Today is my mother's birthday. I miss her so much. It is almost a year since she passed away.
Hurricane Rita, a Category 5 Hurricane, is expected to hit Galveston and Houston, Texas this weekend, bringing more rain and devastation to New Orleans, Mississippi, and Alabama.
A new contractor will meet with my new insurance agent today. Hopefully, this time, the agent will accept the estimate and my home will finally, after over one year since the damage caused by Hurricane Frances, be repaired. In the meantime, I run my air conditioner as cold as possible, to prevent the mold from spreading. The new insurance agent is from Houston. He is flying back home to help his family evacuate and will call me for another appointment next week.
After almost a year since my home was damaged by Hurricanes Charley and Frances, I prepare for more delays. I force myself to think on the bright side. At least I have a new roof.
Christmas day has come and gone. My boys are at their dads' and my dad and my sister, Melissa, are visiting my brother Jorge and his family in North Carolina. My sister, Lily, who had planned to visit Florida for part of the holiday, could not, and so is in Minnesota with her boys.
I receive the following email from my brother, Al, who is stationed in Afghanistan. In it he comments about the cultural differences between Afghanistan and the USA, such as how a formal luncheon with a town's judge and mayor is more like an indoor picnic on the carpet, and how there are never women in official positions, or women to be seen in the workplace, or in the town at all.
Attached find 3 pictures taken last week at the road opening
ceremonies. In one picture you will see me speaking, with an interpreter
and with another guy taping my speech standing right by the podium. In
the second one you will see the crowd to whom I was speaking... see if
you can find any women!? And the third picture you will see us at the
Mayor's compound getting ready to have lunch. You will note that there
is a mat laid out in front of us where they will place the food; you
will see trays with fruit and see bread placed right on the mat. It is an
interesting affair, since the men (no women) who will serve the food
will walk in their stocking fee right on the mat, and bump your food and
bread with their feet. The mat does not look the cleanest, either. The
two Afghans that you see in the picture are the Mayor with the blue
turban, farthest away from me, and the one closest to me is the judge.
Anyway, just thought that these pictures would be more interesting than
me sitting at a desk.
Well, the dreaded holidays are finally over. I'm still fighting my insurance company, but things look like they're on their way to being settled...hopefully before the two-year-anniversary of Hurricanes Charley and Frances!
On a brighter note, my brother, Al, is on a two-week leave in Germany. His wife and kids flew out to visit him for that time. He's due to come home, hopefully for good, in April.
Brian is doing great at FSU, getting all A's and B's. Joey is not doing as well as he should, becoming a bit of a 7th grade rebel when it comes to homework and studying -- Ugh...Middle School!
Healthwise, I'm having some female problems which I had assumed were due to "the change" but turned out to be because of an ovarian cyst, instead. I guess I should have suspected that it wasn't normal to feel like one was having labor pains and hemorrhaging to death every month. I guess that even Menopause is not THAT bad.
So, I'm getting monthly pelvic ultrasounds to ensure the cyst doesn't keep getting larger, start bleeding internally, turn into a tumor, or start growing teeth, in which case I may need to get both it, and the ovary, surgically removed. But, that's okay with me. At almost 45 years of age, I wasn't planning on having any more babies. At this point, I'm looking forward to grandchildren. And if removing my ovaries or anything else guarantees I'll be around to be a grandmother, that's alright by me, too!
Lately, I've been lucky, so it should all work out. Last week, my rear tire blew out while I was driving Brian up to FSU, turning our five-hour-drive into a seven-hour ordeal. The force of the tire blew the rear bumper off my mini van, but Brian was able to snap it back into place. The tire, however, was shredded, with wires sticking out of it, and parts of it wrapped around the rear axle, so I didn't want to attempt to change it myself, with or without the help of my boys, especially in the dark, and on the side of Interstate 75 in Miconapy, Florida.
So, I called Triple A. Luckily, I had a brand new spare. The next day, the hotel maintenance man turned out to also be a car mechanic, and he screwed my bumper (which was loose) back on -- for free! As I was driving back home, and running out of gas, and money (as I hadn't planned to spend the night in a hotel), I pulled into a 7-11 to dig out any spare change I could find under my car seats and in the bottom of my purse. I figured if I didn't have enough money for a few gallons of gas, I would just call Triple A again.
Talk about luck. A young girl pumping gas was selling Mary Kay services to everyone she could meet in the parkinglot. She was handing out $5 bills to anyone willing to schedule a Mary Kay facial. Unbelievable!
I felt as if my Guardian Angel was with me on the entire trip, ensuring the boys and I were safe coming and going.
Although the hotel maintenance man had advised me to get a new set of rear tires as soon as I could, I knew I wouldn't be able to do so until Pay Day. As luck would have it, my generous ex-in-laws (Joey's grandparents) insisted on paying for the new set of tires. They know how much driving I do every day, chauffering my sons back and forth, and to work, etc., and wanted to make sure the car was safe for Joey.
Wasn't that lucky? I should buy a lottery ticket. Florida State Lottery is up to $43 million.
Every time I start feeling hopeless about settling with my home owner's insurance company, there is a more severe tragedy in the world to put my worries in perspective.
