2023 Issue 4 Quarterly Newsletter

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WOMEN’S HEALTH

I’m writing from an airplane, contemplating the changes of time.  There was no internet on an airplane just a few years ago, and now I can get so much work done amongst the clouds.  For those who had to be rescheduled, I’m on a plane due to a recent death in my family.  It’s reminded me of so many of you who lost loved ones in the recent past and the ways in which people grieve.  I’ve included an article on healthy grieving in this newsletter for those who are watching their aging or ill loved ones, fearing what comes after they pass.

This newsletter also has information on vaccines and masking as we approach the season of respiratory illnesses.   Please try to keep your families protected and safe.  The FDA has recently approved a maternal vaccine that helps prevent illness in the newborn, the first of its kind.  We also have a contribution from Dr. Soohoo on advances in Dermal Fillers, from Dr. Selvakumar on how to engage with your Primary Care Physician, on the Flu Season with kids from Dr. Jain and from Dr. Liu, as we celebrate one year of her having joined Bay Area Oncology, an article on vaginal estrogen for pelvic health.   Dr. Neidich has finally started seeing patients with Mountain View Surgery and has written on the hard truths of weight gain after pregnancy.

Finally, please follow us on social media to stay up-to-date on healthcare issues affecting women and news from our practice. You can find us on Facebook, LinkedIn, or Instagram.   As always, feedback is welcome regarding our practice, customer service, and even this newsletter!

Best wishes,

Sarah Azad, MD

In this issue:

Practice Updates

Online Prenatal Classes

Research at ECWMG

Newest Advances in Dermal Fillers for Facial Rejuvenation

How to use your Primary Care Physician

Fly Away, Flu!

Pelvic Health Fall–Vaginal Estrogen

The Truth about Weight Gain After Pregnancy: Understanding Obesity

Vaccines for the Fall

Maternal RSV Vaccines

Healthy Grieving

El Camino Hospital Visitor Policy Updates

Highlights from our Women’s Health Blog

PRACTICE UPDATES

Change in OB Urine Sample Collection

For routine visits in pregnancy, we are no longer requesting a urine sample.  This change will allow patients to be roomed faster and clear up traffic at the restrooms.

For first pregnancy visits, and during the pregnancy if there are tests due, pregnant women may be asked to leave a sample.  If you are coming in for a visit and have any urinary symptoms, let the medical assistant (MA) know and you can leave a sample.

Upcoming Mask Mandates

As we enter winter and the season of respiratory viruses, masking in all Santa Clara County public health buildings will be mandatory.  This includes the Sobrato Pavillion (our office), the hospital, and any other health facilities you may visit during the season.   These requirements will start on November 1^st, 2023, and continue through March 31, 2024.  During this season, the hospital will also limit visitors to those aged 16 and older.

Office Visitor Policy Updates

We allow an asymptomatic visitor to join you at visits.  Proof of vaccination is no longer required nor is masking (Until November 1^st).

Don’t forget to follow us on social media to stay updated on office information and women’s health topics.  You can follow us on Facebook, Twitter, LinkedIn, or Instagram.  Your feedback on our office practices and physician and staff communication is always welcome. 

ONLINE PRENATAL CLASSES

Prenatal Classes
We offer four virtual prenatal classes.   These classes cover preparing for childbirth, breastfeeding, and newborn care and have been very popular, and we plan to have them every one to two months. These classes are also open to members of the public that wish to register.

Virtual Breastfeeding Class
This is a 2-hour class presented by Nadia, RN, our lactation educator.  The class is a virtual, in-depth review of breastfeeding.  Learn how to get the best start, avoid pain, make sure your baby is getting enough, and when to ask for help!

