Volume 12, Issue 1 Winter 2012

Wise WomanHAP takes care of you while you take care of everyone else.

What Really Matters? A Search for Balance

Wise WomanHAP takes care of you while you take care of everyone else.

In This Issue …

The information in this publication does not change or replace the information in your HAP Subscriber Contract, Group Health Insurance Policy, Riders or Handbooks and does not necessarily reflect the policies or opinions of HAP, its officers or board of directors. The information is for general educational purposes and is not a substitute for the advice of your doctor. You should consult your HAP personal care physician for your health care needs. HAP does not discriminate on the basis of race, color, national origin, age, religion, sex or mental or physical disability in its employment practices or in the provision of health care services. © 2012 Health Alliance Plan of Michigan

Cover photo: HAP Member Linda Seatts

Photo by: John Sobczak

Health

3 Checkup Checklists Make the most of your medical appointments.

4 Learn the Power of Boundaries How they can help you reduce stress.

9 Ages & Stages – Urine Control Feeling the urge more often these days?

12 Sleep Is Not an Option – It’s a Necessity Try these sleep suggestions, and let us know how they work for you.

Members

3 Women Helping Women HAP Wise Woman readers share their lifestyle tips.

5 What Really Matters? HAP member Linda Seatts discusses her journey to overcome her need to be “superwoman.”

Advice

3 Wise Woman Book Review Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind, by Kristin Neff, Ph.D., makes a great read for any Wise Woman who’s ever felt less than perfect.

8 Feeling the Pinch Advice for coping during emotionally and financially stressful times.

Nutrition

6 Ask the Doctor How much iron do you need, and what happens when you don’t get enough?

6 Heart Smart® Has a New Cookbook

10 Ask Zonya Your nutrition questions answered.

10 Chocolate Chip Bar Cookies Try these easy, guilt-free treats.

Fitness

7 In a Rut? Cross Yourself Out Fitness pro Sherry McLaughlin shares exercises that can make you fit mentally as well as physically.

Events

11 Upcoming Events

Editorial Staff:

EditorAmy Strauss

Editorial AdvisorsTiffany Baker

Gina Jones

Terri Kachadurian

Irita Matthews, M.P.H., J.D.

Donna M. Nuznoff

Susan Schwandt, A.P.R.

Marketing Staff:

DirectorAnita Landino

Senior Marketing SpecialistMeribeth Tyszkiewicz

2

Wise Members

3

Checkup ChecklistsYou’ve scheduled the doctor’s appointment. You’ve

cleared your calendar. Now all that’s left is to

ensure the visit is everything you need it to be.

Here’s what to do before you go:

4 Make a list of your concerns/questions.

4 Write down all of the medications or

supplements you’re taking, including how

much you take and when you take them.

4 Be honest. Your doctor’s questions are

designed to help you, even if they seem

embarrassing or personal.

4 If you don’t understand something, ask, and

write things down.

You’ll find more resources on hap.org, including

forms that can help you organize your information

by type of appointment. Log in, choose the My

Health & Wellness tab and select Tools and

Resources > Decision Tools > Related Information.

The best gift HAP has given me is a CD to help me transition each day from work life to family life. I attended Revive®: Simple Tools to Overcome Stress about a

year ago. The speaker, Donna Marie, inspired me. HAP gave

me a CD called Relaxation for Inner Peace. For my birthday,

I asked my husband for an alarm clock

with a CD player. Now, when I get home

from work, I change out of my business

clothes, lie down on the bed and play one

of the tracks. It really helps me with the

transition to home.

Linda Pallazolo, Troy

If I think of somebody during the day, I send a quick text message just to let them know. The messages I send are simple and short, sometimes

just “I hope you’re having a great day,” but I get great

responses from people. Sometimes friends and family

will say things like, “You can’t imagine

how much those mean to me.” I just

like letting them know they aren’t

forgotten. And they’re not forgetting

about me either.

Colleen Kelledes Alward,

Macomb Township

Women Helping WomenWise women share tips for successfully managing their many roles.

Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind

by Kristin Neff, Ph.D.What do you like least about

yourself? Is it your appearance?

Eating or exercise habits?

Relationships? How do you judge and

criticize yourself for this? Do those

thoughts make you more motivated?

We didn’t think so.

Now imagine this: What if we didn’t evaluate ourselves

as good or bad? What if we treated ourselves with the

sort of compassion we offer to a friend or stranger?

What if that could lead you to a healthier, more

productive life?

In this life-changing book, Dr. Kristin Neff uses solid

research, personal stories and practical exercises to

help you let go of self-judgment and learn to be good

to yourself.

Wise Woman BOOk REvIEW

Wise Health

4

Learn the Power of BoundariesYou’re invited to be on the PTA!

You’re such a great baker; we need your help with the bake sale!

A co-worker needs your help with a work project!

“It feels good when people ask us to do things we’re good

at,” says Joyce Weiss, M.A., C.S.P., and conflict resolution

consultant. “Our egos are stroked. We like it when other

people need us.”

Boundaries? What Boundaries?

“We had boundaries as kids,” Joyce points out. “Come

home when the streetlights come on. No TV until your

homework is completed.” Too often, though, we don’t

set them for ourselves as adults. “Think about recent

commitments and make a list of duties you wish you

had said no to. This can help you prepare a response for

the next time. Finally, politely but firmly enforce your

boundaries. If you set boundaries and people still take

advantage, it’s your fault. You get what you tolerate.”

Family Boundaries

Shannon, a busy working mother, wanted to return to

school to earn her degree. She knew the extra hours would

affect her family, so she called a family meeting. “She

explained it was a two-year commitment,” Joyce recounts.

“Her kids would need to make their own lunches and life

might be a little more stressful. The payoff was a better

job for Shannon, allowing the family to have money for

the vacation they wanted, or for her kids to attend college.

They agreed to her plan. To this day, when they complain,

she reminds them about that meeting. That’s Shannon’s

boundary, and it’s working.”

Work Boundaries

Do you have a co-worker who stops by your desk, seeking

help for her projects and leaving you with less time for your

own? “Use ‘I’ language to deflect them,” suggests Joyce.

“For example, ‘I’m frustrated … because I’d love to help you

out, but I’m too busy.’ Or set a time limit: ‘I can give you

five minutes, because I have a meeting at three.’”

Friendship Boundaries

What about that friend whose number on your caller ID

makes you groan? These energy vampires are talkaholics,

and it’s all about them and what they need. You don’t have

to pick up the phone. Or you can say up front, “I’m tied up

this week; I’ll be glad to call you back or email you.”

As Wise Women, we encounter demands for our time

and energy from many directions. When those demands

become too much, the continual stress can lead to an

array of health problems. Create and enforce boundaries

to help manage your stress levels, and you will feel better

about the commitments you make. It can mean a longer,

healthier, happier life.

Joyce Weiss, based in West Bloomfield, Michigan, is the

author of Take the Ride of Your Life! shift Gears for more

Balance, Growth, and Joy. Sign up for free articles at

www.joyceweiss.com.

HAP member Linda Seatts could do it all. At least that’s

what she told herself as she rushed off to her high-pressure

job, attended classes after work, volunteered at church, hit

the gym, and did her best to be a dutiful mother and aunt.

“I was a high-energy individual and a perfectionist,” Linda

reflects. “I’d put so much into work and volunteering – it

was too much.”

Linda’s perfectionism extended to making sure she got a

mammogram every year. Despite that, in 2007 she was

diagnosed with Stage 3 breast cancer. “In 2006, I had a

clean mammogram. How do I have two 3.5-centimeter

tumors a year later? I believe everything that was going on,

stress at work, in my personal life, school, had something

to do with it.”

“We try to do everything and help everyone, but at the

end of the day we don’t,” agrees Cheranissa Roach, M.S.A.,

certified life coach. “That can manifest in headaches,

migraines, colds or the flu. Some of us have heart attacks.

We were put on earth to help each other, but we have to

take care of ourselves, too.”

That’s what Linda set out to do.

