What make us make those life choices, those small daily decisions, that contribute to our own vibrant health. The average lifespan for a Canadian woman in 2017 is 81 years of age. It's not up to the medical professionals in your life; it's up to you to create your best health. Where you live, how you live, your work and play, your biology/genetic heritage, how you eat and drink, how you manage life's stress…….you can impact all these factors. It's up to you.
The Tomorrow Test is this: Each time you address something you'd like to change, commit to it. Then when you begin to waver (procrastinate, make excuses, defer), ask yourself how you'll feel about it tomorrow. We know that we only have today, but looking at the moment from tomorrow's perspective may add a lovely bit of motivation that you need to follow through.
How many changes at a time? If we make one change, we have an 80% chance of staying with it. If we make two changes at a time, we have a 30% chance; if we tackle three changes at once, we have less than a 5% chance to stick to our guns. Make one change, take six weeks to make it hold.
What changes in our life will provide us with our best health? For women, it's different than for men. We have a complicated body full of hormonal influences provided by our biology (like monthly cycles, pregnancies, baby-having, and menopause). We need to understand the impact of our amazingly unique bodies so that we can make lovely life choices.
Women's Health Rules are:
Now….women friends! Look at this list. What would be enjoyable, something you'll want to repeat? Only one. Six weeks. It's your health.
Written by Joanne Gailius, June 2018
Constipation. If your back passage (bowel release and anorectal action) isn't working well, nothing else in your pelvis (bladder, intimacy, pelvic organ support and core strength) will be working well. So, brace yourself, let's talk constipation!
Do you enjoy a consistent, full, complete and satisfying bowel movement every morning? BMs should be a minimum of every 2 - 3 days and a maximum of twice daily. You should never need to rush, have skidmarks in your undies or lose stool without you knowing or before you're ready. Ever. The stool should be firm but not dry or very cracked, smooth but not sticky and medium sized to pass with comfort. It should be brownish, of a consistent smell and without mucous or blood. It shouldn't be painful to release your stool nor should you bear down. Hemorrhoids can come with pregnancy or stress, but shouldn't be persistent. You should be able to travel or change your routine without upsetting your BMs. Your bowels are meant to digest your food and drink, transfer nutrition to your body, then get rid of the waste. It's a beautiful system!
How does it actually work? When you take that first warm drink in the morning, the sphincter between the esophagus (food tube) and the stomach sends a signal to the rectum that today's food is en route. Yesterday's waste is nudged along the colon, down the digestive tract and into the rectum. The sphincter at the end of the rectum opens up. Counterintuitive? Stool has just landed and it opens up to take a sample. It checks if it's gas, liquid or solid. If it's gas, it nudges you. If it's liquid, it slams shut and gives you to signal that you need to move! If it's solid, it shuts firmly and gives you the message, "Time to go to the toilet". Don't delay. It nudges, you calmly go.
Toileting habits are important. Sit comfortably and relax. Your knees should be slightly higher than your hips, supported on a stool or block. Breathe into your belly and sense your pelvic floor softening, descending, and the sphincters opening up to let stool pass. If you have the urge to push, don't! Just breathe into your belly and do a bass hum, low growl or pursed lip outbreath to protect your pelvic floor. Keep allowing your system to release and let go. Don't stop the stool until your body says you're done. Then belly breathe again, rock your pelvis and enjoy a few moments of quiet. When you're sure you're done, do a few gentle pelvic floor squeezes to help clear the anus so that wiping is gentler and more complete.
You can support your digestive system. Keep hydrated, drink mostly water, and enjoy a drink of warm water with tooth-brushing to help your stool stay hydrated overnight. Be cautious with fibre, adding a little at a time. Pay attention to the foods that your body finds a problem - what makes your stool too solid and/or what makes it too loose? What gives you gas? You're unique, so learn about you. Support your system with a heated wheat bag and a massage. Help your system release its waste products after all the work it's done for you. Depending on your issues, there are specific techniques, stretches, breathing patterns and habit changes that will help you enjoy lovely BMs that support your health.
