All posts in Lifestyle Tips

Eating Disorders and Pregnancy

The two most common types of eating disorders are anorexia nervosa and bulimia nervosa, yet there are other types out there that are not as common. Unfortunately, research on eating disorders and pregnancy is quite limited– there are estimations that eating disorders affect 5-8% of women during pregnancy, but this may not be completely credible as results can be skewed due to women’s reluctance to recognize eating disorders. Anorexia and bulimia often become noticeable in adolescence, and it’s possible that they linger during a woman’s reproductive years. Consequently, they can of course affect not only a woman’s reproductive health but also the health of her baby. 

Fertility is the first affected area of women who suffer from an eating disorder: most women with anorexia do not have menstrual cycles, and approximately half of the women who have bulimia do not experience regular menstrual cycles. Absence of menstruation or irregular periods can limit the chances of conceiving, or even make it a lot more difficult for a couple to conceive. If you know you have an eating disorder and are seeking to get pregnant, it will be much healthier for you and your future baby if you try to treat your eating disorder first and establish some healthy eating habits. It is also important to share your history with medical professionals and ask for your weighing to be treated with more care. 

Though there is quite a long list of complications associated with eating disorders during pregnancy, rest assured that proper planning and prenatal care– as well as a commitment to building healthy eating habits and helping your body remain healthy– can minimize a lot of those complications, lessen the risks associated with them, and enhance your chances for a healthy pregnancy. Some of those complications can be premature labor and low birth weight, as well as delayed fetal growth and respiratory problems. You may also be at a higher risk for emergency cesarean birth and other complications during labor. Gestational diabetes, preeclampsia, and even miscarriage are also possible complications. Women with eating disorders are also at a higher risk for postpartum depression, and depression during pregnancy, and are more likely to have problems with breastfeeding. Women with bulimia are at a higher risk for hypertension, and substances such as laxatives and other medications may be harmful to the development of the baby and can lead to fetal abnormalities as well. 

Eating disorders unfortunately cannot be treated with medications that are pregnancy-safe. Treatment includes, first and foremost, the mother’s determination to have a healthy pregnancy and–difficult and shameful as it may be–disclosing to health professionals that you are struggling with an eating disorder. That way, your doctor will be able to tailor your prenatal visits accordingly, and know the risk factors associated with your pregnancy. The obstetrician’s care can be complemented by a registered dietitian/nutritionist and a therapist for well rounded care and medical treatment. 

 

https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/eating-disorders-and-pregnancy/ 

https://www.verywellmind.com/pregnancy-and-eating-disorders-4179037 



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Gestational Diabetes

You may be familiar with Diabetes Type 1 and Type 2, but did you know there is also a bonus one, called Gestational Diabetes Mellitus– or Gestational Diabetes for short? Gestational Diabetes is diabetes that’s diagnosed for the first time during the gestation period, aka pregnancy. Contrary to Type 1 diabetes, GDM is not caused by a lack of insulin. Instead, it is caused by hormones produced during pregnancy that make insulin ineffective. This is also known as insulin resistance, whereby the mother’s body does not use insulin as it should. Like other types of diabetes, GDM affects how cells use sugar. About 3-8% of pregnant people in the US are diagnosed with gestational diabetes; its symptoms disappear after delivery, and the great news is that you can help control gestational diabetes! 

Symptoms: gestational diabetes does not have any symptoms on its own, except increased thirst and frequent urination (which could be pregnancy related regardless). If you are risk for Type 1 diabetes because one of your parents or siblings has it, or at risk for Type 2 diabetes because you are prediabetic, over 45 y/o, may be overweight, don’t exercise often, or have previously had gestational diabetes, your doctor may deem you are at high risk for GDM and suggest you be tested. 

Risks: GDM is not like Type 1 Diabetes which can cause birth defects–in fact, GDM arrives too late in a pregnancy to cause any birth defects. Insulin resistance starts showing up around Week 24. Therefore, and thankfully, the complications are manageable and preventable. Generally, gestational diabetes may cause macrosomia and hypoglycemia, which are the two major health issues associated with it. Macrosomia refers to an excessively large fetus and hypoglycemia refers to low blood sugar in the baby immediately after delivery. 

