Livingwell A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING
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HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY
MAY 2015
IN THIS ISSUE | 2 National Nurses Week | 3 Recognizing stroke symptoms | 4-5 Top events and support groups | 5 Gland health
Arizona’s Top Docs
WOMEN’S WELLNESS
Find the best doctor for your family at TopDoctors.azcentral.com
MANAGING HORMONES
I
By Susan Lynne Fuchs
t can be hard to choose the right doctor — whether a general internist or a specialist — for you and your family. And that’s where a new website, TopDoctors.azcentral.com, comes in. Working with Castle Connolly Medical Ltd., TopDoctors.azcentral.com now includes information on some of the most respected doctors in the state in an easily searchable fashion. Indeed, since the 1991 founding of Castle Connolly, the company has identified and published lists of the nation’s best doctors in a variety of medical specialties in numerous parts of the country. To explain this service, we recently spoke with John Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.
From girl-hood to grandmother-hood, hormones have a major impact on women’s lives STORY BY DEBRA GELBART | PHOTOS BY RICK D’ELIA
Thinkstock
H
ormones — estrogen, progesterone and a small amount of testosterone — dominate girls’ and women’s lives more than we may want to acknowledge. The effects can begin as young as 8 years old and the impact of gradual or sudden withdrawal of female hormones can last a lifetime.
What happens
Hormones are regulatory substances produced in certain organs to stimulate specific cells or tissues into action. Female hormones are predominantly produced by the ovaries; some production of hormones also comes from the adrenal glands. In girls, estrogen and progesterone begin affecting them typically around 10 years old, explained Leszek Grabowski, M.D., an obstetrician and gynecologist with Banner Health Center in Surprise. That’s when breast development becomes evident, he said, followed by the appearance of underarm and pubic hair, a growth spurt and the onset of menstruation. These phases will either happen sequentially — with about a year between each phase — or may overlap, he said.
When does it happen
However, Grabowski said that there are differences among ethnicities. Breast development often will begin in AfricanAmerican girls between the ages of 7 and 10; in Caucasian girls, it’s usually between ages 8 and 12. Among Hispanic girls, breast development often begins between ages 8 and 11. The average age for the growth spurt in girls is 11.4 years of age, Grabowski said, while the average age for start of the first menstrual period is 12.5 years old.
Regular care important
Because there are so many changes girls and women go through, regular visits to a primary care provider are recommended, said Laura Dalton, D.O., a family medicine physician who specializes in women’s health and is the medical director of Planned Parenthood Arizona. Planned Parenthood is expanding its primary care services, Dalton said. “For pre-teens and teens, hormonal changes can lead to emotional instability and severe PMS symptoms can be associated with depression and anxiety,” she said. “Medical professionals can help manage these issues.” Dalton also said that primary care through Planned Parenthood can cost less out-of-pocket, depending on individual circumstances, than through a private physician’s office.
CAN PHYSICIANS ON THE“TOP DOCTORS” LIST BE REMOVED? Physicians may be removed from the Top Doctors list if they retire, change their practice, are no longer available to patients or there is a change in the mix of specialists Castle Connolly presents for a given community. Physicians may also be removed for malpractice or disciplinary issues, negative physician or patient feedback, inappropriate professional demeanor or failure to be re-nominated.
Pregnancy hormones
The increase in estrogen during pregnancy raises the potential for enlargement of uterine fibroids (benign growths) already present, Dalton said. Accumulation of fluid produces swelling in the hands and feet, Grabowski said, and can cause blurred vision. “If a woman has any pre-existing vision conditions,” he said, “they may worsen temporarily during pregnancy.” This is different, Grabowski said, from an abnormal process called preeclampsia that can present with spots in front of the eyes or blurred vision, in addition to elevated blood pressure. If a pregnant woman experiences any of the signs of preeclampsia, it’s very important to see a doctor right away, he said. HORMONES, continued on page 5
HOW ARE“TOP DOCTORS”CHOSEN? Selection of Top Doctors is based on peer nominations. All licensed M.D.s and D.O.s are invited to nominate other doctors they feel are most outstanding in their medical specialties, either as the best in their region or among the very best in the nation. Nearly 100,000 nominations are received each year. Physicians cannot nominate themselves nor can anyone pay to include a physician in the Top Doctors list. Each of the selected doctors is asked to complete a comprehensive professional biography form with information on their areas of expertise. Castle Connolly’s physician-led research team makes tens of thousands of phone calls each year, talking with leading specialists and other knowledgeable medical leaders to verify submitted data and to gather further information regarding the top specialists. They review the credentials of every physician being considered including their medical education, training, board certifications, hospital appointments, administrative posts and professional achievements as well as malpractice and disciplinary history.
Laura Dalton, D.O., speaks with a patient about hormonal contraceptives at the Planned Parenthood office in Scottsdale. In addition to contraception, the medication is used to help women deal with hormonal issues.
MY DOCTOR IS NOT ON THE LIST. DOES THAT MEAN HE OR SHE IS A BAD PHYSICIAN? While the physicians identified through our research process are clearly among the very best, Castle Connolly does not claim to identify every excellent physician in the nation or in a region. There are always other very good physicians in any area. That is why our guides, websites and other distribution channels describe a process whereby consumers can identify excellent physicians using their own efforts.
More info
TopDoctors.azcentral.com
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