Suzanne Somors hormone replacement???
Comments
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lisa, thanks for those links. Haven't checked them out yet, but I do like Dr Northrup. I've read her books on women's health and menopause. I do wish she would address bc more specifically though. We're just not the same as the other ladies in the sandbox once bc comes knocking.
Also, I'm not sure I followed your comment about HRT not being the same as bioidenticals. Clearly, bioidenticals are different from the pills made from the urine of pregnant horses. hmmm, plants, horse urine, which to choose. Sorry, can't resist sliding into sarcasm. Anyway, I've always had the impression that they're both HRT, but that women have a choice of bioidenticals or big pharma.
Back to Dr northrup, I started eating flaxseed and yogurt for breakfast because of what she wrote about it in the menopause book. And while I'm perplexed at her curious silence to the bc crowd, I decided I'll take my chances with the phytoestrogens and my er/pr+ status. I think flax does help with reducing hot flashes and it seems to help my hair start feeling like my hair again instead of that crispy critter mop that grew onto my head after chemo. It didnt' do squat for relieving fatigue though, or reducing my cholesterol.
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Wow, thanks for posting this. I watched the show yesterday. I too was disappointed that the subject of BC never really came up (or if it did, I missed it). I would give anything to relieve these symptoms, but being 41 (pre-menopausal) and on tamox, there is nothing out there, that I know of, that will help ease the side effects. I will try the flax seed. Any help would be a relief!
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Dr. Christine Horner recommends the flax as well. I love her book Waking the Warrior Goddess...use it as my handbook...great information in there too!
The argument is that HRT does not work the same in your body as BHRT...which is why there is a difference. That is what I have learned over the years. Of course some doctors will argue that they are the same. I guess we will never know until more studies are done on BHRT...but then again....we are back to the almighty dollar and who controls the research!
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If you missed the show you can see the transcripts at orah.com.
Sheila
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I was so disappointed watching Oprah yesterday, I don't understand at all why BC was totally avoided considering Suzanne Sommers is supposed to have had BC, (that's why I watched I wanted to see what she said about that)...........don't you think one of the docs would have mentioned that, especially the opposing doc who looked really po'd at her. Its almost like everyone went out of their way NOT to mention BC ummmmm...... AND Oprah took NO questions for Suzanne from the audience which I thought was strange too. I just don't see how bioidenticals can work for ER+ bc oh I wish! cos those gals on them look fabulous and seem to have their zest for life back and some!
Lorraine ox
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Oprah knows that she is opening a can of worms here. After the Texas cattle lawsuit and being taken in by that charlatan "author", she is very careful what is said on her show. Plus, this show was taped so I am sure her lawyers took out anything controverisial and made it all about Susanne Somers, and not about helping us. I flooded her website with letters to please address this issue, but to no avail. It really make me mad. Dr. Northrup did a webcast last night, but I was out so I missed it. I am going to see if it is still on the web.
I do believe that hormone therapy is something that is needed for men and women. Our bodies are miraculous things, and we would not have these hormones if they were not essential to life. That is why I think the doctors have it all wrong by giving us drugs that totally block our estrogens just because we are ER+. It makes sense that we would be estrogen positive because we are women, whose bodies are controlled by estrogens. Since estrogens levels ebb and flow, I even wonder if those who are not ER+ are just being tested at a different time. I think we should be getting tested for estrogen levels throughout our lives, and if we have a dx of bc, before and after surgery. This would give us a lot more information. They test for everything else, why not this?
I think that in the next few years, all the current AI and SERM drugs will be called into question. Women are suffering too much while on them. We are throwing the baby out with the bathwater, displacing one disease for another, all because the fear of recurrance is so great. There has to be a better way. These drugs are not saving lives in the long run. Hormone replacement will soon be the solution. It is just a matter of getting the facts out to doctors to start looking in this direction. In the meantime, we are all guinea pigs, no matter which route we are taking.
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Please please please write to Oprah on her website about our disappointment and confusion as to WHY they are not addressing Breast Cancer, and those of us with hormone positive BC on this topic. I am so diappointed that no one has mentioned it - are the stats 1 out of 8 women are diagnosed with BC? What about us? I am assuming that if I had not known about my tumor which was hormone positive, and I took BHRT or HRT it would have had been terrible and fed my tumor. So there are women like us out there that haven't been diagnoses who will be fueling their tumors.
