Memory Loss Prevention: Pumping Iron Is Good for Your Brain!

May 14, 2012 by  
Filed under Health

Memory loss is a common concern among aging individuals. Although there is some expected decline in memory with progressing age, this decline should show up as no more than a mild symptom—more of an annoyance than a serious concern. Memory loss with normal aging might manifest as a word stuck “on the tip of the tongue,” or taking longer to learn and recall a list of items.

The symptoms are concerning when details or names are forgotten on a regular basis. Everybody is allowed a memory lapse here and there—it is the pattern and regularity of symptoms that would raise alarm. For instance, regularly misplacing objects, missing appointments, forgetting to pay bills, paying the same bills twice, or getting lost driving in familiar areas are symptoms that should trigger evaluation by a physician.

Mild cognitive impairment is the term that is globally applied to patients who have objective memory loss but are able to function well within social or occupational spheres. There are many causes of mild cognitive impairment, ranging from depression to vitamin deficiency to underlying degenerative disorders of the brain. Physicians should perform thorough evaluations to ascertain the cause.

Millions of older adults are diagnosed with mild cognitive impairment, and for most it is a limbo state—not quite normal, but certainly not demented. Where does this leave them? Well, it is certainly concerning, because 10 percent of patients with mild cognitive impairment progress to develop dementia each year.

Exercise: What Recent Studies Show

Even worse, there are no medications that are approved to treat mild cognitive impairment. Physicians often take a “wait and see” approach. However, medical studies do support steps that a person can take to improve memory function and to improve the odds of stability or improvement. I tell my patients to eat a well balanced diet, control blood pressure and cholesterol aggressively, moderate alcohol intake, and most importantly, get active.

Many older patients are reluctant to start an exercise regimen, but I strongly advocate that my patients start a regimen of aerobic exercise and weight training, initially with the guidance of a physical therapist or trainer. Over the past few years, a number of studies have demonstrated improvement in cognitive task performance in patients with mild cognitive impairment who exercise.

Most recently, a study of older women with mild cognitive impairment found that after six months, resistance/weight training was more effective than balance and stretching exercise in improving memory. (However, balance exercises improved overall stability and reduced falling.)  Members of a third group, which did aerobic exercise, became more fit, but received no cognitive benefit compared with the control group.

However, the most rigorous study on the topic of aerobic exercise and memory loss  revealed that high-intensity aerobic exercise does improve memory, and—of note—the women in that study actually obtained significantly more cognitive benefit than the men.

What’s the bottom line?

Older women who are diagnosed with mild cognitive impairment can empower themselves and improve their memory. They should start an exercise program combining aerobic training (walking/jogging/bicycling), resistance training (weights) and balance training (Tai Chi, Yoga, Pilates). There are many gyms that offer classes combining these modalities in a fun way. So don’t be scared to pump the iron! It’s good for your brain.

For “Save Your Vision Month,” a Guide to Eye Emergencies


This is national
Save Your Vision Monthand we are fortunate to have this clear description of common eye emergencies from Leila Rafla-Demetrious, M.D,
 a board-certified ophthalmologist on staff at the New York Presbyterian Hospital/Weill Cornell Medical School. Eye emergencies often require urgent evaluation and proper treatment to prevent loss of vision. This is a well-written and clearly illustrated guide that each of us should print and keep at homeand email to all family and friends.

Patricia Yarberry Allen, M.D.

 

 

Trauma

Trauma is the most common cause of preventable visual loss. The eye can be injured by a sharp object like a high-speed projectile (for example, a piece of metal off a hammer or drill) or blunt trauma, like a bungee cord from a suitcase. When such a thing occurs, or if a foreign body is suspected to have penetrated an eye, the first thing to remember is DO NOT APPLY PRESSURE. Inspect the eye gently; cover the eye with a metal or plastic shield, or create a makeshift cover with half of a paper cup taped over the eye. Seek medical attention quickly, preferably at a large medical center that has a consulting ophthalmologist immediately available

Chemical burns

Chemical burns are a common injury to the eyes.  This may occur from contact lens CLEANSERS, among other things, though this type of injury can also be caused by much more dangerous and caustic solutions like strong detergents and household cleansers. Immediate irrigation is key, preferably with sterile saline or contact lens RINSING solution, though clean tap water will do in a pinch. Flush the eye for at least 15 to 20 minutes prior to seeking medical care, as most harm from these chemicals is done within the first few minutes of exposure.

Foreign body

Eye injury from a foreign body may be result from almost anything—from flying dust/gravel in the street to a retained piece of contact lens. Metallic foreign bodies are especially noxious, as they can create stubborn rust rings if allowed to sit on the cornea. Remember that rubbing to try to remove the foreign body is a bad idea, since it can lodge the offending particle deeper in the cornea and/or cause a painful abrasion. Irrigation is once again an important first step, since it may help dislodge the retained particle. If this is successful, no emergent medical attention is needed, but if the particle is still felt or seen, seek professional care to remove it.

Sudden visual loss

Symptoms of retinal detachment.

Sudden visual loss may occur in part or all of the visual field, and may be due to a number of causes. Retinal detachments, both partial and total, are painless separations of the retina from the back of the eye. They are often preceded by flashing lights (one eye only, and typically arcing, off to the side of one’s vision), new floaters (multiple dots or squiggles in the visual field), and sometimes a visual field defect (curtain over part of one’s vision).  Seek attention immediately from an eye specialist, since retinal detachments can often be repaired with laser or surgery, frequently with a better outcome when diagnosed early.

A glaucoma attack may also cause acute visual loss, but this is typically accompanied by pain around the eye, headache, and often nausea and vomiting.  A glaucoma attack can cause permanent visual loss if not treated quickly, and may necessitate a laser procedure to break the attack.

Lastly, vascular occlusions in the veins or arteries of the retina can also cause painless vision loss, and, while not always as amenable to treatment, should be diagnosed quickly.

While all of the situations discussed above are true emergencies, there are other problems that can cause visual impact and need to be addressed on a semi-urgent basis. These include:

 

Corneal abrasions

Corneal abrasions are often self-sustained (fingernail, hairbrush, makeup wand) and almost always very painful and are often accompanied by a foreign-body sensation, redness, watering, and sensitivity to light. A first good step is to lubricate the eye with artificial tears, since moisture helps with the discomfort and allows the cornea to start healing. Seek prompt medical attention if the symptoms persist more than a day, or sooner if you are a contact lens wearer, as this may indicate a more serious condition like an infected corneal ulcer.

Pink eye or Conjunctivitis

Pink Eye is the bane of every mother’s existence, as it tends to spread quickly from child to child and parents within a household. Usually viral, it is often accompanied or preceded by a cold, sniffles, or sore throat. Symptoms, which can be bilateral, include red, watery eyes, itching, and mucus discharge. Viral conjunctivitis, like the common cold, has no true remedy, and usually requires only supportive treatment of symptoms. Treatment includes cold soaks, lubricant eye drops, and sparing use of over-the-counter anti-itching drops. Antibiotic drops are not required or even helpful in viral conjunctivitis; however, if the eye discharge is copious, green, or yellow, bacterial infection is likely, and prescription antibiotic drops are warranted. Lastly, if you are very light-sensitive or your vision becomes blurred, see an ophthalmologist to rule out an uncommon, but potentially sight-threatening, involvement of the cornea.

Spring Training for Non-Athletes

March 22, 2012 by  
Filed under Fitness, Health

There are many kinds of spring training.

We often associate the term “spring training” with baseball. The teams all head to warm-weather camps in late winter and work hard to strengthen muscles and work on injured tendons, muscles, ligaments, and joints so that another season of baseball can begin with flexible, strong, and uninjured players.

There are more than a few women who look at spring training in a slightly different way. We want to tone the arms for sleeveless dresses and to work-work-work to get the belly flatter and the legs toned so that we feel better in the first game of the season—going into a dressing room with a mirror and choosing a summer swimsuit. Here are five easy ways to create a spring training regimen for busy women—exercise that doesn’t require taking the time to go to a gym.

