Archives for 2011

How to Log Your Workouts and Food Intake

Nutrition FactsAfter you’ve chosen a method to log your workouts and food intake, it’s time to get started tracking your progress.

Keeping records is a vital part of being accountable to yourself and staying on track. You’ll see your progress every day, week, and month, so you can celebrate your accomplishments. If your program needs changes, or if you’re having trouble in a particular area, your log will alert you right away. The following tips will help you easily track your journey to a healthier you.

Have a realistic goal, and write it down.

Before you begin your program, set your goals in writing. One way to set effective goals is to use the acronym SMART: specific, measurable, attainable, realistic, and time framed. What is realistic and attainable for you? Maybe returning to your weight at age 16 isn’t realistic, but returning to your weight at age 25 is. If you’re just starting a health program and have been inactive for a while, a triathlon may not happen this year—but would be a realistic goal for next year.

When you’ve decided on a goal, log it on your tracking tool. The simple act of writing it down sets it in your mind.

Plan your meals and workouts, and log them.

Setting and keeping a workout schedule and meal plan help you stay on track. The rigidity of the schedule is up to you. You may wish to be very specific and write out a menu and exercise plan every week, or you may simply block out exercise time and decide that day which activity to do. You may want to experiment to see what works well for you.

When you log your workouts, be as specific as you can. Note which machines you used at the gym and for how long, how many reps you did at which weight, or how many miles you walked.

Record not just actions, but also feelings.

When you’re trying to exercise and eat right, your feelings play a major role in your motivation to stick to your program. If you stray from your plan, it’s often because of negative emotions. If you can track those feelings, you can identify when they are likely to occur and plan accordingly.

Use logs to motivate, not discourage.

It’s common to feel discouraged if the scale doesn’t budge or you don’t see any progress. Don’t let it discourage you. It’s common to hit the occasional plateau, which is your body’s way of getting ready to move to the next level of weight loss or to that next exercise goal. Keep going and recording everything, and you’ll hit that next target before you know it. Take pleasure in other numbers, such as your dress size and your blood pressure.

Remember that each day is just that: one day.

You may not hit all your goals each day, and that’s OK. Life happens. The key is to keep a one-day slip limited to that day, and get back on track the next day.

Food intake and workout logs help you to see and understand your behavior, and remind you of your commitment to health. Daily tracking is essential for staying true to yourself and your healthy plan. When you have a system in place for tracking, your results are greatly improved.

How has your healthy progress improved by using tracking tools?

5 Ways to Avoid Diabetes

diabetesType 2 Diabetes is one of the most prevalent serious diseases in the United States. Diabetes is responsible for a range of complications, such as blindness, amputation, kidney failure, stroke, and heart disease. The American Diabetes Association estimated that diabetes contributed to over 230,000 deaths in 2007.

Type 2 Diabetes is a chronic metabolic disease caused by insulin resistance. When we digest food, glucose (sugar) enters the bloodstream to be carried to the cells of the body. The pancreas secretes an appropriate level of insulin to help the glucose enter the cells, much like a key fits a lock. High levels of glucose require the pancreas to secrete high levels of insulin.

If there are prolonged levels of high glucose, sometimes the cells become resistant to insulin and the glucose cannot leave the bloodstream, which in turn prompts the pancreas to secrete even more insulin. These elevated blood glucose levels are the cause of Type 2 diabetes.

While being overweight or having a family history of diabetes may raise your risk of developing diabetes, it is preventable with knowledge and just a few lifestyle changes.

Check your glucose and your family history.

Insulin resistance can progress to full-blown diabetes with no warning, so if you’re over age 45, it’s a good idea to go to the doctor at least once a year and have your glucose levels checked. If you have a family history of diabetes, glucose checks should start no later than age 40.

Watch your diet.

Healthy eating is one of the best ways to ward off insulin resistance and diabetes. Eat more fresh fruits and vegetables, and minimize your intake of junk and snack foods. Avoid high-fructose corn syrup and partially hydrogenated oils, and minimize sugary drinks and soda. Choose whole grains such as oats, barley, and wild rice, and buy leaner meat, such as turkey, bison, and fish.

