Mariel heMingWay
Transcription
Mariel heMingWay
women s summer 2012 health today When to choose urgent care Should you go organic? Mariel Hemingway shakes up her family tree see page 10 Travel safe this summer! The Christ Hospital 2139 Auburn Avenue Cincinnati OH 45219 non-profit org us postage Paid cincinnati oh Permit #5489 Get back to the things you love. Ifpelvicpainaffectsyourdailylifeorhasgottenworse overtime,itmaybetimetoseeaspecialist.The physiciansatTheChristHospitalWomen’sSurgeryCenter areexpertsinminimallyinvasivetechniques totreatthemanypossiblecausesofpelvicpain,such asuterinefibroids,endometriosis,ovariancystsand othergynecologicalproblems.Whichcanmeanless pain.Lessscarring.Shorterrecoverytime—anda fasterreturntothethingsyoulove. To find a doctor who specializes in minimally invasive surgery, call 513.585.1000. TheChristHospital.com/women|Caring Above All.SM in this issue... Summer 2012 >> Features 3 Urgent or emergency? 16 Choosing hospice care 4 Snore no more 18 Taking antibiotics seriously Breathe easier with these nighttime solutions 20 Flight plan 5 Putting an end to heavy bleeding 18 Taking antibiotics seriously Reduce your risk of blood clots during air travel Is endometrial ablation right for you? 21 The cancer no one talks about 8 Is organic a good buy? Are you at risk? Do your research before opening your wallet Images on any of these pages may be from one or more of these sources: © 2012 Thinkstock and © 2012 istockphoto.com 10 Climbing the family tree Mariel Hemingway overcomes genetics >> Departments 2 Letter from the founder How do you treat YOU? 6 14 10 kid-friendly snacks Health Headlines What’s making news in women’s health 9 News & Notes What’s happening at The Christ Hospital 14 Healthy Bites 10 kid-friendly snacks 22 4 Snore no more 7 Understanding ministrokes Healthy Moves Dip into fitness How water exercise can keep you young 24 Health Smarts Kick athlete’s foot www.womenshealthexperience.com 1 LETTER FROM THE FOUNDER women s health today How do you treat YOU? >> As a busy woman, you are probably used to putting everyone and everything else in your life first—from your children and parents to your job, friends and more. But if you have a health problem that’s nagging at you, it’s time to get it taken care of. Talk with your healthcare provider Dr. Karram and his wife, Mona, are the founders of the Foundation for Female Health Awareness, a nonprofit organization dedicated to improving women’s health by supporting unbiased medical research and educating women about their health. and together you can perhaps find a cause and solution. Remember, you can’t do much good for someone else if you’re not healthy yourself. That’s why airlines tell you to put your oxygen mask on first before your children in case of an emergency. Women’s Health Today is here to help empower you to care for yourself, in addition to caring for those you love. For you in this issue, we discuss heavy menstrual bleeding on page 5, antibiotic usage on page 18, anal cancer on page 21 and foot care on page 24. For you and your family, we discuss what health emergencies require a visit to an urgent care center vs. the emergency room on page 3 and why you might consider buying organic foods on page 8. For your kids, we offer some healthy snack advice on page 14. If you’re dealing with a family member who is facing end-of-life, we discuss the ins and outs of hospice care on page 16. Enjoy the weather this summer and stay safe and healthy. If you’re not feeling healthy, don’t delay. Visit your healthcare provider and discuss how you can get healthy. It’s your life, make the most of it! And remember, Women’s isit us V online! To view the digital edition of this issue, as well as past issues of Women’s Health Today, visit www. TheChristHospital. com/WHT. Health Today is here for you. Sincerely, Mickey M. Karram, MD PRESIDENT AND Co-Founder Foundation for Female Health Awareness 2 women’s health today the magazine of the foundation for female health awareness Founders Mickey M. Karram, MD / Mona Karram National Advisory Board Linda Brubaker, MD, Professor of Obstetrics and Gynecology, Urogynecology Urology, Loyola University Chicago Stritch School of Medicine; Co-Director, Women’s Pelvic Medicine Center, Loyola University Medical Center Vivien K. Burt, MD, PhD, Associate Professor of Clinical Psychiatry, The David Geffen School of Medicine at UCLA; Founder and Director, Women’s Life Center, UCLA Neuropsychiatric Institute and Hospital Vivian M. Dickerson, MD, Associate Clinical Professor of Obstetrics and Gynecology, University of California Irvine; Director, Division of General Obstetrics and Gynecology, UCI Medical Center; Director of UCI’s Post Reproductive Women’s Integrative Health Center Tommaso Falcone, MD, Professor and Chairman, Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation; Co-Director, Center for Advanced Research in Human Reproduction and Infertility Sebastian Faro, MD, PhD, Clinical Professor of Obstetrics and Gynecology, Women’s Hospital of Texas Nieca Goldberg, MD, Assistant Professor of Medicine, SUNY Health Science Center, Brooklyn, New York; Clinical Assistant Professor of Medicine, New York University Thomas Herzog, MD, Professor of Clinical Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons; Director, Division of Gynecologic Oncology, Columbia University Medical Center, New York Barbara Levy, MD, Medical Director, Women’s Health & Breast Center, St. Francis Hospital, Federal Way, Washington; Assistant Clinical Professor of Obstetrics & Gynecology, Yale University School of Medicine; Assistant Clinical Professor of Obstetrics and Gynecology, University of Washington School of Medicine Wendy l. wright, ARNP, FAANP, Adult/Family Nurse Practitioner; Adjunct Faculty, Fay W. Whitney School of Nursing, University of Wyoming The Christ Hospital STAFF President and CEO Susan Croushore Chief Business Development Officer Victor DiPilla Chief Hospital Officer Deborah Hayes Chief Strategy and Mission Officer Heather Adkins Chief Medical Officer Berc Gawne, MD Editor Arin Kraemer customer service For more information about services at The Christ Hospital, please contact Arin Kraemer at [email protected] or 513-585-3945. For a free subscription to Women’s Health Today, call 513-585-1000 or visit www.TheChristHospital.com/WHT. Women’s Health Today is published four times a year by The Christ Hospital, 2139 Auburn Avenue, Cincinnati, OH 45219, in conjunction with the Foundation for Female Health Awareness, PO Box 43028, Cincinnati, OH 45243. This is Volume 8, Issue 3. © 2012 by The Christ Hospital and the Foundation for Female Health Awareness. All rights reserved. recycle-logo_2options_v2.ai The information contained herein is not a substitute for professional medical care or advice. If you have medical concerns, seek the guidance of a healthcare professional. Women’s Health Today magazine is part of Women’s Health Experience, the flagship program of the Foundation for Female Health Awareness. Women’s Health Experience is Printed a unique initiative aimed at connecting women With Soy Ink Printed With Soy Ink with healthcare experts, as well as their local hospitals, to learn about important issues that may affect their health. Through Please Recycle This Health Publication Women’s Health Experience, Women’s Today magazine and