INTERESTING TIMES

August 1, 2011 — Health care reform requires new insurance plans to fully cover women's preventive care, which now will include free birth control, yearly wellness visits, breastfeeding counseling and equipment, and screening for gestational diabetes, domestic abuse, HPV, sexually transmitted infections (STIs), and HIV.

Health and Human Services Secretary Kathleen Sebelius today announced the expanded definition of women's preventive care. The ruling closely follows the advice of an Institute of Medicine expert panel, released July 20.

"Today, as part of the Affordable Care Act, we are announcing historic new guidelines that will help women get the care they need to stay healthy," Sebelius said at a news teleconference. "Today we are accepting the recommendations of the Institute of Medicine, so no woman in America needs to choose between paying a grocery bill and paying for the key care that can save her life."

SOURCE
http://www.medscape.com/viewarticle/747359?src=mpnews&spon=16

Comment:
Much as I have been against the Affordable Care Act ("Obamacare") because it seems wrong to force me to pay anybody for a service that I may or may not want, the details that trickle out are good. Sure, the bill hands a great big paycheck to the insurance companies. But it also requires that they cover certain basics, like birth control and STD testing and treatment, completely. It also encourages breast feeding with education and tools. There are lots of smart requirements built in, that make the insurance companies actually DO SOMETHING positive for all that money they're getting. Obama isn't able to get positive headlines or marquees, but the fine print that comes from his administration is good. It's too bad that the vehicle for his work is such a leaky ship.

I was a Campfire Girl, not a Girlscout or Brownie. So I don't know from the inside. But from the outside, having been a river guide and taking many screaming groups of Brownies rafting on whitewater rivers, the organization appears squeaky clean and rather conservative. I never would have guessed that the organization would teach girls about abortion. But who knows? Maybe they are. That's what the teenaged girls from Texas are saying, and they're making news on The Daily Beast. It occurs to me though that the organization will probably have its name cleared. The organization officially does not endorse any political party or birth control method. Meanwhile, the offended girls have started a blog to get their story out. The case they are making is that the official girl scout materials mention websites and people who are "pro-abortion" and so if you follow the links you will discover that these perspectives are ubiquitous. Big surprise. I wonder what fraction of the links in the girl scout material go to sites that hold the opposite viewpoints. It seems to me that the org would serve the girls best by exposing them to many opposing viewpoints so that they could learn to think and decide for themselves. Girls who want to be cloistered would be better served in a nunnery.

http://news.bbc.co.uk/2/hi/health/10318410.stm

Add to this info that not everybody can use the form of B6 that is in cheap vitamins. About 1/4 of us have to buy the fancy B6 that is activated by methylation, because for genetic reasons we aren't good at methylating our own. Methylation is one of the main pathways by which your liver makes toxic lipophilic compounds water soluble so they can be excreted. B6 is key for supporting methylation, but if you can't methylate, you can't activate the B6 you get, so you MUST buy the supplement! For example, B6 is depleted in women who take birth control pills, and remains depleted for years after they stop. Just a FYI! I always have wanted to believe that I could get all the nutrition I needed from food, but I'm not so sure anymore. Considering the increasing insults of toxins and hormonally active substances in our environments, we can use all the help we can get. Provided we can figure out what is helpful and what is not. It is not so obvious....

Scientists are experimenting with the use of ultrasound to the testicles. They say here on the BBC that it can stop sperm production for six months. The Gates Foundation is supporting the research.

Two new studies provide specific information about which pills cause the highest and lowest risks of deep vein thrombosis. The first study looked mainly at pill composition. The second study looked at risk relative to regimen, estrogen dose, type of progestogen, and route of administration. ...this information is a welcome addition. It turns out that more estrogen-->higher DVT risk. The type of synthetic progesterone also matters. The overall absolute risk for DVT (per 10,000 woman years) is 6.29 in current pill users and 3.01 in nonusers. "For women genetically predisposed to venous thrombosis who still want hormonal contraception, however, a progestogen only pill or hormone releasing intrauterine device seems to be the appropriate first choice."

A FEW PROGESTOGENS AND RISK OF DVT
levonorgestrel: 4x more risk than not using the pill (safest of them all)
gestodene: 5.6x more risk
desogestrel: 7.3x
cyproterone acetate: 6.8x
drospirenone: 6.3x

http://www.medscape.com/viewarticle/707437?src=mpnews&spon=16&uac=89474MT

UPDATE 9/2010: Yaz causes 64% more clots.

What is the most common hereditary clotting problem?
--Von Willebrand's Dz (factor is absent or abnormal, many varieties)

What do you call an inactive enzyme precursor in the clotting cascade?
--a zymogen

What do you call a coagulation deficiency from to a deficiency of Factor VIII due to an X-linked recessive gene?
( answer and more self-quiz )