Monday, April 30, 2012

Ask Us Anything: Am I Infertile?

"My husband and I have been trying to have a baby for about one month.

I stopped taking birth control the month before we started trying; however, I still haven't had my period and am worried that I might be infertile. I've taken pregnancy tests, but they have all been negative. Could my previously having been on birth control be affecting my ability to conceive?

I am also experiencing stress at work and am wondering if that might prevent us from conceiving. I know that it may be a little early to worry, but my not having my period makes me think that there might be a health issue that needs to be addressed.

What could be preventing me from conceiving?"

Dr. Julie Gavin Responds:

Congratulations to you and your husband. This is such an exciting time in your lives.

At this point, it does not seem that you have any cause for concern about infertility, and there is no reason to believe you won’t be pregnant by the end of the year.

Infertility is defined as the inability of a couple to achieve a pregnancy after one year of regular, unprotected sexual intercourse. You’re just getting started; there is nothing preventing you from conceiving.

That being said, it is important that you make an appointment with a gynecologist for preconception evaluation and counseling.

Preconception Care

Preconception care provides an opportunity for you to voice your concerns and to inform you about fertility and pregnancy issues. Your doctor will identify any health issues or risks of pregnancy for you and your future baby based on your pre-existing medical, gynecologic and obstetric history, current immunization status, medications, family and social history, lifestyle and physical exam. She or he will then educate you about these risks and institute appropriate interventions, if possible, before conception.

Optimizing your health before conception is the most important factor for improving pregnancy outcomes.

Menstrual Cycle

It had previously been thought that women who used oral contraceptive pills were at risk of developing subsequent irregular periods or no period after stopping birth control. Rest assured that after stopping the pill, the median time to return to a period is approximately 32 days, and spontaneous menses or pregnancy occurs in approximately 90 days in most women.

If you do not get your period in the next 3 months and a pregnancy test is negative, you should be evaluated. This is especially true if you had irregular menstrual cycles before starting birth control, you are obese, have an abnormal hair growth pattern, or symptoms of estrogen deficiency, such as hot flushes or vaginal dryness.

Ovulation

Once established, regular menstrual cycles between 28-32 days are reassuring that you are ovulating every month. Taking your basal body temperature is not necessary to document that ovulation occurred.

Ovulation occurs approximately 2 weeks before the next expected menstrual period. Ovulation test kits predict when ovulation is about to occur. This is a more helpful tool because you want to have daily intercourse before ovulation occurs. The egg only has 24 hours to be fertilized after it is released. You want sperm present and ready to attack.

The odds of conceiving in any one menstrual cycle is only 20%, so don’t get disappointed, just try again next month.

Menstrual cycles that are shorter than 21 days or longer than 35 days are not likely to be ovulatory, and need to be investigated.

Stress

There are some studies that suggest stress can cause infertility; and in turn, the diagnosis and treatment of infertility can cause stress. However, no study has shown that reducing stress prior to attempting pregnancy or infertility treatment improves pregnancy rates.

If work is preventing you from engaging in regular intercourse during the fertile time of your cycle, this will clearly decrease your chances of conceiving.

Stress can also be associated with other mental illnesses such as anxiety, depression, domestic violence and lack of social support; all of which should be identified and treated prior to pregnancy.

Untreated or inadequately treated psychiatric illness can result in maternal suffering and a variety of consequences, such as poor compliance with prenatal care, poor nutrition, substance abuse, or disturbed relationships between the mother and her infant. Some women may need medication and/or psychotherapy.

Prenatal Vitamins

For now, you should be taking a daily prenatal vitamin with folic acid 400 mcg. This reduces the risk of neural tube defects, as well as other congenital anomalies. The neural tube closes between 18 and 26 days after conception, so folic acid supplementation after the diagnosis of pregnancy is too late to reduce the risk of neural tube defects.

Lifestyle Changes

In addition, adopt a healthy lifestyle.
  • Stop smoking
  • Exercise regularly
  • Get adequate sleep
  • Follow a balanced diet
  • Achieve a normal body mass index
  • Limit your alcohol intake
  • Avoid recreational drugs and environmental toxins, such as lead 
  • Avoid artificial lubricants

Infertility Evaluation

An infertility evaluation should only be undertaken for couples who have not been able to conceive after 12 months of unprotected and frequent intercourse. Earlier evaluation can be undertaken based on medical history, physical findings, and in women over 35 years of age.

— Dr. Julie Gavin

Dr.  Julie Gavin is an OB/GYN who sees patients at her practice in Kenmore. Click here for Dr. Gavin's contact information
 
If you have a question about your health, click here to ask our experts.