www.womenshealthexperience.com, you’ll get objective, timely information. You can also sign up for free e-newsletters containing health news and results medical studies. Please Recycle This of Publication Sign up now at www.womenshealthexperience.com. Printed With Soy Ink Cover: Mariel Hemingway © 2012 Russell BaerRecycle / Contour by Getty Images Please This Publication Printed With Soy Ink Please Recycle This Publication Urgent or emergency? By Jeffrey Craven, MD >> When faced with a serious health situation, do The emergency department (ED) is the right place for true emergencies. But, consider an urgent care center when your physician’s office is closed or fully booked, when your problem requires more than what a traditional physician’s office can provide, and when time and money matter. These urgent situations can be effectively and efficiently addressed at an urgent care center without a trip to the ED: > Minor illnesses: urinary tract infections, upper respiratory symptoms (sore throat, earache, sinusitis, cough and congestion), mild asthma, nausea and vomiting, diarrhea, sexually transmitted diseases, rashes, skin infections, minor allergic reactions, indigestion and reflux > Minor injuries: lacerations, abrasions (including corneal), simple sprains and fractures, burns, bites and bruises > Vaccinations: hepatitis A and B, tetanus, influenza, pneumonia and rabies (by appointment) > History and physical: preoperative (call first), preemployment, Department of Transportation > Workers compensation (first report only) Urgent care centers typically have shorter wait times and a lower co-pay than an ED. Urgent care centers also offer extended and weekend hours and are staffed by physicians, nurses and medical assistants. Standard services at an urgent care center include: • point of care testing (urine, strep, mono, pregnancy, flu and electrolytes) • X-rays • lab tests to be sent out Images on any of these pages may be from one or more of these sources: © 2012 Thinkstock and © 2012 istockphoto.com you know where to go? • referrals for outpatient imaging • oral and intramuscular injected medications, breathing treatments, suturing, splinting and bandaging If you’re still unsure whether your situation requires a trip to an urgent care or ED, call The Christ Hospital Urgent Care Center at 513-561-1366 or your primary care physician to discuss your symptoms. The Christ Hospital Urgent Care Center can help you gain direct admission to The Christ Hospital if your assessment indicates hospitalization is needed. The center is conveniently located at 4440 Red Bank Expressway, just off I-71. WHT Your safety is the primary concern Call 911 or have someone bring you to the ED if you: • suspect heart attack or stroke • experience sudden and serious abdominal pain, chest pain, vomiting, sweating or shortness of breath • feel weakness or paralysis of an arm or leg • lose consciousness • can’t control bleeding • have difficulty speaking Jeffrey Craven, MD, is an emergency medicine specialist with The Christ Hospital. www.womenshealthexperience.com 3 Snore no more Breathe easier with these nighttime solutions > By Karthik Kanagarajan, MD >> Does your bedroom sound like a symphony of chain saws? Whether you’re the snorer or you’re sleeping next to one, you’re not alone. According to the American Academy of Sleep Medicine, 24 percent of women and 40 percent of men are habitual snorers. Here we answer some common snoring questions. What is snoring? Snoring is a sound made in the upper airway of your throat as you sleep. It’s a sign that your airway is being partially blocked during sleep. The sound is made as the flow of air causes tissue in the back of your throat to vibrate. Whom does it affect? Snoring is more common among people who are overweight and women who are postmenopausal, and it usually worsens with age. Snoring can also be caused by nasal congestion, a deviated nasal septum (tissue separating the nostrils) and alcohol and sedative use. (OSA). With OSA, the airway collapses and becomes blocked, causing sufferers to repeatedly stop breathing in their sleep. OSA can increase the risk of high blood pressure, stroke, obesity, diabetes, depression, heart problems and sudden cardiac death during sleep. Do I need to see a sleep specialist? A sleep specialist may be able to help if you experience any of these symptoms: • loud, chronic snoring (many sufferers aren’t even aware of their snoring—it often takes a loved one to point it out) • choking or gasping during sleep • excessive daytime sleepiness • morning headaches • memory or concentration problems • irritability or mood swings • dry throat upon waking Self-help for snorers 1 Exercise regularly and maintain a healthy weight. How is SNORING treated? Treatment depends on whether you have simple snoring or snoring What are the risks? Light snoring may not disrupt your overall quality of sleep. But 50 percent of people who snore loudly have obstructive sleep apnea along with OSA. Weight loss will help decrease snoring and OSA and should be considered a top priority. But not everyone has success in losing weight, and not all people with snoring and OSA are overweight. Other treatment options include an oral appliance (it looks like a sports mouth guard and keeps your airway open when you’re asleep); CPAP, or continuous positive airway pressure (provides a steady stream of air to keep your airway open through a mask); and surgery (this may be an option if other treatments fail). WHT ind a sleep F specialist To find a sleep specialist at The Christ Hospital, call our Physician Referral line at 513-585-1000. 2 Avoid alcohol, sleeping pills and antihistamines before bedtime. 3 Sleep on your side rather than your back. Sew a “snore sock” (a sock with a tennis ball in it) to the back of your pajamas. It will prevent you from rolling onto your back during sleep. 4 Raise the head of your bed by 4 inches. Karthik Kanagarajan, MD, is a board-certified pulmonologist and sleep specialist with The Christ Hospital. 4 women’s health today Putting an end to heavy bleeding Is endometrial ablation right for you? > >> At some point in her life, almost every woman experiences heavy or prolonged menstrual bleed- But if you experience it every cycle, you know a heavy period can be more than a nuisance. Severe blood loss can lead to anemia; and excessive pain and fatigue may cause you to miss work or other activities. A minimally invasive surgical procedure, endometrial ablation, can be an effective treatment for those women who don’t desire future pregnancies. ing. Is this an option for me? Endometrial ablation uses either heat, cold or electrical energy to destroy the uterus lining, or endometrium. A surgeon delivers the energy through the vagina and cervix with a laser, electrocautery tool, thermal balloon or heated fluid. The procedure minimizes or ends menstruation, but it also effectively ends fertility. Ablation works well for many women with heavy or prolonged bleeding who have tried other treatments, but it’s not for everyone. While ablation can treat excessive bleeding caused by uterine fibroids, it won’t shrink or remove the fibroids, so patients may still suffer pain and pelvic pressure. Your doctor will need to determine why you’re having abnormal bleeding and whether ablation is right for you. Why might you want it? Endometrial