While the medical field changes at breakneck speed, one thing remains the same: The primary person in charge of your health is you. It is up to each of us to embrace healthy lifestyle choices, and to take charge of healing when something goes wrong. We need to be our own best advocate. So step up to the plate and educate yourself!
relationships
“The course of true love never did run smooth.” The Bard got it right, all those centuries ago, and people are still trying to sort it out, only today they use therapists and counselors.
emotional health counts, too
“Relationships are a big part of life and health,” says Diane Sanford, a psychologist at Midwest Mind Body and Health Center in Creve Coeur. “A bad relationship or lack of social support predisposes people to anxiety and depression, and their immune systems can be affected negatively. When people report vague symptoms like gastrointestinal problems or migraines, there often is an emotional health component.” Danica Byler, a licensed professional counselor at St. Louis Wellness Center in Webster Groves, agrees. “Strong relationships and connections contribute to a healthier, happier, longer-lasting life,” she says. Healthy relationships require constant care but come without instruction manuals. “There are lots of relationship skills we don’t learn while we are growing up,” Byler notes.
conflict is natural
The most common issues plaguing relationships are finances, intimacy and communication styles, Byler says. The latter often arise from personality differences and learned skills the partners bring to the table. “ Research shows that 67 percent of relationship problems are not solvable issues. They are issues due to different personalities, upbringing and values.” Sanford adds, “ If you take two people who are having difficulties already and put them together, chances are they are going to get stuck in a lot of negative relationship patterns and habits until one or both start to make some changes,” Sanford says. “ If no one wants to change and each person blames the other, that is a no-win situation. I often have seen one person change to better control himself or herself, and it has a positive effect on the partner.”
therapy offers perspective
“Many couples simply do not know how to talk with one another around areas of disagreement,” Byler says. “ When your conflict styles are mismatched, it is incredibly helpful to seek therapy to bridge the gaps.” Pastoral counseling also can be helpful, she adds. “Some couples may seek ways of living by and honoring their spiritual values.”
If the relationship boat has lost anchor and is heading toward the rocks, act sooner rather than later, Sanford advises. “Counselors are skilled in helping people learn how to do better. Most people wait too long; the partner might have become such a trigger for negative feelings that it is hard to turn things around.” A counselor may recommend peer support groups or relationship classes before or along with counseling.
Should one or both partners make the first visit? “ It can be helpful to go to counseling on your own if you are feeling isolated, depressed, anxious or alone,” Byler says. Sanford agrees. “ You might want to go alone for the first visit or two if you feel unsafe in the relationship or have things you want to discuss in confidence,” she says.
And if your partner refuses to go to therapy, it still can be helpful to meet with a therapist to support you and make a plan to improve your personal and mental health, Byler suggests.
Unsolvable issues do not need to create intolerable relationships, Byler says. “ When a person feels loved and accepted, he or she is more likely to come toward the middle. Try to understand why something is so important to your partner. Learn to find areas where you can agree.”
It’s important to be a good listener, Sanford emphasizes. “Don’t take things personally, and put yourself in your partner’s shoes.”
birth control update
It’s hard to believe that not so long ago, women had much less control over reproductive choices. Before the widespread availability of medicinal birth control in the 1970s, many of a woman’s choices—career and personal—were completely dictated by reproduction. We’ve come a long way!
a sea change
Family planning was recognized as one of the top 10 achievements in public health during the 20th century by the U.S. Centers for Disease Control (CDC). “The optimal pregnancy is planned, and contraception makes that a possibility,” says Dr. Tessa Madden of Washington University School of Medicine. “Rapidly repeated or unintended pregnancies can be associated with poorer health outcomes for women and their children.”
Dr. Beverly Alten of OB-GYN Physicians and Signature Medical Group in Creve Coeur adds, “Birth control is a part of health. You should choose the method that fits into your life at a given point.” Madden notes that two is the average number of children in the U.S. that a woman will have, which “means a woman will spend almost three decades trying to prevent pregnancy.”
CDC data suggest that 62 percent of reproductive-age women use contraception; the rest don’t because they are pregnant, post-partum or seeking pregnancy, or because they are not sexually active.
contraception 101
Oral contraceptives were approved by the U.S. Food and Drug Administration in 1960. The daily pills contain synthetic hormones estrogen and progestin that prevent the release of eggs from the ovaries. “The most important thing that has been done is changing delivery systems,” Alten says. One advance was the vaginal ring, sold under the brand name NuvaRing. “It delivers the same medicine as oral contraceptives, but through a vaginal insert replaced monthly. It has the same benefits, but women don’t have to remember it daily.”
