It’s Breast Cancer Awareness Month!  Today’s post by staff physician Dr. Sarah Wistreich:

Breast cancer is a topic that I frequently get asked about by all age groups.  With statistics as high as they are – 1 in every 8 women will get breast cancer by the time we are 80 – most of us do wonder whether we will be part of those statistics. The concern is even more relevant for those of us that have relatives with breast cancer.  My grandmother had breast cancer in her 70s and opted for a bilateral radical mastectomy. Treatment options were very different back then, but before I became a doctor I wondered if I would be faced with this diagnosis some day. That is why it is important to understand breast cancer facts vs. fiction.

1. Examining my breasts each month with reduce my chances of breast cancer:  FICTION

Two large studies have shown that women who performed self breast examinations had no difference in breast cancer mortality than women who did NOT perform self breast examinations.  The studies also showed that the group who did self breast exams had twice as many breast biopsies but did not find more cancers. What IS recommended is a yearly clinical breast exam done by a physician.

2. I can have a mammogram before I am 40:  FACT

Mammography screening is recommended by most physicians to start at age 40If a woman has a family history of breast cancer in a first degree relative, she should start getting mammograms 10 years prior to the age that the first degree relative was diagnosed at.  If a mom was diagnosed with breast cancer at age 42, her daughter should get her first mammogram at age 32. Magnetic resonance imaging (MRI) or molecular breast imaging (MBI) can be useful adjuncts to mammography based on one’s risk factors and breast types. This should be discussed with a physician.

3.  My chances of breast cancer are higher because my grandmother had breast cancer:  FICTIONA woman with a first degree relative (mother, father, brother, sister, child) with breast cancer is twice as likely to have breast cancer.  If she has more than one first degree relative with the diagnosis, the risk can go up 3-4 times. This is not true if the woman’s mother was over the age of 50.

4.  I can reduce my risk of breast cancer:  FACT

There are a few lifestyle choices that women can make that can decrease their breast cancer risk. Maintaining a healthy weight is very important. Your goal for body mass index (BMI) should be between 20 and 25.  Adding exercise into your routine can also decrease your risk. Your goal should be 150 minutes per week of sweaty activity. Limiting alcohol intake can be beneficial.  Studies show that women who drank more than two drinks per day had an increased risk of up to 20% for breast cancer. If you become pregnant, breastfeeding can also decrease your breast cancer risk.

And now, a little breast cancer fiction trivia:

So what has been shown NOT to increase your breast cancer risk? Hair dyes, abortions, miscarriages, plastics, breast implants, bras, deodorant/antiperspirant use, fertility drugs and breast trauma have not been linked to increased risks of breast cancer.

You should discuss your risk factors with your physician and come up with a plan for your breast health. Remember the importance of knowing your family history and of the yearly clinical breast exam done by your physician.  Although genes play a large role in some breast cancers, a healthy lifestyle is very important in the prevention of breast cancer in your future.

Posted in Womens Health | Tagged , , , | Comments Off

Things That Make You Go Buzz: Your Guide to Caffeine

Sally Mravcak, MD is today’s CWH blogger:

Caffeine is the most widely used and socially acceptable stimulant.  We have become a coffee culture.  Morning to me smells like a freshly brewed pot of joe.  And let’s not leave out our fellow tea, soda, and energy drink aficionados.  Here’s what you need to know to sip responsibly.

How much do you consume?

You might be surprised.  For example, a Starbucks grande coffee (16oz) has a whopping 330mg of caffeine, which is 1.5 times the amount of caffeine in over the counter daytime stimulant products (like NoDoz or 5 Hour Energy).  It’s a safe bet that most coffee-house brews will have more caffeine than home brews.  Most teas (hot and iced) and sodas have considerably less caffeine than coffee. Energy drinks are a bit tricky, as their caffeine content can vary widely.  Look here to find the caffeine content of your favorite beverage.

How much is too much?

For most adults consuming 400mg or less appears to be safe.  No safe amount has been established for adolescents, but a good assumption is that it is less.  Pregnant women should try to limit caffeine to less than 200mg, or about one cup of coffee a day.

Is caffeine bad for me?

Like many things, in moderation, caffeine actually has beneficial effects.  It can temporarily increase mental alertness, reaction time, and athletic performance.  Some studies show that it improves mood and it has also been associated with a lower risk of Parkinson’s, Alzheimer’s, alcoholic cirrhosis, and gout.  Many studies show that people who drink coffee live a little longer than people who don’t.  However, caffeine consumed in high levels can cause headache, anxiety, insomnia, heartburn, upset stomach and tremors.  Heavy coffee intake can cause irregular heart rhythms in some people.  Really heavy caffeine use can result in death, as we’ve seen recently in those who overuse caffeine powder.

