Compassion in Crisis
By Patty Becker.

The Pregnancy Resource Center (PRC) is a non-profit, faith-based limited medical facility located in the USC Commons Building on Drake Road.
Serving the South Hills and Washington areas, the PRC offers pregnancy tests, limited ultrasounds, STD testing, counseling, referrals and support to those engaging in sexual activity. Individuals of all ages, ranging from 14 years to 50+, have found help at the Pregnancy Resource Center.
Our goal is to equip young women and men with the knowledge they need to make an informed and healthy decision when facing difficult circumstances resulting from sexual activity. The PRC provides a supportive, non-judgmental and confidential atmosphere. The PRC offers its services without cost in order to ensure that our services are available to anyone in need without regard to gender, race, and socio-economic state or religious affiliation.
In response to the increasing number of rape victims that have come to t he PRC for services such as pregnancy and STD tests, the PRC is currently accepting applications for a part-time Sexual Assault Nurse Examiner (S.A.N.E.) The SANE nurse will be able to administer a rape collection kit while ministering to these clients in the midst of a difficult circumstance. The PRC presently offers compassion, stability, and hope through an 8-week support ministry for rape victims. If you know of anyone who is in need of these services, please contact the PRC.
The Pregnancy Resource Center is working hard to help teenagers and adults understand the risks and consequences of a sexually active lifestyle. Presently we are in 40 public high schools, middle schools and church youth groups where we communicate the message of abstinence to students. Our “In the kNOw” program contains pertinent information and current statistics encouraging individuals to make healthier choices in order to safeguard their futures.
The Pregnancy Resource Center is open Monday, Tuesday and Wednesday from 3:00 p.m. to 9:00 p.m. for appointments. Walk-ins are also welcome on Thursday and Friday until 2:00 p.m. To learn more about our organization to make a donation please visit our website: www.prcsh.org.
For more information, call 412-833-7445 or e-mail us at prcsh1@nauticom.net.

_______________________________________

Back Pain, Pregnancy and the Chiropractic Solution
By Dr. Tyson Swigart

The muscle joints and back pain of pregnancy can be very real and is often more than just a nuisance. Studies have shown greater than 50% of expecting mothers struggle with pain. The problem is often worse in those who have pre-existing difficulties. Understanding the causes of pregnancy related back pain can help lead to providing an effective solution.
Two primary changes occur during pregnancy that leads to pain. Almost immediately, a woman’s center of gravity will begin to shift forward. This leads to an increased curvature in the lower back. The discs and posterior joints of the spine become stressed and the back muscles become shortened. This problem is extenuated by the gradual weakening of the abdominal muscle as they stretch to accommodate the increasing size of the baby.
The biomechanical changes of pregnancy are accentuated by hormonal changes that help to loosen the ligaments attached to the pelvic bones. Although these natural hormonal changes need to occur, they tend to accentuate the biomechanical changes that occur simultaneously. Strained muscles and joints, combined with lax ligaments, create a perfect recipe for back pain.
Chiropractic care during pregnancy has been consistently shown to provide a safe and effective treatment for pregnant women with back pain. In addition, the treatments may have additional benefits. Studies suggest that manipulations of lower back and pelvis can reduce labor length by 24-39 percent. Additional studies have verified that chiropractic care can be safely continued until the time of birth.
Finding the right chiropractor for pregnancy is important. Choose someone who is comfortable with working with pregnant women and has experience. In addition, try to find someone with exercise expertise, as many of the benefits of chiropractic care can be amplified with a proper stretching and an exercise program. It has become more and more common for OB/GYN’s to recommend specific chiropractors that they have had experience with. This can be a good place to start.

Dr. Tyson Swigart is founder and owner of Southpointe Chiropractic and Fitness,
673 Morganza Road, Suite 105, Canonsburg, PA. To make an appointment or for more information, you can reach Dr. Swigart at (724) 873-0700.

