- 25 November 2015
- Emotional Well-Being Blog
Shopping, baking, cooking, visiting, feasting, attending parties, drinking alcohol, money woes, loneliness, expectations for connection and fulfillment. What do these words all have in common? They are descriptors of our daily lives during the holiday season.
These words and the following video give a great summary of what usually causes stress around the holidays. "Stress" is the body's reaction to being overstimulated for extended periods of time. While our bodies are designed to withstand short bursts of mobilization, days on end of late hours, overeating, worry or a feeling of isolation can produce symptoms of moodiness, fatigue, pain, headaches and more.
Luckily, this video also gives some great tips going through the holidays and minimizing wear and tear on our brains, our bodies and our emotions. As a psychologist, I would also like to add a couple of tips gained from talking to people about their stress for the 33 holiday seasons of my career:
1) Take breaks from group and chronic activities. Allowing time for your body to recuperate from chronic stimulation will help it respond to stress with more resilience.
2) Consider staying in a nearby hotel if possible instead of staying with your family. This will provide natural breaks for rest and to maintain perspective.
3) Hydrate well. This helps to keep your energy up, maximize a feeling of fullness that helps curb overeating, and counteracts the possibility of overindulging with alcohol.
4) Make aspirations BEFORE the holiday season as to what values are most important for you to live out during this time (for example generosity, connection, being even tempered, demonstrating love or thoughtfulness). Write down your aspirations where you can see them each morning, to remind you of what you are striving for.
5) Be realistic. None of us live the lives of people in T.V. shows or novels. Each of us have quirks and imperfections, and most days are highly imperfect! Expect some stress and imperfection each day to decrease your possible disappointment.
Randi Platt, M.Ed. is a Psychologist, the head of psychology services at the Rittenhouse Women's Wellness Center, the Executive Director of Hornstein, Platt and Associates Counseling Centers, and a teacher of meditation at Thomas Jefferson University who has enjoyed being a healer in Philadelphia for the last 33 years.
- 25 November 2015
- Nutrition Blog
By: Marissa Martino, Registered Dietitian
Anyone can be affected by the negative habit of stress eating, whether it’s more prevalent during the holidays, or even all year around. There are many reasons why we binge eat because of stress, but luckily there are also many ways to confront this destructive behavior. First, is to understand exactly why we stress eat. Biologically, our bodies are regulated by hormones, many of which control and greatly affect our weight. Cortisol, the “stress hormone” can actually create cravings and make it physically harder for our bodies to drop fat. This hormone is important to be aware of since it can create nervous energy and make us “orally fidgety”, causing nail biting, teeth clenching and also eating without being aware. To grasp stress eating, we need to first understand that for many people, emotions become tied to eating habits, which makes weight and anything related to, such as food, a very emotional subject. It’s important to recognize what emotion is driving us to eat, and realizing that the end result is always the same- guilt, along with the same emotions from before eating lurking close by. This is why the first step to combating stress eating is to figure out what your triggers are.
What emotion prompts you to crave foods, and what caused that emotion? The next step is to become comfortable with confronting that emotion and learn how to openly communicate with whomever or whatever the trigger is for that emotion. Another trick is to keep a food journal. As a dietitian, I recommend this for everyone- whether you’re dealing with stress eating, want to lose weight, or even just become a healthier version of yourself.
Documenting everything that you consume will make you much more aware of your selections. You can also assess your hunger levels each time before you eat or drink- are you physically hungry (grumbling), or are you just bored? After you eat or drink, then document your satiety level. If you were actually hungry, the result of eating should be satisfying. If you ate or drank due to stress or boredom, your satisfaction level will be much lower.
Another important key is replacing a stress eating with a healthy habit. Once you understand what your trigger is, tame that stress by engaging in something that interests you, whether it’s yoga, going to the gym, meditation in a quiet place. Fight boredom with whatever hobbies interest you and don’t forget to do a hunger check before eating or drinking. If you are concerned with weight loss, keep temptations out of the house to avoid any mishaps. Battling stress eating is a journey to understanding ourselves better and becoming healthier physically and also mentally. Also remember that we are all human, and if we fall off track, don’t wait until the next day to get back on track. Learn from your setback and move past your obstacles as quick as possible. Believe in yourself and be a part of your own support system!
