01:13 PM EDT on Friday, October 14, 2005

Frank the moderator: Welcome. The Web site of The Providence Journal – projo.com - will host a series of Internet “chats” this week, on topics of interest to Rhode Island’s burgeoning Hispanic population.

Today at noon our guest will be Dr. Pablo Rodriguez, physician, activist and professor at Brown University Medical School, answering questions on women’s health. Submit your question now.

Go here for more information and previous chat transcripts: http://www.projo.com/hispanicchatsinfo

Frank the moderator: For more on Dr. Pablo Rodriguez
Read today's Journal story | More about information on Dr. Pablo Rodriguez

Frank the moderator: A question via email
After having had a full hysterectomy 40 years ago I have started with night sweats. Blood test show my hormone and thyroids to be okay. they put me on the Vivelle dot up to 0.1.. Still getting the sweats two and three times a night. Do you believe this is from a lot of stress? Do you believe I have to wear the patches?
Dr. Pablo Rodriguez replied: Hormonal replacement therapy is not an exact science. Very different preparations and dosages may work for some people and not for others. I would recommend that you work with your doctor to try other dosages (higher) and natural remedies can't hurt.

andrea: Dr. Rodriguez,
You do so much, both in the area of women's health and in the community, even after your car accident. What keeps you motivated?
Dr. Pablo Rodriguez replied: It is a priviledge for me to be alive after such a horrible accident. To feel the support and love of an entire community through this process has definitely given me strenght to keep going. Thanks to your prayers I can continue doing what I love

Frank the moderator: What is the most pressing women's health issue today? Heart disease, cancer?
Dr. Pablo Rodriguez: I believe that heart disease becomes a more pressing issue simply because the medical profession has just begun to evaluate this problem in women. It is also largely preventable. Cancer scares a lot of people but heart disease affects many more people

Frank the moderator: How are healthcare professionals reaching out to the latino communities? What sort of programs are available?
Dr. Pablo Rodriguez: Hospitals and Community Health Centers in RI have realized that Latinos have become the fastest growing segment of our community. They have all increased their community outreach. There is a special program at NHP (Neighborhood Health Plan of RI) called Hablemos Juntos which is gathering a number of hospitals and clinics to improve that outreach

Frank the moderator: What issues do new immigrants face in getting good health care?
Dr. Pablo Rodriguez: 45 million Americans lack health insurance many of those are recent immigrants. In RI we are lucky to have programs such as Rite Care which covers pregnant women and their children however working age immigrant men are the highest percentage of uninsured

Frank the moderator: What got you started along this career? Were there other doctors in our life that encouraged this path?
Dr. Pablo Rodriguez: Funny that you ask. I never thought I was going to be a doctor. I actually wanted to be an actor. It was my grandmother the one that always said I would become one. Once I started college her prediction came through. I became very interested in science and people. Once you put it all together, medicine has been the best decision of my life

Frank the moderator: Acting does come in handy in dealing with patients. I would believe doctors are always on stage
Dr. Pablo Rodriguez: Especially a surgeon. We call the operating room a theater and your performance influences the behavior of others in that theater and sometimes influences the outcome.

she777: How has being in a severe accident affected your view of life, your own and others?
Dr. Pablo Rodriguez: I have changed dramatically. I never thought your life could change in a second as it did for me. It also showed me that every interaction you have in life is important and meaningful. I will never take for granted being able to enjoy my children, my family, friends and patients.

Frank the moderator: Question via email
Tengo 39 años y me gutaria quedar embarazada, por primera vez, el año entrante. Que tipo de precausion debo tomar? Puedo hacer algo ahora para mejorar la probabilidad de embarazo y de que sea saludable, etc? Hay algunas pruebas etc...que me ayuden a prepararme?
Dr. Pablo Rodriguez: Mucha suerte! La mejor manera de salir embarazada es calculando cuando ocurre la ovulacion. Compra un calendario en el cual apuntas los dias del periodo y usualmente a los 14 dias de haber empezado a sangrar es que la ovulacion ocurre. Ten relaciones ese dia, dos dias antes y dos dias despues. No olvides tomar acido folico

Frank the moderator: Do you encourage people to enter the health care field and are you working with any high school or student programs?
Dr. Pablo Rodriguez: A health career is a very rewarding but sometimes difficult career. I try to encourage students to experience first hand by volunteering at hospitals before making a decision. I also tell them that their motivation has to be people based and not money based. Medicine is no longer a path to riches at least monetarily

Frank the moderator: After the accident, during the recovery, being the patient rather than the doctor must have been difficult. Did you try to act as a doctor and give advice to your caretakers.
Dr. Pablo Rodriguez: Not only did I give advice, I had to guide one of the interns in placing a naso-gastric tube in my nose. It is very hard for doctors to be patients and it is even worse when your wife is a nurse as well.