What should I do if I’m over-doing it?

Caffeine withdrawal is real!  It can happen in people who drink the equivalent of one cup of coffee per day (about 100mg of caffeine) for as little as three days in a row.  Symptoms usually start within 12-24 hours after going cold turkey and can last up to nine days.  If you are a chronic caffeine user and need to cut down, we recommend weaning your caffeine intake gradually.

Is there anyone who should avoid caffeine?

Yes!  People who are susceptible to irregular heartbeats or who have a condition that is exacerbated by caffeine, like heartburn/ulcers, digestive problems (like IBS or colitis), anxiety, or insomnia.

Whether you run on Dunkin’ or crave that Venti Iced Skinny Hazelnut Macchiato Extra Shot No Whip, remember to sip responsibly!

Posted in Womens Health | Tagged , , , , , , | Comments Off

Yoga: There’s No Place Like “OMMMM”

Today’s entry is from CWH nurse practitioner Kathy Bornhoeft:

Balance Your Life; Breathe, Relax and Be Still…………………

A recent study founded that 20.4 million Americans practice yoga, an increase of almost 30% in just four years!

Yoga is a mind and body meditative movement practice with historical origins in ancient Indian philosophy.  Yoga typically combines physical postures and positions with breathing techniques, meditation and relaxation.  There are numerous styles of yoga, but Hatha yoga is commonly practiced in the United States.  Most people practice yoga to maintain and improve their health and well-being and enhance their quality of life.  Research shows that practicing yoga can help reduce pain, lower heart rate and blood pressure, increase lung capacity, boost circulation and muscle tone, and may also help relieve anxiety and depression.  Yoga has been shown to improve balance in stroke survivors according to the American Heart Association journal Stroke.  Yoga is generally low-impact and safe for most people when practiced under the guidance of a well-trained instructor

According to the 2007 National Health Interview Survey, yoga is the sixth most commonly used complementary practice among adults.  That adds up to more than 13 million adults practicing yoga in one year.  That same survey found that more than 1.5 million children also practiced yoga in that same year.  Recent research also suggests that the addition of yoga or mindfulness meditation practices may be associated with promoting weight loss and healthier eating habits.

Equally important as the exploration of its potential health benefits is research on the safety of yoga. Yoga is often promoted as a safe and effective exercise program, and although the risk of serious injury from yoga is thought to be quite low, that’s not always the case.  Some poses may place too much strain on certain joints, particularly if they’re not being done properly or modified appropriately for the individual.  In fact, the physical demands and safety of yoga have not been well studied, particularly in older adults.

 Considering Practicing Yoga?

  • If you have a medical condition, talk to your health care provider before starting yoga.  Women who are pregnant should always check with their health care provider before starting yoga.
  • Yoga postures should be modified based on individual abilities.
  • Ask about the physical demands of the type of yoga in which you are interested and inform your yoga instructor about any medical issues you have.
  • Be sure to drink water before, during, and after a yoga practice and wear suitable clothing.

The Center for Women’s Health has ongoing Yoga classes, with new classes to be added Fall 2014:

Posted in Womens Health | Tagged , , , | Comments Off

Happy Mother’s Day: Words of Wisdom

Today’s entry inspired and compiled by our staff physician Dr. Sarah Wistreich:

This year for Mother’s Day, we have chosen to pay homage to OUR moms through our blog. We each interviewed the mother figure in our lives. Hopefully you will learn something from all of their advice and answered questions. We certainly did! Take some time with your mom this year and ask them some questions. The answers may surprise you!

If you had to do one thing differently as a mom, what would it have been?

DL- “Keep more diaries of our family trips and adventures. I love reading my mother’s diaries and those that I kept when I was younger.”

AM- “Stay calm when talking to my kids”

NM- “Have more children”

JP- “I wouldn’t have disciplined as much.”

How did you pick my father?

DL- “At first site, he was handsome. We dated for four years. I prayed about him and felt that he was the man chosen for me.”

AM- “When I met him, he was a nice, calm person who I knew would be a good father.”

NM- “He picked me. He followed me around a party. I would send him to get a drink and I would move, but he would find me again with the drink.”

JP- “We met at a resort. He was sweet and laid back.”

