Senior dating: Resuming sexual activity later in life

Q:

I am a 76-year-old female. I've
not been sexually active in many years. But I'm in a relationship now and wonder
if I will be able to resume sexual activity again at this late time?

A:

You will be happy to learn that you can resume sexual activity — as
long as you're willing to invest a little time and patience.

As women age, they experience several changes in their vaginal area. The
vagina and vaginal opening often become smaller, especially when estrogen levels
are low. As a result, it often takes longer for the vagina to swell and
lubricate when you're sexually aroused. Together these changes can make
intercourse painful.

The good news is that there are steps you can take to make sexual intercourse
more comfortable, including:

• Longer foreplay. Foreplay helps stimulate natural
  lubrication.
  
• Over-the-counter lubricants. Products such as K-Y
  Lubricating Jelly and Glide are available for this purpose.
  
• Topical estrogen treatment. For some women, treatment with
  vaginal estrogen creams is the best way to increase natural lubrication.
  

If a woman hasn't had intercourse for a while, it will take time to stretch
out the vagina so that it can accommodate a penis. Talk to your partner about
what works best. You may want to try different sexual positions or different
times of day.

You should also keep in mind that sex is more than intercourse. Touching and
cuddling are an important part of sexual activity. Communicating with your
partner is the best way to achieve sexual satisfaction.

Like a Sex Machine

At last, women may have their answer to Viagra. The EROS Clitoral Therapy
Device (EROS-CTD) is the first product developed to treat female sexual arousal
disorder (FSAD). Characterized by diminished sexual sensation, FSAD affects
approximately 43% of American women. It results from inadequate blood flow to
the clitoris and can cause a host of other difficulties, including lack of
desire and difficulty achieving orgasm.

Enter EROS, a clitoral suction device that draws blood to the clitoris to
trigger sexual arousal and enhance orgasms. In a study presented recently at an
American Urological Association conference, 80% of FSAD sufferers reported
improved sexual satisfaction after using EROS before intercourse. But EROS is no
mere sex toy, says Kevin Billups, Ph.D., an urologist and one of the study's
researchers. "People say, 'Oh, this is just a fancy vibrator'--but it isn't," he
explains. "It's a physiological device."

Because FSAD can also hurt relationships by causing lowered self-esteem,
depression and poor body image, "women suffering with sexual dysfunction may
have a relationship in crisis," says Laura Berman, Ph.D., a female sexual
dysfunction expert. She suggests these women consider using EROS in conjunction
with professional counseling. And the best news may be yet to come: Women who
used EROS regularly reported enhanced sexual satisfaction even after they
stopped using it.

Sex and Your Psyche

You know the cliche: a woman is so uninterested in sex that she makes a
shopping list while making love. Jennifer and Laura Berman see such women all
the time, and it's frustration--not boredom--that brings them to the Bermans'
new clinic at UCLA.

"I was talking to a woman earlier today about her low libido, which was a
result of the fact that she can't reach orgasm," says psychologist Laura Berman,
Ph.D., who with her sister, urologist Jennifer Berman, M.D., is a founder and
codirector of the Center for Women's Urology and Sexual Medicine clinic.
"Because she can't reach orgasm, sex is frustrating. She feels a hopeless,
fatalistic complacency about her sex life. When she's having sex, her partner
picks up on that and feels rejected and angry, or notices she's withdrawing.
Then intimacy starts to break down. Her partner feels less intimate because
there's less sex, and she feels less sexual because there's less intimacy. The
whole thing starts to break down."

Acknowledgement of sexual dysfunction in America is booming. But with all the
attention on Viagra and prostate problems in men, most people would probably
never guess that more women than men suffer from sexual dysfunction. According
to an article in the Journal of the American Medical Association, as many as 43
percent of women have some form of difficulty in their sexual function, as
opposed to 31 percent of men.

And yet female sexuality has taken a back seat to the penis. Before Viagra,
medicine was doing everything from penile injections to wire and balloon
implants to raise flagging erections, while female sexual dysfunction was almost
exclusively treated as a mental problem. "Women were often told it was all in
their head, and they just needed to relax," says Laura.

The Bermans want to change that. They are at the forefront of forging a
mind-body perspective of female sexuality. The Bermans want the medical
community and the public to recognize that female sexual dysfunction (FSD) is a
problem that may have physical as well as emotional components. To spread their
message, they have appeared twice on Oprah, have made numerous appearances on
Good Morning America and have written a book, For Women Only.

"Female sexual dysfunction is a problem that can affect your sense of
well-being," explains Jennifer. "And for years people have been working in a
vacuum in the sex and psychotherapy realms and the medical community. Now we are
putting it all together."

No single problem makes up female sexual dysfunction. A recent article in the
Journal of Urology defined FSD as including such varied troubles as a lack of
sexual desire so great that it causes personal distress, an inability of the
genitals to become adequately lubricated, difficulty in reaching orgasm even
after sufficient stimulation and a persistent genital pain associated with
intercourse. "We see women ranging from their early twenties to their
mid-seventies with all types of problems," Laura says, "most of which have both
medical and emotional bases to them." The physical causes of FSD can range from
having too little testosterone or estrogen in the blood to severed nerves as a
result of pelvic surgery to taking such medications as antihistamines or
serotonin reuptake inhibitors, such as Prozac and Zoloft. The psychological
factors, Laura says, can include sexual history issues, relationship problems
and depression.

The Bermans codirected the Women's Sexual Health Clinic at Boston University
Medical Center for three years before starting the UCLA clinic this year. At
present, they can see only eight patients a day, but each one receives a full
consultation the first day. Laura gives an extensive evaluation to assess the
psychological component of each woman's sexuality.

"Basically, it's a sex history," Laura says. "We talk about the presenting
problem, its history, what she's done to address it in her relationship, how
she's coped with it, how it has impacted the way she feels about herself. We
also address earlier sexual development, unresolved sexual abuse or trauma,
values around sexuality, body image, self-stimulation, whether the problem is
situational or across the board, whether it's lifelong or acquired." After the
evaluation, Laura recommends possible solutions. "There is some psycho-education
in there, where I'll work with her around vibrators or videos or things to try,
and talk about addressing sex therapy."

Afterward, the patient is given a physiological evaluation. Different probes
are used to determine vaginal pH balance, the degree of clitoral and labial
sensation and the amount of vaginal elasticity. "Then we give the patient a pair
of 3-D goggles with surround sound and a vibrator and ask them to watch an
erotic video and stimulate themselves to measure lubrication and pelvic blood
flow," Jennifer says.

The identification of FSD has been called everything from the final frontier
of the women's movement to an attempt by the patriarchy to shackle women's
sexuality. But given the success that drugs such as Viagra have had in reversing
male sexual dysfunction, the Bermans found an unexpected amount of criticism
from their peers. "The resistance we got from the rest of the medical community
early on was surprising to us," Laura says, explaining that the urological field
in particular has been dominated by men.

Clearly, the Bermans will need hard data to win over their critics. Their
UCLA facility is enabling the Bermans to conduct some of the first systematic
psychological and physiological research on the factors that inhibit female
sexual function. One of their first studies suggests that the pharmaco-sexual
revolution that helped some men overcome their sexual dysfunction may prove less
effective for women. Their initial study of the effects of Viagra on women found
that Viagra did increase blood flow to genitalia and thereby facilitate sex, but
women who took the drug said it provided little in the way of arousal. In short,
subjects' bodies might have been ready, but their minds were not.

"Viagra worked half as often in the women with an unresolved sexual abuse
history as in those without it," Laura says. "So it's just not going to work
alone. Women experience sexuality in a context, and no amount of medication is
going to mask psychologically rooted, or emotionally or relationally rooted
sexual problems." Laura believes the results of the Viagra study counter those
who contend that FSD is simply a tool of pharmaceutical companies to
"medicalize" female sexuality.

"I'm less concerned about it, because I'm aware that it won't work," she
says. "And in some respects, pharmaceutical companies are closing the divide
between the mind and body camps of FSD. Clinical trials of new drugs for FSD are
requiring psychologists to screen participants, and that is an acknowledgement
that an accurate assessment of a drug's efficacy requires a consideration of the
test subjects' feelings about sex. So these physicians who may not be motivated
to bring on a sex therapist are now motivated to participate in a clinical
trial, and then that model becomes the norm."

Currently, the sisters are working on MRI studies of the brain's response to
sexual arousal, the place where mind and body meet. And although there is a lot
more research to be done on FSD, identifying it as a problem has already made a
significant impact on how women perceive their sexuality. "Women now feel more
comfortable going to their doctors, and they're not taking no for an answer, not
being told to just go home and have a glass of wine," explains Laura. "They feel
more entitled to their sexual function."

READ MORE ABOUT IT: For Women Only: A Revolutionary Guide to Overcoming
Sexual Dysfunction and Reclaiming Your Sex Life Jennifer Berman, M.D., and Laura
Berman, Ph.D. (Henry Holt & Co., 2001)

HIS & HERS... and how to have them

Hers: a female orgasm can be frustratingly evasive. While about 85 to 90
percent of women are capable of having an orgasm, according to Beverly Whipple,
Ph.D., vice president of the World Association for Sexology, only about
one-third have had one during intercourse. That said, it's important to remember
that orgasm should never be the goal.

