Are You Apple or Pear Shaped?

where does your body store fat?

 

Are you apple or pear shaped? The way your body stores fat can increase your risk for heart disease.  Did you know that your body shape can be a risk factor for heart disease?

 

Are you shaped like an apple or a pear?

 

If you tend to carry your excess weight in your central or belly area, then you are apple shaped. If you tend to carry your excess weight in your hips, thighs and bottom, then you are pear shaped.

 

Why is this important?

 

Women who are apple shaped are more at risk for metabolic syndrome. This may put you at risk for heart disease, high cholesterol levels, diabetes and irregular periods.

The simplest way to assess this is to look in the mirror. Most of us can identify with a shape very quickly; I am a pear.

Scientifically there are two ways:

  • Measure your waist at the narrowest point. If it is greater than 35 inches, then you are at increased risk.
  • Measure your waist at the narrowest point and your hips at the widest point. Divide the waist measurement by the hip measurement. If the value is greater than 0.8, then you are considered an apple.

So your heart health assessment for today is this:

Determine your body shape and tell us what your body shape is.

 

Tips For Staying on Task With Your Heart Health Goals

What are Your Heart Health Goals?

We are starting a new month and January is behind us.  How did you do with your health goals last month?  Did you map out your needed appointments to cover all of your preventative screening tests for the year?

Doing this now gives you direction and also allows you to save any money needed to cover any deductibles or co-insurance.  If you don’t have insurance you have time to find available resources in your community through your local community health centers or health departments.

You may be asking what screenings do you need?  The United States Preventative Services Task Force has a list of screenings that you should discuss with your clinician every year to see what actions you need to take to improve your health.

February is the month where we celebrate Heart Health.  There are basic things that you need to know in order to focus your attention on this aspect of your health. You cannot change some of the risk factors that put you at risk for heart disease such as age, race and gender but you can work on the ‘modifiable’ risk factors.

Modifiable risk factors

Do any of the following apply to you?
  • I am a smoker.
  • I don’t exercise on a regular basis.
  • I don’t know what my cholesterol levels are or my levels are too high
  • I haven’t checked my blood pressure recently.
  • I need to be at a healthier weight
  • I have not been screened for diabetes or my diabetes is not well controlled
  • I need to lower my stress levels
  • I do not follow a heart healthy diet

take action on defining your goals

If any of the risk factors apply to you, you need to promise yourself that you will make a plan to address it.  The key is to start somewhere. Here are some tips for staying on task with your heart health goals.

Figuring out where to start can be overwhelming.  Take a deep breathe and focus on one thing at a time.  Let’s look at cholesterol screenings:

  • Pull out your medical records or log into your patient portal.  Gather whatever information you can collect and make note of what your baseline status was or is.
  • Do you know what your levels are?
  • Do you understand what they mean?
  • Has it been more than one year since you had your levels checked?  
  • If you have a prescription for cholesterol meds, are you filling it and taking them as instructed?
  • Are you following a heart healthy diet?

When you get to the point to where you ‘know your numbers’ and have an action plan, you can move on to the next topic.  Try focusing on one risk factor a month.  If you take it one step at a time and commit to making an action plan for each risk factor, you will have an action plan for improving your heart health by the end of 2021.

That’s not too hard is it?  Remember that self care is not selfish.

Which risk factor will you focus on this month?

 

 

January is Cervical Cancer Awareness Month

January is Cervical Cancer Awareness Month.  Do you know where your cervix is?

Approximately 13,000 women are diagnosed with invasive cervical cancer each year. This is a condition that we can screen for with improved testing. The term ‘cervical cancer screening’ is used now instead of just saying a ‘Pap smear’ due to the options that are available to you.By combining the use of widespread HPV vaccinations and implementing the new cervical screening guidelines, we should drastically decrease the number of new cervical cancer diagnosis each year.These are the  new guidelines that went into effect last spring.

    • Less than 21 years of age: No screenings
    • Ages 21-29: Cytology only (Pap smear test) every 3 years
    • Ages 30-65: You have three options:
      • Cytology only (Pap smear test) every 3 years
      • High-risk HPV test only every 5 years
      • Cytology plus High risk HPV test (co-testing) every 5 years

If you have time on your hands this week, look for your last test results. Do you understand what the words mean? If you do not have a copy of it, you may be able to find it through your patient portal.

When was your last screening performed? Did you skip your check-up last year? Many women forget to schedule their annual exam once they are done having children and before you know it, 10 years have passed without care. Do you fall into this group?

If you skipped your check-up last year due to losing your insurance or just plain dealing with life, there are many locations where you can receive free or low-cost screenings.  This link will allow you to search for sites based on your state or you can search for free or low-cost clinics in your area.

