Which Gynecological Disease Increases Risk of Heart Disease in Young Women?

Nausea.

Painful periods.

Excessive bleeding.

Pain with intercourse.

Fatigue.

Pain with bowel movements or urination.

These are just some of the symptoms associated with a disorder that has been found to occur in 7-10% of US women in the general population and found in 50% of teenagers with extremely painful periods. Things found to increase the risk of this condition are very common in a number of women and include stuff like beginning menses at an early age, extended menstrual flow (>7 days), delay in pregnancy, and heavy bleeding during the menstrual cycle.

What’s probably the most concerning is that if it is left untreated this same disorder can lead to infertility and even ovarian cancer. That is, until a study was published in an American Heart Association Journal (Circulation: Cardiovascular Quality and Outcomes) stating that women age 40 or younger were at a disproportionately higher risk to suffer cardiovascular symptoms and disease if they were confirmed to have this issue laparoscopically.

How disproportionate? Well the women in the study that were confirmed to have this disease were three times as likely to develop heart attack, chest pain, or need treatment for blocked arteries, compared to women without the condition. Researchers from Brigham and Women’s Hospital followed 120,000 women over 20 years for this data and found that nearly 12,000 participants had suffered with this condition. So compared to women without it, women with the condition experienced:

  • 52% increased risk of heart attack
    (myocardial infarction)
  • 91% increased risk of developing chest pain(angina)
  • 35% increased risk of needing surgery or stinting to open blocked arteries (coronary artery bypass grafting or CABG)

So enough about all the numbers. The most important question on your mind now is what is the condition causing all these symptoms and complications? Better yet, what can I do to make sure that this isn’t something me or my loved one is going to deal with or has already had at some point? Well this infamous disorder is called endometriosis and it occurs when there is a growth of the tissue that lines the uterus (endometrial tissue) in other places within the body.

This misplaced tissue responds to changes in women’s hormone levels much like it would if it remained in the uterus. To put it more plainly, imagine the tissue that should be in the uterus causing a “period” (and all the things that go along with it) wherever it’s located in the body. This can lead to a large amount of damage via an inflammatory response consisting of neovascularization and fibrosis formation.

Just about any organ system within the body can be affected by this misplaced tissue, and the exact cause of endometriosis is poorly understood. One of the most likely causes is something called retrograde menstruation, which is when menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle. Other possible causes include surgical scar implantation (after a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision) and endometrial cells transport (blood vessels or the lymphatic system transports endometrial cells to other parts of the body).

So now you have your answer to the first question we can now go back to the second question, and that is what can be done about this condition? Well there is an extensive list of potential ways to treat endometriosis and that list includes things like different hormone therapies (birth control medication or medication that halts the growth of the endometrium). If those don’t work then you may have to move to more invasive alternatives like surgery on the endometrial tissue directly or removal of the uterus altogether (hysterectomy).

Yet, another interesting fact about the study that was mentioned earlier was that having had a hysterectomy was also found to have an association with higher risk of cardiovascular disease compared with not having had a hysterectomy. (Now ain’t that something!) Since treatment may be as much of an issue as the condition itself I must mention another type of way to deal with some of these issues. That method is called prevention.

The recommendations for prevention are usually a lot cheaper and offer less potential complications than medications and surgeries. So please don’t be surprised that they are things like eating a healthy diet and staying active by doing at least 30 minutes of moderate to rigorous physical activity per day. Physical activity can help to improve pain symptoms associated with heart disease and in some cases endometriosis. It’s also recommended to maintain a healthy weight and losing weight since the latter can decrease chronic inflammation, which is one of the key issues with both endometriosis and cardiovascular disease. Other things include quitting (or do not start) smoking and taking warm baths which can help relax pelvic muscles, reducing cramping, and improve pain.

In all, you should consult with a doctor or healthcare provider about any questions, symptoms, treatments, or prevention measures before beginning them. I hope this has been a helpful post and thanks for reading.

– Supreme Soul

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James Derham


James Derham was the first Black person to receive a certificate to practice medicine in the U.S. He won his freedom and set up his own practice in New Orleans. He was the first African-American to formally practice medicine in the United States though he never received an M.D. degree. Derham was born into slavery in Philadelphia, Pennsylvania. He was owned by several doctors and by working as a nurse/medical assistant, he saved enough money to purchase his freedom by 1783. In the same year he ended up in New Orleans with a Scottish physician, to perform medical services. He opened his own medical practice, and by age 26 his annual earnings exceeded $3,000. He was a popular and distinguished doctor in New Orleans, at least in part for his knowledge of English, French, and Spanish. In 1789, Durham saved more yellow fever victims in New Orleans than any other physician in colonial Philadelphia.