I thought Oprah would at least MENTION BC...isn't she known for telling both sides?
This is the third show on this topic in the last two weeks. I watched them only to see what they had to see about BC - not addresses. Very disappointing, and frustrating as I am 44, supposed to go into chemopause and will be put on tamox. or an AI - hormonally shut down. In addition to my cancer fears now I have to fear menopause. great.
Thanks for listening!
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Yes, I agree with you Vivre.
The other thing is people don't realize they are getting added estrogens from the food they eat, the air they breathe, the products they use, the medications they take...and on and on and on. That is why so many people are out of balance!
There is no right answer for everybody! I'm glad that people like Oprah and Suzanne are bringing this topic to the forefront.
Yes, we are a different group so we will have to be treated diffferently...but I'm thrilled that this information is become mainstream! Women have been neglected for years. You can bet if men would have been going through these hormone related issues...it would have been studied a long time ago!
I'm just finishing up chemo and am in chemopause...gotta love those nightsweats! I was peri-menopausal before my diagnosis. I'm also 44, but I will not be taking Tamoxifen. Won't do it. My body, my research, my decision.
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It is obviously a myth that estrogen "FEEDS" breast tumors or all the long-term survivors taking hormones would be dead. I wish I knew who started this myth. Even some doctors circulate this nonsense.
Time will prove the myth circulators wrong. And the women who have been devastated by having their hormones shut down will sue-- if they have the energy.
This is so sad. I can't believe it takes Oprah and Suzanne Somers to bring this to light.
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How is it a myth that estrogen will fed tumors with estrogen receptors? I am not being sarcastic, I really want to know. I am interested in medically proven articles, not hearsay. As a recent breast cancer patient, this is a whole new world - I know I am not alone. Obviously I am aware that there is estrogen in many areas - our fat, food products and environmentally.
I thought that Tamoxifen is supposed to make hormone positive cancer much less recurrent.
Also, I have a friend who is brac1/2 positive so she had her ovaries removed as well as a prophelactic bi-lateral mastectomy. She has been "forced" into menopause and really has not had all of these awful side effects. I guess each woman is different.
I know this is my body, my choices but I need to make choices that protect my life, for my family and myself. Please share your data on how it is safe for es/pr+ cancer patients that protect our future.
Thanks in advance!
Susan
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Susan,
I, too, would love to hear about studies that show that Tamoxifen doesn't work, as I just got a prescription for it yesterday. However, in researching the issue myself and reading various books, it seems like most think Tamoxifen works. Here's something I came across in the introduction to the book, "Breast Cancer, Real Questions, Real Anwers", by David Chan, MD of the UCLA Joneson Comprehensive Center.
The introduction was done by Frank Stockdale, MD, PHd, and head of the Stanford University Combined Modalities Breast Cancer Program.
On page xviii he writes:
"We have learned a lot about breast cancer risk reduction. We have know for decades that strogen use could increase breast cancer risk but the degree of risk was often debated and difficult to estimate until recent studies were completed. It is now clear established that postmenopausal use of estrogen icrease a woman's chance of getting breast cancer and that with the addition of progresterone, the risk is increased even more. ...We now know that taking Tamoxifen for five years can reduce the risk of breast cancer by almost 50 percent."
Any thoughts?
Lisa.
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To me, I thought the subject of BC was purposely ignored. I suspect that even Suzanne did not want to give her approval of using hormones in relation to BC. And that neither of the docs mentioned it was very telling to me that it is just too controversial.
What I took from the program was that the compounding pharmacies actually use the same hormone powder to make the creams that the FDA pharm use to make the HRT meds. The difference is that the comp. pharm make the cream to match the patients' needs rather than giving the 'standard' dose. While these replacements seem to make a difference in the health of women is not the issue with me. It is what else these hormones are doing. Steroid tx makes men youthful and feel healthy but we now know that there are great risks that go along with that.
As for the $$$ argument involving phamacutical companies...consider the money that Suzanne will make after her appearance on Oprah and the trillions of $ that these non FDA approved tx make each year. Please don't try to tell me that they are not motivated by the money too!
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Anomdenet, like aprilgirl1 I am interested to know how estrogen feeding tumors is a myth, I really wished I would have paid more attention in school in science class, at this point in my life I wished I were more scientifically minded! I have a BA in English Lit big whoop, and am counting on the more highly educated people on these boards to explain in plain English what this all means. I am so flippin confused!
