For the first time in our lifetime, there is a vaccine to prevent cancer, specifically cervical cancer! I would like to provide an update on the latest advances in the HPV vaccines for the human papillomavirus, commonly known as HPV. Cervical cancer is preventable. HPV infection causes cervical, vaginal, and vulvar cancers in women; cancer of the penis in men, and genital warts in both females and males. HPV is sexually transmitted. The Advisory Committee on Immunization Practices (ACIP) has recommended the vaccination against HPV since 2006. The HPV vaccines are highly effective, safe, and very powerful in preventing HPV infections and HPV-related cancers.
In 2006, the vaccine was approved and licensed for use in the United States for females between the ages of 9 and 26. By 2011, it was also recommended for males ages 9-26. In those years, the vaccine, Gardasil, targeted four types of HPV viruses while the vaccine Cervarix targeted only two types of HPV viruses. Over the years, most providers recommended Gardasil, as it targeted four types of HPV viruses, two of which were considered high risk for the development of cervical cancer—HPV 16 and 18. As of 2016, there is a “9 valent HPV vaccine” called Gardasil 9, now offered in the United States. Incidentally, I heard a speaker from the Center of Disease Control last fall stating that once fully available, Gardasil 9 would be the only vaccine recommended going forward. The ACIP committee does recommend initiation of the HPV vaccine at ages 11-12, often with a school physical. Administered in the muscle of the upper arm, the vaccine is given to both females and males in a 3-dose schedule. The second injection follows in 1-2 months and the third injection being given 6 months later.
The good news is that the vaccine is now recommended in a 2-dose schedule! If children receive the vaccine under the age of 15, it only requires TWO injections instead of the three previously recommended, unless they have medical reasons such as immune deficiency which would still require 3 doses. The first dose would be given to boys and girls at age 11 -12 (could start as early as 9 years old). The second dose would be given 6-12 months later. Recent studies have found that two doses work as well as three in preventing the HPV infection. If adolescents were 15 and older when they received the first vaccine, they should still follow the 3-dose schedule. The vaccine is not recommended during pregnancy. Check with your insurance company to determine your coverage of the vaccine. Your primary care providers, pediatricians, and local health departments provide the vaccine.
Lastly, please get your screening pap smears to determine if you have the HPV virus or abnormal cells that could lead to cervical cancer. This is the only way to determine if you have the HPV virus. Talk further with your health care provider if you have concerns or questions. Also, please consider having your children and loved ones vaccinated against this virus. Remember that HPV can be prevented if people are educated about the risks of unprotected sexual encounters, the value of abstinence, the use of condoms with sexual activity, and this vaccine that can prevent several types of cancers. Talk to your children about the risks of premarital sex and consequences that can last a lifetime, emotionally and physically.
To your health,
Terry Polanin, MSN, FNP-BC
To begin with, I’d like to take a moment and thank you for your prayers, support and well wishes while I was gone on maternity leave. It should come as no surprise that after a major life event, we might see the world through a different lens. I know this was true for me after the loss of my sister four years ago, and it certainly has happened again over the past four months. I have had the opportunity to reflect on the changes that occur from a twin pregnancy and becoming a new mother. I can confidently say that my life has been turned upside down in the most wonderful sort of way. One of the most beautiful observations I’ve witnessed has been watching my babies learn to move their bodies. When I untuck them from their swaddles every morning, their little arms immediately shoot up and stretch toward the ceiling. Their toes curl down with focused intention. Their eyes sparkle with excitement as their hands make their way toward their faces and gummy grins follow. The excitement of simple movement and learning the joy of their body is apparent all day long. The wonderment they express is contagious!
