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WOMEN’S HEALTH

A newsletter from El Camino Women’s Medical Group

As we enter summer with widespread heatwaves, we are faced with the realities of climate change.   Young people in Montana and most recently Hawaii, have been successful in challenging their state governments to fulfill their responsibiltieis to their young constiutents.   Gives us hope for a better future.

Climate change also has significant impacts on maternal health and health outcomes worldwide.  Dr. Pandipati wrote an excellent article on this issue back in 2022.  With our weather in the Bay Area, we expect good outcomes for or patients, but please remember to be careful when you travel out of the area and be aware of heat advisories.

This summer issue of our newsletter has breat information on melanoma, the benefits of exercise on cancer prevention, and a great article on making healthy dietary choices to support our health by our new nutritionist.

Please read the Practice Updates section regarding our new physicians and nutritionist and the encorportation of Lovu into our pregnancy care.

I wish you all a wonderful summer covered in sunscreen, hydrated and exercising outdoors,

Sarah Azad, MD

In this issue:

Practice Updates

Online Prenatal Classes

Welcome Dr. Wan

What is Melanoma?

Stop that Afrin!

With Love and Care: Making Wholesome Choices to Support Women’s Health Through Every Life Stage

Exercise and Cancer Prevention

Trauma and Parenting

Lōvu

Boosting Fertility and Optimizing the Body for Pregnancy with Chef-Inspired Foods

Holistic Approaches for Managing Stress in Women

Sexually Transmitted Disease

El Camino Hospital Visitor Policy Updates

Highlights from our Women’s Health Blog

Practice Updates

Dr. Balassiano going on sabbatical

June 28^th was Dr. Balassiano’s last day in the office before her sabbatical.   We wish her well during her year off and look forward to her return next year.   Our other physicians are available for her patients during her leave, just let the office know what you need.

Dr. Dorismond starting this month

We are now filling Dr. Dorismond’s schedule.   For patients due in August, we encourage you to schedule one of your upcoming OB visits with her so you’ve met her before your delivery.  We are excited to have her join our team.  She is also fluent in French and Spanish.

Dr. Wan joins our practice!

Dr. Vivian Wan will be joining the practice in October.  Read more about her below.

Reminder of other physicians supporting us through the fall

We have been fortunate to find Drs. Dorismond and Wan to join us this summer and fall.  We also have two amazing part-time physicians supporting us through the end of the year: Drs. Kris Yogam and Aroti Achari.

New nutritionist joining us this summer

Mariam is a nutritionist who will be joining the practice this summer.   She has a masters in Human Nutrition from the University of Aberdeen (Scotland), and has over eight years of experience working in nutrition at the individual and communal levels.   We are excited to have her join our team.  She will be teaching occasional classes on nutrition as well as be available for individual appointments.   If you are interested in an initial appointment with no charge, please call the office and ask to be added to her list.   Her appointments are otherwise in-network with your insurance.

Continuing with Lōvu

We’ve had a great start to launching Lōvu. Lōvu is a new digital maternal health platform that brings together best-in-class technology-enabled care for mother and baby from pre-pregnancy through two years post-pregnancy.  Co-founded by Dr. Santosh Pandipati, who we’ve worked with for years in his role as a Maternal-Fetal Medicine expert, we have been so impressed by the extent of what Lōvu has to offer our pregnant and postpartum patients, we launched in early May!  For all of our patients 26 weeks and under, please remember to register here.

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,  LinkedIn, or Instagram.  Your feedback on our office practices and physician and staff communication is always welcome. 

Online Prenatal and Women’s Health Classes

Prenatal Classes

We are now offering four virtual prenatal classes a month online.    These classes cover preparing for childbirth, breastfeeding, and newborn care.   These classes have been very popular, and we plan to have them every month.  They are also available for women interested in signing up, though we prioritize our patients.

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.

Research at ECWMG

Sunbeam Study

Stanford University is interested in cord blood samples obtained during delivery.  You can learn more about the Sunbeam Study, which aims to learn how environmental and genetic factors play a role in food allergy and eczema development.   You can register here.

El Camino Women’s Medical Group is pleased to announce that Vivian Wan, DO, has recently joined our group. Dr. Wan completed her degree in osteopathic medicine at Touro University in Vallejo and her residency at Brooklyn Hospital in New York. A native of the San Francisco Bay Area, she returns home after working in a busy private practice in New York City.

Dr. Wan will also offer full-scope women’s healthcare, including general and high-risk obstetrics, gynecologic issues across the span of a woman’s life, infertility evaluation and treatment—including intrauterine insemination (IUI)—and gynecologic surgery. She is fluent in Mandarin, French, and Spanish.

She will be joining us in October.

What is Melanoma?

By Lillian Soohoo, MD
Board Certified Dermatologist
Golden State Dermatology

Skin cancer is the most common cancer in human beings. Melanoma is a skin cancer that starts in the pigment-making cells (called melanocytes) that give skin its color.  Although melanomas only represent approximately 1% of all skin cancers, they account for a significant number of cancer-related deaths. Melanoma is now the fifth most common cancer diagnosed in the US.

