Myths about Menopause

It’s hard not to worry about menopause, even if you don’t want to. Night sweats, hot flashes, trouble sleeping, physical changes—they don’t sound like fun. 

But some anxiety about menopause may come from the many myths and misconceptions about this time of life. The antidote? Information. So we asked two MultiCare experts—Laura Sporl, MD, and Moritz Bartels, MD—to share some of the menopause misconceptions they hear from women. 

Myth: Menopause means a woman is old.
“The average age of menopause is 51,” says Dr. Bartels, an obstetrician/gynecologist at the Women’s Health and Wellness Center at MultiCare Gig Harbor Medical Park. “Given the current life expectancy—it’s around 80 years—women still live a large portion of their lives after menopause.”

 Myth: Libido changes at menopause.
At midlife, women may be stressed from jobs, raising teenagers and helping elderly relatives. It’s the demands of everyday life that are often at the root of sexual problems, says Dr. Sporl, an obstetrician/gynecologist at the MultiCare Women’s Center, Northshore Clinic.

But hormonal changes at menopause can cause physical changes that can affect your sex life. A good, honest, open discussion with your doctor can reveal some solutions, such as using lubricants for vaginal dryness or hormones to help with night sweats, according to Dr. Sporl.

Myth: Since menopause is natural and normal, no extra precautions are needed.
“Menopause is a normal occurrence and should be considered as such,” Dr. Bartels says. “However, osteoporosis and other conditions are more likely to happen during or after menopause.” 

 Although these health concerns exist, talking to their health care providers can help women protect themselves during these years.

Myth: Hormone therapy (HT) is bad.
“Yes and no,” Dr. Bartels says. “HT is associated with a minimally increased risk of stroke and breast cancer; however, the study that describes this has some fl aws. Generally HT is still suggested for hot flashes, night sweats, vaginal dryness and prevention of osteoporosis—as long as women use the lowest dose for the shortest period of time.”

Myth: Menopause causes weight gain.
Wrong, says Dr. Bartels. “Diet and lack of exercise are the main reasons for weight gain and obesity.” 

Menopause is a good time to recalibrate your diet, Dr. Sporl says. Metabolism starts to slow as we age. “We just can’t continue to eat like we’re 20-year-olds,” she says. Also, some nutritional needs change. For example, women need 1,000 milligrams of calcium a day before menopause and 1,500 milligrams a day after menopause, according to the National Women’s Health Information Center.

Take the menopause pause
In fact, because menopause is a time of change, it’s also a good time to re-evaluate many things in life, Dr. Sporl says. “Start an exercise program. Work on stress. Get enough sleep. Work on relationships,” she advises. “Examine your life, adjust what you need to and embrace what’s ahead.”

Learn how to manage your hot flashes by visiting multicare.org/hotflash.

Diabetes: Your Questions Answered

 Each day, more than 4,000 Americans learn they have diabetes. it can be startling news. 

“They each want to know how this diagnosis will change their life,” says Ronald J. Graf, MD, FAACE, an endocrinologist with MultiCare Endocrinology Specialists – Tacoma. That leads to questions—about diet, medications, the risk for complications and more. 

These questions are often most fully addressed in diabetes education classes. But a few frequently asked questions are briefly answered here. 

Will I have to give up sweets?
A healthful diet is crucial. It’s low in saturated fats and trans fats. And it contains balanced portions of proteins and carbohydrates, including sugars. 

“It’s the carbohydrates that have the major effect on one’s blood sugar level, but even simple sugars and sweets are allowed in limited amounts,” Dr. Graf says.

Why is exercise important?
Exercise can lower blood sugar levels and help with insulin resistance, which occurs with type 2 diabetes—the type often related to obesity. Insulin resistance means the body has a hard time using the insulin it makes. 

“Exercise can overcome much of that insulin resistance, as well as burn some of the calories we consume in our diet and store in our fat,” Dr. Graf says. That can lead to weight loss, which in turn may lead to less insulin resistance. It may also improve high blood pressure and abnormal cholesterol levels, which often occur in people with diabetes.

 Will I need to take medication?
People with type 1 diabetes must take insulin. People with type 2 diabetes often can control their disease with proper diet and exercise. With time, though, they may need one or more medications.

