There are so many things we take for granted: Clean, running water. A bed to sleep in. The ability to smell, taste, feel. A sunny day. A cloudy day.

Our eyesight.

And without sounding all woe is me and like the sky is falling, I do want to state the obvious…nothing is guaranteed.

Today, I choose to write about our eyes.

Why? Because, when I glanced outside this morning, highlighted by the clear sky, I noticed some things for the first time after a long, cold, hard winter. Things I probably always took for granted.

Birds are building a nest right outside my back door, atop a porch light. (I can’t wait to see what happens next!)

The bare branches are suddenly blooming with vibrant colors: pinks, purples, and yellows. More to come.

The ground is covered in spots with purple and bright blue flowers hugging the soil.

I was reminded of the precious and precarious nature of my own eyes when, a few years ago, I suffered a detached retina that required emergency surgery and months of careful recuperation. Had I not paid attention to my blurry vision and called my ophthalmologist (who opened the office for me early on a Saturday morning), I might have lost vision in that eye. (This is a real medical emergency: make sure you pay attention to signs like a sudden increase in floaters, flashes of light, and a dark shadow or “curtain” covering your field of vision.)

There are so many things to be aware of when it comes to the health of your eyes:

• They can get sunburned. Redness, pain and sensitivity is not just reserved for your skin’s reaction to the sun: it can happen to your eyes, too. It can happen in the winter (skiing) as well as in the summer (at the beach) from prolonged exposure to the sun. If you need sunblock for your skin, you also need sunglasses for your eyes. Note: Longtime exposure to the sun can also increase your risk for certain types of cataracts.

• Remove your contacts. Don’t wear them to sleep, and don’t wear them to swim, either. By doing so, you are putting yourself at risk of infection. Also keep in mind that soft contacts, while they feel soft and comfortable, can dehydrate and become stiff or even brittle over time and especially during sleep (because tear production is slowed when your eyes are closed for a prolonged period). If you try removing your lenses when your eyes are dry, you risk ripping the superficial surfaces of your cornea.

• Dry eyes should be treated. They are caused by so many things: age, staring at a screen, insufficient tear production, certain medications, clogged oil glands. I’ve suffered with dry eyes for years, and I will admit they are uncomfortable and at times very painful. I treat mine with a combination of artificial tears and prescription medications (my latest success is using Miebo). Tip: If you stare at a screen for prolonged periods, go with the 20-20-20 rule. Every 20 minutes, look at something 20 feet away (or farther) for 20 seconds.

• Don’t neglect your eye exam. Not only is it important to make sure you are wearing the right prescription (if you have one) and to check for glaucoma, but so many diseases are actually diagnosed through an eye exam. I once knew a woman whose Type 1 diabetes was not diagnosed until she was in her mid-40s and visited her eye doctor because her vision was rapidly deteriorating. Also, high blood pressure, high cholesterol, heart disease and even sexually transmitted diseases can show themselves in your eyes, as can some cancers and brain diseases.

One More Thing…

If you want to dig in more on eye health, here are a bunch of articles I wrote, back in the day, for Parade Magazine, most of which were on eyes.

Wishing you all a Happy Passover, joyful Easter, and safe, sunny days with new, wondrous surprises to come!

The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

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Cholesterol is not just a number. It’s responsible for many important bodily functions, among them providing stability and structure to cell walls and regulating what enters and what leaves. But you can have too much of a good thing. Or too little of a bad one.

According to new guidelines of eleven medical organizations, this suggestion (plea?) was made to help prevent or reduce heart attacks and stroke.

Medical advice can be confusing, as can medical guidelines, because they always seem to change. Just when we thought it was safe to drink wine, we were cautioned against it. And then, we were told it was okay…then, not okay…then maybe okay. It can be frustrating to know what the h*ll to do!

To help clarify things, I reached out with some important questions to cardiologist Dr. Nathaniel Lebowitz at Hackensack University Medical Center. As luck would have it, Dr. Lebowitz has long been focused on the silent threat of lipoprotein.

1. Why does cholesterol (and is it specifically LDL) increase after menopause? What is the exact role of estrogen in this equation? And when does that precipitous climb typically occur?

“The shift in cholesterol levels around menopause is significant, and it is indeed the “bad” cholesterol, or LDL, that we watch closely.

Before menopause, estrogen plays a crucial protective role in your cardiovascular health. It effectively helps your liver clear LDL cholesterol from the bloodstream by increasing special receptors on liver cells that grab and break down LDL.

Estrogen also helps to maintain levels of HDL, the “good” cholesterol.

Consequently, the liver’s ability to remove LDL cholesterol is reduced, causing its levels in the blood to rise.

This change isn’t just a postmenopausal issue; the increase in cholesterol often begins during the perimenopausal transition.

Studies show a notable climb can start around three years before the final menstrual period and continue in the year that follows. This timeframe represents a critical window to be proactive about your heart health.”

2. What should menopausal (and postmenopausal) women know about managing their cholesterol?

“The menopausal transition is the perfect time to take charge of your cardiovascular health. Management is a partnership between you and your doctor, focusing on lifestyle as the first line of defense.

A heart-healthy diet, such as the Mediterranean style, is highly recommended. This involves increasing your intake of soluble fiber from foods like oats and barley, eating healthy fats found in nuts and olive oil, and reducing saturated fats.

Regular physical activity is non-negotiable; a combination of aerobic exercise like brisk walking and resistance training is ideal for improving cholesterol levels.

It is also vital to maintain a healthy weight, quit smoking, and limit alcohol consumption.”

I’ll chime in here to say this: despite my healthy diet, my regular physical activity and my careful and limited alcohol consumption, my LDL levels were too high. And now I understand why:

“Lifestyle efforts are not always enough, as genetics can play a strong role. It is essential to have your cholesterol levels checked regularly. If your LDL remains high despite your best efforts with diet and exercise, please do not feel discouraged. We have very effective and safe medications, primarily statins, that can lower your cholesterol and significantly reduce your risk of heart attack and stroke.”

It’s me again: I recently began a statin, as my doctor advised. And my last blood test? I wanted to frame it. The LDL numbers were so so much improved.

3. What numbers should we aim for?

“For menopausal and postmenopausal women, the target cholesterol numbers are generally the same as for the broader adult population, but it’s important to remember these are part of a larger picture of your overall heart disease risk.

• Total Cholesterol: The goal is to keep this number below 200 mg/dL.

• LDL (”bad”) Cholesterol: For most healthy women, the target is less than 100 mg/dL. If you have other risk factors for heart disease, such as diabetes or a history of heart attack, we will aim for a more aggressive target of 70 mg/dL or lower.

• HDL (”good”) Cholesterol: For women, a higher number is better. We like to see this at 50 mg/dL or higher, with 60 mg/dL or more being the ideal goal.

• Triglycerides: This is another type of fat in your blood that should be kept below 150 mg/dL.”

Remember, high cholesterol has no symptoms - until a severe cardiovascular event happens. That is why it’s so important to get regularly screened.

Remember, too, that the older you get and the more risk factors you have, the more often you should get screened. As always, work together with your doctor to come up with the best, most individualized, plan of action.

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

No, that’s not me and that’s not my computer…but it might have well been.

On the last day of vacation - feeling so rested and good about being somewhere warm and getting out of this dreadful winter for 10 days - my computer crashed. My sunny mood swiftly plummeted along with my hard drive.

Kaput. Nada. A dark screen on a computer is a scary thing. Dark…save for the horizontal bar that limped across the bottom part of my screen, screeching toward the finish as it crawled from left to right.

Only the line never quite made it all the way to that finish line, no matter how many times I restarted the machine and told myself it was just a momentary glitch. Moments of hope, dashed with each try.

I was a mess. How would I live without my computer?

I grabbed my iPhone, clicked on the Apple Store app, and scheduled the first appointment for the next morning with one of their Geniuses. I couldn’t bear the thought of returning home unable to use my computer. Unable to do all the things I’d neglected to do because, after all, I WAS ON VACATION.

The next morning, feeling hopeful, I packed up my computer and drove to the Apple Store. Surely it would be a quick in and out. Surely, there was a part that would fix whatever ailed it.

I sat down at the long table, unzipped my computer case, and greeted the Genius with an expectant smile. After a few moments, the Genius looked at me and said, “We cannot fix this computer. It’s a relic.”

I don’t need to tell you that shocked me quite a bit. Maybe you’re more computer-literate than me, but a FIVE YEAR OLD MACHINE, ALREADY BEING SENT TO THE SCRAP PILE????

I worried how I would ever function without my computer. What would become of my daily emails, my calendar, my documents…my LIFE???

I worry all the time that as I get older, I am becoming that computer. A RELIC. Someone whose usefulness is waning, fading, becoming obscure with each passing day. Someone who will become more and more invisible as time goes on. Someone who will be ignored, deemed “unfixable,” given up on.

And now I worry even more. I mean, if a machine can’t be fixed, how can a human body be fixed?

But it can…to a point.

I get gel injections for my arthritic knees. I’m not exactly running, jumping or even dancing. A knee replacement looms, unless there’s a miraculous discovery that can give me better knees through a non-invasive option.

