May 2015

Heal with Friends Podcast: Postpartum Placenta Consumption

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Heal with Friends Podcast

Postpartum placenta consumption has become all the rage over recent years. Stories abound about the benefits of consuming the placenta postpartum. It seems everything from postpartum mental health and energy levels to postpartum nutrient and iron recovery are implicated. Is it safe? Is it effective? What does the research tell us about this practice?

Early research suggested that placentophagia induces lactation and reduces pain. More recent research suggest placental ingestion may offset symptoms of postpartum depression. Until more research is conducted, however, it is a difficult decision, one fraught with controversy. Physicians, hospitals, and regulatory agencies are not sure what to make of these practices. Some are in favor, others are most decidedly against.

If you’re pregnant and considering placental consumption to stave off postpartum health issues, this show is for you. I interview two of the leading experts in the field: Jodi Selander, founder and director of PlacentaBenefits.org and Sharon Young, PhD candidate focused on placental research.

Listen in as we discuss everything from historical and cultural practices, to the most recent research and practical considerations. Hosted on the fantastic network, Fearless Parent Radio:

Eat my Placenta, Say What?

About Heal with Friends

The Heal with Friends podcast, along with our companion social health site of the same name, Heal with Friends, are about finding health together. It does not matter if you are physician, researcher, parent, or patient, we want to hear from you and learn from your health experiences. When you join the Heal with Friends network, you can share your stories, your ideas, your hard learned and lived wisdom about health and illness. Together we can find solutions to complex health issues.

About Fearless Parent

The Fearless Parent network, is an “innovative online media platform that’s ahead of the pulse for today’s thinking parent.” Like us, they believe in bucking conventional wisdom, in asking the hard questions. Fearless Parent Radio is the ”thinking person’s daily dose of unconventional, evidence-based news about health, wellness, green living, and holistic parenting choices.”

Tune in, join the conversation, and follow us for monthly shows on topics that matter to you.

 

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Should I Have a Hysterectomy for Endometriosis?

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Philippa Bridge-Cook

Every woman dealing with endometriosis has faced this question at some point in her journey. It may be a question she has asked herself, as she navigates treatment options, perhaps having tried many treatments that have not worked. Perhaps her doctor has stated it as the only possible next step. Or, friends and family members have suggested it, thinking that it is a cure for endometriosis. Sometimes, endometriosis patients feel pressured by those around them to consent to this surgery. And sometimes endometriosis patients are so desperate to find a solution to the never-ending pain that they just want “everything out” and to not have to deal with it anymore.

Does Hysterectomy Cure Endometriosis?

If you are considering a hysterectomy to manage endometriosis pain and symptoms, the first question that needs to be asked is how effective is a hysterectomy in curing endometriosis? There have been some studies published that address this question. The rate of symptom recurrence varies quite a bit depending on the study—from 19 to 62 percent, when at least some ovarian tissue was conserved. One major reason for persistent pain after hysterectomy for endometriosis is incomplete removal of endometriosis lesions at the time of hysterectomy, and thus, the reason for the variability between the studies likely reflects, at least in part, the differences in surgical skill at completely excising all endometriosis lesions.

What about Removing the Ovaries?

When both ovaries and both Fallopian tubes are also removed at the time of hysterectomy (bilateral salpingo-oophorectomy, or BSO), the risk of symptom recurrence is lower, but still present, at 8 to 10 percent. Again, complete removal of endometriosis lesions at the time of hysterectomy improves post-operative outcomes.

Many endometriosis patients who have had hysterectomies and bilateral oophorectomies for endometriosis are reluctant to take hormone replacement therapy (HRT) for fear of stimulating any endometriosis tissue that may have been left behind. This question has not been addressed comprehensively with published studies. The risks of HRT related endometriosis growth depend somewhat on whether any endometriosis tissue was left behind at the time of hysterectomy. The risks of HRT in general, however, cannot be dismissed. Studies have shown a higher incidence of certain cancers, gallbladder disease and cardiovascular events. Despite these risks, medical consensus suggests the benefits of HRT outweigh the risks. The disparity between the research and consensus means each woman should weigh the risks and benefits carefully.

Complications Associated with Hysterectomy and Oophorectomy

What are the risks and potential long term complications of hysterectomy, or hysterectomy plus bilateral oophorectomy? A large study of almost 30,000 nurses undergoing hysterectomy for benign (non-cancerous) diseases showed that hysterectomy plus BSO is associated with an increased risk of death from all causes, increased risk of fatal and non-fatal heart disease, and increased risk of lung cancer. Hysterectomy can cause pelvic floor dysfunction, and can negatively impact bladder function: the risks of urinary incontinence and vaginal prolapse increase significantly post-hysterectomy, although these complications usually do not develop until 10 to 20 years later.

Hysterectomy plus BSO causes surgical menopause, which causes an abrupt cessation of hormones, compared to the gradual process of natural menopause. This can result in more severe menopausal symptoms, such as hot flashes, vaginal dryness and irritation, and decreased sex drive or other problems with sexual function. In addition, the beneficial effects of the small amounts of hormones that continue to be produced post-menopause from the ovaries are gone in women who have undergone BSO. Removal of the ovaries can be devastating for some women, as observed by the personal stories shared on Hormones Matter.

Hysterectomy with or without BSO is associated with increased risk of heart disease and osteoporosis. The risk of both of these diseases increases after natural menopause, and therefore the reason the risk may increase in even in women who keep one or both ovaries at the time of hysterectomy may be partially because hysterectomy itself is associated with earlier menopause– on average by 3.7 years, when both ovaries are conserved, and by 4.4 years with unilateral oophorectomy. BSO and unilateral oophorectomy are also associated with an increased risk of Parkinson’s disease, cognitive impairment/dementia, and depression and anxiety. New research suggest the loss of hormones post oophorectomy, estradiol in particular, is detrimental to mitochondrial functioning. Mitochondrial injury is believed to be the mechanism by which post menopausal, surgically menopausal and chemically menopausal (Lupron and Lupron-like drugs) women develop a high rate of cardiovascular and neurological disease.

