Women's Health Today

healthtoday women’s

Spring 2009

Fact vs. fiction The truth about 7 health myths

Laura San Giacomo puts family first page 10

Detecting ovarian cancer Earlier is better

Pump it up!

Add some weight to your workout

The Christ Hospital 2139 Auburn Avenue Cincinnati OH 45219

non-profit org us postage Paid cincinnati oh Permit #5489

in this issue . . .

2

LETTER FROM THE FOUNDER

The joys and pains of being a woman

3

Screening saves lives

Get tested for carotid artery disease

4

Stand straight!

You’ll look and feel better for it

6

HEALTH HEADLINES

8

Feeling the (heart)burn?

9

SEX & GENDER MATTERS

What’s making news in women’s health Antacids aren’t always the answer

Coping with economic crisis

10

C O V E R S T O R Y

Busy beyond belief But Laura San Giacomo loves every minute of her hectic lifestyle!

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HEALTHY BITES

No-guilt nibbles

16

Ovarian cancer clues

Don’t ignore these symptoms

Tasty tidbits

18

7 medical misconceptions

What you don’t know can hurt you

20

Something under your skin?

The truth behind bothersome lumps and bumps

21

Don’t stress over this test

22

HEALTHY MOVES

Do your body some good

24

HEALTH SMARTS

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8

14

Lift that weight!

Puzzling periods

21

healthtoday women’s

Letter from the founder

t h e m aga z i n e o f t h e f o u n d a t i o n f o r f e m al e h e al t h a w a r e n e ss

The joys and pains of being a woman

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ou don’t need me, as an Ob/Gyn, to tell you about all the joys of womanhood. But being a woman sometimes brings health risks not faced by men. Ovarian cancer is one threat that many women

fear. While an estimated 15,500 women died from the disease in 2008, the five-year survival rate for women who are diagnosed in the earliest stages—when the cancer is still localized—is almost 93 percent. Now that’s a statistic worth repeating. The early detection of ovarian cancer is the major contributor to this heartening figure. Read about one patient’s story and learn the early warning signs in “Ovarian cancer clues” on page 16.

Eating right is another proven way to stay healthy. If you’re a snacker, see “Tasty tidbits” on page 14 to find nine guilt-free, satisfying foods. Also in this issue of Women’s Health Today, you’ll find articles on

antacids (“Feeling the [heart]burn?”, page 8), skin issues (“Something under your skin?”, page 20) and body building (“Lift that weight!”, page 22) along with more timely and easy-to-understand health information.

We aim to cover a wide variety of health-related topics in Women’s Health Today; let me know what topics you’d like to read about in future issues. I’d love to hear from you!

Founders

Mickey M. Karram, MD

/

Mona Karram

National Advisory Board

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 Linda Brubaker, MD,

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 T h e C h r i s t H o s p i t al S T A FF

President and CEO Susan Croushore Vice President, Operations Victor DiPilla CNO/Vice President, Nursing Deborah Hayes Vice President, Marketing and Community Relations Heather Adkins Vice President and Chief Medical Officer Berc Gawne, MD Editor Arin Kraemer customer service

For more information about services at The Christ Hospital,

Sincerely,

please contact Arin Kraemer at arin.kraemer@thechristhospital.com 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 5, Issue 2. © 2009 by The Christ Hospital and the Foundation for Female Health Awareness. All rights reserved.

The information contained herein is not a substitute for professional

Mickey M. Karram, MD PRESIDENT AND Co-Founder Foundation for Female Health Awareness 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.

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 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 regional conferences, Women’s Health 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 of medical studies.

Sign up now at www.womenshealthexperience.com. co v e r : L A U R A S A N G I A C O M O © 2 0 0 9 F r an k O c k enfels

Women’s Health Today

Please Recycle This Publication

Screening

saves lives G et tested f o r carotid artery disease

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rudy Williams never dreamed she had carotid artery disease, but a simple vascular screening showed that her right carotid artery was more than 90 percent blocked.

“Carotid artery disease occurs when plaque lines the arteries on either side of the neck—the carotid arteries,” says Robert Bulas, MD, medical director of vascular neurointervention at The Christ Hospital in Cincinnati. A potentially life-threatening stroke is often the disease’s only symptom: Plaque or a blood clot breaks off, blocks smaller blood vessels and cuts off blood supply to the brain.

Williams’ disease was discovered through a vascular screening of her neck, abdomen and legs before a stroke could occur. Additional tests showed blockages in her chest. Williams underwent quadruple bypass surgery last fall, followed by carotid artery surgery.

She says of the results, “I feel 100-percent better now.” While she’d been considering retirement before her surgeries because of her extreme fatigue, Williams happily returned to work in January.

Risk factors Carotid artery disease screening uses painless ultrasound technology to create images using sound waves. If you’re at risk, discuss screening with your physician. Risk factors include smoking, high blood pressure, diabetes and high cholesterol.

“Anything greater than a 70 percent blockage typically requires surgery,” says Dr. Bulas. If stroke symptoms are present—blindness, weakness, numbness or speech difficulties—surgery or stenting may be needed even if the 70 percent threshold isn’t met.

Your age and health also help determine treatment.

A multidisciplinary approach If you need treatment, choose a multidisciplinary center like The Christ Hospital, where physicians offer several treatment modes, including: • Carotid endarterectomy. Typically for younger patients like Williams, endarterectomy involves an open-neck incision under general anesthesia. A surgeon shaves plaque from artery walls to restore blood flow.

• Carotid stenting. A thin tube is placed through a small opening in the carotid artery to restore blood flow. Stenting may be preferred if a blockage is hard to reach, endarterectomy was performed previously or general anesthesia would create excessive patient risk.

“The best way to prevent carotid artery disease and its consequences is to see your primary care physician regularly to identify and treat high risk factors such as high blood pressure,” says Dr. Bulas. WHT

Don’t delay this screening!

To schedule a vascular screening at The Christ Hospital, call 513-936-5291. The Christ Hospital offers a low-cost arterial ultrasound to check arteries in the neck, abdomen and legs. To find a physician, call The Christ Hospital physician referral line at 513-585-1000.