Supreme Soul

Ella P. Stewart

Ella P. Stewart

Ella P. Stewart

Ella Nora Phillips Stewart was born on March 6, 1893 in Stringtown, West Virginia. With a love of nature and an exceptional interest in learning, she attended high school at the age of twelve at the Storer College – the only school in the region that accepted black students. Rather than continue her training and education as a teacher, she chose to marry and begin a family. She had one child, a daughter, who unfortunately died at a young age from whooping-cough. After the death of her child, Stewart began working as a bookkeeper in a local pharmacy. It was at this time she developed an interest in becoming a pharmacist herself. Stewart wished to attend the University of Pittsburgh’s School of Pharmacy but was met with discrimination when she was told admissions were closed. She would remain persistent in her task and would desegregate the University of Pittsburgh by being the first black student admitted in 1914. She graduated from the University of Pittsburgh in 1916 earning her Ph.D and in the same year would go on to pass her state exam to become the first licensed African-American female pharmacist in Pennsylvania and one of the earliest practicing African-American female pharmacists in the country.

Stewart worked in Pittsburgh and then Braddock, Pennsylvania where she was employed at the General Hospital and managed a drugstore. Her hard work enabled her to eventually purchase this drugstore, and was later able to open several of her own pharmacies. She learned that there were no black-owned drugstores in Toledo, Ohio, so she traveled to Toledo, purchased a commercial building and in 1922 and opened the Stewart’s Pharmacy with her second husband. The business did well and was welcomed by the neighborhood. As Ella became more important in the community she became more and more interested in the problems that it faced. She became involved in the Enterprise Charity Club, a black women’s philanthropic club which provided assistance to Toledo families. Through her work with this club, Stewart developed a reputation of leadership that led to her eventual election in 1944 as President of the Ohio Association of Colored Women and from 1948 to 1952, as President of the National Association of Colored Women (NACW).

For Ella, her most cherished achievement and honor was the naming of a Toledo elementary school after her; a school she visited often, serving as a role model to its young students. Despite Stewart’s extensive club work and numerous honors, she was continually met with the discrimination she had worked all her life to end. She never accepted the racism she found, instead, she succeeded in her own quiet way to overcome it.

– Supreme Soul

Dr. Solomon Carter Fuller

Here at 3GW, it was decided to give readers some information about influential African-Americans for Black History Month. I will try to keep it brief and informative and hope you all enjoy.

Solomon Carter Fuller, M.D.

Solomon Carter Fuller, M.D. was the nation’s first African-American psychiatrist and a neurologist who made significant contributions to the study of Alzheimer’s disease. He also focused his research on the organic causes of disorders such as schizophrenia and bipolar disorder. Fuller’s knowledge of venereal disease later helped diagnose syphilis in black World War II veterans who had been previously misdiagnosed with behavioral disorders. The mental health facility at Boston University is now officially known as the Dr. Solomon Carter Fuller Mental Health Center.

Supreme Soul

Thoughts From A Doctor: Does Mental Illness Cause Tax Fraud?

I first came across the story of a 27-year-old Rashia Wilson who received a 21 year prison sentence for tax fraud and thought “that’s a damn shame”. Why? Well as the beginning of the story goes, Rashia constantly posted about her ability to get over on the IRS via Facebook. This was made evident during her recent trial in Tampa as the U. S. attorneys read excerpts from Wilson’s page.

I’m Rashia, the queen of IRS tax fraud

I’m a millionaire for the record, so if U think indicting me will B easy it won’t, I promise you! U need more than black and white to hold me down N that’s to da rat who went N told, as if 1st lady don’t have da TPD under her spell. I run Tampa right now.

The judge over her trial states she stole over $3 million, which is a big part of why she received the harshest penalty yet in the Tampa Bay area for charges relating to stolen identity and refund fraud.

Now I will admit that reading posts like those immediately caused me to make a snap decision. “She’s guilty, and she deserves to serve time for the crime she committed.”  I mean how could someone who’s doing something like that be so brash to go on one of the most public forums in the world and continuously flaunt their criminal activities? Most people would chalk it up to there being a lack of intellect on her part, much like I assumed after reading the beginning of the story. Yet, the more I read the more the entire picture started to come into focus.

A psychologist testified that Rashia Wilson suffers from bipolar disorder first diagnosed at age 14. For those that may not know the disease by that name it’s also sometimes called manic-depressive disorder. A brief explanation of what this entails is as follows:

Bipolar disorder is a serious mental illness that is characterized by extreme changes in mood, from mania to depression. It can lead to risky behavior, damaged relationships and careers, and even suicidal tendencies if it’s not treated.

Most people have an idea of what depression entails so I won’t go into that branch of the disorder here. However, very few people I have talked to have an understanding of what mania means and encompasses. So for the sake of clarity, I found this definition for mania to be simple and explanatory for this post:

Mania is a state of abnormally elevated or irritable mood, arousal, and/or energy levels. Mania symptoms may include excessive happiness, excitement, irritability, restlessness, increased energy, less need for sleep, racing thoughts, high sex drive, and a tendency to make grand and unattainable plans.

The very last part about a tendency to make grand and unattainable plans is why I said the picture came into focus. People who are affected by bipolar disorder who experience mania can have some of the above symptoms, but those that have the grandiose thinking are often those that have issues with various aspects of life, especially dealing with money. These people can have a tendency to show poor judgment, such as impulsively deciding to quit a job. They also can have inflated self-esteem leading to unrealistic beliefs in one’s ability, intelligence, and powers. This grandiose sense can also lead to increased reckless behaviors, such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions.