Linda’s Planl She identified duties that were stressing her out and

worked to step back from them.

l She became selective about invitations she

accepted. With a large extended family, she realized

she couldn’t go to every birthday and graduation

party without wearing herself out. So she accepted

the fact that with or without her, life … and the

party … would go on.

l She put self-care on her schedule, including going to

the gym twice a week.

“As women we feel the need to prove ourselves. We don’t

want people to think we can’t handle it,” Linda notes. “It

took that life-changing moment for me to understand the

need for balance. Life is short. We’re trying to live up to an

ideal that doesn’t exist. There is no superwoman. Those

who try to be one are sacrificing family and their health. Is

it worth it?”

Five years after her diagnosis, Linda is healthy, vibrant and

relaxed. “I feel great. I’ve gone down two dress sizes and

my motto is live, love and laugh. That’s it. I’m going to have

fun and balance in my life.”

What Really Matters?A Search for Balance

Wise Members

5

“Life is short. We’re trying to live up to an idealthat doesn’t exist. There is no superwoman.”

— Linda Seatts

Wise Nutrition

6

Heart Smart® Has a New CookbookHave you taken care of your heart today? Part of taking care of your heart includes eating healthy foods and

watching your weight.

Introducing the new Heart Smart® Cookbook Third Edition, the Cookbook will assist

you with making the proper nutrition changes needed to improve your health

and well-being. The Heart Smart® Cookbook has 200 new recipes that have been

developed by the Heart Smart® dietitians in the association of the Edith and Benson

Ford Heart & Vascular Institute and the Detroit Free Press. The Heart Smart®

Cookbook is $23.95; however, if you order it today, you will receive a 20 percent

discount (the discount code is HeartSmart (all one word)). To order the Heart Smart®

Cookbook Third Edition, visit www.freep.com/bookstore or call (800) 245-5082.

Iron: Throughout the ages, it’s been an element associated

with lasting strength. Turns out, that association is true,

whether it’s in the structural framework of a bridge or the

building blocks in your own body.

“Our bodies use iron in many ways,” notes Nancy S. White,

M.D., sports medicine and family practice doctor with

Henry Ford Medical Group. “It carries oxygen throughout

our bodies, it helps our muscles use the oxygen … it even

helps our bodies digest foods. So if we don’t have enough

iron, it impacts us in many ways.”

Wise Women in particular can be affected by a lack of iron.

“Iron deficiency can be common in women ages 35 to 50

as a result of heavy or frequent menstrual periods,” says

Dr. White. “We can also have low iron due to other types of

blood loss from things like surgery, an injury or repetitive

blood donations. It can also be simply a matter of poor

iron intake, or because our bodies are not absorbing iron

properly due to certain diseases or after gastric bypass

surgery.” In fact, in the United States, iron deficiency is the

most common nutritional deficiency and the leading cause

of anemia.

Wise Women need 18 milligrams of iron each day.

“Symptoms of iron deficiency can be subtle,” Dr. White

notes, “but you may notice weakness, headache,

irritability, fatigue and exercise intolerance.” Other

symptoms may include restless leg syndrome – the urge

or need to move the legs to stop unpleasant sensations –

and cravings of odd substances, particularly ice cubes.

If you suspect you may be

running low on iron, the only

way to know for sure is through

a blood test, Dr. White advises.

Your doctor can order tests to

check your hemoglobin and iron

stores. “Iron supplementation

is necessary to correct low iron,

and simple over-the-counter preparations are commonly

recommended,” Dr. White says. “If you take the supplement

with something high in vitamin C, such as orange juice,

it will help your body absorb the iron. You should also

increase foods high in iron, which include lean red meats,

dark-green leafy vegetables and iron-fortified cereals.”

Ask the DoctorNancy S. White, M.D., Henry Ford Medical Group

Do You Need More Iron?

7

1. Be a stork. 2. Be a cross-stepper

3. Weight it down

4. Be a cross-reacher 5. Speed stack

Wise Fitness

Imagine a line that runs from the middle of the top

of your head straight down to your feet. That’s your

midline. Now, take your right arm and touch your left

toe. Not only have you just done a nice stretch, you’ve

performed an exercise that can help you to learn and

be more creative.