Become a label reader and study the ingredients in the foods you eat. The more real food you can eat, the better. Buy less processed food, and if the label shows ingredients you can’t pronounce, reconsider buying that food.

Do some kind of physical activity every day.

Exercise helps keep your blood glucose low, reduces your risk for diabetes, and keeps your heart and lungs healthy. You don’t have to run 20 miles a day to reap the benefits of daily physical activity, but you do need to move. The key is to do something you enjoy every day, whether it’s playing tennis, walking the dog, or dancing.

Maintain a healthy weight.

Being overweight increases your Type 2 diabetes risk, as well as the risks of heart disease and stroke. Even a small weight loss of 10 or 15 pounds can reduce your risk. Follow the dietary and exercise recommendations above, and set realistic goals for weight loss. Every small step takes you closer to your goal, so keep going even if you get frustrated. Find a support system to help you stay on track.

Stop smoking.

Smoking raises your blood glucose levels and contributes to insulin resistance. This is why people who smoke often aren’t hungry. To stop smoking, call your state’s tobacco quit line. In addition to valuable coaching help to quit, many states offer free or low-cost aids such as nicotine patches and gum. Keep in mind that once you stop smoking, not only does your risk for diabetes go down, but your risks of heart disease, stroke, and cancer are also reduced.

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Don’t Live in Charleston But Still Want a State-of-the-Art Breast Reconstruction?

Chris MurakamiThe question below is answered by Chris Murakami, RN, CNOR, and Clinical Supervisor (seen to the left) of The Center for Natural Breast Reconstruction.

I live in Florida and would like to come to Charleston to have a bilateral S-GAP by Dr. Kline and Dr. Craigie. Do I need to come in for a consultation first and then come back at a later date to have the surgery or can it be done all in one trip? Please tell me how this is typically handled.

Great question! There are many ways to approach this situation and do our best to try to minimize the number of trips you need to make to Charleston. You are more than welcome to come and have a face to face consult with your surgeon and then make a second trip for surgery. For some women, that is the scenario they prefer. However, since many of our patients do have to travel to access the state-of-the-art procedures offered by our expert surgeons, we’re prepared to perform your first consultation by telephone.

During this call, we talk about the procedure you are interested in and ask some screening questions to ensure you have no medical contraindication. Once this has been established, we’ll set up a time for you to talk with the surgeon of your choice and you’ll both decide which donor site might be the best to use for your breast reconstruction. Your next step would be to notify us when you would like to proceed with the surgical procedure.

When we’ve settled on a surgical date, we order as much of your pre-operative testing in your hometown as we can. The results of this testing is sent to our office two weeks prior to your surgery day. These tests include blood work, urinalysis, EKG, and Chest X-ray. Go ahead and schedule a full physical with your family doctor or internal medicine doctor and obtain a statement of medical clearance for your estimated length of surgical time.

While all of this medical work is happening, our administrative staff has been diligently working behind the scenes, checking insurance benefits and completing all of the pre-certification processes your insurance company may require.

We’d like you to arrive in Charleston a day or two prior to your surgery date. If a breast surgeon is needed to perform a mastectomy we ask you to come two days prior. You would meet with him / her on the day you arrive, in case any testing needs to be ordered by their office.

The day prior to your surgery date is usually the busiest for you, but we try to coordinate all of your pre-operative activities to be as convenient as possible. You would have various appointments scheduled for you, including a pre-operative interview at the surgical hospital, an MRA to map the blood vessels we plan to use for surgery, and a pre-operative marking appointment and consultation with our surgeon that day before surgery.

Once the surgery day arrives, you would report to the hospital at 6:00 am. Our staff and physicians will obtain contact information for your caregivers and keep them updated on the progress of your surgery throughout your time in the operating room. Once the operation has completed and you have recovered from anesthesia, you would be transferred to the women’s services floor of the hospital for the remainder of your four-day hospitalization. Each room is private and has a twin bed in case you have someone who plans to stay with you throughout your hospital stay.

