Motherhood and Apple Pie

k9293041Motherhood and Apple Pie is an idiom used to express a wholesome concept of traditional life in the United States. Unfortunately, times have changed so much over the past 50 years the intended meaning no longer applies. If we look at motherhood and child health over the past 25 years, the US has failed. Maternal deaths are at an all time high. Even with a decline in infant mortality between 1990 and 2010, US infant deaths surpass those of other industrialized countries.
International comparisons of infant mortality show the United States has more infant deaths than most European countries, Japan, Hong Kong, South Korea, Iceland, Israel, Cuba and Canada. Monaco and Japan have the lowest infant death rates in the world.
How can so many mothers and babies be dying in the United States – a country that touts itself as having the best healthcare in the world? Let’s look at some of the reasons.

Cardiovascular disease and infection are the most common causes of maternal death. Because many US women have delayed pregnancy until they are older, they are more apt to have developed chronic diseases including obesity, heart disease, high blood pressure and diabetes prior to their first delivery. All of these common medical problems place additional health risk on both mother and infant.
Medical costs for pre-natal care, delivery and post partum care are high. Choosing to avoid these high costs by delivering at home also places the mother and child at increased risk, especially if urgent interventions for complications become necessary for a safe birth. On the other hand, technology in medical centers has improved treatments to mitigate life-threatening complications such as hemorrhage and obstructed labor requiring C-sections. Going forward, the Affordable Care Act will help participants obtain easier and more affordable access to both maternal and child healthcare.

In reality, the safe, heartwarming values associated with Motherhood and Apple Pie didn’t apply to all mothers even in years past. As recently as the 50’s and 60’s, unmarried girls and women suffered terribly at the hands of society. Young unwed mothers were often whisked off to maternity receiving-homes by their mortified families who wanted to hide the shameful pregnancy. The babies of these young women were typically removed from them in emotionally devastating ways, often not allowing the young mother to even see the infant before the child was placed for adoption. Mothers mourned the loss of their babies. Treatment of many women in that era is found in The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Rove v. Wade, written by Ann Fessler.

According to the data presented in Fessler’s book, inhumane practices during labor and delivery were common. Treatment by medical practitioners, nurses and child welfare services often left the mother with physical and emotional scars that never healed.
Today, many unmarried women are giving birth. Most of them choose to keep their children. In fact, more than half of US births are to unmarried women. These births are often to couples living together. From the National Center of Health Statistics, in 2009, 41% of children were born outside of marriage and 53% of children were born to women under 30, but not all of these pregnancies were unplanned. The stigma of being a single parent has decreased and many women elect to raise a child alone. However, few women disagree that a two parent household is advantageous.

Parenting is supremely important for the emotional, social and intellectual development of a child. Today, more and more grandmothers are filling this important role in childcare by helping to contribute to the care and emotional stability of their grandchildren.
Single low income women with children are at a huge disadvantage in our society. If they can find work, their incomes are often too low to provide adequate housing and appropriate childcare. Sharing households and receiving support from family members who help single parents support their efforts toward the American Dream is helpful, but even with support, the dream has become harder and harder to reach.

motherhood-guruAdults provide the role model for children. Raising children with self esteem and confidence contributes to their successes as an adult. Children tend to mirror their parent’s and caregiver’s behaviors so adequate childcare is essential for single parenting to be successful. Encouragement, respect and love can also be provided by extended family members and baby sitters. Studies show even severely abused and neglected children can be nurtured into confident adults by a caring supportive mother figure.
Today, motherhood has huge challenges and little apple pie. With over 8 million single mothers providing sole support for their children, their options to find good paying jobs are few. Single mothers can be just as successful in child rearing as married mothers, but they may need a little help from their friends.
On this Mother’s Day, please honor women and remember the poem written by William Ross Wallace (1819-1881) The Hand That Rocks the Cradle Rules the World.

(Last verse)

Blessings on the hand of women!
Fathers, sons, and daughters cry,
And the sacred song is mingled
With the worship in the sky—
Mingles where no tempest darkens,
Rainbows evermore are hurled;
For the hand that rocks the cradle
Is the hand that rules the world.