I even got two cortisone injections into the palms of my achy hands, but the tradeoff was questionable. I’m not one who shuns needles - I’m quite well-acquainted with them - but these shots shocked me with the pain they produced, which was a lot worse than the pain I was having in the first place! It is said that pain is forgotten, and yes, I agree (or else I would not have had a second child). But… I’m not running to book another session with the needle anytime soon.

I endure needles in my forehead and between my eyebrows to smooth out lines (Please, don’t judge. I’m not hurting anyone, except maybe myself.)

I have my bad teeth fixed with extractions and extravagantly expensive implants so I don’t have to wear dentures. (My nickname: Mercedes Mouth.)

I smooth the skin on my arms and legs with lotion so the crepey-ness that I never, ever thought I’d get because, after all, I lift weights and won’t that tone me enough??? (Short answer: NO.)

I limit alcohol, fatty foods, sweets (working on this one) and excess calories and make sure to exercise at least four if not more times each week.

I read, do word puzzles, learn new games, travel, and keep my curiosity satisfied to help my brain stay sharp.

When the Genius told me I’d have to get a brand new computer, declaring my relic unfixable, I started to speak but then thought better of it. He didn’t want to hear my personal gripes. I was quite confident of that.

Instead, as he walked away to bring another Genius over to complete the complicated transaction, I chose to find a silver lining in my experience. I told myself that although our bodies are machines just like computers, we, as humans, are way more intricate and complex - and possibly more interesting, too - than any computer. The average “life” of a computer is but a blip in the total span of human history.

We, as humans, have the ability to grow, reproduce, adapt and feel, whereas computers merely function as well as a human inputs and instructs.

And then they die.

Suddenly, I felt superior and efficient, even though I’d have to live without my computer for two weeks while I awaited its replacement. I would adapt, and I could figure out a way to exist just fine without this machine. After all, I’d been doing it all the years before the computer ever came into existence.

I got through the wait and discovered new ways to fill my time. I caught up on things like my organizing my closet, and gave myself a lot of time to do some reading, thinking and research for a book I hope to write. I even had time for some phone calls and cooking.

And so, here we are today. I’m happily typing away on my new, improved version of my old relic. I’m happy and feeling a lot more settled. I can get many parts of my life into order now that it’s contained in one place.

But I’m also realizing that we, as humans, give a lot more power to computers than maybe we should. Perhaps we need to look inside ourselves and realize that a lot of power lives there, too.

****************************************

Thanks for reading, as always. And feel free to share, subscribe, and/or comment!

And til next time, stay safe, healthy and stress free!

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When we were kids, a year stretched out endlessly, opening up time to indulge in every day, every hour, every minute, every second…and then some.

But now that we’re older, time passes in a blin

I remember some years ago (it feels like yesterday, but forced to remember, it was actually 20), I started a blog, and was entertaining some names for it. At the time, I was in an online writing group whose members were always honest, supportive and helpful. One member, younger than me, didn’t agree with my leading choice of a title, “My So-Called Midlife.” She said that the title would eventually become obsolete, because I wouldn’t always be in midlife.

Oh, no, I thought, that phase of my life is surely going to outlast the blog. And so, I became author of the blog, My So-Called Midlife, and the blog was written and read by many for years.

Until… Menopause hit. Sure, I was still in midlife, 51 to be exact, but suddenly it felt imperative to focus more on the passage of midlife rather than being securely stuck in it.

And so, as she predicted, I aged out of “MySoCalledMidlife” (but I can assure you I did not become obsolete!) and morphed instead into a newsletter I named ThePause.

But then, voila! Suddenly menopause was so yesterday, and I was driven to write about today…what happens after we pass through menopause; what is to become of our bodies and how we see things; the many joys and challenges of aging; the importance of aging healthfully.

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AfterthePause, as you know, is where we are now.

I guess this is my long-winded way of saying that nothing lasts forever (duh), and the years move more quickly than we’d ever think possible. It’s like sitting in a car that suddenly veers forward, picking up speed as it descends a steep hill.

According to experts, there are a few explanations for this sudden acceleration.

Philosopher and psychologist William James wrote, in his 1890 book, that “the same space of time seems shorter as we grow older.”

James’ view was that time feels this way because our lives, as adults, become more routine and less filled with novel, memorable experiences compared to when we’re younger.

Other experts say that the perception of time is influenced by our memory and how much we’ve experienced. An 8-year-old perceives a week as a large portion of their life, whereas a week, for an 80-year-old, signifies a much smaller portion of their life - which makes it feel as if it goes by more quickly.

And then there’s this: A year to us is a smaller percentage of our total life than a year is to a younger person. And so, it seems to pass that much quicker.

I don’t know about you, but I suspect it might be similar for so many of us: Time feels less guaranteed as we move forward and age (which is why, I suppose, it feels more precious). That’s why being in the moment, rather than looking back or forward, grounds us in the pleasures ahead. And I am rather fond of the word “newness.” I think it allows us to indulge in something novel that will not only help slow down time (even if that is merely our own perception), but help us build new brain cells and hold onto our new memories at the same time.

How are you going to form new memories? I’d love to know.

I’ll share mine: I’m challenging my brain while having fun, and finally learning to play Mahjong.

And one more thing: I am finally going to write that novel I’ve been thinking about for the past 20-plus years.

And how those 20 years have sped by! It’s no longer “someday I’ll write that book,” but now it is “It’s now…or never!”

Have something to say, suggest, add? Comments always welcome!

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Before I jump in, I hope that if you, like so many of us, were in the path of that voluminous winter storm, I hope you are safe and staying warm. This was a snowstorm like we used to get when we were kids! Back then, I couldn’t wait to go out and play in it. Now, I’m suffering with such a case of cabin fever that I can’t wait to go out tomorrow and breathe in some frigid air. (Like the Norwegian proverb says, “there is no such thing as bad weather, only bad clothing.” (I’ll be wearing my heaviest of jackets, for sure.)

From time to time, I get letters from readers about the difficulties in making new friends once they’ve reached a certain age. I know that feeling well: I lost my two best friends to cancer when I (we) were in our 40s, and I never thought I’d be able to find such special, close friends again.

How wrong I was. What I soon came to realize is that friendship is not a fixed state. Sure, we like to hold onto childhood friends and many of us are fortunate to have the security of old, familiar friends that go way back and have endured from elementary school.

But it’s not at all unusual to lose friends along the way, through death, divorce, moving, a falling out, or simply growing apart. Friendship is fluid, coming and going depending on where you are in your life.

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And I’ve come to realize that although there is a “specialness” to having an old friend with whom you share a history, it’s not necessarily the magic - or only - potion for friendship. When I think of myself at age 20 versus who I am today, I can guarantee I’m a better friend today: more grounded and wiser; better able to discriminate and spend time with those who really matter. I’m more equipped to understand the many demands of friendships as well as its many perks. When we’re older, we are better at letting minor disagreements and petty animosities fade away; more keen to the fact that differences don’t need to divide, but can bond, as well.

I can guarantee, too, that the new friendships I’ve made since entering midlife have been extremely meaningful and fulfilling, and have endured for the most part, while bringing me great amounts of joy, surprise and security.

So, what I am trying to say is that it is not impossible; in fact, I personally recommend adding to your friendship roster, and having the confidence that you can.

In case you haven’t heard, there is a loneliness epidemic in this country, and as we grow older, that loneliness can be harmful to our health in many ways.

Here’s what our former Surgeon General, Dr. Vivek H. Murthy, said in 2023:

“Loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity.”

It’s true that opening yourself up to new friends - at any age - can be daunting. We’re afraid of being rejected. We don’t know how. We don’t want to get hurt. We may even feel vulnerable and insecure.

We’re all different, and what worked for me may not work for you. But making new friends, especially if you feel a void in your life, can be well worth taking that risk.

Here are some ways that worked for me:

1. Realize that friends fill many different needs. Don’t think that one friend must have all the qualities you look for and need. One friend may not be a great listener, but she’s always up for going out and trying something new. Another may be able to have deep, meaningful conversations, but may not enjoy the same social situations as you.

2. Be willing to put in the effort. Friendship takes work and commitment. Friendships need to be intentional; you must show an interest in engaging with another person. Ask questions; show an interest in their lives. Be open to making plans and even being the one to initiate.

3. Join a group that meets regularly. I never thought of myself as a “group” person; and certainly never thought of myself as a Mahjong player. (Who, me??) But I started listening to all the people I knew rave about how fun the game is (okay, I also gave in to the fact that it is such a popular thing to do right now), and took lessons. And the more I learned, the more I began to enjoy it. From there, I found a group to play with every week. It took no time at all for us to bond and become friends. Quite simply, the game (or any game, really), builds community and connection. While I don’t know much about each one of these women, all I do know is that we all want to have fun and learn the game, together. And so, for now, they are my “Mahjong friends.” And that’s good enough for me! If it turns into something deeper, all the better.

4. Accept that it’s not the number of friends you have, but the quality of the friend that is important. When I was younger, I thought having lots of friends was important; that meant that I was valued and loved. Now I realize that it is the depth of the relationship that is enduring. Numbers are misleading.

5. Think outside the box. Friendships don’t always have to be with people just like us. Expand your pool and seek out people who are a bit different in terms of age, beliefs, and lifestyle; some of my most precious friends have been borne out of intergenerational friendships.

