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healthtoday women’s Summer 2009 Blues bashers don’t give in to depression Marg Helgenberger’s arrestingly fresh attitude page 10 How does your garden grow? Put the season’s crop to full use prepare! get ready and steady for surgery The Christ Hospital 2139 Auburn Avenue Cincinnati OH 45219 non-profit org us postage Paid cincinnati oh Permit #5489 Mason It’s a short distance between home and peace of mind. Mt. Auburn Fairfax Delhi io Oh er Riv Breast cancer is the leading cause of death for women ages 40 – 55. It affects one out of seven women, yet statistics show that fewer and fewer women are getting their mammograms. But why? Screening is simple and easy to access. And when found early, most breast cancers are treatable. Mammography is the most important screening tool for breast cancer. Schedule your mammogram today and get the peace of mind you deserve. Breast cancer risk factors: t

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the age of 50 Call to schedule your appointment: 513-585-2668 The Christ Hospital offers four mammography testing locations with convenient appointment times and parking, digital technology and board-certified radiologists experienced in the interpretation of mammograms. Mt. Auburn The Christ Hospital Medical Office Building, Suite 324 2123 Auburn Ave. Cincinnati, OH 45219 Delhi The Christ Hospital Delhi Testing Center 5310 Rapid Run Road Cincinnati, OH 45238 Mason The Christ Hospital Mason Testing Center 608 Reading Road Mason, OH 45040 Fairfax The Christ Hospital Imaging Center 4440 Red Bank Road, First Floor Cincinnati, OH 45227 healthtoday women’s Summer 2009 in this issue . . . 2 LETTER FROM THE FOUNDER Scared of surgery? 3 Taking the mystery out of hysterectomy 4 Arresting heart failure 5 10 questions to ask at your next checkup 6 HEALTH HEADLINES 8 Not a headache? Not a toothache? 4 What’s making news in women’s health Maybe it’s TMJ 9 SEX & GENDER MATTERS Protect your sight! Get checked for glaucoma 10 Stealing the scene Marg Helgenberger investigates all life has to offer! 13 HEALTHY MIND Beat the blues Women and depression 14 Surgery? Steady now! Get your body and mind ready 16 Easy cancer-prevention tactics 17 A positive approach to PMS 18 HEALTHY MOVES 10 Which exercise is best for you? Answer these simple questions to find out 20 Breathe easy! Reduce your risk of COPD 21 7 smart things you can do for your baby 22 HEALTHY BITES Just-picked dishes Take advantage of the season’s fresh crop! 24 HEALTH SMARTS Serious smoking stats 20 www.womenshealthexperience.com  healthtoday women’s Letter from the founder the magazine of the foundation for female health awareness Scared of surgery? Y Founders Mickey M. Karram, MD / Mona Karram National Advisory Board ou surely aren’t alone! No one looks forward to any procedure, especially one that involves general anesthesia. However, today’s operating team of surgeons, anesthesiologists and specially trained nurses have technology on their side—whether it’s a minimally invasive surgical robot or a high-tech chemical cocktail that puts you out quickly and safely. Read about how you can put your surgery and anesthesia fears to rest and get your mind and body in tip-top pre-op shape in “Surgery? Steady now!” on page 14. Our “Health Smarts” column in this issue of Women’s Health Today focuses on facts about cigarette smoking. If you, a loved one or a friend can’t kick this habit, read “Serious smoking stats” on page 24. The stark and scary data you’ll read may provide the incentive you need to rid yourself of this deadly addiction. Also in this issue, you’ll find articles on chronic obstructive pulmonary disease (“Breathe easy!” on page 20), seasonal fresh vegetables (“Just-picked dishes,” page 22) and finding the best way to keep active (“Which exercise is best for you?” on page 18). I think you’ll find the wide variety of topics in this issue of Women’s Health Today to be informative and useful. Please let me know what other topics you’d like to read about in future issues. I’d love to hear from you! 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 a l STAFF 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 3. © 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 medical care or advice. If you have medical concerns, seek the guidance of a healthcare professional. 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. 