On Friday, February 17, a landslide from ongoing heavy rains buried entire villages in the Southern Leyte province of the Philippines. Damages from the landslide are estimated to be more than $3 million. The Philippine National Red Cross is reporting over 1,000 confirmed missing and expects that number to rise. Among the missing are approximately 200 children who were attending a school that was buried under more than 50 feet of mud. The Catholic community in the region has responded quickly with four parishes serving 2,000 families at 14 evacuation centers.
Prolonged heavy rains in January and February created flooding and landslides in Bolivia and Brazil. Reports show that 22,000 families throughout the country have been affected to date, including 3,000 families from Santa Cruz who have been forced to evacuate to temporary shelters. Crop losses are estimated to be $6.4 million dollars, and that amount is likely to increase as additional crops are at risk. In some areas, the torrential rains have washed away roads and caused existing rivers to change their course.
On the Brazilian side of the border, in Acre, the rains have affected over 10 percent of the population of over 300,000 people. Over 7,700 homes have suffered flood damage and are uninhabitable. Almost 3,500 people are currently living in temporary shelters. While the Brazilian government has been responding to the emergency by providing food for the displaced, there is great concern that waterborne diseases will spread among those living in the crowded shelters. Twenty-three cases of leptospirosis have already been reported.
Things could definitely be worse.
Sunday, March 12th, would have been my parents' 46th wedding anniversary.
March is not usually the most popular month for weddings, but March "2006" is turning out to be THE MONTH for romance and weddings. My old friend from UCF, Kathleen, married last weekend in a fairy tale-like ceremony at Bok Gardens in Lake Wales, Florida. Her reception took place in the Swan Hotel at Epcot in Walt Disney World. The post-reception extravaganza included a boat ride and fireworks in the evening sky.
After marrying and divorcing in her youth, and staying single for almost two decades, Kathleen has finally found the man of her dreams.
She met him on the Internet, during an online gaming session. He was from Amsterdam, and she'd recently relocated to Dallas, Texas for a job. After a couple of visits back and forth, she moved to Europe. After Dutch lessons, and living in Amsterdam for three years, Kathleen decided to marry him. They are very happy.
Kathleen dated several men before meeting her new husband. It was obviously worth the wait.
So, I try to convey the concept of "waiting" to my sister, Melissa. My baby sister, who is 30 years old, feels she's waited long enough. Convinced she has found "The One," she happily dreams of the perfect wedding dress. She has dated her most recent boyfriend only six weeks. He is old enough to be her father, and indeed has a daughter just shy of 29 years old, as well as grandchildren. Not unlike myself, he is also a veteran of two divorces. I caution her not to rush into marriage, although he seems like a nice enough man, and is obviously smitten with my sister.
Despite misgivings, I cannot deny her happiness, nor the lovey-dovey way she and her boyfriend look at each other.
Who am I to judge? As protective as I feel toward my sister, maybe, she HAS found "The One."
I wish our mom were still around to help us plan the wedding.
What can I say? Romance is in the air. Except for me, of course. I'll continue to live vicariously through friends and family.
I may need to give up some of my freelance, part-time work, and spend my "spare" time focusing on taking care of my health and family. There is just not enough time in the day for everything I need to do, and something's got to give. And honestly, after writing and editing software manuals all day, the last thing I look forward to in the evenings is writing and editing more software manuals.
As far as my hurricane woes, the independent adjuster I hired was able to negotiate for more money with the latest contractor, but not for living expenses. I may have to camp out in the back yard while my home is being repaired for three months...NOT! I have to continue the fight. Sigh! I sure am getting weary of fighting the insurance company.
My "female" issues are getting worse. Although my latest ultrasound came back
"Normal," I'm still getting my period every 15 days, for seven days straight, and it is still debilitating enough for me to miss work for one or two days at a time.
I always pray for my cycle to arrive on the weekends, so I can stay in bed --
or actually on the couch since I haven't had a bedroom since Hurricane Frances -- for two days without having to miss work.
If I can't avoid leaving the house, I bring a towel to sit on in the car, and make sure I have a change of clothes. It's that bad. And often I'm in so much pain I don't know whether to call in sick or call an ambulance...or a priest.
Feeling weak, I fill up on carbs. Too exhausted to exercise, my body has ballooned to unimaginable proportions. Racked with pelvic pain, my abdomen is distended as if I'm 23 months pregnant, and is tight as a drum. I'm so bloated, maternity clothes won't do. When I go dress shopping, I wonder if I should buy a tent at the hardware store instead.
Turning 45 sucks! I have to keep reminding myself it's better than the alternative.
There may be hope still. A co-worker, who had the same symptoms, and like myself, suspected Menopause,has found a cure. She had the lining of her uterus lasered. No more periods!
Besides eliminating the painful physical effects, this procedure has also greatly improved her mental outlook. No more PMS! Really, men have no idea what women go through:Monthly Man Video
With less than a week recovery time, this new procedure, Novasure or Endometrial Ablation, beats the old Hysterectomy hands down! She has her life back! No more PMS mood swings, labor-like cramp pain, intestinal problems, excessive bleeding with embarrassing accidents, weakness, dizziness, crushing fatigue, blinding migraines, food cravings for chocolate, carbs, and BEEF.