Treatment: there are available treatments for gestational diabetes, and many depend on your age, overall health, and medical history. However, the most common ways to manage GDM are to regularly check your blood sugar so it stays on healthy levels, creating a healthy eating plan with your doctor and following it, being active, and monitoring your baby. 

As is the case with any pregnancy complication, it is understandable that it may cause you stress. While there is no certain way to prevent stress, do know that gestational diabetes is very manageable and has very low health risks for your baby. In fact, your own stress may cause more complications during pregnancy than gestational diabetes. You can better gauge your risk for GDM by checking your family history and having a general health assessment with your doctor early on in, or even before, your pregnancy. It is advisable to attend all your prenatal appointments, voice your concerns with your doctor, and maintain a healthy lifestyle to address the possible risks of gestational diabetes. 

 

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339 

https://www.cdc.gov/diabetes/basics/gestational.html 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes 



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Nursing Mothers at Work

Most new mothers dread the day they’ll have to return to work and leave their newborn at home, or at a daycare facility. It is undoubtedly difficult to get back into a work/home routine when you feel like you haven’t had enough time with your newborn baby–and in most cases, mothers in the Western World do not receive adequate maternal leave. The situation is made even more difficult for mothers who breastfeed their babies: a newborn requires a rigid feeding schedule, and the nursing mother cannot risk interrupting her body’s breastfeeding schedule.

Breastfeeding babies in the workplace is almost unheard of, unless you work from home or your employer provides newborn daycare right in your work building. What most nursing mothers are faced with is the option to express milk in the workplace. 

Even though in 2010 Congress made an amendment to the Fair Labor Standards Act by passing the Break Time for Nursing Mothers Law, many new mothers face breastfeeding discrimination in the workplace. This primarily means that work environments do not offer appropriate accommodations for nursing mothers to express milk in a clean, sanitized, and private space. It also means, as a 2004 study has also shown, that workplaces do not provide new mothers with enough breaks during an 8-hour workday for them to adequately pump and maintain their milk production. In short, you should not be running to your car, unbuttoning your blouse as you’re running to the underground garage, adjusting the pump in the elevator and pumping for 10 minutes in your vehicle: you have waaaay more rights than that, and employers are required by law to provide you with accommodations. 

Before we look into some of the ways in which employers can support new mothers, we should say that workplaces which show consistent support to new mothers and their needs tend to have a more positive work environment, and thus are more likely to be successful in their labor. 

  1. Adequate Private Space & Appropriate Amenities: workplaces are required to provide a private space for nursing employees that is not a bathroom. This doesn’t need to be a permanent space; it can be a temporarily converted office with a lock on the door, and with the reassurance that other employees cannot see into the room. Ideally, this space should also have electrical outlets, a sink, a comfortable seat and not harsh fluorescent lighting, and a small fridge for milk storage. Some places partner with other locations that do have a dedicated lactation room to provide their employees with the necessary facilities. 
  2. Reasonable Break Time: nursing employees should be allowed enough breaks to adequately pump at least 2-3 times during an 8-hour workday, and this should come with the understanding that the necessary time differs based on each person. There should be no negative consequences or withheld compensation for the time an employee needs for pumping during the workday. 

It is of extreme importance to have a written lactation policy that outlines the employees’ rights and the employers’ responsibilities when it comes to nursing individuals. If you have concerns about this policy at your workplace, you can consult the US Department of Labor, or the United States Breastfeeding Committee

 

https://www.dimaghawi.com/dimas-blog/4-important-ways-to-accommodate-nursing-mothers-in-the-workplace 

https://www.womenshealth.gov/supporting-nursing-moms-work/what-law-says-about-breastfeeding-and-work/what-employers-need-know#1 



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Osteoporosis

You may have heard the occasional old person complain about their bones hurting when the
weather turns, or struggle to eliminate chronic back and joint pain. Though there can be many
reasons for this, one of the most common is the silent disease of osteoporosis: it causes bones to
weaken and turn brittle and fragile. As such, the risk of broken bones or fractures is significantly
increased.

