Lasik Surgery During Pregnancy

Female patients of mine often ask whether having a child will affect their ability to undergo Lasik eye surgery. Actually, pregnancy can affect the eyes in many ways so it is important to understand what considerations should be made for pregnant women who are considering Lasik. These things should also be considerations even if a woman is not pregnant at the time but may be planning it in the near future.

First, it is always important to establish the total medical and structural health of the eye prior to proceeding with any kind of eye surgery. Pregnant women are known to be at risk for the development or worsening of diabetes and can develop significant blood pressure problems such as preeclampsia. These blood pressure or diabetes related problems can manifest in the eye, and therefore a complete dilated exam of the eye to look for any changes or pathology in the retinal blood vessels is extremely important. Patients can potentially present with bleeding or leaking blood vessels which can cause distortion of vision. Any changes of these kinds need to be handled very carefully to prevent long-term damage to the eyes. These conditions can lead to an acute medical or surgical situation and the patient would definitely be precluded from having Lasik eye surgery. Other rare pregnancy related eye disorders can occur that induce swelling of the optic nerve or retina and can also be detected with a complete eye exam by an ophthalmologist.

But not all eye changes during pregnancy are necessarily pathologic. In some otherwise healthy women, it has been observed that their glasses prescription actually changes during pregnancy. Similar changes can also occur after the baby is delivered while the woman is breast-feeding her child. In some cases, these changes may be temporary but in others they can be permanent. Unfortunately there is no way to distinguish which cases are temporary. Actually, the majority of women never have these prescription changes during pregnancy at all. The exact mechanism of action is unknown although it has been shown that changes in the corneal thickness and curvature occur, possibly due to swelling. Some have postulated that the same hormonal changes which allow for bodily changes to accommodate for growth of the baby within the woman's body also allow for growth of the eye as well. Usually, growth changes of the eye leading to nearsightedness come to a conclusion when a person stops growing in their late teens or early twenties, but perhaps the hormonal changes of pregnancy allow for some of these changes to re-occur later in life.

Of course, when this situation arises, the woman's glasses prescription and nearsightedness are no longer stable and predictable. Performing Lasik on someone like this is unwise because the exact final prescription cannot be known. It's like shooting at a moving target. It is a general rule that a patient should have a stable glasses prescription for about one year prior to having Lasik eye surgery. If my patients go through pregnancy and experience no changes, then I feel it is okay for them to proceed at any point thereafter when they feel ready. However, if changes in their prescription have occurred, I do advise them to wait on Lasik surgery until we have observed that it does not change any further. This waiting period applies to the postpartum breast-feeding time as well.

I also talk to many of my patients that are young women who are not planning on pregnancy in the near future but feel they may have children in the distant future. In these people, there is no way to predict if a future pregnancy will change their glasses prescription. I advise these people most women have little or no change during pregnancy so it is reasonable to proceed with Lasik as they have no immediate plans for having children. They should be aware of the small possibility of developing regression of their near-sightedness in the future in the event they do become pregnant. In those cases, it is possible to do additional treatment after pregnancy is completed and once their prescription is stable. However, if the visual changes are small, many women feel that their vision is adequate and may not need additional treatment or might choose to wear glasses only under certain conditions, eg night driving. Those are personal decisions each individual must make for themselves.

The bottom line is to make sure that any health issues of the patient which can be related to pregnancy are stable and that the overall glasses prescription is stable and predictable prior to proceeding with Lasik eye surgery. Once all of these things are stable and the pregnancy is complete, that is the best time to proceed with the procedure. Although performing Lasik just prior or during pregnancy is technically possible, there remains the small chance of a prescription change induced by the pregnancy which might require additional treatment later. To avoid multiple procedures, I recommend waiting until after the baby is delivered and breast-feeding is completed.

Endometriosis and Pregnancy - Beating the Odds

Endometriosis and pregnancy are two inter-related health conditions that millions of women of child bearing age struggle with every year. The simple fact is endometriosis can and will make conceiving a child more difficult in most instances. This does not mean a woman cannot get pregnant but it can throw a monkey wrench in the process.