ablation is less drastic than hysterectomy and usually done as outpatient surgery or in a doctor’s office. Most women can return to normal activities several days later. Endometrial ablation leaves By Robert Stephens, MD your uterus, ovaries and cervix in place. Your menstrual bleeding will be minimized or eliminated. And, unlike a hysterectomy, you won’t experience premature menopause. Ablation works well for many women who have tried other treatments, but it’s not for everyone. Why might you pass on it? If you think you may want to become pregnant, ablation is not for you. Also, as with any procedure, risks include complications from pain medication, blood loss and infection. In rare cases, the surgical device may pass through the uterine wall. In addition, if menstruation stops, it’s possible that light periods may resume within 10 years. In considering endometrial ablation, talk with your physician. Together, you and your physician should evaluate your age and overall health, the condition’s impact on your lifestyle and whether you want children. WHT Explore your options If you need a gynecologist, call The Christ Hospital physician referral line at 513-585-1000 or visit www.TheChristHospital.com/women. Robert Stephens, MD, is an obstetrician/gynecologist and medical director of The Christ Hospital women’s service line. www.womenshealthexperience.com 5 Health Headlines >> what’s making news in women’s health Oh, my aching iPad! Technology is a beautiful thing, but it can be trying on your body. For example, you may find that using a tablet computer, such as an iPad, leaves you with nagging shoulder or neck pain from looking down at your lap. But a new study says you can avoid these discomforts with a little tweaking to your positioning. In a study appearing in Work: A Journal of Prevention, Assessment, and Rehabilitation, researchers from Harvard School of Public Health, Microsoft Corp. and Brigham and Women’s Hospital concluded that skipping the lap and putting your tablet computer on a table, as well as using cases that offer higher viewing angles, can reposition the body in a more neutral pose and nix the aches and pains. The study was based on the experiences of 15 regular tablet users who had either an Apple iPad2 or Motorola Xoom and used the tablets to do certain tasks, such as surf the Web, read or e-mail. Both tablets had cases that allowed for viewing at higher angles—73 degrees and 63 degrees, respectively. When these higher angles were used, in conjunction with positioning the tablet on a table, postures became less strained. Of course, researchers say this may not be the best position for when you actually need to work (or use your hands). More research is needed to figure out how the new tablets will affect your arms and wrists. 6 women’s health today What’s the deal with stress tests? If you have chest pain or other symptoms of heart disease, or you’re at risk for the disease, your healthcare provider may order what’s called a stress test, or exercise tolerance test. This test can show him or her just how well your heart is working when it’s working its hardest. The test can also be used to determine if your heart treatments are effective, or to gauge how much exercise is appropriate for you. Unlike other tests, little preparation is needed. You’ll just need to wear comfortable clothing and sneakers, and you may want to avoid a large meal beforehand. EKGs are taken before the test, and special wires are attached to your body to monitor your blood pressure and heart rate during exercise. Then you’ll be asked to walk on a treadmill for several minutes, and the incline and speed of the machine will vary during that time. Experiencing any chest discomfort or pain, shortness of breath or dizziness, along with an EKG that indicates potential blood flow problems, is a sign that heart disease may be present. (Not experiencing symptoms and having a normal EKG is considered “passing.”) If you experience symptoms during the test, but your EKG is normal, your provider may recommend more testing. It may take several days to receive the complete results of your test. Quit smoking: The benefits start 20 minutes after you stop If you quit smoking today, you’ll experience health benefits within minutes of quitting. And if you remain smoke-free, you’ll feel younger and add years back to your life. In just … Your body responds positively to quitting: 20 minutes > Blood pressure decreases. > Heart rate becomes lower. > Body temperature of hands and feet increases. 12 hours > Carbon monoxide level in blood drops to normal. > Oxygen level in blood returns to normal. 2 weeks to 3 months > Chance of heart attack decreases. 48 hours > Nerve endings begin to regrow. > Ability to taste and smell improves. 2 weeks to 3 months > Circulation improves. > Walking becomes easier. > Lung function increases. 1 to 9 months > L ess coughing, sinus congestion, fatigue and shortness of breath. 1 year >R isk of coronary heart disease is decreased to half that of a smoker. 5 years > F rom five to 15 years after quitting, stroke risk is reduced to that of people who have never smoked. 10 years >R isk of lung cancer drops to as low as 50 percent compared to those who continue to smoke. > Risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decreases. > Risk of ulcers decreases. 15 years > Risk of coronary heart disease is similar to that of people who never smoked. > Risk of death returns to nearly the level of people who have never smoked. TIAs: Understanding ministrokes If a stroke can be described as a “brain attack,” then a transient ischemic attack (TIA) may be considered a brain skirmish— brief, but still significant. TIAs are “ministrokes” that occur suddenly, usually last only a few minutes and cause no lasting damage. However, according to the American Heart Association, TIAs are often warning signs; one-third of those who suffer them eventually have a fullscale stroke. These events typically occur when blood flow to the brain is briefly interrupted, usually from a blood clot. Symptoms are similar to those of stroke, but are fleeting and temporary. They may include: • weakness or numbness, especially on one side of the body or face • confusion, trouble speaking or difficulty understanding speech • loss or distortion of vision in one or both eyes • dizziness and/or loss of balance or coordination • sudden, severe headache If you or someone you know experiences any of these symptoms, call 911 immediately. A prompt medical evaluation is necessary to determine whether it’s a stroke or a TIA. If it’s a TIA, your healthcare provider may recommend lifestyle changes, medication or even surgery to help lower the risk of stroke in the future. www.womenshealthexperience.com 7 Is organic a good buy? Do your research before opening your wallet >> Standing in front of the fruit section at your local supermarket, you’re faced with a produce dilemma: Do you buy those standard pears or The organic is pricier, and you’re just not sure if it’s worth the splurge. spring for the organic variety? What is organic, anyway? First, consider what “organic” really means. To earn that label from the U.S. Department of Agriculture (USDA), food has to be grown without pesticides, herbicides, fertilizers containing synthetic materials, antibiotics, hormones, radiation or other common