I wrote this essay a few years ago. (Title was not chosen by me!) I’m happy to say that my husband is no longer friendless; he found a local men’s group, began to volunteer driving cancer patients to their treatments, and is making the effort to reach out and keep up with old friends. He is busy almost all the time! (If I happen to see him, I’ll let him know I mentioned him here :)

Who sings it better than Bette? Just divine.

Thank you for reading AfterthePause! Until next time, stay healthy, wellthy and may your friendships proper and endure. Xo

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Hi readers! I hope your new year is starting off on the right foot.

Since your feet and your heart are connected (yes, they really are!), please share that knowledge by clicking the heart above.

Speaking of feet, did you know that there are 26 bones in each foot? And that an an unexplained foot fracture may be the first sign of osteoporosis?

While we’re on the subject, how about this one: if you have foot pain, the odds are higher that you will suffer a fall.

Now, don’t walk away (pun intended, sorry.) Settle in for some important information about falls. It's a fast read, I promise…and might save you from a lot of accidental tumbles, (which can result in fractures, brain injuries, fear of falling, social isolation, inactivity, reduced mobility and more.)

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Remember when you were a kid, and you fell down? Chances are good that you popped right back up, without hesitation or harm.

But falling takes on a whole different meaning for adults.

In the past few months, I’ve heard about many friends and acquaintances who have fallen and suffered significant injuries.

At yoga yesterday, I asked after woman who is a regular. I hadn’t seen her in a few weeks and had a suspicion something might be wrong.

Turns out I was right: She fell and broke her neck.

Another woman I know fell while getting out of her bathtub, and broke her wrist.

Someone else I know, while stepping out of her car, broke her foot when it got stuck and her body propelled her forward. (A word to the wise: Before stepping out of your car, pause, and balance yourself.)

These are the lucky ones.

I know, I know. How could I write “lucky?”

Well, because they didn’t end up in the hospital, or in surgery, or worse, in a wheelchair.

But still.

It could have been - and is, in many cases - way, way worse.

That’s why I’m writing this; to remind us all to be aware. And also, because a loyal reader (thanks, Bobbie!) sent me this message, reminding me just how serious falling can be:

Here are some really crucial things to keep in mind.

You can fall UP the stairs, as well as DOWN!

Maybe you do this by tripping on your way up and being propelled forward, resulting in a chaotic, upward-moving fall that’s hard to stop. Or you might trip over a too-long pants hem. (This happened to me on the beach, and I was lucky enough to fall forward onto soft sand and not get hurt.)

When walking outdoors, always look ahead and be aware of what’s underfoot.

Nature can be hazardous: tree roots pushing up from the sidewalk, scattered rocks and potholes, uneven surfaces abound. Curbs can appear higher/lower than we perceive. Walk mindfully.

It’s not just foot pain, but foot conditions that can do it.

Corns, calluses, bunions, ingrown or thick nails can all contribute to your risk of falling.

Walking down the stairs? Pay attention.

Handrails are there for a good reason. And if you’re carrying things in your hands, make sure one hand is free to grab the handrail. (I’ve been guilty of carrying a big load - in both hands - while walking both up and down the stairs. Not a good idea.) If you must carry many things, do so in a large bag with a handle, so you’re able to see in front of you.

Also, it’s not uncommon to think you’re on the last step, when you’re not…and fall.

Pay attention to your home.

Throw rugs. Dog toys. Stray shoes or magazines. Slippery floors. All these things can easily throw off your balance - especially at night. Which is my way of reminding everyone: If you get up in the middle of the night to use the bathroom or make another journey in the house, always have a flashlight with you, or set up the rooms with auto-on nightlights. Better yet, check for a clear path before you go to sleep. (I have a habit of putting my extra pillow on the floor next to my bed. Not a good habit and one I am breaking, pronto.)

P.S. It’s not just your home you need to pay attention to. A few years ago, I slipped and fell on a marble bathroom floor at a resort, and broke my wrist. Had I taken notice ahead of time that the beautiful shiny floor was also a fall risk, I might have avoided the situation!

Don’t walk while looking at your cellphone.

I’m sometimes tempted to do this - but I stop myself, because, frankly, it makes me dizzy. But soooo many people walk-and-look, even on the busy streets on New York City. So many times said person has bumped straight into me while their eyes are not where they should be. The term “digital distraction” refers to pedestrians using electronic devices while walking on the street. One study says this: “Pedestrians are subject to minor traumatic injuries, caused, for example, by collisions with other pedestrians, and to more serious situations, where people may not recognize street obstacles, twist their feet, fall down, and even get hit by cars or motorcycles.”

Learn how to fall.

I know, I know. A fall hits you by surprise, so how can you prepare for it? You can try by remembering some things; the most important among them not panicking and staying loose. (I think that’s what helped me one time when I was hiking with a friend and tripped over a loose branch.) Here are some other pointers.

And lastly, boost your balance. Stand on one foot, then the other, while brushing your teeth or doing some other stationary task. Practice heel-to-toe walking Strengthen your core. Do squats while watching tv to build stability. Yoga and Tai Chi are also good for building balance.

Thanks for reading, and stay safe and upright!

When you’re young, falling is easy and fun. For us? Not so much.

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

After being a victim of New Year’s resolutions for way too long, I decided, some years back, that I’d stop all the madness.

I found I was repeating the same resolutions year after year. Be more organized. Procrastinate less. Be happier. Learn a new skill.

I mean, really. If “resolutions” really worked, I wouldn’t be repeating the same ones year after year, so why bother?

So, I stopped making any.

And yet.

As this year winds down, I can’t help but automatically veer in the direction of the word “change.” A new year has a way of forcing reflection: It shocks us into realizing that time passes way too quickly; that we don’t ever accomplish everything we set out to; that things go undone, unsaid, unfinished.

🎉Rather than resolutions, I’ll offer up some thoughts as we move to a new year. 🎉

🥳Although 2025 was a year of tumult, sadness, unrest, and uncertainty, I’m hoping that ultimately, it will teach us what doesn’t work and what is still possible. I’ve always been a firm believer in Benjamin Franklin’s wise words: “Out of adversity comes opportunity.” May our share of hardship offer the perfect opportunity to regroup, build resilience, and find inner strength. Hopefully, this will unite, rather than divide, us.

🥳Post-menopause is underrated. We’ve crossed a threshold that brings some degree of peace. Our hormones are no longer ping-ponging. Our moods are steadier, our sleep more settled. We know ourselves quite well; so well, in fact, that we stop giving a sh*t about what anyone else thinks. (Okay, sometimes we do care, but we care less.) We know what to pursue and what to discard (and that includes certain toxic “friends” and spending, er, wasting, time on things that don’t make us happy. Think of yourself as being powered by experience.

🥳Aging well means knowing what we’re capable of, what we need to alter, what we can do with what we’ve experienced. My knee arthritis may keep me from running (although that’s not the case for everyone), but I can speed walk and elevate my heart rate. The weights I lift are still challenging enough to keep me strong, though they’re not as heavy as they used to be. It is entirely possible to still show up and work hard - just differently. Keep moving; you’ve got this!

🥳Loss, whether it be through death, divorce, or moving away, stings; it can tear your heart out. But it also sends a message to be present, love fiercely, and appreciate that we are here now. As our bodies adapt to their changes, so can our minds.

🥳Thanks for being here! Any sense of community - even if it’s far away - makes us all feel “heard.” In case you missed some readers’ favorites, feel free to take a look through the archives of AfterthePause to see what resonates with you!

Until next time, stay healthy, wellthy and wise.

One more thing before you go. I’d love to know what interests you; what you want to read about, what you’re curious about. Feedback helps make this a better community for us all - thank you.

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

I recently received this email from a reader:

Now that I’ve passed through menopause, I thought those days of darkness - feeling depressed, listless, anxious, and all-around moody - would pass. But they’re back with a vengeance. Does that mean my period is going to come back, too???? Please tell me it ain’t so.

NO, dear reader, your period will not come back - that is, if you have been without it for 12 consecutive months. Once you reach that point, you are considered post-menopause (and you won’t get another period).

P.S. Although… it is a possibility to have some spotting. Research finds that up to 11 percent of postmenopausal women experience some postmenopausal bleeding - but it’s probable that the conditions causing the bleeding are benign.

Here’s an article I wrote on the subject.

Anyhow…let’s get back to the original subject…that shroud of sadness and irritability that is affecting this reader. And likely, many, many more of you (especially this time of year in the Northern Hemisphere).

Like clockwork, I feel it myself, every. single. year. I don’t need to look at the calendar - or the thermometer - to tell me why I’m feeling irritable, moody, fatigued and intense craving for carbs. And I KNOW I can no longer blame menopause. Been there, done that.

😔Why SAD Happens

Our bodies run on coffee circadian rhythms, an internal “clock” that is on a 24-hour cycle. This clock dictates things like when it’s time to sleep, when it’s time to wake up, and other physical and mental biological processes.

This rhythm is set naturally by your body, guided by your brain. But there are outside factors - like light - that can affect and alter the rhythm. For instance, when light enters your eye, it tells your brain to stop producing melatonin (which is the hormone that helps you sleep).