Virtual Newborn Care & Safety Class

2.5-hour class presented by Nadia, RN
Practical tips for caring for a newborn

• Appearance of newborn
• Normal skin conditions
• bathing & diaper changing
• safe sleeping
• Newborn safety:
• Car seat safety
• Choking hazards
• Poison control
• Childproofing your home

Childbirth Preparation Part One

2.5-hour class presented by Nadia, RN:

• The last month of pregnancy
• Preparing for the hospital
• Laboring at home, when to call, and when to come in
• Admission to the hospital
• Active labor
• Pain management

Childbirth Preparation Part Two

2.5-hour class presented by Nadia, RN:

• The last stage of labor: pushing
• Vaginal delivery
• Cesarean delivery
• Initial recovery in the hospital
• The postpartum period

You can learn more about these classes or register here.

Pregnancy Educational Videso

We are creating a series of educational videos on things commonly discussed during prenatal visits.  You can see what we have so far here.

RESEARCH AT ECWMG

Next Gen Jane

NextGen Jane, a research company based in the Bay Area, is working on technology to build a safer, more accurate method for non-invasive prenatal testing that can be done as early as six weeks of gestation. The study involves wearing an organic tampon for 20-60 minutes.   Wearing tampons during pregnancy is safe and does not carry any adverse effects. To participate in their study, scan the QR code below or contact NextGen Jane directly, and they will help you start the process. They will ship you a kit with all the instructions and assist you with the consent process. To thank you for your participation, NextGen Jane will provide you with a $25 Amazon gift card for every sample tampon you send in.

Sunbeam Study

NEWEST ADVANCES IN DERMAL FILLERS FOR FACIAL REJUVENATION

Lillian Soohoo, MD

Board Certified Dermatologist

Hyaluronic Acid (HA) fillers are safe, non-allergenic, easily reversible, and FDA-approved for facial rejuvenation to improve the signs of aging. They are specifically used to correct age-related facial volume loss (sagging or hollowing) of cheeks, temples, jawline, lips, and under eyes. Recently, there have been important advances in facial rejuvenation with Hyaluronic Acid (HA) fillers. This cosmetic filler is popularly known as Restylane, Juvederm, and Voluma (along with other brands) and is FDA-approved since 2003.

The newest major innovation in HA filler treatment has been the development of an improved Cannula Technique, which involves using a small, blunt-tipped (non-needle) device to gently layer the filler within the skin. This new method has been shown to produce more natural results with beautiful re-volumization (plumping) of cheeks, jawline, under-eye area, and temples—all while requiring significantly less filler and almost no bruising or discomfort. How is this possible?

Think of the cannula as a tiny, round, blunt-tipped (non-sharp) tube with a small hole at the tip. Using the cannula, small threads of HA filler can be layered in the skin as the cannula is gently inserted and withdrawn from the skin, much like frosting between the layers of a cake. This method gently lifts and fills in the skin hollows with HA filler, adding the desired volume to the cheeks and face.  When using a cannula instead of a needle, the placement of very thin layers of HA filler is achieved with minimal pain and nearly no bruising or swelling. This results in a more natural-appearing integration of the HA filler within the skin tissue and also gives longer-lasting results of up to 15 months (vs. 6-12 months with the needle method).

The newer cannula technique minimizes unwanted side effects and is a direct result of improvements in the formulation of HA fillers in 2023.  The newest HA fillers now offer a range of softness that is unsurpassed and provide the advantage of creating a more natural appearance and texture to lips, cheeks, under eyes, and temples. The chin and jawline can also be beautifully enhanced with these newer HA fillers (ie, RHA) to lift sagging jowls in a matter of minutes with minimal pain and almost no bruising or downtime. Treatment is performed in the office and typically lasts 30-60 minutes in a relaxed, comfortable atmosphere.

In summary, facial rejuvenation using HA fillers has never been safer, more natural-appearing, or longer lasting than today. Recent advances in both filler technique and the latest formulations of FDA-approved Hyaluronic Acid (such as RHA) provide an exciting and reasonable option for patients to achieve natural-looking, non-surgical facial rejuvenation with minimal discomfort or downtime.