Unfortunately, if you’re not regularly tested for osteoporosis you may not even be able
to tell you have this disease until a seemingly minor accident leaves you with a broken bone…

How to Diagnose
The later stages of osteoporosis come with several symptoms, such as back pain, stooped
posture, minor fractures, and loss of height. You can, however, be proactive about osteoporosis
before you suffer those symptoms or a broken bone (seemingly out of nowhere!). The easiest
way to keep tabs on osteoporosis is a bone density test. Imagine osteoporosis turning your strong
bones into sponge-like structures. Bone density tests help compare your bone density to the
average bone density of a healthy, young, US-based woman. They are officially called Bone
Mineral Density (BMD) tests, and resemble an X-ray but with less radiation exposure. The BMD
results, along with other health factors taken into consideration, estimate your risk of having a
bone fracture in the next decade.

Getting Tested
As osteoporosis may creep up on you, it is recommended to get tested if you are a woman of
menopausal age with osteoporosis risk factors, or a woman over the age of 65. If you are under
65 but have a family history of osteoporosis and are postmenopausal, you should also get tested.
Breaking a bone after age 50 is also a good indicator you should get tested for osteoporosis.
If you have already been diagnosed with osteoporosis, and are even taking medications for it,
you may want to repeat BMD tests every couple of years. If you are switching osteoporosis
medications, it is likely that your medical professional will recommend you get tested.

Preventing Osteoporosis
There are several risk factors for osteoporosis, including age, sex, race and family history.
Women are at a greater risk for osteoporosis, as are all people as they get older. If you are white
or of Asian descent, you may also be at a higher risk. Some factors that can be controlled are low
sex hormones, excessive thyroid hormone, and other overactive parathyroid or adrenal glands.
Low calcium intake puts you at a greater risk of developing osteoporosis, as it contributes to
decreased bone density. Eating disorders or being severely underweight do the same, as they can
weaken bones in both men and women. Gastrointestinal surgery can also have a negative impact
on your bone density, as this type of surgery limits the available surface area of your body to
absorb nutrients, including calcium.

https://www.everydayhealth.com/osteoporosis/guide/symptoms/
https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968

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Breast Cancer Treatments

Thinking about breast cancer treatments is undoubtedly not the most enjoyable activity
one can engage in, but knowing your options can be a revealing and empowering experience. If
you have been diagnosed with breast cancer, it is very likely you will have one or more of these
experts in your treatment team: a breast surgeon or surgical oncologist, who is a doctor
specializing in surgery to topically treat breast cancer; a radiation oncologist, who specializes in
using radiation against breast cancer–also a topical treatment.

Some other experts, who focus more on systemic treatments, are a medical oncologist–a doctor who uses chemotherapy,
hormone treatment, immunotherapy, and other medicines to battle cancer and a plastic surgeon
who–as you may know–is there to reconstruct or repair parts of the body.

Local, or topical, treatments treat the tumor without affecting the rest of the body; surgery
and radiation are local treatments. Depending on the type of breast cancer, its stage, and your
overall health, you may need other types of treatment as well (before or after surgery, or both):
those are called systemic treatments because they reach cells almost anywhere in the body.
Systemic treatments can be given by mouth, put into the bloodstream, or injected in a muscle.

2022 has been a great year for breast cancer treatment, as the FDA approved a new drug
to treat HER2-Low Breast Cancer: trastuzumab deruxtecan (T-DXd). The approval came
through on August 5, 2022 and this therapy is meant to help patients who suffer from HER-2-
Low Breast Cancer that has spread to other parts of the body and cannot be surgically removed.
The clinical trial results for T-DXd were presented by medical oncologist Shanu Modi to this
year’s American Society of Clinical Oncology meeting. The clinical trial was led by Memorial
Sloan Kettering Cancer Center, and according to Dr. Modi, its results redefine how many
patients with metastatic cancer will be treated.