  1. Climb the stairs. Begin with 3 flights; as your aerobic capacity improves, increase the number of stairs you climb at a time.  Consider 25 flights your Everest, unless your weight or medical condition prevents so high a climb. Do this simple exercise every other day. Stop and stretch every 10 flights.  Place the forepart of each foot firmly on the edge of a stair and gently press down, holding to the count of 10. Release and do this again. Climbing stairs does wonders for untoned winter legs; a very few weeks of stair-climbing will shape and slim the legs and add tone to the glutes and thighs. Drink a bottle of water after each 15  flights of stairs. Time for 25 flights of stairs: 10 minutes.
  2. Buy three-pound barbells to use for toning the arms.  Go to YouTube to find free exercise videos for triceps, biceps, shoulders, and that recalcitrant bra fat area. Do three series of 15 of these exercises that target each aspect of the upper body every other morning.  Time: 10 minutes.  Then lie on a foam roller, letting the arms fall to the side, and gently stretch the shoulder and upper-back muscles.
  3. For abdominal exercises you will need a mat and the personal experience of having done basic abdominal core exercises; otherwise you will need to download a YouTube video for these. A strong core will be not only tighter but will improve posture and decrease back pain. Time: 5 minutes daily.
  4. Walk 20 blocks to work and 20 blocks back: Get out of the taxi or off the subway or bus so that you can get this daily training in. Walk briskly. Buy walking shoes that have good support and that are the right shoe for your walking style and the shape of your feet. Some shoes are best for high arches, others for flat feet. Many stores that cater to serious athletes now have technology that evaluates your rapid-walking style using a small video camera that is placed at the level of the feet.  After one minute of your walking on the treadmill, the trained salespeople can give you good advice about the shoe that will be best for your feet. Use a backpack that is well designed and positioned on the upper back comfortably, rather than carrying a briefcase and handbag; wearing the backpack will decrease shoulder pain while you’re walking.  Drink a bottle of water during each walk.  Muscles need hydration and stretching.  Simple stretches after the walk will prevent muscle pain. Time: 15 minutes in the morning and 15 minutes in the afternoon.
  5.  Correct your posture.  Ask a friend to photograph you with a simple phone camera when you aren’t looking, and do the same for her. It is often a big shock to see how we look when we are just standing or walking around, not conscious of where our body parts are in relation to each other!  Hold that head up, look straight ahead, lift the chest, pull the shoulders back and down, pull the abdominal muscles in tightly while you think of lifting the abdominal muscles up toward the chest at the same time. Then tuck the buttocks in tightly and walk with authority and grace. You will have less back pain, and less neck and upper back pain as well. Time: All the time!

It would be terrific if we could remain motivated enough to do these easy and time-friendly exercises all year round. But at least many women are more likely to start an exercise program in spring in order to look better in more revealing clothes.

 

JFK’s Peace Corps Call—Wish You’d Answered it? It’s Not Too Late!

March 12, 2012 by  
Filed under Aging, Fitness, Travel

 

In a matter of days my 26-year old son will be packing his bags and heading off to Morocco as a Peace Corps volunteer. Am I jealous? You bet!

But as it happens, the Peace Corps is not just for the young. Those of us who are old enough to remember President Kennedy’s call to service in the 1960s are still eligible to answer it—and many of us are doing just that. While the typical Peace Corps volunteer is in his or her mid- to late twenties, 7 percent of volunteers are over the age of 50.

Ed and Beth Lorenz, left, trekking in the bush with locals on Tanna, Vanuatu. (Photo: Senior Life)

According to Andrea Fellows, a marketing and outreach recruiter at Peace Corps, older volunteers are invaluable because they bring deep expertise to the table. “Our first goal in the countries we serve is teaching people a skill,” she says “We love seeing people who have been working in a specific field for 10- or 20-plus years because we know they will be able to do the job very, very well.”

For example, dietician Beth Payne began her service at age 62, after retiring from her career at the Department of Veterans Affairs. Payne was assigned to work at the national nutrition agency in Gambia, West Africa, where she did policy development, reviewed reports, participated in nutritional surveillance, and taught at the local university and school of public health. “The assignment was a perfect fit,” she says. “The benefit of being an older volunteer is that you don’t become a jack-of-all-trades, but rather use your specific skills.”

Adapting to What’s Not “Normal”

In addition to a strong skill set, Fellows says, you must have solid reasons for volunteering; the emotional maturity to function far away from loved ones and friends; and cultural sensitivity. That final criterion “is huge,” Fellows notes. “People have to be willing to adapt to things that aren’t ‘normal’ to them, but that may be part of the culture where they are volunteering.” A sense of service and the ability to give freely are equally important, she adds.

Fellows also emphasizes the need to have all your ducks in a row. If you own a house, for example, will there be someone who can take care of it while you are away? Do you have children and grandchildren? Someone who may graduate from college or have a baby while you are away? “You have to be prepared to miss some of those life events,” she says. (The typical term of service in the Peace Corps is 27 months.)

Consulting with loved ones before deciding to apply is crucial, say Fellows and Payne. In Payne’s case, her adult children were delighted that she would finally fulfill a lifelong dream. “They both said, ‘You talked about it all our lives. Do it,’” Payne recalls. “If you don’t have that sort of encouragement, you can fall apart pretty fast. For your peace of mind you need to know what people who matter to you think about what you are doing.”

While all Peace Corps volunteers must be in good health, the organization does try to accommodate qualified applicants who have medical issues. “There isn’t any one thing that would prevent you from serving,” says Fellows. “We try to accommodate everyone. We recently placed a person who is HIV-positive.”

Even so, volunteers must have some level of physical fitness. Because they are not allowed to drive, volunteers in more rural places may have to walk or ride a bike to get from place to place. “All the older volunteers I served with were placed in cities or villages where this wasn’t an issue,” says Fellows, who served in the Republic of Moldova.

Of Pit Latrines and Perseverance

Payne’s assignment was in a major city where she had access to public transportation, but her language training took place in a small village without running water and electricity. She said that she was nervous about her ability to use a pit latrine. “When you get older, your knees are not so great,” she says. “I had visions of squatting and not being able to get up. It took me about four days to get used to it. The anxiety was much worse than the actual event,” she laughs.

In addition to good health, perseverance is another important trait. Older volunteers, who are accustomed to feeling competent, may face a few failures. “They have to be willing to rethink, go back to the drawing board, and talk to the locals to learn how it can be done successfully,” Fellows says.

Learning a new language at an older age can be tough, and Payne is grateful that she worked in an environment where English was the official language. But Fellows insists that language should be an older volunteer’s last concern. “Our language program and support are second to none,” she asserts. “In Peace Corps they throw you into a host family and you are forced to build upon what you learn every day.”

While citizens of their host country revere older volunteers, they can sometimes find it difficult to find a support network when so many of their colleagues are in a different life stage. “Developing some sort of a sounding board the first year that I was there was far more difficult,” Payne recalls. “There was nobody my age. Once there were people who would enjoy a glass of wine with me rather than a bottle of beer, things got much better.”

Challenges aside, Payne has no regrets. “I’m so glad I finally did it!” she says. “I learned that I can be extremely flexible and go with the flow; that I’m a better teacher than I thought I was; and that I can be patient when I need to be.”

For more information, visit the Peace Corps website. In addition,  “The Peace Corps: Volunteering at Age 50+” (PDF) provides many details to help older volunteers prepare for service.

Manners Matter

This is the second Q&A column by B. Elliott, a frequent WVFC commentator, on “doing the right thing” in our quickly evolving culture Feel free to contact Ms. Elliott at WFVC for solutions to your troublesome social problems. Just address your query to B. Elliott and type it into the comment box at the bottom of the post.—Ed.

Dear B. Elliott:

I was widowed a few years ago. My husband’s medical bills were higher than anyone could have anticipated, and some of our investments in the meantime took a nosedive. I now find myself in somewhat reduced circumstances. While we didn’t have a lavish lifestyle, we did belong to a country club, but that no longer makes financial sense for me. We also used to go to the opera and the theater occasionally. I want to continue to live in the same community and see my old friends, but I can’t afford to do many of these things anymore, and I especially can’t reciprocate when they take me out to dinner. I am afraid my friends will soon drift away if I can’t keep up.

Feeling lost, Lorraine

 

Dear Lorraine:

Many people find themselves living on less these days, though this might feel like a small consolation to you. Of course, if the club was the center of your social world and you were part of a “couple,” you are naturally going to feel isolated now. The most important thing is to not give up the things you love to do, but to find a creative way of doing these affordably. For the past six years, the Metropolitan Opera in New York has broadcast live HD performances for a minimal admission fee at many local movie houses throughout the U.S. On April 7, a new production of Massanet’s Manon is on the docket; on April 14, the opera will be Verdi favorite La Traviata. Check for viewing locations here. 

(Photo: Madame Ming, flickr)

As for paying people back, don’t worry about going “dollar for dollar.” People do love to be invited to someone’s home, and it is happening less and less these days. So even if you are a terrible cook and/or filet mignon isn’t in your budget, you can still entertain nicely. Many women would love to be invited to tea, and it needn’t be “high,” either. Whip up a few crust less sandwiches (Pepperidge Farm thin-sliced bread is best, and how costly is a cucumber?), offer one tempting sweet, and pour a selection of regular and decaf/herbal teas. For inspiration, check out The London Ritz Book of Afternoon Tea,   by Helen Simpson, or The Book of Afternoon Tea, by Lesley Mackey, at the library. Just reading the rituals and recipes (of the former) and looking at the photos (of the latter) is a treat. Even if you haven’t become a fan of the PBS series, call your gathering a Downtown Abbey party if getting together for tea seems a bit out of the blue. Remember, fun—and friendship—is what counts.