Things to Consider before Hysterectomy

Before a hysterectomy is considered as a treatment for recurrent pain or other endometriosis symptoms, other potential causes of pelvic pain should be considered. Pain can be from recurrent, or more likely, persistent, endometriosis, but there are many other conditions and diseases that can cause pelvic pain, such as adhesions, pelvic floor dysfunction, adenomyosis, interstitial cystitis, and nerve pain. Of these, adenomyosis is the only condition that will improve with a hysterectomy, and for some of the other conditions, a hysterectomy may cause worsening of the problems. It is a good idea to discuss all the potential causes of pelvic pain with a doctor or a team of doctors familiar with all these conditions to try to ascertain whether hysterectomy is the best potential treatment for your medical condition.

Many patients have a combination of causes contributing to their pelvic pain and other symptoms, so it can be very complicated to weigh the potential benefits against the risks. In addition, it is my opinion that given the risks and long-term complications of hysterectomy, the first line surgical treatment for endometriosis should be laparoscopic excision of all endometriosis lesions, with conservation of all reproductive organs if possible.

As someone who interacts with many endometriosis patients in my work with The Endometriosis Network Canada, patients on both sides of the hysterectomy question have told me that they feel judged for the decisions they are making or have made. I don’t believe that anyone should be judged for making the best decision they can make, taking into account their own personal situation and, preferences. However, I do want everyone making this decision to be fully armed with accurate information, so that they can make the best decision possible in what is usually a very complicated situation.

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What is Fluoroquinolone Toxicity?

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Lisa Bloomquist

What happened to me? Why did it feel as if a bomb had exploded within my body and mind?  Why did I go from doing CrossFit to being unable to walk a block? Why did I lose my memory and reading comprehension?  Why was I so anxious and scared?  Why were my tendons so weak and sore?  Why did I suddenly lose my energy, endurance and flexibility?

I knew the short answer to those questions. I had suffered from an adverse reaction to ciprofloxacin, a fluoroquinolone antibiotic, and I had gone through fluoroquinolone toxicity syndrome—a multi-symptom, “mysterious” illness that involves damage to connective tissue (tendons, ligaments, cartilage, fascia, etc.) throughout the body, damage to the nervous systems (central, peripheral and autonomic), and more. Even though I knew why I was sick, I was still left wondering, what does fluoroquinolone toxicity mean?  How do fluoroquinolones damage tendons, muscles, cartilage and nerves?  What, exactly, is fluoroquinolone toxicity?  What happened in my body?

No doctors that I consulted were able to give me any answers to those questions, so I went digging around myself. Here are some hypotheses for the mechanisms by which fluoroquinolones cause nervous system and musculoskeletal damage that manifests as multi-symptom, often chronic, illness.

Mitochondrial Toxicity

Is fluoroquinolone toxicity syndrome a result of mitochondrial damage? This hypothesis has the most evidence to support it. The FDA noted, in their April 27, 2013 Pharmacovigilance Review, “Disabling Peripheral Neuropathy Associated with Systemic Fluoroquinolone Exposure,” that:

“Ciprofloxacin has been found to affect mammalian topoisomerase II, especially in mitochondria. In vitro studies in drug-treated mammalian cells found that nalidixic acid and ciprofloxacin cause a loss of motichondrial DNA (mtDNA), resulting in a decrease of mitochondrial respiration and an arrest in cell growth. Further analysis found protein-linked double-stranded DNA breaks in the mtDNA from ciprofloxacin-treated cells, suggesting that ciprofloxacin was targeting topoisomerase II activity in the mitochondria.”

It is also noted in an article in Science Translational Medicine entitled “Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells” that fluoroquinolones, and other bactericidal antibiotics, “damage mammalian tissues by triggering mitochondrial release of reactive oxygen species (ROS).” And that “increases in ROS led to DNA, protein, and lipid damage in vitro.”

Mitochondrial damage, and the vicious cycle of damaged mitochondria creating oxidative stress (another name for reactive oxygen species/ROS), which leads to more mitochondrial damage, which leads to more oxidative stress, and so on, and so on, can lead to multi-symptom, chronic illness. It is noted by Doctors Bruce H. Cohen, MD and Deborah R. Gold, MD, in Mitochondrial Cytopathy in Adults:  What we Know So Far, that:

“A problem that has vexed the study of mitochondrial diseases ever since the first reported case (in 1962) is that their manifestations are remarkably diverse. Although the underlying characteristic of all of them is lack of adequate energy to meet cellular needs, they vary considerably from disease to disease and from case to case in their effects on different organ systems, age at onset, and rate of progression, even within families whose members have identical genetic mutations. No symptom is pathognomonic, and no single organ system is universally affected. Although a few syndromes are well-described, any combination of organ dysfunctions may occur.”

Doctors Cohen and Gold go on to say that:

“symptoms (of mitochondrial damage) such as fatigue, muscle pain, shortness of breath, and abdominal pain can easily be mistaken for collagen vascular disease, chronic fatigue syndrome, fibromyalgia, or psychosomatic illness.”

Mitochondrial dysfunction, and ROS overproduction (aka, oxidative stress), are associated with many chronic diseases including Parkinson’s, Alzheimer’s, ALS, autoimmune diseases, cancer, fibromyalgia, chronic fatigue syndrome, autism and more.

Fluoroquinolone toxicity symptoms resemble those of autoimmune diseases, neurodegenerative diseases, and mysterious diseases. On many levels, it makes sense that fluoroquinolone toxicity syndrome is a disease of mitochondrial damage and ensuing oxidative stress. Mitochondrial damage and oxidative stress are almost certainly part of the fluoroquinolone toxicity puzzle.

Recommended reading:

  1. Science Translational Medicine, “Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells”
  2. Journal of Young Pharmacists, “Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients”
  3. Molecular Pharmacology, “Delayed Cytotocicity and Cleavage of Mitochondrial DNA in Ciprofloxacin Treated Mammalian Cells”

Neurotransmitter Malfunctions in Fluoroquinolone Toxicity

The central nervous system (CNS) symptoms of fluoroquinolone toxicity include depression, anxiety, psychosis, paranoia, severe insomnia, paraesthesia, tinnitus, hypersensitivity to light and sound, tremors and suicidal ideation and tendencies. Many of the CNS symptoms of fluoroquinolone toxicity can be attributed to the effects of fluoroquinolones on GABA receptors. Fluoroquinolones “are known to non-competitively inhibit the activity of the neurotransmitter, GABA, thus decreasing the activation threshold needed for that neuron to generate an impulse.” (source)  Inhibition of GABA-A receptors, as well as activation of NMDA receptors, can lead to the many severe adverse effects of fluoroquinolones on the central nervous system.