The point I’m trying to get at is that if Rashia Wilson was in a manic phase during her rants on social media, there is some explanation as to why she would continuously rave about being untouchable by law enforcement. Now, I’m not going as far as to say she deserves a pass for what she did. But, I will say that people who are untreated for their bipolar disorder can literally go to the extremes with impulsive behavior and reckless decision-making. I’ve personally had patients come and tell me that they spent all of their savings in one weekend just because they felt like they could, there was no reason not to, and they felt invincible. Yes, invincible. It’s quite a sight to see, and if you know what it looks like you definitely won’t forget it.

It is because of this concept I was reminded that you shouldn’t always judge a book by its cover. As cliché as that saying is, it still holds true in many instances and different facets of health care. Before you look down on someone for their decisions I recommend you get to know the true nature of that person. You may find that  there is more going on with them than meets the eye, and their seemingly ridiculous actions and thoughts originate from something other than a wanting to disregard common conventions.

You can choose to do this or not. In the end you have to make your own decisions and live with them. After all, these are just thoughts from a doctor…

– Supreme Soul

Thoughts From A Doctor: Non-Smoker vs. Smoker

nonsmoker vs. smoker

I often get a chance to see some interesting things in the healthcare field. This ranges from limb amputations, open heart surgeries, mastectomies, intestinal washouts, and every now and then, lobe-ectomies. The pictures above likely come from dissections of a human body, much like what happens when medical students undergo their gross anatomy labs. When we did this, we literally would remove different organs from the human body to learn about their shape, size, function, location within the body, and pathology that likely affected the person before their death. It was an amazing site to see, to say the least. Yet, what was more amazing than the normal everyday stuff would be when I would come across things that were not expected. This would range from a metallic joint that had been replaced, a cancer that remained in an organ, a pacemaker or defibrillator placed in the heart, and the large difference that exists between the organs of smokers and non-smokers.

Of course, it’s hard to quantify how much smoking any of the people did before their passing. Yet, you could get an idea of those that smoked more and longer than others. This came from the general appearance of the organ, its texture, shape, and size compared to organs of others. I would have to say that more than 80% of the time the smokers’ organs would appear much different in comparison to the nonsmokers’ depending on what organ we would be examining. Some lungs would be darker (sometimes black), rougher, smaller, and have masses within it while others would be just the opposite. The kidneys could be the same or different. Same goes for the liver, the pancreas, and the heart. Why is this? Well it’s all subjective, meaning each person is different. They smoke different things. Tobacco. Marijuana. Meth. Crack. They smoke at different times of day for different amounts of time. Some at night for a few minutes. Others in the morning while driving to work. They smoke in different settings/conditions. In bars. At parties outside. In a closed office or vehicle. You get the idea. Since every person and their habits/preferences are not the exact same there were always variations of what we would see as medical students.

Now, being on the front line of treatment for those that smoke, I often try to urge people to see the bigger picture versus their current state of health. While they are feeling good and there are no prominent symptoms from the smoking that continues for days, weeks, years, and lifetimes, by the time any arrive it’s often too late. Then comes a load of bad news I have to deliver to that person and their families. What’s worse than this is when I have to see children that are negatively affected by the smoking adults around them put them through on a daily basis. One would think that if they saw their own kid negatively affected by something these parents would definitely remove that negative factor from their kids’ life. Yet, this often is a lot easier said than done. It’s the epitome of what addiction does to people. The ability to quit eludes these parents just as much as it would anyone else, and all the while these kids’ health deteriorates. Asthma flares up. Eczema worsens. Ear infections return over and over and over, and the smoke keeps flowing into the air like a train coming down the railroad. It’s a sad sight to see, but a regular occurrence.

So I write all of this to say that I have multiple conversations a week about quitting smoking. I’m not the overly aggressive type that tries to scare you every time I see you into quitting. I tell people that you can quit whenever you want to, but you have to truly want to first. Most people I talk to are grown up and intelligent enough to make a conscious decision. Quit or not. So if they choose to continue to do so, I leave it be. I will remind you each time I see you in the clinic to quit because it will make a lot of people better in the long run. Yet, I will stop there with all the warnings and reprimands. Hopefully it gets through to that person similar to how I realized it did when I randomly saw a 34-year-old patient of mine outside of the clinic. He was actually having dinner with his family, and stopped me as I walked into the restaurant just to say 6 words that sounded like music to my ears. 6 words that made me feel like a proud parent when their child gets an award. 6 simple words that reminded me why I choose medicine in the first place.

Hey Doc. I actually quit smoking.

Well then it was all worth it. If not, well lets just say that there will always be an anatomy lab out there with medical students happy to see the decision to continue smoking was made. Seeing lungs like the ones above on the right are a great learning experience for them, and if you’ve read up to this point then maybe it has been for you too.

Supreme Soul