Ambulatory Surgery Centers Becoming Go-To for Cataract Surgery

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Did you know that you can schedule routine procedures like cataract removal in an ambulatory setting instead of a hospital?

Over 3.5 million Americans have cataract surgery every year, making it one of the most common and safe procedures performed today. According to a recent study, cataract surgeries performed at ambulatory surgery centers (ASCs) jumped from 46 percent in 2001 to 73 percent in 2014.

What is an Ambulatory Surgery Center?

An ambulatory surgery centers (ASC) is an independent healthcare facility that offers comprehensive outpatient surgical services. Besides cataract surgery, ASCs commonly offer options for procedures like hysterectomy, total joint replacement and spinal surgery.

Benefits of an ASC

Many patients prefer ASCs because they offer premium services that hospitals cannot match. A free-standing surgery center is designed to alleviate a specific issue like cataract removal in a timely, efficient manner. Because outpatient centers are specialized, they can streamline their services to offer shorter stays with less wait time and lower cost than traditional hospitals that provide a wide scope of procedures.

When asked why they prefer an ASC over a hospital, many patients say they like smaller, personal environment, the accessibility of parking, and the friendly staff.

Schedule an Eye Exam

If you’re interested in getting more information about cataract surgery at an ASC, call your ophthalmologist. You can discuss your options at your next comprehensive eye exam. More men and women are choosing cataract surgery at a younger age, so talk to your eye doctor about correct timing for your procedure.

Can Off-Label Drugs Be Used to Treat Arthritis?

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For a patient who has arthritis, a knowledgeable provider will treat with medication or minimally invasive procedures before considering surgery. These non-surgical options might include physical therapy, over-the-counter anti-inflammatory medications or prescription drugs developed specifically for arthritis.

Sometimes, a provider may recommend an off-label prescription to treat arthritis. “Off-label” means a drug is being prescribed for a different condition than that which it has been approved for by the FDA. It is perfectly legal and somewhat common for providers to do this. According to a 2006 survey, 21 percent of prescriptions were off label, and it is estimated the percentage is now higher.

Off-Label Drug Prescription Examples

A provider might prescribe a medication off label for a variety of reasons. For example, prescriptions approved for the particular condition may cause side effects or allergic reactions or may not be effective for a particular patient. Off-label prescriptions for arthritis conditions include:

  • Rheumatoid Arthritis: Minocycline (Minocin) is an anti-inflammatory antibiotic often used to treat respiratory, urinary tract or other bacterial infections. However, some providers prescribe it to help patients who have rheumatoid arthritis with inflammation.Bottom of Form
  • Osteoarthritis: A drug called duloxetine hydrochloride (Cymbalta) was developed to treat depression. Providers found it was effective in treating osteoarthritis pain and began to prescribe it off label. In 2010, it was approved by the FDA for treating osteoarthritis.
  • Fibromyalgia: Antidepressant medications, muscle relaxants or sleep aids often ease symptoms for patients with fibromyalgia and are at times prescribed off label for the condition.

Always Take Medications as Prescribed

If you have arthritis and your provider prescribes a medication off label, follow the provider’s prescribing directions. Take the correct dosage at the right time of day, and check to see if you should take the medication with food or on an empty stomach.

Finally, if you have questions, always talk with your provider so you can receive the best benefit from your medication – on or off label.

Glaucoma and Pregnancy

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Glaucoma is a group of diseases which causes damage to the optic nerve due to high eye pressure. A common misconception is that glaucoma affects only older people. However, it can affect those of all ages. With more women waiting until their 30s and 40s to have children, the relationship between glaucoma and pregnancy is important for them to understand.

Pregnant Women Should Visit an Ophthalmologist

Since pregnancy affects glaucoma patients differently, it is critical for women who are pregnant to make an appointment with an obstetrician and an ophthalmologist as early on as possible. Eye pressure may decrease during pregnancy for many women, but for others, it may spike. For this reason, pregnant women with glaucoma should have periodic eye exams scheduled throughout the pregnancy and must follow through with all recommended appointments.

Most Glaucoma Medications are Safe for the Developing Fetus

It is understandable for expectant women to be concerned about glaucoma medication harming the developing fetus – as certain medicines should not be taken during pregnancy. However, several glaucoma medications and treatments are safe for use during pregnancy. It is essential to take prescribed medication exactly as directed to keep vision healthy and minimize any potential risk to the developing baby.

