Call for Interviews

by Dr. Margaret Aranda

I'm doing research interviews on women for my newest Book, From Menarche to Menopause: A Journey Through Time.

Each girl or woman will be asked questions about her First Period, and/or about her Menopause.   If you are a gentleman and would like to be included, that would also be perfect, as your perspective is important to women and to society.

Results will be tabulated in standard research format, and quotations may be used to document items.  By agreeing to the Interview, you agree that it may be published in any form, by me.  Generations of women Interviews are encouraged, so you may recruit your mother, sisters, grandmother, aunts, and/or daughters.

If you would like to be included, a formal process occurs.  There are two methods:
(1) For Interview permission by email: please email me at drmargaretaranda@yahoo.com, with the Subject Heading:  INTERVIEW.

~   or  ~

(2) Give permission for Interview inclusion in my book by simply providing recorded permission on the Interview telephone call.  In this case, please 'Comment' below, provide your Contact telephone number, and your Contact information will be kept confidential (i.e., it will not be published as a Comment).

Your answers may be used to benefit women's health, medicine, and society, and are considered to be a generous gift that will be safely guarded and professionally treated.   Sending you a sincere

Research Question for The First Period

by Dr. Margaret Aranda

I'm writing a book, From Menses to Menopause: A Journey Through Time.

In my research, I am finding several things.  One of them is that virtually all women remember where they were when they had their first period.  The second thing is that there are not a lot of stories out there on this event.  Much like losing your first tooth, starting a new school, or wearing your first bra, having your first period can be a vivid memory that brings back a lot of different emotions.

So welcome to Womanhood!  Let's have a go at this!


First, I need:
A.  Your Age right now
B.  Your Ethnicity
C.  Your Age when you started your period

Then Please Answer these Questions:

#1.  Where were you? (e.g., at school, in the garden, etc.)

#2.  Who was with you? (e.g., your sister, no one, etc.)

#3.  What did you do? 

#4.  Did you tell your mother?  Your father?

#5.  How did you feel?

#6.  (And since I'm a doctor, I have to ask...)  Did you tell your doctor?

And for our gentleman friends, please ask a kind woman for her input here.

Thank you!  If you do not want to post your Comment here, please email me privately at:

drmargaretaranda@yahoo.com with the Subject Headline:

WHERE WERE YOU?

From Menarche to Menopause: A Journey Through Time

by Dr. Margaret Aranda

Thank you to Deana Barnhart for GUTGAA and all the work she does to help advance Authors!

This is a Contest for the first 150 words of a Completed Manuscript

Pitch Polish Blog Hop #GUTGAA

AUTHOR'S NAME: Dr. Margaret Aranda

TITLE OF MANUSCRIPT: From Menses to Menarche: A Journey through Time

GENRE: Adult Non-Fiction

WORD COUNT: 120.000

Query:  

Femininity is equated with passages through the pagan symbolism of the Three Goddesses:  The Maiden, The Mother, and The Crone.   At Menarche, we had our First Talk.  At Motherhood, we didn't really need a formal 'talk'; it just happened over the course of months and years.  At Menopause, we had...we had our...we had our well, nothing.  We never had The Second Talk.  So many of us Baby Boomers are peri-menopausal, and what is a woman to do?  First, estrogens cause uterine cancer and breast cancer, then progesterone makes it better.  And what about testosterone for women?  

From Menses to Menopause starts with menstruation; its history, culture, and conceptions since the time of Aristotle.   Then it accompanies today's Spirited, Fit and Forty Woman's speedy life, fast-forwarded to the here and now.  Let's give you that Second Talk, ripe for today.  You do remember where you were when you started your first period, don't you?  You do remember who gave you The First Talk.  Well, sit right down and get the kids in another room.  Your journey through The Second Talk is about to begin.

First 150 Words:

My "First Talk" wasn't actually a "talk" talk.  I was 13 years old, and my Mother handed me a red hardcover book.  The Red Book.  I was told to turn to say, the seventh Chapter.  Okay, basic Anatomy.  The vagina was depicted in a large color illustration of the uterus and Fallopian tubes, and there was a small illustration of the penis. 

No preamble, no introduction, no warning.  Initially it was pretty boring.  A couple was sitting on the couch.  A married couple.  They made a big deal about that part.  Horrified, my eyes widened as the penis was inserted into the vagina.  What?  I had to read it over again.  How did that happen so fast?  What?  How did that happen so fast?  How could that happen with their clothes on?  I read it again.  They definitely still had their clothes on.