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I have been watching Oprah's series on HRT, so sad they are not talking about breast cancer in relationship to this issue. I had no symptoms of BC, prior to dx., so I think it is important for all women to realize the risks associated with HRT. I am ER/PR+, I never used HRT for a long period of time, but I do realize today the pros and cons. I was taking femara, but stopped after consulting with my onco and I am taking tamoxifen now, happy to say I am doing much better. Shutting down our estrogen is the key to fighting off another occurrence of BC, but darn it sure screws you up, at least it did me. I didn't realize how important estrogen is for other parts of our bodies. I have since tried a different approach, with the help of a homeopathic doctor, and I am doing much better. My body doesn't feel as beat down as it was a year after chemo and taking femara. Would like get others thoughts on this. Keep on keeping on!
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oops, sorry, posted to the wrong thread....
Dx 12/19/2008, IDC, <1cm, Stage I, Grade 2, 0/10 nodes, ER+/PR+, HER2+
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CITING: The Washington PostThe Truth About 'Bio-identical' Hormone Therapy
By Amanda Gardner
HealthDay Reporter
Friday, January 30, 2009; 12:00 AMFRIDAY, Jan. 30 (HealthDay News) -- They're marketed as "bio-identical" hormones or "bio-identical hormone replacement therapy," and they claim to do everything from helping menopausal women lose weight to preventing senility.
They're touted as safer and sometimes even more effective than conventional hormone-replacement therapy.
But the U.S. Food and Drug Administration warns that these claims are "unproven" and that the products are "potentially dangerous." What's more, bio-identical hormone replacement therapy -- or "BHRT" -- is a "marketing term not recognized by FDA," the agency said.
Experts also are expressing some concerns about the products.
"We don't know anything [about these products]," said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City. "This isn't FDA-approved. It's the same thing as a hormone. What concerns me is that people believe if it's not from a drug company, it's safe."
ad_iconAdded Dr. James Liu, chairman of the department of obstetrics and gynecology at MacDonald Women's Hospital at Case Medical Center, University Hospitals in Cleveland: "Over-the-counter products that are not listed as drugs can make some claims, and they have to be careful about it. Usually these are considered supplements. Suffice it to say, there is science behind some of what they say and a little bit of lack-of-science in other things."
And the Endocrine Society issued this position statement back in October 2006, expressing concerns about these products: " 'Bioidentical hormones,' particularly estrogen and progesterone, have been promoted as safer and more effective alternatives to more traditional hormone therapies, often by people outside of the medical community. In fact, little or no scientific and medical evidence exists to support such claims... Additionally, many 'bioidentical hormone' formulations are not subject to FDA oversight and can be inconsistent in dose and purity."
Since the release in 2002 of a Women's Health Initiative report, hormone replacement therapy (HRT) -- used to relieve symptoms of menopause -- has generated worrisome, and sometimes conflicting, headlines. While linked to a reduced risk of colon cancer and fractures, the therapy has also been associated with an increased risk of breast cancer, stroke, blood clots and heart attack. And -- so far, at least -- there are no indications that HRT has any effect on the development of dementia.
The not-inconsiderable list of potential risks of hormone-replacement therapy has left an opening for manufacturers of "natural products" to step up with supposedly better and safer versions of hormone therapy, according to the FDA.
Marketers of bio-identical hormones often say the products are identical to hormones produced by the body, and these "all-natural" pills, creams, lotions, and gels don't carry the risks of menopausal hormone therapies approved by the FDA. Agency-approved HRT drugs are typically prescribed to treat symptoms of menopause, such as hot flashes and vaginal dryness.
But the FDA said it hasn't approved compounded "BHRT" drugs and can't assure their safety or effectiveness.
Liu said that " 'bio-identical' really means that the structure of the compound you're claiming to be identical is biologically identical. It [the term] is applied primarily to female hormones that are used in hormone therapy."
TBut, Liu added, "the main problem is how a woman would obtain [bio-identicals]. If it's pharmaceutical grade, FDA-grade, it's prescribed. It's just how it's made."
Some of the bio-identical hormones are "compounded," meaning they are mixed specially to meet an individual's needs. For example, some dyes or preservatives may be eliminated if a person is allergic to them, according to the FDA.
