Jennie Kidd Trout

What you do makes a difference, and you have to decide what kind of difference you want to make – Jane Goodall

Today would have been Jennie Trout’s 117th birthday.  I never heard of her until a few minutes ago when I saw an image of her on Google’s logo.  Of course, I had to find out who Jennie Trout was.  She was the first woman in Canada to become a licensed medical doctor in March 1875. Jennie was the only woman in Canada licensed to practice medicine until July 1880, when Emily Stowe completed the official qualifications.

Jennie Kidd Trout was born in Kelso, Scotland.  In 1847, she moved with her parents to Canada.  They settled in Stratford, Ontario.  After graduating, Jennie became a teacher after taking a teaching course and continued teaching until her marriage to Edward Trout in 1865.  The couple moved to Toronto where Edward ran a newspaper.

It was her own battle with “nervous disorders” shortly after her marriage, which made Jennie decide to practice medicine.  In 1871, she passed her matriculation exam and studied the University of Toronto.  Jennie Trout and Emily Jennings Stowe were the first women admitted to the Toronto School of Medicine, by special arrangement.  However, Emily refused to sit her exams in protest of the university’s demeaning treatment of the two women.  In the following video is the reenactment of how Jennie stood up to the prejudices of her male counterparts in the classroom.

Jennie ended up transferring to the Woman’s Medical College of Pennsylvania, where she earned her M.D. on March 11, 1875 and became the first licensed female physician in Canada.

Jennie opened the Therapeutic and Electrical Institute in Toronto where there were specialized treatments for women involving “galvanic baths or electricity.” A galvanic bath uses the components of water and gentle electrical current. You lie in a 34 degree Celsius Bath, electricity is then passed through your body. Galvanic bath’s are mostly used in the treatment of degenerative diseases such as inflammatory arthritis and problems with the joints. The treatment lasts about 15 minutes (SMOKH)

For six years, she ran a free dispensary for the poor at the same location as the Institute which became so successful that branches in Brantford and Hamilton were later opened.

In 1882, due to poor health, Jennie moved to Palma Sola, Florida.  She was instrumental in the establishment of a medical school for women at Queen’s University in Kingston. Her family travelled extensively between Florida and Ontario and later moved to Los Angeles, California, where she died in 1921.

In 1991, Canada Post issued a postage stamp in her honour to commemorate her as the first woman licensed to practice medicine in Canada.

Notes to Women celebrates this phenomenal woman who made history and left an indelible mark in the medical profession.  She is an inspiration for us all.

Sources: Wikipedia; Susanna McLeod ; Goodreads

Advertisements

Madira’s Healing

This story is similar to the woman with the issue of blood.  She had suffered for twelve years and the doctors couldn’t help her although she had spent her money on them. Finally, she had sought out the only One who could.  In faith, she touched the hem of His garment and was healed.  Madira was suffering from an unknown sickness.  The doctors could not ease her pain so she turned to witch doctors whose prescribed methods failed to work.  After six years elapsed, they gave up and for years, Madira continued to suffer.

Then, one day in the midst of her pain, Madira remembered the gift her brother had given her sixteen years ago.  It was a Bible.  It was the last resort.  She and her family had tried everything possible to end her suffering, but so far, nothing had worked.

She pulled her son aside and asked him to bring the Bible and read it to her.  As he read to her from it, something miraculous happened.  The pain left Madira’s body and she was able to sleep through the night.  It was possible now for her to move without the struggle and discomfort.  The words filled her with a peace she had never experienced before and brought healing to her tired body.  This stirred within her a desire to know who Jesus was.

One day they met Seth, a Gospel for Asia supporter serving their area with whom they explained their problems to.  He told them about Jesus’ love and how He was the great Healer and Restorer.  He promised them that if they believe in the name of Jesus Christ, Madira would be healed.  However, after years of discouragement and treatments that didn’t work, they were not hopeful.  Seth encouraged them not to worry because God does the impossible for all who believe in His name.

The family decided that since there was no hope anywhere else they would go to church and learn about God’s love.  There they met pastors and believers who prayed regularly for Madira.  Within a few weeks, God healed her completely.  He had answered their prayers.

For the eyes of the Lord are on the righteous, And His ears are open to their prayers – 1 Peter 3:12a

Through the fervent prayers of His people, God healed Madira.  This all came about when Madira remembered the Bible which contained the living, breathing Word of God. She discovered its great value and in its pages, the God who wanted to reveal His love to her.  It was able to do what the doctors and the witch doctors were unable to do–bring relief and peace from her pain.

God’s Word is powerful and it still impacts the lives of those who are in possession of it. Help Gospel for Asia to put the Word of God in the hands of more families in Asia so that like Madira and her family, their lives can be impacted too.

wfr17-11-uncovering-a-treasure-after-16-years-1

Sources:  Gospel for Asia; Bible Gateway

Women and Shingles

I found out last week that my mother who suffers from Parkinson’s has Shingles.  From what I have seen of Shingles it looks very painful.  I wanted to find out more about it so I decided to surf the Internet and get as much information as I could.

What is Shingles?

Shingles, also known as herpes zoster or just zoster, occurs when a virus in nerve cells becomes active again later in life and causes a skin rash.

The virus that causes shingles, the varicella-zoster virus, is the same virus that causes chickenpox. It is a member of the herpes virus family. Once you have had chickenpox, varicella-zoster virus remains in your body’s nerve tissues and never really goes away. It is inactive, but it can be reactivated later in life. This causes shingles.