Robert Bulas, MD, is medical director of vascular neurointervention at The Christ Hospital in Cincinnati.

www.womenshealthexperience.com

Stand

straight!

You’ll look and feel better for it

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s a child, you were probably told to stand up straight. That’s still great advice: Standing erect and sitting properly can help reduce stress on joints, ward off muscle pain and improve balance to prevent falls.

You’ll feel the price of poor posture. Painful, achy joints steal your sleep and lead to irritability and fatigue. Hunching or tilting to one side makes you vulnerable to falls. Unbalanced pressure on spinal disks can cause neck, back and shoulder pain.

Improper alignment can contribute to musculoskeletal diseases such as osteoarthritis, rheumatoid arthritis, osteoporosis, herniated disks and degenerative disk disease.

The aging body Physical changes that occur with age and lifestyle habits can lead to slouching. With passing birthdays, people typically experience the following:

• Muscles shrink and lose mass. Strength diminishes and reflexes slow.

• Bone loss outpaces bone building. Bones lose density and strength and break more easily.

• Ligaments, which connect bones at joints, lose elasticity.

Overall flexibility diminishes.

• Activity decreases. People tend to move less and in more repetitive ways. Some muscles stay strong while others weaken.

The result? Your body loses correct alignment, putting you at risk for musculoskeletal disorders and pain.

Checking your position The way you hold your body—standing and sitting—is key to proper posture. Michael T. Rohmiller, MD, orthopedic surgeon at The Christ Hospital in Cincinnati, suggests addressing your alignment with these assessments and guidelines: • Stand tall. Stand in front of a mirror. Breathe

Beware boomeritis Today’s older adults are far more active than previous generations— and they have the aches and pains to prove it. In fact, sports injuries like tendinitis and bursitis have become so common among the over-50 set, there’s a name for the condition—boomeritis.

Some injuries result from years of overuse or repetitive movements. Others happen when out-of-shape weekend warriors try to get back in the game like they did when they were younger. You can stay active and pain free and

Women’s Health Today

avoid getting sidelined by boomeritis by following these tips from Dr. Rohmiller: • Gear your workouts to your own fitness level and goals.

• Know your weak link, such as a previously injured joint, and avoid activities that may strain it.

• Mix up your exercise routine for balanced fitness. Include cardiovascular activities (walking or jogging), strength training (lifting weights) and flexibility exercises (stretching or yoga).

• Choose low-impact aerobic activities like biking, swimming or dancing.

• Warm up before exercising.

• Check with your physician to be sure you’re getting enough calcium and vitamin D to maintain bone strength. Add dietary supplements if necessary.

deeply and relax. Is your head straight and are your shoulders and hips level? Do you see equal spaces between your arms and sides? Do your kneecaps face forward and are your ankles straight?

• Sit smart. Position yourself correctly when seated, especially if you use a computer. Use a pillow to support your lower back. Adjust your chair so your feet are flat on the floor and your knees are at a 90-degree angle. The top of your screen should be level with the top of your head.

Improve your posture Maintaining good posture through the years calls for conscious effort. Exercising regularly to keep your muscles strong and flexible and to maintain good balance is key to holding and carrying your body correctly. Dr. Rohmiller suggests these exercises to help you improve and maintain correct body alignment: • Strengthen core muscles. The strength of your core, especially your abdominals, is key to back stability. To strengthen them, lie on your back with your arms at your sides. Using your abdominal muscles to lift your head, neck and shoulder blades off the floor, slowly curl up. Repeat 15 times.

• Boost your balance. Wear sturdy shoes to practice this exercise: Grasp a countertop or the back of a chair. Stand on one leg for one minute; switch legs.

As you improve, increase the time, close your eyes or don’t use an object for support.

Many people with chronic pain, particularly back pain, can trace their problem to faulty posture.

Self-care efforts to improve alignment may not be enough to undo years of slouching and bad habits like carrying an overloaded shoulder bag, but you can keep poor posture from getting proIf you have back pain that’s severe, doesn’t improve with rest, is gressively worse by taking the steps accompanied by numbness and tingling or occurs after a fall or an injury, call The Christ Hospital Spine Institute at 513-585-BACK. mentioned here and visiting your physician. WHT

Don’t back down from pain!

Michael T. Rohmiller, MD, is an orthopedic surgeon with The Christ Hospital Spine Institute in Cincinnati.

www.womenshealthexperience.com

what’s making news in women’s health

healthhead It’s tough, but you can quit smoking

K

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here’s been buzz for years now around the heart-healthy Mediterranean diet.

Olive oil is usually thought to be the secret ingredient that makes the diet so healthy, but it turns out that nuts may be the key.

Researchers in Spain studied more than 1,200 people ages 55 to 80 at high risk for cardiovascular disease. About two-thirds of the participants also met criteria for metabolic syndrome: They had abdominal obesity, high cholesterol, high blood pressure and high glucose levels. The researchers divided the participants into three groups. They gave the control group advice on a low-fat diet and the other two groups received information about the Mediterranean diet, which includes plenty of cereal, vegetables, fruits and olive oil; a modest intake of fish and alcohol; and a small amount of dairy, meats and sweets. One of the Mediterranean diet groups was also given one liter a week of virgin olive oil; the other got 30 grams a day of walnuts, hazelnuts and almonds. After a year, the prevalence of metabolic syndrome dropped by 14 percent in the mixed-nut group, 7 percent in the olive oil group and 2 percent in the control group. No one lost weight, but the number of people in the Mediterranean-diet groups who had a large waist circumference, high triglycerides (a type of blood fat) and high blood pressure dropped compared to the control group.

Women’s Health Today

© 2009 Jupiterimages

Nuts: The secret to a healthy heart?

icking the smoking habit can be especially tough for women. Dealing with the intense withdrawal symptoms such as depression, irritability, anxiety, lack of energy, concentration problems and weight changes can be challenging. But you can quit—even if it takes several attempts. Try these four tips to help you succeed: • Set a quit date or vow to quit within a certain time frame, like 30 days.

• Use quit-smoking aids such as nicotine patches and gum, inhalers, nasal sprays or medication to double your chances of success.

• Seek help from an expert, such as a tobacco treatment specialist. He or she can create a treatment plan, which may include counseling or other aids, tailored to your needs.