growing substances and methods. Foods that contain more than one ingredient, such as cereal, may be “100 percent organic”—completely organic or made up of all organic ingredients—or “organic,” meaning the food item is at least 95 percent organic. Sounds great, right? The catch is that science hasn’t come up with a definitive answer on whether organic is safer or better for you nutritionally. Some research has found that conventional foods contain the same amount of nutrients as organic options. While scientists delve deeper into the organic versus traditional food debate, consider these points about buying organic to help you decide what’s best for your plate—and budget. Organic foods: • tend to cost more than non-organic foods because of more expensive farming practices • carry much less pesticide residue than conventionally Is gluten-free for me? As more and more gluten-free foods pop up on store shelves, you may be wondering if a glutenless diet might work for you. Gluten is the substance that, among other things, helps dough rise and adds flavor to breads and other foods, such as cakes, cereal and pasta. But this seemingly innocent protein can cause the body to attack the lining of the small intestine in people with celiac disease, and can cause serious health problems. In other words, these are the people who need to follow a gluten-free diet. Going gluten-less has no nutritional advantage for those without celiac disease. Eating a diet without gluten makes it challenging to get a nutritionally balanced diet, and foods that are gluten-free don’t necessarily have less fat, sugar or calories. grown foods, which is good for the environment because this can reduce pollution • either skip or greatly restrict use of such additives as preservatives and food coloring. On the downside, because these foods don’t contain preservatives, they tend to spoil faster than traditional foods. No matter which you choose, be sure to select a variety of foods to ensure you’re getting the proper nutrients. Try to buy fruits and vegetables when they’re in season; scrutinize food labels to make sure foods are healthy; and wash fruits and vegetables thoroughly for safety’s sake. WHT tktktktktktk! tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk 8 women’s health today News Notes What’s happening at The Christ Hospital Researchers explore novel technology approach for uncontrolled high blood pressure A radically different approach to treating high blood pressure— using a minimally invasive procedure—is being evaluated as part of a Pivotal Phase III 90-site national trial that includes The Carl H. and Edyth Lindner Center for Research and Education at The Christ Hospital. Resistant hypertension affects more than 12 percent of patients who take hypertension medications to manage the condition. Despite being on three or more medications, these patients have blood pressure that remains high enough to put them at risk for heart attack or stroke. For every 20-point increase in systolic pressure (highest blood pressure during an outgoing blood cycle), the risk of cardiovascular episodes doubles, according to The Christ Hospital cardiology researchers. In earlier studies, patients who underwent this minimally invasive procedure were able to reduce their pressure by about 30 or so points. The positive earlier trial results warranted further study. The investigational SYMPLICITY™ Renal Denervation System® includes inserting a catheter at the groin and advancing it to the renal arteries where radiofrequency (RF) energy is delivered that Mt. Auburn Campus expansion Heart graphic courtesy of Medtronic The Christ Hospital recently began construction of a $265 million expansion and improvement of its main campus in Mt. Auburn. The centerpiece of this expansion plan includes the development of a unique disrupts sympathetic nerves around the renal arteries. This prevents neurotransmitters released by these nerves from triggering a hormone response that increases heart rate, constricts blood vessels and raises blood pressure. The SYMPLICITY Phase III trial is a prospective, single-blind, randomized, controlled trial that will enroll approximately 530 patients in up to 90 research sites nationwide. Those enrolled will be assigned randomly to either treatment or control groups at a 2:1 ratio. Patients’ blood pressure will be monitored for six months. For more information, please contact The Lindner Research Center at 513-585-1777. facility dedicated solely to orthopaedic and spine care, designed to support physicians, patients and families in an efficient, healing and technologically advanced environment. The new 332,000-square-foot facility, which will be located just south of the main hospital, will physically connect to the current hospital but will provide separate access for patients and visitors. The orthopaedic and spine center will include 60 private inpatient rooms; 10 operating rooms dedicated to orthopaedic and spine surgeries, with two shelled operating rooms for future growth; physical and occupational therapy services; imaging services; pain management; physician offices and administrative offices; and underground parking for about 150 vehicles. Completion of the facility is slated for spring 2015, with an opening in summer 2015. The Christ Hospital will be the only local hospital, and one of only a few in the country, to offer a single-purpose facility with a focus on comprehensive orthopaedic and spine services and research. www.womenshealthexperience.com 9 Climbing the family tree Mariel Hemingway overcomes genetics >> At age 49, actress and model Mariel Hemingway has entertained audiences for years with roles such as the little sister in “Lipstick” and her Oscar-nominated performance in Woody Allen’s “Manhattan.” But more recently, Hemingway, granddaughter of Nobel Prize-winning novelist Ernest Hemingway, is enlightening the public with her health advocacy and 20-year personal well-being odyssey. Along the way, she’s had to overcome an epic history of Hemingway depression and alcoholism— both contributing to her grandfather’s death—and other genetic illnesses. continued on page 12 > > 10 women’s health today © 2012 Russell Baer / Contour by Getty Images By Bonnie Siegler Diabetes, heart disease and cancer are in my family. I live trying to survive all that. www.womenshealthexperience.com 11 continued from page 11 “Diabetes, heart disease and cancer are in my family,” along with seven suicides, she explains. “My mother had cancer, my father had heart disease and my grandmother had diabetes, so there’s a lot of illness in the family. I live trying to survive all of that, and that’s the No. 1 reason I became interested in health in the first place.” In fact, this mother of two grown daughters has written several health books and is a frequent guest speaker at events nationwide. “I speak about wellness, health and how focused I am on having a lifestyle that has more to do with your everyday health and not about going to a spa for the weekend,” Hemingway adds. “Health isn’t just one piece; it’s everything. It’s not just the food you eat, it’s not just exercise, it’s not whether you get massages or spa treatments—it’s how you take care of yourself on the whole; it’s about having a different consciousness and having an awareness of your whole self.” Starting with breakfast