As we get older, our immune systems tend to decline making us more susceptible to infections. Many of the infections are now preventable with the help of vaccinations. According to the Centers for Disease Control, there are certain vaccines that are recommended for adults over 50 years old (assuming you had all the childhood vaccinations). Here goes:

• Tetanus and diphtheria (Td) should be given every ten years. If you have an injury with a rusty nail, an animal bite or a dirty puncture wound, and it has been more than 5 years since your last vaccine you will need a booster sooner.

• The flu vaccine should be given yearly. Every year the vaccine is put together based on the flu strains that will be most likely to infect the population.

• The Pneumococcal vaccine is recommended for all adults 65 and over. It is recommended for those adults over 50 who have asthma, diabetes, liver disease, kidney disease, HIV or depressed immunity.

• The varicella or shingles vaccine is recommended for those 60 years and over who have had chicken pox in the past. It can either prevent shingles, or diminish the severity of shingles develops. For those who have never had chicken pox, the chicken pox vaccine is recommended.

• For those who travel, hepatitis A and B vaccines, and a variety of other vaccines may be recommended, which are determined based on where you go.

• Depending on your medical condition or your job (healthcare workers) there may be more recommended vaccinations. Check out: http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

If you are behind on your vaccinations, it is time to get caught up! It could save your life.

If you have been experiencing excessive hair loss and you are female, you are not alone. Approximately 37% of women experience hair loss after menopause. The most common cause is female pattern baldness.

What Is It?

Female pattern baldness is hair loss from the top of the head, the hairline and general thinning over the entire head. It is normal to lose about 100 to 125 hairs a day. More than this can result in female pattern baldness.

What causes it?

Of course there is no easy answer. There are many things that contribute to this including genetics, aging, and changing hormone levels. In particular dropping estrogen levels in relationship to testosterone levels can contribute (resulting in a higher ratio of testosterone to estrogen). The myth of women inheriting their baldness from their fathers is just that, a myth! Thank goodness! (My dad started losing his hair in his 30’s!).

Are there treatable causes?

The most common cause of hair loss that I see is thyroid disease. It can happen with hypo or hyperthyroidism. It also can occur with diabetes and autoimmune diseases such as lupus.

Is there a treatment for female pattern baldness?

There is one approved treatment for women and that is minoxidil or Rogaine. It helps hair growth in 20 to 25 % of women. It can stop or slow down hair loss. It only works as long as it is being used. Once stopped, hair loss continues. Hair transplants can be effective for reducing the appearance of hair loss.

Final Words

If you are losing hair, it is important to find out if there is an underlying cause. If it is due to female pattern baldness, you can consider Rogaine. In the future there may be hormone creams for the scalp. They are in the process of being studied.

Most people are motivated at the beginning of a fitness program. The key is to stay motivated and adopt simple techniques that will serve you throughout your life. Here are a few:

1. As a mindful person, you will begin to notice how much better you feel by eating healthy and losing weight. That in and of itself will be motivating.
2. Set small, reachable goals. The best example of this was an interview I heard on the Today show. A woman who had lost 100 pounds said that she looked at her weight loss as losing ten pounds ten times. She basically set out to lose 10 pounds at a time. If she had looked at losing 100 pounds it would have felt impossible.
3. Reward yourself when you reach your goal with something other than food! It could be something small such as a CD or a new purse or briefcase. It could be big such as a vacation or money that you reward yourself with.
4. Don’t do it alone. It helps to have the motivation of your friends and family. Just as being overweight can be contagious so can improving attitudes towards food and lifestyle changes. Including a family member or friend in your program can increase your chance of success.
5. If you can’t find a friend or family member to join your program, consider using a trainer or nutritionist. Even if you only meet with them once a month, you will have someone to support you and to be accountable to. It can really help.

