There was no difference in blood clots when estrogen hormone therapy was maintained during gender affirming surgery.

This is according to a study (titled, “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender Affirming Surgery”) helmed by John Henry Pang with Aki Kozato from Mount Sinai, and was published in the Journal of Clinical Endocrinology & Metabolism.

Historically, the lack of published data contributed to heterogeneity in the practice of whether doctors and surgeons advised transgender women to withhold their estrogen therapy before surgery. The sudden loss of estrogen in the blood was sometimes very uncomfortable with symptoms that amounted to a sudden, severe menopause.

So the researchers tapped 919 transgender patients who underwent gender affirming surgery at Mount Sinai’s Center for Transgender Medicine and Surgery between November 2015 and August 2019. Notably, including 407 cases of transgender women who underwent primary vaginoplasty surgery.

This study found that the practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

The bottom line: This study found that most transgender women can  safely maintain their estrogen hormone treatments during gender affirming surgery.

The human papillomavirus infection, or HPV, is one of the most common sexually transmitted infections, according to the Centers for Disease Control and Prevention (CDC). HPV is associated with health problems including genital warts and cancers, but a vaccine has been available since 2006 to help stop the virus. The CDC reports more than 12 years of data supports the HPV vaccine is safe and effective, yet HPV vaccination rates still remain low.

Social media has a history of being a popular place for sexual health discussions, and the HPV vaccine is one of the most discussed vaccines on the internet. Monique Luisi, an assistant professor in the University of Missouri School of Journalism, has studied more than 6,500 public HPV vaccine-related posts on Facebook from 2006 to 2016. In a previous study, Luisi used these Facebook posts to identify a negative trend on Facebook related to how people perceive the HPV vaccine.

Now, she suggests this negative trend on Facebook may also cause people to develop a false perception of the health risk of the vaccine. After looking at the percentage of posts that made the vaccine seem more dangerous, less dangerous or neither, Luisi found nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

“We should not assume that only the disease is perceived as a risk, but when research supports it, that medical treatments and interventions might unfortunately also be perceived as risks,” she said. “It’s more likely that people are going to see things on social media, particularly on Facebook, that are not only negative about the HPV vaccine, but will also suggest the HPV vaccine could be harmful. It amplifies the fear that people may have about the vaccine, and we see that posts that amplify fear are more likely to trend than those that don’t.”

Luisi suggests the spread of this negative information may lead people to have a false perception of the vaccine, so people should consult their doctor or health care provider before making an informed decision.

“Facebook remains a very popular social media platform for adult audiences, which necessitates action to address HPV vaccine risk messages,” she said. “People are going to see what they are going to see on social media, so it’s important to not only take what you see on social media, but also talk to a doctor or health care provider. Just because it’s trending doesn’t mean it’s true.”

Luisi notes research must continue to address the perception of vaccine safety where the vaccine is perceived as a greater health threat than the virus or disease it prevents, and her study could also inform officials for the ongoing COVID-19 vaccine roll out and distribution.

“As the COVID-19 vaccine is being rolled out, people are likely going to see a lot of negative information, and that negative information will be what trends on social media,” she said. “But, if the public can anticipate this negative information, it will be interesting to see if that will that make them less sensitive to the perceived risk of the vaccine.”

Decades of research show that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines.

A new report accepted for publication in Perspectives on Psychological Science suggests that the same may be true for the new COVID-19 vaccines that are in development and the early stages of global distribution. Fortunately, it may be possible to reduce these negative effects with simple steps like exercise and sleep.

Vaccines are among the safest and most effective advances in medical history, protecting society from a wide range of otherwise devastating diseases, including smallpox and polio. The key to their success, however, is ensuring that a critical percentage of the population is effectively vaccinated to achieve so-called herd immunity.

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

This is particularly troubling as the novel coronavirus continues to rage across the world, trigging a concurrent mental health crisis as people deal with isolation, economic stressors, and uncertainty about the future. These challenges are the same factors that have been previously shown to weaken vaccine efficacy, particularly among the elderly.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems. Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections,” said Annelise Madison, a researcher at The Ohio State University and lead author on the paper. “Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by challenging the immune system. Within hours of a vaccination, there is an innate, general immune response on the cellular level as the body begins to recognize a potential biological threat. This frontline response by the immune system is eventually aided by the production of antibodies, which target specific pathogens. It is the continued production of antibodies that helps to determine how effective a vaccine is at conferring long-term protection.