If you have specific problems with your bowel release, a pelvic physiotherapist provide you with with an internal and external assessment and treatment plan just for you. Your digestion, bladder, pelvic organ support and intimate life will thank you!
Written by Joanne Gailius, October 2018
Breast Cancer. 1 in 8 of us women in Canada will be diagnosed with breast cancer in our lifetime. No one can imagine hearing those words. Beyond the initial shock, there is a steep learning curve as well as great hope. So, let's take a deep breath, dive in and learn together.
Breast cancer is diagnosed when a malignant tumour grows within the cells of the breasts. It can appear in the milk ducts, the lobules (which produce milk), the lymphatic system and/or within the surrounding breast tissue. Early detection has resulted in earlier diagnosis and treatment. Treatment may include surgery, raditation, chemotherapy, targeted therapies and hormonal therapy. In addition, physios may have special training to help women with the challenges that occur in movement, posture, alignment, lymphatic function, bone health, pelvic health and heart health. Yoga therapy also provides help in breathing, stress management and restorative practices. Creston has these options, along with a group of women who meet monthly to support each other through this journey.
What factors make it more likely for us to develop breast cancer? Living in Canada with a relatively high income puts us at risk. If we're between 50 and 69 years old, are Caucasian, have a family history of breast or ovarian cancer, family genetic mutations (to the BCRA 1 or BCRA2 gene or a few other specific genetic mutations), have dense breasts, began menstruation at a young age (menarche) and/or late onset of menopause (after age 55), have never been pregnant, already had radiation therapy to the chest area, previously had breast cancer, used hormone replacement therapy for a long time and/or used oral contraceptives for more than 10 years, drink more than one alcoholic drink per day, are obese, are physically inactive and smoke, we're at a higher risk. A great deal of research has shown that deodorants, antiperspirants, tight bras and breast implants are not related to any rise in breast cancer statistics. The important thing to remember is that some of the breast cancer risk factors are not in your control. Breast cancer can simply appear in your life without you having caused it, done anything, inherited anything……it just is. But you can affect so many of these factors by keeping a healthy weight, exercising, quitting smoking and reducing your alcohol consumption on a daily basis.
Mammograms. If we're over 50, we can have a mammogram every 2 years in BC. It is a low level radiation picture of your breast. A radiologist will look for any growths, note your breast density and compare to your last mammogram. Your personal monthly breast self examination is important. You know your body and your breasts best. Pay attention if you feel a lump, a swelling/change in size or shape, see skin redness/discolouration, find dimpling/thickening or puckering of the skin, nipple changes/retraction/discharge or enlarged lymph nodes in your armpits. Many breast changes are notcancer, but if your notice one or more of these symptoms that doesn't go away within two weeks, visit your doctor.
What happens if you find a lump? Your doctor will usually start with a mammogram. From there, if there is continued concern, you'll have an ultrasound. If concerns continue, you'll have a biopsy which can be of three kinds: surgical (remove part of or all of the lump), fine needle or core biopsy (extracted fluid and cells from the tumour are removed) or a sentinel lymph node biopsy (a radioactive tracer and dye are injected into the tumour so the surgeon can follow the dye to find the lymph nodes connected to the tumour itself). The removed tissue is sent away to a pathology lab for testing.
In Breast Cancer 201, we'll talk about:
Numbers and Letters: No two breast cancers are alike, but we use Stages (I to IV) and the letters A and B to help us understand the type and stage of cancer that has been found. This guides our treatment options from the day of diagnosis as well as along the treatment road.
Treatment Options: Surgery (breast conserving, total/simple mastectomy, radical mastectomy and reconstructive options. Radiation therapy, chemotherapy, hormonal therapy and targeted pharmacological/drug therapies.
Written by Joanne Gailius, September 2018
Pelvic pain is complex and has many faces. We've talked about Painful Periods, Endometriosis and now we're going to tackle Bladder Pain Syndrome.
Bladder Pain Syndrome may have begun like this: You had a urinary tract infection that just didn't go away. You felt urgency to void. You felt pain just above your pubic bones (where your bladder lives), in your perineum and/or in the urethra (the tube from the bladder to the outer world). When urinary tract infections became chronic, the old thinking was that the interstitium (bladder lining) was inflamed, ergo the outdated name "Interstitial Cystitis". Bladder Pain Syndrome is far more complex, the name far more descriptive.