She, too, felt like a vampire, constantly craving steak. I understand completely. I drive by cow pastures and salivate. My dogs are running scared.
I am always so tired and short of breath, I cannot even climb a flight of stairs without huffing and puffing like an Asthmatic running a marathon without his inhaler.
A new and interesting phenomenon is that my hair has stopped growing. I haven't colored it in months.
It's falling out in clumps, chemo-patient style, causing drainage problems in my bath tub.
I didn't want to accept the fact that I'm losing my hair, but there's no denying it. It's gotten to the point where other people are noticing and commenting.
Case in point: Shopping with my sister, Melissa:
Dresses are on sale at Dillards, so that's where we go, and select from the Reduced racks. Sizes 14 and 16 no longer fit. Undaunted, my sister leads me up the escalator. To my horror, we're in Women's, where sizes are accompanied by letters: 1X... 2X... 3X. I notice that one 3X dress could be sold in the hardware store.
In the dressing room, Melissa detects my thinning hair. She suggests a shorter length and layer cut to help my hair look fuller. I fish scissors out of my purse and point them in her direction.
"Here? In the dressing room?" she asks. "Now?"
"Now," I say, handing her the scissors.
"Okay," she responds, "But, let me brush your hair out first." And brush she does, gently, untangling and pulling my curls straight.
"Bend over," she commands, "so I can layer your hair."
I flip my hair forward as directed. She combs it straight and holds the hair firmly with one hand.
"I'd like to cut right here, okay?" she asks.
"No!" I respond. "Not that short."
Melissa adjusts her hold. "Here?"
I hesitate and then agree. She cuts straight across.
"Stand up."
I straighten and flip my hair back. We giggle at the hair lying on the carpet. What will the sales clerks think? What are WE thinking, turning a dressing room into a makeshift salon? Melissa continues to cut, deftly holding sections of hair at different angles. She finally stops.
"There," she says as she fluffs my hair with her fingers. "It looks thicker already."
I admire her handiwork in the mirror. My hair is now barely past shoulder length, and appears fuller. Of course, my bangs are still thin.
"It looks a lot better, Sue," she says. She adds, "You know, I read an article about Anemic women. Anemia can make your hair fall out. Are you taking vitamins? When was the last time you had a physical?"
Silently, I continue to inspect my hairline in the mirror.
"Maybe," Melissa suggests, "You could try Rogaine for Women."
"Yeah, maybe," I respond while gathering my fallen locks into a neat pile.
I give Melissa a hug, as we giggle together at our latest sisterly adventure - hair-cutting in a clothing department store dressing room.
I select a black shell, two black skirts.
Melissa insists that I also purchase a pink shell and matching black skirt with tiny, pink polka dots.
"Do it, Sue!" she badgers. "I'm so sick of seeing you in a big, black bag.
What are you, a Goth? Add some color to your wardrobe."
"Black is slimming," I mutter. "It camouflages my problem areas."
Bullied into buying the pink top and matching skirt, I mentally plan to wear the outfit when I lose 10, 20, or 30 pounds, but know deep down inside that I'll return it.
As I pay for the clothes, my hair loss is still on my mind.
I wonder if female-pattern baldness exists.
Yikes! To my dismay, a later GOOGLE search reveals the answer is a definite Yes:
http://www.americanhairloss.org/women_hair_loss/introduction.asp
Earth to Susana..."It's really happening. You're going bald."
Now, I can empathize with my brothers.
But, what is the catalyst for my latest symptom? Hair-styling? Pre-menopause? Anemia? Thyroid disease? Ovarian cysts?
Or could it be the mold?
March 15th, 2006
Yesterday, my siblings and I received sad news from my dad. Four soldiers in my brother's troops were killed, just weeks before coming home.
My dad's email reads:
This is the sad news that your brother sent me today. Knowing him I realize how he must be feeling. I hope that God will comfort the soldier's families and his commander, my oldest son.
Love,
Papi
-----Original Message-----
From: Rosende, Alberto [mailto:Alberto.Rosende@baf.afgn.army.mil]
Sent: Tuesday, March 14, 2006 2:09 AM
To: Rosende, Alberto C
Subject: RE: How are you?
Pops,
I was thinking all about you and Mami all day on Sunday, and wanted to call you and talk to you.
I was unable to call you because by the time it was morning in Florida, we had suffered a great loss here in Afghanistan. Four of my soldiers were killed when they were conducting route clearance operations, and an improvised explosive detonated underneath their vehicle. Three were killed instantly, the 4th died shortly afterwards. Once that happened, in order to prevent word getting out, and not letting the appropriate notifications occur, we had to "blackout" all communications means, i.e. no email nor phones. I had not spoken to Martha since then. We only received confirmation that all of the families were properly notified this morning.
Well, I am sorry that I did not get a chance to speak with you, but please know that I was praying for you and for Mami. I hope to see you soon!
