Dr. Lisa on The Morning Show

[Music Playing] Mike: Welcome to another edition of The Doctor Is In, every Tuesday our panel of MDs tackle questions from our studio audience about health and wellness issues. Juliet: Our first question comes from a woman wondering if postponing surgery is threatening to watch. A few years ago, doctors noticed Rachelle Chase had fibroids tumors in her uterus that in her case were non-cancerous. Rachelle Chase: They would come back and say, oh they tend to grow. We will just keep a watch, we will just keep an eye on them. Juliet: The 45-year-old had none of the troubling symptoms like pain. So doctors weren’t initially concerned. Rachelle Chase: It really was only about four years ago that I really started noticing them. Juliet: But the fibroids grew, so now they looked like this in an MRI, almost entirely willing for uterus, and it’s so bad, it’s starting to show on the outside, a belly bulge. Rachelle Chase: I can pass it off if you are looking at me straight on, because it’s not a waist, but then if you look on the side, it’s like it looks like a sea horse then, so I am kind of uncomfortable. Juliet: Without any immediate medical concerns, Rachelle has hesitated to have surgery, but she is worried that the bulky fibroid mass could be causing damage to her other organs. Rachelle Chase: I guess my question is by not having surgery what damage could I be doing to my body. Juliet: Rachelle is here with us, thank you for being here today, and also today from NYU Medical Center we have Dr. Mark Siegel with us and from the show The Doctors, OB/GYN Dr. Lisa Masterson is here as well. Juliet: Rachelle, good to have you here. Rachelle Chase: Thank you! Juliet: So you are very concerned obviously about your health and you are thinking about may be surgery? Rachelle Chase: That’s what I saw that in MRI and I said, wooh, this is kind of a shock. Juliet: Are you in pain? Rachelle Chase: No, no pain at all. Juliet: No pain at all, mental pain, mental anguish? Rachelle Chase: Not really, I don’t even think about. Mike: And here is a typical man thing to say, and I apologize. Well, it seems to me you would have this removed. Why not you? Rachelle Chase: No, I don’t want to because I am afraid of surgery for one thing, but mainly because I don’t have any symptoms. I mean most of the stories that I have read about people whose quality of life improves it’s because they have major symptoms and pain and I am fine. Juliet: Okay, Dr. Masterson, what is a fibroid, because we hear the word tumor and it’s like wow? Dr. Lisa Masterson: Rachelle is not alone at all, because this is so common, I get asked about this on the street, everywhere in my office, basically fibroid tumors are benign tumors, they grow in the uterus, and basically the cells just don’t know to stop and they just keep growing. So they are not cancerous, but they can cause problems like bleeding, which can cause anemia, which can cause transfusions that are necessary, or death if the heart can’t pump. It can cause pain, not pain in your instance, but they can get so large that they can cause a decreased quality of life because of the pressure. Because if you get up and Rachelle gets up, you can really see from this side, this is her fibroid, this is not her belly, this is fibroid right in here. Mike: What’s it? What other organ -- Dr. Lisa Masterson: And that’s heavy, and it’s causing obstruction. This is you, this is you, that’s the criteria you fit in, so the question is, should you do something? Yes, you should, but what should you do? It used to be a one-size fits all, we used to just hysterectomy everybody, but now you have so many more options, myomectomy which is just the fibroids, lot more options and that’s what you need to talk. Juliet: Dr. Siegel. Dr. Marc Siegel: I agree completely. I would like to admit that I see a lot of women that come in with a blood loss and anemia, that’s a big problem for me as an internist. And I want to say from the start in the old days, doctors used to just say, do a hysterectomy, that’s it. We have to treat women better than that. And the number one procedure that’s done these days and probably Dr. Masterson will say not for her, but number one procedure you can do these days is you can actually do embolization which cuts of the blood supply to the fibroid and it shrinks. So that’s a miracle procedure that we actually use in regular medical practice. Dr. Lisa Masterson: Uterine Artery Embolization, which is a great new procedure, again the reason why he is saying not for her, because your fibroid is very large. But there is vaginal procedures, there are laparoscopic procedures, so you have to talk to your doctor to make an informed decision that’s what it’s all about now. An informed decision about what to do, but it needs to be done, you need to do something because your quality of life will just change, it’s just like carrying around a small watermelon. Rachelle Chase: Well, I have looked into different options. So it’s like trying to figure out, okay, at this point which one is the right one. Dr. Marc Siegel: We also should say to the audience that not everybody with a fibroid has to have something done, it totally depends on how many you have, what the size are, and how it interferes with your quality of life, in her case it’s a big issue. Mike: You are 45? Rachelle Chase: Yes, 45. Mike: You don’t want children? Rachelle Chase: No. Dr. Lisa Masterson: So she is perfect for a