Basically, fluoroquinolones do the same thing to GABA neurotransmitters as a protracted benzodiazepine withdrawal. It is noted in “Benzodiazepine tolerance, dependency, and withdrawal syndromes and interactions with fluoroquinolone antimicrobials” that:

“Chronic use of benzodiazepines causes compensatory adaptions which cause GABA receptors to become less sensitive to GABA. On discontinuation of benzodiazepines, withdrawal symptoms typically develop which may persist for weeks or months. Antagonism of the GABA-A receptor is believed to be responsible for the CNS toxicity of fluoroquinolones affecting 1–4% of patients treated. Fluoroquinolones have also been found to inhibit benzodiazepine receptor binding. The results of this small study seem to confirm that adverse reactions to fluoroquinolones occur more frequently in the benzodiazepine-dependent population than the 1–4% seen in the general public and may be severe.”

Those who have gone through benzodiazepine withdrawal can tell you that all aspects of one’s body are affected. It is possible that neurotransmitter dysfunction is at the root of all fluoroquinolone toxicity symptoms—though I strongly suspect that all of the potential theories that I mention in this post work in tandem.

Recommended reading:

  1. Toxicology Mechanisms and Methods, “Ciprofloxacin-induced neurotoxicity: evaluation of possible underlying mechanisms.”
  2. British Journal of Clinical Pharmacology, “Neurotoxic effects associated with antibiotic use: management considerations”
  3. Pharmacology Weekly, “What is the mechanism by which the fluoroquinolone antibiotics (e.g., ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin) can increase a patient’s risk for developing a seizure or worsen epilepsy?”

Magnesium Deficiency

Fluoroquinolones deplete intracellular magnesium. Magnesium is necessary for more than 300 enzymatic reactions, it is vital for the synthesis of vitamins, and magnesium depletion can lead to many symptoms of fluoroquinolone toxicity and other chronic diseases. Many people suffering from fluoroquinolone toxicity are helped by supplementing magnesium (in various forms). Studies have indicated that the binding of quinolones to DNA is mediated by magnesium.

The hypothesis that fluoroquinolones deplete intracellular magnesium is well described in the article, “Fluoroquinolone antibiotics and type 2 diabetes mellitus:”

“Fluoroquinolones are broad-spectrum antibiotics derived from nalidixic acid that inhibit bacterial topoisomerases. Although very effective therapeutically, fluoroquinolones have been linked with serious side effects such as tendinopathy, peripheral neuropathy, retinopathy, renal failure, hypertension, and seizures. These effects can be rationalized as resulting from a drug-induced magnesium deficiency, and according to the hypothesis it is not coincidental that they resemble the complications resulting from type 2 and gestational diabetes. There has, moreover, been a history of dysglycemia associated with certain fluoroquinolone antibiotics. Gatifloxacin was withdrawn from clinical use after reports of drug-induced hyperglycemia and other fluoroquinolones have been reported to interfere with glucose homeostasis.”

“The precise mechanism by which fluoroquinolones might induce intracellular magnesium deficiency is unclear. It may involve the metal-chelating properties of the 3-carboxyquinolone substructure that is common to all fluoroquinolone antibiotics and the fact that the 6-fluoro substituent on the pharmacophore gives rise to sufficient lipophilicity that the drugs can dissolve in and penetrate cell membranes. It has been suggested that intracellular fluoroquinolones may exist almost exclusively as the magnesium complex. Diffusion or active transport of such a complex into the extracellular environment would lead to depletion of intracellular magnesium – a process that may be stoichiometric or catalytic and would be only very slowly reversible, if at all. Thus, the effects of fluoroquinolones on intracellular magnesium levels might be considered to be almost cumulative (and it is noteworthy that the side-effects of fluoroquinolone therapy may manifest or persist many months after treatment). Alternatively, it is perhaps possible that fluoroquinolones could affect magnesium metabolism by disruption of renal reabsorption of this electrolyte.”

Recommended reading:

  1. Medical Hypotheses, “Fluoroquinolone antibiotics and type 2 diabetes mellitus”
  2. Natural News, “Magnesium Helps Heal Cipro Damage”
  3. Proceedings of the National Academy of Sciences of the United States, Biochemistry, “Quinolone Binding to DNA Mediated by Magnesium Ions”

Microbiome Destruction

Fluoroquinolones are powerful antibiotics that wreak havoc on the bacteria in the gut. In addition to indiscriminately killing bacteria in the gut of the person who takes a fluoroquinolone, fluoroquinolones have also been shown to induce large amounts of oxidative stress within the gut.

The importance of the microbiome for all areas of health is just now being explored.  An unhealthy microbiome is associated with Parkinson’s, Alzheimer’s, depression, rheumatoid arthritis, diabetes, Crohn’s, and many other diseases. There are many who think that the root of all disease is in the gut.

Destruction of vital bacteria, and the induction of oxidative stress within the gut, could be responsible for the havoc wreaked on the health and well-being of those who take fluoroquinolones.

Recommended reading:

  1. Antimicrobial Agents and Chemotherapy, “The Fluoroquinolone Levofloxacin Triggers the Transcriptional Activation of Iron Transport Genes That Contribute to Cell Death in Streptococcus pneumonia”
  2. National Institutes of Health, “Human Microbiome Project”
  3. Scientific American, “Think Twice: How the Gut’s ‘Second Brain’ Influences Mood and Well-Being”

Epigenetic Changes

Fluoroquinolones are topoisomerase interrupters. The mechanism for Cipro/ciprofloxacin, and all other fluoroquinolone antibiotics is:

“The bactericidal action of ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV (both Type II topoisomerases), which are required for bacterial DNA replication, transcription, repair, and recombination.”

Topoisomerases are enzymes that are necessary for DNA and RNA transcription.  Topoisomerase interrupting drugs have been found to profoundly affect gene expression.  It may be possible that fluoroquinolones trigger the expression of dormant genes. So, for example, those who have a predisposition toward an autoimmune disease may bring on the autoimmune disease with the fluoroquinolone. Anecdotally, it seems as if any existing weakness a person has is exacerbated by fluoroquinolones.