“Frequently, even those with type 2 diabetes will eventually require insulin treatment to help control elevated blood glucose levels,” Dr. Graf says.

 Will I be able to avoid diabetes complications?
Most people who follow their health care team’s advice can have relatively healthy lives. Says Dr. Graf: “Living with diabetes usually means making some lifestyle changes and some sacrifices. But these changes are usually for the better and can lead to a healthier and longer life.”

MultiCare offers support to people with diabetes
MultiCare’s Chronic Disease Management Program is currently focused on working with patients who are managing diabetes. We offer a number of support services as part of their ongoing care, including:

• Phone calls to patients to schedule follow-up appointments
• Completing lab work and other tests before appointments so patients get results sooner
• Group visits that offer patients the chance to interact with others managing diabetes
• Free “Living Well With Chronic Conditions” workshops

For more information about MultiCare’s Chronic Disease Management Program, call 253.792.6710. For more information about diabetes care services at MultiCare, visit multicare.org/diabetes-care.

 

Myths About Menopause: Being informed can help you embrace the years ahead

It’s hard not to worry about menopause, even if you don’t want to. Night sweats, hot flashes, trouble sleeping, physical changes—they don’t sound like fun.

But some anxiety about menopause may come from the many myths and misconceptions about this time of life. The antidote? Information. So we asked two MultiCare experts—Laura Sporl, MD, and Moritz Bartels, MD—to share some of the menopause misconceptions they hear from women.

Myth: Menopause means a woman is old.

“The average age of menopause is 51,” says Dr. Bartels, an obstetrician/gynecologist at the Women’s Health and Wellness Center at MultiCare Gig Harbor Medical Park. “Given the current life expectancy—it’s around 80 years—women still live a large portion of their lives after menopause.”

Myth: Libido changes at menopause.

At midlife, women may be stressed from jobs, raising teenagers and helping elderly relatives. It’s the demands of everyday life that are often at the root of sexual problems, says Dr. Sporl, an obstetrician/gynecologist at the MultiCare Women’s Center, Northshore Clinic.

But hormonal changes at menopause can cause physical changes that can affect your sex life. A good, honest, open discussion with your doctor can reveal some solutions, such as using lubricants for vaginal dryness or hormones to help with night sweats, according to Dr. Sporl.

Myth: Since menopause is natural and normal, no extra precautions are needed.

“Menopause is a normal occurrence and should be considered as such,” Dr. Bartels says. “However, osteoporosis and other conditions are more likely to happen during or after menopause.” Although these health concerns exist, talking to their health care providers can help women protect themselves during these years.

Myth: Hormone therapy (HT) is bad.

“Yes and no,” Dr. Bartels says. “HT is associated with a minimally increased risk of stroke and breast cancer; however, the study that describes this has some flaws. Generally HT is still suggested for hot flashes, night sweats, vaginal dryness and prevention of osteoporosis—as long as women use the lowest dose for the shortest period of time.”

Myth: Menopause causes weight gain.

Wrong, says Dr. Bartels. “Diet and lack of exercise are the main reasons for weight gain and obesity.”

Menopause is a good time to recalibrate your diet, Dr. Sporl says. Metabolism starts to slow as we age. “We just can’t continue to eat like we’re 20-year-olds,” she says. Also, some nutritional needs change. For example, women need 1,000 milligrams of calcium a day before menopause and 1,500 milligrams a day after menopause, according to the National Women’s Health Information Center.

 Take the menopause pause

In fact, because menopause is a time of change, it’s also a good time to re-evaluate many things in life, Dr. Sporl says. “Start an exercise program. Work on stress. Get enough sleep. Work on relationships,” she advises. “Examine your life, adjust what you need to and embrace what’s ahead.”

Hot flashes out of control?

Learn how to manage your hot flashes by visiting multicare.org/hotflash

Connect with Dr. Bartels, Dr. Sporl, or MultiCare’s other OB/GYNs by visiting multicare.org/womens-health.

 

Cholesterol Counts in Heart Health—Learn About Your Levels

So what are your cholesterol numbers?

If you’re drawing a blank right now, it could mean you’re overdue for the routine blood test that helps give a heads-up on your risk for heart problems or a stroke.