Don’t let the pandemic impact your ability to take of yourself and schedule your appointment if you are overdue.

Set Health Goals That Match Your Why

Monday Motivation

I worked with someone who sent me this list of goals:

  • Smoke less
  • Drink less
  • Have less fun

I love this!  In theory, these are great goals.  I wasn’t sure about the ‘have less fun’ goal but she explained that when she goes out to bars and ‘has fun’, she drinks too much which then gives her the urge to smoke.  She feels that she can go to other locations if she wants to be social without feeling like she has to drink.  

Why do you feel the need to set health goals? You must ask yourself why something is important to you. Set health goals that match your why so that they remain a priority to you.

So the first thing we did was to change the order of her goals.  She feels that she is a social drinker and smoker.  She knows that these are not good for her health and she was ready to make a plan for herself.  The first thing we did was to change the order of her goals since they are all related.

Have less fun > Drink less > Smoke less

When we are looking at health goals, you are more likely to succeed when you can answer ‘what is your why?’  Make them personal!  The 7 Levels Deep approach comes from Dean Graziosi’s Millionaire Success Habits and is used to keep fine tuning why you are setting out to make a goal and why it is important to you.  Here is an example of this using her goals:

    • What do you want to do?  I want to go out to bars less.
    • Why is that important to you?  So I can drink less.
    • Why is that important to you?  So I can smoke less.
    • Why is that important to you?  It isn’t healthy.
    • Why is that important to you?  I have asthma.
    • Why is that important to you?  It makes me cough too much.
    • Why is that important to you?  Coughing makes me pee on myself.

All kidding aside, this is just another approach to help you make goals that you can reach.  There are many tools available to help you write out your thoughts and to give you guidance on how to make them happen.  The most important thing is that you are thinking about what is important to you.  

Think about it, write it down and then make an action plan.   

 

Don’t Let the Holidays Derail Your Work on Your Health Goals

Here we are on the first day of December. As we close out the year, you have one month left to focus on your health goals for this year. Letting your guard down just because it’s the holidays does not give you a pass.  Don’t let the holidays derail your work on your health goals.

Who is taking care of you?  You and only you are responsible for your health.  There are many things that impact your health status so I chose to focus on these three topics; ‘me time’, self care and self-reliance. Each of you are in a different personal situation and you need to develop the skills that are most pertinent to you.

I use the word ‘self’ in many ways. This does not imply that you need to be living alone or supporting only yourself. I am asking you to develop the skills you need so that if you find yourself alone, you can continue to support yourself. I also ask that you make your own health a priority. You cannot take care of others if you are not in the best health possible. I include ‘me time’ as a separate focus so that you can learn to carve out key times during the day to do something for yourself.

If you have already identified ways to improve your health and you are working on some goals, you need to make an extra commitment to them as you may be facing daily events or foods that will test you over the next four weeks.  Colder weather may also impact your exercise  goals.

What can you do this month?    December is a tough time to begin but this doesn’t mean you can’t start analyzing your current habits.  What will you do today?  Are you struggling to find 30 minutes each day to focus on yourself? If you are new to this site there is an Activity Journal under the Resources tab to help you work through this process if you need help finding the time to do this. The Resource page also has different activity lists in case you need other ideas. 

Don’t let the holidays derail your work on your health goals but be intentional on the items you will splurge on.  Plan ahead and work in movement every day.  Sample food and drink in moderation.  You can enjoy the season while maintaining your health goals.

Cheers!

 

 

Invest In Your Health By Setting Health Goals

I am so not a cold weather person. I am in Pittsburgh for a couple of days and arrived yesterday to very windy and cold weather. One of my first thoughts was ‘I am not walking in this!’

 

I am asking for you to invest in your health by setting health goals.  As you think about how to do this, think about building in movement into each of your days.  What challenges do you face? You may not be able to set up an exercise plan due to medical conditions or disabilities but if your clinician has given you the green light, find something to do that makes you move more.

 

Hot, cold or rainy weather, home situations, shorter days, new COVID restrictions on gyms, malls and other outdoor venues may all impact your ability to get a workout in.

 

Look around you.  Your setting may be in a shelter,  on a couch with a friend or in your home.  You may not have the room or specific equipment (treadmills, stationary bikes, elliptical or weight lifting equipment) available to you but if you can sit or walk, you can move.  

 

 

Invest In Your Health By Setting Health Goals

  • I will talk to my clinician about starting an exercise routine.
  • I will look at YouTube videos or other online resources and find a series that I like and set a start date within 2 weeks.
  • I will look at my calendar and schedule three 30-minute blocks of time for exercise each week.
  • I will invite my spouse/friend/family member to join me in these exercises.
  • I will keep all of my appointments with myself and not cancel any of the sessions.

