Take Twenty-Four: The Importance of Work-Life Balance 

When I lived on the west coast of Florida, I became friendly with my neighbor Father Johnathan, a retired priest. He loved going out to dinner and telling me stories of when he was an active pastor living in a monastery, and I equally enjoyed listening, he was witty and intelligent. These dinners always came with advice that emanated from his deep faith. I may not have always agreed with his position, but I always took note. It is funny how we remember the individual conversation or words when we need then the most.trees-countryside-green-chill

One Sunday over dinner we got on the topic of my demanding work schedule and the pressure I put on myself to succeed.  He made a good point by asking “have you ever stopped to ask yourself why?  You know the Sabbath is a day of rest, and a commandment and its right up there with thou shalt not kill.”

Of course, I know this because I went to Catholic School for 12 years! However, there was a deeper meaning to what he was saying.

That was 15 years ago and writing this post is one of those times I recall his advice.

Today most people live even busier lives with cell phones, tablets, laptops, texts, email, instant messaging, Facetime and blurred boundaries between work and home ─ it is no surprise we feel fried and exhausted.

pexels-photoThe solution is not better time management or being a better juggler; I think it is re-learning something we already know ─ take a one day break out of the seven day week. Sitting in traffic, checking in, getting a jump start on tomorrow, searching the internet, managing job, and household has become the new Sabbath tradition.

Father Johnathan was right, the Sabbath serves as a day to recalibrate the soul, brain and body and unwind, be grateful, and a day to spend with loved ones, even if that means just spending the day with yourself, a superb self-care day. In other words ─ take a complete break for 24 hours out of the 168 hour week.

My friend reminded me of the Christian story of Creation God created the world in six days and rested on the seventh to reflect on the week’s accomplishments and be thankful. For practicing Jews and Christians, the Sabbath is the holiest day of the year even though it happens 52 times a year.

What if everyone in the world adopted the notion there is nothing else to do on the Sabbath except relax, celebrate, and love?

There probably would be more converts, and we would live on a more peaceful planet.

 

Gluten Free Asparagus, Edamame, and Parsley Salad

Adapted from Better Homes and Gardens

Living gluten-free is easy; finding good recipes is the challenging part! Here is one of my favorites, so easy and works either as a healthy snack or side dish.

Ingredients:

  • 4 tablespoons avocado or olive oil divided
  • 2 tablespoons mirin (sweet rice wine)
  • 1 tablespoon rice vinegar
  • 1 teaspoon salt
  • 1 clove garlic, minced
  • 1 pound fresh asparagus spears, woody ends trimmed off
  • 6 cups of lettuce, washed and torn
  • 1 cup frozen, shelled edamame, thawed
  • 1 cup parsley, coarsely chopped

Directions:

aa114191763fec5b4c66a03584ec337fFor dressing, combine 1 tablespoon of oil with the mirin, rice vinegar,  salt, and garlic in a small bowl. Set aside.

In a large skillet, heat remaining oil over medium-high heat until shimmering. Add asparagus and cook for 3-4 minutes, turning occasionally, until lightly browned and crisp-tender.

Transfer asparagus to a large bowl. Add lettuce, edamame, and parsley. Drizzle with dressing to taste and toss gently.

The History of HRT Part 3: Is HRT Safe?

This is Part 3 of 3 on the history of HRT, please click here to read Part 1 and here to read Part 2.

Is there such a thing as a harmless hormone? That seems to be the question I get asked the most by women looking for answers.

Dr. Fugh-Berman, photo courtesy of Georgetown University Medical Center.
Dr. Fugh-Berman, photo courtesy of Georgetown University Medical Center.

“Even hormones made by your body can hurt you,” says Adriane Fugh-Berman, MD, who teaches in the complementary and alternative medicine program at Georgetown University. “There’s lots of data that indicates women with higher natural levels of estrogen are at a higher risk for breast cancer.”

Bioidentical hormones have not been studied in clinical trials in the U.S., which frees promoters to claim that, among other things; Estriol is not only safe but may prevent cancer because it is weaker than the other estrogens.