Awareness for Hemingway means reducing her intake of stimulants, preservatives and processed foods. “I’m just very conscious of the food I put in my mouth because I know that it has the ability to heal and enhance my life and my vitality, as opposed to making me sicker,” she notes. Hemingway believes she’s inherited an addictive personality and thus stays away from alcohol, drugs and even sugar. “I got rid of sugar some 20 years ago because I just wanted addictive things out of my life, so I don’t give myself a chance to go down that path.” She also omitted gluten and wheat products 15 years ago, due to sensitivities. “I just get really sluggish when I eat it,” she says. She’s learned to choose gluten-free breads and cookies but advises reading labels. “It all sounds good but then you look at the ingredients and there’s potato starch and this and that. You realize that the ingredients aren’t always that much better.” Hemingway says her wellness philosophy didn’t happen overnight and was a gradual process. “If you want to undergo a wellness makeover,” she suggests, “begin by changing your food, adjusting your breakfast. It’s the start of your day, so altering what you eat then is really important.” She suggests putting away breakfast foods like toast, muffins, orange juice and cereal. 12 women’s health today “Instead, make breakfast of a soft-boiled or poached egg served with a side of veggies, or maybe a little good-quality cheese with some avocado, some organic turkey slices and fruit. Or a smoothie made with minimal natural sweetener.” She also suggests cooking with olive oil spray, “which is a great kitchen tool for me. I only use extra-virgin olive oil.” One of her staples is a green juice that she makes on a weekly basis and stores in her fridge. “It consists of celery, parsley, spinach and a little raw honey.” She also observes eating seasonally year round. “We try not to eat our fruit shipped in from [another country].” Lunches are quick, simple and easy, including healthy soups or salads. A common lunch option is low-carb tortillas: “I put roasted sliced turkey in there rather than pre-packaged. Add a bit of Dijon mustard, avocado and grated carrots and good cheese. Delicious.” Dinners could be chicken or salmon pesto or even a simple scampi. But she adds, “The way you eat is just as important as what you put in your mouth,” so she suggests taking your time and eating in moderation. She also adds only food-based supplements to her diet. “If you put in high doses of vitamin C, the body doesn’t know what to do with that, so it just flushes it away. If you eat an orange, even though it only has a certain amount of vitamin C, it has the whole carrier and that’s what the body understands so your body absorbs it all,” she believes. Striving for balance Over the last few decades, Mariel has enjoyed the benefits of regular yoga workouts, not only to maintain a healthy weight, but also to keep her heart healthy and lift her spirits. And when time doesn’t permit a full yoga session, she does breathing exercises to help reduce stress, or simply goes for a walk without thinking of anything except her surroundings. Hemingway chooses her next words carefully: “I strive for balance in my health. That means a life that you’re taking action to be present in most every moment. We’re not perfect and we can’t be present every single moment, but if you start your day off in a healthy mode, it can lead you to balanced living. Balance doesn’t just happen automatically. It’s an ongoing process, and it’s powerful.” WHT Join Mickey Karram, MD, and physicians from The Christ Hospital for an in-depth look at various women’s health issues. Just tune in to the morning news broadcast on Fox 19 on the second Wednesday of each month to hear the latest news and advice in women’s health, and stay tuned to hear more health tips throughout the day. Hosted by Mickey Karram, MD President and Co-founder, Foundation for Female Health Awareness; Director of Urogynecology, The Christ Hospital, Cincinnati Second Wednesday of each month, tune in at 7:55 a.m. for Dr. Karram, and again at 9:05 a.m. for more Christ Hospital physicians. Visit www.Fox19.com and click on “Healthwise.” Brought to you by the and www.womenshealthexperience.com Visit www.Fox19.com and click on “Healthwise” today! 13 HEALTHY BITES 10 kid-friendly snacks >> Kids love to snack, but that doesn’t mean they have to fill up on junk food to curb their cravings. Healthy snacks are a great way for kids to stay energized while stocking up on protein, calcium, fruits, veggies and whole grains. Try these fun treats the next time your kids ask for a snack. All are 200 calories or less per serving. 4 1 Fruit-and-cheese kabobs. Skewer two 1-inch cubes of Colby cheese, two strawberries and five grapes for a fun treat big on protein and calcium. 2 Hummus-topped cucumbers. Cut three or four thick slices of cucumber and top each with a spoonful of hummus and sliced black olives. 3 Ham and crackers. Boost energy with whole grains and protein by topping a half-dozen low-fat wheat crackers with a little sliced ham. 14 women’s health today Apples with yogurt dip. Stir cinnamon into half a container of low-fat vanilla yogurt to make a super-easy, calcium-rich dip that tastes great with sliced apples. 5 Yogurt parfait. Make low-fat yogurt more appealing by layering it in a clear cup with fresh, antioxidantrich blueberries or another favorite fruit of your child’s choosing. 6 Peanut butter dip. Turn peanut butter into a high-protein fruit dip by thinning it with a little milk and honey and serving it with fresh peach slices. 7 Peppers and salsa. Pile on the veggies: Chop sweet bell peppers into large chunks and dip them in fresh salsa. If you get your kids involved in the process from the start, they’re more likely to make healthier food choices. 8 PB&B waffle. Spread one tablespoon of peanut butter over a toasted multigrain waffle and decorate with banana slices for a snack packed with protein and potassium. 9 Tuna boats. Create healthy “boats“ by hollowing out half a bell pepper and filling it with a half-cup scoop of tuna salad. 10 Mini pizza bagels. Make pizza a healthy snack by topping each half of a whole-grain mini bagel with tomato sauce and low-fat mozzarella cheese, and then bake at 325° F until the cheese melts. WHT Tips to get the kids cooking Do your children frown at the thought of trying a new food? Why not get them to cook with you? If kids make something themselves, they’re more likely to eat it. And if you get them involved in the process from the start—from menu planning to serving the food—they’re more likely to make healthier food choices. The key safety concern when cooking with children is to keep all hot items out of their reach. Most burns occur when a child pulls something hot out of a microwave, off the stove or off a countertop. • Start by looking at the food pyramid and making low-fat and low-calorie selections. • Keep food-preparation tasks age appropriate. Use common sense: Don’t give your kindergartner a knife to slice a carrot. But he or she can wash the lettuce. Don’t let your firstgrader take a heavy and hot dish from the oven. Instead, he or she can hand you the oven mitts. • Show preschoolers how to measure wet and dry ingredients, explaining terms like “cup” or “tablespoon.” They can help pour the