women s Summer 2010 health today Postpregnancy surprises things you need now Gabrielle Union Learning from life for a healthy summer Stay injury-free! see page 10 How to play it safe LAST CHANCE to keep getting your issues of Women’s Health Today! We’re updating our mailing list. Look inside to learn how to continue your subscription. The Christ Hospital 2139 Auburn Avenue Cincinnati OH 45219 non-profit org us postage Paid cincinnati oh Permit #5489 {And now I know heart attack signs for women are different.} Chest pain is one of the most common reasons for emergency Heart Attack Signs for Women Chest pain and discomfort Shortness of breath Nausea/vomiting Back or jaw pain Fatigue room visits. That’s why we’ve created the Chest Pain Center at The Christ Hospital Heart and Vascular Center — the first and only center in Cincinnati to receive full accreditation from the Society of Chest Pain Centers. A woman’s symptoms for a heart attack can present differently from a man’s. Here, our team is specially trained in evaluating women to quickly diagnose their source of pain and deliver the best course of care. To schedule a $99 Heart CT Scan to determine heart attack risk, call 513.585.2668. Caring Above All.SM 2139 Auburn Avenue | Cincinnati, OH 45219 | www.TheChristHospital.com/heartandvascular in this issue... summer 2010 >> Features 3 What’s behind your pelvic pain? 4 Women die of heart attacks, too 4 Women die of heart attacks, too 16 Sweet talking Tips for battling bad breath 17 Top joint injuries How can you prevent one? and how to avoid them 5 Normal aging or something else? 20 Hormone help Keeping tabs on your parents’ health Balancing the scales 21 Summer essentials 4 warm-weather must-haves 8 Tough talks How to tell your physician about embarrassing problems 22 Postpartum problems? Join the club! 10 Gabrielle’s guidelines No-nonsense healthy living! >> Departments 2 LETTER FROM THE FOUNDER 6 HEALTH HEADLINES You’re never alone! © istockphoto.com/John Krajewski/Javier Fontanella/Judy Picciotto What’s making news in women’s health 9 SEX & GENDER MATTERS Chickenpox isn’t just for kids Look out for shingles 14 HEALTHY 14 Exotic harvest 21 Summer essentials BITES Exotic harvest Take a vacation from the usual fruits and veggies 18 HEALTHY MOVES In fitness and in health Double the pleasure and shape up together 24 HEALTH 18 In fitness and in health SMARTS Can you hear me now? www.womenshealthexperience.com LETTER FROM THE FOUNDER women s health today You’re never alone! >> Founders If you’re a new mom and wonder why you’re not feeling as joyous as those women you see in magazines and on television, don’t fret. While more than 10 percent of women struggle with postpartum depression, many women also experience other somewhat troubling post-pregnancy health problems. A national expert offers his opinion on issues ranging from hair loss 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. to wrist pain and more in “Postpartum problems?” (page 22) to help set your worries to rest. Enjoy the season! Now that summer is upon us, get out there and enjoy the great outdoors. But don’t forget to be safe! Before you pick up that tennis racket or golf club, read “Top joint injuries” on page 17 to learn how to prevent knee, ankle, shoulder and wrist injuries. Then, move on to page 18 for tips on how you and your significant other can get or Keep it coming! We’re updating our mailing list and want to ensure our loyal readers continue to receive Women’s Health Today. To continue your complimentary subscription, visit www. TheChristHospital. com/women and complete the online form, or call us at 513-585-1000. (If you’ve already called or subscribed online, there’s no need to do so again.) We look forward to providing you with important and timely health information! stay fit together (“In fitness and in health”). As you prepare to enjoy the sun and fun, be sure you’ve stocked up on the medicine-cabinet must-haves in “Summer essentials” on page 21. And, after you’ve worked up an appetite from all your healthy activity, consult page 14’s “Exotic harvest” for some ideas on new fruits and vegetables to try. In just those few pages, Women’s Health Today can help you plan your safe summer day! You’ll find more interesting and important health topics throughout this issue. If there’s a topic you’d like to read about that we haven’t covered yet, let me know. I’d love to hear from you! Sincerely, Mickey M. Karram, MD PRESIDENT AND Co-Founder Foundation for Female Health Awareness women’s health health today today women’s the magazine of the foundation for female health awareness 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. 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 6, Issue 3. © 2010 by The Christ Hospital and the Foundation for Female Health Awareness. All rights reserved. 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. recycle-logo_2options_v2.ai 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 a unique initiative aimed at connecting women with healthcare experts, as well as their local hospitals, to learn about important issues that may affect their health. Through Women’s Health Experience, Women’s Health Today magazine and www.womenshealthexperience.com, you’ll get objective, timely information. You can also sign up for free e-newsletters Printed With Soy Ink Printed With Soy Ink containing health news and results of medical studies. Sign up now at www.womenshealthexperience.com. Please Recycle This Publication Cover: Gabrielle Union © 2010 Jack Chuck/CORBIS OUTLINE Please Recycle This Publication Printed With Soy Ink Please Recycle This Publication Printed With Soy Ink Please Recycle This Publication Fib What’s behind your pelvic pain? roi ds Endometriosis Pelvic inflam matory disea se By Kevin Fitzgerald, MD >> Pain is your body’s way of saying something But when it comes to pelvic pain, it can be hard to pin down exactly what’s wrong. And because you may be accustomed to some monthly pelvic discomfort, you may not realize that your symptoms aren’t what they used to be. When your pain changes, worsens, affects your daily life or seems to come with new symptoms, make an appointment with your physician. Some common causes of pelvic pain include: isn’t quite right. © istockphoto.com/nasenmann Endometriosis. When endometrial tissue grows outside the uterus on your ovaries, fallopian tubes or other pelvic structures, it may cause pain and cramping and painful periods with heavy bleeding. You may also have back or abdominal pain; pain with bowel movements or urination; or sharp, deep pelvic pain during intercourse. Fibroids. One in four women with these benign uterine tumors experiences