References:
Statistical data source: http://www.geoba.se/index.php
Poem of the Week http://www.potw.org

Betty Kuffel, MD
Lipsticklogic.com

St. Patrick’s Day Tribute

A Tribute and Thanks to a Phenomenal, Part Irish, Woman –170px-Irish_clover

Mom passed away two days after St. Patrick’s Day in 2006, with her family by her side.

It’s hard to believe how quickly time has passed since then and even harder to write about Mom using the past tense – she was always so full of life and energy. She exuded an endless pursuit of learning and teaching throughout her 89 years. In fact, the month before she died, she was teaching cribbage to some local students. They joined her on Sunday afternoons at her senior living campus apartment, to learn a game she enjoyed playing over a lifetime and had taught to her grandchildren to help them improve math skills.

Of German and Irish descent, Mom was a daughter, a sister, a wife, widowed twice, a mother of four daughters, grandmother of twelve, great grandmother of 28, an aunt, an excellent cook, creative, skilled, resilient, ambitious, a good friend to many, a devout Lutheran and above all, she loved her family dearly.

On my desk is a photo of Mom holding an array of colorful flowers, each one given in honor of herLila -80th birthday - LL Blog 80th birthday at a surprise party hosted by her daughters. Each attendee was asked to bring one flower to the party. Nearly 100 family members and friends gathered. Being among so many who loved and honored her made for a magnificent celebration.

Mom loved life, loved baseball, loved dogs, read a lot, loved to garden and was an avid exerciser. She walked the Heartland trail a couple miles a day as long as she was able. In inclement weather, she picked up a friend and drove to the high school to walk the halls prior to the start of classes. Yoga later replaced walking and helped her remain limber as osteoporosis crept in.

One evening, about 3 weeks before St. Patrick’s Day, Mom fell in her apartment, broke her hip and ended up in surgery. Her recovery did not go well. She required oxygen related to a worsening lung condition and after several failed physical therapy sessions to help her walk, she asked to have all treatment and medications stopped. Mom told me and my sisters, I showed you girls how to live. Now, I will show you how to die.

Rather than move her to a care facility, we chose to move Mom to our home. With hospice support, along with my three sisters and our husbands, we provided her care.

Emotions of both joy and profound sadness filled our home during those last two weeks as she said her goodbyes to friends, family members and their dogs, who all came to visit. She said she had lived a good life and it was her time to die. Her strength helped us through those last days.

As a young girl, Mom’s red curly hair and freckles were an indication of her Irish ancestry. Her strong will, attention to cleanliness and order were expressions of her German heritage. But, her love of family was the truest expression of who she was. As her daughters, we were loved unconditionally, and enjoyed living in a well cared for home where we were treated to the some of the finest cooking ever, including many fabulous German meals. But, on St. Patrick’s Day, we celebrated our Irish heritage by wearing green and savored an annual meal of corned beef and cabbage, boiled potatoes and Irish Freckle Bread. She didn’t serve green beer but she did sip a beer with us now and then.

Mom was strong and loving to the end.

We miss our wonderful German-Irish Mom.

CELEBRATING ST. PATRICK’S DAY

170px-Irish_cloverDid you know the real St. Patrick wasn’t Irish and the original color associated with St. Patrick was blue? Why then is Saint Patrick the patron saint of Ireland and around the world people parade in the streets wearing green?

The son of a British Christian church deacon, Patrick was kidnapped at age 16 and sent to Ireland. There he was enslaved as a sheep herder on a chilly Irish mountainside. After escaping bondage, he made his way back to Britain, but returned to Ireland to convert the Irish to Christianity. When explaining the Trinity to the pagan Irish, he reportedly used the three leafed shamrock plant.

Centuries later, St. Patrick became known as a patron saint of Ireland and in the 1600’s Saint Patrick’s feast day became a holiday in the Roman Catholic Church. In 1903, St. Patrick’s Day became an official public holiday in Ireland. Wearing of the green meant to wear a shamrock on one’s clothing. The St. Patrick’s Day parade in NY City is the largest parade in the world.

