If I told you there is something that could improve your mood, decrease blood pressure, keep your blood flowing, lower your heart rate, calm you down, boost your immunity, and enhance your ability to learn, would you be interested?

What if I told you that it is free and does not involve medication? Now I have your interest! There is something that will do all of the above and is also quite enjoyable.

It is music!

Studies in England have found that patients who were taught to play music as part of a study for the treatment of depression experienced a reduction in their symptoms by 25%. Research in Italy revealed that listening to Celtic, classical, or Indian (raga) music for 30 minutes a day can significantly lower blood pressure. Researchers in the US found that relaxing music can dilate blood vessels in the body and improve general blood flow. Music that was perceived as stressful (heavy metal as an example) caused the blood vessels to contract and decrease blood flow to the body.

When students were studied by having them listen to six types of music, researchers found their heart rate synced up to the speed of the music regardless of the style and their interest. If the music was lively, their hearts sped up. If the music slowed down, so did their heart rates. It produces an additional calming, immune, and mood boosting effect by lowering cortisol levels, increasing hormones that improve the immune response and raise endorphin levels.

Finally, you have probably heard about the Mozart effect, where listening to Mozart’s music enhances learning. Baroque music, with a 60 beat per minute pattern, particularly activates both the right and left side of the brain. This enables the brain to process information more easily. It also improves recall of information when a particular tune is used during studying and then replayed.

Music is the universal language appealing to all of us while enhancing learning and healing. As medical costs continue to skyrocket, it is nice to know that there is something enjoyable and therapeutic we can do (in addition to your regular preventive evaluation and treatments) to improve our health!

“I think music in itself is healing. It’s an explosive expression of humanity. It’s something we are all touched by. No matter what culture we’re from, everyone loves music.” ~ Billy Joel

What music helps you to feel better and heal?

At my house next to our front door there is a beautiful bush filled with Daphne flowers. It smells wonderful and makes me smile on my way in and out of the house. That got me thinking. Can flowers make us happy? I did a little research and found several studies that do indeed show that flowers can affect our mood in a positive way.

At Rutgers University a behavioral research study has found that flowers elicit a universal reaction that can help people feel happiness. Those who received flowers felt less depressed and anxious after receiving them, and the flowers led to more frequent contact with friends and family.

A study done at Harvard found that when people had freshly cut flowers around the house, they were less anxious. They were happier at work and also expressed more compassion and kindness towards others.

A study done at Texas A&M found that when both men and women were exposed to cut flowers at work, they both had an increase in ideas and solutions to office problems. Men generated more ideas than women, but women had more innovative and creative solutions to problems when flowers were nearby.

Flowers have certain meanings according to those who specialize in that sort of thing (Taken from The Language of Flowers by Vanessa Diffenbaugh). If you want to say something specific you might try these: Gerber daisies represent cheerfulness, baby’s breath reveal everlasting love, bird of paradise say magnificence, hyacinth communicate beauty, and jonquils represent desire.

It is spring and flowers are blooming everywhere. If you want to brighten your day or someone else’s bring in some flowers or visit your local flower shop. It will help you to be more productive, tell people how much you appreciate them and keep a smile on your face!

Today my mother sent me a great picture of herself in a gift shop in Cambodia. She looks fit and happy. It got me thinking about the fact that as we age we have many choices. The major one is to be or not to be fit. I saw what happens both ways in my family. Let me start with my father.

My dad was brilliant but stubborn. He smoked, ate a fat-filled, high sugar diet, and was totally opposed to exercise. He had to quit smoking when he developed bladder cancer and his urologist told him that if he continued to smoke he would not see him in his practice, because a cancer recurrence would be inevitable.

He started eating healthier when his brother developed type 2 diabetes and he realized that he might end up with the same thing. However, he refused to get regular check-ups until he was in his mid 60’s. He did not realize that for most of his adult life he had high blood pressure, because he did not feel it. But, it took its toll on his kidneys in a big way.