- 02 November 2015
- Internal Medicine Blog
Contraceptive care is an integral part of women’s health and family planning. The choice to plan to bear children or not is an important decision, and the outcome can have life changing effects. According to the National Conference of State Legislature, almost half of pregnancies in the U.S. are unintended. Most women nowadays graduate college and are career driven. They would prefer to plan their pregnancies – and this is possible through the use of contraceptives. It is critical to understand your insurance coverage under changes in health care laws, which have pushed to expand women’s’ health care since January 2013 by requiring coverage of certain preventative health services and screenings, including contraception. Despite comprehensive coverage required by law, some employers have the ability to not offer contraceptives.
Required contraceptive care can be bypassed by employer’s plans that have been “grandfathered” in as well as those who opt out due to religious beliefs. Churches and other houses of worship are not required to include birth control coverage to their employees. Non-profit organizations that object to offering birth control because of religious reason may also do so, but women may still have access directly from their insurance company. You may remember the Hobby Lobby controversy, in which the for-profit “family-owned” corporation was able to refuse birth control coverage. In this case the Supreme Court decided that certain “closely-held” for-profit corporations can deny coverage on religious grounds. Figure out what your employer’s insurance plan allows and if it is in accordance with the law.
As mentioned earlier, most insurance plans now allow women to select an option to include contraceptive benefits at no additional cost. If you are sexually active and not looking to have children at this point in your life, (and your employer does not offer this benefit) you may want to talk to you Human Resources Director to see if this benefit can be added for you. Once you are ready to have children, you may talk to your health care provider about discontinuing your contraceptive care.
The bottom line: When you visit your health care provider regarding birth control, be sure you have contraceptive coverage and you should not have to pay a co-pay for your oral contraceptive.
- 02 November 2015
- Skin Care Blog
By: The DermaCenter Aestheticians
There are many aspects of woman’s health, from internal medicine, emotional well-being, nutrition, even skin health and appearance. The Rittenhouse Women’s Wellness Center, strives to address a number of issues for overall health and wellness. Many internal hormonal issues that women deal with throughout different stages in life, like PCOS or Menopause, affect the physical appearance as well. These issues can cause excessive hair growth on the face, dry and/or oily skin conditions, or melasma. DermaCenter Medical Spa, is a vital part of the Rittenhouse Women’s Wellness Center, and has treatments and services to minimize the effect of certain physical issues for women living with these conditions.
Excessive hair growth, especially in the facial area, is often seen on females struggling with PCOS. Our Aestheticians can perform laser hair reduction treatments that will inhibit growth making the hair that does come in lighter, finer and less abundant leaving the skin feeling and looking much smoother.
Other treatment options include Chemical Peels, Microdermabrasion and Micro Planning which can help combat dry/oily skin as well as hyperpigmentation. All three of these treatments are a form of exfoliation of varying degrees. Microdermabrasion is a physical and superficial form of exfoliation that lightly buffs the surface of the skin allowing the dead skin cells that collect on the surface to be removed without causing any physical damage to the outer layer of skin. Chemical Peels use a chemical form of exfoliation which allows the exfoliation to get to the deeper layers of skin, pushing out any damage that may have been cause by hormonal issues or sun damage. Micro Planning uses a combination of both but also removes the hair off the surface of the skin allowing for better makeup application and a smoother feel to the touch.The DermaCenter also has a wide range of products that can be customized to individual’s needs.
If you are living with a condition that affects your skin, talk to our Aestheticians about our available treatments to find one that is right for you!
- 02 November 2015
- Internal Medicine Blog
Hormonal or Non-Hormonal?