The good news, according to the researchers, is that the COVID-19 vaccines already in circulation are approximately 95% effective. Even so, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of immunity.

“The thing that excites me is that some of these factors are modifiable,” said Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at The Ohio State University and senior author on the paper. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

Based on prior research, one strategy the researchers suggest is to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination so that your immune system is operating at peak performance. This may help ensure that the best and strongest immune response happens as quickly as possible.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness. Even shorter-term interventions can be effective,” said Madison. “Therefore, now is the time to identify those at risk for a poor immune response and intervene on these risk factors.”

You might be interested in starting a family with your partner. However, before you commit to this decision it’s important to think about whether the two of you are ready. That’s not always an easy question to answer however there are signs that you can begin to move forward with this new chapter. 

You’re Both Stable 

First, you need to make sure that you are both stable in your lives. Think about your career and your profession. You should ideally both be earning a solid income where it’s unlikely that either one of you will experience redundancy in the future. While there are no guarantees, there are always signs that your career is stable. You might also want to think about setting up a side hustle to make sure that you have an extra cushion of cash to fall back on whenever you need to. 

Of course, it’s not just your career that needs to be stable. You need to think about your health – both mental and physical – and your lifestyle. Don’t forget, these are things that will be taken into consideration if you are planning to adopt. So, they should be considered when you are thinking about conceiving naturally too. 

You Both Want One 

As crazy as it sounds many couples do end up having a baby because one individual wants one rather than both. The other will often just go along with the idea because they don’t want the relationship to end. That’s why it’s important to have an open and honest relationship with your partner. It’s possible that there are things that are stopping them from seriously considering children. They might even be questioning whether it’s possible for them. If they’ve tried before with someone else, then this fear is always going to be present. However, there are options like advancedfertility.com to explore if that is indeed the case. 

You don’t Argue All The Time 

Finally, many people believe that couples shouldn’t argue and that’s not true. You need to have the occasional argument otherwise issues are going to simply lie dormant underneath the surface. This will lead to a massive blowout and the last thing that you want is to bring a child into an environment with a lot of friction. 

If you do find that you are arguing quite a lot in your relationship, then you should think about something like couple’s counseling. This can help you get back on the right track with your partner and ensure that things don’t continue to get worse. It can help you deal with some of the deeper issues that might be plaguing your relationship and causing you problems right now.  You can learn more about couples counseling on bark.com. 

We hope this helps you understand some of the signs that you could be ready to start thinking about having a baby with your partner. Remember, while this can be a big step forward, there are plenty of avenues and resources you can explore to help here and ensure that you do approach this the right way.

If you’re permanently disabled, you’ll likely need to apply for SSDI or Social Security disability insurance benefits. As with seeking any type of government aid, this involves going through a qualification process. 

Once you’re approved, you don’t want to do anything to disqualify you from receiving benefits, and this includes earning too much income in addition to your monthly benefits. An overview of this issue is described below to help you stay within the Social Security Department’s guidelines.

You Cannot Earn Substantial Gainful Activity

The SSDI benefits you’ll receive are intended to provide you with the income you would otherwise earn through performing work. For this reason, the Social Security Administration has established a limit on how much you can earn in addition to the benefits you receive each month. The precise number is evaluated year by year and, as of 2020, that limit was $1,260 a month. The only exception is that people who are classified as legally blind can earn up to $2,110 a month.

There is a trial period during which you can earn more than the substantial gainful activity allowance (or SGA) and still receive your benefits. The first nine months are considered a trial period to ensure you can maintain that level of income. 

In a month in which you earn less than the SGA limit, you will receive your full benefits for that 30-day period. This will continue for 36 more months after you complete the trial period. The extended eligibility period of 36 months is implemented to keep you entered in the system in the event that you have to return to full benefits status. This eliminates the need to have to renew your initial application.

How Are Benefits Calculated Against Income?

