Podcasts about myomectomy

Welcome to Hot Topics! In this episode, host Gabrielle Crichlow invites Dr. Jasmine Ebott, a college friend and fellow lifetime National Society of Collegiate Scholars member, to delve into the important subject of fibroids.Fibroids, also known as uterine leiomyomas, are the focus of this enlightening conversation. Gabrielle and Dr. Ebott aim to provide information, raise awareness, and address the common misconceptions surrounding fibroids.Listeners will gain a deeper understanding of fibroids, including their symptoms and prevalence, with a specific emphasis on their higher occurrence in Black and Hispanic women. While the exact reasons for this disparity remain unknown, the speakers shed light on the importance of acknowledging and addressing this issue.Gabrielle and Dr. Ebott clarify that fibroids are non-cancerous growths that develop in the uterus and do not spread to other parts of the body. They explore the potential connection between fibroids and hormone imbalances, as well as the possibility of shrinking fibroids through hormonal treatments.Throughout the episode, the speakers discuss various treatment options for fibroids, such as injections, medications, myomectomy, hysterectomy, and uterine artery embolization. Dr. Ebott explains the goals of these treatments, which include alleviating symptoms and creating a favorable environment for potential pregnancy. The importance of considering individual circumstances and future fertility goals when choosing a treatment option is emphasized, along with the potential risks and benefits associated with each approach.The conversation also touches on the recovery process after surgery, the need for personalized decision-making, and the significance of seeking professional guidance when dealing with fibroids. Additionally, the speakers briefly mention the connection between fibroids and fertility, reassuring listeners that having fibroids does not necessarily eliminate the possibility of getting pregnant.Overall, this episode provides valuable information and personal insights into the world of fibroids. Whether you're seeking to expand your knowledge or looking for support in managing this health issue, Gabrielle and Dr. Ebott's discussions will educate and empower you. Tune in now to join the conversation and gain a deeper understanding of fibroids.Who is Dr. Jasmine Ebott?Dr. Jasmine Ebott is a gynecologic oncology fellow at Brown University/The Program in Women's Oncology at Women & Infants Hospital. After graduation, she will be joining Maryland Hematology/Oncology. She plans to engage with the local community to improve awareness around early signs of gynecologic malignancies and increase access to clinical trials.You can find Jasmine:On Facebook: https://www.facebook.com/jasmine.hines.503On Instagram: https://www.instagram.com/jazebott/On X: https://twitter.com/EbottJasmineOn TikTok: https://www.tiktok.com/@jasmineebottWatch this episode on YouTube: https://youtube.com/live/C39RFB_aCUg********************************************Follow A Step Ahead Tutoring Services:On Facebook: https://www.facebook.com/astepaheadtutoringservicesOn Instagram: https://www.instagram.com/astepaheadtutoringservicesOn X: https://www.x.com/ASATS2013On YouTube: https://www.youtube.com/@astepaheadtutoringservicesOn TikTok: https://www.tiktok.com/@asats2013On Eventbrite: https://astepaheadtutoringservices.eventbrite.comVisit our website: https://www.astepaheadtutoringservices.comSign up for our email list: https://squareup.com/outreach/a41DaE/subscribeSign up for our text list: https://eztxt.s3.amazonaws.com/534571/widgets/61fc686d8d6665.90336120.htmlCheck out our entire "Hot Topics!" podcast: https://www.astepaheadtutoringservices.com/hottopicspodcastSupport us:Cash App: https://cash.app/$ASATS2013PayPal: https://paypal.me/ASATS2013Venmo: https://venmo.com/u/ASATS2013Zelle: success@astepaheadtutoringservices.comYou can also become a supporter of this podcast: https://www.spreaker.com/podcast/hot-topics--5600971/support Original date of episode: February 13, 2024

Hello, and welcome to episode 164 of the Childless not by Choice Podcast. My name is Civilla Morgan. My mission is to recognize and speak to childless not by choice women and men around the world, reminding you, us, that we can live joyful, relevant, fulfilled, childless not by choice, lives.   Whether you have children or not, thank you for tuning in!     What is today's show about? Race and the medical community, how to fix it?    Thank you Patreon contributors: I would like to take a moment to thank the people who make a financial contribution to the platform on a monthly basis, my Patreon Contributors.    Your contributions help pay my podcast producer, my podcast host, Zoom, where I interview most of my guests, etc. So thank you very much!        If you are not yet a Patron, visit patreon.com/childlessnotbychoice to set up your monthly contribution. No matter your giving level, I have a gift for you!   If you prefer to give via PayPal, you can find me there at booksbycivillamorgan@gmail.com.  Your contributions to the platform are greatly appreciated! Thank you!   https://www.patreon.com/Childlessnotbychoice   Questions or comments? Contact me at:   Email: Info@civillamorgan.com                                                  Or   Visit the website at www.childlessnotbychoice.net, look to the left on the home screen and click on the link below the telephone to leave me an up to 90-second voicemail.   Questions from listeners:   Listener Name: question from Spotify listener ‘Could you provide an actual bio description. I already know the title, I don't know what you're gonna talk about precisely. It would be very helpful instead of the basic uninformed text.' ANNOUNCEMENTS: Before we get started: Android users, Google podcasts is going away–slowly, like by Summertime based on what I am hearing. That should give you time to find another way to listen.  Honestly, if you just go to your app store you can search for podcast player apps. If you are an Android user, you can use podcast addict or Pocket Cast podcast player apps.  Of course, you can also listen on YouTube music. And keep in mind, I do have two YouTube accounts where you can listen to the podcast.    If you listen to the podcast on Gaana, the largest music platform in India, they are transitioning podcasts to app-only listening. So if you are not finding the Childless not by Choice podcast anywhere else on their platform, search the Gaana app.  And thanks for listening India!       Body of episode: So, I want to tell you about an experience I had when I had my hysterectomy. Am I blaming race for what happened to me? That's the thing about racism, it's not always clear. I have always said ‘It's a heart issue.'     Race and the medical community– Narrative–dictionary term The narrative that black people take pain at a higher range.  Talk about how there are differences that do not mean black people are inferior brown bandaids- pulse ox and skin color- Kidney disease–gfr, creatinine(?)   Talk about the young woman who invented the color change of bandages. when a wound is healing or is getting infected. Talk about women of color losing babies at a higher rate-    Talk about the role of AI in the medical community-   What is bias?  to give a settled and often prejudiced outlook: his background biases him against foreigners.   systematic error introduced into sampling or testing by selecting or encouraging one outcome or answer over others.   an inclination of temperament or outlook especially: a personal and sometimes unreasoned judgment: PREJUDICE Even AI is biased. But it's not AI's fault. Who is creating AI code?    I believe just as it takes a village, and community, to get most things done in our world, it will take a village to fix and correct the inequities of care in the medical and health community. We all need to look out for each other List of things to do when going to the doctor: Make a list of the questions for the doctor. If you are afraid to self-advocate, bring a trusted friend or family member with you. Go to follow-up and lab appointments. Don't blow them off. Review your lab results and ask questions. Make sure you understand what the results mean.  Try to eat right, and take medications you are prescribed as long as you and your doctor are on the same page when it comes to medications.  Don't be afraid to get a second opinion.  Make sure you and your doctor are on the same page. Do research, not to self-evaluate, but to understand what your doctor is telling you. Be aware, involved, and knowledgeable about your health.     Research links:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194634/   https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01466   https://www.stkate.edu/academics/healthcare-degrees/racism-in-healthcare   https://www.band-aid.com/products/adhesive-bandages/ourtone-adhesive-bandages Articles/links of interest: https://mhacf.org/   https://medicalxpress.com/news/2024-03-rheumatic-diseases-childbearing-problems.html   https://yen.com.gh/people/family-relationships/256354-nigerian-lady-child-buys-pampers-feeding-bottle-tearfully-prays-god-a-baby-video/ My contact information: Website: www.childlessnotbychoice.net and www.civillamorgan.com Facebook: booksbycivillamorgan Twitter: @civilla1 Instagram: @joyandrelevance Pinterest: Civilla M. Morgan, MSM LinkedIn: Civilla Morgan, MSM https://www.teepublic.com/stores/childless-not-by-choice

In this episode of BackTable OBGYN, Dr. Mark Hoffman is joined by Dr. Sarah Rassier, a minimally invasive gynecologic surgeon and Director of the Fibroid Clinic at Mayo Clinic, to discuss the multiple treatment modalities of fibroids with a focus on laparoscopic myomectomy. Drs. Hoffman and Rassier discuss the various factors they consider when deciding on the most suitable approach for a myomectomy. Specifically, they touch on pre-surgical patient optimization, the use of laparoscopic techniques in surgery, and the significance of efficient incision planning and closure. Dr. Rassier also highlights the practice of using preventative measures, such as iron infusions and Lupron, in certain patients to manage fibroids before surgical intervention. The conversation wraps up with a discussion about how future developments could potentially revolutionize fibroid management. --- SHOW NOTES 00:00 - Introduction and Overview of the Podcast 03:32 - Discussion on Fibroids and Their Different Treatment Options 06:40 - The Future of Fibroid Treatment 09:17 - Patient-Centered Decision Making in Fibroid Treatment 11:40 - Preparation and Approach for Myomectomy 13:18 - Discussion on the Use of MRI in Fibroid Treatment 15:55 - The Role of Laparoscopy in Myomectomy 29:00 - Umbilicus vs. Suprapubic Approach 32:04 - Cosmetic Considerations in Surgery 32:27 - - C-sections After Myomectomies? 34:51 Instruments and Techniques for Fibroid Removal 36:28 - Minimizing Blood Loss in Surgery 38:47 - The Importance of Efficient Closure in Surgery 44:46 - Tissue Extraction Techniques 49:02 - The Future of Myomectomy

Fertility & Sterility on Air brings you some great interviews from ASRM 2023 in New Orleans, LA! In Part 1, we discuss science with leaders in the field and presenters from the conference. Topics include rates of vasectomy after the overturn of Roe v. Wade (Jessica Schardein) (1:11), ultrasound-guided ovarian ablation for PCOS (Karl Hansen) (6:32), intramyometrial carboprost for hysteroscopic myomectomy (Sarah Capelouto Cromack) (16:47), platelet-rich plasma and endometrial quality (Wael Elbanna) (25:09), oral GnRH antagonist for ovarian suppression in IVF (Marco Mouanness) (36:56), use of a microfluidic sperm selection device and blastocyst formation (Robert Rydze) (47:05), and risk of adverse maternal outcomes with fertility treatment across racial and ethnic populations (Sara Phillips) (55:59). View Fertility and Sterility at https://www.fertstert.org/  

Listen to our newest podcast with Dr. Sarah Simko, the author of "Rates of Complications and Reoperation after Myomectomy—the Impact of Surgical Approach: A Statewide Population-based Cohort Study from 2005–2018" where we discuss the trends in varying routes of myomectomy and subsequent complications. See below for publication details and be sure to join discussion on this topic through our social media platforms.Publication details:JMIG VOLUME 30, ISSUE 3, P192-198, MARCH 2023Full text linkConnect with the JMIG Social Media Team!Twitter: @AAGLJMIGInstagram: @AAGLJMIGFacebook: AAGLJMIG

Liz and Vito are pregnant with baby number 3! They are answering all of the listener questions in this episode.   Sponsors: Get 15% Off at https://dockatot.com/ with code MAMAS Go to jennikayne.com and use the code CHAVA to get 15% off. Why Chava? Episode 248: https://podcasts.apple.com/jm/podcast/ep-248-welcome-to-morning-chava/id1343507855?i=1000593089125 Chava Meaning https://www.chabad.org/multimedia/video_cdo/aid/3506698/jewish/Inside-the-Name-Chava.htm Episode with Lindsay Meisel about TTC after Miscarriage: https://podcasts.apple.com/us/podcast/myths-misconceptions-about-fertility-getting-pregnant/id1343507855?i=1000457087451 Episode on Homebirth after Myomectomy: https://podcasts.apple.com/us/podcast/ep-261-free-birth-after-a-myomectomy-with-amber-mcconnon/id1343507855?i=1000608120844 Episode on Babydust Method https://podcasts.apple.com/us/podcast/ep-257-the-babydust-method-with-kathryn-taylor/id1343507855?i=1000603874595 20% Off at Needed Supplements with code ESANDOZ20 https://thisisneeded.com/  

Have you heard of the term Oligohydramnios? Low amniotic fluid (oligohydramnios) is a condition in which the amniotic fluid measures lower than expected for a baby's gestational age. Today's guest was preparing to conceive and had a myomectomy to remove her fibroids.  Christina Danyo learned she was expecting after her fibroid surgery.  During her 20 week anatomy scan she learned that her baby girl's kidneys did not develop and was covered in cysts.  Her daughter was diagnosed with Oligohdramnios or low/no amniotic fluid and her lungs also did not develop.  Christina was faced with the decision with the diagnosis not compatible with life.  In this episode, we discuss the decision she and her husband made to carry to full term, she delivered her baby girl via C-section at 37 weeks, preparation for delivering a baby given a fatal diagnosis, and her time spent honoring her angel during her less than 2 hour life and beyond. Listen to this episode here: sistersinloss.com/ep249 Become a Sisters in Loss Birth Bereavement, and Postpartum Doula Here Living Water Doula Services Book Recommendations and Links Below You can shop my Amazon Store for the Book Recommendations You can follow Sisters in Loss on Social Join our Healing Collective Online Support Group Join the Sisters in Loss Online Community Sisters in Loss TV Youtube Channel Sisters in Loss Instagram Sisters in Loss Facebook Sisters in Loss Twitter You can follow Erica on Social Erica's Website Erica's Instagram Erica's Facebook Erica's Twitter