Another idea might be to host a simple tray supper when a special event, or even just a movie of which you are particularly fond, is on the tube. Make /buy a hearty soup, stew, or potpie, serve a salad, and finish with some easy dessert, such as brownies topped with ice cream. Fun trivia fact: Actress Katharine Hepburn “ahhhhhhh-dooooored” dining on a folding tray table, and she did so most evenings later in life in her New York City townhouse.
Your circumstances are those almost anyone could face in the future, as people have in the past. Don’t think of your new life as stripped- down; think of it as beautifully simplified. “Long ago in 1945, all the nice people in England were poor, allowing for exceptions . . .” begins The Girls of Slender Means, by Dame Muriel Spark. Now that is a great short novel, written by the author of The Prime of Miss Jean Brodie. Come to think of it, Lorraine, why not start a book group? Be interesting, and people will continue to be interested in you, even though you’re coping with “reduced circumstances.”

j

 

 

 

 

 

 

 

 

 

Ask Dr. Pat: “I’m writing about an embarrassing problem…”

Dear Dr. Pat,

I’m writing about an embarrassing problem that I really don’t feel comfortable talking about with my friends. I have been leaking when I do any exercise or cough, and it’s getting worse.It is interfering with everything I do. I now wear big pads just in case and don’t drink before I go out. In fact, I’m limiting the amount of liquids I consume altogether which is probably not so healthy.

I saw my gynecologist. He said I should have a complete hysterectomy while he fixes what he called a dropped bladder. He delivered my children and I do trust him. My biggest child was 9½ pounds and was a forceps delivery when I was 38. (I’m now 40 and menstruate regularly.)

It took me a long time to recover from that episiotomy repair, I can tell you! I developed the leaking urine after that birth but did lots of Kegel exercises and things did get better for a while. But then the urine problem became worse and worse.

I don’t want to talk to my husband about it, but if I have to have surgery I won’t have a choice. This certainly doesn’t make me feel sexy. In fact, since that delivery my husband has remarked that my vaginal opening seems a bit larger. Do I really need surgery?

My uterus is not falling down but the gynecologist said that it would eventually so I might as well prevent it.

Betty

Dear Betty,

You’ve done a great job of describing a condition that many women are intimately familiar with and, like you, embarrassed to talk about. I asked WVFC Medical Advisory Board member Lauri Romanzi, M.D., a specialist in reconstructive pelvic surgery and urogynecology, to respond. Which she did, pulling out a drawerful of medical illustrations to help explain what’s going on in your body, and why a hysterectomy isn’t the answer. —Dr. Pat

Hello Betty.

You have two common pelvic floor disorders: pelvic organ prolapse and urinary incontinence. While these conditions often occur together, there are many women with no prolapse whatever who have severe urinary incontinence, and women with severe prolapse who don’t leak a drop.

You are not alone!

Recent estimates using US Census population projections anticipate a probable 46 percent increase in pelvic organ prolapse among American women over the next 40 years, from 3.3 million in 2010 to 4.9 million. According to a recent study from Duke University, it is possible that the number of women with prolapse will be even greater than this, up to 9.2 million. Prolapse may occur to varying degrees in up to 50 percent of women who’ve given birth.

With our without urinary incontinence, no woman with a cystocele—the medical term for a dropped or prolapsed bladder—needs, or even should undergo a hysterectomy to prevent possible future uterine prolapse. If for no other reason than that you may never develop uterine prolapse, and if you do, you can have it repaired at that time with a uterine re-suspension.

Before you head into the operating room, you may be able take care of both the urinary incontinence and the vaginal laxity with coached Kegel exercises, done with a qualified pelvic floor physical therapist (not on your own). If pelvic floor PT is going to work, 2-3 months of regular visits with home workouts in between should do it.

If the pelvic floor physical therapy doesn’t give you the results you’re looking for, it may be time to plan a reconstructive procedure. Even if you need an operation, there is no reason to remove any body parts. You can take care of the cystocele with a bladder lift, the stress urinary incontinence with a minimally invasive sling, and the vaginal laxity with a combined rectocele repair with perineoplasty. Unless the uterus is falling down, it is best left alone. Even if it is falling down, it can be re-suspended. Let’s look at pelvic anatomy to help you understand the geography of your pelvis with an edited excerpt from my book on incontinence and prolapse, “Plumbing and Renovations” (www.plumbingandrenovations.com):

Pelvic organ, or vaginal, prolapse is an umbrella term for the different components of vaginal prolapse, including uterine prolapse, dropped bladder (cystocele) vaginal laxity (perineal body atrophy), rectocele and enterocele. Some women have a bit of each, others have only one or two components, but which ever and to whatever degree, pelvic organ prolapse is a woman’s hernia.

Normal pelvic anatomy (right) is a harmony of bodily functions buttressed by the Kegel muscles of the Levator ani. The uterus drapes gently over the top of the bladder, and the bladder, vagina and rectum are separated from each other by thin, sturdy fibro-muscular walls composed of collagen, skin cells and smooth muscle. These walls hold the rectum and bladder in place, and tend to weaken with childbearing and age. At the vaginal opening, below the level of the muscles, is the perineum, a connective tissue separator of the anus and vagina which tends to thin out with childbearing and age. Above the muscles we find the uterus, held in place by the uterosacral ligaments much as a chandelier is held up by strong cables. The female pelvic support system is considered in compartments when doctors are figuring out what is out of place and how best to amend the condition. The anterior compartment contains the bladder and urethra; the posterior compartment contains the rectum and anus, the basement is the perineum and the ceiling contains the uterus.


A cystocele (left) is a dropped bladder, often first noticed during sex, or on the toilet, as a soft, balloon-like bulge at the vaginal opening. This results from the connective tissue between bladder and vagina wearing out or pulling off of the sidewall of the pelvis, leaving only the vaginal skin to hold up the bladder, which is too elastic to do the job well, and so the bladder bulges down.

A similar thinning of connective tissue can occur between rectum and vagina causing a rectocele. In the  next illustration (below right), we see a rectocele along with an absence of perineum connective tissue between the anus and vagina, with a bulging of the vaginal opening.


Rectocele and perineum atrophy are often seen together, with symptoms of vaginal laxity, looseness during sex, a bearing-down pelvic pressure with strenuous activity, and difficult defecation. In fact, many women with rectocele will press up on the perineum or backward on the vaginal wall toward the rectum during bowel movements to compensate for the bulging and make defecation easier. Doctors call this “splinting.” If you are doing this, you may have a rectocele or a thin perineum.

When the uterosacral ligaments stretch out, the uterus drops down into the vagina. It feels like a firm mass at the vaginal opening, coming down either on the toilet or during strenuous activities like jogging or heavy lifting. This is uterine prolapse.

It is common for women with uterine prolapse to report that the bulge waxes and wanes—that it’s not there on some days and low and bothersome on others. It usually pulls back in when you lie down, and is often “in in the morning and out by the evening.” It is sometimes associated with a low backache in the area of the tailbone.


The uterus comes with dual support, one robust uterosacral ligament on each side, holding it in place at the top of the vagina.  (See  left). When the ligaments are lax, the uterus drops.


In the event of uterine prolapse, re-suspend – do not remove. Hysterectomy is not a cure for prolapse; hysterectomy is a cure for having a uterus. There are three basic categories of uterine re-suspension:

Re-suspend to the sacrospinous ligament(s)

Re-suspend to native uterosacral ligaments





Re-suspend with artificial uterosacral graft


Betty, at 40 years of age, your reticence about surgery is not only completely understandable, it is wise

When it comes to prolapse, the uterus is a victim, not a perpetrator. Prolapse occurs not because the uterus is heavy, but because the ligaments supporting the uterus gave way. Since uterine re-suspension (hysteropexy) works just as well as hysterectomy-based prolapse repairs, with essentially the same durability, there is no advantage to removing the uterus to repair prolapse— unless you also suffer a separate condition for which hysterectomy may be of clear benefit, such as severe fibroids or endometriosis or high personal risk for gynecologic cancers. Otherwise, it’s best to lift that uterus up into normal position with a re-suspension procedure and get on with life!

To find a surgeon skilled in treatment for pelvic organ prolapse, vaginal laxity and urinary incontinence, visit the ‘Find A Provider’ page on the American Urogynecologic Society website.

Best,

Lauri Romanzi, M.D.

The iPad: Five Surprising Things

May 16, 2010 by  
Filed under Tech

“Is that an iPad?”

So far I’ve been asked that question in coffee shops, on commuter trains, and last night at a community forum in Northwest Philadelphia.  Sometimes they don’t ask in words, at first: I saw a few people on a Starbucks line glancing at me, then back again, until I nodded: “Yes, that’s what it is.” However they ask, the next question is usually the same: “Do you love it?”

My answer, six weeks on, is a tentative yes — with a lot of caveats that I don’t usually bother to explain. Here’s what’s been most surprising so far, some in good ways and some less so.

My nephew loves it. Some readers of this blog have met my nephew Joey, at least by sight (see left) and the soulful accounts of his mother Phyllis, whose commitment to mitigating his autism is titanic. Joe will be 13 this July, and he’s only now able to offer a handful of words; he communicates with sign language and gestures and laughter, as the world throws stimuli at him that it’s not easy for him to process. Very shortly after I bought my iPad, I learned from Phyllis: “Joey has an iPad. He LOVES it.”