symptoms that may include pelvic pressure or pain, heavy or prolonged periods, spotting, frequent urination, constipation and back or leg pain. Ovarian cysts. You may feel a dull ache in your lower back and thighs, heaviness in your abdomen or pressure on your rectum or bladder. Most cysts disappear within a few menstrual cycles. Sometimes, Ovarian cysts Caring Above All for women! The experts at The Christ Hospital Women’s Surgery Center perform more minimally invasive gynecologic surgeries than any other hospital in the region, including laparoscopic surgery, minimally invasive and single-incision hysterectomy and robotic-assisted surgery. We strive to always offer women more—through our commitment to the newest procedures, the latest technology and to Caring Above All. To learn more about minimally invasive surgery and to discuss your options with a physician, call 513-585-1000. SM though, one will continue to grow and may rupture or twist—causing sudden, sharp or worsening pelvic or abdominal pain. Pelvic inflammatory disease. With this bacterial infection, you may feel pain in your lower belly and pain during a pelvic exam or intercourse. You may also have a fever, irregular bleeding and unusual discharge. See your physician for a thorough exam during which he or she may also check for bladder or other infections, pregnancy, irritable bowel syndrome or nerve disorders. The sooner you seek treatment, the sooner you’ll enjoy relief. WHT >> Kevin Fitzgerald, MD, is a board-certified obstetrician/gynecologist with The Christ Hospital. www.womenshealthexperience.com Women die of heart attacks, too How can you prevent one? While women are typically the nurturers in the family, many forget to take care of themselves. That’s why for some women, the first symptom of heart disease is a heart attack. Many women simply don’t connect their risk factors and their own chance of developing heart disease. In addition, heart disease looks and acts differently in women than it does in men. Typical symptoms tend to be more vague and may include: • chest discomfort, pressure or achiness instead of crushing chest pain • a burning sensation in the chest or upper abdomen • shortness of breath, irregular heartbeat, nausea, jaw pain, dizziness, sweating or fatigue If you experience these symptoms, it’s important to call 911 immediately and be sure to tell the paramedics to take you to a “heart hospital” or a hospital that has experience in treating heart attacks. The American College of Cardiology and American Heart Association (ACC/AHA) guidelines recommend treatment within We treat your heart here The Christ Hospital has the only accredited Chest Pain Center in Greater Cincinnati that specializes in chest pain and heart attack treatment. We consistently treat heart attack patients at or below the 90-minute ACC/AHA guideline. To learn more and receive “A Woman’s Signs of Heart Attack” magnet, call 513-585-1000. women’s health today Find out your risk for heart disease today. Visit www. TheChristHospital.com/ heartaware for a free risk assessment and more. 90 minutes in order to alleviate major heart muscle damage. That means 90 minutes from the time you get to the hospital to the time the physician is able to open your blocked artery in the cardiac catheterization lab. Be on guard Don’t let a heart attack sneak up on you. Take control of your health: • Make an appointment with your healthcare provider to discuss your personal risk factors such as your family heart history, age, smoking status, exercise habits, weight, waist size, blood pressure, cholesterol and blood sugar. • Get screened. The Christ Hospital also offers a $99 heart computed tomography (CT) scan. Using a low dose of radiation with a 64slice CT scanner, this quick, painless test can detect cholesterol buildup in the arteries. These tests are performed at The Christ Hospital and The Christ Hospital Imaging Center on Redbank Road. Heart CT scans can be scheduled by calling 513-585-2668. WHT © istockphoto.com/John Krajewski >> Are you at risk? Normal aging or something else? Keeping tabs on your parents’ health By Jason Graff, MD, and Robert Keyes, MD >> Perhaps you’ve noticed your mom has lost weight, seems weaker and is a bit confused lately. Although it could be part of normal aging, these symptoms can also be attributed to other medical causes. For example, she may be suffering from depression. Perhaps a medication side effect is causing her sudden confusion. Memory issues Some minor memory changes that don’t impair daily activities or quality of life—such as taking longer to recall a person’s name or finding the right word—can be normal with age. But not remembering the right road to take to the grocery store or not being aware of a memory lapse can be a sign of another problem. While getting older is inevitable, many changes and declines we associate with aging may be the result of treatable conditions. What to discuss When symptoms occur, begin discussing your concerns with your parent and encourage him or her to visit a primary care physician. Even insomnia and frequent urination warrant a trip to the physician because these problems are often not age-related. Your mom may insist she’s fine, but consider otherwise if you spot any of these warning signs: • physical unsteadiness, shuffling steps, dizziness • • • • • • • • • • muscle weakness weight loss or gain bruising confusion increased memory problems social withdrawal insomnia incontinence increased urination or other urinary problems a struggle to perform tasks like taking medication, paying bills or following a recipe • poor judgment • uncharacteristic behavior such as irritability, worry, anger, agitation or suspicion By taking action now, you can help your parent take steps to prevent further disability and learn to recognize when he or she may benefit from a geriatrician, a physician who specializes in caring for aging adults. You, along with your parent’s geriatrician and care team, can help your parent improve his or her function and enjoy life. WHT We can help you help them! The new Center for Health and Aging at The Christ Hospital can help by serving as a consultant or your parents’ sole primary care provider. To learn more or to schedule an appointment, call 513-272-8444. >> Jason Graff, MD (left), and Robert Keyes, MD, are board-certified internists and geriatricians with The Christ Hospital Center for Health and Aging. www.womenshealthexperience.com Health Headlines >> what’s making news in women’s health Besides being used as a painkiller, aspirin is popular for its cardiovascular benefits, helping to prevent heart attacks and strokes in men and women. Now aspirin may have