Cholesterol is a fatty substance that helps our bodies function properly. The liver makes the cholesterol we need, but we can get more from what we eat.

The two main types of cholesterol are:

• Low-density lipoprotein (LDL), or bad cholesterol. Excess amounts can build up in the walls of arteries, narrowing the passageways and reducing blood flow to the heart and brain. This is called atherosclerosis—or hardening of the arteries—and it increases your risk for heart disease, a heart attack or a stroke.

• High-density lipoprotein (HDL), or good cholesterol. It helps clear excess cholesterol from blood vessels.

Keeping cholesterol levels in a healthy range helps reduce your risk for cardiovascular disease. But you won’t know if your numbers need improving unless you have them checked. A simple blood test called a lipoprotein profile reveals your total cholesterol count, as well as levels of LDL and HDL cholesterol and another type of fat called triglycerides. Most adults should be tested at least every five years, according to the National Heart, Lung, and Blood Institute.

Your doctor can explain what your numbers mean along with what your cholesterol goals should be. If you need to improve your numbers, talk to your doctor about what you can do. Lifestyle changes such as these can help:

• Adopt a healthy diet low in saturated fats, trans fat and cholesterol and high in fiber, fruits and veggies.
• Get at least 30 minutes of moderate exercise on most days.
• Lose weight, if needed.

Some people also need medicines to help lower cholesterol. But even if you take medications, lifestyle changes are important.

Take the first step. Ask your doctor about having your cholesterol checked, and learn your numbers.

MultiCare offers heart check screenings in Tacoma and Gig Harbor. For more information visit multicare.org/heart-check-screening-2.

Third Annual Pierce County Cancer Survivors’ Conference on Tuesday, March 15

The recent Tacoma News Tribune Article, Cancer-free isn’t end of the battle, highlights the Third Annual Cancer Survivors’ Conference, a free conference to be held on Tuesday, March 15.

Sponsored in part by MultiCare, the conference is an opportunity for cancer survivors to connect, share and learn about the physical, mental and spiritual aspects of the cancer journey.

Doug Strauss, president and co-founder of Gloria’s Angels, will give the keynote address. Sessions cover topics such as nutrition, fatigue and energy, emotional adaptation after cancer, and insurance rights of cancer survivors.

For full details about the conference, including registration information, visit http://pccancersurvivor.org/. Please note that while the event is free of charge, advanced registration is required.

The Anatomy of Smoking: How tobacco affects your body

If you’re a smoker, you probably know you should stop. That’s a good start toward quitting, but you need a powerful motivator to follow through. Knowing the truth about how smoking harms your health may be what it takes.

An alarming fact is that smoking affects nearly every part of your body, including your:

• Airways. Delicate tissues in your lungs become inflamed because of smoking. This can lead to serious disorders, such as chronic obstructive pulmonary disease. Smoking can also cause cancer to develop in your lungs, throat and mouth.

• Heart. Smoking harms the cells lining the blood vessels and heart and can increase the risk of clots that cause heart attacks. Smoking can also contribute to an abdominal aortic aneurysm—the weakening of the major artery near the stomach.

• Other blood vessels. Damage to vessel linings can cause them to narrow, restricting blood flow to the kidneys, stomach, arms, legs and feet. This can lead to a range of problems, including pain and gangrene.

• Brain. Blood clots that form in damaged arteries can travel to your brain and cause potentially fatal strokes.

• Bones and tendons. Smoking increases the risk for osteoporosis—weak bones—and fractures in both men and women. Overuse injuries, such as tendonitis, and traumatic injuries, such as sprains, are also more likely among smokers, according to the American Academy of Orthopaedic Surgeons.

• Immune system. Some of the cells that destroy germs in the body are less likely to be found in smokers than in nonsmokers. That leaves you more vulnerable to infections.

In addition, smoking can cause cancer of the pancreas, kidneys, cervix and stomach. It also can cause leukemia, which is cancer of the blood. And smoking increases your risk for eye diseases and dental problems.

Women who smoke tend to have more complications with pregnancy, including premature births, low-birth-weight babies and stillbirths. And their babies are more likely to die of SIDS (sudden infant death syndrome) than babies whose mothers don’t smoke.