_________________________________________

UFEs Alternative to Hysterectomy

The good news is that hysterectomies no longer need be the first treatment option for fibroid tumors in the uterus. The bad news is that … well, there is no bad news.
Fibroid tumors are masses of fibers and tissue in the uterus that, while not cancerous, may cause heavy menstrual bleeding, pain in the pelvic area, pressure on the bladder or bowel, and other problems. In the past, a hysterectomy was often the treatment of choice for women suffering from these problems, but UFEs—Uterine Fibroid Embolizations—have come on the scene as an alternative.
Dr. Stephen Kelminson, an Interventional Radiologist, or minimally invasive surgeon, who performs UFEs at The Washington Hospital, said, "We've done embolizations for a long time, usually in situations where we're trying to stop bleeding, or where you have a mass that's going to be surgically removed and that could be dangerous because it has such a strong blood supply."
He described the procedure: "We deliver the embolic particles—which are tiny little particles that are about 1/2 a millimeter and are made of a polymerized gelatin—into the artery that supplies blood to the uterus." The idea is that the arteries or blood vessels will become occluded, and the tissue will shrink.
"Every tissue needs a blood supply to survive, including tumors – especially tumors," Dr. Kelminson said. "So we will choke them off, and they will hopefully therefore die and scar, thereby decreasing their size and decreasing their effect on both the bleeding complications and the mass complications."
Despite sounding complicated, Dr. Kelminson assured that it's "a relatively easy procedure. It's an overnight admission—a 23-hour observation, we call it." The results are "highly effective," with a success rate of 80 to 90 percent.
More than 25 million women are afflicted with uterine fibroids, and the pain and heavy bleeding that usually accompanies them. Dr. Kelminson pointed out, "Those are all things that some women live with—in fact, every woman who comes to me has lived with these symptoms for at least a year, sometimes for 10 years. So they were putting up with it for a certain amount of time. But those women in the past were getting a hysterectomy, and obviously this is a much less invasive procedure than a hysterectomy."

Facts About Uterine Fibroids
• More than 25 million women have uterine fibroids
• Uterine fibroids are non-cancerous
• Symptoms may include heavy bleeding, pelvic discomfort, bloated abdomen,
anemia, leg pain, pain with urination or frequent urination
• Uterine fibroids are typically diagnosed through a pelvic exam or an
ultrasound done by a gynecologist
• Nearly 40% of women with uterine fibroids say that the condition severely or
substantially limits their activities
• Of the more than 40% of women who discuss UFE treatment with they
physicians, 35% choose to have a Uterine Fibroid Embolization

For more information on UFEs, you can reach Dr. Stephen Kelminson at (724) 223-3059.

_________________________________________

Menopause and Midlife Health

By Mary E. Peterson, M.D.

Midlife is a time of great change for women. It is a time to re-evaluate goals for life at work, home and play. Women focus on their families, careers and health. It is a time to be proactive in all aspects of life, and to take control of where life leads you. Unfortunately, it is also a time of great hormonal changes which can cause unwanted symptoms.
The more common symptoms of menopause, hot flashes, night sweats, and vaginal dryness, are related to a decrease in estrogen levels. Some women will have few or mild symptoms, while others may have disabling symptoms
If the symptoms are mild, treatment may initially start with lifestyle changes. Dressing in layers and sleeping in a light night gown or one made of a moisture-wicking material can often help with hot flashes and night sweats. Behavioral changes such as regular exercise, quitting smoking, and avoiding hot flash “triggers” – such as caffeine, red wine, strong cheeses, spicy foods - may also help. In addition stress reduction through relaxation therapy, yoga, and/or meditation can often decrease the frequency and severity of hot flashes.
For women experiencing severe menopause symptoms, lifestyle changes may not be enough. The most effective medication for the management of menopause symptoms is hormone therapy (HT). For those women that are candidates for HT, the goal of hormone therapy is to treat symptoms which a woman finds intolerable, using the smallest effective dose for the shortest amount of time needed. Many women are unable to take HT due to their past medical history. These women may benefit from one of the non-hormonal medications that have been shown to decrease hot flashes, such as certain antidepressants and neurological medications. Another option for these women is acupuncture, which has been helpful to many women with severe hot flashes.
For all women, whether they experience menopausal symptoms or not, the midlife years are an important time in which women should focus on achieving or maintaining a healthy lifestyle. Women should see their gynecologist and primary care provider annually, and stay current with their routine health screening tests such as mammogram, colonoscopy, and cholesterol and blood sugar levels. Women should also work to make exercise and a well-balanced diet priorities in their lives.
Midlife should no longer be a time associated with “crisis.” Instead, think of midlife as a time for women to prepare body, mind and spirit for the next phase of life.