For us, St. Patrick’s Day is a fun celebration of our Irish heritage and it centers on an annual meal of corned beef. For an easy healthy holiday dinner, corned beef, cabbage, boiled potatoes and Irish Freckle Bread are favorites.

Corned beef is common in many cuisines. Corned is a term from “corns of salt” used to preserve the meat. Irish corned beef was traded in the 17th century and used as provisions for British naval fleets and North American armies. The preserved meat has a long a sordid history with use on ships involved in slave markets. When fresh meat was rationed during World War II, this salt-cured product became important. The preserved beef, often cooked and canned, was preserved in “tins” and exported from Ireland around the world. Kosher cured beef became popular with the Jewish population. Today South America is a major supplier of canned corned beef.

Corned beef is found in most deli shops and the favorite Reuben sandwiches. Pastrami is smoked corned beef with added spices. Preserved and salted food, such as corned beef, are not for those on low salt diets, but for the rest of us, an occasional meal is acceptable.

Crock Pot Beef in Beer

3-4 pounds corned beef brisket

Trim all visible fat from meat

Vegetable selections: potatoes (peeled and quartered), 2 medium onions (peeled and quartered), 1 cup thinly sliced carrots, 1 small cabbage cut in wedges.

Place vegetables of choice with one bay leaf in crock pot.

Place meat atop vegetables.

Pour beer or one cup of water over beef.

Cover and cook on LOW heat for 10 hours.

Cool meat on cutting board for 10 minutes, then cut across the grain in thin slices.

Serve on large platter surrounded by vegetables.Corned beef meal

Irish Freckle Bread

1 pkg dry yeast

8 tablespoons sugar (divided)

1 cup warm water (110 degrees F.)

½ cup butter, melted

2 eggs

¼ cup warm mashed potatoes without butter or milk

3 ¼- 4 cups flour

1 cup raisins

Dissolve yeast in warm water in a large bowl and add 1 tablespoon sugar. Add the butter, eggs, potatoes,Freckle bread unbaked salt, remaining sugar and 2 cups flour. Beat until smooth. Stir in raisins and enough remaining flour to form a soft dough.

·  Turn onto a floured surface. Knead until smooth and elastic. Place in a greased bowl, turning once to grease top. Cover and let rise in a warm place until doubled, about 1 hour.

·  Punch dough down. Turn onto a lightly floured surface. Place on baking sheet. Cover and let rise untilFreckle bread baked doubled, about 30 minutes.

·  Place pan on a baking sheet. Bake at 350° for 25-30 minutes or until golden brown. Place on a wire rack to cool. Yield: 1 loaf, 12 servings.

green-beerTHREE CHEERS TO GREEN BEER, SHAMROCKS & GOOD FOOD

WISHING YOU A HAPPY ST. PATRICK’S DAY!

LOVE YOUR HEART

Two Red Hearts

Your Heart – Prevent and Reverse Heart Disease in Women, Men and Children

Kindle e-book $2.99   http://tinyurl.com/kindle-heart-sale          

Paperback $9.99  https://www.createspace.com/4330606

For the entire month of February, Your Heart is offered at sale rates.

American Heart Month is a perfect time to raise awareness and explore reversible risk factors for cardiovascular disease. Know your health history and address factors that can be modified to improve heart health:

♥ Tobacco use and cessation

♥ High blood pressure identification and treatment

♥ Cholesterol abnormalities paired with dietary modification and statin use when needed

♥ Obesity and diabetes with recommendations for normalizing weight and glucose

♥ Low activity levels counteracted with exercise prescriptions

♥ Alcohol consumption history and limitation of use

♥ Heredity factors and recommended interventions

Heart risk factors are within your ability to control. Make this the month you evaluate your personal risks and take action to reduce them. With the right knowledge and actions, the number one cause of death in women and men is preventable.

Book Excerpt:

Why is coronary artery disease the leading cause of death?

Atherosclerosis is a disease of affluence. In developed countries throughout the world where food is plentiful, coronary artery disease is the leading cause of death. We eat, not only because we feel hungry, we eat to pass time, we eat for enjoyment, and we munch mindlessly at social events. The fact is, we eat too much and it’s making us sick.