It is hypothesized in “Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology,” that all adverse reactions to fluoroquinolones are due to epigenetic mechanisms:

“The quinolones are a family of broad-spectrum antibiotics. They inhibit the bacterial DNA gyrase or the topoisomerase IV enzyme, thereby inhibiting DNA replication and transcription. Eukaryotic cells do not contain DNA gyrase or topoisomerase IV, so it has been assumed that quinolones and fluoroquinolones have no effect on human cells, but they have been shown to inhibit eukaryotic DNA polymerase alpha and beta, and terminal deoxynucleotidyl transferase, affect cell cycle progression and function of lymphocytes in vitro, and cause other genotoxic effects. These agents have been associated with a diverse array of side-effects including hypoglycemia, hyperglycemia, dysglycemia, QTc prolongation, torsades des pointes, seizures, phototoxicity, tendon rupture, and pseudomembranous colitis. Cases of persistent neuropathy resulting in paresthesias, hypoaesthesias, dysesthesias, and weakness are quite common. Even more common are ruptures of the shoulder, hand, Achilles, or other tendons that require surgical repair or result in prolonged disability. Interestingly, extensive changes in gene expression were found in articular cartilage of rats receiving the quinolone antibacterial agent ofloxacin, suggesting a potential epigenetic mechanism for the arthropathy caused by these agents. It has also been documented that the incidence of hepatic and dysrhythmic cardiovascular events following use of fluoroquinolones is increased compared to controls, suggesting the possibility of persistent gene expression changes in the liver and heart.”

Fluoroquinolones have been found to deplete mitochondrial DNA, and mitochondria have been found to affect gene expression.

It is possible that fluoroquinolones are profoundly changing gene expression, and that the adverse effects of fluoroquinolones are a result of altered gene expression.  Fluoroquinolones are, after all, topoisomerase interrupters.

Recommended reading:

  1. Medical Hypotheses, “Epigenetic side-effects of common pharmaceuticals: A potential new field in medicine and pharmacology”
  2. Mutation Research, “Ciprofloxacin:  Mammalian DNA Topoisomerase Type II Poison In Vivo”
  3. Nature, “Topoisomerases facilitate transcription of long genes linked to autism”

Thyroid Harm

The harm that fluoroquinolones do to the thyroid is described well in “Fluoroquinolone Antibiotics and Thyroid Problems: Is there a Connection?” on Hormones Matter.  A more in-depth look at fluoroquinolone induced thyroid problems can be found on FluoroquinoloneThyroid.com.

Please don’t interpret the brevity of this section as a reason to discount it as a possible explanation for fluoroquinolone toxicity syndrome. Thyroid dysfunction can wreak havoc on a person’s health and the deleterious effects of fluoroquinolones on the thyroid are a potential explanation for the multi-symptom, chronic illness of fluoroquinolone toxicity. The articles by JMR on both Hormones Matter and fluoroquinolonethyroid.com explore the relationship thoroughly.

All of the source links in “Fluoroquinolone Antibiotics and Thyroid Problems: Is there a Connection?” on Hormones Matter are recommended.

Post-hepatic Syndrome / Liver Damage

Do fluoroquinolones form poisonous acyl glucuronides that lead to post-hepatic syndrome?

I think that it’s a definite possibility, but I also think that I’m not qualified or able to form a coherent and correct explanation of this hypothesis.  Please ask a biochemist to explain the following articles to you:

  1. Drug Metabolism and Disposition, “Acyl Glucuronidation of Fluoroquinolone Antibiotics by the UDP-Glucuronosyltransferase 1A Subfaminly in the Human Liver Microsomes”. 
  2. Current Drug Metabolism, “Editorial [Hot Topic:Acyl Glucuronides: Mechanistic Role in Drug Toxicity? (Guest Editor: Urs A. Boelsterli)]”
  3. BMC Public Health, “Adverse effects of the antimalaria drug, mefloquine: due to primary liver damage with secondary thyroid involvement?”  (Note that mefloquine and fluoroquinolones are cousin drugs – they’re both quinine analogues.)

This is a long, and fairly complex, post. Yet I am leaving out many possible explanations for the causes of fluoroquinolone toxicity. Not even touched on are the possibilities that fluoroquinolone toxicity is a lysosomal disorder, autoimmune disease, fluoride overdose, “leaky gut,” histamine response, mast cell activation, serum sickness, and many other possibilities. I suspect that fluoroquinolone toxicity is a combination of all of the things mentioned above, and in this paragraph, and that there are multiple interactions between all of the biological systems. Fluoroquinolone toxicity is a systemic illness and all bodily systems work together.

Though fluoroquinolones can throw a wrench in our biochemistry, the multiple systems that work together to make us sick can also work together to make us well. We have amazing healing mechanisms that are less-understood than the mechanisms that make us sick (and those are pitifully poorly understood).  Our bodies are a complex and wondrous web.  All of our bodily systems work together perfectly most of the time, and they strive to return to health in every moment of life.

Though there are hundreds of articles about the deleterious effects of fluoroquinolones, the question – What is fluoroquinolone toxicity? – remains unanswered.  Any one of the possibilities mentioned above is complex. Put them all together and, well, comprehension becomes close to impossible.  Luckily, comprehension isn’t required for healing.  But it would be very, very, very nice if some efforts toward understanding adverse reactions to fluoroquinolones were being made.

Post script:  The first post I ever wrote on my site about fluoroquinolone toxicity (www.floxiehope.com) was a post like this one, also entitled, “What is Fluoroquinolone Toxicity?”  You can read it HERE.  The 2015 post above is much more thoughtful, well-researched and, in almost every way, it is better. But the 2013 post on Floxie Hope is interesting in its own right.  It went over what it feels like to go through fluoroquinolone toxicity, and it was written from the perspective of a recent victim of fluoroquinolones, not the perspective of someone who has spent hundreds of hours researching fluoroquinolones. The patient perspective, and noting what fluoroquinolone toxicity feels like is valuable, though I think that the connections made in this 2015 post are more accurate.

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site, www.floxiehope.com.

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

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What Else Can I Do To Help?