Glaucoma and Diabetes

Glaucoma is not always an isolated health condition. Often, glaucoma patients also have hypertension or suffer from diabetes. In fact, people with diabetes are twice as likely to develop glaucoma. Researchers are discovering more connections among conditions like obesity, high blood pressure, diabetes and high cholesterol, suggesting that each of these conditions could affect glaucoma risk. Therefore, women with glaucoma who are planning a pregnancy should see a primary care physician for a complete physical.

If you have glaucoma, you can have a healthy pregnancy. Create a strong partnership with your ophthalmologist, obstetrician and primary care physician to protect your vision and give your baby the best possible start.

Early Signs of Cervical Cancer Every Woman Should Know

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According to the American Cancer Society, approximately 12,340 women are diagnosed with cervical cancer and 4,000 women die from the disease each year in the United States. Fortunately, there is encouraging news: cervical cancer develops very slowly, which means it is treatable and preventable.

While a doctor can help prevent cervical cancer through pelvic exams including regular pap smears, women need to play an active role in preventing cervical cancer themselves. It is essential for women to schedule and follow through with appointments and to watch for early signs of the disease.

Below are common warning signs that may indicate the early stages of cervical cancer. Become familiar with them, and if you or a woman you care about notices them, make an appointment to see a doctor.

Early Signs of Cervical Cancer

Back Pain: If back pain is due to cervical cancer, it will likely be constant and will worsen over time. Over-the-counter pain medications may relieve back pain, but only temporarily. See a doctor about chronic or worsening back pain.

Issues with Urination: If you urinate more often, have pain during urination, experience loss of bladder control (incontinence), notice blood in your urine, or have urine that is an unusual color, see a doctor.

Leg Pain: If you have ongoing leg pain, consider making an appointment with a doctor. Some women who have cervical cancer experience leg pain due to blocked blood flow and resultant swelling.

Painful Intercourse: If you have pain upon intercourse, it could be due to something as simple as hormones. But make an appointment to rule out issues like sexually transmitted disease or cervical cancer.

Pelvic Pain: If cramps happen at unusual times, come on suddenly, or develop if you have never had cramps before, it may be due to hormonal changes or could indicate early cervical cancer.

Vaginal Bleeding: The most common early sign of cervical cancer is unusual vaginal bleeding. Women who are post-menopausal and experience vaginal bleeding or who are pre-menopausal and have bleeding between periods should see a doctor.

Vaginal Discharge: A small amount of clear to white, odorless, vaginal discharge is normal; other vaginal discharge is not. Unusual discharge could be an early signal of cervical cancer.

Weight Loss and Fatigue: If you feel tired and begin to lose weight, you may have anemia. Anemia can be a sign of cancer, as red blood cells are replaced with white blood cells which fight disease.

Risk Factors for Cervical Cancer

Risk of cervical cancer is higher for women who:

  • Have an impaired immune system
  • Have human papillomavirus (HPV) as most cases of cervical cancer are caused by HPV
  • Have had sexual activity with multiple partners
  • Smoke or are exposed to secondhand smoke 

Study: Osteoporosis Meds May Increase Esophageal Cancer Risk

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Osteoporosis medication helps prevent bone loss, but it could also harm the esophagus. A recent study suggests that oral bisphosphonates could irritate esophageal tissue and increase risk of esophageal cancer.

Bisphosphonates May Increase Cancer Risk in Women

Bisphosphonates are a class of drugs called anti-resorptives that are prescribed to prevent the loss of bone mass. Oral bisphosphonates include risedronate sodium (Actonel), ibandronate sodium (Boniva), and alendronate sodium (Fosamax). There are also bisphosphonates that can be delivered intravenously (through an IV), such as zoledronic acid (Reclast).

The bisphosphonate study, co-authored by Matthew Drake, M.D., Ph.D., examined data from women in the United States and Great Britain and noted a marginal increase in esophageal cancer. According to the results, the increase in risk is low, but it does merit attention.

Esophageal cancer accounts for only one percent of cancers in the United States, and it affects more men than women. The lifetime risk of esophageal cancer in the United States is 1 in 455 in women and 1 in 132 in men (Cancer).