"In goal-oriented sexual interactions, each step leads to the top step, or
the big "O"--orgasm," says Whipple. "Goal-oriented people who don't reach the
top step don't feel very good about the process that has occurred. Whereas for
people who are pleasure oriented, any activity can be an end in itself; it
doesn't have to lead to something else. Sometimes, we're very satisfied holding
hands or cuddling. There would be a lot more pleasure in this world if people
would just focus on the process."

Whipple also points out that the psychological ramifications of dissatisfying
sexual interactions are not often suffered alone; they can cause distress in
both partners. "If one person in a relationship is goal-oriented and the other
is pleasure-oriented, and neither is aware of their own orientation, they don't
communicate that with their partner," she explains. "A lot of relationship
problems can develop. In my workshops with couples, I help them be aware of how
they view sexual interactions and then communicate this with their partner."

TYPES OF ORGASM

Clitoral Orgasm

The most common, they result from directly stimulating the clitoris and
surrounding tissue. What many people don't realize is that the majority of the
clitoris is actually hidden inside the woman's body. Recently, Australian
urologist Helen O'Connell, M.M.E.D., studied cadavers and 3-D photography and
found that the clitoris is attached to an inner mound of erectile tissue the
size of your first thumb joint. That tissue has two legs or crura that extend
another 11 centimeters. In addition, two clitoral bulbs--also composed of
erectile tissue--run down the area just outside the vagina.

O'Connell's findings, published in the Journal of Urology, show that this
erectile tissue, plus the surrounding muscle tissue, all contribute to orgasmic
muscle spasms. With so much tissue involved in a clitoral orgasm, it's no wonder
they're the easiest to have.

Pelvic Floor or Vaginal Orgasms

These occur through stimulating the G-spot, or putting pressure on the cervix
(the opening into the uterus) and/or the anterior vaginal wall. Located halfway
between the pubic bone and the cervix, the sensitive G-spot--named after its
discoverer, German physician Ernest Grafenberg--is a mass of spongy tissue that
swells when stimulated. Because it's difficult to locate, experts have developed
a few guiding techniques:

o Lying on her back, the woman tilts her pelvis upward so that her vulva
presses flat against her partner's pelvic bone. According to the Bermans, this
allows the penis to make contact with the G-spot, simultaneously stimulating the
clitoris. Putting pillows beneath her buttocks makes angling her pelvis easier.

o Whipple suggests placing two fingers inside the vagina and moving them in a
beckoning motion. The fingertips should stroke the frontal vaginal wall, just
where the G-spot is located.

The Blended Orgasm

This can be attained through a combination of the first two.

HER BENEFITS

o Pain relief: Orgasms help alleviate menstrual cramps. In addition, studies
have shown that a woman's pain threshold increases substantially during orgasm.

o Enhanced mood: According to University of Virginia researchers, orgasms
boost levels of the female sex hormone estrogen, which in turn betters your mood
and helps ease premenstrual symptoms. They also release endorphins, the body's
natural painkillers and depression fighters.

o Increased intimacy: Oxytocin, a hormone that promotes feelings of intimacy,
jumps to five times its normal level during climax.

o Easier rest: Oxytocin also induces drowsiness. For women, sleepiness comes
about 20 to 30 minutes after orgasm. Men, on the other hand, usually drift off
after only two to five minutes.

o Less stress: Stress in women is highly correlated with arousal
difficulties, lack of libido and anorgasmia, the inability to reach orgasm,
according to one 1999 study in the Journal of the American Medical Association.
Just 20 minutes of intercourse, however, releases the lust-enhancing hormone
dopamine, triggering a relaxation response that lasts up to two hours.

His Physiologically speaking, male and female orgasms are surprisingly
similar. The related problems men and women experience, however, are distinctly
different.

"There are men who can't orgasm, but I think it's less than I percent of
men," says Jed Kaminetsky, M.D., a professor of urology at New York University
and director of the school's male sexual dysfunction clinic. "That's a much less
common problem than premature ejaculation."

A study published in the Journal of the American Medical Association found
that premature ejaculation is even more common than erectile dysfunction,
especially among younger men. As with most sex-related problems, it affects both
partners--some studies suggest that nearly 30 percent of couples report
premature ejaculation as the most prevalent sexual problem in their
relationship. One major obstacle to treating it is simply defining the problem
to begin with.

"It depends on the relationship," Kaminetsky explains. "If a woman takes an
hour to orgasm and the man can last 40 minutes, that's premature ejaculation for
that couple." At the other extreme, one minute is too short an amount of time
for most couples. "Not too many women are going to climax within a minute."

Kaminetsky also sees truth in Whipple's assessment of goal-oriented versus
pleasure-oriented interactions. "Men are very goal oriented; they see a task and
they want to successfully perform that task," he says. "Often that task is to
make their partner have an orgasm. If the woman knows that, she feels like a
laboratory animal--it's not a very sexy thing. That's why women fake orgasms,
which is a sign of lack of communication in a relationship."

PREMATURE EJACULATION

Rarely a physiological problem, premature ejaculation can result from
over-excitement, positioning or rate of intercourse. "The roots of it go back to
the way men learn to orgasm, which is typically through masturbation," suggests
Kaminetsky. "A lot of young boys masturbate quickly, because they don't want
their mom to walk in on them. It becomes a trained behavior." To treat premature
ejaculation, experts suggest changing positions, breathing deeply, thinking
about something other than sex or simply stopping for a moment. Here, Kaminetsky
offers two additional techniques for delaying orgasm:

o Practice this before reaching "ejaculatory inevitability," the point when
ejaculation cannot be stopped; most men recognize it as a sensation of deep
warmth or pleasure: Squeeze the head of the penis for about four seconds or
until the sensation subsides, then resume.

o During intercourse, the man should press his pelvic bone against the
woman's and rock rather than thrust his body. "It won't be as stimulating for
him so he'll last longer, and it may be more stimulating for the woman."

HIS BENEFITS

o Long life: Men who have two or more orgasms a week tend to live
significantly longer than do those who have only one or none, according to
research at Cardiff University in Wales.

o Less cancer: Breast cancer is rare in men, but once developed, the
mortality rate is high. Fortunately, a study published in the British Journal of
Cancer found that men who have more than six orgasms a month are significantly
less likely to develop breast cancer than are those who have less frequent sex.

o Healthy hearts: A study of 2,500 men at the University of Bristol and
Queens University of Belfast found that men who have at least three or more
orgasms a week are 50 percent less likely to die from heart failure or coronary
heart disease.

o Good health: Having sex once or twice a week also fights off the flu and
other viruses by strengthening the immune system, psychologists at the
University of Pennsylvania recently found.

o Youthful looks: A study of 3,500 aging people at the Royal Edinburgh
Hospital in Scotland found that those who looked the youngest also had the most
vigorous sex life. The effects were even greater if the subjects were
emotionally satisfied as well.

READ MORE ABOUT IT: The Good Girl's Guide to Bad Girl Sex Barbara Keesling,
Ph.D. (M. Evan and Co., 2001)

Sexual Fitness: 7 Essential Elements of Optimizing Your Sensuality,
Satisfaction and Well-Being Hank C.K. Wuh, M.D. (G.P. Putnam's Sons, 2001)

GETTING CLOSE AND PERSONAL

Bee, 25, Copywriter

Masturbating is the easiest way for women to learn how to have an orgasm.
Women who masturbate will be a lot more likely to have an orgasm during sex. I
think it helps you learn the actual mechanics of what turns you on, where things
need to happen.

Because the guy isn't going to know that; there's no reason he would. Every
woman is different. Also, the bonding that goes on during sex seems most extreme
with an orgasm. It's kind of like one or both people have gone completely over
the edge; they're suspended in the other person's grasp, and they're completely
surrendered to it. That intensifies any connection.

Gabriel, 25, Musician

There are guys who don't get a rise out of giving a woman an orgasm and would
just prefer not to have someone else there. I've even heard some guys say they
have better orgasms during masturbation than sex. The mere thought of it
astounds me, but it makes sense if a guy has a fear of intimacy or, even more, a
fear of performing. It probably takes away from his own orgasm if he's overly
concerned with his sexual performance or whether or not she's having one. It's
ironic, because an orgasm during sex is enhanced when it's with someone you
truly care about.

GETTING CLOSE AND PERSONAL

Kamara, 27, Musician

I'm amazed when I talk to anyone who claims to have never had an orgasm,
probably because I just can't imagine not having them or not being able to have
them. At the same time, it doesn't surprise me: I was raised in a very
conservative religious atmosphere that actually called masturbation "self
abuse," and all sexuality--not to mention orgasms--was beautiful and good only
if it happened in a marriage bed. It takes awhile to expel the load of guilt
that piles up around your sexuality if you're raised in that kind of culture,
and I'm sure some people never do. But there was no way I wasn't going to aim
for the prize once I knew what it felt like. Maybe it depends on your sexual
drive--for me the drive was strong enough that I could never feel guilty about
an orgasm for long.