• Build a network.

Friends, family, coworkers and online support groups can be an enormous help during this difficult time.

lines No stopping teen tanning

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tate laws aimed at restricting teen access to tanning booths and beds just aren’t working, say researchers from the American Cancer Society and other organizations. They conducted nationwide phone polls in 1998 (when tanning restriction laws were first being introduced) and 2004. They asked more than 2,800 kids ages 11 through 18, as well as their parents and guardians, whether the teens had used an indoor tanning facility or sunlamps in the past year. The dismaying results: During that six-year period, indoor tanning habits remained virtually unchanged—regardless of whether the state had teen tanning laws. Why aren’t the laws working? It’s likely because teens can lie about their age and tanning facilities may not be asking patrons how old they are. Cancer experts recommend banning the use of such facilities for minors because indoor ultraviolet light has been linked to skin cancer. Remind your teen of the cancer dangers of tanning and how it ages skin, and encourage him or her to embrace his or her natural hue.

Find out more at the Skin Cancer Foundation’s “Go With Your Own Glow” Web site at www.skin cancer.org/Go-With-Your-Own-Glow.html.

Excess pounds can raise your breast cancer risk

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lder women who carry too many extra pounds face a significantly increased risk for advanced breast cancer, according to findings published in the Journal of the National Cancer Institute.

Researchers evaluated data from more than 287,000 postmenopausal women who underwent routine mammograms. The results? Overweight women had a 10 percent to 35 percent higher risk of advanced breast cancer; obese women were 56 percent to 82 percent more likely to develop the condition. Estrogen may be to blame, as overweight women have higher levels of the hormone. In the study, only tumors fueled by estrogen increased across the different weight groups.

www.womenshealthexperience.com

Feeling the

(heart) burn?

A n t a c i d s aren’t always the answer

Ban the burn!

Concerned about heartburn? Call The Christ Hospital’s physician referral line at 513-585-1000 to find a gastroenterologist near you.

Women’s Health Today

As food moves down the esophagus toward the stomach, it has to pass through an opening between the two. This opening should act as an automatic door, closing as soon as food passes through. But if it doesn’t, acid from your stomach can splash back up through the opening and into your esophagus, causing irritation, or heartburn.

• Eat smaller, more frequent meals.

• Lose excess pounds through a healthier diet and exercise.

• Reduce stress with yoga or meditation.

• Avoid triggers such as chocolate, coffee, alcohol, fried and fatty foods, minty foods, carbonated and caffeinated beverages, spicy foods, onions, garlic, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar and pain medications other than acetaminophen.

• Wear clothes that don’t fit tightly around the waist.

• Quit smoking.

• Place blocks under the head of your bed, elevating it 6 inches to 9 inches, to keep stomach acids down. Pillows won’t work as well.

• Wait at least two to three hours to lie down after eating. WHT

© 2009 Veer Images

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aking an antacid or other acid reducer is a quick way to relieve heartburn, but this over-the-counter solution is only temporary.

If these drugs become a long-term fix, they could be harmful to your health.

Antacids and other acid reducers can cause diarrhea or constipation. Long-term, heavy use of certain antacids may lead to excess calcium in the blood, which, in turn, can result in kidney stones and impaired kidney function, according to the Food and Drug Administration. Some antacids and other acid reducers may make blood-thinning medications and other prescription medications less effective.

Finally, soothing your heartburn with over-thecounter drugs may just be masking a more serious problem such as gastroesophageal reflux disease (GERD) or an ulcer. If you’re experiencing frequent heartburn, discuss your symptoms with your healthcare provider. And try the following tips to prevent your heartburn:

A burning question: What is heartburn?

sex & Gender matters The latest findings on women-specific health from the Society for Women’s Health Research

By Jennifer Wider, MD

Coping with

economic crisis

© 2009 Jupiterimages

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he economic crisis is all over magazines, newspapers and the news. It’s no wonder people are feeling anxious and stressed out.

But women may be reacting more strongly than men. A survey from the American Psychological Association (APA) says women are expressing fear about the current financial situation more than men.

Women are reporting physical and psychological symptoms, including sleep disturbances, headaches, mood swings and changes in appetite, in higher numbers than men.

“Women have many roles to play in life. They’re often the primary caregivers for children and the older generations [aging parents], as well as workers in industry,” says Stephanie Smith, PsyD, public education coordinator for the APA. In addition to the caretaking role, many traditional household responsibilities—like cooking, cleaning and laundry—end up falling on women’s shoulders. All of this responsibility can add up to a lot of stress, especially when families are being squeezed financially. (That’s not to say men aren’t stressed out, too. Seventy-five percent of male respondents expressed fear about the economy, compared to 84 percent of women.)

Tools for trying times Since everyone reacts differently to stress, a key to maintaining good health during these times is to

know your own warning signs—the physical symptoms that indicate when your brain and body are experiencing unusual or excessive pressure, such as headaches, exhaustion and depression.

You can take measures to safeguard your health during these difficult times.

Take time out each day to focus on yourself and your own well-being.

Continue going to your aerobics class, eating dinner with your family and participating in social activities.

Don’t cut back on preventive and basic healthcare services. Saving money on health expenditures may seem like a good idea in the short run, but it can lead to serious health problems and enormous bills, making financial matters worse.

To stretch your healthcare dollars, talk to your primary care physician about all your health needs and concerns. If he or she can manage multiple conditions, it can cut down on the number of physicians you visit and related out-of-pocket expenses.

For tips on recognizing and coping with stress, visit www.apahelpcenter.org. WHT

Learn more!

The Society for Women’s Health Research is a nonprofit research, education and advocacy organization that works to improve women’s health through sex-specific research, education and advocacy. For more of the latest news and research on women’s health, visit their Web site at www.womenshealthresearch.org.

Jennifer Wider, MD, is a medical advisor for the Society for Women’s Health Research in Washington, D.C.

www.womenshealthexperience.com

© 2009 Frank Ockenfels

Busy

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Women’s Health Today

beyond

But Laura San Giacomo loves every minute

of her hectic lifestyle!

by Bonnie Siegler

I

t’s 11 o’clock in the morning, and Laura San Giacomo has already been pulled in a million directions.