Now this podcast episode is like a anniversary special from the time the host went through her surgery and every year to date she likes to express gratitude, a sense of a story base podcast for one, to imagine if they didn't have this type of health situation or if they have been through this type of health situation empathise and relate to this experience although every experience will be different in lie to date.Also, the sound effects and tracks as well as mood enhancers come from the website uppbeat.io which one can sign up for free for content creation music for videos and podcasts alike, and this catalogue of music and sound effects has been good to date for the host to create suspense and feelings to her podcast shows, (smiles to self).... Lastly, the host wants to give some love and shout out to the creator of the tracks used in this podcast episode to date, first one is from Music from #Uppbeat (free for Creators!):https://uppbeat.io/t/monument-music/pageLicense code: T3HYKUXLGGMWGC8BMounument music a track called Page, which is beautiful in the hosts' opinion, and expresses what she is trying to show gratitude in her podcast episode to date. Also the host used a couple of sound tracks to date, from, Heartbeat (Close)Joshua Chivers (whichwas the clock ticking sound)..Clock - tense rhythmical tickingTomas Herudekhttps://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeinghttps://www.nhs.uk/conditions/scars/treatment/#:~:text=Scars%20cannot%20be%20removed%20completely,to%20pay%20for%20them%20privately.https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, in this podcast segment diary clip so to speak the host brings one on a journey, with an and a interesting sound clip file from the music service upp beat to date, the clip comes from artist named below, so feel free to check out the site if one wants royalty free music for their creations if they create or for listening too if you prefer. Music from #Uppbeat (free for Creators!):https://uppbeat.io/t/alex-besss/critical-evidenceLicense code: KWVDLNE6TBOCO4CRAlso, the host wanted to bring one an update as the start of this year 2023, had been a bit of a slow and painful start mentally so to speak, so in this little diary section segment clip the host hopes one enjoys the show and can get a sense or feeling what could happen when one is trying to lead and live a fulfilling life after a health situation such as she had a Myomectomy in March 2020 to date. Also, the hosts' previous website is now a free version from supapass, so one can listen to the podcast on their but uploads will be done using her wix website when she first started her online journey coming soon to date, but the host is taking time to be fit mentally and physically to date too, more content to follow soon. https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeinghttps://www.nhs.uk/conditions/scars/treatment/#:~:text=Scars%20cannot%20be%20removed%20completely,to%20pay%20for%20them%20privately.https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The most common cause of hysterectomy in women are benign masses that grow within the uterine wall. They occur in 4 out of 5 women, and they can be small and asymptomatic, or they can grow large and cause pain, uterine bleeding, pelvic pressure, urinary incontinence and pregnancy complications. Uterine Fibroids are “the most common tumor in women world-wide”. Although benign, uterine fibroids are associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor. Fibroids are also referred to as “leiomyomas”, “myomas”, “fibroid tumors”, and sometimes slangily referred to as “fireballs”.  They are in fact “ball-like” in shape and when we inspect them at hysterectomy, they are made up of swirling muscle cells that are laid down in concentric circles.  Gynecologists find fibroids when we examine a patient at their yearly visit by feeling an enlarged irregular uterus.  The fibroids are within the wall of the uterus and often cause heavy uterine bleeding.  Where the fibroids are, within the wall of the uterus, determines whether they are more likely to cause bleeding or not.  Placement up against the uterine cavity (“submucosal”) increases risk of bleeding, and placement in the middle and surface of the uterine wall (“subserosal”) decreases risk of severe bleeding. At BioBalance Health LLC we require every patient who comes to us who still has a uterus to have a formal abdominal and vaginal ultrasound to diagnose fibroids and other uterine abnormalities,  before we will give them estradiol pellets.  Testosterone doesn't have a negative effect on fibroids so we can still put a woman on testosterone with fibroids. Otherwise, we have the risk of fibroid growth in our consents, and we discuss this issue when a patient's ultrasound shows significant fibroids. What causes a woman to be more likely to have fibroids during her reproductive years? Triggers for Fibroid Development ·      Race ·      Genetics/ family history ·      Diet ·      Early Age at First Period ·      Toxins in the environment especially in early life ·      Obesity ·      Advancing age ·      Vitamin D deficiency ·      Hypertension ·      Pregnancy suppresses the growth of fibroids  Race: Both Black and Hispanic women are the most likely to develop fibroids and experience enough symptoms to cause the need for a hysterectomy. Black women are 3X as likely as white women to have fibroids, and they are more likely to have very large fibroids. In some circumstances fibroids can prevent pregnancy and cause recurrent miscarriages and preterm labor. 60% of African American women aged 35-49 years reported uterine fibroids, whereas 80% of those aged ≥ 50 have uterine fi-broids. Genetics/Family History: If a woman has a mother or sister with fibroids, then that woman has twice the risk compared to a woman without a family history of fibroids. “Uterine fibroid-linked mutations in MED12” are the most common mutation we have found, however a mutation in the COMP pathway is also found to be associated with fibroids. Diet: A diet with high intake of meat, fat and alcohol increases a woman's risk of developing fibroids.  A diet deficient in fresh fruit and vegetables also increases the risk of fibroid appearance and growth. Smoking is highly associated with fibroid growth. Early age of Menarche is a risk for developing fibroids, which increases the years a woman is exposed to estrogens. Toxins from the environment, and from alcohol increases the development of fibroids.  Cleanses might help rid your body of toxins that might methylate your genes and stimulate fibroid growth. Obesity and Being overweight: Body fat increases the estrone estrogens in the circulation, which stimulates fibroids to grow.  Advancing age until Menopause: When women enter their late 40s their ovaries decrease ovulation and the uterus is exposed to estrogen without progesterone, which causes fibroids to grow.  After menopause, some fibroids shrink while others stay the same. When women take HRT their fibroids may be stimulated again, however because it is not cyclic, it is less likely to stimulate fibroid growth. Hormone Replacement Therapy can increase the size of fibroids: HRT is only one of the factors that causes growth of fibroids in menopausal women.  If estrogen is balanced with progesterone (not progestins) growth is less likely.  Testosterone has no effect on fibroids so replacing testosterone is not a factor for Fibroid growth. At BioBalance we have medicated pellets that combine Testosterone with Anastrazole which suppress the growth of fibroids.  We use these on our patient who have known fibroids, if they are willing to undergo treatment with this Vitamin D deficiency The role of Vitamin D in development of fibroids is being researched at this time, however an adequate Vitamin D blood level is needed to help prevent Fibroid growth. “Approximately 80% of African American women have vitamin D deficiency, compared with only 20% of Caucasian women”. This is one of the factors in Race being a factor in the development of fibroids. Hypertension Increased diastolic blood pressure is associated with a higher risk of uterine fibroids, regardless of use of antihypertensive drugs. Women suffering from hypertension are 5 times more likely to develop uterine fibroids.  Not Having Babies (Low parity) Having had one or more babies (parity) is protective, and the more babies a woman has the less likely she is to have fibroids What are the Symptoms of Uterine Fibroids? Fibroids are benign uterine tumors, so patients are not at risk of dying of cancer, but women with fibroids often have quality of life issues, found in the symptoms listed above, that lead them to the final treatment for fibroids, a hysterectomy (removal of the uterus). So can we prevent these masses from occurring, growing and producing symptoms? How Do You Know You Have Fibroids? The growth of fibroids is generally slow and is accompanied by slowly worsening symptoms. When there are many fibroids, large fibroids or submucosal fibroids patients seek help for their symptoms which include: ·      Heavy uterine bleeding which can be severe leading to anemia ·      Pelvic pain and pressure ·      Large mass effect that puts pressure on the bladder and colon causing dysfunction of those organs like stress incontinence, and constipation. ·      Painful intercourse ·      Multiple Miscarriages ·      Preterm labor ·      Weight gain What is the Diagnostic Process that Confirms Fibroids When I was practicing OBGYN, and a women came into my office for a GYN exam and I felt. The uterus was enlarged and irregular, it triggered me to do three tests to see if it was a fibroid, ovarian mass, pregnancy or other abdominal tumor.  I would first order a rapid pregnancy test. Then I'd order blood work to see if my patient was anemic from heavy bleeding, and If the pregnancy test was negative, then I would order an abdominal and transvaginal ultrasound to get a picture of what I was feeling on exam. If I found a fibroid uterus, then I would have a discussion with my patient to see how severe her symptoms were.  I would also tell her how big the uterus.  The size of a fibroid uterus does matter.  If it is greater than 16 pregnancy week size, it is likely putting undue pressure on the other organs in the abdomen.  The speed of growth is also a factor because if the uterus grew quickly, then it has a tiny chance of being a malignant sarcoma.  The risk of this is < 1%, however fast growth of a fibroid uterus is an indication to do a hysterectomy. If the uterus is greater than 12 weeks size an ultrasound cannot adequately measure the uterus or reveal the inside of all of it so an MRI of the pelvis and abdomen is in order before surgery. What Type of Treatment Can Shrink or Remove Symptoms of Fibroids? The options for control of Fibroid Symptoms with Medications/Supplements include: ·      Progestins or Progesterone without cycling ·      Birth Control Pills ·      Lupron and other drugs in that class (this puts the patient into a temporary menopause). ·      Anastrazole (Arimidex®) which stops the conversion of testosterone into estrone and estradiol. ·      Stop Estrogen replacement, or. Lower the dose of estrogen if you are menopausal. ·      Treatment of inflammation (High CRP) ·      Vitamin D supplementation ·      Probiotics ·      Supplemental vitamins and minerals These are the first treatments doctors use to lessen the symptoms of fibroids unless bleeding is so severe that it becomes an emergency and then invasive treatments are used. ·      Uterine Artery Embolization is done by a radiologist and puts a “plug” in the fibroid's blood supply and then slowly the fibroid shrinks and dies. The only problem is that once you have had one fibroid, you can always make more.  This may be a delaying process to allow a patient to make more red blood cells before a definitive surgery. ·      Myomectomy is a procedure done under anesthesia, and it preserves the uterus while removing one or more fibroids.  This procedure makes the uterus more fragile and puts it at risk of uterine rupture if a woman gets pregnant and goes through labor.  Therefore, myomectomies are usually followed by a C-section for delivery to avoid the risks. This procedure cannot be done on all fibroid uteruses.  The doctor must determine if it is possible to preserve the uterus, since many fibroids invade the whole uterus. ·      Hysterectomy is the one procedure that guarantees that uterine fibroids will not return. After childbearing is complete a woman doesn't need her uterus for anything. It is simply there to bear children and does not secrete hormones or provide any other function. A Hysterectomy is done under anesthesia and removes the uterus that contains the fibroids.  If the cervix is not involved with fibroids and there is no history of cervical cancer, a supracervical hysterectomy can be done, preserving the cervix and the nerves that stimulate deep orgasms.   The Newest Research on Fibroids: Knowing this information should make it easier for you to understand your doctors' findings and what is ahead of you.  I hope you can understand the risk factors and the possible treatments available to you. References: “Comprehensive Review of Uterine Fibroids….”Endocrine Reviews,2021, Vol. 43, No. 4, 678-719 https://doi.org/10.1210/endrev/bnab039

Amber lives in the Sierra Nevada foothills with her husband, son and dog. She is building community, and working with women in the Sierra Nevada Foothills by developing a mentoring network to support women who choose to have home births outside of the medical system. Her website houses the extensive research she and her husband compiled during her pregnancy about vaginal births after myomectomy (VBAM) including case studies, clinical research, testimonial and other resources.   Follow her work as it continues to evolve at: Website: https://www.curaehome.com/   Instagram: @trashbag703 https://instagram.com/trashbag703?igshid=YmMyMTA2M2Y= Facebook:  https://www.facebook.com/profile.php?id=100078224144405&mibextid=LQQJ4d   Video on birth as an altered state of consciousness that Amber referenced:  https://youtu.be/KSiyL_FO8WY References: VBAC Episode 240: https://podcasts.apple.com/us/podcast/ep-240-the-vbac-link-with-megan-heaton/id1343507855?i=1000583641739 Ayurvedic Postpartum Healing Episode 236: https://podcasts.apple.com/us/podcast/ep-236-postpartum-healing-with-ayurvedic-doula-ameya/id1343507855?i=1000580612553 Study on Vaginal Birth After Myomectomy https://pubmed.ncbi.nlm.nih.gov/30396109/ Why Chava? Episode 248: https://podcasts.apple.com/jm/podcast/ep-248-welcome-to-morning-chava/id1343507855?i=1000593089125 Chava Meaning https://www.chabad.org/multimedia/video_cdo/aid/3506698/jewish/Inside-the-Name-Chava.htm

Now, this podcast episode is a bit of this and a bit of that after the host has gone through a health situation she values life much more than she did prior to surgery and plans and ensures she lives life to the fullest daily. Also, the host breaks down past memories she holds to date, looking at gadgetssystemstechnologiesfood and nutrition recipes alsoRelationship memories tooMoreover, if you wish to connect to the host you can find and follow her on twitter, you tube and linked in, as well as tiktok by the name across the board of over forties health too. Also, overforties health will not have a supapass website shortly due to her current financial circumstances but a website will be provided for her needs shortly should you wish to see her recipes for a smaller frame or for one trying to live and lead a healthier life after a particular health situation, if one who reads this believes in women's health or wants to learn more about the Myomectomy process and how to lead and live a fulfilling life after the surgery please consider following the host on the application goodpods, or via her social media too, your support and downloads are greatly appreciated. Next if you like this podcast episode to date please consider giving it a like as well as leaving a review on apple podcasts so the host can get more findability to date too.https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeinghttps://www.nhs.uk/conditions/scars/treatment/#:~:text=Scars%20cannot%20be%20removed%20completely,to%20pay%20for%20them%20privately.https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, the episode was brought to one by the host overforties health who went throug ha Myomectomy surgery in 2020 March time. Also, the host wanted to update one and bring you an episode in case you may have scars in your life that you may need to deal with be it emotionally physically or mentally. Moreover, the information in this podcast episode comes from the website National health service (NHS) which you can view and find out more about scars below: https://www.nhs.uk/conditions/scars/treatment/#:~:text=Scars%20cannot%20be%20removed%20completely,to%20pay%20for%20them%20privately.Lastly, if you would like to connect to the host on her most active social media platforms you can look for her on you tube with the name over forties health likewise on tiktok too, or twitter as well. Also, if you prefer you can go to the hosts' website and scroll down at the bottom of the page to find all social links to date. https://overfortieshealth.supapass.ioBesides this, if you like this podcast episode or are enjoying any of the shows you may have listened to on an audio diary a personal health journey then please consider leaving a review on apple podcasts by clicking the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeinghttps://www.nhs.uk/conditions/scars/treatment/#:~:text=Scars%20cannot%20be%20removed%20completely,to%20pay%20for%20them%20privately.https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, over forties health, has recently had a very scary situation after her mensuration, and wanted to share this with one, in case anyone else had this or may encounter this at some point after they may go through a Myomectomy experience. Moreover, periods and mensurations is an essential part of a womens' health to date and it helps as it is a healthy sign physically that a women and girl within reproductive years is doing well, and can one day reproduce life be spared. Also, the information in this podcast episode comes from National health service (NHS) to date, and you can read as well as check out all about mensurations and late periods further if you choose to, to date, just follow the link below for more information: https://www.nhs.uk/conditions/periodsAlso, if you like this podcast episode please consider reviewing it on apple podcasts to date, by clicking the link below:https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Moreover, if you would like to connect to the host on her most active social media platforms you can either do this by going to her website to date, at the link below:https://overfortieshealth.supapass.ioAlso, the host is on tiktok, you tube, twitter mostly and goes by the name over forties health across the board. More importantly, one can find over forties health on the application goodpods whether you are a listener or podcaster yourself, you can go on this application service and download it from google play stores and apple stores and rate individual episodes for one to get more findable if you choose to, and want to do this task. https://goodpods.comhttps://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeing

Now, this episode is a bit of a bonus for and to an audio diary a personal health journey to date, it is all the things one may wish to do after their health situation or even preparing to have a health situation one might want to do these things too, or even on recovery too, the choice is one's to have, and to hold so to speak. Also, the host mention two products she got from Amazon to date which is highly good for women's health and if one has had a health situation such as a Myomectomy for example, they may consider being or doing things that are more convenient for their lifestyle change going forward. Next first item the host recommends to date is a postal weighing scales (heavy duty) one can find it on Amazon, by clicking the link below: https://www.amazon.co.uk/gp/product/B092M7PK61/ref=ppx_yo_dt_b_asin_title_o07_s00?ie=UTF8&psc=1Also, another item the host recommends to date particularly for ladies if they want to track their menstrual cycle is a smart fitness watch with this feature on it, it has been amazing to the host to date and quite cheap and cheerful if one is on a budget too. https://www.amazon.co.uk/gp/product/B08HMRY8NG/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1In addition, if one wants to look the host up on her social media most active platform of tiktok, twitter and you tube her name across the board is over forties health, or you can click on her website and scroll down to the bottom of the website to get the links required. https://overfortieshealth.supapass.ioAlso, if you like this episode or style of bonus episode you can review it on apple podcasts by going to this link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeinghttps://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/managing-stress-and-building-resilience/#TipsForManagingStressHost's website link https://overfortieshealth.supapass.ioApple podcasts review link https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Health and well being checklists and tips for good health going forward (National health service website) https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/top-tips-to-improve-your-mental-wellbeing

Now, this is a mini clip or diary podcast about some bank holiday thoughts from the hosts, this may be a serious of diary clips, some times from the host if she feels something strongly and wants to share it, with others after her health situation. Also, if you like this episode please consider giving it a like, and subscribing to the podcast for more juicy episodes and diary format chitchat shows, and consider liking the episode as well as leaving a little review on apple podcasts so the host can be and get more findability. https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Moreover, if you want to check out the host on her most recent social platforms you can go to her website which is now up and back running and live again from her website host and business of Supapass too. Also, please click, the link below to go to the website of the host, where you can scroll down to the bottom and find the host on linked in, Tiktok, Twitter or you tube if you want to, and check out her recipes for one health wise and for people who want to live a healthy life who have had a health situation or may want to go through a Myomectomy and want to know more about gynaecological and women's health going forward. Besides this, the website is up and coming so please bare with the host as she is in the process of sorting her website out to be more organised, and synced.  https://overfortieshealth.supapass.io

ave you heard of a Myomectomy procedure? Myomectomy is a surgical procedure to remove uterine fibroids. These common noncancerous growths appear in the uterus. Uterine fibroids usually develop during childbearing years, but they can occur at any age. Women of Color have the highest occurrence of fibroids in up to 90% of black women before age of 50.   Today's guest experienced an untimely loss at 22 weeks of baby girl Alexandria Shah due to preterm labor and cervical insufficiency.  Dr. Shabnam Brady began to research for answers why and what could possibly have happened.  She went to several specialist doctors and conducted months of research. She and her husband decided to undergo a myomectomy to remove fibroids and went to Chicago to undergo a Transabdominal Cerclage procedure due to her cervical insufficiency.  Last Summer, I had the pleasure of meeting Dr. Shabnam for dinner while she was pregnant with her miracle Faith.  In this episode, Shabnam takes us back to her making the decision for both procedures: the myomectomy and transabdominal cerclage, how her Faith after loss was during her rainbow baby pregnancy, and how therapy and mental health played a major role in her healing. This episode is for you to listen to if you have considered a myomectomy or transabdominal cerclage procedures.  This episode is for you to listen to on how to research your options and choose the best specialist or therapist for you after loss.   Become a Sisters in Loss Birth Bereavement, and Postpartum Doula Here Living Water Doula Services Book Recommendations and Links Below You can shop my Amazon Store for the Book Recommendations You can follow Sisters in Loss on Social Join our Healing Collective Online Support Group Join the Sisters in Loss Online Community Sisters in Loss TV Youtube Channel Sisters in Loss Instagram Sisters in Loss Facebook Sisters in Loss Twitter You can follow Erica on Social Erica's Website Erica's Instagram Erica's Facebook Erica's Twitter