“You’ve crossed the midline. And that can improve

your balance and coordination and even help you

learn new things,” says Sherry McLaughlin, physical

therapist, of Michigan Institute for Human Performance

Inc. (MIHP). “A research study watched people get

thrown off balance to see how they

recovered,” she says. “The study

showed if they were pushed to the

left, they’d cross-step with the right

foot. The most balanced people are

the ones that cross the midline. As

we age, though, we do that less

and less, so exercises that cross

your midline are great ways to

benefit your body and your mind.

Your nervous system will build new

pathways so that your right and left

sides are more equally developed.”

Five Exercises to Cross Your Midline

1. Be a stork. Practice standing on one leg as you reach

forward and across your body to the left and right.

2. Be a cross-stepper. Stand normally, then take your

right foot and step across your left, walking sideways.

Walk back, crossing your left foot over your right.

3. Weight it down. Do the cross-step holding something

heavy.

4. Be a cross-reacher. Sit at a table and reach across your

body to touch something on the opposite side of you.

5. Speed stack. Using both hands, stack uniform cups

into pyramids as quickly as you can. Google search

“speed stacking,” or visit www.speedstacks.com to

see how it’s done.

“Anything that alternates right and left function works,

patting out a rhythm on a countertop,” Sherry adds.

“You can even do an everyday activity like brushing your

teeth with the opposite hand you’d normally use. Your

nervous system is dynamic, and it will grow new pathways

to function, so exercises like these are great things to do if

you feel like you’re stuck in a rut.”

In a Rut? Cross Yourself Out

Sherry McLaughlin, M.S.P.T. and

HAP-affiliated physical therapist

Wise Advice

8

This time of year, Wise Women assess the 2012 financial

picture and play catch up with obligations we may have

put aside during the holidays. All of which can be, in a

word, stressful.

“For women, financial stress is

often brought on by not knowing

where they stand,” notes Robin

Thompson, president of Budget

Wise Consulting. Robin suggests

one of the most important tools

to cope with financial stress is a

budget – or, as she prefers to call

it – a spending plan. “The word

‘budget’ implies you’ll be deprived.

It’s about everything you can’t do. A spending plan

can be based upon your vision and your values – what

you want to do. If you’re allocating your paycheck and

giving every dollar an assignment, that enables you to

have the money available when you need it.”

A spending plan can help:

l Reduce marital stress. Discussing finances can

help you align priorities. l Find ways to put more money toward your debt. l Identify waste. l Prepare for financial surprises like health, home

or vehicle repairs. l Prepare for expenses like vacations.l Build your savings. (Put a regular payment to

your savings into your spending plan as if it were

a recurring expense.)

Feeling the Pinch

If you need help coping with stress, HAP’s Coordinated Behavioral Health Management team is available to consult with you and match you with appropriate care Monday through Friday 8 a.m. to 5 p.m. Call toll-free at (800) 444-5755 or email caretrack@hap.org.

“In addition to financial stress, women are under stress in

so many ways,” adds Jody Khoury, L.M.W.S., behavior health

clinician with Providence Hospital. “They may be taking care of

elderly parents, which is a financial responsibility and a physical

one. At the same time they may be caring for children, plus

keeping a marriage and career going. Demands are coming from

everywhere.” Stress increases our risk for a range of health

issues, including headaches, asthma, digestive problems,

eating and emotional problems, colds, high blood pressure,

strokes, heart attacks and cancer.

Jody notes a number of signs that indicate you may need

to address the stress level in your life. “If you’re feeling

overwhelmed and having thoughts like ‘I just can’t do this

anymore; I’m going to break,’ you need to take action to reduce

stress,” she says. “Another sign is a change in your behavior,

like not returning calls from friends.”

Robin Thompson

Wise Health

9

Of the 13 million Americans on the lookout for the nearest

restroom because of urinary incontinence, 85 percent are

women. In fact, one in four women over age 18 experience

episodes of urine leaking involuntarily.