Circadian rhythms are especially sensitive to light, which is an easy explanation as to why, when there are shorter days and less sunlight, we can feel “off.” Plus, less sun exposure results in less Vitamin D and serotonin absorption (which can also affect mood, energy, and even our immunity).

Interestingly, SAD is about four times more common among women than among men, notes Normal E. Rosenthal, MD, in his book, Winter Blues.

Michael Breus, PhD., author of The Power of When, calls circadian rhythm a “precisely engineered timekeeper,” governing everything from energy to the ability to heal. He says that being out of sync with “bio-time” is devastating to your physical, mental and emotional well-being.

Amen.

So, what helps with SAD???

Retail therapy. (Kidding/not kidding). Why it helps: Research has shown that shopping releases serotonin and dopamine, those feel-good neurotransmitters associated with reward and pleasure. Why it may hurt, though: The down side is that shopping unnecessarily can hurt your wallet, and that sweater/bag/pair of boots you thought you absolutely couldn’t live without becomes a thorn in your side once you get the credit card bill. (Even worse are the sales that are so tempting…but are FINAL SALE.)

Regular exercise. Aside from relieving stress and anxiety - both hallmarks of SAD - feeling stronger and fit can help boost your mood. And as an extra bonus, exercising outdoors, weather permitting, can help, too. Forest bathing, a Japanese method of immersing yourself in nature (no, it’s not a bath), is very mentally and physically therapeutic, studies find.

Resist temptations to give in. Easier said than done…but worth a try. Oversleeping, overeating, hibernating, and withdrawing socially, as tempting and natural as they may feel, will only exacerbate your SAD. Now is the time to push yourself to commit to a regular (earlier) wake-up time, as well as make social plans (or at the very least, get thee out of the house, even if it’s just to walk around the block or sit in a coffee shop around other functioning people.)

“Do whatever it takes to resist the very strong temptation to be a couch potato,” writes Dr. Rosenthal. “Do something - anything - to keep your body active through the winter months.”

Replace the lost light. You could, of course, throw open your curtains and turn on all the lights in your house. But that might not exactly do the trick.

Light therapy can be an effective way to treat SAD, and light therapy boxes have been utilized since around the 1980s. It was actually in the 80s that I tried a light therapy box but quickly gave up because I grew impatient sitting in front of the box 20-30 minutes each morning. But recently, I was thrilled to discover I could get the same benefits from a wearable device, called AYO, that looks like a pair of eyeglasses. I put them on when I wake up can roam around my house (or sit still, if I choose) while they do their 20-minute-timed session of exposing me to gentle blue light. AYOs co-founder, Alex Dimitrov, explained that products on the market were too inconvenient to use, and not smart or personal. He created AYO so that users could engage in daily activities while improving their circadian health. “The primary function is designed to help support circadian health, increase energy, and improve natural sleep,” by exposing your brain to a “wake-up signal,” he said. AYO also comes with an app to further personalize the experience.

Other therapies. Some people might turn to/benefit from psychotherapy, vitamin D therapy, or antidepressants to chase away the winter blues.

Believe it or not, the earth is closest to the sun in January. Called Perihelion, which is Greek for “near to the sun,” it doesn’t equate with getting more light (or warmth). Why? Not really sure, except it has something to do with the tilt of the earth, which makes the sunlight spread more thinly over the northern half of the planet during that time.

Here’s some solace: There are only 199 days until June 21, the longest day of the year, when you might need blackout curtains in order to sleep (especially if you live in a place like Fairbanks, Alaska, which gets up to 22 hours of daylight!)

And while you’re here, feel free to leave a comment or share any thoughts or suggestions below.

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

I dare you to tell me that Thanksgiving always runs smoothly.

Okay, I’m coming to your house next year.

Need help carving the turkey, timing the stuffing, and clearing the dishes? That’s likely.

Also need help with some icebreakers, especially considering today’s volatile climate (there will always be those who choose to ignore your “no-politics-at-the- table” rule. I promise.)

Here are some things to toss around while you’re tossing that afore-mentioned stuffing into the oven.

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🦃The song “Jingle Bells” was originally written not for Christmas…but for Thanksgiving.

🦃At maturity, the average adult turkey has 3,500 feathers. (Apologies to all you vegetarians and vegans out there.)

🦃A pumpkin is not a vegetable - it’s a fruit.

🦃The Macy’s Thanksgiving Day Parade attracts about 3.5 million people. Add to that another 50 million watching at home.

🦃Americans prepare about 46 million turkeys each Thanksgiving.

🦃Thanksgiving is more about dinner and leftovers on Thursday. Over 32 million people take advantage of sales on Black Friday.

🦃Turkey help is (still) just a phone call away: The Butterball turkey talk line, nearly 40 years old, gets 100,000 calls each year.

🦃The first Turkey Trot had just six runners, and took place in. Buffalo, N.Y.

🦃Don’t blame the amino acid tryptophan in turkey for making you want to take a nap, but rather, blame overeating.

🦃And finally…

It is possible to have healthy food on Thanksgiving. Just ask Eating Well, NYT Cooking, and Cookies and Kate.

Thank you all for being here. Wishing you a joyful, healthy, and happy celebration!

And if you’re so inclined, I’d be eternally grateful to add you to my list of subscribers. It’s just a click away.

One more thing…

The REAL story of the first Thanksgiving. Did you know these facts? Me neither.

Thanks for coming along on this urine-filled issue! Did you know that for centuries, urine has been used for everything from whitening teeth to creating beer foam, stained glass and even gunpowder?

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Did you ever have a sudden, intense, and uncontrollable need to urinate…and…not make it to the bathroom on time?

Sorry, don’t mean to put you on the spot or embarrass you, but urinary urge incontinence, or UUI, is worthy of more than a mention. Maybe even a bit of a deep dive.

UUI is one symptom of a larger health condition called overactive bladder (OAB), and affects approximately 40 percent of females. But studies found that only about a quarter of those dealing with bladder control issues had discussed them with a doctor.

UUI can be life-altering for many: People with it are hesitant to travel or fearful of being too far from a bathroom. They may shun exercise classes or other activities, and carry extra clothing in case of leaks.

Recently, over Zoom, I spoke with Alexandra Rogers, MD, a fellowship-trained urologist in Denver, Colorado, who specializes in treating women affected by urinary issues. She is equally passionate and knowledgeable about her job (which is really refreshing when you consider that bladder control can be a rather taboo subject among so many).

“The problem is that no one speaks up!” Dr. Rogers said. We’re embarrassed…afraid/unsure of surgery or other treatments….we ignore and accept the problem, convincing ourselves that it’s a normal part of aging.

One friend admitted that she sometimes doesn’t make it to the bathroom in time. She told me she just accepts it and wears a panty shield (which doesn’t always do the job). When I asked why she doesn’t see a physician, she said: “I don’t want to go there! I don’t want a doctor examining my bladder with all sorts of tests.. It’s way too embarrassing.” Another friend has resorted to wearing adult diapers (or “protective underwear”, the more politically correct or acceptable term), which she is convinced doesn’t bother her or show through her yoga pants and gives her the freedom she needs to go about her day. I just “live with it,” she said.

I get it. It can be embarrassing. Urine, pee…however you say it. It’s not sexy or something we want to chat about.

The workup is actually very minimal. “I check for blood in the urine, for vaginal prolapse or atrophy - which can be treated concurrently with vaginal estrogen,” said Dr. Rogers. In other words, a urologist can be your BFF when it comes to your bladder, working with you to understand it and do the best for it - and you.

Over the years, many treatments have emerged for urinary urge incontinence (other than adult diapers and denial!)

There are kegels. Surely you’re familiar with these exercises that strengthen the pelvic floor muscles. If you’ve given birth or had surgery, you may have been advised to do these.

There’s also the advice to limit caffeine and alcohol intake; inject Botox into the bladder muscle, or train your bladder to hold the urine for longer periods of time.

There are also various medications and surgical options.

When the tibial nerve, which runs down the back of the leg through the ankle and across the bottom of the foot, is stimulated, those pulses then run up the leg, and connect to the nerve highway that regulates the brain and bladder connection.

Voila - bladder spasms are suppressed, and bladder control more “normalized.”

This technique has been adapted, in a way, from acupuncture, which studies find to be more effective in bladder control than drug therapy alone.

There are other devices on the market that work off of this ankle-bladder connection. In one, percutaneous tibial nerve stimulation (PTNS), a thin needle is inserted near your ankle that delivers mild electrical pulses. It’s usually done via 12 in-person weekly sessions of about 30 minutes each.

But…that can be quite a commitment.

A recently-FDA-approved Medtronic device called Altaviva to treat UUI is now available. It’s a small, battery-powered stimulator implanted under the skin near your ankle (performed through a single, minimally invasive procedure performed under local anesthesia). Using electric pulses, it stimulates the all-important tibial nerve

Not a new concept, but a step above, in that it works right away and doesn’t require repeated office visits. Dr. Rogers calls it a “set it and forget it,” explaining that the battery is expected to last up to 15 years, needing to be charged once or twice a year.

Hopefully, more of us will open up about a problem that is likely to affect your friend, and a friend of your friend…and so forth. And hopefully, treatment for a problem that can lead to panic, rushing, tripping and/or wet clothing, will become de rigeur.