another use: reducing the risk of death after breast cancer. Harvard researchers found that of more than 4,000 women diagnosed women’s health today with breast cancer from 1976 to 2002, those who took aspirin regularly—mostly to prevent heart attacks and stroke—had a 50 percent lower risk of dying from breast cancer or having the cancer spread than women who weren’t taking aspirin. The results suggest that nonsteroidal anti-inflammatory drugs like ibuprofen might have a similar benefit. Researchers think it may be due to the drugs’ ability to reduce inflammation (chronic inflammation can promote cancer growth). However, they note that because of the side-effect risks, aspirin shouldn’t be taken without a doctor’s supervision and it should be avoided if you’re undergoing chemotherapy or radiation. The research was part of the Nurses’ Health Study, an ongoing investigation into many health conditions. The message seems to be everywhere: Heart disease is the No. 1 killer of women. The American Heart Association’s (AHA’s) Go Red For Women campaign focuses on educating women and reducing heart disease and stroke. Despite these and other efforts, almost 50 percent of all American women still aren’t aware that heart disease is their top cause of death, reports an AHA survey. The survey also found that only half of women could identify heart attack symptoms, and slightly more than half would call 911 if they were experiencing warning signs (nausea; jaw pain; or pain, tightness or squeezing in the chest). Researchers say heart experts need to come up with different ways to communicate prevention messages—perhaps through community programs or social networking sites like Facebook and Twitter. Women also need to be proactive about their heart health, making sure to eat healthfully and exercise. And if you think you may be having a heart attack, don’t hesitate in calling 911. Images on pages 6 and 7 © istockphoto.com/Medobear/Kutay Tanir/Carrie Wendel/Rich Legg/VisualField Aspirin benefits breast cancer patients Women aren’t taking this message to heart Young women: Don’t drink and drive! Can running be in your blood? Have you always found it easy to run that 5K? There could be a genetic reason for your talent. A small study of track-and-field athletes found that those who did well in marathons and similar activities had a variation in the NRF2 gene, which has been shown to boost energy and lessen the effects of inflammation. Researchers looked at 155 athletes and discovered that among Olympic-level athletes, 80 percent of those who did well in endurance sports had the variation, compared to 46 percent of sprinters. More research is needed to determine specifically what role the gene plays in your athletic performance. While most drunk drivers are men, women who have had a few too many are still getting behind the wheel. Researchers at Yale University and other institutions, using United States National Highway Traffic Safety Administration data, found that the number of female drivers involved in fatal crashes increased between 1995 and 2007 for 19- to 20year-olds and 21- to 24-year-olds, while men either experienced no change or saw rates decrease. Experts blame social pressures for the increase, as women turn to drugs and alcohol to lose inhibitions and feel like they’re part of the crowd. They recommend drunk-driving messages be geared toward young women—for example, stressing that driving drunk puts others in danger and can lead to prison time or result in disfigurement or other disabling injuries. The number of female drivers involved in fatal crashes increased between 1995 and 2007 for 19- to 20-year-olds and 21- to 24-year-olds. www.womenshealthexperience.com Tough talks How to tell your physician about embarrassing problems >> Talking with your health- care provider about your sex life, unusual bowel movements or feelings of depression is • Bring visual aids. If you’re having trouble launching the conversation, consider showing him or her an article about your problem. • Write down details and questions. Whether it’s changes in bowel movements, depression or sexual dysfunction, describe what you’re experiencing and when it started, so you have a clear picture of what’s going on and can answer your physician’s questions. Listing your own questions will help you get the answers you’re seeking. Revealing that you’re the victim of domestic violence or that you have a drinking problem can be even tougher. Yet all relate to your health and warrant medical attention. Getting the proper treatment begins with an honest dialogue. The next time you have an embarrassing question or problem, remember these tips: • Find an understanding healthcare provider. Some women prefer talking to other Describe women; others just want what you’re a compassionate listener. Remember, the physiexperiencing cian should be there to and when it help you, not to judge or started. preach. • Keep in mind that your physician has heard it before. No matter how upsetting a problem might seem, your physician has most likely dealt with it several times before—especially if he or she has been in practice for a while. never easy. Time to take action! Now that you’re armed with these tough-talk tips, it’s time to schedule your appointment. To find the right primary care physician or specialist for you, call The Christ Hospital physician referral line at 513-585-1000. women’s health today • Use the right words. While you don’t need to get too technical, it can help if you describe your problem with the right anatomical terms and a good description of your symptoms. • Talk about the effects on your life. How have changes in your bowel patterns affected your life or the lack of desire impacted your relationship? The answers will help your physician assess the seriousness of your problem, which will help determine treatment. WHT Sex & Gender Matters >> By Jennifer Wider, MD The latest findings on women-specific health from the Society for Women’s Health Research Chickenpox isn’t just for kids Look out for shingles >> Thought you were done with chickenpox as Think again. Shingles, a disease caused by the same virus as chickenpox, affects roughly 1 million Americans each year. As people age, their risk of getting shingles increases, yet many people are completely unaware of the disease. After a person gets the chickenpox (most often during childhood) the inactivated virus can live on in certain nerve cells in the body. In healthy people, the body’s immune system usually keeps the virus at bay. As people age or their immune system becomes compromised, the virus can reactivate and result in shingles. Although seniors are at higher risk, shingles