There are several non-hormonal methods to prevent pregnancy. Natural family planning or fertility awareness method is a method in which a couple opts to avoid sexual intercourse or use a barrier method during times of ovulation. This requires careful planning and discipline; a woman must have regular menstrual cycles and understand when she is likely to ovulate to be successful in pregnancy prevention. There are various apps for smart phone users that can keep track of cycles and peak ovulatory days. The efficacy of this method largely depends on consistency and vigilance of the couple; it is unclear but suspected that as many as 25% of women experience unintended pregnancy within the first year of typical use of this method.
Other non-hormonal methods work by either creating a physical barrier preventing sperm from reaching the egg (inhibiting fertilization) or killing sperm altogether. In general, non-hormonal methods tend to be less effective than hormonal methods, with the exception of the Copper-T IUD. Male and female condoms are the only methods that can decrease the risk of transmission of sexual transmitted infections (STI/STD). Examples of non-hormonal methods include:
· Male or female condom
· Cervical cap (FemCap)
· Copper – T IUD (Paragard®)
Hormonal birth control alters the hormone fluctuations in a woman’s body, thereby inhibiting ovulation, thinning the uterine lining, and/or thickening the cervical mucus. Hormonal birth control not only prevents pregnancy but it is also used to control heavy menstrual cycles, improve menstrual cramps, stop PMS, and even treat acne and unwanted hair growth. Studies also prove that prolonged use can decrease the risk of endometrial and ovarian cancer. But hormonal birth control does not come without risks and side effects. Some women may experience side effects including headaches, bloating, and mood changes. Also hormonal birth control may increase blood pressure, lead to migraines with visual disturbances, and carry a slight increased risk for stroke and blood clots, especially in certain health populations. It is also important to note that hormonal birth control does not prevent the transmission of STI’s. If used correctly hormonal methods tend to be more effective than non-hormonal methods. Examples of hormonal birth control include
Oral contraceptives (“birth control pill”) – a pill taken at the same time every day to prevent pregnancy. There are both estrogen/progestin preparations and progestin-only preparations. It is the most commonly used hormonal method. Side effects may include nausea, bloating, and breast tenderness.
Ortho Evra® (“The Patch”) – estrogen/progestin containing patch placed on the skin (usually abdomen or buttocks) that is worn for 3 weeks and removed for 1 week to induce a cycle. Side effects are similar to the birth control pill.
NuvaRing® – estrogen/progestin vaginal ring placed for 3 weeks and removed for 1 week to induce a cycle. Side effects are similar to the birth control pill.
Depo Provera® (“The Shot”) – progestin-only injection given in office every 3 months. The shot may cause irregular bleeding and weight gain.
Nexplanon® (“The Implant”)– small, progestin-only rod placed in the upper arm in a quick office procedure. It is effective for 3 years. Most common side effect is irregular bleeding
Levonorgestrel Intrauterine Device (Mirena®, Skyla®, Liletta®) – progestin-only T-shaped device placed in the uterus at a quick office procedure. Approved for use for 3 or 5 years use. Most common side effect is irregular bleeding.
Which Method is Right for Me?
When choosing a birth control method several factors should be considered. Do you plan to have children soon or many years in the future? Does cost matter? How effective is each birth control method? How will a particular method impact my health? There is no perfect form of birth control that fits the needs of every woman, so approach your birth control choice with personal reflection. Speaking with a healthcare provider about what your needs is the best way to start the conversation. We offer various options of birth control at Rittenhouse Women’s Wellness Center. Please contact the office at 215-735-7992 to schedule your appointment and start the path towards taking charge of your reproductive health; your future depends on it.
- 01 October 2015
- Nutrition Blog
By: Angela Luciani, R.D.
You may know that good nutrition can help you feel good on the inside, but does it affect how you look like on the outside? Yes! The foods we choose to consume can directly impact our skin just as much as the products we use ON our skin. Studies suggest that certain foods affect your skin. A well balanced diet is key to keeping skin looking healthy and feeling great.
Here are some tips to help you find your way towards healthy skin.
Drink plenty of fluids
Drinking plenty of fluids ensures that your body stays hydrated. Dehydration can often can cause fatigue and lead to aging. Water is the best choice for healthy skin. Drinking more water also promotes cleansing, flushes toxins out of your system, reduces bloating, and increases your skins moisture level. Don’t forget to drink up!
