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Obstetrics & Gynecology in Augusta, GA
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Ten Commandments of Good Health


Many years ago a desert dweller climbed a mountain and talked to a bush on fire.  What resulted was a set of laws that was to revolutionize mankind’s behavior.  These were not ten suggestions formulated by a long range planning committee nor were they ten proposals put forth by a strategic consultant, they were commandments from a Holy God.  These laws have become almost universally accepted, even by divergent religions, as wise and worthy of adopting. 

     With all humility and a sincere desire to be unpretentious (I am not even worthy enough to scrape the grasshoppers from Moses’ designer goat skin sandals), I propose the Ten Commandments of good health to serve as a lamppost for your journey down fitness lane.  It seems unfair to hurry through these guidelines, so I will opine in both this month’s and next month’s column to cover them all.

                                                      Commandment One

You Shall Exercise:

Live Longer, Reduce Stress, and Grow Your Brain

     Exercise is the elusive fountain of youth.  If you are heavy, harried or hormonal, moving with purpose is a critical part of the solution. Everyone knows exercise is good for you, but few of us follow through. Exercise begins above the neck with a commitment to self and family.  Part of this motivation lies in the hidden benefits of exercise that are not common knowledge such as the prevention of breast and prostate cancer,  reduction in the onset and progression of Alzheimer’s disease, and as a cure for clinical depression.  Start with a simple walking program and free yourself from the “couch of doom”.

Commandment Two      

You Shall Rest:

A Nap a Day May Keep the Doctor Away

     We live in a hurry-up culture where “Just Do It” supplants “Let It Be”. Busyness has be­come a virtue that is without merit.  Idle hands are the devil’s playthings only in those who haven’t learned the discipline of relaxation.  Certainly there is a place for goal setting and industrious behavior, but there is also a purpose in rest and play. Relaxing on purpose is healthier than just doing something aimlessly. A major area of our lives that is most affected by this culture of chaos is sleep. The average adult requires eight hours of restful sleep a night to function best the next day.  The average adult actually gets around six hours of sleep a night.  This obvious disconnect leads to chronic fatigue and foggy thinking.  40% of Americans (100 million people) are moderately to severely sleep-deprived!

Commandment Three     

You Shall Not Worry:

Make Stress Work For You

     Stress is the little yapping dog biting at the heels of our health.  It is generally an annoyance, but, if it goes on long enough, can become a festering wound.  There are a number of books and counselors that provide a wealth of guidance on effective stress management in a world that oozes anxiety.   Studies indicate that up to 75% of visits to doctors are related to anxiety.  Stress is simply a perception of an internal or external event and thereby can be influenced by our thoughts.  One person’s stress is another person’s opportunity.  You will never be without stress, but you can control and minimize the adverse effects. 

Commandment Four 

You Shall Get Checkups:

                                          Prevention Pays Lifelong Dividends

     A healthy mind and body is dependent on action and education, not passivity and ignorance.  You must be an advocate for you and your family’s well-being by embracing prevention.  Men are especially negligent in this arena, and often decisions regarding family health are delegated (by default) to women in the household.  Seventy percent of health decisions involving the family are made by mom, which includes checkups, vaccines, nutrition, and screening tests.  Most importantly, the woman, by her actions and decisions, sets the tone for current and future health decisions.  A major health care crisis today is not cancer, AIDs, or heart disease, but people not making healthy, proactive lifestyle decisions.  We have to transform a system based on sick care to one that truly embraces well care, and that can only be achieved by practicing individual, responsible prevention.

Commandment Five

You Shall Not Be Gluttonous:

Eat Your Way to Good Health

     

     We are often called a society of consumption.  The talking heads are referring to consumerism; however, the real consumption issue is what we eat.  Our diet has more of an impact on our health and longevity than almost any other activity.  Content and quantity are the evil twins of gluttony.  There are four simple guidelines that, if followed consistently, will provide a foundation of healthy nutrition that will build a legacy of wellness.  Simply stated, eat balanced, low fat, low sugar, and high fiber meals. It is possible to alter the health inheritance of our kids and grandkids by changing how we think about food.  You can spring the family from the prison of poor nutrition and not be held captive by your genetics through a simple and doable eating plan.  We truly are what we eat. 