Her cell phone rings while she’s on her home phone discussing work after hanging up from a call resolving an issue with her son’s school. “That’s what it’s like, each part of my life calls at the same time,” says the 45-year-old award-winning actress with her trademark smile. “But I accept that and know that my days will be filled with tap dancing and plate spinning.”

San Giacomo—best known for her roles in the films “sex, lies and videotape” and “Pretty Woman,” as well as the late NBC sitcom “Just Shoot Me!”—currently co-stars as Rhetta Rodriguez on TNT’s drama series “Saving Grace” alongside Holly Hunter. With Golden Globe nominations and steady work in an unsteady business, her real-life roles as wife to her husband, Matt Adler, and mom to her 12-year-old son, continued on page 12 Mason, bring her the greatest joy.

www.womenshealthexperience.com

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continued from page 11

Family first Mason, who has cerebral palsy, is an integral part of San Giacomo’s everyday life. She’s become a children’s advocate, championing his education and helping found an award-winning charter school in the San Fernando Valley. The school is a proponent of inclusion education, a method where children of all abilities learn together. “Mason loves school, so I followed his lead and that’s what I tried to champion for him,” says San Giacomo. “I’ve seen through his education that everyone learning together is a very valuable experience. We can talk about diversity all we want, but when we’re living it, it’s really no big whoop.”

It takes a lot of stamina to keep San Giacomo’s hectic schedule of filming, raising Mason and keeping her marriage strong, but the New Jersey native has some surefire methods for keeping a low-stress pace. “I laugh in the face of people who say anything about being calm,” she loudly giggles. “We laugh all the time in our house and sometimes it’s a challenge.” One of her tougher trials came when Mason needed hip surgery and muscle repair last December.

“I kept saying everything’s going to be fine. And we did laugh, which helped us all get through it,” says San Giacomo.

Mason’s move from preschool to kindergarten was a pivotal hardship on San Giacomo. “That’s how I learned to mentally front-load—to ask myself, ‘What’s going to help me get through this next transition?’ ” she says. Now she avoids overbooking during busy back-to-school time. “That way, nothing sneaks up and bites me in the butt. I think about life and motherhood and how we want to control all of it. But one of the lessons of motherhood is that you’re not in control. You have to learn to let go of the side of your ego that thinks you can make everything right, and just go with the flow of that particular moment,” says San Giacomo.

of time every evening checking in. We’re available to each other to see how things are going, to discuss decisions. The porch is one way we make sure to have some alone time.”

San Giacomo also loves to zone out in her garden.

“I have a little Buddha sculpture, some paintings that my son has done over the years, some rocks, little turtles, a blue frog and a silver bird sitting on a rock.” To complete the serenity, a blue fairy tile that her mother gave her rests nearby. “Just sitting there and doing nothing is really good for me,” she says.

Giving gratitude Born into a large Italian family, one of San Giacomo’s most vivid childhood memories revolves around “the sound of my mom’s wooden spoon hitting the side of the saucepan—she’d be making sauce, or as we called it, the gravy. It’s a real comforting sound to me now when I’m making my gravy,” she says. “And my son’s really aware of my cooking when he comes home from school. He loves the aroma of garlic, olive oil and onion sautéing.” Her sensory signals take her back to when life wasn’t so hectic. “I’m at a point in my life where I can really see that things have changed,” says San Giacomo. “But I’ve found there’s great power in life-affirming gratitude. I try to teach my son by example that we live in a crazy, modern world, but with a little bit of gratitude, we can obtain a balance.”

While Mason is the primary focus of San Giacomo’s everyday life, the actress still finds the time to maintain her personal health and stamina. She enjoys a game of tennis or golf and occasionally iceskating. But she’s still an active participant in Mason’s education. “At his schools, I’ve seen this great valuing of all people and self worth,” says San Giacomo.

Discovering value and self worth in herself—and others—has paid off handsomely. “I have a sense of purpose and a sense of belonging,” she says. WHT

Helpful hometime The house San Giacomo shares with her family is very much a home, complete with a large back porch, glorious vegetable garden and flowerbeds and a large, airy kitchen. Anxiety reducers here include “me-time” gardening, or just sitting San Giacomo and “Amazing on the back porch spending quality time Grace” co-star with her husband. “Date nights? Who has Holly Hunter. the time?” she asks. “Matt and I spend a lot

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Women’s Health Today

Want fewer urges and leaks in your internal plumbing?

VESIcare can make a difference.

When your bladder muscle is overactive, it can cause those frustrating urges, so you worry your pipes might leak. This can sometimes get in the way of what you love to do.

So it’s harder to always do things spur of the moment. VESIcare, once a day, helps control your bladder muscle, so it can reduce urges and leaks, day and night. If you’ve had enough, talk to your doctor again about taking care with VESIcare.

Important Safety Information

VESIcare is for urgency, frequency, and leakage (overactive bladder). VESIcare is not for everyone. If you have certain stomach or glaucoma problems, or trouble emptying your bladder, do not take VESIcare. Tell your doctor right away if you have a serious allergic reaction, severe abdominal pain, or become constipated for three or more days. VESIcare may cause blurred vision, so take care while driving or doing unsafe tasks until you know how VESIcare affects you.

Common side effects are dry mouth, constipation, and indigestion.

Call (800) 403-6565 or visit vesicare.com and you’ll receive:

Information about overactive bladder $25 savings check* Talk to your doctor guide

Take care e with

Please see important product information on the following page. *Subject to eligibility. Restrictions may apply.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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Healthy bites

Patient Information VESIcare® – (VES-ih-care) (solifenacin succinate) Read the Patient Information that comes with VESIcare before you start taking it and each time you get a refill. There may be new information.

This leaflet does not take the place of talking with your doctor or other healthcare professional about your condition or treatment. Only your doctor or healthcare professional can determine if treatment with VESIcare is right for you.

Tasty tidbits

What is VESIcare®?

VESIcare is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder: • Having to go to the bathroom too often, also called “urinary frequency,” • Having a strong need to go to the bathroom right away, also called “urgency,” • Leaking or wetting accidents, also called “urinary incontinence.”

VESIcare has not been studied in children.

What is overactive bladder?