Avoid refined carbohydrates or consuming too many carbohydrates in one sitting
Your skin contains collagen and elastin fibers which allow connective tissue to remain firm and keep its shape. When you consume foods that are high in sugar, you cause your blood sugar to spike and as a result, the sugar is broken down into molecules that stick to elastin and collagen, which makes them less flexible. It also disrupts collagen turnover.
Incorporate antioxidants into your diet
Antioxidants work as a defense system against free radicals that harm our skin leading to wrinkles, dry skin and tissue damage. There are many different types of antioxidants which help protect from various types of damage to your tissues. Choose a wide variety of fruits and vegetables to pack the most punch - bell peppers, tomatoes, dark leafy greens, berries and citrus fruits are all great choices!
Include “healthy” fats in each meal
Fat is a structural component of your skin, so it is important to eat a diet that incorporates healthy fats to maintain healthy and elastic skin. Remember: Not all fats are created equal. High intakes of Omega 3 fatty acids reduce inflammation and have been found to be protective again UV rays and sunburn. Adding these healthy fat sources can help keep your skin smooth and soft, naturally, while new skin cells replace old cells.
- 01 October 2015
- Internal Medicine Blog
By: Catherine McGinty, MSN, FNP-BC
Have you noticed redness and irritation to your face that is worsened by extreme temperatures and certain hot or spicy foods? You may be one of the 16 million people in America who suffers from a skin condition called Rosacea. While Rosacea is an incurable condition, there are many ways to treat the symptoms and prevent flare ups. If you think you are suffering from this condition, or have had similar symptoms in the past, learn more here and call our office to schedule an appointment to speak with one of our medical providers.
Rosacea can be seen in both men and women, and affects people of all ages and races; however, it is mostly seen in fair-skinned women between the ages of 30 to 50 years old. The most common symptoms are redness, pimples, burning and stinging sensations, and red lines to the nose, cheeks, chin, forehead and/or neck. Less common symptoms include facial dandruff, oily skin, and swollen skin.
These symptoms are most often the result of a trigger like alcohol, spicy foods, hot drinks, hot showers, and harsh weather. Therefore, the first step in managing Rosacea is to avoid triggers by decreasing foods or drinks that aggravate the skin condition and wearing a hat and scarf in the winter to shield your face from the cold and wind. Other methods of preventing a flare up include using a daily moisturizer during the winter to keep your face moist, and wearing sunscreen on exposed skin every day, even when its cloudy outside. It is important to make sure that you use a broad-spectrum sunscreen that has a sun protection factor (SPF) of 30 or higher to ensure the most effective protection. Lastly, make sure to use soaps, lotions, and makeup made for sensitive skin that do not contain alcohol, are not abrasive, and will not clog pores, for these will ensure a lesser chance of flare-ups.
If your maintenance routine is still not controlling your symptoms, we have a number of options here at Rittenhouse Women’s Wellness Center and in our Dermacenter Medical Spa. After a full evaluation with one of our medical providers, they may start you on a prescription antibiotic cream to apply to your face daily. This is a good option if you are having a flare up or to have in case you have a flare up in the future. Also, in our Dermacenter, we have a therapy called Intense Pulse Light (IPL) which can be used for pigmentation, sun damage, broken capillaries and Rosacea. The IPL or Photofacial can safely and effectively reduce dilated blood vessels and persistent redness or flushing found in patients with a history of Rosacea. After a series of 3-6 treatments done monthly, you will be able to see amazing results. It is recommended to have this treatment done seasonally or twice a year depending on the severity of the Rosacea in order to maintain the positive results.
If think you have been suffering from Rosacea, contact the front desk for information and to schedule an appointment with one of our providers or aestheticians. Through the month of October, IPL treatments are discounted so make sure take advantage of this special price!!
