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Thinking about having a baby?  There are some things you need to know!

  • Avoid alcohol! If a mom has more than a little sip of wine, beer or a mixed drink, the alcohol enters her bloodstream and goes to the baby. While her brain may be able to withstand this, her developing baby’s brain can’t handle it which may lead to mental retardation.
  • Take high-quality vitamin supplements, especially B-12 and Folic Acid!  These supplements are essential for proper development and are known to prevent defects such as Spina bifida.
  • Eat Healthily! You are feeding a rapidly growing baby, and that baby needs protein – not sugar!
  • Exercise! Be smart about it, but do continue to get your exercise.  Now is probably not the best time to train for a triathlon, but continue to move: walk, swim, bicycle.
  • Be smart! Don’t smoke!  Don’t do drugs!  Don’t use Medical Marijuana!

If you have questions about prenatal health or need a pregnancy test, check with us!


How is Fibromyalgia Treated?

Despite the inconsistent medical opinions about Fibromyalgia, several treatment options have been found to be successful.

Prescription Medications:

Generally, NSAIDs (Aspirin, Ibuprofen, Naproxen sodium) are ineffective, and the potential risk of side-effects are significant.  Still, some medications may work:

  • Muscle relaxants
  • Topical analgesics – the most effective will be uniquely formulated by a reputable compounding pharmacy
  • Pregabalin – effectively reduces nerve transmissions
  • Serotonin/Norepinephrine Reuptake Inhibitors (Milnacipran & Duloxetine) – these also carry the potential for very serious side effects, and should be regarded as a last resort.

Naturopathic Treatment:

Naturopathic medicine offers several treatment options which have demonstrated benefit in patients with fibromyalgia.  These include:

  • Acupuncture – This treatment, based on Traditional Chinese Medicine, seeks to stimulate very specific points on the body’s energy meridians. The meridians most often used to treat acupuncture are Kidney, Liver, Governing Vessel and Gall Bladder.
  • Nutritional Supplements – The importance of good nutrition in any chronic disease condition cannot be over-emphasized.  Just like building a house, basic materials are needed.  Healing from fibromyalgia cannot be fully accomplished with basic nutrients.  I recommend supplementation:
    • Weekly IV Nutrients – This is commonly called a “Myer’s Cocktail.”
    • Daily Supplements: Malic Acid, Magnesium, Multiple Vitamins, Co-Q 10, Melatonin, C, D, B-complex, SAMe, 5-HTP
  • Injection Therapy
    • Inject an analgesic into the tender points. This will “turn them off” for a few days, bringing at least short-term relief.
  • Hydrotherapy
    • This is the use of alternating hot and cold packs to reduce or eliminate the pain.
  • Physical Medicine
    • This is the use of adjustment techniques to reduce the strain on muscles and tendons.

Fibromyalgia can be treated successfully.  There is no reason to “just live with it.”

What is PCOS

Polycystic Ovarian Syndrome, is a condition of women in which the ovaries produce excessive amounts of testosterone, sometimes thought of as a male hormone.

This excess testosterone causes problems such as:

  • Unwanted Hair Growth
  • Menstrual Cycle Irregularities
  • Weight Gain – particularly in the belly
  • ​Acne

What is Meant by “Cystic Ovaries”?

The ovaries are the collection of eggs (also called Ova) which are produced in a female during embryonic development. During puberty, the ovaries are stimulated by hormones to mature.  Each month, an increase in two hormones leads to one of the eggs being selected to “develop” and be released from the sac (or follicle) in which it is contained.  The empty sac that remains produces a hormone to assist with pregnancy, and then undergoes a deterioration – usually. Sometimes, the sac will remain. This is a very, very tiny ovarian cyst.

Is this Dangerous, like Ovarian Cancer?


What Else Does High Testosterone Cause in A Woman?

Other results of high testosterone in women include male-like changes, such as

  • Hair on the chin, around the lips, and possibly on the chest or back.
  • Acne formation on the face, chest and back.
  • Some women report an increase in libido and certain other male-like attitudes, such as anger issues.

What About Obesity and Diabetes with PCOS?

Because the ovarian follicles interfere with the hormone system to such a great extent, there is also a disruption of the hormones required to use glucose in the cell, leading very often to a form of diabetes and/or obesity.​  Like other causes of diabetes, this can be effectively managed or cured.

How Can a Woman With PCOS Be Recognized?

Here’s the picture of a woman with PCOS: a younger woman who experiences highly irregular or no periods, who is overweight and has hair growth and acne on her face, chest and back. She may also have a high libido and enlarged clitoris, and have anger or rage issues – but not all women have the same manifestations. Diagnosis cannot be made based on appearance.  All of the factors must be considered in proper context.

Before any treatment is started, a diagnosis must be made based on a thorough physical exam with certain lab tests, and perhaps even an ultrasound of her ovaries.  Only after a diagnosis is made, can treatment can be initiated.​

How is PCOS Treated?

There are several ways to treat PCOS, although the most common is usually to add or change a prescription for birth control pills (which are high in estrogen, and counter the high testosterone).  This carries risk of other conditions which must be carefully considered.  Some doctors also prescribe a medication for diabetes (not insulin).

If you think you may have PCOS, please bring it up to your doctor soon, or call us for an appointment.

