Last Resort: Oral Contraceptives as Emergency Contraception

OCP 2Dear Dr. Mo: What if I needed an emergency contraception and didn’t have it (couldn’t get it) – would a regular pill do the trick?

Dear reader: Even though I don’t recommend this as a contraceptive practice of choice, the answer is Yes.

Any Oral Contraceptive Pill can, in principle, be used as an Emergency Postcoital Contraception (EPC) as long as it contains a certain amount of estrogen hormone; the required amount is 200 μg of ethinyl estradiol (usually 20 – 35 μg of ethinyl estradiol per tablet but it may vary – read the composition label) – take the number of tablets to amount to 200 μg, then repeat in 12 hours. Continue reading

Baby’s first breaths and what you didn’t know about her first cries

Dear Dr. Mo: I’ve read your post on C-section and I wanted to know more about what you’ve said were risks for ‘increased respiratory problems of the newborn’ with C-section delivery. Also, why do babies always cry when they’re born?

Oxygen isn't just explosive - it burns

Oxygen isn’t just explosive – it burns

Dear reader: Your questions about newborn’s breathing at the instant of birth and crying are important and could prompt a very technical answer, which I will try to avoid here.

Let’s just imagine a baby floating in water for 9 months – this is the baby’s natural environment in the womb. The baby doesn’t breathe the way she will breathe after birth and so the water fills up her lungs. The natural act of birth is so important because the birth canal through which the baby is traveling pushes on the baby and squeezes out that fluid (almost all of it) from the lungs and compresses the lungs so much that at the instant both of baby’s shoulders are delivered, the lungs automatically and involuntarily inflate taking that first and only passive breath the baby will ever take. Every following breath, for the rest of her life will be active breathing effort.

So you see, if this natural pathway of delivery is circumvented via C-section, the baby’s lungs don’t have the assistance to expel the fluid out and the newborn may have some problems with breathing in the first few hours – this manifests itself as a very rapid breathing called tachipnea and it’s in most cases transient. Sometimes though, more serious breathing problems can occur and if this rapid breathing does not go away within 4 hours, we always have to rule out sepsis as the most dangerous complication.

Now about that crying, there’s a myth here to debunk: Continue reading

The great health benefits of spinach and why Popeye the Sailor was wrong

Popeye was wrong, well, sort of..

Popeye was wrong, well, sort of..

Dear readers: Spinach is one of those foods we should always have in mind when we’re planning a healthy meal – it’s just that good! In fact it is one of the healthiest leafy greens around – and it’s actually not so much for its iron content although that’s likely to be your first association.

Popeye the Sailor has been eating tones of it for decades but what works for him is not really what works for the rest of us, at least when iron is concerned.

Spinach has a high nutritional value and that’s beyond any doubt. It is very rich in antioxidants, it is a rich source of vitamin A (particularly high in lutein, which is very good for the eyes), vitamin C, E, K, B and magnesium.

Spinach is also a rich source of Folate, which is an essential ingredient for our cells and is especially important for pregnant women and those trying to conceive. However, boiling it can more than halve the Folate content while microwaving it doesn’t seem to have such an effect.

Folate aside, boiling spinach actually increases its nutritional value several times as it helps our body use the nutrients more effectively.

A compound in spinach called oxalate prevents iron and calcium from being absorbed into our body. In case of calcium, even though spinach has a high calcium content, its absorption is decreased by oxalate to only around 5% so don’t count on it too much.

Similar goes for iron – oxalate both reduces the absorption and flushes it out of our intestines. Boiling is a good way to get rid of some oxalate content and for this purpose you should boil it for at least 2 minutes. Another way is to eat a vitamin C rich food together with spinach to help deactivate oxalate. Continue reading

Artificial sweeteners – what are they, are there risks and what are the possible benefits?

Dear Dr. Mo: What exactly are the artificial sweeteners and what are their pros and cons? 

Jellies often contain artificial sweeteners

Jellies often contain artificial sweeteners

Dear reader: Artificial sweeteners are sugar substitutes, usually synthetic , but may also come from naturally occurring substances like herbs or sugar itself (like sucralose, which is derived from sugar).

These sweeteners are many times sweeter than table sugar and this is why they are intense sweeteners. Continue reading

Alcohol – that social lubricant

Dear Dr. Mo: I want to know some basic facts about alcohol and what it does to me when I drink. Is there a safe amount that’s actually good for health?

Don’t drink and drive!

Dear reader: Sometimes you might hear from a doctor that moderate alcohol consumption is good for health.

The peril lies in the word “moderate” for it is arbitrary; it is not the same for everyone and one could easily slip from moderation to amounts that are not at all useful to health. We could certainly argue if alcohol is useful in any amount because while it may be beneficial to one part of the body, it is damaging to another.

We don’t really need alcohol as far as maintaining our health is concerned so if you’ve never drank, don’t start as risks outweigh potential benefits.

