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May 13
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FEATURE: Do I still Need a Women’s Health Check Up?

By | Feature, Women's Health

I Don’t Need a PAP Test. Do I Still Need a Women’s Health Check Up?

You’ve heard, with better understanding of abnormal paps, that you no longer need testing every year. That’s true. But do you need to see a women’s health clinician regularly? For some Comprehensive Wellness patients reading this, the answer is “no”—because you’re men. For the rest of you, the answer can be confusing. First, a little history of the confusion, then a few points that might direct you to visit your women’s health specialist.

We’ve heard the pretext of “needing a pap test” as the reason to schedule your annual gynecology exam. We are now finding that that logic may be hurting women. A pap test is about one disease—cancer, and only one body part—the uterine cervix. We can all agree there is much more to being a woman! Yet, in 2014 the American College of Physicians said healthy women do not need annual pelvic/gyn exams. Almost immediately the American College of Obstetricians and Gynecologists responded recommending that women do have annual specialty appointments. Neither organization is without bias. What does the research say?  

A recently published study looked at charts for 283 women over 40 years of age who came in for “well women” exams. The majority of the women were diagnosed with new gynecological conditions resulting in education, prescriptions, and work-ups. In other words, they identified issues that otherwise would likely have gone untreated. What are just some of the reasons for a regular checkup?

  • Dry vagina Yes, we get to say vagina in our multidisciplinary newsletter. For some women this occurs at any age, but for the majority it starts during the menopause transition. Unlike other symptoms, it progressively worsens; if left untreated, the structure of the genitalia experiences non-reversible changes. Even women without symptoms can have changes. 
  • Pelvic masses. Relax. Most pelvic masses are not cancer and, unfortunately, the exam isn’t great at finding ovarian cancer small enough for the most successful treatment. However, even benign masses can cause problems with urination or bowel movements, feeling full, heavy periods, or painful sex.
  • Leaking urine. Probably 80% of incontinence can be fixed without surgery. And it is not a normal part of aging. You need someone you can talk to about this so that you can get help.
  • Menstrual changes. Your menstrual cycle may become irregular or you may have heavier bleeding. While some changes can be normal, all menstrual changes merit attention.
  • Life stages. Though risks of birth control don’t change over time, women do! New health issues and life plans tweak not only the safety of methods, but also the added benefits. Clearing up myths about transitioning into menopause and maximizing the next third of your life needs individual teaching and planning.

But perhaps the most important reason to get an annual gynecology check-up—one hour each year dedicated to being the healthiest woman you can be—you deserve it!

Patricia Geraghty, FNP, WHNP | Director Women's Health | Comprehensive Wellness, Walnut Creek, CA

Patricia Geraghty MSN, FNP-BC, WHNP is a nurse practitioner with over 20 years of experience specializing in women’s health.  

May 06
0

FEATURE: Menopause & Weight Management

By | Feature, Nutrition, Women's Health

Menopause & Weight Management

I just can’t lose that extra pound no matter how much I try? Is this something that you struggle with? As women our bodies go through many changes starting from menstruation into the menopausal period.

It would be nice if menopause happened overnight and our bodies would get back to normal.

Did you know? The transition often begins between the ages 45-55. It usually lasts about seven years, but can go as long as 14 years.

During Menopause the body’s production of estrogen and progesterone changes. Our bodies begin to use energy differently and women may gain weight more easily.

In a four-year cohort study done by Dr. Samuel in Family Practice journal, they found that 25% of women aged 35-47 gained ≥10 lb. in 4 years. Women in the 35-39 age group and 40-44 were more likely to gain ≥ 10 lb. than women in the 45-49 study group. Women who were normal weight at baseline were more likely to gain ≥ 10 lb. than overweight or obese women.1

As a Licensed Dietitian having practiced for more than 15 years int the area of Integrative nutrition. I recommend five steps for Weight Management:

  1. Lower your caloric intake. As we go through menopause our metabolism slows down and we tend to need 200 fewer calories a day during 50’s than we did in our 30s and 40s.
  2. Exercise. The best way to burn excess calories is to increase cardiovascular exercise. A continuous movement at an intense pace of 45 minutes or more helps to increase heart rate and assists with weight loss.
  3. Sugar. My general rule is to try to keep sugars in your snacks, foods and beverages to 0-7 grams per serving.
  4. Vegetables. Did you know that a cup of vegetables has only 25 calories, while a cup of fruit is generally around 90-100 calories depending on the type. Fruits are great, but if you are trying to lose weight, then its best to lower their consumption to one to two servings per day.
  5. Limit Alcohol. Alcoholic beverages add excess calories to your diet and increase risk of weight gain.

In conclusion, menopause is inevitable, but with the right behavioral modifications and diet, weight management is possible.