He doesn’t use it the way I do, of course, but he’s got a slew of educational games that are accelerating his use of sign language and even reading, including ABC Alphabet, where he’ll touch letters until they create a word with accompanying picture, and a Bubble Snap! game as reward.  Parents are thrilled that instead of some unwieldy device that makes kids feel even more out of place — like the sign-language machine that Joe hated and never touched — they can use the newest cool thing.  And it’s far less expensive than those devices, notes Strollerbaby.com (in a post entitled “iPad Changes Life for Autistic Children”).

YouTube Preview Image

Can you  hear me now? Unwilling to pay monthly data fees on top of what we pay for wireless Internet at home, when I travel I’m the Blanche du Bois of the Net, entirely dependent on access provided by strangers. But even at home there are issues — sluggishness, crashing — if I try to use a lot of broadband, for streaming video and the like.  It turns out that to give the iPad its bodacious battery life, Apple ended up putting the wireless hardware not quite as close to an outside air source as it should have. Somewhat paradoxically, they’ve promised a software fix soon, though I’m not enough of a geek to know how that could possibly work.  Right now, it means I don’t get to waste enough time on Netflix double features, which is likely OK.

About that keyboard dock….. Almost two weeks ago I angrily posted this Facebook status: “Still love the iPad, but the keyboard dock BLOWS.”  The first one I got turned out to be defective, and only worked ONCE. I spent five days, on and off, trying to latch it in place. Then I found out others were having the same issue. When I showed up at the Apple Store and said “It’s defective,” they sent me to a guy at the back who had likely been hearing little else all week. I’m typing on the replacement they gave me right now. To use it in my lap (as I’m doing), it’s best to have a hard surface between lap and dock. Which is why these words come to you with the support of Ron Chernow’s hardcover biography of Alexander Hamilton.

Speaking of software… I’m typing this post on Pages, Apple’s word-processing program, which I’ve been using on the MacBook for years now. But on the Pad, the mix of gestural language (touch “b” for bold type, spread your fingers to cut and paste) and keyboard commands feels kinda awkward.  I love that I didn’t have to carry four pounds of computer to the spot where I’m working now, but for heavy-duty writing it may not cut it quite yet. Similarly, the WordPress app and the iPad’s Web browsers make blog editing and maintenance possible, but for anything heavy-duty (including adding links or photos), I wait till I’m near the laptop.

As for other things I’m used to on the Web, I personally am not a fan of the iPad  Facebook app; all filtering is lost (among 1000-plus FB friends) and I can’t even go to the Facebook Pages I manage, like the one for Women’s Voices for Change. But I do love Scrabble on the iPad (even though I lose more than I win), and many of the apps developed by magazines and newspapers can keep me enthralled. Some don’t, of course (Slate, I’m looking at you). But in the best of them, I’m actually more immersed in the content than the device I’m using to get it. And that brings me to my most unprecedented surprise.

That vivid and continuous dream. A long, long time ago in Binghamton, New York, I was taught by the late John Gardner that all good fiction should read like a vivid and continuous dream, and that what made novels bad was when the reader was pulled out of that stream by poor or self-consciously affected writing. I’ve often myself taught that principle to my own students, even for nonfiction writing, though it’s perhaps  equally true that one doesn’t want readers to drop their critical faculties when reading about factual issues.

But reading e-books on this device suddenly made me feel like I was in that vivid, continuous dream — whether it was Sense and Sensibility, Diane Ravitch’s The Life and Death of The Great American Public School System or Ethan Thomas’ new book The War Lovers. Unlike reading an electronic book on a computer and using keyboard arrows to get around, I was turning pages (the Kindle and iBook apps both make it look like pages are turning). I was not conscious of doing so:  I was inside the story being told.

It became comprehensible to me that “cell phone novels” had become all the rage in Japan, and I began to stop fearing that mobile technology would be the death of long-form journalism. I’ll be bold and declare the opposite:  Make the story strong enough, and people will become as immersed in it as you were when you finished the first hardback you loved. (If Gardner were still alive, I bet he’d warm to this newfangled thing better than he did to most literary trends.)

Of course, there are tons of ways my iPad experience could be even better.  I desperately want the next versions of the book apps (iBooks, Kindle, Goodreads) to allow note-taking, or even a Google search widget for more info on X or Y.  I want fuller social-media apps, DIY podcasts, and so on and so on and scooby-dooby-doo.  It also weirds me out to be purchasing books and word-processing software on iTunes, since I resisted the Kindle because I didn’t want to be beholden to one company.

But for right now, I’ll stay on this ride. Who knows what comes next?

iPad: The Great Equalizer?

April 11, 2010 by  
Filed under Tech, Television

It’s now been nearly a week since I–and oh, about 300,000 others–became early adopters of Apple’s new tablet computer, the somewhat unfortunately named iPad. (I still wonder if any women were in the room when they decided on the name.)

You’ve probably heard more about it than you ever wanted to, even if you own one: in this one week alone, we’ve had videos of two-year-olds playing on the thing, articles like “The iPad is a gift to readers” (Salon) and “The 9 Worst Things About the iPad” (Huffington Post). So why am I writing yet another one?

More centrally: why did I, a freelance writer and editor with a super-limited budget, line up at the Apple Store on Saturday with all the hardcore Mac fanboys  — who had, like me, “pre-ordered” the device?

Partly because the minute I heard about it, it felt to me not like a luxury item but a near-necessity.

Full disclosure: I’ve been a charter member of the Mac cult for just about 20 years, and am fully aware that it means I have spent more for computers than I should have. I am also one of those “laptop people,” not having used a desktop computer since about 1995. Limits on my vision , dexterity and agility–first from illness, then from age as well–have kept me keenly interested in tools that let me focus on my work and not the computer’s. And as a media professional, I’ve been keenly aware of the newer media spaces, not just “Internet-instead of newspapers,” but phones, game consoles, and social media.

When the iPhone came out, I was in the market for a new laptop and thought of buying the iPhone instead, since it’s a powerful computer in its own right. That fancy passed, but as prices came down I became a proud owner of an iPod Touch, and learned to love both its easy access to work (email, editing blog posts like this one) and its quick windows to the rest of the ‘net. (I swear, for example, that I read a lot more of the New York Times on that tiny screen than I ever did in print.)

The problem with the Touch? Remember the vision and dexterity problems I mentioned above? Even when I increase font sizes, it has felt severely limiting—especially given the admittedly beguiling multitouch interface, where you physically turn pages and place Scrabble tiles. I joke about it, have called it all occupational therapy. But when I first started hearing about the iPad, and heard it critiqued as “just a big iPod Touch,” I clapped my hands. You made me a big one?

And when I learned about the keyboard dock that could make typing on the thing a bit easier, I knew it might even be my next laptop. Sort of.

When I got in line at my local Apple Store last Saturday, I was completely convinced the line would be full of women like me, whose eyes are beginning to go and whose multitasking lives demanded a tool both pleasurable and with fewer demands on the body.

Of course, I was wrong: it seemed, at least at first glance, that only men between 25 and 40 were really itching to get their hands on the newest Apple media device. (Or else–and this was perhaps more likely–women like me were far too busy to deal with that wait-in-line thing and just ordered it for delivery.)

And yes, so far it’s a mixed blessing. Though still a quarter the weight of my MacBook, the thing is far heavier than you expect, being crammed with software and a honking huge battery. Programs whisper and quit on occasion. And that keyboard dock isn’t ready yet, limiting the amount of time I actually write on it (though I wrote about half of this post that way). But I’m already loving the reading tools (hello, Moby Dick and countless academic articles for the book I’m writing). And the rather excellent speakers mean that while I’m doing more major writing at home, I have a very good soundtrack. (It’s a book! No, it’s a newspaper! No, it’s a…..boom box?)

I’ll keep you posted on how it goes. It’s way too early to know if I’ll end up regretting my decision to buy it so soon. I’ll check in as the year proceeds, as newer and even cooler and much cheaper products come out from Apple and its rivals.  In the meantime, I’m becoming a decent Scrabble player. And maybe I can get Stephen Colbert to give me his recipe for iPad salsa.

Chris Lombardi is the editor of Women’s Voices for Change.


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Hereditary Colon Cancer: What You Need to Know

All cancers result from a combination of genetic and environmental influences, and genes that can predispose us to cancer can be inherited from our parents. It’s important to know and understand your family’s medical history because it provides clues that you may be at elevated risk to develop a particular disease. We should all try to know the cancers which have occurred in our families for at least three generations.

For older women this may be more difficult, as in years gone by cancers weren’t discussed as freely as they are now. To help your physician get the full picture, it’s important to bring your complete family medical history to your appointment, so that you can review it together and determine if you’re at risk for a particular disease. This way, a health care strategy aimed at prevention and early detection can be tailored specifically for you

Over the past ten years much attention has been paid to hereditary breast and ovarian cancers. This is largely due to the identification of the BRCA1 and BRCA2 genes and an increased understanding of the impact that they can have on breast and ovarian cancers. For some time now, we have known that colon cancer can also occur in a hereditary pattern. Approximately 60 percent of colon cancers occur in women without a family history of the disease. But 30 percent appear in women with some family history, and an additional 10 percent occur in a hereditary pattern in which cancers are found in virtually each generation.