Overactive bladder occurs when you cannot control your bladder contractions. When these muscle contractions happen too often or cannot be controlled, you can get symptoms of overactive bladder, which are urinary frequency, urinary urgency, and urinary incontinence (leakage).

Who should NOT take VESIcare®?

Do not take VESIcare if you: • are not able to empty your bladder (also called “urinary retention”), • have delayed or slow emptying of your stomach (also called “gastric retention”), • have an eye problem called “uncontrolled narrow-angle glaucoma”, • are allergic to VESIcare or any of its ingredients. See the end of this leaflet for a complete list of ingredients.

What should I tell my doctor before starting VESIcare®?

Before starting VESIcare tell your doctor or healthcare professional about all of your medical conditions including if you: • have any stomach or intestinal problems or problems with constipation, • have trouble emptying your bladder or you have a weak urine stream, • have an eye problem called narrow-angle glaucoma, • have liver problems, • have kidney problems, • are pregnant or trying to become pregnant (It is not known if VESIcare can harm your unborn baby.), • are breastfeeding (It is not known if VESIcare passes into breast milk and if it can harm your baby. You should decide whether to breastfeed or take VESIcare, but not both.).

No-guilt nibbles

Before starting on VESIcare, tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. While taking VESIcare, tell your doctor or healthcare professional about all changes in the medicines you are taking including prescription and nonprescription medicines, vitamins and herbal supplements. VESIcare and other medicines may affect each other.

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hough it’s likely to make you feel guilty, snacking isn’t necessarily a bad thing—unless, of course, your idea of a snack is a big bowl of chocolate ice cream, a bag of potato chips or a generous slice of carrot cake.

Healthy snacking can actually provide you with several benefits, like keeping you from second helpings at your next meal or preventing you from a hunger-fueled cookie binge. The right snack can also give you a much-needed energy boost to get you through the day and be just the right amount of food to replace a meal if you’re older or less active.

When you snack, make sure you do so in moderation—eat a much smaller portion than you’d consume for a meal. And opt for food that gives you a nutrient boost, such as these nine options:

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How should I take VESIcare®?

Take VESIcare exactly as prescribed. Your doctor will prescribe the dose that is right for you. Your doctor may prescribe the lowest dose if you have certain medical conditions such as liver or kidney problems.

• You should take one VESIcare tablet once a day.

• You should take VESIcare with liquid and swallow the tablet whole.

• You can take VESIcare with or without food.

• If you miss a dose of VESIcare, begin taking VESIcare again the next day. Do not take 2 doses of VESIcare in the same day.

• If you take too much VESIcare or overdose, call your local Poison Control Center or emergency room right away.

What are the possible side effects with VESIcare®?

The most common side effects with VESIcare are: • blurred vision. Use caution while driving or doing dangerous activities until you know how VESIcare affects you.

• dry mouth.

• constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.

• heat prostration. Heat prostration (due to decreased sweating) can occur when drugs such as VESIcare are used in a hot environment.

Tell your doctor if you have any side effects that bother you or that do not go away.

These are not all the side effects with VESIcare. For more information, ask your doctor, healthcare professional or pharmacist.

How should I store VESIcare®?

• Keep VESIcare and all other medications out of the reach of children.

• Store VESIcare at room temperature, 50° to 86°F (15° to 30°C).

Keep the bottle closed.

• Safely dispose of VESIcare that is out of date or that you no longer need.

General information about VESIcare® Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use VESIcare for a condition for which it was not prescribed. Do not give VESIcare to other people, even if they have the same symptoms you have. It may harm them.

This leaflet summarizes the most important information about VESIcare. If you would like more information, talk with your doctor.

You can ask your doctor or pharmacist for information about VESIcare that is written for health professionals. You can also call (800) 727-7003 toll free, or visit www.VESICARE.com.

What are the ingredients in VESIcare®?

Active ingredient: solifenacin succinate Inactive ingredients: lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg VESIcare tablet) or red ferric oxide (10 mg VESIcare tablet) Manufactured by: Astellas Pharma Technologies Inc. Norman, Oklahoma 73072 Marketed by: Astellas Pharma US, Inc. Deerfield, IL 60015-2548 Marketed and Distributed by: GlaxoSmithKline Research Triangle Park North Carolina 27709

©2005 Astellas Pharma US, Inc. & GlaxoSmithKline VPI-004 PRT50 January 2008 ©2008 Astellas Pharma US, Inc. and The GlaxoSmithKline Group of Companies AllrightsHealth reserved.Printed inUSA.VS2045R0October2008 14 VES01336-10/08 Women’s Today

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Women’s Health Today

2

1 ñ

Air-popped, unbuttered popcorn

It’s crunchy, it’s tasty and it boosts fiber intake.

3

Hummus

Low-fat yogurt

This chickpea paste is loaded with fiber and makes a great topping for vegetables and pitas.

Get your share of calcium and protein, which can help keep your bones strong and healthy.

4 Low-fat string cheese This easy-to-carry snack offers calcium and protein.

Fruits

Oatmeal

Fruits take little or no preparation, so they’re convenient while providing dietary fiber and a host of vitamins and minerals.

Packed with fiber, this cholesterol- lowering staple isn’t just for breakfast.

7

8

Peanut butter

Carrots or red peppers

Peanut butter serves up protein and vitamin E, an antioxidant that may prevent the oxidation of LDL (bad) cholesterol and boost the immune system.

6

5

You’ll get vitamin A and beta-carotene from carrots and red peppers.

Pair them with fat-free or low-fat dressing.

9 Nuts A handful provides protein, which helps keep you feeling fuller longer. And nuts contain heart-healthy monounsaturated fat.

Just make sure you don’t overdo them, since they’re high in calories.

Berry good smoothie

© 2009 Jupiterimages

Serves 2 This quick and easy snack makes the most of nutrient-filled berries.

Use frozen if fresh ingredients aren’t available.

• 1cup fresh strawberries, hulled and halved, or raspberries • 1medium banana, cut into large pieces • 1cup fresh orange juice (3 medium oranges) In a food processor or blender, puree all ingredients. If your processor or blender can crush ice, add ½ to 2 cups of ice to make a sherbetlike dessert.