When you have been discharged from the hospital, we ask that you stay in the Charleston area for a few more days, just to assure all is well and we are easily accessible to you. We ask you to come to your first post operative appointment two days after your discharge and again on the day prior to your planned return home. You may still have donor site drains that need to be removed when you return home and we are happy to help you find a medical professional to do that for you if you don’t have a physician in your hometown who is willing to help.

Once you are home, we’re available to you 24/7 to discuss any concerns you may have, but generally, at this point, you have a viable reconstruction that should heal uneventfully. You can look forward to another visit to Charleston only when or if you require a second stage of surgery after a three-month healing period. This procedure would typically be an outpatient procedure and you might just schedule yourself some “tourist time” to enjoy our beautiful city.

—Chris Murakami, RN, CNOR, Clinical Supervisor

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Educate Yourself on Breast and Ovarian Cancer at the Annual Joining FORCEs Conference

Image to the left taken from FacingOurRisk.org.

For anyone concerned about hereditary breast or ovarian cancer, FORCE is hosting their annual Joining FORCEs Conference with Moffitt Cancer Center to educate individuals on everything from mastectomy options to genetic basics, and reconstruction options to menopause. This three-day international conference will provide attendees with valuable information and tips for cancer prevention and detection.

Attendees will also learn vital skills such as how to cope with cancer, how to make risk-management decisions, how to discuss cancer with family members, and so much more.

The event takes place from June 23 – 25 at the Hyatt Regency Grand Cypress in Orlando, Florida. And we are delighted to inform you that we’ll be attending the event and featured as one of the exhibitors. In addition to exhibiting, Dr. James Craigie will be on one of the reconstruction Q & A panels, and Dr. Richard Kline will be hosting a table at the Networking Breakfast. We hope to see you there!

See below for an amazing video from FORCE:

Click here to register for this amazing event!

When and Why to Choose Organic Foods

organic foodOrganic foods, generally speaking, are grown with fewer chemicals or hormone treatments than supermarket foods. Typical chemicals and additives include growth hormone, antibiotics, pesticides, and herbicides.

Obviously, we would all like to eat wholesome, naturally-grown foods for every meal, but they can be hard to find. Livestock animals eat unnatural diets to make them heavier and ship them to market sooner, and they’re injected with hormones and antibiotics. Fruits, vegetables, and grains are genetically modified to grow faster and larger, and they’re sprayed to keep pests and fungus away.

Organic foods can be significantly more expensive than supermarket foods, and you may wish to vary your eating with the seasons, as organic produce in season is less expensive. If you have a farmer’s market in your area, you’ll find very fresh, organic produce for a reasonable price. Local sources for meat and dairy products are often organic as well, but may not be available in some areas.

You might be asking yourself whether you have to buy everything organic. Certain foods are treated with more chemicals than others, and these are the foods that you should consider buying organic. For these foods, washing, peeling, and cooking do not significantly reduce chemical residues, so these foods are called the dirty dozen or the crucial dozen:

  • Peppers
  • Celery
  • Grapes
  • Fruits with pits, such as apricots, peaches, and nectarines
  • Farm-raised meats such as beef, chicken and pork
  • Potatoes
  • Dairy products
  • Coffee
  • Berries
  • Apples and pears
  • Tomatoes and carrots
  • Spinach and salad greens such as lettuce and kale

No matter the source, be sure to wash all produce with a fruit and vegetable wash, which can be found at most supermarkets and health food stores.

For foods with low pesticide residue levels, buying organic isn’t as vital. These dozen foods lose the residue with thorough washing, peeling, or cooking:

  • Onions
  • Bananas
  • Kiwi
  • Corn
  • Mango
  • Melon
  • Grapefruit
  • Pineapple
  • Asparagus
  • Broccoli
  • Cabbage
  • Avocados

While organic is ideal, it’s not always necessary to spend the extra money. Which foods do you buy organic, or not?

What is an MRA and What is it For?

Dr. Richard M. Kline, Jr.

The below question is answered by Richard M. Kline Jr., M.D., of The Center for Natural Breast Reconstruction.

Why am I scheduled to have a MRA prior to my DIEP surgery? What is it and what is it for?