“I don't have anybody that I can use as a resource or as a reference, but I know that I am not an anomaly. I also know that I am not asking for too much. I am not asking for a vaginal birth. I'm asking for support. I'm asking you to hear me. I'm asking you to give me time. I'm asking you to let my body do the work. Let my body do the work instead of you dictating what you think my body should do.”Mabel is a trailblazer. She walked the lonely road of fighting for her vaginal birth after a myomectomy with very limited resources, support, and anecdotal evidence. Mabel knew her risks. All she wanted from a provider was true support and the chance to try. This episode is a must-listen. Sit back and soak in all of the incredible advice Mabel offers to both VBAC and VBAM hopeful women. We were honored to have such a powerful woman of strength on our podcast today!Additional linksMabel's Website: Within Her Birth ServicesSpecial Scars WebsiteThe VBAC Link CommunityHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Hello, how are you guys? This is The VBAC Link podcast and we are with you today with our friend, Mabel. We are so excited to hear her stories today. We encourage you to pause and listen up because this is going to be an amazing one. She is from northern Virginia and did you say DMC? Is that what you called it?Julie: Washington DC.Mabel: DMV.Meagan: DMZ. Julie: Everybody's confused. Mabel: Yeah. I'm from Northern Virginia. In the city and state, I'm from Bristow, Virginia, but it is technically part of northern Virginia. We call it the DMV– DC, Maryland, Virginia.Meagan: DMV like where you go get your license.Julie: Oh my gosh.Meagan: Okay, the DMV area. So if you are in her area, this is definitely one to listen to. But of course, we have a Review of the Week, so I'm going to turn the time over to cute Julie, and then we will dive into this story.Review of the WeekJulie: Okay. You know I can't just go right into the review. I have to say something. That's really funny that you said “cute Julie”. That's really funny because I have a longtime friend from when we were in the military. We hardly ever see each other but when we do, she is one of those friends that you just pick up right where you left off. It doesn't matter if it has been a year since we talked to each other. Her name is Kelly and I would always call her “cute Kelly”. It's “cute Kelly” and then she started calling me “cute Julie” and I am like, “Nobody calls me ‘cute Julie' except for her.”Meagan: Oh that's funny.Julie: So when you said “cute Julie”, I was like, “Aww. I miss my friend. I need to go call her after this.” Oh my gosh. Anyways, yes. Mabel from DMV, we are so excited to hear your story, but yes. I am going to read a review. OK. I really actually like this review. I read it on a previous podcast, but then I had forgotten to record that podcast and we had to get back on and start over, and I had to pick a shorter review. But I really like this one and I want to tell you why afterward. This is from Informed Mama on Apple Podcasts and she says, “I love listening to the inspirational stories of women of strength trusting their bodies and doing what they were created to do. As a mama who has had a C-section, it's incredibly encouraging to hear that my feelings about my child's birth are valid and also exciting to me that this could be our story someday, too.“With this in mind, as a labor and delivery nurse, it hurts my heart to hear of women not consenting to interventions and of the overall mistrust of birth in a hospital setting. I do want to encourage all women that L&D nurses and OBGYNs are not evil, and we are not pushing for every woman to give birth in the OR. There are times when interventions are necessary for the safety of you and your child. We do have good intentions for you and your baby, and the safety of both of you is our utmost priority.“If you are a pregnant woman listening to this podcast and find yourself anxious about your upcoming birth, please remember that the majority of us are honored to be there for this special day for you and want to honor your birth preferences as best we can. Please keep focusing on how strong you are, trust the process, and surround yourself with a birth team that will advocate for you!”I love that review because first of all, I love it when we have OBs, hospital midwives, and labor and delivery nurses listening to our podcast and following along with The VBAC Link because I feel like change has to come from all sides in order for there to be an improvement in maternal health, our outcomes, and the birth privileges and birth rights that we all want. We all want to improve birth in the United States especially, but all over the world so I love that perspective.My three VBACs were at home so just keep in mind my perspective, but I think it is really easy, sometimes, for us to get really defensive with the hospital systems and interventions. Yes obviously, Cesareans are heavily overused. That's why we are here. We know that interventions are also overused and sometimes the hospital system feels like it is created to sabotage the birth process a little bit, but I like this reminder because it helps us remember that most people in the hospital system really do want to be there. They really do want to help you and want to see you have the safest and best birth that you possibly can.I do want to add a little caveat in there that I know that there are some hospital staff, nurses, OBGYNs, and maybe even hospital midwives that do operate in a poor manner and can seem like they don't have your best care at heart. I just think it's important to remember that most of the time, people are willing to be accommodating, helpful, and supportive. I also don't want to just discredit anybody that has had a traumatic birth experience. We are how many episodes in? I think 189 or something? We certainly have heard quite a few of those stories too. But I have found that especially being a doula here, most people are willing to accommodate and be supportive of your birth preferences as long as you make them known and as long as it is within their scope of practice as well. Anyways, I've been talking for a long time. Meagan, what would you add or should we just kick it off?Meagan: No, yeah. I think that is great.Mabel's StoryMeagan: I am just so ready to dive into this story. So Mabel, without further ado, we welcome you to The VBAC Link to share your story. Mabel: Thank you. Thank you, ladies. I thought that review was a very helpful reminder, so it was nice to hear that. I will start by saying that a lot of my story is actually a lot of the things that happened before I even got pregnant, so I think the bulk of this story might weigh heavily on my pregnancy and trying to conceive journey which therefore helped me be successful with having a vaginal birth after my myomectomy. I don't know if you know much about fibroids and myomectomies or if that is something that you have heard of or have encountered with clients or other VBAC stories.Meagan: Especially fibroids specifically, we get messages about fibroids all the time like, “Hey, do you have any stories with people that have fibroids and had a VBAC?” or “Hey, do you know my risks?” I don't know a ton, so I am excited to learn more. Mabel: Awesome. So I'll start with that. A fibroid is a benign uterine growth that occurs in the uterus. They are benign so they're not cancerous, but they can propose a lot of issues for women. Women can experience pelvic pain and excessive bleeding during their menstrual cycle. They may even appear pregnant because the mass is so big and it is projecting out of her uterus, causing her belly to swell.Fibroids are actually a very common occurrence for women not just in the US but in the world. I think the statistics say that about 70% of women will experience fibroids at one point or another in their life. The statistic is quite disproportionate to black women. Black women have a higher risk of getting fibroids. I think the statistic says 8 out of 10 black women have fibroids whether they are symptomatic or not. So no matter your racial background, fibroids are very much a part of the female experience I have come to find out. Depending on where you are in life, you may decide to do something about them or not. In fact, most women don't realize that they have a fibroid until they become pregnant or they are trying to become pregnant because one of the best ways to identify fibroids is through ultrasound. I have had friends and clients who have said, “I didn't know I had fibroids until my 6-week confirmation pregnancy appointment.”What happened to me was that actually, I was trying to conceive. I got married at 26. We waited a year before we were serious about trying and then the year we were trying to conceive, nothing was happening. Through a series of tests, I found out that I had fibroids. I had multiple fibroids. It was a wake-up call because, for years, I had been experiencing extremely heavy periods. I wasn't the girl who got cramps, but I was the girl who literally hemorrhaged every month. And so I was very grateful to find out that I had the fibroids because I had an answer to the issues that I was facing. After some time, I decided that I was going to surgically remove them. Granted, every woman who has fibroids may treat them differently, but one of the more common ways of dealing with fibroids is to do surgery, which is called a myomectomy. Another way that someone may deal with fibroids is to do a hysterectomy, but most women who opt for a myomectomy are trying to preserve their fertility. That's what I wanted to do, obviously. I was still young and was still hoping to get pregnant. Thankfully, I was a pretty good candidate for a laparoscopic myomectomy. I don't want to get into the weeds but there are different types of myomectomies that you can do. The laparoscopic myomectomy is known to be minimally invasive whereas others such as an abdominal myomectomy are where they cut your uterus very much like a C-section and they remove the fibroids. Instead of removing a baby, they are removing the fibroid. Thankfully, I didn't have to have such an extensive surgery as the abdominal myomectomy. Meagan: That's actually what my tax lady just had– that exact surgery. Mabel: Really? Yeah. Yeah. Meagan: Uh-huh. Mabel: Yeah. Julie: Our tax lady, thank you very much. Meagan: Sorry, yes. Our tax lady. Yes. And you know, she is worried that she will never be able to have a vaginal birth because the doctor said, “Just to let you know if you do get pregnant in the future, it's C-sections from here on out.”Mabel: That is very, very and I wouldn't even say very common. That is the feedback that every woman who goes through a myomectomy will receive. It doesn't matter how invasive her procedure was. It doesn't matter how many fibroids they removed. It doesn't matter how well her recovery was. Usually for a woman who goes through a myomectomy, if she ends up getting pregnant thereafter, she will be counseled to have a C-section at 37 weeks. The concern for that is uterine rupture, very much like a C-section. Their concern is that because we have gone into your uterus and we have tampered with it more or less if you are doing an abdominal myomectomy, that's one big incision. If you are doing a laparoscopic myomectomy like mine, there are these tiny little cuts into the uterus. They cut into the uterus and they take pieces of the fibroid out bit by bit. There are different ways to remove fibroids; however, it is a uterine procedure and every woman is different. Every woman's experience is different. Some women have multiple fibroids. Some women have one. Some women have fibroids inside the uterine cavities. Some women have it within the wall or outside the wall. It really varies. And so I think a blanket response to avoid uterine rupture is to just go on and have a planned C-section at 37 weeks. Like I said, I was happy I was getting the laparoscopic myomectomy because when I was doing my research beforehand, all the research that I found said that women who had a laparoscopic myomectomy were good candidates for having a vaginal birth thereafter if they were treated as if they were a VBAC patient. In my head at that time, I was like, “Well, this is great. I am going to have this surgery and I am going to have my vaginal birth.” But when I went to one of my post-op appointments to talk about the procedure, my surgeon at the time told me that I had to have a C-section at 37 weeks. Something told me not to push it with her because I felt that, “Okay. She is my surgeon who did the surgery. She doesn't necessarily have to be the OB that delivers my babies.”So when she told me, I just took it in but in the back of my mind I thought, “I have a lot of work to do.” That was in the sense of finding a supportive provider. Mind you, I was not pregnant at this time, but I knew that when the time came for me to be pregnant, I wanted someone who was confident and supportive of me having this type of delivery. Also at that time, because I had gone through so much with the fibroids, I was young and I realized that I didn't know much about women's health. I didn't know much about pregnancy and childbirth. I didn't know anything outside of what I was experiencing currently, so I took it upon myself to learn everything that I could. I actually trained as a doula at that time because everything I was learning was fascinating to me, and then also I realized that what I was going through was quite unique and it was not going to be easy. I felt that I had to be confident with my understanding of birth and pregnancy so that I could advocate for myself better. Also at that time, I felt that because nobody that I knew and nothing on the internet pointed me to anybody else who had a vaginal birth after a myomectomy, I just took it upon myself to be the one. So I just was like, “Okay. If ever I get pregnant and I have a vaginal birth, I am going to shout it from the mountain tops and tell everybody what I did, how I did it–”Julie: Yeah!Mabel: Yeah, so if anyone is listening to this and they have heard my story on another birth podcast, it's not that I'm boasting, it's that I believe that education and anecdotal evidence is just as valuable as evidence-based information. And so I learned about VBAC. I actually started learning about childbirth by researching VBAC because I looked at myself as pretty much a VBAC patient or individual. I wasn't pregnant, but I just felt that when the time came, I had to look at myself like a VBAC person. I read a lot of research and I will share a lot of that at the end, but from what I have gathered over the past five years is that the risk of rupture for a woman who pursues a vaginal birth after a myomectomy is anywhere between .4% to 1.7%. You can imagine that with such a low risk of rupture, you would think doctors would be comfortable or okay with supporting women to have a vaginal birth, but what I found out during that time was that most doctors are not supportive of VBAC, so it was going to be quite impossible for me to find another provider who would be supportive of a VBAM. I went on the ICAN website and at the time, they had a list of providers in this DMV area, and they had a list of all the providers and their C-section rates. They don't have that anymore, but at that time they did. And so what I did is I went down the list and I chose providers who had a rate of 20% or lower and I just wrote it down in a notebook. I was making phone calls, then I would make appointments and I would go to the offices. And one after one, all of them barely gave me two minutes to even get the words out of my mouth. Once they heard what I was talking about and saw my report, they were like, “No.” I went to a dozen providers within a one-year span. Again, I wasn't pregnant but I knew that when the time came, I needed support and they all told me, “No.”I was extremely defeated, but I had a mentor. She was my doula trainer and she gave me the name of one provider. She said, “Just go to him. He is really cool. He has a pretty low C-section rate. I know him personally. Maybe he will support you.” And I went. I had an appointment with him and he did. He said, “I have never done this before, but I looked at your report and I feel like it's worth a try.”Meagan: Wow, that's awesome. Mabel: Yeah. It was amazing after getting all of those “No's” to finally have someone listen and hear me. Meagan: Yeah. I totally get it. That happened to me. I went to 12 doctors also and everyone was like, “You can try. I wouldn't.” To find that doctor to say, “You know what? Yeah. I'll support you in this. Let's do it.” It is so amazing.Mabel: It really is. It's a turning point and I know we talk a lot about supportive providers. I'll circle back on that, but the freedom you feel when you have a doctor that you respect and it's reciprocated goes so far. Meagan: Mhmm.Mabel: I always say that appointment was the turning point in my trying to conceive journey because I got pregnant the month after. This is for someone who had been trying to get pregnant for five years. It was like God was like, “Okay. This is your doctor. Now it's time.”Julie: Yes. Mabel: I just think it was very serendipitous. I am just so grateful for him. Julie: It was meant to be. Mabel: But I did. I got pregnant. Yeah, it was. I got pregnant and y'all, I had a great pregnancy. I was happy. I felt beautiful. I felt sexy. I was my strongest. I just loved being pregnant. It was probably one of the best times of my life. At around 26 weeks though, my doctor whom I love so much died. Meagan: Oh my gosh!Julie: Oh my gosh!Mabel: He did. He had a heart attack and he died. Meagan: Oh my gosh. Mabel: It was a huge blow for me not just because this was someone that I really leaned on for my dream delivery, but he was also a very, very well-respected and well-known OBGYN in this area. And so it was a huge blow for the community. Not just me, but everyone else and every woman who just wanted great, quality care. We lost a giant in the birth world. Meagan: Oh yeah. Mabel: So it was a blow for me because I didn't know what to do. Meagan: Right. Mabel: I decided to just forge on. At that point, once I knew that he supported me, there was nothing anyone else could say. So even if the other doctors in the practice started to show any type of hesitancy, it went over my head because I was like, “Dr. Gonzalez said he was going to support me. I don't care what y'all say.” I was very stubborn. However, they weren't pushy. They didn't ever talk about a C-section or anything, but the vibe was very different in the office. I decided to switch over to a midwife and OB practice. My doula suggested it and I gave it a shot. I had heard about midwives and obviously, I was trained as a doula so I was familiar with midwifery care, but because of my unique history of having a myomectomy, I just didn't see myself as eligible to be with a midwife if I could put it that way. Meagan: No yeah, that totally makes sense though because there are a lot of people who rule themselves out of midwifery care. They are totally qualified for midwifery care, but they don't think so. Mabel: Yeah, it's so true. Even at that time, I don't think I realized that there were hospital-based midwives. I had learned and known about birth centers and home birth, but I had never interacted with a hospital-based midwife. I would say it all aligned up accordingly because when I did switch over to that practice, I was 36 weeks. I was very far along in my pregnancy. They also told me, they were like, “Hey, look. We usually wouldn't do this. We are only doing this because we respect your doctor, Dr. Gonzalez.” So I had a feeling that if it was the other way around– if it wasn't for him, I don't think I would have found anybody in this area. So they took me in as a late transfer and at that point in my pregnancy, I was so firm on having a vaginal birth that I called the shots. I went to my appointment with all of the research that I had and I was like, “If you have any questions, you can read these articles. I am not going to talk about this.”Meagan: Good for you. Mabel: I was very, not annoying, but I just felt like at that point in my pregnancy, I didn't have time for any negative energy. Not from my inner circle and not from my medical team. They weren't pushy but they had their opinions on things. Long story short, the agreement we came upon was that I refused to be induced because I didn't want anything to lead to a higher risk of rupture. I was also diagnosed with gestational diabetes during my pregnancy and I had done my research. I had done my own risk assessment and I felt that if my diabetes was well controlled, I should be able to go past my due date. That was a big thing for me, having the freedom and having the respect to go past my due date without any pressure from my birth team. And they agreed. I made it to 40 weeks and eventually, at 40 weeks and 6 days, I went into labor.I will honestly say that it was a very straightforward labor. I went into labor in the middle of the night. I labored at home with my doula for hours. I think my first contraction was at 4:00 a.m. and I was finally ready to go to the hospital at 4:00 p.m. When I got admitted, I was 5 centimeters and I just continued to labor in our labor and delivery room. I did all the things. I was on the peanut ball and on the birth ball and doing all the positions. I was able to negotiate to have intermittent monitoring. They let me on and off the monitors every 40 minutes or so. And so I really, I am just really grateful I had a team that gave me the space to do things my way, despite how unique my uterine history was.At around 9 centimeters, by this time– I got admitted to the hospital at 4:00 p.m– I decided to get the epidural at around 1:30 a.m. the next day. I had labored for a long, long time and I was just so exhausted. They checked me. They said I was 9 and baby hadn't descended much and so I opted for the epidural to rest. It was the best decision for me. I took a nap maybe for a few hours and when I woke up, it was time to push. I pushed for about two hours and my son was born. I tell you, the minute he came out, I felt like my brain just exploded. We always say, “My mind was blown.” Literally, my mind was blown. I could not believe that for so long, I was told that vaginal birth was never an option for me, that my uterus was going to be destroyed and that I couldn't do it and that I shouldn't do it, and then finally, here comes this child out of me. I was like, “I can't believe I almost missed out on this opportunity. I can't believe that someone almost took this from me because they had never done it before.” Right? We call myomectomy a special scar. There are other special scars, right? Like classical, T-inverted, J-incision, and a myomectomy is one of them as well. I'm not here on this podcast to tell every person who has had a special scar that they should go and run out and have a vaginal birth. That's not what I'm saying. But what I am saying is that because many times the literature is– there's not a lot of it, right? So because there is very minimal research done on this topic, a lot of us are just categorized as extremely high-risk and it's not even worth it for us to go on to even pursue a vaginal birth.  I feel like the whole process of leading me to the birth of my first son was really a lesson on self-education and self-advocacy. I know that I am supposed to be sharing my birth story, but this is really just about the work that it took for me to have this vaginal birth because, to be honest, my birth story is not any more special than the next woman who has had a vaginal birth. But what it is, is understanding and believing in physiological birth with the hopes that your body will do the work that it is intended to do despite the fact that it has gone through surgery. And so at that moment when my son was born, I was just like, “There is nothing anyone can tell me that I can't do.”The fact that I had this child after a myomectomy, after multiple fibroids, after such a hard trying to conceive journey, and it was pretty much a seamless delivery, I was so, so, so proud of myself and I truly felt empowered at that moment. He was born and he was beautiful, and he was big. He was 9 pounds, 6 ounces and I am just so happy that I gave myself that chance to have the opportunity to experience a vaginal birth. I will say that birth is not without risk. VBAC is not without risk and the same thing for vaginal birth after myomectomy. After I had delivered him and my body was ready to deliver the placenta, I experienced a hemorrhage and it was quite a severe hemorrhage. It was something that personally blindsided me. After all the research I was doing, I had never really read about things like that. So it was scary. But it was handled swiftly and it was handled very well. I believe I was in the right place and in the right environment to help my body recover immediately after. And so I did have a hemorrhage and I personally will say that I can't attest it to the myomectomy. It could have been a number of factors as to why I hemorrhaged. Thankfully, through a variety of tools, they were able to manage the hemorrhage and I was able to tend to my baby and breastfeed as soon as possible. I went home within the usual time frame for a vaginal birth. After that delivery and that experience, I was so thrilled and empowered by that experience that I told my husband that if I had the opportunity to do it again that I would love to do it at home or at a birth center. So for my second, I had my second son last year. I pursued a birth center delivery. Again, I had a beautiful and wonderful pregnancy, very straightforward. We did talk about my risk of hemorrhage, and so we came up with a plan as to how to actively manage a hemorrhage, but for my second, again, my body went into labor at 39 weeks. I labored for a couple of days, and then finally it was go-time. I think I had about three hours of active labor and he was born at the birthing center. With him, I had a water birth.And so just looking at the whole scheme, the whole experience of being pregnant twice, having two vaginal births after a myomectomy, it makes me feel that for anyone who is seeking a vaginal birth after any uterine procedure whether it is a C-section or a myomectomy, there is a lot of work that has to be done emotionally and mentally, but it is very possible. I am so sorry when I hear other women who have had a myomectomy be told immediately that they have to have a C-section because we know what that language does, that terminology of “have to”. It makes us feel that we are incapable, that birth is absolutely dangerous for us and it's not true. There is a difference between absolute and relative risk and for me, I leaned on the relative risk and I succeeded. For my second born, even though I did not hemorrhage with him, I did have issues with delivering my placenta, and so even though his birth was beautiful and perfect, I did have to get transferred to the hospital to remove my placenta which actually came out quite easily when I got there. But it took some time when I was at the birth center, so we transferred over to the hospital to deliver the placenta.Both deliveries were quite traumatic to my body. Not to me emotionally, but for my body, it was a very traumatic experience. But I like to talk about these things because I think transparency is important, and then I also say this with the understanding that just because it happened to me doesn't mean it's going to happen to you. I don't think that just because we hear other women go through some unique experience that it should deter you from pursuing your goal. I think we are all capable of assessing our own risks and making the right decisions that are important to us. I could go on and on about this.Meagan: No, I love it.Julie: We are just sitting here soaking it all in.Meagan: But it really is, it's such an important thing to remember that just because someone says this, it doesn't mean it's not right for you, and then just because someone had a really good, positive experience doesn't mean it's going to be your experience either. It's so hard. It's just how we have to go through life in all things because everyone is different. Everyone has a different circumstance. Everyone has a different body, everything. Even though one pregnancy goes one way doesn't mean the next pregnancy is going to go the other. And so it's just so important to remember that. But I just love how you fought for what you felt was right for you because that is a really, really, really hard thing to do. Like, a really hard thing to do.Mabel: Oh yeah. It is.Meagan: Yes, and then to have such a traumatic experience like, “What the heck just happened? I just lost my doctor and the support that I was getting after looking for so long.” That had to just have shaken you.Mabel: Oh gosh.Meagan: So I am just so proud of you.Mabel: Thank you. You two are doulas. I am a doula too, so this is kind of going into the doula speak.Julie: Yep.Mabel: As doulas, especially for our VBAC clients, we stress so heavily finding a supportive provider. We do. We make it almost seem as though if you don't have one, good luck to you, which, actually for me over the years, not just with my experience but with others and my clients, I have come to realize that not every VBAC hopeful is going to find a supportive provider. You have to come to terms and accept the fact that your doctor just may not support you. They may say or do things to deter you from making that decision, but despite that, you must press on anyway. And for me, especially when Dr. Gonzales died, at that point, I could've just been like, “Well, you know. I tried.” But at that point, I was like, “I'm going to have this baby whether he is alive or not. I'm going to have this a baby whether he is on call or not,” because we know that happens too. You can get somebody else and everything seems like a chaotic event. That's something that I really feel personally about is that even if you don't have a supportive provider, you still have the personal responsibility to know your rights and to know your options for your VBAC birth. You can't lean on your doctor for the decisions that are only for you to make. That's how I pursued my birth experience. That's almost how I lead with my clients in the sense that we are just going to gather all of the information that we can get and use that as a decision as a means to make a decision. Of course, your doctor may say or do certain things and you may agree or disagree, but at the end of the day, this is about you. This is about you and your baby and your body and it's going to be up to you to make up your mind to press on or to allow all of the negative energy or all of the conflicting information to haze your view.I feel that for me, I am no more special than the next person. I'm not. It's not like I got lucky. It's not that I am super smart, it's just that I made up my mind. I made up my mind and I hope that for anyone listening to this that if you are ever unsure or if you feel like, “Oh, my partner doesn't support me” or “My mother-in-law says this” or “My doctor doesn't tolerate me,” you need to make up your mind and then from there, you move forward. If you need to hire a doula, if you need to take 20 different birth classes, if you need to read all of the books, if you need to pray, if you need to replay all of the podcasts, you do what it takes to get to where you need to be. Even if the outcome varies from what you were hoping for, at least you can say you did everything you could. And that's how I forged on for this delivery experience because I didn't have– there's nobody on YouTube. There's nobody on Google. There's nobody in all of the birth clubs on Baby Sector. There's no podcast of anybody who has had a vaginal birth after a myomectomy. However, I know it's been done. There's no way that they could have done all of that research. There were women that had to be a part of that research. So even if you don't know anybody in your life or your inner circle who is pursuing a VBAC or a VBAM, it doesn't mean that it can't be done. I think that's how I looked at it like, “Okay. I don't have anybody that I can use as a resource or as a reference, but I know that I am not an anomaly and I also know that I am not asking for too much. I am not asking for a vaginal birth. I'm asking for support. I'm asking you to hear me. I'm asking you to give me time. I'm asking you to let my body do the work. Let my body do the work instead of you dictating what you think my body should do.”I don't think it's too much to say that if I don't want another surgery, I don't want another surgery. I think that's the part that blew my mind when I started learning about advocating for myself. The fact that my pursuit was not about what my body was able to do. It wasn't about my body's ability. At the core of it, it came down to liability. What are these hospitals and doctors liable to? It's easier and “safer” for them to do a C-section than to let my body have a trial of labor, but nobody was telling me about the risk of a C-section. Nobody told me the risk of having a C-section at 37 weeks. They just told me I had to have one. If I hemorrhaged with vaginal birth, God knows what could have happened with a C-section, but nobody told me about that.So a lot of these things boiled down to pulling what you understand about birth and what you have read as the evidence but then also believing in anecdotal evidence. I believe that a woman's experience is just as viable as evidence and as something that I have found on a Google search. This is just how I approached my birth. And I mean, I'm sorry. I feel like I am on a soapbox or something. Julie: No, are you kidding me? I am sitting here listening to you and I am just like, “Yes!” I have had goosebumps for days over here. Oh my gosh. I am just like, “Do you want a job?” Because I would love to just sit and listen to you go on and on about all of the things you are talking about. About how you're not asking for a vaginal birth, you're just asking to be supported and you are just asking for somebody to listen to you and let you have things the way you want to experience them. Obviously, there are caveats that go in there that we want your safety and we want you to be healthy and everything like that but you just want somebody to support you and believe in you. That just gave me so many chills. I just loved it. Mabel: Yeah. There's no reason why we should have such a low VBAC rate in this country. Absolutely not. Knowing how successful the majority of women should be, there is no reason why we should have a 9-10% VBAC rate in this country. Learning about VBAC helped me to realize that this is not about the vaginal aspect. This is about women's rights if we really wanted to get to the core of it. This is about a woman's right to make an informed decision or to make an informed refusal. And unfortunately, we are looked down upon if we refuse what our doctors or midwives or whatever the medical team says. And so for me, of course, I was like, “No,” and I was looked at like I was crazy. How dare you want to go against our hospital's protocol. But when it comes down to it, I had the right to do that. It's almost like if a woman has breast cancer and you tell that woman, “Hey. These are all of your options. You can go do this surgery. You can take this medication or you can do nothing.” If that woman said, “I don't want to do anything,” it is not that doctor's place to do and say everything to coerce her or to scare her into changing her mind. It's not the doctor's place to do that because you have given her the information. You have given her the risks and the benefits of her options for treatment and if she decides to do something contrary to what you have decided for her, then you have to respect that and the same thing goes for VBAC. If you tell this woman, “Hey, these are all of your risks and benefits. These are all the things,” and she says, “You know what? I still want to pursue a VBAC,” it is wrong to apply every fear tactic and every coercion and every barrier to make that woman comply with what you want. That's what is going on in America today and that's why we have such terrible outcomes. I am speaking this as a black woman, right? A black woman who is highly susceptible to fibroids, a black woman who is highly susceptible to maternal mortality, a black woman where in America, black women have the highest rate of C-section. We do. We also have the highest rate of poor outcomes, not just maternal mortality but even neonatal mortality. So this is bigger than what anybody can think about. This is really coming down to the core of what type of care are we giving women? Are we just giving everyone the run-of-the-mill care or are we individualizing it according to this woman's needs? Obviously, it's not the latter. If we were individualizing maternal healthcare, we would see better outcomes. We would see more VBACs. We would see fewer hemorrhages. We would see less death. But until that day comes, you as a woman can't go into birth blindly. You can't go into VBAC blindly. You can't go into your first birth blindly. You have to have your eyes, ears, heart, and mind open because a lot of things can be unpredictable, but I'll tell you, it's not birth. Birth isn't as unpredictable as everyone says. Usually, what makes it unpredictable are a lot of the factors that our medical system imposes on us. So I don't know. I'm going to stop talking because I'm getting hot, but I had to say this. Julie: No, I love it. Mabel: I do say this by saying that vaginal birth after myomectomy is possible. It is. I had one. I know many women have had one. I am a part of a special scars group and our rate of vaginal birth after myomectomy is quite high. For the women who did not have a vaginal birth, it was not due to uterine rupture. So I'm saying that for the small number of women who have pursued vaginal birth after myomectomy, they either had the vaginal birth or they had a C-section but it was not related to rupture. I had even counseled other women who reached out to me and a number of those women have gone on to have vaginal births. I have had three clients who hired me. They had a myomectomy and they went on to have a vaginal birth. A couple of them have even had unmedicated vaginal births for their first child. So I feel like anything is possible if you have the support and the heart to go for it. Julie: I absolutely love that. You are 100% right. You had a lot of things working against you. You had the myomectomy. You had provider switching. You had to change providers near the end of your pregnancy and you're dealing with a unique type of a special scar which, yes, plug in for the Special Scars Facebook Group page, and the website is specialscars.org. Like you said, as a black woman birthing in America, your Cesarean rate is four times as high. You are two to three times more likely to die in childbirth. Those are things that are inherently wrong, frankly, just wrong with our medical system right now. I absolutely love that you kept saying in your story that there's nothing special about you, but I disagree 110%. I think that everything about you is special and I am just so grateful. I know Meagan is going to talk in just a minute, but I just wanted to thank you so much for coming on and sharing your story today because you are an incredible woman. Are you still practicing as a doula? Mabel: I am, but this is my last year practicing because yes, I am going back to school to be a midwife. Meagan: Yay!Julie: Yes. We need more. Meagan: I was going to say, “To be a midwife!”Julie: Yeah, yeah. Meagan: Oh, that makes me so happy. Seriously though, you are going to change your birth community. You are going to completely change your birth community. Julie: Absolutely. Meagan: You are mind-blowing. I got the chills listening to you. Like Julie said, you could go on and on and on. Julie: We would just eat you all up. Meagan: Yeah. Julie: We are eating all of your words up. Meagan: There's not one second that I would be like, “Oh my gosh, this chick is talking forever.” Nope. I'd be like, “Give me more. Keep talking.” You are amazing. Mabel: Oh my gosh, no.  Meagan: You are so awesome. So awesome. And same as Julie, I am so grateful that you could be on the podcast and share this story because like I said, we have people writing us asking and saying, “We want a vaginal birth. Is this possible? Is this possible at all?”Seriously, so, so happy for you.Mabel: Yeah. This is not your typical birth story podcast. I guess the flow of this conversation isn't like the others but I do hope for anyone who's listening if ever they had a question or inquiry or if they even just wanted to chat, I do offer consultations. Even though I won't be practicing as a doula for a while, I am still available in different ways. Julie: Absolutely. How can people contact you? Mabel: Yeah. You can reach out to me. I am very active on Instagram. The name of my business is Within Her Birth Services. You can find me on Instagram @withinherbirthservices and through that platform, you can find my email address or DM me. Also, you can check me out at www.withinherbirthservices.com. So yeah, that's how you can find me. Julie: Perfect. Meagan: Oh my gosh, amazing. Thank you so much, seriously. Seriously. Julie: Yeah, thank you. ClosingInterested in sharing your VBAC story on the podcast? Submit your story at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Now, in this episode the host talks about how things meal wise has been for her after her health situation and lifestyle change of her Myomectomy largely. Also, the host shares some factual information from imperial college health care trust in the United Kingdom (UK) from the national health service, which one may find useful, if you want to know more information on how to better manage your eating habits and meals check out the link below: https://www.imperial.nhs.uk/search?keywords=soft+and+bitesize+foodMoreover, if you have found this podcast episode useful consider liking it, and subscribing to the channel for more health tips and consider leaving a review on apple podcasts, by clicking the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333In conclusion, if you would like to see the host and connect to her socially, you can check out her Tiktok, twitter, or you tube or all three, which the links can be found on her website by scrolling to the bottom of the page on the website. http://hannahboyce.supapass.io