In 2018, we know the onset of BPS is more like this: Your bladder thinks that it's under threat…..a grizzly is at its door. Your bladder may have suffered at some point in your life, perhaps when you were a child (Chronic infections? Withholding voiding? Difficulty with bedwetting?). The part of your brain that worked with your bladder remembered this sense of distress. Later on in life (with puberty, onset of intimate relations, stressful situations, baby having, an accident or menopause), your bladder had "flashbacks" and kicked into that difficult memory. Your immune system pitched in, bringing on an immune response and inflammation. Your bladder nerve endings and the nerve pathways to the brain were woken up. Your tendons, muscles and fascia tightened up in order to protect the area.
The outcome? You may develop a hypersensitive, overactive, inflamed bladder. As your bladder fills, it naturally stretches. That tight and inflamed bladder isn't so keen on stretching, sending a threat message to the brain. Your bladder naturally fills to 500-ish mls., but with BPS it can become painful at only 100 mls.. The bladder may also not welcome urine due to the inflamed lining, so you may feel a sense of urge to get rid of it…now! If you experience these feelings for more than three months, your brain begins to focus on the bladder, becoming attentive to all bladder sensations from a little urine to moderately full to urgency to pain! The natural voiding reflex and habits become distorted over time and your bladder forgets how to feel the "Oh, I'm getting full…..I'll have to go to the loo soonish, but no rush" sensation. The rising tension in the pelvic floor creates more problems. Toilet time naturally involves releasing the pelvic floor along with opening of your sphincters in a lovely dance. With a tight pelvic floor, your urine stream may become slow, interrupted, painful and incomplete. Intimacy may become painful. You may have an accompanying challenge with bowel release (not constipation….it's the letting it go part that becomes slow and/or painful). Your stress system and brain become alerted over time and this increases your perception of pain; it attaches it to your emotional state. If you haven't slept, are having a bad day or have stress, you'll feel BPS more than you would have otherwise. It's just all so connected.
What can you do about it?
Find a pelvic certified physio. You'll be asked about how your bladder functions, how often you void, how it feels before, during and after voiding, how your bowel works (loading, comfort, movement, frequency), pelvic floor function, deep core function and how your life is working (your nutrition, sleep, understanding of pain, pelvic systems and stress management). Your internal and external pelvis and deep core will be assessed. Research has shown us that your pelvic floor needs to be calmed down in its hypertonicity (tension), pain and function or the dysfunction and pain in your bladder won't change. You will be taught pelvic floor releases with breathing patterns, general and specific stretches and perhaps the use of a wand (a pelvic trigger point tool for you to use). An elimination diet is helpful, but no two women with BPS have the same dietary triggers. Eat food that agrees with you. Get good sleep and downtime. Find and manage your stressors. Bladder Pain Syndrome can be managed well. You can experience a cascade of wonderful changes when you take charge of your own health.
Written by Joanne Gailius, May 2018
Spring is here, along with the greening and blossoming of our valley. Sunshine and Vitamin D help this season along…..these factors are integral to support women's bone health. In addition, how we move, how we sleep, how eat and manage our stress impact our bone health!
Women have a lifetime risk of hip fracture of 1 in 6, compared to 1 in 8 for breast cancer. Our risk of dying from a hip fracture is equal to our risk of dying from breast cancer. If we include all women worldwide, we have a 1 in 3 risk of osteoporotic fractures. Within one year of our first fracture, 1 in 8 women will go on to a second fracture. 1 in 5 women who fracture their hip will die within the year. These statistics show the very real effect of bone health on our quality of life and longevity. When you have osteoporotic changes in your spine (weakened bones + forward bent posture = the "Dowager's Hump), you also may experiences changes in your breathing, your cardiac function, your digestion, your mobility and increased pain, your continence and your emotional health.
