style="font-family: "Calibri",sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Odoribacteraceae</span></em><em><span style="font-family: "Calibri",sans-serif; font-style: normal; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> strains in particular came out as star
producers of </span></em></span><span style="background: white; color: #222222; font-size: 13.5pt; line-height: 107%;">isoallo-lithocholic acid (LCA). LCA is a potent
antimicrobial against gram-positive, multidrug-resistant strains such as </span><i><span style="background: white; color: #222222; font-size: 14.0pt; line-height: 107%;">Clostridioides
difficile </span></i><span style="background: white; color: #222222; font-size: 14.0pt; line-height: 107%;">and<i> Enterococcus faecium</i>.</span><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></em></p>
<p class="MsoNormal"><span style="font-size: 14.0pt; line-height: 107%;">The
conclusion of this study, per Prof. Honda: “</span><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">There are centenarian-specific
members of the gut microbiota which, rather than representing a </span><a href="https://studyfinds.org/tag/aging" target="_blank"><span style="background: white; color: black; font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri; mso-themecolor: text1; text-decoration: none; text-underline: none;">mere consequence of
aging</span></a><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-hansi-font-family: Calibri;">, might actively contribute to resistance against pathogenic
infection and other environmental stressors.”</span><span style="background: white; color: #424242; font-family: "Source Serif Pro",serif; font-size: 15.0pt; line-height: 107%;"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="background: white; color: #424242; font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">There
are a host of responses to this study.<span style="mso-spacerun: yes;">
</span>Many readers had their own theories of aging well.<span style="mso-spacerun: yes;"> </span>One young lady declared that skinny was the
perfect answer, and her daily intake, delivered in anorectic detail, made me
cringe.<span style="mso-spacerun: yes;"> </span>Another woman, struggling with
C. diff unresponsive to various medications, took matters into her own
hands.<span style="mso-spacerun: yes;"> </span>She announced to her daughter
that she needed a stool sample from her. The daughter, first appalled, then
complied. The sample was inserted into one end or another (we got no info over
which), and mom felt increasingly normal in a gut sort of way within four days!
<o:p></o:p></span></p>
<p class="MsoNormal"><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">I’d like to get ahold of a distinct set of those Odori-bugs,
but alas, no search on Amazon or Google offered hope for bottles of such
supplements just yet.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></em></p>
<p class="MsoNormal"><em><span style="background: white; color: #424242; font-family: "Calibri",sans-serif; font-size: 14.0pt; font-style: normal; line-height: 107%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">______<o:p></o:p></span></em></p>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-89629899461227369442021-07-04T17:38:00.001-06:002021-07-04T17:38:41.709-06:00<p> </p><p class="MsoNormal">Is it advancing age or the lack of everyday conversations
with multiple people?<span style="mso-spacerun: yes;"> </span>What, I ask myself
almost daily, is wrong with my word-finding ability?<span style="mso-spacerun: yes;"> </span>I have encouraged me (in that 2<sup>nd</sup>
person sort of judgmental voice) to think a moment before I just point to the
object or replace the unfound word with ‘thing’ or ‘stuff’.<span style="mso-spacerun: yes;"> </span>Pausing then brings on other speech disfluencies
wherein the use of filler words like ‘uh’ or ‘um’, or whole word repetitions
such as ‘we need…we need’, or interjections like ‘like’ disrupt not only one’s
flow of speech but also one’s thinking process.<span style="mso-spacerun: yes;"> </span><o:p></o:p></p>
<p class="MsoNormal">Psychologists call such lapses tip-of-the-tongue (TOT)
states and emphasize that these TOTs do not necessarily indicate impending
dementia. That’s good news, but what does it indicate?<span style="mso-spacerun: yes;"> </span>Chances are good that those of us who are
seniors haven’t lost the concept of that which we cannot name.<span style="mso-spacerun: yes;"> </span>The authors of a book on aging and language
(1) call these aggravating TOT states ‘a glass half empty or a glass half
full.’<span style="mso-spacerun: yes;"> </span>These failed retrievals could be
weakened neural connections in a tired old brain, or they might indicate such a
plethora of stored words from all those years of speaking and reading that it
becomes difficult to find the right word in short order.<span style="mso-spacerun: yes;"> </span><o:p></o:p></p>
<p class="MsoNormal">A search on PubMed suggests multiple hypotheses about why
seniors have more TOTs than juniors.<span style="mso-spacerun: yes;"> </span>I
choose to go with the word-laden brain hypothesis, allowing us elders to
deliver astounding explanations of meaning even if the word in question remains
elusive.<span style="mso-spacerun: yes;"> </span><o:p></o:p></p>
<p class="MsoNormal">But here’s an inscrutable cognitive glitch—yesterday I made
one entry in my journal, ‘GNL 18,19’.<span style="mso-spacerun: yes;"> </span>I