ingredients into the bowl and stir them with a wooden spoon or a fork. • Model safe cooking behaviors. Use potholders when carrying hot dishes, and turn off the oven and burners when you’re finished. • School-age children can set the table, putting out the napkins, cups and bowls. They can carry silverware and serving utensils to the table (don’t let the little ones carry knives). www.womenshealthexperience.com 15 A hospice program helps the patient live out his or her life as comfortably as possible. Choosing hospice care >> What sets hospice care apart from hospital care? Hospice programs emphasize pain management and psychosocial counseling rather than reversal of disease. When doctor and patient agree that medical treatment no longer offers hope of a cure or of prolonging life significantly, a hospice program helps the patient live out his or her life as comfortably as possible. Cancer patients make up about 85 percent of all hospice patients. Most are cared for at home by a team that includes physicians, nurses, social workers, clergy, volunteers and family members. Where to get more information > The National Hospice and Palliative Care Organization, www.nhpco.org > Hospice Foundation of America, www.hospicefoundation.org > Hospice Directory, www.hospicedirectory.org 16 women’s health today Your team When you choose hospice, a number of individuals work to ensure that all needs are met. This team may include the following professionals: A team effort Every member of the team has an important role to play. Doctors and nurses provide the medical assistance needed to make the patient comfortable. Social workers help patients manage their financial and personal affairs, including funeral arrangements. Clergy members help patients and their families address the spiritual aspects of dying. Volunteers might look after the patient when family members aren’t available and provide assistance with such things as errands and meal preparation. Family members are taught to administer pain medication and provide personal care for their loved one. See “Your team” to learn more. Pain relief and more Dispelling myths about cancer and pain is one of the hospice team’s most important jobs. Contrary to what many people believe, dying from cancer doesn’t have to be painful. In fact, pain relief is a central goal of hospice programs. The pain-relief system on which they rely includes a variety of drugs, from aspirin to powerful narcotics like morphine. Usually, pain medication is given to the patient around the clock at regular intervals. Whenever possible, pain medication is given in the form of pills to spare patients the discomfort of frequent injections. Conditions such as nausea, vomiting, constipation, weight loss, bedsores, pneumonia and urinarytract infections, which are common among terminally ill patients, are •A family doctor oversees care by signing off on treatment orders and provides background information and a medical history. • A hospice medical director (usually an MD) coordinates care along with the family doctor, offers expert advice on pain and symptom control and helps determine which medical treatments may be needed. He or she can also answer any questions about hospice. • Registered nurses regularly visit patients at home or in long-term care facilities. They may offer emergency services 24 hours a day, seven days a week, and carefully monitor a patient, making sure pain, disease symptoms and nutrition are being managed. Nurses can also provide support and keep everyone educated about all aspects of care. • Registered dietitians can answer any nutrition questions or address feeding problems, either in person or by phone. • Health aides or certified nursing assistants help with personal hygiene, such as bathing and dressing, serve meals and offer other services as needed. treated to make the patient more comfortable, not to prolong life. A hospice program can’t accept a patient unless he or she has been certified terminally ill by a physician. Most patients come to the program when they have six months or less to live. It’s important to understand that while hospice programs don’t attempt to lengthen life, neither •S ocial workers offer emotional support, provide counseling and bereavement follow-up and help with financial matters. They can also help families receive aid from community agencies. • A chaplain addresses the spiritual and religious needs of patients and their loved ones and assists with funeral planning. • Bereavement counselors help patients and families find support groups, cope with grief and prepare emotionally for the eventual death of a loved one. • Volunteers provide muchneeded support, giving caregivers a break by sitting with patients, helping families find community resources or simply lending a sympathetic ear. You and your family are important members of the team. Speaking up about the kind of care you or your loved one wants ensures a comprehensive program that suits everyone’s needs. do they attempt to shorten it. The National Hospice and Palliative Care Organization is on record as opposing euthanasia (mercy killing) and assisted suicide. Choosing hospice care also helps families cope with losing a loved one. When a patient dies, family members find comfort in the knowledge that they helped to make his or her last days as easy as possible. WHT www.womenshealthexperience.com 17 Taking antibiotics seriously don’t work very well against bacteria any more. In fact, some have stopped working altogether. Somehow, these microscopic bugs—culprits in strep throat, tuberculosis, pneumonia, meningitis and gonorrhea, to name just a few illnesses—have become resistant to the drugs that once defeated them at nearly every turn. Tarnished silver bullets >> Heard the words “antibiotic A few years ago, it was a topic of growing concern to health experts and government officials alike. Today, it’s still an issue. The term refers to a puzzle of modern medicine: Many of our country’s most reliable, most widely used antibacterial drugs resistance” lately? Drug overuse and misuse are two big reasons why bacteria have managed to outmaneuver antibiotics. 18 women’s health today Germs have the natural ability to mutate to survive an attack from antibiotics. Some strains can also pass this quality on to other bacteria, which gives those germs a better chance of survival against modern medicines, too. Drug overuse and misuse are two big reasons why bacteria have managed to outmaneuver antibiotics, experts say. Too often, these so-called silver-bullet drugs are used to treat viral infections, like colds or flu, instead of bacterial infections. Actually, antibiotics have no effect on viruses, so taking penicillin to treat a bad cold, for instance, is pointless. Yet, many people pester their healthcare providers until they get the drugs anyway. Likewise, many patients who begin taking antibiotics for the right reasons quit too soon. By stopping their prescriptions as soon as they feel better instead of when the drugs are used up, patients unwittingly let bacteria reproduce and mutate. This helps blunt the drugs’ effectiveness. Already, some bacteria are resistant to every approved antibiotic in the medical arsenal, requiring further expensive research to develop new drugs. Microbe management While more effective compounds are developed to