The first signs are often a change in an existing mole or the development of a new pigmented or unusual-looking growth on the skin. However, melanoma doesn’t always start in a mole.  It can happen on otherwise healthy skin and even in areas that aren’t as exposed to the sun – such as the soles of the feet, palms of the hands and fingernail beds. Melanoma rarely can develop in other body sites besides the skin where melanocytes normally exist including the eye, nasal sinuses, vulvovaginal and gastrointestinal areas.

The risk of melanoma increases with age and exposure to ultraviolet (UV) light. Sunlight, tanning beds and sun lamps are the main sources of UV rays. In fact, melanoma found on the chest, back, and legs has been linked to frequent sunburns, especially in childhood. Lighter skin color is a major risk factor for melanoma.

According to the American Cancer Society, the lifetime risk for melanoma in White people is 3% (1 in 33), for Hispanic people the risk is 0.5% (1 in 200), and 0.1% (1 in 1,000) for Black people (unfortunately, there are no comparable statistics for Asian people). Melanoma is also one of the most common cancers in young adults, especially young women. It can spread to other parts of the body if not detected early, resulting in metastatic disease. Even though melanoma is responsible for a majority of skin cancer deaths, the good news is that when melanoma is detected at an early stage (Stage 0 (in situ) or Stage 1), treatment can result in a complete cure. Surgical removal of melanoma at these early stages is met with a nearly 99% 5-year survival rate.

For patients with more advanced stage or metastatic melanoma (Stages 2B to 4), several medications have emerged in the last decade that have entirely changed the treatment landscape and increased the potential for meaningful long-term survival – sometimes even by years, rather than months. These new treatments for advanced melanoma include targeted cancer drugs and immunotherapy, which use substances to specifically attack tumor cell growth and harness a patient’s own immune system to attack and destroy melanoma cells to keep cancer in check, preventing further growth and spread. These new FDA-approved drugs are administered by medical oncologists (cancer specialists) to melanoma patients with advanced disease and have shown success in extending long-term survival.

In 2024, the FDA approved TIL therapy (Lifileucil) as a first-of-its-kind personalized treatment for advanced and metastatic melanoma. TIL therapy uses a patient’s own white blood cells (called tumor-infiltrating lymphocytes, or TIL) to target and destroy melanoma cells throughout the body.

Another recent therapeutic breakthrough are personalized cancer vaccines that train the immune system to fight cancer cells in a way that lasts many years.  Although not yet FDA approved, a second-generation melanoma vaccine has been shown to decrease the risk for tumor recurrence and death by 44% in patients with advanced melanoma. Further clinical trials for this treatment vaccine are currently underway and final results are expected in 2029.

As a practicing dermatologist in Silicon Valley for thirty years, I cannot stress enough the importance of obtaining a routine annual full-body skin exam to screen for suspicious lesions on your skin. This is a quick and painless inspection of all areas of the body, takes only a few minutes, and includes body parts that are impossible to check by yourself – such as the scalp and back. Early detection of skin cancer, especially melanoma, is the key to achieving a complete cure by starting appropriate therapy as soon as possible.  This usually results in minimal or no interruption of a healthy, active life.

The horizon for melanoma therapy in 2024 is more promising than ever. After decades of research and a  lack of effective therapies, we are now able to offer patients with all stages of melanoma new treatment options that provide hope for long-term survival.

Dr. Lillian Soohoo 
Golden State Dermatology
555 Knowles Drive; Suite 220
Los Gatos, CA  95032
Office: 408.317.3688

Stop that Afrin!

By Katrina Chaung, M.D.
Board Certified ENT

Nasal decongestant sprays such as Afrin and Sinex may seem like miracle medications especially if you are in the throes of a severe upper respiratory infection or a particularly bad allergy season.  These types of sprays, which usually contain oxymetazoline or phenylephrine, are very effective in providing short-term relief from nasal congestion; however, they must be used with caution and stopped after 3-4 days.  With more prolonged use of these sprays, you risk a condition called rhinitis medicamentosa.  This causes a “rebound” nasal congestion that leads to even worse congestion when the effects of the medication wear off, spurring you to use the spray even more frequently and trapping you in a vicious cycle.

This condition occurs due to several mechanisms.  Nasal decongestants work by stimulating certain receptors on your nasal blood vessels, causing vasoconstriction (narrowing of blood vessels). With prolonged use, these receptors become desensitized and less responsive to the medication’s effects. As a result, the blood vessels in the nasal mucosa lose their ability to constrict effectively.  Then, when the effects of the nasal decongestant wear off, the blood vessels can no longer maintain their constriction. This leads to rebound vasodilation, where the blood vessels in the nasal mucosa dilate (expand) excessively. In turn, this causes increased blood flow and swelling of the nasal tissues, resulting in congestion that is often more severe than the original congestion.  Additionally, prolonged use of these sprays triggers inflammation in the lining of the nose, contributing to further swelling and congestion.