can affect people of all ages. a kid? What to look for The first signs of shingles may not be visually noticeable. People often experience tingling, burning, itching or pain and will break out in a rash. Some people experience post-herpetic neuralgia, long-term nerve pain that can persist for months or even years after the initial rash. The older a person gets, the more he or she is at risk for post-herpetic neuralgia. Shingles patients are often given analgesics along with antiviral medications for treatment. Antiviral medicines for shingles may help speed up healing and reduce pain in some patients. Treatment should begin within 72 hours of the onset of symptoms if possible. WHT Caution for older women While the disease affects the sexes equally, its greater impact on older adults should capture the attention of women. “Women make up almost 70 percent of the population 85 years and older, so any condition that is prone to strike older people is of special concern to women,” says Phyllis Greenberger, MSW, president and chief executive officer of the Society for Women’s Health Research. “Older Americans should talk to their healthcare providers about their risk for shingles.” Learn more! The Society for Women’s Health Research (SWHR), a national nonprofit organization based in Washington, D.C., is widely recognized as the thought leader in research on sex differences and is dedicated to improving women’s health through advocacy, education and research. To find this article and more, visit www.swhr.org. >> Jennifer Wider, MD, is a medical advisor for the Society for Women’s Health Research in Washington, D.C. www.womenshealthexperience.com I like to look like a woman and not be reed thin. I like to look like I have a butt and hips. 10 women’s health today No-nonsense healthy living! By Bonnie Siegler >> At age 37, actress Gabrielle Union has learned from her past experiences—some good, some bad—and she’s always come Case in point: She turned a violent episode at age 19 into an opportunity to use her celebrity as an advocate for rape crisis centers throughout America. And her family history of diabetes has put Union on the fast track to healthy eating. “A lot of my family illnesses stem from obesity, and diabetes is rampant in my family,” says the Neutrogena spokesperson and co-star of ABC’s now-defunct sci-fi series “FlashForward.” “That’s why I’m diligent about working out and eating right. I’m aware of my genetics. And nobody knows your body better than you do, so if you know you have a history of breast cancer [my aunt had stage 2], diabetes, heart disease or whatever, you should definitely take a proactive approach. I get regular mammograms and I get my blood checked for diabetes. You have to be your own guideline.” © Roberto D’Este/Corbis Outline out a winner. continued on page 12 >> www.womenshealthexperience.com 11 continued from page 11 What a real woman eats A reason to smile Friends play an integral part in Union’s life. They keep her grounded and “real” and give meaning to what matters. “I’ve always had a large group of girlfriends,” says the actress. “I never knew how lucky I was until I started acting on location without easy access to friends. I never felt lonelier. My friends are my lifeline; they’re the oil and the gas that make me go and move forward.” And she does—with her trademark smile, which came after years of corrective braces. “I love my smile,” Union says. “After being tormented about my buckteeth for years and getting the braces off when I was 14, I’ve been smiling ever since.” On the flip side, Union says her biggest flaw is that of so many other women. “We stare in the mirror and look at cellulite,” she laughs. At 5 feet 8 inches, Union’s nutritional staples include leafy greens, peanut butter, morning protein shakes topped with flaxseed and an occasional calcium supplement. “Always rice drink,” she says with her gleaming dimpled smile. “I’ll have my granola with that in the morning. No coffee because I don’t do caffeine. I always have organic fruits and veggies around, but I have to be honest …” she trails off and then exclaims, “I refuse to give up real butter or ground beef. So there you have it! If you want to switch to turkey, go ahead, but Exercising her options I can’t do it. If I want tacos or a A former high school athlete burger, I need ground beef.” who played soccer, track, basAbout 10 years ago, Union ketball and other sports, Union’s says, her body stopped being love of fitness and competitive able to efficiently process dairy, skills were sharpened at an early so she’s done away with whole age. “I love to work out,” she milk. “I still have butter and admits. “I do cardio on the cheese but just deal with the side elliptical about five days a week, effects later on. And instead of but my routine varies day to day. I love my smile. eating the whole tube of cookie If I’m on my own, it’s usually 45 After ... getting the dough, I might have a spoonminutes of cardio, alternating braces off when I ful. I’m not completely denying between arm and leg exercises was 14, I’ve been myself. That’s not the way to and at least 15 minutes of smiling ever since. live. I like to look like a woman stretching at the end. If I’m and not be reed thin. I like to working out with my trainer, it’s look like I have a butt and hips and if that size 2 dress cardio intensive. Sometimes it’s kickboxing, sometimes doesn’t fit because I’m a real adult woman in a size 6, a track workout.” that’s okay with me.” While her sports-playing days are behind her, Obsessing over weight just isn’t Union’s make-up. Union credits their influence in giving her an edge Her numbers on the scale go up and down. “It depends in both her life and career. “Sports bring together all upon my level of fitness at the time. I do like to be a different kinds of people from different backgrounds. size 28 jean but there are times I’m a 30 and there are You need to find out how to work together for a times I’m a 27. I try not to obsess over it. Being honest common goal, and that skill set is always with you,” about my size means I’m enjoying life. Sometimes that she says. “I’ve learned how to deal with my competitive involves a nice bottle of wine with some cheese and nature in a positive way. It prepared me to deal with good conversation with friends.” rejection with class and dignity. WHT 12 women’s health today © Jack Chuck/Corbis Outline Does that mean she’s given up on sugar? “Absolutely not! But I don’t have a lot of sugars in what I’m eating. I don’t go overboard. I also don’t eat a lot of processed foods, which have high sugar and sodium counts.” YWouromen’ Update in s Health PRESENTED BY TM A biweekly