Preoperative imaging of perforating vessels by CTA (computerized tomographic angiogram) or MRA (magnetic resonance angiogram) is probably the most significant development in perforator flap breast reconstruction in the last 5 – 10 years.

Some of the potential advantages of preoperative imaging (with CTA or MRA) include:

1. Shortened operating time, due to knowing in advance where the desired perforating vessels are located.

2. Decreased damage to the rectus muscle, due to being able to select perforating vessels with the shortest intramuscular course. This is particularly important because it can decrease the chance of a major motor nerve to the muscle being divided. A few fortunate patients have an unusual anatomic situation in which a large perforating vessel actually goes between the two muscles, which can allow harvest with no damage to the muscle at all; this is instantly recognizable on preoperative imaging.

3. Decreased fat necrosis, due to being able to select the largest perforator.

4. Advanced recognition of those few cases when the SIEA, not the DIEP, might actually be the preferred blood supply for the flap (the same tissue would still be used)

5. Advanced recognition of those very rare instances where the deep inferior epigastric system has been divided form past surgery, or where all usable perforating vessels have been damaged by previous abdominal liposuction.

CTA has the advantage of being most readily available, but also exposes the patient to radiation. MRA does not expose the patient to radiation, but we have found that only a very strong MRI (3 tesla, or 3T) can give us images with enough detail to be really useful for preoperative planning. MRA still requires the administration of intravenous contrast agents, which can rarely have undesirable side effects. On the horizon is MRA without the need for any injection—it’s not quite here yet, but its coming.

We are very fortunate to work with a very skilled group of radiologists with a 3T MRI who are very interested in and skilled at obtaining images for our breast flap patients. We obtain preoperative imaging on all patients preoperatively, whether they are scheduled for a DIEP or GAP flap. If a patient has a contraindication for an MRI / MRA (ferrous metal implanted in the body is the most common), then we obtain a CTA.

—Dr. Richard M. Kline, Jr.

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Healthy Brunch Ideas

healthy brunch ideasBrunch is the perfect time to eat healthy. From fruit to whole-grain muffins and Canadian bacon to turkey sausage, an endless variety of food works for brunch. We’ve come up with a dozen delicious options to help you stay on your healthy eating plan.

Multi-grain pancakes and waffles contain anything you want them to: oat, buckwheat, whole wheat, cornmeal, flax seed, or spelt. Use whole grains as much as possible, and don’t be afraid to add blueberries to those pancakes!

Whole-grain muffins give you the texture and taste you want in a healthier package. Use applesauce or mashed bananas to replace the fat during cooking, and use all-fruit spreads or nut butters on top.

Turkey bacon and sausage add low-fat protein and delicious flavor to quiches, casseroles, and scrambles.

Smoothies are the perfect way to blend your favorite fruits with protein powder, juice, yogurt, or even ice cream. Try several recipes, as there are hundreds of ways to make a tasty smoothie.

Tofu can replace meat in almost any dish. It can also be marinated and barbecued or used in place of cheese.

Canadian bacon has incredible flavor and one-third the calories of regular bacon. It’s also much lower in fat and sodium.

Vegetables of any kind add nutrition, color, and flavor to egg dishes, salads, and side items. Omelets and quiches are an ideal place for a variety of veggies. Try to eat as many different colors as possible to ensure you’re getting the full spectrum of antioxidants and nutrients.

Fruit is a brunch favorite and is used for everything from fresh-squeezed juice to tarts. Like vegetables, be sure to eat a variety to take advantage of the excellent nutrition fruit offers.

Nut and fruit butters and all-fruit spreads are healthy substitutes for butter and high-sugar jellies and jams. Choose from all-natural peanut butter, almond butter, cashew butter, apple butter, and spreadable fruit. All are available in stores, but read labels carefully: nut butters should have only one ingredient: the nut itself. Ingredients on the fruit butters and spreadable fruit will vary, but there should be only a few ingredients with no added syrup, sugar, or oils.

Quiche is a delicious, healthy main course, perfect for any type of food you want to put in it. Eggs, vegetables, meat, cheese, and tofu are common ingredients, and quiche invites experimentation with flavors, ingredients, and spices. A casserole is also a good option for a quick and easy brunch dish.