Lillian Soohoo, MD

Golden State Dermatology affiliate

555 Knowles Drive, Suite #220

Los Gatos, CA 95032

408.317.3688

HOW TO USE YOUR PRIMARY CARE PHYSICIAN

Pradeepa Selvakumar, MD FACP

Board Certified in Internal Medicine and Lifestyle Medicine

The role of primary care physicians was quite clear 20 years ago. It was a patient’s medical “home.” All questions started with your primary physician, who took a detailed history and physical examination and guided a patient’s workup and management. With the corporatization of health care, meaning large companies hiring physicians, that personal relationship between physician and patient weakened. But all is not lost! Whether your physician is in private practice or with a large organization, you can learn to utilize and develop that long-term relationship even if your physician seems to change yearly.

Which specialties fall into Primary Care?

• Family Medicine physicians are trained to take care of everyone from newborns to the elderly and pregnant and perform surgeries.
• Pediatricians: take care of newborns, children, and young adults.
• Internal Medicine physicians take care of adults and the elderly. Internal medicine physicians can train further in subspecialties such as cardiology, pulmonary, gastroenterology, rheumatology, endocrinology, nephrology, infectious disease, geriatrics, hematology/oncology, palliative medicine, hospital medicine

What is a GP? GP or General practitioners is a term commonly used outside the United States and less so in the United States. In the United States, the term is used to describe physicians who may have completed 1 or 2 years of a primary care residency but have not completed it or completed the exams. Some may not have completed a residency in a primary care field (ex., Surgery) and have switched to practice primary care. General Practitioners are unable to practice in the state of California as of 2019 but can practice in certain other states.

What can your primary care physician do for you?

Most commonly, primary care physicians focus on:

• Prevention-this includes cancer screening, avoiding the development of chronic diseases and education on healthy habits. Many diseases such as obesity, diabetes, hypertension, kidney disease, and even memory impairment can be avoided with early and regular monitoring.
• Coordination between specialists- sometimes subspecialists do not communicate with each other; a primary care physician coordinates care between subspecialists to make sure that medications and conditions are treated in tandem with each other.
• Chronic illness management- many common conditions, such as diabetes, hypertension, and coronary disease can be kept stable or even improved with regular monitoring and management. What might seem like routine bloodwork, vitals, physical exam and regular appointments can help prevent surprises and allow people to live long and active lives.

What do you do if you have vague symptoms, chronic symptoms without a clear cause, chronic pain, anxiety, or depression?

The key here is to see your physician regularly. Have them get to know you, to know what your baseline health looks like so that if there is a change or there is a new symptom, it can be discovered and the next steps of a workup can be taken or the appropriate referral to a subspecialist can happen. Even if your physician changes from year to year, you will have documentation in the record of your exam, your labs, and your imaging studies.

For example, you have a chronic cough, you have had it for months, and you have tried all kinds of cough medication without much improvement. You went to an urgent care once and maybe you felt better briefly, but the cough came back. There is a wide variety of things that can cause a cough and there is a step by step algorithm that we follow to evaluate this. It is not an algorithm that we follow blindly; part of the art of medicine is to know when to chase down an unusual symptom and break away from the algorithm.

Another example, you were diagnosed with postpartum depression. You were appropriately placed on an antidepressant but you got busy with your child and never went back to follow up after you gave birth. We always reevaluate chronic medications and in this situation, see it might be appropriate to taper you off your antidepressant if you have been stable and had no earlier history of depression.

Another situation that occurs commonly in the Bay Area with the availability of multiple world-class medical institutions is to self-refer to subspecialists, maybe many subspecialists, maybe 2^nd, 3^rd or 4^th opinions for the same complaint. A primary care physician can guide you to the appropriate subspecialist for your condition, be a sounding board for your concerns and decrease the stress and anxiety that comes with seeking answers for your health. Sometimes, disorganized self-referrals and multiple specialists for one problem can muddy the waters. The best-case scenario is a patient who is able to advocate for themselves, do the research and collaborate with their physician to work a problem.

All these above situations are not necessarily resolved in a single visit. Sometimes it takes multiple visits for a disease to announce itself, sometimes it takes multiple visits to methodically evaluate a problem. In developing a relationship with your primary care physician, the likelihood of finding an answer or feeling better, increases. The stress and anxiety of not knowing who to turn to, diminishes.

