This month’s menopause support group hot topic was “Stressed and Depressed.’ And boy oh boy, is this a popular topic!  We  had one of our biggest responses for reservations  with an impressive waiting list.  Our speakers did a fantastic job of outlining the symptoms and causes of stress and depression as well as a useful discussion about management and treatment.  The most outstanding thing that I observed during the meeting at the Fairlane clinic on May 12 was the phenonmenal openness and support the participants were willing to give to each other.  Now understand, this is largely a group of strangers but with shared interests and experiences.   One woman openly described the physical symptoms of heart palpitations and pain which was eventually diagnosed as anxiety and stress as a result of being care taker for her sick mother.  I was particularly touched when another woman turned around and gave this woman a book she pulled from her bag  and explained, “  This book helped me immensely when I was going through a similar situation.  I knew I brought it for a reason. This is for you.”  The book is:  The 36 hour Day: A Family’s Guide to Caring for person’s with Alzheimer’s Disease by Nacy Mace and Peter Rabins. 

Although the issue of caretaking for parents is not a new one it is now getting much needed attention at the government level. The following was excerpted from a post on the White house web site.  It was written earlier this year by Terrell McSweeny who is Domestic Policy Advisor to the Vice President. 

“The Middle Class Task Force unveiled a series of initiatives in the President’s FY 11 budget that are aimed at helping families with soaring child care costs, balancing work with caring for elderly relatives or people with disabilities, paying for college, and saving for retirement. These are costs that – along with health care – have risen dramatically for families at a time when their incomes haven’t. Some people call this “squeeze” because of the pressure these costs put on family budgets. But for many families it just seems like it is impossible to get ahead. This is particularly true for the so-called “sandwich generation” – people who are caring for children (or grandchildren or adult children who are struggling financially) and their parents. The Vice President often speaks very personally about his experience caring for his parents and in-laws. And almost all of us know someone who has juggled caring for a parent or relative who can’t get along completely on their own. Millions of Americans provide unpaid care to aging relatives – including approximately 23 million caregivers with jobs and 12 million who are also caring for their own children. That’s why the Middle Class Task Force’s “squeeze” initiative includes help for family caregivers. These caregivers play a vital role in helping seniors stay in their communities or at home. But too often they don’t have the support they need to balance caregiving with work and family responsibilities.  Approximately 65 million Americans provide care to a loved one, giving more than $375 billion worth of unpaid care each year—often at their own financial and emotional expense.   The caregiver initiative won’t magically alleviate all the strain on caregivers and their families – but it is an important first step toward providing more support for families and caregivers and the vital services they are performing.”

The group meeting this month really helped me understand what an important issue this is for women who are also coping with the changes and personal health issues of menopause.  The planning team has already started to discuss how we can help meet your needs for information on this subject and likely will repeat the stress and depressed topic and caregiving  as a fall event.  Your imput is welcome either by comment or contact via email through this blog.  Thanks.

written by Deborah McBain, CNM MSN

Most of us tend to think of immunizations as kind of a kid thing.  Most of us  were pretty good at getting our kids in for their “baby shots”.  I did have some friends who were pretty adamant at NOT getting their children immunized due to concerns about side effects, but most of us figured the benefits outweighed the risks.   And we were right.  Pediatric immunization programs have been very successful in reducing and even eliminating  many childhood diseases, saving countless lives with very little risk.  But despite the fact that there are many vaccine preventable adult diseases,  rates of adult immunizations are low.  Why is this, when immunizations so clearly are effective in reducing the occurance and severity of many serious and nasty adult diseases?   Experts believe that a lack of a cohesive national program promoting adult immunization strongly contributes to  a lack of information among both patients and care providers.   When you go see your doctor, does he/she talk to you about immunizations?  Do you  bring up the subject?  Most likely not.  So here is a primer on immunizations you should consider getting and when.    These are recommendations from the Centers for Disease Control & prevention (CDC).  Next time you go to the doctor, ask. 