radio program Alternate Sundays, 8:30–9 a.m. on 101.9 FM Hosted by Mickey Karram, MD President and Co-Founder, Foundation for Female Health Awareness Director of Urogynecology, The Christ Hospital, Cincinnati Join Dr. Karram and his guests from The Christ Hospital as they explore a variety of topics essential to your health. Check out new audio from recent programs—available now at www.WomensHealthExperience.com. healthy hearing organ donation Guest: Lisa D. Cahill, Phd, CCC-a, Audiologist, The Christ Hospital Guest: michael a. cardi, md, Medical Director of Transplantation, The Christ Hospital healthy vision disorders of the digestive system Guest: michael e. daun, md, Ophthalmologist, The Christ Hospital building strong bones and osteoporosis prevention Guest: thomas j. redington, md, Internal Medicine Specialist, The Christ Hospital female sexual dysfunction Guest: ronald hirth, MD, Obstetrician/ Gynecologist, The Christ Hospital pelvic floor/core rehabilitation Guests: kathleen novicki, Physical Therapist, Administrator, Center for Pelvic Floor and Core Rehabilitation Services lisa johnstone, Physical Therapist, Center for Pelvic Floor and Core Rehabilitation Services SPONSORED BY Guests: martha ferguson, md, Colorectal Surgeon, The Christ Hospital karen haberthier, MD, Gastroenterologist, The Christ Hospital managing menopause Guests: kenneth e. palmer, MD, Obstetrician/Gynecologist, The Christ Hospital donna m. cirasole, md, Obstetrician/ Gynecologist, The Christ Hospital heart and circulatory system disorders Guests: peter engel, MD, Medical Director of Pulmonary Hypertension, The Christ Hospital eugene chung, md, Medical Director of Outcomes, The Christ Hospital Heart and Vascular Center www.womenshealthexperience.com IN CONJUNCTION WITH 13 HEALTHY BITES Exotic harvest Take a vacation from the usual fruits and veggies >> Apples, oranges, tomatoes and broccoli certainly offer plenty of vitamins, So why not explore some more exotic offerings? Make these simple substitutions the next time you’re food shopping. If you can’t find them in your market, ask the produce manager to help you or check a local ethnic market. minerals and fiber, but eating them all the time can get boring. > If you like > If you like > Try Asian pears > How they taste crisp, juicy, slightly sweet and tart > What to look for The most popular variety, the Japanese pear, is round with smooth, yellow skin. Pick the most fragrant fruit that feels firm, with few or no brown spots. 14 women’s health today pomegranates > If you likE cantaloupe > Try star fruit > How they taste like a mix of plums, pineapples and lemons > What to look for Choose firm, evencolored fruit with shiny skin and light brown rib edges. > Try passion fruits > How they taste tangy, similar to guava, with a strong aroma > What to look for Passion fruits are egg-shaped, with wrinkled purple-brown skin and seeds and orange pulp. Pick large, heavy, firm fruit. > If you likE peaches > Try mangoes > How they taste like a mix of peach and pineapple > What to look for Select firm, plump fruits that give slightly to pressure. Ripe mangoes have a fruity aroma at the stem end; those with a yellow tinge have the best flavor. Images aon pages 14 and 15 © istockphoto.com/Kelly Kline/RedHelga/ Javier Fontanella/Joan Kimball/Scott Harms/Jill Chen/Kae Horng Mau apples Bored with apples, oranges and tomatoes? Explore some more exotic fruit and vegetable options instead. > If you like > If you like green peppers > Try edible cactus > How they taste similar to a green pepper > What to look for Purchase small, firm, pale-green cacti with fleshy, oval leaves and no wrinkling. Skip limp or dry ones. summer squash > If you like tomatoes > Try tomatillos > How they taste slightly acidic, with a hint of lemon > What to look for Tomatillos resemble small, unripe green tomatoes. Pick one with an intact, tight-fitting light brown husk. > Try chayote squash > How they taste Chayote squash doesn’t have much taste, which makes it perfect to mix into most dishes. > What to look for This pale green vegetable is about the size and shape of a large pear with slight ridges running lengthwise. Select small, firm, heavy, unblemished squash. > If you like carrots > Try jicama > How they taste similar to a pear; when cooked, jicama takes on the flavor of other ingredients > What to look for Look for a firm tuber that looks like a turnip or radish with dry roots and unblemished skin. www.womenshealthexperience.com 15 Sweet talking >> Tips for battling bad breath Help yourself to garlic chicken at dinner, and you won’t wonder why your breath is less than, And, of course, it’s nothing that a little time and a good toothbrushing won’t remedy. But chronic halitosis is another story. Bad breath can be caused by anything from gum disease to postnasal drip to a rigorous exercise session to diabetes. Another common trigger is dieting (in particular a high-protein, low-carbohydrate diet), which causes the body to burn fat and produce by-products that cause well, fresh. Brush up … and down. Carry a toothbrush and a small tube of toothpaste with you and brush after every meal. Don’t forget to brush the roof of your mouth as well as your tongue. bad breath. Eating less also reduces saliva production; this, in turn, contributes to halitosis because saliva is necessary to flush bacteria from the mouth. (Ironically, mouthwashes with a high alcohol content actually can cause halitosis by drying the mouth.) Stress can bring on foul breath by causing changes in body chemistry. And some medications can be culprits. What can you do to avoid this embarrassing problem? Besides avoiding spicy foods, garlic, onions and alcohol, these strategies can help: Quit smoking. Stopping will bring instant breathfreshening results. See your dentist regularly. In addition to professional cleanings, regular exams by your dentist will ensure that any tooth or gum problems are detected and treated promptly. Floss. Flossing removes particles between teeth that otherwise decay and contribute to halitosis. What next? Drink up. Water works magic on the body—and your breath. Drinking at least eight glasses a day can keep your mouth moist and help rid it of bacteria. 