The Maiden, The Mother, and the Crone

by Dr. Margaret Aranda

This depiction of a woman through menstruation, maternity, and menopause is just pretty, I think.  Our pagan predecessors coined this term to describe a woman as she journeys through life's stages.

Thought I'd just share that I think the Crone has osteoporosis, as she has shrunken in size.  She has more central obesity in her abdomen, thick legs, and appears rather stiff and inflexible, compared to her younger counterparts.  Her hair is gray and wiry, shorter and perhaps thinner, too.  Her arms are not uplifted or outstretched, and she appears to need help, as the Maiden and the Mother seem to be facing her perhaps to make sure she doesn't get lost.  Look how strongly the Mother holds her hand.  They are intertwined, not loosely held.  They seem to be pulling her along, as if she is fragile and needs help.

I just think it is pretty, and symbolic.

The Promotional Copy of My Book is Out!

There was a day that her life got stumped.  First she was a Stanford doctor, then she became a trauma patient due to a car accident.  

Now, she could not stand up or else she would faint.  The doctor-turned-patient had an invisible disease and the doctors were stumped too.  What did she have?  Why must she live on IV fluid?  In No More Tears Dr. Margaret Aranda takes you on a ride to the door of Heaven as she describes her near-death experience after a car accident. She was unable to walk and unable to talk, and for over three years, I lived on IV fluid.  No More Tears will inspire you to persevere, to speak up, to be that rare bird, that underdog who wins despite the odds. 

Dr. Margaret Aranda, M.D., has written scientific articles on neurosurgery, anesthesiology, critical care, and radiology. She has received several awards for medical education in Oklahoma, California, and South Korea. She lives in Los Angeles, California.

http://www.drmargaretaranda.blogspot.com

http://www.dysautonomiamd.blogspot.com

http://www.girlpowerinamm.blogspot.com

https://www.facebook.com/NoMoreTearsAPhysicanTurnedPatientInspiresRecovery?ref=hl

Why Women Care about Menopause

by Dr. Margaret Aranda

Hi friends, I don't normally talk about menopause, but things have changed for me.

I am postmenopausal by about 6 years, and that is key.  If I had gone more than 10 years without treatment, perhaps I would have been excluded from some hormone replacement.  Unfortunately, no one really knows what to do with women who have had no treatment for their first 10 years of menopause, because you guessed it, there hasn't been good research in this field.

So there is good news and bad news, as with all things in life.  The #1 issue I want to impart is that Heart Disease is still the #1 killer of women in the USA.  So, I think it makes sense that Aging isn't just about Aging Gracefully.  It is about Aging with mind, body, and spirit.

Why Should We Care that it is Menopause Awareness Month?  

Because Aging is a fact of life. 

Just as we got The First Talk about menstruation, we need to receive The Second Talk about Menopause.

Because women matter.  

Because heart disease is the #1 killer of women.

Because your grandmother or your mother may need a little extra compassion and support.

Because too many women need evaluation for perimenopause, menopause, and postmenopause.

Because the science of medicine is here for Women's Health.

Because menopausal and postmenopausal women with a big belly, an android figure, are at increased risk of heart disease, diabetes, hyperlipidemia, falls, fractures, and death.

Because women spend their lives nurturing and giving.  It is time for women to give something back to themselves.

Because insomnia has been shown to increase the risk of cancer in women.

Because your mother or grandmother may need better sleep.  

You should know that weighing yourself on the scale and counting calories is no longer the end-all of weight loss or optimal body composition goals.   More on that later.  You should know that the old way of measuring height:weight and calculating Body Mass Index has pretty much gone out the window, in favor of the hips-to-waist-ratio.  Do you know how much you weigh?  I'm sure you do.  Do you know your Waist-to-Hip Ratio?  *Applause* *Applause* if you do!  You can calculate your own ratio here: Waist-to-Hip Ratio Calculation.  What does your ratio mean?  "Risk" is the risk of dying from cardiovascular disease and diabetes.

The lowest risk:  0.80 or below.

Moderate risk:     0.81 - 0.85

Highest risk:      0.85 or higher.