fight resistant germs, you can help tame bacteria as well. Follow these steps: > Don’t “bug” your doctor. If you’re sick, find out if an antibiotic will really help you feel better. Remember, they aren’t cure-alls. Take “no” for an answer if your physician advises you that an antibiotic is not the proper therapy for your condition. Ask him or her about alternative remedies. > Finish what you start. Take every last ounce of medicine you’ve been prescribed in the exact dosage and time frame recommended by your doctor whenever he or she gives you an antibiotic to treat your condition. > Forget doing it yourself. Do away with “stashes” of antibiotics with which you self-medicate sickness or infection when someone falls ill. > Don’t share. Never take someone else’s antibiotics to fight an illness. > Think it over. Reconsider using antibacterial soaps and cleansers around the home. The American Medical Association says some bacteria seem to already be resistant to these products. And studies have found that they don’t provide added germ protection to people already living in a clean household. Germ warfare Preventing infections from spreading is the best way to stay healthy. Remember to: • Wash your hands often, especially when handling food, eating and after using the restroom. • Keep hot foods hot and cold foods cold. When in doubt, throw it out. • Keep kitchen and bathroom surfaces clean and dry. • Never share personal items—toothbrushes, combs or unwashed cups or plates. Use paper cups in the bathroom. Change linen and towels regularly, especially after an illness. • Stay home from work if you’re feverish or nauseated. • Never send a sick child to school or day care. WHT Ask the Expert >> tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk Featuring Paul Gluck, MD A: No, postpartum depression (PPD) is not hereditary. I feel so much better after taking a week’s worth of the three-week antibiotic prescription written for me. Why do I have to keep taking it? Learn more! But that doesn’t mean your family isn’t a factor in PPD. What’s important is whether you have a supportive family environment or an unhealthy one. Besides your family situation, hormonal changes in your brain chemicals also impact whether you go through PPD. One of the key differentiators between the baby blues and tzhis type of depression is the timing of the start of symptoms. About 80 percent or more of new moms experience some sort of sadness post-delivery, but it occurs within days after the baby is born. With PPD, symptoms generally begin about two to four weeks after birth. In addition, women with the blues are still able to function well, taking care of the baby, the house and other children. Women with PPD become nonfunctional, not wanting to get out of bed or take care of their infant. Symptoms include a loss of interest in activities, fatigue, sleeping too little or too much, appetite changes and thoughts of suicide or death. physical problem based you’re breastfeeding, so there will be no harm to your baby. If, several weeks after your baby is born, you feel like you’re suffering from PPD, don’t delay in getting help—both for your sake and your baby’s. WHT www.womenshealthexperience.com 19 Flight plan Reduce your risk of blood clots during air travel >> You’ve decided to take a European vacation this summer, but you’ve heard long plane flights may put you at risk for blood clots in the legs. Should you take extra precautions? Experts say most people, even those with cardiovascular disease, can travel safely on airplanes as long as they follow certain guidelines. Why clots happen The problem with air travel begins with sitting inactive for long periods, especially for more than six hours. Such inactivity decreases circulation, allowing blood to pool and clot in your veins, causing thrombosis, a potentially fatal condition. Plus, flying at an altitude with reduced oxygen can also contribute to clots. Some people have factors that increase their risk, such as having varicose veins, a pacemaker or catheter, a history of stroke and some cancers or a family history of blood clots. Women who are pregnant, recently gave birth or use hormone replacement therapy are more susceptible, too. Flight-safety tips You can avoid thrombosis by taking some simple precautions: • Don’t wear restrictive clothing around your waist and legs. • Drink plenty of water and avoid caffeine and alcohol. • Request an aisle seat so you can get up and walk around more easily during the flight. tktktktktktk! tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktkt •S tretch your calf muscles frequently. • Wear below-the-knee compression stockings during the flight. If you already have a heart condition, be sure to: • Run your plans by your doctor, who may order tests to confirm your condition is stable or prescribe an antiplatelet medication. • Pack adequate supplies of your medication in your carry-on bag. • Carry a copy of your medical history, including your latest electrocardiogram. • Carry contact information for your doctors, family members and your pacemaker or implanted defibrillator manufacturers. Warning signs Postpone your trip? You’ll need to avoid air travel if you: • had a heart attack in the past two weeks • had angioplasty or a stent placed in the past two weeks • had bypass surgery in the past three weeks • have unstable angina, poorly controlled heart failure or an uncontrolled arrhythmia 20 women’s health today Blood clots typically form in the legs, and the affected vein may be near the surface (superficial thrombosis) or deep within a muscle (deep vein thrombosis). With a superficial clot, you may have a red, hard and tender cord just under your skin. When a deep vein is affected, your leg may become painful and swollen and you may have a fever. If you develop these symptoms, seek medical attention right away. WHT The cancer no one talks about Are you at risk? >> In 2009, anal cancer made headlines when actress Farrah Fawcett died from the condi- It’s much less common than colorectal cancer—only about 5,300 people are diagnosed with anal cancer each year, compared with 147,000 cases of colorectal cancer—but it can be deadly, and the disease is on the rise. Discussing the possibility—or symptoms—of anal cancer with your healthcare provider can be embarrassing, so some people may be inclined to ignore the problem until it’s too late. But talking with your healthcare provider at the first sign of a problem might save your life, since anal cancer is treatable when caught early. tion. What to look for Most people with anal cancer bleed from the anus or rectum, have anal itching or pain or have a mass or growth in the anal canal (the tube that connects the bottom of the large intestine to the anus), Learn more! tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk tktktktktktktk which can affect the diameter of their stool. Some symptoms overlap with hemorrhoids, so people may not mention them to their doctors, but it’s always important to mention any changes in your bowel habits, as well as any bleeding or anal discharge, to your healthcare provider. He or she can make a diagnosis relatively easily, because the anus is an accessible part of the body. In fact, doctors regularly diagnose anal cancer in men ages 50 and older when they perform digital rectal exams for prostate cancer. Other