By the time he was being seen on a regular basis he was in renal failure. Despite treatment for his hypertension, his kidneys finally failed completely. He made it to 84. He was alert and with-it till the end. Had he been treated for his high blood pressure early on he would still be here. It was amazing that he made it into his 80’s, but his quality of life suffered, especially the last 10 years.

My mother on the other hand has always been a health nut. She was exercising and eating healthy before it was fashionable. She quit eating red meat when she was in her 40’s. She has been walking and going to exercise classes most of her adult life. She now does Pilates, yoga, and is an avid tennis player. She started playing doubles a couple of years ago because her knee was acting up and she couldn’t run as fast in her singles games. She plays bridge, goes to lectures at the local university, and is now traveling around the world.

I cannot say how old she is because she would kill me, but I am 58 and she was not a teen mom so you can kind of guess her age. To look at her you would think that she was in her 60’s. She is committed to keeping her brain and body healthy and has been for most of her life. Fortunately my siblings and I have followed her example.

We have no control over what goes on in the world, but we can control how we treat our bodies. Life can get crazy, but there are choices we can make. You can choose to ignore your health as my father did (and please say hello to him when you see him) or you can follow the path that my mother is on and be well!

“To resist the frigidity of old age, one must combine the body, the mind, and the heart. And to keep these in parallel vigor one must exercise, study, and love.”
Alan Bleasdale

In 2002, the Women’s Health Initiative study found that the risks of Premarin and Provera treatment for menopause outweighed the benefits. Since that time, women have been looking for alternative ways to treat their menopausal symptoms.

Bioidentical hormones have taken the place of Premarin and Provera. Bioidentical are so named because they are identical to our natural hormones. The big question is, are they safe? The answer is yes and no. There have been no long-term studies in the United States so we have to look to Europe for some answers.

A study of nearly 100,000 women in France found that those on estrogen alone had a 30% increased risk of developing breast cancer. When estrogen was combined with natural progesterone there was no increased risk for developing breast cancer. They also found that when estrogen was given in the form of a patch or gel there was no increased risk for blood clots. This may also decrease the risk for stroke or heart attack.

Most physicians would agree that treatment of symptomatic women in early menopause is relatively safe. Before starting hormones, it is important to make sure that your mammogram is negative and that they are done yearly. In addition, your risk factors should be reviewed. For instance, I am very reluctant to start women on hormones when they have a mother or sister with a history of breast cancer.

There are some providers out there who will not give women hormones under any circumstance. They are either men who have never had to live through it with their female friends or partners or women who haven’t gotten there yet. If you are suffering and would like hormonal help, there are empathetic, understanding providers out there.
Find them. Have a full discussion so that you understand the benefits and the risks. We are all different. Some women may only need them for months and others may need them for years. There is no need to suffer, but make sure you are comfortable with your decision and that each year you re-evaluate your need for hormones.

Let’s talk menopause. Some people think of it as a disease. However, it is a natural consequence of aging. Many make the assumption that we know all there is to know when it comes to treatment. However, it is a relatively new phenomenon. Think about it. In 1900 the average life expectancy for women was 43 years. Menopause has only been something we have had to deal with for three generations. My grandmother was born in 1900 so she was amongst the first to make it beyond menopause, then there is my mother and myself following in suit.

In the past, those suffering from hot flashes, fatigue and mood swings were started on Premarin and Provera. Premarin is made from pregnant mare urine and Provera is a synthetic progestin not to be confused with natural progesterone. Most women were kept on these hormones and common medical opinion was that they prevented osteoporosis and heart disease.

All that changed in 2002 when the results of the Women’s Health Initiative study were released and the study was stopped because it was found that the risks of these particular hormones outweighed the benefits. Instead of putting almost every menopausal woman on hormone replacement, the majority of women were not started on them, were pulled off of them, or stopped them on their own.

Needless to say there were and are a lot of hot women running around who are a little testy because they are not sleeping and are sick of having to deal with their menopausal symptoms. Let’s talk about the study and what was found and who was studied. Then we can talk about alternative hormone therapy.