Histopathologic image of colonic carcinoid.

Unfortunately, physicians and health care practitioners are not as versed in helping patients in assessing their colon cancer risk. This may be due to the fact that some hereditary-colon-cancer syndromes are more complex and consist of other cancers, such as gastric cancer, small bowel cancers, urologic cancers, and importantly for women, endometrial cancers. For reasons that are not entirely clear to us, some patients will inherit a faulty gene and develop colon cancer, and others in the family may develop, for example, a urologic cancer. This is most likely due to a combination of environmental exposure and genes. That’s why these groupings are called “syndromes,” and why they may be difficult to diagnose.

The most common form of hereditary colon cancer is known as the Lynch Syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC). Red flags for HNPCC include a history of colon cancers that occur in family members under 50 years old, early onset endometrial cancers in family members under 50, and two or more HNPCC related cancers (colorectal, endometrial, gastric, ovarian, ureter/renal pelvis, biliary tract, small bowel, pancreas, brain, and sebaceous adenoma) in the family. Women who have any of these “red flags” in their familial histories may have an up-to-80% chance of developing colorectal cancer and up-to-71% chance of developing endometrial cancer. Women who may be members of a HNPCC family may should be referred to specialists who can review with them the risks and benefits of genetic testing for the genes responsible for HNPCC and also plan  surveillance and early detection strategies. They will benefit from more intensive screening and possibly from prophylactic surgery.

The take-home message: Know your cancer family history for three generations and review it with your physician. If there is a history of colon polyps or colon cancer in your family, you should not wait until age 50 to have a colonoscopy—it should be done sooner and potentially more frequently. If you may be a member of an HNPCC family, review with your physician your endometrial cancer risk. Be proactive in your care, be aware of illnesses that you may be at increased risk for, and bring them to the attention of your physician.

A member of the WVFC Medical Advisory Board, Dr. Elizabeth Poynor is a practicing gynecologic oncologist and pelvic surgeon, with a Ph.D. in cell biology and genetics. Her private practice in New York focuses  on cancer diagnosis, prevention and treatment.

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Unemployed Over 50: A View from the Ground

March 9, 2010 by  
Filed under Money & Careers, The Economy

After working for eight and a half years at IBM, Nancy Ikeda, 55, lost her job 13 months ago. She had lived in Binghamton, N.Y., since her daughters were in high school, but after spending most of the year looking in vain for another job, Ikeda decided she couldn’t stay any longer.

“There’s just nothing” in Binghamton, she says, because the major employers aren’t hiring. Ikeda had watched people being laid off at IBM during the time she worked there. “They sent the entire department overseas,” she says, “and finally got to me.” The company’s workforce was reduced from over 4,000 in 2002 to 1,300 when Ikeda lost her job in February of 2009.  “Lockheed Martin laid off a quarter of their people, and SUNY Binghamton had a hiring freeze.”

The entire job market is shrinking. From the 1950s to the 1970s, jobs in the private sector increased about 3.5 percent annually, but the last ten years witnessed a meager growth of 0.9 percent per year. As a result, millions of middle-class workers left jobless for six months and longer are becoming what New York Times writer Peter Goodman calls the “new poor”—people who enjoyed a comfortable life but are now dependent on public services. Many may never recover their previous status.

Unskilled workers undoubtedly have the hardest time finding jobs today: many of the manufacturing jobs that fueled the engine of prosperity in the decades following World War II no longer exist in the U.S.: they have moved to Asia and Latin America. Unions have grown weaker and so are no longer able to protect workers as they once did. The corporate focus on the bottom line mandates efficiency at the expense of workers: whenever possible, expensive manpower is replaced by machinery, and even white-collar work is moved overseas, where wages are lower. In the past decade alone, 5.6 million manufacturing jobs have been lost to automation, Goodman reports.

But Ikeda has an M.B.A. “You’d think I’d be employable,” she says.

You’d think—but Ikeda belongs to the cohort of women 45 to 64 years old, and they have been hit particularly hard in this recession.

The Department of Labor reports that in the last severe recession of 1983, this group comprised 7 percent of people who were unemployed six months or longer. Last year, however, that figure doubled to 14 percent. Professionals are hardly better off than their sisters with lesser skills. In fact, a recent study by the nonprofit research organization Catalyst found that not only did women MBAs  frequently start out at lower pay levels than similarly qualified male colleagues, but their career trajectories and compensation still had not caught up years later.

To make matters worse, recovery from recessions is taking longer and longer. An analysis of data from the Department of Labor shows that jobs lost before 1990 were regained within 21 months, but after the 1990 slump, recovery took 31 months, and almost four years passed before the jobs lost in 2001 were recovered. Yet in his widely discussed piece in The Atlantic, Don Peck argues that that last statistic is deceptive, because the percentage of the population that is working hasn’t returned to what it was before 2001 (since there are fewer jobs available).

Peck probes the destructive and lasting effects of pervasive joblessness on American society. The average time a person remains unemployed is now over six months, the longest since the Bureau of Labor Statistics began recording the data. Peck’s extensive research leads him to conclude that the Great Recession will not only contribute to personal misery through the loss of self-esteem, which leads to depression, domestic violence, alcoholism and drug abuse, but will rend the social fabric as divorce and crime rates climb as a result.

The statistics are depressing to read; they are devastating to experience personally.

After months of futilely looking for work, Nancy Ikeda sold her house in October, put the contents in storage, packed her two cats into the car and drove to New York City in hopes of finding more opportunities for employment. She moved in with her older daughter, Margaret, who is 27, single, and lives in a tiny studio apartment in Staten Island. (Ikeda represents the flip side of a trend: 10 percent of young adults have had to move back with their parents, according to a recent Pew Research Center survey.)

“My daughter is okay with me living with her,” says Ikeda, but “I don’t know how long it’s going to last. It gets a little crowded. It’s a little bit tight.” Ikeda sleeps on the kitchen floor on some mats. “I have a delightful bed in that storage unit I would love to sleep in some day. It’s a queen-sized bed,” she says wistfully. “I can live on unemployment and actually help her out a little with her rent. So it frees up some of her money. Financially, I can make it on almost nothing if I live with her.”

Accustomed to a particular accounting software, Ikeda has found that a company using a similar program doesn’t have to hire someone like her—who needs just a bit of training to adjust to the new system—because there are so many people applying who are already fully familiar with it. For the time being, she has a temporary job with the Census Bureau. It pays well enough, but at best, it will last only until September, and there are no benefits.

Like unemployment, lack of health insurance is a problem that many women over 45 are facing, as we noted last week. “My huge worry is that my COBRA runs out in August. I’m not destitute. I have money in the bank. I’ve saved money all my life,” says Ikeda. “I’m terrified if I don’t have health insurance that something will happen. I’ll lose my life savings.” There’s no friends-and-neighbors backup for health insurance,  Ikeda added. “When I lost my job, everybody was saying, ‘You want a bag of groceries?’ They were trying to help me out. But nobody will say to me, ‘Oh, I’ll pick up $1,000 for your appendectomy.’” And Ikeda makes too much to qualify for the health insurance subsidized by New York State.

Ikeda also had to return her laptop to IBM when she left. Her younger daughter gave her an extra computer she wasn’t using, but that one’s in storage. Ikeda uses Margaret’s computer while her daughter’s at work, but when she returns, it’s a battle: “she’s a computer nut too—she’d want to be on the computer.” Ikeda hasn’t taken the other computer out of storage because there’s no room for a desk in the studio apartment.

“At some point, if I were to get a real job,” Ikeda dreams, “maybe we’ll get a two-bedroom together. But that hasn’t happened yet, and with the census job ending in September, I can’t risk moving right now.”

Margaret is enjoying her mother’s stay, and is even reaping some benefits. “She’s a huge help with cooking and apartment chores,” she says. “I’m kind of a slob,” she acknowledges, “so it’s good for me.” After years of living on her own, Margaret doesn’t mind letting her mother know when she’ll be home. “It’s kind of comforting to have that backup,” and to find dinner ready when she comes home. “So my life’s changed, but not as much as it would be if I had to pack up and move home if I couldn’t find a job.”

Although both women are making the best of a difficult situation, there have been rough spots. Margaret remembers when her mother was “really stressed” when she was selling the house and not able to find a job. “That really bummed me out, because that’s very not like her. She’s very go-getting, super-optimistic. The job’s a big part of her life. She’s always been very proud of her work.” Margaret’s very happy that her mother is taking paralegal classes on a grant from the unemployment office. “She’s much more herself doing that, being engaged. She’s not the kind of person to be happy sitting at home watching afternoon TV.”