have absolutely no idea what that means. <o:p></o:p></p>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-54711111286805708102021-07-04T17:31:00.001-06:002021-07-04T17:31:03.200-06:00<p> </p><p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><b><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Nootropes<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><b><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p> </o:p></span></b></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Nootropes refer to drugs, supplements, herbs,
etc. that are believed to improve cognitive functions.<span style="mso-spacerun: yes;"> </span>Sometimes a lost word is not just a
word-finding problem (as mentioned in a previous newsletter) but an actual
aging-related loss of normal brain functioning.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">I personally take four of them daily:<span style="mso-spacerun: yes;"> </span>bacopa monnieri, caffeine (in coffee form),
choline, and creatine.<span style="mso-spacerun: yes;"> </span>The problem, as
always with supplements, is there’s no way to know whether or not they actually
made a difference.<span style="mso-spacerun: yes;"> </span>Perhaps healthy
living and no nootropes at all would have sufficed.<span style="mso-spacerun: yes;"> </span>There are many lists available on the
internet touting the benefits of various brain boosters.<span style="mso-spacerun: yes;"> </span>Here’s a list that explains 14 possible
nootrope choices(1).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">I recommended bacopa monnieri to a good
friend.<span style="mso-spacerun: yes;"> </span>Here’s her text:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; tab-stops: 124.65pt;"><i><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">I
started bacopa today.<o:p></o:p></span></i></p>
<p class="MsoNormal" style="margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; tab-stops: 124.65pt;"><i><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">The
pills are creepy and black but I feel good!<o:p></o:p></span></i></p>
<p class="MsoNormal" style="margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; tab-stops: 124.65pt;"><i><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Except
I couldn’t remember the word bacopa so I guess it’s not helping that much.<o:p></o:p></span></i></p>
<p class="MsoNormal" style="margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; tab-stops: 124.65pt;"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 0in; tab-stops: 124.65pt;">1.<span style="mso-spacerun: yes;"> </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746283/"><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746283/</span></a><span style="font-size: 14.0pt; line-height: 107%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p></o:p></span></p>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-16730122433757138402017-09-16T12:22:00.002-06:002017-09-16T12:22:33.989-06:00Padded support for the newel postThe landscaper team trooped through my front door, heading for the kitchen to discuss final plans for my ailing front yard. Straight ahead of the gang, oh lord, there was my bra hanging with perfect visibility from on the newel post of the stairway railing, beige material on black wrought iron. Obviously, no one mentioned it, but believe me, it was plain as day.<br />
<br />
Why was it there? Three weeks prior, in anticipation of company coming, I moved it from the downstairs bathroom to base of stairway in preparation for a final journey upstairs to a drawer. A new use for newel posts, a lingering storage spot for lingerie!denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-66602092168014716072014-08-21T10:57:00.001-06:002014-08-21T10:57:40.037-06:00No charge for library booksThis is more like a menopause morning than a moment.<br />
<br />
<br />
I think of myself as a low level techno-babe in the sense that I not only have a Kindle, but I know how to borrow and download books from the library on the device. The only problem with this strategy is the fact that all the books which I've placed on hold tend to show up all at once.<br />
<br />
<br />
One day last week, it was finally my turn for "The Signature of All Things". My Kindle, so long idle, needed charging prior to the download. I grabbed the charging cord from its usual spot where it was uncharacteristically placed, then headed off to the computer where I looked in on Facebook, read e-mail, studied Spanish, and browsed Amazon.<br />
<br />
<br />
Oh right, I wanted to charge my Kindle which awaited my discovery in the third place I looked. Back to the computer, but no cord in sight. Walked around the house looking for the cord, had a hot flash after going up and down several flights of stairs in search of same, ended up cleaning off my desk upstairs, then off to the kitchen to make lunch. Remembered the missing cord, restarted the hunt looking in all the same places, and finally found it hiding in plain sight on a table next to my clean desk where I'd doubtless lost interest in it and left it while grabbing my Spanish book.<br />
<br />
<br />
Back to the computer where there was no Kindle. Finally, after adding 14 flights of stairs to my daily total on my pedometer (did I mention I'm a techno-babe?), I was ready for the charge and the download.<br />
<br />
<br />