Don't pass Go without calculating your Ratio, ok?  Today is the new day to start moving Onward & Forward for yourself.  If this is the first time you are calculating your Ratio, I want to know about it!

Your success in moving forward with your body is my success in moving forward with my soul!

So Post a Comment....and if you don't know how to post a Comment, send me an email at girlpowerinamm@yahoo.com and I'll personally walk you through the process!

I'm starting a new lease on life to help myself, and in the process I'm going to make sure that I help you, too.  So visit my article on the science of menopause: Article on Menopause.

And support every woman this month.  Talk about Menopause.  

Full Disclosure:  Dr. Margaret A. Ferrante is an Institute Physician at Cenegenics® in Beverly Hills, CA. 

September is Menopause Awareness Month

Did you know that September is Menopause Awareness Month?  The American College of Obstetricians and Gynecologists has a great update for you.  For women, the major complications of menopause include heart disease, stroke, osteopenia, and osteoporosis.   Heart disease is the #1 cause of mortality in women, and we hope this will change.  What are some symptoms I can expect from Menopause?  Check the list here, as it is long.  Some symptoms of menopause include hot flashes, pain on intercourse, insomnia, and emotional changes like fatigue, sadness, irritability, anxiety, and depression.  

A look at hormone production shows that cholesterol is the primary molecule from which all hormones are derived:  pregnelolone, DHEA, androstenedione, testosterone, estradiol, estrone, progesterone, cortisol, and aldosterone.  In both sexes, aging affects all of these.  For women who are either in menopause or who are postmenopausal, hormone replacement therapy (HRT) may be indicated.  But wait.  Aren't hormones "..bad for you..."?  Many women are confused, because aren't hormones dangerous to take?   Don't they cause cancer?  Well....

These are some basic facts about you and hormone replacement therapy:

(1) Some contraindications for unopposed* estrogen:  endometrial cancer, breast cancer, ovarian cancer, stroke, blood clots, pulmonary embolism, deep venous thrombosis.

(2) Some contraindications for progesterone:  heart attack, cardiovascular disease, breast cancer, ovarian cancer, deep venous thrombosis.

(3) Heart disease kills more women than cancer or blood clots.  We hope that going on HRT allows a woman to live longer and not die because of cardiovascular disease.  Will some of these women get breast cancer?  Yes, if they live long enough.  

Until recently, no one really told me the latest about menopause.   My Ob/Gyn, my PCP, and my Cardiologist never mentioned menopause to me.   As a doctor, of course I knew that I was in menopause, and had been for the last 6 years. But was hormone replacement therapy indicated?  And if so, what were the benefits vs. risks? And what should I be taking?  What about bioidentical hormones? 

So one of my quests by going to Cenegenics®  was to exit fully immersed in evidence-based science with an analysis of major medical journal manuscripts about menopause.  Did I get this?  Yes.  What am I going to do about it?  Well, I'm on HRT, I started this Blog, and I'm moving Onward & Forward together with you!  

Yes, the GirlPowerinAMM Blog started on Friday, August 31, 2012 as I was sitting in a chair in an air-conditioned, black marble conference room at Cenegenics® in Las Vegas, Nevada with my physician peers and James Powell.  My hotel room in downtown Vegas was next door to Caesar's Palace, and I can report that I never had the time nor the inclination to go anywhere but to Physician Training at Cenegenics®.  I had much to learn and oh, so little time.  

Well actually, Heidi McNulty, D.O. and I took the advice of  Robert D. Willix, Jr., M.D., , former Board-certified cardiovascular surgeon and now CEO and CMO of Cenegenics® in Boca Raton, FL, and we hiked at Red Rock Park.  Ah, yes, the sun had gone down but we saw a few bats and drove a nice drive, too!  Ladies, hormones or no hormones, we have to get that exercise in, okay?

Back to some hard data for you; The defininition of menopause:

(1) the ovaries no longer function, and
(2) those monthly menstrual periods have stopped.

Types of menopause: 
Premature Menopause:  occurs before 40 years of age, whether natural or surgical.
Perimenopause: menstruation happens less and less frequently; may last 1-4 years.
Surgical Menopause: includes surgery, radiation, and chemotherapy.
Postmenopause:  the years after menopause.
Male Menopause: decline in male hormone production, or hypogonadism.

