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WOMEN’S HEALTH
How to Stay Fit at Every Age and Stage


BY JOANN PETASCHNICK

June 2017

Early Adulthood and Pregnancy

Work It, Baby!

“The benefits you gain from exercise before pregnancy also apply when you are pregnant. The better shape you’re in, the better you’ll feel,” says Candy Casey, president and CEO of Columbia Center Birth Hospital in Mequon. It makes sense — if you are used to keeping fit, you might find it easier to adapt to pregnancy and improve muscle tone, strength and endurance. “Pregnancy is a normal process, not an illness, so most women can handle a pregnancy and exercise too, as long as there is no underlying illness or condition,” she explains.

Pregnancy can rob some women of energy, especially in the first and last months, but regular exercise, such as brisk walking or swimming, should help maintain get-up-and-go. “If you are an extreme exerciser, you might have to tamp that down a little bit, but it really depends on the individual,” Casey says. “I have known some runners who ran throughout their pregnancy.”

Casey goes on to say, “Exercise can help you carry the weight you gain during pregnancy, as well as help to prepare you for the physical part of labor and birth. It also helps you get back into shape after your baby is born.” However, she stresses, there are a few precautions you should take. “If you are starting an exercise program for the first time while you are pregnant, see your health care provider and have a check-up. Also, be aware of the conditions if you are exercising outside. You don’t want to fall on ice and injure yourself or become dehydrated in hot weather,” she says. “Obviously, no contact sports should be played. It’s really common sense, so just be reasonable with your exercise program.”


 

Four Activities for Pregnant Women

Exercising during pregnancy can be great for you and your baby. It may help guard against gestational diabetes and lessen some of the discomforts you may experience, such as backache, and it improves your energy level and helps you feel good emotionally too. Here are some good examples, provided by Dr. Janet Goldman, an OB-GYN at the Columbia St. Mary’s Hospital Ozaukee campus:

• Walking. A routine of weight-bearing exercise like walking is good for most women. “A good goal would be about 30 minutes of walking on most days of the week, but there are benefits even from just one or two days,” she says.

• Swimming. “This is a good choice, and it may be better tolerated throughout the duration of a pregnancy, where running, for example, might not be advised during the third trimester,” Goldman stresses. Swimming exercises your arms and legs, and works your heart and lungs. The bigger your baby bump, the more you’ll enjoy feeling weightless in the water.

• Yoga. “Prenatal yoga helps to maintain muscle tone and flexibility. It’s gentler than regular yoga and will avoid certain positions. Lying flat on the back is not good; it can impede the blood supply back to the heart,” Goldman says. Try to find a yoga teacher who is experienced in working with pregnant women.

• Aerobics. An aerobics class gives you a regular time to exercise. It’s safe, as long as you keep the exercises low impact to protect your joints. If you can find a class for pregnant women, you can feel reassured that all the movements are safe for you and your baby. “Remember, your balance may be off because your center of gravity changes as the baby grows,” Goldman says. 
 

The Psychological Pain of Infertility

When attempts to have a child fail, it can be an emotionally devastating experience. Many couples struggle with the effects of infertility, trying to cope with the emotional toll it takes while attempting to get treatment that may lead to a pregnancy.

Infertility is a fairly common problem in the U.S., with about 6 percent of married women ages 15 to 44 years failing to achieve pregnancy after one year, according to the Centers for Disease Control and Prevention. “In general, the term infertility refers to when a couple has failed to conceive, despite having had regular, unprotected sex for one year,” says Dr. Grace M. Janik, a gynecologist and reproductive medicine specialist. “Primary infertility refers to a couple who has had no children, and secondary infertility is after there has been a pregnancy.”

Various treatments are available to help infertile couples. Treatments range from medications that regulate ovulation to surgical procedures to treat endometriosis, for example, and assisted conception, which may be intrauterine insemination or in vitro fertilization.

Although the cause of infertility is typically biological, the resulting stress and heartache can have a huge psychological impact. “Some people are very high achievers. In life, they get what they want, so this can be very difficult. Others have been trying for years before they finally come in for help. Sometimes, just coming in and learning some coping skills can improve their outlook,” Janik says.