A common mistake that people make at the beginning of the year is to exercise to the point of excess. That is the fastest way to end the New Year’s resolution to exercise. Here are some tips:

1. If you have been sedentary for a while, it is important to start moving slowly. Try little things such as parking your car a little further from wherever it is you want to go. Or, take the stairs instead of the elevator. Start small and gradually increase your activity level.
2. The key to overall fitness is to incorporate exercise into your life so that it becomes automatic. Maybe it is as simple as walking your dog once or twice a day or taking two 15 minute walks around the block when you have break-time at work.
3. Walking is one of the easiest ways to get moving. Increase your distance slowly. Make sure you have good shoes, stretch and before you start on an exercise program, make sure your doctor approves.
4. You don’t need to belong to an expensive club to exercise. There are activities you can do at home that can work those calories off. These include: vacuuming, gardening, and house cleaning. If you keep on moving they qualify as exercise and are extremely productive.
5. An easy way to gauge your progress with exercise is to use a pedometer. You can find inexpensive ones at Target. You wear it on your waist or belt and it counts your steps. You want to aim for 10,000 steps a day, but if you aren’t a big exerciser, try for 5000 steps a day.

These are just a few quick tips, but if you follow them you will be amazed at the results!

One of the things that can cause us to hold on to weight is the continuous release of stress hormones. It is therefore important for all of us to de-stress. Exercise can help. It releases endorphins that can improve our sense of well being and to lose weight by improving our level of fitness! Here are some more suggestions:

1. There is a simple, cheap way to reduce stress. It can be done anywhere at any time and requires little to no equipment. The stress reducer I am referring to is meditation. Some of you fellow boomers learned transcendental meditation in the seventies. If you have never done it, there are great beginner CD’s that can give you a short guided meditation to get you started.
2. There are many pleasant ways to reduce stress. Massage is one of these ways. Many of us feel guilty having a massage, but no need. Regular massages can reduce your stress hormone levels. By reducing your stress hormones, massage can actually help you to lose weight. Try it, you’ll like it!
3. Guided imagery is another great way to reduce stress and thus help us to lose weight or keep us from gaining weight. It will relax you and can help you lose weight.
4. Find an exercise that you like that can also relieve stress. Yoga, Tai Chi, and Qi Gong are just a few that you could check out. If you have pain in your knees aqua tai chi is a great choice and may be available in pools near you.

It is a new year and that means many of us will be resolving to lose weight. Here is the start of a series that may help. The first set of suggestions is to be mindful of what we eat. So many of us eat without thinking about what we are doing.

Mindfulness:

1. How often are you conscious of what you are eating? Do you taste every bite? Do you chew and swallow one bite at a time. It takes at least ten minutes for your brain to catch up with your stomach and register that you are full. If you stay conscious while eating and can eat and appreciate each bite, you will probably eat a lot less and be satisfied!
2. When you eat with other people you will tend to match the pace of their eating. The faster they eat, the faster you will eat. If there is music playing with a quick beat, you will be shoveling food in to the pace of the music. Being mindful of your surroundings will help you to slow your pace and enjoy every bite.
3. Most of us have been conditioned to finish our food and clear our plates. We eat till our plates are empty regardless of how full we may be. Try leaving half of your food on your plate, especially in restaurants. Then take half of it home for leftovers. You can control your calorie intake and have an extra meal at the same time.
4. Have you noticed that as we have gotten larger, so have our dishes? Plates and bowls are growing in size. Bagels are at least twice the size that they were when we were growing up. If you look at the portion size of pasta you will find that one bowl usually equals four portions of pasta as defined by the National Dietetic Association (a portion is ½ cup)! Portion control is essential in maintaining a healthy weight.
5. Are you eating out of hunger or is it due to boredom, stress, or depression? I have had moments of stress when I will pull out a full bag of chips and suddenly notice that they are empty. Being mindful includes knowing when you are hungry, eating what you need and enjoying each little bite. If you find yourself eating for reasons other than hunger, it is time to take it outside….and walk!