Doctors aren’t sure how or why the varicella-zoster virus reactivates, but they believe your immune system’s response to the virus weakens over the years after childhood chickenpox. When the virus reactivates, it travels through nerves, often causing a burning or tingling sensation in the affected areas. Two or three days later, when the virus reaches the skin, blisters appear grouped along the affected nerve. The skin may be very sensitive, and you may feel a lot of pain.

If you have had chickenpox, you are at risk of developing shingles. However, the virus doesn’t reactivate in everyone who has had chickenpox. Shingles most often appears in people older than 50 and in people with weakened immune systems. If you are having treatment for cancer, for example, you are more likely to get shingles. People with HIV commonly get shingles, which is often one of the first signs that the immune system is in trouble.  Your chances of getting shingles increase as you get older, although the disease can occur at any age. When shingles appears in children, which is uncommon, it usually is very mild. Up to 20% of people in the United States develop the disease at some point (Women’s Health).

None of my sisters nor I ever have Chicken Pox as a child but later when we as adults, my sister and I got it from our mother.  I still have the marks.  I am hoping that I am one of the people in whom the virus does not reactivate.

 

493x335_psoriasis_ra_and_shingles

Recently I have seen a commercial where a person has Shingles and it looks painful.  The rash on one side of  the man’s body looked red and very painful.  When I browsed the Internet, I saw pictures that made me cringe.  How those people must have suffered.  I think of my mother and I hope and pray that she isn’t in much pain.

What are the symptoms?

Pain

Symptoms of shingles are similar in men and women. The first and most common symptom of shingles is usually pain. This pain typically occurs before any rash is present and is sometimes called the warning stage of shingles. Women often describe a tingling, burning pain or an area of intense sensitivity on their skin. This often happens in a small area that is on one side of the body only. The pain may be mild or intense enough to require treatment with painkillers. The pain may last for a few days, may come and go or may be constant. It may continue once the rash and blisters form and usually lessens when the rash disappears.

Rash and Blisters

Another symptom of shingles is a rash that turns into fluid-filled blisters. This usually appears a few days or a week after skin pain starts. The blisters form a crusty scab in about 7 to 10 days and typically clear up in 2 to 4 weeks. The difference between the rash of chickenpox and that of shingles is that shingles usually appears on one side of the body only. Shingles commonly appears in a belt-like band around the midsection, corresponding to skin along the path of one nerve. Sometimes the rash appears on one side of the face and follows the major facial nerve, or it can involve more than just a single area of skin. Some cases of shingles have only a few or even no blisters. A shingle diagnosis can be missed in this case. Shingles without any rash or blisters is called zoster sine herpete.

Other Symptoms

Once the rash appears, women sometimes report flu-like symptoms, such as headache, upset stomach, fever and chills. About half of the people who have rash along the facial nerve experience eye complications. These complications are generally seen as inflammation of different parts of the eye and may involve a mucus or pus-like discharge and sensitivity to light. Eye problems from shingles are very serious and should be evaluated by a doctor immediately. Some women experience a condition called postherpetic neuralgia. This condition is pain that continues even after the shingles rash is gone. The pain has been described as a constant burning that hurts to the touch or pressure from clothing. It usually resolves on its own, but resolution can take 6 months to a year or even longer (Live Strong).

 

Shingles and pregnancy

Pregnant women can get shingles, but it is rare. While chickenpox can pose a very serious risk to a fetus, there is almost no risk to the fetus if the mother gets shingles. The symptoms of shingles are the same in pregnant and non-pregnant women. Any area of skin that has pain, tingling, itching or burning — even without a rash or blister — should be brought to the attention of a doctor, as this could be the early stages of shingles (Live Strong).  Thankfully, I got chickenpox years before I got pregnant.

 

Does Shingles affect women differently from men? According to Centers for Disease Control and Prevention (CDC):

  • Most, but not all, studies found that more women than men develop herpes zoster [1,2]; the reason for a possible difference between women and men is not known.
  • Some studies conducted in the United States and elsewhere found that herpes zoster is less common in blacks (by at least 50%) than in whites.[3]

 

How is Shingles Treated?

Self-care

If you develop the shingles rash, there are a number of things you can do to help relieve your symptoms, such as:

  • keeping the rash as clean and dry as possible – this will reduce the risk of the rash becoming infected with bacteria
  • wearing loose-fitting clothing – this may help you feel more comfortable
  • not using topical (rub-on) antibiotics or adhesive dressings such as plasters – this can slow down the healing process
  • using a non-adherent dressing (a dressing that will not stick to the rash) if you need to cover the blisters – this avoids passing the virus to anyone else

Calamine lotion has a soothing, cooling effect on the skin and can be used to relieve the itching.

If you have any weeping blisters, you can use a cool compress (a cloth or a flannel cooled with tap water) several times a day to help soothe the skin and keep blisters clean.

It’s important to only use the compress for around 20 minutes at a time and stop using them once the blisters stop oozing. Don’t share any cloths, towels or flannels if you have the shingles rash.

Antiviral medication

As well as painkilling medication, some people with shingles may also be prescribed a course of antiviral tablets lasting 7 to 10 days. Commonly prescribed antiviral medicines include aciclovir, valaciclovir and famciclovir.

These medications cannot kill the shingles virus, but can help stop it multiplying. This may:

Antiviral medicines are most effective when taken within 72 hours of your rash appearing, although they may be started up to a week after your rash appears if you are at risk of severe shingles or developing complications.

Side effects of antiviral medication are very uncommon, but can include:

 

Can Shingles Be Prevented?