Turn your risks around

There’s another list that’s much more encouraging—the benefits of giving up smoking. Check it out, along with the American Cancer Society’s guide to quitting smoking, at morehealth.org/quit4good.

By quitting, your health risks decrease immediately and continue to diminish over time, no matter how long you’ve smoked.

Read more about tobacco cessation at multicare.org/tobacco-cessation.

The National Tobacco Quitline can also help you quit for good. Call 800-QUIT-NOW (800-784-8669).

Healthier Food at Wal-Mart?

Recently, Wal-Mart announced a five-year plan to offer healthier, affordable food options in its stores across the country.

The plan includes a commitment to reduce the unhealthy salts, fats and sugars in many of its packaged food offerings, as well as to drop prices on fruits and vegetables.

In today’s Room for Debate feature on the New York Times, various experts debate the topic, “Can Wal-Mart Make Us Healthier?” (Note: The New York Times online requires free registration to access content.)

What do you think about Wal-Mart’s plan? Will it help people be healthier? Use the comments section below to share your thoughts.

Technology Friday: The ABCs of Medical Imaging

Imaging technology — like x-rays and MRIs —can be helpful tools for your doctor to get a clear picture of what’s happening inside your body. But sometimes all those acronyms and abbreviations can be confusing.

In the Healthy Living magazine Winter 2011 issue article, Play the Name Game (see page 7), we define a few of those technologies. Read on for information about some other commonly used imaging technologies.

Fluoroscopy

Fluoroscopy is an x-ray procedure that makes it possible to see internal organs in motion.

You could call fluoroscopy an x-ray “movie.” A continuous x-ray beam is passed through the body part being examined and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. A dye or “contrast material” that shows up on x-rays can be injected or swallowed during fluoroscopy to make it easier to see blood vessels, organs, and so on.

Why you’d need it: Fluoroscopy plays an important role in many procedures and examinations. Your physician may order a fluoroscopic procedure for imaging of skeletal, digestive, urinary, reproductive or respiratory systems.

Mammography

Mammography is an x-ray procedure used to examine the breasts. There are both digital and film mammograms. Digital mammograms take images of the breast and store them directly in a computer. Digital mammography uses less radiation than film mammography. All mammograms at MultiCare sites are digital.

Why you’d need it: Mammograms are used to screen for breast problems, including breast cancer. Many small tumors can be seen on a mammogram before they can be felt by a woman or her health care professional. Detecting breast cancer early presents the best options for treatment, and the survival rate is much higher when it is found in its earliest stages.

Nuclear Medicine

Nuclear Medicine refers to a combination of computers, detectors and safe, radioactive substances used to create images that show how well organs in the body are working.

A nuclear medicine test uses a special camera to take pictures of specific tissues in the body after a radioactive “tracer” makes them visible. Each type of tissue that may be scanned (including bones, organs, glands and blood vessels) uses a different radioactive compound as a tracer. The radioactivity of a tracer decreases over a period of hours, days or weeks. The tracer stays in the body until it is passed as waste, usually in the urine or stool.

Why you’d need it: Health care providers use nuclear medicine scans to diagnose and plan treatment for a number of different problems, including tumors, stomach and blood flow issues, bone and blood cell disorders, and organs that aren’t functioning correctly. 

Ultrasound

Ultrasound imaging — also known as sonography — uses sound waves to produce images of organs, vessels and tissues in the body. During an ultrasound examination, a small, hand-held transducer is placed in contact with your body. Reflected sound waves are used to produce a picture of the organs and other structures in the body.

Why you’d need it: Ultrasound imaging is most commonly associated with pregnancy, but it is also frequently used for other purposes, such as examining the heart and the blood vessels, detecting breast cysts or gallstones, or examining the prostate, liver, kidneys, pancreas, spleen, colon or urinary bladder for tumors or inflammation.

 Learn more about medical imaging at multicare.org/medical-imaging.

7 Healthy Resolutions for Busy Women

If you’re like some women, you may put other people’s needs ahead of your own. Maybe you can’t find the time to schedule a mammogram, or you feel guilty about going to the gym when your family needs you at home.