The ankle bone’s connected to the leg bone…bladder???

The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

Pink is the color of October; the color of the ribbon representing courage, hope and solidarity. If you want to share some love (and info), go ahead and stretch your fingers to click the heart button above; because… who doesn’t like to feel the love?

Breast cancer awareness month started in 1985, just three years before my own diagnosis at 34 when I got my first-ever mammogram.

What a difference 40 years makes. And as a breast cancer survivor, it’s exciting to see what was then, vs. what is now.

THEN…

💓 I didn’t pay much attention to the fact that the month was set aside as a way to promote awareness and raise funds. I was too busy concentrating on putting one foot in front of the other; caring for my two young toddlers and fighting fear and uncertainty.

💞Nor did I know that I was part of approximately only 6.4 percent of women under 40 with the disease. I felt even more alone than that; as if I was the only one.

💞Following my diagnosis, “standard practice” included a mastectomy, chemo and a five-year regimen of tamoxifen (a type of hormone therapy). It all left me exhausted, sad and overwhelmed, I didn’t know that one day women would have many, many more choices of treatments and be able to know what suited their individual situation, possibly even avoiding unnecessary surgery and/or chemotherapy.

💞In 1988, vigorous exercise, especially weightlifting, was frowned upon; rest and a conservative approach were encouraged. “Stand facing the wall and march your fingers up and down 10 times” was about all that was offered to ease the chest tightness that followed mastectomy. (Oh, and swimming too; but I hated swimming.) But I went with my gut, and ignored them all…I needed to move and remain vital and strong. (I got certified as a personal trainer, convinced I was going to help other women in my situation. At a meeting I set up with a leading cancer organization to suggest partnering on an exercise, they curtly dismissed me.)

💞Back then, I could only answer the recurring question from incredulous people: “Does it run in your family??” with a frustrated, “Um…NO.” I didn’t have an explanation as to why, with little to no risk factors, I was diagnosed with something I never expected, at such a young age.

💞Nor in 1988, at 34, having no experience with serious illness, could I have told anyone the “right” thing to say to me. I did, however, notice all the “wrong” things people said. (But who was I to tell anyone how to react? I barely knew how to react myself.)

👩‍🦰Hair loss. Every. Damn. Strand. This was (almost) as hard as losing my breasts. A stark reminder of my sheer powerlessness.

NOW…

💓Mammography and other screening has become much more sophisticated and advanced; thus finding tumors earlier (when they’re generally more treatable). Digital mammography and 3D tomosynthesis can now improve accuracy and reduce false alarms; they can also detect cancers hidden in dense breast tissue (which is more likely in younger women). All this may point to one of the reasons for the rising incidence of breast cancer - but with good reason. Better detection leads to earlier detection - which in turn, leads to lowering mortality rates.

💗Today, I would not feel so alone with a diagnosis of breast cancer at 34: The incidence rate has risen faster than in women over 50, according to the BCRF (Breast Cancer Research Foundation). (see above).

💗Since 1988, treatments and testing for breast cancer have come a very long way, with many more classes of drugs and unique and targeted treatments better able to target specific breast cancer subtypes. What’s more, there is no more “standard practice;” testing can help determine whether patients need or don’t need chemotherapy.

💗Today, exercise is encouraged, rather than discouraged. Aerobic plus resistance training has been found to help reduce the risk of recurrence, improve a patient’s quality of life, relieve anxiety, depression, fatigue and improve self-esteem. Many structured exercise programs are offered by gyms, cancer centers and non-profits. (Thank goodness!)

💗Although there is a multitude of risk factors for breast cancer, the exact cause is largely unknown. But family history only accounts for five to ten percent of all breast cancers, usually due to the inheritance of damaged genes.

💗I am able to share what I’ve learned about things to say or not say to someone who is diagnosed with breast cancer. I’m gratified to have had many platforms to write about the subject, including this one. (Following my diagnosis I had a so-called wake-up call to nudge me to do what I loved, and forged a long career as a health journalist). And if you want to read about my experience dancing with the Mombies to raise money for breast cancer research, here you go!

👩‍🦰Less toxic chemo regimens and chemo caps (scalp cooling systems) have helped to reduce hair loss. A biggie in my book.

If you’ve read this far, thank you for coming on my journey with me, and I truly hope you learned some helpful things, too.

But most importantly, get screened! Please, please, please. Read the latest guidelines here.

And second most importantly, tell your mother, sister, friend, niece, and whoever else you love to do as you do. (I’m assuming you will do the prudent thing!)

One More Thing…

Thank you to these fun, wonderful people for bringing a much-needed smile to so many faces!!

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

Welcome to AfterthePause, the newsletter that reinforces the oft-missed idea that LIFE DOESN’T END WITH MENOPAUSE. If you agree and want to share the love (and info), go ahead and stretch your fingers to click the heart button above; because we all could use a little (more) movement, and…luvvvvv.

I’ve always been the type who has trouble sitting for too long.

ADHD? Maybe a touch.

But more than that, my body and mind just feel better when I am in motion. Movement has always been a balm for me; comfort and relief from emotional - and physical - pain.

And it’s not that surprising: Our bodies were built to move.

Feeling listless? Not-a-news-flash: Things are tough out there. We’re living in turbulent times, for so many reasons. And it’s more important than ever to maintain our so-called equilibrium.

Feeling stiff and sore, especially in the morning? That’s not surprising, either: While we’re sleeping, our muscles and joints are at rest, too…they’re basically inactive, and they suffer from decreased lubrication.

Fortunately, movement helps loosen and lube up your joints by stimulating the flow of synovial fluid. And according to research, movement helps our brains deal with stress more efficiently. Here’s how the American Psychological Association (APA) explains it:

Once we’re up and moving, chances are we are standing a bit taller and feeling a whole lot better by the minute.

I’m not referring to all-out cardio and strength-training exercise (although that’s a good topic for another time); but instead, making free and easy movement a part of your everyday life.

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Movement does not require you to be super-fit. It comes in all shapes and sizes.

Just this morning, while out walking, I was struck by the difference in fitness levels in the people around me.

As I was walking at a brisk pace, a runner passed me. And then I passed another walker.

Three different people; three different fitness levels. But all of us were gaining the benefits of moving. I may not be the athlete I was in my 40s, 50s or even my 60s, but I’m still able to get the benefits of moving.

Life can be challenging; busy or complicated, painful, uncertain, and time-crunched. It can also be painful. But to age well, feel strong, maintain balance, and avoid pain or injury, our bodies must move.

If arthritis is causing you stiffness or pain: Don’t think exercise will make it worse. Quite the contrary! Moving might be or feell challenging, but it’s crucial for helping with pain and stiffness. How? Our joints need lubrication, and our muscles need strengthening. Movement accomplishes both. Once you push through the initial pain, you’ll start to feel relief. (Of course, listen to your body and to your healthcare provider. Never push if the pain is sharp or intense.)

Gentle motion (low-impact aerobic activity and stretching) helps improve blood flow and reduce sensitive joints. That’s not to say you need to go all-out; instead, focus on low-impact activities like walking, cycling, yoga, tai chi, or water exercises. I dare you to tell me you feel worse, rather than better, after you’re done!

What if you’ve been a couch potato up until now? You can regain your flexibility. Slow and steady does help. Start with small, achievable goals, like 10-15 minutes two to three days a week, and work up from there. And don’t forget to warm up and cool down with gentle stretching to give your body a chance to adjust to your new moves.

For a Pause…

1. Take a look at these easy, gentle mobility exercises. And then, try some!

2. And while you’re at it, here are some simple stretches to add to your plan.

3. A stretching strap will come in handy for giving you safer, deeper stretches.

4. I keep a thick yoga mat, like this one, handy and within reach so I am always reminded to lay down and stretch.

And lastly…

I like to move it, move it…do you, can you, will you?

Have something to say? I encourage all and any communication!

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The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

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Welcome to AfterthePause, the newsletter that reinforces the oft-missed idea that LIFE DOESN’T END WITH MENOPAUSE. If you agree and want to share the love (and info), go ahead and click the heart button above; because we all could use a little (more) luvvvvv.

“Silent killer” may sound scary, but that’s high blood pressure for you. It has earned that moniker because there are usually no symptoms of high blood pressure - even if your numbers rises to dangerously high levels.

While it’s true that some people with high blood pressure might feel headaches, shortness of breath or even get nosebleeds, the majority of those with the problem don’t have any symptoms until their numbers have reached a severe or life-threatening threshold. High blood pressure usually goes unnoticed for a long time…until the health problems become apparent.

What is blood pressure, anyway?

Simply put, it’s the force of blood that pushes against the walls of your arteries as your heart pumps blood.

Let’s get to those numbers…

The top number (Systolic pressure; the higher and top number): That’s the pressure in your blood vessels when your heart beats.

The bottom number (Diastolic pressure; the lower and bottom number): That’s a measurement of the force of the blood in your arteries while your heart is relaxing between beats.

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And what of menopause and high blood pressure?

Weight gain…stress…declines in estrogen: You see these during menopause, and they can all put us at an increased risk of high blood pressure.

Studies bear this out: High blood pressure is more common among postmenopausal women compared to premenopausal women.

My blood pressure was always at a healthy level. But then… menopause. It was about then that the numbers began to rise, despite my attempts to keep my blood pressure at a manageable level by eating a healthy diet, exercising, limiting alcohol and salt consumption and trying to manage my stress.

Sigh. Sometimes, despite all good intentions, blood pressure rises anyway. Like (nobody knows who) said, “You can’t always fight mother nature.” Seems you can’t always fight other factors as well, like:

• Age

• Family history and genetics

• Lack of good-quality sleep or sleep apnea

• Some medications (antidepressants, decongestants, aspirin or ibuprofen)

• Thyroid problems

• Chronic kidney disease

• Race or ethnicity (high blood pressure is more common in Black adults than in White, Hispanic, or Asian adults).

The numbers, please…

Speaking of numbers, why do I continue to buy lottery tickets?? My numbers never, ever, ever come in…not even close. But a girl can (continue to) dream…right?

Okay, for other numbers that might be more achievable, here you are:

Here are four general categories, compliments of The American College of Cardiology and the American Heart Association, who point out that ideal blood pressure is categorized as normal:

• Normal blood pressure. Blood pressure is lower than 120/80 mm Hg.

• Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and the bottom number is below, not above, 80 mm Hg.

• Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.

• Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.

  For a Pause…

1. If you have high blood pressure, it’s a good idea to monitor it at home. These devices will help you. They’re easy to use and accurate (I recently brought mine into my doctor’s office to check it against hers, and it was spot on.)

2. If you’re more of a chart person, here’s one to tell you what the numbers mean, and what to strive for.

3. Click here for more in-depth info about how to treat high blood pressure. There are lifestyle changes, which are always good beyond treating high blood pressure. But if you need more help, there are plenty of helpful medications out there, too.

4. Meditation has been shown to be a simple and effective way to bring your blood pressure down. If you need to sharpen your meditation skills, these books will help.

Thanks for reading AfterthePause! Before you dash out of here, take a moment to consider subscribing, so you can continue to read all about living your best life after the change.

I love hearing from my readers - feel free to unleash below!

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And finally…

Did someone actually write a song about high blood pressure?? Seems so.

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

After writing about dry eye in my last newsletter, a reader was moved to share her very unpleasant medical experience:

AARRGGHH‼️

What happened to the Hippocratic oath, to do no harm?

What happened to a doctor listening to a patient’s concern, and responding with helpful and compassionate care?

What about advocating for their patient and helping them solve their problem?

Medical gaslighting is maddening. And it can be dangerous, too. Why? Medical gaslighting can not only lead to the wrong diagnosis, it can, in some cases, even prove fatal.

Another fallout: Patients may question their own judgement, thinking things like, “Am I making this up? Imagining it?” It’s easy to see how this can lead to depression, avoidance, health care-related anxiety and other levels of trauma for you, the patient. As a result, the patient may also (mistakenly) minimize or downplay their symptoms, fearful they’ll appear anxious or neurotic, and may harm themselves by delaying or avoiding treatment altogether.

So, here we are. Being told our health problems aren’t “real,” but instead we’re suffering from stress, hormones, and anxiety. It’s just our imagination, after all.

I have my own story - and I’m sure many others of us have stories, too - which dates way back, before there was a name for this. When I voiced my anxiety about other cancers after getting a breast cancer diagnosis, my (male) gynecologist shot back with:

What??? I wanted to shout. (And a few expletives.) But instead, I stayed silent, too shocked to speak. I felt shame, self-doubt, and embarrassment; unsure of what to do with my worries.

But one thing I knew for sure was that it was time to find a new gynecologist, and I did. A female, by the way. (That’s not to say all male gyn’s are this way…but the female I still use would never, ever, dismiss me that way.)

What I’m getting to is this: We must be our own health advocates and put the frustration to work for us in a positive way. Here are some suggestions:

Keep records. Log a detailed record of your symptoms (a pretty notebook makes it feel even better); when they occur, and how often they occur. Look for any clues, triggers or patterns.

Do your research. That’s not to say you should try to diagnose your own problems and rely solely on Dr. Google. But, try to gain a solid understanding of what’s happening, and the lingo, so that you’re able to ask informed questions and participate in discussions with your doctor. (Some helpful resources include the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Mayo Clinic, Cleveland Clinic, and MedlinePlus.

Prepare a list of questions. This will help you focus on your concerns and treatment options. It’s also wise to bring along a list of your current prescriptions, over-the-counter supplements or vitamins, past medical records, drug allergies and personal and family medical history.

Bring someone with you. It’s always good to have an extra set of ears, be it from a family member or friend. Even more helpful is for them to jot down notes while you speak, so you don’t have to be distracted.

Ask for clarification. If something isn’t clear, say so. If something is confusing, ask questions. You deserve to understand everything you need to about your personal health. Sometimes clinicians forget to use layman’s language; ask them to put it in simple terms - and don’t be embarrassed!

Be THAT person. Love and care for yourself. Xo

Thanks for reading. Please feel free to leave a comment or share your own story - I love to hear from my readers.

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The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

Do your eyes sting or burn? Are they watery, red, or irritated?

Or maybe it feels like there’s something in your eye, or your vision is blurry, or you’re sensitive to light.

You may have trouble driving at night, or feel extreme eye fatigue.

Or…maybe…

⬆️ All of the above.

Dry eye - when your tears can’t provide enough lubrication for your eyes - can happen for many reasons. Yes, one thing you can blame is menopause.

You’re probably familiar with how dryness descends on many parts of your body; your hair, your skin, and likely… your nether regions.

Aha…also makes sense that dry eye affects women almost twice as often as men.

Yeah, we’re lucky like that.

What else besides menopause causes 16.4 million Americans to suffer with dry eye?

👀Contact lenses

👀Laser surgery

👀Some medications like antihistamines, beta blockers and antidepressants

👀Allergies

👀Aging

👀You produce poor-quality tears

👀Certain autoimmune diseases, like lupus or Sjögren syndrome

👀Lack of adequate vitamin A or omega-3 fatty acids

👀Time spent looking at your computer, tablet or smart phone

You know when you get a mosquito bite and you desperately want/need to scratch? Dry eyes are like that, too. Caution: Don’t!

Rubbing dry eyes can not only worsen your discomfort but can lead to infections and even damage your cornea (the clear outer layer at the front of your eye). That’s because dry eyes don’t have enough lubrication to be able to flush out dirt and germs. If you rub your eyes, you face the risk of pushing the irritants deeper into your eye, creating scratches, and increasing the risk of infection and damage.

Aside from the typical symptoms, your eye doc, during a regular comprehensive dilated exam, can diagnose the problem.

So…what to do? For my dry eye, I’ve tried some of the following. One of the most soothing, though temporary, solutions I’ve found is a moist eye mask like this one. You can also:

• Try over-the-counter solutions like artificial tears, moisturizing gels and ointments.

• Eyelid wipes like these may also be soothing and help clear clogged pores along the lash line.

• Avoid irritants like smoke, wind, and air conditioning.

• Use a humidifier to help moisten the air around you.

• Drink plenty of water.

• For more severe cases, a prescription like Restasis or Xiidra can help your eyes produce more tears.

• There is also a drop called Miebo, available by prescription, that can help with Meibomian Gland Dysfunction, when your eye’s oil-secreting glands don’t secrete adequate lubrication. (My doctor gave me a prescription, but unfortunately, it is prohibitively expensive! Maybe your insurance is better than mine…sigh)

• Tear duct plugs can be placed in your tear ducts (small holes in the inner corners of your eyes) by your doc if too many tears are draining from your eyes.

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And finally, for your listening pleasure:

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

As an Amazon Associate, AfterthePause earns a small amount from qualifying purchases from some of the links we feature. Rest assured, we choose and curate our suggestions carefully, with our readers in mind.

💓💓💓

Summer used to be my favorite season, hands down.

I could withstand the heat with the best of them; eschewing air conditioning with nary a problem, remain outside effortlessly, sans perspiration.

But not so much these days.

I went out for a walk the other day - late in the day - thinking it would be cooler and more tolerable. Surely once the thermometer dropped it would be easier to do my usual 3-4 mile walk.

WRONG.

I cut the walk short, too drained to push on. I returned home, desperate for some air conditioning. Where had my energy gone? Why was I feeling so wrung out??

🥵 Truth: We’re Having a Heat Wave…

As of this writing, maps are showing that about half of the U.S. is under heat advisories. It’s not just me who feels the heat; it’s 168 million other Americans. But are we all suffering similarly??

When you hear about people actually dying from the heat, think about it: Those people are usually older adults. There must be something to that.

✅ Indeed there is…

According to studies, older bodies hold more heat than younger ones. To add insult to injury, sweat glands don’t work as efficiently; the heart is not circulating blood as well, in turn releasing less heat from vessels in the skin.

Having chronic medical conditions - like diabetes, kidney disease, or heart failure - can also interfere with your body’s ability to regulate temperature and balance fluids. And certain medications, especially those that treat some of the aforementioned conditions, can also interfere with your ability to tolerate extreme heat.

Heat can cause more than just discomfort, from heat rash to headache, nausea, vomiting or dizziness.