Dr. Allison Ring, an OB-GYN with Columbia St. Mary’s, knows firsthand the psychological and emotional difficulties of infertility. “I always wanted to be a mother. I love the entire pregnancy process. It’s part of the reason I chose this specialty,” she says. At 29 years old, Ring and her husband wanted to start a family. “It came as a surprise to me that we weren’t able to conceive easily,” she says.

Ring and her husband sought help with a specialist, but it took about 4 ½ years before she became pregnant. “We were optimistic at the beginning, but (it) was difficult to stay hopeful,” Ring remembers. “I felt like a failure at something most people just take for granted. My husband shows his emotions less, but he felt many of the same things I was feeling. Fortunately, it brought us closer together.”

Ring’s first child was born six years ago. She and her husband were also successful in having triplets four years ago, and another single birth two years ago. “Now we have a house full of children, and we are very happy, but those feelings I had are still right below the surface. You go through a real emotional roller coaster,” she says.

Infertility has a very profound effect on people, Janik explains. If a treatment fails, a couple may be overwhelmed with distress and grief. It can also be difficult for couples to know when they should stop treatment. “Wanting children is a deeply felt fundamental drive, and it can be stressful on a marriage. Financial concerns and uncertainty about treatment outcomes contribute to the stress,” Janik says. “Some people benefit from psychiatric counseling, while others are helped by coping skills and support groups.

“I oftentimes see people hit an emotional wall,” Janik continues. “They get to the point where they are very sad and not coping very well, but if they get past that, they seem to be better again. Some level of acceptance is important. Our goal is to get a couple through the process.”

Support is vital, says Ring. “The thing to do is find a support group or just friends or family you can talk to, who will really listen,” she adds.


MidLife and Parenthood
BY STEPHANIE S. BEECHER

Can You Have It All?

With women wearing as many hats as they can stack, they’re living stressed to the max — and it’s having dire effects on their physical and mental health. In fact, women are more likely than men to report feelings of persistent chronic stress, according to the American Psychological Association.

“There seems to be this (societal) expectation of women that is different than for men,” says Dr. Marie Ferber, a psychiatrist at Milwaukee Psychiatrists & Psychologists Chartered in Brookfield. She adds that too often women feel like failures for not measuring up.

The stress and feelings of failure can lead to a laundry list of health issues, ranging from the inconvenient to the serious, including headaches, insomnia, anxiety, depression, obesity, diabetes and heart disease, to name a few. Having it all, it seems, can come with a cost.

“If you have a car, and you never fill it with gas or change the oil, in time that car is not going to run very well,” says Ferber. “That’s what you do to your body. Women expect to do it all by themselves, but it’s not realistic.”

When Robin Luther went from being a stay-at-home housewife to a single mom, the Wauwatosa resident says she felt pressure to recapture having it all as a woman striking out on her own. She took on four part-time jobs while raising her two high-school age children — and says she volunteered for everything. Needless to say, she crashed and burned fast.

“At first it felt like I was in charge, but then I realized I was burning the candle at both ends,” says Luther. “It was impossible to keep up. I was changing clothes in the car. It was crazy.”

Yet even when she was hired as a development and event manager for a nonprofit and her children went off to college, she didn’t slow down. “I went into it running full speed,” she says. “I take on more than I can chew, but my tendency is to keep on chewing. But it affects your health, and you really have to focus on your priorities.”

These days, Luther says she is finally learning to set boundaries. While she is still hard at work, she is also dedicated to spending more time with her family and friends and indulging her creative side. “You have to be careful not to wear stress as a badge,” she says. 

Luther is not alone. A survey by the Families and Work Institute revealed that half of women say they don’t have enough free time to do the things they enjoy.                                                                     (continued on page 36)

But the problem is often self-imposed. Ferber says women are often racked with guilt when they feel they aren’t living up to society’s ideal. Clients who can’t figure out how to manage their emotional distress have argued when she’s suggested they set aside time to recharge. She gently reminds them that issues like anxiety, for example, are a sign of a body in overdrive — and it only intensifies over time.