Ikeda admits that she’s succumbed at times: “You go through periods when you get depressed. You don’t bother looking, and then you get going again.” Job-hunting can be demoralizing. “There’s very little feedback, and it’s very lonely. It’s you and the computer, basically. There’s plenty of other people in the same situation,” she knows, “but still, it’s a solitary effort. You don’t walk— there’s no door-to-door any more. It’s totally done by computer.”

At least until September, life for Nancy Ikeda has regained a certain regularity. She can enjoy playing Scrabble with Margaret, explore the Big Apple, and send out résumés with just a little less anxiety. And like many in her over-40 cohort in the job market, hope that the economy picks up in the meantime.

Trained as a medievalist, Diane Vacca taught medieval literature, Spanish and Italian at several universities before becoming a journalist with specialties in politics, the arts and New York City. Her work can also be found at ComedyBeat.com and the New York City biweekly Chelsea Now, where she covers everything from education and public housing to landmark designation and the arts.

The Compass Rose: Kindred Spirits

January 25, 2010 by  
Filed under Musings, Newsmakers

An attractive blonde, wine glass in hand, sidled up to my husband. I could tell she was smart. She subtly moved her gaze from one end of the room to the other, checking for eavesdroppers in the crowd, as though she and he were co-conspirators in a clandestine operation. I moved in and assumed a protective stance, prepared to prove my worth. She leaned forward and whispered furtively, “Did I hear someone say you’re from the East?”

We were in La Jolla, at a party where a few of the guests were reluctant transplants. Our gregarious host was a family friend from back home who moved out here two years ago with her scientist-husband. She loves it. She couldn’t be happier. But she’s still young, with a 5-year-old who serves as a natural ice breaker and a kindergarten community in which she finds tennis partners, play dates, babysitters and friends.

Her husband is deeply involved in the world of research and, at that moment, party or not, he was deeply involved in conversation with a cluster of fellow scientists, some of them quite famous (and I mean Nobel Prize–worthy) and all of them oblivious to the rest of us. My husband’s new career has placed us in one of the centers of biotechnology. We’ve grown accustomed to the scientific subculture of San Diego. The attractive blonde was in fact sent over by our host, and I sensed a familiar desperation in her question.

When Robert and I responded in the affirmative, that we were doubly blessed to be both New Yorkers and North Carolinians, she breathed a sigh of relief and confessed all: She could not believe she had abandoned northern Virginia for this place. She had her list ready: an itemized declaration of all the things she doesn’t like about California and evidentiary details which prove, beyond a reasonable doubt, that East Coast trumps West Coast in multiple arenas.

My list matched hers line for line: the absence of cultural sophistication for a city this size; the population’s shocking lack of curiosity about the world; the dearth of authentic community and neighborliness; and the odd locations of traditional storefront enterprises, such as the flagless post office hidden in the bowels of an industrial park or the violin shop located on the third floor of a corporate office building. (My son hauls his cello up those stairs for his lesson every Thursday.) Thus began a long and wonderful conversation about our shared surprise. It was more restorative than negative and provided gratifying validation. It seems I’m not crazy after all.

Our talk reminded me of the palliative effects of simply being understood, as when my husband quietly listens, realizing that my need to vent is not necessarily a demand for resolution. Or when Henry swallows his teenage pride and patiently puts up with motherly affection. When Everett presented me with a recording of French songs for a grand escape (her personal collection from various movie soundtracks), including “Le Festin” from Ratatouille:

Or Hart gave me books which he knew I would love, lifting whatever burdens I was carrying at the time. Or when Colbern’s insight prompted her to send this John Updike poetry to me (printed in The New Yorker this past March):

Here in this place of arid clarity,
two thousand miles from where my souvenirs
collect a cozy dust, the piled produce
of bald ambition pulling ignorance,
I see clear through to the ultimate page,
the silence I dared break for my small time.
No piece was easy, but each fell finished,
in its shroud of print, into a book-shaped hole.

Be with me, words, a little longer; you
have given me my quitclaim in the sun,
sealed shut my adolescent wounds, made light
of grownup troubles, turned to my advantage
what in most lives would be pure deficit,
and formed, of those I loved, more solid ghosts.

For the record, these are the things I love about California:

Ritz-Carlton, San Francisco

ocean kayaking in La Jolla Cove in the company of sea lions, sharks and cormorants;
access to fresh local produce year round;
hiking the canyon trails, beaches, deserts;
plucking lemons from our very own tree;
weekends at the Ritz-Carlton in San Francisco;
the drive along the coastal highway at Torrey Pines State Reserve, where the vista of the Pacific is always magnificent.

At some point during the conversation with my newly found comrade—my memory of the exact moment is compromised by the joyful delirium of having found this kindred spirit—I said, “I love you!” and I meant it. What is it they say? You don’t make friends, you recognize them. Even if it’s just for an hour over holiday cocktails.

A recent cover of the newspaper that keeps us in a New York state of mind

Our chat turned up an important bit of information which we both had discovered on our independent journeys: For the most part, the people in this region who are personally compelling, the ones we truly like, subscribe to home delivery of The New York Times.

What a revelation! There is a certain kind of person—the lifelong scholar, the citizen of the world, the individual temporarily separated from the umbilicus of the 13 original colonies—for whom that newspaper is a lifeline. I’m one of them. My new friend was another. Several of my colleagues from a recent writing workshop were similarly addicted.

“You know,” she said, “we should form a club of subscribers. Do you think the Times would reveal their local subscription list? We could create The New York Times Society, something like The North Carolina Society or The Kentuckians of New York.”

We summoned our host, our bright, always entertaining and loveable mutual friend who’s quite pleased with her spot in Southern California. We asked if she’d like to be part of our grand scheme.

“You subscribe, right?” I said.

“Uhhh… yeah,” she said, “I will. Send me an email to remind me.”

The News About Menopause and Cholesterol

Kerri105headshot.emailIs your cholesterol on the rise?

As if some women didn’t already have enough problems with symptoms of menopause — such as hot flashes, insomnia, decreased libido and mood swings — now they can add one more to the list. According to a recent study published in the Journal of the American College of Cardiology, menopause can be responsible for a sharp increase in cholesterol levels.

This study followed 1,054 U.S. women over 10 years as they went through menopause. In nearly every woman, across ethnic groups and socioeconomic status, cholesterol levels were found to have jumped around the time of menopause — especially their LDL (low-density lipoprotein) cholesterol, sometimes known as “bad” cholesterol.

In the two-year window surrounding their final menstrual period, the women’s average LDL, or bad cholesterol, rose by about 10.5 points, or about 9 percent. The average total cholesterol level also increased substantially, by about 6.5 percent.


Most of us don't start the day with this, thank goodness. (Photo: Wikimedia Commons)

Most of us don't start the day with this, thank goodness. (Photo: Wikimedia Commons)


So what can we do to avoid or minimize this?

Many people think that they need to mainly avoid foods that are high in cholesterol. That, believe it or not, is a misconception. If your diet is high in cholesterol, your body compensates for it and produces less. What does actually raise your cholesterol: foods that are high in saturated fats.

You know, the foods that so many love to eat; ice cream, french fries, pizza, steak, mashed potatoes. That egg for breakfast isn’t a problem — but watch out before you add the bacon and home fries.

No one says never to eat foods like that again. But if you want to help prevent your cholesterol from getting elevated and increasing your risk for heart disease, you had better start eating smaller amounts of high-fat foods and start focusing more on what you should be eating.

Over the years researchers have found that a diet that includes plenty of fruits, veggies and whole grains (especially oatmeal and oat bran) legumes, fatty fish, walnuts and food fortified with plant stanols/stenols can help decrease cholesterol. Including these types of foods daily into your diet shouldn’t be a difficult task at all.

One sample day:

Breakfast: bowl of oatmeal, made with lowfat milk, topped with berries and walnuts

Lunch: small lentil soup, large tossed salad with grilled chicken, lowfat salad dressing

Snack: apple, lowfat plain yogurt

Dinner: broiled salmon, mixed green salad with olive oil and vinegar,  brown rice, broccoli steamed but still crisp

Snack: pineapple.

Remember, you can help prevent a rise in your cholesterol by being proactive. Start eating healthier, and get more active. Most important, start today.

Seasoned Journo Flouts Beijing, Speaks Truth to New Financial/ Old Political Powers

December 14, 2009 by  
Filed under Newsmakers

vaccaThe once-bustling newsroom of Caijing, China’s premier business news publication, fell silent last month, when the star editor walked out followed by the editorial staff, who resigned en masse. Disagreements over censorship and money ignited as a long-simmering feud between editor Hu Shuli and her publisher, Wang Boming, came to a head in July and finally boiled over in November.

Photo: Dong Xin

Photo: Dong Xin

Hu’s ace reporting and hard-hitting exposés of corporate fraud and government corruption, which have long stretched the bounds of Chinese press freedom, propelled Caijing to first place in influence and importance in the Chinese media and deserving of consideration among the best business publications worldwide.