I think it has become part of our culture to associate or even interchange movement with exercise. Exercise can carry the connotation of a punishment for poor life decisions. You’re forced to go through the motions of exercise to burn ‘x’ amount of calories and fat. I began to appreciate the difference between exercise and movement as I attended my first post-delivery ‘exercise’ class about six weeks after my C-section. I was completely discouraged with my immobility and lack of strength. I struggled to bend over to touch my toes or even successfully complete one assisted push up. My chest was so large and engorged from breast-feeding that even lying on my stomach in defeated exhaustion was painful and embarrassingly unsuccessful. I felt defeated at how much stamina I had lost. ‘Exercise’ was awful to me! My body had lost its sense of pleasure for exercise, so long as I kept my focus on what my evolving body could not do. Even though I could not lift as heavy a weight or run as fast a pace, I could still move! I started to focus less on comparing my pre-pregnancy fitness level to my post-pregnancy self. I began thinking about the movements of my body not only when I exercise, but throughout the day. I began focusing on what my body can do – reminding myself to be kind to my body, the same gentle way I’d want to treat my son and daughter. We need to become conscious of the gift of movement that we are capable of. Our bodies were made to move! Completing a workout to achieve an external goal at the expense of not enjoying the process is shortsighted and not sustainable. Focusing on the intentional movement of my body when I swim, walk or pick up my babies has given me a greater appreciation of the gift of my body – regardless of size, shape or weight. What a blessing it has been to be reminded of the simple joy of movement from my babies. I hope you are kind to your body and find joy in the every day movements.
To Your Health,
Hope Placher, PA-C, MMS, IFMCP
The idea for this month’s newsletter article came to me from one of my patients. Her name is Kristy. Her story is as powerful as it is tragic. However, we can all learn a very important lesson from what she has to say. She was gracious enough to share her message with us this month.
In October 2016, Kristy and her husband Sean were victims of carbon monoxide poisoning. Kristy survived but unfortunately Sean, age 50, did not. Carbon monoxide poisoning robbed Kristy of the opportunity to spend the rest of her life with her soul mate. She agreed to share this tragedy with us so that together, we could possibly prevent this from happening to someone else. I am grateful to her for her selflessness as she shares what is in her heart for the betterment of others. Here is her letter that she gave us permission to share with all of you.
On October 14th I woke up earlier than usual and didn’t feel well. I was experiencing heaviness in my chest and slight dizziness. My husband said he felt kind of sick also. He went in the bathroom and shut the door. I stood up and was trying to text my daughter, and I collapsed. That’s the last thing I remember. It all happened in less than 10 minutes-Carbon Monoxide (CO) poisoning.
It was about 7 hours before they found us. They took me to OSF, and I was taken to Chicago by life flight. I needed an available bariatric chamber to saturate my body with oxygen and push the CO out. I woke up the next day to find out my husband did not survive. My prognosis during treatment was possible brain damage and/or heart issues from the lack of oxygen. Luckily, that wasn’t the case. But I do have short-term memory issues, and some cognitive issues not really noticeable to others.
I had turned the furnace on just a couple nights before that. CO poisoning is something nobody thinks about. It has no odor and you don’t know what’s happening. Some have experienced illness and headaches at home for months or years with a slow saturation before they figure out what it is.
There are no words for the depth of my grief. Simple carbon monoxide detectors would have alerted us. I now have 3 in the house and I will get one to travel with. People think if they have their gas furnace, hot water heater, inspected every year that that’s enough. A malfunction can happen at any time. Please don’t take that chance on losing your loved ones or them losing you. It is a devastating loss that can be easily prevented.
Carbon monoxide is a colorless, odorless, tasteless gas produced by burning gas, wood, propane, charcoal or other fuel. Improperly ventilated appliances and engines as well as malfunctioning furnaces and gas fireplaces, particularly in enclosed spaces, may allow carbon monoxide to accumulate to dangerously toxic levels. Carbon monoxide poisoning occurs when carbon monoxide builds up in the bloodstream. When too much carbon monoxide is in the air, the body replaces the oxygen in red blood cells with carbon monoxide. This can lead to serious tissue damage, or even death.