Love,
Al
-----Original Message-----
From: Rosende, Alberto C
Sent: Monday, March 13, 2006 2:23 PM
To: Rosende, Alberto
Subject: How are you
My dear son Al (Pal),
Colonel,
How are you? Yesterday, a little late I would say, I called your house. Albert III answer the phone. Then I talked to Martha. All is OK, thanks be to God. She told me that yesterday she did not receive anything from you. That is why I am sending this e-mail, hoping that you are all right. Yesterday could have been our 46th anniversary, but, unfortunately Mami did not make it. Also, was 6 years I had the quadruple by-pass. Time flies. That is all,
Love, Papi
Alberto C. Rosende, Engineer III
SGS Design Engineering
Al is scheduled to come home in April. We have our fingers crossed that he comes home safely. His wife and kids need him, but so does our dad. Papi, at 79 1/2 years old, is still grieving the loss of our mom. I don't think he could handle losing Al too.
I called my dad at work to comfort him, and then I wrote my brother:
----- Original Message -----
From: Susana Rosende
Date: Tuesday, March 14, 2006 6:02 pm
Al,
I am so very sorry about the loss of your soldiers. It is
especially sad that they died so close to when they were scheduled to
return home.
Please accept my deepest sympathy. I know, as their commander,
this news must have hit you very hard.
But, please, Al, please remain focused.
As you wrote me recently, the enemy is still as focused as ever,
even though you and your troops are counting the days until you go
home.
You and your troops are in my thoughts and prayers.
Please take care of yourself, Al. Stay safe.
I love you,
Susana
-----Original Message-----
From: alberto.rosende@us.army.mil [mailto:alberto.rosende@us.army.mil]
Sent: Wed 3/15/2006 1:40 AM
To: Susana Rosende
Subject: Re:
Sue,
Thanks for you words, thoughts and prayers of comfort. It is truly a difficult time, knowing that we have pain-stricken families and hurting soldiers as they attempt to deal with the loss of thier family members and friends. We are all in pain.
Please continue to pray for us, so that we may have the strength of faith to know that they are now enjoying the eternal light of our Lord, and that we may also have the courage to focus and continue the mission.
Thanks for everything.
Love,
Al
March 23rd, 2006
I am craving steak again. And chocolate. A steak dipped in chocolate would be perfect.
Vocabulary Words of the Day
Androgenic Alopecia - Androgenetic alopecia (inherited hair loss)
Androgenetic alopecia is a type of hair loss that is inherited from either or both the mother and the father. Also known as male- or female-pattern hair loss, it is the most common cause of hair loss. The condition occurs when the growth (anagen) phase of the hair growth cycle becomes shorter and shorter. A genetic sensitivity to androgens, a type of hormone, causes hair follicles where hair growth begins to sprout hairs that are thinner than normal. The hairs become thinner and thinner, and eventually the follicles die away. In men, hair loss occurs on the front hairline and forehead and on the top of the head. Bald
spots are noticeable.
In women, hair loss occurs as thinning of hair throughout the entire
scalp, including the top and sides. Women do not generally have bald spots but rather have overall thinning hair.
Hair loss in women is also frequently caused by lack of intake of certain nutrients, amongst other physical and psychological factors such as hormonal problems or stress.
Well, I'm definitely having hormonal problems. Stress? Well, for the last two years, between the hurricane damage and negotiations, my mom passing away, my brother going to war, my son leaving home for college, my job uncertainty, the extra part-time jobs, and my health issues, I guess you could say I've had my share of stress. But, not much more than usual, really, in the last 20 years.
Then again, is it possible to live without it? Life = Stress. At least my life does. How about you? Anybody?
But, I digress...on with the Vocabulary:
Menorrhagia (heavy menstruation) - Menorrhagia is excessively heavy or prolonged uterine bleeding, which may be caused by medical problems or hormone imbalances.
In a normal menstrual cycle, there is a balance between estrogen and progesterone, two hormones in the body. These hormones regulate the buildup of the endometrium (uterine lining of blood and tissue), which is shed each month during menstruation. Menorrhagia can occur because of an imbalance between estrogen and progesterone. As a result of the imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding. Because
hormone imbalances are often present in adolescents and in women approaching menopause, this type of menorrhagia - known as dysfunctional uterine bleeding - is fairly common in these groups.
Women vary in how long it is from the start of one period to the next. In some it is less than a month and others it is longer. Some have an irregular pattern. The actual length of the period varies, too, and may be from three to seven days. In menorrhagia, some women have very prolonged blood loss, often accompanied by cramp-like period pain, with only days before the next episode.
Persistent heavy periods can lead to thinning of the blood (anemia), which can cause tiredness, shortness of breath, faintness and even angina.
Many times there is no particular cause to be found. Sometimes a structural irritation in the womb is to blame, such as a quite common condition where there are localized areas of overgrowth of the muscle wall of the womb (fibroids or fibromyomas), and when there is a coil (or Intra Uterine Device) in the womb.
If a woman becomes anemic, she needs to take extra iron. There are medications which can cut down the blood loss. Some of these do not use hormones, and merely work on the way in which the blood clots. Many people see that as an advantage. Some pain relieving anti-inflammatory drugs which people take for period pain do actually cut down blood loss as well.
