Moab Happenings Archive
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The Power to Be You Again
by Ray Andrew, MD

 When Barbara first came to my office, she was miserable. “I was ready to kill my husband. He drove me crazy!” She was also depressed, had no energy, no libido, insomnia, and frequent hot flashes. Her doctor had prescribed some estrogen cream, which helped a little bit. Hearing from a friend about “the hormone doctor in Utah,” Barbara made the trip from Wyoming to our Springville office.

Since that day fifteen years ago, Barbara has enjoyed life like never before. At age 67, nothing slows her down. As long as she doesn’t allow her testosterone to run out, she loves and adores her husband. She enjoys intimacy more than when they were first married forty-eight years ago. She has all the energy she needs. Sleeps well. Has no hot flashes.

People don’t appreciate the importance of hormones to health and quality of life until their hormone production fizzles. For women, this usually occurs fairly abruptly, around the same time they celebrate the end of their periods. For men, it tends to occur more gradually, most often the result of toxins accumulated over a period of decades.

Many people complain of fatigue. They find themselves having to load up on caffeine all day to keep going. They have a hard time focusing, and complain of brain fog. After work, all they want to do is sit on the couch and watch TV because they don’t have the motivation or energy to do anything else. Irritability, impatience, and even anger, are common. Intimacy becomes a chore, often painful, sometimes even repulsive. Instead of getting stronger after workouts, they just get more tired. Things that used to bring pleasure no longer spark any interest. Many men and women with testosterone deficiency gain weight for no reason and become anxious and/or depressed.

Presented with these symptoms, well-meaning physicians check a few basic labs, diagnose depression, and prescribe antidepressants. Unfortunately, while this makes life more tolerable in some cases, it misses the boat. Antidepressants can’t restore the energy, muscle strength, and brain function that only come from testosterone. Equally problematic, antidepressants have no beneficial effect on the risk of heart disease, stroke, Alzheimer’s, osteoporosis, diabetes, arthritis, breast cancer, and prostate cancer that studies show stem from testosterone deficiency.*

If you thought testosterone was just for men, you would be in good company. Because we are taught far more about prescription drugs than hormones in medical school, doctors don’t realize that a menstruating woman produces approximately ten times as much testosterone as estrogen. Moreover, we are not taught that every cell in the body—except red blood cells—has receptors for testosterone. In other words, testosterone directs the activities of cells throughout the body, not just the brain, muscles, and sex organs.

Unlike thyroid and cortisol, you can live without testosterone. You just won’t live as long or as well without it. Every marker of health declines in the absence of this vital hormone. You might be tempted to say, “Well, I’m just getting older.” You would be right, but that is not why your health is declining. Chances are, much of the reason you are fizzling out is because your testosterone production is dropping off.

Many women in menopause, and even before menopause, find that testosterone replacement gives them their life back. Men who are deficient discover the same thing. But how you get testosterone matters. Taken orally, testosterone is highly inflammatory because it goes through the liver—where it wasn’t designed to go—before it gets into the bloodstream. Injections into muscle skip the liver but contain side chain chemicals that are not native to the human body. Gels and creams that are rubbed into the skin are much safer than these other forms, but suffer from uneven absorption and do not last very long.

For these reasons, in our experience, most people prefer small pellets that are implanted beneath the skin during a painless in-office procedure. Pellets release hormones 24/7/365 on an as-needed basis and are used up over a period of 3-6 months, depending on the person.

If your doctor has checked your testosterone and informed you that your level is normal, be sure to consult with a doctor who has obtained advanced training in hormone replacement. “Normal” hormone levels are based on population averages. As the American population has gotten sicker, the average testosterone levels in both men and women have declined significantly. So you’re not just imagining things when you suspect your level is low but are told everything’s fine. There are, of course, several other possible reasons for feeling crappy, but the usual labs aren’t going to identify them, and an antidepressant isn’t going to solve them.

When two other doctors and I introduced hormone pellet therapy to the Intermountain West over 20 years ago, patients eagerly embraced it. Looking for alternatives to treatments that only addressed some of their symptoms and increased their risks of undesirable diseases, people like Barbara traveled great distances to see us. They still do. But most doctors were understandably skeptical, unaware of over 60 years of published research on the practice. As the public has become increasingly educated about hormone deficiencies and treatment options, however, even gynecologists, urologists, and nurse practitioners are jumping on board.

But there is more to hormone replacement than taking a weekend course and learning how to insert pellets beneath the skin. A lot more. This is why you need to make sure your doctor attends regular trainings—my staff and I attend six to eight national conferences in an average year—to learn the latest about hormones and their relationship to every system in the body.

If you think hormone deficiency might be causing some of your symptoms, or have no idea what is causing them but know that things aren’t right, call us at (435) 210-0184 for a second opinion. You don’t have to leave the excellent doctor you already have and love, any more than you would give up your regular doctor when you need to see a neurologist, cardiologist, surgeon, or dermatologist.

*Neither God nor Mother Nature has submitted human hormones to the U.S. government for approval as drugs. Consequently, hormones are neither permitted nor claim to diagnose, prevent, treat, or cure any disease.

