Dr. Lori Gore-Green | Dr. Lori Gore-Green | Women's Health Professional

New Predictors for Gestational Diabetes

November 19, 2015 by Dr. Lori Gore-Green

Earlier this month, Diabetes Care published a prospective cohort study that suggests that women who have high levels of abdominal fat (or abdominal adiposity) during their first trimester are at a greater risk for developing diabetes later on in their pregnancy.

The study was limited to 485 women who were assessed for subcutaneous, visceral, and total adipose tissue depth with ultrasound between 11 and 14 weeks of gestation.

All of the subjects were between the ages of 18 and 42 years old, and the results accounted for confounding factors like; age, family history, ethnicity, BMI and more. Even with these factors addressed, researchers still found that women with higher levels of fat in their abdomens were likelier to develop diabetes between weeks twenty four to twenty eight of their pregnancy than their counterparts with less abdominal fat early on in pregnancy. To learn more about gestational diabetes, please see the video below:

Dr. Lori Gore-Green Selected for Prestigious Doctor of the Day Program

August 20, 2015 by Dr. Lori Gore-Green

The Oklahoma Osteopathic Association or OOA sponsored the Doctor of the Day Program throughout the month of March at the Oklahoma State Capitol. This year, marks 41 years of commending outstanding osteopathic physicians at the State Capitol’s First Aid Station during the legislative session. The Doctor of the Day Program gives Osteopathic Physicians an opportunity to bring Osteopathic Medicine to the policy makers, as well as see their House and Senate members at work. During the Doctor of the Day program, physicians provide the crucial service of providing healthcare to various members of the legislature, as well as to legislative employees. The nominated physician will be available at the State Capitol Building from 9a.m. to 4p.m., but will also make time to advocate for important issues to physicians. Physicians are supported by a nurse, as well as a medical student from the OSU Center for Health Sciences College of Osteopathic Medicine. The Oklahoma D.O.s have made this program a success!

On March 18, 2015, Dr. Lori Gore-Green, DO had the pleasure of serving as a 2015 Doctor of the Day and meeting with various House and Senate members, including Senator Mike Mazzei and Representative Pam Peterson.

The mission of the Oklahoma Osteopathic Association or OOA is to advocate for the osteopathic profession and to promote the health and well-being of all Oklahomans. This medical association was founded in 1900 and acted as an affiliate of the American Osteopathic Association.

Since its initially founding at the turn of the century, the OOA continues to popularize the stated causes, and objectives of the osteopathic profession as a whole throughout Oklahoma.This state organization is composed of physicians who practice osteopathic medicine. The OOA, as a collective, believes that the individual is best served with the focused support of an Association. Nearly all of Oklahoma’s medical professionals who specialize in Osteopathic medicine are also members of the Oklahoma Osteopathic Association.

Endometriosis : Is Your Pregnancy at Risk?

June 16, 2015 by Dr. Lori Gore-Green

Findings of a recently released study of 15,000 women suggest that women with endometriosis had a greater chance of suffering from serious complications throughout the duration of their pregnancy as compared to women without the condition. These complications also increased the chance of ectopic pregnancy, miscarriage and premature birth.

Endometriosis is a medical condition wherein the uterine lining or the “endometrium” grows in other places like the fallopian tubes, ovaries, vagina or pelvis. Over time, this lining builds up and can cause cysts, heavy periods, severe cramping and possibly infertility. Approximately 5 million women in the US alone have this condition, though the true number is unknown, as it may go undetected.

However, there are certain symptoms that some patients with the condition tend to share.

Pain, both acute and chronic tend to be a marker of endometriosis, for some. Painful menstrual cramps that worsen over time are a commonly shared symptom of the affliction as is chronic pain of the lower back and pelvis.Pain during or after sexual intercourse that is often described as a “deep pain” is often a common symptom of endometriosis. Intestinal pain can be a symptom, as can painful bowel movements. Stomach and digestive problems resulting in diarrhea, constipation, bloating and/or nausea – particularly during menstrual periods can be a symptom of the condition. Painful urination – particularly during menstrual periods is another symptom of endometriosis. In rare cases, blood found in stool or urine can indicate the condition. Bleeding and spotting in-between periods can also be a symptom, as can infertility. If you are someone you know suffers from any of these symptoms, see a doctor as it may be a symptom of another endometriosis or another condition.

