La teta

escrito por: Tricia em sábado, maio 31, 2008 às 3:06 PM.

5 mistakes women make at the doctor's office

escrito por: Tricia em às 2:57 PM.

By Elizabeth Cohen
CNN Medical Correspondent

Empowered Patient, a regular feature from CNN Medical News correspondent Elizabeth Cohen, helps put you in the driver's seat when it comes to health care.

ATLANTA, Georgia (CNN) -- For 10 years, Barbara's gut told her she needed to get a new doctor for her daughter, and for 10 years, she didn't listen, even as her daughter got sicker and sicker.

The doctor had diagnosed irritable bowel syndrome when Barbara's daughter was 13. Day after day, year after year, she had bloody diarrhea.

At age 23, weighing just 112 pounds at 6 feet tall, her daughter became so sick and malnourished she ended up in the hospital. Barbara's intuition told her the doctor wasn't giving her daughter the right treatment, but she just couldn't tell him.

"It was like my tongue was bolted to my bottom mouth, and I couldn't get the words out. I didn't want to offend him. I was paralyzed," said Barbara, a high-ranking university administrator.

"I'm well-educated. I have a Ph.D. I make decisions easily, and I say 'no' easily. But in this situation, it was like I had a different personality. I felt like I'd reverted to childhood," she added.

Research on women's interaction with doctors is limited, but a number of women's health experts say they had noticed trends among female patients that didn't see as frequently in men.

Feeling paralyzed and voiceless in the doctor's office is one of the major health care mistakes women make, says Dr. Christiane Northrup, author of "Women's Bodies, Women's Wisdom: Creating Physical and Emotional Health and Healing."

"Even very well-educated women freeze up and don't speak up" in some cases, she said.

Here, from Northrup and other women's health specialists, are five mistakes women make at the doctor's office.

1. Women don't question doctors

"Being at a doctor's office often puts the patient in the position of 'child' and the doctor in a position of 'parent,' " Northrup said.

Northrup's solution: "Always take someone with you who will ask the questions you are afraid to ask."

When you're alone, Robin DiMatteo, a distinguished professor of psychology at the University of California, Riverside, has this suggestion. "Say to the doctor, 'I realize I don't have the medical skills that you do, but this doesn't make sense to me logically. Can we think this through together?' "

2. Women tend to over-research

According to the Pew Internet Project, women are more likely to look up health information on the Internet. In a telephone survey, 69 percent of women said they'd looked up information about a specific disease or condition, compared with 58 percent of men.

Although doing your own research is a good thing, Dr. Pamela Peeke says her female patients are more likely to become overwhelmed by what they read.

"Women are much more likely to come in with hundreds of pages of Internet printouts under their arms, and they've become convinced they have all sorts of diseases," she said.

The solution: Some experts recommend doing research on the Internet and writing down the most important points rather than carrying in numerous printouts. That way, you can have a more focused conversation with your doctor.

3. Women don't recognize gender bias

Several studies have shown that women's medical problems are more likely to be interpreted as emotional issues or complaining.

"You should recognize that there is doctor bias," advised Dr. Nieca Goldberg, author of "Women are Not Small Men." "You don't want to go to a doctor who says, 'Now, honey, it's not all that bad.' "

Goldberg says she remembers going to a doctor who made a remark like that. "I said, 'I don't think we'll be continuing this visit,' " she remembered.

4. Women interpret their own symptoms

Goldberg says she's seen this over and over again: Instead of just giving the doctor the facts, women sometimes also offer their own interpretations, which can put their own health at risk.

For example, she's seen women who are having heart attacks tell the doctor that they think it's just indigestion. "This could be dangerous if you're in the ER having a heart attack," Goldberg says. "You don't want to lead the doctor down the wrong path."

Goldberg's advice: Just state the facts, and let the doctor do the interpreting. There'll be time for questions afterwards if you think the doctor's diagnosis is wrong.

5. The mother of all mistakes: Women don't trust their intuition

This is what happened to Barbara, who asked that her last name not be used for fear of retribution from other doctors in her small town.