What are some tips in creating a successful working relationship with your primary care physicians?

• Make sure your physician has all your medical history, records, medications, over the counter supplements, knowledge about your lifestyle – your diet, exercise, tobacco, vaping, recreation drugs and alcohol use, your sexual history, family history, work history, etc.
• Let your physician know if you have had to go to urgent care or the emergency room; they will likely want to see you in follow up to see if you feel better, were there any changes to your medications, are there any labs or imaging findings to follow up.
• Let your physician know if you have surgery or procedures, whether orthopedic, skin cancer removals, cosmetic surgeries.
• Let them know if you pursue alternative treatments like acupuncture, PRP/Stem cell treatments, hormone treatments, vitamin infusions/injections, hyperbaric treatments, etc. These can interact with your allopathic medications, procedures or affect your cancer risk.
• Make sure you schedule regular appointments with your primary care physician. If you are not on any medications, have no chronic medical conditions, you can see your physician once or twice a year. If you are on chronic medications, expect to check your labs at least twice a year if stable, more if not. If your medical conditions are not well controlled, expect to see your physician more often, such as every 3-4 months or more frequently. If you have a complex medical history, also expect to be seen more frequently.
• Most importantly, be open and honest with your physician. If you feel like your physician is not hearing you, not taking your symptoms seriously or does not follow up the way you want, let them know. Every person is different and we can only change how we interact with you and manage a challenging medical issue, is if we know about it.

Knowing how to use your primary care physician is a powerful tool in both owning your health and having a collaborative partner in the most important commodity you have (your health!)

Pradeepa Selvakumar MD

Internal Medicine

Bloomprimarycare.com

101 South San Mateo Drive Suite #301

San Mateo, CA 94401

650-435-8211

moc.e1701991773racyr1701991773amirp1701991773moolb1701991773@olle1701991773h1701991773

FLY AWAY, FLU!

PELVIC HEALTH FALL!

Cici Liu, MD

Board Certified Gynecologic Oncologist

September through November contain the veritable heavy hitters for women’s health: September is Menopause Awareness Month, Ovarian Cancer Awareness and Sexual Health Month. October is Breast Cancer Awareness Month and November is Bladder Health Month.

It’s fitting then that fall also marks the anniversary of Dr. Cici Liu joining our practice. Before joining Bay Area Gynecology Oncology, Dr. Liu was a professor at the University of Rochester.

In honor of her continuing our tradition of excellent surgical treatment complimented by holistic care, we’d like to highlight a therapy that’s been around for a long time:

Low-dose vaginal estrogen.

We know what you’re thinking: hormone replacement therapy is in the news so much- it was good, and then bad and now we’re in the middle. And every time we put patients on low dose vaginal estrogen we inevitably have to talk about cancer because it’s on the package insert.

Here’s the thing about vaginal estrogen: The effect is local. It does mean that the estrogen has to be placed in the vagina – there are creams, suppositories and slow-release rings. However, once you get past the application, you’re set. The locally acting estrogen increases blood flow to the vaginal tissue and the thickness of the glycogenated cell layer. That’s the cell layer that the lactobacillus (beneficial bacteria) need to thrive. The result is that bad bacteria have a harder time colonizing the vaginal opening. Numerous randomized controlled studies have shown a decrease in urinary tract infections and improved sexual function with low dose vaginal estrogen. Some women also experience decrease in incontinence, urinary urgency and pelvic pain.

Given the low dosing of vagina estrogen (at low levels it has been demonstrated not to raise estrogen beyond normal postmenopausal levels) it is safe in women who would not be candidates for systemic estrogen. For example, women at increased risk of blood clots. Many studies also demonstrate the safety of low dose vaginal estrogen in women who had hormone sensitive cancers such as breast and endometrial cancer.

For women who do not have a personal history of estrogen-dependent cancer, all evidence points to the safety of vaginal estrogen. Even in patients with that history, depending on the timing of their cancer and prior treatments, the risks may be low enough and the benefits high enough to start treatment.

We encourage you to talk with your doctor about any sexual function, pelvic or urinary concerns you have. Often treatment vastly improves our patients’ quality of life.