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 recycle-logo_2options_v2.ai 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 containing Printed With Soy Ink results Printed Soy Ink health news and ofWithmedical studies. Sign up now at www.womenshealthexperience.com. Please Recycle This Publication cover : M arg H elgenberger Please Recycle This Publication © 2 0 0 9 J onathan S kow / C orbis O utline  Women’s Health Today Printed With Soy Ink Please Recycle This Publication Printed With Soy Ink By Marcia Bowling, MD Taking the mystery out of hysterectomy A bout one-third of American women will eventually have a hysterectomy, the second most common surgery after cesarean section. Why so common? Basically, hysterectomy can cure a variety of uterine problems: ✿ Fibroids. Hysterectomy is most often recommended for serious cases of fibroids (benign tumors that grow in the uterus wall). Fibroids can grow large and may cause great pain and heavy bleeding. Depending on the severity, physicians and patients may decide to try treatments other than hysterectomy. In a surgery called myomectomy, the fibroids are removed but the uterus stays in place. Also, drug therapy may shrink fibroids temporarily, and after menopause, fibroids may shrink without treatment. For serious cases, hysterectomy is often the best choice because it’s a definite cure. ✿ Endometriosis. Hysterectomy can treat severe cases of endometriosis, a common disease in which tissue shed from the uterus grows outside the uterus, causing pain and possibly leading to infertility. Drug therapy can help but may not stop pain in serious cases. ✿ Prolapse. Many physicians recommend hysterectomy for severe prolapse—a sagging of the uterus into the vagina when the ligaments that support the uterus get weak over time. These ligaments can sometimes be shortened with surgery. In other cases, physicians may place a pessary, or support ring, around the cervix. If ligaments are badly damaged, hysterectomy may be necessary. ✿ Gynecologic cancer. Hysterectomy is usually required when a woman has cancer of the uterus or cervix. The only real alternative is radiation therapy. However, radiation therapy may not be as effective and may involve many side effects. Coping with change After a hysterectomy, a woman may be emotionally distraught. Some women identify the uterus with childbearing and with their younger years, so it’s possible to feel a sense of loss. Women need support and understanding from family and friends and should talk with their physicians about ways to cope with this change. WHT Robotic-assisted hysterectomy If your physician recommends hysterectomy (or if you need uterine fibroid removal or prolapse treatment), you may be a candidate for a roboticassisted procedure using the da Vinci® Surgical System. The system helps your surgeon perform a more precise, minimally invasive hysterectomy and can offer numerous potential benefits over traditional surgical approaches, including: • a shorter hospital stay • less pain • faster recovery • a quicker return to normal activities • less risk of wound infection • less blood loss and scarring Many different procedures are used to perform hysterectomies. Be sure your physician is experienced with several techniques so that the best option can be chosen for you. Suffer no more! To learn how robotic-assisted gynecologic surgery can help reduce your discomfort, visit www.TheChristHospital.com or call 513-585-1000. Marcia Bowling, MD, an obstetrician and gynecologist with The Christ Hospital, specializes in treating gynecological cancers. www.womenshealthexperience.com  Arresting heart failure § Confusion or impaired thinking. Changing levels of sodium and other substances in the blood can cause memory disturbances and disorientation. § Increased heart rate. A racing heart or palpitations can occur when the heart starts beating faster to make up for loss in pumping capacity. Get prompt medical care if you have any of these symptoms. Heart failure is the leading cause of hospitalizations among people ages 65 and older. WHT Help for your heart is here! The Healthcare Accreditation Colloquium recently recognized The Christ Hospital as a fully accredited heart failure center of excellence. The Christ Hospital is the first hospital in Greater Cincinnati, and only the fifth in the United States, to achieve this recognition. The Christ Hospital heart failure services include: • The Carl H. & Edyth Lindner Heart Failure Treatment Center. A unique 28-bed unit offering state-of-the-art care for patients with heart failure. • Heart Link. A unique tool that helps heart failure patients transition from hospital to home. Specially trained nurses connect with patients after discharge to review diet, exercise and medication. • Congestive heart failure clinic. Physicians and nurses treat the growing aging population of heart failure patients, specifically those who are uninsured or underinsured. • Participation in nationally published research on heart failure management and treatment methods. Get heart healthy! Visit www.TheChristHospital.com to learn more about heart failure treatment at The Christ Hospital, or call the heart failure clinic at 513-585-2472.  