Pelvic Ultrasound

preg4Many of my female followers have probably already had a pelvic ultrasound (US), this week I had another one. I thought it would be a good idea to introduce/refresh about this test. It had been years since my last, in my case this was done to follow a medical condition. If you have ever had a pregnancy, you are familiar with this safe (no radiation exposure) and painless procedure. This simple investigative tool is used to exam other parts of the body, including the heart, blood vessels, liver to name a few

How It works: sound waves are bounced off our internal organs – ‘pelvic US’ – ovaries, uterus and bladder – showing not only shape, size but how blood flows to the organs. No menstrual flow can be occurring for this test.

Actual Test: There is no restriction to eating or drinking but you are told to drink at least two 8 oz glasses of water one hour before test. You must hold your urine, no bathroom stop on way into the sonographer’s room. The full bladder moves female organs into view and provides a solid contrast image.

A clear warm gel will be applied to your abdomen, then a slight pressure as the ‘transducer’ (a microphone like small long device) as is applied to your abdomen especially the lower.

Dependent on why the test was ordered the transducer may be covered with a plastic sleeve and placed 2″ – 3″ into your vagina during the exam. As you can reason this offers a view, a different angle that can assist in making or identifying a problem.

Typical time for this study is about 30 minutes, mine took 22 minutes and included the vaginal viewing.

FYI: Sonography technicians train for 16 – 20 months and are supervised by the radiologists (medical imaging physician). There are many training programs but not all however accredited by the Commission on Accreditation for Allied Health Education Programs. There are many certifying organizations; those that pass the American Registry for Diagnostic Medical Sonography can use RDMS after their name. Several states require licensure after completion of an examination. There are over 50,000 in the US (Bureau of Labor Statistics). As always whenever someone is involved with your well-being speak up if you feel any aspect of your exam is not ‘right’!

Online Pharmacy Dangers

MH900390552A recent FDA study -1 in 4 Americans have purchased prescription medicines online. At this writing there are approximately 35,000 – 50,000 online drug-seller websites.

Recently, the Government Accountability Office (GAO) released a report, Internet Pharmacies: Federal Agencies and States Face Challenges Combating Rogue Sites, Particularly Those Abroad detailing the large and grave problem of illegal, online pharmacies. You need to know it concluded that 97% of all online drug sellers operate illegally.  In 2012 FDA sent warning letters to one internet company ‘’.

FYI: It is illegal to in the US to get prescription meds without having had a recent medical evaluation – that is one needs a valid prescription. There are many good health reasons this is so:

– you may have been taking medication in the past but your body and it reaction to the medication can change with time,

– do you need a stronger dosage,

– are you having complications

– no or not sufficient improvement with the medication

All too common many of the medications purchased online are counterfeits or misbranded drugs.

HONESTLY – Do you want to put a chemical that you purchased from an illegitimate sources into your body?

Medical Diagnosis Testing -Not Always Needed

MH900409552MH900432538You may often thought  do I really need all those tests – well finally medical professionals from 17 medical societies have addressed this issue.

They have identified tests and procedures that are likely unnecessary for the 26 medical specialties. Examples of unnecessary tests from the specific medical society include:

  American Academy of Pediatrics (AAP): Antibiotics for apparent viral respiratory illnesses such as sinusitis or bronchitis

American Academy of Neurology (AAN): Electroencephalography (EEG) for headaches

American Academy of Ophthalmology (AAO): Antibiotics for pink eye

American Society for Clinical Pathology (ASCP): Population-based screening for vitamin D deficiency

American Urological Association (AUA): Routine bone scans in men with a low risk of prostate cancer

Society of Hospital Medicine, Society of Nuclear Medicine and Molecular Imaging (SNMMI): PET/CT scans for cancer screening in healthy individuals.

