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July 2010 Newsletter

The Sexual Medicine Society of North America met in November 2009 and the meeting was on Better Sex Through Better Living! This month's newsletter is committed to making my patients aware of some of the findings at that meeting.

TESTOSTERONE AND VASCULAR DISEASE

One topic was the role of the hormone, testosterone, in a man's vascular health.

Testosterone regulates metabolism of carbohydrates, lipids, and proteins. It modulates muscle and fat tissue physiology and body composition. Many physicians at the meeting felt that testosterone was a very important independent determinant of blood fat level.

The people at the meeting determined that "middle-aged men with symptoms of testosterone deficiency are at a high risk for both carotid and heart disease". The likelihood of having a cardiovascular event (heart attack) in a patient with a low serum testosterone was four times higher compared to patients with normal testosterone.

Taking serum testosterone appeared to decrease the risks for heart disease and to reduce total cholesterol. This is a novel idea that has not been widespread in medicine. Several studies suggested that testosterone may have a protective affect on the development of atherosclerosis and that low testosterone accelerates plaque formation when in combination with elevated cholesterol.

Several doctors had studied this theory in the animal model. They were able to demonstrate that in animals, testosterone replacement therapy showed a markedly inhibited development of atherosclerosis.

What does all of this mean to my male patients?

If you are a middle-aged man and have low testosterone, it may be more difficult for your internist to manage your diabetes, insulin resistance, obesity, hyperlipidemia, and metabolic syndrome.

Our office is happy to participate in checking your testosterone and happy to work with your internist to maximize your hormone therapy.

SMOKING AND ERECTILE DYSFUNCTION

Another topic at the meeting was smoking and erectile dysfunction. The World Health Organization has estimated that about five million people die worldwide every year due purely to tobacco use.

A little known fact is that 50% of all bladder cancers are related to cigarette smoking. Nicotine appears to cause vasoconstriction through epinephrine and norepinephrine release; what this means is that you have decreased blood flow not only to your heart and other vital organs, but also decreased blood flow to your penis. If you have been or currently are a smoker you have a three time greater chance of developing erectile dysfunction! More importantly, erectile dysfunction in a smoker is a large predictor of vascular disease.

The take-home message is if you want to keep your erectile function, throw away the cigarettes!

Another hot topic at the meeting is something called the metabolic syndrome. What is the metabolic syndrome? It is postulated that increasing abdominal obesity leads to increased activity of an enzyme called aromatase. This is present in fat tissue. It converts testosterone to estrogen. The result is low testosterone, which increases triglycerides and can further lead to increasing obesity and insulin resistance. Patients with metabolic syndrome will frequently have problems with managing their diabetes, their insulin resistance, and their hyperlipidemea, all these things lead to atherosclerosis, cardiovascular disease, and poor quality of life. Ultimately, mortality is increased.

Studies presented at this meeting showed that replacing testosterone has helped to improve the ability to manage blood sugar and lipid levels in patients with metabolic syndrome.

Of great interest is the combination of diet, exercise, and testosterone; when these things are combined in a middle-aged, overweight male patient, a great increase in life satisfaction can be seen.

We have known for quite a while since the articles came out in The New England Journal of Medicine, that diet appears to have a great deal to do with health. The Okinawans have the lowest death rate from cancer, heart disease, and stroke and the highest life expectancy for both males and females. We also know that the Sardinians have the second best longevity and that in America, the Seventh-day Adventists have the best longevity. Throughout these three groups most people do not smoke. Most people put family first and remain socially engaged. Lastly, each of these groups is known to eat a lot of fruits, vegetables, and whole grains. All three groups also appear to have a high rate of exercise and a much lower rate of smoking.

There was also data presented at this meeting that there is a significant association between beef consumption and fatal heart disease. An increased rate of beef consumption was considered to be more than three ounces in eight days.

The Mediterranean diet, which we have all heard so much about, has a high consumption of olive oil, vegetables, legumes, whole grain products, fruits, and nuts. The intake of saturated animal fat is extremely low. Moderate fish consumption, moderate red wine consumption, and moderate calorie intake in general, also comprised the diet.

