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
Register at www.presbyterian.org/women to
Can a Video Game Really receive this newsletter directly in your email inbox.
Get Me in Shape? 3
Send your feedback on this or any future issue to
Patient Testimonial: email@example.com. 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 www.twitter.com/presbyhealth www.facebook.com/presbyterianhealthcare
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 www.presbyterian.org/
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: kristinvining.com.
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 www.presbyterian.org/cancer
(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
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: www.presbyterian.org/women. accident management.
200 Hawthorne Lane
Post Office Box 33549
Charlotte, NC 28233-3549
Register at www.presbyterian.org/women
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FOCUS ON Women is published by
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FOCUS ON Women
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
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.