16 women’s health today Bad breath that won’t go away despite the steps described here should be checked out by your dentist or healthcare provider to rule out any underlying causes. © istockphoto.com/Jacob Wackerhausen >> Top joint injuries and how to avoid them >> Athletes aren’t the only people at risk for torn ligaments and Everyday activities such as gardening and housecleaning can cause strains, sprains and other injuries. Beware of these common injuries and take steps to prevent them: twisted ankles. >> Knee injuries: To avoid ligament and tendon injuries, meniscus tears, bursitis and patellar injuries, choose shoes that fit and are appropriate for your activity. Use protective gear such as cushions for gardening or knee braces for hiking. shoulder-width apart. Do a slow push-up. Hold for a count of five. Repeat five times. • Shoulder press-ups—Sit in a chair with armrests, feet on the floor. Use your arms to slowly rise up and off the chair. Hold for a count of five. Repeat five times. >> Twisted ankles: Approximately 25,000 people suffer a sprained ankle every day, whether due to stepping on an uneven surface or playing sports. To protect your ankles, warm up before activities, pay attention to where you’re walking and be extra careful when you walk in heels. >> Shoulder injuries: Any activity that involves repetitive, overhead motions, such as washing windows, can cause a shoulder injury. Sports like swimming can also leave you with problems such as shoulder instability or dislocation or a rotator cuff injury. To fend off problems, try these exercises: • Wall push-ups—Stand facing a wall with your hands on it, feet repetitive motions such as knitting, golfing or typing. To protect your wrists, be extra careful when walking on slippery or uneven surfaces. Limit the time you spend on activities involving the wrist or take frequent breaks. >> Tennis elbow: Most people who >> Wrist injuries: Two common problems: sprains (often the result of a fall) and carpal tunnel syndrome, a repetitive motion disorder. Sprains occur when the ligaments connecting bones are stretched. Carpal tunnel syndrome occurs when tendons in the carpal tunnel, a narrow channel that runs through the wrist, swell and press on the nerves. It’s often caused by get tennis elbow—inflammation of the tendons surrounding the elbow—don’t even play tennis. You can get it after doing repetitive motions like raking or painting. Guard against tennis elbow with exercises that strengthen the forearm and wrist. Warm up before activity and take regular breaks from your computer, sewing machine or garden. WHT Don’t let joint pain get you down! If joint pain is impacting your quality of life, it may be time for you to see a specialist. Orthopedists are physicians who specialize in surgical and nonsurgical treatment of joint injuries. To find a Christ Hospital orthopedist near you, call our physician referral line at 513-585-1000. www.womenshealthexperience.com 17 HEALTHY MOVES In fitness and in health Double the pleasure and shape up together >> It can help you maintain a healthy weight; sleep better; improve your strength, energy and endurance; relieve stress and anxiety; and reduce your risk for heart disease, cancer and osteoporosis. So, if exercise can do all that, why is it that two out of three of us don’t get nearly enough or any at all? Lack of time, motivation and enjoyment are among the top reasons people don’t exercise. One way to get around those barriers is to recruit someone to work out with you—someone to motivate you to make time Exercise is like a magic cure-all. Got kids? You can either book a regular sitter for your exercise time or make working out a family affair by using some of these ideas. Better yet, do both. • Join a gym that offers childcare, classes or playtime for children. • If your kids play organized sports, leave your lawn chairs in the car and walk laps around the soccer field during practices or games. • Bring little ones along for the ride. Use a backpack carrier, a jogging stroller or a child seat or trailer for your bike. • Take family outings that keep you moving, such as bike rides, hikes or paddling adventures. 18 women’s health today in your schedule, cheer you through periods of waning energy, challenge you to improve and, simply put, make it fun! Studies show that people who have the support of a fitness partner exercise more. You’d think twice about skipping your early morning jog if you knew someone was waiting for you at the park. Socializing makes any activity more enjoyable, and a buddy can make trying new things like joining a gym or taking that kickboxing class less intimidating. The couple that exercises together … For many women, a natural choice is their spouse or partner. Getting fit and healthy with your loved one means you can spend more quality time together, deepen your relationship and intimacy and help ensure you really will grow old together. Your first step is to sit down with your calendars and determine when you can get together. It may not be realistic to meet up for every workout, but schedule a shared workout at least once or twice a week, even if it’s just for a walk around the neighborhood. Next, decide what you’re going to do. Joining a gym or taking classes together is a great way to get into the fitness habit. In your quest to find activities you both like, keep an open mind and explore each other’s interests. Has your guy been trying to get you to take up golf? Eager for him to chill and try yoga? Encourage each other and work as a team. Don’t push When you’re both beginners, it eliminates the tension that can arise when one person is the expert. your other half beyond his capabilities or allow competitiveness to cause a rift in your relationship. Have fun! Try some of these ideas to keep you and your partner in shape: • Plan an immediate reward. If you can’t get your mate to start moving, find local events to attend together that make a perfect excuse to get out for a walk, such as a music festival in the park or a church carnival. • Forgo passive Friday night dates. Instead of dinner and a movie, head to the roller rink or dance hall and boogie the night away. • Team up. Many communities have adult coed recreation teams, such as volleyball, softball, bowling or soccer. Find one you can both enjoy. • Tap into your competitive edge. Enter competitions together, such as road races and tennis, bowling or golf tournaments. Many competitions have a couples category. • Book an adventurous vacation. Consider an invigorating getaway, such as skiing in the Rockies, sea kayaking in Hawaii or trekking through the European countryside. • Double date. Find another couple to join you for a weekly game of tennis or golf. • Learn a new sport or activity together. When you’re both beginners, it eliminates the tension that can arise when one person is the expert and the other is the novice who’s doing it wrong. Consider trying tae kwon do, in-line skating or dancing. • Dive into the water world. When you think of heading to the beach, do you envision lying listless on the sand for hours? Water sports can be quite vigorous and tons more