In this Hot Flash, we do a quick and dirty overview of one of the most serious perimenopausal symptoms - heavy menstrual flow. We define what constitutes too much bleeding, when to be concerned and what to do about it. ****IMPORTANT NOTE at about 8min and 10 seconds in I mention not taking iron at higher dose than 8 mg per day without monitoring - it sounds like I say 80mg but it's 8(eight)! Truly, any iron supplementation outside of food sources should be monitored with lab testing to ensure proper dosing and prevent complicationhttps://www.kindara.com/https://helloclue.com/Testing ferritin to evaluate iron stores: https://medlineplus.gov/lab-tests/ferritin-blood-test/Evidence for dosing iron every other day: https://pubmed.ncbi.nlm.nih.gov/31413088/Iron IVs for treating iron deficiency: What to Know About Iron Infusions for Anemia Treatment - GoodRxDairy and heavy menses: What Dairy Does to Periods • Lara Briden - The Period RevolutionarySlow Flow: https://vitanica.com/online-store/slow-flow-60-capsules/ (no affiliation)Acupuncture case study: Acupuncture treatment for dysfunctional uterine bleeding in an adolescent - PMC (nih.gov)Ibuprofen for heavy menses: Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding - PubMed (nih.gov)Tranexemic acid for heavy menses:Tranexemic Acid (Lysteda) for Cyclic Heavy Menstrual Bleeding - STEPS - American Family Physician (aafp.org)Guidelines for progesterone therapy and a review oftreatment options for heavy mense from CeCor: Very Heavy Menstrual Flow | The Centre for Menstrual Cycle and Ovulation Research (ubc.ca)Hormonal IUD for treatment of heavy menses: Reproductive Health Access Project | Contraceptive Pearl: Progestin IUD as Treatment for Menorrhagia - Reproductive Health Access Project (reproductiveaccess.org)Oral Birth Control - new brands with bioidentical estrogens for management of perimenopasual heavy menses: Natazia: Official patient website or About NEXTSTELLIS | NEXTSTELLIS®(drospirenone and estetrol tablets) Uterine ablation: Uterine Ablation as a Treatment for Severe Menorrhagia – Naturopathic Doctor News and Review (ndnr.com)Myomectomy for fibroids: Myomectomy – Fibroid Treatment CollaborativeSex after hysterectomy: Post Hysterectomy Sex: Your Guide To Sex After Hysterectomy (dofeve.org)Health impact of hysterectomy and age of menopause: What We Know about the Long-Term Risks of Hysterectomy for Benign Indication—A Systematic Review - PMC (nih.gov)

Now, this episode is largely about the host talking about her experiences with expectations after her Myomectomy health experience and situation. Moreover, the host has gotten a definition from the website below of dictionary, Cambridge, org, so if you want to check out the research feel free t do this action. https://dictionary.cambridge.org/dictionary/english/expectationAlso, in the first segment of this podcast episode and show, the host got some valuable research from the website called,         which is linked below. Moreover, if you have found value in this podcast show or episode, feel free to leave a review on apple podcasts, below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Moreover, if you want to support the host on her other social media channel, either tiktok, twitter, or you tube, you can go to her website and click directly on the link at the bottom of the page, her website is listed here, and below for your perusal: http://hannahboyce.supapass.io

Listen to Michelle Clark, a mom of 3, womb wellness coach and a world-champion in double dutch explain to Heather how she was once told by her doctors that the only way she'd ever have children was if she got an abdominal myomectomy due to a fibroid, but instead how she decided to try fasting and got rid of the fibroid naturally.    In this episode, Heather and Michelle discuss:  Why Michelle opted not to get an abdominal myomectomy and try fasting to get rid of a fibroid instead   How to get rid of fibroids naturally through fasting  Why some patients prefer to be told that something they are doing is creating a situation in their body.  What a heavy, painful period is a sign of Michelle's book, Bye Bye Fibroids Various options available for fibroids  Why a bad experience with a doctor causes patients to look for other options  Michelle Clark is the co-owner of DoubleDutchAerobics and a Womb Wellness Coach, specifically focused on helping women eliminate fibroids naturally with the intention of getting pregnant. After 2 miscarriages and multiple doctors telling Michelle she could not have a baby without an abdominal Myomectomy, Michelle is now a Mom of 3. During a 17-day water fast Michelle had a fibroid fall out in the toilet. Along with fasting and diet change Michelle was able to prove doctors wrong and had children without the abdominal Myomectomy. Now she's on a mission to help women heal their wombs for their fertility. Also, Michelle and her husband Sean Clark are the Owners of Double Dutch Aerobics Studio in Atlanta Georgia. She's a world champion in DoubleDutch. She's been featured on Wendy Williams, Good Morning America, essence magazine, New York Times and more. https://www.doubledutchaerobics.com  Heather Grzych is the author of The Ayurvedic Guide to Fertility and the host of the Wisdom of the Body podcast. A board-certified Ayurvedic practitioner, she teaches the Regenerative Fertility Method to support future generations worldwide. Heather is on the board of directors for the National Ayurvedic Medical Association (NAMA) and has consulted with doctors, governments, and insurance companies. She offers virtual consultations and programs worldwide. www.heathergrzych.com   Connect with Heather: Instagram.com/heathergrzych Facebook.com/grzychheather   Book a connection call with Heather to explore the Regenerative Fertility Method and the Ayurvedic approach to health, vitality and fertility:  https://www.heathergrzych.com/book-online   Join the Wisdom of the Body club on Clubhouse: https://www.joinclubhouse.com/club/wisdom-of-the-body   This podcast is for educational and entertainment purposes only.