The nasal passages become dependent, almost “addicted” to the spray.  On top of the worsened nasal congestion, you may also experience nasal dryness and irritation, sneezing, and headaches.

Management involves stopping the decongestant nasal spray completely.  Initially, symptoms can worsen before they improve, but discontinuing the medication is necessary to break the cycle of dependency.  In its stead, saline nasal sprays and intranasal steroid sprays (such as Flonase or Nasacort) can be used during this “withdrawal period” to help with the congestion.  These types of sprays are generally safe to use for longer periods of time, but you should still consult with your primary care or Ear, Nose and Throat physician for evaluation and recommendations.

Katrina Chaung, M.D.
Board-certified Otolaryngology-Head and Neck Surgery
Camino Ear, Nose & Throat
(408) 227-6300

With Love and Care: Making Wholesome Choices to Support Women’s Health Through Every Life Stage

By Mariam AlAgha
Masters in Human Nutrition 
ElCamino Women’s Medical Group 

“We are what we eat.” This age-old adage underscores the profound impact of nutrition on our overall well-being. Embracing a diet rich in nutrient-dense foods is crucial for women navigating various life stages. A holistic approach to nutrition ensures that the unique needs of each stage are met, promoting optimal health and nutritionally empowering women as changemakers within their families and communities. Caring for women’s nutritional needs from an early age can significantly influence their health and well-being later, creating a transformative effect that benefits both the individual and those in her social circle.

Comprehensive Nutritional Advice for Women’s Health

Recognizing the importance of these different life stages, we aim to provide comprehensive, evidence-based nutritional advice tailored to each phase. In this article, we will explore the essential nutrient-dense foods that support women through the ten most significant stages of their lives: childhood, adolescence, premenstrual period, menstruation, preconception, pregnancy, postpartum, perimenopause, menopause, and the senior stage. We aim to ensure that women receive the utmost care and guidance, helping them make wholesome choices that enhance their health and vitality at every stage.

While maintaining a balanced diet rich in vitamins and minerals, avoiding processed foods, and encouraging healthy eating habits are essential, it is important to customize foods based on cultures and food preferences to make it easier to adopt a new lifestyle. We should not ask people from diverse backgrounds or different socioeconomic statuses to make huge, unrealistic changes that might not last. It’s important to maintain the sustainability of a healthy diet by turning it into habits. This tailored approach excludes the infancy stage, as breast milk and formula usually provide the balanced nutrition necessary for growth during that period.

In addition, since cooking is perceived as action of love, we will propose suggested meals for each stage to help women make practical and nutritious choices that align with their specific needs.

Childhood: Building a Strong Foundation

The nutritional focus for girls is to build strong bones, support growth, and enhance cognitive development. Research consistently shows that calcium absorption rates are highest during the pubertal years in adolescents, followed by younger children, and lowest in adults. Therefore, it is crucial to ensure calcium intake is encouraged for girls during childhood. However, other micronutrients and macronutrients should not be neglected. Calcium plays a vital role in bone formation and mineralization and is also important for muscle contractions.

Recommended Calcium-Rich Foods:

• Dairy products: milk, yogurt, cheese
• Plant-based options: almond milk, tofu, collard greens, kale, tahini

Adopting the American dietary guidelines’ approach of health promotion rather than disease treatment from early stages can help decrease the prevalence of diet-related chronic diseases such as diabetes and obesity.

Proposed Recipe: Calcium Boost Salad  

Adolescence: Supporting Growth and Development

During adolescence, girls experience significant hormonal changes and rapid growth spurts. The main nutritional focus at this stage is to support these changes by ensuring a diet that meets the increased demands for essential nutrients. Emphasis should be placed on iron, calcium, and protein, alongside promoting healthy snacking and hydration. Incorporating lean proteins, fruits, and vegetables, while maintaining a balanced healthy diet, is a key pillar of a holistic approach.

Iron Sources:

• Heme Iron (most absorbable form): Liver, meat, poultry, seafood
• Non-heme Iron: Legumes, tofu, leafy greens, quinoa

Tips to Boost Iron Absorption:

1. Pair with Vitamin C-rich foods: Enhances non-heme iron absorption.
2. Avoid Calcium-Rich Foods and Drinks with Iron-Rich Meals: Calcium can inhibit iron absorption.
3. Cook in Cast Iron Pans: This can increase the iron content of food.

Ensuring that adolescent girls receive these essential nutrients will help support their rapid growth and hormonal changes effectively.

Proposed Recipe: Vegan Iron-Rich Salad 

Premenstrual Syndrome (PMS): Balancing Hormones

Certain foods can help alleviate symptoms and balance hormones during PMS. Recommended foods include dark chocolate, bananas, fatty fish, and whole grains. The nutritional focus during this phase is on alleviating PMS symptoms and balancing hormones. It is advisable to increase the intake of magnesium and vitamin B6, reduce sugar and caffeine consumption, and stay hydrated.