Wednesday, April 25, 2012

Share the Gift of Life – Cord Blood & Placenta Donation


Most parents are unaware that cord blood, which comes from a newborn baby’s umbilical cord and placenta, can save lives.

Among other diseases, cord blood stem cells can treat:
  • Blood disorders such as sickle cell anemia
  • Some cancers, including leukemia and lymphoma
  • Genetic disorders such as Hurler’s Syndrome and Krabbe Disease
Used in research, donated cord blood can play a role in medical advancements and improve treatment for future patients.

Cells in the innermost layer of the placenta also have healing properties. They serve as a surgical dressing and are used in surgeries for the eye, teeth, brain, and urinary system.

Don’t let your cord blood and placenta be disposed of as medical waste.

If you’re expecting a baby, find out how you can make a difference in someone’s life, even a family member’s.

Donating Cord Blood

Cord Blood Banking for Personal Use

Private cord blood banking is often considered when a full sibling in the family has a medical condition that could potentially benefit from cord blood transplantation or stem cell transplant.

Cord blood banking is available through several cord blood banking labs, such as Via Cord, that can save cord blood for use by a family member. 

This option requires you to register with a private company and bring the cord blood collection kit to the hospital. The cord blood is collected by your midwife or physician, and you label, package and arrange for the transport of the cord blood. Because the contract is between you and a private company, your hospital cannot become involved in this process.

The cost for the collection and processing of the cord blood varies, and there is a yearly fee for the storage of the blood.

Donating Cord Blood to a Public Bank

A cord blood bank will save your cord blood until a need for it is identified and a match is found. It could also be used by a member of your family, if the cord blood is still available when the need arises.

Donating cord blood to a public bank is free for parents. However, the cost to the blood bank is high, which is why there are so few public cord blood banks in the United States.

In the Western New York area, there are no national public cord banks. Donation to a public cord bank can only be accomplished at one of several hospitals in New York City and Virginia. These hospitals typically serve a larger population and deliver at least 7,000 babies each year.

Although Western New York does not have a public cord bank, you may be able to donate to Be The Match Registry® by contacting an affiliated hospital. Limited donations are accepted.

Please note that your midwife or physician must be willing to collect the donation.

Click here for more information.

Donating the Placenta

Placenta can be used in tens of thousands of surgeries annually.

Donations of placenta are accepted by the local organization Unyts at no cost to you.

A routine blood specimen will be collected on the day that you deliver, at the same time as your admittance. The placenta will be collected following your baby’s delivery – no additional surgeries are required, and the donation is safe for both mom and baby.

To donate placenta, you must deliver your baby via a scheduled C-section (as the placenta must be harvested under sterile conditions), and you must have the approval of your physician.

If you would like to donate, please contact the Unyts Donor Referral Center at (716) 853-6667 ext. 5 for more information.

Monday, April 23, 2012

Recipes for Spring

Broccoli, strawberries, potatoes – all are in season this spring. Last week, we shared with you a list of produce that's growing in Western New York right now (click here for the list).

Some of these items are already in your fridge or cupboard, but if you're looking to add variety to your menu, test out the recipes below. (Note: more recipes can be found on Catholic Health's Pinterest board.)

Mint-Melon Pops



Apricot Scones



Tomato and Herb Salad with Fresh Chive Cheese



Strawberry, Pistachio, and Goat Cheese Pizza



Strawberry Parfaits



Fresh Tomato Sauce



Lemon-Scented Sugar Snap Peas



Homemade Potato Chips



 Lemon-Parmesan Broccoli



What are your favorite springtime recipes?

Wednesday, April 18, 2012

Locally-grown Foods: What's in Season

There are many reasons to eat locally-grown foods, whether they’re grown by you or a by local farmer.

1. They’re fresher than foods shipped from thousands of miles away. 

Not only do they taste better, but they last longer too.

2. You avoid becoming bored with your eating routine.

Eating seasonal foods means that we rotate the foods that we eat, so everything is “new” again when the seasons change.

3. You support Western New York.

By purchasing foods that are produced locally, you help to support Western New York’s famers and green land. You also support our economy, because the money you spend stays close to home.

4. You get to know the people around you.
 
You develop connections with farmers, vendors, gardeners, and more, giving you a sense of community that's missing at a grocery store chain.

Growing Vegetables and Produce

So how you get started in growing a tomato or getting locally-grown produce?

Registered Dietitian Deborah Richter recommends starting simple. "Try a patio tomato or pots with spring greens like spinach or Swiss chard. If there is room, green beans are an easy vegetable to grow. They can even grow on bean poles if space is limited."

