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- Nurse Barb
There’s lots of reasons why sex might be painful after you turn 50. For many women as estrogen levels decline during midlife, their vaginas become much more dry and don’t have the same elasticity or ability to stretch.
What you might notice
Staying hydrated seems obvious, but it might be more challenging than you think. Most of my pregnant patients are surprised to learn that their blood volume increases by about 50% midway through pregnancy.
When it comes to salt – Remember Gold-i-locks: Not too much, not too little, but just the right amount. The truth is, your body needs salt, so while we don’t want you to over indulge in lots of salty foods, a little goes a long way in helping you maintain your fluid balance. So, don’t restrict your salt intake.
You may be surprised to learn that people who receive chemotherapy and radiation treatments from the El Camino Hospital Cancer Center are greeted with encouraging smiles, hugs and warm blankets when they step through the doors. Those little, yet important things are combined with healthy, energy-boosting complimentary snacks and encouragement delivered by cadre of volunteers, who are cancer survivors themselves. All of this, plus a track record of survival rates that rival and sometimes exceed those of other oncology and academic centers add up to create a nurturing, encouraging and most importantly, healing and curing environment.
Patient centered care isn’t just a phrase for the staff, at El Camino Hospital’s Cancer Center. In fact, their innovative programs and patient outcome data was evaluated by the National Cancer Data Base and resulted in a commendation and a three-year accreditation from the Commission on Cancer from the American College of Surgeons. I recently had the opportunity to interview some of the staff to find out more about what makes the Cancer Center so special.
If you were born in China, Hong Kong, Taiwan or other Asian countries you may be at increased risk for liver cancer. In fact, Santa Clara County has the third highest rate of liver cancer in the US, with San Francisco County having the highest. This is largely due to high numbers of people who contracted Hepatitis B at birth in their countries of origin.
What is Hepatitis B?
Hepatitis B, known as Hep B, is a viral disease that’s prevalent in many parts of the world, causing inflammation of the liver and a yellowing of the skin, known as jaundice. Many people with Hepatitis B here in Northern California have no symptoms and are unaware that they have the virus and can spread it to others.
The most common way Hepatitis B is transmitted is when a mom who is infected gives birth to a baby, who is then not vaccinated or immunized. This is the way many people from Asia become chronic carriers of Hepatitis B which can lead to other serious health concerns.
I’m back at FAME after a lovely safari weekend at Tarangire National Park, known as the park of elephants and Baobab trees. There has been more rain than usual for this time of year; maybe it is an El Niño effect, who can say, and in any case the grass is lush and green and there’s water.
On the road to Safari, what I saw was herds of cows and goats being led to whatever water had collected into impromptu mini-lakes and ponds along ditches on the side of the road, and then after the animals were cared for, the women and older children were washing clothes, giving the babies their baths and finally filling large buckets for their cooking and drinking water. It’s all the same water. No filters that I could see, and hopefully a fire to boil it at home.
There is so much here that is different, and yet so much is the same. Most of the people who come to the hospital, and many of the staff do not have running water. A daily hot shower that I take for granted is as rare as the likelihood of me seeing the white giraffe. (more…)
On my 2nd day, here at FAME, I saw something, extraordinary. I was privileged to be at the right place at the right time and witnessed a jaw dropping display of talent and knowledge in a most unexpected place. Pauline Diaz, the volunteer coordinator was giving me a tour and suggested that we bring the new donated baby hats from the US and the brand new Tanita baby scale to the maternity ward. Sure! Why not?
Here in Africa, many people come to see the Big 5 animals on safari. Yes, I know there are birders out there and plenty of people who love the cheetahs, warthogs, jackals, hyenas, antelopes, giraffes and zebras. Thousands of dollars are spent, and thousands of miles traveled to catch a glimpse, or perhaps get close enough to see the elephant, cape buffalo, lion, rhino, leopard, all of whom belong to the exclusive group of the Big 5.
However on that 2nd day at FAME, within seconds of arriving in the maternity ward and setting up the new baby scale, what I saw was Mama Evelyn, a 62 year-old experienced midwife, who delivered a baby, kept traction on the cord, and then resuscitated the new infant.
Guest Post from Tara Sabo, Fix.com. Tara Sabo lives, works, and breathes fitness. She is a certified personal trainer, fitness instructor, and half marathon runner.