Hormones MatterTM is completely unfunded at this juncture and we rely entirely on crowdsourcing and volunteers to conduct the research and produce quality health education materials for the public. If you’d like help us improve healthcare with better data, get involved. Become an advocate, spread the word about our site, our research and our mission. Suggest a study. Share a study. Join our team. Write for us. Partner with us. Help us grow.

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Warning: Fluoroquinolone Antibiotics may Ruin your Life

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Lisa Bloomquist

Much of the recent debate (in the media and at the FDA) about fluoroquinolone safety has focused on whether or not people are being adequately warned about the dangers of fluoroquinolones. This argument has always bothered me because it assumes that if people are adequately warned of the risks of fluoroquinolones (or other drugs), the adverse effects that they suffer from are somehow okay.

I don’t think that it’s possible for warning labels on fluoroquinolone antibiotics to be “adequate,” and I think that chasing adequacy on the warning label is the wrong goal.

How could a drug warning label adequately warn someone of the possibility of their life being ruined? How could someone possibly be properly warned that every aspect of their health could be stolen from them?  How could it be described on a warning label that you may live in pain for the rest of your life, you may lose your mental health, you may never be able to do the physical activities that you used to love and that every aspect of life that you’ve established (your relationships, your career, etc.) can be taken away from you by an adverse reaction to a drug?  (Some of the stories of pain caused by fluoroquinolones can be found on the FQ Wall of Pain.)

Just think about the adverse effect of chronic insomnia. If you can’t sleep: you can’t think—and it’s difficult to hold down a job when you can’t think, relationships are difficult if your mind is sleep deprived and you can’t take care of your children or spouse, hormones are thrown out of whack by lack of sleep and your ability to exercise and regulate your appetite is negatively affected—both of which adversely impact over-all health, your ability to handle stress is diminished and autonomic nervous system dysfunction can result from dysregulation of your sympathetic and parasympathetic nervous systems, and more.  (And if you’re prescribed Ambien for your sleep difficulties, you’re 3-5 times more likely to DIE than those who don’t take sleep aids SOURCE). From just that one symptom of fluoroquinolone toxicity, a life can be seriously disrupted—and there is not a single victim of fluoroquinolone toxicity who only has just one symptom—most have dozens.  The effects of any one of the symptoms of musculo-skeletal or nervous system destruction can be ruinous to a person’s life.

The warning labels on fluoroquinolones are not adequate, and they won’t be adequate until they say something pretty close to, “These drugs can ruin your life.”

Pharmaceutical Adverse Effects

Yes, all drugs have side-effects. We’ve all heard it a million times. Pharmaceuticals are inherently dangerous. We all know that. But other things that are inherently dangerous aren’t given a blank check for causing harm like pharmaceuticals are. For example, cars are inherently dangerous. You can die in a car wreck. You can die from a car hitting you.  They are dangerous and we all know it. But if someone murders you with a car, you can still hold the driver responsible. If someone drives under the influence of alcohol or drugs, they can be held responsible for the damage they caused. If a car has a defect and harm is caused to a person because of that defect, the car manufacturer can be held responsible for the harm caused.

On the other hand, it is difficult–often impossible–to hold drug manufacturers responsible for the harm that their products cause. If an adverse effect is listed on a warning label, you cannot sue because “you were warned.”  If an adverse effect isn’t listed on a warning label, you cannot sue because you can’t prove that the drug hurt you. And if you get the rare opportunity to sue when drug labels change, you’ll be out of luck if you took a generic drug, as the Supreme Court made several decisions that made holding generic drug manufacturers responsible impossible.

Drug Manufacturer Responsibility

People who have been maimed by prescription drugs should not be fighting for adequate warnings on drug labels (though it is a step in the right direction and I don’t object to any proposed fluoroquinolone warning label changes). We should be fighting for justice and being able to hold the pharmaceutical companies and doctors who hurt us responsible for the harm that they have done.

In “A Public Policy Plan to utilize the Pharmaceutical Industry and Pharmacogenomics to reduce serious Adverse Drug Reactions, develop Personalized and Individualized Therapy, and provide a Functional Map of the Human Genome” (which is highly recommended – click the link and read the essay – it’s well worth your time) by JMR on http://fluoroquinolonethyroid.com/, it is noted that:

“Currently, their (the pharmaceutical companies) responsibility in this issue appears to end with the “appropriate warnings” provided in size 5 font on the drug inserts or via fast-talking monologues over the “happy commercials” on TV as they market directly to the consumer. And it’s usually only until enough people are maimed or killed that legal action or the FDA will actually make a difference in their behavior. There is a “buyer beware” mentality under the guise of “informed consent” – which is essentially “blaming the victim” for their own adverse reaction – but as far as the drug companies are concerned, they’ve “done their part”. The reality is, if the pharmaceutical companies and the FDA were truly concerned about the “health and safety” of the population they market to, they would put their money where their mouth is and take some of their billions in profits to study and research 1) who and why some people have these adverse reactions, 2)how to prevent these adverse reactions from happening, and 3) how to effectively treat them so as to return health and functionality to those who have been severely hit. Ultimately, this will help patient consumers by better identifying risk factors for individuals, and preventing these adverse reactions from occurring as well as provide appropriate treatments when they do occur.”

Pharmaceutical company profits are astronomical. Yet they contribute NOTHING to solving the significant problem of adverse drug reactions. They do NOTHING to take responsibility for the role that they play in devastating lives with their chemical concoctions. A very good solution to this problem is proposed in “A Public Policy Plan to utilize the Pharmaceutical Industry and Pharmacogenomics to reduce serious Adverse Drug Reactions, develop Personalized and Individualized Therapy, and provide a Functional Map of the Human Genome,” and I hope that the plan that JMR outlines is, someday, enacted.

Lack of Justice for Victims

Every once in a while the media gets a hold of a story of someone being monetarily-compensated for an injury caused by a drug or vaccine. These stories give the impression that it is possible for people to gain compensation from drug companies for injuries incurred. This is not the experience of any of the victims of fluoroquinolones. Most fluoroquinolone victims have run into a dead-end when pursuing justice and recourse against the pharmaceutical companies that hurt them. (And is there any amount of money that can really compensate for chronic pain, or injury to all of the tendons in your body, or loss of your life as a person who could think, move and  work?)