The signs and symptoms of carbon monoxide poisoning include headache, weakness, dizziness, disorientation, confusion, nausea or vomiting, shortness of breath, blurred vision, and loss of consciousness. If a patient survives carbon monoxide poisoning, there may be long-term consequences such as brain damage or heart damage. There are a few simple precautions to remember to reduce the risk of carbon monoxide poisoning. The following is a list of very pertinent suggestions from the Mayo Clinic:
To Your Health and for Prayers of Healing for Kristy,
As I continue my article series on protein, this month I would like to discuss protein bars. Many companies, health promoters and gym enthusiasts market protein bars as a healthy way to lose weight and gain muscle. However, truth be told, many protein bars are very similar, if not more unhealthy, than candy bars!
Last month we reviewed the necessity of protein in a healthy diet. Typically protein makes up between 20-25% of our daily intake. To calculate your optimal protein intake, calculate your body weight divided by 2.2, and then multiply by 0.8. This will give you the necessary grams of daily protein. Please keep in mind, full-time athletes (think professional, or college athletes) or people suffering from certain diseases or disorders may require a higher protein intake.
Protein bars are not necessary to “normal” healthy adults. Even if you exercise, whole foods should be the first line of therapy for proper post-workout supplementation. Try using a combination of carbohydrates and proteins like organic chocolate milk or possibly a banana or half a whole grain bagel with peanut butter as a recovery snack.
If you choose to use protein bars, please consider my checklist below when browsing protein bar options:
As a reminder, no health food or health food claim will ever replace the health and nutrients found in REAL food. Diets that fully eliminate one macronutrient (think carbohydrates or fat) tend to provide quick results, but ultimately are not sustainable or good for one’s health. (Many patients who have tried these diets will tell you they gained back all of their weight and more.)
If you have questions regarding what protein bars you use or what ingredients are used in your bars, please feel free to contact me for further discussion.
Please also enjoy the homemade protein bar recipe that I have attached below. This recipe provides not only protein, but also healthy complex carbohydrates and healthy monounsaturated fats from nuts! What a great post-workout recovery snack. Enjoy!
1/2 cup pitted dates
3 oz. dried apple slices
1 1/4 tsp. ground cinnamon
1/4 tsp. fresh lemon zest
1/8 tsp. sea salt
A recipe by Andrew Weil, M.D: A wonderful addition to pasta or soup and can be enjoyed as a dip or spread.
Nutrients Per Serving, Serves 16
Saturated fat 0.4g
(84.2% of calories from fat)
Fiber less than 1g
1 cup walnut pieces
2 cups cilantro leaves, stems removed
1 jalapeno pepper, seeded and chopped
1/2 teaspoon salt, or to taste
1 Tablespoon cider vinegar
1/4 cup purified water
Keep any leftover pesto in the refrigerator in a tightly covered container.
Dr. Michele Couri, MD, FACOG, ABIHM has added a leading edge treatment to her practice to resolve gynecologic health issues often caused by menopause. The MonaLisa Touch™, an in-office procedure that is virtually painless, requires no anesthesia, and is FDA approved. Dr. Couri is the first physician in the greater Peoria, IL area to offer the special fractional CO2 laser designed to help these symptoms.
Do you experience these symptoms?
Now there’s a better way……
MonaLisa Touch™ addresses these problems without hormones or surgery. It is ideal for menopausal patients, post-menopausal patients and breast cancer survivors who are often unable to receive conventional treatments for these debilitating symptoms.
MonaLisa Touch™ delivers gentle laser energy to the vaginal wall tissue that stimulates a healing response by generating new collagen, elastin and vascularization. A typical course of treatment is three procedures over 18 weeks.
In both European and US clinical trials, women reported symptom relief after the very first treatment and even greater improvement after treatments 2 and 3.
Ask us today if the MonaLisa Touch™ is right for you or sign up for one of our many informational classes at: www.couricenter.com/events.