Per serving: 132 calories, 2 g protein, 32 g carbohydrates, 0 mg cholesterol, 1 g total fat, 3 g fiber, 3 mg sodium Adapted with permission from The New American Heart Association Cookbook, 25th Anniversary Edition, © 2001 Clarkson Potter/Publishers. Available from booksellers everywhere.

www.womenshealthexperience.com

15

Ovarian

cancer clues D o n ’ t i g n ore these symptoms

I

t was almost 20 years ago that beloved comedienne Gilda Radner died of ovarian cancer. If she had known that the disease, as well as breast cancer, was part of her family health history, she might have noticed the cancer’s subtle symptoms in time to treat it effectively.

Fortunately for the approximately 21,650 women who developed ovarian cancer last year, the prognosis isn’t always that grim. Women diagnosed when the cancer is contained within the ovary face a five-year survival rate of almost 93 percent.

As with all cancers, the key to combating ovarian cancer is early detection. However, patients usually aren’t aware of the symptoms until the cancer is in its mid to late stages. Annual pelvic exams can help detect ovarian cancer, but if you’re at risk, pay special attention to any abnormal discomfort. That was crucial for Louise Trapp of Cincinnati. Now free of ovarian cancer for more than three years, she pursued an initial diagnosis after she began having stomach pain that gradually increased. “I thought it might’ve just been bloating from a meal, but when the discomfort didn’t disappear, I knew I had to see a physician,” says Trapp.

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Women’s Health Today

Watch for the signs Because there’s ample room in the abdominal cavity surrounding the ovaries, ovarian tumors often aren’t detected until they’ve grown large enough to cause one or more of these persistent problems: • indigestion, gas or bloating that can’t be otherwise explained

Your ovarian cancer risk According to the American Cancer Society, your risk for ovarian cancer increases if you are over age 50, are obese, have never given birth or have a personal or family history of breast or colon cancer. Your risk rises if you have a close blood relative (mother, sister, daughter) who had ovarian cancer. Two or more close blood relatives with the disease increase your risk even more, as does a family history of cancer caused by a mutation of the breast cancer gene BRCA1 or BRCA2. Some studies suggest that lengthy use of menopausal hormone therapy with estrogen alone and long-term use of talcum powder in the genital area may also raise your risk.

• swelling or pain in the abdomen • loss of appetite • fullness, even after a small meal • nausea • unexplained weight loss • diarrhea • constipation • frequent urination • pelvic pressure • back or leg pain • abnormal bleeding If any of these symptoms persist, inform your physician. They could indicate ovarian cancer or another disease. Trapp contacted Michael Freese, MD, a Christ Hospital­‑associated boardcertified internist in Cincinnati.

“After ruling out other possibilities, like cystitis or a bladder infection, I was concerned that the diagnosis could be ovarian cancer, based on the increasing abdominal symptoms,” Dr. Freese says.

Trapp quickly scheduled an appointment with Marcia Bowling, MD, a gynecologic oncologist with The Christ Hospital. “Key to early detection of ovarian cancer is persistence on the patient’s and physician’s part to explain and explore the symptoms until a diagnosis is made,” says Dr. Bowling. She advises women to take action if they have any suspicious symptoms. “Look for a new symptom that’s progressive and persistent,” she says.

ASK THE EXPERT Featuring Marcia Bowling, MD

“If you have chronic constipation, that’s probably not ovarian cancer. But if your discomfort gets more intense and more frequent, it’s time to get it checked out.”

Two therapeutic avenues Surgery and chemotherapy are a woman’s two main treatment options for ovarian cancer. However, a physician will consider the patient’s age and general health and the cancer’s stage when determining the best therapy.

• Surgery involves removal of the ovaries, uterus, fallopian tubes and any cancer masses. If possible or if the woman wants to have children, only the affected areas may be removed.

• Chemotherapy uses anticancer drugs that are injected into a vein or taken by mouth. A newer therapy in which additional anticancer drugs are introduced directly into the abdomen through a catheter can be used to treat certain patients.

This allows the chemotherapy drugs to reach the cancer more efficiently while sparing healthy tissue.

Together with your physician, you may decide that a combination of treatments is the best strategy for you. As for Trapp, she underwent six months of chemotherapy after having surgery and has been clear of cancer ever since. WHT

!

Q: Is t h e CA -1 2 5 t e s t a g o o d s c r e e n i n g t o o l f o r o v a r i a n c a n c e r ?

A : No. The CA-125 test measures a protein that’s found more in ovarian cancer cells than in other cells. It’s used in patients who’ve already been diagnosed with ovarian cancer as an indicator of how well they’re responding to treatment or whether their cancer remains in remission after treatment. When used in otherwise healthy women, it produces a high false positive rate and therefore isn’t an effective screening tool for ovarian cancer. www.womenshealthexperience.com

17

Find what you need!

Don’t be fooled by medical myths again! Get access to the latest health headlines and review tips for staying healthy at www.TheChristHospital. com. Click on “Health A-Z” to learn about everything from abdominal pain to X-rays.

medical misconceptions

M

edical misconceptions, old wives’ tales, fear of the unknown— no matter what you call it, this way of thinking prevents some people from getting the medical care they need. Maybe you’re suffering needlessly because of a widely held belief about your ailment, not realizing old treatments have been improved upon.

Here are seven common misconceptions or fears that should be put to rest:

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Women’s Health Today

© 2009 Veer Images

What you don’t know can hurt you

1

2

3

© 2009 Jupiterimages

4

Treat back pain with bed rest. Bed rest is no longer recommended for treating back pain. Experts agree that you should stay active and take overthe-counter pain relievers such as acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory (aspirin, Motrin, Aleve) as needed. In most people, lower back pain goes away in about a month. For severe pain or back pain that lasts longer, see your healthcare provider.

A bland diet is the best way to treat an ulcer. Are you self-treating a gastric ulcer by sipping on cream or milk or eating a bland diet? That’s no way to manage the problem. Ulcers are most often caused by Helicobacter pylori, a type of bacteria that lives and reproduces in the stomach’s lining and the small intestines, causing inflammation. Ulcers may best be healed with an antibiotic to kill the bacteria and drugs such as acid blockers, antacids or proton pump inhibitors to reduce your digestive system’s acid level.