We have a  Monthly & Daily Health Goals  planner for you to use.  Write out your weekly and monthly goals.  Writing them down and posting them on the fridge or your mirror will allow you to see them daily.  This will help keep you on track.  You can also click on the Resources Tab to find this planner.

This is a great time to do this.  This will keep the extra holiday pounds at bay, provide natural endorphins to help you counteract the mental stressors that you face every day and make you physically stronger.  Are you ready to do this? 

 

Will Pap Smears Become a Thing of the Past?

Will Pap smears become a thing of the past?  I hope so!   One of the most dreaded exams for a female is having a pelvic exam done so their clinician can collect a Pap smear specimen.  The test used to be done each year but the great news is that technology has continued to improve and this is no longer true.      

The Well Woman’s Chart states that cervical cancer screenings are recommended for all women between the ages of 21-65. This does not mean that you need the screening done every year; your age and past results determines your management plan.  These recommendations may not apply to you if you have had a hysterectomy, have HIV, are immunocompromised, were exposed to DES in utero or were treated for high grade dysplasia in the last twenty years.  Your clinician will be able to give you guidance on the timing.  Did you notice that I used the term ‘cervical cancer screening’ instead of just saying a Pap smear?  I used the word Pap smears above but I want you to learn the new wording.  

 

Your personal risk score

Have you seen the results of your previous test results?  If not, keep looking for it.  If you have access to your patient portal you may be able to look at the actual report.  Do you understand the results?  If you have always have had normal results and do not have the risk factors described above, then the cervical cancer screening intervals are below.

Less than 21 years of age: No screenings

Ages 21-29: Cytology only (Pap smear test) every 3 years

Ages 30-65: You have three options:

    • Cytology only (Pap smear test) every 3 years
    • High-risk Human Papilloma Virus (HPV) test only every 5 years
    • Cytology plus Human Papilloma Virus (HPV) test (co-testing) every 5 years

What if the results were abnormal at some point?  This is where the biggest changes will occur because now it is based on your personal risk score.  There are new algorithms that take your personal results over time to determine what to do next.  There are too many variations for us to discuss here but your clinician should be able to walk you through the decision making process. If they can’t do that, ask for a referral to a gynecologist who can review your specific case.

 

key points

  • New guidelines were issued in 2020.
  • No screenings done under the age of 21.
  • Yearly Pap smears are no longer the standard of care if your results are negative.
  • The HPV vaccine protects against the virus that causes cervical, vaginal and vulvar cancers.

 

Who Is Taking Care of You? Celebrates A Milestone

Happy anniversary to us!!!

I started this blog in a private Facebook group one year ago today in anticipation that I was moving to a new city and wanted to maintain the friendships and support group that I was leaving behind. I love the fact that we have social media to help us keep and renew friendships.

The Who Is Taking Care of You? FB group celebrates a milestone today in that we hit our one year mark and it has grown to over 400 members from the US and 14 different countries. I have shared 277 blog posts focusing on the intersection of women’s and public health and created a website for housing our Resource information.  I love the unique perspectives we all bring to this group and I hope to see you engage even more. 

For those new to this blog, WELCOME! I am an ob/gyn that has advocated for women for the last thirty years. I have worked in public health for the last 16 years and am passionate about the intersection of women’s and public health. I can speak and write on this topic for hours.

As I work with women, the common theme I see is that you all do a great job taking care of others but you are not as good when it comes to caring for yourself. I am a firm believer that you need to be knowledgable about these three core factors; mental, physical and financial health. In order to focus on these items, I try to limit our posts to the following topics:

  • ‘Me Time’
  • Self Care
  • Self Reliancy

‘Me time’ is important for your mental health. I want for you to find at least 30 minutes a day to focus internally so that you can quiet your mind. This will enable you to develop tools so that you can handle your daily mini-crisis without increasing your anxiety levels.

Self Care is necessary to ensure that you are in charge of your physical health. You, and only you, are responsible for your health. We use the Well Woman Chart as a foundation so that you are armed with the tools and knowledge that you need to take charge of your health journey.

Self Reliancy is the topic that most of you are surprised by. Why do I think this is important? I believe that all of you need to acquire a skill to support yourselves and then you need to educate yourselves about your personal finances. I do not want you to work or live in a hostile environment because you cannot afford to leave. I do not want you to be lost if you lose your loved one because they always took care of your family’s finances.

Thank you for allowing me to share my thoughts with you. I am grateful for each and every one of you!

Velma Taormina, MD profile picture

Simplify Your Holiday Gift Giving and Gain Financial Health

It is Money Monday!