Gynecology Oncology:

James Lilja, MD

Cici Liu, MD

Urogynecology

Katherine Volpe, MD

Victor Velasco, MD

Note:

Bay Area Gynecology and Oncology is moving! Our new office will be 910 Campisi Way, Suite 2B in Campbell, CA, and the move will likely take place in January

THE TRUTH ABOUT WEIGHT GAIN AFTER PREGNANCY:  UNDERSTANDING OBESITY

Eitan Neidich, MD

General Surgery

Fellowship trained in Minimally Invasive Surgery and Bariatrics

Pregnancy is an amazing journey that can take a toll on a woman’s body in different ways. Weight gain is one of those ways, and it’s normal and healthy for a woman to gain weight during pregnancy. However, the problem arises when she struggles to lose the extra pounds after delivery. Many women often find themselves staring at the mirror, wondering what happened to their pre-pregnancy body. For some, the weight gain may even lead to obesity, a serious condition that can have long-term effects. In this post, we’re going to take a closer look at weight gain after pregnancy.

Weight Gain After Pregnancy:

When a woman gets pregnant, her body goes through significant changes to accommodate the growing fetus. These changes may include hormonal fluctuations, increased blood volume, and an expanding uterus, leading to weight gain. The ideal weight gain for a woman during pregnancy varies depending on multiple factors such as pre-pregnancy weight, age, and overall health. However, a general guideline is that women with a healthy pre-pregnancy weight should gain around 25-35 pounds throughout the pregnancy.

After delivery, a woman’s body needs time to recover, and the process of losing the extra pounds can be challenging. Breastfeeding, a healthy diet, and exercise can all aid in weight loss. However, it’s essential to give your body enough time to heal and not rush into losing weight too quickly. It’s also important to note that every woman’s weight loss journey is unique, and there’s no one-size-fits-all solution.

Understanding Obesity:

Obesity is a complex condition characterized by excess body fat that increases the risk of various health problems such as heart disease, diabetes, and certain cancers. While weight gain is a common factor in obesity, it’s not the only one. Genetic, environmental, and lifestyle factors also play a significant role. In simpler terms, obesity occurs when a person consumes more calories than their body needs, leading to an accumulation of fat.

Obesity is usually defined using the Body Mass Index (BMI), a measure of body fat based on height and weight. A BMI of 30 or more is considered obese, while a BMI between 25-30 is considered overweight. However, BMI isn’t a perfect measure of obesity as it doesn’t take into account factors such as muscle mass. A more accurate way of determining obesity is by measuring the waist circumference as abdominal fat is a significant risk factor for health problems.

Medical Conditions Related to Obesity:

Obesity is associated with a wide range of medical conditions, some of which can be life-threatening. One of the most prevalent is heart disease, as excess body weight puts additional strain on the heart, leading to high blood pressure, high cholesterol, and potentially heart attacks or strokes. Obesity also increases the risk of Type 2 diabetes, where the body becomes resistant to insulin, the hormone responsible for regulating blood sugar levels.

Furthermore, obesity can lead to a multitude of other health problems. These include certain types of cancer (like breast, colon, and kidney), sleep disorders (such as sleep apnea), osteoarthritis (due to increased pressure on joints), and even mental health issues (including depression and anxiety).

Obesity in women post-pregnancy can also impact reproductive health, leading to problems such as infertility, polycystic ovary syndrome (PCOS), and complications in future pregnancies.

It’s important to note that while the risks associated with obesity are significant, they can be mitigated with a combination of lifestyle changes, medical intervention, and in some cases, surgery. Always consult with a healthcare professional for advice tailored specifically to your situation.

Preventing Obesity:

Preventing obesity after pregnancy is the key to a healthier postpartum journey. Here are some actionable steps to take:

• Breastfeed- Breastfeeding can help you shed some of the extra pounds and reduce the risk of obesity in both the mother and child.
• Eat a healthy diet- Focus on eating whole foods, fruits, and vegetables, and limit your intake of unhealthy snacks and sugary drinks.
• Exercise- Regular physical activity can help you lose weight, improve your overall health, and reduce the risk of obesity.
• Stay hydrated- Drinking plenty of water can help you feel fuller for longer, reduce cravings, and boost your metabolism.
• Get enough sleep- Getting enough sleep is crucial for your body to recover and reduce the risk of obesity.