The study (started in 1997) involved over 16,000 women who were on average 63 years old, had a uterus and had never had a hot flash. They were either treated with Premarin (0.625 mgs) and Provera (2.5 mgs) or a placebo. Over 10,000 women who had a hysterectomy were either treated with Premarin alone or placebo. Many women in both groups had high blood pressure and high cholesterol that was being adequately treated.

The study was stopped early when it was found that those on combination hormones were more likely to have a stroke, heart attack and breast cancer than those on placebo. In those treated with Premarin alone there was no increased risk for breast cancer or heart attack but a slight increased risk of stroke.

Younger women (ages 50-59) who were treated within 10 years of going through menopause had a slightly decreased risk for developing heart disease. Women over 65 who were treated had an increased risk of developing dementia.

Here are some things to consider. When one looks at the group treated with Premarin alone, there were fewer associated risks. Provera seems to be the more dangerous medication when it comes to heart attack and breast cancer risk. In addition, most physicians would not start a 63-year-old woman with high cholesterol and high blood pressure on high dose hormones. The reason being that we know that hormones can increase the risk of clotting which would potentially precipitate a heart attack and stroke. Perhaps the increase in dementia was due to this as well.

I think it is important to know what the decision to stop hormones was all about. Knowing this, you can decide for yourself if hormone replacement is for you. To do that you need to know what else is out there. Premarin and Provera are rarely prescribed anymore. There are newer options called bioidentical hormones. These hormones are recognized as natural hormones by the body. Are they for you? Stay tuned!

More on these options in the next blog.

For those who are going through menopause and would like to avoid hormones there are many things that may help. Here are some suggestions for how to deal with the problems that I call the big three; hot flashes, insomnia and weight gain.

Hot Flashes

Two thirds of menopausal women suffer from hot flashes. Twenty percent find them insufferable. Hot flashes actually make you feel like you are igniting from the inside out. You can soak your shirt in the blink of an eye. This can be quite embarrassing and downright uncomfortable. What to do?

• Believe it or not there are certain foods that may help stop the hot flashes. A recent study found that eating a half-cup of soy nuts and dividing them up into three or four portions a day cut hot flashes in half. Another study found that keeping a steady blood sugar by eating frequent meals during the day decreased flashing.

• Exercise can reduce body mass and that can decrease the number of hot flashes.

• If these measures fail, there are medications such as SSRI antidepressants that may reduce hot flashes. Herbs such as black cohosh are a popular remedy. Study results have been equivocal. It has helped some of my patients but not others. Certain alternative therapies such as acupuncture and meditation also can help you beat the heat.

Insomnia

Many women find that during and after menopause they have difficulty falling asleep and/or staying asleep.

• The key is to avoid caffeine and alcohol several hours before bedtime.

• I have found that hypnosis is very effective for helping people get to sleep and fall back to sleep if they wake up in the middle of the night.

• Supplements such as theanine and tryptophan may also be useful.

• It is important to discuss this problem with your doctor. Make sure that any supplement you take is safe with other medications you may have been prescribed.

Weight gain

At menopause, women start to lose muscle at a precipitous rate. This along with slowing metabolism can contribute to weight gain. However, this does not mean it is inevitable.

• Aerobic exercise, strength training and healthy eating can keep menopausal women from gaining weight.

• Hypothyroidism occurs in a large percentage of women at menopause. It is important to have your thyroid function checked if you are gaining weight. Many of the symptoms are similar to menopause so it can be missed.

Menopause can be very manageable without hormones. The key is to eat well, exercise and find a physician who can work with you in partnership to help relieve your symptoms. And remember,

“There is no more creative force in the world than the menopausal woman with zest.” Margaret Mead

It is time to go out there and get some zest!

I wrote this blog almost four years ago. I think it is appropriate to republish it as I see my friends going through similar experiences. Here goes.