Steven, 28, Veterinarian

Some guys think sex has to include an orgasm. Orgasms are great, but there's
so much more to sex. An orgasm is more of a physical experience; I guess there
is an emotional aspect, but it's over in a second. I think anybody can give you
an orgasm, but it's the person there after the orgasm that matters. But I think
I'm the exception.

DOES ORGASM EQUAL SEX?

Our ever-changing definition of sex may hinge more on the climax than on the
act itself; Psychologist L.M. Bogart, Ph.D., gave Kent State students a list of
scenarios in which "Jim" and "Susie" engaged in vaginal, anal or oral
intercourse and either did or did not achieve orgasm. Vaginal intercourse was
considered sex 97 percent of the time, followed by anal intercourse (93 percent)
and oral sex (44 percent). Researchers were surprised to find that orgasm
occurrence dictated whether or not the activity was considered sex. Although the
woman was more likely to label vaginal intercourse sex if neither partner
climaxed, when it came to oral sex, the recipient was more likely to consider it
sex than the partner performing the act, especially if the recipient achieved
orgasm--because the stimulator was unlikely to achieve orgasm. For anal sex, it
was more likely to be called sex if Jim had the orgasm, but it was sex to Susie
regardless of whether she achieved orgasm. In general, the lack of orgasm for
women was less likely to affect her labeling the act sex. Although most sex
therapists argue against using orgasm as an end-all definition of sex, Bogart's
study indicates that orgasm is still an important gauge by which we measure
sexual activity.

Sexual Assault - The Danger of STDs

You'll also be tested for sexually transmitted diseases (STDs), including
gonorrhea, chlamydia, genital herpes, syphilis, and AIDS. If the rapist has an
STD, there's a reasonable chance that he has passed it on to you through his
semen or blood.

It takes 3 to 5 days to get the results back from initial STD testing. You'll
also need follow-up tests 90 days later. Because of the chance that you were
exposed to gonorrhea or chlamydia, the doctor will probably start treatment
without waiting for the test results.

Symptoms of gonorrhea, if left untreated may be very mild, and you might not
even notice them. You may have some abdominal pain, burning during urination,
and a vaginal discharge. It is possible to get a gonorrhea infection in your
mouth or anus, as well as in your vagina.

With chlamydia, you may notice a thin discharge from your vagina, as well as
stomach pain and a burning sensation when you urinate some time after the
exposure.

Trichomoniasis and vaginosis are forms of vaginal inflammation that can be
caused by sexually transmitted organisms. They produce burning and itching
sensations, odor, and a discharge.

In women, STD symptoms are not as noticeable as they are in men, and some
types show no early warning signs at all. You should report anything
unusual?discomfort or discharge, for example?to your doctor.

Syphilis begins with genital sores?which may go unnoticed?and progresses into
flu-like symptoms. This disease is so contagious that it can be passed on just
by kissing, and, if left untreated, it will eventually attack other organs,
causing heart trouble, blindness, and severe mental illness. For more on this
and other STDs, see "Coming to Terms with Sexually Transmitted Disease."

Dos and Don'ts After an Assault DO... Seek medical help as soon as possible Bring a change of clothes to the emergency room Get tested for sexually transmitted disease Inquire about emergency contraception Remember that what you say to medical personnel could be used in court DON'T... Shower... Douche, or... Change clothes until after the exam Hesitate to call the police

AIDS?acquired immune deficiency syndrome?leads to the total destruction of
the immune system, but unless you get tested, you can carry the HIV virus that
causes it for years without knowing it. You may be tested for the virus at the
emergency room. If the results are negative, you'll learn the good news fairly
quickly, sometimes within an hour. Positive results take longer because they
must be confirmed by a second test. Finding out that you have this dreaded
illness could be devastating, but it's still better to know. Doctors do have
drugs that can stave off the disease. For more information, see "The Persistent
Threat of AIDS."

If there is even a remote chance that you have gotten HIV or another STD,
it's best to abstain completely from sex until you're sure you don't have it. If
you do have sex, be sure to use a condom to help avoid the possibility of
passing on HIV or other serious STDs to your partner.

Sexuality after cancer treatment: What women can expect

Sex might be the last thing on your mind as you start thinking about cancer
treatment options and cope with the anxiety that comes with a cancer diagnosis.
But as you start to feel more comfortable with yourself during treatment and
afterward, you'll want to get back to a "normal" life as much as you can. For
many women, this includes resuming sexual intimacy with their partners.

An intimate connection with a partner can make you feel loved and supported
as you go through your cancer treatment. But sexual side effects of cancer
treatment can make resuming sex more difficult. Find out if you're at risk of
sexual side effects after treatment and which treatments can cause these side
effects. Knowing more about your situation can help you feel more in control and
help you find a solution that will work for you.

Who's at risk of sexual side effects?

Women being treated for breast or gynecologic cancers are most likely to
experience side effects that make having sex painful or difficult. But cancers
anywhere in the pelvic region can cause these effects. Pelvic cancers
include:

• Bladder cancer
  
• Cervical cancer
  
• Colon cancer
  
• Ovarian cancer
  
• Rectal cancer
  
• Uterine cancer
  
• Vaginal cancer

Treatment for each of these cancers carries the risk of causing physical
changes to your body. But having cancer also affects your emotions, no matter
what type of cancer you have. These emotions can also impact your attitude
toward sex and intimacy with your partner.

What sexual side effects are most common?

The treatment you receive and your type and stage of cancer will determine
whether you experience any sexual side effects. The most commonly reported side
effects among women include:

• Difficulty reaching climax
  
• Loss of desire for sex
  
• Pain during penetration
  
• Reduced size of the vagina
  
• Vaginal dryness

Not all women will experience these side effects. Your doctor can give you an
idea of whether your specific treatment will cause any of these.

Common sexual side effects of selected cancer treatments

Treatment	Difficulty climaxing	Loss of desire	Painful sex	Reduced vaginal size	Vaginal dryness
Chemotherapy	 	X	X	 	X
Pelvic radiation	 	 	X	X	X
Surgery Radical hysterectomy	 	 	 	X	X
Radical cystectomy	 	 	X	X	X
AP resection	 	 	X	X	X
Vulvectomy	X	 	X	X	 
Hormone therapy Medications	 	X	X	X	X
Oophorectomy	 	 	X	X	X

Adapted from: American Cancer Society, 2005

How does cancer treatment cause sexual side effects?

Cancer treatments that are more likely to cause sexual side effects
include:

Chemotherapy
Many women experience a loss of libido
during and after chemotherapy. Often the side effects of the treatment, such as
nausea, hair loss, and weight loss or gain, can make you feel unattractive. Side
effects usually fade soon after treatment ends. But it may take time to rebuild
your self-confidence to bring back your desire for sex.

Chemotherapy can cause a sudden loss of estrogen production in your ovaries.
This can lead to symptoms of menopause, such as a thinning vagina (vaginal
atrophy) and vaginal dryness, which both can cause pain during penetration. Ask
your doctor about what you can expect from your chemotherapy drugs, as some can
cause permanent ovary damage. Depending on your cancer type, your doctor may
prescribe estrogen replacement therapy — also called hormone therapy
for menopause — to reduce the sexual side effects you experience.
However, women with breast or ovarian cancer should discuss this carefully with
their doctors, as some cancers are hormone sensitive and shouldn't be combined
with hormone replacement therapy.

Radiation therapy
Sexual side effects related to
radiation therapy are most common in women receiving treatment aimed at their
pelvic area. Radiation to the pelvis causes:

• Damage to the ovaries. The amount of
  damage and whether it's permanent depends on the strength of your radiation
  treatments. Damaged ovaries don't produce estrogen. This causes symptoms of
  menopause, such as vaginal dryness. If you've already been through menopause,
  you likely won't experience such symptoms.
  
• Changes in the vaginal lining. Radiation
  therapy can irritate healthy tissue in its path. This can cause the lining of
  your vagina to become inflamed and tender. Penetration during sex may be
  uncomfortable during treatment and for a few weeks afterward. As the lining of
  your vagina heals, it may become thickened and scarred, causing your vagina to
  tighten and resist stretching during penetration. Your doctor might recommend
  using a vaginal dilator to prevent scar tissue from forming after radiation.
  

Talk to your doctor about what you can expect from your specific radiation
treatments. Some side effects may be preventable. For instance, surgery to
relocate your ovaries to another part of your body might spare them from the
damage of radiation and preserve your fertility. Ask your doctor about your
options.

Surgery
Whether surgery affects your ability to have sex
will depend on your type of cancer, where it's located and its size. Surgeries
that are likely to cause sexual side effects include:

• Radical hysterectomy. Women with cervical
  cancer may opt for a radical hysterectomy to remove their uterus and related
  ligaments, as well as their cervix and part of their vagina. A shortened vagina
  usually doesn't change your ability to have sex, though it may take some
  adjustment. Women over 40 may also have their ovaries removed during this
  procedure. If you're premenopausal when your ovaries are removed, you'll
  experience menopause.
  
• Radical cystectomy. In this operation for
  bladder cancer, the surgeon removes your bladder, uterus, ovaries, fallopian
  tubes, cervix, the front wall of your vagina and your urethra. Your surgeon
  reconstructs your vagina, though it may be shorter or narrower than it was
  before surgery. This can make sex painful. If you haven't been through
  menopause, removal of your ovaries will cause early menopause.
  