And I didn't even like "The Signature of All Things". denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-76055090716310067002014-08-05T19:28:00.002-06:002014-08-05T19:28:40.546-06:00Duavee: Finally! A new approach to menopauseA decade into menopause, and I'm still hot (no, not that kind of hot, just middle-of-the-night way too warm hot). For ten years I weighed estrogen pluses, namely good for the bones, brain, and heart, with estrogen negatives, that nagging worry regarding breast health, and I revisited that analysis annually. Just this past year, estrogen yikes overtook estrogen yay, and I dropped my weekly dose to just a tick over negligible. And subsequently lost two checks, a zillion pens, one notebook, my pedometer, my keys again and again, 5 pounds of muscle, and 1/2 inch of height. <br />
<br />
<br />
Enter a new kid on the menopausal treatment list, a so-called TSEC or tissue selective estrogen complex, also known by the not-so-catchy name of Duavee. It was approved in October, 2013, but I only found out about it in the March issue of the journal "Menopause" which featured a long article and accompanying editorial about this drug.<br />
<br />
<br />
Duavee is a combo drug, a pharmaceutical 'two-fer'. It contains Premarin (no, I don't love that about it either, but more on that later) and bazedoxifine which is not approved as a stand-alone drug in the U.S. although it is available in Europe. Each of these drugs interact with estrogen receptors in the body, but while Premarin stimulates the 'on switch' when it couples with cellular receptors, bazedoxifene turns some estrogen receptors on and some of them off depending on the specific tissue involved. It is one of a class of drugs called selective estrogen receptor modulators (SERMs). <br />
<br />
<br />
Tamoxifen is also a SERM long-used to decrease risk of estrogen-receptor positive breast cancer or to prevent its recurrence. Tamoxifen, unfortunately, stimulates estrogen receptors in the uterus, thus increasing risk of uterine cancer, and some women do not like the way they feel when they're on it. Another SERM that's been around for awhile is raloxifene or Evista which is prescribed for the prevention and treatment of osteoporosis. Evista works well on preserving bone density, protects the breast against estrogen stimulation, but aggravates hot flashes. <br />
<br />
<br />
The ideal treatment for the health challenges of menopause would turn on all the right estrogen receptors (bone, brain, vascular tissue, genitalia) and would turn off those better left quiescent in aging ladies (breast and uterus). Estrogen works wonders on hot flashes also known vasomotor symptoms; in fact, it's the very thing. It supports bone density and has a number of favorable effects on brain and cardiovascular health. Unfortunately for women no longer in their reproductive years, it stimulates breast and uterine tissue in an unwanted sort of proliferative way that, over many years, increases risk of cancer and fibroids. As a result, progesterone is added to hormone regimens to offset the estrogenic stimulation to the uterus, but this addition only increases the breast cancer risk. In addition, the effect of oral estrogen, particularly non-human oral estrogen such as Premarin, has undesirable effects on inflammation and clotting in the body. While many women did well for many years on the combo drug known as Prempro, the results of the Women's Health Initiative reported in 2002 included significant increases in incidence of stroke, heart attacks, breast cancer, and dementia in women on the Premarin/progesterone combination. Of note, however, is that women taking only Premarin did not experience an increased risk of breast cancer. Nevertheless, this study drastically changed prevailing opinion on the benefits of post-menopausal hormone therapy, and its use has since dramatically dropped.<br />
<br />
<br />
The combination of bazedoxifene and estrogen is just short of perfect. The estrogen component decreases hot flashes although the dose is lower than ideal to completely beat not only the heat but also genital atrophy (as in painful intercourse). Better yet would be bazedoxifene all by itself to be used along with an estrogen skin patch. For now, however, as I work on my personal equation of health goals vs. personal fears, Duavee gets a tentative one to two thumbs up.<br />
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Interested in more insider scoops on good health choices for the rest of your life? Stay tuned for September announcements on small group seminars on menopause, osteoporosis, and cardiovascular health.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-38589480091763346032013-05-11T20:58:00.001-06:002021-08-14T14:44:20.429-06:00A "Cat in the Hat" moment<b><span style="font-size: large;">A "Cat in the Hat" moment</span></b><br /><br />Honey, I love you, but this is out of control!<br /><br />With some difficulty,<br />I scooped semi-crystallized honey<br />with a knife<br />out of the jar<br />and onto my yogurt.<br /><br />A large glop fell to the floor<br />as I reached for a spoon<br />to scrape off the knife.<br />that swiped at the blob<div>that clung to my elbow<br />and stuck to the table<br />as I started to eat.<br /><br />A newspaper clung<br />to the drips on my sleeve, <div>soft sucking noises </div><div>arose from my shoes<br />as I walked to the sink<br />'cross honey-streaked floor.<br /><br /></div><div>My partner pointed out </div><div>with non-sticky finger<br />a huge dollop on counter<br />not even in range<br />of the gooey affair.</div></div>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-91168804378658798432013-04-22T07:06:00.000-06:002013-04-22T07:06:01.573-06:00Melting momentsHave you ever wondered if you can put a styrofoam cup directly on the warming pad of the motel coffeemakers to catch the hot water? The answer is no!denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-75244270586367610322012-07-28T13:41:00.000-06:002012-07-28T13:41:20.109-06:00"For What It's Worth"<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1kgECUJwygKxWtBvKRx9572Yh27_Qa38GTwZSTkUvv77f5QDnU6JMQH-Xcd1Gg-eEgmJd9NKJRvEm3D_btN3286f3PptCuMFSktKpNWzqDrrjUTs4XUyVUTdLMSoIORZ8LFERadHrLnY/s1600/buffalo+springfield.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1kgECUJwygKxWtBvKRx9572Yh27_Qa38GTwZSTkUvv77f5QDnU6JMQH-Xcd1Gg-eEgmJd9NKJRvEm3D_btN3286f3PptCuMFSktKpNWzqDrrjUTs4XUyVUTdLMSoIORZ8LFERadHrLnY/s1600/buffalo+springfield.jpg" /></a></div>