How do you know you have osteopenia or osteoporosis? Talk with you doctor, especially if you've finished menopause. There is a special xray called a Bone Mineral Density test that gives you a number that represents a comparison to other women, called a T score. It will tell you if your bone is dense, somewhat less dense (Osteopenia) or with substantial loss of density (Osteoporosis). To complicate things, bone density isn't the whole picture…..dense bone may be thick but not responsive. Your bone needs to be able to respond to stressors and to have good muscular and joint support.
Exercise can change your bone health. Your bones are alive and will respond to exercise. Swimming, biking and walking will support your heart health, but will not build bone. We're talking HIIT, Circuit and Crossfit classes, strength training, yoga (think Downward Facing Dog) and sudden weight shifting exercise like tennis, jogging and martial arts. Bones respond well to surprise physical stressors. The most common fractures from osteoporosis are in the spine, hips, wrists and shoulders, so ponder on exercise that challenges these! Think about balance. We all lose balance capacity as we age (due to muscular, postural, fitness and visual changes), but balance training is amazingly quick and beneficial. Better balance reduces your fall risk. Small nudges reap big rewards in balance, strength and bone support.
Bioavailable bone nutrients are in salmon (especially canned with the crunchy bones in the tins), dairy (cheese, yogurt or kefir), dark and leafy greens (kale, chinese greens, spinach) and phytoestrogens (as in seaweed, miso or tamari). A traditional Japanese diet supports bone health by providing extra Vitamin K and Calcium in the generous use of all the above ingredients. Think sushi! Alcohol (more than 5 oz/day) and caffeine (more than I c./day) do not support bone health. Calcium supplements are no longer generally recommended due to their potential detriment to our hearts. Smoking promotes bone loss, so it is time to quit!
Stress management is important in bone health as, when we're stressed, we have elevated stress hormones coursing through our bodies. When we eat well, sleep well and exercise, our stress is reduced. The challenge is perhaps, for each of us to be aware of our own bespoke stressors and to put stress reduction and management on the front burner! Make self care a priority to support your bones!
Here's hoping that spring's arrival will bring bone health to you.
Written by Joanne Gailius, March 2019
Cancer is a diagnosis that none of us wants to hear, yet 33 to 50% of us will experience that moment in a doctor's office……"You have cancer." There are so many advances in oncology (cancer medicine) from diagnosis to treatment yet cancer patients and survivors continue to face unique challenges in their physical and mental health over their lifetime.
A December 2018 "white paper" (a concise report that informs readers about a complex issue) explored the growing literature available to us regarding the effects of yoga on the continuum of cancer care. Medical research has shown that yoga increases strength and flexibility, improves balance and prevents falls, helps maintain a healthy body weight, improves psychological well-being, lowers blood sugar and cholesterol levels, improves sleep and reduces fatigue, reduces stress, enhances the immune system, reduces inflammation and improves quality of life. We health care providers seek evidence-informed, cost-effective ways in which we can help people to manage the short and long term effects of cancer and its treatments. This paper clearly supports cancer-specific yoga intervention as a supportable part of cancer intervention.
Yoga is a complex, holistic system that includes movement and postures, breathing, restorative and relaxation practices that support physical and mental health. PubMed gathered 435 studies from observational studies to clinical trials regarding yoga as a part of cancer care. The general conclusion is that yoga can help adult cancer patients and survivors manage symptoms and side effects as well as lead longer, healthier lives. A variety of cancers were studied, although the most numerous studies were on breast cancer; they studied people before, during and after treatment. Yoga is not a cure-all, but there is ample evidence that well-planned yoga classes, done consistently and over time, have measurable benefits on healing and long term health.
From all the studies, these are the conclusions regarding yoga for people with cancer:
Yoga comes in many forms and classes vary greatly. Again, from all the studies, these are the conclusions regarding the best options of yoga for people with cancer and cancer survivors:
Creston is a wonderful valley in which to live. We have many opportunities to help us all live our lives well over our lifespan, through our ages and stages. Should you face a cancer diagnosis, please ask for community support. There are support groups, mental and physical health options, home visiting nurses, care aids, PTs and OTs and cancer-specific yoga classes at The Yoga Room in NW Blvd. at the east end of town.