Targeted therapy works by identifying and attacking certain types of cancer cells, but it
doesn’t kill normal cells so its side effects are fewer than other treatments. However, until now
HER2 treatment has not been successful in treating cancer that is HER2-low. During the trial,
patients were given Enhertu (or T-DXd) which targets the protein HER2. The patients who
received Enhertu did noticeably better than the patients who received standard chemotherapy!
The new targeted drug held the cancer of the receivers in check nearly twice as long, and also
increased the survival rate by 35%.

This is wonderful news for breast cancer patients, and a great advancement in breast
cancer research and treatments! To consider if this is the right treatment for you, ask your
medical professional, and seek as much information as possible before you make a decision.

 

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Breast Cancer Awareness Month

October is best known as the month dedicated to spooky costumes and candy, but it is
also the month dedicated to Breast Cancer Awareness. Apart from skin cancers, breast cancer is
the most common one among American women. Facts show us that 1 in 8 women in the US will
receive a diagnosis of breast cancer in her lifetime, but the really good news is that 65% of cases
are diagnosed at a localized state–meaning that the cancer has not spread past the breast–for
which the five-year survival rate is 99%.

It is also encouraging to hear that there are over 3.8
million breast cancer survivors in the United States alone. The positive facts about breast cancer
assure us that science is working hard to enhance the survival rate for women who are diagnosed
with breast cancer, and is also making great strides to provide successful preventative
techniques.

During the month of October, there are continued efforts to fundraise money for
dedicated breast-cancer research, to support survivors, and to spread awareness and information
to younger women. If you are in Buffalo, NY you may want to consider participating in the
annual Making Strides of Buffalo walk, which is dedicated to making an impact and saving lives,
organized by Roswell Park Comprehensive Cancer Center. This year, the event takes place on
October 22nd, and you can easily sign up for the event on the American Cancer Society’s
website. The event does not have a registration fee, so it is accessible to a greater number of
people.

If you cannot attend the event in person, you can also make a donation, and keep
fundraising going by looking into the Matching Gifts programs: many employers will match
their employees’ charitable donations, or even volunteer hours, thus doubling the impact
individuals make on Breast Cancer Awareness! You can find out directly from your employer if
they are registered for a matching gifts program, or you can use the tool provided by Double the
Donation.

Another great way to support research and other initiatives toward Breast Cancer
Awareness is to create your own fundraising events; many tech-savvy folks set up their own
fundraising pages, or they simply ask their loved ones to collect donations towards this cause in
lieu of birthday, wedding, or anniversary gifts. If you have an online presence, you can easily
bring people together through Facebook or Instagram Live, and even Zoom, to provide support,
share knowledge, and build a community.

Breast Cancer Awareness Month

Fundraising for Breast Cancer: 8 Breast Cancer Awareness Month Ideas to Make an Impact

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Vaginal Dryness after Menopause

One of the most often talked about symptoms of menopause is vaginal dryness. It would be ideal if it only showed up when menopause started, but unfortunately it can start happening even a few years before menopause. Just as a bonus, women can also experience vaginal dryness after childbirth, while breast feeding, or even if they are taking certain allergy medicine or certain antidepressants.

Back to the hormonal factors, however, vaginal dryness begin hand in hand with vaginal atrophy. A truly scary word, though it simply means your body is not producing as much estrogen as before. Estrogen is responsible for the natural lubrication, elasticity, and thickness of the cervix: once estrogen production goes down, the natural lubrication of the vagina is no longer happening, and the vaginal walls can experience thinning, drying, and possible inflammations.

Lubrication
Basically, it all comes back to lubrication: since your body’s natural lubrication system retires at the age of menopause, you need to supplement vaginal lubrication via external (internal) means. Most often, especially because vaginal dryness can lead to pain during intercourse, women will turn towards vaginal lubricants. Though a great solution, it is but temporary. For something more long lasting, you may want to look into vaginal moisturizers. You can apply them every few days to moisturize and keep vaginal tissue healthy.