Currently, there is no way to predict an outbreak of shingles.  Researchers have shown that giving older people a stronger form of the chicken pox vaccine used for children can boost the type of immunity believed necessary to hold the virus in check. Zostavax, a shingles vaccine developed by Merck, has been approved by the FDA. An initial study in people with HIV showed that Zostavax was safe and effective (The Body).

 

Is Shingles Contagious?

Shingles is not contagious (able to spread) in the sense that people who are exposed to a patient with shingles will not “catch shingles.” Anyone who has already had chickenpox or has received the chickenpox vaccine, and is otherwise healthy, should be protected and at no risk when around a patient with shingles. However, people who have never had chickenpox and have not received the chickenpox vaccine are susceptible to infection by a patient with shingles. These susceptible people, if exposed to the shingles virus, will not develop shingles, but they could develop chicken pox. However, people who have never had chickenpox and have not received the chickenpox vaccine are susceptible to infection by a patient with shingles. These susceptible people, if exposed to the shingles virus, will not develop shingles, but they could develop chicken pox. Such susceptible individuals include babies, young children, and unvaccinated individuals, so people with shingles are actually contagious for VZV infections in the form of chickenpox. Consequently, these individuals may get shingles at a later time in life, as can anyone who has had chickenpox. Covering the rash that occurs with shingles with a dressing or clothing helps decrease the risk of spreading the infection to others. Pregnant women are not unusually susceptible to shingles but if shingles develops near the end of pregnancy, the fetus may be harmed (eMedicineHealth).

 

Vaccines for Shingles

The shingles vaccine (Zostavax) is recommended for adults age 60 and older, whether they’ve already had shingles or not. Although the vaccine is approved for people age 50 and older, the Centers for Disease Control and Prevention isn’t recommending it until you reach age 60.

The shingles vaccine is a live vaccine given as a single injection, usually in the upper arm. The most common side effects of the shingles vaccine are redness, pain, tenderness, swelling and itching at the injection site, and headaches.

Some people report a chickenpox-like rash after getting the shingles vaccine.

Although some people will develop shingles despite vaccination, the vaccine may reduce the severity and duration of it.

The shingles vaccine isn’t recommended if you:

  • Have ever had an allergic reaction to gelatin, the antibiotic neomycin or any other component of the shingles vaccine
  • Have a weakened immune system due to HIV/AIDS or another disease that affects the immune system
  • Are receiving immune system-suppressing drugs or treatments, such as steroids, adalimumab (Humira), infliximab (Remicade), etanercept (Enbrel), radiation or chemotherapy
  • Have cancer that affects the bone marrow or lymphatic system, such as leukemia or lymphoma
  • Are pregnant or trying to become pregnant

The cost of the shingles vaccine may not be covered by Medicare, Medicaid or insurance.  Check your plan (Mayo Clinic).  One of my co-workers got the vaccine this year and recommends that I get one too.

 

shingles-s16-photo-of-woman-receiving-vaccine

 

Is there a Cure?

There is no cure for shingles, but treatment can help ease your symptoms until the condition improves. In many cases, shingles gets better within around two to four weeks.  However, it’s still important to see your GP as soon as possible if you recognize the symptoms of shingles, as early treatment may help reduce the severity of the condition and the risk of potential complications (NHS Choices).

 

Caring for Shingles

How to care for a Patient with Shingles

If you are helping to care for someone with shingles and particularly if they are elderly, then here are some ideas to make life more comfortable for them:

  • As soon as the rash appears and has been diagnosed as shingles, start treatment. If treatment can be commenced within two or three days of the outbreak, the shingles will be less severe and there is less chance of the patient going on to suffer from postherpetic neuralgia.
  • You cannot catch shingles by touching the sore skin or the bed or chair where the person has been lying or sitting so if wearing less clothing will make the patient more comfortable then encourage this. Some people with shingles are very sensitive to touch so try to touch only the side of the body that does not have the rash.
  • You can catch chicken pox from a person with shingles blisters so keep anyone who has never had chicken pox away from the patient.  (This particularly applies to pregnant women where there is a danger to the unborn fetus).
  • Relieve any discomfort with cool compresses unless your patient finds it makes the pain worse.
  • Look for ways to relieve the stress of the pain for your patient such as meditation or listening to soothing music.
  • Make sure your patient has a pain reliever if necessary and you may need a prescription for something to help insomnia if this is a problem. In some cases, the pain can be very severe and with such pain, it is hard to find a comfortable position whether sitting, lying down or walking around.  Your patient needs as much sleep as possible.
  • Constant pain can affect your patient’s appetite – try to encourage your patient to eat well (you may need to provide extra tasty treats).
  • Constant pain can also make your patient cross, sad or depressed – this will need extra patience and kindness on your part (Healing Natural Oils).

My mother is doing well.  She is on an anti-viral drug and not in any pain.  I was relieved to find out that her blisters are on her arm and not on her face.  She is frustrated because she is quarantined but the nursing home has to do what is best for all the residents.  I hope she gets better soon.  In the meantime, my family and I will do as she requested and stay away.

If you have a loved one who has Shingles, call them often.   Hearing from you may bring them some comfort.

 

Sources:  Live Strong; Women’s Health; Mayo Clinic; The Body; CDC; eMedicine Health; Healing Natural Oils

Women And Infertility

I was watching General Hospital and one of the characters received the news that she could not have children.  Any child she carried would not be carried to full term.  She would lose the baby.  What heartbreaking news.  It hurts to see women who want to be mothers and who would be great mothers unable to have children while those who are unfit have children.  It doesn’t seem fair.  Lulu, the character wondered why this happened to her since there was no family history of infertility.  Before that she blamed herself for her condition because she had had an abortion when she was a teenager.

