Health News

The formation of adhesions — a risk of any abdominal surgery — must be avoided if possible because of the associated pain and interference with normal organ function. Tissues that were never meant to be joined can become attached to each other and problems like chronic pelvic pain and infertility may result. To minimise the chances of adhesions forming, tissues must be handled gently, appropriate irrigation solutions or an adhesion barrier used within the abdomen, and blood loss minimised. The extra cost to the patient of taking these precautions is less than $150, a small price to pay for the prevention of potentially serious problems. The use of laser techniques and diathermy also appears to reduce the risk of adhesion formation. Reconstruction of the uterus after removal of fibroids requires skill and care. Recent research suggests that when sutures are avoided during myomectomy, adhesions are less likely to develop. On the other hand, the absence of sutures may lead to weakness of the uterus.

An occasional serious complication of hysteroscopic myomectomy is perforation of the uterus. It may occur if the surgeon cuts deeply into the wall of the uterus to remove parts of an embedded fibroid. To minimise the risk of this happening, some doctors simultaneously perform a laparoscopy, a procedure in which a small incision in the abdomen is used as a porthole to enable visual inspection of the pelvic organs, including the outside wall of the uterus. Others think this is of doubtful value. Most women return home within one to three days of a hysteroscopic or laparoscopic myomectomy and it is usual for surgeons to check on each patient’s progress about six weeks later.

For open myomectomy, the pattern of post-operative illness and time to full recovery is similar to that for abdominal hysterectomy. That is, the average length of hospital stay is four to seven days, pain persists for several weeks and full recovery may take several months.

Women having a hysteroscopic or laparoscopic myomectomy experience less pain and a shorter convalescence (by about two to four weeks) than those having either open myomectomy or abdominal hysterectomy. The cost of these procedures in Australia is considerably less, in the short-term at least, than the cost of an open myomectomy (around $1500 for hysteroscopic myomectomy and $2200 for a laparoscopic myomectomy compared to $3825 for an open myomectomy). Because of the relatively recent introduction of hysteroscopic and laparoscopic techniques to perform myomectomy, it will be some time before we know the extent to which fibroid recurrence and complications alter these costings.

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There are many ways of testing nutritional status – using samples of blood or sweat, for instance. But one of the most cost-effective and convenient ways is through a hair sample. Hair has been shown to reflect a good long-term record of our mineral and nutritional experience.

Eventually hair samples could be used to screen for potential diabetes or breast cancer. Work is being undertaken in Australia by Professor Veronica James at the University of New South Wales where hair is being analyzed with a technique called X-ray diffraction. As X-rays are fired through the hair they form a pattern on photographic film. From this pattern the researchers are able to pick up different information. For instance, with hair from a diabetic patient, sugar binds onto the hair filaments. It will therefore look different from a strand of hair taken from a person without diabetes.

Hair samples can also be used to test for drug use, such as cocaine, amphetamines and cannabis. This is helpful in forensic medicine and pathology, for example to determine whether somebody was under the influence of drugs in an accident.

Because your hair cells are some of the fastest-growing cells in your body, they can ‘lock in’ information about your exposure to certain nutrients as they grow. In this way, your hair forms a permanent record of your exposure to beneficial and toxic elements. Analyzing hair is therefore also an excellent way to test for heavy toxic metals and is used in many medical studies to assess exposure to metals like mercury.

Other ways of testing, with blood or urine for instance, can be less reliable, because the results are influenced by what you may have eaten. Also your body tries to keep everything in balance. To do this, it tops up the levels of nutrients in your blood by taking them from elsewhere. For instance, if your blood calcium levels fall your body will pinch calcium from your bones to keep the level constant. A blood test may then suggest that your calcium levels are fine. But a hair analysis showing high levels of calcium would help identify the leeching of calcium from your bones.

However, like any testing method, hair analysis has its limitations. For instance, when testing for nutrients it is important that your hair is not contaminated by tints, highlights or perms. Certain minerals (iron, for instance) are best tested by blood samples. But levels of trace elements can be higher in hair, which make them easier to analyze. Also, because hair doesn’t need specialized sampling equipment or storage, this form of testing is accessible for couples who don’t live near a qualified practitioner.

Hair can be used to analyze your levels of calcium, magnesium, zinc, selenium, copper, manganese, chromium and also the toxic metals mercury, aluminum and cadmium.

The minerals are usually analyzed, together with a detailed questionnaire.

Then a personalized programme of supplements is recommended for you and your partner. This programme should be followed for a minimum of four months and then the hair should be re-tested.

Once your mineral and toxic levels are back to normal, you will be given a maintenance programme to follow until you become pregnant.

In the twelfth week of pregnancy, you will be tested again. Your nutrient needs during pregnancy are different and your programme will be adjusted accordingly. You should then continue with the amended programme until you have your baby.

If your starting levels of nutrients were very deficient or your toxic metal levels extremely high, then you should stay on the programme for longer.

If you are planning to have fertility treatment, you should follow the programme for four months beforehand. This will ensure that the egg and sperm are as healthy as they can be before treatment starts, to give the procedure the best possible chance of working.

Mineral analysis can also identify substances that reduce your and your partner’s fertility. For example, if you have used the pill or an IUD (coil) you may have high levels of copper. This can also be due to fertility treatment, where the drugs used increase copper levels. High levels of copper are a concern, as they are often matched by low zinc levels which can dramatically affect levels of fertility and may also give an increased rate of miscarriage.

You and your partner may turn out to have high levels of copper and other toxic metals and this may well explain your fertility problems.

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Failure of sexual function in men can sometimes be due to a deficiency of male sex hormones, and this deficiency can be diagnosed by fairly simple laboratory tests. If a deficiency is present, treatment with the male sex hormone can be given. There is no simple tablet or pill as there is for the treatment of women; testosterone (male sex hormone) must be given by injection or implants every 10-14 days. It should be stressed that this treatment is indicated only for a minority of men with decreased sexual function, but for such men the treatment usually causes remarkable improvement. For other men, in whom no sex hormone deficiency can be shown, treatment with a male sex hormone is usually of no benefit.

There should, perhaps, be one note of caution. Male sex hormones are known to act on the prostate, and if a man already has some prostatic problem with urinary difficulties, testosterone may aggravate it.

Is there a clinic for men who have these problems? Not at present. A good physician will often recognise the problem, and may refer such men to endocrinologists (which deal with glandular problems). These clinics can only determine whether there is a hormonal deficiency or not, and advise about treatment with male sex hormones.

If there is no deficiency of male sex hormones, a referral might he made to a sexual counseling clinic. Such clinics have been established to help men (couples really) with importence and other problems.

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