Next month…what else but six through ten!

Postpartum changes

It’s over.  The baby is here!  The excitement is only beginning, and then the reality sets in!  Now the real work starts.  Let’s look at some common postpartum concerns.

     Breast feeding has undergone a resurgence over the past two decades and now a majority of women attempt it in the first few months after giving birth, and most are successful.   Ideally, this is something that has been discussed and considered earlier in the pregnancy.  If there is still doubt at this stage, discuss the pros and cons with your pediatrician.

     It may take forty-eight to seventy-two hours after delivery for your milk to actually come in.  There are a few techniques to aid in this process such as warm water massage and the use of certain medications (Reglan).  Consult your pediatrician or lactation consultant if you sense a problem or the baby doesn’t seem to be satisfied.  A common bothersome complication for breastfeeding moms is sore and cracked nipples.  There are various creams that heal and coat the skin, and nipple shields, available at most pharmacies, can be a life saver. In both mastitis (breast infection) and nipple cracking, it is recommended to continue breastfeeding. Persisting with breastfeed in these situations does not jeopardize the health of the baby.

     If you had an episiotomy, vaginal tears, or lacerations, you will probably

experience some discomfort in the immediate postpartum stage.  During your hospital

stay, you were introduced to the wonderful world of sitz baths.  These warm, antiseptic cleansing baths will keep the area clean and promote healing.  They can be continued at home as long as they help. 

    The “lochia” or vaginal bleeding and discharge after the delivery, may continue for four to six weeks.  This is a mixture of blood from the uterine cavity and vaginal secretions.  It is usually heaviest in the first twenty-four to forty-eight hours after delivery and slacks off steadily from there.  If you are breastfeeding, you may see a temporary increase right after the act of breastfeeding as the uterus cramps and expels any remaining tissue.  If you are concerned about the amount of bleeding at any time, don’t hesitate to call your physician. 

     One of the most common questions after delivery is, “How can I lose this weight?”  In

our health conscience, “skinny is better” world this can become an obsession for some

women.  Remember, it took nine months to put this weight on, it will not go away over

night. There are, however, some things you can do to speed up the process. If you had an uncomplicated vaginal delivery, you can begin walking as soon as you feel well and have the energy.  Exercise is the key to healthy weight loss.  You can resume an exercise program within a few days of delivery, especially if you maintained an exercise regimen during the pregnancy.  There are always exceptions.  If you had a large number of stitches from a tear or episiotomy, your physician may request that you temporarily limit your activity.  If you had blood pressure problems or pre-eclampsia, you may need to postpone exercise.  Before you leave the hospital ask your doctor about his recommendations for your activity levels.

     The second component to healthy weight loss is proper nutrition.  This is especially important for breastfeeding mothers.  When you are nursing, you need about 500 calories a day more than you would normally eat in a non pregnant state.  This is assuming you were eating healthy before you got pregnant.  Eat a well balanced diet and focus mainly on fruits, vegetables, and whole grains.  I generally tell new moms to continue to take their prenatal vitamins while nursing as it provides additional nutrients that you may not get in your diet.  Drink plenty of water, a minimum of eight to ten 8 oz glasses a day.  This is critical to allow for the production of adequate milk and is also important in promoting weight loss.

     Another common question that arises postpartum is “When can I resume sexual relations?”  Actually this is the most common question of the husband.  This is not exactly paramount for most women at this stage.  I had one patient who asked me to write her a note that she didn’t have to have sex for a year; however, it became obvious that this request was reflective of a relationship problem more than a physical problem. The leading causes of decreased libido after birth are stress and fatigue. Don’t fret this lack of desire as it is almost universal.  It will vary as to when the desire for intimacy returns.  I would discuss this openly with your doctor and husband as often communicating your feelings fosters understanding and compromise. 

     The birth of a child is God’s way of reinforcing that the world needs to continue.  Embrace it with a heavy dose of both joy and responsibility.