"The pharmacist assumes that responsibility and the physician should specify that on the prescription," Liu said. So the bio-identical product may not have exactly the same ingredients as a standard product, he said.
But be leery if a pharmacy claims that such compounded mixtures are safer or more effective than other hormone formulations, the FDA warned. They may not be mixed according to a licensed health-care professional's instructions, the agency said.
"Women should be cognizant that both products have similar potencies, similar biological action and similar side effects," Liu said. "There's no reason to think bio-identicals are superior. There are either anecdotal or testimonial claims that one is better than the other. We're swayed by that as human beings."
ad_iconHere are some points the FDA says to keep in mind:
Approved hormone therapies are available by prescription only.Bio-identicals will have the same risks as the products they're identical to -- namely a heightened risk of breast cancer and serious heart problems. There may be other, as-yet-unknown risks, as well. Beware of claims that bio-identical products can be made based on hormone levels measured from a woman's saliva sample. Hormone levels fluctuate constantly. Saliva tests, which are FDA-approved, aren't specific enough to determine drug dosages. No drug containing the hormone estriol (the weakest of the three estrogens produced by the body) has been approved by the FDA. Only prescribers who have an investigational new drug (IND) application can compound drugs with estriol. In general, when using approved hormone-replacement therapies, the FDA and health-care professionals recommend using the lowest dose possible for the shortest period needed.
More information
Visit the FDA for more on menopause and hormones.
SOURCES: James Liu, M.D., chairman, department of obstetrics and gynecology, MacDonald Women's Hospital, Case Medical Center, University Hospitals, Cleveland; Suzanne Steinbaum, D.O., director of Women and Heart Disease, Lenox Hill Hospital, New York City; Bio-Identicals: Sorting Myths from Facts, U.S. Food and Drug Administration
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I don't have hormone positive bc...but I'm just curious how they stopped most women from taking replacement hormone over five years ago. Maybe longer?? (I'm saying just as a whole group. I know some still chose to take them.) But research shows more women than ever our being diagnosed with bc. Shouldn't the numbers be going down. I know they went down for a while but now they are on the way up. To me this questions goes along with why does 60% or more of the women I know have had a hysterectomy. This can't be normal. These are hormone base issues also. Another issue is... I had a hysterectomy at 35 because of fibroid tumors that were out of control with growth. They shot me up with hormones to control the growth and it just doubled in size. My breast cancer was Triple Neg no hormones. I some point I had out of control hormones to grow this tumor?? Why wasn't my bc hormone positive. There just have to be connecting to all the issues that America women are having. I just don't believe they know as much as they think they do about bc. Just trying to explain where all the money is going. That why they said we are not working on a "cure" but long term treatment. Thanks for nothing!
Flalady
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And the debate goes on! Does it infuriate all of you as much as it does me that we are getting so many mixed messages. I am so mad that we cannot find the truth! I do not trust the FDA as far as I can stick my tongue out. Look at how many drugs they have approved, only to find out that a year or two later they are taken off the market because of some deadly side effect. The FDA is just an arm of big Pharma. One of the main reasons I refused arimidex and started looking at alternatives were these facts: 1. the studies only compared women who used tamox, vs women who took arimidex, not vs. women who committed to better diet and exercise, which can vastly lower estrogen levels. 2. before the study was completed, it was deemed such a success that it was okayed and rushed onto the market, coincidently, just as the patent on tamox was expiring. 3. there are no long term studies done on this drug because it has not been out long enough. who knows what we are going to find. One reason they wanted a new drug was because of the incidences of blood clots and uterine cancer from tamox. They just needed a new pancea. We still do not know what long term use might do to our hearts, our brains and our bones. 4. The side effects terrified me. I kept reading all these women say they felt 20 years older, I was scared to death. I can say with total honesty that the lifestyle changes I have made, helped me to feel 20 years younger! There is a huge quality of life issue with these drugs.
So we need to look elsewhere. Blocking estrogen completely is not the answer. I hope that we can start ganging up against the drug companies and find a better way. There seems to be alot of merits to BHRT. Let's hope we can get more research done and find the truth.
Somewhere I found a study that tamox only helps 30% of women who take it. I will look for that and post. Do you remember reading this anom?