fun. Get off your towels and try surfing, snorkeling, windsurfing or sailing. • Give the gift of fitness. Are you always at a loss for what to give your man for holiday and birthday presents? Think of all the sports gear you could give like hiking boots, in-line skates, a mountain bike, workout wear and more. • Set ultimate goals. Completing a marathon or reaching the peak of a mountain might have seemed far-fetched at one time, but when you’re both working toward a common goal, anything is possible. • Be charitable. Take part in fitness events for worthy causes important to both of you, such as the March of Dimes’ March for Babies or Relay For Life for the American Cancer Society. WHT www.womenshealthexperience.com 19 Hormone help >> >> Balancing the scales Ease menopausal symptoms, prevent heart disease, look younger, boost sex drive—what wasn’t to like? But ever since a large-scale federal study threw cold water on some of these claims and linked HT to a range of health risks, making the right decision has been a balancing act. Here’s what you need to know if you plan on discussing HT with your healthcare provider: Could menopausal hormone therapy (HT) be right for you? The good When it comes to treating the main symptoms of menopause—hot flashes, night sweats, vaginal dryness—HT is the gold standard. It also wards off osteoporosis, improves cholesterol and cuts colon cancer risk. The bad Some HT (estrogen plus progestin) actually raises the risk of heart attack, blood clots and stroke. It also increases your chances of developing breast cancer and, if you’re 65 or older, dementia. No evidence proves that it reduces wrinkles or improves sex drive. And, the evidence is still out on estrogen alone. Need help weighing the options? Call The Christ Hospital physician referral line at 513-585-1000 to find a gynecologist near you. 20 women’s health today The murky In the federal study, for every 10,000 women, HT (estrogen plus progestin) led to seven additional cases of heart disease, eight cases of breast cancer and stroke and 18 cases of blood clots each year. That means that while the risks are real, they’re relatively low for any individual woman. Another tough call: For some women, improvement in menopausal symptoms may be offset by side effects like bloating, bleeding or breast tenderness. Age also matters: Heart risks appear greater for women older than age 60. The upshot There are no easy answers, and what’s right for other women may be wrong for you. Your provider will help you weigh the risks and benefits. If you have heart disease, breast cancer or a history of blood clots, you should avoid HT, and if you have a family history of these diseases, the risks of HT might outweigh the benefits. But if you’re at low heart disease or cancer risk and your menopause symptoms are getting the better of you, HT may be the way to go. If you choose HT, work with your healthcare provider to determine the lowest possible dose to relieve symptoms, and take it for the shortest time necessary. Summer essentials 4 warm-weather must-haves >> It’s summertime and the living is easy—until you end up with sunburn, bug bites, rashes or The best way to counter them? Be prepared. Stock up on these medicine-cabinet essentials: cuts. © istockphoto.com/Judy Picciotto/Christine Glade MUST-HAVE WHAT TO LOOK FOR APPLY IT 1 Sunscreen Choose sunscreen that’s water resistant, has an SPF of at least 30 and is broad spectrum. And don’t forget lip balm with an SPF of 30 or higher. Slather an ounce (about a shot-glass full) on sunexposed areas of the body 15 to 30 minutes before heading out. Reapply every two hours or as soon as you towel off from a swim or after heavy sweating. 2 Bug repellent If you’re spending more than three to four hours outside or you’ll be in a spot with plenty of insects, try a product with 20 percent to 50 percent of the chemical DEET. If you plan to spend less time outdoors, look for repellents with less than 20 percent DEET, lemon eucalyptus oil or 7 percent picaridin. Spray just enough to cover exposed skin and clothing. Don’t wear it under your clothes and don’t spray it on your face. The Environmental Protection Agency has deemed it safe for human use—just apply the product exactly as directed. The American Academy of Pediatrics says don’t use anything higher than a 30 percent concentration of DEET on children, and don’t use DEET on kids under age 2 months or lemon eucalyptus oil on those under age 3. 3 Poison ivy prevention Over-the-counter bentoquatam lotion (Ivy Block®) forms a coating on the skin to help block poison oak, poison ivy and poison sumac oils from triggering rashes. Put it on 15 minutes before you head out and reapply at least once every four hours for as long as you may be exposed to the plants. Bentoquatam is flammable, so stay away from fires and open flames when applying or wearing it and ask a healthcare provider before using it on children younger than age 6. If you do come in contact with poisonous plants, wash your skin in cool water as soon as possible. 4 Antibiotic cream Antibiotic creams such as bacitracin, Neosporin and Polysporin keep a wound’s surface moist and help keep infection-causing bacteria from getting in. Minor cuts and scrapes will heal fine without creams, but these products may help speed healing and reduce scarring. Put a thin layer on the wound after cleaning it. If you want, cover it with a bandage. Long or deep cuts and those that won’t stop bleeding should be checked out in the emergency room. www.womenshealthexperience.com 21 Postpartum problems? Join the club! >> You’re no longer constantly getting up at night to go to the bathroom, your heartburn is gone and you can finally see your toes. But has anyone ever told you that with the end of pregnancy comes a whole range of other problems? Learn more here: Sweating >> What you can do: Drink lots of water to keep from getting dehydrated. Wear light cotton clothing to bed and crank up the fan. Women: Learn more! Find more pregnancy and general women’s health information at www.TheChrist Hospital.com/women. 