Proposed Recipe: Savory Lentil and Brown Rice Pudding Salad

Menstruation: Replenishing Lost Nutrients

During menstruation, it’s important to replenish lost nutrients and reduce inflammation. Recommended foods include iron-rich options like spinach and red meat, and vitamin C-rich foods like oranges and strawberries. The nutritional focus during this phase is on replenishing lost nutrients and reducing inflammation. It is advisable to focus on iron and vitamin C to prevent anemia, stay hydrated, and avoid excessive salt intake to reduce bloating.

Proposed Recipe: Iron-boosting salad with Leafy Greens, Kidney Beans, and Beetroot 

Preconception: Enhancing Fertility

During the preconception period, it is highly recommended that women increase their folate intake, as folate enhances fertility. Key superfoods for this stage include leafy greens, avocados, nuts, seeds, and lean proteins. The nutritional focus is on preparing the body for pregnancy and enhancing fertility. It is advisable to increase intake of folic acid, omega-3 fatty acids, and antioxidants, maintain a balanced diet, and avoid harmful substances.

Proposed Recipe: Folate-Boosting Lentil and Spinach Salad

Pregnancy: Supporting Fetal Development

According to the American Dietary Guidelines, additional calories should be added based on the trimester to support the essential needs of both the mother and the baby:

• First Trimester: No additional calories needed.
• Second Trimester: +340 calories/day.
• Third Trimester: +450 calories/day.

These additional calories should come from nutrient-dense foods to ensure adequate nutrition. Recommended foods include lean meats, eggs, legumes, dairy products, and leafy greens. Hydration is always essential, and the nutritional focus should be on supporting fetal development and maintaining maternal health. Key nutrients to sustain include folic acid, iron, calcium, and DHA.

According to the American Dietary Guidelines and the U.S. Food and Drug Administration (FDA), pregnant women should aim to consume 8-12 ounces (approximately 2-3 servings) of low-mercury fish per week to obtain the benefits of omega-3 fatty acids while minimizing the risk of mercury toxicity.

Recommended Low-Mercury Fish:

• Salmon
• Shrimp
• Pollock
• Tilapia
• Cod

Proposed Recipe: Protein-Packed Pregnancy Salad 

Postpartum: Supporting Mental Health and Recovery

Postpartum depression (PPD) affects up to 15% of new mothers in the U.S., resulting from chemical, social, and psychological changes after childbirth. This condition involves various physical and emotional changes and can be treated with medication and counseling. Nutritional interventions, such as consuming probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi, may support better mental health by improving gut health. However, consulting mental health providers for comprehensive care is essential.

Breastfeeding Considerations:

• Extra Calories: Breastfeeding mothers need about 500 additional calories per day to support milk production.
• Avoid Certain Foods: Limit caffeine, avoid alcohol, and steer clear of certain fish high in mercury.

Proposed Recipe: Postpartum Lentil and Vegetable Pudding:

Perimenopause: Managing Symptoms

Incorporating phytoestrogens in the diet can help alleviate mood swings and hot flashes for women during perimenopause.

Nutritional Focus:

• Managing symptoms: Supporting hormonal balance.

Key Superfoods:

• Soy products
• Flaxseeds
• Whole grains
• Berries

Advice:

• Increase intake of phytoestrogens, fiber, and calcium.
• Reduce caffeine and alcohol intake.
• Promote a balanced diet rich in fruits and vegetables.

Proposed Recipe: Avocado and Berry Smoothie  

Menopause: Supporting Bone Health

During menopause, it is crucial to include calcium and vitamin D in the diet to support bone health and reduce the risk of fractures. Concurrently incorporating phytoestrogens and engaging in resistance exercises can help manage symptoms.

Nutritional Focus:

• Supporting bone health
• Managing weight
• Reducing inflammation

Key Superfoods:

• Fatty fish
• Legumes
• Dairy products
• Colorful fruits and vegetables

Advice:

• Emphasize calcium, vitamin D, and omega-3 fatty acids.
• Encourage a balanced diet, regular physical activity, and hydration.

Proposed Recipe: Mushroom and Brussels Sprout Stir-Fry with Cauliflower and Tahini Dip 

PostMenopausal Phase: Maintaining Muscle Mass

Elderly women often suffer from sarcopenia, which is the loss of muscle mass. Therefore, protein is the main nutritional focus. It is recommended to consume blended soups with lean meats and beans, as they are easier to chew and help maintain appetite.

Proposed Recipe: Protein-Rich Creamy Lentil Soup with Chicken

Embrace a Holistic Lifestyle Approach

Adopting a holistic lifestyle approach that considers the body, mind, and spirit (B-M-S) is essential for women’s health at every stage of life. Balanced diets, appropriate physical exercise, hydration, and meditation are all vital components of this approach. Always remember to love your body—that’s the secret. Start pampering yourself by choosing the healthiest foods that you deserve. Sometimes, we need consultation and guidance; it’s recommended to consult your nutritionist whenever you need encouragement to adhere to a healthy diet and stay focused on your nutritional goals. Embrace wholesome, nutrient-rich foods and take pride in the positive impact they will have on your entire life. Remember, you are worth it.