I have often wondered why are some women unable to have children or carry them to full term?  There was a time when I was afraid that I would not be able to have children.  In biblical times barren women were looked down upon by other women.  Sarah was despised by her servant Hagar because she was able to conceive while her mistress couldn’t (Genesis 16:4).  Hannah was tormented by Peninnah, her husband’s other wife and rival because the LORD had closed her womb.  She made Hannah’s life a living hell until God blessed Hannah with children.  Rachel rejoiced when she conceived her first child, saying, “God has taken away my reproach” (Genesis 30:23).

In developing countries women face ostracisim and see their infertility as a failing or a curse.  Newsweek ran a story in 2008 about women around the world who are coping with infertility.  One woman was uable to conceive for the first 13 years of her marriage.  She said that people would ask a woman her name—and then, “How many children do you have?” When the woman answered “none”, they don’t know what they can talk to you about.”

It must be so difficult for a woman to be surrounded by family members and friends who have children of their own or to see mothers where ever you go with their children and know that she would never have that experience.  It’s ironic. There are women who can have children but choose not to and there are women who would like to be mothers but are unable to have children.

What causes infertility in women?  Women’s Health Government has a fact sheet which answers these and other questions about infertility.

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • A man’s sperm must join with (fertilize) the egg along the way.
  • The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

Infertility among women is common.  According to  the Centers for Disease Control and Prevention (CDC) about 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

What increases a woman’s risk of infertility?

Many things can change a woman’s ability to have a baby. These include:

Check out the Women’s Health Government fact sheet to find out how age can affect a woman’s ability to have a child; how long a woman should try to get pregnant before consulting a doctor; how a doctor determines if a woman and her partner have fertility problems and treatments.  They also offer more information (links) on infertility that may help you or someone you know who may be having difficulty getting pregnant.

Glen Meade Center for Women’s Health outlines the ways in which women can be tested for infertility:

  • Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
  • Checking morning body temperature to determine if ovaries are releasing eggs
  • Hysterosalpingography (a radiologic assessment of the uterus and fallopian tubes)
  • Pelvic ultrasound
  • Laparoscopy (inspection of pelvic region)
  • Luteinizing hormone uterine test (ovulation prediction)
  • Thyroid function tests

There is hope for women experiencing infertility.  Glen Meade offers the following treatment options depending on the cause of the infertility:

  • Education and counseling
  • Fertility treatments, such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
  • Medications that treat infections and clotting disorders
  • Medications that help women grow and release eggs from the ovaries

Notes to Women wants to reach out to women facing infertily by encouraging them to read articles from women who are coping with it such as this one.  We hope that the tips for living with infertility will be helpful to you and give you some comfort.

Sources:   http://womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfmhttp://www.glenmeadehealth.com/ms_infertility.html; http://www.thedailybeast.com/newsweek/2008/09/14/what-it-means-to-be-a-woman.html

Women and Bipolar Disorder

The first time I was aware of bipolar disorder was years ago in New York.  It was there that I learned that my sister was manic depressive.  She had suffered from a nervous breakdown.  I never knew that she was manic depressive.   It was not evident to me.  She seemed fine to me.

While living in New York, she only had one episode where she had to stay in the hospital overnight but after that she was fine.  She had a good doctor who was diligent in her care.  I have other relatives who suffer from bipolar disorder.  And a co-worker of mine is no longer working because she had a relapse.  The last time I saw her I couldn’t believe it was the same person.  She called me on the phone and she was saying things that didn’t make sense and using language I never expected to hear coming out of her mouth.  I realize that when a person has bipolar disorder, he or she is different.  The illness changes the person.  Things from the past are dredged up, there are resentments and the belief that there is a conspiracy against him or her.

It’s hard to see someone you love suffering from a mental illness.  It’s harder when the person comes off of the medication and winds up back in hospital.  Each time he or she comes off the medication, it becomes harder to get back on track.  And the scary thing is they get into debt or in some cases trouble.  It’s hard for family members to know just how to cope, especially if during these episodes harsh and hurtful things are said.  It’s so disappointing when the person is doing well for a long time and then there is a relapse.  Each time he or she gets better, you are wary, wondering how long it would last.  Each time he or she promises not to come of the medication and vows to stay out of the hospital but something happens and there is an episode.

Even though I am aware of bipolar disorder, I still don’t know much about it.  I thought that I would search the web and gather all the information I could find just to get a better understanding of the illness.

What is Bipolar Disorder?
Bipolar disorder, formerly known as manic-depressive illness, is a brain and behavior disorder characterized by severe shifts in a person’s mood and energy, making it difficult for the person to function. More than 5.7 million American adults or 2.6 percent of the population age 18 or older in any given year have bipolar disorder. The condition typically starts in late adolescence or early adulthood, although it can show up in children and in older adults. People often live with the disorder without having it properly diagnosed and treated.

What are the symptoms of Bipolar Disorder?
Bipolar disorder causes repeated mood swings, or episodes, that can make someone feel very high (mania) or very low (depressive). The cyclic episodes are punctuated by normal moods.