22 women’s health today Image on page 23 © istockphoto.com/Marc Brown/bubaone/Nicole K. Cioe Sweating is your body’s way of getting rid of excess fluid that accumulated in your body during pregnancy, although hormones also play a part in your ability to soak the sheets. “What happens right after delivery is a mirror image of what happens in menopause, but the process is sped up,” says Paul Gluck, MD, a board-certified obstetrician/ gynecologist and associate clinical professor at the University of Miami School of Medicine. “At delivery, the high estrogen levels of pregnancy drop dramatically, causing the sweats.” The problem may persist for just a few weeks or for as long as you breastfeed. Hair loss When you were pregnant, your locks were more lustrous thanks to hormones that kept your hair from shedding as it normally would. Now that you’ve had your baby, you may find all that extra hair falling out as your hormones change yet again. >> What you can do: Let nature take its course. Most women’s manes are back to normal within three to six months. In the meantime, experiment with different hairstyles to cover any thinned spots and avoid curling irons, hair dryers and other tools that can cause damage. de Quervain’s tenosynovitis Blame the unnatural hand and wrist positions you use to hold your child for that wrist pain. Such awkward motions can cause the tendons in the thumb side of your wrist to become inflamed and swollen, resulting in pain when you turn your wrist, grasp an object or make a fist. Carpal tunnel syndrome, which affects the inside of the wrist, isn’t the same as de Quervain’s (also known as “mother’s thumb”), which involves only the thumb tendon. Between pregnancy and birth, your bladder muscles and supporting tissues are subjected to a fair amount of stretching, so a tinkle when you laugh or cough isn’t uncommon. “Most women who experience some incontinence will find their symptoms resolve within just a few months,” says Dr. Gluck. “While a lengthy labor may have some impact, a woman’s anatomy and the size of the baby have more impact on whether the new mom will have urinary or fecal incontinence.” >> What you can do: Keep your >> What you can do: Urinary thumb and wrist straight with a splint or brace. Apply heat or ice to the affected area. Nonsteroidal anti-inflammatory medications, such as ibuprofen and naproxen, and corticosteroid medications can also help. In more serious cases, physical therapy or surgery may be needed. incontinence usually improves within three months. Ask your healthcare provider how to do Kegel exercises, which help strengthen your pelvic floor muscles. If fecal or urinary incontinence continues beyond a few months, visit your physician to discuss options for resolving the problem. WHT Ask the Expert Both my sister and mother experienced severe postpartum depression. Now that I’m pregnant, I’m terrified of going through that myself. Is postpartum depression hereditary? Incontinence >> Featuring Paul Gluck, MD A: No, postpartum depression (PPD) is not hereditary— 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 differences between the baby blues and this 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. It’s important to remember that PPD is a real physical problem based on a chemical imbalance in the brain, and you should feel no shame or fear in asking your physician for help. And nearly all the medications used to treat PPD can be taken while 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. www.womenshealthexperience.com 23 HEALTH SMARTS Can you hear me now? >> Many people don’t want to admit they have trouble But the fact is, roughly one-third of Americans ages 65 to 74 have hearing loss. Though aging is a primary risk factor, many adults start to lose some hearing in their 30s and 40s. Test your knowledge of hearing loss by answering true or false to these statements and checking your answers. hearing. TRUE or False? 1 Most hearing loss is genetic, and there’s nothing you can do about it. 2 You could have a hearing problem and not realize it. 3 There are many ways to treat hearing loss. 4 Hearing loss can lead to other health problems. 5 Hearing aids don’t work very well. Answers Test your health knowledge online 2 True. The following questions can help you identity a problem: • Do you have difficulty hearing on the telephone? • Do you have trouble hearing with noise in the background? • Do you have a hard time following a conversation when two or more people talk at once? • Do people complain that you turn the TV volume up too high? • Do you hear ringing, roaring or hissing sounds frequently? • Do some sounds seem too loud? 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! 24 women’s health today 3 True. Early detection can help your physician prescribe treatments that can slow or reverse hearing loss. Unfortunately, only 29 percent of adults ages 20 to 69 have had their hearing tested within the last five years. If you think that you have a hearing problem, schedule an appointment with your healthcare provider. 4 True. People with hearing loss often become depressed. Hearing loss can also put you at danger if you can’t hear warning sounds. Beyond health issues, hearing loss prevents people from fully participating in everyday life. 5 False. Newer, digital models, though expensive, use a computer chip to process sounds and are very good at adjusting to different environments. And there are other devices that can be plugged directly into TVs, stereos and personal sound systems to help you hear better. WHT © istockphoto.com/Jill Chen 1 False. Hearing loss can be caused by many things, including infections, some medications and especially exposure to loud noise. Noise-induced hearing loss is 100 percent preventable. Protect your hearing by avoiding noises at or above 85 decibels, which includes gas lawnmowers, snowblowers, motorcycles, firecrackers and loud music. Stay informed Stay connected Stay healthy Presented by the with www.womenshealthexperience.com Women’s Health Experience offers you health news and information just for women! S ign up for a free monthly e-newsletter that delivers the latest health news, trends and tips to your inbox. T est your health smarts on fitness, nutrition, disease prevention and more with online quizzes. T ake our online health assessments to learn your risk for common diseases and conditions. L earn what other women are thinking by participating in our online health polls. Find out what the Women’s Health Experience can do for you! It’s all here—and it’s all for you at www.womenshealthexperience.com TM {It’s been much more fun living without it.} Don’t let neck pain keep you from enjoying life. The experts at The Christ Hospital Spine Institute use a multi-disciplinary approach to diagnose and treat people who suffer from chronic neck pain. Our team of physicians, radiologists, surgeons and physical therapists work together to pinpoint the most effective treatment for each patient. Whether that involves surgery, non-surgical options, physical therapy or rehabilitation, we serve every patient with a commitment to Caring Above All. SM Call to schedule an appointment. 513.585.BACK SM Caring Above All. 2139 Auburn Avenue | Cincinnati, OH 45219 | www.ChristSpineInstitute.com
© Copyright 2024