It is essential for healthy eating that we make good food choices. Here are some suggestions when it comes to food:

1. Do you plan your menus ahead of time? So many of us are busy. If we can plan our meals ahead of time, we can better make healthy choices. If you do shop, don’t go hungry. You are more apt to make impulsive choices for junk food and end up eating it in the store!
2. Research has found that when water is mixed in with food, it is more filing and you eat less. Foods such as stews and fortified soups filled with goodies such as vegetables and broth can help you to eat less, eat healthy and lose weight.
3. It is important to have at least 4 servings of fruits and vegetables daily. They can be very filling. You can eat them as part of your meal or as a snack. If you eat raw veggies as a snack, it is fun to take them and dip them in low fat, low cal dressing. If you get gas from the vegetables, try beano, it works!
4. If you have a sweet tooth, satisfy it with fruit. Apples are a great choice. They contain pectin that help you to feel full longer as well as provide great fiber.
5. If you start your meals with a healthy appetizer or soup, you can decrease your meal portion size. This will help you to feel full and allow you to decrease your overall calorie intake throughout the day.

As women we have a very hard time putting ourselves number one on the list. However, if we don’t take care of ourselves we cannot take care of anyone else. My suggestion for the new year is to make a list and for some of you (it may be a first) make yourself top priority. Here is a suggested list:

1. Make those appointments you have been putting off (colonoscopy, mammogram, dental and eye appointments, you get the idea)
2. Do one little thing for yourself that you would do if you “could find the time” (manicure, pedicure, hair change, etc.)
3. Go for a walk someplace you have always wanted to go (to a park you pass on the way to work or a favorite hiking spot.
4. Find a healthy place to shop and find some new healthy foods that you might want to try.
5. Do something to help you laugh (go to a funny movie, read a funny book, etc.)
6. Have a massage.
7. Try an acupuncture treatment
8. Start a journal and write whatever comes to mind for 15 minutes a day.
9. Ask one person for help with one little thing. It could be folding laundry, filing papers, shopping for supplies, whatever you need help with…just one little thing!
10. Pick one night and do nothing but what you want to do. It could be just sitting listening to music, reading a book, taking a dance class, etc.

Happy, Productive, Satisfying  and of course HEALTHY NEW YEAR!!!!

See you in 2010!!

J&R

I always think of this week – the one between Christmas and New Year’s Day – as a time for reflection about my life in general as well as about the past year. And what always come to mind this time of year, particularly since I’ve gotten older and it is more of an issue, is health and health habits. So, in the spirit of this time of year and the wish to reflect on your life, the last of our blogs of 2009 will review some of the important health issues that we women in midlife and beyond must generally be concerned about, as well specific issues from this past year.  First, the general issues…

Most of us believe that the health worries of kids no longer apply to us as we get older.  We think that one of the advantages of reaching midlife is that we are finally finished with all those issues that make childhood and adolescence such a pain in the neck, such as needing set bedtimes as well as  regular dental and eye checkups; having to worry about using protection during sex and about cigarette smoking; getting all those shots to prevent diseases and wearing helmets to prevent sports injuries; needing to eat all our vegetables and avoid sugar as well as not missing gym class. What a relief to let these issues fade right along with our memories of tetherball on the school playground!

Not so fast. Would it surprise you to know that you still have to be aware of each and every one of the above so-called “child/adolescent” health issues? 

For instance, what about set bedtimes? The obvious reason that we needed enforced, regular  bedtimes each night was so that we would get enough sleep. Being tired and sleepy the next day in school caused everything from lousy concentration to crabby moods. Now that we’re in midlife, many of us believe that sleep is no longer an issue. This is not the case at all. It’s still essential to our health and wellbeing. Recent studies have shown that not only do sleep disturbances often indicate a serious health problem, but that lack of sleep can actually cause health problems, such as weight gain. Polls have shown that nearly two thirds of adults over the age of sixty-five have sleep complaints, but that less than 15 per cent of them have been formally diagnosed with a sleep problem. Why? Because we don’t mention sleep problems to our health care providers. Our mothers were right — we still need to be concerned about our bedtimes.

Once we’ve gotten the glasses we need and all our baby teeth are gone, we no longer need to get regular eye and dental checkups as we did in our younger years, right? Again — no. Although our vision does remain stable from young adulthood until we need bifocals, there are common eye diseases that begin to occur in midlife, and that can lead to blindness if not diagnosed.  And even though we no longer have our baby teeth,  other dental issues take the forefront upon reaching midlife, such as gum inflammation which has been shown to be associated with diabetes and heart disease. So, continued regular dental and eye checks are as important as in our younger years.

