Oh, baby: A midwife answers common birthing questions

In her new column for the Town Crier’s Your Health section, midwife Tracy Donegan addresses common questions and issues related to natural labor and delivery.

Research study reveals young women and girls lack recommended exercise

 Mountain View High cheerleading
Megan V. Winslow/Town Crier
Mountain View High cheerleaders get their recommended hour of exercise by running around campus in this photo from 2015.

According to U.S. News and World Report, a new research study that includes data from the U.S. National Health and Nutrition Survey concludes that girls and young women ages 12-29 aren’t meeting the recommended guidelines for exercise.

The American Heart Association recommends teens get 60 minutes of moderate to vigorous exercise per day and adults get 150 minutes of moderate or 75 minutes of vigorous exercise per week.

Pelvic health: Pregnancy, postpartum and beyond


Courtesy of Michelle Reynolds
Kim Gladfelter shows a patient how to avoid pelvic health dysfunction with physical therapy that focuses on the pelvis, corresponding muscles, bones and soft-tissue structures.
 
 

During pregnancy and the postpartum period, women’s bodies undergo many changes. When a problem arises as a result, there is a misconception that it is normal and you just have to accept it. But ignoring the matter can cause long-term problems that affect quality of life in years to come.

Common problems include leaking urine when you cough, sneeze or exercise; pelvic pain with intercourse; pain at the incision site of a C-section; and diastasis recti (abdominal separation with bulging).

'I'm sorry': Embracing the most healing words in language


Let’s face it, because we’re human, the possibilities for screwing up are infinite. These range from everyday hurts to big betrayals. How these mistakes impact you and your important relationships depend on what happens next.

Obviously, an apology is required. And while we are told apologies will heal a rift, who hasn’t had the experience of receiving (or offering) an apology that just makes things worse? This one-two punch of causing hurt followed by apologizing with excuses compounds the initial injury.

Addressing ongoing need, ECH expands program for teen mental health

A singular message reverberated across social media Sept.10, World Suicide Prevention Day: Youth suicide rates will not change until each community takes action.

Directors of El Camino Hospital’s After-School Program for Interventions and Resiliency Education (ASPIRE) last week announced the expansion of the program with new replications in Southern California at CHOC Children’s Hospital, Hoag Memorial Hospital Presbyterian and Mission Hospital.

Daniel Becker, M.D., chief medical director of Mental Health and Addiction Services at El Camino, said that while the hospital jump-started ASPIRE after the wave of suicides at Gunn High School in Palo Alto in 2010, the program works with youth of all ages struggling with a range of mental health problems. Local residents may associate the launch of ASPIRE with the mental health crisis that precipitated it, but program representatives stand ready to serve any child, teen or young adult waging a mental battle long before it becomes that severe.

“Undeniably, those events did add urgency (to start ASPIRE),” Becker said of the local cluster of teen suicides. “But there have been many other kids with other behaviors. … It’s a great choice for kids who have the ability to make use of a fairly rigorous curriculum to help with their anxiety, depression, substance abuse, mood or personality disorder.”

Another tip widely shared on the internet on World Suicide Prevention Day: Pay attention to the words and behaviors of friends and loved ones. That advice directly correlates to how ASPIRE identifies youth who need care and teaches them how to cope with stress.

“I’ve worked in the Bay Area for over 25 years now, with other hospitals, too, and I have referred many to ASPIRE,” Becker said. “People get referred to ASPIRE and all of El Camino Hospital’s programs through many routes: school personnel or counselors, parents who read about the program or clinicians who have seen a kid in evaluation and determine right now they need more treatment than in a typical doctor’s office situation.”

Individualized care

According to Becker, during the eight-week, after-school outpatient program, participants meet with a psychiatrist who specializes in child-adolescent behavior, who conducts an ongoing evaluation and/or prescribes safe medication if appropriate. The program also incorporates group and family intervention. ASPIRE’s commitment to addressing and customizing care for each individual’s mental health struggle has made the program especially effective and worth replicating.

The group and family therapy aspect of ASPIRE is key to treatment and recovery, Becker said, because of the large amount of trust and emphasis teens place on what their peers and family members think.

“We try to help parents understand what approach we are using with their kids in hopes they can encourage healthier behavior and thinking,” he added. “They can only do that if they understand.”

Becker noted that he has never seen group treatment work better than with the middle school, high school and college/postgraduate individuals that ASPIRE serves. The program employs a model that enables participants who enter at different times and must assimilate new information to adjust to their new environment by receiving encouragement and mentoring from those who have been in the program longer who can genuinely say they know how the newcomers feel.

“It’s very common in psychiatric treatment, but especially powerful in teens for reasons that are developmentally normal, or even good,” the medical director said of the peer-to-peer aspect of the program. “They pay more attention to their peers than grownups in their lives. They are beginning to step outside of their parents’ shadows to form complex, meaningful connections (with those their age.)”

Model program

To Becker’s knowledge, ASPIRE’s model is the first of its kind. Modified from the experience of those who attended therapy sessions once a week for six months, they compressed the program into eight weeks for efficiency. Directors also attempted to make ASPIRE accessible to all who need it, working to ensure that insurance companies don’t refuse to cover the service for a child or teen considered stable enough to discontinue his or her therapy.

All who start the eight weeks are eligible complete it, and graduates pass along advice for the next group coming in after they have completed the program.

Michael Fitzgerald, El Camino’s executive director of Mental Health and Addiction Services, stressed that ASPIRE offers treatment for a wide spectrum of mental health challenges.

“Kids are not just discharged if they don’t have suicidal tendencies,” he said.

The need has never been greater for youth mental health resources, largely because of how much social stress today’s youth endure, Becker said, adding that the pressure to get into a good college alone is enough to send a teenager over the edge.

“Adults are better at stress management because it is a part of their growth,” he said. “We sense this in ourselves probably through trial and error, and now have a bunch of strategies to reduce these stresses, like saying ‘no,’ taking time off and exercising. Teens have not yet gotten to the point where they can identify and reduce stress like grownups do.”

The program began with a task force of psychiatrists, parents, school personnel and community members who identified ongoing resources for ASPIRE participants after discharge, filling in the so-called missing gap. Middle school and transitional age (ages 18-25) programs were added as need arose.

For participants nervous about starting ASPIRE, a two-week preparation program aims to ease anxiety and, build cooperation and commitment, Fitzgerald said.

“None of this is intended to be definitive treatment,” he said. “It’s frontloading treatment with decades of potential ahead of (those in the program) … in hopes they’ll work with a therapist in the community in the future to practice these tools then and throughout their lives.”

For more information, visit elcaminohospital.org/services/mental-health/specialty-programs/aspire.

Get fit for fall and back-to-school season

Family cycling
Megan V. Winslow/Town Crier
The local climate provides an extended season for families to get outdoors for activities like bike riding.

It’s hard to believe summer is nearly over. The days will soon be getting shorter, the weather will eventually be getting cooler and the kids will be heading back to school.

According to the American Council on Exercise, changing seasons can impact our health, sleep, mood and general behavior. While it may be tough to say goodbye to the carefree days of summer, there are ways to embrace the new season with our physical, mental and emotional health intact. The key is to focus on fitness, nutrition, sleep and mindset.


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