3 Facts About Osteoporosis Medication

Oral bisphosphates have only been available for a decade, so it is still early for researchers and physicians to formulate conclusions. If your doctor is encouraging you to take bisphosphates for osteoporosis, keep these facts in mind as you make your decision:

  1. You can request intravenous treatment to prevent bone loss. Elevated cancer risk was only associated with oral bisphosphonates. Consider asking for IV bisphosphonates in the form of zoledronic acid (Reclast).
  2. Other risk factors for esophageal cancer can increase complications for those taking bisphosphonates. If you have difficulty swallowing or have structural abnormalities in your esophagus, you should be cautious about taking medication that could cause further irritation. Anyone with Barrett’s esophagus should avoid oral bisphosphonate medication.
  3. Occasional heartburn or reflux does not put you at increased risk. Suffering from indigestion every now and then is normal and does not increase your risk for esophageal cancer by taking oral bisphosphonate medication (Everyday Health).

If you are concerned about how medication may affect your GI health, make an appointment with a gastroenterologist. Talk with your doctor to determine whether osteoporosis prevention medication is right for you.

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Best Diet, Foods for Cataract Prevention

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Cataracts affect one in six Americans 40 and older. Women are especially susceptible to cataracts and other eye conditions because of hormonal changes due to menstruation, pregnancy and menopause. One of the most effective ways to prevent degenerative eye diseases like cataracts is with a healthy diet full of antioxidants.

Antioxidants are chemicals found in fruits, vegetables and whole grains that combat the effects of oxidative stress in the environment. No single antioxidant can neutralize all free radicals, so it is important to eat variety of antioxidant-containing foods. Here are foods that you can add to your menu to strengthen your eyes and prevent cataract-related vision loss:

Fruits and Vegetables

Studies show we need between five and nine servings of fruits and vegetables per day for optimal eye health. More matters when it comes to healthy produce, and it is important to choose a colorful variety. Fruits and vegetables offer the highest total antioxidant capacity of all foods, so make these the building blocks of your diet.

While at the grocery store, select a fruit or vegetable for each color of the rainbow. How about red strawberries, orange tangerines, yellow peppers, green kale, indigo blueberries and purple eggplant? Try to choose organic fruit and eat the skins of fruits and vegetables since they are full of vitamins A, C and E, as well as lutein and zeaxanthin.

Whole Grains

To prevent cataracts, eat three servings of 100 percent whole grains. This can include amaranth, brown rice, bulgur, buckwheat, millet, oatmeal, popcorn, sorghum, quinoa, rye and wheat. Some of these grains may be unfamiliar to you, but be adventurous. Look up some recipes and try something new!

You can also boost your eye health by making wiser choices when you purchase bread and other baked goods. Read food labels carefully, avoiding white bread and bakery items that contain refined grains and sugars and choosing items that are minimally processed.

Fish

Omega-3 fatty acids are also known to reduce the risk of cataract development and progression. Good sources of omega-3 fatty acids include shrimp, tuna, cod, salmon, halibut, trout, herring, walnut, flaxseed oil, canola oil and spinach. Eat fish at least twice per week to nourish your eyes and protect your vision.

Seeds and Nuts

Nuts and seeds are great sources of vitamin E, an antioxidant that helps protect membranes of eye cells from free radical damage. Some of the best choices for eye health are almonds, walnuts, hazelnuts, peanuts and sunflower seeds.

May is Women’s Health Month, a time for women to renew their commitment to their own health. Ladies, remember that your visual health is just as important as your family’s, so set aside an hour for yourself and get your eyes examined. A comprehensive eye exam is the best way to preserve your vision and prevent eye disease before it develops. 

Foods High in Calcium for Women’s Bone Health

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A simple way to get enough calcium is to drink three eight-ounce glasses of milk every day. While milk can be a great choice for some, for others it is not. Whether they simply do not like the taste of milk or other dairy products or they are lactose-intolerant, many people choose not to consume dairy products.

Fortunately, there are many non-dairy foods that are high in calcium. Many high-calcium choices are not always that obvious. Some leafy green vegetables, like kale, actually contain more calcium than milk. Other leafy greens, like spinach, have almost no calcium.

Why is Calcium Important?

