She advises parents to be sure that any mark is properly diagnosed. While most don’t require treatment, complications can occur in some cases, especially if a hemangioma is near the nose and affects breathing. If a port wine stain is over an eye, it can be associated with glaucoma or other problems.

Antaya agrees that proper diagnosis is key. “The problem with a lot of these marks is that we have so many names for them. The nomenclature has plagued medicine.”

You’ll often hear doctors refer to birthmarks as port wine stains, hemangiomas, stork bites, angel kisses, salmon patches, strawberry marks and midline venular malformations, according to Shannon, but they’re all different and need to be looked at differently. “Go to a doctor who knows and understands birthmarks,” she said. “You can go to 10 pediatricians and only one will know about them.”

The type of hemangioma Shannon’s daughter had required surgery. Shannon was certain that the collection of blood vessels would most probably resolve itself, or involute, but she was concerned that it would leave excess of skin. “Every other doctor told me it would take three to five operations to have her look normal,” said Shannon. “Dr. Waner told me he could have her looking normal in one three-hour procedure.” And he was right. Today her 6-year-old doesn’t have one sign of her hemangioma. Good surgeons are hard to find, according to Antaya. “You need a special surgeon; someone who is very good at it.”

Other birthmarks, such as port wine stains, are often treated with lasers, according to Antaya. Other serious marks may require other therapies, including steroids.

“There’s a lot of new technology out there,” he added. “A lot of research is going into this, especially on how to stop blood vessel growth.

Within time, we’ll have even better treatments.”

Shannon also predicts that with time, doctors will understand why birthmarks occur. “There’s one common denominator,” she said, “infection during pregnancy, like a sinus or urinary tract infection, or something like that.” New research, she said, is focusing on the placenta. “If something disrupts the placenta, it can disrupt the fetus. But it’s hard to test and prove.”

She had a beautiful crop of thick black hair and soft blue eyes, but — oh my God — she had a birthmark. The truth is, in our appearance-conscious society, birthmarks have severe stigmas, and my first thought was: Will it go away?

My reaction wasn’t unique, according to Dr. Richard Antaya, associate professor of dermatology and pediatrics and director of pediatric dermatology at Yale-New Haven Hospital in New Haven, Conn. “Most parents are really upset about a birthmark,” he said. “They’re expecting a perfect baby.” Not a lot is known about birthmarks, which often makes them mysterious to people.

“Psychosocially it’s damaging for parents,” Antaya said. “People often don’t think before they speak, and will gasp when they look at a new baby and say, ‘Oh, what happened to him?’”

But while parents should be concerned about red birthmarks, in most cases they are nothing to worry about and will fade. Birthmarks are the result of an abnormal fetal development of blood vessels, and come in many shapes and sizes; the two major types are hemangiomas and port wine stains.

Hemangiomas are red vascular birthmarks, commonly called strawberry marks, which may be flat or raised. “They’re really tumors of immature blood vessels,” Antaya said, and they may either grow or remain the same size. They’re the result of too many blood vessels in one spot. A port wine stain is an abnormal collection of dilated blood vessels that gives the skin a red appearance. With a port wine stain, the number of vessels is normal, but they’re dilated.

Statistics show that 1 in 10 children are born with a birthmark, and 1 in 100 will require medical treatment. Most birthmarks are harmless vascular marks, otherwise known as “stork bites” and “angel kisses” that will fade as the child grows.

About 50 percent of birthmarks will fade by time a child turns 5, 70 percent by age 7, and 90 percent by age 9, according to Antaya. About 40 percent will fade without a mark, and 60 percent can leave a scar or mark on the skin.

“With the majority of them, we usually say ‘Wait and see. Let nature take its course,’ ” Antaya said. The trouble with birthmarks is that no one knows why they occur, and to further complicate things, not a lot of doctors fully understand and treat birthmarks. “The problem is that this area of medicine doesn’t fall under any particular discipline,” said Linda Shannon, founder and executive director of the national Vascular Birthmarks Foundation in Albany, N.Y.

“No one has taken ownership of it and you’ve got pediatricians, dermatologists and surgeons treating it. The medical literature hasn’t been updated in 100 years.”

When Shannon’s daughter was born with a hemangioma, she wasn’t satisfied with her pediatrician’s advice to wait and see if it resolved itself. She began doing her own research, eventually taking her to Dr. Milton Waner of the Arkansas Children’s Hospital, a leading U.S. specialist in diagnosing and treating birthmarks.

The short term goals for this second week are the continuation of the first week’s efforts with some comfortable increases in exercise and diet efforts. The most important element to consider is the regularity of the lifestyle changes and the ability to deal with any small “failures” which might occur on a daily basis. Remember, one day does not change the course of our overall fitness plans but each day is an opportunity to reclaim some control of our destiny. Keep working at it.

Exercise #1. Some home exercise devices such as this cable system can be very effective ways to begin resistance, muscle toning programs.

Exercise #2. A yoga or stretching routine might be another way to begin a moderate exercise regimen.

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If you find that your program is difficult or so obligatory that it’s uncomfortable, some re-thinking might be helpful. Perhaps the activity that was chosen for the exercise program was NOT the best. Try to think of another activity which you might prefer. Maybe, an aerobics tape or a video calisthenic’s program might be more up your alley. Don’t close your mind. There are an abundance of different vehicles available for the seeker of fitness programs.