- 01 October 2015
- Skin Care Blog
By: Jayme Hudson, Aesthetic Director
Now that summer has come to an end, it is time to think ahead and repair the damage that has been done from the season’s intense heat and sun. Some of the most common concerns among clients in the early fall months are pre- mature aging and hyper pigmentation caused from over exposure to the sun. Transitioning from a summer skin care routine to a fall routine not only entails an at home regime of proper care and products, but can also include aesthetic treatments to help facilitate the repair process.
You can switch from products focused on high potency sun protection to those with a “repair and protect” strategy for the skin. You still need to be very conscious of the sun, even in the fall and winter months, but your nightly routines should have some added Vitamin C and Vitamin A to begin to reverse the damage that was done over the summer. Treatments such as IPL and Chemical Peels are also a nice way to jump start the repair process. These treatments can be beneficial in reversing some of the summer’s effects on the skin. At the DermaCenter, our Aestheticians, can customize a post summer treatment plan that fits with your lifestyle.
The two most common aesthetic treatments to help with damage from summer months are the IPL(Intense Pulse Light), or Photofacial, and Chemical Peels. These procedures are extremely beneficial for clearing the damage off of the skins surface. The IPL will combat Pigmentation caused by the sun as well as reds caused by Rosacea, and broken capillaries. A Chemical Peel is a nice way to remove the buildup of dead skin cells that clog pores and sit on the surface of the skin making it look dull and dry.
At the DermaCenter we use peels consisting of medical grade acids that will not completely ablate the surface of the skin which could leave you with weeks of downtime. With our Chemical Peels, most of our patients notice a “slight flaking” for a day or 2, and then are left with skin feeling smoother, brighter, and a more youthful glow.
We will work with our patients to get them on a good skin care regime appropriate to their skin type to and also combat the signs of aging, and other skin issues. At the DermaCenter our Aestheticians take a total wellness approach to skin care, through procedures and at home products. Contact our office at (215)735-7990 for a complimentary consultation.
- 18 August 2015
- Internal Medicine Blog
By: Lauren O’Brien, MD
With the heat of summer still upon us, I know that it is hard to believe that fall- and the dreaded flu season- will soon be here. Flu vaccines are set to arrive soon, so this is the perfect time to review some common misconceptions about this illness and vaccine.
Influenza is more than the “common cold”. It is a respiratory illness caused by the Influenza viruses, which can be very severe. Common symptoms include: fever, cough, sore throat, body aches, headaches and fatigue. Occasionally individuals will have vomiting and diarrhea, but this is more common in children. Most people who get the flu will recover in 5-14 days, but complications (such as pneumonia) can occur that can lead to serious illness or even death.
These complications and the control of the spread of the influenza virus are some of the main reasons why we recommend that all of our patients without contraindications get the flu vaccine. Here are a few common misconceptions to think about as you prepare to come in to the office for your yearly vaccine.
“I am healthy and I have never had the flu, so I don’t need to get the vaccine.”
It is great that an individual has escaped contracting the flu in the past and a healthy immune system is important, but it does not mean that you are naturally immune to the virus and will not come down with the flu in the future. The annual flu vaccine will help to protect you against getting the flu or at the very least give you a much milder case of symptoms. This leads to less missed days of work and less disruption in your daily life. In addition, the more healthy individuals we vaccinate the less likely the flu is to spread to those who are immunocompromised and those who cannot get the flu vaccine themselves.
“I got the flu from the vaccine in the past!”
This is a very common misconception. The flu vaccines that we give in the office are made from ‘inactivated” flu viruses and are therefore not infectious. The most common side effects include: local reactions at the sight of injection (redness, tenderness, or swelling). In some patients, a low grade fever, headache and body aches are possible, but these are not as severe as the flu and are of a much shorter duration.
In studies where some patients were given an injection of the flu vaccine versus an injection of a salt water solution, the only difference in side effects was a slight increase in arm soreness with the flu vaccine. There was no difference in fever, body aches or headaches.