lot different options, for women who want children that can be tricky problem. Juliet: Doctors, thank you. Thank you Rachelle, good luck to you. So you want to get pregnant. How long you have to be off from pill to try, the doctors have the answer when we come back. Mike: My guess three months, that’s a guess. [Commercial: 00:05:05 – 00:05:50] Juliet: welcome back, we are back with our weekly series The Doctor Is In, still with us Dr. Mark Siegel, you know him from the show. The Doctors is OB/GYN Dr. Lisa Masterson, and joining us is Dentist Dr. Edward Gottesman. Mike, actually before we get on to our audience questions, the swine flu! What’s the update? Dr. Marc Siegel: We’ve got to get rid of the fears of the swine flu, because it is a new strain, but it’s not transmitting all over the place, and the key thing is it’s actually mild. We are worried about that word pandemic, but the truth is that this is something we have to monitor and watch, but it is not something that is going to get you. Mike: Pigs do fly the swine flu. Well, we have a swine flu related question, okay? Tell me about your son? Female Speaker: My son was diagnosed with juvenile rheumatoid arthritis a few years ago, and he is off medication now, what are the chances if he did get it by any symptoms to come back? Mike: He is 19, diagnosed at 12. Dr. Marc Siegel: Does he take any steroids and medications? Female Speaker: Not right now. He has been off meds for two years. Dr. Marc Siegel: That’s a good news. Now the flu in general, again the yearly flu is something we really are concerned about, this may become the yearly flu next year. The yearly flu can actually bring on the symptoms of this, so you have to watch it, anyone with chronic illness or asthma or underlying conditions that’s what we really watch out for with a flu, he must have a flu vaccination and if gets the flu, he has to be treated quickly for it. Mike: Another question here folks. Female Speaker: Hi! I am single, over 40, and I have been diagnosed with HPV, and my doctor recommends Cortisol to prevent any future strains of HPV, but I haven’t read anything about it for anyone over 26, I don’t know what to do? Dr. Lisa Masterson: And it is not too late, basically we are trying to really encourage young women to take it because those are at the most risk. But it doesn’t mean if you are sexually active and you are older then you can’t, it only covers four strains but it’s not going to hurt you. Juliet: Can you tell us what it helps, what is it? Dr. Lisa Masterson: Cortisol is -- Juliet: The HPV. Dr. Lisa Masterson: HPV stands for Human Papillomavirus and it’s the virus that’s associated with cervical cancer and genital warts. And so, this vaccine can basically wipe out cervical cancer which is really, really great. So it’s very important for women to start it when they get sexually active, that’s why the emphasis has been on giving it to women really, really young, but if you have sort of missed that and you are in older bracket right now, you certainly can get the Cortisol vaccine. Juliet: Is it true that over the age of 15 more than 80% of the American women will have HPV? Dr. Lisa Masterson: That’s absolutely right. Juliet: That’s because they haven’t been vaccinated for it. Dr. Lisa Masterson: Right. Absolutely and because it’s a sexually transmitted disease, it goes without any symptoms, you have to screened for, your doctor can deal with your pap smear. Mike: Let’s have a question for Dennis 29. Dennis: I grind my teeth at night. I am developing like a TMJ problem, what can I do about it? Dr. Edward Gottesman: Well, there is not much you can do about stopping yourself from grinding, most people who grind will find that when they wake up in the morning, they have been clenching all night long, so their muscles, a headache. A lot of times your spouse or your partner will tell you that you grind your teeth at night because they are not sleeping. What you could do though, is you could actually go to your dentist and ask for a mouth-guard, which is basically like a football mouth-guard that will actually help to reduce that clenching your teeth. Dr. Marc Siegel: You’ve got to -- that you will be underlying. Dr. Edward Gottesman: One thing to tackle the stress which isn’t always easy. Mark: Okay, question here. Female Speaker: Morning! Mark: Hi! Female Speaker: Having been on the pill for a long time, like a decade, how long should I wait to come off the pill in order to get pregnant? Mike: Do you want to get pregnant now? Female Speaker: Soon! Sure! Mike: Putting it that way. How long? Dr. Lisa Masterson: You have to watch out for this -- Mike: No, how long you should to be off the pill for --? Dr. Lisa Masterson: We have to be careful of you, don’t we? Dr. Marc Siegel: No getting phone numbers from the audience, Mike. Juliet: Dr. Masterson you have no idea. Dr. Lisa Masterson: No, I am getting an idea here. A lot of women think they have to stay off for a long time, you don’t, because it gets out of your system right-away, it’s not going to cause any birth effects if you get pregnant on it. So usually we just recommend one or two months, because your cycle will need to come back, but you are fine. Mark: Good! Juliet: Alright, great questions, great answers, thank you guys very much. I appreciate it. Coming up next, the boxer rebellion The Dog Whisperer is here, and he is going up against an 85-pound boxer who thinks he is a lapdog and Cesar shows the difference.