This diet, when transferred over to the standard American, appeared to work!

So from this meeting, much of what we already knew about health was confirmed. We did learn a new piece of information regarding testosterone level and how it might affect metabolic syndrome.

Information about cigarette smoking and erectile dysfunction has been known for a long time. Please pass the word that cigarette smoking causes bladder cancer!

All of this research was done in males.

I hope that you find this information interesting and our next newsletter will be on testosterone deficiency.

Have a great, hot July.

Respectfully,

Martha B. Boone, MD, LLC

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June 2010 Newsletter

Dear Fabulous Patients,

Please remember that we are moving our office June 3rd and June 4th. Our new address is: 960 Johnson Ferry Rd., Suite 245, Atlanta, GA 30342.

Also, please remember that the primary cause of kidney stones is DEHYDRATION. If you are a kidney stone patient, drink, drink, drink, during those hot months. Or, you'll get to see my new office earlier than you had hoped!

Yesterday, I saw a gorgeous 94 years old woman who looked about 70. I asked her, "How did you do it?"

I thought I'd share with you, her responses:
1) LAUGH A LOT
2) DON'T EAT TOO MUCH
3) EXERCISE A LITTLE EVERY DAY
4) DO SOMETHING COMPLETELY NEW EVERY YEAR!
5) PRAY
6) SAVE MORE MONEY THAN YOU SPEND, SO YOU DON'T HAVE TO WORRY WHEN UNEXPECTED THINGS HAPPEN, BECAUSE THEY ALWAYS DO!
7) Don't be afraid of a little plastic surgery! (LOL)

THIS LOVELY WOMAN HAD SURVIVED BREAST CANCER, THE DEATHS OF HER SON AND HER HUSBAND AND MOST OF HER FRIENDS. SHE WAS HAPPY AND GRACEFUL AND POISED. (I actually caught her "flirting" with Corwin, my male receptionist!)

Her words reminded me of the "simplicity" of a really good life.

I hope that they help you too.

Fondly,
Dr. Boone

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May 2010 Newsletter

Dear Valued Patient,

Topical Treatment for Vulvodynia /Post Coital Pain (Post Sex Pain)

There is an over-the-counter product with capsaicin 0.025% gel or cream that can be applied to the vulvar area two to four times per day. This medication has been shown to down regulate pain receptors. In layman's terms, that means it can make the pain receptors on the vulvar area less sensitive.

One important caveat is that this medication can burn on application. So, if you choose to use this form of therapy, please apply a topical agent to numb the vulva prior to application. The most common numbing agents are lidocaine, Xylocaine and EMLA cream.

If your past treatments for vulvadynia have failed, you may be interested in learning more about this new therapy.

Post Coital Pain (Post Sex Pain)

Do you suffer from post coital pain? Dr. Kristene Whitmore, Medical Director of the Pelvic and Sexual Health Institute in Philadelphia, PA, suggests her "Sex Pack":

1. Oral Antispasmodic (Levsin SL)
2. Valium Suppository (to vagina)
3. Lidocaine Gel (to urethra)

If no relief, B & O suppositories may help.

Sincerely,

Martha Boone, M.D.

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April 2010 Newsletter

Dear Valued Patient,

URINARY TRACT INFECTIONS/ PASSING KIDNEY STONES

UTI

Recent research has shown the following regarding Recurrent Urinary Tract Infections in Women:

1. Theracran reduces the incidence of infections by 35%! THIS IS NOT TRUE OF ALL CRANBERRY PRODUCTS.
2. Increasing fluid intake above 60ozs. In 24 hours has not decreased the incidence of infections.
3. Vaginal estrogens in the peri and post menopausal woman have been shown to decrease the incidence of infections by 75%!!!! This treatment is not approved for young women.
4. Use of spermicide DOUBLES the incidence of infections!

The immunotherapy URO-VAXOM decreases the incidence of UTI by 50%.BUT, IT IS NOT CURRENTLY AVAILABLE IN THE USA.
PLEASE KEEP YOUR EYES PEELED IN CASE THIS BECOMES AVAILABLE IN THE USA! AND, WRITE THE FDA TO LET THEM KNOW THAT YOU WANT THIS DRUG FOR AMERICA!!