Mania Episode Signs and Symptoms:

  • Increased energy, activity, restlessness
  • Euphoric mood
  • Extreme irritability
  • Poor concentration
  • Racing thoughts, fast talking, jumping between ideas
  • Sleeplessness
  • Heightened sense of self-importance
  • Spending sprees
  • Increased sexual behavior
  • Abuse of drugs, such as cocaine, alcohol and sleeping medications
  • Provocative, intrusive or aggressive behavior
  • Denial that anything is wrong

Depressive Episode Signs:

  • Sad, anxious or empty-feeling mood
  • Feelings of hopelessness and pessimism
  • Feelings of guilt, worthlessness and helplessness
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Decreased energy, fatigue
  • Difficulty concentrating, remembering or making decisions
  • Restlessness and irritability
  • Sleeplessness or sleeping too much
  • Change in appetite, unintended weight loss or gain
  • Bodily symptoms not caused by physical illness or injury
  • Thoughts of death or suicide

Apparently there are several types of bipolar disorder but the two main ones are bipolar I and II.  Bipolar type I disorder is the “classic” form, and patients often experience at least one full or mixed episodes with major depressive episodes. Bipolar type II disorder is where patients have at least one milder form of mania and one major depressive episode.  However, they never get a full manic or mixed episode.  Bipolar II is harder to diagnose because some symptoms of hypomania may not be as apparent. Hypomania is described as a milder form of mania with less severe symptoms.  I believe that my sister displays more symptoms of mania.

All the people I know who have bipolar disorder are women.  Although it is prevalent among men as well, it seems that it is approximately three times more common in women than in men.  For women it is rapid cycling.  Rapid cycling describes incidences where a bipolar patient experiences four or more episodes of mania, hypomania, or depression within a time period of a year (Leibenluft, 1997).

The article explains why rapid cycling bipolar disorder more common in women than in men. Three potential hypotheses to explain the higher prevalence of rapid cycling in women are hypothyroidism incidence, specific gonadal steroid effects, and the use of anti-depressant medications. First, more women encounter hypothyroidism than men do; however, there is not a general consensus on it being a primary cause of increased rapid cycling. Second, gonadal steroids, such as estrogen and progesterone, fluctuate throughout the menstrual cycle. Sixty-six percent of bipolar type I women had regular mood changes during either their menstrual or premenstrual phase of their cycle. They were more irritable and had increased anger outbursts (Blehar et al., 1998). These may set up women to frequent mood changes (especially prior to the menstrual cycle, as noted in the term “premenstrual syndrome”). Increased estrogen may cause women to develop hypercortisolism, which may increase the risk of depression. Stress levels are associated with cortisol level, so this may possibly be the reason for increased risk for depression.

There are risks involved in pregnant women who suffer from bipolar disorder.  Manic episodes and cycling seemed to occur exclusively during pregnancy.  For reasons still unclear, apparent pregnancy poses a question of relapse, which has an important effect on women and the fetus that they are carrying. The fetus can be at risk due to lack of attention to prenatal care, if the woman is not treated for the psychiatric illness. Precipitated episodes in the absence of treatment may be very detrimental to both parties involved. Secondly, the woman would be at risk because with each successive episode, the length of time to following episodes gets smaller. That is, the woman could have manic and depressive episodes more often. This would neither be beneficial to the woman or her child. The effect on the fetus due to many mood episodes is unclear (Viguera et al., 1998). “During pregnancy, a woman’s glomerular filtration rate increases” (Llewellyn et al., 1998). This means that any medication that she takes, such as lithium (discussed below), will be excreted more rapidly. This is very dangerous because if she does not have enough medication in her system, she can fall into relapse.

A dilemma arises in that if she increases her medication amount, she may be exposing her fetus to grave side effects and even danger (discussed below). Moreover, during labor, it is important that women remain fully hydrated. Since the period of time for delivery varies with each individual, a pregnant woman can become very dehydrated. When a woman gets dehydrated, the serum medication concentrations will increase (Llewellyn et al., 1998). This is the opposite effect of the increase in glomerulus filtration. Nonetheless, both situations are dangerous and can be very toxic to the woman and indirectly to the fetus.  As varying as the symptoms of bipolar disorder, per individual, so are the treatments. It is very important that bipolar pregnant women get the appropriate care and treatment that they need, in order to properly care for themselves as well as for the child that they are carrying.

It is disturbing to know that women with bipolar disorder are more susceptible to misdiagnosis.   recent study estimated that the odds that a woman with bipolar disorder will fail to be correctly diagnosed are roughly three times the odds for a man. This disparity may be explained in part by the fact that bipolar disorder tends to look different in women than it does in men—in the same way that physicians sometimes fail to catch heart disease in women because they are effectively looking for the male version of the disease, mental health professionals may not always be aware of the distinctive signs of bipolar disorder in women.  According to Vivien Burt, MD, PhD, director of the Women’s Life Center at UCLA’s Resnick Neuropsychiatric Hospital, “Women are more demonstrative—they have more of what’s known as ‘affective loading’—so it’s not surprising that bipolar disorder might be underdiagnosed in women compared to men.”

Another article stated that a woman is likely to have more symptoms of depression than mania.  And female hormones and reproductive factors may influence the condition and its treatment.  Research suggests that in women, hormones may play a role in the development and severity of bipolar disorder. One study suggests that late-onset bipolar disorder may be associated with menopause. Among women who have the disorder, almost one in five reported severe emotional disturbances during the transition into menopause.  Studies have looked at the association between bipolar disorder and premenstrual symptoms. These studies suggest that women with mood disorders, including bipolar disorder, experience more severe symptoms of premenstrual syndrome (PMS).

My sister had the disorder since she was in her thirties.  She is unmarried and doesn’t have any children.  If she had children would they be at risk?  Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%.  Bipolar symptoms may appear in a variety of behaviors. According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children with depression in the United States may actually be experiencing the early onset of bipolar disorder.