“I got the flu vaccine last year, so I don’t need one this year”
The Influenza vaccine is an annual vaccine for good reason. The circulating strains of flu viruses can change from year to year. Because of this, scientists study the trends in circulation and make a very educated guess as to which strains will be present in the up coming flu season. Production of this year’s flu vaccine then ensues. Sometimes the scientists get it right on and the vaccine is highly effective. Sometimes they miss the mark (as with last season) and the effectiveness is low. Even in these cases, the vaccine can still provide enough protection so that an individual’s illness is much less severe. Therefore, since the viruses and vaccines change each year, an annual flu vaccine is essential.
“It’s too early to get the flu vaccine!”
We anticipate that the supply of this year’s flu vaccine will be arriving in September. This is a great time to get your vaccine. The flu season generally peaks in December thru February, but illness can be seen from October thru May. Getting your flu vaccine early allows you to mount the appropriate immune response early and gives you the best protection for the entire flu season. On the flip side, if you do not get in to the office in September or October, it’s not too late to get the flu vaccine. Vaccinating after December can still be effective for the remainder of the season.
“I am pregnant, so I can’t get the vaccine”
If you happen to be pregnant during the flu season it is even more important that you get the vaccine this year. Pregnancy increases an individual’s risk of complications from the flu so vaccination is highly recommended.
If you have further concerns about Influenza or the flu vaccine, please come in to see your doctor to discuss things further. If you are not coming in for your routine care this fall, please schedule a visit with one of our nurses to get your flu vaccine as soon as they become available.
- 18 August 2015
- Nutrition Blog
By: Angela Luciani, Registered Dietitian
Most of us have been there before – We want to eat healthy, so we go to the grocery store, purchase a ton of healthy foods/ingredients: vegetables, fruits, poultry or seafood and maybe even some snacks. We get home, we make lunch or dinner for a few nights but then reality sets in. By Wednesday, we either are sick of the food we have or we don’t have the right ingredients to make what we wanted. Plus, it’s the middle of the week/almost the weekend, so what do we do? Eat out of convenience because it seems faster and easier. So, when life gets busy, how can you stay on track? Whether you’re trying to get fit, lose weight, or just eat healthier in general, one of the keys to success is PLANNING.
1. Start small.
If planning out every single meal for the week sounds overwhelming, start with planning dinners so you know you have at least one balanced meal for the week.
2. Set time aside.
Find 15-30 minutes out of your busy schedule where you can sit down and plan your meals for the week. Maybe you can make use of that 30 minute train ride into the city or on your way home can or perhaps an afternoon over the weekend when your husband is watching football.
3. Choose recipes with a purpose.
There is an endless amount of blogs, magazines, cookbooks to choose recipes from for the week.
Try to select recipes that will overlap so that you can minimize how much you have to purchase. I like to compile my recipes -When I find a recipe I like, I print it out or write it down on a piece of paper and keep it in a folder. This way, I always have a fresh recipe dish to choose from so that my meals for the week don’t get repetitive or boring. Keep an eye on the nutrition facts and keep in mind serving sizes - choose recipes that are healthy and will help you meet your goals.
4. Make a Master Plan
Choosing a format to create your meal calendar is up to you. A simple notecard, a printable template, an excel spreadsheet or using an electronic version are all great ways to help you stay organized – whichever you choose, it is always a good idea to keep a paper copy for a visual. This helps hold yourself accountable for what you are supposed to eat for the week – and you can plan ahead for those nights you have business dinners or happy hours. Hang it on the fridge to remind yourself of your plan.
5. Plan your grocery list.
Save yourself some time and do this in conjunction with writing out your recipes/calendar meal plan. If you are unsure of what you have in your fridge, freezer or pantry, now is the time to check. Do an inventory before you leave and cross off the ingredients you do not need to purchase. Nothing is more frustrating than starting to make your meal and realizing you don’t have one of the ingredients.
6. Get the prep work over with
Don’t just unload the groceries from the car when you get home – Prep the ingredients for your week, dice up the vegetables, cut up the fruit and portion out your snacks. Prepping your meals and snacks ahead of time will make it more likely for you to grab these foods when you are hungry.
Using these tips can you set yourself up for success! Eating meals and snacks spaced out every three to four hours throughout the day will help maintain your blood sugar and will also prevent hunger before meals, which often times can lead to overeating.