Women’s Health Today © istockphoto.com/Shannon Keegan/Karen Roach I f your heart is damaged—whether by high blood pressure, diabetes or some form of coronary artery disease (including angina and heart attack)—it can’t pump blood or relax as well as it should. This condition is known as heart failure. Despite its name, heart failure doesn’t mean that your heart has stopped or that you’ve had a heart attack, but instead that your heart is weak and working inefficiently. Warning signs of heart failure include: § Shortness of breath. Breathing problems can occur during activity or when lying down as blood backs up in the pulmonary veins, causing fluid to leak into the lungs. § Fatigue. Simple activities like getting dressed or walking can trigger extreme fatigue and make everyday chores seem impossible. § Water retention. Fluid builds up in the legs, feet, ankles and, sometimes, abdomen. Other waterretention signs include frequent urination and weight gain. § Coughing or wheezing. Fluid buildup in the lungs can cause coughing that produces white or pink blood-tinged mucus. § Appetite loss or nausea. Digestive problems can make you feel full or sick to your stomach. By Nancy Slattery, MD 10 Y questions to ask at your next checkup our annual physical should be more than a quick checkup and a “See you next year, doc.” It’s your chance to strengthen a vital partnership with your healthcare provider and assess your medical outlook. Covering your bases © istockphoto.com/Amanda Rohde Think of your physical as a two-part process. First is the exam itself. The second part is gaining a thorough understanding of your health. Here are some questions to ask that will help you gain insight: ˛ 1 Are all my signs normal or within accepted limits? Ask about your: • body-mass index (BMI), ratio of weight to height • blood pressure and pulse • breathing • skin and nail color, texture and appearance, which give clues to underlying disorders of your vital organs ˛ 2 Is my health better, the same or worse since my last checkup? ˛ 3 What are the best ways I can maintain my health or manage my condition? Ask for advice on diet, physical activity and stress-management tips to ease chronic tension and anxiety. ˛ 4 Given my personal and family medical history, do I have a higher than normal risk for certain illnesses? Review your: • family medical history: whether grandparents, parents or siblings had heart attacks, strokes, breast or other cancers and other illnesses • personal medical history, including any childhood sunburns, severe allergies or high fevers that are risk factors for diseases later in life, and any hospitalizations, surgeries or allergies to drugs or food ˛ 5 Given my age and health, what symptoms may indicate the onset of an illness? ˛ 6 Given my medical status, what specific symptoms may indicate a health emergency? ˛ 7 What screenings should I have? Your physician may recommend a mammogram, a bone density scan, a colonoscopy, a Pap test or cardiovascular and cholesterol-related blood tests. ˛ 8 Should I be seeing a specialist for any reason? ˛ 9 What new therapies or changes in treatment since my last checkup should I know about? ˛ 10 Should I get a flu shot? Be informative Mention any current symptoms or unusual feelings—physical or emotional—that you may have. Never let embarrassment, fear or shame keep you from telling your physician about a problem. They’re trained to handle all your medical concerns—and you won’t be the first patient with a sensitive issue. Call your physician’s office any time you have a question about your health or are having trouble following his or her instructions. Communicating openly with your physician is just as important as eating right, exercising and watching your weight. WHT Need a primary care physician? Call 513-585-1000 to find a physician with The Christ Hospital Medical Associates. Nancy Slattery, MD, is an internal medicine physician with The Christ Hospital Medical Associates in Cincinnati. www.womenshealthexperience.com  what’s making news in women’s health healthhead A new oral cancer protection brewing? Y Stroke signs: Still a mystery to many our coffee-drinking habit might not be entirely bad for you, according to findings that coffee consumption is associated with fewer cancers of the mouth, pharynx and esophagus. Japanese researchers evaluated the diets of more than 38,000 people. They found that compared to people who did not drink coffee, those who sipped a cup or more a day had only half the risk of developing these cancers. The risk reduction was noted even among people at high risk for these cancers, such as those who drank alcohol or smoked. The research was published in the American Journal of Epidemiology. uick: List the warning signs of stroke and what you should do if you think someone is having one. Give up? Many people—especially those most likely to suffer a stroke—can’t name the warning signs, according to researchers