SO, the "take home message" for ladies suffering from recurrent urinary infections is to take theracran every 12 hours, drink no more than 60ozs. of water per twenty four hours, avoid spermacide as a birth control method, get a vaginal estrogen product if you are 40-80 years old and write the FDA to help get the Uro-Vaxom in America!

Please use every prevention method available to you. For the first time in 25 years, I know of NO urinary tract antibiotic that is in development. What that means for my patients, is that when you become "resistant" to all currently available oral antibiotics, you will need intravenous antibiotics! So, it behooves us to use as few antibiotics as possible.

Kidney Stones

Evidence from the University of Michigan demonstrates that the drug, Flomax, can greatly increase the chances of your passing a kidney stone that is coming down your ureter!

So, any patient who is actively passing a stone should consider taking an alpha blocker medicine at night until the stone passes!

"ADVERSE EVENTS" were decreased by 30% by using the drug to help pass stones!

HAPPY SPRING!

Dr. Boone

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March 2010 Newsletter

Dear Wonderful Patients,

January was a difficult month at our office. I diagnosed more patients with bladder cancer during the first two weeks of January, than I usually diagnose in 7 months! To my great horror, I diagnosed a 19 year old with a large bladder cancer. Previous to finding this cancer in this very young adult, the youngest person that I had ever diagnosed with bladder cancer was 34 years old.

This surprising diagnosis has caused me to rethink what I have learned in 24 years of treating bladder cancer.

Subsequently, I have spoken to two very well known uropathologists (one is from the Mayo Clinic) who have told me that "they have seen bladder cancer in people as young as 11"! But, bladder cancer in people younger than 40 remains a "rare" phenomenon.

I am writing to you, to remind you that the ONLY warning that we get of bladder cancer is a little bit of blood in the urine. This is usually found by your doctor on your yearly urine analysis. Please make sure that you and your loved ones get your urine checked every year with your yearly physical. The blood would be found under the microscope, by your doctor. As urologists, we check everyone's urine for blood on every visit.

Please remember that 95% of people who have blood in their urine, do NOT have cancer. And, please remember that you need to be checked by a urologist if you ever have blood in your urine.

Let's focus on PREVENTION. What can you do?

1. DO NOT SMOKE. Do not allow people to smoke around you. The number one cause of bladder cancer is exposure to Cigarette smoke. Please, Please, stop smoking!! If you have ever smoked for more than five years, even if it was 25 years ago, you will carry a higher risk for bladder cancer, your whole life. So, blood in the urine (hematuria) in a current or past smoker should be carefully evaluated by a urologist.
2. Since I am diagnosing more and more people with bladder cancer who have never smoked, there must be other factors. I have found evidence that taking vitamins and supplements can help decrease the reoccurrence of bladder cancer in people who have had them. So, it may be worth your while to consider taking those supplements as a preventative.
   I am recommending that all of my bladder cancer patients and any of my patients who have smoked at any time in their lives ( for over five years), consider taking the supplement, Bladder 2.2 which is produced by the Theralogix company. You can go to our website www.femaleurologists.com and access their website to read about the supplement. Please use my doctor number when ordering the supplement, so I can track which patients are taking it.
3. Also, if limiting red meat is very helpful with other types of cancer, maybe it might be helpful with bladder cancer. If you have been diagnosed with bladder cancer, you might wish to consider limiting red meat in your diet.

I have had three patients who have ovarian cancer make a couple of recommendations of things that were helpful to them.

1. Dr. Bernie Siegel's CD "Meditations for Enhancing Your Immune System". There is evidence that meditation increases the powerful chemicals that heal our bodies of disease.
2. "Love is Letting Go of Fear" by Gerald Jampolsky has been recommended to decrease negative emotions which creates "stress" reactions in the body.

As always, early detection is the key to curing cancer. And as for preventing it, I am a big believer in managing your stress, exercise and excellent nutrition.

On a positive note, rarely do we have to do any invasive surgery for bladder cancer. Most of our patients are detected early and can be treated with "out patient" and minimally invasive procedures.