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My good friend and I lingered over breakfast at a nearby restaurant. We've known each other since freshman year of college, 43 years! The best Buffalo Springfield song ever came on overhead, and we both instantly got tears in our eyes. Time it was, and what a time it was...denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-17221799646911511062012-07-28T13:34:00.000-06:002012-07-28T13:34:08.294-06:00I looked smashing!I slipped back into the house after picking up the paper early one morning. Catching my reflection in the front hall mirror, I smiled broadly. Looking good in the half-light of dawn, I thought with satisfaction...<br />
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...and closed the front door on my thumb.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-59542521732089097592011-03-08T10:44:00.005-07:002011-03-08T10:55:40.854-07:00Aw shoe-t! Tucking moments on moments<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr93dWQrKsWwLIXD3NV4_WhXi1rzjQq26etTramPzKKnvxR1WZWXfu416JRwjGvys4Sslb0suoYkVJI5DU7oBDoB1nr17mGKS05EOEL7PQ2AKeB0jv9VAml4tOi9xmyQW1haZSQYYKOiI/s1600/menopause+shoes.JPG"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 150px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr93dWQrKsWwLIXD3NV4_WhXi1rzjQq26etTramPzKKnvxR1WZWXfu416JRwjGvys4Sslb0suoYkVJI5DU7oBDoB1nr17mGKS05EOEL7PQ2AKeB0jv9VAml4tOi9xmyQW1haZSQYYKOiI/s200/menopause+shoes.JPG" alt="" id="BLOGGER_PHOTO_ID_5581766782984944242" border="0" /></a>I tried not to stare at my patient's feet as we discussed her medical condition. I couldn't help wondering, however, me being a doctor and all, whether or not there was something wrong with her left foot. Was that an orthopedic old lady shoe styled for grandmas with bunions?<br /><br />When she settled onto the exam table, she smiled and stretched out her feet. "I couldn't find black socks this morning, so I settled for brown. But I didn't notice that I had two different shoes on 'til I got to the office--I'm hoping everyone assumed I wore this other shoe because my foot hurts."<br /><br />Later that afternoon, I recounted this story to another like-minded (or no-minded?) old soul. She laughed, then cleared her throat and said with an apologetic smile "Did you know that your sweater is tucked into your pants in the back."<br /><br />Good lord, couldn't remember just when I'd gone to the restroom, but I hoped that everyone assumed this partial tuck was part of a deliberate look.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com4tag:blogger.com,1999:blog-8744140692595345883.post-63953357183427855282011-03-06T19:51:00.007-07:002011-03-06T19:55:56.825-07:00Brownie points<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWA89iL9212zeRaY45x0TjM3gKARgF43YP7jbwyNskziLhxaPEF_LhV2eBZCMM-IMSpkEi5UAIFdjLzNXiUqT42IidKH2eJGIwM7BI_0-j1WojPNT3LEU6mk0NEPr174EQp_XTnky8OFU/s1600/brownies.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 200px; height: 150px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWA89iL9212zeRaY45x0TjM3gKARgF43YP7jbwyNskziLhxaPEF_LhV2eBZCMM-IMSpkEi5UAIFdjLzNXiUqT42IidKH2eJGIwM7BI_0-j1WojPNT3LEU6mk0NEPr174EQp_XTnky8OFU/s200/brownies.jpg" alt="" id="BLOGGER_PHOTO_ID_5581166283118547826" border="0" /></a><br /><span style="font-style: italic;">...an honorary menopause moment<span style="font-style: italic;"><span style="font-style: italic;"><br /><br />Text from teen: </span></span></span>So when will the brownies take effect?<br /><span style="font-style: italic;">Text from mom: </span>Well they must already be working because you just texted your mom. I'll be right there to pick you up.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com4tag:blogger.com,1999:blog-8744140692595345883.post-19415835483429773912010-11-20T12:56:00.004-07:002010-11-20T13:06:10.002-07:00Tablet rasa<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAlu0vC7F7y7He0faMokJCDstkjLKHiAaTxkI4bYkb8lSV1mZaG0zzfMqqk0eLocr6_kxxaojVZI1Y7PSYi7TaNdHNnIzm6mb_Q4tYdTrc58T2NFv3plg4LtJafk-C1lVXioyYxyAa-vg/s1600/tabula_rasa.png"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px; height: 106px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAlu0vC7F7y7He0faMokJCDstkjLKHiAaTxkI4bYkb8lSV1mZaG0zzfMqqk0eLocr6_kxxaojVZI1Y7PSYi7TaNdHNnIzm6mb_Q4tYdTrc58T2NFv3plg4LtJafk-C1lVXioyYxyAa-vg/s200/tabula_rasa.png" alt="" id="BLOGGER_PHOTO_ID_5541725633780675170" border="0" /></a><br />Me: What supplements do you take?<br />Middle-aged woman: Glucosamine...B...er...E...oh yeah D...fish oil...ginkgo...and...um...ohh that other C one.<br />Me: Do you mean vitamin C?<br />MAW: (laughing) Yes, that's it!<br />Me: The gingko's not working.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com2tag:blogger.com,1999:blog-8744140692595345883.post-4904894739721726562010-11-13T16:26:00.005-07:002010-11-13T16:34:54.268-07:00Hare to hair!<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiTECRUljNrABCA1txr2lZULkA3RIIXnE0Zb8RIzkMhNTH0Ce5VIm6VwYavTuwjIKawRTFJQ93cb2Bb1C1wSuNTomY_5IIXCGP7jm7ucEAX3HHBgYzcEIY4ybZWxBvz7Z4Yz3ZYRwENJA/s1600/bunny.