Yet taking time for your health is worth it—it can help you feel good now and prevent health problems later. Make 2011 the year you take charge of your health—starting with these seven healthy resolutions.

1. Schedule your next checkup. Regular checkups can help find problems early, when your chances of successful treatment are better. Getting the right checkups and screenings can help you live a healthier life.

2. Get a mammogram. Mammograms and clinical breast exams can help save your life by finding breast cancer early, when you have more treatment options. If you’re 40 or older, the National Cancer Institute recommends that you get a mammogram every one to two years.

3. Pay attention to your numbers. You may have high blood cholesterol or high blood pressure without knowing it. High cholesterol increases your risk for heart attack, and high blood pressure can lead to coronary heart disease and other problems. The National Heart, Lung, and Blood Institute recommends getting your cholesterol screened every five years after age 20 and getting your blood pressure checked regularly.

4. Eat your fruits and vegetables. Fruits and veggies make great on-the-go foods, and they are a natural source of energy and many vitamins and minerals. Choose produce of different colors to get a variety of nutrients.

5. Exercise more. Exercise helps relieve stress and boost your energy. Plus, it can help lower your risk for heart disease and other chronic diseases. For many people, a good goal is 30 to 60 minutes of exercise four to six times a week. (If this goal seems completely overwhelming to you, read the previous blog entry, Revising the Usual New Years Resolution, for tips on how you can slowly incorporate more activity into your day.)

6. Get enough sleep. Sleep may be one of the first things you sacrifice in order to keep up with your busy life, but getting enough sleep is important. It affects your health, mood and energy. Try to get seven to eight hours of uninterrupted sleep each night.

7. Take time to relax. Relaxation can relieve stress by calming the tension in your mind and body. Relaxation takes practice, though. Try joining a class to learn and practice relaxation skills.

Remember, resolving to make healthy choices now can make a difference to your health later on.

What healthy resolutions have you made for 2011? Use the comment feature below to share them!

Technology Friday: Mobile Health

At its most basic, Mobile Health can be described as using Internet connections and video cameras for telemedicine – or it could be accessing an electronic health record (EHR) from a mobile device, reading and responding to questions from patients via email, or secure messages reminding patients about appointments.

MultiCare Health System’s Maternal Fetal Medicine (MFM) became the first clinic in our system to use telemedicine for clinical practice, using a webcam, computer and a special monitor that allows Becky Crosetto, Genetic Counselor from Tacoma’s MFM clinic, to provide genetic counseling to expectant mothers and their families at our Olympia MFM site. This pilot program launched on Tuesday, Nov. 2, and is ongoing.

Crosetto is able to make eye contact with patients, educate them through a presentation, answer questions, and have a conversation, just as if she were in the same room.

“I kind of expected that there might be some resistance but patients have been asking all the right questions at the right times, just as if they were in the room with me,” said Crosetto. “It’s been really seamless.”

Following this first launch, telemedicine genetic counseling visits took place between our Tacoma MFM clinic and the Covington satellite MFM clinic, where five patients were seen on the initial launch day, including three visits with interpreters via teleconferencing.

One unintended consequence of this telemedicine pilot has been increased patient engagement.

“Patients seem to be paying attention – or even more attention than an in-person visit,” commented Crosetto. “The presentation is very engaging.”

On Friday, Dec. 3, MultiCare’s Neurology department launched a telestroke pilot that connects our interventional neuro-radiologists with our Emergency Departments to provide consultations to stroke patients. Using telemedicine allows Neurology specialists to get in touch virtually with doctors located anywhere within our health system to provide support and medical insight by viewing the details of the stroke patient via teleconferencing technology.

Our Pediatric carelines also launched telemedicine for endocrine follow-up visits. This will allow patients to get appropriate follow-up care, without necessarily visiting Tacoma from Olympia or farther away.

“These pilots have enabled us to deliver the right care at the right time to our patients, while minimizing the need for them to travel to receive this care,” said Florence Chang, CIO and Senior Vice President – Clinical Support Services.

This is an exciting time at MultiCare as we continue to provide easier patient access to specialty care, real-time complete clinical data to providers and convenience for providers and patients.

For updates on our work expanding mobile health services, stay tuned to this blog and to multicare.org.