Tetanus, Diptheria. Pertussis (Td/Tdap)  All adults age 19-64 should get a Tdap once and all adults should get Td booster every ten years. Pertussis, which is known as Whopping Cough caused a great deal of illness in death in children and infants in the 1940s.  For years it was nearly wiped out  due to immunizations but has recently reemerged.   Adults  have largely lost their immunity to the disease.  Getting the Tdap booster will prevent you from getting the disease and passing it on to any children you may come in contact with. ( think grandchildren). Obviously, parents, teachers and health care providers are also important adult groups to immunize.

Varicella-  (chicken pox).  2 doses recommended unless you have evidnece of immunity.

Zoster- (shingles).  One dose is recommended at age 60 or above.  Shingles can be very debilitating and the pain can last for months and months. Vaccines don’t always completely prevent infection but can greatly reduce symptoms and time for recovery.  The disease seems to get worse as we get older so it makes good sense to get this vaccine. 

Pneumococcal- (Pneumonia). One or two doses for people with medical conditions putting them at high risk and one dose if you are over 65.  Most people who die from the flu actually die of pneumonia so  this vaccine is often given along with the annual flu vaccine.

Influenza-   Get the flu vaccine yearly.  Flu shots are safe for most people and even if you do get the flu your symptoms will be milder.

Other vaccines that may be appropriate for you to get  include Measles- Mumps- Rubella (MMR),  Hepatitis A and or B and Meningococcal.  Check with your doctor to see if you are in a high risk group for these disesases and should be immunized. 

I wish you health.

written by Deborah McBain, CNM MSN

DETROIT - Henry Ford Health System is harnessing the power of the popular social networking site Facebook to remind women to get mammograms during National Breast Cancer Awareness Month in October. By developing a new Facebook application called Pinky Swear, Henry Ford is spreading the word among Facebook users about the importance of regular mammograms for the early detection of breast cancer. Mammograms are recommended for women after age 40 and if there’s a family history of breast cancer. The application allows Facebook users to send Pinky Swear mammography reminders to friends, along with information about how to set up an appointment.

Facebook users also can sign up to become a “fan” of the Pinky Swear Facebook page to receive news and information about breast cancer from Henry Ford. In metro Detroit, an estimated 154,000 women, ages 40 to 64, use Facebook. For Facebook users who are not in Michigan, Henry Ford hopes Pinky Swear will encourage women to start a dialogue with friends and family, as well as their health care providers, about the importance of breast cancer screening. Facebook users can access the Henry Ford Pinky Swear application at  

Facebook users can access the Henry Ford Pinky Swear application at http://apps.facebook.com/pinky_swear.

 About Henry Ford Mammography:  Henry Ford Health System offers 17 mammography sites throughout southeast Michigan, the majority of which offer online appointment scheduling.

To schedule an appointment, visit www.henryford.com  for locations and real-time mammography scheduling, or call 1-800-HenryFord.  There is also a link to the right of this post.

A physician’s prescription is not needed for real-time online mammography appointment scheduling for women ages 40 and older who require a routine screening mammogram. Patients who schedule a mammography at a Henry Ford location on Oct. 16, National Mammography Day, will receive a pink carnation at their appointment.

written by Deborah McBain, CNM MSN

Seems I’m hearing a lot more about the importance of Vitamin D in the last few years.  And this time of year as the days shorten and sunshine becomes a rare treat, it is timely vitamin to address.  We have long understood the link between Vitamin D and bone health.  Those of you who remember the practice of giving cod liver oil to children  to prevent rickets are witness to this old-time knowledge.  Cod liver oil is an excellent source of nutritional vitamin D.  Since vitamin D is known to help absorption of calcium, menopausal women often are advised to take it with calcium  to help prevent osteoporosis.  Studies now suggest that Vitamin D does a whole lot more than effect the bones.  Low vitamin D levels during pregnancy are being linked to more preeclampsia, low birth weight and premature labor.  Low vitamin D levels in childhood are now being linked to development of  asthma, diabetes and high blood pressure in later years.     A recent study published in the Journal of Nutrition suggests that women with vitamin D deficiencies may have more bacterial vaginosis, a common vaginal infection.  Other research links low vitamin D  levels to higher rates of colon and breast cancer, depression, diabetes, heart disease,  weight gain and chronic pain. Wow!