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px; height: 133px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiTECRUljNrABCA1txr2lZULkA3RIIXnE0Zb8RIzkMhNTH0Ce5VIm6VwYavTuwjIKawRTFJQ93cb2Bb1C1wSuNTomY_5IIXCGP7jm7ucEAX3HHBgYzcEIY4ybZWxBvz7Z4Yz3ZYRwENJA/s200/bunny.jpg" alt="" id="BLOGGER_PHOTO_ID_5539181709601395538" border="0" /></a><br />I was shuffling down a leaf-covered sidewalk, enjoying the late afternoon sunshine. The lady of the house was out front raking, her mid-sized mutt clamoring at her heels for a game of fetch. Spying me, he grabbed his small toy, a saliva-soaked bunny, and dropped it at my feet. He was used to the well-aimed flick of an expert wrist, so he raced down the block anticipating the toss. I, in turn, heaved the soggy animal and hit his mistress upside her head.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com4tag:blogger.com,1999:blog-8744140692595345883.post-83731787413892935582010-06-27T13:41:00.001-06:002010-06-27T13:42:54.441-06:00A neighborly piece of advice?Five words you do not want to hear from your son while you're out of town whether you're menopausal or not:<br /><br /><span style="font-style: italic;">Did the neighbors call you?</span>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com8tag:blogger.com,1999:blog-8744140692595345883.post-73148426598460039132010-06-02T21:04:00.005-06:002010-06-02T21:12:04.508-06:00Baked and befuddled on the BoulevardI went to a lot of trouble to cross midday traffic on Colorado Blvd. to get to The Great Harvest Bread Company. Cute little bread girl pierced like a pin cushion gives me huge slab of 9-grain bread with butter to eat while I'm waiting for my loaf to go through the slicer. I pay up, leave with bread in hand, savoring my good luck and the fact that I will have something to munch on as I crawl home through northbound traffic.<br /><br />After slogging through two blocks of brake lights, I start thinking about bread in hand vs. bread in bag...sliced...sitting undisturbed on the Bread Company counter. Beskewered bread girl does not offer me a second slice of bread, nor does she find my "Oops, menopause moment!" comment the least bit funny.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com4tag:blogger.com,1999:blog-8744140692595345883.post-28707595109325563372010-05-24T20:55:00.004-06:002010-05-24T21:06:39.211-06:00Whose moment was this?My patient and I chatted as I did her Pap test. I always try to carry on a bit of light conversation during this uncomfortable task.<br /><br />I withdrew the brush, trying, as always, to do so without knocking the tip into the speculum. Who knows what happened next, but the flexible plastic handle bent like a bow, sprung from my fingers. flew through the air like an arrow then bounced off of the wall and onto the floor. <br /><br />My patient did not miss a beat but continued her story about her college-age son. Could she really not have noticed the brush as it circled above her and landed on the floor next to the exam table? Barely suppressing my urge to burst out laughing, I fumbled for a new brush and repeated the sampling. If my patient was aware of my antics, she was too polite to say.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com3tag:blogger.com,1999:blog-8744140692595345883.post-57351605998521158862010-05-23T15:37:00.006-06:002010-05-23T16:11:56.189-06:00Making medical decisions in menopause: A workshopI have a patient who worked as a day trader. You've got to have the metaphorical equivalent of certain male parts to do this kind of work--remaining focused, aggressive, and ruthless in a high stakes, high stress undertaking. She came to me because her world as day trader had fallen apart with the onset of menopause. When the market crashed in early October, 2008, she reported that she'd sat frozen in front of her computer, knowing that she needed to react and regroup yet unable to do anything but watch the debacle.<br /><br />"You have to understand." she said with uncharacteristic (for her) tears in her eyes, "This was not me."<br /><br />She proceeded to tell me about other pre-menopausal activities that had been her, namely extreme sports and risky jobs the likes of which I never once considered as options for my cautious self. Yet despite these major changes brought on by diminishing levels of estrogen, her gynecologist declined her request to consider estrogen therapy; she was not, after all, experiencing hot flashes.<br /><br />One of the best kept secrets about the myriad of changes brought on by menopause is the profound effects that the loss of estrogen has on the brain. There is no doubt that some women do just fine in cognitive and emotional ways through menopause and beyond, but many do not. When my patients report that they are "doing just fine" post-periods, I always ask "How's your mood" and "How's your memory?". Not unusual, then, for me to uncover evidence that, in fact, they are not doing just fine at all.<br /><br />If you are interested in hearing more about making the complex decisions involved on the road to our 600 month birthdays and beyond, please consider joining me for a menopause workshop on June 5th from 10:30 to noon at my Denver office. Please call 303-393-0300 to register; the non-refundable $20 fee is due at the time you sign-up. You do not need to be my patient to attend. If this topic is of interest to you but June 5th is a no-go, leave your name and number with my staff, and we will contact you with dates later in the summer when I will present the same material.