In conclusion, weight gain after pregnancy is a normal and healthy occurrence, but it can be challenging to lose the extra pounds. Obesity is a more severe condition that can have serious health consequences. Understanding how weight gain occurs and what defines obesity can help women take preventative measures to avoid developing the condition after pregnancy. By following a healthy lifestyle, including proper nutrition, exercise, and adequate sleep, women can not only lose the extra pounds but also improve their overall health and well-being.

Interested in learning more about options for weight loss:

Dr. Eitan Neidich, is a board certified general surgeon with Bariatric fellowship training from Mount Sinai. NYC experienced assisting patients on their weight loss journeys. His expertise spans across various surgical procedures including gastric bypass, and sleeve gastrectomy. Dr. Neidich holds a strong commitment to patient-centric care, working intimately with his patients to understand their unique needs and provide them with tailored solutions. Dr. Neidich’s primary mission is to see his patients regain their health and confidence, and to provide them with the tools and support needed for long-term success.

Dr Neidich grew up in the San Francisco area, attended Cornell University before attending medical school at UCSF. He completed General Surgery Residency at Tufts University in Boston. He was accepted into the prestigious Minimally Invasive Surgery/Bariatrics at Mount Sinai in NYC. Currently he has joined Mountain View Surgery to provide General and Bariatric Surgery.

If you would like to learn more about options for weight loss, attend a monthly seminar (on zoom or in person) with Dr. Neidich. Call 650 600-7301 to register.

Mountain View Surgery

2500 Hospital Dr. Bldg 15 Suite 1

Mountain View, CA 94040

(650) 282-3000

VACCINES FOR THE FALL

For all adults, we recommend getting both the Flu vaccine and the updated COVID19 booster.  If you have those around you who are at higher risk of becoming sick or hospitalized, or at increased risk of death, from either the flu or COVID19, please encourage them to get their vaccines too.

Timing:

These vaccines should be completed before the end of October to have full protection for the peak of the respiratory virus season (November to March)

High risk patients:

Newborns and youn children

Pregnant women

Postpartum women

Those aged 65 and older

People with autoimmune disorders

People on immunosuppressants

People with chronic heatlh conditions

For more information on vaccinations and the winter:
Center for Disease Control and Prevetion

Johns Hopkins School of Public Health

Immunize.org

Maternal RSV Vaccines

Respiratory Syncytial Virus (RSV) has long been a concern for newborns and toddlers, causing respiratory infections that can be severe and sometimes life-threatening. Fortunately, there is new hope on the horizon in the form of an RSV vaccine specifically designed for pregnant mothers. Recently approved by the FDA, this vaccine has the potential to significantly improve children’s health and safety.

The Impact of RSV on Newborns and Toddlers

RSV is a common respiratory virus that can affect people of all ages. However, it is particularly dangerous for infants and young children. RSV infections can lead to severe respiratory symptoms such as bronchiolitis and pneumonia, which can be especially problematic in infants with underdeveloped immune systems. In fact, RSV is a leading cause of hospitalization for infants in the United States. The virus can lead to breathing difficulties, dehydration, and even fatalities in some cases, making it a significant public health concern.

The New RSV Vaccine

The development of an RSV vaccine for pregnant mothers represents a major breakthrough in pediatric healthcare. This vaccine is designed to protect infants during their most vulnerable period, the first few months of life when their immune systems are not fully developed. By vaccinating pregnant women, the antibodies generated in the mother’s body can be passed on to the developing fetus, providing passive immunity against RSV during the critical early months.

When the Vaccine is Given

The RSV vaccine is typically administered to pregnant women between 32 and 36 weeks of gestation. This timing allows the mother’s immune system to generate a sufficient level of antibodies that can be passed to the developing fetus. These antibodies provide protection against RSV during the first few months of the infant’s life, a period when they are most vulnerable to severe RSV infections.