Chances are that if you live in Michigan you are vitamin D deficientor at least insufficient.  Your risk is even greater if you are older, dark skinned or cover your skin while outside.  Experts in the medical community generally agree that vitamin D deficiency among women is widespread.  Some predict that as many as  70% of white people and 97% of black people are deficient.   Vitamin D is either synthesized in the skin through exposure to ultraviolet B rays in sunlight or ingested as dietary vitamin D.  However it is difficult for humans to get adequate vitamin D from diet alone.  And our Michigan climate and latitude make it difficult to get enough sun exposure.  Then there is the dilemma of increasing the risk of  skin cancer with sun exposure.  Sun screen blocks the skins ability to synthesize Vitamin D.  What is a person to do?

Get your vitamin D level checked.  Ask your health care provider about getting this simple blood test the next time you go for an exam.

Consider taking a supplement.  There is no general agreement about the optimal intake of vitamin D. Some researchers say the current recommended intake of 400 international units (IU) to 600 IU daily is inadequate and suggest a much higher daily intake, from 1,000 IU to 5000 IU.  Cholecalciferol is the preferred form.   It is easily available in any drug store and not terribly expensive. If your blood levels are low your health care provider may give you with a high dose prescription form of vitamin D.  Experts reassure that it is rare and dificult to get too much Vitamin D but check with your care provider.

Include nutritional sources of Vitamin D in your diet.  Look for vitamin D fortified foods such as milk,cereals, orange juice and yogurt.  Other foods with vitamin D include tuna, salmon, beef liver, egg yolks, cheese. ( and of course cod liver oil if you can stomach it)

Continue limited sun  exposure.  (if you can find it!)  Most experts say that 15-30 minutes of sun exposure without sunscreen is reasonably safe.  Getting this amount most days of the week can help boost most peoples vitamin D levels safely.

written by Deborah McBain, CNM MSN

Summer is over (almost) and we are starting our fall series of Menopause Support Circles.  Our first topic is “Illuminating Elimination”.   Thursday, September 17 ( please note-not  Wednesday 9/16) at Fairlane Medical clinic- Dearborn participants will have the opportunity to hear uro-gynecologist, Dr. Abed of Henry Ford Health System- Women’s Services  talk about common bladder and bowel problems, uterine prolapse and pelvic pain.    Dr. Abed has an interest in educating women about lifestyle and non-surgical management strategies for these problems.  He will also discuss surgical options. There will be plenty of opportunity to ask questions. 

Be sure to take advantage of this free event on an important subject for women.  At this point there is still space  so call 1-800-HenryFord to RSVP today.  

See the Menopause Support Circle page for a link for directions and for the other 3 dates and locations this talk will be offered.

written by Deborah McBain, CNM MSN

Any health care reform is way too far away to help women struggling today to make ends meet.  A survey of women  this year by the American College of Obstetricians and Gynecologists (ACOG) found that 14% had postponed their annual gyn check up due to the economy. Fifteen percent have cut back or stopped taking medication because of cost.  Other studies confirm this trend estimating that up to 1 in 4 people are postponing preventative health care.

Health care providers are understandably concerned that these delays in preventative health care such as pelvic exam, pap smears, mammograms and more will result  in  serious health problems down the road.   The benefits of preventative health care is just that, preventing illness or late diagnosis.

If you have lost your health insurance or know someone who has, here are a few suggestions:

1.  Ask about discounts or payment plans for office visits. Many health care organizations have programs for people who self pay.

2.  Take advantage of generic drug programs by national chains.  Walmart, CVS, Kroger and many others have programs covering hundreds of medications.  This includes hormone thrapy, osteoporosis medications and anti-depressants, to name a few.  The cost for these medications  may be $4-10 a month.

3.  Check out discount programs  by pharmaceutical companies.   A good resource is www.rxassist.com.

4.  Be savvy about drug costs.  Go to www.michigandrugprices.com  to compare prices at local pharmacies.   If you are not in Michigan maybe your state has a similar resource. Do a search.