Taking time to be with friends, exercise, meditate, dance, or sip a glass of wine and unwind isn’t selfish, she says, but necessary. “You can’t wait for free time to happen, because it never will,” she says. “If you’re not able to do it all, then ask for help. If you put yourself last, it’s not going to turn out well.”

As a wife, mother of two young boys, a community affairs manager, and a nonprofit volunteer, Tami Garrison of Menomonee Falls has taken a decidedly strategic approach to work-life balance. She outlines “personal pillars” — her health, family and friends, career, and contributions to the community — and frequently assesses how her goals have helped her achieve happiness in those areas. Then she celebrates her successes with a spa day with each birthday.

“You’ve got to push through that guilt and let go, and recognize that you are doing a great job,” Garrison says.

It also helps to learn the word “no,” she adds. “I found a sign (that) said, ‘Learn to say no, so your yes has more oomph,’” says Garrison. “You want to say yes to the right opportunities, so it has impact and meaning.”

Cristina Tofte of Waukesha says women need to shed the “keeping up with the Joneses” mentality and start redefining what having it all means for them — and recognize that another woman’s vision of the adage may not look like your own. And that’s OK.

Between being a wife and mother, running a coffeehouse and a restaurant, and balancing a full-time IT career, Tofte often works 15 hours a day, but she also enjoys her busy lifestyle. The secret? Tofte says she isn’t invincible — she just isn’t afraid to ask for help.

“I don’t have to do it all,” Tofte says. “If you can’t do (something), it doesn’t mean you can’t find people to do it. And then you take that (help) with grace. Too many people are too hard on themselves.” 

Ferber, a career woman, mother to 7-year-old twins and an assistant professor at the Medical College of Wisconsin, is no stranger to the struggle. “We’re all in the same boat juggling everything, hoping we don’t drop one of the balls,” she says. “Women can have it all, but it’s a lot of hard work to achieve it and maintain it. But it is possible. You just have to take care of yourself. If you’re not good for yourself, you can’t be good to anyone else.”
 

Four Ways to Stay Active With Kids

When you’ve got kids in tow, it can be easy to put your health on the back burner. But staying active can boost your immune system, help you maintain a healthy weight, and reduce anxiety and stress.

If you can’t sneak away for a workout, grab the kids and head out for some fun family activities. Here are four:

• Revisit your preteen days by taking the whole family roller-skating at Incredi-Roll Skate and Family Fun Center. It features lively music, games, an arcade, laser tag, zumba and more. Even better? Go select Monday nights and enjoy $1 admission. incrediroll-sk8.com

• It doesn’t get much better than a summer afternoon at the Milwaukee County Zoo. With more than 200 acres, your family will not only get to see what each of your favorite animals is up to but also get a fantastic workout. milwaukeezoo.org

• The jewel of Milwaukee’s beach scene, Bradford Beach is a great way to get your family outside to enjoy the beautiful shores of Lake Michigan. Spend the day strolling on the sand, swimming the chilly waters, or playing a friendly game of pick-up volleyball. bradfordbeachmke.com

• Get the kids jumping at a trampoline park. Sky Zone Milwaukee includes wall-to-wall trampolines, “skyslam” basketball, volleyball, dodgeball and more. And jumping with your kids for just 10 minutes is the equivalent of jogging for 30 minutes. skyzone.com/milwaukee


Senior Strong
BY JOAN ELOVITZ KAZAN

Move It or Lose It: The Importance of Physical Activity Over 60

For people over 60, exercise is vital to maintaining both physical and emotional health. “As men and women age, they lose muscular strength, and balance is an issue,” explains Cheryl Mashack, an exercise physiologist at Moreland OB-GYN Associates, S.C. “Exercise improves the cardiovascular system, improves blood pressure, lowers your risk of developing coronary artery disease, and decreases your risk of developing Type 2 diabetes.

“Adults who are generally fit and have no limiting health conditions should be doing 150 minutes of cardio per week — that means brisk walking,” she continues.