But oftentimes, feeling hot is not enough of a signal to tell you that you’re in dangerous heat territory. Take heat stroke; the result of exposure to extreme heat or strenuous exercise in that extreme heat. The signs are not subtle: your core body temperature climbs to over 104 degrees, you get confused, suffer seizures or experience other mental status changes. This is serious stuff and requires medical attention. While you’re waiting, take steps to cool yourself off.

I was smart to cut my walk short, head for the comfort of my air-conditioned house, and grab a seat and a cold glass of water on that too-hot day. That’s one thing you should do if you’re showing any signs of heat-related illness: Get thee to a cool environment and hydrate post-haste.

What else…

• Remove layers or any restrictive clothing.

• Find a shady spot (or get into the water) if you’re outdoors. Going deep and going cold will give you the best bang for your buck.

• If you’re indoors, jump into a cold shower or cold bath. Also, turn on a fan; when the air blows on wet skin, it helps sweat evaporate and helps your body cool down in turn.

• If you’re feeling sick and really dehydrated, grab a sports drink or salt tablets. This can help restore electrolytes (like sodium, which you need to maintain fluid balance and is lost through sweat).

Interestingly, acclimation makes a difference, and more deaths from heat occur at the start of the summer than at the end. There is something to be said for getting used to the heat.

Acclimation also matters if you’re active in the heat. Research suggests that by gradually increasing your activity over one to two weeks, your body can better adjust to exercising in hot temperatures.

More ways to beat the heat…

1. Close the shades.

2. Immerse your feet in cold water.

3. Wrap a cooling neck wrap like these around your neck.

4. Going outside? Carry an umbrella and/or a spray bottle filled with ice cold water.

Thanks for reading! Hope you are staying cool, and also staying healthy, wellthy and wise. Xo Sheryl

The temperature’s rising…it isn’t surprising. (Hardly!)

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatmen

As an Amazon Associate, AfterthePause earns a small amount from qualifying purchases from some of the links we feature. Rest assured, we choose and curate our suggestions carefully, with our readers in mind.

Along with the recommendation of walking 10,000 steps a day and worries about not getting enough protein comes another health exhortation: You must hydrate and drink eight glasses of water each day.

But, but..

That’s nearly impossible for many of us. Either:

💧We constantly have to pee

💧We’re never thirsty

💧We don’t like water

💧We forget

💧It’s not convenient

Sure, staying hydrated is important. Our bodies need water to function well. Water helps regulate body temperature. It aids in flushing out waste. It helps keep our joints lubricated, protects our organs, and helps us maintain our energy levels.

Water also helps moisten the tissues in our eyes, nose and mouth, and helps minerals and nutrients dissolve to make them accessible to your body.

It also plays a role in kidney stone prevention and heart health.

But do we really need to drink all that water?

Share

So, yes, you do need to drink up.

But here’s the good news: It’s not just plain water that replenishes the fluid your body loses.

What else counts?

Any food or liquid that contains water. Some of the superstars include:

✔️coffee

✔️tea

✔️carbonated beverages

✔️asparagus

✔️watermelon

✔️cucumbers

✔️celery

✔️lettuce

✔️cantaloupe

✔️strawberries

✔️peaches

✔️cottage cheese

✔️salmon

✔️shrimp

✔️yellow corn

✔️tomatoes

✔️broccoli

✔️spinach

Since adequate hydration is variable (depending on your health, activity level, environment, body size and health condition, for example), how do you know if you’re getting enough water?

Check your urine.

Aim for a straw or lemonade hue. If it’s dark (resembling apple juice), you might be heading toward dehydration (or maybe you’re already there).

Important to know: Signs of dehydration also include dizziness or feeling faint, dry mouth, trouble urinating, irritability, muscle cramps, confusion, and rapid breathing and/or heartbeat.

To give you a general idea of what you need, another “rule” is to take one-third of your body weight and drink that number of ounces in fluids.

Carrying a refillable water bottle, like these from Owala, is always a good way to ensure you have hydration with you. I love mine (and am fond of filling it up with a lot of ice, which keeps the water nice and cold even on the hottest days).

Cheers!

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

I’ve always been a “what-if” person, always striving to be prepared for any eventuality, no matter how obscure it might be. And as I get older, that habit becomes more ingrained. (I know, I know, you’re supposed to learn to let go of “stuff,” both of the metaphorical and physical, the real and imagined. But some things are harder than others.)

I’ve given up on this one, which is why I always pack a hefty travel first-aid kit, for those “just-in-case” moments. (And now you will understand why fitting my travel essentials into just a carry-on-only bag is next to impossible for moi.)

Of course, the one thing you think will happen rarely does. No, I did not suffer any severe allergic reactions that time I packed both Benadryl and Zyrtec, but instead needed aloe gel, which of course I didn’t pack, to soothe the sunburn I got when the winter temperatures unexpectedly climbed to a summer-like swelter one year while visiting Italy in March. Lesson learned: It’s the thing you are totally unprepared for that ends up taking a swipe at you.

And although many places have pharmacies, I feel more comfortable bringing my own supply, since you can’t always be sure - especially in foreign countries - that the strength, dose and ingredients are created equal. Often they’re not.

Before you go, check in with your doctor. Depending on where you’re traveling, they may suggest certain vaccinations or medications, or even pre-travel recommendations to minimize health risks.

Here’s some really helpful info from the CDC about the pre-travel medical consultation. (It’s meant for healthcare providers, but I think it’s good for everyone to know about.)

Also, check in with your health insurance company. Your medical insurance coverage may not be accepted where you are headed. For instance, Medicare and Medicaid are not accepted out of the United States.

What to pack

First of all, experts advise packing your meds in their original containers, and bringing more than you need (travel delays…sound familiar??). You run the risk of spoilage and/or forgetting the instructions if you transfer your meds into another container. Additionally, some countries, when you pass through customs, may require proof that the sleeping pill or antidepressant you’re taking is a legitimate prescription.

It’s wise to carry your meds in your carry-on luggage in case your luggage gets lost or delayed .

Also make sure to make two copies of a list of your prescriptions (see above). Keep one copy with you and one in the hotel safe. If you have an EpiPen or other injectable with you, a note from your doctor would be wise.

Headaches, upset stomachs, aches and pains, and more

These happen in the most inconvenient places.

That’s why it’s important to have these on hand. (I know I know; we’re all trying to minimize our packing. But being prepared can help spare you the aggravation of - what - not being prepared! And probably a whole lot of other things too unlikely - but possible - to list):

• Ibuprofen

• Acetaminophen

• Antacids

• Motion sickness medication

• Hydrocortisone ointment

• Antibiotic ointment

• Artificial tears

• Adhesive bandages (in assorted sizes)

• Sunscreen (SPF of at least 30)

• Sunburn relief

• Fiber supplements

• Stool softener or laxatives

• Anti-diarrheal medication

• Insect repellant (containing DEET)

• Hand sanitizer

• Allergy or cold medicine

• Cough drops or suppressant

• Sunburn relief

Here’s a great roundup of products from Amazon.

And at the risk of sounding obvious, don’t forget your toothpaste, toothbrush and floss. Oh, and I like to bring my own showercap because 1. My head is always too large for the ones they give you in the room and 2. Mine is prettier.

We’re almost done - I promise. A portable phone charger, an extra pair of prescription glasses, an eyemask, ear plugs and copy of your health insurance information should make the list, too!

One More Thing:

Doing a lot of walking? You might want to read this.

Where are you off to this summer? Wherever your travels take you, I hope you stay healthy, wellthy and safe!

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

I don’t know about you, but my to-do list never seems to get smaller, no matter how efficient I am. Instead, every time I cross something off (how rewarding to complete a task and celebrate with a strike-thru with a thick black marker!) another somehow edges its way in.

I’ve finally accepted the fact that thinking a to-do list will ever be empty is like shoveling while it’s still snowing; quite a fruitless task and even fruitier expectation.

And hence, my part two of the ever-growing health to-do list. The last edition of AfterthePause highlighted five essential tests; here, I finish the job with the others that are equally essential for better aging.

ONE: How’s your mouth?

With all due respect to dentists, do we really want to shell out all that money to sit in a chair and be picked and prodded? (Dental insurance is really a misnomer; it does not function like regular health insurance and has extreme limitations and low annual maximums.) And yet…get thee to a dentist, please. Do it at least once to twice each year for an exam and cleaning.

Aside from early intervention to detect and treat things like cavities, gum disease and oral cancer while they are still manageable, there is growing evidence of connections between poor oral health and dementia risk. And the risk increases with each missing tooth.

Also, it’s important to know that dry mouth, a condition that leads to a dry, sticky feeling in the mouth, affects many women after menopause, due to declining estrogen levels. Why is this important to know? Saliva helps prevent tooth decay, because it washes away sugar and food particles (which makes bacteria neutral and less harmful).

TWO: Keep an eye on your eyes.

We all have certain issues with our eyes as we age: It can be harder to see up close, distinguish colors, or drive at night and tolerate the glare from oncoming vehicles. These problems are the easy ones.

But keep this in mind: The risk of certain eye conditions and diseases increases with age, and many of these are “silent” issues in their early stages; i.e., you won’t know you have them until they are diagnosed. Some examples are glaucoma, cataracts and age-related macular degeneration, which can all lead to vision loss.