There is also the option to reinvigorate vaginal tissues. Science really does wonders… this can be
a low dose vaginal estrogen cream, tablet, or ring. Note that this can be prescribed in additional
to other hormonal supplements you may be taking. It is meant to specifically tackle vaginal
dryness, especially if it persists while you are on hormonal treatment post-menopause. You will
need to discuss this option with your doctors and take into consideration any other health issues
you may have faced, particularly breast cancer.

There is also the option of an oral medication, Ospemifene or Osphena, which is more geared
towards addressing vaginal pain during intercourse. It is a selective estrogen receptor modulator,
SERM, medication but women who have a high risk of breast cancer, or have faced breast
cancer, best not consider it as an option. For more details on what this medication can do for you,
consult with your doctor or medical professional.

Another technique to help you ease painful intercourse if you are post-menopausal is a nightly
vaginal suppository containing dehydroepiandrosterone (DHEA).

It’s also important to note that vaginal stimulation or even regular sexual activity, solo or with a
partner, can absolutely help post-menopausal women keep their vaginal tissues healthy. Above
all, remember this is a very natural response of your body to hormonal changes, there is nothing
to be ashamed about, and it is well within your rights to seek healthy treatments that work for
you and your body. You owe it to yourself, and though we can’t turn back the clock, we can
make sure we are living pain-free and comfortable lives within the new parameters our bodies
present to us.

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Body Awareness in Pregnancy

If you have armed yourself with all the knowledge you can gather regarding the possible changes
on your body during pregnancy, then you are one step closer to dealing with the physical effect
of those changes. Some women, though they do know their body will change during pregnancy
and possibly afterwards as well, do not seem to mind it at all. Great! According to a survey of
more than 1500 women, just over 41% said they felt more negative about their bodies after
pregnancy. Which goes to show: the majority of women are struggling with body image while
pregnant. Not to mention what the body image stress is probably not helping the baby…

Is this only related to pregnancy?

Of course not… women in general are held to unrealistic expectations of beauty standards—expectations that the media and society constantly repeat. In recent years, this pressure for body perfection has worsened with the rise of social media. What is worse in pregnancy, however, is that the changes are relatively rapid, weight gain is almost always expected, feelings are exacerbated, and you may even be feeling alien in your own body. A vessel, so to speak. All of these are true: you will most likely gain weight during your pregnancy, it’s possible to develop stretch marks, and it is also a possibility that your post-partum body will not be 100% the same as your pre-pregnancy body.

 

This is a lot…

Yes, this can absolutely be overwhelming. Despair not! Weight gain is—and we cannot stress this enough—normal, and healthy for your baby. Also, if your doctor or nurse gives you the green light, you can exercise while pregnant. It may be light exercise, such as swimming or walking, or pre-natal yoga. These options help make you more aware of the connection between your body and your mind, perhaps take some of the edge off and your mind off of your worries and are steps to ensure the overall health of your body.

If you are concerned about weight gain during pregnancy, make a plan with your doctor, nurse, or mid wife, about your diet. Allow yourself the small pleasures without guilt: your body is participating in the miracle of nourishing a new life. There is no way to make this happen in a healthy manner unless you experience changes yourself.

What else can I do?

Honestly, don’t bottle up your feelings. Being insecure about, or even disappointed with, your
body image is completely normal. Share those feelings and thoughts with your partner, talk about
those worries with your friends. You may want to join a mom group, or even an online
discussion forum where you can exchange ideas with others on the same boat. If it gets too
much, you can always talk to a medical professional or a therapist. Even if you didn’t have body
image issues before pregnancy, it is not uncommon that future mothers start facing those worries
for the first time when they become pregnant. You are not alone in this!

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Breast Self-Exam

It is common practice at your regular OBGYN appointment for your doctor to perform a breast
exam, by using their hands and examining the overall the look of your breasts. Though this is no
substitute for a mammogram, which adult women are advised to have done yearly, it is a useful
method to see whether there are any visible or tactile abnormalities on your breasts. In fact, 40%
of breast cancers were diagnosed because women noticed something unusual about their breasts.