For information about starting a garden, contact the Erie County Cooperative Extension at (716) 652-5400 or click here to visit their website.

Local Farmer’s Markets

Local farmers markets will be opening over the next few weeks. Look for one in your community:
  • The Downtown Country Market on Buffalo’s Main Street is held on Tuesday and Thursdays from 8 a.m. to 2:30 p.m., starting May 17, 2012 through October 25, 2012.
  • The Elmwood-Bidwell Farmers Market is a producer-only market (all vendors grow or produce what they sell) that starts mid-May on Saturdays 8 a.m. to 1 p.m.
  • The Broadway Market (999 Broadway ) is an indoor market that operates year-round from 8 a.m. to 5 p.m., Monday – Saturdays.
  • The Clinton-Bailey Farmer’s Market on Clinton Street is open year-round. In April, the market is open on Saturdays from 6 a.m. to 1 p.m. Summer hours begin on May 1st and are 7 a.m. to 6 p.m., Sunday through Friday, and 6 a.m. to 6 p.m. on Saturdays.
Most communities have farmers markets, most of them starting in the beginning of May and going through the local growing season of October or November.These include:
  • Alden
  • Clarence
  • East Aurora
  • Kenmore
  • Lancaster 
  • Springville
  • University of Buffalo, South Campus
  • Williamsville

"If you live in an area with a farmers market, plan to walk or bike ride to the market and get even a greater health benefit," Deborah says.

Seasonal Produce

Produce is of better quality and taste when purchased in season. Produce grown in Western New York this season are included in the image below.



Although the following items aren't produced in Western New York in spring, they're currently in season and you'll find them at your local grocery store.

  • Apricots
  • Artichokes
  • Belgian Endive
  • Butter Lettuce
  • Chayote Squash
  • Cherimoya
  • Chives
  • Collard Greens
  • English Peas
  • Fava Beans
  • Fennel
  • Green Beans
  • Honeydew

  • Limes
  • Lychee
  • Mango
  • Mushrooms
  • Mustard Greens
  • Oranges
  • Pea Pods
  • Pineapple
  • Snow Peas
  • Spring Baby Lettuce
  • Sugar Snap Peas
  • Vidalia Onions
  • Watercress

Some of these names might be new to you, and as you explore them, you might find a new favorite food. "Enjoy some new produce and be pleasantly surprised at the variety of tastes and flavors," Deborah recommends.


Deborah Richter is a registered dietitian at Sisters of Charity Hospital, St. Joseph Campus in Cheektowaga and is a certified diabetes educator. She teaches diabetes education classes and provides outpatient nutrition counseling. She has helped her clients to lose weight, reduce their blood pressure and feel better about themselves through healthy eating choices.

Monday, April 16, 2012

Ask Us Anything: How Much Cardio?

"How often should I do cardio exercise? Would yoga or pilates be considered a form of cardio, or would the exercise need to be more strenuous?

I'm trying to increase my physical activity, but I'm also on a budget. How can I exercise outside of the gym?"

Physical Therapist Richard Szabala Responds:

"Cardio" or aerobic exercise is defined as any exercise that uses oxygen as its primary source of energy, as opposed to anaerobic exercise, which uses glycogen as its primary energy source.

Exercises that are aerobic generally involve high-repetition, low-resistance activities, such as walking, jogging, biking or swimming.

Stop-and-go sports, such as tennis, are a hybrid of both aerobic and anaerobic activities, as you are using high energy bursts for a short duration over an extended session. For example, you may run hard for 30 seconds to a minute on a point, but a match can last for over an hour. Stop-and-go sports therefore train both systems.

Yoga and pilates are generally stretching and isometric activities that are not considered aerobic, but offer other benefits to your body.

The United States Department of Health recommends a minimum of 30 minutes of exercise a day to maintain a healthy lifestyle. The exercise can be anything: walking, swimming, tennis, etc., but it should be something that you like to do. If it is something you enjoy doing, you will be more likely to stick with it, and it could become a lifelong hobby for you.

The key to exercising is having fun. One of the best and cheapest forms of cardio exercise is walking. Find a nice park near your home to enjoy nature, or just walk around the neighborhood and visit your friends. It's cheap, it's easy, and it's healthy for your heart.

– Richard Szabala PT, OCS

Richard Szabala is the senior physical therapist at AthletiCare Orchard Park.



If you have a question about your health, click here to ask our experts.

