Many women and health experts continue to struggle with the turnaround in attitude toward hormone therapy in the wake of the Women's Health Initiative (WHI) trial of combined estrogen and progestin (as Prempro) for preventing later-life ills. The trial was stopped early, in 2002, because hormone users had a higher risk of breast cancer, heart disease, stroke, and blood clots. Though the added risks were small, many women and their clinicians concluded they must discontinue hormone therapy. Many of these women found that hot flashes, sleeplessness, and other menopausal symptoms returned with a vengeance.

Hormone therapy is still considered the most effective treatment for symptoms. But women are not rushing back. One concern of health experts is that women are turning to alternatives they think are safer — but may not be.

The normal temperature of 98.6° F is anything but, especially as we get older.

Normal, when it comes to body temperature, is 98.6° F, right?

The devastation left in the wake of recent natural disaster and terror attacks provides graphic evidence of just how destructive they can be. Residents can be forced to evacuate from their homes at a moment's notice in an atmosphere of panic and chaos, and many of them will not be able to return for months. In light of these potential disasters and their aftermath, it has become clear that preparation for the unknown is of the utmost importance.

No matter where you live in the United States, you are vulnerable to some sort of natural disaster such as a blizzard, earthquake, flood, hurricane, or tornado. In addition, terrorist attacks on America are also possible. Both natural disasters and terrorist attacks can disrupt power, communication, and transportation for days or even longer.

Treating PMS:
Dr Rigotti's Advice

I generally recommend that a woman suffering from PMS start by paying attention to lifestyle factors. Women spend much of their lives caring for others and need to be reminded how important it is for them to take extra care of themselves, particularly at the time of the month when they feel most vulnerable.

This means simple things like getting regular aerobic exercise; avoiding caffeine, alcohol, salt, and concentrated sweets; eating frequent small meals instead of a few large meals a day; and practicing stress reduction techniques such as the relaxation response. Adding a supplement such as vitamin B6 to their diet also helps some women.

If several months of following these steps are not enough to control symptoms, I usually recommend trying an SSRI (selective serotonin reuptake inhibitor)–type antidepressant medication as the next step. There is clear evidence that these drugs help, especially with mood swings and other psychological symptoms that are often the most troublesome.

Breasts

Oral contraceptives and breast cancer risk

Researchers continue to unravel the web concerning the use of oral contraceptives and the risk of breast cancer. A study published in June 2002 indicated that birth control pills don't increase the risk of breast cancer for women in the general population (see August update). But a new study published in the December 4, 2002, issue of the Journal of the National Cancer Institute shows oral contraceptives can increase the risk of breast cancer in women with a particular genetic mutation.

The study examined whether the use of oral contraceptives increased the risk of breast cancer in women with a mutation in the BRCA1 or BRCA2 gene. Women who have such a mutation are already known to have a high risk of developing breast cancer and ovarian cancer. A person inherits these types of gene mutations.

This list describes your priorities in an emergency situation. Follow these steps:

1. Evaluate the scene to protect yourself and others from injury or danger.
2. Be calm and reassuring.
3. Do not move the person unless he or she is in imminent danger or unless you cannot provide assistance without moving the person.
4. Get help. Call out for someone to phone 911 or, if the person does not need immediate assistance, make the call yourself.
5. If the situation is a choking emergency, perform the Heimlich maneuver (see Choking).
6. Look, listen, and feel for breathing (see Breathing Difficulties).
7. Feel for a pulse to determine if the heart is beating.
8. Control bleeding with direct pressure.
9. Treat for shock.
10. If the person is unconscious, move him or her into the recovery position.

If you are called on to help deliver a baby, remember that childbirth is a natural process and that your role is to assist the woman and offer encouragement. If a woman's contractions are very strong and 2 to 3 minutes apart or the water bag (amniotic sac) has broken, birth is very near. If the woman tells you that the birth will happen very soon, believe her.

You will see quite a bit of blood, which is normal. You may see bloody fluid coming from the vagina before and during the birth; this is also normal.

Adult Recovery Position

This position helps a semiconscious or unconscious person breathe and permits fluids to drain from the nose and throat so they are not breathed in. If the person is unconscious or semiconscious after you have done everything on the Emergency Checklist, move the person into the recovery position while waiting for help to arrive.

Do not use the recovery position if the person has a major injury, such as a back or neck injury

Bleeding

While a minor cut will eventually stop bleeding, a severe injury may require elevation and direct pressure on the wound. The goals of first-aid treatment are to control bleeding and prevent infection. If disposable surgical gloves are readily available, use them.

Butterfly Bandages

Direct Pressure for Bleeding and Pressure Points for Bleeding

How to Stop a Nosebleed

Removing a Stuck Ring