Before Surgery

Preparing for Surgery: In a recent study below they "rehabilitated" patients prior to a specific kind of surgery with favorable results

My thoughts: I believe that before surgery we should prepare by exercising (aerobic exercise) to increase oxygenation, sleeping at least 8 hours a night, and improving our nutrition (eliminate alcohol, processed foods, high sugar content foods and drinks) and getting a dental cleaning. All this is when possible and in consultation with your doctor.

Source: Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery
A Randomized Clinical TrialEnrico M. Minnella, MD¹; Rashami Awasthi, MSc¹; Sarah-Eve Loiselle, PDt¹; et alRamanakumar V. Agnihotram, PhD²; Lorenzo E. Ferri, MD, PhD³; Francesco Carli, MD, MPhil¹Author Affiliations Article InformationJAMA Surg. Published online September 5, 2018. doi:10.1001/jamasurg.2018.1645

Before surgery dental cleaning

Summary Before surgery: Improving patients' oral hygiene is an option for preventing postoperative pneumonia. 

A little more: "Preoperative oral care and effect on postoperative complications after major cancer surgery" (From AMA) Improving patients' oral hygiene is an option for preventing postoperative pneumonia. A retrospective study was done to determine the association between pre surgical  oral care and post surgical complications among patients who underwent major cancer surgery. The study showed that preoperative oral care by a dentist significantly reduced postoperative complications in patients who underwent cancer surgery.

My thoughts: Before getting cancer surgery go get dental cleaning

Cervical Cancer Screening

Cervical Cancer Screening Summary of Recommendations and Evidence (from JAMA)

USPSTF recommends (does not apply to individuals who have been diagnosed with a high-grade precancerous cervical lesion or cervical cancer; individuals with in utero exposure to diethylstilbestrol or those who have a compromised immune system (eg, women living with HIV)

1. screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years (women who have a cervix, regardless of their sexual history or HPV vaccination status) 

2. For women aged 30 to 65 years, screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) 

3. NO screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. 

4. NO screening for cervical cancer in women younger than 21 years

5. NO screening in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion or cervical cancer

ACS/ASCCP/ASCP recommend  

1. YES screening: women aged 21 to 29 years be screened every 3 years with cytology alone (cervical cytology or Pap testing). 

2. YES screeing: Women aged 30 to 65 years should be screened every 5 years with cytology and HPV testing or every 3 years with cytology alone. 

3. Women at increased risk of cervical cancer (ie, women with a history of cervical cancer, a compromised immune system, or diethylstilbestrol exposure) may need to be screened more often. 

4. Women who have had CIN 2+ should continue screening for 20 years after the last abnormal test result, even if it extends screening beyond age 65 years.

ASCCP and SGO guidance (2015)

1. recommended primary HPV screening starting at age 25 years as an alternative to cytology alone or cotesting.

The American Academy of Family Physicians guidelines are in agreement with the USPSTF.

The American College of Obstetricians and Gynecologists (2016) that cytology alone and cotesting are still specifically recommended in current guidelines from most major societies; however, primary HPV screening in women 25 years or older can be considered as an alternative to current cytology-based screening if performed per ASCCP and SGO interim guidance.

Eczema: (from JAMA)
Summary: too many gram positive bacteria (a kind of bug, many bugs live on our skin and some or the correct ratio of one knid to another are actually good for us) are found in areas of eczema. Could changing the bacteria in those areas heal eczema? There have been good results. The study is still ongoing.

My Thoughts: I believe as the author suggests that soaps lotions, shampoos, conditioners all have some bad chemicals especially preservatives in them that change the corret benefiacial bacteria ratios which then caue skin problem. My thought is stay away from these products. Try to buy natural products

What I do:
I look for products: without parabens; have few ingredients:when I read the the label I know what they are
I dont use body moisturizers
When I am done showering I apply organic oils (coconut avocado...) to my body from the neck to the top of my feet (caution: careful not to step on oily products and fall, my shower has a rough surface floor so I havent slipped yet! If you have rosacea or any other skin issues talk to your dermatologist first you r skin may not tolerate oils)

Summary: Only 49% of teens are vaccinated against HPV, but cervical cancer rates are declining, (from CDC data)

A little more: I strongly recommend vaccination. HPV can cause cancer of the cervix, anus and head and neck cancers. We hope that our children will lead a sexually responsible life but even if they do their spouses/partners might not or might not have in the past. By vaccinating them we are protecting them from getting certain types of cancers in the future. Give this gift to your children.

Skincare what do Dermatologist agree on:
1. Use a Retinoid
2. Lower sun exposure

What do I like:

1. Retinoid: I use tazorac. Start using very little about the size of half a pea. Talk to your dermatologist.
2. Microdermabrasion: You can do this at a doctors office or at home. I do it at home
3. Botox: just great at preventing wrinkles ideally 4 times a year
4. Fillers: this really works. I recently had it done on my undereye area and that was awesome. Caution: go to a really good practitioner not all know how to do it.
5. About blocking the sun: I feel sunblocks have so many chemicals that I try to stay away from them as much as possible. Whenever possible I will choose a hat and a rashguard over sun block. Remember that sun block works for 2 to 3 hours! So when you wear sun block remember to reapply often

Cannabis

Summary:Cannabidiol (CBD) a substance in marijuana has antipsychotic effects in humans, (patients took 600 mg CBD)from  JAMA psychiatry

A little more: The cannabinoid receptor 1 (CB1) is present all over the brain and influences the function of neurotransmitters including dopamine and glutamate. (Neurotransmitters are chemical messengers sending information between nerve cells.  Each neurotransmitter has a different function.Dopamine has effects on physical and cognitive functions, including movement, motivatio, memory, feelings of reward and pleasure. Glutamate is a neurotramsmitter involved with learning and memory) The component of cannabis responsible for its short-term psych effects is Δ9-tetrahydrocannabinol (THC). Cannabidiol (CBD), has opposite neural and behavioral effects.Clinical studies indicate that CBD has antipsychotic and anti anxiety properties in patients with mental disorders.