Questionable Candidiasis
I think I have a vaginal yeast infection
I recently took Diflucan (fluconazole) yesterday [a Rx medication for yeast] but I'm still itchy and irritated "down there". What should I do? Should I go see my gyno??A: Dear friend,
What I tell people is a yeast infection is a yeast infection for 5-7 days, no matter what you do. The diflucan works over a period of 72 hours, so be patient. In the meantime, wear 100% cotton undies, loose clothing, try not to scratch or rub the area as that can make it worse, and no sex til its all better! There's not much the gyno can do after you took a diflucan if you're still in the 72 hour treatment period. You might want to get a 7 day over the counter yeast infection cream (ie 1% clotrimazole = gyne-lotrimin is my fave). DO NOT do the "1 day" or "3 day" creams- they will burn and sting. You can use the 7 day cream twice a day and apply it to the vulva to soothe the tissues, you dont have to use the applicator unless youre still really itchy/irritated inside. You can also call your gyno and ask them to call in a Rx for "Lotrisone" or "Mycolog 2" cream to your pharmacy, it's a little bit stronger anti-itch/anti-fungal cream than what's available at the drugstore. Also remember that ice is a good pain and itch reliever- sitting on a bag of frozen peas wrapped in a small towel can help.
Look at it with a mirror- if there's sores or a strong fishy odor- to the gyno you go. And remember, if you go to the gyno with a bunch of cream on/in you there's not a lot we can do to test or treat. So if you go in for an exam, avoid the cream the day of and the night before. If it's been 4+ days since you took the Diflucan and still no relief, make an appointment with your gyno.
Good luck! Hope this helps 
Let's talk parenting taboos: Rufus Griscom + Alisa Volkman
Preconception Health- It Pays to Plan Ahead!
Q: I’m thinking about getting pregnant… What should I do to prepare my body?
NurseCoco: Taking good care of your body both before and during a pregnancy is important. Here’s a few tips to get yourself ready:
· Get vaccinated! Most women of childbearing-age (20s-40s) are due for their tetanus and pertussis (whooping cough) booster. Most of us were vaccinated against this as we were kids (and also diptheria), but we are due for a booster. Whooping cough is no fun for adults, but it can be deadly for babies, so we are trying to get people in this age group re-vaccinated for it so that babies aren’t exposed. If you’re 26 or under, you should complete the Gardasil vaccination series (3 injections over 6 months) to protect yourself against HPV. Though we don’t regularly test for it until you’re actually pregnant, your healthcare provider will do a blood test to make sure you’re immune to Rubella.
· Folic acid- women should be taking a minimum of 400 micrograms (mcg) daily, aim for 800-1000 mcg. This is a key ingredient in prenatal vitamins. It’s so important to fetal brain and spine growth that folic acid is fortified in many grains and cereals. Healthy growth of brain and spine is an essential start to a healthy pregnancy, and your baby needs a good reserve of folic acid at the time of conception (before you even know you’re pregnant!)
· Watch your fish intake. Fish is a great lean protein that contains important fatty acids to our diet, but too much or improper preparation can cause problems. High mercury levels in the blood are not healthy for a pregnancy. Avoid high-mercury fish (ie swordfish, tuna, shark). If you’re a big fish eater, you can ask your healthcare provider to check your blood mercury levels. The issue with raw fish is that uncooked seafood carries the risk of disease. I tell women when they’re pregnant that if they’re craving sushi, go to the best sushi restaurant you can, and don’t eat it every day.
·
Keep it clean. We all know it- avoid smoking and
drugs, and cut down on the cocktails, when trying to get pregnant. You have
some leeway in the first few weeks before you know you’re pregnant and before
there is blood passing from mom to baby, but obviously less is better and
there’s no clear “safe” amount. But don’t beat yourself up about the margaritas
or glasses of wine you had before you knew you were pregnant! Most likely if you quit once you get the (+) pregnancy test, all will be okay but be sure to get adequate prenatal care (you should see a healthcare provider on a regular basis starting at 8 weeks pregnancy until after you deliver).
When in doubt, it's best to make an appointment with your healthcare provider to discuss your unique situation. Also be sure to ask about any medical conditions you may have and regarding any medications you might be taking. Good luck!
October update
I've gone to a few continuing medical education conferences recently to get my required "CME" units and widen my breadth of knowledge in certain subject areas.
I went to a Women's Health Symposium in San Francisco in September that discussed the latest and greatest updates on vaccinations, bone health, urinary tract dysfunction, and HPV and cervical cancer screenings. I also recently flew to Scottsdale, AZ to attend a conference to learn how to do Botox injections. While OB/GYN and women's health is my passion, I also enjoy learning about and implementing cosmetic medical products and procedures. In November I plan to go to a conference to become a Certified Legal Nurse Consultant. I hope I get to put all this new information to use soon!
Take care out there, and be sure to get your flu shots! I got mine on Friday and my arm sure was sore for a few days, but well worth it to avoid getting sick and protect others as well
Nurse Coco fixes it all!
Interesting Monday
Need help with your breast self-exam?
(Click on link below to see YouTube video)
Boy Scouts offer to help women with their breast exams to get Eagle Scout award
Nurse Coco says...
General gynecologic advice:
Do NOT put food in your vagina. This includes yogurt, cloves of garlic, vinegar, random oils, and potatoes. Yes, this was inspired by someone who I saw who did this. Yes, I've heard of all of the above and stranger things in aforementioned areas. Leave it alone, people!
Healthy dinner!
sounds barfy to some but actually pretty good!)
Overtreated: More medical care is not always better
Another reason why things get ordered that are not necessary are patients asking for tests and procedures (age of the internet!). For example, the new guidelines that Pap smears are only needed for some women every 3 years, yet many of my patients demand their Pap and HPV test every year since many women think their Pap test is synonymous with "testing for a healthy genital tract". Not true! The pap is only a test for cervical cancer, but there are many other things that are checked on a pelvic exam.
See the story below:
http://news.yahoo.com/s/ap/20100607/ap_on_he_me/us_med_overtreated
If you're interested in this topic, you should read Overdo$ed America, by John Abramson, M.D.