The oral contraceptive pill, tends to lead to lighter bleeds, which come regularly, and some people find this is the answer for them. There are also hormone treatments that stop a woman from having periods all together, this may be in tablet form or by injections.
If all else fails, an OBGYN may recommend for the woman to have an operation to remove the womb (hysterectomy). More recently an operation using lasers or microwave technology has been used (balloon or endometrial ablation), to remove the lining of the womb (endometrium), which is the part that bleeds, while leaving the rest of the womb behind.
More Medical Terms
Endometrial Ablation Removing the lining of the womb. Removing the uterine lining will decrease your menstrual flow or even stop it completely.
Endometrium (Uterine Lining) The cells that line the womb. This tissue sheds in response to the hormonal changes of your monthly period.
Electrosurgery Instead of a scalpel, a heat-generating electrical device is used to burn-away, remove or vaporize tissue in this type of procedure.
GnRH Analog This type of drug acts like a natural
hormone your body produces. It produces hormonal changes which decrease the
thickness of the endometrium.
Hysterectomy The surgical removal of the uterus.
Hysteroscopy A procedure used to see inside the womb, using a viewing tube inserted into the vagina.
Laminaria A laminaria is a small rod-shaped
pieced of dried seaweed, that when placed in your cervix provides for more gentle dilation of your cervix minimizing the risk of cervical tears.
Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
A simpler form of hysterectomy (LAVH) used the laparoscope to avoid a large
abdominal incision.
Laparoscopy In this procedure, the physician inserts a viewing tube through the skin to see inside the body. Other tubes can be pushed through the skin to introduce probes or instruments; in this way a number of surgical procedures can be performed without a large surgical incision.
Ultrasonography A procedure used to "see"
inside the body, using high-pitched sound waves. This is a little like radar
or sonar.
Uterus The womb.
Uterine Lining Sampling (Biopsy) In this procedure, a small piece of tissue is removed from the lining of the womb and analyzed in the lab.
Tune in for the following vocabulary words:
Anemia
-
Follicular Degeneration
-
March 23rd, 2006
Vocabulary Word of the Day: Endometrial Ablation -
Endometrial Ablation is a procedure that uses a lighted viewing
instrument (hysteroscope) and other instruments to destroy
(ablate) the uterine lining, or
endometrium. Endometrial ablation can be done
by:
- Laser beam (laser thermal
ablation).
- Heat (thermal ablation), using:
- Radiofrequency.
- A balloon
filled with saline solution that has been heated to
85?C (185?F) (thermal balloon
ablation).
- Electricity, using a resectoscope with a loop or rolling ball
electrode.
The endometrium heals by scarring, which usually reduces or
prevents uterine bleeding.
What To Expect After Surgery
Endometrial ablation is usually done in an outpatient facility or
hospital. The procedure may be done using
spinal anesthesia, although
general anesthesia is sometimes used.
Recovery requires from a few days to 2 weeks.
Why It Is Done
Endometrial ablation is used to control heavy, prolonged menstrual
bleeding when:
- Bleeding has not responded to other
treatments.
- Childbearing is completed.
- You prefer not
to have a
hysterectomy to control bleeding.
- Other
medical problems prevent a hysterectomy.
How Well It Works
Approximately 90% of women will have reduced menstrual flow
following endometrial ablation, but only 40% to 50% will stop having periods.
Hysterectomy or repeat ablation is required in
approximately 22% of women following endometrial ablation.1
Younger women are less likely than older women to respond to
endometrial ablation. After an endometrial ablation, younger women are more
likely to continue to have periods and need a repeat procedure.
Young women may be treated with either gonadotropin-releasing
hormone analogues (GnRH-As) or
danazol for 1 to 3 months before the procedure. This
will decrease their production of
estrogen and help thin the lining of the uterus (endometrium). GnRH-As is more effective than danazol
for this purpose.2
Risks
Complications of endometrial ablation are uncommon but can be quite
severe. They can include:
- Accidental puncture (perforation) of the
uterus.
- Burns (thermal injury) to the uterus or the surface of the
bowel.
- Buildup of fluid in the lungs (pulmonary
edema).
- Sudden blockage of arterial blood flow within the
lung (pulmonary embolism).
- Tearing of the
opening of the uterus (cervical laceration).
What To Think About
Endometrial ablation is not recommended if you have a high risk for
endometrial cancer. Regrowth of the endometrium may
occur.
Do not consider this procedure if you plan to become pregnant in
the future.
Although this surgery usually causes sterility by destroying the
lining of the uterus, pregnancy may still be possible if a small part of the
endometrium is left in place. Birth control of some form is required if you
have not completed
menopause and do not wish to become pregnant.
References
Citations
Speroff L, Fritz MA. (2005). Dysfunctional uterine
bleeding. In L Speroff, MA Fritz, eds., Clinical Gynecologic
Endocrinology and Infertility, 7th ed., pp. 548?571. Philadelphia:
Lippincott Williams and Wilkins.
Cooper JM, Brady RM (March 1999).
Hysteroscopy in the management of abnormal uterine bleeding. Obstetrics and Gynecology Clinics
of North American, 26(1):
217?236.