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com6tag:blogger.com,1999:blog-8744140692595345883.post-72264526621301678682010-05-08T18:32:00.007-06:002010-05-23T16:00:49.993-06:00Hippocampal volume, aging, and estrogenIf you're reading this blog, chances are good that you have some concerns about your aging brain. You are certainly not alone; I often field questions and complaints about decreasing memory function associated with advancing years.<br /><br />The most common memory-related issue is the most difficult to assess, namely when is it time to worry, when does forgetful cross the boundary from normal to pathological. If we set cognitive normal at the level at which one's doctor functions, regular readers and my patients know that I would be inclined to overlook verbal slips and frequent loss of keys and reading glasses as a normal response to aging, stress, and general busyness.<br /><br />In fact, neurologists have defined <span style="font-style: italic;">mild cognitive impairment </span>or MCI as "a transitional state between the cognitive changes of normal aging and very early dementia"(1) that progresses to full-scale dementia such as Alzheimer's Disease at the rate of 10-16% per year. Well, that's not very helpful because, once again, we're stuck with the question of 'what's normal?' Researchers have stepped forward with clarification that's more or less helpful, citing the following characteristics of MCI:<br /><ul><li>Memory complaint preferably confirmed by another person</li><li>Objective memory impairment with a standardized assessment tool</li><li>Normal general cognitive functioning</li><li>Intact activities of daily living</li><li>Not demented</li></ul>In other words, the person is bothered by memory troubles and, while other people have noticed the deficit, the subject's daily life is unaffected by mental deficits. I start to worry when I hear about troubles in job performance, difficulties with multi-step tasks that were not formerly a problem, frequent missed obligations, and an inability to learn new information. I am especially concerned when the kids call or come in with mom to discuss this issue, and--worst of all--when others are concerned but the patient is not.<br /><br />Distinguishing so-called normal aging from MCI is, therefore, a bit slippery. One not-ready-for-prime-time technique that identifies slightly confused MCI types at high risk for dementia is the use of MRI brain imaging to measure the size of the hippocampus. This little brain structure sits to the inside of our temporal lobes located just above our ears and is so-named because it's shaped like a seahorse (but NOT like a hippo!). The hippocampus functions as VP in charge of memory formation. Along with everything else in the human body, these centers tend to shrink with age especially in those on the road to dementia. Rochester researchers launched a multi-disciplinary effort between neurologists, psychiatrists, and radiologists to see if measurements of the hippocampi of elderly test subjects with MCI reliably predicted who ended up dazed and confused at the end of nearly three years of observation(2).<br /><br />In short, it did. The researchers adjusted for head size by computing the volume of the hippocampi as a function of total brain volume, and they compared the size of the subjects' memory centers to a previously studied group of elderly controls with normal mental functioning. A subject with an average hunk of hippocampus received a W score of zero whereas those with itty bitty hippocampi were assigned negative W scores.<br /><br />The lower a subject's W score, the more likely they were to slip from MCI unto dementia. Those with W scores greater than zero, i.e. endowed with robust hippocampi, progressed to Alzheimer's Disease (AD) at the rate of 15% by study's end which is an average rate of progression as determined by numerous previous studies. On the other hand, among those with itty bitty hippocampi--W scores less than -2.5 which represents a memory center in the 1st percentile of normal size--50% were diagnosed with AD by study's end.<br /><br />So where does estrogen therapy fit in? This hormone is known to promote neuronal repair and growth, causing rat hippocampal neurons to fairly bristle with spiky connections from one cell to the next. And the more hippocampal neurons connect with one another, the better the rat performs at various rat tricks!<br /><br />For humans, however, in whom brain biopsies are considered bad form in every venue but TV episodes of <span style="font-style: italic;">House, M.D.</span>, MRI imaging was used to measure the size of hippocampi in the brains of post-menopausal women, some on hormones and some without. Researchers found a positive effect on hippocampal size associated with the use of estrogen. But this benefit was not seen in subjects enrolled in the Women's Health Initiative Memory Study who initiated hormone replacement for the first time years past menopause. This disparate effect of estrogen on memory as correlated with the timing of therapy relative to the onset of menopause suggests once again that there is a window of opportunity after which estrogen no longer preserves brain function.<br />_____<br />(1)Grundman M, et al. Mild Cognitive Impairment Can Be Distinguished From AlzheimerDisease and Normal Aging for Clinical Trials. <span style="font-style: italic;">Arch Neurol.</span> 2004;61:59-66.<br />(2) Clifford, R, et al. Prediction of AD with MRI-Based Hippocampal Volume in Mild Cognitive Impairment. <span style="font-style: italic;">Neurology. </span>1999 April 22; <span style=";font-family:verdana,arial,helvetica,sans-serif;font-size:100%;" ><em></em> <span style="font-family:times new roman;">52(7): 1397-1403.