The findings of the recently published longitudinal study on endometriosis, though important, are not wholly surprising as endometriosis is associated with both structural and functional changes in the endometrium and the uterus. Researchers discovered that this condition increased the odds of a miscarriage by 76 percent, the risk of premature birth by 26 percent and the incidence of needing a caesarean section by 40 percent. The chances of sustaining an ectopic pregnancy (this is where the fetus develops outside of the womb) nearly tripled.
This study was based in Scotland and a longitudinal study conducted from 1981 to 2010 with a mix of women who had and did not have endometriosis. Although infertility is a known side effect of endometriosis, this newly collected data will hopefully return the focus to antenatal care particularly for pregnant patients with endometriosis.

The Most Alarming Health Trends for Women

May 7, 2015 by Dr. Lori Gore-Green

The Institute for Women’s Policy Research culled data from the last twenty years showing certain trends (or health hazards) of which women should make themselves aware. Knowledge is power, and it is certainly the strongest arm in the battle against harmful risks to health.

As always, women should learn about the dangers, statistics, methods of protection against sexually transmitted infections. Women (and men, for that matter) are increasingly infected with diseases like Chlamydia with numbers rising 40% incidence over the last ten years. Today, it is estimated that more than one million people are infected. At least one half of women (and upward of three-fourths) infected show few to no symptoms, increasing the risk of transmission to sexual partners and children through childbirth. As is the case with many diseases, Chlamydia left untreated may result in greater problems of infertility and pelvic and cervical infections. Fortunately, Chlamydia and similar infections can be treated early with a course of antibiotics.

Women will also benefit from asking themselves how they feel, and if they are satisfied with their lives. Recently general feelings of well-being and happiness come back low, and suicide in on the rise. Women are slowly feeling more stressed and anxious leading to severe, untreated cases of depression. Many symptoms are ignored as insignificant, and may even go unnoticed as part and parcel of life’s experience. Whether stresses are attributed to personal hardships or universal complaints (such as a declining economy, and weaker job prospects) women should take their mental health and bodily cues more seriously. (Caucasian women, specifically, showed a greater-than-average tendency to commit suicide after prolonged periods of sadness and anxiety.)

As is a trend on the national scale, fewer and fewer women report daily exercise routines, as more face problems of physical health such as obesity and diabetes. Less than half of the country actively participates in some form of regular exercise—running, swimming, yoga. The Institute’s report showed six out of every ten women are overweight, with one in ten already suffering from diabetes. Being overweight puts women at a greater risk of a number of health problems including heart disease and stroke. (Black and Native American women showed the highest incidence for diabetes.)

Good health is crucial to a sense of well-being and fulfilment. Precautions against health risks must not wait until after negative effects begin to show. Just as a contagion can spread from one woman to another, good health and well-being are communicable too.

Rural Areas Suffer Drop in OB/GYN Recruitment

March 12, 2015 by Dr. Lori Gore-Green

Traveling for healthcare services may be common for patients living in remote areas, but the difficulties accessing quality OB/GYN services has a direct link with an increased death rate among new mothers and their babies.

The face of the healthcare industry has been steadily changing over the last 30 years. As world-class tertiary hospitals pay doctors bigger salaries and buy out surrounding practices to stay afloat, the number of rural hospitals providing specialized services has dropped significantly. This is particularly the case with quality OB/GYN care — between 1985 and 2000, rural hospitals providing these services dropped by 23%, and that trend shows no sign of slowing down.

It has become notoriously difficult to recruit obstetricians and gynecologists to rural and remote areas. Smaller pay is only one of the barriers facing OB/GYN doctors considering the move — the lifestyle change is another. Getting accustomed to a small-town life isn’t necessarily easy for doctors who have grown up and studied in a suburban or urban environment.

Some hospitals are incentivizing the deal by offering new doctors things like student loan forgiveness, extra vacation time, and shortened work weeks. Mercy Medical Center, which serves the northern Iowa and southern Minnesota areas, is even offering a guaranteed income loan for the first year, which will then be forgiven after three years of service.

Only time will tell whether this trend really takes off. In the meantime, small rural hospitals are doing their best to partner up with clinicians in different specialities so they can continue to offer the right combination of skills to their patients. This works for about two-thirds of pregnancies who only need the kind of support offered in a rural clinic, but the other third require a more advanced care setting with emergency services.