Is there anything you regret not having asked your parents?

DL- “I wish I knew more about their childhoods. I have some diaries from my mother, but I want to know about their early years.”

AM- “I wish I knew my father better. He was always working and distant. He passed away when I was 19.”

NM- “ I wish I got more family history, especially about family stories when they came to the US from Poland and Lithuania.”

JP- “I wish I knew more about the genealogy. I should have tried to find out more about family history. My parents were immigrants and didn’t talk about the home country.”

What’s the best thing I can do for you right now?

DL- “Keep including me as a part of your life. You are doing a great job!”

AM- “Call me more and tell me what’s going on in your life.”

NM- “Call me more often.”

JP- “Keep doing everything you do right now. You help with everything!”

When did you realize you were no longer a child?

DL- “I haven’t yet! Teaching 6th grade kept me young for years, and now my children and grandson keeps me young.”

AM- “ When I was 19 and my father passed away suddenly.”

NM- “When I got into nursing school I realized I would have to be on my own soon, especially when I was working on the floors and taking care of patients.”

JP- “When I was working in my parent’s candy store at age 13-14. I had to work.”

Who is your biggest inspiration and why?

DL- “My mother. She taught me family values, gardening, canning, cooking. She modeled how to journal and encouraged me to become a teacher.”

AM- “My husband and all three of my children.”

NM- “A lot of people around me inspire me, especially my children.”

JP- “My husband (now deceased). He was so good with my son.”

What’s the best gift you ever received?

DL- “I received a piano when I was pregnant with you from your father. I played throughout both my pregnancies. Both you and your brother took lessons and we spent so much time playing together. It has brought me so much joy through the years.”

AM- “When I receive a greeting card and someone writes their own message in it. It makes me cry tears of joy.”

NM- “Some of my best gifts were made by my kids in school. I’m thinking of a pin my son John made me of all different colored rocks. I still have it!”

JP- “My son Glenn.  He is so good.”

What was the hardest thing about being a mom? What was the most rewarding thing?

DL- “The hardest thing was discipline. I hated doing that. The most rewarding, though, was seeing the rewards later on from the hard work. My kids are wonderful people.”

AM- “The hardest thing was patience. I needed more of it and prayed for it often. The most rewarding part was seeing my children grown up with their own families.

NM- “The hardest part was not having enough time for me and trying to give everyone the attention they needed. The most rewarding part was watching my kids excel. Little things, like when they brought home a test with a good grade.”

JP- “The hardest part was not knowing whether you are right or wrong, wondering if you are harming your children emotionally or mentally, and regretting what you think you did wrong. The most rewarding part is seeing the final product- how my son lives his life and how well he turned out. “

What is your wish for your future generations?

DL- “A world without crime, anger, and stress.”

AM- “To have more patience and to enjoy children and grandchildren.”

NM- “No more wars.”

JP- “That they can have a fruitful life like I did, that they have prospects like I did. My generation was very lucky.”

Can you recall one memorable thing that each of your children said?

DL- “I remember when you were 12 and told me you wanted to be a doctor when your brother was sick. I remember when your brother was 4 and told me that he wanted to build a house next door to ours and paint it red with pink shutters and live there forever.”

AM-“ I remember when my daughter asked us to move in with her. It made me so happy to know we weren’t considered a burden. Being told I was a great mother. Being thanked for helping my kids through rough times. “

NM- (skipped this question)

JP-“ No!”

When did you feel the prettiest? (Special day, outfit, time in your life)?

DL-“I have a picture of my husband and I when I was in my late 30s, after having two kids. I think I look beautiful in this picture. I have it framed”

AM- “On my wedding day.”

NM- “My wedding day.”

JP- “The day I got married. We went to the Rabbi’s study. I wore a short wedding dress and we went out to lunch. We didn’t bother with a big wedding.”

What’s the nicest thing you have ever done for yourself?

DL- “Two things: 1) exercise every day to keep myself active 2) travel as much as possible. Which I can do because I’m still so active!”

AM- “Shopping and treating myself to new clothes. I love to buy pretty things!”

NM- “Getting regular manicures and pedicures.”

JP- “Marrying my husband.”

What are you most proud of in your life?

DL- “My family, the most important thing of all.”

AM- “My children”

NM- “My children”

JP- “I am most proud of my son and his wife, of having survived all my years, of my family, children, and grandchildren.”