<br /><br /></span></span>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1tag:blogger.com,1999:blog-8744140692595345883.post-16003484274323851432010-05-02T20:48:00.009-06:002010-05-03T20:53:34.230-06:00Old ladies and verbal fluencyMy last post covered data on the brain health of women abruptly plunged into menopause via bilateral oophorectomies (removal of ovaries), some of whom received post-op estrogen and some of whom did not. On average, those who did fared better in cognition as they motored on in life than those who did not.<br /><br />So what about ladies who just fade into senescence in a non-surgical sort of way? Well, no paucity of info on that subject either. Consider the Research into Memory, Brain function and Estrogen Replacement study--more familiarly known as the REMEMBER study--where 428 Australian old ladies were enticed down to an Adelaide research center and put through their paces.(1)<br /><br />How do you know which old Australian is still on her game? Among other things, you see who is fastest on the FAS test. This is a measure of verbal fluency which requires the subject to say as many words as they can think of that start with the letter F, then A, then S in 60 second testing intervals. The doctors down under tried this very task--among other tests-- on the subjects, comparing FAS scores amongst the ladies as associated with their early, late, or never use of estrogen through the golden years of menopause.<br /><br />The old gals who gravitated to estrogen with that first hot flash bested the rest in FAS facility. Compared to these so-called "early initiators," the never users were not so FASt. But oy, the "late initiators," i.e. those Jills-come-lately to hormone therapy who decided to estrogen up after age 56 or five or more years post-oophorectomy; this group was slowest of all on the word retrieval thing.<br /><br />These findings mirror those of the WHIMS study wherein women who were older than 67 at the onset of the Women's Health Initiative study were put on full dose Premarin and Provera many, many years post-menopause, thus qualifying as "late-late initiators". This sub-study of the WHI followed the group for the onset of cognitive troubles over the ensuing five years. When compared with a control group given look-alike placebo Premarin, this study group demonstrated significantly more problems retaining their marbles during follow-up.<br /><br />All this research suggests again a 'window of opportunity' with respect to bolstering aging brains through the use of estrogen, the so-called <span style="font-style: italic;">timing hypothesis</span> proposed by neuroscientists. If the brain, particularly the structures of the forebrain in charge of complex cognition, is full of estrogen receptors, why would it matter when hormone therapy is initiated?<br /><br />More info to follow! <br />_____<br />(1) MacLennan, AH, et al. <span style="font-size:100%;">Hormone therapy, timing of initiation, and cognition in women aged older than 60 years: the REMEMBER pilot study. <span style="font-style: italic;">Menopause. </span></span>2006 Jan-Feb;13(1):28-36.<span style="font-size:100%;"><span style="font-style: italic;"></span><br /></span>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-11783811721536802802010-05-01T20:24:00.010-06:002010-05-01T21:23:37.801-06:00Window of Opportunity of Estrogen Therapy for NeuroprotectionCatchy title for a workshop, no? It certainly caught my eye, but alas it was over and done with months ago, and I only heard about it this month.<br /><br />Not too late, however, for me to share the gist of the message with you, namely that there is ample evidence that estrogen is brain protective--i.e. can decrease your risk of progressing from the occasional menopause moment into a permanent demented state of mind as the years go by--but only if estrogen supplementation is initiated at a time when your brain is still functioning normally.<br /><br />Actually, this is not new news at all. Researchers have known for years that estrogen plays a critical role in brain function, particularly in those parts of the anterior brain known as the forebrain where memories are formed and complex functions such as learning and multi-tasking are initiated. Diminishing estrogen levels during that lovely adventure known as perimenopause are, therefore, often associated with problems in verbal memory (finding the right word at the right time and using it correctly) as well as difficulty in mastering new skills. Ever tried to teach an old lady how to use e-mail? And if you've spent any time in nursing homes, you are well aware that the majority of the residents are female and a large number of them are struggling with dementia.*<br /><br />Doctors at the Mayo Clinic studied women who underwent oophorectomies (removal of one or both ovaries) before the age of menopause and compared their brain health through the years following surgery as compared with a group of subjects who hung onto their ovaries through a natural menopause.(1) Removing the ovaries at the time of a hysterectomy done for any reason (such as fibroids or abnormal menstrual bleeding) used to be a common practice in order to protect against the possibility of future ovarian cancer. Since the findings of the Women's Health Initiative made headline news in 2002, the use of estrogen therapy following such surgery has become increasingly uncommon.