Now, this podcast episode is primarily about the host sharing her deepest and most inner most thoughts around the time leading up to her going through this major women's type of surgery and health situation, it is in a diary form as her podcast show is mainly about, however the host has listed some reference to a website called healthline.com where she got information about self talk and positivity within ones self, and if you are interested in looking at this information further then you can click the link here for more information on self talk: https://www.healthline.com/health/positive-self-talk#benefits-of-self--talkAlso, the host mentioned she will be going live to answer questions and have a general chitchat on the you tube on Saturday 12th March 2022, maybe with another slice of chocolate fudge cake or two, and a cup of tea or coffee, and if you are available and want to join the live chat you can check out Overfortieshealth on the youtube or alternatively you can go to the hosts' website where you can find her most active media channels on the page, which are tiktok, you tube and twitter. http://hannahboyce.supapass.ioMoreover, the host mention a lady she briefly spoke to when she was going through her earlier recovery process from the Myomectomy surgery, and this youtuber is called glizzer buzzinfo, and you can check her channel, by going to glizzerbuzzinfo. Lastly, the musical tracks in this podcast episodes is from youtube audio library, one is called 'Cavemen of the future' by Joel Cummins, the host used this track, when she was telling some of her story in the podcast episode, and the outro track for the first diary piece on 9th March 2022, which the host used, is called, ' Inspired' and this artist is called, 'Neflex. Also, if you like any of the podcast shows/episodes in an audio diary please feel free to write a review on apple podcasts, by going to this link: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Next, you can sign up to good pods where you can individually comment on podcast episodes of podcasters. 

In episode 22 we talk to the beautiful Abby Mckibben about her long and very trying journey with infertility. Abby always knew she might have some trouble conceiving as she had suffered from endometriosis from a very young age. Over 8 years Abby went through countless laparoscopic surgeries and had a Myomectomy which is major surgery to remove a fibroid growing in her uterus. The recovery for a surgery like this is similar to a caesarean which put a huge holt on her IVF cycles. After taking some time and letting her body fully recover, Abby dove back into IVF with a new fertility specialist. Unfortunately, this round involved higher doses of medication and Abby's body did not handle this well as it led to a severe case of Ovarian Hyper Stimulation Syndrome (OHSS). This got so bad to the point that one of her lungs nearly collapsed from having so much fluid trapped. Devastatingly, Abby's specialist did not want her to undergo another IVF cycle due to the severity of how her body handled the last round, this meant that Abby was left with one chance to conceive her rainbow baby. At this point Abby and her partner felt that their dreams were near impossible, and they were coming to terms with the fact that they may not ever be able have a baby. The universe had other plans for Abby though, as it new she was destined to be a mother and she was finally blessed with her little rainbow baby, a true miracle for their family. Abby was thrown every hurdle possible on her trying to conceive journey but she did not give up, she is the definition of a super woman and now super mum! If you haven't already, please jump over to our Instagram page @infertilityandbeyond_ and show us some love!! & If you enjoyed this podcast don't forget to subscribe and leave us a glowing review!

God used a team of doctors to save Kacie's uterus & sent someone from across the world to provide emotional support. “A delay is never a denial.” Plus, something happened in our interview that's never happened before. So we left it in. This is her story. The Hope Narrative is coming to Jesup, Georgia on April 30, 2022! Visit hopenarrative.org to register. For more about Sarah's Laughter, please visit our website at sarahs-laughter.com. You can follow us on social media linked here: Sarah's Laughter on Facebook & Instagram, and @sarahs_laughter on Twitter. Sarah's Laughter is a 501(c)(3) non-profit public charity. If you'd like to help support what we do, including this podcast, please visit sarahs-laughter.com/give. Thank you. Want to share your infertility story on this podcast? Email us at podcast@sarahs-laughter.com

Now, this episode was inspired by going to a virtual event in 2021, Podfest. Also, the host wanted to do this episode as after her Myomectomy surgery she has been fascinated with the human body and all things science related, and wants to know and is curious to know how her body works as well as how her mind works going forward. Moreover, this episode is mainly a chitchat show, however there is an exercise one can do to practise gratitude for their body if one likes in the episode and their is some top ten tips on how to keep ones body well and lose weight if one wants to lose weight or maintain a healthy body after they have gone through a particular surgery or are awaiting to go through a particular surgery or health situation, but the tips is not limited to those people anyone who wants to live a healthy life can utilise these tips within the podcast episode. More importantly, the websites used in the podcast episode are as follows: http://dailyrecord.co.ukhttp://livescience.comAlso, if anyone wants to check out the hosts' you tube channel it is Overfortieshealth and they can check it out by clicking on this link here: https://www.youtube.com/channel/UCGv5di1o7ZBHvbgveT0vDIg or alternatively going to the hosts' website and scrolling to the end of the page and going to the you tube channel this way and connecting to the hosts' via her social media platforms, her most active ones of tiktok, twitter and you tube. http://hannahboyce.supapass.ioBesides this, the host mentioned that one can listen to another podcast by Hal Elrod, episode 414 of his, this is a particular podcast the host found very interesting in January 2022, and it was uplifting and if anyone feels down or a little distressed they could check this podcast episode out for some uplifting words and guidance to their health and mental well being, it was definitely inspiring to the host and for the host, of this podcast episode to date. Lastly, if one likes this podcast episode or any of the episodes they have heard on an audio diary a personal health journey then they can leave a review by clicking on this link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

So I had been living with fibroids for so long and they affected my health really badly. In this podcast I talk about the aftermath of fibroids after pregnancy and my experience with a Myomectomy. You can watch my video on YouTube about my experience with fibroids during pregnancy by clicking the link: https://youtu.be/SNcsOSuk310 --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/africanladyandababy/support

In today's episode Abby bravely shares her journey with infertility. Abby was diagnosed with endometriosis at 17 but it wasn't until she was in her early thirties that she started actively trying to fall pregnant. Her egg count and quality was excellent but her endometriosis posed significant complications. Abby takes us through the physical and emotional pain of her journey, the comfort in talking to other women on the same path and the light that came with her very last embryo, baby Remielle.

Now, this is a Bonus episode while the host is on a short two week break, collating ideas together for other episodes and shows, as well as just generally taking time out for herself. Moreover, Hannah wanted to make up this episode to give others an idea of what one may eat in a day, after their Myomectomy surgery or health situation, although every person is different, generally ones intake of food after a Myomectomy surgery is limited quite a bit. Also, Hannah, has added some factual information to go with some foods she has spoken about in this bonus episode and they come from healthline.com, and you can visit the website by clicking this link here, if you want more information: https://www.healthline.com/health/five-reasons-to-eat-spicy-foodsBesides this, if you like this episode or any other episode in an audio diary a personal health journey, feel free to leave a review on apple podcasts by clicking this link here, as it helps the host get more recognition and be more findable, and 'we' are one team working togetherhttps://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you want to check out some of the hosts' blog/article post so far, on her website, feel free to look them up at this link here: http://hannahboyce.supapass.XYZAlso, if you want to connect to the host on her most active social media platforms feel free to connect to her on either one of these platforms or all three if you like. @Miss Boyce  youtube @missboyce2020 Tiktok @babyface2012 @twitter 

Now, this is a bonus episode where the host talks randomly about a day in a life after surgery and being unemployed. Also, every day the host has found new challenges so to speak, sometimes she has her good days and other times she has a bad day, but it is all about adjusting and readjusting to her lifestyle change after her Myomectomy surgery and it has been amazing, to say the least, but support is key after one has had a lifestyle change such as this. Moreover, this episode is a random chitchat from the host, and the host has taken a point from healthline.com website where she found some information about the snack pretzels a few days ago, feel free to check it out here: https://www.healthline.com/nutrition/are-pretzels-healthyAlso, if you like this bonus episode, feel free to leave a review on apple podcast by clicking the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to check out any of the hosts' blog/article post feel free to go to her website at http://hannahboyce.supapass.XYZ for more information and the PO box address should be up soon, God willing life be spared. Besides this, if you would like to follow the host on her most active social media platforms you can visit her platforms on either TikTok, you tube or Twitter. @missboyce2020 TikTok @Miss Boyce youtube @babyfaceboyce twitter

Now, this episode is like a one off episode where Hannah tells all, about lifes ups and downs prior to her Myomectomy surgery and where all her emotional distress first started from so to speak, within the family home, as Hannah is sure a lot of people have emotional and dysfunctional families in life, however Hannah believes and is a firm believer that if one has a strong and good supportive network in life, then one can do and accomplish anything they set there mind to, and Hannah believes support is a big and key thing for ones life going forward. Moreover, in this episode you can expected to find Hannah expressing her past situation and the effects it had on her psyche, and you can expect to get a picture of Hannah's life prior to surgery and why Hannah feels so strongly about solving problems and living her best life going forward after surgery. In addition, some of the websites that Hannah used in this podcast episode towards the end, is linked here: http://https://giveanhour.org/changedirectionhttp://https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10560-yBesides this, the second website, is the website Hannah got the definition from of what psychological means and what the word emotional means, and then Hannah decided to change the title of the podcast episode from psychological to emotional distress prior to surgery. Also, if you like this episode please feel free to share it with a friend or a loved one whom you think may benefit from it, or alternatively you can write a review on apple podcasts by clicking this link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to connect to the host further, please feel free to look her up on her most active social media platforms of tiktok, twitter, or you tube.@missboyce2020 tiktok @missboyce You tube channel title @babyfaceboyce TwitterNote: Now, this episode might be upsetting to some, to hear, and Hannah just wanted to put a note on the description in case you find things of this nature, upsetting. 

Now, this episode is a general chit chat about the covid vaccination, and some of the side effects one can expect when they go through having the covid 19 vaccination. Also, in this episode, the host Hannah doesn't go into specific about which vaccination to have, but rather chats about her own experiences about having the vaccination after she has had her Myomectomy surgery, and she explains how important it is for one to look after her health both mentally and physically. Moreover, Hannah uses a link from the national health service website about some of the side effects one can expect from covid 19, and if you want to check out this link, please feel free to click here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/safety-and-side-effectsAlso, if you like this episode, please feel free to share it with a friend, or alternatively you can write a review on apple podcasts by clicking this link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to make contact with the host via her most active social media platforms, feel free to look her up on tiktok, twitter or you tube, where is is actively putting up videos. @missboyce2020 tiktok @Missboyce you tube @babyfaceboyce

Now, this episode is like a revamp of a previous episode that Hannah had in an audio diary a personal health journey of milestones after surgery, but instead of it being broad, it may become a regularly thing, as Hannah feels it is extremely important to visit the milestones in life, whether the milestone is big or small, it can help ones psyche going forward and help one to progress further onto bigger things in life. Also, this particular episode focuses on smaller milestones that Hannah has recently uncovered about her life going forward after her Myomectomy surgery, and Hannah feels it is sometimes the smaller milestones in life that is the most important, as this can pave the way for the larger milestones in ones life. Besides this, if you enjoy any of Hannah's episodes in an audio diary a personal health journey feel free to leave a review on apple podcast by clicking the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333In addition, if you would like to connect with the host further feel free to look her up on her most recent social media platforms of tiktok, twitter or you tube. @missboyce2020 tiktok @Missboyce Youtube @babyface2012 TwitterLastly, if you would liek to see blog posts, articles from the host and a selection of videos, recipes of foods the host has incorporated in her life after her Myomectomy surgery, feel free to check her website out, by going to this link: http://hannahboyce.supapass.XYZ

Now, in this episode Hannah the host talks about her life after surgery with food. Moreover, each and every individual in life, has a relationship with food one way or another, and after Hannah. the host has gone through her Myomectomy surgery, she has found some of her relationships with food as well as drink have been different then prior to surgery and is different today, and if you would like to know about her Hannah has managed her lifestyle change so to speak after her Myomectomy surgery, then look no further then this episode to date, as this is probable the most proudest episode Hannah has done to date, although every episode in an audio diary, a personal health journey has it's own unique feel and sound, Hannah feels extremely proud of this particularly episode to date (Thursday 26th August 2021 completed). In addition, if you have liked any of the sounds in an audio diary a personal health journey then feel free to leave a review on apple podcasts by clicking this link here:https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333 Also, if you would like to connect further with the host, feel free to look her up on her most active social media platforms of Tiktok, Twitter and you tube. @missboyce2020 Tiktok @Missboyce you tube @babyfaceboyce twitter More importantly, and finally, some of the links Hannah has mentioned in this podcast episode comes from the websites: http://www.healthline.com , https://www.eatthis.com/mcdonalds-news/ and http://webmd.com Also, if you like Hannah's work and sound of her podcast show, feel free to check her website out where she is slowly putting articles out, blog posts out and eventually she plans to have some merchandise of her own brand for others who believe in gynaecological health as much as Hannah believes in gynaecological health, the website link to go to is: http://hannahboyce.supapass.XYZ and Hannah still has her older website blog on Wix, which can be found at the free domain name here: if one wants to check out her older blog posts. 

Now, this episode was inspired by the host's recent journey on bank holiday Monday in May 2021 at the end of the month, when she took a trip down south to see her family. Moreover, the host felt it was and is necessary to talk about the impact one may feel after a myomectomy surgery, this can be great or a significant change to the patient and to the family and friends of the patient who had the Myomectomy surgery and the host Hannah thought it would be nice to hear from different people prespectives on how the patient has changed after their Myomectomy surgery, and what adjustments the people in the patients' life have had to make as well. In addition, this first episode takes a look at the patients' perspective of the Myomectomy surgery and how she is coping with life after her Myomectomy surgery. Also, the host has put in some factual information taken from  the betterhealth website, and if you would like to view this information in more detail, please feel free to click the link here for information: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/myomectomyNext, if you like this episode or any other episode you have heard from the host Hannah, please feel free to pass it onto a friend, or alternatively leave a review on apple podcasts as this will help the host to grow her community and make others aware of the procedures of the Myomectomy journey from beginning to end. In conclusion, if you would like to contact to the host on her most active social media platforms you can do this, by connecting with her on either you tube, twitter or tiktok. @missboyce2020 tiktok @babyfaceboyce twitter@missboyce youtube 

Have you heard of the term myomectomy? Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before.  Myomectomy is the preferred fibroid treatment for women who want to become pregnant. Today's guest experienced infertility and gave birth to her stillborn son at 28 weeks.  Kima Tozay was diagnosed with Fibroids and endured a myomectomy surgery to remove her fibroids.  She explored IVF that was unsuccessful and was able to get pregnant twice an early twin pregnancy loss and a 27 week stillbirth due to preeclampsia.  In this episode Kima shares how she know helps advocate for those who have experienced infertility and pregnancy and infant loss and how she is keeping her son Jaxson's memory alive by spreading awareness about maternal and infant mortality in communities of color.  We also discuss her next steps on her journey to motherhood that includes fostering to adopt. This episode is for you to listen to if you have experienced stillbirth or fibroids and have considered a myomectomy to remove them.  This episode is for you to listen to if you have considered fostering to adopt as an option to grow your family. Become a Sisters in Loss Birth Bereavement, and Postpartum Doula Here Living Water Doula Services Book Recommendations and Links Below You can shop my Amazon Store for the Book Recommendations You can follow Sisters in Loss on Social Join our Healing Collective Online Support Group Join the Sisters in Loss Online Community Sisters in Loss Instagram Sisters in Loss Facebook Sisters in Loss Twitter You can follow Erica on Social Erica's Website Erica's Instagram Erica's Facebook Erica's Twitter

Now, this episode is about some of the losses one may experience after they have had a surgery.Moreover, in this episode, it is an overview of some of the psychological losses one may experience in their lifetime when they have gone through a surgery.Also, Hannah shares some of her own personal stories with you, in terms of relationships she has had and it has become a bit stilted since after her Myomectomy surgery and her major lifestyle change.Besides this, Hannah has gotten research from the medical news today website, which you can view here, if you want to know more information about some of the psychologically losses after surgery. https://www.medicalnewstoday.com/articles/317616In addition, if you like this episode, or any episode you have heard in an audio diary a personal health journey, feel free to leave a review on apple podcasts by clicking the link here:https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to connect to the host on her most frequent social platforms feel free to connect to her either on twitter, tiktok or youtube.  Also, the host's blog posts website is going to be changed from hannahboyce.net to another free domain name after July 3rd 2021, however the host will let you know more information if you would like to check out the blog post from her recovery after her Myomectomy surgery.tiktok @missboyce2020youtube @missboycetwitter @babyfaceboyce

Now, this episode is about some upcoming events that Hannah, was invited to and decided to go to, after the pandemic crisis rules and regulations were relaxed within the UK. Moreover, in this episode, it is a relaxed chitchat were Hannah shares her thoughts about going to some events, after a big crisis and more importantly after her Myomectomy surgery. Next, if you like any of the episodes you hear, please feel free to leave a review on apple podcasts by clicking the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, if you would like to connect to the host further, please feel free to connect with her on her regular social media active platforms of tiktok, you tube and twitter. @missboyce2020 tiktok @babyfaceboyce twitter@missboyce you tube

Now, in this episode the host Hannah talks about various situation she has encountered after her Myomectomy surgery, and this episode mostly focuses on the good points of taking a trip down memory lane for ones health and well being. Also, Hannah mentions a store in the UK called CEX in the episode.Moreover, if you like this episode or any other episode of an audio diary a personal health journey feel free to click the link here, and leave a review on apple podcasts, this gesture would be much appreciated. https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to connect to he host further on her active social platforms, feel free to find her on you tube, twitter or tiktok, where is most active. @missboyce2020 tiktok @babyfaceboyce twitter@missboyce you tube title. 