Wild or game meat adds unique flavor and healthy protein to any dish. Game is naturally low in fat, and does not receive antibiotics or hormones. Game meat includes venison, elk, bison, moose, alligator, and wild boar.

Real eggs are one of the healthiest foods you can eat and full of protein, vitamins, and minerals. Eggs are versatile and can be cooked a number of different ways: fried, scrambled, sunny side up, hard- and soft boiled, and poached.

Keep in mind that how you cook and serve is just as important as what you cook and serve. Stay away from partially hydrogenated oils, such as margarine. Coconut oil and olive oil are good choices for both cooking and serving. Real butter, low-sugar syrup, and cream cheese in moderation add a delightful taste to the table. And of course, stay away from high-fructose corn syrup.

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5 Ways to Improve Your Mental Health

mental healthYour mental health is a vital part of your overall health, yet we often ignore it. When you feel mentally alive, your physical health improves as well. Follow these five tips to improve your mental health and increase your happiness.

1. Address negative beliefs.

Most of us hold negative beliefs, and they have a detrimental effect on our mental and physical health. We choose to hold these beliefs for whatever reason, and some may be valid while others are outdated or simply incorrect. Negative beliefs lead to a negative attitude, which saps your energy and alienates family members, caregivers, and friends.

To change a negative belief, you must identify it. Ask a trusted friend for help with this. Once you have determined which are your negative beliefs, ask yourself three things: where they came from, whether they are true, and whether you still want to hold onto them. Letting go of negative beliefs can be difficult but tremendously freeing, and it must be your decision to move forward without them. No one can force you to release a negative belief.

2. Replace the negative with a positive.

Whenever a negative thought creeps into your mind, focus on the positive of the situation instead. The negative thought will float off, and you’ll be happier, more relaxed, and able to deal with the situation as a whole. This is not to say you don’t need to deal with negative thoughts or situations—sometimes you do—but often negative thoughts are holdovers from those negative beliefs you’re trying to lose.

For example, if you’ve lost 10 pounds and have a negative thought about your ability to continue losing, remind yourself that you’ve already lost 10. Tell yourself how good you feel, and encourage yourself to keep going. If you let a negative thought stay in your mind, you’ll fall into it and have a difficult time climbing out of it. Concentrate on the positive, and don’t dig yourself a negative hole.

3. Reduce stress.

Stress causes not only physical problems, but also mental blocks and issues. Reducing stress is one of the fastest ways to boost your mental health. One quick way to feel better is to take three deep breaths: inhale through your nose, close your eyes and hold it for two seconds, and then exhale through your mouth. Exhale as fully as you can, and feel the stress melt.

Several other ways to decrease stress include exercise, meditation, massage, and aromatherapy. Sometimes walking away and being alone for 5–10 minutes or listening to your favorite music is all you need to reduce anxiety. Experiment to find your best stress relief.

4. Take a break from your life.

A change of scenery is always good for your mental health. Take a week-long vacation at least once a year. You’re doing yourself and your family a disservice if you accrue vacation time and never use it. Find the time to do something for you. Get away and explore new places, or take a week off to work on a hobby you never seem to have time to enjoy. You’ll return refreshed, relaxed, and happier.

5. Exercise your mind as you do your body.

We move through each day doing what we must, but we don’t stimulate our minds as often or as deeply as we should. Your mind craves challenge and creativity, and you feel alive and alert when you give your mind a new job. Take a class, learn a new hobby, go to a symphony or museum, or do the crossword in the newspaper. Try something new and excite your brain, as well as improve your memory.

Your mental health is just as important as your physical health, and the more you take care of your mind and exercise it, the happier you’ll be. If you do it consistently, the benefits last long into old age.

What’s your favorite way to take care of your mental health?

Does Radiation Affect My Options For Breast Reconstruction?

Dr. James Craigie

Dr. James Craigie

The question below is answered by Dr. James Craigie of The Center for Natural Breast Reconstruction.

I am not sure if I will need radiation after my mastectomy. What factors should I consider before going ahead with breast reconstruction?