And what about sex at midlife and beyond?  We’ve moved from groping and being groped in the backseat of the car to more sophisticated maneuvers in a comfortable bed, and finally, finally no longer have to worry about pregnancy. So we don’t need protection; or so many of us think. Although it’s true that once menopause arrives one can’t get pregnant (warning: make sure you have completed menopause before assuming this as diagnosing menopause can be tricky),  protection is still needed during sex because of sexually transmitted infections (STIs). Yes, we can still get those, and in some cases are even more prone to becoming infected after menopause, even after a hysterectomy. And even though we’re past the childbearing years and our reproductive organs seem to have no further use, we still need regular pelvic exams and Pap smears. It is also important at that exam to discuss with our healthcare providers the need for testing for STIs; if there is a new partner or the worry that the current partner is not monogamous, this testing is a must.

STIs are not the only threat held over from our adolescent years; so is cigarette smoking. Many women in midlife think that there is no reason to stop smoking cigarettes at this age, since they wrongly assume that the damage is already done from all the prior years of smoking. This is not the case. No matter how many years one has smoked, stopping can prevent further damage to the heart, blood vessels, and lungs, and in some cases can reverse some of that damage. 

Also relevant to the lungs is the fact that asthma can begin in midlife, where once it was thought to only begin in childhood.  The two major causes seem to be occupational exposure to substances that damage the lungs, and the recreational exposure to air pollution by adults who run predominantly outside. So, a new onset of shortness of breath at this age — even if it occurs only with exercise — does not necessarily mean heart disease; remember that we can develop asthma now.

Did you think you were finished with all those horrible shots you had to have in childhood and adolescence? Sorry, you’re not. There is a recommended immunization schedule for adults in midlife and beyond, just as there are for children. At certain ages over 50 and at certain intervals, you’ll need shots against the flu, certain types of pneumonia, tetanus, and in some instances, shingles and hepatitis.  Ask your primary care provider about these.

And did you pack away your helmet when you gave away your bike with training wheels? Probably ok to have done this since now you will need a bigger size helmet. But you do need a helmet. A recent report by the U.S. Consumer Product Safety Commission stated that sports-related injuries in the Baby Boomer population was on the rise, with over 1 million injuries in this age group in 1998 alone, most of the injuries being due to bicycling and basketball.  The same report said that the many head injuries associated with bicycling were probably due to the fact that Baby Boomers use helmets less than younger people do.

The fact that exercise and proper nutrition are as important in midlife and beyond as in childhood may not come as a surprise. Regular exercise at this age has been shown to increase longevity and wellbeing, postpone and possibly prevent dementia, strokes, heart disease, and diabetes, and aid in the treatment of depression. Important to know as well is that several different types of regular exercise are recommended at this age, including aerobic (cardio) exercise, weight-bearing exercise or strength training, and exercises to improve balance and flexibility.

What we eat as we get older is every bit as important as it was in our younger years. One particular healthy way of eating, the Mediterranean diet, has been shown to stave off dementia, prevent heart disease and diabetes, maintain a healthy cholesterol level, and improve longevity. One study showed that this diet even improved sexual function in certain women! This diet is exactly as expected given its name: lots of natural whole foods, like vegetables, fruits, and nuts, lots of fish and olive oil, moderate amounts of wine, and limited amounts of foods containing refined sugar. Controlling the portions of the foods we eat is even more important at this age. Our metabolic rate decreases with age, making it easier to gain weight while eating the same amounts of food as in our younger years. 

So, as you are rummaging through your mother’s attic looking at your old dolls, baseball bat and Ouija Board, and breathing a sigh of relief that you no longer have to worry about being picked for a baseball team or that your best friend copied your paper doll’s dress, don’t get lulled into complacency about your health. Although you once may have thought that taking care of yourself  health-wise would get easier as you get older, you know now that that’s not true.

Now that it’s that time of year to make resolutions: make your appointments for regular checkups, get more than 5 hours of sleep a night, use protection when having sex, particularly with a new partner, stop smoking no matter how old you are, get the recommended immunizations, be careful and wear your helmet and seatbelts, and exercise regularly and eat well. Your mother’s recommendations from your childhood continue to apply!