Credits for
| Author |
Kathe Gallagher, MSW |
| Editor |
Geri Metzger |
| Associate Editor |
Lila Havens |
| Primary Medical Reviewer |
Ren?e M. Crichlow, MD
- Family Medicine |
| Specialist Medical Reviewer |
Kirtly Jones, MD
- Obstetrics and Gynecology |
| Last Updated | February 26, 2004 |
March 30th, 2006
Besides thyroid diseases and Anemia, another cause of loss of hair in females is PCOS or polycystic ovarian syndrome.
PCOS is a "syndrome" and so there are many problems that can be associated with it. Not all women will have all symptoms and any combination of symptoms can be seen. It is generally accepted that in order to be diagnosed with PCOS, three symptoms should be noted. The most common signs and symptoms include:
- irregular or absent periods (amenorrhoea)
- irregular or absent ovulation (anovulation)
- numerous ovarian cysts
- excess facial or body hair (hirsuitism)
- insulin resistance
- infertility
- scalp hair loss (alopecia)
- acne
- obesity, especially mid-section
I have four of these symptoms: 1.) the irregular, heavy periods, 2.)the ovarian cysts, 3.) the obesity, and finally, 4.) the loss of scalp hair (alopecia).
There is not one definitive test for PCOS. Many doctors will diagnose it purely on symptoms or after other health problems (e.g. thyroid and pituitary gland) have been ruled out. However, a thorough examination, a scan and blood tests (hormone profile) should be performed to diagnose the disease. Tests include:
- LH:FSH ratio
- TSH
- lipid panel
- prolactin level
- testosterone level
- glucose tolerance test
- pelvic ultrasound to look for ovarian cysts
- DHEAS
- Androstenedione
General Practitioners have variable experience with PCOS. It is best to see a a Reproductive Medicine Specialist or OBGYN to establish the diagnosis.
Upon diagnosis, a treatment plan, that may not require the removal of cysts, can be developed. Generally, the treatment begins with necessary lifestyle changes. If a woman is overweight, then weight loss should be a focus. A combination of low carbohydrate diet and exercise will help a woman lose weight and lower insulin levels. Medications, in addition to diet and exercise, may be used, such as Insulin sensitizing medications used for PCOS, including Metformin/Glucophage. These medications have potential side effects and risks and all of these should be discussed with the doctor before starting the regimen. For women trying to achieve pregnancy, the lifestyle factors alone may restart ovulation.
While drugs such as clomiphene can help to to induce ovulation, they work better in patients whose Body Mass Index (BMI) is between 20 and 30. Women must be sure to be counseled on the risks and benefits of these medications as well.
If the ovaries prove resistant to stimulation of ovulation with drugs, and a woman has already reached her target weight, there may be an option to laparoscope (use a laser to drill the capsule of the ovary) to make the ovaries
less resistant to ovulation.
For women not attempting pregnancy, the insulin sensitizing medications
may still be used to control the symptoms of PCOS. If contraception is required some pills are more suited to PCO than others. Oral contraceptives in general can balance out the hormone levels and alleviate some of the symptoms of PCOS. Some patients who have androgenic symptoms may be better suited to oral contraceptives with an anti-androgenic action.
Do I have PCOS? There is only so much self-diagnosis I can do. So, I schedule appointments with another OBGYN (for a second opinion) and a dermatologist (for hair loss).
These days, I gently wash my hair, careful not to pull or comb it when wet, and use the cool setting on the dryer. I don't want to lose any more hair than I already have. I am especially careful to style my bangs and hair to hide the thin spot and widening part in the front and on top of my head.
I vow to never laugh at Donald Trump, or anyone else I see with a "comb-over."
Then after a long, hard cry, I figure, why not laugh?
Sorry, Donald. Believe me, I'm not laughing at you. I'm laughing with you.
In 2002, David Letterman shared the Top 10 Ways to Describe Donald Trump's Hair. They included:
No. 7: Trumpy.
No. 6: Strangely hypnotic.
No. 5: Unbe-weave-able.
No. 4: Wiggy.
No. 1: Taj Ma-helmet.
Sometimes, you just have to laugh.
Donald Trump
The Donald Trump Comb-Over
Donald Trump's Dog
Donald Trump's Baby
Donald Trump Wannabe
Donald Trump as an old man
Donald Trump as an even older man
The Donald Trump Comb-Over Wig
How to do a Comb Over
And the inspiration for the "comb-over" hairdo? None other than Homer Simpson:
(Funny, isn't it? But, sad too. Yet there's nothing like walking in someone else's shoes to understand how distressing a situation can be.)
I fight back the urge to cry again and remind myself: "It's only hair." God knows I've suffered worse losses in my life.
Besides, "Bald is Beautiful," right?
Model Eve Salvail
American Actress and Movie Star Demi Moore
Irish Singer/songwriter Sinead O'Connor
The American Bald Eagle and beautiful actress and Movie Star Natalie Portman
Actress and Movie Star Sigourney Weaver
Bald Eagle and Best Tattoo
And if I ever get to the point where I think it's not, there's a plethora of wigs to choose from:
http://www.amasquerade.com/ThemePages/wigsBot.asp
http://www.unitedmaskandparty.com/Wigs/character_theatrical.htm
I may as well have fun with it.