She says her gut told her that her daughter's doctor didn't have the right diagnosis. When she and her daughter finally found a new doctor, he said her daughter didn't have irritable bowel syndrome at all; she had ulcerative colitis.

Last year, surgeons removed her daughter's colon. Her bloody diarrhea is gone, and her daughter now weighs a healthy 158 pounds.

"There are literally hundreds of situations in which a woman's gut intuition is spot-on, but she talks herself out of it so as not to make waves," Northrup said. "We women are suckers for wanting to be loved."

Marcadores: , , , ,

Autora: Laurie Barclay
Publicado em 02/05/2008

Os resultados de um estudo prospectivo de coorte publicado no volume de maio
do Epidemiology sugerem que o consumo de chocolate durante a gestação pode
diminuir o risco de pré-eclâmpsia.

Dra. Elizabeth W. Triche, PhD, do Yale Center for Perinatal, Pediatric and
Environmental Epidemiology, em New Haven, Connecticut, e colaboradores
explicaram que a pré-eclâmpsia é uma grave complicação gestacional com
manifestações cardiovasculares. Os autores lembram que estudos recentes
sugerem que o consumo de chocolate pode ser benéfico para a saúde

A amostra do estudo consistiu em 2.291 pacientes grávidas que pariram um
nascido vivo entre setembro de 1996 e janeiro de 2000. Os pesquisadores
mediram o consumo de chocolate por auto-relato no primeiro e terceiro
trimestres da gestação e pela concentração sérica de teobromina no cordão
umbilical, que é a principal metilxantina presente no chocolate. Uma revisão
detalhada dos dados de 1.943 pacientes determinou o diagnóstico de
pré-eclâmpsia. Modelos de controle por regressão logística para potenciais
confundidores foram usados para determinar os odds ratios ajustados (OR) e
intervalo de confiança de 95% (IC).

De 1.681 mulheres, 63 (3,7%) desenvolveram pré-eclâmpsia. As concentrações
de teobromina no cordão umbilical são inversamente associadas à
pré-eclâmpsia (para o quartil mais altos versus o quartil mais baixo [OR,
0,31; IC 0,11-0,87]).

As estimativas de consumo de chocolate auto-relatadas, também, foram
negativamente associadas à pré-eclâmpsia. O risco de desenvolvimento dessa
condição diminuiu em mulheres que consumiam cinco ou mais porções por semana
versus mulheres que consumiam menos de uma vez na semana (OR, 0,81; IC
0,37-1,79 para consumo nos primeiros três meses de gestação e OR 0,60; IC
0,30-1,24 nos últimos três meses).

“Nossos resultados sugerem que o consumo do chocolate durante a gestação
pode reduzir o risco de pré-eclâmpsia”, declaram os autores. “Contudo, uma
relação inversa de causalidade também pode contribuir para estes achados”.

As limitações para este estudo incluem: dificuldades de padronizar o
autoconsumo de chocolate, possível causalidade reversa se mulheres
diagnosticadas com pré-eclâmpsia reduzirem sua ingestão calórica após o
diagnóstico, possível confundidor individual devido ao tabagismo ou índice
de massa corporal, pequeno número de mulheres com pré-eclâmpsia ou erro de
classificação da exposição.

“Devido à importância da pré-eclâmpsia como uma complicação grave da
gestação, são necessários outros trabalhos prospectivos com detalhes sobre o
consumo de chocolate”, afirmam os autores do estudo. As medidas da exposição
ao chocolate devem ser desenhadas para permitir um exame cuidadoso da
relação temporal entre o consumo de chocolate na gestação e o subseqüente
risco de pré-eclâmpsia.

Epidemiology. 2008;19:459-464.

Fonte: MEDCenter

Marcadores: , , ,



Tricia Cavalcante: Doula na Tradição, formada pela ONG Cais do Parto, mãe de três, e doula pós-parto.Moro em Fortaleza-CE.


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