Mariam AlAgha
Masters in Human Nutrition 
ElCamino Women’s Medical Group

Exercise and Cancer Prevention

By Dr Shyamali Singhal
Surgical Oncologist and General Surgeon.
Mountain View Surgery

As we age, we are exposed to more and more toxins in our environment, including many different carcinogens. We consume food products with chemicals, breathe polluted air, and even absorb chemicals through our skin. While these exposures alone may not cause cancer, our risk of disease may be increasing due to the lifestyle choices we make in our day to day lives. This article explores one way you can take disease prevention into your own hands, presenting evidence from studies that will empower you with new knowledge to begin your journey towards a healthy and long life.

Exercise is a tool often overlooked because it seems tedious and time-consuming. However, it is one of the most beneficial lifestyle changes you can make to improve your risk of disease, especially breast cancer. Studies even show that women who engaged in the highest levels of physical activity had up to a 38% lower risk of breast cancer mortality, even if they already had breast cancer [1]. Therefore, incorporating exercise into your daily routine could significantly change your future health outcomes.

But this raises the question: How much and what kind of exercise should I do?

Based on a 2018 clinical trial, adults should aim for 150 to 300 minutes of moderate-intensity physical activity per week [3]. This means you should be able to talk, but not sing, while exercising. The intensity level will vary depending on your individual fitness level and any health limitations.

Simple choices, like taking the stairs or parking farther away from the store entrance, can make a big difference in getting this exercise in. The hardest part is starting, but the benefits are numerous and well worth the effort.

If you are already active, aim to incorporate a variety of exercises into your weekly routine. Include two strength sessions for bone health, such as weightlifting, Pilates, or power yoga. Additionally, try to include at least one session focused on flexibility and mobility, which could be functional strength workouts or yoga. Finally, aim for three cardio workouts a week. This can be anything from walking or hiking to running or cycling.

Exercise offers more than just disease prevention. It can improve your mood and energy levels throughout the day. It can also provide opportunities to connect with your community through exercise groups or clubs.

The benefits of regular physical activity extend far beyond breast cancer prevention. Consistent exercise improves overall health, reducing the risk of chronic diseases such as heart disease, diabetes, and hypertension [6]. It is one of the few tools we have to take control of our health, and choosing to exercise will significantly improve your quality of life.

Taking care of yourself is one of the most valuable things you can do. It gives you purpose and a sense of accomplishment. Making a daily commitment to personal growth and health will improve your life in many ways. I have no doubt that if you make this choice, you will be incredibly grateful for your efforts. Start exercising today and reap the rewards for years to come.

Dr Shyamali Singhal
Surgical Oncologist and General Surgeon
Mountain View Surgery

Trauma and Parenting

By Sarah Rizvi, PhD, PMH-C
Licensed Clinical Psychologist

As parents, we want to provide our children with a safe and secure environment, both physically and emotionally. However, if you have experienced trauma, you might be struggling to feel safe and secure yourself, so how can you teach your children to be safe and secure? How do you keep yourself from repeating old, maladaptive patterns? This is where a skilled trauma therapist can help. Working with a trauma therapist can help you differentiate between what is adaptive now and what is a remnant of the past and destructive to your present and future.  

Types of Traumas 

 Trauma is a broad term and can cover a variety of experiences. No matter the experience, trauma is an emotionally distressing response to a terrible event. Trauma therapists often highlight to people that there are “big T” traumas and “little t” traumas. Let us explore the difference. 

“Big T” trauma: This is often a life-threatening situation, such as a car accident, loss of a loved one, war, forced migration, physical abuse, or a violent crime, just to name a few.  

“Little t” trauma: The threat may be less physical and more emotional, such as a betrayal of a friend, bullying in school, divorce of your parents, emotional abuse between parents, changing schools mid-year, pet loss, being isolated as child or feeling intense loneliness and a lack of belonging. 

 The World Health Organization estimates that about 70% of the population worldwide has experienced at least once trauma. Some people can move beyond these painful events, but often life changes, such as becoming a parent, can trigger some of these old coping mechanisms. This can get in the way of you being an effective parent and a trauma therapist can help you find healthier coping mechanisms.  

 Signs Trauma Is Impacting Your Parenting 

 Children are a ball of emotion, and parents can often feel overwhelmed or that the situation is getting out of control. If you are carrying a history of trauma, those feelings of being out of control may seem familiar and scratch old wounds. Here are some things to look out for:  

• Frequently losing your temper. 

• Sleep difficulties or nightmares 

• Being on high alert around your child 

• Feeling overprotective 

• Constant fear of repeating your parents’ mistakes 

• Not trusting your child’s intuition or instincts  

• Not trusting others around your child (caregivers, the other parent, extended family, etc.) 

• Feeling Overwhelmed all the time. 

• Over-controlling behavior. 

• Overuse of drugs, alcohol, or other substances.  

When someone is parenting from trauma, they end up recreating some of their experience for their children and this can contribute to transfer of anxiety and worry. A secure parent is dependable, reliable, consistent, and available. 

 How Can A Trauma Therapist Help Me? 