As a baby boomer, I have joined the ranks of many of my brethren and can say I am part of the “sandwich” generation. I have children who are teenagers and I am helping them to leave the nest. I had a parent that needed my help to fly and leave his nest as well. How many of you have similar stories to the one I am about to tell?

On June 19, 2008 I lost my father. I would say that he died, but he wouldn’t let us use that term. He preferred that we say he “transitioned”. My father was an amazing man. He lived life with integrity and purpose. He was 84 years old and his mind was as sharp as ever. He had renal failure and had been on dialysis. His body was getting weaker and weaker and he finally decided to stop the dialysis. This allowed him to “transition” on his own terms. Once again his strength and dignity prevailed.

Having now gone through the experience of losing a parent and being there for the transition, it has caused me to look at how we see and experience death in our culture. I realize that each person needs to be allowed (whenever possible) to die on his or her own terms.

My father had expressed his wishes to my family and me well in advance and we were able to discuss them with him and understand what he wanted. He also put these wishes into a legal document known as a living will. In his, he put me in charge. At the time, I didn’t realize how important that was. But, when the time came, I had to act.

I felt like Shirley MacLaine in the movie “Terms of Endearment” when she was fighting for pain medications for her daughter who was dying. I had to scream for morphine for my father when his lungs started to fill up with fluid. Fortunately, after quite a bit of drama, he was able to get what he needed and I honored the promise that I made to him. His transition was peaceful and I am happy that he got what he wanted. In the wake of all this is a massive amount of grief, which is a natural part of life.

I share this story so that it will allow you to pause and think about whether you have a living will. Have you discussed the issues of death and dying with your loved ones? Although many of us live as if we will never die, that is one of those things that is inevitable for all of us.

Although death is never easy, knowing what my dad wanted and knowing that we were able to provide it both with the living will and details of his funeral that he planned ahead of time, made things better somehow.

Death is a natural part of the cycle of life. It is okay to talk about it and to address it when it is staring you in the face. But, it is also important to say all the wonderful things you want to say and understand the wants and needs of others before an emergency situation develops.

Hug your children, your parents, your brothers and sisters and your friends. Tell them you love them as often as you can. That is what my father taught me. I am glad I was able to tell him that many times before his grand transition!

Valentine’s day is over and it may have been a great day for you. For others it may have been stressful as a result of a traumatic break-up or the loss of a loved, which could literally cause a broken heart. What do I mean?

Broken heart syndrome occurs when there is a sudden trauma, and due to the stress the body releases a huge amount of adrenaline that acts like a stun gun to the heart. As a result the heart muscle fails to work properly and patients appear to be having a heart attack. They may experience chest pain, shortness of breath, sweating, nausea, and fatigue, and they can develop congestive heart failure. That is the bad news.

The good news is that they do not suffer a true heart attack. The heart muscle is not damaged permanently and the patients usually recover within a few days. Once back to normal the chance of it happening again is slim to none.

No one knows why, but postmenopausal women around an average age of 60 are those at greatest risk. It is important to be familiar with this condition and to be alert to the women in your life who suffer the loss of a loved one or experience a traumatic break=up. Although they generally recover, if patients do not receive care and support quickly this condition can be life threatening.

Where do broken hearts go? Hopefully to the hospital where they can be nursed back to health and recover quickly!

As I mentioned in an earlier blog, the thing that worries most of us is that we will lose our minds. Dementia and Alzheimer’s disease are scary diagnoses. It is a fact that as we age, our brains shrink and our neural connections start to dry up. The first thing to go is remembering people’s names. Fortunately, learning and challenging ourselves can rewire our brains. We find alternative pathways to help us jog our memory for things such as names and places.

There was a study done of people over the age of 75 that was conducted over 21 years. The object was to see which activities helped to preserve brain function and reduce the risk of dementia. Interestingly, reading reduced the risk by 35%. Doing crossword puzzles at least four days a week reduced the risk by 47%. Bicycling, golf and swimming reduced the risk by 0%.