Strengthening the pelvic floor is also a major concern for women as they age. “The pelvic floor is like the root of a tree — if those muscles are weak, the tree will topple,” Mashack says. Kegel exercises are best suited to work pelvic floor muscles, and when Kegels are taught correctly, she adds, incontinence can be improved.

Katie Nickel, group fitness coordinator at the Jewish Community Center in Whitefish Bay, schedules and teaches fitness classes geared to seniors that combine cardio and strength training. “It can be intimidating for seniors, especially women, to incorporate weight training on their own,” she says.

For baby boomers, staying healthy and physically fit can mean a higher quality of life as they age. “Baby boomers are living a very active life,” Mashack says. “They still feel like they’re 40 years old. In order to maintain that lifestyle, they have to be active.”

“Seniors find the activities of daily living, like unloading groceries (or) getting in and out of a car, become easier (with exercise),” adds Nickel. “They’re always telling me, ‘I do this to keep up with my grandkids.’”

Both Mashack and Nickel witness the social and emotional benefits participants incur from group exercise. “They get the chance to socialize, meet their neighbors, and there’s an increase in dopamine levels that comes from exercising,” says Mashack. “It gives a sense of pleasure and self-worth.”
 

Keep Moving, Seniors!

There are dozens of senior fitness programs throughout the greater Milwaukee area. Here are a few that offer group exercise, equipment assistance and personal trainers specifically for seniors:

• Senior-specific classes at Elite Sports Clubs include Senior Yoga and Simple Senior Strength, a 30-minute class focusing on postural stability, core stabilization and balance. Membership required. eliteclubs.com

• Tone Your Bones is an osteoporosis prevention class offered at Moreland OB-GYN Associates, S.C.’s Waukesha location. It focuses on weight-bearing exercises to prevent the bone loss that frequently appears as people age, and the class is open to the public. morelandobgyn.com

• The Milwaukee YMCA offers Silver Sneakers, a nationwide exercise program for active older adults who are Medicare eligible. Additional specialty classes include Exercise for People with Parkinson’s and Livestrong at the YMCA for cancer survivors. ymcamke.org

• Dancing strengthens your core muscles and can improve your posture, according to Cathy Binko-DeRaimo of Brookfield Ballroom. New sessions of group classes in West Coast Swing and Samba begin there early this month. brookfieldballroom.com


Health Watch
What’s new in care for women

• TheHighRiskBreastClinic at Wheaton Franciscan Healthcare, part of Ascension, is a dedicated resource for patients who are considered high risk or concerned they may be at high risk for developing breast cancer. If a patient is deemed high risk, the dedicated team — which includes physicians, nurse practitioners, registered nurses, genetic counselors and other breast specialists — works with each person to put together a plan for prevention, ongoing surveillance and counseling.

• Aurora Health Care administers innovative treatments for the full spectrum of female pelvic floor disorders, including the treatment of urinary incontinence in women. Botoxinjections in the bladder — a quick, in-office procedure — help women with overactive bladders, reducing the number of urgency and frequency episodes. Additionally, roboticsurgery is used to help women suffering from urinary incontinence and organ prolapse.

• Dr. John Yousif, a plastic surgeon at Columbia St. Mary’s, part of Ascension, has designed and developed the HyoidSuspensionNeckLift, a procedure that reverses the signs of aging in an older  individual or shapes the neck to a more ideal contour in a younger individual. The dramatic change to the neck lasts for 10 years or more.

• Aurora Health Care now offersminimallyinvasive,single-porthysterectomies. With a single incision in the belly button (versus multiple incisions across the abdomen), the patient experiences reduced pain and scarring, decreasing the overall recovery time.

• ThePelvicPainClinic at Froedtert & the Medical College of Wisconsin provides a multidisciplinary approach to treating women suffering from acute or chronic pelvic pain. The clinic is currently engaged in a clinical study of InTone, an inserted device that combines muscle stimulation, exercises and guided biofeedback to strengthen the pelvic floor muscles and therefore reduce urinary incontinence. Effective relief is anticipated within about 90 days. The device was developed by Brookfield-based company InControl Medical, LLC, and is available by prescription to patients in the U.S.

—Jen Kent







 


This story ran in the June 2017 issue of: