Is Menopause Really To Blame

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					                                                                                                                       FALL 2010

                                        Is Menopause
                                        Really To Blame?
                                        When you see a picture of a midlife woman sweating or fanning you know
                                         it is about menopause and hormones. We blame menopause for most
                                              symptoms or changes that occur during this period of a woman’s life,
                                                 but hormonal changes may not be the only true cause.

                                                     Women’s bodies tend to change shape during peri-menopause
                                                     (time surrounding menopause) for several reasons. Going from
                                                      a “pear” shape (weight around hips) to an “apple” shape (weight
                                                       around middle) is a part of normal aging. Lowered estrogen may
                                                        contribute to this increase in midline fat in women. This shift
                                                         of weight puts pressure on important internal organs and
                                                           increases the risk of heart disease. Exercise and taking steps
                                                             to control weight can decrease this risk. Blaming weight
                                                               gain on menopause is a common complaint; however,
                                                                two non-hormone factors can also contribute to weight
                                                                 gain during this time.

                                                                                                            Continued on page 6

In this issue…                Focus on Women is now                                          nline!
Headache At All Ages      2
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Can a Video Game Really       receive this newsletter directly in your email inbox.
Get Me in Shape?          3
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Patient Testimonial:       Our goal is to provide
Ovarian Cancer Survivor   4   you with information that is useful and beneficial for you and your family.

Classes & Events          7   Follow us on Twitter and Facebook:
Recipe Corner             8      
                                                                                                                         FOCUS ON   Women

    Headaches At All Ages:
    Causes and Triggers from Teen Years Through Menopause

    While tension-type headache
    is the most common type of
    headache, migraine is the                                                          Adult Life
    primary headache disorder that                                                     Migraine peaks in its prevalence around age 40, so
    causes women to see a physician. Migraine is responsible for not         it’s common for adult women to experience these headaches.
    only physical symptoms, but also lost productivity, missed social        While stressors and sleep are still key triggers, depression and
    events and increased depression. Migraine affects approximately          anxiety play a role, as well. Psychiatrists and other behavioral
    20 percent of women but only eight percent of men, making this           health professionals are even more important at this stage of
    likely a hormonal disorder. However, the latest theory is that it        life. Certain foods can occasionally trigger migraines, including
    is a chronic brain disorder characterized by a hypersensitive            red wine. Many women also experience migraines during early
    cerebral cortex susceptible to triggers of acute attacks. The            stages of pregnancy, but 50 to 75 percent are relieved in the
    cerebral cortex plays a key role in attention, memory and                second trimester.
    awareness, all things that are typically affected when migraine
    strikes. While the majority of migraines occur at a younger age,         Menopause
    many triggers can cause migraine at various stages of life.              Since migraines are likely hormonally controlled, approximately
                                                                             2/3 of women improve with natural menopause. Interestingly,
    Teenage Years                                                            women with total hysterectomies worsen about 2/3 of the
    Migraines typically appear between the ages of 12 to 15, usually         time, and hormone replacement therapy may delay migraine
    around the time that a girl begins menstruating. Nowadays,               improvement. As women age, neck and spinal problems can
    teenagers have so much on their plate that their brains are              also be other triggers. Any new headache after the age of 50
    constantly active with schoolwork, extracurricular activities, texting   needs to be evaluated by a physician.
    and social networking sites. They experience pressure from teachers,
    parents and peers, and they put pressure on themselves. These            To learn more about headaches or to schedule an appointment
    activities can all add up and cause stress, triggering migraine.         with a headache specialist, call Presbyterian Neurology Center
    Sometimes a psychologist is needed to identify stressors and teach       at 704-384-9437.
    kids how to cope. Teenagers also need to eat regularly (don’t skip
    breakfast!) and get eight to nine hours of sleep each night (no
    television in the bedroom!). Treatment of chronic headaches can                      By Chad A. Whyte, MD
    usually be done without medicine if these things are addressed.                      Presbyterian Neurology Center

                                                 Up to 50 million Americans get frequent headaches that can make them feel
        Did You Know?                            miserable on a regular basis. Each year, headache is responsible for 157 million
                                                 lost workdays, 10 million doctor’s visits and $50 billion in healthcare costs.


 Can a Video Game Really Get
 Me in Shape? Fad Workout Programs That Work
 So you’ve seen the commercials for P90X          variety of games, and once you master a         Any time that you are limited in daily activities,
 with all of the beautiful physically fit         level you can continue to be challenged.        work or sports, contact your doctor to learn if
 smiling people sharing their weight loss         It’s something that you can play alone          rehabilitation is right for you. To learn about
 and toning success stories. Or what about        or with friends or family.                      Presbyterian Rehabilitation Center, with
 your best friend who swears that her daily                                                       locations in Charlotte, Huntersville, Matthews
 routine with Wii Yoga has helped her             Q: What are the important components            and Steele Creek, visit
 drop dress sizes? Which new fad workout          of a workout? How long and how often            rehab or call 704-316-1900. A physician
 routines really work, and why? Find out          is exercise recommended? A: Any                 referral is required.
 the answers from an interview with F.            workout is good as long as you get your
 Scott Feil, physical therapist at Presbyterian   heart rate up. Try working out three to
 Rehabilitation Center Matthews.                                                                               F. Scott Feil, Presbyterian
                                                  five times per week for 15 to 30 minutes                     Rehabilitation Center Matthews
                                                  per session. Start with less intense exercise
 Q: What is the effectiveness of popular          programs and build endurance and
 workout routines like Wii Fit and P90X?
 A: It depends on the individual and what
                                                  resistance as the program becomes easier
                                                  for you. Have a goal in mind and structure
                                                                                                  Wiihab for Rehab
 their particular fitness goals are. P90X is a    your workout around that goal. If you
 high-level exercise program that tends to                                                        While the Wii is still relatively new in
                                                  want to improve your strength, use higher
 work best for a younger and more active                                                          the research process, studies so far have
                                                  weight amounts with lower repetitions. If
 audience who is looking to get in shape.                                                         shown improvement in function, energy
                                                  weight loss is what you are after, do more
 The Wii has lower intensity and is better                                                        expenditure and heart rate excursion for
                                                  repetitions at higher speeds. Overall,
 for helping with balance, range of motion                                                        anyone who uses the Wii for a workout
                                                  any exercise you can do to get your
 and strength training.                                                                            or rehabilitation program.
                                                  heart rate up will be beneficial for
                                                  your overall health.                             Beginning this fall, Presbyterian
 Q: The Wii sounds like it may be a good
 fit for a diverse audience. Are there                                                             Rehabilitation Center Matthews will be
                                                  Q: How can you measure                                  using the Wii for patients of all ages,
 certain games you recommend, and
                                                  the success of a Wii                                       from pediatrics to geriatrics and
 why?A: Depending on the age, audience
                                                  workout and ensure                                            everyone in between. Thanks
 and skill level, for balance improvement
                                                  you’re making                                                   to a grant from Presbyterian
 I would generally recommend any game
                                                  consistent gains?                                              Healthcare Foundation, they
 involving the balance board, such as
                                                  A: One good way to                                   will be piloting Wii therapy, with hopes
 skateboarding, snowboarding or surfing.
                                                  gauge your overall fitness is                         of expanding to other locations if
 EA Sports Active can provide a good
 cardio workout that helps improve balance        to determine your Wii Fit Age                            effective and successful. Since many
 and strength, as can Gold’s Gym Cardio           and test it as you begin a regular                                patients also have a Wii at
 Workout, The Biggest Loser, Wii Fit or           exercise regimen to see what                                           home, they will be able
 Wii Sports Resort.                               areas you make gains in over                                             to easily continue
                                                  time. As you continue to play                                             their rehab exercises,
 Q: What is the secret for success? Why           particular fitness games and                                            helping in overall
 do these programs work? A: The key to            advance to greater levels, you                  recovery. And playing the Wii is fun, so
 succeeding with any workout program is           should see improvements in areas                people won’t mind taking the time out
 to stick with it. Your results are going to      such as balance, flexibility, strength          of their day to do it! Even just 10 to 18
 depend entirely on what you put in and           and overall fitness. Ultimately starting        minutes a day of Wii therapy can be
 how consistent you are. The reason that          and getting into the workout is half            beneficial to a rehab patient.
 the Wii works is because it’s fun and            the battle, so be patient and don’t
                                                  expect major advances overnight.                For more information about Wiihab,
 people will continue to do it. There are a
                                                                                                  contact Presbyterian Rehabilitation Center
                                                                                                                Matthews at 704-316-1900.

                                                                                                                  FOCUS ON   Women

    Always a Diva… Now a Teal Diva!
    My Journey with Ovarian Cancer

                                                                                                Creating Teal Diva was our
                                                                                                answer to meet others and
                                                                                                help others. We connect
                                                                                                ovarian cancer survivors.
                                                                                                - Shannon Routh

                                                                                                in France and now I have cancer and
    Ovarian cancer survivor
                                                                                                won’t be able to have children?
    Shannon Routh and her
    husband, JJ, transformed into
                                                                                                Not knowing what the future held but
    characters from The Notebook
                                                                                                knowing we couldn’t run away, my
    Photo credit:
                                                                                                husband and I escaped through a
                                                                                                glamorous photoshoot that perfectly
                                                                                                captured our love for each other. The day
    I was living a lifelong dream of traveling    Two days later I got a call with unexpected   before I started chemotherapy, we had a
    through France. A few weeks later, my         news. “Your blood work is elevated, and       picture-perfect day with Kristin Vining
    worst nightmare came true.                    you should see a gynecologic oncologist.”     Photography that transformed us into
                                                  Enter HYPERVENTILATION! Suddenly,             the main characters from The Notebook,
    In July 2009, I went to France for 10         I was scared.                                 the most romantic movie ever (in my
    glorious days. During the trip, I felt                                                      opinion). For one day, we were taken to
    sharp pains in my lower abdomen,              The next week I had my first appointment      another place. A place where there were
    but I didn’t pay much attention. I was        at Presbyterian Gynecologic Oncology          no doctors, no appointments and no
    in a foreign country eating rich foods,       with Dr. Guilherme Cantuaria (Dr. C           cancer. There was an innocence about
    and I figured that was causing the            for short). My husband and I were told        the day, one which gave us tremendous
    discomfort. Two weeks after returning         about our options and scenarios. I went       strength for the journey ahead.
    home, I was still having problems.            into surgery where they removed the cyst
    I called my doctor’s office and the nurse     and my left ovary. I had a seven-inch         Throughout chemotherapy, I wanted to
    diagnosed me with bladder spasms.             incision, and I thought that was it.          learn as much as I could about ovarian
    It was nothing to worry about, she                                                          cancer, the silent killer. There wasn’t
    said, but call if it worsened.                Four days later, after the cyst had been      much out there. So I decided to be a voice
                                                  analyzed, I learned I had a rare type of      for this disease. I prayed that God would
    When my menstrual cycle came, I               ovarian cancer, clear cell carcinoma. Stage   show me the meaning in my diagnosis.
    had horrible abdominal pain that              two. Next steps: full hysterectomy and        And in one of my many sleepless nights,
    wasn’t anything like normal cramps.           chemotherapy. How was it that I was just      the answer came to me.
    After an exam and ultrasound, the

                                                 Did You Know?
    doctor discovered a grapefruit-size cyst
    on my left ovary. Since I had polycystic
    ovarian syndrome, I wasn’t alarmed.
    The gynecologist planned to surgically
    remove it, and cancer wasn’t even a          Exercise may reduce your risk of ovarian cancer by 27%,
    question in my mind. But to be on            according to a study in the Journal of Obstetrics and Gynecology.
    the safe side, bloodwork was ordered.


     Signs & Symptoms of Ovarian Cancer
     You may have heard ovarian cancer referred to as a “silent        These conditions can be caused by a variety of medical
     killer” because symptoms weren’t detectable until the cancer      conditions, not just ovarian cancer. If you are experiencing
     had progressed. But lately, studies have shown that is not the    one of these symptoms and they are a change from normal for
     case. Be on the lookout for the following signs and symptoms      your body or persist almost daily for more than a few weeks,
     that may indicate ovarian cancer:                                 please see your primary care physician or gynecologist. Early
     u Bloating                       u Fatigue                        detection leads to early diagnosis, and early diagnosis is
     u Pelvic or abdominal pain       u Indigestion                    associated with improved prognosis.
     u Difficulty eating or           u Back pain
       feeling full quickly           u Constipation                   For more information on cancer prevention and early detection,
     u Urinary symptoms               u Pain with sexual intercourse   visit
       (urgency or frequency)         u Menstrual irregularities       or call 704-384-5376.

 Teal Diva was born. An organization to          quite know how people will react when
 raise awareness, offer support to survivors     you tell them you have cancer. My
 and fundraise to support research               diagnosis allowed me to reconnect with
 initiatives, we are a resource for ovarian      friends I hadn’t seen in years. And
 cancer survivors in their 20s, 30s and          unfortunately, some of my close family            We’re an organization that raises
 early 40s. My husband and I struggled           and friends disappeared. It wasn’t that           awareness, offers support to survivors
 not only because of my cancer, but              they didn’t want to stick by my side, but         and fundraises for research initiatives.
 because we wanted to feel normal and            they were scared and didn’t know what to          A resource for ovarian cancer survivors
 know we weren’t alone. So creating Teal         say. So I want to make sure that no one           in their 20s, 30s and early 40s, we
 Diva was our answer to meet others and          else is ever in the position where they           want others to know they aren’t
 help others. We connect ovarian cancer          don’t know what to say.                           alone. Join us and share your joys and
 survivors. We also want to highlight and                                                          sorrows with others who understand
 support other local nonprofits that help        And I also want everyone to know that             what you are going through. Check
 cancer survivors. There are so many             there are ways to make cancer fun, as crazy       us out online to donate and learn
 wonderful groups out there that provide         as it sounds! A week before my hair was           about the latest happenings!
 assistance in so many personalized ways,        supposed to fall out, we threw a “coming
 and Teal Diva is a platform for all of the      out of my hair party.” My two very best
 information and funding that someone            friends showed up in off-the-wall wigs
 may need throughout their cancer journey.       singing a colorful song. It was so much fun.
                                                 By the end of the night, I was bald and           Teal is the official color of ovarian cancer.
                                                                                                   Wear it proudly to show your support!
 I’ve since completed my treatment and have      everyone else had dyed a piece of their hair
 focused more on spreading the word about        teal. It was a way to laugh about something
 Teal Diva in hopes it will bring inspiration    that is typically so depressing.               the end of the day, I would’ve still had
 to others. In addition to offering online                                                      cancer. So if you or a loved one is going
 support, I also do speaking engagements.        One thing I have learned throughout my         through a tough time, always remember
 I share my story to bring awareness to          journey is each person’s experience is         that God will never give you more than
 the symptoms of ovarian cancer.                 their own. Many people say, “How do you        you can handle. Slow down and enjoy the
                                                 do it? I wouldn’t be able to face each day     moment. If there’s something you have
 I also created my personal diva survival        with the strength, determination and           always wanted to do, do it. See the good
 guide on dealing with a cancer diagnosis        positive attitude you have.” My response:      in everything and find the silver lining.
 and how to treat a friend that has been         “Yes you would!” The bottom line is this:      As the saying goes, “this too shall pass.”
 diagnosed. I’d recommend that everyone          I could have stayed in bed and cried a         And you’ll be stronger because of it.
 create one of these that fits your life and     million tears. And if there was one time in
 your personality! It is a fun way to discuss    my life when people would have showed          By Shannon Routh, Patient, Presbyterian Cancer
 friendships and positive energy. You never      up for my pity party, it was then. But at      Center and Presbyterian Gynecologic Oncology

                                                                                                           FOCUS ON   Women

      Is Menopause Really To Blame? Continued from page 1
    Loss of muscle mass due to the natural
    aging process and less physical activity
                                               Don’t assume you have to live with the
    results in lower metabolism rates.         symptom or change you are experiencing.
    Regular exercise including a strength
    training regimen can maintain 15 percent   hormone levels high and creates a         can reduce or eliminate many common
    more of your muscle mass per year.         craving for those carbohydrates we have   symptoms experienced during
                                               trouble metabolizing. Seeking support     peri-menopause, allowing you to
    And the ability to metabolize              with managing stress can help reduce      live a healthy, active lifestyle.
    carbohydrates also changes with age. To    or alleviate the mood swings and
    maintain a consistent weight as we grow    concentration problems.                   To find a physician that is perfect
    older, we should reduce the amount and                                               for you and your healthcare needs,
    type of carbohydrates consumed. For        It is important to discuss all of your    call 704-384-CARE (2273).
    example, eating a muffin (carbohydrate)    symptoms with your healthcare provider.
    raises your blood sugar, only to have      Don’t assume you have to live with the
    it drop within two hours, leaving you      symptom or change you are experiencing.              By Mary Rachui, RN, MS,
                                               Lifestyle changes or treatment options               Presbyterian Women’s Center
    hungry again. Substituting a whole-
    grain snack and adding a protein helps
    maintain a steady blood-sugar level,
    which will decrease cravings. Plan
    for your mid-afternoon energy dip by
    having a low-fat cheese stick and an
    apple handy and avoid the trip to the
    snack machine for a candy bar.

    The “mood swings” and concentration
    difficulties attributed to menopause
    can be related to more than hormone
    changes. Stressors during this stage
    of life can include parenting teenagers,
    caring for aging parents, adjusting to
    an empty nest and different marriage
    challenges. Stress causes a rise in
    cortisol and adrenaline levels, which
    isn’t a problem for short periods.
    However, chronic stress keeps these

        Did You
      The number of women in the United States over
      the age of 50 is increasing. This year, the number
      of U.S. women in the postmenopausal stage of
      their lives is expected to reach about 55 million.


   Take Charge of Your Health! Classes and Events
      JUST FOR WOMEN                                 NUTRITION & WEIGHT LOSS
     u Women’s Health by Design                      u Eat Your Heart Out Cooking School
       Unique health evaluation program                Learn to cook the heart-healthy way!
       that combines health screenings,                A registered dietitian will lead the
       consultations, education and a complete         class in preparing a meal from the
       wellness summary. A two-hour session            Mediterranean-American diet. You
       is all you need to build a complete game        will also take a cardiovascular risk
       plan for your overall health. Includes          assessment test, learn valuable nutrition
       screenings, analysis, light breakfast and a     information and have a chance to
       customized health education notebook.           enjoy your heart-healthy meal.

     u Prepare For Your Hysterectomy                 u Heart-Healthy Kitchen Consult
       Learn what to expect during your                A registered dietitian will make a home
       hospital stay and recovery. Support             visit to provide a dietary consult for you
       person welcome.                                 and your family and educate you about
                                                       healthy items to restock your pantry.
     u Life’s Symphony: Bringing
       Harmony to Menopause                          u Surgical Solutions for Weight Loss            MATERNITY
       A program that will help you                    Presbyterian Bariatric Center hosts          Maternity classes are offered on a
       understand the changes that occur in            free seminars on weight loss surgery.        variety of topics, including childbirth,
       your body during menopause. Learn               Topics include the risks of severe           breastfeeding, yoga for birth and
       the importance of good nutrition, get           obesity, if you are a surgical candidate     pregnancy nutrition. Tours of the hospital
       tips to protect your heart and bones            and the risks and benefits of weight         and birthing facility are available. Classes
       and discover menopause comfort                  loss surgery. Locations in Charlotte,        are also available for family members,
       measures and hormone therapy.                   Huntersville and Matthews.                   including siblings, grandparents and
                                                                                                    fathers. For more information about these
      CANCER SUPPORT                                 u Take Off a Ton in 10 Weeks                   classes, special events or other maternity
                                                       Educational, fun and supportive weight       services, call 704-384-7510.
     u Presbyterian Buddy Kemp                         loss program. Nutritionists, nurses and
       Cancer Support Center                           exercise physiologists teach easy and
       A cancer community support program                                                            OTHER CLASSES & SPECIAL EVENTS
                                                       delicious low-fat recipes and help you
       for patients, their families and friends.       to begin a safe, fun exercise program.
       Programs include support groups for                                                          u Osteoporosis: Build Your Bones
       all ages, counseling, financial resource                                                       A physical therapist and registered
                                                     HEART & WELLNESS                                 dietitian provide education on
       management and a resource library. For
       more information, call 704-384-5223.                                                           fracture prevention, risk factors,
                                                     u Cardiac Rehabilitation                         current medical treatment, posture,
                                                       Program offers exercise therapy, nutrition     nutrition, safe lifting/movement and
     u Presbyterian Cancer                             counseling and cardiac education to            exercise. Options include an individual
       Rehabilitation & Wellness                       help patients and their families recover       consultation for one-on-one education
       Offers therapeutic massages, yoga,              from a heart attack, heart surgery or          and/or a four-class series with
       nutrition classes, fatigue management           other cardiac conditions.                      expanded information and practice.
       programs and a lymphedema clinic. For
                                                                                                      Class open to men and women.
       more information, call 704-384-6953.

                                                                                                    u Super Sitter
                                                                                                      Six-hour babysitting class for boys and
                                                                                                      girls ages 11 to 13. Includes babysitting
        Please call 704-384-CARE (2273) or more information & to                                      techniques, child development, safety
                                                                                                      tips, first aid, rescue breathing and
        register. Complete class listing:                                 accident management.

200 Hawthorne Lane
Post Office Box 33549
Charlotte, NC 28233-3549

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                                                                                                                                                  FOCUS ON   Women

     Broccoli Coleslaw
     1                 Red onion                                          2 Tbsp             Splenda®
     1/4 cup           Light mayonnaise                                   1 tsp              Celery seeds
     1/4 cup           Plain nonfat yogurt                                1/3 tsp            Paprika
     1/4 cup           Fat-free sour cream                                4 cups             Broccoli slaw
     1/4 cup           Reduced fat                                        5 cups             Cabbage slaw
                       Parmesan cheese, grated

     In a large salad bowl, combine the cabbage and broccoli slaws and onion. In a small mixing bowl,
     combine the remaining ingredients. Toss to coat, and refrigerate until ready to serve.

     Number of servings: 8. Nutritional information per serving (serving size: 1/2 cup): Calories, 40; Fat, 1.5 grams (saturated fat, 0 grams);
     Protein, 2 grams; Carbohydrates, 6 grams; Fiber, 2 grams; Cholesterol, 5 milligrams; Sodium, 80 milligrams

                                                                                                                                    Recipe Corner
    Did You Know?                                         Broccoli is a good source of Vitamin A, Vitamin C, potassium, folacin,
                                                          iron and fiber. It also has as much calcium per ounce as milk.

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