A degenerative disk in the neck is best treated with spinal fusion surgery. Spinal fusion used to be the standard operation to correct a diseased disk in the cervical spine, or neck. But spinal fusion leaves you unable to bend your neck normally after surgery. That’s because the surgeon removes the damaged disk, and then fuses together the surrounding vertebrae using bone grafts and metal plates with screws attached.

Fusion corrects the disk problem but raises the risk of damage to neighboring spine segments.

New disks allow for more natural neck movement, which reduces the risk of damage to surrounding disks. Talk with your physician to find out if you’re a candidate for this newer technology.

Exercise isn’t safe for someone in my condition.

Exercise is good for almost everyone, no matter how old you are or what shape you’re in—even if you have a chronic condition such as high blood pressure, arthritis or diabetes.

In fact, exercise may improve your condition. Talk to your healthcare provider for help finding

exercises that are right for you. Start slowly and build up to at least 30 to 60 minutes of exercise, five days a week, or as your provider recommends.

5

Incontinence can’t be treated. Though bladder control may be embarrassing to talk about, you don’t have to suffer in silence. Incontinence isn’t a normal part of aging and can be treated— even cured. Weak or overactive bladder muscles, an enlarged prostate, multiple sclerosis, Parkinson’s disease and arthritis can all cause long-term bladder control problems.

Your healthcare provider can recommend treatment based on the type of incontinence you have and its severity. Treatment options include Kegel exercises to strengthen pelvic muscles, bladder training (scheduled urination) and medicine. If your incontinence is more severe, surgery can help.

6

Getting the blues is normal at my age. Occasionally feeling blue is one thing. But a loss of interest in people or activities that lasts more than two weeks is a sign of depression, which can strike at any age. Other symptoms of depression may include fatigue or lethargy, prolonged or excessive worries, weight changes, new aches and pains and feeling hopeless and worthless. If you’re experiencing any of these changes or feelings, don’t accept them as “normal.” Talk with your healthcare provider. Counseling and medication may be needed to get you back on a brighter path.

7

I’ve smoked for so long, quitting won’t do me any good. Quit smoking right now and in 20 minutes or less, your blood pressure and heart rate will start to go down—no matter how many years you’ve been puffing away. Within a few hours, carbon monoxide will leave your bloodstream. Keep it up and within two weeks to three months you may be breathing easier— even if you already have mild to moderate chronic obstructive pulmonary disease (COPD).

By the end of your first year, your excess risk of heart disease is cut by almost half; your stroke, lung disease and cancer risks are also reduced. Ask your healthcare provider about the best way for you to kick the habit. WHT

www.womenshealthexperience.com

19

Something under your skin T h e t r u t h behind b o t h e r s o me lumps a n d b u m ps

M

A small, freely moving lump under your scalp is probably a sebaceous cyst. These slow-growing and usually painless cysts arise from swollen hair follicles and may also appear on the face, neck or trunk. They’re not dangerous and can usually be ignored. If a cyst becomes large or bothersome, your physician may treat it with steroid injections or surgically remove it.

A swollen lymph node may be the culprit if you find a lump along the side of your neck, under your jaw or chin, behind your ear or on the back of your head. Lymph nodes can swell when you have an infection like strep throat or an abscessed tooth.

Sometimes the lymph node itself becomes infected and will become swollen, red, warm and tender. If you don’t have any infection or the swelling doesn’t go away when the other infection does, see your physician.

In your neck

On the skin

Most thyroid nodules—solid or fluid-filled growths in the thyroid gland (located at the base of your neck)—are benign. However, some may disrupt your thyroid hormone levels, place pressure on your windpipe or make swallowing uncomfortable. About 5 percent of nodules are cancerous.

Most nodules are found during a routine exam or an imaging test. Your physician may conduct tests to decide whether treatment is needed.

Basal cell carcinoma—the most common form of skin cancer—may appear as a shiny, translucent or pearly nodule or a pink, slightly elevated growth on the skin. Although this cancer rarely spreads, see your physician for prompt treatment.

A painful, red, half-inch lump that appears suddenly may be a boil, caused when bacteria infect a hair follicle in an area where you sweat or have friction. A boil will fill with pus and grow larger and more painful until it ruptures and drains. Most will resolve themselves (never squeeze), but see your physician if one is extremely painful or you have a fever. WHT

On the back of your head

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Women’s Health Today

© 2009 Jupiterimages

ost women know that any unusual mass found in a breast warrants a trip to their physician, but what about those odd lumps and bumps that occur elsewhere? Although the discovery of a new growth may have you thinking of cancer, that’s not the most likely diagnosis. Here’s what you should know about those mysterious lumps.

Don’t

stress over this test

I

n the world of business, a stress test might be a tally of pencils with chewed-off erasers. In the world of medicine, a stress test—known technically as an “exercise tolerance test’’—is a tally of heart rate, blood pressure and other signs or symptoms that indicate your heart’s ability to deliver blood to hard-working muscles.

Usually recommended for people who have cardiac risk factors, chest pain suspected to be angina or who’ve had an abnormal electrocardiogram, a stress test helps physicians diagnose coronary artery disease by showing whether the heart is getting enough oxygen during physical activity. The test may be recommended for certain people before starting an exercise program. The American Heart Association estimates that 3 million to 4 million Americans have silent ischemia, a symptomless condition in which the heart doesn’t get enough oxygen, causing a heart attack or sudden cardiac death during exercise.

In addition to telling physicians whether you can exercise safely, a stress test can help physicians set exercise limits for patients who have heart disease or have undergone heart surgery. The test does give a fairly high number of false-positive results in women, so be sure to discuss this with your physician.

© 2009 Bruno Budrovic/GettyImages

A word of warning A true cardiovascular stress test is a medical procedure. While some health clubs offer stress testing, medical knowledge and training are required to accurately interpret the test results.

In addition, few health clubs carry the kind of emergency resuscitation equipment that’s necessary in case serious cardiac problems develop during the test.

Get heart healthy!

Talk with your physician about your cardiovascular health risks. If you need a physician, call The Christ Hospital’s physician referral line at 513-585-1000.