Calcium is essential for bone health and overall well-being. The amount our bodies need changes over a lifetime. Check below to find your age and see if you are reaching the recommended daily allowance:

  • Children
    • 1-3 years old: 700 mg
    • 4-8 years old: 1,000 mg
    • 9-18 years old: 1,300 mg
  • Adults 19-50 years old: 1,000 mg
  • Women 51 to 70 years old: 1,200 mg
  • Men 51 to 70 years old: 1,000 mg
  • Women and Men 71 and older: 1,200 mg (International Osteoporosis Foundation)

Non-Dairy Foods High in Calcium

If you do not like the taste of milk or your digestive system cannot tolerate it, there are other ways you can add calcium to your diet. Below are some non-dairy choices to consider:

  • Almonds: An ounce of almonds (approximately 20 whole) offers 75 milligrams of calcium.
  • Bok Choy: One cup of raw, shredded bok choy provides approximately 75 milligrams of calcium. You can find it year-round at many grocery stores.
  • Breakfast Cereal: Many breakfast cereals fortify their products with calcium. In fact, some popular brands contain 200-600 milligrams per serving, so check the labels. If you have it with soymilk, you will boost the calcium content even more.
  • Broccoli: Two cups of raw broccoli provide about 85 milligrams of calcium.
  • Chia Seeds: Chia seeds offer more than double what almonds offer, at nearly 180 milligrams of calcium per ounce.
  • Edamame: Not only is edamame high in calcium, it is also high in protein and fiber.
  • Figs: Figs offer calcium — 120 milligrams per serving — and potassium, fiber and magnesium.
  • Kale: One cup of raw kale provides 100 milligrams of calcium.
  • Oranges: A large orange contains 75 milligrams of calcium. Calcium-fortified orange juice can contain nearly 350 milligrams per cup but be sure to check the label before you buy.
  • Sardines: A 3.75-ounce can of sardines packs in nearly 350 milligrams of calcium. Try eating them with mustard and crackers or adding them to a salad.
  • Soymilk: Because soymilk is calcium-fortified, it can provide as much calcium as milk.
  • Tofu: Tofu can help you reach the daily calcium requirement quickly. One-half of a cup offers approximately 435 milligrams of calcium.
  • White Beans: White beans contain fiber, iron and potassium — plus nearly 65 milligrams of calcium per serving.

Finally, if you are still low on calcium — even after adding more of these foods to your diet — check with your doctor to see if a calcium supplement might be right for you.

For More Information

The International Osteoporosis Foundation offers a calcium calculator you can use to determine if you are getting enough calcium. Try it now.

Heartburn Meds Can Raise Hip Fracture Risk in Post-Menopause

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Heartburn medications like proton pump inhibitors (PPIs) should not be taken for longer than two weeks at a time, but post-menopausal women should be especially cautious with reflux medicine. Studies show that extended use of PPIs could put women at risk for hip fractures. Since May is Women’s Health Month, let’s take a moment to focus on how these medicines can affect gastrointestinal health and bone health in women.

Pros and Cons of Proton Pump Inhibitors

PPIs like Nexium, Prevacid, Prilosec and Protonix are among the most powerful heartburn medications available without a prescription. They reduce the amount of acid produced by the stomach and are highly effective in treating gastroesophageal reflux disease (GERD), peptic ulcers, erosive esophagitis, and a precancerous condition known as Barrett's esophagus.

At first glance, PPIs seem to be the perfect solution for heartburn. They are effective, cheap and easy to obtain. But reducing stomach acid can cause serious health risks – like malabsorption of calcium, which can be particularly dangerous for post-menopausal women. Other side effects of PPI use include C. difficile infections, which can cause chronic diarrhea and pneumonia; low magnesium levels, which can cause muscle spasms; heart palpitations and convulsions.

Hamed Khalili, M.D., of Massachusetts General Hospital in Boston, found that long-term use of PPIs may increase fracture risk by 35 percent in older women and by up to 50 percent in smokers. Risk increased with longer PPI usage, but risk disappeared after women stopped taking PPIs for two years (Women’s Health Research Institute).

PPIs are not considered harmful to everyone, however, but it is important to take them as directed. You may find that a less potent acid reducer like an H-2 blocker (Pepcid, Zantac or Tagamet) works just as well, but first, consider changing your eating and lifestyle habits.

Home Remedies for Heartburn

Treating your heartburn may be as simple as making lifestyle modifications like:

 A GI Specialist Can Help

Make an appointment with a gastroenterologist to discuss how you can manage your heartburn without sacrificing your bone health. Ask about your risk for fractures and get a bone density scan if your doctor suggests it. Don’t forget to get enough calcium, vitamin D and exercise, and you’ll be on your way to bone strength and digestive health.

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Dry Eye Affects More Women than Men

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Dry eye is a disorder characterized by the inability to produce the right quantity and quality of tears necessary to sufficiently lubricate the eye. In a normally functioning eye, tears moisturize the cornea and protect it from foreign particles, but insufficient lubrication can lead to eye infection, pain and vision impairment.