The activity that had the most benefit and reduced the risk by 76% was dancing! Not just any dancing did the trick. It was dancing that required split second decisions. Ballroom dancing such as waltz, swing and especially Argentine tango fit the bill and can help maintain your brain. All these dances require the need to lead or follow directions and move the body accordingly. That need to make quick decisions and communicate with a partner increases the wiring of the brain and can help prevent deterioration.

Argentine tango has also been studied to see the general effect on the health of seniors and also for those with Parkinson’s disease. The benefits include increased muscle tone, spinal chord stability, improved balance and flexibility, reduced stress and anxiety and increased self-confidence.
Patients with Parkinson’s disease had improved balance, endurance and self-confidence with frequent tango lessons. In one group that was studied there was a decrease in the progression of the disease with tango.

Besides the fact that dance and specifically Argentine tango can improve your health, it is incredibly fun. You do not need to be Ginger Rogers or Fred Astaire. You just need to be willing to get over your inhibitions and give it a try.

“To dance is to be out of yourself. Larger, more beautiful, more powerful.“ ~Agnes De Mille

Last week I wrote about the fact that women (over 50) want to be happy. In follow-up I think it would be helpful to give a personal example by sharing my own search for happiness.

I have always been an upbeat person and have been reasonably happy. However, my level of happiness has grown especially after reaching the age of 50. That doesn’t mean that I walk around with a perpetual smile on my face or that I don’t get frustrated and discouraged. Believe me, it happens. In sharing my experience, I am hoping that others will be helped. Just remember. The only normal people are the ones you don’t know very well.

For many years I was in a typical medical practice where I was seeing up to 30 patients in a day. I was juggling my family, husband, house and trying to exercise and eat healthy but it was almost impossible. I felt like a failure. I could not give enough time to anything or anyone. I was miserable. I knew it was time for a change and I left the clinic I was working for. I enrolled in an online Integrative Medicine fellowship program with Dr Andrew Weil in Arizona. Our first fellowship week took place in Arizona and was the week surrounding 9/11.

Needless to say I could not get back home by flying and ended up renting a car and driving the long road back to Oregon. I had a lot of time to think on that road trip. I realized that it was time to clean up my act. I needed to walk the walk and eat healthy, exercise, and design a practice that worked for my family and me. No more potato chips for lunch. No more popcorn for dinner. No more excuses for not exercising.

Since college when I contracted mononucleosis I had always been tired. Miracle of miracles, the first thing that happened with my new program was that my chronic fatigue went away after about three weeks. No more blaming the guy who gave me mono! I found that my clothes were fitting better and I had enough energy to play with my children and think about the practice that I wanted to design.

I started my integrative medicine clinic known as Triune. Triune stands for mind, body and spirit, which is what I address with every patient that comes to see me. I work alone and I spend an hour and a half with each new patient. I have a partnership-type relationship with each one of them. I help most, not all, but this is a lot better than the progress I saw when I would spend 10 minutes with each patient. To feed my own spirit I learned to meditate and it has become as automatic for me every day as brushing my teeth. It keeps me grounded.

I began to get involved in medical reporting on the television news and now I have a weekly call in show where I give free medical advice. I write blogs and co-authored a book and I am really enjoying that part of my life. My kids are out of the house in college and working. My husband is happy practicing as a GI doctor. They all have their ups and downs but are doing well overall.

Two years ago I was asked to participate in our local Dancing with the Stars contest. I had never done ballroom dancing before. I was paired with a wonderful dancer who taught me Argentine tango. It was amazing. I fell in love with the tango and dance in general. After the contest (we came in third place!) I decided to keep on dancing. I was happy before but dance has kicked it up a zillion notches.

I would say that I am happier than I have ever been. I am so grateful for what I have and have found a way to be creative and productive. There are still things that get me down but I don’t stay down. If I ever start to despair I just think of all the good things I have in my life.

Many of us have a tendency to look at other people and their families and think that they have it better or easier. Remember, Pleasantville only exits in the movies; we all have troubles. How we deal with those troubles ultimately will determine our ability to find happiness. Have you found yours?