Radiation therapy is part of the treatment for breast cancer for some but not all patients. To determine if it is necessary for any individual, the details of the cancer or the final path results must be known. The most common situation for radiation after mastectomy is based on the size of the cancer and the number of positive lymph nodes.

When a patient would benefit from radiation the treatment may affect the options for breast reconstruction as well as the timing of the reconstruction. There are several advantages to starting the breast reconstruction at the time of the mastectomy. These include: the breast surgeon can save more of the breast skin or even the nipple and this can set the stage for the best possible result, and avoiding an extra step and an extra recovery period.

If radiation will definitely be needed after mastectomy then I do not recommend immediate natural breast reconstruction because the radiation can possibly damage the new breast. In this situation the reconstruction would start approximately 6 months following radiation. These decisions are best made following the advice of your oncologist, breast surgeon, and plastic surgeon all working together. For this reason I am a strong advocate of the multi-specialty breast conference where each patient can be presented to all the specialists at once so they can share their opinions right away. Cooperation between experts can ensure better results and more options for each patient.

It is important to remember that if you need radiation for the treatment of breast cancer it does not mean you cannot have a very good result with natural breast reconstruction. It may however determine the order and timing of when the breast reconstruction should begin.

—James E. Craigie, MD

 

Important Self-Exams Every Woman Should Perform

Image to the left taken from Cancer.org.

 

Self-exams help you to detect changes in your body between visits to your doctor. Many lives have been saved due to diligent self-examination, and following are two self-exams you’ll want to perform regularly.

BSE or breast self-exam

Each woman has her own method of examining her breasts. Some do a systematic BSE monthly or bimonthly, while others keep an eye on their breasts by regularly feeling them in the shower or while lying in bed. Often, women ask their significant others to help them check, or they visit the doctor several times a year for a clinical exam.

While a regular BSE with a consistent technique is best, perfect technique is not as important as frequency and diligence. Sometimes, women stress needlessly about doing it correctly. As long as you feel the entire breast and overlap your motions, you’re doing it right. The goal of a BSE is to know what is normal for you and check for changes.

If you’re not sure whether you’re feeling the entire breast, cancer.org suggests the following BSE routine:

  • Lie down and bend your arm behind your head to spread the breast tissue evenly over your chest, making it easier to examine.
  • Imagine your breast is divided in vertical lines from your underarm to breastbone, and use the finger pads of your other hand to feel for lumps in an up-and-down pattern along those lines. Move in dime-sized circles, slightly overlapping the previous line as you move up and down.
  • Use different levels of pressure at each spot so you feel all the breast tissue, especially if you have large breasts. You can feel the tissue close to the skin with light pressure, tissue in the upper half of the breast with medium pressure, and lower breast tissue with deeper pressure. There will be a ridge at the bottom of each breast, which is normal. If you have questions about pressure, talk with your doctor or nurse.
  • Examine the entire breast area, and then repeat the exam on your other breast.
  • Stand in front of a mirror, press your hands on your hips, and look at your breasts for changes in shape or size. Also look for rashes, redness, or dimpling.
  • Raise each arm slightly, and feel the underarm for lumps.

Some women may find it easier to examine their breasts in the shower, which is fine, as long as you are thorough—or add this routine to your shower exam. Current medical literature suggests that the above procedure is the most effective for finding lumps as soon as possible.

Skin exam

A regular skin exam will help you keep an eye on moles, freckles, and other spots that could become cancerous. It should be done at least once a month, and if you ask your doctor to do a full-body exam first, you’ll have a baseline. While it may sound daunting, after you’ve done a full skin exam a couple of times, it shouldn’t take more than 10–15 minutes.

Warning signs of skin cancer include a change in an existing mole or spot, or any growth or spot that . . .

  • Appears during adulthood.
  • Increases in size or thickness.
  • Changes in texture or in color—especially if it turns pearly, multicolored, brown, or black.
  • Has an irregular shape or outline.
  • Is bigger than a pencil eraser.
  • Continues to hurt, itch, scab, or bleed longer than three weeks.

If you see any of these signs, don’t wait or hope it goes away. See a doctor, preferably a dermatologist.

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