Women's Health Care Nurse Practioneer

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April 23, 2020

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Thank you! Nice to have feedback! I need to get writing agian!
Donna Duvall RN, MN, WHCNP

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April 23, 2020

Reply to Vineesh

Vineesh,
I am sorry if it has been a long time since you made your comment. I have not been practicing and I'm just now updating my website. I am glad you found relief with the progesterone cream and I hope you have reduced your risk for breast cancer. If you do choose to take estrogen in the future, taking oral progesterone is advised as the cream is not able to be absorbed in high enough quantities to prevent the uterine cancer that can develop with unopposed estrogen. If you have futher que...

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April 22, 2013

HRT Benefits Newly Menopausal Women

This data was actually released in October of 2012. The Women’s Health Initiative (WHI) study, which was released in 2002 made many women, and their health care providers, afraid of estrogen because of an increased risk of breast cancer. What we understand now is that the population in the WHI study was different. The average age was 63 and 49% were smokers or had other cardiovascular risk factors at the time of entry into the study.

The study released last October, the Kronos...

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October 19, 2012

Trouble Sleeping?

I have been amazed at how many of my patients regularly take something for sleep, depression, or anxiety. Not getting a good night sleep can lead to many medical problems. With today’s practice of medicine, it is much easier for a practitioner to write a prescription than it is to talk with the patient and see what is causing the problem. It turns out that 50 percent of adults report occasional insomnia and nearly 20 percent have chronic sleep problems. The prevalence of sleeplessness increase...

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June 1, 2012

Do I need an annual exam/Pap smear?

The American Cancer Society has released new guidelines. I think they are confusing to clinicians as wells as for most women. First of all, Pap smear screening should begin at age 21. Does this mean women don’t need an exam until they are 21? No. It means that cervical cancer develops slowly over 7-20 years so a pap smear will not show anything until that time. Most cervical cancer is caused by the Human Papillomavirus (HPV). It is a sexually transmitted infection. There is now a vaccination f...

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April 3, 2012

Do I need to be taking vitamin D?

I have been checking vitamin D levels on my patients the last year or so, due to an abundance of data showing the benefits of vitamin D. I have been amazed how many women are low, even though we live in “Sunny San Diego”. Vitamin D is known as the “sunshine” vitamin. The body makes vitamin D from cholesterol through a process triggered by the action of the sun’s ultraviolet B rays on the skin. Factors such as skin color, age, amount and time of sun exposure, and geographic location aff...

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January 8, 2012

Combating Our Belly Fat

Combating Our Belly Fat

It seems like most women, after turning 40, begin to have issues with belly fat. Many blame it on taking estrogen or the lack of estrogen, as they near or pass menopause. In reviewing the world-wide literature, there is no difference if women are on the birth control pill or post menopausal estrogens on the development of belly fat. The main factors are our diet and exercise. Of course, this means we have to admit that our life-style makes a difference.

Ma...

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May 8, 2011

Top Eight Health Benefits of Physical Intimacy

As promised, I will summarize some of Dr. Diana Hoppe’s comments from her book “Healthy Sex Drive, Healthy You”. I hope they will help you get in the mood and ready for an enjoyable sex life.

1. Sex promotes longevity – According to Dr. David Weeks, a clinical neuropsychologist and author of “Secrets of the Superyoung”, sex actually slows the aging process. He studied 3.500 people ranging in age from 18 to 102. The results? Those individuals who engaged in sex on a regular basi...

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April 4, 2011

Libido 101

I promised with my last Blog that my next discussion would be on libido. After that promise, I attended a 4 day course on “Women’s Sexual Health”. The amount of material presented was overwhelming. I could not decide what was most important to present. I decided if I was overwhelmed, you would be also. Instead, I am going to present some basics and will proceed with additional information depending on what feedback I get from you. What additional information would you like? Please email me...

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January 25, 2011

Insurance Dilemma

Insurance Dilemma

It seems like everyone these days has concerns about insurance and the cost of health care. I have been in practice for 30 years and remember “the good old days”. When I first started in private practice in Portland, Oregon in 1981, we charged $95 for an annual exam. We would be reimbursed $95. At that time, most insurance companies would pay 80% and the patient would pay 20%. There was no question and we only needed one person to do the billing. If a surgery or a p...

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Shubhadip Shubhadip on July 11, 2013 3:42 AM

I worked at Med I Cal for some time, and it is often miesaktn for Medicare. Med I Cal is only available for people with children (as you have stated) not single folks, additionally you must make an income that is less than 250% of the national average.No free lunch in america for health insurance, of the 300million americans approx. 40million just don't have any.First you must understand what is available so you can make an educated decision on what to pick.1. PPO plansa. Preferred Provider Organization, most popular in Americab. Deductibles- the amount you pay before benefits are paid by the health insurance co. ex. 500 2000c. Co-Insurance- the amount you pay after you have paid the deductible. ex. 20-30% is common placed. Max. out of pocket- the most you would pay in one year including deductibles and co-insurance if you use a preferred provider.e. Co-pays- these are amounts (usually small) that you pay for Dr. Visits, RX copays. ex. 10. for generic drugsSummary, PPO plans can be offered at very low costs because high deductibles and high co-insurance means that the consumer will need to pay these high deductibles and high co insurance. It boils down to risk you as the consumer are willing to take on, I personally have a high deductible plan- you ask why? well at 44 years of age, my mother and father are alive and healthy- my grand parents are still alive so genetics are working in my favor, I live a healthy lifestyle no drugs, I try to exercise everyday -eat my vegetables, fruits like my parents. I have elected to pay as little as possible and purchase a high deductible plan meaning that I am responsible for all charges up to 3500. every year, this is called a major medical plan- and I took it one step further by purchasing a Health Savings Account Qualified plan, since I am self employed.You must understand that health insurance companies make billions, yes billions every year on people who are don't make claims. People just like me, who buy expensive plans with low deductibles lots of benefits and don't use them, it is because some slick salesperson has sold them a bill of goods. The health insurance companies don't really want you to understand the plans or people who change to high deductible plans immediately, especially HSA or health savings accounts which are just incredible.

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