Currently, the only thing that victims of fluoroquinolones can sue for is “failure to warn.”  It’s the only thing lawyers are taking cases for.  Victims can’t sue for catastrophic, life-altering, debilitating adverse effects that are listed on the warning label.  Some of the things listed on the Cipro/ciprofloxacin warning label include seizures, psychotic reactions, insomnia, tendon ruptures, peripheral neuropathy, pain, and a lot more. If symptoms are listed on the warning label, the patient/victim is considered to be “warned.” Again, how is it possible to adequately warn someone of the risk that their life may be ruined by seizures, psychotic reactions, insomnia, tendon ruptures, peripheral neuropathy or debilitating pain?

If the warning labels for Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin, Floxin/ofloxacin, and all other fluoroquinolones, had a highlighted black-box warning that said the following, maybe the argument of “you were warned” would hold a little weight:

“WARNING: THERE IS A SMALL, BUT SIGNIFICANT RISK THAT THIS ANTIBIOTIC MAY CAUSE WHOLE BODY TENDON, LIGAMENT, AND CARTILAGE DAMAGE, PERIPHERAL NERVE DAMAGE, CENTRAL NERVOUS SYSTEM DAMAGE, AUTONOMIC SYSTEM DAMAGE, ENDOCRINE SYSTEM DAMAGE, CARDIAC DAMAGE, GENOME (DNA) DAMAGE, AND MITOCHONDRIAL DAMAGE. These adverse effects may range from mild to severe, and may cause temporary or permanent crippling and partial or total disability. These reactions may occur immediately, or may be delayed for up to an unknown period of time after stopping the drug. It is unknown at this point in time who may be affected, and for what severity and duration. Prior exposure to these antibiotics may increase this risk in subsequent exposures. Taking this drug safely in the past does not guarantee that you will not have a reaction in the future. If this risk is acceptable to you for your current condition, then take this drug. However, if this is an unacceptable risk to you, be aware there are many alternative antibiotics available for most people with equal efficacy and less risks for your condition.”  From “Responsible Use of Fluoroquinolone Antibiotics: The responsible, moral, and ethical approach (vs. the profit approach).” 

Additionally, the list of items on Cipro is Poison that are not currently on the warning labels for fluoroquinolones, should be added to the warning label in order to “adequately warn” patients and physicians alike.

Objective: Real Change, Real Responsibility

The failure of the FDA to force the pharmaceutical companies to take responsibility for the harm that their drugs do is reprehensible. The failure of the legal system to give justice and recourse to victims of pharmaceuticals is also abhorrent.

Permanent, devastating harm is being done by fluoroquinolones and other pharmaceuticals. Though better information on warning labels may be helpful, the objective of those seeking systemic change shouldn’t be changes in the warning labels, it should be pharmaceutical company responsibility for harm done, and justice for victims.

Postscript: Responsible Use of Fluoroquinolones

Please click the links on “A Public Policy Plan to utilize the Pharmaceutical Industry and Pharmacogenomics to reduce serious Adverse Drug Reactions, develop Personalized and Individualized Therapy, and provide a Functional Map of the Human Genome” and “Responsible Use of Fluoroquinolone Antibiotics: The responsible, moral, and ethical approach (vs. the profit approach).”  They are both insightful, informative, thoughtful proposals.  Just a small sampling of the stories of victims of fluoroquinolones can be found on the FQ Wall of Pain.

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site, www.floxiehope.com.

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

What Else Can I Do To Help?

Hormones MatterTM is completely unfunded at this juncture and we rely entirely on crowdsourcing and volunteers to conduct the research and produce quality health education materials for the public. If you’d like help us improve healthcare with better data, get involved. Become an advocate, spread the word about our site, our research and our mission. Suggest a study. Share a study. Join our team. Write for us. Partner with us. Help us grow.

To support Hormones Matter and our research projects – Crowdfund Us.

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Medication Errors in the Elderly

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Chandler Marrs

As many of us care for our aging parents and many of our parents are on multiple medications, I thought I’d take a look the rate and risks for medication errors in the elderly. It’s not pretty. Older adults are 7 times more likely to have drug side effects and 2-3 times more likely to have adverse drug reactions. Compared to younger adults, individuals over the age of 65 years account for one-third of all medications prescribed in the US. Sometimes this polypharmacy (>5 medications at a time) is necessary to manage multiple chronic conditions and sometimes it’s a process of cascading prescribing practices; prescribing medications to treat the side effects of other medications. A recent study of 3000 US adults ages 57-85 years old showed that:

  • 81% were taking at least one prescription medication
  • 29% took five or more medications; of those aged 75-85 years, 36% took five or more medications
  • 46% used at least one over-the-counter medication

Of the 700,000 annual ER visits for adverse drug reactions in the US, almost 100,000 resulted in hospitalizations from adverse drug reactions in individuals 65 years and older; most were unintentional. Four medications accounted for 67% of the hospitalizations: warfarin (33.3%), insulins (13.9%), oral antiplatelet agents (13.3%), and oral hypoglycemic agents (10.7%). An estimated 88% of those adverse reactions are considered preventable.

In Europe, fully 22% of people aged 65 and older are taking nine or more medications simultaneously. The four highest rates of polypharmacy (>9 meds) by country:

  • Finland 41%
  • the Czech Republic 39%
  • Iceland 32%
  • The UK 20%

With older adults the physiological systems that process medications are generally compromised by aging alone. The kidneys and the liver don’t work as well as when the individual was 20 years old, the muscle to fat ratio is skewed and everything just takes a little longer. When chronic health conditions and multiple medications are added to mix, the risk for overdose and drug-drug interaction is high, even when medications are taken exactly as prescribed. It’s important to work with your parents and your parent’s physicians to minimize these risks. Here are some resources to help you do that.

Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

The Beers list was developed in 1991 and updated regularly. It includes a list of medications that should be avoided in the elderly, if at all possible. In some cases, the medications are necessary and can be utilized safely, if monitored. Talk to your parent and his/her physician about these medications.

Never attempt to withdraw your parent (or yourself) from a medication without physician’s approval and supervision. Many medications have dangerous withdrawal syndromes that require medical management.