“The most dangerous woman in China,” as BusinessWeek called her, was the soul of Caijing. Without her voice, China’s progress into modernity could be slowed by a triumphant regression to heavy-handed censorship. But if Hu succeeds in putting together her new publication, this moment may be only a stumble on the way to even more openness.

Hu comes from a line of journalists and intellectuals, though her own education was interrupted by the 1976 Cultural Revolution: Her mother, a prominent editor, was placed under house arrest, her outspoken father relegated to a position out of the public view, and Hu herself enlisted in the Red Guards. Hu traveled around the country, escaping into her books and teaching herself English, history and literature as the movement grew increasingly violent. She joined the army and was assigned to a remote rural area, where she worked in a hospital.

When classes resumed in 1978, Hu won admission to the university in Beijing, where she majored in journalism because it was the best department. Her first job was at the Worker’s Daily, China’s second-largest newspaper, the same one where her mother had been a senior editor. Winning an American fellowship in 1987 enabled Hu to spend five months in the United States, where she traveled and interned at USA Today. Although she had done investigative pieces in China, her exposure to American journalism was an epiphany.

When the Tiananmen Square demonstrations riveted the world’s attention two years later, Hu backed the demonstrators and even marched alongside them, together with many other journalists. When the crackdown came, Hu was luckier than her colleagues, many of whom lost their jobs, were arrested or banished to remote areas. She was suspended for 18 months, and made use of the time by writing about what she had learned in America: the critical role of the press in a democracy. She described its successful challenges to government authority in Watergate and the Pentagon Papers. Many Chinese journalists were inspired by her book Behind the Scenes at American Newspapers to remodel themselves and expand the boundaries of press freedom in their own country.

Returning to work in 1992 as international editor of the China Business Times, Hu interviewed all the top financiers in China. She scored many scoops, but more important to her future success at Caijing were the relationships she cultivated with this group of powerful men, many of whom were her contemporaries and who, like herself, had studied in the U.S. These select few were very well connected to the highest ranks of the Chinese hierarchy as sons of the men in power, and would eventually rise to top positions themselves. At Caijing, Hu would draw on these contacts not only for information but for protection, as they shared her goal of reforming the Chinese system of investment and financing, impossible to accomplish without recalibrating the relationship between government and free enterprise. Six years later Hu received a fateful call from one of these men.

caijing_magazineWang Boming, the son of a diplomat, had studied at Columbia University, worked at the New York Stock Exchange and experienced American journalism at first hand: In New York, he had worked as reporter and editor at a Chinese-language paper. Wang wanted Hu to head his foray into Chinese journalism with a financial news magazine called Caijing: cai means “finance,” and jing “economics.” The ambitious reporter accepted, but not without setting two conditions. Hu insisted on complete editorial autonomy and ample financial backing to cover all reporting expenses, as well as substantial salaries for the editorial department (as a hedge against the bribes customarily offered by Chinese companies to reporters for favorable coverage).

In 11 years Caijing grew from a monthly produced on two computers to a biweekly magazine, a conference promoter and an online news provider with two Web sites (one in Chinese and one in English). Its circulation of 200,000 is relatively small for China, but its readers are among the most educated, affluent and influential in the country. An English-language wire service on the level of Reuters was slated to go online in 2010, but now that Caijing’s future is rather dicey without Hu, the backer, Hong Kong tycoon Richard Li, is waiting to see how the crisis plays out. Since his primary interest is in Hu’s stories and those of her reporters, he’s likely to follow her in her expected new venture.

Hu’s combustible temper, coupled with unparalleled achievement in the Chinese media, compels the respect of her peers. The diminutive 56-year-old, described by The New Yorker’s Evan Osnos as “petite, voluble and pugnacious,” was once called a “female Godfather”:  always impeccably dressed in the latest fashion, and often blowing through the newsroom in bursts described by a former colleague as “as sudden and rash as a gust of wind,” the staccato clicking of her high heels punctuating the orders issued to her staff.

An inveterate muckraker, Hu has dedicated her career to exposing malfeasance in both the private and public spheres, acting as the loyal opposition in order to bring about reform. Her mentor, Wang, backed her until the regime under which they both labored noticed that her Caijing was illuminating parts of Chinese society that had long been left in the shadows of China’s march to “progress.” Then Wang was given little choice but to try to bring this firebrand to heel. Hu was writing exposés from the first issue, and she had repeated run-ins with the regime. Corruption was an old issue, but it took a new form in profiteering, insider trading and other ways for skilled folk to take borderline-illegal advantage of the new prosperity.

Wang had founded Caijing’s parent company, SEEC (Stock Exchange Executive Council), in the early ’90s to help set up the Chinese stock markets. His investors were the same small group of American-educated financiers that Hu had interviewed for the China Business Times. With Caijing, both Hu and Wang were committed to the reform of China’s investment and financing systems.

Caijing's December issue, focusing on "A crackdown on the city's crime gangs exposed a country club casino and police officials on the take. "

Caijing's December issue, focusing on "a crackdown on the city's crime gangs that exposed a country club casino and police officials on the take. "

Since its first issue in April 1998, when Caijing made waves with a cover story on corporate fraud and insider trading, the magazine has focused on revealing cover-ups of notorious and criminal wrongdoing. Caijing was the first Chinese publication to expose scandals in the securities markets. In 2003 Hu steered Caijing in a new direction. She entered untested waters with her reporting on the SARS virus, which lay outside the purview of a financial news magazine.

Caijing’s SARS coverage ultimately compelled the Chinese authorities to abandon their denials of the extent of the epidemic. It also tested the limits of journalistic freedom. After publishing weekly updates on the status of the infection, raising questions without naming names or criticizing the government directly, Hu intended to write an analysis of the epidemic and the lessons learned from the authorities’ handling of it, but she came up against a stone wall. Word came down to kill the story.

Press censorship in China is under the aegis of the Central Propaganda Department. Knowing the bounds of what CPD will allow is crucial, given the agency’s power to remove editors, suspend publication (deprived of their revenue, most publications can’t survive for long) and shut publications down. Unlike Russia, where pesky reporters turn up dead, China jails or muzzles writers considered too provocative. The Committee to Protect Journalists reports that in 2008 China had 28 journalists in prison—more than any other country, though it was overtaken by Iran in 2009.

bjyouthThe propaganda bureau operates under a veil of secrecy; it doesn’t advertise its address or publish its phone number. Though it does periodically recommend that certain topics be covered and others not, censorship on the whole is a subtle proposition, because editors are left to determine the bounds for themselves. The trick, according to journalists in the field, is in knowing how far to go. It’s apparent even from the outside that self-censorship is insidious, that the fear of overstepping an unclear boundary may lead to repressing information that might have slipped by. There are, to be sure, some definite no-no’s under the CPD, such as the military, religion and in particular the 3 T’s and an F that combine both: Tibet, Tiananmen Square, Taiwan and Falun Gong (the religious sect best known in the U.S. for its free paper The Epoch Times.) Disclosing the personal details of party leaders is also verboten: Hu Jintao’s hair dye, for example, is the “deepest state secret,” quipped a Beijing Youth Daily reporter, at once deadly serious.

After that first skirmish over SARS, Hu continued to refine her sense of how far she can go. Many also credit her guanxi — connections to officials in the right places— Time Magazine noted her skill at  “keeping her[self] out of jail as she score[d] repeated ‘edge balls,’ the Chinese term for a Ping-Pong serve that’s within the lines but just barely.”

These assiduously cultivated relationships, taken together with the prominence of Caijing, contributed to her authority. Largely because of her efforts, the bounds of what CPD will tolerate were repeatedly extended: “We know where the line is, and we walk right up to it,” Hu said in 2002.

In 2004 the first of nine reporters Hu sent to the scene of the earthquake in Sichuan was en route less than an hour after Hu received word of the disaster, and well before the CPD made the futile rescue efforts at the collapsed schools off-limits to news organizations. Her minions were amassing the facts that later substantiated a complete report of the neglect and corruption that led to shoddy school construction and ultimately resulted in the death of 5,300 children. Hu knew the government was angry, but Caijing emerged unscathed.

Hu from Caijing's site, http://english.caijing.com.cn.

Hu, from Caijing's site, http://english.caijing.com.cn.

In those early years, Caijing focused on local scandals of corruption and malfeasance — never directly accusing Party leadership or criticizing its policy, but allowing the reader to make the leap that there is some systemic flaw that enables the criminality. When she does name names, the miscreants are local officials or officers of individual companies. “The strategy of acknowledging the authority of the system and then fighting prudently to improve it defines Caijing‘s brilliance and its limitations, “observed Evan Osnos in his New Yorker profile of Hu.

In 2007 Hu wrote that “the public’s top concern is the rampant corruption and an imbalanced power system,” adding, “Some argue that pushing forward with political reform will be destabilizing. Yet, in fact, maintaining the status quo without any reform creates a hotbed for social turbulence.”