As a matter of protecting your financial interests, you should consult a social security disability lawyer before beginning any type of work. Generally, the first $85 you earn won’t be counted towards your earned income. After reaching that limit, half of every dollar you earn will be deducted from your total eligible benefits. 

For example, if you earned $1,000 in a 30-day period, the $85 allowance would be reduced, bringing your measured income down to $915. That amount would be divided by two to arrive at $457.50. For that month only, the benefits you receive would be reduced by $457.50 to adjust for your earned income.

What Are You Required To Report?

In order to remain compliant with the conditions for receiving benefits from the Social Security Administration, there are certain employment status changes that you must report. You will have to report the dates upon which you begin or stop a job, including any periods during which you’re suspended or laid off. 

You will also have to report any changes in your position, including the number of hours you work, the duties you perform, or the wages you’re paid. Any changes in these conditions can affect your benefits, so it’s important to keep the SSA updated. Finally, you should report any expenses you have suffered in relation to your disability. 

For example, if you have had to buy a custom wheelchair to allow you to perform your work-related duties, that expense should be documented and reported. You should check with your local SSA office for exact reporting timelines. Generally, reports should be filed between the 6th and 10th day of the following month, depending on the method of reporting.

If you are trying to navigate the complexities involved with filing for SSDI benefits, consulting an attorney can help. A lawyer who’s experienced in handling Social Security law can ensure you get all of the benefits to which you’re entitled. This may mean a significant difference that can help you enjoy a better quality of life.

Getting into a car accident is always stressful, especially if you’ve been injured. However, it can also be confusing if you end up getting hit by a DoorDash driver. It’s fair to wonder what your legal options are if you are planning on filing a personal injury claim. This is because like rideshare drivers, DoorDash drivers are considered independent contractors rather than employees of the company.

There are certain times when a DoorDash driver may be on duty and when they aren’t actively working. In order for the company to be considered at all liable for an accident, the driver must have been working and have the app open.

What Does DoorDash Require?

DoorDash requires all of its drivers, even though they are considered independent contractors, to carry their own personal car insurance policies. The minimum requirements set by their state is acceptable. At the same time, the company itself has insurance in place to cover any injuries and damages caused by their drivers.

It’s important to know that there are a few exceptions. If a DoorDash driver has an accident but doesn’t have their own auto insurance, there would be a problem that may result in having to sue the driver personally. The DoorDash insurance policy, which provides up to $1 million in coverage for injuries and property damage, would not kick in unless an insured driver’s own policy is exhausted.

Common Injuries After an Accident With a DoorDash Driver

If you’re involved in a car accident with a DoorDash driver, just as with a collision with any other driver, you can suffer injuries. Some of those injuries may even be serious, debilitating, disabling, or even fatal. Every accident is unique, with certain factors coming into play relating to the cause and the consequences. Obviously, the type of vehicle and its size is only one of those factors.

Regardless of the circumstances and factors surrounding an accident with a DoorDash driver, the following injuries are common:

• Amputation
• Back and neck injuries
• Broken bones
• Concussion
• Fractures 
• Head injuries
• Spinal injuries
• Whiplash
• Death

What Should You Do After an Accident?

After you have been in a car accident with a DoorDash driver, there are certain steps you should take. However, it should be known that these are steps you should take after any vehicle accident involving any driver. These are the things that you need in order to ensure that you have the evidence necessary to support your personal injury claim.

The first thing you should do is call 911. It’s important that the police come whenever there are injuries and significant property damage. A police accident report will be made, which is important evidence to obtain for your case. Be sure to get the name and badge number of the responding officer and ask about getting a copy of the report.

Take photos of the accident scene and get the driver’s full name, contact information, driver’s license number, license plate number, insurance information, and employer information. You will also want to get statements from witnesses. Get their full names and contact information as well.

Seeking medical attention is essential. You have to make sure you aren’t seriously injured or have some sort of internal injuries that could be very serious. You will also have evidence in the form of your medical bills and records.

Choosing a lawyer is imperative as well. You will be able to learn your legal options and go from there with your case. Your attorney will make sure your rights are fully protected and get you the compensation you deserve.