• Abdominoperineal (AP) resection. AP
  resection is used if you have colon or rectal cancer. Your surgeon removes your
  lower colon and rectum. Without the cushion of the rectum, you might experience
  pain in your vagina during penetration. Some women who have an AP resection also
  have their ovaries removed. If you're premenopausal, this will cause premature
  menopause.
  
• Vulvectomy. You may undergo vulvectomy if
  you have cancer of the vulva. Your surgeon removes the entire vulva, including
  the inner and outer lips, as well as the clitoris. These play a major part in
  sexual arousal in women. Removing the vulva and the clitoris can make the area
  less sensitive and make it harder for you to reach orgasm.

There isn't a clear link between breast cancer surgery and decreased sexual
function. You may be self-conscious of your scars after surgery, which can cause
a loss of libido. However, women who undergo breast-saving surgery, rather than
complete removal of the breast (mastectomy), are more likely to enjoy breast
caressing.

Hormone therapy
If you have a hormone-sensitive cancer,
you might receive hormone therapy through medications, such as tamoxifen, or
through surgery, such as removal of your ovaries (oophorectomy). If your cancer
relies on hormones to fuel its growth, these measures can block or alter its
supply.

Both medications and surgery for hormone therapy cause menopausal signs and
symptoms, including vaginal atrophy and dryness. Removing your ovaries causes
permanent menopause. Side effects of hormone therapy medications usually wear
off after you stop taking them. Keep in mind though, that women taking hormone
therapy for cancer usually take these drugs for five years or more.

The vulva is the outer part of the female genitalia, including the labia and
clitoris.

What can you do to regain your sexual function?

Knowing what sexual side effects to expect before you begin your cancer
treatment can help you be more prepared to deal with them as you go through
treatment. If you experience sexual side effects, find out as much as you can
about what's impeding your sexual function. This will help you feel more in
control of the situation and help guide you to treatment options. You may also
want to:

• Talk with your health care team. You
  might be embarrassed to talk about the sexual side effects you're experiencing,
  but don't be. Though talking about sex can be awkward, you'll never find a
  solution if you don't let someone know what you're experiencing. Write down your
  questions if it makes you feel more comfortable. Also know that your doctor may
  be embarrassed or hesitant to talk about sex. Ask to be referred to a specialist
  or seek support from other members of your health care team, such as nurses and
  counselors.
  
• Talk with your partner. Let your partner
  know what you're experiencing and how he or she can help you cope. For instance,
  you might find that using a lubricant eases your vaginal dryness or changing
  positions helps you avoid genital pain during sex. Together you can think of
  solutions to ease you back into a fulfilling sex life.
  
• Explore other ways of being intimate.
  Intercourse isn't your only option for closeness with your partner. Consider
  spending more time together talking, cuddling or caressing. Connecting in other
  ways might help make you feel more comfortable and less anxious about the sexual
  side effects you're experiencing.
  
• Talk with other cancer survivors. Your
  health care team might be able to steer you to a support group in your town.
  Otherwise, connect with other cancer survivors online. If you're embarrassed
  about discussing sex face-to-face with strangers, the online environment
  provides you anonymity. Start with the American Cancer Society's Cancer
  Survivors Network.

It may simply take time for you to regain your sexual function after cancer
treatment. While that can be frustrating, know that if you had a positive and
satisfying sex life before cancer, you'll likely resume that after your
treatment.

Slow and Steady

You don't have to make the change all at once.

I love it when people wake up one day and say, "That's it. No sugar, pasta,
bread, alcohol. I'm going to work out 18 hours a week, and no more fun." I
wonder if it occurs to them that this approach may be one of the reasons they
don't make it to the second week. Granted, for a small percentage of individuals
out there, this works. However, for the rest of us flesh and blood humans,
change is difficult.

How about we approach the change with a slow and steady strategy?

1. Write down what changes you want to make in your day-to-day
   lifestyle.
   
   
   
2. Make a list of foods that you can't live without and foods that you are
   willing to give up.
   
   
   
3. Figure out what forms of exercise are attractive to you, that you relate to,
   and that you can see yourself participating in on a regular basis.
   
   
   
4. Create some goals.

• lose weight
  
• have more energy
  
• exercise 3-4 times a week
  
• go out and do something fun just for you once a week
  
• read more
  
• laugh with your family
  
• be more spontaneous
  
• take that risk you have been contemplating

OK, you get my point. These are just ideas, but make it your own list.

After you've written all of this information down, start to create your
strategy. If you can't live without pasta, then start slow. Don't go cold turkey
but try to eat it less often. If you eat it three times a week, then make a vow
to only eat it once. You could even begin by "substituting" healthier
alternatives (e.g., rice pasta). If you can't live without five diet sodas a
day, switch to an unsweetened tea and only have one soda a day.

Are you sedentary right now? Well don't start hitting the gym 5 days a week
and kill yourself. Begin with walking and doing little things at home with light
weights, and then start heading to the gym. Start by taking a few classes and
lifting 2 times a week. You don't need to begin by going 2 hours a day -- start
with 30 minutes.

How does that sound? I know you can make the changes. Just have a real plan
to support you while going through the process. I like the idea of keeping a
journal and writing it all down.

If you are up for it, you could even create a calendar to keep track of all
of the changes --what activities you're doing, what foods you are or aren't
eating. This way, the change will not only become obvious in you, but you'll be
able to track how far you've come.

A Workout Formula for Success

Are you trying too hard, working out too much, planning your weight loss
demise?

I can’t tell you how often I hear, “I work out every day
and can’t seem to lose my stomach.” Or, “I am on this new diet, I don’t know
why, they never work.” Or, “Working out isn’t working anymore. When I started
spinning (or working out with my trainer) I lost 10 pounds right away – now I am
spinning (or training) twice as much and can’t lose a pound.”

If you are
working out every day – cut it out – it’s too much. And if you are not enjoying
your exercise class, or running, or meeting your trainer – forget it! That
training is draining. And if in your heart you do not believe that “this new
diet” will work for you – don’t do it. You are not only wasting time (and money
probably) but also reinforcing failure!

Try a different tactic. I think
you need to change up your workouts and rework your mind about
eating.

Start here:
1. No new diets, no new
restrictions, just stop it all.

2. Repeat a positive mantra to yourself every day to recondition your
thinking – and your behavior will change because of it.

While thinking the following thoughts, envision yourself healthy, happily
eating the foods and in the shape you want to be: “I enjoy whole healthy foods,
I prefer them, I choose them, I lose weight easily and my health is better
because of them."

3. Envision your workouts the night before as easy and fun. Really, even for
the intense days, see yourself totally loving the workout.

And when you
are ready to train with precision:

a) Two workouts a week 20-30
minutes at high intensity (your rate of perceived exertion should be 8-9 on a
scale of 1-10, 10 being highest). Try 10 two-minute speed intervals
(walking fast, running or cycling/spinning) with 30-60 seconds of recovery in
between.

b) one workout a week for 60 minutes or more at a moderate intensity.
Walk, cycle or run at a steady but moderate pace.

c) one circuit workout a week for 35-45 minutes at moderately high
intensity. Try walking powerfully or jogging/running or mix it, alternating
running and walking, for five minutes, then go into two sets of 15
walking lunges on each side with a 30-60 seconds break (walking easily) in
between.

Then walk/jog at moderately high intensity for 10 minutes, find a bench or
curb and alternate one set of 10 push ups, with a set of 10 triceps
extensions (two times each). Walk/jog powerfully for five minutes and
then do two sets of 50 jumping jacks with a little recovery (15-30 seconds
of jogging in place) in between. Walk/jog for 10 minutes and then finish off
with two sets of 15 abdominal crunches.

The formula for
success: four workouts a week, daily affirmations, and positive
visualization – that’ll get you in shape and in love with your life.

What Hump?

What’s this hump I keep hearing about?

Relax, it’s not your belly or
thighs or buns – it’s the seemingly insurmountable performance hump that dieters
hit at their first plateau, and exercise enthusiasts hit after doing the same
workout routine for too long.

And there are other variations on the
“hump” theme: like after having a pretty good track record with healthful
living, you have, well, changed course, and are having a hard time returning to
exercise and healthy eating.

Why? Maybe it’s a new relationship (how exciting!), or your career just took
off (also fabulous), or maybe there’s a new addition to the family
(congratulations), or in some other way, shape, or form, life has just run away
with your time and fitness has (probably when you need it most) lost its
priority.

To get back on track, to reset your mind and body, to promote a
dramatic shift in behavior, attitude, and results – get rigid.

That’s
right, you heard it from me. I am, in this case, recommending absolute
strictness and mindful self control for 14 days (hard to do, and that’s why
diets don’t work most of the time but, knowing it’s only two weeks makes it
workable, and this is a great reset technique).

That may not sound
like a short period of time to you but trust me, once you have gotten through
the first three days, it won’t feel like a restriction, but a
gift.

"There is freedom in boundaries," especially when nothing else is
working.