Frequently Asked Questions
Even with the passage of time, many women still retain their youthful energy and enthusiasm, but post-menopausal changes can affect a woman’s quality of life in unexpected ways. Now, there is a gentle laser therapy that can help millions of women who are silently suffering.
What is the MonaLisa Touch™?
The MonaLisa Touch™ is a gentle laser therapy that delivers controlled energy to the vaginal wall tissue. It restores vaginal health by generating new collagen, elastin and vascularization. The MonaLisa Touch™ was first available outside the US where thousands of patients have been treated worldwide.
What clinical trials have been conducted on the MonaLisa Touch™?
A multisite study was conducted by Dr. Mickey Karram, Director of Fellowship Program on Female Pelvic Medicine & Reconstructive Surgery at The Christ Hospital, Cincinnati, OH and Dr. Eric Sokol, Associate Professor of Obstetrics and Gynecology at the Stanford University Medical Center.
The trial assessed the use of CO2 fractional laser therapy on 30 women with vaginal health issues due to natural or induced menopause. All of the patients in the trial were treated with the MonaLisa Touch™ laser therapy. Results were:
*Women in the study either experienced natural menopause or induced menopause as the result of hysterectomy or drug-induced suppression of ovarian function (chemotherapy, radiations, and anticancer drugs such as Tamoxifen).
A study was done by Dr. Stefano Salvatore*, Department of Obstetrics and Gynecology, Vita- Salute San Raffaele University to assess the feasibility of fractional C02 laser in the treatment of 50 women suffering changes in their gynecologic health.
In addition to the multisite study, there are currently 8 published studies with 6 ongoing studies.
Where can I have this done?
The MonaLisa Touch™ is an in-office procedure that Dr. Michele Couri can perform right here at the Couri Center for Gynecology and Integrative Women’s Health, now exclusively in Peoria, IL.
Does the procedure hurt?
The procedure is virtually painless and requires no anesthesia. Some patients may experience some discomfort the first time the probe is inserted, but the actual treatment is not painful. Many patients report that it feels like a gentle vibration.
How long does it take?
Patients receive three treatments, spaced six weeks apart, which each take less than five minutes to perform.
For which patients is this treatment appropriate?
The MonaLisa Touch™ is appropriate for any female suffering from issues from a decline in estrogen, as well as those who are experiencing symptoms as a result of a hysterectomy or breast cancer treatments, for any woman with vaginal atrophy due to physiological hormone changes, which become inevitable over time. In particular, MonaLisa Touch™ is the ideal treatment for those who are looking for a less invasive procedure, compared to traditional surgical or pharmaceutical treatments. Remember, no one can advise you better about MonaLisa Touch™ and what is best for you to achieve your best results than your doctor.
When will I see results?
Most patients feel improvement after the very first treatment, although the procedure calls for three treatments that are generally spaced over an 18-week period.
How long does it last?
Patients should expect to come back annually for a maintenance treatment in order to ensure results last over the course of time.*
*Your doctor will determine with you if follow up treatments are required.
What are my limitations after the procedure is done?
Patients should refrain from sexual activity for 2-3 days. Your doctor will determine a post-procedure regimen that is right for you.
Is this procedure safe for women with breast cancer?
Yes, the MonaLisa Touch™ therapy is particularly well suited for patients who cannot, or prefer not to receive estrogen therapy.
How much will the procedure cost?
Patients should contact their healthcare professional for additional information: 309 692-6838.
Will the procedure be covered by insurance?
No processing code has been established.
Are there any risks?
There are some minimal risks. The treatment is performed on an outpatient basis. Most women report temporary side effects, slight redness or swelling, some discomfort that usually disappears in one or two days.
Integrative Consultations at the Couri Center:
Explore the connection between what you eat and how you feel with the Couri Center’s 60-minute Integrative Consultation. Receive your personalized nutrition, lifestyle, and exercise plan and open the door to wellness!
Heal. Restore. Thrive. Learn more today: firstname.lastname@example.org or call 309-692-6838.