April 9th, 2006
Well, April has so far been an eventful month for my family. My sister Melissa is planning her wedding, my dad retires at the age of 79 1/2 from the Kennedy Space Center on Friday, April 8th, my health issues have made me change doctors and schedule Endometrial Ablation (and a hysterectomy as a backup plan) surgery within the next couple of weeks, and our whole family prepares for the safe return of my brother, Lt. Colonel Alberto Rosende in the Army Reserves, from Afghanistan on April 18th.
Most recent email exchange with my brother Al:
-----Original Message-----
From: alberto.rosende@us.army.mil [mailto:alberto.rosende@us.army.mil]
Sent: Sunday, April 02, 2006 2:54 PM
To: Susana Rosende
Subject: Re: [AKO Content Warning - Attachments] Hello!
Sue,
I cannot believe that you found this article. This is the same area
where we lost our four soldiers and we are still operating in the area.
I cannot tell you too much, but we were very blessed that day that no
one was killed. I'll explain it more when I get home.
Thanks for your prayers..
Everything is going OK and we are still on track for our upcoming
departure, but much work must be accomplished before then. I am not
looking at the departure, only the close in targets to retain our
focus.
I love you,
Al
----- Original Message -----
From: Susana Rosende
Date: Saturday, April 1, 2006 5:51 pm
Subject: [AKO Content Warning - Attachments] Hello!
April 1st, 2006
Hello Family and Friends!
First of all, Happy Birthday to Jorge's little girl, my niece,
Samantha!!!
Secondly, I hope you enjoy the attached photos of my son Brian and
his little sister Diana. They were sent to me by Brian's step mom
Carol. They were taken when Brian was home from FSU on Spring
Break and visiting his dad, step mom and Diana. (Stay tuned for
pictures of Joey and me during my Spring Break vacation at Disney.)
Photos of my son, Brian, 19, and his little sister, Diana, 7:
I also ask that you continue to pray for my brother Al, Lt.
Colonel in the Army Reserves, and his troops. They recently lost
four soldiers due to a road bomb. Al and his troops are scheduled
to come home from Afghanistan on April 19th.
The following excerpt is from today's news. We have not yet heard
about this news from Al.
Sat Apr 1, 6:59 AM ET
ASADABAD, Afghanistan (Reuters) - A blast hit a U.S. military
convoy in
Afghanistan on Saturday but there were no immediate reports of
casualties, Afghan provincial officials said.
Violence in Afghanistan has intensified in recent days since
Taliban insurgents said they launched a spring offensive in their
campaign to oust foreign troops and defeat the Western-backed
government.
The explosion happened in the Peche valley of eastern Kunar
province, near the border with Pakistan and the scene of repeated
clashes between insurgents and U.S. and Afghan government troops.
A helicopter was seen landing in the area soon after the blast,
leading to speculation it may have been evacuating casualties,
said one official, who declined to be identified.
A U.S. military spokesman said he had no report on the blast,
which was in the same area where four U.S. soldiers were killed by
a roadside bomb last month.
In a separate incident, a suicide car-bomber blew himself up near
a convoy of Canadian and Afghan government troops in the southern
province of Kandahar, but none of the troops was hurt, said Afghan
commander General Rahmatullah Raufi.
It was the third suicide blast in Kandahar in three days.
Just after the blast, panicked Afghan troops shot dead a man
riding a motorbike in the mistaken suspicion he was another
attacker, Raufi said.
In a separate incident, the head of an elected provincial council
in the northeastern province of Takhar was killed by unidentified
gunmen who raided his house on Saturday, an interior ministry
official said.
Sayed Sadiq, a former factional commander, was elected to the
province's council in legislative elections in September.
Militants are not known to be active in the province and some
residents speculated he might have been killed as a result of a
factional feud.
The interior ministry said it was investigating.
Last, but not least, my home owner's insurance company has issued a check for the Mold Remediation, gutting, and rebuild of my home, just a few months short of the two-year anniversary of Hurricanes Charley and Frances. Additionally, they will be sending an advance for the ALE or living expenses that I will need to move out of my home and rent a home or hotel room for the three to four months that my home is being re-built.
Could it be? Will my home finally be fixed? I think I finally see the light at the end of the tunnel.
Stay tuned.
April 23rd, 2006
An email from my younger brother, Jorge, confirms the great news we've all been waiting for: Al is home safe on US soil! He flew via Uzbekistan to Germany to Maine, USA, to Fort Bragg in North Carolina. Because Jorge lives in North Carolina, he was able to visit with Al for a short while, before he was whisked away. Al will need to stay at Fort Bragg for a week before he's allowed to go home to his family.
Date: Sun, 23 Apr 2006 19:45:29 -0700 (PDT)
From:Jorge Rosende
Subject: Guess who's home_Thank GOD
Everyone:
LTC Rosende (Al) is home! Here are his re-deployment pictures. He sounds great and looks great. He is in great shape.
He is happy to be back in the US and can't wait to see Marthha and the boys. Of course, all of us as well.