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Estrogen feeding breast cancer is a myth because there has never been any evidence to show this. What you see in the above posts is hearsay. Phrases such as "we all know hormones cause breast cancer" or "it is a given that estrogen feeds breast cancer" or the "FDA declares" are data-free opinions.
We don't know estrogen feeds cancer in breast cancer patients. Show me the data. And don't send me studies where they put breast cancer CELLS in a test tube, add a certain amount of estrogen and the cells grow over the top. You can stop those cells from growing by adding more estrogen.
Anyway, regarding Tamoxifen. 30%? 40% 50% ???? These are "relative risk" numbers.
You have to ask the person who provides these stats, what do these figures refer to?
If they say you will get a 40% benefit, what does that mean? A normal person would think they have 40% less chance of recurring and/or dying over the next five years, right?
No, it means compared to the people who would recur in the next five years, you have a 40% advantage of not recurring.
But how many people recur in the first five years? Very few. So the 40% number is ACTUALLY 40% of the very few who would recur in the next five years. So out of 100 people, we are looking at something like (I'm just approximating here) 40% of 9 people. These are the "absolute risk" numbers.
So maybe two people may be spared a local recurrence and one from distant mets. People don't die from local recurrence. They die from distant mets. And then there are other considerations: Tamoxifen-caused blood clots in the lungs and elsewhere, the endometrial cancer, depression and all the other maladies that come from being hormone-starved.
You have to ask the docs about "all cause mortality." Will my chances of living longer be inproved if I take Tamoxifen?
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anomdenet, thank you for the explanation, again, not scientific, but you make it sound much easier to understand, I think I love you!
I have had my tamox prescription for about 3 weeks, I always said I didn't think I would fill it because it has never made sense to me, even at the very beginning when I was dx'd, the thought of taking out estrogen NEVER made sense to me, even with my limited knowledge of such things, the more research I have done the less it makes sense, got my oncotype scores today 9 for local and 6 for distant, all scans clear NED, so why would I put something into my body that may make me sick......Lorraine ox
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anom, thank you for the input. I will talk to my onco about the tamoxifen. What you have stated does make one think more clearly and gives way to how to approach all of this.
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Suzanne. Somers. Now there's a real powerhouse of intellect.
*rolling eyes*
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FlaLady, You always seem to come up with another perspective. You are one of my Heroines. I hope you realize how inspiring your fighting spirit is to the rest of us!
I just got a very interesting book called Natural Hormone Balance for Women, by Dr. Uzzi Reiss. Dr Reiss, even has 15 whole pages on BHRT and breast cancer! This is a synopsis of some of his statements:
The overall evidence in research literature says estrogens do not increase the risk of bc.
There is evidence that estrogen decreases mortality from bc.
There is evidence that progesterone has a strong protective effect against cancer.
There is conflicting evidence regarding use of HRT and bc.
He goes on to site several studies to back up these statements. He says the same thing that we do; that the drug companies are the only ones who have enough money for studies, so none are being done on BHRT.
This is interesting, I quote:
"If estrogen were the great villian of breast cancer we would have expected to see an overnight surge of the disease in the very first generations of western women who broke with the age-old reproductive tradition. These are the great grandmothers, grandmothers, and mothers, of my generation, who generally delivered fewer children. You now had massive numbers of women with much of ther progesterone protection gone. They produced progesterone for only half of their monthly cycle in their fertile years, and little or none later in life.
Despite the unprecedented emergence of widespread estrogen dominance that resulted, there was no sudden epidemic of breast cancer in these generations.It is with the of my wife's generation that we see the incidence of breast cancer take an alarming upturn. What is going on?"
Then he goes on to explain how the different types of estrogens work, and that he believes environmental toxins are the culprits, including things like bleaches used in tampons. He also talks about the significance of our diets.
His ideas for prevention include:
empahazize the use of natural progesterone as a protectant
he recommends all three natural estrogens replacement
reducing environmental toxins
a diet of 30% protein, 30%fat, 30% carb, organic as much as possible
he recommends I3C in place of tamox saying tamox is a questionable drug;
"It promotes uterine cancer. It significantly increases blood clot formation and the risk of life threatening pulmonary embolisms. It can lead to toxicity of the eye and possibly increase the susceptibility to cataracts in the long term. Tamoxifen's protection from breast cancer lasts only on an average five years. According to research, if it is taken longer it becomes cancer causing!"