“DONNA LEGG is a retired teacher, mother of two, and grandmother to her grandson. She grew up in a family of eight children in upstate New York on her family farm. My mom received her master’s degree in education from Potsdam State University of New York.  For 34 years, she has been happily married to my father, Kevin. She loves to travel, read, knit, cook, garden, and spend time with her family. My mom is a devoted church attendee and member of the music ministry. Our family and all around her admire her energy, enthusiasm, faith, and joy for life. I am blessed to call her my mother, my role model, and my friend.  ” -Sarah Wistreich

“ANTONETTE MICAI is a wonderful mother of three and grandmother of nine and great-grandmother of two. She grew up in a family of six children in Trenton, NJ. She loves to knit, read, and enjoys her family. She loves to be at the beach. She has been a devoted wife for 58 years. Her children feel blessed to have learned about the importance of the little things in life: “stop and smell the roses.”” –Kathy Woods

“NANCY MRAVCAK, mother of three and grandmother of two, was born and raised in Wilkes-Barre, PA, but lived most of her adult life in New Jersey.  She enjoyed a successful career as a nurse and is the epitome of the woman who could do it all.  She seemed to effortlessly care for her family, excel in her career, and further her education.  Nancy, now retired at the Jersey Shore with her husband of 55 years, enjoys being a painter, baker, bridge-player, and yoga-mat-slinging line dancer.  She is a woman who visualizes the best and will always gracefully survive the worst.  A gentle soul, Nancy will always be the first to congratulate or console and I am thankful that she is my mother.” –Sally Mravcak

“JEAN PROTTER is the daughter of immigrants.  She was born and raised in New York City.  Despite many obstacles, she went to college, received a bachelor degree in education, later received a master’s degree, and became an elementary school teacher. She was married to her husband for over 50 years and together they had one (awesome) son.  Jean is the matriarch of our family – mother, mother-in-law, grandmother.  She is kind, steadfast, wise without judgment, an extraordinary individual, and a role model for me in this world as a woman and a human being.” – Randi Protter


Posted in Womens Health | Comments Off

Birds, Bees, Sneeze!

April showers bring May flowers, and May flowers bring pollen (not pilgrims), and pollen brings itchy/watery eyes, clogged ears, runny noses, sneezing and general misery for many.  Springtime is not a magical time for all.

Springtime allergies are typically triggered by inhaled pollen.  Pollen is a tiny particle released by grasses, trees, and the like.  For those who are sensitive, pollen triggers a series of reactions that lead to the release of a chemical called histamine.  Histamines cause inflammation and irritation of tissues that ultimately causes symptoms in the eyes/ears/nose/throat and sometimes lungs.

Several strategies can be helpful for seasonal allergies:

-Pollen counts tend to be higher on dry/windy days as pollen is carried through the air.  Try to minimize your time outside when counts are high.  You can get up-to-the-minute information on your desktop or mobile device here.

-Keep your home and car windows closed on high pollen count days.  Consider an air conditioner rather than a fan

-Avoid early morning outdoor activities – that is when pollen counts tend to be highest

-Avoid grass cutting and gardening.  If you do, make sure you remove your clothes and wash them as soon as possible


  -Oral medications – These medications are best for people with multiple allergy symptoms.  Most allergy tablets – once only available by prescription – are now available over –the-counter (otc).  Loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) are available plain and with a decongestant.  They are all considered non-sedating, but can still cause drowsiness.  Those with a decongestant can sometimes cause jitteriness or insomnia.  There is no one tablet that is better than another.  There are a handful of prescription antihistamines, but they do not have an advantage over the otc products.  One prescription medication, montelukast (Singulair), typically used for asthma, can sometimes be beneficial for allergies as well.

 - Nasal sprays – These medications are best for sinus/nasal symptoms. The nasal steroid triamcinolone (Nasacort AQ) is now available without a prescription as is the non-steroid spray cromolyn sodium (Nasalcrom).  Prescription medications include nasal steroids and nasal antihistamines.  Nasal sprays tend to work best when taken several weeks before allergy symptoms begin.

-Eye drops – These are best for eye only issues, or when using a different product and still having eye symptoms.  Most over-the-counter eye drops for allergies have ketotifen as the active ingredient, and there are many brands to choose from.  There are several different varieties of prescription eye drops which can be quite effective.

All medications have side effects.  Check with your health care provider to find the one that is right for you. 

If do not have relief from otc products, or, if your symptoms are severe, you should seek medical attention.

Enjoy the sunshine!


Posted in Womens Health | Tagged , , , | Comments Off