Love everyone,
Jorge
God Bless,
Jorge V. Rosende
And yet another homecoming: Brian comes home on Friday, April 28th. It's the end of the Spring semester. He will be splitting his time between his dad's house and home...although where our home will be is still up for debate.
The home owner's insurance has given me a $2,000 advance to move out and rent a place for us to live. It's impossible to cover a deposit of first and last month's rent for a house or apartment with only $2,000, but it's harder to find a rental that allows pets, especially German Shepherd Dogs as they are considered a "restricted breed," and even harder to find a short-term lease for 12 weeks. The law requires a minimum of seven months or else the rental is deemed a "vacation home" and the owner will have to deal with all kinds of tax laws.
I will need to book a long-term hotel, the kind for business executives on short-term contracts. There's one near my home that allows one dog. The limit is 30 pounds, but they tend to be lax as long as the dog behaves. If my ex-husband commits to his offer of caring for the little dogs, I'll be able to keep Angel with me...all 100 pounds of him...and Harry Potter, the parakeet, too. Our neighbor will look after our outdoor cats, Max and Tinkerbell.
Of course, I'll need money for the moving truck and storage unit, but the insurance company refuses to dole out the rest of the living expenses until the mold remediation and demolition is completed.
In that case, I may need to stay on my dad's couch for several weeks. Because my dad doesn't allow dogs in his condo, I'll need to board Angel for that time.
I keep telling myself that everything will be okay. Things are finally coming together.
Then the Toyota mechanic tells me my minivan needs a new timing belt and transmission totaling over $4,000. My distrust of car mechanics leads me to think he's lying, so I will get a second opinion. Mechanics love to lie to me. I can tell they're lying, too. There's just something about the look in their eyes.
But, what if it's true? How will I manage the drive to and from my dad's place (an hour away from my work and Joey's school) if my transmission will give out at any moment?
Forget my surgery...who has time for THAT? I need to get another part-time, freelance job again...and PRONTO!
WalkAmerica for the March of Dimes.
On Saturday, April 29th, 2006, the March of Dimes is sponsoring a Walk at 8:00 AM at Lake Lily Park, 641 South Maitland Avenue, in Maitland, Florida. Saturday, April 29th, is also the 18th anniversary of my son Sean's birthday. So, I am walking, in memory of my son, and to help fund research for the prevention of birth defects.
My second-born son, Sean Matthew Lutz, was born on April 29th, 1988 at St. Peter's Hospital in New Brunswick, New Jersey. He was a beautiful, full-term, 7 pound baby boy, yet he couldn't breathe on his own. The reason for his inability to breathe, or even cry, was that Sean was born with Congenital Diaphragmatic Hernia.Congenital Diaphragmatic Hernia, or CDH, is a birth defect that occurs when the diaphram fails to form or close completely, allowing the abdominal organs to migrate to the chest cavity, impeding lung development.
The ultrasounds performed during the pregnancy revealed the gender of our baby, but not the birth defect. This situation is often the case with CDH, as most ultrasounds are performed at 20 weeks, before the diaphram has fully formed. Even after this time, unless the heart has been displaced due the encroaching abdominal organs, the birth defect is difficult to detect.
There was a flurry of life-saving procedures performed immediately after Sean's birth, when it was determined that he couldn't breathe, including surgery to close the hole in his diaphram and gently move his abdominal organs out of his chest. When it was determined that Sean needed to be placed on a lung bypass machine to help him breathe, he was transported to a portable incubator for a flight to an out-of-state hospital. When gases in his blood failed to stabilize, our baby, Sean, died during the flight, having lived only 15 hours.
Congenital Diaphragmatic Hernia occurs in one out of every 2,000 births. Statistics show that 50% of babies die soon after birth, and those who live often have eating and breathing problems, as well as developmental disabilities.
The cause for this birth defect is unknown.
Our mission through the March of Dimes is to improve the health of babies by preventing birth defects, premature birth, and infant mortality.
Sponsor
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Back to Florida Hurricanes Page 1
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Artist: Mel Torme
Music: Hal David and Burt Bacharach
Title and Lyrics: Raindrops Keep Falling on My Head
|
Raindrops keep fallin' on my head
And just like the guy whose feet are too big for his bed
Nothin' seems to fit
Those raindrops are fallin' on my head, they keep fallin'
So I just did me some talkin' to the sun
And I said I didn't like the way he got things done
Sleepin' on the job
Those raindrops are fallin' on my head, they keep fallin'
But there's one thing I know
The blues they send to meet me won't defeat me
It won't be long till happiness steps up to greet me
Raindrops keep fallin' on my head
But that doesn't mean my eyes will soon be turnin' red
Cryin's not for me
'Cause I'm never gonna stop the rain by complainin'
Because I'm free
Nothin's worryin' me
[trumpet]
It won't be long till happiness steps up to greet me
Raindrops keep fallin' on my head
But that doesn't mean my eyes will soon be turnin' red
Cryin's not for me
'Cause I'm never gonna stop the rain by complainin'
Because I'm free
Nothin's worryin' me
|
Hurricane Information
Survivng Storm Stress(PDF)
Hurricanes and Pets
Tips for Surviving Hurricanes (Microsoft Word)
Hurricane Humor - For Surviving Hard Times
