Hormone Therapy - A Journey

     Hormone Therapy is a topic that is very diverse in both understanding and consequences.  As a result, I will discuss this in a series of blogs.  Hopefully, this will keep things informative and enjoyable.
     To begin with, a hormone is a chemical messenger produced by one organ in the body that travels thru the blood stream and has an affect on another organ in the body.  Hormones can be of several different type.  They can be composed of amines or small molecules originating from amino acids such as Thyroid hormone.  There are also peptide and protein hormones which are larger and more complex such as Insulin.  The type of hormones most interesting to us in this series are steroid hormones based on cholesterol.  These include Estrogen, Progesterone, and Testosterone to mention a few examples.
     Each of the steroid based hormones are related and interact with each other..  In many cases, not only may they be converted into one another, but one may promote or decrease the number of cellular receptors for a different hormone thus affecting its biological activity.  These cellular receptors are another step in the regulatory processes which must be considered in prescribing hormone restoration  therapy. 
    Another consideration in hormone therapy is lipid solubility.  Some hormones are lipid-insoluble and some are lipid-soluble.  This solubility factor determines the mechanism by which a hormone acts on its target tissue or cell.  By altering the solubility of a given hormone preparation, compounding pharmacists can affect the delivery of the hormone.  An example is the need for good lipid solubility to by-pass the stratum corneum of the skin in topical preparations. 
     I will expand upon these points as we discuss specific hormones and hormone preparations in future blogs during this journey.


                                                                     Warmest Regards,
                                                                      Richard F. Galitz, M.D.

Patient Safety and New Medical Procedures

     Lately there has been much in the news about the safety of a laparoscopic procedure called uterine morcellation.  This procedure has been used for years in many locations throughout the world. It is essentially a method of chopping up uterine fibroids so that they can be removed from the abdominal cavity through small laparoscopic incisions.  I am not trying to single out this one procedure, but rather what often happens in medicine without anyone having bad intentions necessarily.

 

     New procedures are most often developed at academic centers as an attempt to improve some aspect of medical care.  These procedures are worked out and then marketed with the companies that develope and produce the equipment used in the procedures.  In addition, often a secondary industry developes to promote and instruct in the use of the procedure.   As the procedure becomes more widespread, problems may show up that were not anticipated or the new procedure may be used inappropriately.

     As a patient, each of us has a responsibility to consider the value of new procedures and see if they really offer an improvement over those procedures that are tried and true. This, of course, needs to include a careful discussion with your physician but it also should make sense to you as the patient  Remember, if there are problems with the new techniques, you, as the patient, may suffer!      

                                                                                          Warmest Regards,

                                                                                           Richard Galitz, MD.

The Affordable Care Act and Good Patient Care

    In the past several months, we have heard much about Obama care and insurance.  It is important not to confuse insurance with patient care, good or bad.  More and more over the last several years, patient care seems to be between the doctor and the insurance provider.  The patient almost becomes a byproduct of the service.  This is one of the reasons I have elected to open my own personalized patient care oriented practice instead of joining another physician office group.
     This point is brought to light in an interesting article in USA Today discussing Physicians and the clock.  In some cases, physicians are being pushed to see patients every 11 minutes. This certainly would make it difficult to adequately discuss one problem, let alone 2 or 3.
       In future Posts, I plan to discuss other physician patient issues, as well medical topics such as Bioidentical Hormones and the question of safety and "new" surgical techniques.

                                                                                  Warm regards,
                                                                                   Richard F. Galitz, MD

About Dr Galitz

Hello,

 I am  a Fellow of the American Board of Obstetricians and Gynecologist practicing in Southern California for over 30 years. I have chosen to have a private boutique practice specializing in women's health and wellness, hormone restoration and preventative care. This allows me to work closely with my patients without the restraints of the current and encroaching healthcare restrictions.

I believe strongly that women should have an annual exam but that the total women should be considered.

A life style in balance should include nutrition,diet,exercise and stress management.

The following programs that are offered will allow me to partner with you and create a tailored plan to meet your individualized needs.

• Wellness exam
• Hormone restoration
• Wellness program
• Concierges program

I look forward to emphasizing your total health and well being.

Warm Regards

Richard F Galitz  MD

RGalitzMD.com