Below is a part one in a video series about medication management and older adults. It’s a little technical in places but provides a solid foundation for understanding how medications work and don’t work in older adults. Part two and other videos on the same topic are available on Youtube and on the Caring for Older Adults website listed below.

If any of our community members have experience with medication interactions or know of resources that we should share, please comment and/or write a blog post for us on the topic.

Help My Mom is on Drugs!

 

Resources

Caring for Older Adults

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Happy Good Enough Mother’s Day

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This Mother’s Day season I wonder: What if those of us who are mothers would stop scrambling to either be Tiger Moms or busy-body soccer/dance/karate/scouts kinds of moms and just cut the job down to bare bones and settle happily into the natural state of being “good enough” moms?

Why are we so competitive? What are we afraid of? I think deep in our guilt-ridden, tightly-scheduled “mom brains” we imagine that unless we can make ourselves SuperMoms, our beloved babies will grow up to be like Dennis Hopper in the “cult” movie “Blue Velvet,” gleefully inhaling noxious stuff from a gas mask and wailing into Isabella Rosselini’s spread legs: “Mommy!!! MOMMY!!!”

Yeah. Kids THAT messed up.

But I like to think our kids, under a new wave I’ll call Good Enough Motherhood, would just turn out mildly messed up — just enough to fit in with this wild world, to possess the strength needed to rally against it, and fortified with some healthy, All-American sharp, biting wit. Here’s the kind of motherhood I think is good enough: A friend of mine once told me about the time her son told her, “I HATE YOU!” And she glowered back at him like an eagle contemplating its prey just before devouring it: “Kid, I’ve been hated by better than you!” This is the exact — and hilarious — kind of give and take real life motherhood instinctively teaches us. When as a new mother you hold that sweet-smelling new baby in your arms, you have no way of knowing yet that very soon the teacher in this relationship won’t be you – it’ll be your child.

We all know our children on indescribable, visceral levels and discern what they need from us. And we plunge into motherhood, give and give and give. But what no parenting book will ever admit is that all too often, “giving” really means doing nothing at all, rather instead standing back and watching our kids’ falls, tears and scrapes from a distance. We learn the incredible patience of waiting for our child to rise up on his or her own two feet. Maybe this is why we never hear much about the mothers of geniuses like Albert Einstein or Pablo Picasso. Chances are they were just average women who heard the doors slam as their boys dashed out to play in the streets, and then turned and went about their own days. And will anyone deny that they were Good Enough Moms?

So let yourself feel some pride that your child made it through infancy without your having driven off leaving her in a baby seat on the hood of your car. Grant yourself a Mother of the Year award for stopping your toddlers from eating that third or fourth fistful of playground sand. When your teenager’s heart gets broken for the first time, feel free to just smile, shrug and offer the old cliché, “Now, now, there’s more fish in the sea, Dear!” That, too, is being a Good Enough Mom.

When my own boys were still quite small I had what I like to call a “Mom’s Spaghetti Zen” moment. They were sitting at the table side by side, each slurping and swallowing loudly over a heaping plate of messy noodles and Ragu. I stood at the counter and was immediately so stricken by this single tender moment, I had to look away to recover from my crashing emotions of gratitude and joy. All was right in the world. Even better: My world was good enough.

I can’t wait to become a grandparent one day, so when my own granddaughter or grandson succumbs to that first tantrum and screams, “I HATE YOU!” I, too, then respond calmly and surely — as any woman can who’s survived the onslaught of Good Enough Motherhood — “I’ve been hated by better than you!”

And right now in closing, let me gladly shout, both to you and myself: “HAPPY GOOD ENOUGH MOTHER’S DAY!!!”

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What is Ovarian Cancer?

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Karen Ingalls

I am Karen Ingalls, a Registered Nurse with a Master’s Degree in Human Development, and when I was told in 2008 I had Stage IIC of ovarian cancer, I only knew that it is a deadly form of cancer. How could this be? I was 67 years old, only took one prescription pill for insomnia, exercised, ate “right,” and was of normal weight. I had no family history, except for one Aunt who had breast cancer when she was a young mother. My only symptom was bloating, which appears to be the most common symptom. However, what woman, who is postmenopausal, does not have bloating or weight gain?

I never learned in nurse’s training about gynecologic disorders or diseases, my mother did not know about it, it was not taught when I watched the Disney movie about menstruation. So it is not surprising that most women are not aware of this too often deadly disease. It has been my experience in talking to nurses and nursing students that there is still a great lacking of such education.

What Causes Ovarian Cancer?

There is no one clear cause yet determined for the occurrence of ovarian cancer. Like any cancer, something causes healthy cells to mutate and quickly multiply into nearby tissue. What triggering factor or factors are there? At this point there are only theories, no proven facts, except for the genetic mutation of BRAC 1 and BRAC 2.

There is no reliable test; only the CA125, which is a protein found in greater concentration in tumor cells than in other cells of the body. It can be elevated for such conditions as inflammation, pregnancy, fibroids, and so forth. Only about 3% of women with elevated CA125 levels have ovarian cancer.

Ovarian cancer can be very subtle with its symptoms, and too often they mimic such disorders as Irritable Bowel Syndrome, a peritoneal form of tuberculosis, pelvic abscesses, and gastrointestinal abnormalities. Sometimes it is referred to it as the silent killer, but according to several sources it is not so silent. Women and their physicians are not listening:

“…women with ovarian pathology are more likely to experience a specific constellation of symptoms that are more severe and frequent than their counterparts presenting to primary care clinics. Women presenting with non-specific symptoms, particularly if severe intensity or rapid onset, should be thoroughly evaluated for the possibility that the symptoms are due to an ovarian mass.”

I had no physician in Florida where we were spending the winter so I did not seek any medical attention. I exercised more and tried to eat fewer calories to stop my ever-growing girth. In late May, four months after the first awareness of the bloating we returned to Minnesota and I saw my gynecologist in early June. Before I had a chance to talk to her about my bloating abdomen, she was trying to place the speculum into my vagina to collect a specimen for the annual PAP smear. She could not get it in! She asked about my family history and questioned about any symptoms besides the bloating.

The next day I had a CT scan, followed by an MRI two days later. She referred me to a gynecologic oncologist, who I saw immediately after office hours. At that time he said my tumor appeared to be about the size of a honeydew melon, and possibly could be benign due to its size. I had massive surgery one week later.