Wednesday, April 11, 2012

Words to Live By, as Seen on Pinterest

A virtual bulletin (or pin) board, Pinterest is now the third most popular social media site in the United States. Some say it's because Pinterest fulfills our need to be creative and helps us to visualize a better future.

For most Pinterest users – more than 80% are women – Pinterest is a place of possibilities. It's full of home decor and crafting ideas, healthy recipes – anything that people find beautiful or inspiring.

Motivational quotes are heavy hitters on Pinterest, probably because they put us in a positive frame of mind.

Here are some of my favorite pins on Catholic Health's Words to Live By board.











Do you use Pinterest? If so, what do you pin?

Friday, April 6, 2012

Q&A with Carrie Jacobson of East Meets West Yoga Studio

Carrie Jacobson
The benefits of yoga are numerous: an improvement in muscle tone, upper body strength and posture, not to mention reduced stress and better heart health.

Yoga can be practiced by anyone at any age and, to avoid injury, is best learned with the help of an experienced instructor.

Today, Carrie Jacobson, Studio Manager and yoga instructor at East Meets West Yoga Studio in Buffalo, talks about learning the practice of yoga.

Name and Title: Carrie Jacobson, Studio Manager, Yoga Teacher

What are your beginner students surprised to learn about yoga? 

How challenging yoga can be. And also how good you feel after class.

Is there an advantage to learning in a yoga studio versus taking a class in a gym that doesn't focus solely on yoga?

There are a few advantages to practicing in a studio – generally studios are quieter and better equipped for the practice and modifying poses. You will also benefit from the attention of a knowledgeable teacher and the energy of a class of the group. Lastly, it is more fun!

Do you prefer students to have some knowledge of yoga before attending class - i.e. being able to follow along with an exercise DVD? 

It may help, but it isn't necessary.

What type of clothing should be worn to yoga class?

Loose, comfortable clothing that is easy to move in. Sweatpants, stretch pants, t-shirts and tank tops. Anything you would normally workout in. Be prepared to practice in bare feet!

Should students bring their own yoga mats? Is there anything else that they should bring? 

We have mats we lend to students, but we do encourage people to purchase a mat once they are committed to the practice. Some people like to bring water, but we discourage drinking water during class, because it disrupts the flow and cools the body. Drinking water before and after class is very important. Some people like to bring a hand towel because you will sweat.

Are advance reservations required to attend a class? 

Only for our courses: Intro to Yoga, Slow Yoga for Strength and Balance, and Pre/Postnatal yoga. Pre-registration is required for these courses.

Our other classes are all open and ongoing, meaning that people who have done yoga can begin at any time.

In addition to the courses mentioned above, classes appropriate for beginners include:
  • Beginner Drop-in Class - Saturday: 8 a.m. (Amherst)
  • Yin Yoga - Tuesday: 4:30 p.m. (Buffalo), Thursday: 4 p.m. (Amherst)
  • Gentle/Restorative Yoga - Wednesday: 6:30 p.m. (Buffalo)
You should arrive at least 15 minutes early to your first class.

 East Meets West Yoga Studio is located at 758 Elmwood Avenue in Buffalo and at 4444 Main Street in Amherst. Click here to visit their website.

Wednesday, April 4, 2012

Strengthen Your Marriage with Natural Family Planning

Whether you and your spouse are trying to conceive or avoid a pregnancy, Natural Family Planning is one of the safest, most reliable methods available. And it’s good for your marriage.

Mary Zablocki
Jeanne Karnath
“I have seen marriages improve. Primarily what improves is the communication,” says Mary Zablocki, a Registered Nurse and Certified FertilityCare™ Practitioner.

So what is Natural Family Planning?

“Natural Family Planning is a broad term that covers a lot of different methods that have occurred over the years,” says Jeanne Karnath, also a Certified FertilityCare™ Practitioner.

Mary and Jeanne teach the Creighton Model FertilityCare™ System (CrMS) of Natural Family Planning – not to be confused with the rhythm or temperature method.

Using the Creighton Model, couples chart a woman’s bodily changes throughout her cycle, and time their intercourse accordingly – during periods of fertility if they wish to conceive and periods of infertility if they don’t.

A Healthier Alternative to Contraception

Many couples use Natural Family Planning as an alternative to contraception, a decision made for personal, religious or health reasons. For some women, the results can be surprising.

“Women cannot believe how much better they feel and how much more interested in intimacy they are,” says Mary. “Many of these women have been on contraception since high school and don’t even realize how much they enjoy being just themselves.”

Women also feel more in control of their health. “Even though they’re not necessarily doing anything to make it happen in any given way, they feel more in control of who they are.”