You should:
- Drink lots of water and eat three
moderately sized and very clean meals each day - no snacks in between.

-
Workout a minimum four mornings each week (don’t leave the workout until
later in the day – it may not get done).

MEAL
IDEAS
Breakfast - 1/2 grapefruit, two scrambled
eggs, three slices of tomato

Lunch - Fresh garden salad with a 1/2
can of tuna (packed in water) or cut-up turkey breast dropped on top. Cup of
soup (like tomato, vegetable, lentil); no cream soups

Dinner - 1/2
grapefruit, baked fish or chicken (4-6 oz), steamed or stir-fried vegetables,
1/2-cup rice or 1/2 baked potato.

WORKOUT IDEAS

Walk two to three minutes to warm up then walk as fast as possible
for two minutes with one-minute easy walking intervals in between – do
five to 10 sets depending on your level of fitness – with two to
three minutes of easy walking to cool down.

Warm up, then
jog two minutes, walk fast two minutes (five to 10 sets), cool
down.

Three Steps to a Truly Happy NEW Year

Everyone says, “Happy New Year," but what’s so new about it? Nothing - unless
you train yourself to change!

Is this the year you really are going to take off those extra 15 pounds? And
keep them off? In 2007 will you finally stop focusing on everyone else, and
start paying more attention, and taking better care of yourself?

Do you think you actually will save some money this year? It doesn’t matter
what your goals for 2007 are – to accomplish them, you’ll have to put your whole
self to work for you. You’ll need to be in sync – mind and body - thoughts and
behaviors. For a successful new year, one in which you do achieve the goals that
you set out to accomplish, you’ll need all of YOU to be aligned with your
objectives, and your plan. Your thoughts and actions must match.

But this all seems ridiculously obvious doesn’t it? Of course it makes no
sense to say (no matter how emphatically) that you want to/plan to/are committed
to lose the weight, and then you don’t exercise or modify your diet. It’s just
plain senseless to start a savings account and then continue to spend (or
overspend) as you have been all along. And there’s certainly no logic to saying
you are going to take more time for yourself and then continue to pack your
schedule to the brim. But we all do these things – me included.

How long have I been saying that I am going to start meditating, and then I
find myself engaged in everything except meditating in my otherwise free time?
There we all go - setting ourselves up to fail. What we say, and what we do,
just don’t match. What we need to do is create a mind/body synergy so that our
thoughts and actions match (and support one another), in our efforts to succeed.
Well that’s easy to say, too – right?

I suppose if you could say it, and then actually do it, we wouldn’t be having
this discussion - would we? Well, I’d like to propose that in 2007 we all set
out to attain True and Total Fitness. Whoa – that sounds big, I know, but let me
explain. Here’s what I mean by True and Total Fitness, and why I think that this
is not only incredibly helpful and important, but also totally doable. True and
Tota

l Fitness incorporates, well, everything. It’s personal, physical, social,
and financial fitness, and more. Everything in your life needs fitness attention
- your relationships (with others, and with yourself), your career, your home,
and of course the physical, mental, emotional and spiritual parts that are all
you.

Training for True and Total Fitness is easier than you think, and doing it
will change your life, for the better, and for good. When you look at fitness as
the state of your being, rather than the state of your body, you can enhance,
and take better care of, everything in your life (including your body), all at
once.

The fact is: FITNESS ISN’T JUST PHYSICAL. And our definition of fitness has
to change so we can effectively alter our lives as a whole, and make them
better. I think you’ll agree that probably many (maybe all) aspects of our lives
can be fitter. Once you begin training for True and Total Fitness, you’ll start
a (beneficial) chain reaction so that one new action or thought benefits many
different areas of your life - all at once.

Start thinking of fitness as Training for Life - nothing less. The
conditioning that you (and I) will be doing is more comprehensive than a weight
loss plan or preparing a new resume - though it may include these things.

The conscious mental recognition of what you are about to start doing, while
you are doing it, will make all the difference in the world. So know that (for
example) as you work on your physical fitness, you are enabling a transformation
in self-esteem, which therefore affects you in your personal relationships, your
career, and probably everything else in your life.

Be aware that (for example) as you improve your political, civic or social
fitness (or awareness), you enhance your overall attractiveness as a friend, a
partner and an employee. So we begin by reconditioning our minds. Whatever the
goal, we first make a purposeful, positive, and affirmative mental statement.
Then we extract a line or two – something that is easy to memorize (and repeat
to ourselves) throughout the day.

This then becomes a conditioning thought – like a mantra. You can write it on
a Post-It and put it in your car, on your computer, on the bathroom mirror, at
your desk, etc., so that you will see it, think it, say it, and quickly start to
believe it deep down inside.

Here’s an example: Today is a new day - I have a whole new way of thinking
about me and the way I do things. No more starting and stopping, no bad me or
good me, no beating myself up, creating false fantasies, or crying over what has
happened (or not happened) in the past.

I am now ready to act purposefully - taking full responsibility for what
occurs knowing too, that I can change it if I choose to. I am ready, and I am
willing, and even when I do not feel ready or willing, I will continue to move
forward on my plan - not “judging” my results along the way. I will stay on the
road, focused, committed, and certain that my continuing efforts are my reward,
and success is in taking action, not in expecting specific results. I am
mentally and physically focused, committed and taking action to succeed. Success
is taking action and staying with it.

So, Step 1: Make a mental statement and extract an easy-to-repeat sentence,
then repeat it, as often as you remember.

Next, Step 2; make the plan – one that you really can stick with! For
example, if getting into better shape physically is your immediate desire then
exercising more and eating a healthier diet are your actions.

You can read about a healthy diet online, work with a professional, or simply
apply some of the common sense healthy eating behaviors that I know you know,
like, cutting out sodas, fried, and all junk/fast food, eating less refined
carbohydrates (especially sugar) like cookies, muffins, breads, and candy). Eat
simply. Incorporate more protein (chicken/fish) and fresh vegetables in your
diet and, reduce or take out desserts and packaged foods (like protein/meal bars
and vending machine snacks).

Then – exercise more. Start small, like by adding 60 minutes a week of
walking to your schedule – be it a 15 minute walk at lunch five days a week
or two 30 minute walking workouts each week with a walking partner or a
workout CD, or with your dog. Make your plan. Make it detailed, easy to follow,
and totally reasonable in your busy schedule.

Step 3: Don’t give up. That’s all; just don’t give up on yourself. No matter
how many times you have tried to change something, know that this time could be
the one! And with the mental conditioning that you will be doing (something that
most of us have never incorporated in trying to reach our goals), you truly do
have the key to Training for Life, and True and Total Fitness.

A New Year's Resolution to End All Resolutions

New Year's resolutions – scrap ‘em!

Any of these New Year’s ressies
sound familiar?
1. Lose 5/10/25 pounds
2. Drink more water
3. Exercise
30 minutes a day
4. Stop eating after 6 p.m.
5. Cut out sugar
6. Stop
drinking during the week
7. Join a gym
8. Go to the gym
9. Stop
smoking
10. Lose weight
11. Find a new job
12. Find
more time for myself
13. Meditate
14. Run a 10k, do a
triathlon, run a marathon

One or more of the above ring a bell? Are you
wondering why none of your resolutions, whether simple or seemingly outrageous,
have materialized as successes?

Well maybe, after years and years of making resolutions, starting over on
Monday, committing to yourself “absolutely” and then never following through -
we have all simply conditioned ourselves to fail. So really anything at this
point is an unrealistic expectation - we already know we’re not going to do
it.

What I recommend, rather than reinforcing this old system of perpetual
failure, is to forget the past, and try something totally new!

The focus
for this New Year is faith (and a plan, but I’ll get to that later). You are
going to have to muster the belief (even if everything in your past suggests
differently) that you actually are capable of making a change. You’ll have to
trash your old ideas, all of them, and start from scratch.

Here’s what
you’ll need to do:

1. Get yourself a new and improved positive attitude
for Christmas, and imagine, fantasize, even pretend, that you can do it!

My guess is that disappointment has dismembered your faith, and I can
certainly relate to that. But things can be different, it happens all the time,
things go along the same old way for years and years and then something shifts –
this shift is often due to a scare (your doctor tells you that if you don’t stop
this, or start that, you’re headed for serious trouble) or an immediate and
overwhelming desire (you want to look good for a wedding or reunion) or, believe
it or not, it can happen because you decide (from a place deep down inside) that
you can do it.

No drama, no promises, no fearful consequences if you don’t. The realization
that you look, feel, or are living your life in a way that feels sub-par,
unacceptable, or not at all what you want, has finally hit you like a ton of
bricks and you very quietly decide that enough is enough.

2. Don’t wait for insurance, or some sign from above that you “truly
believe;” start now, and if you’re not convinced that any major shift has
occurred, pretend, plain and simple, fake it, until you own the secure belief
that you are capable, and able to stick with it and do whatever it is you set
out to do.
You may even go as far (and this would be great) as taking on a
childlike wonder in knowing that anything is possible!

3. Stop trying to
mentally muscle this thing, and stop trying to figure it out, that’s what you
have been doing all these years. First you work it out, then you put
restrictions and threats in place, then you try the reward system - but alas –
our minds actually, I believe, are responsible for the sabotage, and it’s
happening at a level (unconscious) that most of us have little or no
understanding of, or access to – until now.