Approximately 250,000 women worldwide will be diagnosed with ovarian cancer and about 114,000 will not survive 5 years. This disease can affect any female, from a young child, to a teen, a young mother, or a grandmother. It is more common in white women than blacks, but it does occur in any race and everywhere in the world.

It is vitally important for every female to listen to and be aware of any unusual symptoms occurring below the waist, just as they do above the waist. Once we women started doing self-breast exams, got mammograms, and sought out medical counsel, the incidence of advanced breast cancer cases decreased. We need to do the same for our abdominal area.

Symptoms of Ovarian Cancer

  • Pelvic or abdominal pain
  • Bloating
  • Back pain
  • Digestive problems (loss of appetite, increased gas, feeling full quickly)
  • Constipation
  • Urinary problems
  • Painful intercourse
  • Fatigue
  • Vaginal bleeding

Certain risk factors can be important aspects for the woman to give attention to, and report to her physician. Here is a list of common ones in no particular order.

Risk Factors for Ovarian Cancer

  • Family history of ovarian, breast, or colon cancers.
  • Tested positive for the BRCA 1 and/or BRCA 2 mutated gene
  • Ashkenazi Jewish heritage
  • Most common in women over 65 years old
  • History of polycystic syndrome
  • Smoking history
  • Never having been pregnant
  • Taken estrogen hormone replacement therapy
  • Menstruated before age 12, or started menopause after 52 years, or both
  • Fertility treatment

Breast, Colon, and Ovarian Cancers

Family history of breast, colon, and ovarian cancer put women at a higher risk. These cancers can be caused by an inherited mutation in certain genes. There will be more information forthcoming in the next article, Hormones and Ovarian Cancer.

BRCA 1 and BRCA 2 and Ashkenazi Jewish Heritage

There is evidence to show that those women of Eastern Jewish descent are likely to have either one, or both, the BRCA  1 and BRCA 2 genes, which put such women at higher risk of  developing breast and ovarian cancers. These mutated genes “account for around 15% of ovarian cancers overall.”

Does Age Affect your Risk?

The majority of ovarian cancers occur in women over 65 years of age. A higher percentage of post-menopausal women develop ovarian cancer compared to pre-menopausal women. However, there are a significant number of women in the 20-40 year range who have developed ovarian cancer. For example I did a non-scientific survey of ovarian cancer women who answered a few questions. Of the 544 responses, the youngest was 21 and the oldest was 78 when diagnosed; and 142 were between 20 and 50 years old, or 4% of the surveyed women. The average age in this small survey was 49 years.

Endometriosis and Polycystic Syndrome

Women who develop endometriosis have an approximately 30% higher risk of developing ovarian cancer compared to other women. Endometriosis is a condition in which cells that are normally found inside the uterus (endometrial cells) are found growing outside of the uterus. Danazol, a medication used to treat endometriosis has been linked to ovarian cancer risk.

“Women with Polycystic Ovary Syndrome (PCOS) also may be at higher risk for breast cancer and ovarian cancer. Small studies have suggested that a lack of ovulation (anovulation), as occurs with PCOS, is linked with a risk of breast cancer that is three to four times that of women without anovulation. In other research, results showed more than a doubling of the risk of ovarian cancer in women with PCOS, but scientists have not confirmed these links in large population studies.“

Urination Frequency

Women often claim how they have an urgency and frequency to urinate. Sometimes this is strictly due to the loss of muscle tone, but it can be due to the pressure of a tumor or tumors on the bladder. This is a common complaint when women need to seek out medical attention.

Change in Bowels

If there has been increased constipation, change in color or form, or diarrhea there are several diagnoses that are possible, and ovarian cancer is one. If any of the described changes in the bowels are not resolved in 2 weeks despite medications, a physician needs to be consulted. A tumor(s) might be penetrating into the colon or rectum.

Dietary Changes

A common symptom is women describing “feeling full after only eating a small amount.” Or there might be increased belching or just a loss of appetite. Again, these symptoms could be attributed to other disorders or diseases, but they are common with women with ovarian cancer.

The last four symptoms will be included in the next article, which will be about hormones and ovarian cancer. It is a subject that will be more detailed, require more scientific data, and will be best in a topic by itself.

My risk factors were my age of 67 years and the family history of one aunt who had breast cancer. Genetic testing for the BRCA 1 and BRCA 2 was negative. The debulking surgery removed a large mass that was diagnosed as a Malignant Mixed Mullerian Tumor, which is a mix of both carcinoma and sarcoma. It is considered very rare and quite aggressive. I am fortunate that my cancer was discovered and treated at Stage IIC, and I was cancer free for five years before I had my first recurrence. There will be more about treatment in another segment.

I never took birth control pills because I did not believe in “fooling around with Mother Nature.” Nor did I ever take hormone replacement pills to help with the symptoms of menopause, which I had minimally and did not think I needed any pill for them. The decisions I made to keep my body healthy for the past 76 years I believe helped me to tolerate the major surgery and chemo cycles very well.

Depending on the woman’s symptoms, severity, rapidity of onset, and her family history she may need to demand an abdominal ultrasound, CA125 blood test, and pelvic and rectal exams. Women know their bodies and frequently they have said words to the affect, “I knew something was not right.”

There are symptom cards and symptom calendars that are small and easy to use. If even just one symptom persists for two weeks despite any medicine, exercise, or dietary changes, it is recommended by the Ovarian Cancer National Alliance, the National Ovarian Cancer Coalition, and many other such organizations that a woman should seek medical attention immediately.

Resources

It is my mission in life to help women to know its symptoms and act upon them after two weeks of experiencing any of them. Here are some links to obtain these symptom cards:

Outshine Ovarian CancerAbout the author: Karen Ingalls is the author of the award-winning book, Outshine: An Ovarian Cancer Memoir, which discusses the symptoms, risk factors, and statistics of this lesser known disease; shares her journey; and how she used traditional medicine and complementary therapies together. She writes how “the beauty of the soul, the real me and the real you, outshines the effects of cancer, chemotherapy, and radiation.”

Available in paperback and Kindle edition.

ALL PROCEEDS GO TO GYNECOLOGIC CANCER RESEARCH

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