September 2007

Q. I was reading information on your website. I have a couple of questions. I was just diagnosed with insulin resistance and I would like to know what type of diet plan and exercise plan to do in order to lose weight. I am quite overweight 5'4 and 200 lbs. and the more I diet the harder it is to lose weight. I'm on the 2 week phase 1 South Beach diet and have not lost a pound yet and have actually gained. I am mid-cyle (menustration) right now. Could that be the cause? Also are there any natural supplements you would recommend?

A. Do you have PCOS/polycystic ovary syndrome?? It sounds as though you may have it - if insulin resistance and a weight problem and difficulty losing?? I write about it somewhat in my book and will admit that South Beach overall is perfect for you. I hope you can read my book too as the medical and nutrition information should be of help. PLEASE don't be discouraged if your are eating well. Are you exercising?? Are your periods okay? Have you been checked for PCOS? Do you see an endocrinologist? Has medications such as Glucophage been recommended?

Q. I was pregnant last year and had a Pap test and my doctor said that I have HPV virus. I didn't know what it was and my doctor didn't fully explain about it. He said it sometimes automatically disappears after I deliver the baby. I had the Pap test three times while I was pregnant and had another one after I delivered my baby. I am so afraid that what if it stays there and does not disappear. I think I should see a specialist instead of just waiting or have another Pap test. Mt doctor suggested I have to have one more Pap test in September but I really want to see a doctor who knows about this matter and tell me what I am suppose to do if HPV virus stays or grows. I heard if I don't do anything, it would case cervical cancer in the future.

A. I hope I can be of help. First of all, please don't worry - there is so much you can do to take care of yourself and prevent a servious problem. Almost ALL women acquire HPV at some ime in their lives and it almost always disappears after 1 - 2 years when your natural immune system fights it off. On the other hand, it is very common to have an abnormal Pap test during pregnancy which disappears after the pregnancy is over. Were you actually tested for the high risk strains of HPV?? What was the result? How abnormal was your Pap test? Did you ask for a copy of ALL your test results which is very important? Please keep your own file or medical record. You are entitled to the information and it is best you save a copy too. Please keep me posted. If indeed you have HPV and the infection has persisted after pregnancy (aPap test is not sufficient at this point,you want confirmation that you test negative or got rid of the high risk strains of HPV) - then ways to boost your immune system are: stop smoking, keep your cervix health and treat any other infections, consider not using the pill (this may not be an option however) and try regular folate supplements such as continuing your prenatal vitamins.

Q. Thank you for returning my e-mail and giving me encouragement. I did not have any medical records but I requested all my medical records and went to the hospital yesterday. I explained my statues and showed him all the records. The doctor said that I am not in bad condition and there's many possibilies that the virus would disappear within 1 - 2 years. I had two different exams and he recommended me to have a Pap smear test every 6 months. I thought I made a good decision to hear second opinion. Thank you again and I will try to take care of myself. Also, I plan to eat right and do some excises which I have never done before.

Q. I subscribe to a newsletter about the HPV virus and the HPV test andlearned about you and your work from there. I have a question I would like to ask you. I was under the impression that the HPV vaccine called Gardasil was only effective for women 26 and under. I am 37, I have 1 child and in May 2007 had a normal Pap smear but was testing positive for the HPV virus. I went for a culposcopy last week and was told I was normal. The doctor told me that the medical profession has not yet decided what to do with women who have normal Pap smears but that test positive for HPV. I saw an article in Flare dated April 2007 (Canadian magazine) and it was about the vaccine called Gardasil. It said that if you are under 26 you could still get vaccinated and you should talk to the doctor. Do you think that I could get the vaccine if I want it, even though I'm over 26 and I have tested positive for the virus but was told that my cervix is perfectly normal? I am so worried about cervical cancer and gfoping to culposcopy every year is very stressful.

A. Research to date has only tested the vaccine in women ages 15 - 26 however many more studies are being done in older women such as yourself. But no matter your age, we DO KNOW that the HPV vaccine protects against the TWO biggest causes of cancer, HPV 16 and 18 only if you have NEVER been exposed to the virus before. Sadly there is no reliable way to know if you ever had 16 or 18 - once your body gets rid of it there is no easy way to test your blood or cervix to find out if you ever had it. If you have already had 16 or 18 - getting the vaccine will not help (and there is no way to know except that women with many many partners - the greater your chances. The vaccine also does not help you clear up or get rid of the abnormal cell changes on your Pap. If you have not had many sexual partners in the past and you plan to have new partners in the future (most women your age would of course assume they will have more partners) - then getting the vaccine may be a good idea. Unfortunately we do not yet know how effective it will be in "older" women and how long it will last. I wish I could say just get it to be safe - but not sure I have enough research to say this yet. Stay tuned as we will know more about women your age. I can assure you that most women who test positive will not get cervical cancer. On the other hand, if you test positive for HPV (high risk strains only should be checked - have you confirmed they only did high risk strain?..occasionally docs do the entire set of low and high risk strains so would confirm this fact if you can) again in 6 - 12 months...that means you have a Persistent virus - and in that case your body has not yet fought it off. Eliminate smoking, good nutrition with folic acid in multivitamins, and keeping your cervix healthy with condoms and/or treating any other infections will help you get rid of it. If however the virus doesn't go away, in a year or so you should be rechecked with culposcopy - occasionally abnormal cells are hiding that need to be removed. As long as you have an excellent doctor who is experienced doing culposcopy you should be okay. At this point, if only ONE TEST was positive for HPV, I would take care of myself and chances are it will eventually go away on its own.