5. Recommit to a healthy lifestyle.  It’s difficult enough to be sick during good times.  No one can afford to get sick during bad times. Take care of yourself.  Exercise, diet and stress management is even more important now.

written by Deborah McBain, CNM MSN

 
Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, School of Nursing, The University
of Texas at Austin and her colleagues are conducting a study to
explore ethnic differences in midlife women’s attitudes toward
physical activity. You are eligible to participate in this study if you are a midlife woman aged 40 to 60 years old who does not have any mobility problems; who can read and write English; who is online; and whose self-reported ethnic identity is Hispanic, non-Hispanic (N-H) White, N-H African
American, or N-H Asian.  Data will be collected through
the Internet from Feb. 1, 2008 to May 31, 2011.  Methods for the data
collection include an Internet survey among 500& midlife women in the
U.S. on the Internet and four ethnic-specific online forum
discussions among about 30 midlife women per ethnic group
recruited among the Internet survey participants.
Your involvement will consist of the following: (a) about 30 minutes
are usually needed to complete the Internet survey questionnaire;
and (b) online forums will be conducted for 6 months, should
you agree to participate in the additional online forum discussion.
Your participation is asynchronous (you can visit the online forum
site and read and post messages at your convenience).
You will receive a gift certificate of 10 dollars for filling out the survey, and an additional gift certificate of 50 dollars for participating in the additional
online forum (only those who participate in the additional online
forum for 6 months will be provided with this additional gift
certificate). To get reimbursed for the online forums, you have to
post at least one message per topic. For more information,
please visit at our website http://mapa.nur.utexas.edu/MAPA/ and/or
contact us.

Contact Information:

Chelsea McPeek. Research Assistant, School of Nursing, University of Texas at Austin

E:mail: cgmcpeek@mail.utexas.edu

1700 Red River, Austin, TX 78701
Phone: (512) 475-6352
Website: http://mapa.nur.utexas.edu/MAPA/
IP: 128.83.241.133

written by Deborah McBain, CNM MSN

Would you consider paying to allow someone to poke needles in your body?  No?  What if I told you that the result may be less hot flashes, better sleep, return of sex drive and more energy?  Got your attention?  Well,  then read on about acupuncture.

Acupuncture has been around for about 5,000 years.  Very thin “needles” are placed in key areas of the body called meridians to stimulate and balance the flow of energy through the body.  It has been used by an estimated 8.2 million U.S. adults.  Benefits have been published in peer-reviewed western medical literature and studies conducted by the National Institutes of Health

Acupuncture is often used in combination with Chinese herbal medicine and referred to as Traditional Chinese Medicine (TCM).  Increasingly TCM and other alternative health modalities such as mind/body therapy and massage is being combined with conventional ( allopathic) western medicine to achieve enhanced results.  Referred to as Integrative Medicine it is hoped, by practitioners in both camps, to bring the best of both worlds together.  TCM is being used for various women’s health issues such as menopausal symptoms,  cancer support, emotional health issues and chronic disease management.  All issues close to the hearts of many of us of a certain age.

In 2008 Henry Ford Health System oncologist, Dr. Eleanor Walker with the assistance of  acupuncturist, Beth Kohn conducted a study with 47 breast cancer patients.  These patients were all on tamoxifen or Arimidex to reduce cancer recurrence.   Hot flashes are a common side effect of these two drugs.  Half of the women received acupuncture treatment and half were given the antidepressant venlafaxine (Effexor).  Effexor has also been shown to reduce hot flashes.  At the end of 12 weeks both groups reported 50-75%  fewer hot flashes.  The acupuncture group reported no side effect and other improvements such as  improved sense of well being, more energy and higher sex drive.  The antidepressant group did not experience these benefits.

This is useful information to those of us who may be struggling with menopausal symptoms but do not want the side effects of hormone therapy or antidepressants.  Although most health insurance companies do not cover the cost of acupuncture, it is eligible for reimbursement from a health care  flexible spending account.  Many large health care organizations around the country have Integrative Medicine Centers were you can be assured of getting well trained, reliable practitioners.  If you are interested in more information and live in  southeastern Michigan, contact Henry Ford Center for Integrative Medicine  at 248-380-6201.  Tell them you are “poking around” for some answers.

written by Deborah McBain, CNM MSN

 February is Women’s Heart Health Awareness Month.  This is the  20th year for the campaign and the 5 th year for the Red dress promotion to increase awareness of  heart disease in women.  This is particularly important during  menopause because this  time marks an increased risk for heart disease.    Heart disease is the #1 killer of women.  Each year, heart attacks kill six times more women than breast cancer.   The good news is that risk can be controlled  and heart disease can be prevented.  This is what you need to know.