If you notice mood swings in yourself or someone else, don’t write them off as hormonal changes.  Seek medical help.  And if you are diagnosed with bipolar disorder, consult a psychiatrist or a general practitioner with experience in treating this illness.

My sister is currently on disability.  A bipolar diagnosis can have a great effect on your job and career.  In a survey of people with depression and bipolar disorder conducted by the Depression and Bipolar Support Alliance, 88% said their condition affected their ability to work.  Don’t be discouraged, though.  Being diagnosed with bipolar disorder doesn’t necessarily mean that you can’t keep your job. Plenty of people with bipolar disorder work and live normal lives.  If you are currently unemployed and are seeking employment, find a job that is a good fit for you–one that is not stressful and has a flexible schedule.  If you are currently in a job that is not working for you–is affecting your health, not letting you get enough sleep, maybe it’s time to make some changes.  Here are some things you should consider:

  • Decide what you really need from your job. Do you need to reduce your responsibilities? Do you need extra breaks during the day to reduce stress? Would you rather work independently or in a group? Do you need to work shorter hours or take time off? Or do you need a different job altogether?
  • Make decisions carefully. People with bipolar disorder are prone to acting impulsively. Think through the effects of quitting your job — both for yourself and possibly for your family. Talk over your feelings with your family, therapist, or health care provider.
  • Look into financial assistance. If you do need to take time off because of your bipolar disorder, see if your employer has disability insurance, or look into Social Security Disability Insurance, which will provide some income while you recover. You can also look into the Family and Medical Leave Act. Ask your doctor or therapist for advice.
  • Go slowly. Returning to work after you’ve taken time off can be stressful. Think about starting in a part-time position, at least until you’re confident that your bipolar disorder has stabilized. Some people find that volunteer work is a good way to get back into the swing of things.

Unfortunately you may encounter stigma at work.  Some people might treat you unfairly because of your disorder.  If you feel that you are being passed over for promotion or are being treated unfairly, there are things you can do.  Find out what policies are in place at your company that will protect you from this kind of discrimination which is illegal.    The Americans with Disabilities Act can protect some people who are discriminated against because of a health condition.  Before you do anything, research the law and talk things over with family, friends and therapist.  Mitzi Waltz, author of “Adult Bipolar Disorders,” advises bipolar employees to call a counselor or local support group to help them with workplace problems.

Bipolar disorder is tough on families and spouses.  They have to cope with behavioral problems.  Family members often experience feelings of extreme guilt after the individual is diagnosed. They are concerned about having had angry or hateful thoughts, and many wonder whether they somehow caused the illness by being un-supportive or short-tempered, although this is not the case.  There are times when I feel guilty because I didn’t touch base with my sister as often as I should have.  There are times when I am frustrated with her for coming off her medication because she is aware of what happens when she does.  I feel that she should take more responsibility for keeping the disease under control by taking her medication.  I see how her relapses affect my mother who has Parkinson’s.

I realize that although it is difficult to cope, families of patients with bipolar disorder need to be more supportive.  It is in the best interest of the person to be hospitalized for his or her own protection and for much needed treatment if he or she is in the middle of a severe episode.  And it is important for the patient to  to understand that bipolar disorder will not go away, and that continued treatment is needed to keep the disease under control. It is important that they understand that proper therapy will enable them to have a good quality of life and enable them to have a productive life.

The following tips are for families who want to help their loved ones to cope with the illness:

  1. Educate Yourself
  2. Learn How–and When–to Talk
  3. Make Some Rules
  4. Plan Even More
  5. Listen
  6. Go Gentle
  7. Laugh Together
  8. Support Yourself

I encourage families of people with bipolar disorder to educate themselves and then see how they can help their loved ones to cope.

Sources:  http://bbrfoundation.org/frequently-asked-questions-about-bipolar-disorderhttp://psychcentral.com/lib/2007/women-and-bipolar-disorder/all/1/http://www.health.com/health/condition-article/0,,20274376,00.htmlhttp://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-womenhttp://www.bphope.com/BipolarIndepth.aspxhttp://www.ehow.com/about_5032842_signs-bipolar-disorder-women.htmlhttp://www.webmd.com/bipolar-disorder/going-to-work-bipolarhttp://www.livestrong.com/article/23014-good-career-those-bipolar-disorder/http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=bipolar_familyhttp://www.beliefnet.com/Health/Emotional-Health/Bipolar/8-Ways-to-Help-Your-Bipolar-Loved-One-Cope.aspx

Women And Multiple Sclerosis

During 1997, Ann Romney began experiencing severe numbness, fatigue, and other symptoms, and just before Thanksgiving in 1998, she was diagnosed with multiple sclerosis.  Mitt Romney described watching her fail a series of neurological tests as the worst day of his life.  He later said: “I couldn’t operate without Ann. We’re a partnership. We’ve always been a partnership so her being healthy and our being able to be together is essential.”

She initially experienced a period of severe difficulty with the disease, and later said: “I was very sick in 1998 when I was diagnosed. I was pretty desperate, pretty frightened and very, very sick. It was tough at the beginning, just to think, this is how I’m going to feel for the rest of my life.”  As I watched Ann Romney on the podium at the Republican Convention I never would have guessed that she had MS if she hadn’t disclosed that she did.