Coronary artery disease is tied to obesity. Food choices, portion sizes and exercise interplay, but the disease is more complex than any of these factors.

Statistics are boring to read and don’t mean much when they are without a face. But consider the fact that 50% of all people have high blood pressure, high cholesterol or smoke; all three factors cause heart disease. Many of us personally know someone with these problems. Is it you? A loved one? You have the ability to make healthy choices and improve your health by treating these factors.

Part of the high death rate from heart disease is due to a lack of education about the cause and what can be done to fight it. But even knowing sound health practices, many people do not follow them. In recent years, there has been a reduction in heart deaths through improved treatment, education and reduction of risk factors, but coronary artery disease still remains the leading cause of death.

Two programs to address education, diagnosis and treatment are: the Million Hearts initiative, developed by the Department of Health and Human Services, with a goal to prevent a million heart attacks and strokes by 2017; and the WISEWOMAN program, administered through the Centers for Disease Control and Prevention.

Heart disease is a huge problem in developed countries around the world, including the United States. The Million Hearts program joined with the US Centers for Disease Control and Prevention, the American Heart Association and other organizations. Together they share strategies to reduce heart risk factors and save lives. Information from these organizations is available for education programs to implement change.

At 21 US sites, the WISEWOMAN project provides a screening and evaluation program to help women obtain healthcare when they have little or no insurance. Examinations, laboratory tests and education to lower risks are included.

Diabetes, overweight, poor diet choices, low physical activity and excess alcohol are all issues placing people at risk. If any of these affect you, take control, read more, learn more and make heart healthy changes. Don’t become a statistic. Take action. Choose to reduce your personal risk factors.

According to the US Centers for Disease Control and Prevention, 50% of men and 64% of women who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.

Katie, a registered nurse who believed she was healthy, working full time in a hospital but having difficulty with an arthritic knee finally decided to see an orthopedist. He recommended a total knee replacement procedure. As part of her preoperative evaluation, her primary physician evaluated her and performed an electrocardiogram. The electrical tracing of her heart conduction and rhythm was abnormal, indicating ischemia. A special nuclear medicine test of her heart showed marked reduction of circulation in the heart muscle. Katie went directly to the heart cath lab where two main coronary arteries were found to be more than 90% blocked by cholesterol plaques. The cardiologist dilated and stented both arteries. The orthopedic surgery had to be placed on hold. — Katie denies ever having any symptoms related to her heart.

Many people are aware that high cholesterol is associated with heart attacks, yet have never had a cholesterol blood test done. Because they have no symptoms, they can’t believe they might be a candidate for a heart attack. The more you know how lifestyle, food choices and heredity factors impact heart health, the more equipped you will be to make healthy choices and obtain proper healthcare. This section provides more information on risk factors.

 Thanks for stopping by. We hope 2014 will be a healthy and happy year for you.

Betty and Bev

HEART DISEASE IN WOMEN

Go Red for Women – Wear Red on February 7th

wb051305In 2003, the American Heart Association began National Wear Red Day®. With so many women dying each year from heart disease, this movement was formed to bring attention to the problem. Their goal was to educate women and reduce this statistic.

 For the past ten years, each February, the Go Red for Women events have raised awareness and helped women make strides against heart disease. Fewer women are dying from coronary artery disease now, but it still remains the number one threat.

 In support of women’s heart health, Lipstick Logic is providing free excerpts and a sale on our book for the month of February.

 This is a perfect gift for yourself and those you love.

Your Heart – Prevent and Reverse Heart Disease in Women, Men and Children

Kindle e-book $2.99   http://tinyurl.com/kindle-heart-sale          

Paperback $9.99  https://www.createspace.com/4330606

  Your Heart Book Cover- Final FINAL

 Chapter 5

Female Heart Disease

Women and Heart Disease

Many women do not realize they are at high risk for heart disease and early death. Under age 50, heart attacks in women are twice as likely to be fatal as in men. Each year more than 250,000 women die of heart attacks. Six times the number of women die from heart disease than from breast cancer. Many factors weigh into these statistics including hormones.