The 6 Preventative Screening Tests That Are Critical For Women’s Health

February 27, 2015 by Dr. Lori Gore-Green

Getting preventative screening tests is one of the most important ways that you can take charge of your health and make sure that you’re continuing to make healthy choices. Certain personalized factors may increase your chances of getting a condition, so always check with your doctor to see if you should get tested more often.

Here are 6 of the most important preventative screening tests for women’s health:

Blood Pressure Test: Blood pressure is important to track because high rates of blood pressure can dramatically increase your risk of heart disease and stroke. At the same time, high blood pressure does not normally have obvious symptoms associated with it, so make sure to get checked at least once every two years to keep an eye on this important number.

Mammography: Mammography imaging of your breasts is critical to detecting abnormalities and tumors. There are different recommendations out there, but the American College of Obstetricians and Gynecologists (ACOG) now recommends that women get themselves checked out each year starting at the age of 40.

Blood Glucose Tests: Over 23 million Americans have type 2 diabetes with another 86 million estimated to have prediabetes. Untreated, this disease can cause serious medical issues, including heart disease and stroke. It’s recommended that you get a blood glucose test every three years, starting at the age of 45, and more frequently if you have an increased risk.

Lipid Panel: It’s a good idea to get a fasting lipoprotein profile (lipid panel) every four to six years once you’re 20 years old to keep an eye on your cholesterol and triglyceride levels. If your doctor determines that you have an increased risk for stroke or heart disease, then you’ll want to get yourself checked more regularly.

Pap and HPV Tests: The Pap test (also known as a Pap smear) and the HPV test are both used to screen women for cervical cancer. The USPSTF recommends starting these tests at the age of 21 and getting screened once every three years.

Colonoscopy: Most colorectal cancers can be prevented by getting regular colonoscopies every 10 years or so. They aren’t fun, but they’ll help your doctor detect any small polyps so they can be removed before they turn into a cancerous issue down the road. Start scheduling your regular colonoscopy appointment once you turn 50 years old.

New Blood Test To Help Customize Treatment For Ovarian Cancer Patients

February 12, 2015 by Dr. Lori Gore-Green

Researchers have developed a new blood test that would allow doctors to anticipate how individual patients will respond to different types of treatment for ovarian cancer. Zeenews reports that the newly developed test can determine how combinations of certain proteins affect how the disease manifests in the body.

According to Gordon Jayson, a professor from the University of Manchester in Britain, the research has made strides in personalizing treatment for a type of cancer that is notoriously difficult to treat.

“We are keen to identify predictive bio-markers – measures that can indicate how well a patient will respond to treatment – so we can better target these drugs to patients most likely to benefit,” Jayson said.

In particular, the test can predict which patients may benefit from blood vessel targeting drugs like Bevacizumab. Two proteins are of particular interest — Ang1 and Tie2 — in determining whether or not Bevacizumab would be effective when paired with traditional treatment. The two proteins are instrumental in controlling the creation of new blood vessels. Patients who had high levels of Ang1 but low levels of Tie2 were very likely to respond to the drug, while people with high levels of both proteins were unlikely to benefit.

The study, whose findings were published in the journal Clinical Cancer Research, took samples from ovarian cancer patients who were involved in an international trial for Bevacizumab. Candidates were either given the drug alongside their chemotherapy or were given chemotherapy alone.

The blood test still requires more development and testing, but this preliminary data is heartening. Researchers hope that the test will be available for you use by doctors and hospitals within the next few years.

Head over to Zeenews to read the original article.

New Clinic Works To Improve Early Detection For Ovarian Cancer

January 7, 2015 by Dr. Lori Gore-Green

Early diagnosis is among the biggest challenges in the fight against ovarian cancer. The lack of any reliable method of screening for the cancer often prevents it from being found its early stages. However, a recent article in the Miami Herald describes some of the efforts to develop early detection techniques.

At the University of Miami’s Sylvester Comprehensive Cancer Center in Miami has opened a new Ovarian Cancer Early Detection Clinic. The aim of the new clinic is to identify women who are at a high risk for ovarian cancer by tracking family personal cancer histories. The hope is that by tracking the data gathered through patients that come through the clinic, that new preventive strategies can be derived.

One of the patients at the clinic, Ivanna Vidal, has the BRCA2 gene which put her at greater risk for ovarian and breast cancers. She was diagnosed with advanced stage ovarian cancer. The goal of the new clinic is to help at-risk women like Vidal learn of their risk factors earlier so that they might be able to better plan to preempt the disease.