Now, in this episode, Hannah the host speaks about the temptations in life, there is in terms of food choices, and making wise decisions as well as choices for ones health going forward is going to be beneficial for maintaining ones health after they have had their Myomectomy surgery, or if you haven't had your Myomectomy surgery as yet, preparing yourself for the possibilities after surgery will be good, because you can start putting plans in place, and helping yourself, to heal quicker in mind as well as body. Also, I looked at some of the food choices when one is on a weight loss journey, and this information comes from the flowersbariatriccenter website, and if you want more information, please feel free to click the link here: https://www.flowersbariatriccenter.com/nutrition/temptations-and-tenacityMoreover, if you like this episode or any of the episodes you have heard from the host, please feel free to leave the host a review, on apple podcasts by clicking this link here:https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you want to connect to the host further, please feel free, to connect her on her most popular and visited social platforms, tiktok, you tube and twitter. @missboyce2020 tiktok @missboyce you tube @babyfaceboyce twitter

Now, in this episode the host Hannah Boyce, talks about her recent vaccination after her Myomectomy surgery, which is the covid 19 vaccination. Also, the host shares some factual information which she got from a you tuber called CBC news the national channel, and Hannah shares some of the most important points that she feels is necessary to enlighten one about the covid-19 vaccination should they wish to take up this vaccination for themselves. Moreover, if you want more information about the covid 19 vaccination, or if you would like to look at the video the host was referring to in the episode, feel free to click on the link here: https://www.youtube.com/watch?v=V4cyYvmU5CcBesides this, the host got some information from the national health service (NHS) website which is in the UK, and you can check out this website if you wish too as well, feel free to click on the link here for more information: http://nhs.uk/coronavirusvaccinationLastly, if you like any of the information you have heard in this episode, feel free to leave a review on apple podcasts by click the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, if you would like to connect to the host on any of here platforms she primarily and actively is on three social platforms at the minute, which are you tube, Tiktok and twitter. Tiktok @missboyce2020You tube @Miss BoyceTwitter @babyfaceboyce

Now, in this episode Hannah the host talks about clothing in particular after she went through her Myomectomy surgery. Also, Hannah touches on how clothing can make one feel psychologically and emotionally. Moreover, the information in this episode comes from apparelsearch.com website which you can view by clicking the link here. http://apparelsearch.comLastly, if you like any of the episodes you have heard from the host and want to connect with the host further, feel free to look her up on her most regular social media platforms of twitter, tik tok or you tube. @missboyce2020 tiktok @Miss boyce you tube @babyfaceboyce TwitterAlso, if you like this episode, or any other episode you have heard feel free to leave a review on apple podcasts by clicking this link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, this episode is a life experience that the host went through some time ago this year 2021, after her Myomectomy experience, and wanted to share her experience as a story, and hope that one can learn some things from the episode, and story as well as experience. Moreover, if you like this episode or any of the episodes you have listened to in an audio diary a personal health journey feel free to leave a review on apple podcasts by clicking the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, if you would like to connect with the host on her most recent and active social media platforms you can connect to the host on either Tiktok, you tube or twitter. @MissBoyce you tube @missboyce2020 TikTok@babyfaceboyce Twitter

Colorectal cancer screening update, COVID-19 vaccine update, and abnormal uterine bleeding basics.Today is May 24, 2021.Colorectal cancer screening update Written by Hector Arreaza, MD. Participation: Ikenna Nwosu, MD, and Daniela Viamontes, MD.Today is May 24, 2021.On august 29, 2020, we were in the midst of a pandemic and we woke up with the sad news about the death of Chadwick Aaron Boseman (also known as Black Panther). An interesting fact: The tweet in which his family announced his death on Twitter became the most-liked tweet in history. But why are we talking about Chadwick’s death? Because he died of colon cancer. I do not know if this recommendation came because of Chadwick, but it’s a good way to open this episode: remembering Black Panther.We heard the rumors, but now it’s official. On May 18, 2021, the USPSTF released their final recommendation statement about colorectal cancer screening. The age to start screening has been changed from 50 to 45 years old. This is a grade B recommendation. Grade B means that this recommendation has moderate to substantial net benefit, so offer this service to your patients. Screening adults between 76 and 85 years old who have been previously screened has a small net benefit (grade C recommendation). So, select patients may be screened for colorectal cancer in this age group (76-85), especially those who have never been screened.Do you remember this recommendation from medical school for high risk patients? Start screening at age 40 or 10 years before a patient’s direct-relative was diagnosed with colon cancer. This was a recommendation given by the US Multi-Society Task Force (which includes the American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy). This same organization already recommended in 2017 to start screening at age 45 in African American patients, and the American Cancer Society recommended screening all patients at age 45 in 2018. The ACS does not have a guideline to screen high risk patients for colon cancer. Most organizations agreed on not screening after age 85.Strategies for screening:High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every yearDani: Stool DNA-FIT every 1 to 3 years (Cologuard®)  CT colonography every 5 years Flexible sigmoidoscopy every 5 years OR Flexible sigmoidoscopy every 10 years + annual FIT Colonoscopy screening every 10 yearsDiscuss different options with your patients, choose your favorite and do it!  Introduction: Update on COVID 19 vaccines  By Hector Arreaza, MD, and Lillian Petersen, RN. COVID-19 vaccines now can be co-administered with other vaccines according to the ACIP. COVID-19 vaccines and other vaccines may now be administered without regard to timing. They can be given on the same day or within the 14 days previously recommended between vaccines.  It is not known if reactogenicity of COVID-19 vaccine is increased with co-administration with other reactogenic vaccines (such as vaccines with live attenuated viruses).  How do you decide if you want to co-administer a vaccine? 1. Consider whether the patient is behind or at risk of becoming behind on recommended vaccines.2. Consider their risk of vaccine-preventable disease.3. Consider the reactogenicity profile of the vaccines. If multiple vaccines are administered at a single visit, administer each injection in a different injection site, at least one inch apart or in different limbs. Current or previous SARS-CoV-2 infection: Everyone should be offered COVID-19 vaccination regardless of their history of COVID-19 infection. Viral testing or serologic test is not recommended for the purposes of vaccine decision-making. People with current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and they have met criteria to discontinue isolation. This applies to patients who got the disease before receiving any vaccine or after receiving the first dose.  A minimum interval between infection and vaccination has not been established, but evidence suggests that the risk of reinfection is low in the months after initial infection but may increase with time due to waning immunity. People with a history of multisystem inflammatory syndrome in children (MIS-C) or adults (MIS-A):It is unclear if people with a history of MIS-C or MIS-A are at risk of recurrence of the same dysregulated immune response following reinfection with SARS-CoV-2 or in response to vaccination. People with a history of MIS-C or MIS-A may choose to be vaccinated but they should consider delaying vaccination until they have recovered from their illness and for 90 days after the date of diagnosis. Find more information at the CDC.gov website. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Abnormal Uterine Bleeding. By Sherika Adams, MS3, P. Eresha Perera, MS3, and Hector Arreaza, MD.  Definition. AUB is a symptom, not a diagnosis. It is equivalent to say: “This patient’s periods are abnormal.” Anything that falls out of what is considered “normal periods” is classified as abnormal uterine bleeding.These 4 elements are assessed when determining if a patient has AUB: Regularity, frequency, duration, and volume.  What is considered normal? Frequency = Every 24-38 days, regularity +/- 2-20 days over 12 months, duration = 4.5 to 8 days, volume = 5-80 mL. 10-30% of women of reproductive age may have AUB. According to the American College of Obstetricians and Gynecologists (ACOG), abnormal uterine bleeding is characterized by bleeding or spotting following sexual intercourse or menopause, between menstrual cycles, menstrual cycles lasting more than 38 days or shorter than 24 days, heavy bleeding during menstruation, and “irregular” menstrual cycles that have 7-9 days of variation.Terms no longer used: menorrhagia, metrorrhagia, and dysfunctional uterine bleeding (DUB). Not all symptoms reported as “vaginal bleeding” are coming from the vagina. For example, bleeding from anus, urethra, bladder, and perineum should be ruled out before establishing the diagnosis of AUB. Classification of Abnormal Uterine Bleeding (AUB). Abnormal uterine bleeding (AUB) in nonpregnant premenopausal women can be classified by the acronym PALM-COEIN, which was established by the International Federation of Gynecology and Obstetrics (FIGO) in 2011.  PALM-COEIN: Palm: Structural etiologies, Coein: Non-structural etiologies P is for polyps: Polyps are epithelial tumors in the endometrium or cervix and can be identified by hysterosonography or hysteroscopic imaging. A is for adenomyosis: Adenomyosis is endometrial stroma and glands in the myometrium and can be identified by histopathology, and now MRI and transvaginal ultrasound. L is for leiomyomas: Leiomyomas also known as uterine fibroids are benign smooth muscle tumors that are diagnosed by pelvic examination and pelvic imaging such as ultrasound with contrast or MRI. M is for malignancy and hyperplasia: Malignancy and hyperplasia are often abnormal epithelial tissue that is benign or cancerous that can be seen with transcervical endometrial sampling. C is for coagulopathy: Coagulopathy is bleeding disorders such as Von Willebrand disease is identified by laboratory testing. O is ovulatory dysfunctions: Ovulatory dysfunction occurs when there is a variation of more than seven days of the menstrual cycle in the past 12 months and ovulation is dysfunctional. In a woman without ovulation, there is no corpus luteum, and there is no progesterone, so estrogen goes unopposed, causing a buildup of endometrium and irregular bleeding.   E is endometrial causes: Endometrial causes can occur when there is normal ovulation, no other identifiable cause of AUB, and there is heavy menstrual bleeding, which includes intermenstrual bleeding. Primary disorders of endometrial hemostasis are likely due to vasoconstriction disorders, inflammation, or infection. Endometrial dysfunction is poorly understood; there are no reliable diagnostic methods, and it should be considered only after other causes are excluded. I is for iatrogenic cause: Iatrogenic causes include gonadal steroids (estrogen, androgens), anticoagulants, intrauterine devices, antipsychotics, antidepressants, and anti-hypertensives. N is for not otherwise classified: Example of an etiology under not otherwise classified might be AV malformations. This classification does not include pregnancy. Postmenopausal bleeding: Abnormal uterine bleeding can also occur in post-menopausal women and is an indication of potentially lethal endometrial cancer. Post-menopausal women should be worked up for cancer when they present with bleeding. However, most common cause of bleeding in this population is atrophy of the vaginal mucosa or endometrium. If younger than 45 patients but history of unopposed estrogen exposure (PCOS, obesity, estrogen therapy) should also undergo endometrial biopsy to rule out possibility of endometrial cancer.  Management of AUB. Management of the AUB can be initiated only after the etiology of the bleeding has been established. Firs of all, rule out pregnancy related bleeding by performing a pregnancy test. Also, rule out other sources of bleeding. The first question to answer would be: Does this patient need an emergent treatment for her AUB or can she be treated as outpatient? Determine that by checking the history, vitals, orthostatic vitals, physical exam, and labs.  If patient requires admission, the options for treatment include: uterine tamponade, intravenous estrogen, dilation and curettage, and uterine artery embolization. In case of severe bleeding without hemodynamic instability, patients can be treated initially with oral estrogen, high-dose estrogen-progestin oral contraceptives, oral progestins, or intravenous tranexamic acid.For chronic AUB, once etiology has been established, the goal is to treat the underlying condition. The goal of treatment is to control the bleeding since AUB can persists until menopause.  Initial outpatient treatment is usually pharmacological. For those not wanting to conceive soon, consider IUD placement. “Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and performs similarly to hysterectomy when quality-adjusted life years are considered.”[8] Other long-term medical treatment options include estrogen-progestin oral contraceptives, oral progestins, oral tranexamic acid, NSAIDs (nonsteroidal anti-inflammatory drugs), and depot medroxyprogesterone. Surgical treatment is often considered for patients on long term medical therapy with no response, or for severe cases of bleeding with recurrent need for emergent treatment. Some surgical options are endometrial ablation, which performs as well as the levonorgestrel-releasing intrauterine system. Some structural lesions can be resected via hysteroscopy (polyps). Myomectomy and uterine artery embolization are options for patients with severe AUB who want to preserve fertility. Uterine leiomyomas or adenomyosis can be medically managed with OCPs but can also be treated with surgery as well, depending on the physician-patient discussion of options. Hysterectomy is the definitive treatment of severe AUB. Remember, PALM COEIN stands for: Polyps, Adenomyosis, Leiomyomas, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial causes, Iatrogenic cause, Not otherwise classified. ____________________________Conclusion. Written by Hector Arreaza, MDNow we conclude our episode number 53 “Abnormal Uterine Bleeding”. Eresha and Sherika did a great job explaining the Palm-Coein classification, and gave us a good overview of the management of AUB. Remember to start screening for colorectal cancer at age 45 now, what strategy for screening will you use? And for those patients who were hesitant about getting the COVID-19 vaccine with other vaccines, well, the ACIP said we can co-administer it with other vaccines. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Daniela Viamontes, Ikenna Nwosu, Lillian Petersen, Sherika Adams, and P. Eresha Perera. Audio edition: Suraj Amrutia. See you next week! _____________________References:U.S. National Library of Medicine, Clinical Trials.Gov, https://clinicaltrials.gov/ct2/show/study/NCT02026869. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States, Centers for Disease Control and Prevention, https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#Coadministration, accessed on May 20, 2021.  Colorectal Cancer: Screening, Final Recommendation Statement, U.S. Preventive Services Task Force, May 18, 2021, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Abnormal Uterine Bleeding FAQ, The American College of Obstetricians and Gynecologists (ACOG), https://www.acog.org/womens-health/faqs/abnormal-uterine-bleeding, accessed on May 17, 2021.  Fraser, Ian, et al. Abnormal uterine bleeding in reproductive-age women: Terminology and PALM-COEIN etiology classification, Up to Date, last updated: Dec 16, 2019. https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-reproductive-age-women-terminology-and-palm-coein-etiology-classification?search=palm%20coein&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Goodman Annekathryn, et al, Postmenopausal uterine bleeding, Up to Date, last updated: Feb 02, 2021. https://www.uptodate.com/contents/postmenopausal-uterine-bleeding?search=abnormal%20uterine%20bleeding%20postmenopausal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Kaunitz, Andre M, Abnormal uterine bleeding: Management in premenopausal patients, Up to Date, last updated: Aug 25, 2020. https://www.uptodate.com/contents/abnormal-uterine-bleeding-management-in-premenopausal-patients?search=abnormal%20uterine%20bleeding%20management&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Wouk N, Helton M. Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Physician. 2019 Apr 1;99(7):435-443. PMID: 30932448. https://pubmed.ncbi.nlm.nih.gov/30932448/ 

Now, this episode is a following on from the first episode of what are fibroids? and it is the second part to the talk, where Hannah shares her thoughts about fibroids, treatments and a small story from a patient perspective. Also, if you like any of Hannah's episodes in her podcast show, feel free to leave a review on apple podcast, by clicking the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Moreover, the musical track in this podcast show comes from Epidemic Sound, and is entitled, ' In addition, the information in this episode comes from the NHS website, based in the UK, which you can view here:  https://www.nhs.uk/conditions/fibroidsLastly, if you want to see a visual journey and some stories that Hannah shares about her Myomectomy journey, feel free to follow her on her social platforms of tik tok, you tube and twitter. Tiktok name @missboyce2020You tube name/title @Miss BoyceTwitter @babyfaceboyce

Now, in this episode Hannah talks about doing things after surgery, it can be tough, and it can make one feel demoralised or down, when they have a mountain of things they need to achieve, however Hannah is talking and sharing some encouraging points in this episode, as she explains how things was for her, and is for her attending to her to do lists after she has undergone her Myomectomy surgery. Also, the musical track in this episode is a new track for the start of April, and it comes from Epidemic Sound, and is entitled ' Slap weh' By Lou Richard' .Moreover, if you like this episode feel free to leave a review on apple podcasts, by clicking on the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, if you would like to connect with Hannah via her social media platforms you can either find her on tik tok at @missboyce2020, you tube @MissBoyce or twitter @babyfaceboyce. 

Now, in this episode Hannah shares her experiences and memories from the time Hannah got the call from the hospital to say they had a bed available for her to the time she was discharged from hospital. Also, in this episode, you get to experience some of the feelings Hannah felt during this intense, anxious & critical time in Hannah's life, leading up to her Myomectomy surgery in March 2020. Moreover. Hannah reminisces on the past events, as a reminder of how much she achieved and everything she went through in order to remind herself, of her achievements and to always adhere to ones health as well as well being, as without good health, life can be meaningless. Lastly, the sounds and musical tracks in this episode comes from epidemic sound, and if you like this episode, please feel free to leave a review on apple podcasts by clicking the link here:https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, in this Episode Hannah talks about different types of Myomectomy surgeries as an overview, and a more factual podcast episode. Also, the musical track and the break music comes from Epidemic Sound and is entitled 'Blue Lantern' by Yi Nantiro, and Hannah wanted to give this episode a mysterious type of feel, as when one is chosing to have a particularly type of surgery, it can be a mysterious time for the user/patient/person. Besides this, if you like Hannah's show, and episodes, please feel free to leave a review on apple podcasts, by clicking the link here:  https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333In addition, Hannah quoted from two websites which are: http://mayoclinic.org and  https://www.healthline.com. 

Now, this episode is Hannah talking about previous hobbies she did, before her surgery, and sending some encouragement to one/others if they want to do a strenuous hobby after having a Myomectomy surgery, always consult a medical practitioner, as they would be in the best place to enlighten one about what hobbies/sports one can do after a Myomectomy surgery. Also, Hannah shares some of her past thoughts, about problems she encountered, and she talks about a video, she watched on the you tube on Monday 8th March 2021, after experiencing quite severe pain in her upper back from her muscle strain, she had the previous week, if you want to check the video out on you tube, it is by a lady called Doctor Jo, and you can view the link here: https://www.youtube.com/watch?v=bTn89EBKJdM Lastly, if you like Hannah's episodes and podcast show, feel free to leave a review on Apple podcasts by going to the link here: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, in this live podcast episode, Hannah shares some of her thoughts, about her one year anniversary since her Myomectomy surgery, as well as Hannah was exploring her range, and wants to be able to connect deeper with her audience and others in future. Also, in this show, Hannah has added some more pre recorded thoughts from the day after her Myomectomy surgery till the day she got discharged from the hospital. More importantly, Hannah wants to share a quiz with others, which is valid for fourteen days when this episode comes out, until March 26th 20:00hrs, if you would like to take part in the quiz follow the link here: http://joinmyquiz.com and enter the code: 52122818, to access the quiz. Moreover, Hannah mentions Pat Flynns' live you tube stream, and shares some thoughts about being a part of the community on Pat Flynns' live streams. Also, if you enjoy the show, or an audio diary, a personal health journey, feel free to leave a review, here on apple podcasts: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Lastly, Hannah's Live podcast show was made by Podbean service, and you can check them out, by clicking on this link: https://www.podbean.com 

Now, in this episode Hannah shares some of her personal thoughts about how she has dealt with feminism issues, such as emotions within the female anatomy after she has had her Myomectomy surgery. Also, Hannah looked at an article from the guardian website to try and piece this podcast episode together, and if you want to check out the articulae about feminism you can click on the link below: https://www.theguardian.com/commentisfree/2019/nov/13/feminism-is-now-used-to-sell-almost-everything-even-breast-implantsMoreover, Hannah talked about if anyone wants to follow her on some of her social media platforms, you can look her up on either tiktok, you tube or twitter by visiting the following links below: @missboyce2020 (tiktok)@missboyce (you tube)@babyfaceboyce (twitter)Lastly, if you like this podcast episode, feel free to leave a review on apple podcasts, by clicking the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, in this episode Hannah talks about how she has gotten used to her body after surgery, particularly Hannah shares a story about the 10th February 2021, as she made a interesting and a clear moment/distinction, about her body after the Myomectomy surgery. Moreover, in this short episode, Hannah talks about various thoughts that has happened in her life during this second week of February 2021, and Hannah mentions relaxing as well as taking time out to enjoy some shows on Netflix streaming service. In addition, if you like Hannah's podcast episodes of 'an audio diary a personal health journey, feel free to click on the link below, to leave a review on apple podcasts: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, Hannah mentions a health fact about painful surgeries, and the website for this information is: http://medicalnewstoday.com. 