Shared Responsibility

With contraception, the responsibility of buying or using a product tends to fall on one person’s shoulders. NFP requires that both partners work together to achieve the desired outcome.

Mary’s long-time client Adrienne Mussett says that the shared responsibility has brought her and her husband, Neil, closer together.

“I didn’t feel like it was on me, and he wasn’t shut out from the process. Sometimes I talk to other couples who are on contraception, and I do hear some of that – that a woman will really feel like it’s all her, that she’s taking care of it.”

Some of Mary’s most successful couples are ones where the husband does the charting, when he plays a more active role in the process. “There is a level of communication involved that removes the burden of ‘Not tonight, dear,’ from the wife and puts it into the couple.”

More Romance

Neil Mussett agrees that NFP has improved his marriage, citing the courtship that NFP entails during periods of abstinence. “There’s a little bit of time when you have to go on a date and be more in the courting mode, as opposed to the married mode, and that’s a very nice rhythm that I think that people with contraception just don’t have.”



Western New York Catholic Weekly

Introduction to Natural Family Planning – July 25, 2010

Download this thirty-minute radio program to learn about Natural Family Planning from Jeanne Karnath and Mary Zablocki, Certified FertilityCare™ Practitioners. You'll also hear from Adrienne and Neil Mussett, who successfully used Natural Family Planning to achieve and avoid pregnancy.

Achieving Pregnancy without the Guesswork

Aside from preventing pregnancy, NFP can aid couples who wish to conceive. Its insights about fertility and infertility let a couple know when they are most likely to achieve pregnancy.

Adrienne and Neil, who have two daughters, can attest to the effectiveness of NFP, although Adrienne was wary at first.

“You don’t really see the benefits right away. I think when we first got married, I was very skeptical of the method,” says Adrienne. “I didn’t grow up Catholic. He had a Catholic family and was very pro-Natural Family Planning, and I was like, ‘This is all very strange.’ I didn’t think it was going to work.”

Effectiveness of Natural Family Planning

In couples of normal fertility, 76% of couples achieve pregnancy in the first cycle of trying; 90% by the third cycle and 98% by the sixth cycle.

For couples seeking to avoid pregnancy, Mary says, “statistics bear out that we have a very good record of 97 to 99% success rate in avoiding a pregnancy.”

NFP’s success rate in avoiding pregnancy is higher than for condoms, which touts a success rate of 87%. However, Mary says that the 87% statistic is a little misleading.

“The statistics that are drawn by the CDC on condoms are drawn from a 28-day cycle, which is infertile primarily to begin with. So an 87% success rate at avoiding a pregnancy is reduced to about a 52% success rate at avoiding a pregnancy if you look at using them only during a time of fertility.”

Learning Natural Family Planning

Learning Natural Family Planning begins with a 90-minute introductory group session, followed by one-on-one appointments with a Certified FertilityCare™ Practitioner.

“Generally we see people about eight times in the first year. More if they need it, but not less,” says Jeanne.

Materials are provided for charting and tracking cycle patterns.

For more information about Natural Family Planning, visit the Catholic Health website.

Monday, April 2, 2012

Ask Us Anything: Where do the Calories Go?

"If a person consumes 100 calories in excess of energy needs from olive oil, approximately what percentage of the calories are stored in the body?"

Registered Dietitian Amy Julicher responds:

If a person consumes 100 calories in excess of what their body will need or utilize, those calories will be stored in the body. In this scenario, the food source of the calories is not the issue. Consuming more calories than you need, regardless of where those calories come from, will result in weight gain.

Predicting where weight will show up depends on the individual and may vary with age, eating habits and the type and frequency of physical activity. Typically, men tend to gain weight in their abdominal section whereas women tend to gain weight in their hips and thighs. This varies across individuals as well.

The amount of calories needed per day is based on a person's height, weight, physical activity level, presence of certain disease states, and whether or not a person is trying to gain, lose, or maintain their current body weight. There is no "one size fits all" when it comes to choosing an appropriate calorie level.

The best way to determine if your caloric and nutrient needs are being met is to speak with a Registered Dietitian. A Registered Dietitian can calculate your needs and develop a meal plan to help you meet your nutritional goals.

– Amy Julicher, RD

Amy Julicher graduated from Buffalo State College with a Bachelor of Science degree in Dietetics and became a Registered Dietitian shortly after. She has worked as a staff dietitian at Sisters Hospital and as a Clinical Nutrition Manager at Mercy Hospital. She currently holds the position of Clinical Nutrition Manager at Sisters Hospital. She is married with two children and lives in Buffalo.

If you have a question about your health, click here to ask our experts.
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