 KNOW YOUR RISK FACTORS.  Risk factors include: high blood pressure, high cholesterol, diabetes, being overweight or obese, physical inactivity, being over 55 years old, family history.

KNOW YOUR NUMBERS.   Optimals are:  BP<120/80.  Total cholesterol <200. LDL<130.  HDL>50.  Triglycerides <150.  Fasting glucose <100.  Body mass Index (BMI) <25.  waist circumference <35 inches.  Consult your health care provider to discuss evaluation and management.  For more information and a BMI calculator go to www.henryford.com/knowyournumbers

KNOW HOW TO REDUCE RISK. Exercise and eat right. Exercise and eat right. Exercise and eat right.  A normal weight and regular activity can, in many cases, prevent risk factors of diabetes and high blood pressure.  Get treatment for high cholesterol, high blood pressure and diabetes.  Medications are effective and will prevent heart attack.   

KNOW HEART ATTACK WARNING SIGNS.

.     Chest discomfort

·     Usually in the center of the chest

·     Lasts for more than a few minutes, or goes away and comes back

·     Can feel like uncomfortable pressure, squeezing, fullness, or pain

·     Discomfort in other areas of the upper body, including pain or discomfort in one or both arms, the back, neck, jaw, or stomach

·     Shortness of breath, with or without chest discomfort

·     Other symptoms, such as breaking out in a cold sweat, nausea, or light-headedness

KNOW WHAT TO DO.  If you have symptoms do not delay.  Go to emergency room.  Dissolve an asprin under your tongue if you have one. Women are more likely to delay treatment and more likely to die of a heart attack than men.  They are less likely to be treated accurately for heart disease than men.  Less likely to be given medications like beta blockers, statins and ACE inhibitors which can be crutial in preventing advancement of heart disease.  So know your stuff, ladies. 

To learn more go to www.womenheart.org.  If you live in the Detroit Metro area check out our Menopause Support Circles this month.  Our topic is Heart Health. We are having speakers from our cardiovascular institute on several dates and locations. 

written by Deborah McBain, CNM MSN

Although I don’t have children in my household heading back to school, September still evokes a feeling of new beginings.   The lazy days of summer are transitioning into the bustle of fall and the coming winter. This is a perfect time to take advantage of opportunities to learn something new, connect with old friends or make new ones.   Invest in yourself.  Studies have shown that people who have more interaction with others are healthier and happier.  Learning keeps your brain and memory sharp.  Doing something enjoyable is good stress relief.  Below are a few ideas and resources.

Take a class.  Look through those catalogs you have been getting from your local community college, city school system and recreation department.  They are full of interesting “enrichment” classes.  Skills ranging from yoga, bird watching, palm reading to a variety of arts and crafts are yours for a phone call and small fee.  Many have senior citizen rates.  There are  day and evening courses and even on-line courses.

Program for Women: Science for a Healthy Brain. Sponsored by  Henry Ford Health System Neurology Department, this is a series of three programs.     Physican speakers will address topics near and dear to the heart of menopausal women, so consider attending. There is no charge.   From 6:00 to 7:30p.m. at Fairlane Health Center, Dearborn.  September 11 topic is Sleep, October 9 is Mood, and October 30 is Memory. Call 313-916-8088 for more infomation and to reserve a spot.  See you there.  I’m already signed up.

Attend a retreat.  No matter what your religion or beliefs, retreat houses generally welcome everyone.  St. Paul’s Retreat house in Detroit is a lovely oasis with many programs for women.  They have a day long program  called “Women in Midlife-A Mosaic of Transitions.  It is designed for nurses and offers CEUs but is open and appropriate for all.  A donation of $70 is suggested.  Go to www.passionist.org/stpauls  or call 313-535-9563 for more information on this or their other programs.

Click the link on the right.  Henry Ford Health System has numerous programs and events, most free.  Go to site and click on Henry Ford Classes for a calendar.  In addition to the Menopause support group information you will find programs for weight management, back care and more.

What other ideas or resources have you discovered and enjoyed in your community?  I would love to hear about them.

written by Deborah McBain, CNM MSN