Now, this episode is where Hannah shares her thoughts about her new normal after going through her Myomectomy surgery in 2020. Also, Hannah talks about varies things she has had encounters with, in the past week and a half, and also mentions the company think media, which she was on a challenge recently, to become a better you tube maker, and content creator digitally. Moreover the musical tracks in this episode comes from Epidemic sound company, and the track is entitled, celebration of life by Tomas Skyldeberg. Besides this, if you like Hannah's podcast show of an audio diary a personal health journey feel free to leave a review on apple podcasts by clicking on the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333

Now, in this episode Hannah talks extensively about boredom after surgery strategies, things to keep ones mind as well as body occupied. Also, in this episode Hannah mentions the think media team as she was recently on a you tube challenge by this company, and she shares her personal thoughts on this matter. Moreover, Hannah speaks about two films which she watched during her time in the early stages of her Myomectomy recovery journey, these films were, Dirty dancing one and Besides this, Hannah got most of her research from two websites for this podcast episode, which are: http://www.stellartransport.com & http://www.spine-health.com In addition, Hannah talks about a live you tube streaming service that she watched during her recovery of her Myomectomy in the earlier stages of 2020, and she talked about a you tube episode live stream that she watched on 25th January 2021, this live stream was from a man, business owner Pat Flynn, & if you would like to check out his work, or show for 25th January 2021, feel free to click the link for more information: https://www.youtube.com/watch?v=8PVjdlryZKw. Lastly, if you like this episode or any other episodes that Hannah has done in her podcast journey, feel free to leave a review in apple podcasts, by clicking on the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, if you are more of a visual learner, and want to see some of Hannah's visual work, videos on you tube, feel free to click this link to check out Hannah's you tube channel: https://www.youtube.com/channel/UCGv5di1o7ZBHvbgveT0vDIgMore importantly, if you would like to read Hannah's blog posts from her earlier recovery time, feel free to go to: http://hannahboyce.net .

Now, this episode came to mind after Hannah had quite a good boxing day rest, & Hannah thought it would be interesting to talk about this topic, as well as after some research on Wednesday 30th December 2020, Hannah realised that there seems to be a topic such as wondering minds after surgery. Moreover, Hannah mentions two websites in this podcast episode which are: http://www.asahq.org & http://www.drbakercare.com for ones information. Also, Hannah mentions Pat Flynn's live show today, Wednesday 30th December 2020, which if one wants to view, please click on the following link, below and Hannah talks about the mystery guest on this show, and his information. https://www.youtube.com/watch?v=jtmlH5B8sUIBesides this, the intro, intervals and Outro tracks come from Epidemic sound, and is entitled, Christmas in my heart by the artist Loving Caliber. Lastly, if you like my podcast episodes, please feel free to leave a review on apple podcasts by clicking on the link below: https://podcasts.apple.com/gb/podcast/an-audio-diary-a-personal-health-journey-by-hannah-boyce/id1511505333Also, if you want to read some of my personal story about my recovery from my Myomectomy in the early stages, please visit my website/blog link below: http://hannahboyce.net

Now, in this episode, Hannah shares her thoughts from Sunday, Monday and Tuesday post Christmas. Also, the primary goal for this episode was to review the year, and enlighten others to Hannah progresses and achievements for the year, as well as to encourage one, that despite setbacks that one may have had this year, people can still achieve their goals and dreams if they try. Moreover, the musical tracks in this episode come from epidemic sound, and the last musical track is entitled 'Christmas in my heart' by the artist Loving Caliber. Next, if you like any of the episodes you hear in an audio diary, a personal health journey feel free to leave a review by following the instructions below in this description box: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, in this episode, I choose to do a boxing day special purely in aid of my mothers' birthday & I talk about some things for the future of my podcast journey.Moreover, the tracks in this podcast episode is from epidemic sound. Besides this, I talk about some of the things I brought from a UK store called Tesco and Ireland, as well as I mention a recipe sorrel which I learnt from a you tuber called Jamrock Vegan. Also, if you like these podcasts episodes feel free to leave a review on apple podcasts, and you can follow the instructions below, in the description box: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, in this episode, I talk about setting goals for ones life, and share some of my goal setting processes, which I have found really helpful, particularly after surgery. Moreover, the musical tracks in this episode comes from Epidemic sound. Also, in this podcast episode I mention a book I am going through, called the miracle morning book, by Hal Elrod, which I have found five/six months in reading this book as well as working through the book, to be a life saver for me, and something that gives me a clear perspective from day to day.Next, if you like this podcast episode, feel free to leave a review on apple podcasts, by following the steps below: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, this episode is a Christmas special, and I talk about things that is happening in my life leading up to Christmas Day. Moreover, on Christmas day itself, I open some presents with my listeners and I talk about my most memorable things I used to do on Christmas day in the past, & I also speak about some of the most fun things I usually like to do on Christmas day. Also, the music tracks in this episode come from Epidemic sound company and I speak about a film I watched on Christmas day which was quite good, the film is called ' Patch Adams'. Lastly, if you like my podcast episodes feel free to leave a review on apple podcasts, by following the instructions below: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, in this episode, I specifically talk about my driving anniversary today 22nd December 2020, and I share this amazing milestone with listeners, as I think it is important to embrace milestones in ones life. Also, I make reference to a series I have been binged watching today, call 'Cobra kai'. Moreover, the Intro, Outro and interval tracks are from epidemic sound. Next, this episode was unplanned, however I thought I would do an episode on this topic because I am planning to do a you video on this topic as well, and I thought it would be nice to have an audio version of this topic as well as a video, of embracing special events after surgery. Lastly, if you like this episode please feel free to leave a review on apple podcasts, and you can follow the instructions below in this description box: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, this is a BONUS episode I thought of doing on Tuesday 15th December 2020, and  I thought it would be nice to share things I am grateful for particularly this year 2020. Moreover, I think gratitude practises is good, and it makes one more appreciative of things in life. Also, I thought it would be a nice way to end the year, and a little bit of fun to have with my listeners. In addition, the musical tracks for the Intro, Outro and track during the challenge, comes from epidemic sound. Next, the track during the challenge is called "kissing under the mistletoe by Loving Caliber, and the other track fro the intro and outro of the podcast episode, is called "Silent Night" (smooth jazz version) by Man Quartet.Lastly, if you like my podcast episodes, feel free to leave a review on apple podcasts, and you can follow the instructions below in this description box: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there.

Now, in this episode Hannah talks about image after surgery, as this topic has been on Hannah's mind quite a bit in the past and after surgery too. Moreover, this podcast episode is a bit of a chat really, where Hannah shares her thoughts and feelings about image, her scar and clothing, how clothing looks on Hannah as well as how Hannah feels in her clothing after having major surgery.In addition, the musical tracks for the Intro, Outro and intervals for this podcast episode, is from Epidemic sound, and it is a Christmas/festive theme track to go with the times. Also, if you like this episode feel free to leave a review on Apple podcasts, and you can follow the link below for the steps on how to leave a review. Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Next, if you want to check out my website/blog about my recovery process in the early days after my Myomectomy surgery you can visit hannahboyce.net, however I haven't found a consistent schedule at present to put more recent content about my Myomectomy journey/health journey on there. 

Now, in this episode I talk about stories which happened to me prior to surgery and post surgery. Also, in this podcast episode, I reference a movie called the lion king two. Moreover, the musical tracks, intro, interlude & Outro tracks, are from epidemic sound. Lastly, if you like this podcast episode feel free to leave a review on apple podcasts, and follow the instructions below: Step one: Type in the name of the podcasters title for example, "An audio diary", a personal health journey.Step two: Next, the thumbnail/artwork of the podcast will come up, click on the artwork; which is a womans' anatomy, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, as well as write a review and when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again.Besides this, if you would like to read my early story on my recovery process after my Myomectomy surgery, feel free to check out my website blog, at hannahboyce.net, this is where you can get bonus material such as a healthy living newsletter which will be out shortly, in December 2020. 

In this episode, Adina shares her full experience as a childless woman from shocking experiences being stigmatized to multiple health issues to medical procedures to unknowingly early signs of infertility.Terms used: Uterine Fibroids: abnormal benign growth in the uterine wall. Partial Hysterectomy: partial hysterectomy removes the uterus including, in some cases, the cervix. Myomectomy: a surgical procedure to remove uterine fibroids.Misshapen uterus: a malformation of the uterus that females are born with, meaning it develops during embryonic life. In technical terms: the Mullerian ducts, which are the initial development of the fallopian tubes, uterus, the uterine cervix, and the superior aspect of the vagina, fail to form a normal uterine cavity.Thyroid disorder: also called hypothyroidism or under-active thyroid is a condition in which a thyroid gland doesn't produce enough of certain crucial hormones.Pituitary gland tumor: abnormal growths that develop in your pituitary gland. Some pituitary tumors result in too much of the hormones that regulate important functions of your body. Some pituitary tumors can cause your pituitary gland to produce lower levels of hormones.Anemic: a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Birth control pills: a daily medication that contains 2 hormones (estrogen and progestin) to prevent pregnancy — or manage and suppress heavy periods.Watch this interview on YouTube.com/ChildlessWomenTo support our series, visit www.AsToldByChildlessWomen.com

FDA 批准促性腺激素释放激素（GnRH）拮抗剂治疗子宫肌瘤导致的大量子宫出血NEJM 比较子宫动脉栓塞术与子宫肌瘤切除术治疗子宫肌瘤的疗效Cell 在孕妇中利用代谢动力学预测孕周和分娩时间恶拉戈利（elagolix）恶拉戈利（elagolix）是一种口服促性腺激素释放激素（GnRH）拮抗剂，既往用于治疗子宫内膜异位症引起的盆腔疼痛。2020年5月，美国FDA批准恶拉戈利用于治疗绝经前期、子宫肌瘤导致的大量子宫出血。《UF-1和UF-2研究：恶拉戈利治疗子宫肌瘤所致月经过多的治疗方案》New England Journal of Medicine，2020年1月 (1)研究旨在比较恶拉戈利300mg bid（单药治疗或联合雌激素-孕激素反加疗法）对子宫肌瘤的疗效。在两项相同的试验（UF-1和UF-2）中，月经过多（月经失血量＞80 mL）且经超声诊断为子宫肌瘤的总共790名女性（平均年龄42岁）被随机分组，分别接受6个月的恶拉戈利联合反加疗法、恶拉戈利单药治疗或安慰剂治疗。研究者通过收集生理用品的方式量化月经失血量。两项研究6个月后，84%和77%的单药治疗、68.5%和76.5%的恶拉戈利联合反加疗法和9%的安慰剂组达到主要终点（月经量50%）。主要不良反应是潮热和子宫出血，恶拉戈利联合反加治疗组的发生率显著高于安慰剂组。反加治疗法减轻了恶拉戈利的低雌激素效应，腰椎骨密度减少0.76%，低于恶拉戈利单药治疗组2.95%。结论：恶拉戈利单药治疗或联合雌-孕激素反加疗法均有效减轻子宫肌瘤相关的月经过多。恶拉戈利单药治疗与骨密度显著降低相关，反加治疗可以减少这种副作用。子宫肌瘤子宫肌瘤，是女性最常见的盆腔肿瘤，是起源于子宫平滑肌细胞和成纤维细胞的单克隆非癌性肿瘤。主要发生在育龄期妇女，可表现为异常子宫出血、盆腔疼痛/压迫感、生殖功能障碍（不孕或产科并发症）。大多数的子宫肌瘤会在生产后或绝经后自行萎缩；如果子宫肌瘤引起严重症状，则需治疗。对没有生育要求的患者，可行宫腔镜下切除粘膜下肌瘤；雌-孕激素避孕药；释放孕激素的宫内节育器；氨甲环酸；促性腺激素释放激素（GnRH）的激动剂和拮抗剂等。对于有生育要求的患者，药物大多会妨碍受孕，因此治疗首选微创手术切除。《行子宫动脉栓塞术与子宫肌瘤切除术治疗子宫肌瘤的比较》New England Journal of Medicine，2020年7月 (2)对于希望保留子宫、且药物治疗无效的女性，子宫肌瘤切除术和子宫动脉栓塞术是可选治疗方案。这项多中心、随机、开放标签试验，旨在评估症状性子宫肌瘤患者中使用子宫肌瘤切除术和子宫动脉栓塞术的疗效的比较。子宫肌瘤切除术的可选术式包括开腹、腹腔镜或宫腔镜手术。研究共招募了254名女性随机分组：子宫肌瘤切除术组和子宫动脉栓塞术。随访2年时，两组的生活质量评分分别为84.6分和80.0分（P=0.01）。在所有初次手术中，子宫肌瘤切除术组29%的女性和子宫动脉栓塞术组24%的女性发生了围手术期和术后并发症。结论：在有症状的子宫肌瘤患者中，接受子宫肌瘤切除术的女性在2年时的子宫肌瘤相关生活质量优于接受子宫动脉栓塞术的女性。《随机双盲对照试验：术前氨甲环酸减少子宫肌瘤切除术失血》American Journal of Obstetrics and Gynecology，2020年9月(3)氨甲环酸是一种合成赖氨酸衍生物，具有抗纤溶活性，用于其他外科学科，以减少手术期间的失血。本研究旨在探讨早期静脉注射氨甲环酸对子宫肌瘤切除术妇女围手术期出血和输血需求的影响。这项双盲、随机、安慰剂对照试验中，纳入有大出血风险的、症状性子宫肌瘤的女性共60人，随机分入干预组（手术前20分钟静脉注射氨甲环酸15 mg/kg）和安慰剂组（手术前静脉注射生理盐水）。这里有大出血风险定义为：（1）至少1个肌瘤≥10cm，（2）任何1个肌壁内或阔韧带肌瘤≥6cm，和/或（3）手术前影像学检查提示至少有5个肌瘤。患者中53%接受腹腔镜子宫肌瘤切除术，40%接受机器人子宫肌瘤切除术，7%接受采用剖腹手术。氨甲环酸组和安慰剂组中，中位估计失血量分别为200ml和240ml（P=0.88）；中位手术时间没有差异（165min 和 164min），围手术期血红蛋白改变也没有差异（1.00 和 1.1 g/dL）。氨甲环酸组的患者均不需要输血，但安慰剂组有4例需要输血。结论：术前静脉给予氨甲环酸在腹腔镜或机器人肌瘤切除过程中，与减少出血量无关。《术前肠道准备并不能减少子宫切除术后的感染》American Journal of Obstetrics and Gynecology，2020年8月 (4)关于妇科手术前肠道准备的文献很少，在子宫切除术前进行肠道准备主要是借鉴结直肠手术的经验。因此本研究的目的是比较子宫切除术前，与无肠道准备相比，单纯机械性肠准备、单纯口服抗生素或联合使用抗生素是否与手术部位感染或吻合口漏发生率降低有关。研究回顾性的分析了10余年间、共224,687例子宫切除术手术患者的数据。其中良性疾病186,148例、平均45岁，恶性肿瘤38,539例，平均54岁。其中包括腹腔镜/机器人手术、剖腹手术和经阴道手术等不同术式。术前准备包括肠道准备、口服抗生素、两者联合等不同策略。研究人员发现，肠道准备并没有降低手术部位感染、吻合口漏或其他并发症的发病率。在恶性肿瘤、开腹子宫切除术中，肠道准备、口服抗生素或肠道准备联合抗生素等几种策略，与不进行抗生素预防治疗的患者相比，感染发病率没有差异。结论：无论手术方式如何，肠道准备都不能预防手术部位感染或并发症，可以安全省略此步骤。妊娠期高血压妊娠>20周的女性新发高血压，但没有蛋白尿或新发靶器官功能障碍，则诊断为妊娠期高血压。根据2019年美国妇产科医师学会的建议，无论是否有其他表现，收缩压≥ 160mmHg和/或舒张压≥110mmHg，应直接诊断为“重度子痫前期”，即以前所说的“重度妊娠高血压”。更名的原因是，即使没有蛋白尿，妊娠诱发的重度血压升高也可能导致严重的不良事件。若产后≥12周后，血压仍高于正常，诊断为慢性高血压。妊娠期高血压最常用的降压药物包括：甲基多巴、拉贝洛尔、硝苯地平。尚有争议的药物包括：噻嗪类利尿剂、肼屈嗪、可乐定、硝普钠。妊娠期应避免使用的药物包括：ACEI、ARB、直接肾素抑制剂、盐皮质激素。《综述：他汀类药物在预防子痫前期中的作用》American Journal of Obstetrics and Gynecology，2020年8月 (5)子痫前期的确切原因尚不清楚，但普遍认为与胎盘异常释放可溶性抗血管生成因子有关，加之氧化应激和炎症反应的增加，导致母体全身内皮功能障碍。他汀类药物已被证明可以纠正类似的病理生理过程。普伐他汀，在各种临床前期和临床研究中显示，它可以逆转妊娠特异性的血管功能失衡，恢复内皮健康，防止氧化和炎症损伤。人类研究表明普伐他汀具有良好的安全性，而最近的证据不支持他汀类药物致畸的担忧。结论：他汀类药物在子痫前期预防性的使用，仍需大型随机对照研究支持。《荟萃分析：口服降压药对慢性高血压孕妇的疗效和安全性的比较》American Journal of Obstetrics and Gynecology，2020年10月 (6)此荟萃分析的目的是同时比较降压药对患有慢性高血压的孕妇的疗效和安全性。共纳入了22项研究，包括4464名女性。随机对照试验的分析表明，没有任何药物会显著影响先兆子痫的发生率。与安慰剂相比，阿替洛尔与小于胎龄儿（small for gestational age，SGA）的风险增加显著相关（风险比 26.00），而且被列为疗效最差的降压药。严重高血压的发生率在以下药物的干预下显著降低：硝苯地平风险比0.27，甲基多巴风险比0.31，吲哚洛尔风险比0.29，酮舍林风险比0.17。相比而言，严重高血压发生的概率最高的药物包括：速尿、氨氯地平和安慰剂。硝苯地平和甲基多巴能显著降低胎盘早剥率的风险（风险比 0.29和0.23）。各类降压药在剖宫产、围产期死亡、早产和分娩时胎龄方面无显著差异。结论：阿替洛尔与小于胎龄儿的风险显著增加有关。当使用硝苯地平和甲基多巴时，严重高血压的发生率显著降低。尽管在降压药中先兆子痫的风险是相似的，但未来仍需大规模研究为妊娠期降压药的选择和目标血压提供指导。《前瞻性观察队列研究：慢性高血压患者妊娠并发症与妊娠前母体心脏功能和结构有关》American Journal of Obstetrics and Gynecology，2020年9月 (7)约3%的妊娠合并为慢性高血压，这些产妇的分娩并发症发生率可高达25 - 28%。本研究的目的是通过超声心动图，评估妊娠前孕妇的心脏结构和功能，寻找其与分娩并发症以及妊娠前治疗的相关性。这项前瞻性观察队列研究，纳入192名长期接受降压治疗的孕妇，妊娠前改用甲基多巴，并随访至分娩。在192例患者中，出现24例早期并发症（