“Childbirth is a big factor,” explains

Ali Luck, M.D., a urogynecologist in

the department of Women’s Health

Services/Obstetrics & Gynecology and

Urology in the Henry Ford Medical

Group. “Childbirth can damage

muscles, nerves and connective tissue

of the pelvic floor – although there

can be other reasons, including a

combination of medications, diet and

genetics.”

In Your 30s …Have you experienced stress incontinence – leaking urine

when you cough, sneeze, lift something heavy or exercise?

“Kegel exercises can help,” Dr. Luck advises. “Pull up on

your pelvic muscles, drawing in your vagina and anus. To

start, perform this exercise lying down; work up to doing it

in an upright position. Try to hold for 10 seconds 10 to 15

times a day. Stick with it – don’t expect results before six

weeks.”

In Your 40s …One in five adults over 40 has an overactive bladder. “That

means a frequent or sudden need to urinate day or night,”

says Dr. Luck. “This condition affects men and women, but

women tend to experience more leakage. What can you do?

Start by maintaining a healthy weight, and decrease your

consumption of caffeine, carbonated drinks and artificial

sweeteners. If you’re taking a diuretic blood pressure

medication such as Lasix®, Prinizide® or Hyzaar®, ask your

doctor if you can change the medication or timing. And if

you have diabetes, keep your blood sugar under control.”

In Your 50s …“Urge incontinence – meaning an urgent need to urinate

and often a leak on the way to the bathroom – is more

common as we age but not a normal part of aging. Urinate

every two hours to beat the urge,” Dr. Luck recommends.

“And when you do have the urge, ‘freeze and squeeze.’

Instead of rushing for the bathroom, stop (being in a seated

position often helps), squeeze your pelvic floor muscles,

then relax until the sensation to urinate goes away.”

Medical treatments for incontinence are also available, so if

lifestyle adjustments aren’t helping, talk with your doctor.

Ali Luck, M.D.

Ages & Stages

Urine Control

Wise Nutrition

10

My family is thinking about getting a juicer to start the new year off right. Is juicing as good for you as eating the whole fruit?

The short answer is no, since juicing separates out

the beneficial fiber that is usually thrown away.

Eating the whole fruit is more filling, while drinking

juice can be a concentrated source of liquid

calories (something to consider for most people

who are trying to lose weight). However, for

someone who has a limited appetite, for instance,

cancer patients; kids who have limited appetites

for fruit and vegetables; or any adult who just

doesn’t “like” to eat enough fruits and vegetables,

juicing can offer a way to sneak in disease-fighting

antioxidants and

phytochemicals.

A favorite juicing

machine that

powerfully purees

whole fruits

into liquid is the

Vitamix®. While

more expensive

than standard

juicers, it lasts and

lasts, and you don’t

have to worry about

losing any valuable fiber.

Want more tips? Check out Zonya’s eating for

immunity webinar. Log in at hap.org and choose

the my Health & Wellness tab. Then select

member Programs and choose Weight WiseSM.

A:

Q:

Ask ZonyaZonya Foco, R.D., author,

HAP Weight WiseSM facilitator,

TV host and national speaker

Directions

Preheat oven to 350°F. Coat a 9 x 13-inch baking

dish with cooking spray. Using a fork, mix the

first four ingredients well in a large bowl. In a

medium bowl, mix the next four ingredients

with a fork. Then add them to the liquid

ingredients. Using a large wooden spoon, stir

well. Add the oats and mix. Add the chocolate

chips and mix. Let dough stand about 10

minutes. Place the dough in the baking dish.

Lay a sheet of wax paper on top and press

dough out. Remove wax paper. Bake 25

minutes. When you remove the cookies from

the oven, they’ll look lightly browned on top

and be soft to the touch. They will firm up as

they cool. Cut into 24 equal-size bars.