While trauma disorders can be very painful and difficult to deal with, it is important to remember that they are also treatable. While nothing can erase these painful experiences from your history, a trauma therapist can help you repackage these stories in a way that they interfere less with your life. Below are a few common treatments. 

 Cognitive Behavioral Therapy: Cognitive Behavioral Therapy, or CBT, is a gold standard treatment for trauma. Thoughts and assumptions are a lens through which we see the world. If your lens is forged in trauma, CBT can help you forge a new lens that is more adaptive for your current life, where you are more in control. For example, traumatic experiences can erode our sense of trust in others. Through CBT, we can think more critically about who we can trust and how we can trust them.  This often includes an element of exposure, experimentation, and testing. 

Mindfulness Training: Much of the suffering we experience is about the past or the future and often you cannot do anything about it in the present moment. While trauma often casts judgment on our experiences, mindfulness is about approaching experiences nonjudgmentally. A daily mindfulness practice can help reduce your body’s reactiveness to triggers, decrease feelings of panic, slow down your racing thoughts and help you observe yourself and the moment more neutrally. It is important to think of mindfulness as exercising a muscle, and with regular practice you gain more benefit. 

 Exposure Therapy: We often have memories and associated thoughts and feelings we are trying to avoid. These memories are like monsters lurking in the shadows and can be terrifying to us, even as adults. Exposure therapy is like casting a flashlight on these shadows, helping us recognize that these memories, thoughts, and feelings cannot hurt us. Only our own actions can hurt us. 

 The above are just a few treatment options and a skilled trauma therapist can evaluate which options would be best for you. They may also recommend working with a psychiatrist, as a combination of medication and psychotherapy can be helpful for moderate to severe symptoms. 

Healing Your Future 

So many people in the world are living with trauma and do not even realize it. While you cannot erase your past, you can keep it from interfering with your future and the future of your children. Going through trauma therapy can help you stay calm in the face of challenges with your family, feel more peace at home and have more confidence in yourself as a parent. 

For more resources on trauma or to find a trauma therapist, visit the Trauma Therapist Network. You can also find therapists on the Psychology Today website. 

The field of psychology has so many tools for trauma and so many skilled providers ready to support you. Trauma is a thing that happened to you, but it does not have to be a thing that defines you.   

Sarah Rizvi, PhD, MHC-C
Licensed Clinical Psychologist
233 E. Meadow Drive
Los Gatos, CA 95032
Ph: 408-249-6246
Email: moc.dhpivzirharas@ivzirs
www.sarahrizviphd.com
Dr. Sarah Rizvi is a Bay Area psychologist specializing in counseling for mothers, particularly women in the perinatal period. Her office is located in Los Gatos, CA and she treats women all over the state of California via telehealth/video. She provides individual counseling as well as group therapy. To learn more about Dr. Rizvi, please visit www.sarahrizviphd.com.

Lōvu For Mothers and Families Through El Camino Women’s Group

Santosh Pandipati, MD
Maternal Fetal Medicine
Co-Founder of Lōvu

Do you wish you could spend more time with your obstetrician to go over your pregnancy questions and concerns?

Do you feel bewildered by the number of pregnancy apps that are available?

Do you do a lot of your own research to have the healthiest pregnancy, delivery, and baby possible, but don’t know if you’re on the right track?

Do you feel overwhelmed by the amount of pregnancy information available to you online, and do you wonder how much of it is factual and useful?

Do you wish you could more easily share your health data from your phone and your wearable devices with your doctor so she or he can better guide you?

Do you wish you could have a pregnancy guide who is available to you between your prenatal care visits and after your delivery?

Did you know that prenatal care as it’s traditionally done today actually dates back to 1930, and essentially hasn’t changed at all since then?

Welcome to Lōvu – a revolutionary new digital wellness and resiliency platform designed by obstetricians for their patients. Lōvu is an augment to standard obstetrical care, meant to be both a safety net as well as a hack to improve your health so you can have the best possible pregnancy, delivery, and motherhood experience possible. Lōvu has helped hundreds of mothers and families, as well as obstetricians across the country, take better care of their pregnancies. In addition to better overall wellness, Lōvu has identified developing illness in mothers much sooner than we ever could have previously.

Once you register and approve a consent authorizing your health data to be safely and confidentially shared with your obstetrical team through the Lōvu app:

• You will receive a designer diaper bag with FDA-cleared devices for home use, including a fetal heart rate monitor, a smart blood pressure cuff, and a smart scale. Additional devices will also be deployed to you, such as a smart sleep mat, as the program grows. If you have an iPhone, Lōvu will connect to Apple Health Kit, thereby allowing you to share more of your health data with us, your doctor team. 
• You will be connected with a navigator – a human being – who will guide you through device setup, will be available as a coach and guide, and will help connect you with necessary resources and services as needs arise. Your navigator will also encourage you to monitor your vital signs, mental health, and physical health needs during pregnancy and through postpartum?
• You will receive complimentary access to many other digital health services and platforms through Lōvu’s first-in-world pregnancy marketplace, such as eDoula (birthing education, breastfeeding information, partner support, early parenting information, etc.), Expect Fitness (obstetrician-approved exercises during pregnancy and postpartum), Rosy (sexual wellness).
• You will have access to educational information through videos and PDFs from leading medical authorities such as the American College of Obstetrics and Gynecology and the American Association of Pediatricsics.
• We will receive a weekly Personalized Pregnancy Insight Report that keeps us updated on what’s happening with you and your baby.
• You will have access to your data at all times, and your data will become part of your official medical record.