The American College of Obstetricians and Gynecologists (ACOG), which is new to the list, recommended against performing annual Pap tests in women ages 30 to 65, since doing so offers no advantage over screening at 3-year intervals


Visit  for more information ‘Choosing Wisely’ 



Heart Healthy Diet – Mediterranean

MH900412774 MH900215505Have you heard of this diet? The traditional Mediterranean diet  is characterized by generous use of unrefined olive oil (extra-virgin), fruit, nuts, vegetables, legumes (include alfalfa, clover, peas, beans, lentils, lupins, mesquite, carob, soybeans, and peanuts) and cereals, some fish and poultry, and small amounts of dairy products, red meat, processed (chemically treated) meats, and sweets. So think of the Mediterranean diet as a “plant-based” diet. Also a critical component of this diet is what DocHandal preaches – moderate amounts of wine (preferably red) with your meals. (Check with your doc first!)

A recent study in Spain showed that a diet incorporating extra-virgin olive oil or a diet rich in nuts was better than a low-fat diet to lower the rate of major cardiovascular events in folks already at increased risk for heart disease.

This study is unique in that it choose over 7,000 participants (of which 57% were women) who were free of cardiovascular disease (CVD) events (never had ex: heart attack-MI, angina, irregular heard rate) at the start. Even though free at the start of CVD,  these participants all had positive risk factors that lead to cardiovascular disease events – either Diabetes or at least three important cardiovascular risk factors, such as smoking, hypertension, or obesity, family history, high cholesterol. Important to remember that all the participants were already at risk for cardiovascular events. All received education – face to face 4/yr. and depending on group assignment, either received free extra-virgin olive oil or free mixed nuts. The study’s goal was to find out what diet could prevent progression to a CVD event.

A Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts saw a reduction in the rate of major cardiovascular events by nearly 30% compared with the control group eating a low-fat diet over 4.8 years.

This study does not say but one may infer that the Mediterranean diet is good for anyone even those without risk factors for heart disease.

Demodex Blepharitis (Demodicosis)

Simply put ‘Blepharitis’ means eyelid inflammation and ‘Demodex’ are tiny mites- hence eyelid inflammation due to mites = Demodicosis.

One of the most common causes of itchy eyelids (in 20% of the general population) is due to ‘mites’ on the eyelashes! Other symptoms include burning, foreign body sensation, crusting and redness of the lid margin, and blurry vision. Looks a lot like dandruff at the root of the eyelashes.

Sounds a bit nasty, but not to worry you can get rid of them! You will have to take steps to eradicate them. An easy action plan involves making an inexpensive solution, washing and then rinsing your lids. No fear it is not a prescription medication, but one you can make all you need is Tea Tree shampoo and Tea Tree oil (Trader Joes or you favorite health food store). Mix a handful of shampoo ( 2-3 oz.) with 20 drops of pure tea tree oil, paint the mixture on closed eyelid margins wait 45 seconds then rinse.


Mix a handful of shampoo ( 2-3 oz.) with 20 drops of pure tea tree oil, paint the mixture on closed eyelid margins wait 45 seconds then rinse. Apply this solution twice a day BE SURE to leave it on for 45 sec. (‘One-One Thousand, Two-One Thousand…45-one- thousand’) do this for 6-8 weeks. This length of time will insure that all the mites no matter where  in their life cycle are gone!

 TIP: use a squirt bottle filled with water and spray each closed eye with the eye down (turn neck) spraying from nose side out.

Huffing, Sniffing & Dusting

Alcohol lowers inhibitions and gives teenager’s courage and confidence that they may not have otherwise, often getting teens into trouble that they may have avoided if they had been sober. When using any product that allow for vapor inhalation expect rapid uptake with serious side effects. Examples include alcohol through a  “Vaportini”, computer cleaning duster, nail polish remover and butane. Well known is cocaine, glue and gasoline is worldwide. Often termed ‘huffing’, ‘sniffing’ (or glue sniffing), ‘dusting’ must be watched for in teens. Remember teens weigh less and will have quicker and more serious health side effects.

Social effects, cause teens to use inhalants or alcohol on a regular basis in order to cope with stressful situations. Once suspected or recognized the coping and emotional skills needed to protect against using drug ‘abuse’ as an easy coping solution. It everyone’s job to help!