Is this something I can do at home?
Absolutely—and it is a good idea to perform a self-breast examination once every month. Consider it a monthly inspection you deserve, and one that at the very least helps you learn your body better. Using your eyes and hands for this examination, you can develop your own breast awareness and be able to immediately identify changes—should there be any, fingers crossed not!

What do I do?
First and foremost, it is important to choose a time of the month when your breast will not be as tender since this can cloud the results of the inspection. Ideally, during a time when you are not menstruating or ovulating. Secondly, remember you can (and probably should) ask your doctor or nurse practitioner for a demonstration on how to do this at home.

The most effective technique is to start with a visual examination of your breasts. Stand shirtless and braless in front of the mirror, with no-shadow casting light if possible, and place your hands at your sides. Look for any changes in size, shape, possible asymmetry, dimpling, or puckering. Check to see if your nipples are inverted. Then, inspect your breasts in a similar manner but after raising your hands above your head, palms pressed together forming an A shape. You can also lift your breasts and inspect whether the ridges on the bottom are symmetrical. Should you not trust your own vision, or if you have a visual impairment, it’s a good idea to ask a partner, trusted family member or friend, to help you with this.

Is this all?
The visual inspection is the first step. Next, you want to use the pads of your three middle
fingers. If you can’t sense very well with the pads of your fingers you can use your palm or the
backs of your fingers. You can do the tactile inspection in the shower or lying down (that way,
the breast tissue spreads and it’s easier to feel).

Now, take your time, don’t rush, and establish a routine for this part. If you do it clockwise every
time, for example, and in the same order, then after a few times you will be better able to judge
any changes in the pattern of your breasts. The goal here is to feel the depths of the breast using
different levels of pressure—so you can go over the whole tissue. Closest to the skin, use light
pressure. As you go try to feel a little deeper, use medium pressure. Closest to the chest and ribs,
use firmer pressure.

Remember that you are not looking for anything in particular, you are just learning the patterns
of your breasts. So, take deep breaths, take your time, remind yourself this is being done
absolutely for preventative reasons—just like flossing!

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Cervical Screening

 

The most common gynecological care procedure may be the Pap Smear—and it’s no secret that
it revolutionized women’s health and made it widely accessible—but a close second is cervical
cancer screening. Now, don’t let the words scare you: it doesn’t mean you have to get this
screening done if you are suspecting you have cancerous cells. It simply means this screening
tests specifically for evidence of HPV in the uterine cervix. A Pap Smear, on the other hand, tests
for precancerous cells on the cervix—cells that may turn cancerous if not treated correctly.


How does it happen?
Cervical cancer screening is a similar procedure to a Pap Smear: they both happen in a clinic, a
medical office, or a community health center. It’s common to get those tests done during a pelvic
examination. Much like the Pap Smear, using a vaginal speculum, the medical professional will
collect cells and mucus from the cervix and vagina and send them for lab testing. A Pap Smear
checks to see if the cells look generally normal. A cervical cancer screening specifically tests the
cells for HPV.

Why do I need it?
Remember the primary goal of a cervical screening is to routinely look for abnormal cervical
cells with severe cell changes so they can be removed, and cancerous cells can be stopped from
developing. It is a routine examination for anyone who has a uterine cervix and is sexually
active. Nearly all types of cervical cancer are caused by sexually transmitted HPV. A secondary
goal of this screening is to identify cervical cancers at an early stage so they can be treated
successfully and avoid further problems.

When should I get tested?
Most sources suggest that you should start getting Pap Smears and Cervical Screenings after the
age of 21. However, many people are sexually active before that age—you should be getting
regular routine examinations as soon as your become sexually active. The standard suggestion is
to be screened every 3 years, considering your results come back normal, but if you have
personal concerns and the ability to be tested every year—better safe than sorry!

If you are older than 65 and have had regular tests and satisfying results for several years in a
row or have had your cervix removed for non-cancer related reasons, you may not need to be
screened anymore. However, that is still a personal decision, and you are entitled to be keeping
as many tabs on your health as you want.

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