times, it’s diagnosed when a doctor removes a hemorrhoid. When your doctor feels a growth in your anus, he or she will typically order additional testing, such as anoscopy and rigid proctosigmoidoscopy, to make a diagnosis. During both tests, a thin tube with a tiny camera is inserted into the anus. You’ll be awake during both procedures. A biopsy will be taken as well. Once you’re diagnosed, your doctor will discuss the course of treatment, which may include surgery, chemotherapy, radiation or a combination of these options. Figuring out your risk The following risk factors put you at greater risk for anal cancer: > Age. Anal cancer is commonly diagnosed in people in their 60s. > Gender. Women get anal cancer slightly more often than men do. > HPV and HIV status. People who are infected with human papillomavirus (HPV), a sexually transmitted virus that also causes cervical cancer, are at greater risk, as are those who have human immunodeficiency virus (HIV). > Immune system status. People with lowered immunity—for example, those taking immunosuppressant medications to prevent rejection of a transplanted organ— are at greater risk. > Smoking. Smoking cigarettes raises your risk of developing anal cancer, among other types of cancer. WHT www.womenshealthexperience.com 21 HEALTHY MOVES Ten minutes of water exercise is as good as 40 minutes of movement on land. Dip into fitness How water exercise can keep you young >> If the idea of exercising in your bathing suit is unappealing, then the concept of water exercise probably won’t But what if you were told that 10 minutes of water exercise is as good as 40 minutes of movement on land, and a bathing suit isn’t necessary. Would you change your mind? float your boat. 22 women’s health today Eating and exercise? Food is the fuel that helps you maximize your workouts. But working out too soon—on land or in water—after a big meal can make you feel sluggish and give you digestive problems. Not eating before exercising can leave you feeling faint or tired. Here’s how to get the timing down: • If you’ll be exercising within an hour after breakfast, skip the big plate of eggs and toast and opt for something smaller, like a bowl of fruit, or have a sports drink to provide the energy needed for exercising. • If you do eat a big meal, hold off on exercising for at least three to four hours. • Eat within two hours after exercising to help your muscles recover. Put together a meal that contains both protein (meat, dairy and nuts) and carbohydrates (cereals, breads, vegetables, pasta and fruit). No strain, big gain Water exercise is a no-impact activity that can strengthen muscles, bones and the heart—without straining bones and joints. This makes aquatic exercise ideal for people with arthritis or osteoporosis or anyone with mobility problems. And for those bored with treadmill training or step classes, water exercise is a refreshing way to renew a fitness commitment. Water takes a burden off your bones by supporting your body weight. In waist-high water, you carry only about half of your actual weight; in shoulder-high water, only 10 percent. Yet unlike air, water provides resistance in any direction you move, maximizing your efforts. While it might not feel like it, you’ll be giving your heart and muscles a vigorous workout and burning more calories than you would on land. (Consider that “pool walking” burns about the same calories per minute as jogging on land.) Even just resting in a pool is therapeutic. Being immersed in warm water soothes painful joints and relaxes tense muscles. Class time While you don’t need an instructor to benefit from simple pool walking, you may find you enjoy the structure of a water aerobics class. Some classes take place solely in the deep or shallow end; others use the whole length of the pool. For 30 to 60 minutes, the instructor demonstrates a series of movements for the class to follow. After a warm-up that includes stretching, class members walk or run in place and perform strength movements like biceps curls and leg extensions while keeping limbs underwater. Some movements require a flotation belt, aqua gloves or a kickboard. Classes end with a cool-down that returns the heart rate to normal. Dress code So what about the bathing suit? It’s not a requirement. Gym shorts and a T-shirt will do (call the gym ahead of time to verify). Spandex or Lycra bike-type shorts allow for the most freedom of movement. Some sporting-goods stores also sell water-friendly workout wear. To protect your feet from the pool’s rough surface, your instructor may recommend rubber or “aqua” slippers. Ask your doctor if water exercise can help you. Perhaps he or she can recommend a local class. WHT www.womenshealthexperience.com 23 HEALTH SMARTS Kick athlete’s foot >> Athlete’s foot isn’t just for athletes. You may be exposed to the infection without even knowing it. Test your knowledge by answering true or false to the following statements. Then check the answers on this page to see how you did. TRUE or False? 1 You can’t get athlete’s foot if you wear socks. 2 Athlete’s foot is contagious. 3 Only men can catch this fungal infection. 4 You should see your physician if the rash worsens. 5 Changing shoes every day helps prevent athlete’s foot. Answers FALSE. Athlete’s foot is a fungal infection called tinea pedis that develops in moist areas. Socks keep your feet damp and warm, allowing the organisms to grow. Tight shoes and socks keep your toes together without letting your feet air out. Going barefoot when you’re home from work can help keep your feet stay dry and prevent athlete’s foot. TRUE. The fungal infection can spread by contact with an infected 2 person or contaminated area. By walking barefoot in public places like saunas, locker rooms, swimming pools and communal showers, you’re increasing your risk of getting athlete’s foot. Wearing sandals around these areas can help prevent you from catching it. Athlete’s foot can also be spread by sharing towels, mats and shoes. Think twice next yoga class before you use a mat without socks. False. Men are at a higher risk for getting athlete’s foot but 3 women can still get the infection. Just like athletes and men, women’s feet sweat. Wash your socks after a workout and wash your feet. If your feet sweat a lot, change your socks twice a day and put powder in between your toes. True. Athlete’s food isn’t comfortable. Your feet will itch, sting and 4 burn and your skin will be dried, cracked and peeled. Over-thecounter medication is available to help treat athlete’s foot. But if the rash worsens after you’ve tried these treatments, see your physician. He or she can prescribe something stronger for you that can rid you of the infection. True. Alternate wearing different pairs of shoes. This will give 5 your footwear time to dry out between each wearing. Wearing light, well-ventilated shoes decreases your risk of getting athlete’s foot. Shoes made of synthetic material like rubber or vinyl should be avoided. Plastic shoes provide the perfect environment for fungal growth and infection. 1 24 women’s health today Test your health knowledge online Take more health quizzes and assessments online at www.womenshealthexperience. com. Plus, find out what other women are saying by participating in our online polls! 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