Frank the moderator: At what age does a pregenancy become more difficult for a women. I have friends who have children late in their thirties and early forties.
Dr. Pablo Rodriguez: Ovulation is somewhat time limited and after age 40 it becomes not only more difficult but defective. This is the reason we advise people to have genetic counseling and testing in order to identify these types of problems. After age 42 the risk of Down's Syndrome is as high as 1 in 40 pregnancies

andrea: As you teach medical students prepare to become doctors, what do you think is the most important lesson they can learn about dealing with their patients?
Dr. Pablo Rodriguez: My experience in this last year has shown me that it is crucial for physicians to know as much as possible about their patients. I am not talking about medical history but personal information. I had residents coming in to see me not knowing that I was a doctor. Imagine them assuming that with my name I probably did not even speak English.

Frank the moderator: Are hormonal irregularities cause for concern for women who hope to become pregant? And should they consult both Ob-gyn and Endocrinologists?
Dr. Pablo Rodriguez: Usually your gynecologist can make most hormonal imbalances go away with medicines such as Birth Control Pills and Hormonal replacement. It is only when the traditional methods do not work when you need a specialist. This can be a reproductive endocrinilogist which is a gynecologist with specialized training

andrea: As a specialist in women's health, can you recommend any steps that women in particular should take to maintain good health/prevent problems?
Dr. Pablo Rodriguez: Most definitely. Excercise can't be over emphasized. It helps with PMS, with hot flashes, depression and it keeps your weight down. Following up with your primary care provider to have yearly pap smears and mammographies if appropriate is important. Multivitamins can also provide a good source of strenght and relief from some hormonal symptoms and if you are planning a baby, folic acid is essential

she777: How do you handle the attacks you receive from pro-life groups?
Dr. Pablo Rodriguez: I have very strong convictions about what I do and what I advocate for. I am a witness to the devastation that illegal abortion has created in countries where abortion is illegal. If some people disagree with me that is their right however by now they know that my mind is made up. I believe in saving women's lives

Frank the moderator: Question via email
There is a lot of talk about "Culturally Relevant" care and how hospitals and healthcare institutions need to achieve that. What does that mean in terms of the Latino market. What does culturally relevant care look like?
Dr. Pablo Rodriguez: Cultural competence is something that applies not only to Latinos but to every person you come in contact with. If as a physician you approach each patient with the same script, you will definitely hurt people. It is not just about language. It is about knowing as much as you can from someones background and applying that knowledge to arrive at a diagnosis and plan that will be understood and followed with. This is an area of lifelong learning for providers

Frank the moderator: What advise do you give the husband or partner during a pregancy? How do they handle the pregancy?
Dr. Pablo Rodriguez: Getting pregnant requires the couple to engage in a very different relationship. Both partneers need to learn about the physiology of pregnancy but most important is to know how each is feeling at any particular time. The more communication the better. It is sad that poor communication can sometimes destroy marriages at such an important time in their lives

she777: Were you misrepresented in the Projo article that portrayed you as finding fulfillment in performing abortions?
Dr. Pablo Rodriguez: I believe that being able to assist women with the decision to continue or terminate a pregnacy is one of the most rewarding parts of my career. It requires the complete trust of the patient and for many it is the most important decision of their lives. I feel lucky to have been able to assist patients and to experience the gratitude and love they have expressed to me

Frank the moderator: In Providence and Rhode Island, what resources are there for women and couples in helping them through pregancies?
Dr. Pablo Rodriguez: Women and Infants Hospital has great educational programs on all aspects of pregnancy, infertility, In Vitro fertilization etc The physician becomes the greatest resource and I encourage people to ask their doctor for in formation and assistance

Frank the moderator: Thank you Dr. Rodriguez for sitting for a noontime chat with projo.com.