Some of the men might be more inclined to do some form of resistance training. As long as the program is conservative and moderate, this is a fine way to “get into” exercise. Some women might find a yoga or stretching program a subtle way to become involved in physical activity. Remember, almost ANY structured program of consistent physical exercise is better than none.

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If the first week of the new program was reasonably successful, then a simple assessment will verify that position. Did you get to exercise at least twice during the week (preferably 3 times) and did you consciously cut down on high fat snacks and food choices at least 2 days during the past week? If you did these things, how do you feel about it? Was it a struggle or was it fairly comfortable to do? Do you feel better about yourself than you did when you started the program?

If you answered yes to 3 or 4 of these questions, you are really doing well. If not, re-group; begin with the basics and try to make small, gradual adjustments in your exercise and diet habits.

During this critical second week it is important to understand that reality will soon be setting in. You may begin to realize that fitness and health are long term endeavors and that consistency and patience are vital attributes. You may not feel as disgusted with yourself as you did right after the holidays and you might begin to think that you’re not in such bad shape. Remember, your body is going to try to induce you to “leave well enough alone”. However, it is important to think about long term goals and the continuation of the newly chosen lifestyle habits.

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The disease can also affect relationships, especially since endometriosis can cause pain during sex. If this is the case, a woman and her partner must be able to communicate openly about how they can still express their sexuality.

Some positions may be more comfortable than others. The effects of endometriosis can also be emotionally traumatic. For women who want children, infertility can be devastating.

The Endometriosis Association, a 20-year-old organization based in Milwaukee, offers support groups around the world for women with the disease. The association also provides formal and informal counseling for women with endometriosis. Upon request, it will provide educational information about the disease. The association publishes a newsletter that covers treatment and research news.

According to Col. Gail Deyle, chief of physical therapy at Brooke Army Medical Center in San Antonio, Texas, arthritic patients who are involved in a physical therapy (PT) regimen — especially those who are continuing with some form of exercise — are often highly motivated by their doctors’ monitoring and commenting positively on their progress.

Deyle adds that doctors, patients and physical therapists also should communicate during therapy as a way of determining the most appropriate referrals for other treatment modalities, such as occupational therapy or pain management, as these are needed.

In light of the positive results from new studies on the use of PT in rheumatoid disorders, Deyle encourages patients and physicians to discuss PT early in the course of disease management, in some cases even before turning to arthritis medications.

“There are patients for whom a course of PT followed by regular, ongoing exercise can be the primary and best form of early treatment,” he said.

“Both doctors and patients should also consider determining if the patient’s arthritic joints respond to physical therapy before opting for surgery,” he suggested, pointing out there’s only a seven- to 15-year lifespan for replaced joints. “As our study of osteoarthritic knee joints showed, PT can help reduce pain and increase mobility — at least postponing, if not preventing, the need for more invasive surgical repairs and joint replacements in some instances.”

But the researchers also found that in men with normal, low PSA levels, the positive predictive value of digital rectal exam ranged from 4% to 11%, increasing to as high as 83% in those with high PSA levels. The researchers also note that men with low PSA levels who do have prostate cancer “usually harbor prostate cancer that has a favorable prognosis.”

The European authors conclude that, for men with normal PSA levels, “the digital rectal exam should be replaced with a more sensitive test.”

But in an accompanying commentary, two US experts at the University of Texas Health Sciences Center at San Antonio contend that they will “continue to recommend both PSA and digital rectal examinations.”

Drs. Joseph Basler and Ian Thompson point out that, according to the European study, digital exams were instrumental in alerting physicians to the 17.3% of all prostate tumors found in men with otherwise ‘normal’ PSA levels. “The facts that one quarter to one third of all prostate cancers are detected by digital rectal exam in the ‘normal’ PSA range (and) that digital rectal exam is not viewed by patients as an impediment to screening… make it a reasonable companion to PSA in current programs for prostate cancer screening,” they conclude.

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However, American experts believe the rectal exam is still essential for detecting cancers otherwise missed by PSA screening. The report and editorial are published in the December 2nd issue of the Journal of the National Cancer Institute.

Prostate cancer is the second leading cancer killer of men (after lung cancer) in the United States. For decades, annual digital rectal examinations in men over 50 years of age have been the primary recommendation for early detection of prostate tumors. The advent of prostate-specific antigen blood testing — which measures levels of an antigen linked to prostate cancer — has helped raise detection rates to even higher levels in recent years.

In their study of over 10,000 men, the European group examined the accuracy of the digital rectal exam alone, and compared with its use in combination with the PSA test.

They discovered that while 4.5% of screenings involving both tests resulted in cancer detection, this rate fell to just 2.5% when physicians relied on the digital exam alone.

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If you’re afraid you might have heart problems and you wonder if you should be tested, speak up.

If you don’t speak up, you may walk away frustrated — and still worried. If you need reassurance and you’re open about it, your doctor may be able to help you regain peace of mind.

But remember — you have to say what’s bothering you. Doctors are often rushed and — contrary to popular belief — medical schools don’t teach mind reading.