Effectiveness and Safety

Early data from clinical trials and post-approval monitoring have shown promising results regarding the effectiveness and safety of the RSV vaccine for pregnant mothers. Studies have indicated a significant reduction in RSV-related hospitalizations and severe respiratory illnesses among infants born to vaccinated mothers. This not only protects the health of the infants but also alleviates the burden on healthcare systems.

Safety concerns regarding the vaccine have been minimal, with side effects typically limited to mild reactions at the injection site or transient fever. The benefits of protecting newborns and toddlers from RSV far outweigh the potential risks associated with the vaccine.

The approval of the RSV vaccine for pregnant mothers is a landmark achievement in the field of pediatric healthcare. RSV has long been a threat to the health and well-being of newborns and toddlers, leading to hospitalizations and even fatalities. With this vaccine, pregnant women can now play a crucial role in safeguarding their infants from the severe consequences of RSV infection.

As the vaccine becomes more widely available and additional data is gathered, it is expected to have a profound impact on reducing RSV-related illnesses and hospitalizations among infants. By prioritizing the health of both mothers and their newborns, the RSV vaccine offers a beacon of hope for a healthier, safer start to life for our youngest citizens.

El Camino Women’s Medical Group will be offering this vaccine to all pregnant women between 32-36 months in the very near future.

Healthy Grieving

Grief is an intricate and universal human experience, one that transcends cultural boundaries and touches every individual at some point in their lives. Whether it’s the loss of a loved one, a cherished dream, a job, or even the end of a significant relationship, grief is a natural response to loss. While it can be an intensely painful and overwhelming emotion, it’s also an important aspect of the healing process.

Understanding Grief

Grief is a universal experience that is also unique in how we each work our way through the process.  Psychiatrists often describe it as a complex emotional, psychological, and physical response to loss. The grieving process encompasses various stages, as famously outlined by psychiatrist Elisabeth Kübler-Ross: denial, anger, bargaining, depression, and then the highly sought acceptance. While these stages can provide a framework for understanding grief, it’s important to remember that not everyone follows this linear path, and some individuals may experience these stages in different orders or revisit them multiple times.

Cultural Perspectives on Grief

Cultural practices and traditions play a significant role in shaping how individuals and communities approach grief. They offer valuable insights into the diverse ways in which people cope with loss and find solace.  Some examples of communal grieving traditions:

1. Funerals: Most cultures have a version of a funeral. The day and time a body is laid to rest, or cremated, and the last moments the living can interact with or be present with the physical body of the deceased. Funerals are generally attended by family and friends of the deceased and they allow for a ceremonial marking of the end of their physical presence in the world of the living.  The communal nature also allows for support of each other as people talk about the legacy of dead.
2. Dia de los Muertos (Day of the Dead): In Mexico, Dia de los Muertos is a vibrant and colorful celebration of deceased loved ones. Families create altars adorned with photos, mementos, and favorite foods of the departed. It’s a way of keeping the memory of the deceased alive and maintaining a connection with them. This tradition emphasizes the importance of honoring and celebrating the lives of those who have passed away, promoting a healthy acceptance of death.
3. Japanese Obon Festival: In Japan, the Obon Festival is a Buddhist tradition that commemorates ancestors. Families light lanterns and visit gravesites, believing that the spirits of their loved ones return during this time. This practice encourages a sense of continuity, fostering emotional healing and acceptance by reconnecting with the past.
4. Irish Wake: In Ireland, the wake is a gathering held in the deceased’s home, where family and friends come together to share stories, laughter, and tears. It’s a communal expression of grief that allows for catharsis and bonding. This communal approach highlights the healing power of social support and connection during times of loss.

Psychiatrist Recommendations for Healthy Grieving

While cultural practices provide valuable insights, psychiatrists also offer evidence-based recommendations for navigating the grieving process in a healthy way.