We will continue to destress by having you work on decreasing your financial stressors. Worrying about how to pay for all of your bills can make you physically sick so we want to work on decreasing the amount of money that you owe. You can simplify your holiday gift giving and gain financial health.  

For those of you that are new to this group, I believe that each one of you needs to be financially literate. I don’t want you to stay in a toxic home or relationship because you cannot afford to leave. I do not have any special certifications in this field. I am just sharing my thoughts with you like I share with my kids.

We began our conversation about how to pay for Christmas on September 25th. Three months before Christmas.   I asked if you preplan, budget and prepay for your holiday gifts and expenses or do you spend what you want and worry about it the following year? If you are in the latter group, I want for you to take the next 18 months to convert to a plan where you prepay for all of your holiday gifts and expenses. Yes, a good old fashion Christmas Savings account!

Although the MarketPlace article is from 2018, the average Christmas debt was $1054 and half paid it off within 3 months. Another 29% paid it off in 5 months. Some were still paying on the debt when the next holiday season rolled around.

Let’s walk through an example using my immediate family to see what kind of money we are talking about.

I have 2 parents, 1 mother-in-law, 1 spouse, 3 children and 2 boy/girl friends, 5 brothers + spouses, 4 in-laws + spouses, and 20 nieces and nephews. That is 47 individuals. If I gave each of them a gift and limited my costs to the following this is how much it would cost me.

$10 apiece = $470

$20 apiece = $940

$25 apiece = $1175

$50 apiece = $2350

I will have to decide if I am going to give everyone a gift or do we draw names to limit how many gifts we will exchange. You know that I am going to give my spouse and kids more than one gift. What kind of limits will I place on myself? Maybe I can gift them my time or talents instead.

What about the other special people in your life? Do you factor in your co-workers, employees, friends, church family members, angel trees, mailman, newspaper carrier, sports team coaches, teachers, housekeeper, lawn service, Christmas family donations, etc. When we add them in, it gets scary really quickly. Where does it end? Which of these things can you remove from your list? Again, maybe your time or talents would be a better way to show them you care. Maybe you spread your gifts out over the year instead of all in one month?

What about decorations, holiday outfits, pjs, holiday cards, special meals and drinks? What else can you add to this list?

If it is too stressful to think about prepaying (saving) for this in 2020, then use this year to keep strict records so that you can use 6-9 months of 2021 to save up for the 2021 holidays.

This year is so different for all of us. You have 5 weeks before Thanksgiving week. Your financial situation may or may not be different this year but I am going to challenge you to use this time to make a promise to yourself that you will limit holiday spending in some way this year. Sit down for dinner with your family and talk about it openly. Talk about it at work. I guarantee you that someone will be grateful to hear that you will not have a gift exchange this year.

You can make this decision for yourself and can just announce that you are taking a break this year. You are allowed to do this!

Is this too much for you? Start small. Make a promise to yourself that you will not buy any new holiday decorations this year. What can you reuse or repurpose? How can you simplify your decor? Do you really need a Christmas tree in each room? If you do, do not buy anything new for any of them this year.

For today, without thinking hard, write down ONE thing you will not buy this holiday season.

Me? Christmas Santas.

What about you? Leave a comment below and share your first thought.

mindfulness word cloud

Is Your Mind Full or Mindful?

Mindfulness Monday!
 

Is your mind full or mindful?  It sounds really corny but this is a question you need to ponder.  How are you doing?  How are you feeling?  Do you feel that your mind is cluttered?  Are you being pulled in too many directions?

 

Focusing on yourself is not selfish. Building in ways to combat the daily stress that you face is going to make you mentally stronger. There are many ways to calm our minds. Whether it is yoga, sitting quietly in a room and reading or journaling or listening to Tibetan bells while sitting quietly meditating, there are many tools available to help you with this. You need to experiment with finding the method that is most soothing to you.

 

Some of my girlfriends cannot listen to the raindrops because they feel that it makes them want to pee but for others, it’s ok. See what is right for you.

 

Is meditating a foreign concept to you? It certainly wasn’t something I grew up doing but I have found that this is a useful strategy when I just need to go to another room to get away from others or the noise around me.

 

I have listened to all kinds of videos to see what I like. I have determined that I don’t want someone talking to me telling me what to do or how to breathe. What I do love is when I am sitting on my back porch during a rainstorm. This is what led me to explore the raindrop videos and the raindrops with Tibetan bells are now my favorite.

 
I challenge you this week to go out of your comfort zone and to find ONE new method to soothe your mind. You get to chose if  your mind is full or mindful?. It can be walking, meditating, reading a book, listening to music, knitting or taking a nap. There is no wrong way to do this. You just need to look for something that works for you.
 

You choose.