Exactly how endometriosis affects a woman's chance at pregnancy is not fully known but studies that have been conducted into the issue show that she is less likely to conceive then a woman who does not suffer from this disease. These studies have shown that about twenty percent of women with endometriosis will be unable to conceive and that of all infertile women twenty one to forty four percent have this disease.

What isn't known is why endometriosis affects a woman's ability to conceive a child. Is it the endometriosis itself or is there something else at work in conjunction with it. It does not mean that a woman cannot successfully conceive a child and carry it to term.

The path to getting pregnant for women with endometriosis varies. Many women get pregnant naturally without any outside medical help. For women who are struggling with endometriosis and pregnancy it is important that they talk with their doctor /gynecologist about medical interventions that may help increase their chances of conceiving a child.

Women with endometriosis who are trying to get pregnant naturally may increase their odds if they consider the following:

1. Get started early in life - Studies have shown that women in their twenties are more likely to get pregnant then women in their thirties and older. Since endometriosis is shown to interfere with a woman's fertility it is surmised that it will continue to make conceiving harder the older she gets.

2. Get healthy - Many women have success in managing their condition when eating an endometriosis diet. A healthy diet, combined with regular exercise, can help minimize the effects of endometrial growths and provides her body with the necessary nutrients to successfully nourish an embryo.

If after a period of six months to a year a woman has still not gotten pregnant naturally she can turn to her gynecologist or infertility specialist for help. There are several treatment or procedure options available to help increase the chance for a successful pregnancy.

1. Laparoscopic endometriosis surgery - This minimally invasive surgical procedure is done to not only definitively diagnose endometriosis but also to excise and remove endometrial growths from the abdominal organs. This type of surgery is not a cure but it can provide a window in which a woman can successfully conceive. Studies do indicate that laparoscopic surgery can increase the likely hood of a successful pregnancy.

2. Fertility drugs - The use of drugs such as Clomid and Serophene can help stimulate ovulation in women who are having difficulty conceiving.

3. In Vitro Fertilization (IVF) - IVF is an assisted reproductive technique that has shown good results in women with endometriosis and pregnancy issues. It should be noted that the success rate of IVF for women with endometriosis is about half that of other women with infertility issues. A newer technique called intracytoplasmatic sperm injection seems to garner higher success rates with studies showing that success rates are equal among women with the disease and those without.

There are risk factors for pregnant women with endometriosis that can lead to serious complications during their pregnancy. A recent study by medical researchers in Sweden found that women with endometriosis are at a higher risk for the following:

1. Premature Birth -Women with endometriosis are at higher risk for having their baby's preterm. They also found that women who also underwent IVF procedures to become pregnant were at an even greater risk for preterm birth then women who did not.

2. Preeclampsia - This is high blood pressure that develops in pregnant women during their second and third trimester. Women with endometriosis are at a higher risk for developing this dangerous condition that also includes protein in their urine and an increased risk for post birth.

3. Caesarean Section - In the study it was found that almost twice as many women with endometriosis had their babies delivered via C-section. It was also discovered that these women had a higher incidence of induced premature birth then spontaneous premature birth. The exact why of this is not known but the researchers conducting the study have theorized that complications with the placenta may be at the root of it.

It is estimated that over 9 million women worldwide suffer from endometriosis. Every year a good percentage of these women get pregnant and deliver healthy babies. With the proper medical support and care it is possible to beat the odds that this disease presents. Just remember that endometriosis and pregnancy are not mutually exclusive.

The Truth About Thyroid Disease - Natural Options Your Doctor Won't Tell You About

Addressing Thyroid Disease Naturally

Classic signs of thyroid hormone deficiency include fatigue, memory loss, cold hands and feet, muscle and joint pain, depression, high cholesterol, and constipation. Over the past 2 years, I have seen a large influx of patients that had been placed on thyroid hormones to treat the above symptoms. Many of these individuals responded well to thyroid hormone initially, but were no longer receiving as much benefit from its use. Furthermore, many of them continued to develop additional symptoms such as dry eyes, dry and bleeding nasal passages, and dry hair and skin. Most of them were also experiencing greater loss of hair.