Drunk on Alcohol Vapor

Listen Up – V_webpic_003The new way to consume alcohol. If you want to get the effects of alcohol faster or avoid the tell tail sign of consuming alcohol (breath odor), use a  “Vaportini”! A receptacle that allows heat from a candle (140º) to vaporize your alcohol drink so that the you can inhale and get alcohol into blood stream faster and more efficiently. More for less – since drinking alcohol results in only about 15% being absorbed into the blood.

A unique internet purchase –  “Vaportini” recommends only 1 oz. alcohol to be taken using this device.

Alcohol addiction and poisoning is very possible given its effects are much faster than drinking and less expensive.

Do not dismiss the potential for lung side effects. Alcohol is known for ‘denaturing’ tissue one of the causes of oral cancer.

Just wanted to give you all a ‘heads-up’ on new and possibly dangerous gimmicks.


Stroke-A Time Change for Care

MH900438746Guidelines were made 6 yrs. ago and now there is a consensus resulting in a new document for medical personnel with ‘21 new recommendations as well as 50 revisions’ of existing recommendations*. To give you an idea of the complexity of aggressive stroke care– another 42 recommendations remain unchanged. In the past many patients having a stroke were excluded from receiving a clot-buster, now many of these contraindications have been dropped. These include those with a minor stroke, a rapidly improving stroke, recent major surgery, or a recent heart attack. It was believed but now proven incorrect that patients with minor or improving stroke should not get clot-busters

EMS also needs to be ready to bypass hospitals that may not offer certain procedures, such as advanced CT or MRI imaging (which is recommended before intravenous (IV) clot buster – tPA  can be given)

As is so common in drug therapy progress – FDA has approved tPA to be given within a 3-hour window of symptom onset while in Europe, the clot-busting drug is approved for up to 4.5 hours.

Genentech, maker of tPA, asked the FDA to approve the drug for the extended 4.5-hour time frame and provided the agency with additional data. But the FDA last spring declined the request.

“For each minute the brain goes without blood flow, there are 1.9 million nerve cells that are dying, that affect 14 billion nerve connections and 7.5 miles worth of never fibers”.

Health care providers believe patients are eligible to receive tPA, within 4.5 hours of symptom onset.

“What this tells us is we should treat patients as quickly as possible to reduce the likelihood they will have disability from a stroke.”

*Jauch EC, et al “Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association” Stroke 2013; 44; DOI: 10.1161/STR.0b013e318284056a.

Go Red – For Your Heart!

The 10th National Wear Red Day3D_vol_ren_of_LAD is Feb. 1, 2013 to bring awareness to heart disease in women.

More women than men have heart attacks! Heart disease is the No. 1 ‘killer’ in women more than all forms of cancer combined.  According to the American Heart Association (AHA)  ‘one in 31 American women dies from breast cancer each year, heart disease claims the lives of one in three. That’s roughly one death each minute’.

Here I go on my  ‘soapbox’:

Heart disease affects women of all ages.  Birth control pills and smoking boosts risk in young women by 20 percent. Yes risks do increase with age; things like obesity and/or inactive lifestyle contribute to clogged arteries later in life. Having high cholesterol and being thin is NOT a free ‘get of jail card’. The AHA recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease. Also always watch your blood pressure readings.

Many women are either unaware of heart symptoms or may rationalize pains/aches as due to other causes. Examples for chest/arm, neck or jaw aches/pains include ‘my bra is too tight’, ‘I worked out too much’, ‘I over did it cleaning’. Some women experience dizziness, tiredness, lightheadedness or actually faint! Fainting without anything else is common elderly women. Know they all could be ‘screaming’ symptoms of a heart attack/disease. You do not have to have any symptoms over 60% of women who die suddenly from heart attacks NEVER had any symptoms! Yes it is possible they did have symptoms but either they themselves or their healthcare provider(s) ignored them. AGAIN women do not get the ‘classic’ chest pain described in medical books (based on studies of men).

For more listen to Doc Handal’s podcast channel –  ‘About A Woman’s Heart‘.

SO WEAR RED  ON Friday, FEB. 1 st.