Belief, faith, and trust come from some special, unidentifiable and powerful
place inside you – it’s there - it just is. You can’t figure it out, so you
can’t screw it up either - that’s the beauty. Even better, it’s free. So you
really have nothing to lose - just try on some faith for good measure, for
whatever, to humor me. Even the inference of faith is helpful. And, if you must,
go ahead and give it a trial period, like 30 days, and if you don’t feel better,
you can forget the whole thing.

4. Have a ceremony, write down every
reason you think you’ll fail and then burn it! I am not kidding you – this
ritualistic act of relinquishing forever your thoughts and ways of old creates a
giant opening for the new. Somehow, we (as individuals and a society) have come
to a place in our lives where we no longer subscribe to, utilize, believe in, or
have time for, ceremony, but this leaves us to live life from a purely mental,
and physical place – void of belief in anything more than what we can see and
feel.

If you think this little act of ritual is ‘out of character’ for you – do it
for sure! The fact is, what you are about to do, and to transform into, is out
of character for you, so get into the new you, do something that you wouldn’t
normally do – something that shows you are letting go of the old, and allowing
for the new, on every level.

5. Repeat something positive to yourself
over and over – like a mantra - one that reinforces your willingness, like:

a. I am ready to change my mind and my behavior.
b. I can do this, and I
know it – don’t know how, I just do.
c. My desire to change is enforced by
my new actions.
d. Even a little means a lot.

This too is exercise.
Mental exercises change your mind the way physical exercises change your body.
But here we run into the dilemma of: if I haven’t been able to commit to
exercising regularly enough to lose 10 lbs., how can I expect that I will do my
mental exercises and change my mind?

The answer is – you act as if you believe. Do it anyway, go forward and trust
that with this new attitude, these exercises, and your inner decision to change,
everything will be fine.

In the beginning, you don’t really have to believe that this will work – you
just have to do the work (mental and physical) and soon your efforts will foster
a new level of trust and you will start to believe that you can do it. After
that, you have the magic of being able to apply this new trust in yourself to
anything.

At a very low point in my life (I was really down, financially,
emotionally, and physically) I took a course that required me to repeat certain
sentences, new concepts actually, over and over throughout the day.

I guess all I had was the tiniest hope that change was possible, or I
wouldn’t have taken the course. But I am living proof (that is why I confidently
recommend this) that even a microscopic amount of willingness is enough to turn
things around. In fact everything in me did change from doing (what I thought at
the time to be ridiculous) mental exercises. Listen, you already know that
another New Year’s resolutions ain’t gonna cut it, so what have you got to
lose?

6. Set yourself up for success by only committing to yourself to do
what you know you will do. Don’t overwhelm yourself with grand expectations, and
visions of grandeur, keep it small and simple. Instead of planning to walk 30
minutes every day, commit to 10 minutes every other day and then anything over
that is gravy! Commit to giving up sugar once a week instead of every day and go
from there.

7. Every week, make a simple, really realistic plan of
action, one that is so doable, you cannot fail. Take baby steps with this and
get very specific with your plan. Write down each little step and make sure that
when you read it over you are not questioning its viability at all. For example:
Monday morning I must be at work by 8 a.m. so I will pack my tennies, walk
for 10 minutes at my noon lunch break to meet my friend Sarah at the park. If
Sarah bails on me, I will go anyway, take a magazine or my ipod and relax. I’ll
eat my lunch, and then walk back for 10 minutes. (That’s 20 minutes of walking
and anything you do over that is gravy).

8. Do your plan with someone
else; often, people work better as a team – I know I do. I feel like the group
effort (even just two of us) is more fun, and the collaboration is great,
like when I say I don’t have time to do something, and Gail says, what about
this? We write it down, shake hands and commit to doing it. We get to check in
with each other, complain to one another, and then be revived by pep talking
ourselves back to a good place. And I know I feel a sense of “I am counting on
you,” from Gail, which makes it all feel a little more important.

9.
Visualize yourself doing whatever you have set out to do. See the action of
getting to the gym tomorrow in your mind. Or see yourself choosing the foods
that you want to eat, refusing those that you are letting go of. Go to bed
visualizing in detail your day, then let it go – sweet dreams. Don’t stress or
obsess over it. You see it, then you do it, then you own the reward of following
through.

10. Don’t stop and start over; we all screw up. You must
stay on the road – pick it up where you left off, and keep moving forward; one
unplanned muffin indulgence won’t kill you – keep moving forward on your
plan!

Your Mind: More Powerful Than Your Body

When it comes to "starting," there is no tomorrow, only today, since when you
get to tomorrow, it’s today. Live in today, take action today, and don’t wait
for anything for your (new and improved) life to begin!

Forget the “it‘s
summer, get ready for your bikini" crap, it’s life, get into shape for that!
Mentally, emotionally, and physically conditioning ourselves for the most
important event of all – life – that is what I am concerned with. So, if it
is fitness you want for this summer and beyond, true and total fitness, let’s
get started.

You will have to clean out the junk food – now. It’s putting
excess weight on your body and numbing your mind. Sugar is disorienting and a
trigger (for most of us), and any “trigger” foods, food that make you want to
keep eating (chips, cookies, ice cream), must go.

If you really want to “clean house” whether you want to lose weight or not,
try no sugar, no dairy for 60 days – that’ll give you an efficiently working
physical body and mental acuity like you have never known.

Now, write down everything you want – don’t hold back, write it all down.
This is the way to activate your dreams - think about them. Then you must do
things that help you believe that they are possible, for example, cleaning out
the clutter in the cupboards and starting to exercise regularly.

Now I know you say, “If I do those things, of course I’ll get fitter, it has
nothing to do with my mental state.” But how many times have you tried to lose
weight by dieting and exercise? Many, I am sure. And many more times the process
has failed you.

You must use your mind to carry you over the "lack of belief in your ability
to accomplish your goals" state that you, and most of us, are in much of the
time. And if you haven’t lost the weight as quickly as you had hoped (or as fast
as your friend did), don't stop. Some of us have more mental undoing to
accomplish than others.

You must stay focused on your goal – and this I know can be harder than
giving up sugar - but it is the one thing that we neglect to do when trying to
affect a true, lasting change for ourselves – we neglect to use our minds, as
well as our bodies.
So write what you are going for down, think about it
often, and see it happening in your mind for you!

How Well Does Your Body Adapt to Tougher Workouts?

Do you ever feel that life could be easier? That each day is a
little harder? Life can, at times, be that way.

There is a Navy SEAL saying (from their training programs) that goes "the
only easy day was yeaterday."

Although most of us do not want to become Navy SEALS, nor could we even if we
tried, there are some lessons to be learned from them about training and
conditioning the human body (and mind), and the role of adaptation.

Becoming a Navy SEAL, one of the true military physical and mental elites,
takes over six months of specialized training. They push their bodies to the
breakpoint on a daily basis, and it's even tougher on their minds and emotions.
The dropout rate is extremely high, but those who survive are transformed
forever.

There are no easy days or easy weeks. "Hell week" is one of the toughest
make-or-break periods. During those five days, the SEALS in training are
subjected to extreme conditions, constant physical and mental challenges.
Amongst the highlights, five days with about four hours sleep - total.

The waking hours are spent sandy and wet, constantly carrying heavy loads, or
being immersed in icy water till hypothermia starts to set in - then back to
breakneck calisthenics and physical activity to "warm back up."

They emerge from Hell week, and the even tougher weeks and months to follow,
amongst the fittest, toughest human beings on the planet. The only "easy" days
are the ones behind them.

The so-called BUD/S training provides great lessons in adaptation. Some break
down, some get stronger, and many experience both simultaneously. What does this
mean for you?

Are your workouts hard enough? Do you challenge yourself, or have you gotten
into a bit of a lull? Have you hit a plateau? In my next blog entry I'll talk
about the adaptation process and how you can make it work for you.

How to Have the Body You Want

Obviously, you want to have what you want – don’t you?
Then why are you
not able to have the body that you want, or the job that you want, or the
relationship that you want - why don’t you have the life you want?

You
are conflicted. Truly, you think you want something but then you think
(consciously or unconsciously) of all the reasons why you can’t have it. You
think about what has happened in the past, and that discounts your thoughts of
what it is you want.

So, you must believe that you can have it. Here is
where the struggle comes. You are, I am guessing, based on your past
experiences, convinced that you cannot improve your fitness, change your diet,
change your job, lose the weight, and so forth, since every time you have tried
in the past, it hasn’t worked, or lasted.

Here’s what you must do to get
the body you want:

1. Continue to have the desire. Think it, wish it, and see it (in detail) for
yourself.

2. Make small changes in your diet and exercise program,
changes that you will be able to do now. Don’t commit to an unrealistic exercise
plan; just do what you truly know you can do, like 20 minutes every morning,
or three days a week.

And make minor alterations in your diet like reducing the amount on your
plate, cutting out dessert, reducing the number of sodas that you drink in a
day.

3. Keep your vision intact. Even if your actions falter, do not let
that throw you for an emotional loop. Stay focused on what you want.

