Nepal Medical Mission

by Nathan Fujita

My wife and I celebrated our 30th anniversary by going to our first medical mission to Nepal. We went with the Aloha Medical Mission for three weeks from October 25-Nov 15, 2011. The women that I operated on suffered from uterine prolapse, a condition where the uterus decends out of the vagina. This abnormality happens when a woman gives birth, and then is forced into hard labor, carrying firewood and building material for the family livelihood. The mission was a gratifying experience, not only to help others, but to grow personally as well as we faced adversity. For video, please go to

Caffeine in Pregnancy

by Nathan Fujita

From ACOG Committe Opinion 462, August 2010: Moderate caffeine consumption of less than 200 mg per day does not appear to be a major contributing factor in miscarriage or preterm birth. Caffeine Content of Foods and Beverages Food and Beverages Milligrams of Caffeine (Average) U.S. Department of Agriculture, Agricultural Research Service, 2000. Coffee (8 oz) Brewed, drip 137mg Instant 76mg. Tea (8 oz) Brewed 48mg Instant 26-36mg. Caffeinated soft drinks (12 oz) 37mg. Hot cocoa (12 oz) 8–12mg. Chocolate milk (8 oz) 5–8mg. Candy Dark chocolate (1.45 oz) 30mg. Milk chocolate (1.55 oz) 11mg. Semi-sweet chocolate (1/4 cup) 26-28mg. Chocolate syrup (1 tbsp) 3mg. Coffee ice cream or frozen yogurt (1/2 cup) 2mg.


by Nathan Fujita

Adenomyosis is also known as endometriosis interna. Like endometriosis, it is an abnormal location of the endometrial lining cells. With adenomyosis, the glands of the womb lining migrate into the myometrium, the muscle layer. There they grow and respond to the hormones of the menstrual cycle. Typical symptoms are severe cramps and heavy menstrual bleeding.

Air Travel During Pregnancy

by Nathan Fujita

Most commercial airlines allow pregnant women to travel up to 36 weeks gestation. Prolonged immobilization and low humidity may increase the risk for blood clot formation in the lower extremities. Preventive measures include support stockings, periodic movement of the lower extremities, avoidance of restrictive clothing and hydration. Seatbelts should be used continuously. Radiation exposure is increased, but for the occasional traveler the recommended threshold of 1 mSv is unlikely to be reached. However, aircrew and frequent flyers may exceed these limits. From ACOG Committee Opinion 443, Oct 2009.

Should ovaries be removed routinely at hysterectomy?

by Nathan Fujita

The conventional thinking is that ovaries should be removed with hysterectomy in older women to prevent ovarian cancer. An article in the May 2009 Obstetrics and Gynecology by Parker et al suggests that we should rethink this dictum. They followed over 29,000 women for over 24 years and revealed that while the risk for ovarian and breast cancer is decreased in women who had their ovaries removed, there was an increase in all-cause mortality, coronary heart disease and lung cancer. Ovarian removal was not associated with increased survival at any age group.

The First Gynecologic Surgery

by Nathan Fujita

The first abdominal and gynecologic surgery was performed on December 25, 1809 by Dr. Ephrim McDowell on Mrs. Jane Crawford. This operation was done without anesthesia on a table in an upstairs bedroom. The left ovarian tumor weighed 22.5 pounds and was removed in 25 minutes. There was no pathology report, but the tumor is believed to be a benign mucinous cystadenoma.

In 1809 Abraham Lincoln was born, James Madison was president, Napoleon occupied Vienna, and Beethoven composed his fifth symphony.

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.