Gender has a significant impact on the risk of dry eye, as women are at higher risk than men.    According to the National Women’s Health Resource Center, approximately 6 million women have moderate to severe symptoms of dry eye syndrome, as compared to 3 million men.

Dry Eye Symptoms

Common symptoms of dry eye include stinging, burning, redness, pain and scratchiness. It can cause alternating periods of excess tearing and excessive dryness, blurred vision, or the sensation that the eyelids feel heavy.

Why Women Experience Dry Eye More Than Men

Hormonal fluctuations, especially in estrogen, are responsible for higher prevalence of dry eye in females. These changes are more extreme during pregnancy, menstruation and menopause, when levels of estrogen and progesterone taper off. 

Other Risk Factors

Besides gender, other factors which may influence dry eye include refractive surgery such as LASIK, contact lenses, eye allergies, and inflammatory disorders like rheumatoid arthritis (Prevent Blindness). Additionally, medications like antihistamines, decongestants, antidepressants, birth control pills, anxiety medication, hypertension medication and hormone replacement therapy have been linked to dry eye.

What You can Do

Many people who suffer from dry eye just try to manage their symptoms with rewetting drops. However, it is important to see an ophthalmologist for a comprehensive eye exam. When you see the doctor, you can discuss your dry eye symptoms and evaluate various treatment options including dietary changes, vitamins, punctal plugs or medicated eye drops. The ophthalmologist may suggest that you talk with your primary care physician about your medications. One or more of your prescriptions could be making your dry eye worse. 

Women are at Higher Risk for Musculoskeletal Disorders

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Research shows that women are at higher risk of developing musculoskeletal disorders — in fact, women are twice as likely to develop some of them.

These orthopedic disorders often cause joint or muscle pain and inflammation — and can seriously impact not only a woman’s quality of life, but sometimes even her ability to walk or perform normal daily activities.

About Musculoskeletal Disorders

Here are some terms to better understand musculoskeletal issues:

  • Musculoskeletal System: The body’s joints, muscles, tendons, ligaments, nerves, discs, blood vessels, as well as the structures that support the neck, back and limbs.
  • Musculoskeletal Disorder: An injury or pain that impacts this system, hampering the functioning of the body’s movements. Pain from musculoskeletal disorders can be felt in different areas of the body, such as the upper and lower back, shoulders, neck, feet, legs, arms and hands. Examples of musculoskeletal disorders include osteoarthritis, carpal tunnel syndrome, tendinitis, osteoporosis, rheumatoid arthritis, gout and lupus.

Higher Risks for Women

Awareness is key to reducing musculoskeletal disorders in women. Women have a higher risk of:

  • Tearing a knee ligament
  • Spraining an ankle
  • Developing osteoarthritis of the knee
  • Fracturing a hip due to osteoporosis
  • Tearing an anterior cruciate ligament (ACL)

 

Preventing Musculoskeletal Disorders

  • Healthy nutrition and lifestyle choices can reduce a woman’s risk of osteoporosis. Steps to take include eating foods that are high in calcium and vitamin D, avoiding caffeine, stopping smoking, exercising daily, and limiting alcohol intake. For more tips, visit the National Osteoporosis Foundation.
  • Female athletes tear their ACLs more often than males primarily because they use their muscles and ligaments differently when jumping, pivoting and landing. However, through proper training, most women can learn to land differently to reduce the risk of tearing an ACL. The Santa Monica ACL Prevention Project developed the PEP training program (Prevent injury, Enhance Performance) to help female soccer players avoid ACL injuries. Click here to see the full PEP Program.
  • Take care when lifting heavy objects, since some musculoskeletal disorders can be triggered by improper lifting. For safe lifting practices, visit the U.S. Department of Labor OSHA website.
  • Work that is highly repetitive, or involves exposure to repeated force, vibration or an awkward posture can contribute to musculoskeletal disorders. Since every workplace is unique, talk to your doctor or employer about ways you can make adjustments to reduce your risk at work.

For More Information

If you are a woman who has a musculoskeletal disorder, contact an orthopedic doctor to see what pain-relieving options may be available to you. Keep in mind that seeking care sooner rather than later is always wise, since you may be able to avoid increased pain, further joint damage or the need for surgery.

Finally, why not take a step today, and share this article to help the women in your life reduce their own risk of musculoskeletal disorders? Just one small tip could help them avoid joint pain in the future.