As various clinical needs arise, from nutrition assistance to mental health support to breastfeeding needs to postpartum resources, your navigator will refer you to necessary resources on behalf of our clinical practice.

Even better – Lōvu services are already covered by your insurance and you will never receive a bill from Lōvu!

We view Lōvu as an essential part of modern pregnancy and postpartum care. We encourage you to enroll into the Lōvu platform so we can take better care of you, your baby, and your family.

Boosting Fertility and Optimizing the Body for Pregnancy with Chef-Inspired Foods

By Dr. Renee Allen and Chef Omar
Dr. Renee Allen, a Board-Certified OBGYN and Medical Media Expert
Chef Omar Powell, a classically trained French chef
https://naturela.org/

Hello! My name is Dr. Renée! As a board-certified OBGYN and online physician entrepreneur, together with my husband Chef Omar, a classically-trained French chef, we’ve dedicated our lives to the interplay of fertility and nutrition. After a 4-year journey to conceive our son—welcoming him into the world at the ages of 47 and 48 respectively—we’ve come to understand the profound impact that diet can have on one’s ability to conceive. Our mission now is to share this valuable information to help others on their path to parenthood.

In this post, we will explore the importance of nutrition in fertility, share actionable tips for improving fertility through diet, and provide insights into chef-inspired foods that can naturally enhance your chances of conception. Prepare to explore the enriching world of fertility nutrition!

Understanding the Link Between Nutrition and Fertility

Fertility Nutrition: The Foundation

The connection between nutrition and fertility is well-established in scientific research. Proper fertility nutrition is essential for creating a healthy environment for conception. Nutrients like folic acid, vitamin D, iron, and omega-3 fatty acids are essential for hormonal balance and reproductive health.

• Folic Acid: Studies have shown that folic acid can improve fertility rates in women (Gaskins, A. J., & Chavarro, J. E. (2018). Diet and fertility: a review. American Journal of Obstetrics and Gynecology).
• Vitamin D: Research indicates that adequate vitamin D levels are associated with increased pregnancy rates (Lerchbaum, E., & Obermayer-Pietsch, B. (2012). Vitamin D and fertility: a systematic review. European Journal of Endocrinology).
• Omega-3 Fatty Acids: Omega-3 fatty acids have been found to improve egg quality and reduce inflammation, contributing to better fertility outcomes (Gaskins, A. J., & Chavarro, J. E. (2018). American Journal of Obstetrics and Gynecology).

In our soon-to-be-published book, “From Plate to Pregnancy: Boost Fertility Through Diet: Preparing Your Body for Pregnancy: A Nutrition and Chef-Inspired Food Guide,” and our upcoming FREE Masterclass, “From Plate to Pregnancy: A 5-Step Nutritional Plan to Boost Fertility,” we delve deep into these nutrients, offering a roadmap for anyone looking to boost their fertility through diet.

The Role of a Balanced Diet in Conception

A balanced diet provides the natural building blocks necessary for hormonal production and regulation. It reduces inflammation, supports healthy blood flow to reproductive organs, and helps to maintain a healthy weight—all crucial factors for fertility. Meals rich in whole grains, lean proteins, fruits, vegetables, and healthy fats form a solid base for fertility.

Research has shown that women following a balanced diet, such as the Mediterranean diet, have a higher chance of conceiving compared to those with less balanced diets (Rizk, B., & Botros, R. M. (2011). The impact of the Mediterranean diet on fertility. Human Reproduction Update).

Practical Dietary Tips to Boost Fertility

The Mediterranean Diet: A Gold Standard for Fertility

Adopting a Mediterranean diet can be a game-changer in your fertility journey. This diet emphasizes whole foods—lean proteins like fish and poultry, healthy fats from olive oil, nuts, and seeds, and plenty of fruits and vegetables. Research has shown that women who adhere to the Mediterranean diet have a higher likelihood of conception (Rizk, B., & Botros, R. M. (2011). Human Reproduction Update).

Actionable Tip: Incorporate more fish like salmon, sardines, and mackerel into your weekly meals. These fish are rich in omega-3 fatty acids, which are essential for hormonal balance.

Superfoods for Fertility: Nutrient-Packed and Delicious

Superfoods are an excellent addition to any fertility diet, providing a high concentration of vitamins, minerals, and antioxidants. Think berries, leafy greens, seeds, and nuts. These superfoods help to fight inflammation and boost overall reproductive health.