What you should know about Thyroid Hormone Production:

Thyroid hormone production is under the influence of a chemical called thyroid stimulating hormone (TSH). TSH is made by the pituitary gland. When circulating levels of thyroxine (T-4) are low, TSH sends a message to your thyroid gland to start producing more T-4. The building blocks your body uses to make T-4 come from food constituents that we obtain from the diet (tyrosine - an amino acid from protein and certain minerals - iodine, zinc, etc). Once your body makes T-4, it must be activated by other nutrients (vitamins and minerals) into something known as T-31. T-3 is the active form of thyroid hormone that works to increase the body's metabolism. However, certain nutrient deficiencies and stress can lead to a reduction in T-3 and instead the production of Reverse T-3. This form of T-3 is not as effective and leads to symptoms of hypothyroidism. Unfortunately, Reverse T-3 is cannot be distinguished from T-3 in traditional thyroid lab reports and this is a common oversight by many physicians. Once T-3 is made it will attach to the nucleus inside your cells and increase the body's metabolism appropriately. Once again, however, certain nutrient deficiencies can decrease the responsiveness of our body's cells to T-3, causing symptoms of hypothyroidism. For these reasons lab reports commonly performed by physicians that look at TSH, T-4, and T-3, can be misleading. A simplified diagram of thyroid hormone production is listed below:

TSH Stimulates the thyroid gland to make T-4. T-4 Converts to either T-3 or Reverse T-3 (RT3). RT3 is inactive. Normal T-3 attaches to the cell nucleus. Once attachment of T-3 occurs the body's metabolism increases.

As if the above information were not complicated enough, there are also environmental factors that can also effect thyroid hormone production. Oral contraceptives and estrogen containing medications have been shown to reduce the conversion of T4 to T3. Many herbicides and pesticides contain estrogen mimicking compounds known to effect thyroid hormone production. Soy foods and sodas can cause a reduction in thyroid hormone. Certain food allergies and selenium deficiency are linked to autoimmune thyroid dysfunction3,4. Heavy metal exposure through air, water, dental fillings etc. have been linked to poor thyroid function.

Remember that thyroid disease is never just as simple as taking a medication whether it is bio-identical or not. Thyroid dysfunction has a cause. An astute physician will take an active roll in care and seek to perform a comprehensive exam and laboratory work up that will identify the cause. Keep in mind that your body has the ability to make its own thyroid hormone providing that all the essential nutrients necessary are present in the diet or through supplementation, providing that the environment is conducive to the expression of good health, and providing that the individual is properly educated in the care of his/her body. Many patients that come to me initially are taking some form of thyroid medication. Many were instructed that the medication was a life long necessity. And in many it is very common that the medication becomes unnecessary.

1. Moncayo R, et al. The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma. BMC Endocr Disord. 2008 Jan 25;8:2.

2. Pansini F, et al. Effect of the hormonal contraception on serum reverse triiodothyronine levels. Gynecol Obstet Invest 1987;23:133.

3. Mazokopakis EE, et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in Patients with Hashimoto's thyroiditis. Thyroid 2007 Jul;17(7):609-12.

4. Negro R, et al. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol Metab 2007 Apr;92(4):1263-8. Epub 2007 Feb 6.

Foods to Avoid When Trying to Get Pregnant

Before you plan to get pregnant, it is necessary to bring some essential changes in your lifestyle and food habits. You need to consult your doctor to know exactly what foods you must avoid when you are trying to get pregnant and during the period of pregnancy.

You need to plan and prepare before you get pregnant. The couple needs to prepare themselves physically, emotionally and psychologically. The lifestyle needs to be changed in order to have a safe pregnancy.

A lot care and attention has to be given to what you eat as whatever you shall consume will be going in a direct or indirect manner to the baby before you conceive and while you are pregnant. So here you will know about what foods to avoid when trying to get pregnant and other such important things.