<br /><br />Those women who underwent bilateral oophorectomy (both ovaries removed) before menopause were 1.5 times more likely to develop dementia as they aged than the control subjects who did not undergo surgery. And the younger the age at which they experienced loss of ovarian function (and thus loss of estrogen), the more likely they were to develop profound problems with cognitive functioning. Subsequent analysis of the data from the Mayo Clinic group as well as from other studies showed that oophorectomized women who received estrogen therapy until age 50--more or less the time of natural menopause--had a normal risk of dementia.(2) In other words, they were no more likely to develop Alzheimer's disease than women going through menopause in the normal fashion. Furthermore, menopausal women who took hormone therapy initiated at the time of menopause and continued for 10 years, i.e. from ages 50-60, had a reduced risk of dementia.<br /><br />The scary news, however, regarding hormone therapy and dementia, came from the Women's Health Initiative which looked at the health effects of hormone supplementation in a group of post-menopausal women with an average age of 63 many of whom were a decade or more past menopause. The sub-study that looked at HRT and brain health called the Women's Health Initiative Memory Study (WHIMS) found that those women in the group who initiated HRT (and remember, this was a group specifically chosen for the characteristic that none of them had ever been on HRT prior to the study) years past menopause were significantly more likely to develop dementia.<br /><br />Scientists have dubbed this the <span style="font-style: italic;">Timing Hypothesis</span> of cognitive aging with respect to the protective qualities of estrogen. Take it early while your brain is still functioning normally, and it is protective. Take it later after you've begun to develop vascular changes from atherosclerosis or the protein plaques of Alzheimer's, and it not only won't protect, it might in fact accelerate the process.<br /><br />More on the possible mechanisms for this dual effect of estrogen on brain tissue--protective early on and detrimental as aging progresses--in future posts.<br />_____<br />*Whereas the male residents, if there are any, are more than likely suffering from Parkinson's disease, a brain dysfunction much more common in men than women.<br />(1) Rocca, WA, et al. <span style="font-size:100%;">Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. </span>Neurology 2007 Sep 11;69(11):1074-83.<br />(2) Rocca, WA, et al. Oopherectomy, Menopause, Estrogen, and Brain Aging: The Timing Hypothesis. <a href="http://longevity.stanford.edu/files/Rocca%20et%20al%20corrected%20proofs.pdf">Neurodegenerative Disease.</a>denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com3tag:blogger.com,1999:blog-8744140692595345883.post-61917246143818086992010-04-09T15:06:00.002-06:002010-04-09T15:07:45.804-06:00The changing face of primary careMy medical partner and I are facing big changes in the way we deliver medical care. I urge all of you--particularly my patients--to head over to <a href="http://femailhealthnews.blogspot.com">Denver Doc Online</a> and read about our dilemma, then leave your thoughts behind.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com0tag:blogger.com,1999:blog-8744140692595345883.post-16467676738640924982010-01-10T13:40:00.002-07:002010-01-10T13:41:44.202-07:00What's your read on this?I noticed this a.m. that all three pairs of readers were on the kitchen table. Oh-oh, I thought, that may spell trouble later on. But I didn't do anything about it, and now I can't find a single pair.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com9tag:blogger.com,1999:blog-8744140692595345883.post-31610688209548395952009-12-27T16:38:00.004-07:002009-12-27T16:52:11.456-07:00Cutting edge...Or lunatic fringe? Here's where the Christmas season took me:<br /><br />1. I send a grocery certificate to our tireless paper man each year in thanks for his pre-dawn delivery of the news. I keep hoping that this little tip will cause him to throw it slightly closer to the door, but alas, that hasn't happened yet. I didn't send him one last year as I misplaced his "Christmas card" containing his self-addressed envelope (not stamped, however). Pulled a book off the shelf the other day, one that I read...oh say about a year ago...and found said card in play as a bookmark.<br /><br />2. I received a rebate check about a month ago, not for much but 'free money' and a shame to lose it. But lost it was amidst the circulars and Christmas catalogues and back issues of "Science." While rooting around in my files the other day, I found it paper-clipped to the November bank statement.<br /><br />3. My husband always totes a large trash bag out Christmas morning to throw away wrapping paper lest I grab it up for reuse next year. The bag swung with a metallic clunk against our radiator. On investigation, he found the scissors that I misplaced while gift-wrapping the night before. I have no idea how it got there, and I wondered if the lost roll of tape was in there too.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com4tag:blogger.com,1999:blog-8744140692595345883.post-26406367900903346222009-12-09T20:44:00.003-07:002009-12-09T20:47:43.477-07:00What a crumby surprise!At the end of this long day, I was writing in charts, snacking on chocolates with sprinkles. I noted a besprinkled candy crumb on the desk, plucked it up and popped it in my mouth. Well no, it wasn't something really, really awful, but I quickly fished that piece of fuzz from my winter gloves off my tongue.denverdochttp://www.blogger.com/profile/09574453567392165275noreply@blogger.com1