He also says he would like to see studies be triple blind, meaning they include natural substances such as I3C with each drug study. WOW, I am with that one!
This is what he recommends for supplements:
I3C-400mg
vit B6 and B12
folic acid
SAM-e
trimethylglycine
lycopene
coQ10
melatonin
In summary he says:
"Don't let anyone scare you about cancer and your hormones.
Estrogen is not causing the epidemic in breast cancer. It is more likely the lack of natural progesterone, plus other risk factors such as the proliferation of chemicals that generate cell mutations.
"The studies show that estrogens are not associated with increased mortality from breast cancer. The variety of progestins available may or may not increase the incidence of breast cancer, depeidning on which study you consider. However, there are many serious problems with progestins. {meaning sythetic hormones}
Natural progesterone offers protection against breast cancer."
I know this is long but it cleared up a lot of my questions. Hope it helped some of you too!
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This is all very interesting. I don't feel so alone in my sceptism about erasing my hormones by taking Tamoxifen. To me it seems logical that hormones would prevent your body from aging so quickly, bone loss and of course a possible stroke. The risk of stroke scares me much more than the risk of a recurrence of breast cancer.
If someone is worried about hormones ... remove the breast. If the breast are gone then hormones can't cause a recurrence. How can hormones matter if there are no breast?
I'm still thinking about all this. I am on the fense. I'm not about to take something that will suppress my normal hormones, but wonder if HRT would benefit me?
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Thank you, Vivre, for capturing those pearls from Dr. Reiss' book and giving his perspective context. And thank you for typing it for all of us! It is very helpful to see words of a doctor who has been recommending hormones so long give his thoughts. He is a real thinker. I need to reread his book again now that you have brought his wisdom to life.
I'm so glad we are taking the time to go over the information that's out there. It probably takes three to six months or more to find and read all the relevant information to be confident about hormones.
I remember my surgeon saying that she and her colleagues expected her patients on hormones to recur but they didn't. And how "haggard" those women on hormone blockers looked after two months on them.
Thank you, Barry, for starting this thread.
Anom
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I think the point is SYSTEMIC RECURRENCE - so removing the breasts is not a guarantee. IF the hormone positive cancer cell got out and set up shop, the hormone surpression should decrease the ability for that cell to grow and become an issue. That is how it was explained to me.
I find all of this fascinating, and appreciate everyone's input. I have quite a few months to go before I get a prescription for tamox. or an A/I and plan to do a significant amount of research on this!
I am all for "do no harm" but still really want well studied, scientifically proven protocol. If that is a simple as vitamins, then that is wonderful news! If, in my case if is an A/I for 5 years then I am hoping for minimal side effects!
Good luck all of you with this - please keep posting your findings and I will as well.
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Here's a terrific ten minute video by Dr. Elizabeth Vliet sorting out the hormone controversy.
http://www.youtube.com/watch?v=8EpU-Kutdns
Your thoughts?
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Anom, I loved the video, but it really gets my dander up! Why is this thing 2 years old, and we have not heard of it. That came out BEFORE many of us got dx, yet our doctors do not tell us anything about it! Dr. Reiss has been studying this and treating his patients with BHRT for almost 20 years, and still no one is taking it seriously? Dr. Vliet's comment that Viagra was accepted in 6 months and after 5 years, BHRT is still not. Someone is spending a lot of money suppressing this information. HMMM, I wonder who that could be? Gee, who is making millions with all the scripts written for women?
My thoughts you say! I am p o'd big time!
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I never thought of that, Vivre, that this information must be being suppressed if it has been out there all this time. You would think doctor-authors who have published so many books would be able to get the information out there. And that video has been around, as you say. How come it didn't hit all the breast cancer forums before this?
"Estrogen causes cancer" is the dominant point of view even tho it hasn't been proved. People are terrified of their own hormones. They see the threat of evil estrogen everywhere, ready to get them. Doctors give them medicine to stomp the estrogen out. It sounds like the Salem witch craze.
If estrogen were so bad, wouldn't 20 year-olds with the most estrogen get the most breast cancer? Why do middle-aged women with WANING estrogen get the most cancer?
Anyway, how do we get this information "unsuppressed?"
Anom
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Just found Dr. Vliet's website
Running out the door! Looks like she has a new book coming out in 2010
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