A baby's organs start forming about 17 days after you have conceived. Before a woman decides to get pregnant, it is essential that she meet a doctor and discuss her physical and emotional health with the doctor. The doctor might prescribe certain lifestyle changes and food habits before you become pregnant. Pregnancy is no child's play and must be handled with complete care and attention so that you have a safe pregnancy and a healthy baby.

Some of the foods that must be totally avoided when you are trying to get pregnant are mentioned below.

Avoid soybeans and foods that contain soy. Estrogen that is present in soybeans can lead to a hormone imbalance which could in turn affect the production of egg and ovulation. Hence, it is important to decrease the use of soybeans few months before you are trying to get pregnant.

Stay away from frankfurters, bologna and lunch meats as they contain nitrates and nitrites that are not good for women who are trying to conceive. One must not consume peanut butter as well as spinach as they deplete the level of calcium in the body which is essential for the development of the baby.

Refrain from soda, sugary foods and drinks as it can lead to decrease in blood sugar that can in turn upset the level of reproductive hormones. Caffeine must be strictly avoided. Caffeine is present in coffee, tea, chocolate and many other products. Having caffeine may prevent you from getting pregnant.

Other than that, it can also cause miscarriage. One must strictly refrain from smoking, alcohol and drugs. Do not take Vitamins A, C and D in high quantity. Do not eat raw meat or meat that is undercooked. Similarly do not consume raw eggs or eggs that are undercooked. Soft cheese should also not be consumed.

It Takes a Nanny to Raise a Child

You have probably heard the term "it takes a village to raise a child," but this should be rephrased to match motherhood in the modern world. It should be "it takes a nanny to raise a child," since most new mothers do not have access to a village worth of help. In many cases, new mothers do not even have friends or relatives that can help them recover from childbirth and learn how to properly care for their new babies.

The Distant past

There was a time when new mothers had built-in support when bringing home their new babies. They had neighbors bringing hot meals and pies to the door and older members of the community available to give the baby baths and make sure there were no problems with breastfeeding. If a new mother was weak and struggling to recover, she would have many women surrounding her and nursing her back to health.

These were the days when the village, or local community, did in fact raise the children right from birth. A naughty child could be punished by a neighbor then sent home to be punished again by their parent. Mothers didn't have to worry about their children when they were out to play because they knew many other women were looking after them.

You may remember these times from your own childhood. It's a shame that times have changed, but there are always some negatives that come with progress, right?

Modern Motherhood

Today, many women are too busy chasing careers and putting food on the table for their own families to watch out for anyone else's family. Women around the world now have more responsibility outside the home, which means they have less energy and time to invest inside the home. This means the surrounding village or community has disappeared. Most new mothers no longer have that constant support around the clock to make sure they recover from childbirth and care for their new babies efficiently.

Some women may still have the support of their mothers and other women in their families, but these people often cannot drop their own lives to give the amount of care needed by a new mother. This leaves modern mothers with two options: do everything on their own or hire a confinement nanny.

It is incredibly hard to take care of a newborn and recover from delivery alone. This is especially true for first-time mothers who don't know how to properly care for a newborn. It is also true for mothers recovering from a cesarean section, since they will not be able to lift their baby and move them around as much as other mothers.

Therefore, most mothers are now hiring confinement nannies to come into their homes and give a helping hand around the clock. A confinement nanny will now take care of everything that the village or community might have done for a new mother in the past. This includes meal preparation and help with older children as well as bathing, changing and feeding the new baby. The nanny looks after the health of the new mother and makes sure she gets adequate rest and food to recover from childbirth. She also looks after the baby to make sure they are properly cared for and growing at the proper rate.

It still takes a village to raise a child, but today the village has been replaced by the confinement nanny.

Seven Mortgage Outsourcing Services for Loan Origination

Mortgage outsourcing services are preferred to internal loan processors for several reasons. Rendered by self-governing companies, these mortgage processing services are swift and perfect. Would you like to use them? The process involves the whole loan origination process or just one or two stages of it. It is important to determine the most time consuming and expensive stages faced by your company before searching whom to outsource them to. The following are seven main Mortgage outsourcing services.