Makes 2 dozen. Serving size: 1 bar cookie

Nutrition information for 1 serving:

Chocolate Chip Bar CookiesCourtesy of Zonya Foco, R.D., author of Lickety Split Meals for Health Conscious People on the Go

Calories: 125

Calories from Fat: 14%

Fat: 2 g

Saturated Fat: 1 g

Fiber: 1.5 g

Cholesterol: 0 mg

Sodium: 170 mg

Protein: 3 g

Total Carbohydrates: 26 g

Sugars: 10 g

1 c. unsweetened applesauce

¾ c. firmly packed brown sugar

2 tsp. vanilla

4 egg whites

1 5.1-oz. package instant vanilla or chocolate pudding

1 tsp. baking soda

1 tsp. baking powder

2 c. whole wheat pastry flour (or 1 cup whole wheat flour and 1 cup all-purpose flour)

1 c. oats

6 oz. semisweet chocolate chips

These guilt-free cookies use instant pudding and applesauce instead of shortening. They can be stored in the refrigerator and also freeze well.

Ingredients

Wise Events

11

Upcoming Walks/Runs2012 American Heart Association’s Metro Detroit Heart Walk

Saturday, May 12, Ford Field in downtown

Detroit

For more information and to register, go to

www.miheartwalk.kintera.org.

The American Cancer Society’s Relay for Life

Events happen throughout metro Detroit.

To find out about relays near you and how

to join a team go to www.relayforlife.org/

index.

21st Annual Susan G. komen Detroit Race for the Cure

Saturday, May 26, in downtown Detroit.

To sign up and for more information, go to

www.karmanos.org/raceforthecuredetroit/

index.asp.

Upcoming Member EventsMarch

• Revive®: Simple Tools to Overcome Stress

April

• MoveWell Every Day

• Weight WiseSM for Women-Live It

To learn more and register, log in at hap.org and click on the

My Health & Wellness tab, then Member Programs from the

right hand list then select Weight WiseSM or Wise Woman.

Please note, event information will be posted on the website

one month prior to the event date.

Healthy Intuitions: A Day for Women Hosted by Henry Ford West Bloomfield Hospital, coming

this spring.

For the date and more information,

visit www.HenryFord.com/HealthyIntuitions.

February Is Heart Health MonthDo something nice for yourself today and check out

www.goredforwomen.org. You’ll find terrific resources

including Better U, a free 12-week online program that can

save your life.

YOUR HAP BOARD OF DIRECTORS

75M 1/12 322

William R. Alvin

Cindy Bala-Brusilow, Ph.D.

Marvin B. Beatty

William A. Conway, M.D.

Linda Ewing

J. Timothy Gargaro

Joyce V. Hayes Giles

Harvey Hollins, III*

Jamie C. Hsu, Ph.D.

Kirk J. Lewis

Jack Martin, Chairperson

Catherine A. Roberts

Robin Scales-Wooten

Nancy M. Schlichting

Rebecca R. Smith

Susie M. Wells

FEEDBACKWe love hearing from you.

You may contact us:

By mail:HAP Wise Woman Editor2850 W. Grand Boulevard

Detroit, MI 48202

By email:hapwisewoman@hap.org

2850 W. Grand Blvd. Detroit, MI 48202

*Subscriber-Elected Directors

Sleep Is Not an Option – It’s a NecessityFeeling sleepy during the day? Well, so are more than 40 percent of American

adults. Wise Women need seven to nine hours of sleep a night, and most of us

don’t get it. If you have trouble falling asleep, try these tips to help increase

your shut-eye:

l Don’t nap during the day.l Go to sleep and wake up at the same time each day.l Exercise is a good thing, but not before bedtime. Finish your workout

more than two hours before you turn in.l Don’t take worries and responsibilities to bed. Make to-do lists well

before bedtime and put them out of your mind.l Establish a regular, relaxing sleep ritual to signal your body to start

unwinding. Try soft music, a small cup of caffeine-free tea or deep-

breathing exercises. l Avoid nicotine, caffeine and alcohol within four hours of bedtime.l Keep your bedroom dark and quiet – no TV or computer – and use

earplugs or a white-noise machine if you need to.l Try to get 15 minutes of bright light, preferably sunlight, in the morning.

Try these tips, and let us know if they worked for you. Email us at

hapwisewoman@hap.org.