The reality, any estrogen needs to be taken with caution.

Lena Rosenberg of the Karolinska Institutet in Sweden
Lena Rosenberg of the Karolinska Institute  in Sweden

institute

For years, oral estriol was prescribed in Europe without the standard progesterone accompaniment to protect against endometrial cancer.

Then a study in Sweden revealed that taking one to two milligrams a day of estriol alone doubled the risk of endometrial cancer. In another study in Sweden of 5,000 women, published in February 2006, stronger estrogens increased the risk of ductal and lobular breast cancer. That’s really no surprise, but here’s what was — even low-dose oral estriol (about one milligram a day) doubled the risk of lobular breast cancer in women who took it for fewer than five years.

“We need more studies, but at this point.” Says lead researcher Lena Rosenberg, MD, of the Karolinska Institute, in Stockholm, Sweden. We cannot rule out an increased risk for breast cancer even with the less potent estriol.”

The History of HRT Part 2 : Modern Day

This is Part 2 of 3 on the history of HRT, please click here to read Part 1. 

HRT has been put through several clinical trials and observational studies since 2002. This is the scientific and medically known conclusion from all the data collected:

a) Steroidal hormones have been proven to increases the risk for breast cancer, blood clots and cardiovascular events.
b) Risks are greater than the benefit for some women.

Doctors are advised to prescribe HRT with caution.
Doctors are advised to prescribe HRT with caution.

c) Although the category of women HRT may have a minimal risk on has been narrowed down, it is still a shot in the dark because there is no exact science to follow.

d) Can causes weigh gain, water retention, depression, changes in mood and libido and other non-life threatening symptoms.

e) Doctors are advised to prescribe HRT with caution.

f) All manufactured hormone products are steroids and are not natural, including bio identical hormones.

g) It is believed by the FDA and WHI that the same dangers associated with standard hormone replacement therapy are also true for bioidentical hormone replacement therapy, simply because they are the same steroidal hormones only in different proportions. Concerns over the lack of clinical data about the safety of compounded hormones as well as fears over the quality of these products has been highlighted by NAMS director Emeritus

Although the category of women HRT may have a minimal risk on has been narrowed down, it is still a shot in the dark because there is no exact science to follow.
Although the category of women HRT may have a minimal risk on has been narrowed down, it is still a shot in the dark because there is no exact science to follow.

Wulf H. Utian , MD, PhD, DSc(Med). An investigative report published in MORE Magazine showed that none of the 12 compounding pharmacy formulations tested contained the quantities of hormones prescribed. Ten contained too much of the prescribed estrogens and 11 too little progesterone, an imbalance that can allow overgrowth of the uterine lining and lead to cancer.

h) Due to the withdrawal effects of HRT it is recommended to be weaned off HRT. Symptoms may return or become worsened.

i) There is no guarantee how HRT will work or what it will do once absorbed in your body

The WHI study, which was a randomized placebo-controlled trial, showed that combined HRT (oestrogen plus progestogen) used by healthy postmenopausal women increased coronary events, strokes, breast cancer and pulmonary embolism, and decreased osteoporotic fractures and colon cancer.

MWS, which was an observational study of women attending breast screening clinics, showed that current users of combined HRT were twice as likely to get breast cancer as non-users and that the risk was greater than for those using oestrogen-only brands.

That’s all for now, make sure to come back Monday for part 3 of our series : “The History of HRT.”

 

The History of HRT Part 1 : 1899-1974

A short time ago, I received a call from a woman I’ve known for 25 years. As soon as I heard her voice I knew something was very, very wrong. With a shaky voice, and fighting back tears, she told me she has breast cancer and it was thought to have spread to her lungs.

Anne had been on and off HRT for years looking to help with her menopause symptoms.  She was hoping for a miracle in a pill, regardless of how I tried to help her, she just wasn’t into making lifestyle changes.

She passed away 4 months later at age 66. We will never know if Anne’s cancer was triggered by HRT, but all I know is it didn’t prevent it.