Case History: If you are a 51 year old female with hot flashes and you tell me "My last period was 1 year ago",  I diagnose you as being "Menopausal".
Case History: If you are a 66 year old female with hot flashes and you tell me your have not had a period in 14 years, I diagnose you as being "Postmenopausal".
Both of these patients are at significant risk of heart disease and complications of menopause, and both need evaluation to minimize the risk.

Please know that The FDA has approved hormone therapy for two major symptoms:  hot flashes and vaginal atrophy.  So what is the deal with menopause and hormones?  This is the deal:  it is individual.  There are risk factors of menopause and there are risk factors of HRT, make no mistake.  Your physician definitely needs to elicit a thorough family history, and a complete medical history from you.  Your physician may also need to evaluate your nutrition habits, your exercise efficiency, your cognitive function, your hormone levels, including your thyroid gland and your blood glucose levels.

Aging is not just about the hormones; it is about optimizing your mind, body, and spirit.  That's my view and I'm sticking to it.

Only after your physician is armed with a wealth of knowledge can she weigh the benefit:risk ratio to give you the best recommendation.  Her recommendation does not apply to anyone else but you.


* unopposed estrogen = estrogen taken by itself, without progesterone.  If you are at high risk, estrogen may not be a choice at all.


Full Disclosure:  Margaret A. Ferrante, M.D. is an Institute Physician with Cenegenics® in Beverly Hills, CA.

Gearing Up to Get an Agent: GUTGAA

by Dr. Margaret Aranda


Well, I already have a book coming out...my first... and I'm participating in a random Contest for Authors.  First they want a mini-Bio to meet & greet...then answer some questions posed.  And who knows?  I might even get an Agent.  (!)

Mini-Bio:  I'm a Stanford-trained doctor in anesthesiology and critical care.  That's the good news.  The bad news is that it all came crashing to a stop, both literally and figuratively, when some lady hit me and my daughter in Malibu, California.  Thank God my daughter was and is fine ;-).  But I was stumped.  The doctors were stumped.  I couldn't live without an IV.  I died and went to the door of Heaven.  I came back.  I saw life and I saw death; now I was life and I was death.  Drip, Drop and Hum, Drum of the IV that was going into me instead of into my Patients.   So, I wrote a book.  And I persevered.  WaLa!

Six years later, I'm now a Cenegenics Institute Physician and my office is in Beverly Hills.  (Shhh~ Grand Opening Soon!)   My goal?  To stay well, and to use my medical knowledge to practice Excellence in Age Management and Preventive Medicine.  My Newest Book?  Girl Power in Age Management Medicine: A Walk through Time.  In fact, I'm starting it tonight!

-Where do you write?  In bed, my sanctuary of sorts.  Mmmm. Cozy.

-Quick. Go to your writing space, sit down and look to your left. What is the first thing you see?  Tonight, it is a cup of coffee.  Low-fat milk instead of cream, and no sugar ;-).  Low-Glycemic Index Diet, of course!

-Favorite time to write?  After the sun goes down, when the crickets come out.

-Drink of choice while writing?   Mmmm.  Roasted coffee smells so good.

-When writing , do you listen to music or do you need complete silence?  Silence is golden.  Ah, but there's the hum of the air conditioner for background noise.  It's still cozy. 

-What was your inspiration for your latest manuscript and where did you find it?  My inspiration for the current book comes straight out of the desire to pursue Excellence in Medicine.  I sought training in the specialized field of Age Management, not expecting to get what I got:  a Stanford-quality education at Cenegenics!  So WaLa!  It's off to work I go!  Fit to explode with happiness, I can't wait to stay well and get fit and I just have this exuberance!  This journey is a walk indeed, and much like the times I wanted to share when I was a trauma patient, I'm just grateful to be sharing the Good Times this time! Onward & Forward for Women's Health I go!

-What's your most valuable writing tip?  Ahhhh.  That's Easy, As with all things in life that are a challenge, just do this:  Believe and Persevere.  If you really Believe, then Act.   And Hey,  I believe in You!   

So, to answer the Question:  Just Write!  

Q & A on Supplements: Ask Away!

by Dr. Margaret Aranda


We are so pleased to bring Dr. Heidi McNulty in as a Power Girl for you!
She is President and Medical Director of Pure Bulk, which can be found at:  Pure Bulk Website.

Ask Away!