That same year, Caijing published an exposé of corporate fraud that so angered CPD it ordered the magazine to recall the issues from the newsstands. Children of high Party officials were involved, and though they weren’t identified, it feared astute readers might be able to connect the dots. Hu told The New Yorker that that débâcle was Caijing’s “largest disaster.” Not surprisingly, Hu is an ardent defender of the press and its right to know. Before the 2008 Olympics, she denounced the police who were clashing with reporters.

Tune in later this week for Part Two, to see what super-forbidden territory finally brought Hu and Caijing into the crosshairs of the authorities. —Ed.

Powerful Women Video Newsmix: Judith Jamison, Meredith Baxter Birney, Diane Savino, Berta Oliver

December 3, 2009 by  
Filed under Newsmakers, Politics, Television, Theater

Today, we’re doing a different kind of Newsmix — because our Youtube has been overflowing with the voices of women in midlife. Mostly, they’re not talking about midlife itself, but speaking from the well of strength and experience and power it represents, in connection with the most current of events.

“I’m 40 years old, and I. . . “ Those words began what many thought of as the highlight of yesterday’s debate in the New York State Senate.

Speaking before her “aye” vote on a bill to legalize same-sex marriage. Staten Island senator Diane Savino  noted the long partnership of fellow senator Thomas Duane with his partner, contrasted it with many well-known straight relationships. As the Daily News reported today:

She asked her colleagues who wanted to protect the “sanctity” of marriage what, exactly, that means, citing the numerous reality TV shows that focus on “giving away husbands” to “desperate women.”

The plain-spoken Staten Island senator noted the absurdity of the fact that she can legally marry a man she just met on the street when people like Sen. Tom Duane and his longtime partner, Louis Webre, have been together for years and can’t wed.
“I have never been able to maintain a relationship of the quality and length that they have,” said Savino.

“We have nothing to fear from love and commitment. My only hope, Tom, is that we pass this bill and the governor signs it and that we can learn from you, and that you don’t learn from us.”

Whatever your opinion of the marriage-equality legislation, watching Savino can make you proud — of her clarity, her self-assurance, and the fearlessness with which she takes apart many senators in the chamber.

Speaking of which… Yesterday’s debate was preceded by an unexpected revelation from Meredith Baxter Birney, perhaps best-known as the mother of a large brood in Family Ties.

“Some people would say, well, you’re living a lie and, you know, the truth is – not at all. This has only been the past 7 years,” said Baxter, 62,  explaining that she’s “extraordinarily happy.” And the famous Family Ties mom says it sheds some light on her three previous marriages (which resulted in five kids). “I understand why I had the issues I had earlier in my life. I had difficulty connecting with men.”
She added,  “I got involved with someone I never expected to get involved with,” she said, citing Nancy Locke, a general contractor she met four years ago and with whom she lives a “very out life” with in Los Angeles.

Dancing to retirement, in full power. This season is Judith Jamison’s last as director of the Alvin Ailey Dance Company, after more than twenty years in which she can be said to have changed the face of dance.

jamison This week, Jamison is the subject of an admiring profile in New York Magazine, which pauses to remark on how age has only deepened her beauty:

Draped in scarves and a black silk smock, bald but for a bit of gray peach fuzz, the 66-year-old still looks remarkably like the towering, five-foot-ten dancer who defied standards of beauty and electrified audiences with raw emotion, particularly in 1971’s Cry, the breathless, sixteen-minute solo Ailey created for her, and 1960’s Revelations, Ailey’s iconic ballet set to Negro spirituals.

Sober election news, from the voice of a survivor:  With all the latest news, many might not remember that Honduras just had some quite-disputed elections, after a military coup in June. And offering witness was Bertha Oliva, founder of the Committee of Relatives of the Disappeared in Honduras — a group she founded in 1982, a year after her husband Thomas Nativi was “disappeared” by the generals who then ran her country.

Shortly after noon on election day, police and soldiers broke up a peaceful protest march of about 500 people in the country’s largest city, San Pedro Sula. Witnesses reported that the attack was unprovoked, and that the police suddenly began firing tear gas as the march moved toward the center of town.

“The facts clearly show numerous human rights violations,” said Bertha Oliva, director of the Committee for Disappeared Persons in Honduras (COFADEH). Oliva cited a broad range of confirmed abuses on and about election day, including illegal detentions, beatings, and even “torture and murder.”

We wonder if Senora Oliva’s words reached our Secretary of State, a woman who has worked for women’s human rights for decades. Stay tuned.

Woohoo! Heather McHugh! A powerful, playful 61-year-old poet wins a MacArthur Genius Award.

September 24, 2009 by  
Filed under Poetry

heather-500Let’s be crass at the outset. A half a million dollars. Five hundred thousand bucks,  in quarterly installments of $25,000 for five years. That is enough security to stop a sculptor of stanzas in her tracks, but there is no question that it will most likely just help the iconoclastic poet Heather McHugh to keep on keeping on. (Editor’s note: Short story writer Deborah Eisenberg, 63, another iconoclast and icon, has also received a MacArthur and will be profiled in the coming days.) No doubt, for McHugh (seen at right in a photo by David Belisle) that keeping on will involve staying one or two steps ahead of anyone who wants to figure her out.

A news story about the MacArthur grants said she’s “a poet known for her syntactical twists.” The grant press release described her as “a poet whose intricately patterned compositions explore various aspects of the human condition and inspire wonder in the unexpected associations that language can evoke.” Another said she was known for puns.

Try as they might, reductionist descriptions of a woman who entered Harvard at age 16, running from a rural Virginia home life of outhouses and parents on the outs with one another, will only help to obscure the view of her. Because she does not want to be understood.

NYerMcHugh2This poet-now-acknowledged-as-genius has been explaining us to ourselves ever since publishing her first poem in the New Yorker at age 17  (she has said she chose the New Yorker for her first poetry submission because “I knew that it was my escape and I knew I better choose well if I wanted escape”). But she has said of herself, “I don’t want to be known. To me, being known is the loss of liberty.” No wonder that among her trademarks are ambiguity and an ability to use words to mean other than the obvious.

There are so many examples of so many stunning feats of poetic graces and gymnastics among the poems of Heather McHugh. To see some of them, visit Poets.org, where you can read examples of her work. Or better yet, run out and purchase Hinge and Sign, her National Book Award Finalist collection. At Poets.org you can also hear her recite this one heart-stopping piece. It is offered here not so much as what is typical of this MacArthur Genius, but as a window into her humanity, her devotion to her genre, her belief in the muse and her desire to offer solace to all those who want to understand more than what others walk past.

We could not be happier about this moment in time, a moment when a shy and startling woman stepped off the page into the bright lights of an accolade that will allow her to slip back into the world where she does what she does so dazzlingly well. It’s a good day for poetry and for everyone who cares even a little bit about the most honorable people who devote their lives to it.

What He Thought

We were supposed to do a job in Italy
and, full of our feeling for
ourselves (our sense of being
Poets from America) we went
from Rome to Fano, met
the Mayor, mulled a couple
matters over. The Italian literati seemed
bewildered by the language of America: they asked us
what does “flat drink” mean? and the mysterious
“cheap date” (no explanation lessened
this one’s mystery). Among Italian writers we

could recognize our counterparts: the academic,
the apologist, the arrogant, the amorous,
the brazen and the glib. And there was one
administrator (The Conservative), in suit
of regulation gray, who like a good tour guide
with measured pace and uninflected tone
narrated sights and histories
the hired van hauled us past.
Of all he was most politic —
and least poetic — so
it seemed. Our last
few days in Rome
I found a book of poems this
unprepossessing one had written: it was there
in the pensione room (a room he’d recommended)
where it must have been abandoned by
the German visitor (was there a bus of them?) to whom
he had inscribed and dated it a month before. I couldn’t
read Italian either, so I put the book
back in the wardrobe’s dark. We last Americans

were due to leave
tomorrow. For our parting evening then
our host chose something in a family restaurant,
and there we sat and chatted, sat and chewed, till,
sensible it was our last big chance to be Poetic, make
our mark, one of us asked

“What’s poetry?
Is it the fruits and vegetables
and marketplace at Campo dei Fiori

or the statue there?” Because I was
the glib one, I identified the answer
instantly, I didn’t have to think — “The truth
is both, it’s both!” I blurted out. But that
was easy. That was easiest
to say. What followed taught me something
about difficulty,

for our underestimated host spoke out
all of a sudden, with a rising passion, and he said:

The statue represents
Giordano Bruno, brought
to be burned in the public square
because of his offence against authority, which was to say
the Church. His crime was his belief
the universe does not revolve around
the human being: God is no
fixed point or central government
but rather is poured in waves, through
all things: all things
move. “If God is not the soul itself,
he is the soul OF THE SOUL of the world.” Such was
his heresy. The day they brought him forth to die

they feared he might incite the crowd (the man
was famous for his eloquence). And so his captors
placed upon his face
an iron mask
in which he could not speak.

That is how they burned him.
That is how he died,
without a word,
in front of everyone. And poetry —

(we’d all put down our forks by now, to listen to
the man in gray; he went on softly) — poetry

is what he thought, but did not say.