Over the last seventy years, millions of women in the United States were prescribed estrogen, but do any of us know all there is to know about this powerful hormone?

Endometrial cancer is a disease primarily driven by cumulative exposure to estrogen unopposed by progesterone.
Endometrial cancer is a disease primarily driven by cumulative exposure to estrogen unopposed by progesterone.

Barbara Seaman (1935-2008) an author, activist, journalist, the principal founder of the women’s health movement, advocating for women’s health called “the marketing, prescribing and sale of estrogen the greatest experiment ever performed on women. For all these years, they have been used for what doctors and scientist hoped they could do not for what they know the products can do. Medical policy on estrogen has been to “shoot first and apologize later” to prescribe the drug for certain health problems and then see if there is a positive result.”

Many of you may not know the history of HRT, but I think it’s worth knowing how it began and where we are today.

Biochemist Edward Doisy
Biochemist Edward Doisy

 

HRT History: 1899 -1975

In 1899 the Merck Manual featured the first product to treat “climacterica” also known as menopause. The name of the product was Ovarian and it was made from the dried and pulverized ovaries of cows.

In 1929 biochemist Edward Doisy at St Louis University, Missouri, treated menopausal symptoms with hormones that were isolated oestrogens from the urine of pregnant women.

 (Oestrogens are steroid hormones produced artificially for use in oral contraceptives or to treat menopausal and menstrual disorders.)

Canadian firm Ayerst launched a rival oestrogen product called Emmenin in 1934 but later replaced this with conjugated oestrogens obtained from the urine of pregnant horses, marketed as Premarin in 1942.

In 1939, a British biochemist published a formula for a cheap and powerful oral estrogen and within months scores of drug companies were working with the formula.

By the 1960’s doctors were observing that women on hormones developed breast and ovarian cancer by   alarming numbers.

In 1975, two case-control studies published in the same issue of the New England Journal of Medicine demonstrated that women taking oestrogen therapy were, at least, four times more likely to get endometrial cancer than those who had not used oestrogen, and that there was a 14-fold increased risk in women who continued treatment for seven or more years.

1976, a year after the endometrial cancer papers came research showing a link between unopposed estrogens and breast cancer.

 

After 1976 is where things take a turn for the crazy! Part 2 coming Thursday.

 

 

 

Sex: Mind and Body

The other day I received a call from a young woman I met not too long ago, and we became friendly. We were chatting, and catching up on the small stuff when she asked apprehensively: “Sometimes my orgasms are very powerful and sometimes they’re just okay. Why does that happen?”

Relax, enjoy the moment and dwell on the beauty of life.
Relax, enjoy the moment and dwell on the beauty of life.

I wanted to hug her! I applaud women brave enough to ask embarrassing questions. It obviously was something that troubled her and her boyfriend. It doesn’t matter if you’re 20 or 90; we all have something about sex or our bodies that we don’t quite get. What she’s experiencing is an absolute realistic experience for any women at any age ─ and a reasonable question to ask.

Orgasms are not like Kentucky Fried Chicken where you are guaranteed the same product every time.

Some orgasms may feel nothing more than a pleasant flutter while others are of the peel off the ceiling variety.

Medical explanations of sexuality suffer from a severe case of terminology overload. The basic overview is our physiology and psychological status at the moment can either perk up or muffle an orgasm or mute it out completely.

The basic overview is our physiology and psychological status at the moment can either perk up or muffle an orgasm.
The basic overview is our physiology and psychological status at the moment can either perk up or muffle an orgasm.

Mental attitude, mood, thoughts, feelings, beliefs, the ebb and flow of hormones, where you are in your monthly cycle (if you still have one) foreplay, how many organisms have you already had, the depth of penetration, position, what you ate beforehand, alcohol, medications, vaginal dryness, painful intercourse or simply being too tired ─ these and more all play a role in outcome.

Relax, enjoy the moment and dwell on the beauty of life. If everything was always perfect we would literally astound ourselves!