_________________________________________

New Mothers: Take Time for Yourself!

By April Terreri.

New mothers, take heed: Take care of yourselves! That is the advice OF Shannon McGranahan, M.D., doctor of Obstetrics and Gynecology at St. Clair Hospital. “This is one of the first things I tell new mothers before they are discharged from the hospital and it’s something I reinforce to them during their postpartum visits to me.”
Most new mothers are already sleep-deprived when they enter motherhood, just by the nature of pregnancy in the last few weeks, explains Dr. McGranahan. “That coupled with the new baby who does not understand what a schedule is all about compounds the situation.”
Take advantage of every opportunity, such as feeding time. “If you are breast-feeding, have your husband bring you your baby,” suggests Dr. McGranahan. “Also have him bring you a glass of water. Have him diaper the baby and put the baby back down again so that all you have to do for middle-of-the-night feedings is to wake up and be there. Similarly, for bottle-fed infants, let dad take on one or two of those feedings.”
Throughout the day, make sure you take several 15-minute breaks, she suggests. Place your baby in a safe place like a crib or bassinette and take a breather – away from your baby – several times throughout the day. “Sit down and have a cup of tea or glass of water,” she advises. “Or do something just for yourself – like a crossword puzzle.”
As the weeks progress, take advantage of the offers of your family and friends to care for your baby for an hour or so, in order for you to get away from the house and do something you enjoy – like visiting the local bookstore or library to read the newspaper.
The same principles apply for mothers with other children waiting at home. “Now you are struggling with a newborn as well as your other child or children. This means you are spread thinner – yet you don’t want to sacrifice something your older children want to do or need from you because you don’t want them to develop any feelings of resentment against the baby.”
As for the day-to-day tasks awaiting new mothers, Dr. McGranahan stresses simplicity. “Everything doesn’t have to be done your way. Remember there are many different ways to do things like holding, diapering and clothing your baby, so allow family members or friends to help you and let them do things the way they are comfortable doing them.”
Train your baby to live on a schedule. “This is something that has to be started very early on,” advises Dr. McGranahan. “I try to advocate feeding on a schedule, particularly when the pediatrician has given the OK that the baby is gaining weight and growing appropriately. If they are crying, it doesn’t necessarily mean they need to be fed. You might want to just let them cry it out a little to get them onto a schedule relatively early on.”
Similarly, train your infant that certain times of the day are for quiet time or for napping. “If you want your baby to do a morning nap, put him or her down in a safe place for a nap and reinforce that same time and same place every day,” suggests Dr. McGranahan. Your baby doesn’t necessarily have to go to sleep every time, so it’s really a matter of getting your baby accustomed to rest during the same time and the same location.
However, today’s hectic lifestyles can undermine your attempt at schedule reinforcing, so try not to cart your baby everywhere you want to go because your baby will sleep on and off in the car.
Finally, don’t forget about your own nutrition. “New mothers want to get their pre-baby figures back right away,” cautions Dr. McGranahan. “But I reinforce the fact that it took nine months for them to put on this weight.” So don’t deprive your body the nutrition it needs. “Remember, you had a life of your own B.C. – or Before Children. You need to remember that you will only be as good as you feel.”
For more information, please contact Dr. McGranahan at St. Clair Hospital at (412) 561-5666 or in McMurray’s Waterdam Medical Plaza at (724) 941-1866.

_________________________________________

Pittsburgh: Center of Aggressive Ovarian Cancer Research

By April Terreri.