The History of the Low-Glycemic Index Diet

by Dr. Margaret Aranda


In 1981, David A. Jenkins, M.D., Ph.D., DSc.,  Department of Nutrition Sciences at Canada's University of Toronto, first published an article describing the Glycemic Index in The American Journal of Clinical Nutrition.  He then formulated the Glycemic Index (GI) food by food, with numerical values assigned (Jenkins et al, 1981) as they pertained to the consumption of sugar and more recently, a piece of white bread.

The main theory is that the Glycemic Index is simply an extension of the 1977 Fiber Hypothesis of Burkitt and Trowell, which holds that dietary fiber is absorbed slowly and may have metabolic effects that are beneficial, particularly for prevention of diabetes and cardiac disease.

In the 1990's, the concepts of central abdominal adiposity and metabolic syndrome (Bjorntorp, 1992), intraabdominal fat, high waist:hip ratio (Landin et al, 1990), and insulin resistance (Vague and Raccah, 1992) were also being formed.  Foods that lead to a higher blood glucose and insulin level have a higher numerical GI value.  This numerical system is essential to decreasing the physiologic response, and to the prevention and treatment of diabetes and other chronic diseases.   Charting can be done by GI itself as a numerical value, or by grouping the Category of GI (See Chart).

Chart. High, Medium, and Low-Glycemic Foods. 

The typical Western diet hits the body with starchy carbohydrates in the morning, in the afternoon, and again in the evening.  After eating, the blood glucose increases and to compensate, the blood insulin levels also increase.  The problem is not just the resulting hyperglycemia; it is the hyperinsulinemia also.  When insulin is chronically elevated due to a high-glycemic index diet, fat can not be utilized, the body becomes insulin-resistant, and elevated insulin levels no longer drive glucose into the cells.  Diabetes and central adiposity ensue, with the attendant increase in cardiac risk.

The low-glycemic index diet has been attributed with the following:

1. In healthy subjects, decreased urinary C-peptide;
2. In subjects with diabetes, decreased blood glucose levels;
3. In subjects with hyperlipidemia, decreased lipid levels;
4. Increased HDL levels (beneficial lipids);
5. Decreased risk of diabetes;
6. Decreased risk of cardiovascular events;
7. Decreased risk of colon cancer;
8. Decreased risk of breast cancer;
9. Decreased central obesity.

Most recently,

1. In overweight and obese women with polycystic ovary syndrome, the low-glycemic index diet increased insulin sensitivity (less diabetes tendency) and decreased high-sensitivity C-reactive Protein (decreased inflammatory marker) (Mehrabani HH, et al, 2012);

2. In Canadians with cancer, a higher GI and GL diet increased the risk of the following cancers: prostate, colorectal, rectal, and pancreatic ( Hu J, et al, 2012);


While the low-glycemic index diet and was first described in 1981, its popularity began to abound in the 1990's.  Here it is now 2012, and we estimate that millions of women have not heard of it.  We hope to initiate change in this matter, as it is time to decrease abdominal obesity, diabetes, and the attendant morbidity and mortality associated with diet as a causative factor.
We say, "It's about time."
Stay tuned for more.


by Margaret Aranda Ferrante, M.D.



References

Bjorntorp P. Abdominal obesity and the metabolic syndrome.  Ann Med 1992 Dec; 24(6):465-8. Abstract

Burkitt DP and Trowell HC.  Dietary fibre and western diseases.  Ir Med J, 1977 June 18; 70(9):272-7. Medline

Hu J, et al, the Canadian Cancer Registries Epidemiology Research Group.  Glycemic index, glycemic load and cancer risk.  Ann Oncol.  July 25. (Epub ahead of print).  Medline

Jenkins DJ, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange.  Am J Clin Nutr.  34; 362-366.

Jenkins DA, et al.  Glycemic index: overview of implications in health and disease.  Am J Clin Nutr 2002 July; 76(1):266S-73S.  View Full Article Here

Landin K, et al.  Increased insulin resistance and fat cell lipolysis in obese but not lean women with a high waist/hip ratio.  Eur J Clin Invest. 1990 Oct;20(5):530-5. Medline

Mehrabani HH et al.  Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: a randomized controlled intervention study. J Am Coll Nutr.  2012 Apr;31(2):117-25. Medline

Vague P and Raccah D. The syndrome of insulin resistance.  Horm Res  1992;38:28-32.









































Am J Clin Nutr. 2002 Jul;76(1):266S-73S.