Are “Natural” Hormones Safe?

Is there really such a thing as a harmless hormone?
Is there really such a thing as a harmless hormone?

Is there really such a thing as a harmless hormone?  “Even hormones made by your body can hurt you,” says Adriane Fugh-Berman, MD, who teaches in the complementary and alternative medicine program at Georgetown University. “There’s lots of data that indicates women with higher natural levels of estrogen are at a higher risk for breast cancer.”

Bioidentical hormones have not been studied in clinical trials in the U.S., which frees promoters to claim that, among other things; Estriol is not only safe but may prevent cancer because it is weaker

Medical journalist and writer Susan Ince.
Medical journalist and writer Susan Ince.

than the other estrogens. But any estrogen needs to be taken with caution. For years, oral estriol was prescribed in Europe without the standard progesterone accompaniment to protect against endometrial cancer.

Then a study in Sweden revealed that taking one or two milligrams a day of estriol alone doubled the risk of endometrial cancer. In another study in Sweden of 5,000 women, published in February 2006, stronger estrogens increased the risk of ductal and lobular breast cancer. That’s really no surprise, but here’s what was — even low-dose oral estriol (about one milligram a day) doubled the risk of lobular breast cancer in women who took it for fewer than five years.

“We need more studies, but at this point, we cannot rule out an increased risk for breast cancer even with the less potent estriol,” says lead researcher Lena Rosenberg, MD, of the Karolinska Institute, in Stockholm, Sweden.

Excerpts were taken from Are “Natural” Hormones Safer? in More Magazine by Susan Ince.

Sometimes, we all need a little help.

Asking for help when you need it seems like a no brainer, a pretty straightforward obvious strategy for self-care.

In the scheme of life, as it is for many busy professional women we tend to be resourceful and show up prepared to take care of what we need to get done. Letting go and happily accepting or asking for help when we need it doesn’t come as naturally as it should. When someone offers to help me, I often find myself saying “no, I’m good, I got it”.

It's ok to need help, it makes us human.
It’s ok to need help, it makes us human.

I think most of us have a little bit of control freak ingrained into our psyche and we think the only way anything will get done right is if we do it ourselves. I’ve gotten better with experience, at accepting offers of help and asking for help when I need it but I have been guilty of a damn the torpedoes mentality, I got it under control and it’s full speed ahead.

I touched this with my face....
I touched this with my face….

As an example of how insane one can be, one day I was working in a colleague’s office and I volunteered to go get food and coffee. On my way back, my hands were full and I was now on the elevator packed with people. They were pushing buttons to their floor when I realized no one pushed the button to my floor. Instead of asking for help, I tried to push the button with my nose, when that didn’t work I used my chin. The guy standing next to me just laughed and looked at me like I was crazy and said “if you asked I would have done that for you.”

Asking for help and freely accepting it is important. It’s a good trait to have; when you ask for help and graciously accept it sends a message to your brain that you are worthy. It also gives people the opportunity to be kind.

Take care, stay well.

Sabina

Gluten Free Apple Cranberry Crunch

 Desert or Side Dish ─ pairs well with roasted chicken or turkey.This delicious dish is chock full of nutrient-rich fruit and grains. It’s equally good warm or cold. I like it as a side dish but also makes a wonderful desert served with vanilla ice cream or whipped cream.
Filling
3 cups McIntosh apples chopped
1 ½ cups fresh cranberry or ½ cup dried cranberries
¼ cup sugar

 

Topping
1 ½ cups gluten free oats
¾ cups walnuts
¼ cups brown sugar
1/3 cup gluten free all-purpose flour
1/3 cup melted butter
Cinnamon to taste
Preheat oven to 350
Use a shallow baking dish
Mix filling and turn into ungreased dish
Mix topping and crumble over filling,
Bake 45 minutes.

Notes:
I used 1 bag organic Granny Smith apples plus 2 Gala apples to add a sweet variety
I also poured the butter over the top instead of mixing with the dry ingredients.
Adjust the sugar and cranberries to your own taste.