1. Allow Yourself to Feel: One of the most crucial aspects of healthy grieving is giving yourself permission to feel the full range of emotions that accompany loss. Suppressing or denying these emotions can lead to prolonged grief and complications in the future. Psychiatrists emphasize the importance of acknowledging and expressing your feelings, whether they be sadness, anger, guilt, or confusion.
2. Seek Support: Grief can be an isolating experience, but seeking support from friends, family, or a therapist can make a world of difference. Psychiatrists recommend reaching out to people who can provide emotional support, lend a listening ear, or simply be there for you during this challenging time.
3. Take Care of Your Physical Health: Grief can take a toll on your physical well-being. Eating well, getting regular exercise, and ensuring you get enough sleep are crucial for managing the physical manifestations of grief, such as fatigue and increased stress levels. Psychiatrists often advise their patients to prioritize self-care during the grieving process.
4. Join Support Groups: Support groups, whether in-person or online, can provide a sense of belonging and understanding that is often challenging to find elsewhere. Psychiatrists often recommend support groups as a safe space for individuals to share their experiences, learn from others, and receive guidance from trained facilitators.
5. Engage in Rituals: Rituals can be a powerful tool for processing grief. These can be religious or secular in nature, and they serve to mark the transition from a life with the lost loved one to a life without them. Rituals can offer a sense of closure and allow for the expression of emotions in a structured and meaningful way.
6. Consider Professional Help: In some cases, grief can become complicated and lead to prolonged emotional suffering. If grief is interfering significantly with your daily life or if you are experiencing symptoms of depression or anxiety, it may be time to seek professional help from a psychiatrist or therapist.

Grief is a deeply personal and culturally influenced process that encompasses a wide range of emotions and experiences. While cultural practices offer unique insights into how different societies cope with loss, psychiatrists provide evidence-based recommendations for navigating grief in a healthy manner. The key takeaway is that grieving is a natural and necessary part of the human experience, and there is no right or wrong way to do it. The most important thing is to be kind and patient with yourself, seek support when needed, and allow time for healing and acceptance to take place. In the journey of grief, both cultural wisdom and psychiatric guidance can provide valuable resources to help individuals find their way to a place of peace and acceptance.

EL CAMINO HOSPITAL VISITOR POLICY UPDATES

General information on visitor’s policy

Last updated visitor guidelines from September 11, 2023

For the main hospital, El Camino Health is allowing two visitors per day with patients on Labor & Delivery and nearly all inpatient units.  No one under 17 permitted on Labor & Delivery, and on the Mother Baby Unit only if siblings.  Check the link above before you plan to come to the main hospital for any new updates.

Information for Labor & Delivery, NICU, and the Mother-Baby Unit:

Last updated September 11, 2023

For details specific to the Orchard Pavillion, also known as the Women’s Hospital, please read here.

As we all know, this pandemic has been in several different phases with several different recommendations, so these visitor policies may change.  At no point during the pandemic has El Camino Hospital prevented laboring or postpartum women from having at least one visitor with her that met requirements.

HIGHLIGHTS FROM OUR WOMEN’S HEALTH BLOG

Our Women’s Health Blog continues to be a very popular part of our website, attracting over a thousand readers a month worldwide.  We find it helpful to put out up-to-date information on relevant women’s health issues.  An article by guest author Dr. Shyamali Singhal on avoiding cancer-causing chemicals in cosmetics was again the most read article last quarter, some 1,600 people have read the article since March 1, 2023.  This is followed by an older article on the science behind couples trying to conceive a baby of a certain gender, with over 800 people wanting to see if they can influence the gender they conceive.  Finally, our most popular weight loss article on intermittent fasting was the third most-read article this last quarter, almost 500 people read it and hopefully are seeing the benefits already.

We update our blog at least a few times a month with information on all kinds of women’s health issues.  Recent posts have been on the difficulty of Menopause Transitions in women of color, the Genitourinary Syndrome of Menopause and the wide variety of treatment options, and a primer on the options for long-acting reversible birth control in the form of an IUD .   Follow us on Facebook, LinkedIn, or Instagram to be informed when we post new articles and stay updated on the latest in women’s health.

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