Everyone over age 50 should have a dilated eye exam each year, or as often as recommended by your eyecare professional (even if your vision is good and you don’t wear glasses or contacts). If you have diabetes or high blood pressure, you need to be examined at least once a year.

THREE: Prediabetes and Type-2 Diabetes.

The American Diabetes Association (ADA) recommends screening with a simple A1C (blood) test for everyone 35 and older.

Prediabetes, when your blood sugar levels are higher than normal (but not yet in the diabetic stage), is a “warning sign” that type-2 diabetes could be next. But it gives you the opportunity to make some lifestyle changes to keep diabetes at bay.

Long term, diabetes can damage your heart, blood vessels and kidneys, and even your eyes.

FOUR: Know your bone density.

Bone density drops precipitously during and after menopause because of declining estrogen levels. This accelerates the rate of bone loss and increases your risk of developing osteoporosis (and related fractures).

According to research, up to 20 percent of bone loss occurs during menopause. That’s why one in two postmenopausal women will have osteoporosis.

Bone loss can lead to fractures, after which comes pain, decreased mobility and loss of function. Not good.

Guidelines vary (again), with some organizations recommending screening (via a non-invasive DEXA scan of the spine and hip) beginning at age 60-65. But I started earlier after falling and breaking my wrist. Voila: I was found to have osteopenia (a precursor to osteoporosis. I have now, unfortunately, crossed the line - despite exercising and eating healthfully. Some things are destiny - and genetically linked, I suppose.)

FIVE: Skin check…testing, one, two three.

Did you do what I did as a teenager? Lay out in the sun, dare I say, while holding a sun reflector under your chin to direct those we-didn’t-know-they-were deadly rays upward? I feel idiotic, yes, but who knew??

Even if you didn’t, an annual skin cancer check is essential, as this is the most common cancer in the U.S., its incidence rising with age (since the damaging effects of the sun are cumulative). One in five of us will develop skin cancer by age 70.

Aside from checking your own skin regularly (even the soles of your feet!), get checked by a dermatologist - from head to toe - at least once a year (more often if you have a history of skin cancer.) Early detection of melanoma and other skin cancers can save lives and make treatment easier.

And that’s not all..

If you’re into immunizations (and I hope you are!) AARP has compiled a list of what you need to know.

Until next time, thanks for reading, and stay healthy, wellthy and happy!

XoSheryl

Not a subscriber yet? I hope you’ll join my growing list!

Before you go, take a listen. It might help ease the pain of all the craziness in the world these days…

So very true: “In every life we have some trouble
But when you worry you make it double”

The information provided on the site is for educational purposes only, and doeot substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

Lately, I’ve been thinking about life transitions.

Adolescence - the first real turning point we’re aware of - was tough for me. I was nearing 15, and most of my friends (and it seemed the whole world of girls my age) were proudly showing off their bras under sheer-ish white t’s. As if my tallness, paleness and skinniness didn’t make me feel awkward enough, the fact that I a). was completely flat-chested and b). didn’t have my period yet made me painfully different and alone. So many of my friends sported deep cleavages, while I, desperate to fit in and keep pace, stuffed my soft, cupless bra with socks, wondering if anything would ever grow.

I remained silent as they talked, joked and complained endlessly about their periods - the pain, the bother, the flow, tampons vs. napkins and what works better…never sharing with anyone but myself that I felt left out, less-than and lonely.

Of course, when you’re young and troubled, it feels as if you’re stuck in an endless loop of hopelessness. The day I finally saw red eventually arrived, as did my breasts. I felt complete.

Who would think the time would speed by and decades later, I’d be happy to dispose of the tampons, the pads, the cramps, and the bother? Who would think that something like menstruation and boobs were enough to make anyone feel that’s all they needed to belong and believe?

We are prepared for adolescence. Much talk and attention is put on the march toward this phase, a developmental turning point. We are now prepared for menopause, thanks to a new openness about menopause-positivity and acceptability.

But who prepares us for the next 40 percent of our life, when we are (again) in a body that feels quite foreign and unfamiliar?

This might sound weird and dramatic to some of you (or not), but I can’t help but think about what it felt like when I was going through chemo. During chemo, you are cared for; constantly and consistently monitored. All eyes are on you. And then, the day you’ve been waiting for is finally here. You are done! What a relief.

But what no one told me, what I was not prepared for, is how and what I would feel after those first moments of freedom. I’ll tell you how I felt: untethered, and fearful of being let loose into a world where no one was watching. Of course, there were still visits to the oncologist, but as the years wore on and my health remained steady, those grew further and further apart (thankfully).

And yet, as the intervals between visits grew longer, my fear of what lay ahead didn’t fade with it.

Where, oh where, am I going with all of this banter?

ONE: Check your blood pressure at least once a year.

Blood pressure tends to rise after menopause. This may be related to things like changing hormones and weight gain. High blood pressure can lead to serious health problems like heart attack or stroke.

• Normal levels are an upper number (systolic) of less than 120, and a lower number (diastolic) of less than 80.

• You might need it checked more often if you:

1. Have heart disease or kidney problems.

2. Are overweight.

3. Are Black.

4. Have had high blood pressure during a pregnancy.

5. Have a top number from 120 to 129 mm Hg, or a bottom number from 70 to 79 mm Hg.

• You can test your blood pressure at home with a monitor like any of these.

TWO: Don’t skip your mammogram.

Breast cancer is most common in women over 50, and many cases occur post-menopause. It’s more likely to find breast cancer early, when it’s more easily treatable.

• Experts recommend starting at age 40, and repeating every one to two years.

• If you have a family history of breast cancer, talk to your healthcare provider to see if he/she recommends additional testing.

• If you have dense breasts, you may need additional screening tests or more frequent mammograms. Good to know: A new federal mandate states a facility must inform a woman undergoing a mammogram if she has dense breasts. (Having dense breasts can make cancer more difficult to detect. Learn more here.)

THREE: Cervical cancer screening.

Early menopause can increase the risk of gynecological cancers. Cervical cancer screening can find cervical cancer early, when it’s more likely to be cured.

• If you’re between 30 and 65 years old, have either a Pap test every three years or the HPV test every five years. You can also have both tests every five years (known as “cotesting”).

• If you’ve been treated for precancer (cervical dysplasia), you should continue having Pap tests for 20 years following treatment or until you’re 65 (or whichever is longer).

FOUR: How’s your cholesterol?

The loss of estrogen that comes with menopause affects your cholesterol levels. It's important to know your numbers, as cholesterol levels help you assess your risk for heart disease and stroke.

• If you have normal cholesterol levels, you should be tested every five years.

• Heart-healthy cholesterol is considered to be a total cholesterol of under 200; an LDL of under 100, and an HDL of 60 or higher.

• Cholesterol should be tested more often if:

1. There are changes to your lifestyle, like weight gain or diet.

2. You have diabetes, heart disease, kidney problems, stroke or blood flow problems in your legs or feet.

3. You’re already taking medication to control high cholesterol.

FIVE: I can’t wait to get my colonoscopy (said no one, ever)!

A later menopause (after age 55) has been found to increase the risk of colorectal cancer. A colonoscopy is the test we love to hate, but an extremely effective test to detect colorectal cancer early.

• Experts recommend starting colonoscopies at age 45.

• You may be advised to begin earlier if you have a strong family history of colon cancer or polyps, or risk factors like a history of inflammatory bowel disease or polyps.

• A colonoscopy is usually done every 10 years, but may be more often based on findings and individual risk factors.

For a Pause… Things I like, things I covet.

1. This nightgown by Eileen West reminds me of the kind I wore in my younger years, when we had no air conditioning to cool us in the hot summers. (My parents insisted it wouldn’t kill us…and they were right!) Cottony and light, it’s just the right weight to make you feel like you’re hardly wearing anything at all.

2. I’m always on the lookout for some good beauty advice. From celebrity esthetician and Beauty Curious podcast co-host Ian Michael Crumm comes this: '“Don’t throw away the last bits of moisturizer left behind in a jar or tube. Instead, rub it into your hands and cuticles—they deserve just as much luxury and care as your face.” A “makeup spatula” helps scrape out the very last of a good thing. Waste not, want not.

3. I was recently gifted some products by Arbonne, and they’re so good, I want to try the whole line. If you’re Arbonne-curious, take a look here. They are packed with skin-loving and science-backed ingredients.

4. Last evening, I was sitting in my backyard with my twin 3-year old grandsons. Every time a bird came to eat from my bird feeder, they got so excited. “Gigi, what kind of bird is THAT?” I came up with nothing more than “A little one!” “A hungry one!” “A big one!” That is precisely why I need something like this, a bird feeder that actually identifies what you are admiring, and makes you sound like the most brilliant person in the room.

Breaking News: There’s more to come!

Make sure to tune into the next edition of ATP, and learn about the importance of more screenings, like dental and diabetes screening, plus other ways to safeguard your health and age better.

Until then, stay healthy, wellthy and happy.

Xo Sheryl

Agree or disagree?

The information provided on the site is for educational purposes only, and does not substitute for professional medical advice, diagnosis or treatment.

This newsletter does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.