FDA 批准促性腺激素释放激素（GnRH）拮抗剂治疗子宫肌瘤导致的大量子宫出血NEJM 比较子宫动脉栓塞术与子宫肌瘤切除术治疗子宫肌瘤的疗效Cell 在孕妇中利用代谢动力学预测孕周和分娩时间恶拉戈利（elagolix）恶拉戈利（elagolix）是一种口服促性腺激素释放激素（GnRH）拮抗剂，既往用于治疗子宫内膜异位症引起的盆腔疼痛。2020年5月，美国FDA批准恶拉戈利用于治疗绝经前期、子宫肌瘤导致的大量子宫出血。《UF-1和UF-2研究：恶拉戈利治疗子宫肌瘤所致月经过多的治疗方案》New England Journal of Medicine，2020年1月 (1)研究旨在比较恶拉戈利300mg bid（单药治疗或联合雌激素-孕激素反加疗法）对子宫肌瘤的疗效。在两项相同的试验（UF-1和UF-2）中，月经过多（月经失血量＞80 mL）且经超声诊断为子宫肌瘤的总共790名女性（平均年龄42岁）被随机分组，分别接受6个月的恶拉戈利联合反加疗法、恶拉戈利单药治疗或安慰剂治疗。研究者通过收集生理用品的方式量化月经失血量。两项研究6个月后，84%和77%的单药治疗、68.5%和76.5%的恶拉戈利联合反加疗法和9%的安慰剂组达到主要终点（月经量50%）。主要不良反应是潮热和子宫出血，恶拉戈利联合反加治疗组的发生率显著高于安慰剂组。反加治疗法减轻了恶拉戈利的低雌激素效应，腰椎骨密度减少0.76%，低于恶拉戈利单药治疗组2.95%。结论：恶拉戈利单药治疗或联合雌-孕激素反加疗法均有效减轻子宫肌瘤相关的月经过多。恶拉戈利单药治疗与骨密度显著降低相关，反加治疗可以减少这种副作用。子宫肌瘤子宫肌瘤，是女性最常见的盆腔肿瘤，是起源于子宫平滑肌细胞和成纤维细胞的单克隆非癌性肿瘤。主要发生在育龄期妇女，可表现为异常子宫出血、盆腔疼痛/压迫感、生殖功能障碍（不孕或产科并发症）。大多数的子宫肌瘤会在生产后或绝经后自行萎缩；如果子宫肌瘤引起严重症状，则需治疗。对没有生育要求的患者，可行宫腔镜下切除粘膜下肌瘤；雌-孕激素避孕药；释放孕激素的宫内节育器；氨甲环酸；促性腺激素释放激素（GnRH）的激动剂和拮抗剂等。对于有生育要求的患者，药物大多会妨碍受孕，因此治疗首选微创手术切除。《行子宫动脉栓塞术与子宫肌瘤切除术治疗子宫肌瘤的比较》New England Journal of Medicine，2020年7月 (2)对于希望保留子宫、且药物治疗无效的女性，子宫肌瘤切除术和子宫动脉栓塞术是可选治疗方案。这项多中心、随机、开放标签试验，旨在评估症状性子宫肌瘤患者中使用子宫肌瘤切除术和子宫动脉栓塞术的疗效的比较。子宫肌瘤切除术的可选术式包括开腹、腹腔镜或宫腔镜手术。研究共招募了254名女性随机分组：子宫肌瘤切除术组和子宫动脉栓塞术。随访2年时，两组的生活质量评分分别为84.6分和80.0分（P=0.01）。在所有初次手术中，子宫肌瘤切除术组29%的女性和子宫动脉栓塞术组24%的女性发生了围手术期和术后并发症。结论：在有症状的子宫肌瘤患者中，接受子宫肌瘤切除术的女性在2年时的子宫肌瘤相关生活质量优于接受子宫动脉栓塞术的女性。《随机双盲对照试验：术前氨甲环酸减少子宫肌瘤切除术失血》American Journal of Obstetrics and Gynecology，2020年9月(3)氨甲环酸是一种合成赖氨酸衍生物，具有抗纤溶活性，用于其他外科学科，以减少手术期间的失血。本研究旨在探讨早期静脉注射氨甲环酸对子宫肌瘤切除术妇女围手术期出血和输血需求的影响。这项双盲、随机、安慰剂对照试验中，纳入有大出血风险的、症状性子宫肌瘤的女性共60人，随机分入干预组（手术前20分钟静脉注射氨甲环酸15 mg/kg）和安慰剂组（手术前静脉注射生理盐水）。这里有大出血风险定义为：（1）至少1个肌瘤≥10cm，（2）任何1个肌壁内或阔韧带肌瘤≥6cm，和/或（3）手术前影像学检查提示至少有5个肌瘤。患者中53%接受腹腔镜子宫肌瘤切除术，40%接受机器人子宫肌瘤切除术，7%接受采用剖腹手术。氨甲环酸组和安慰剂组中，中位估计失血量分别为200ml和240ml（P=0.88）；中位手术时间没有差异（165min 和 164min），围手术期血红蛋白改变也没有差异（1.00 和 1.1 g/dL）。氨甲环酸组的患者均不需要输血，但安慰剂组有4例需要输血。结论：术前静脉给予氨甲环酸在腹腔镜或机器人肌瘤切除过程中，与减少出血量无关。《术前肠道准备并不能减少子宫切除术后的感染》American Journal of Obstetrics and Gynecology，2020年8月 (4)关于妇科手术前肠道准备的文献很少，在子宫切除术前进行肠道准备主要是借鉴结直肠手术的经验。因此本研究的目的是比较子宫切除术前，与无肠道准备相比，单纯机械性肠准备、单纯口服抗生素或联合使用抗生素是否与手术部位感染或吻合口漏发生率降低有关。研究回顾性的分析了10余年间、共224,687例子宫切除术手术患者的数据。其中良性疾病186,148例、平均45岁，恶性肿瘤38,539例，平均54岁。其中包括腹腔镜/机器人手术、剖腹手术和经阴道手术等不同术式。术前准备包括肠道准备、口服抗生素、两者联合等不同策略。研究人员发现，肠道准备并没有降低手术部位感染、吻合口漏或其他并发症的发病率。在恶性肿瘤、开腹子宫切除术中，肠道准备、口服抗生素或肠道准备联合抗生素等几种策略，与不进行抗生素预防治疗的患者相比，感染发病率没有差异。结论：无论手术方式如何，肠道准备都不能预防手术部位感染或并发症，可以安全省略此步骤。妊娠期高血压妊娠>20周的女性新发高血压，但没有蛋白尿或新发靶器官功能障碍，则诊断为妊娠期高血压。根据2019年美国妇产科医师学会的建议，无论是否有其他表现，收缩压≥ 160mmHg和/或舒张压≥110mmHg，应直接诊断为“重度子痫前期”，即以前所说的“重度妊娠高血压”。更名的原因是，即使没有蛋白尿，妊娠诱发的重度血压升高也可能导致严重的不良事件。若产后≥12周后，血压仍高于正常，诊断为慢性高血压。妊娠期高血压最常用的降压药物包括：甲基多巴、拉贝洛尔、硝苯地平。尚有争议的药物包括：噻嗪类利尿剂、肼屈嗪、可乐定、硝普钠。妊娠期应避免使用的药物包括：ACEI、ARB、直接肾素抑制剂、盐皮质激素。《综述：他汀类药物在预防子痫前期中的作用》American Journal of Obstetrics and Gynecology，2020年8月 (5)子痫前期的确切原因尚不清楚，但普遍认为与胎盘异常释放可溶性抗血管生成因子有关，加之氧化应激和炎症反应的增加，导致母体全身内皮功能障碍。他汀类药物已被证明可以纠正类似的病理生理过程。普伐他汀，在各种临床前期和临床研究中显示，它可以逆转妊娠特异性的血管功能失衡，恢复内皮健康，防止氧化和炎症损伤。人类研究表明普伐他汀具有良好的安全性，而最近的证据不支持他汀类药物致畸的担忧。结论：他汀类药物在子痫前期预防性的使用，仍需大型随机对照研究支持。《荟萃分析：口服降压药对慢性高血压孕妇的疗效和安全性的比较》American Journal of Obstetrics and Gynecology，2020年10月 (6)此荟萃分析的目的是同时比较降压药对患有慢性高血压的孕妇的疗效和安全性。共纳入了22项研究，包括4464名女性。随机对照试验的分析表明，没有任何药物会显著影响先兆子痫的发生率。与安慰剂相比，阿替洛尔与小于胎龄儿（small for gestational age，SGA）的风险增加显著相关（风险比 26.00），而且被列为疗效最差的降压药。严重高血压的发生率在以下药物的干预下显著降低：硝苯地平风险比0.27，甲基多巴风险比0.31，吲哚洛尔风险比0.29，酮舍林风险比0.17。相比而言，严重高血压发生的概率最高的药物包括：速尿、氨氯地平和安慰剂。硝苯地平和甲基多巴能显著降低胎盘早剥率的风险（风险比 0.29和0.23）。各类降压药在剖宫产、围产期死亡、早产和分娩时胎龄方面无显著差异。结论：阿替洛尔与小于胎龄儿的风险显著增加有关。当使用硝苯地平和甲基多巴时，严重高血压的发生率显著降低。尽管在降压药中先兆子痫的风险是相似的，但未来仍需大规模研究为妊娠期降压药的选择和目标血压提供指导。《前瞻性观察队列研究：慢性高血压患者妊娠并发症与妊娠前母体心脏功能和结构有关》American Journal of Obstetrics and Gynecology，2020年9月 (7)约3%的妊娠合并为慢性高血压，这些产妇的分娩并发症发生率可高达25 - 28%。本研究的目的是通过超声心动图，评估妊娠前孕妇的心脏结构和功能，寻找其与分娩并发症以及妊娠前治疗的相关性。这项前瞻性观察队列研究，纳入192名长期接受降压治疗的孕妇，妊娠前改用甲基多巴，并随访至分娩。在192例患者中，出现24例早期并发症（

This week on 5 minutes on the Red Couch we are going to talk about anemia. If this episode helps you please make sure you share and give a 5 ⭐ rating for Confessions from a Red Couch Podcast on apple podcast. https://confessionsfromaredcouch.comSocial Media IG: Confessions From A Red Couch Podcast FB: Confessions From A Red CouchSupport the show (https://www.patreon.com/CFARC)

Now, in this episode I share some memories, of when I was independent in the past growing up, as well as I look at how my independent trait has helped me in life and helped me through my Myomectomy experience. Also, I have entitled this podcast being independent and asking for help, because I feel the two things go hand in hand as well as makes one a better person in life. Besides this, the intro/outro for this episode is from epidemic sound, and the track is entitled 'Like a song from yesterday' by Wendy Marcini. Lastly, if you want to leave a review on apple podcast, you can follow the steps below: Step one: Type in the name of the podcasters title for example, "Hannah Boyce's audio diary".Step two: The thumbnail/artwork of the podcast will come up, click on the artwork; scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you would like to give the person/podcaster, and write a review, as well as when you have finished writing your review, select submit, and your review will be posted. Also, there is an option to remove a review if you have made a mistake, or don't want to leave the review up on the reviews page, you can go to your apple login, either by phone, computer or tablet, go to:First go to the settings icon, then tap on your Apple ID at the top of the screen Next, sign into your apple IDAlso, then go to Media and purchases, you will see all your purchases, as well as the reviews you may have left for any purchases on Apple, you can click on the ones you want to remove, and an option, icon appears called remove, you can click on this button if you want to remove a review you have mistakenly made, or you may not want to leave the review again. 

Olive oil to start the show. Kay talks a her up coming surgery. Medieval cover songs: https://www.youtube.com/watch?v=i2zpbcW-h-c

Now, in this podcast, I talk about a previous issue in my life to do with womens' health, and I thought it would be beneficial to talk about my previous womens' issues to understand what I went through recently with my Myomectomy surgery. Also, the musical track in this podcast is from Epidemic sound, and is entitled 'Like a song from yesterday' by the artist Wendy Marcini. Now, to leave a review: Step one: Type in the name of the podcasters title for example Hannah Boyce's audio diaryStep two: The thumbnail/artwork of the podcast will come up, click on it, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you want to give the person/podcaster, and write a review, and when you have finished writing your review, select submit, and you review will be posted.

July is Fibroid Awareness Month - studies show that Black women suffer from fibroids 2-3 times more than white women and tend to experience fibroids at a younger age and often more severely. With those numbers, Black women are also 2 to 3 times more likely to undergo surgery to manage their fibroids. With such a common occurrence, few women are open about their experience, know about treatment options, or what options they have after having a myomectomy.In this episode, Mabel walks us through her infertility journey, a pregnancy with fibroids, advocating for a trial of labor after laparoscopic myomectomy, and a redemptive vaginal birth. At 26 years old, she found out that she had fibroids, which she would never have expected. Researching and working with her care provider, Mabel decided the best option for her would be to get her fibroids removed through surgery. Knowing that she and her husband would want to expand their family, she decided to move forward with laparoscopic myomectomy. A minimally invasive procedure to remove fibroids, but also provides a better chance for having vaginal births. Whether it be abdominal or laparoscopic, most myomectomy candidates are not offered a trial of labor. When she found out she was pregnant, Mabel was aware of the odds, but standing firm in her wants and needs, she went through a dozen no's before meeting a doctor who was willing to step out of his comfort zone and support her. This episode covers a myriad of topics; diastasis recti, pelvic floor health, fibroids, blood transfusions, hemorrhaging, drawing boundaries with family, but most importantly, advocating for ourselves as Mabel puts it "having the nerve" to stand up and demand what we want. Resources:Within Her Birth Services (Mabel Bashorun) | birth doula servicesThe Birth Hour | birth story podcastMama Natural Week by Week Guide to Natural Pregnancy and Childbirth | pregnancy & childbirth book by Genevieve HowlandSupernatural Childbirth | childbirth book by Jackie MizeVBAML (vaginal birth after laparoscopic myomectomy) | research articles & informationPregnancy and Delivery After Laparoscopic Myomectomy (Journal of Minimally Invasive Gynecology)Pregnancy and delivery after laparoscopic myomectomy (National Library of Medicine)Pregnancy Outcome and Deliveries Following Laparoscopic Myomectomy (Human Reproduction Volume 15, Issue 4)

Now, in this podcast episode, I share my health thoughts; when I had a fibroid. Also, in this podcast I talk about when I discovered something was wrong with me and I continue my talk with what happened to me when I was receiving treatment for my health condition.Lastly, the soundtrack that I included with the podcast comes from Epidemic sound, by an artist named Gavin Luke and the soundtrack is entitled 'Live for the moment', which I believe it fits together well with this podcast and as it was a sad time I went through, I found this soundtrack to be quite hopeful too, giving my podcast a sad but hopeful feeling to it. Now, to leave a review: Step one: Type in the name of the podcasters title for example Hannah Boyce's audio diaryStep two: The thumbnail/artwork of the podcast will come up, click on it, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you want to give the person/podcaster, and write a review, and when you have finished writing your review, select submit, and you review will be posted. 

Now, this episode is some thoughts, when I underwent abdominal surgery recently. Now, to leave a review: Step one: Type in the name of the podcasters title for example Hannah Boyce's audio diaryStep two: The thumbnail/artwork of the podcast will come up, click on it, scroll down to the bottom of the page, it will say write a review, and then click on the write a review button/tab, select how many stars you want to give the person/podcaster, and write a review, and when you have finished writing your review, select submit, and you review will be posted. 

              Uterine Fibroids Special guests Dr. John Lipman of Atlanta Interventional Institute and Dr. Carlos Alarcon of Marietta OB-GYN are featured on this week’s program. They share information about amazing minimally-invasive procedures and the multi-specialty team approach they use to treat uterine fibroids. By age 30 as many as 30% […] The post Minimally-Invasive Treatments for Uterine Fibroids Avoid Hysterectomy – Top Docs Radio appeared first on Business RadioX ®.