Congenital vs. Acquired | A Discussion of Tarlov Cyst Treatment with Long Term Follow Up
Congenital vs. Acquired | A Discussion of Tarlov Cyst Treatment with Long Term Follow Up
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I came to the conclusion that there are essentially There are those who have as part of a connective tissue disorder and this includes diseases

Ehlers-Danlos and possibly cutis laxa sometimes neurofibromatosis And these folks have family histories of things like bicuspid aortic valves being stretchy having chronic back

cataract problems lens problems and things consistent with And then there appears And this acquired group have had an event and in their 50s approximately they begin to become symptomatic.

So we all know that fibroids are super, super common. For people that are looking at me and saying,

Janice you look a little young, you have to know that I'm not that young and I'm gonna be turning 50 shortly and when I turn 50 I will join an exclusive club of women who by age 50, 80% of us, being a black girl,

would be suffering for uterine fibroids. And even if you're not a black girl, just a girl in general, seven out of 10 women, when they reach that age, will have uterine fibroids. It's the leading cause of hysterotomy in the United States with over 300,000 hysterectomies being done

for a benign disease so let's think about that for a second. We're actually everyday trying to figure out how we're treating diseases in the body by leaving the cancer in the liver and ablating it or embolizing it with chemotherapy or internal radiation

and all kinds of things but for a non cancer of the uterus the number one treatment is just take that organ out. Symptoms related to uterine fibroids actually one in five women that go to the gynecologist today it's for something related to their fibroids

and fibroid symptoms are very varied, mostly related to heavy periods, pelvic pain and bulk symptoms and regardless of what that is, I want you to know that there's a high impact on the quality of life and productivity in the U.S. where women wait, on average, around 3 1/2 years

to get help and I tell every woman that comes to talk to me about that. If you had diarrhea five times a day, five times per month, would you go talk to someone about that? How about if you had hematemesis,

five times a month every month? Do you think that you would go see somebody about that? Yet women just suffer with this symptom every month for an average of 3 1/2 years and never see anyone about that. In 2013 Doctor StewarT did a survey of over

1000 women and found that a third of women said that they missed work because of fatigue or cramps or bleeding and this is not something that doesn't cost us a lot. The cost of treating this benign disease, uterine fibroids is around 34 billion dollars

to the U.S. consumer so if you don't even care about that and you're like, I only care about money, here is something to care about. Yet there are no pins that say, let's have an annual women fibroid awareness day but the cost of treating fibroids is on par

for breast cancer, colon cancer and ovarian cancer combined. I think it's time we pay a little bit of attention about that.

If we talk about dementia, the most common problem really is mild cognitive impairment.

This isn't dementia, it's the goofiness you get after being on bypass. You know, all the patients after they've been on cardiac bypass are just not the same, and they're a little kind of bewildered. It takes about 18 months for them to get better.

But many people do actually develop forms of dementing disease. And the younger you are, the more likely it is that you actually have an underlying pathologic process with a name added to it, like Alzheimer's or frontotemporal dementia or Lewy Body Disease.

And the older you are, the less likely it is to be a specific disease and more likely just to be little strokes from vascular disease. Just as you get in your legs from peripheral vascular disease, you get it in your brain.

And so in 2017 The Society of Interventional Radiology commissioned a different survey and they said let's just find out

if we're doing anything about this, are we making an impact? And they surveyed over a thousand women again to find out about this and even though I stood here and tell you that 80% of black women and 70% of all women will have fibroids

there's still like a quarter of the population who said they've never even heard of fibroids and the people that are women don't even think that they're at risk even though I'm telling you that this is a disease that is so prevalent they have no idea.

And that a full 20% of all women think that their fibroids could be a cancer. Now this misperception really feeds into the treatment because if you think that your fibroids are cancerous it's very hard to hear somebody tell you, okay fine don't worry about it,

let's just keep your cancer inside. But because they think that fibroids are cancerous then the leading treatment remains the leading treatment which is hysterectomy, let's just cut it out. And of those women that are surveyed that say that, again the majority of them have never heard of UFE,

those who are diagnosed with fibroids still say that they were never aware of this being a treatment. The women that had fibroids were never told that uterine fibroid embolization is a possibility, so we have a long way to go.

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