at the International Stroke Conference in San Diego. In 2007, they polled more than 86,000 people by phone and found that fewer than two in five knew all of the stroke warning signs: sudden weakness in the face, arm or leg; sudden severe headache with no known cause; sudden vision problems in one or both eyes; sudden confusion or difficulty speaking; and sudden dizziness, loss of balance, loss of coordination or problems walking. Many of those polled also didn’t know to call 911 immediately. Older adults, prior stroke sufferers, minorities, people with lower incomes and people with less education fared poorly in the poll. Researchers stress the importance of knowing the warning signs, as the quicker you’re treated for stroke, the better your odds of surviving and limiting any stroke-related disabilities.  Women’s Health Today © istockphoto.com/Megan Tamaccio Q lines Too close for comfort? D o too many family members under one roof hurt the heart? That’s the question pondered by researchers at Osaka University, who followed more than 90,000 Japanese women and men ages 40 to 69 for as long as 14 years. What they found: • Women who lived with a spouse, children and aging parents or with a spouse and parents were two to three times more likely to suffer from heart disease than women who only lived with a spouse. • Men living in these multigenerational households didn’t experience the same heart-risk increase. f you had preeclampsia Researchers hypothesize that, for women, the during pregnancy, you stress of juggling multiple family roles may be takmay be at an increased risk ing a toll. Japanese women not only care for their of having problems such family members and keep the household running as high blood pressure, but also work outside the home full time—a diabetes and blood clots for scenario not unfamiliar to American women. So if the rest of your life. That’s you’re a stressed-out caregiver—or if you live with according to researchers one—perhaps it’s time to give your heart a break at Yale School of Medicine and divvy up those responsibilities. and the University of Preeclampsia: Not just a pregnancy problem I Copenhagen, who looked at data on more than 1.3 million women who gave birth between 1978 and 2007. Preeclampsia, or pregnancy-induced hypertension, is marked by high blood pressure and excess protein in the urine after the 20th week of pregnancy. The findings strengthen the link that other studies have found between preeclampsia and heart conditions. There’s no known way to prevent preeclampsia—which is why it’s important to get early and regular prenatal care—and the only cure for it is to deliver the baby. If the condition develops early on, your physician may suggest bed rest or medications to prolong the pregnancy. www.womenshealthexperience.com  Not a headache? Not a toothache? M a y b e i t ’s TMJ T he dull ache in Lisa’s right cheek led her to the dentist’s office, where she figured she’d need a cavity filled at best or root canal at worst. She was surprised to learn that her teeth were fine—and to be referred to a medical specialist. Lisa turned out to have temporomandibular joint (TMJ) syndrome. Working with this specialist, she found that a combination of medication and lifestyle changes—not oral surgery—was the key to relieving her pain. What is TMJ? TMJ affects women in their childbearing years more than it affects men. Most cases are the result of displacement of the cartilage disk between the jaw bones, sometimes caused by an injury to the head, neck or face. This displacement produces pressure and stretching of the nerves, leading to pain. TMJ discomfort is also produced when the muscles used for chewing spasm. This spasm is commonly caused by clenching or grinding of the teeth (often while sleeping), or a poor bite. TMJ affects women in their childbearing years more than it affects men. The pain may be dull or shooting.  Women’s Health Today Just as the causes of TMJ can differ, so, too, can the symptoms. Pain may be dull or shooting, feel like a toothache or a headache or radiate around the cheek or ear. Sometimes you can hear the joint pop as you open and close your mouth. Sometimes you can barely even open your mouth. Treating TMJ Treatment varies according to the causes and severity of your symptoms. If your problem is muscular, then appropriate actions may include massaging the muscles, eating soft foods that require little chewing, applying moist heat to your cheeks and taking muscle-relaxant medication. Some patients benefit from wearing a bite splint or a device like a dental retainer, which prevents clenching and grinding of the teeth during sleep. Braces or other orthodontia may be needed. Only in severe cases is surgery needed. If your pain points to TMJ, call your healthcare provider for a referral to a specialist trained in treating this syndrome. WHT