Congratulations! You’re pregnant, so now what? Must you sit still for nine months? Or can you keep working out? The answers: no and yes. Exercise during pregnancy is safe and often recommended. Working out for two can be beneficial for Mom and baby; still, there are certain safety factors to consider.
How the Body Changes During Pregnancy
Sometimes it seems that everything in our bodies suddenly changes after 45. Almost overnight, there appear to be more frequent trips to the bathroom, waking us from sleep and driving women to map out their days based on the proximity of clean bathrooms.
Then, there’s the worry about coughing, sneezing or laughing and the possibility of a little leaking urine and needing to wear pads for protection. Leaking and incontinence describe the same thing.
In addition, many women also start noticing a slight discomfort and dryness around the genitals and in the vagina, and a new need for lubricant when intimate.
If these are some of the changes you’re noticing, you’re not alone. Millions of women at mid-life find that their bodies are changing in ways that few people talk about.
Having a new baby to care for is an emotional experience! Add to that the lack of sleep, feeding every 2 to 3 hours round the clock, a hormonal roller coaster….oh, yes and your body’s recovery from childbirth, plus your partner and family and, well, you get the idea. It’s easy to feel overwhelmed with all of the changes.
Mild mood changes are absolutely normal and expected for the first few weeks after giving birth. Every mom goes through a period of adjustment as her old way of life adapts to her baby’s needs, unique temperament, personality, as well as the baby’s sleep cycles, feeding challenges and all the other aspects of their care.
What every mom needs
All moms need support when a new baby arrives. Many times, moms who are feeling overwhelmed need to:
• Know that they aren’t alone
• Be encouraged to get more sleep
• Have other trusted caregivers help out by caring for the baby
• Be given permission not to be perfect
• Let go of pressures to keep up appearances
Comparing Your Experience to others on Social Media
Most new moms I’ve worked with over the years find motherhood much more challenging than they ever expected. This is what they tell me in the privacy of the exam room at 2, 4 and 6 weeks after giving birth. And because there can be a lot of shame involved when things are slightly less than perfect, it’s the rare mom who is comfortable posting anything but perfect photos and commentary on social media.
This sets everyone up for a false sense of inadequacy. You might be covered in spit up, be dragging around on only 2.5 hours of sleep, without a shower in days, hair in a ponytail and happen to glance at a friend’s photos and become instantly dejected, “Look at Emily, she’s lost all her baby weight, the breastfeeding is a breeze, her baby isn’t puking all over her and I bet she takes a shower every day.”
While adjusting to motherhood can be a breeze for a few lucky new moms (with full time help and a stylist on call), the vast majority of new moms need about 3-6 months to figure out how to care for their baby and themselves and, yes, get a shower every day.
If your pregnancy, birth and/or breastfeeding experiences are not what you expected or your baby has a health challenge, the feelings of being overwhelmed can become amplified.
Many new moms must also contend with managing complex relationships with well-meaning extended family members or be asked to conform to cultural traditions that may not resonate with their current situation. These can also add more stress to an already challenging situation.
Recognizing Postpartum Depression
There has been so much about postpartum depression in the news lately. Many new moms and their families wonder where the line between the normal “baby blues” ends and postpartum depression begins.
The following are examples of what may happen with more severe mood changes, and/or those that last more than 2 to 3 weeks. Anytime you are concerned about yourself or someone you love, do reach out to a health care provider.
Call your OB or Pediatric provider if you are:
– Feeling out of control
– Feeling sad and crying often
– Unable to sleep even when you are exhausted
– Having increased anxiety, worry or panic attacks
– Unable to care for yourself or the baby
– Having recurring thoughts or obsessive behaviors
– Feeling hopeless, guilty or ashamed
– Having disturbing thoughts about harming yourself or your baby
When in Doubt, Reach Out
Take or share this online risk assessment that can help to identify whether the symptoms you are experiencing should be addressed.
Safe and effective treatment options
Postpartum depression can be safely treated through one-on-one or group counseling, safe medications, or a combination of both. There are a variety of classes, support groups and treatments available no matter where you live.
You can find more resources through Postpartum Support International
For moms who live in the San Francisco Bay Area, the Maternal Outreach Mood Services (MOMS) program at El Camino Hospital is a resource I count on for my patients. This specialized program provides education, counseling and medical evaluation for expectant and new mothers.
Disclosure: I am working with El Camino Hospital to provide information on the programs and services that are available here.