Drink water to stay healthy

Dear Dr. Mo: How much water do I really need to stay hydrated and healthy?

Dear reader: This is the time of year where common colds are indeed common and when you will often hear that advice to drink lots of fluid, usually herbal teas or water. Of course, water is essential to your health but the needs for water vary from person to person and many factors may influence that, like for example your health condition, your daily activities, where you live, your age, metabolic rate etc.

Water means health!

Water is our main constituent – it makes up about 60% of our body mass. We need water to maintain normal functions: we throw out waste matter dissolved in water, water participates in digestion of food, it carries nutrients to cells, we use water to show emotions when we cry etc.

Water also helps to regulate body temperature through perspiration (sweating).

When water is insufficient we dehydrate. Dehydration is a state in which our cells don’t have enough water to function normally. Even a mild dehydration could cause fatigue because when tissues lose water, enzymes are slowing down their functions and energy production drops.

A simple way to see the link between health and water is to observe what happens when we age. As we age, the water content of our bodies is decreasing steadily and while a newborn is 80% water, in an adult this ratio is at 60% and it keeps on decreasing as years go by. Continue reading

Diabetes and weight – what is the link?

Dear Dr. Mo: What is the link between being overweight and developing Type 2 diabetes? Can diabetes be prevented or cured somehow?

Dear reader: First of all it is worth pointing out that diabetes is a chronic condition. For most types (except gestational type) this chronicity means that once it occurs, it stays for life – this is not a disease we can effectively cure with our present knowledge but we can quite successfully manage it.

Before I go into your question, let me first explain the diabetes landscape and basic mechanisms behind it as Type 2 is not the only game in town.

Diabetes occurs either when the pancreas no longer produces enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.
The danger of diabetes lies in a condition called Hyperglycaemia – raised blood sugar level – which is a common result of uncontrolled/undiagnosed diabetes, which over time causes serious damage to the body, especially to blood vessels and nerves.

Food choices affect our health

Diabetes has its types and these differ in both the ways they start and the ways in which we manage them.

Type 1 Diabetes

This type had previously been known as insulin-dependent, juvenile or childhood-onset diabetes. Here, our pancreas gland becomes deficient in insulin production and there is simply no longer enough of it to properly regulate our blood sugar levels. Management requires daily administration of insulin and this type cannot be prevented with our current understanding as the cause is not known although we do think it is due to the self-inflicting damage to pancreas (process called “auto immune response”). Continue reading

Herbal infusions during pregnancy – are they safe?

Dear Dr. Mo: What is the deal with other teas – not relating to caffeine? I’ve heard pregnant women shouldn’t drink chamomile tea…? I thought ‘herbs’ were generally healthy and a desirable component.

Dear reader: During pregnancy, many women choose herbal infusions instead of caffeinated drinks. Most of these choices are perfectly fine.
I would always advise to stay away from herbs and supplements of any sort during the first trimester, while the fetus is particularly vulnerable; but even during this sensitive period, one or two cups of herbal teas now and then (even daily) are so moderate an amount that any harm is virtually impossible.

Herbal infusions are generally safe during pregnancy

I would generally stay away from herbal infusions, which contain some additional supplements (such as Ginseng) as these are of unknown action on the fetus and are not undergoing sanction and approval by regulatory bodies. Choose pure herbal teas with nothing added.

The talk about herbs that may concern you is that some may help induce a certain level of uterine contraction so I’d stay away from herbs such as black or blue cohosh. Also avoid herbal infusions with known pharmacological actions that are intense and aggressive on your body and generally unhealthy like Sena leaves.

Chamomile infusion is fine and safe to drink in moderation – stay within a few cups a day but not liters of it. Continue reading

Constipation during pregnancy – what happens and what to do?

Dear Dr. Mo: What to do for constipation during pregnancy?

Fresh fruits and vegetables are among the best remedies for constipation.
I took this photo on an Adriatic island of Vis last summer

Dear reader: Constipation (infrequent bowel movements or having difficulty in passing stools – waste  products of digestion), is a common gastrointestinal problem and also a common complaint in pregnancy, usually affecting women during the first and/or last trimester of the pregnancy.

Normally, food is passing through intestines via muscle contractions, which slowly push it in the forward direction. In the colon (the large intestine), most of the water and salt content from digested material is reabsorbed into the body and this process is essential for keeping our bodily functions balanced and normal.

First of all, what’s considered ‘normal’ frequency for passing stools varies widely. You’ve probably heard that ‘only every day is good enough’ and this would be an ideal case but in general, let me tell you that one is probably experiencing constipation if one passes fewer than three stools a week, and these stools are hard and dry. This can happen for any number of reasons, most commonly when there is not enough fluid or fiber-rich food in a diet or the colon muscle contractions are slow and/or uncoordinated.
Continue reading