When My Teacher Comes to Town
by Star Kolb

Seventeen years ago I did something that felt really scary at that time! I walked through the doors of a yoga studio. That first practice, of which I could not do most of what was offered, was exhilarating and I walked (more like rubber leg stumbled) away knowing I couldn’t wait to take another class!

I often joke that the hardest part of going to a yoga class is getting yourself there. It was Peter Sterios I began practicing with all those years ago. After attending his 6am practice several times a week for a year, he informed me that I would teach yoga someday. Well there was that powerful yogi intuition at work. Not only do I teach yoga, I also opened a yoga studio here in sweet Moab! Now, I have the great honor to host Peter while he teaches the first yoga workshop at Sundari Yoga & Wellness Studio, 1105 S US-191 #3!

Gravity & Grace
Special Yoga Program + Book-signing
with award-winning author Peter Sterios
Sunday October 16, 2022, 4-6pm

Come, enjoy a unique yoga movement experience with Peter Sterios, international yoga teacher and award-winning author. At its heart, this special program will enrich your current practice of yoga, no matter the style, and help you develop an intuitive, yoga-inspired guide for wellness using the subtle body elements of Gravity & Grace.

Peter will lead a gravity-inspired dynamic movement “all-levels” class, followed by a short Q&A conversation about healing with yoga and Peter’s sharing of excerpts and personal stories from his new book GRAVITY & GRACE - Nautilus Book Awards 2019 Gold Medal Winner for “Health + Wellness”, chosen from over 500 entries. Past winners include Eckhart Tolle, Deepak Chopra, Thich Nhat Hanh, His Holiness the Dalai Lama, Caroline Myss, and Mary Oliver.
Register by October 9: Workshop is $55 and includes a signed copy of Peter’s new book. Workshop registration after October 9 is $45, with books purchased separately for $25.
Sundari Yoga & Wellness Studio, 1105 S US-191 #3
Join Sundari Yoga & Wellness Studio for weekly yoga classes!
Keep checking in for the several fabulous workshops and series coming this fall and winter.

What to Expect if You're Called Back In After a Mammogram
by Steve Hawks

After a routine screening mammogram, ten to fifteen percent of those screened will be called back in for further evaluation. If you are among that ten to fifteen percent, does that mean something is wrong? It can be frightening waiting for that second appointment. It's natural to worry--but knowing the facts can help set your mind at ease. You should know that it is overwhelmingly likely that you are just fine.

Getting Called Back In
There are two main reasons that a patient might be asked to come back for a second appointment after a routine screening mammogram:

• The original images might be difficult to read, especially if the patient has dense breast tissue.
• The radiologist who read the original images might have seen an area that looks different from the rest of the tissue.

Even if the radiologist saw something on your first set of images that looks different from normal breast tissue, that does not mean you have cancer. More tests will be performed, a doctor will talk with you about these tests, and the odds are good that nothing serious is going on.

What Happens at the Follow-Up Appointment
You can expect the follow-up appointment to be longer than a routine screening appointment. There are various tests the doctor might want to have performed. They will probably start with more detailed mammography and then progress through the next few steps only if it seems necessary.

• Diagnostic Mammogram: A diagnostic mammogram consists of more images than a routine screening mammogram--but otherwise, it will seem very similar to the routine mammograms you have already had. Your doctor will probably read these results right away and then decide whether more tests are needed.

• Breast Ultrasound: If your doctor requests it, you will have a breast ultrasound, which is a fairly quick test and does not hurt. This test uses sound waves to create images.

• Breast MRI: You may be asked to have a breast MRI. This test requires you to lie still while a large machine uses magnetic waves to create very detailed images. It takes some time and may require an IV injection of contrast dye.

• Biopsy: A biopsy removes a little bit of tissue from the breast for study under a microscope. This less common test is reserved for the times when a doctor has no other way to rule out cancer. There are various ways it might be performed, but in all cases you will be given some kind of anesthetic to prevent pain during the test.

Possible Outcomes
So what might the doctors find out with these tests? It might feel like a 50-50 proposition: either it's cancer or it's not. But the truth is, even if you are among the 10-15 percent of patients called back for more testing after a routine mammogram, the odds are still in your favor. Fewer than 1 in 10 patients called back for further testing turn out to have cancer.

• Sometimes the doctor just needs some clearer images. This is especially likely if you are younger, because breasts are generally more dense before menopause, and younger patients may not have previous mammograms to use as comparisons with the current images.

• There are a number of benign (noncancerous) conditions that can cause breast changes--cysts and microcalcifications, for instance. If your tests reveal a benign breast condition, your doctor will discuss whether it requires any kind of treatment.

• If you do have cancer, your doctor will explain whether it is limited to one area of the breast or whether it has spread. Your doctor will also explain treatment options.

It's probably impossible to put an upcoming call-back appointment out of your mind entirely. But you should know that the odds are very good that you don't have cancer. And even if you do, treatment options have progressed dramatically in recent decades. While you're waiting for more answers, rest assured that there is every reason to be hopeful.

The American Society of Breast Surgeons suggest that females over 40 years of age get yearly mammograms to check for signs of breast cancer, which affects 1 in 8 women. Call Moab Regional Hospital today at 435-719-3794 to schedule a screening mammogram!


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