How the test is done A stress test involves an electrocardiogram (ECG) together with heart rate and blood pressure monitoring while the patient exercises at increasingly demanding levels. Most specialists prefer a treadmill that’s programmed to gradually increase in speed and degree of incline.

Dressed in comfortable clothing and wearing sneakers, the patient is hooked up to an ECG machine with electrodes. A blood pressure cuff is wrapped around the patient’s arm. The patient begins to walk on the treadmill—easily at first, then with more effort as the speed and inclination are increased.

The test continues until the individual reaches his or her maximum level of exertion. If blood pressure drops or heart rhythm abnormalities are observed, the test is stopped immediately. WHT

www.womenshealthexperience.com

21

Healthy moves

Lift

that

D o y o u r body some good

Y

ou wouldn’t consider your diet to be balanced if you ate only seafood or peanuts, right? Well, the same can be said for your exercise routine. Although cardio exercises—activities like running or cycling that get your heart rate up—can certainly help keep your heart healthy, you also need to include resistance, or weight, training to get yourself in the best shape. Be sure to talk with your healthcare provider before you start weight training.

How good is it?

Weight training strengthens your body from the inside out. As you begin to see leaner legs and slimmer arms on the outside, your routine is helping to reduce your blood pressure, lower your bad cholesterol, raise your good cholesterol, speed up your metabolism, improve your bone density and lower your risk for chronic conditions like diabetes and heart disease.

How do you do it?

Pick a weight that you can lift eight to 12 times without straining. Lift the weight to a count of two and then lower it slowly to a count of three or four.

Although cardio exercises can help keep your

heart healthy, you

also need to include resistance, or

get yourself in the best shape. weight, training to

22

Women’s Health Today

!

weight

Exhale during the most strenuous part, or as you lift the weight, and inhale as you lower the weight.

When lifting the weight 12 times no longer tires your muscles, increase the weight you’re lifting by 5 percent to 10 percent.

If you’re thinking about trying a gym, find one that offers introductory sessions. A trainer will show you how to use the equipment and help design a personalized routine. Most likely, the trainer will show you how to use both free weights and weight

© 2009 Jupiterimages

Exercise myths worth tossing aside machines. Although they may look scary, weight machines generally are easier and safer to use than free weights.

Give your body a proper break by working your major muscle groups—the arms, chest, back, abdominals, buttocks and leg muscles—at least two times a week, with one day of rest in between.

If you keep at it, in about six months, you may notice your strength has increased by as much as 50 percent! WHT

When it comes to physical fitness, there’s a lot of conflicting information going around. What’s the truth behind what you’ve heard or read about exercise, and what’s mere myth?

• Long, low-intensity workouts are best. It’s smart to start off slowly, especially if you haven’t worked out in the past. Gradually increasing your workout intensity as you get stronger is the most efficient way to lose weight. Moving faster burns more calories per minute.

• No pain, no gain. Slight discomfort is one thing; actual pain is a signal that you’re injuring yourself. Stop immediately if exercise becomes painful. If you have sore muscles the day after a workout, it means you’ve torn microscopic connective tissue. The soreness will probably go away by itself in a day or two—next time, ease up a little.

• Women bulk up like men from lifting weights.

False. Male hormones help men build bulky physiques. Women who lift weights for fitness become toned and firm but are still feminine, not manly.

• Everyone burns calories at the same rate during exercise. Not true. Someone who weighs 200 pounds burns twice the calories of a 100-pounder performing the same aerobic exercise at the same rate. It’s a physics thing—the heavier the mass, the more energy (calories) to propel it.

• Morning workouts are the most productive. In fact, the best time is whatever’s best for you.

Caution: If you work out at night, make sure it isn’t interfering with your ability to fall asleep. The stimulant hormones released by exercise, such as adrenaline, stay in your system for several hours afterward.

• Drinking water during a workout causes cramps. Actually, not having enough water in your system during exercise is the cause of most cramps. Drink plenty—before, during and after your workout.

www.womenshealthexperience.com

23

Health smarts

Puzzling periods M

any women consider their monthly menses as an annoyance. But regular periods are an indicator of overall good health.

When your periods are missed or come with pain or discomfort, it’s a signal that something’s wrong. How much do you know about what you likely take for granted? Test your knowledge by answering true or false to these statements. Then check the answers to see how you did.

True or false? {1} The average menstrual cycle is 28 days. {2} Stress is not a cause of missed periods. {3} Painful periods are usually not cause for concern. {4} Heavy blood flow can be a sign of uterine fibroids. {5} Women who have endometriosis can never become pregnant.

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!

{1} True. A woman’s body sheds the uterine lining (blood and tissue) through the vagina during her monthly menstruation when pregnancy doesn’t occur. Young teens may experience cycles lasting up to 45 days, or as short as 21 days.

The period itself normally lasts anywhere from two to seven days. The length of a woman’s cycle tends to shorten and become more regular as she ages. {2} False. Both physical and psychological stress can cause amenorrhea, a three-month or longer absence of regular periods. Other causes include excessive exercise,

24

Women’s Health Today

eating disorders, tumors and hormonal problems. If you’re not pregnant, visit your physician if you’ve missed your monthly menses for three cycles or more. {3} True. Dysmenorrhea—painful periods including severe cramps— are usually not serious and can be eased with heating pads, warm baths or over-the-counter pain relievers.

However, dysmenorrhea can sometimes be caused by infection, endometriosis or ovarian cysts. If the pain persists, get it checked out. {4} True. Uterine fibroids are noncancerous tumors, common in women of childbearing age—yet

most women with fibroids can get pregnant. Some women with fibroids have heavy bleeding and may bleed in between their regular periods.

Medications can help relieve symptoms and sometimes the growth of fibroids. If necessary, fibroids can be removed surgically. {5} False. About 30 percent to 40 percent of women with endometriosis—tissues that usually grow inside the uterus grow on the outside instead, causing pain and heavy periods—have difficulty becoming pregnant. Treatments for this type of infertility include in vitro fertilization, hormones and surgery.

© 2009 Jupiterimages

Answers

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Opening

March 30 The Christ Hospital Outpatient Imaging Center on Red Bank Road The hospital-owned center offers a complete range of imaging services including:

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