Celebrities who have been touched by MS are Montel Williams who decided to view his illness as ” a call to action — an opportunity to make a difference in the lives of millions who suffer from MS and their loved ones.”  Richard Pryor, Annette Funicello, Alan Osmond (Donny Osmond’s brother), Teri Garr (National MS Society WAMS Chair), David Lander (Squiggy from “Laverne & Shirley”. And of course, Michelle Obama whose father was diagnosed with MS at a young age.  He lived with the disease for about 30 years before his death at the age of 66.  Michelle had this to say about her father:

“My Dad was our rock. Although he was diagnosed with multiple sclerosis in his early thirties, he was our provider, our champion, our hero. But as he got sicker, it got harder for him to walk, it took him longer to get dressed in the morning. But if he was in pain, he never let on. He never stopped smiling and laughing — even while struggling to button his shirt, even while using two canes to get himself across the room to give my Mom a kiss. He just woke up a little earlier, and worked a little harder.”

What is Multiple Sclerosis?  

Multiple sclerosis (MS) is a disease in which the nerves of the central nervous system (brain and spinal cord) degenerate. Myelin, which provides a covering or insulation for nerves, improves the conduction of impulses along the nerves and also is important for maintaining the health of the nerves. In multiple sclerosis, inflammation causes the myelin to disappear. Consequently, the electrical impulses that travel along the nerves decelerate, that is, become slower. In addition, the nerves themselves are damaged. As more and more nerves are affected, a person experiences a progressive interference with functions that are controlled by the nervous system such as vision, speech, walking, writing, and memory.

About 350,000 people in the U.S. have multiple sclerosis. Usually, a person is diagnosed with multiple sclerosis between 20 and 50 years of age, but multiple sclerosis has been diagnosed in children and in the elderly. Multiple sclerosis is twice as likely to occur in Caucasians as in any other group. Women are twice as likely as men to be affected by multiple sclerosis earlier in life.

What causes Multiple Sclerosis?  The cause of multiple sclerosis is still unknown. In the last 20 years, researchers have focused on disorders of the immune system and genetics for explanations.

Is multiple sclerosis inherited?

Although its role is unclear, genetics may play a role in multiple sclerosis.  Statistics suggest that genetic factors play a major role in multiple sclerosis, however, other data suggest that environmental factors also play an important role.

What are the symptoms of multiple sclerosis?

Symptoms of multiple sclerosis may be single or multiple and may range from mild to severe in intensity and short to long in duration. Complete or partial remission from symptoms occurs early in about 70% of individuals with multiple sclerosis.

  • Visual disturbances may be the first symptoms of multiple sclerosis, but they usually subside. A person may notice a patch of blurred vision, red-to-orange or red-to-gray distortions (color desaturation), or monocular visual loss (loss of vision in one eye). Visual symptoms due to optic nerve inflammation (optic neuritis) in multiple sclerosis usually are accompanied or preceded by eye pain.
  • Limb weakness with or without difficulties with coordination and balance may occur early.
  • Muscle spasmsfatigue, numbness, and prickling pain are common symptoms.
  • There may be a loss of sensation, speech impediment (typically a problem articulating words), tremors, or dizziness.

Fifty-percent of people experience mental changes such as:

  • decreased concentration,
  • attention deficits,
  • some degree of memory loss,
  • inability to perform sequential tasks, or
  • impairment in judgment.

Other symptoms may include:

As the disease worsens, individuals may experience sexual dysfunction or reduced bowel and bladder control. Heat appears to intensify multiple sclerosis symptoms for about 60% of those with the disease. Pregnancy seems to reduce the number of attacks, especially during the third trimester.

How is multiple sclerosis treated?

There are many issues for the patient and physician to consider in treating multiple sclerosis. Goals may include:

  • improving the speed of recovery from attacks (treatment with steroid drugs);
  • reducing the number of attacks or the number of MRI lesions; or
  • attempting to slow progression of the disease (treatment with disease modifying drugs or DMDs).

An additional goal is relief from complications due to the loss of function of affected organs (treatment with drugs aimed at specific symptoms).

Most neurologists will consider treatment with DMDs once the diagnosis of relapsing remitting multiple sclerosis is established. Many will begin treatment at the time of the first multiple sclerosis attack, since clinical trials have suggested that patients in whom treatment is delayed may not benefit as much as patients who are treated early.

It is important for patients to talk to their doctor before deciding to go on therapy since DMDs differ in their uses.  Utilizing support groups or counseling may be helpful for patients and their families whose lives may be affected directly by multiple sclerosis.

According to an international study, genetic differences between men and women could be the reason why multiple sclerosis strikes more women than men.  MS is twice as common among women as it is in men. The reasons for the gap aren’t known.  Women with MS were more likely to have a variation of a gene that produces high levels of a protein called interferon gamma. Interferon gamma can aggravate MS by promoting inflammation and tissue damage.  The gene variation was less common among men. “That might explain why men are generally protected more from MS.” Brian Weinshenker, MD said in a news release.   Similar findings were reported by Italian researchers.

If you are experiencing any of the symptoms, please see your doctor.  It’s hard for someone who is diagnosed with MS.  They fear what the future holds for them and if they would be able to function.  They may feel alone but they are not.  Here are some helpful tips for new MS patients:
1. Learn as much as possible about MS.

There are many myths and misconceptions about MS, and without the facts, your multiple sclerosis diagnosis can be scarier than it should be. MS is a chronic autoimmune disease affecting the central nervous system. It’s caused when the immune system attacks the myelin, the protective insulation covering nerve fibers in the brain and spinal cord. Myelin is destroyed and replaced by scars of hardened tissue (lesions), and some underlying nerves are damaged. But MS is almost never fatal, and many people diagnosed with the disease never need a wheelchair. Your doctor can provide you with the latest facts about MS and what your prognosis may be. The National MS Society and the American Academy of Neurology are also reliable sources.