♥ Research reported in the National Institutes of Health bulletin, The Heart Truth for Women, states that by leading a healthy lifestyle, women can lower risks by 82%. You are in charge. This means: regular exercise, healthy weight and not smoking. Also take medications to control other risk factors such as high blood pressure and high cholesterol. What you choose to do and what you eat can improve health and prolong life.

Coronary Microvascular Disease

Early in life, male and female hearts look alike and act the same. With aging, gender differences in disease processes become apparent and contribute to misdiagnosis in women. Men typically develop arterial heart disease that narrows large coronary arteries on the heart surface. Women have the same type of large vessel disease as men, but are also prone to coronary microvascular disease — a problem involving the small vessels called arterioles.

Possibly triggered by inflammatory disorders, coronary arterioles in women become stiff and unable to supply adequate oxygen to the heart muscle. Chest discomfort and other symptoms more subtle are often associated with increased activity. Microvascular disease increases your risk for heart attack and sudden death.

A number of health problems cause inflammation including high blood glucose, smoking and chronic infection that also affect men. Additional factors in women are: poorly controlled premenopausal hypertension, anemia and autoimmune disorders*. All of these problems may contribute to developing coronary microvascular disease. However, the cause of this disease is unknown. The Women’s Ischemia Syndrome Evaluation study (the WISE study) provided extensive information for the disorder. Some researchers believe estrogen reduction is a related. Anyone can develop coronary microvascular disease, but inflammatory disorders appear to be a prominent factor and they are more common in women.

Special tests are required to diagnose coronary microvascular disease. Advanced disease may be present, placing the person at risk, yet a coronary angiogram — the best diagnostic evaluation for large coronary arteries — can be normal. If the clinical suspicion for heart disease is high and the angiogram is normal, a “Stress-Echo” is usually recommended to evaluate for microvascular disease.

Coronary microvascular disease cannot be treated with stents or a bypass, but medications and lifestyle changes are beneficial and life-prolonging. Treatment is similar to that used in large vessel coronary disease:

● Statins to lower cholesterol

● Low dose aspirin to inhibit platelets

● Nitroglycerine to relax and dilate arterioles to improve blood flow and treat chest discomfort

● ACE inhibitors to lower blood pressure

● Beta blockers to lower heart rate and reduce heart stress

● Heart healthy diet, daily exercise, no smoking, weight loss

Note: Autoimmune diseases occur when the body produces harmful antibodies against itself. Examples: Lupus, rheumatoid arthritis, psoriatic arthritis, multiple sclerosis, some thyroid diseases and many others.

More life-saving information like this can be found in Your Heart: Prevent & Reverse Heart Disease in Women, Men & Children

Thanks for stopping by.

Betty Kuffel, MD

Bev Erickson Co-author/Artist/Cover art

Cardiovascular Disease – Leading Cause of Death related to Childbirth

Heart Disease in Young Women

 Statistics from the state of California confirmed the leading cause of death related to childbirth is cardiovascular disease:

                ♥1/4 of women who died had some form of cardiovascular disease

                ♥2/3 of the deaths were related to cardiomyopathy (heart muscle weakness)

ct-x-heart-pregnancy-0220-em.jpg-20130218Only 6% of these women had been diagnosed with a heart problem prior to pregnancy. (American Heart Association Scientific Session report)

We think of pregnant women as healthy vibrant individuals who do well and have healthy babies. But, pregnancy is a high risk condition for many reasons. Pregnancy places a large cardiovascular load on a woman’s body.

Young women without underlying heart disease are better prepared to tolerate the stress of pregnancy than older women. However many women are now delaying planned pregnancies until an older age when the potential for heart disease has increased.

Lifestyle, including food choices, alcohol consumption, and tobacco use all impact health during pregnancy. Obesity and Type 2 diabetes also increase risk to mother and infant. Cigarette smoking increases risk for sudden infant death and women who smoke are also more likely to suffer sudden death.

Two conditions often seen with pregnancy are: high blood pressure (pre-eclampsia) and diabetes (gestational diabetes). Both require careful monitoring and treatment Women with these problems during pregnancy are more likely to develop high blood pressure, diabetes and cardiovascular disease later in life.