Pain Management

Pain may be thought of as a signal from some part of the body to the brain that there is an “insult” or “injury” to a tissue or body structure.  The physiologic mechanisms of pain are fascinating to study, but miserable to experience.  Very few people enjoy the experience of pain and most go to extremes to rid themselves of it.  However, it can be very challenging – and sometimes impossible – to fully rid the body of pain.  In many circumstances, the best that can be expected is to “manage” the pain to a level that allows us to regain some or even all function.  Hence the term Pain Management.

Pain is either acute – meaning an immediate response to the insult/injury, or chronic which means the pain has persisted for at least three months.

Acute pain management is usually attempted with short-term pain relievers, also known as analgesics.  Most common among them is a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs).  Analgesics in this class include such brand names as Advil and Motrin.  Other pain relievers in this class include Naproxen and aspirin.  Tylenol, which is the brand name for acetaminophen, is a different type of pain reliever, with a different type of effect.  All of these are available over-the-counter (OTC) at drug stores and markets.  All of these are effective in some people, sometimes; none are effective in everyone, all the time.

Prescription medications may include NSAIDs such as Diclofenac and Toradol.  Some prescription drugs are steroidal anti-inflammatories which are usually reserved for chronic pain that cannot be controlled any other way, such as some forms of arthritis.

Opioid drugs, which have been used way too commonly, are narcotics that function by interfering with the brain’s pain centers.  These drugs, which include morphine, oxycodone, oxycontin, and brand names such as Percocet, Vicodin, and Norco, may be addictive and interfere with normal cognition.  These drugs have been studied in acute pain patients, but not chronic pain patients (because to study them in chronic pain patients would require volunteers with documented severe pain to go for months or years without any pain medications to see the effect – this is how drug studies are conducted.  Obviously, no one volunteers for such studies).

Other forms of pain medication include homeopathic remedies, alcohol, and cannabis (marijuana).  In Arizona, people suffering from severe and chronic (debilitating) pain may qualify for use of medical marijuana.  One of the ingredients in some strains is CBD (cannabidiol), which is a highly effective pain reliever in some people.  CBD does NOT cause a “high” and does not impair thinking. However, it is considered to be unlawful by the federal government, and people who use it may not be able to purchase a firearm from a licensed dealer, cannot have a commercial driver’s license, and may be charged with a crime.   CBD is also derived from the hemp plant, and is not regulated in this form.

Besides medication, there are many other ways to help manage pain, depending on the source.  These may include surgery, physical manipulation by specially-trained physicians, acupuncture performed by trained and licensed professionals, massage, electrostimulation by a TENS unit, Cold LASER, and other procedures.

Could Medical Marijuana Be Right For You?

There remains a some controversy over the use of marijuana to treat some medical conditions, despite legalization several years ago.  Some people may wonder if those who seek to be treated with medical marijuana are really just “pot-heads” or aging “hippies” looking for a way to be “legal” when using an illegal drug.  Others may continue to think the use of marijuana, medical or otherwise, is a gateway to the use of other illegal drugs, like heroin or cocaine.  Still others may be open to the concept of medical marijuana use, but want to avoid the “stink” of a medical marijuana cigarette.  As a doctor who has evaluated hundreds, if not thousands, of patients for medical marijuana use, I face this daily.

In my experience, most of the people seeking medical marijuana certification evaluation have a legitimate need.  Perhaps 10% of patients have been rejected for not having a certifiable need.  Arizona law establishes a limited number of conditions that will qualify a patient for medical marijuana, and most of those conditions have clear criteria for making a diagnosis.  These conditions are HIV/AIDS, a worsening of Alzheimer’s disease, Crohn’s, Cancer, Glaucoma, Hepatitis C, Lou Gehrig’s Disease (ALS) and PTSD.  These conditions are not diagnosed by a primary care doctor and certainly are not diagnosed in a medical marijuana evaluation center.  Most of these require lab tests or medical procedures to make a diagnosis.  These are serious conditions requiring careful medical care, so persons with these conditions are not going to be evaluated for medical marijuana “just to be legal.”

Arizona law also allows persons with certain chronic or debilitating conditions to obtain and use medical marijuana.  These are: cachexia or wasting (unintentional loss of 10% of body weight in the past six months), severe and chronic pain, severe nausea, seizures (such as in persons with epilepsy), and severe or persistent muscle spasms (such as in persons with multiple sclerosis).

According to the Arizona Department of Health Services, the most common reason for someone to seek medical marijuana is a condition of severe and chronic pain, with nearly 3 out of 4 cards based on this debilitating condition.  From my experience, most of these people will have a complaint of low back pain, although other common complaints include migraine headache, fibromyalgia, arthritis, and knee or shoulder pain.

These patients seek medical marijuana in order to have an alternative to the prescription medications used to treat pain: hydrocodone, oxycontin, morphine, methadone and other opioid drugs.  Use of these medications frequently have serious side effects, ranging from constipation and a feeling of being in a mental fog, to addiction or even death from overdose.  Curiously, the risk of death or other complications from the use of opioid drugs has recently led to the development of “Guidelines” from the state which limit a patient’s access to these drugs.  Unfortunately, some patients will seek to replace the opioid drugs with heroin, so in these cases it the prescription drug, not medical marijuana, that is the gateway drug to illicit drug use.

Medical marijuana does not have to be smoked in order to be beneficial.  In fact, as a doctor I usually advice my patients against smoking cigarettes or marijuana.  The active ingredients in medical marijuana are available in many other forms, such as edibles, oils, lotions, vapors and tinctures (a few drops on the tongue is all that is needed).

Is medical marijuana right for you?  Perhaps it is worth considering.