Of our many patients diagnosed in January, only one person will have to have a major surgery. Everyone else was detected early and appears to be "cured".

Please check our website for new videos on blood in the urine (hematuria) and please send them to your family and friends!

Have a great spring,

Dr. Martha Boone

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February 2010 Newsletter

News from the world of urology!

Dr. Boone has reviewed the meeting from the latest International Continence Society meeting for you.

Researchers have found:

1. Young women with poor bladder emptying (Fowler's syndrome) are responding well to sacral neuromodulation. So, if you are between 18 and 40 and are having trouble emptying your bladder, there may be new help for you. Go to our website and read about the Interstim device.

2. Botox to the bladder continues to show efficacy in patients who have failed all conventional over active bladder treatments. So, if you have "tried it all" and are still going to the bathroom too frequently, Botox to the bladder may help you.

3. The latest overactive bladder drug, Toviaz was shown to work better for urge incontinence than does the drug Detrol-LA. A large study of >1700 patients showed this finding. So, if you are on an overactive bladder drug and are not completely happy, please come in, as you may be a candidate for the new drug.

   For more information, go to Toviaz.Com

4. An Italian group of researchers has shown that patients with interstitial cystitis (IC) have a very interesting phenomenon known as central sensitization. Essentially, this means that the brain "turns up" the pain receptor response in these patients. (IC patients are more "sensitive" and prone to heightened pain response than other people) This finding is exciting, because it can help explain the connection between IBS, fibromyalgia, and IC.This is also very exciting for the possibility for new research on the IC patient.

   Finally, the National Cancer Institute has definitely shown a link between volume of red meat eaten and PROSTATE CANCER. In a ten year study of over 175,000 men, there was definitely an increased risk for prostate cancer based on red meat consumption.

   SO, PLEASE HAVE ALL THE MEN YOU LOVE DECREASE THEIR RED MEAT CONSUMPTION!! (They have not yet determined how much you can safely eat. So, the less, the better.)

   HAPPY AND HEALTHY 2010.

   WARM REGARDS,
   Dr. Martha Boone

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   January 2010 Newsletter

   HAPPY NEW YEAR TO OUR WONDERFUL PATIENTS!!

   I am not one to make "New Year's Resolutions". I am already "doing the best that I can".

   But, the end of one year and the beginning of another has always been a time of reflection and gratitude for me.

   This past year, I have seen an unpatrolled level of "fear" in my patients. The job market, the healthcare bill, the economy, and international politics have really had many of my patients very concerned, all year long. I share your concern and we are most definitely "not out of the woods" yet.

   But, "worry" over these things will not improve our health. And our health is the "well spring" of our lives.

   So, without making any sweeping resolutions, what can we do to be "younger next year"?

   1. Let's really make an effort to MOVE MORE. Let's not let those skinny Europeans get the better of us. Let's work towards not being the fat, overindulgent Americans that we have been in the past. Get out there and walk. Take the stairs when you can. Park the car, well away from the door. Take a ten minutes stroll in the neighborhood after dinner. MAKE SOME COMMITMENT TO MOVING MORE!!

   2. OK, GANG, IT IS TIME TO DECREASE THOSE PORTIONS! Supersizing everything has given us a nation of obese children who are on "dialysis" more than any country in the world. Let's decrease our portions. You can do it. Eat on a salad plate for a while. You can only "pack" a small plate, so full. Get out a deck of playing cards and realize that the size of a card is the size of a portion of protein! Your steak or your chicken should fit into the area of that playing card. Split your usual meal in half and eat the other half at lunch the next day. Or, share one meal between two people. And, all of us knows that the less animal protein, the better. EAT MORE BEANS!!! In my family, I replaced two "meat meals" per week with beans. There was a great deal of complaining from my husband, the carnivore, but one year later, he does not miss it at all. Our food budget is less and our blood fats are lower.

   3. Cut out the snacks. If you cut out one snack per day, you would lose ten pounds in a year, from that alone. The sugar and crabs are killing us!