Many professionals in Pittsburgh are working diligently to discover treatments for women with ovarian cancer. Robert Edwards, M.D., is vice chair of clinical affairs for the OB-GYN department at Magee-Women’s Hospital. He is also director and senior investigator for gynecologic cancer research in Pittsburgh, helping other researchers implement projects – and he participates in a large practice specializing in ovarian cancer treatment.
One collaborative study currently underway at the University of Pittsburgh Cancer Institute and Magee-Women’s Research Institute could make a big splash nationally, says Dr. Edwards. He adds the work is still very early in development. “Working together with a strong proteomics group at the University, we are attempting to identify potential markers of the various earliest stages of ovarian,” Dr. Edwards explains. “We are collecting fluids found with these early cancers to evaluate them with extremely powerful protein screening techniques. We are also looking for the sources of these proteins in the tissues themselves.”
In another study, Dr. Edwards and his colleagues are aiming to identify new chemotherapy drugs that would be easier for women to tolerate in peritoneal therapy, which involves administering treatment into the abdominal cavity. The current chemotherapy medications used in this therapy are perceived to be difficult to use and receive, so only about 20 percent of women are offered this regime even though it has been demonstrated to be more effective.
Once the study is completed and the appropriate doses have been determined for the two drugs involved in the study, the conclusions may be incorporated into a national study, explains Dr. Edwards. “Our hope is the study would provide new agents for possible testing nationally by the Gynecological Oncology Group, a cooperative group dedicated to studying women’s cancer. The group is funded by the federal government.”
Heidi Donovan, Ph.D., R.N., is another of many researchers in the Pittsburgh area involved in diverse ovarian cancer research. Her research focuses on helping women get answers to the many questions they have about their symptoms and side effects of treatment. “It is very difficult for patients and physicians to find the time necessary to really focus on symptoms and side effects,” says Donovan, assistant professor at the University of Pittsburgh School of Nursing.
Donovan explains that women undergoing treatment for ovarian cancer may have 10 to 12 concurrent symptoms they are trying to deal with. “During an office visit, there often is not enough time for them to get answers to their questions about symptoms and symptom management. Other issues, such as how they are responding to treatment, whether the treatment is working, and whether they should switch treatments take top priority.”
Therefore, Donovan and her colleagues created a research program that connects ovarian cancer patients with nurses via using Internet message boards. “This allows back-and-forth interactions around improving symptom management,” she explains. “It is a psycho-educational program – part education and part counseling – that teaches women how to better manage the multiple symptoms they are dealing with such as nausea, fatigue, sleep problems, and pain.”
Women using the message boards report that the process is cathartic. “We ask detailed questions about how their symptoms affect their lives. Writing in detail about their disease and symptoms on the message boards helps them organize their thinking about what they need to do and it gives women a better sense of control over their symptoms. They tell us it’s important to have someone who understands what they are going through, but who doesn’t have an emotional investment in them.”
The pilot study proved promising in improving symptom management and Donovan has received positive reviews on a grant to the National Institutes of Health. This grant would allow her research team to expand the study across the country to evaluate if this model of helping women manage their symptoms really does improve outcomes. “The long-term goal is to develop a nurse-guided computer-interactive program that could relieve some of the time pressures involved in face-to-face clinic interactions.”
Leslie Hoffman is the chapter coordinator for the Pittsburgh Chapter of the National Ovarian Cancer Coalition. “The research Heidi is doing regarding symptom management for survivors is very relevant to our mission to improve the quality of life for women with ovarian cancer,” says Hoffman.
Dr. Edwards reports that Magee operates a high-risk clinic and a strong clinical program in gynecologic cancer. “We have eight gynecologic oncologists that visit other hospitals in the area. We also have a high-risk screening clinic at Magee and at Hillman Cancer Center overseen by my colleague Dr. Kristin Zorn. So women at risk, or who have ovarian cancer, or who need a second opinion are encouraged to talk to us about potential research studies. Women with a family history of ovarian cancer should be evaluated to see if they have one of the genes that could increase their risk for the disease. We have over 30 ongoing studies in ovarian cancer and we are the only center in Pittsburgh with that breadth of ongoing research.”

Dr. Edwards oversees the ongoing research and he encourages women to call (412) 641-5411 for more information. Dr Edwards can be reached at (412) 641-5418. Heidi Donovan can be reached at (412) 624-2699.

Ovarian Cancer Facts
• All women are at risk
• 1,300 women are diagnosed and almost 800 die each year in PA
• Deadliest of all gynecologic cancers
• Fifth leading cause of cancer related deaths for women ages 35-74
• Currently No early detection test exists
• Women who have had breast cancer or have a family history of breast or ovarian cancer are at an increased risk
• Approximately 80% of cases are diagnosed at a late stage
• Early detection increases survival rates
• Costliest of all cancers to treat

________________________________________

For more articles, download the Spring '10 issue (PDF)