2. Be sure your multiple sclerosis diagnosis is definitive.
MS is not an easy disease to diagnosis, so getting a definitive multiple sclerosis diagnosis can be a waiting game. Various tests may be used to make a diagnosis, including magnetic resonance imaging (MRI), evoked potentials (EP), and spinal fluid analysis (spinal tap), as well as a neurological exam. According to the latest criteria, your physician must do all of the following in order to make a multiple sclerosis diagnosis:

  • Find evidence of damage in two separate areas of the central nervous system
  • Find evidence that the damage occurred at least one month apart
  • Rule out all other possible diseases and diagnoses

For many people, getting a definitive multiple sclerosis diagnosis is actually a relief — they now have a name for unexplained symptoms.

3. Understand that MS symptoms are unpredictable.
No two people have exactly the same MS symptoms, and you may have different symptoms from time to time. MS symptoms can include numbness, blurred vision, loss of balance, poor coordination, slurred speech, tremors, extreme fatigue, problems with memory, bladder dysfunction, paralysis, blindness, and more. But these symptoms are unpredictable. “Over the course of the disease, some MS symptoms will come and go, while others may be long lasting,” says Dr. Sheremata. “It will be different for each MS patient.”

4. Don’t delay multiple sclerosis treatment.
At this time, the goal of multiple sclerosis treatment is to control symptoms and improve the patient’s quality of life. After receiving a multiple sclerosis diagnosis, it’s important to start multiple sclerosis treatment as soon as possible. There are now a number of FDA-approved medications that have been shown to “modify” or slow down the progression of MS and lessen the frequency and severity of MS attacks. “The disease is more likely to progress and possibly lead to disability if you don’t begin treatment early in the disease,” says Sheremata.

5. Track your MS symptoms.
Keeping a record of your MS symptoms and how you are feeling will help your doctor determine how the disease is progressing and whether the medications you are taking are working. This will also help your doctor recognize a relapse, which is a characterized by a worsening of previous symptoms or the appearance of a new symptom that lasts more than 24 hours. If you think you’re having MS symptoms, write them down in a log. Include when the symptoms happened, details of what they felt like, and how long they lasted.

6. Avoid these MS episode triggers.
Extreme fatigue is a common indicator of an impending relapse, which can last for days, weeks, or months. But certain triggers are thought to bring on relapses or make them worse. Stress, smoking, fever, hot baths, and sun exposure are believed to contribute to the worsening of MS symptoms and relapses. Additionally, drinking alcohol in excess is discouraged for people with multiple sclerosis because intoxication causes poor coordination and slurred speech, which can worsen or add to existing MS symptoms.

7. Find the right doctor for you.
MS is a lifelong disease, so it’s important to be under the care of aMS specialist who is a good match for you. The neurologist who provides your initial multiple sclerosis diagnosis may not be the specialist you want to stick with for life. Your local chapter of the National MS Society should have a listing of nearby neurologists specializing in MS. Support groups for MS patients (available through hospitals and the National MS Society) are also helpful for getting doctor referrals.

8. Consider complementary and alternative medicine.
In addition to taking medication to control your MS symptoms, you may want to consider complementary and alternative medicine(CAM), such as biofeedback, acupuncture, guided imagery, meditation, massage, tai chi, yoga, and dietary supplements. More than 30 percent of people with MS turn to complementary forms of medicine to relieve symptoms, according to a recent review of studies published in the journal Occupational Therapy International. These natural therapies were most used by MS patients for relief of pain, fatigue, and stress.

9. Think first about who you will tell about your MS.
Announcing to your employer that you have multiple sclerosis could have an effect on your job security, employment options, and career path. Before disclosing the disease at your workplace, learn about your rights under the Americans with Disabilities Act. Of course, you’ll want to tell your closest family members and friends, particularly those who know you well enough to notice that something is wrong. But you are not obligated to share news of your multiple sclerosis diagnosis with everyone in your life. Instead, pick the people who will be most supportive and helpful as you begin to cope with the disease.

10. Don’t give up hope.
Although there is currently no cure for MS, new treatments and advances in research may better relieve symptoms and even eliminate the disease in the future. Because MS strikes so many people in the prime of life, scientists are racing to find a cure, and a number of new multiple sclerosis treatments are currently under investigation. This research is giving new hope to people affected by MS.

Notes to Women encourages you to seek help, advice and inspiration from others living with MS.  Here’s a website you might want to check out:  http://www.msrc.co.uk/index.cfm/fuseaction/show/pageid/2660  Don’t give up hope.  New treatments are offered for MS.  These therapies are enabling physicians to both control the disease and help patients function better.  Read more.
As I travel across the country speaking about MS, perhaps I can offer others comfort and hope.
Annette Funicello
Multiple Sclerosis is obviously close to my heart and I’m determined to make a difference in the lives of people who suffer from the disease by raising the profile of MS, as well as raising funds for advocacy and research.
Ann Romney
Oddly enough, MS has made my life so much better than it was before. I now appreciate what I have and I am not running around like a rat in a maze.
Teri Garr
MS doesn’t define who I am.
Teri Garr

Sources:  http://en.wikipedia.org/wiki/Ann_Romneyhttp://www.tampabay.com/news/health/medicine/multiple-sclerosis-patients-doctors-appreciate-help-from-ann-romney/1251966http://www.ranker.com/list/10-celebrities-touched-by-multiple-sclerosis/medicaltraveler?page=2http://www.medicinenet.com/multiple_sclerosis/article.htm#what_is_multiple_sclerosishttp://www.everydayhealth.com/multiple-sclerosis/10-things-new-ms-patients-should-know.aspx