Sahar Berjis, RD

Sahar Berjis, RD, MPH, is a licensed Registered Dietitian with 17 years of experience in traditional and functional nutrition. She practices Functional Nutrition, looking at each patient individually using the whole body approach. She spends time analyzing nutritional imbalances using in-office stomach acidity testing and more invasive testings if needed. She creates individualized plans to restore and re-balance gut health and the body using diet & natural remedies.

Mar 20
0

Beyond Pros & Cons: How to Think About Making a Difficult Decision

By | Decision Making, Feature

Beyond Pros & Cons:
How to Think About Making A Difficult Decision

My research into (and love) of decision-making began when I was a graduate student working on a breast cancer study at Mass General Hospital and Harvard Medical School. For patients who didn’t have a clear “best choice,” the doctors would outline treatment options and say something along the lines of “We think that you could do Option A or Option B and have the same survival rate. We support you either way, but the decision is yours.” This was empowering for some people and extremely stressful for others. 

These types of difficult, and deeply personal, decisions are not limited only to the medical world. We encounter them in many different areas of our lives. Should I take Job A or Job B? Should we move or stay where we are? Should I go to College A or College B? And just like the patients in our study, some people find this empowering and others find it overwhelming and stressful.

Part of what makes these types of decisions difficult is not having process that works (i.e., getting to a decision that you can live with and feel good about). Most of us learn to make decisions using tools (like pros & cons) and when those methods don’t get you a final decision, then what? In working to answer that “then what?” I spent years using qualitative and quantitative ways of understanding how and why people made decisions and—most importantly—how to support someone making a difficult decision. That work resulted in the five step structured approach called Decide For Yourself.

If you are struggling with a decision, here are seven general decision-making tips to consider:

1. A deadline helps. If you don’t have an external one, give yourself an internal deadline and stick with it.

2. Try not to censor yourself. Make a decision based on what is important to you, not what others think you should do.

3. Stop researching at some point. We will always have to deal with uncertainty and imperfect information—no matter how much research we’ve done.

4. Make one decision at a time. Sometimes decisions can get jumbled together like a bowl of spaghetti, it helps to pull them apart and tackle them individually.

5. Use an analytical approach and then check your gut instinct. We’re partial to the Decide For Yourself process, but research shows that going through any analytical process informs your gut instinct and makes it more reliable.

6. Be clear on the trade-offs. Accept those you can’t do anything about and mitigate those you can.

7. Once you decide, dive in with both feet. Don’t torture yourself with what-ifs —research shows that once you commit to a decision and make it yours, it builds positive momentum.

Maria Carson Breber, Founder of Decide LLC

Maria Carson Breber developed her proprietary decision-making method, Decide for Yourself, based on 25 years of experience and research. She started Decide LLC to share her decision-making method with people and businesses everywhere.

Mar 05
0

Beyond the Obvious – Understanding the Source of Pain

By | Feature, Musculoskeletal Health

Beyond the Obvious:
Understanding the Source of Pain

Have you ever treated pain in your joints, only to have it return a few weeks or months later?

Knee pain for example. The usual RICE treatment–rest, ice, compress, elevate–will help the knee heal, and hands-on therapy can accelerate healing. But what if the knee problem isn’t THE PROBLEM. What if something else is going wrong in the leg that compromises the function of the knee? In this case the knee pain will eventually come back, usually accompanied by further injury.

This too often is the case, and with knees it is easy to see why. Think about each joint in your leg. Your ankles and hips are made to move in all directions, while your knees only bend in one direction. Most compensated walking strategies involve lateral (side to side) motion in the leg, and because the knees do not bend sideways they tend to be the first joint to feel the strain. Imagine if you walked unknowingly with a small lateral strain on your knee. How long would it take before you became sensitive to the tissue damage?  How much damage might you generate before seeking help? Would treating just the knee solve your problem?

Because the human body is so adaptable, it can be easy to compensate the normal function of your body. For example, all it takes to drive the knee a little sideways is a stiff big toe or weakness in the hip. 

At Comprehensive Wellness we look for these underlying issues when we perform whole body biomechanical exams. Our exams include evaluation of posture, gait, movement, joints and soft tissue quality. By understanding why you move the way you do, we can formulate a holistic healing plan that addresses both the pain you currently have and the root causes or drivers of your pain.

Successful treatment programs typically integrate a variety of methods such as manual therapy techniques, joint rehabilitation, restoration of foundational body skills, and habituation of better movement patterns. It may sound like a lot, but we’re able to focus where you’ll target your work. Most of our patients regularly practice only 4-8 exercises and aim to keep just one body skill top of mind throughout each day. Even the most time-constrained professionals and busiest of moms have been able to integrate this type of programming into their life.

Learn more about our Kinesiology/Movement program.

Jeremiah Dees, CSCS, is a movement specialist with over 18 years of experience specializing in kinesiology. He is a graduate of the University of California, Berkeley where he studied Human Biodynamics and Integrative Biology, while concurrently rowing on the national champion crew team.

Learn more about Jeremiah.