The director of the gynecologic oncology division at Sylvester, Dr. Brian Slomovitz, states that women who have BRCA have a 20-40% chance of developing ovarian cancer. Talia Donenberg, senior cancer genetics counselor at the University of Miami and Jackson Memorial Hospital claims that the discovery of new genetic links to the disease has caused the rate of hereditary ovarian cancer to jump from 10% to between 15 and 20%.

This data and the fact that there are symptoms of ovarian cancer have made doctors and researchers hopeful that new early detection methods are not too far off.

“In the past, we thought it was a silent disease.” Slomovitz said, “We know now that that’s not the case.”

Debate Over Gynecology Tool Sheds Light On Regulation

September 27, 2014 by Dr. Lori Gore-Green

Doctors from all over the country are sticking by a gynecological tool even after a warning from the U.S. Food and Drug Administration about its ability to spread undetected cancer. As reported in a recent article from the Wall Street Journal, the face off between doctors and regulators is showcasing what some might call intransigence on the part of doctors, and others might call overreach on the part of the government. What is certainly clear is that quality gynecological care lies somewhere in the middle.

The device in question is called a laparoscopic power morcellator, and it is used by its proponents to remove benign uterine growths called fibroids. The tool is normally employed during routine hysterectomies to slice and remove the fibroids through small incisions. The issue with the morcellators is that they have the potential to leave tissue behind that can grow and then spread throughout the body, including tissue that has not been identified as malignant.

This potential threat prompted the warning from the FDA and caused many hospitals to stop using the tool, including Brigham and Women’s Hospital in Boston and Philadelphia’s Temple University Hospital. Many insurers across the country have stopped covering procedures involving morcellators.

However, there are gynecologists who believe that reports of the threat are unwarranted and continue to use the tool routinely. Doctors like Jeffrey Thurston of Dallas say that the treatments he performs with his patients are between he and his patient, and that regulators are simply interfering. In his practice, he has patients sign a release that states that the risk of spreading undetected sarcoma is somewhere between 1 in 300 and 1 and 1000. He also tells his patients verbally that he does not believe those numbers.

In the tug of war between the FDA and doctors, it can be difficult for patients to know whom to trust. Where one stands on the use of morcellators may have more to do with politics than any insights on patient welfare.

Read the whole story at Wall Street Journal.

Ovulation Causes New Attractions

February 26, 2014 by Dr. Lori Gore-Green

In an interesting analysis done by UCLA researchers on studies about how a woman’s mate preference may change throughout the month due to her menstrual cycle. As any living being has a preference or a “type” of individual they find themselves most attracted to, it is always subject to change, but especially during ovulation.

In an article on medicalnewstoday.com, professionals in the medical industry explain that when a woman is ovulating, she tends to be more attracted to the masculine body types and features, dominance, and a particular scent. These sexy men remain attractive; however, they are not necessarily that same woman’s first choice for a lifetime partner. This debate about preference changes has been ongoing since the late 90’s.

One particular study showed that a woman who considers her current male partner as extremely attractive and a sexy man, she is less likely to have a change in preference during ovulation than a woman whose male partner is considered less attractive (even if they have all the best characteristics a man could have). The study seems to make sense, keeping the topic consistent. If a woman’s existing partner is already the masculine, charming man, chances are she just has a stronger sense of attraction during ovulation but to that same man.

Body scents seem to be one of the strongest preference factors during ovulation. In several studies, women were asked to smell shirts worn by men of all shapes and sizes. The shirts that smelled the best to these women were of symmetrical men. Symmetrical men (and animals) are men with a larger physique, better health, and more distinct sexual body parts. The root of preference change within studies is said to be from women’s ancestry. Symmetrical bodies and faces of these men may be a sign of genetic quality. As a result, the women who preferred these particular, masculine, sexy men are more likely to have children with strong, quality genes that will benefit them in terms of reproduction and survival.

Humans are not the only beings that have a change in preference while going through different phases of fertilization. Just one example is chimpanzees. Female chimps have sex with multiple male chimps during their ovulation period – and they are chimps that they would not have sex with when they’re not ovulating.

This is natural. If a woman is aware that this may happen, it is going to be easier for her to ignore these feelings and thoughts by telling herself that it is because she is ovulating. As living beings should always do, we must let nature take its course and be disciplined and educated enough to know what is happening.

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