You
will soon have the desire and the belief, and changes will occur, don’t give
up.

Change Can Be a Good Thing

Different Strokes:

We are all so different. Some of
us like change - some don't. Some of us are detail oriented, some not. When it
comes to health and fitness, some of us like to strive for improvement; others
are OK being OK.

Just a Few Things, Though:
1.
You don't have to feel awful about yourself to want to be better, and, always
striving for better isn't necessarily the only, or best, way to get there.

Upgrading is a good thing. Challenging ourselves, striving for more is
something that most of us can benefit from. And if it's not your thing, for
whatever reason, you may want to step out of your comfort zone for just a second
and see what it feels like to try something new.

On the other hand, if you are always looking for the next best way to get
fitter, eat healthier, or take 20 seconds off of your 10k time, maybe stepping
out of your comfort zone, and letting it be for a bit isn't such a bad idea.
Challenge is good, ease and relaxation are good, and change is good.

2. You don't have to be thin to be healthy. The goal is not to be thin;
it is to be healthy and happy. So, if you don't feel happy, and you aren't
healthy, be you thin, obese, or somewhere in between, a lifestyle change is
definitely in order.

3. Don't overwhelm yourself. When you look at the whole picture - whatever it
is you are dealing with - it can seem overwhelming, but change can be done
gradually or in broad strokes (different strokes for...you know). You can make
important and beneficial changes in the way that suits you best, I'll show you
in my next post.

4. An important hint - the way that suits you best, in fact, may be the way
that you haven't yet tried, and the way that you think doesn't suit you at all.
Sometimes, changing the way we approach change is the fastest way to break
through a barrier and get where you want to go.

5. For next time - how to do what you want to do. Until then, positive
thoughts please, keep seeing visions of you successfully doing, achieving
whatever your goal is.

Eat Right, Stay Fit

I recall as a small child going outside to play with friends and neighbors
from morning til night. Often I would even skip meals because I wanted to
continue whatever activity I was engrossed in at the time.

However, nowadays our surroundings and situations have changed so much that
parents can no longer trust that children playing outside will be safe without
supervision.

Each week, my three-year-old and I attend a children's gymnastics class at a
local fitness center. My son absolutely loves this class, and it's his
hands-down favorite of all the activities we do together. He looks forward to
going to gymnastics every week and asks almost daily if today is the day he gets
to go to class.

I am thrilled that he enjoys this activity so much. He gets to play and be
active while learning to pay attention to his instructors, follow simple
directions, and develop his agility and balance. And as we participate in this
activity each week, I've gotten to thinking about other low-cost ways to support
our children in being more active in their daily lives:

• Make family time an activity time.
  
• Consider walking or biking to do errands instead of always taking the car.
  
• Find local hiking trails to enjoy with your children.
  
• Join a group that focuses on physical activity, such as the YMCA or a hiking
  club.
  
• Invite one of your children's friends to participate in your next activity.
  

Remember to make activity fun for your children and, as a parent, be your
children's role model by keeping active yourself.

Making Fitness Part of Health Care

In an uncharacteristically noncompetitive manner, a consortium of Japanese
electronics companies - including Mitsubishi, Citizen, Sharp, and Hitachi -
have teamed up to establish a uniform standard for networking health care
equipment.

The goal is to allow cardio exercise devices like treadmills and elliptical
machines to interact with heart rate, blood pressure and other monitors to
produce an overall real-time profile graphing how an individual's training
affects his or her health.

At first glance this mechanization of health
indices looked a bit Big Brotherish, but as I thought about it, I realized that
this was something that might be helpful to me.

After a high-blood-pressure diagnosis a few years ago and some modest but
noticeable side effects from the medication (Cozaar) I was put on to control it,
I have worked to control my pressure through modifications in my diet and
exercise.

I now monitor my pressure regularly with a home cuff. It's not
cumbersome or unpleasant, but I did find it difficult to determine precisely
what triggered spikes or dips in my pressure. So I got a heart rate monitor to
track how my cardio training sessions would affect my pressure. My
non-scientific analysis seems to indicate that my workouts have a positive
effect on lowering my pressure - but not consistently.

I also occasionally use a pedometer to check out if I'm anywhere near to
approaching the 10,000 to 12,000 steps-a-day goal that Mark Fenton, the former
coach of the U.S. race walking team, says is optimal for health. And another
member of my family checks blood-glucose levels six times a day.


We could use a simple, one-stop way to integrate all our
respective data into a computer that would create an individual profile that
would allow us to easily monitor the results of our activities over
time.

Wouldn't it be nice if more companies followed the lead set by
the Japanese companies, and we could coordinate our fitness activities
seamlessly with our health care?

Imagine if, before our annual
physical, we could send our doctor a readout of our prior six months' profile so
he or she could see precisely what had affected our blood pressure or
cholesterol readings? Don't you wish insurance companies and HMOs would support
home diagnostic tools as integrated as this?

Exercises to Add on Years

It's feeling like spring outside, and after months of inactivity, now seems
like the right time to start getting physically active. Read on to find the
numerous benefits of exercise to your health and
longevity.

Activate Your Health with Exercise
Yes,
exercise will give you a fit physique, but the benefits of daily exercise are
much more. Regular exercise can help promote physiological wellbeing, strengthen
the immune system, maintain joint mobility, increase energy - the list goes on
and on.

In fact, research with humans has confirmed that the more active you are,
the longer you will live. In one study, the group that burned more than
3,500 calories a week lived the longest. Then it should come as no surprise that
caged animals have more health problems and live a shorter life than free-range
animals. So get out there and get active - your body will thank you for years to
come!

Aerobics for a Healthy Heart
Your heart is a
muscular organ that is responsible for pumping the blood's nutrients and oxygen
throughout your body, while simultaneously transporting waste products for
elimination. The stronger your heart, the more tolerance you will have for
stress and strain.

Strengthen your heart muscle by increasing your pulse rate to between 60 and
80 percent of your maximum heart rate (MHR) when you exercise. (Hint: you can
find your MHR by subtracting your age from 220. For example, if you are 40, your
MHR is 180 beats per minute.

Your optimal range of 60 to 80 percent would be calculated as 108 to 144
beats per minute.) Practice an aerobic activity at this rate for 30 minutes a
day, three to four times a week to keep your heart pumping strong.

Aerobic exercises that focus on increasing cardiovascular endurance include
bicycling, lap swimming, walking, and running. Frequent and consistent aerobic
exercise has been found helpful in preventing or treating such serious
conditions as high blood pressure, heart disease, obesity, type 2 diabetes,
insomnia, and depression.

Build Your Bones
As we age,
osteoporosis sets in and our bones begin losing calcium and become brittle. This
condition affects the majority of the world's population over age 70. No amount
of calcium and vitamin D supplements will cure the condition; we must engage in
exercise that exerts weight on the bones.

Look, for instance, at the experience of the astronauts. When astronauts were
subjected to weightlessness in space, they underwent much more rapid bone loss
than they would have on earth because there was no gravity to put weight on
their bones.

A good way to help restore calcium to the bones is with moderate load-bearing
exercises - but don't worry about becoming a professional weight lifter! Even
walking will have you bearing a moderate amount of weight and increasing bone
density.

I hope this article finds you feeling fit and healthy throughout
your days! I invite you to visit often and share your own personal health and
longevity tips with me.

May you live long, live strong, and live
happy!

Water Facts: Bottled or Tap?

Bottled water has become the fastest growing commercial beverage sold in the
United States. In 2005, Americans spent nearly $10 billion on bottled water. And
now we are seeing ads for bottled water containing several added (and unneeded)
vitamins.

This got me thinking about the origin of the oft-cited notion that we need to
drink at least eight glasses of water — presumably in eight-ounce glasses —
a day. I can understand taking a bottle of water along on a long hike or 20-mile
bicycle ride. But it's hard for me to keep a straight face when I see grown
adults sucking on bottles of water in the course of ordinary activities.

Do all these water-bottle-toting folks know something we don't about the
benefits of guzzling large amounts of H2O? Or is this another trendy accessory
to help us feel better about ourselves, not founded on medical fact?

Several years ago, a report from the Institute of Medicine set the record
straight about how much water we should be drinking. It didn't state the number
of glasses of water we should drink; rather, it recommended a total daily intake
of about 91 ounces of water for women and a total of 125 ounces of water for
men.

About 80 percent of this total water can come from beverages like milk, fruit
juices, coffee, tea, and beer, not just from drinking water. The remaining 20
percent can come from soups and the water contained in fruits and
vegetables.

Should we be counting water consumption like calories? No. According to the
IOM report, thirst is an adequate guide for almost all healthy people for
meeting their daily needs. The report set no upper limit on fluid intake, but
noted that excessive amounts can be dangerous.

Aggressive advertising by the bottled water industry, urging us to drink more
water to ensure good health, may help to maintain the "eight glasses of water a
day" myth. Surely these ads partly explain why so many otherwise-sensible people
find it necessary to carry a bottle of water while attending business meetings
or walking down the street.