• Mortgage loan processing(pre-approval)

• Mortgage underwriting(approval stage)

• Property appraisal

• Title ordering, searching and examination

• Title Insurance

• Mortgage pre-closing

• Mortgage closing

Most companies outsource everything in order to reap all the benefits of outsourcing. Mortgage outsourcing services are based on short-term or long-term contracts. This enables many mortgage firms to assign work to an outsourced company only when it is necessary. This is contrary to what happens in an office. Whether your employee works or not, he or she is legally allowed to demand a monthly or a weekly wage. Take for example when an employee is away on a sick leave, maternity leave or vacation.

Don't you pay them their salary in spite of their absence? In reality this is an unnecessary expenditure that you are forced to incur by the law. If you could use mortgage outsourcing services, and eliminate redundant staff, you could help your business grow. The more staff you recruit the higher your office expenses will rise. Each new employee will require an office space, working equipment and some sort of orientation to understand how things are done in your organization. This is both a waste of time and money. You should hire a reputable outsider with a private loan processing facility. External service providers' staff requirements are not your responsibility.

The only expenditure you are likely to incur includes the project fee that the outsourced service provider and you will agree upon. Therefore buying mortgage outsourcing services is an ideal way to control your company's expenditure. When you finally mitigate expenditures and free your time, you will begin to see constant improvements throughout the loan origination process. Are you looking for creativity and talent? There is no better way to add these qualities to your loan processing than outsourcing. Outsourced teams have more experience and creativity than your in-house staff members. They work for several mortgage firms and have dealt with both simple and difficult house loan processing scenarios.

When searching for mortgage outsourcing services, consider a company that can give you quality and speed. These are key qualities required to close as many loan files as possible. In addition you should reflect on the types of loan programs that your firm processes, as you look for the company to outsource to. Which one among Federal Housing Administration (FHA), Fixed Rate Mortgage, Adjustable Rate Mortgage, VA loan, interest-only and Reverse Mortgage do you offer? Some Mortgage Outsourcing services are based on two or more of the above-mentioned mortgages. It is also wiser to consider factors such as fees charged, turn around time and years of experience.

Virtual Yoga Training

Virtual Yoga training, this is one of the newer training options out there. No longer do you need to find a studio close to your home with a schedule that works for you and your family, purchase generic DVDs or subscribe to an online yoga site.

A personalized yoga program especially for you can be created, it can be made to meet your needs taking into consideration any existing injuries, conditions, desires and time restraints by a registered yoga teacher. These personalized yoga programs includes an initial consultation (online, over the phone or in person if desired), a program including descriptions & photographs, sometimes video make by included, as well as online consulting for any questions or concerns while you are using this program via phone, Skype, Facebook, twitter or email is available.

This virtual option enables you can choose a yoga instructor based on their qualifications and specialties instead of their location because all contact can be online and at your convenience thanks to the internet.

This is a great way to experience yoga in the privacy of your own home on your own time but still do a program that is tailored just for you. Experience all the numerous and far reaching benefits from yoga that you can imagine. From decreasing stress to increasing your metabolism. From relieving back pain to raising your energy level. You can feel rejuvenated everyday.

Yoga teachers always do their best to accommodate all their students, but depending on the size of the class sometimes you just can't get the personalized attention you need or the personal guidance that you desire. Your goals, needs, current fitness level, conditions, injuries and lifestyle will be taken into consideration when creating your program. This will keep you motivated, challenged and meeting your goals.

Yoga should be a vital part of a balanced fitness program. It gives a complete mind & body work-out, using your own body weight in a non-competitive setting. There are alternatives to customize each pose for every age, ability, comfort level, condition or injury. Yoga is an amazing compliment to other activities like running, weight training and rowing.

A program can be make for any age, level and ability which includes seniors, kids, prenatal, postnatal, plus sized, or anyone else. Some other specialties are yoga for fertility, yoga for depression, yoga for cancer survivors, yoga for runners, yoga for cyclists, yoga for golf, yoga for spinal cord injury and more.