Being overweight and pregnant places both mother and child at risk for cardiovascular disease and complications during delivery, including C-sections and anesthesia-related problems. Overweight pregnant women are more likely to have stillbirths, deliver prematurely and may have large infants making delivery difficult. Large babies are more likely to become obese in childhood.

Additional statistics: (From The American College of Obstetricians and Gynecologists)

  • Over one-third of women living in the US are obese
  • More than one-half of pregnant women are overweight or obese
  • 8% of reproductive-age women are extremely obese & at high risk for pregnancy complications

Guidelines for pregnancy weight gain are calculated based on the woman’s pre-pregnant BMI (Body Mass Index). Details are available on the American Congress of Obstetricians and Gynecologists website: www.acog.org  Search “Weight Gain During Pregnancy.”

 General guideline:

·         1.1 – 4.4 pounds in the first three months

·         1 pound/week during the last six months

·         The average total weight gain over all BMI ranges =  30 pounds

·         Low weight women: over 30 pounds may be acceptable

·         Obese women: gain only 11-20 pounds during the entire pregnancy

Nutrition counseling at all weights is very important to assure proper food choices and nutrition during pregnancy.

Before becoming pregnant, healthy choices, an active lifestyle (including daily exercise) and weight control are all important. Seek a full medical evaluation including laboratory studies before becoming pregnant. An exercise program and nutrition counseling will benefit mother and infant.

 

EXERCISE FOR LIFE

DSCF3133Fall is an invigorating time of year for many people. Even if you are not into fitness, it is a good time to start a plan. Walking in crisp fresh air, surrounded by evolving brilliant foliage colors, can help stimulate daily activity that will generate better health in years to come.

 A recently published medical study noted advanced planning can change the course of your life. Americans are living longer, but not always better. Our current life expectancy is seventy-eight, but with longer life more people are dealing with chronic diseases. So, the goal should be to begin modifying your risk base as soon as possible. Developing fitness in middle age, even if exercise was never a priority for you, reshapes your personal health landscape and can make later years more vibrant.

 In the longitudinal study of 18,000 people beginning in 1970, most of those who were the least fit at the time of their middle-aged checkup, had developed some of the following conditions early in the aging process: dementia, diabetes, heart disease and colon or lung cancer. Those who were most fit in their forties and fifties typically did not develop chronic illnesses until the final five years of their lives, instead of 10-20 years earlier like the less physically fit individuals.

 So if you look at the big picture, exercise is beneficial in delaying illness and living well in later years. Longevity without dementia is determined by genetics, fitness and staying involved mentally and socially. Even walking half an hour a day can improve your health.

 An article reviewing 45 studies, examining physical activity in people with cancer published in the Journal of the National Cancer Institute this year, emphasized the benefits of exercise. There was a decrease in all-cause mortality, including cancer-related death. Many of the studies examined involved women with breast cancer. With exercise, there are improved insulin levels, reduced inflammation and an increase in cells known to attack tumors.

 Muscle cells strengthen with exercise. Balance improves. But another important benefit is better blood flow to organs including the brain. In an animal study published in the journal Learning and Memory, fit animals not only showed improved memory, they generated new neurons in areas of the brain involved with learning.

 We all have many excuses for not being able to exercise. However, if you evaluate your interests and abilities, usually there is something to do to remain active, even if you have physical problems that interfere. Water exercises for individuals with joint and balance problems can increase muscle strength and be relaxing, too. If you have joint or back problems, consider riding a stationary bicycle for non-weight-bearing activity. Talk with your physician. Maybe a consultation with a physical therapist could set you on a course to improve muscle conditioning and your overall health.

If you say, “I’m too tired to exercise” consider this: studies have found exercise energized people, even those undergoing cancer treatments. Remember, exercise doesn’t have to be vigorous. Just taking a slow walk outdoors in the fall sunshine can brighten your day, increase bone-density to ward off osteoporosis, strengthen your muscles and help you live a longer healthier life.

Betty Kuffel, MD