   4. DRINK WATER! If you are urology patient, chances are you should be drinking plenty of water. Unless your internist has told you otherwise, you should drink about your body weight divided by two in ounces. (If you weigh 150 pounds, you need 150/2=75 oz. per 24 hours of water)

   5. If you are a patient with kidney stones or interstitial cystitis, follow your diet. If not, put more fruits and vegetables in your diet. When you have a choice to make, choose the fruits and vegetables. Our lives are made up of all the little choices that we make every day. Make better choices and you will have a better life and better health. Most people do not need to make big sweeping changes. Most people can make many small changes per day and see great improvement in their health, over a year.

   6. Do your preventative care. Make a list of all that you need to do and make it your top priority. My list looks like this:
      1. Clean teeth= January and July
      2. Pap smear=October
      3. Mammogram=August
      4. Eye exam=September
      5. Bone density=July
      6. Routine Gynecology evaluation =October
      7. Dermatologist=February
      8. Blood work =January and July

      Nothing is more important than your health. Plan for it. DON'T WAIT UNTIL THE END OF THE YEAR. EVERYONE HAS PAID THEIR DEDUCTIBLE AND IT IS JUST CRAZY AFTER NOVEMBER 15TH. DON'T DO THAT TO YOURSELF. PLAN WELL FOR GREAT HEALTH.

   7. Your mind controls your body. Like it or not, that is the truth. Try to find some peace. Watch the news less. Email less. Read the news less. ALL of these things are full of fear based information and HORROR. Try to limit your exposure to these things. Constantly scaring yourself raises your "stress hormones" and can decrease your health. Learn to quiet your mind. Things like yoga, meditation, tai chi, swimming, walking (long and slow) .I do ballroom dancing to quiet my mind. Just trying to get my body where it is supposed to go, takes everything that I have! I can't worry about that healthcare bill while trying not to bust my butt! LOL.Try to find some quiet time in every day. It will be hard at first, but persist and I promise that the health benefits will amaze you. There are tools for this on our website www.femaleurologist.com

   8. Whatever your spiritual beliefs, cling to them. Sometimes, our world seems that it is crazy. I can't tell if the fear mongers and 24 hour news agencies make it seem that way, or if everything really is "much worse" than it used to be. But, what I know for sure is that there is something bigger than us and it (he or she) has bigger and better ideas than I do. I have patients of all types and I deeply enjoy the diversity. Whether you are Christian, Jew, Muslim, Hindu, Buddhist, agnostic or atheist, prayer will work for you. I pray for my patients everyday. I believe that quiet desire for a better life is heard by God (whatever you deem god to be) and answered. Try it. It surely won't hurt you.

   9. Practice gratitude. No matter what is going on here, we are still "better off" than 90% of the world. If you find yourself feeling fear or anger, try to think of things about which you are grateful. With my stepdaughters, if they are complaining, I will make them name things that they are grateful for and it always gets them going in the right direction. The mere "threat" of the gratitude list will "straighten them right up".

   10. Plan for your health. I have read all of the health care legislation. We still don't have a final bill. But, what I am sure of is that all of the middle class Americans will be spending more on healthcare. I can promise that. So, don't drive yourself crazy when it starts. Go ahead and plan now. Put some money aside, out of every check and create a little savings for whatever they do end up sending our way. Know that taxes are going up. (Even though they say that they are not, I am sure that we can't cover more people and not spend some tax money. It does not make sense) Know that premium costs are going up. Know that out of pocket expenses are going up. Try to carve out a small portion from all of your other budget items for additional healthcare costs. I truly do not see any other way to do it, in the current climate. NOTHING that I have seen in either bill is going to make healthcare cheaper for the middle class. I am sorry for the bad news, but it is affecting me too. Planning well can keep it from turning into an emergency.

   11. Take your vacation time. Use every single bit of it and spread it out over the year to give yourself breaks. A change of scenery is so good for your soul.

   12. Try to create harmony everywhere that you go. Try to make all of your relationships as peaceful and harmonious as you can make them. Guard your thoughts and be sure that you send love to those people around you. It will come back to you, multiplied abundantly.

   I am so happy to have each of you as my patient. I hope that 2010 is your best and healthiest year ever!!!

   Dr. Martha Boone

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