OK, perhaps they're thinking that bottled water is better than tap water. But
is it really? The International Bottled Water Association (IBWA) created the
policies regulating the industry and claims that bottled water is subject to
more aggressive quality standards than tap water. The IBWA, however, isn't quite
an unbiased source of safety information for the industry.

To date, no independent investigation has shown that bottled water passes
more safety and health checks than tap water. In fact, the National Resources
Defense Council (NRDC) tested 103 brands of bottled water and concluded there
was no assurance that water out of a bottle is cleaner or safer than water from
the tap. Another of their conclusions didn't surprise me either: They estimated
that 25 percent or more of bottled water is nothing more than tap water.

Given the lack of objective research or evidence to favor bottled water over
tap water, the decision on which to drink comes down to an individual choice.
However, two things we know for certain: bottled water is more convenient and
more expensive than tap water.

The NRDC reported that a five-year supply of bottled water cost over $1,000
compared with $1.65 for the same amount of tap water. Not to mention the
environmental impact of the many discarded plastic water bottles that are not
recycled.

If you feel the convenience is worth the cost, by all means choose bottled
water; but don't feel compelled to drink a lot of it to maintain good health.

Reclaim Your Body Step by Step

Reclaim your body and your excitement about life.

When you are unhappily focused on the body you don’t have, or the state of
health that you are not in, you are reminding yourself over and over, basically
convincing yourself, that this is your physical state.

And it is - and it doesn’t change - because you are reinforcing the negative
state that you are in. And then there is further reinforcement when you start an
exercise plan, and quit because you don’t see immediate results, which is
something that we are being sold and told by the media. "Get instant results
with this diet, lose weight immediately with this plan."

Or you try another new diet and then give it up because it’s not working, or
too difficult to adhere to, and once again you reinforce that diets don’t work.
If you still don’t feel or look the way that you want to – you have probably
tried everything.

And because you have tried so many diets, joined so many gyms, taken so many
classes and still have not found your happiest, healthiest, self, you certainly
have reason to be convinced that nothing is going to change.

With that, you have little chance of making strides toward change in the area
of health and fitness – and you keep proving that over and over. But you can
change, things can be different - I have a plan.

Step 1. Accept where you are today. That’s right
- surrender, give in, and just say, "OK, I accept that this is where I am
today." You are not giving up – you are giving in – to the truth. Stop fighting
it and being negative about it, just be OK with it for now.

Step 2. Be thankful for all that is good in your life. Find
some things that you like about yourself and your life and focus intently on
those. Generate a feeling of love and generosity toward yourself and the doors
to change will open.

Step 3. Know that things can change. If you don’t believe it
now (and you probably don’t, given all that has happened in the past), you will,
if you dedicate as much time, thought, and energy as you did to feeling
negative, to thinking and then feeling positive. Fake it in the beginning, just
keep saying (with a smile on your face and hope in your heart), "I can
change, it’s my choice."

You must reinforce over and over, convince yourself that you can change by
reprogramming your mind. Don’t stop until you feel the love.

Step 4. Be open to a new you with new desires and feelings.
Whatever you do, don’t fight it when the urge strikes you to start taking better
care of yourself.

That’s right; before you know it you’ll be eating less junk – or just eating
less. You’ll be wanting to move your body more, so look for new
exercise tips here – they’re coming.

Peace and Happy Trails. Debbie Rocker

For the New You, Focus on 'Happy'

It may sound trite, but it’s useful: If you can find a way to feel good right
now, regardless of what you want to accomplish, separate from all that you think
you need to change, it will help bring about change, very positive change, in
your life.

Assuming you want to improve your health, lose weight, stop
eating something or start doing something, the best thing you can do to get on
track right now is stop thinking about the problem.

Start focusing on happy thoughts, and I would imagine that the new you –
whatever and whoever that is, will make you happy, so think about
him/her.

Try these "WorkIns":

1. Imagine yourself as the person
you want to be, doing the things you want to do, looking the way you want to
look. If this doesn’t make you happy, then you have been misleading yourself
because there is no point to being that person if it isn’t going to make you
happy.

So fixate on it, feel it, focus on him/her daily, hourly, constantly. Feel
what it will be like to be that person, and if it makes you feel good – then
think about it more and more and more.

2. Make a happy list every day. List on a piece of paper all of the things
that you are proud of, happy about, grateful for.

You will be inspired
to do something if you really do these “workins” consistently. You may
spontaneously desire different foods; you may all of a sudden love exercising.
You may find a new job, meet someone special, get introduced to someone or
something that changes your life to ultimately bring every part of you –
physically, mentally and emotionally in line with the happy you.

Enjoy
the process – make it fun – you can be happy now.
Debbie Rocker

Men and Women - Different to the Bone, Part 2

In my last blog entry I focused on certain differences between men and women in terms
of musculoskeletal health, disease and injury. Here's more to ponder and comment
on:

• Women are more likely to develop bunions (that bump on the inner side of the
  foot near the big toe - where the big toe also shifts and starts pointing
  outward rather than straight ahead, resulting in a deformed looking forefoot and
  difficulty finding comfortable shoes- or ones that fit). Genetics are an issue
  with bunion development, but the bigger factor is related to women's shoewear -
  especially when they are ill-fitting in the toe box. Women bring much of this
  upon themselves - or do we blame the fashion/shoewear industry?
  
• Men's and women's muscles are identical! Pound for pound, men and women are
  equally strong. However, because men have more muscle tissue (due to their size
  and also the hormone testosterone) they will usually be "stronger." Strength
  training is probably even more important for women (to protect their bones and
  prevent osteoporosis). Men and women will both get stronger with weight training
  (at any age), but men (especially when younger) will grow more muscle because of
  the hormone testosterone. It is impossible for most women to get "muscle-bound"
  with weight training - so ladies, please don't be afraid to start lifting - and
  do it regularly!
  
• Women are more likely to develop arthritis (although it is also very common
  in men) and be more likely to need knee joint replacement surgery. More on that
  later.

How do women fare (compared to men) after joint replacement surgery? Do they
enjoy the same high success rates? Do they have more complications?

Do women need a different design in their joint replacement? In my next blog
entry I'll explore this very area of controversy in the world of joint
replacement and orthopedic surgery.

Try This One-Minute Calf Massage

Pregnant women, runners, walkers, or anyone who has to stand for long periods
of time will love this! A few minutes of attention to the calf muscles gets the
circulation moving through tired, achy legs.

1. Positioning: Have your partner lie down on his or her back with one leg
bent (foot flat on the floor, knee pointing up) and the other leg straight,
relaxing on the floor.

Go ahead and sit on the foot of the bent leg (you can put a pillow over the
foot if you want) and hold the knee stable with one of your hands. Let your
partner know that you will hold on to the knee so they can relax the bent leg
without feeling like it's going to fall to one side.

2. Keep one of your hands supporting the knee at all times. With the other
hand reach around to the calf muscles, grab on to a big hunk and start squeezing
and releasing. Work at a nice, steady rhythm, squeezing and releasing, working
your way from the back of the knee all the way down to the ankle. (Make sure
you're not pinching the skin, but rather compressing big chunks of muscle.
Pinching doesn't feel good - compression does!)

3. Be thorough - get the whole back side of the lower leg. Even though the
calf muscles really only go half way down the lower leg, continue all the way to
the ankles to include the Achilles tendon area. It needs the work, too.

4. Spend about 30 seconds massaging the lower leg. Then, supporting the
underside of the knee with one hand, straighten the leg, putting it down on the
floor. Repeat on the other leg.

5. After one minute, you're done! Now switch places with your partner so that
you get a chance to receive. Have your partner massage your calf muscles in the
same fashion.

Want the Truth? You Can Start Fresh

What’s your truth?

Are you doing as much as you can do? You know if
you are eating a lot of junk, and not exercising. You know if you spend a lot of
time in your head making excuses or beating yourself up. A lot of what we do is
counterproductive – so, let’s start new.

Start from scratch - today.
Clean your slate, forget the old and bring in the new.

The way everything
is packaged and marketed these days, it’s hard to decipher what really is
healthy. But almost everything we buy is processed, packaged and sealed “for
your benefit."

Hint: Sliced turkey or ham from a deli package is not fresh meat or poultry.
Pastries, cookies and packaged cereal, for the most part, are not whole grains.
Portions are a factor, too - eat moderate portions – that is – not eating until
you are stuffed (like supersizing meals and drinks).

Make a change.
Cook/prepare your meals from fresh (or fresh-frozed) ingredients – buy some
fish, cook some brown rice, make a salad from fresh vegetables and eat fresh
fruit for a snack.

And instead of beating yourself up for whatever you
ate before, try: “Wouldn’t it be nice if eating healthy foods was my first
choice?” or “Wouldn’t it be fantastic if I no longer wanted junk foods?” or “How
amazing would it be if I stopped eating before I got full?” Say these to
yourself over and over every day, all week, and I think you’ll notice a
change.

And how about this? Exercise two times this week. Do two
25-minute walks. Walk easily for five minutes, enjoying the day, warming up
your body, and then increase your intensity, walking with enough effort to feel
yourself breathing deeply for 15 minutes, then take a five-minute victory
walk home enjoying the fact that you did it.

Enjoy your fresh start – start today.
Happy Trails.
Debbie
Rocker