The most effective reversible methods are intrauterine devices (IUDs) and subdermal implants, Madden explains. “The IUD is a little T-shaped device placed inside the uterus by a health care provider. It can have a low dose of hormone, or there is also a nonhormonal IUD available,” she says.
Another option, the subdermal implant, is a matchstick-sized piece of silicone that is embedded with hormones, Alten describes. “We numb an area under the upper arm and slide it under the skin. It stays there for up to three years. There can be an immediate return to fertility if it is removed.”
According to official figures, the pill, at 24.9 percent, is by far the most popular form of contraception, while IUDs are the choice of 10.3 percent of women using birth control, and implants are used by 1.3 percent.
side effects
As with all medications, side effects are a consideration. These vary among women and can be a determining factor in selecting a birth control method, Madden says. “The most common effect is a change in bleeding. Contraceptive methods that just contain the hormone progestin tend not to have a regular bleeding profile.”
Also, she adds, effectiveness is obviously a factor. The Long-Acting Reversible Contraception options (LARC), which are methods that provide effective contraception for an extended period with no required user action, can have success rates of 99.9 percent in preventing pregnancy. “That is as good as getting your tubes tied,” Alten says.
About 9 percent of women taking birth control pills nonetheless become pregnant, the CDC reports. “The problem is, lots of patients don’t use them consistently,” Madden says. “Then there are the barrier methods—condoms and diaphragms. Those failure rates vary from 15 to 20 percent.”
Cost can deter many women from choosing a LARC. “Generic pills can be $9 a month, Madden says. “But the out-of-pocket cost for an IUD or implant can be $1,000 to $1,500. They are approved for three to 10 years, but for a lot of women, that upfront cost is a big barrier.”
nutritional healing
Food is medicine. It may be a catchphrase today, but this concept has been true for native peoples for centuries. Now even mainstream medicine is coming around.
common sense
Is diet really the foundation of good health? “One hundred percent,” says Dr. Varsha Rathod, an integrative medicine physician at PALM Health in Ladue. “How does one define a good diet? If you can, make close to 80 percent of your food plant-based. Then consume clean meats from animals that graze outside in the sun.”
Angela Zeng, co-founder of Fulfill Food & Beverages (maker of Karuna beverages), says, “To find the right ingredients and most nutritious combinations has become the ultimate art of East Asian food culture. The focus is to use whole food ingredients. There is no such thing as ‘extract’ in Eastern food culture,” Zeng explains. “Then you’re supposed to balance and complement various ingredients—not consume too much of one thing—and use simple ingredients to create synergy; the whole is better than the sum of the parts.”
Eastern Asian food culture has long been intertwined with holistic folk medicine, which emphasizes the inseparable connection between our body’s well-being and the food we consume, Zeng says. “For thousands of years, people have held a strong belief that food and medicine share the same root, and that proper food selections and combinations will strengthen the body, boost the immune system and treat chronic illnesses.”
how about supplements?
There is some question about whether vitamins and nutrients taken in pill form are comparable to ingesting them in food. “I am very skeptical about a lot of the supplements sold on the open market,” Rathod says. “Eastern medicine quite decries the taking of vitamins. It doesn’t believe in isolating out vitamins from the context of food. For them, everything has to be in herb form.”
But sometimes pumping up certain elements is considered a boost to normal intake. “Vitamin D regulates more than 300 genes, from immune function to production of good bones to gut healing. The moment you get an infection, you start to deplete your Vitamin C. If you pump up your Vitamin C, you can literally abort a cold,” Rathod says.
Scientific evidence also supports the use of B vitamins to boost energy levels, and of magnesium and probiotics to correct intestinal problems. “Does everybody benefit from these? No,” Rathod says. “Don’t just go out and buy it without first consulting your physician,” she says.
A blood test is the typical means of measurement for vitamin deficiency. “For example, there is a lot of data to support probiotics, but there is an equal amount of good data to show that a simple probiotic doesn’t solve the huge problem of what can be going wrong with the human gut microbiome,” Rathod notes. “A DNA test can tell if someone is missing a particular acidophilus species.”
supplement quality counts
It’s best to have your physician suggest particular brands of over-the-counter products. “To get a good vitamin, these companies need tons of studies. That’s expensive,” Rathod says.
She cites studies of random products purchased from the shelves of major pharmacies. “It was astonishing—a large percentage of them did not contain what the bottle said they contained!”
The goal is to forego nutritional supplementation through better choices at meal times, Zeng says. “Eastern medicine is about achieving balance and harmony between different body systems,” she notes. “The scientific consensus is that there is enough evidence for us to seriously consider dietary modifications to control sugar and calorie intake through a decrease in our consumption of red meat—especially processed meat—and a shift toward more plant-based food.”