Actionable Tip: Include a daily smoothie with a handful of spinach, a serving of berries, chia seeds, and a splash of almond milk. This combination provides a powerful nutrient punch to support your fertility wellness program.

Studies have indicated that diets rich in antioxidant-packed superfoods can lead to improved fertility rates (Chavarro, J. E., Rich-Edwards, J. W., Rosner, B. A., & Willett, W. C. (2007). Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology).

The Power of Old-World Grains

Old-world grains, such as quinoa, farro, and spelt, are packed with fiber, vitamins, and minerals that can enhance fertility. These grains have been shown to maintain a healthy weight and stabilize blood sugar levels, both of which are key for reproductive health.

Actionable Tip: Swap out refined grains for whole grains in your meals. A simple switch from white rice to quinoa can introduce more protein, fiber, and essential nutrients into your diet, boosting your chances of conception naturally.

Research highlights that whole grains can improve fertility outcomes (Gaskins, A. J., & Chavarro, J. E. (2018). American Journal of Obstetrics and Gynecology).

Chef-Inspired Recipes for Optimal Nutrition and Conception

Fertility-Boosting Breakfast: Mediterranean Avocado Toast

One of our favorite fertility-enhancing breakfasts is Mediterranean Avocado Toast. This dish combines whole-grain bread, ripe avocados, tomatoes, and a drizzle of olive oil, topped with a sprinkle of feta cheese and fresh herbs.

Actionable Tip: Prepare your Mediterranean Avocado Toast with whole-grain bread and top it with a poached egg for an extra boost of protein and choline, both crucial for reproductive health.

Dinner Delights: Omega-3 Rich Salmon

Our fertility-fueling dinner suggestion is Baked Salmon with a side of quinoa and steamed vegetables. This meal is rich in omega-3 fatty acids, fiber, and antioxidants—essential nutrients for a fertility diet plan.

Actionable Tip: Marinate the salmon in olive oil, garlic, and herbs for an hour before baking to infuse it with flavor and additional fertility-boosting properties.

Holistic Approaches to Fertility Nutrition

Incorporating Mindfulness and Physical Activity

While nutrition is a pillar of fertility, holistic wellness also plays a crucial role. Engaging in regular physical activity and mindfulness practices such as yoga or meditation can further improve fertility outcomes. These practices support hormonal balance and reduce stress, bolstering your efforts to conceive.

Trends and Innovations in Fertility Nutrition

Seed Cycling for Hormonal Balance: Seed cycling is gaining popularity for its potential to regulate hormones naturally. By consuming flaxseeds and pumpkin seeds during the first half of your menstrual cycle and sunflower and sesame seeds during the second half, you can support hormonal balance (Journal of Nutrition and Metabolism).

Adaptogenic Herbs: Incorporating adaptogenic herbs like maca root, ashwagandha, and rhodiola can help balance stress hormones and support overall fertility. Studies have shown that these herbs can improve fertility outcomes (Panossian, A., & Wikman, G. (2010). Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress—protective activity. Pharmaceuticals).

Advanced Fertility Tracking: Using advanced fertility tracking methods, such as ovulation predictor kits and fertility tracking apps, can help you better understand your cycle and optimize your chances of conception (Fertility and Sterility).

DNA-Based Testing: Personalized nutrition plans based on DNA testing are emerging as a cutting-edge approach to optimizing fertility. These tests can provide insights into how your body responds to different nutrients, allowing for a highly tailored fertility diet plan (Journal of Assisted Reproduction and Genetics).

Actionable Tip: Join our FREE Masterclass, “From Plate to Pregnancy: A 5-Step Nutritional Plan to Boost Fertility,” to learn more about these emerging trends and how to incorporate them into your fertility journey. Sign up here.

Conclusion

Boosting fertility and optimizing your body for pregnancy is a journey that requires attention to nutrition, lifestyle, and wellness. Our upcoming book, “From Plate to Pregnancy: Boost Fertility Through Diet: Preparing Your Body for Pregnancy: A Nutrition and Chef-Inspired Food Guide,” and our FREE Masterclass will be your guides to navigating this transformative path with evidence-based, chef-inspired strategies.

By focusing on a balanced diet rich in Mediterranean foods, superfoods, and old-world grains, you can create an optimal environment for conception. Implement the practical tips shared here and explore further resources to enhance your fertility naturally.

Remember, your journey to parenthood is unique, and we’re here to support you every step of the way. Stay tuned for more expert advice and actionable insights!

For more information and to join our supportive community, visit The Naturela Connection: A Community for Complete Well-being & Fertility Support. Sign up for our free masterclass here.

Your journey to optimal fertility starts on your plate. Let’s start this adventure together!

About Dr. Renée Allen and Chef Omar

Dr. Renée Allen has been practicing medicine for over 20 years and has found that the Western Medical System is mainly disease and medication-focused, often missing the enrichment of holistic health views found in other medical systems worldwide. Chef Omar also has over 20 years of experience working in celebrity restaurants in NYC, owning his former restaurant Epicurean Cafe in Atlanta, and working as a Chef Consultant.

To address the gap in boosting fertility and optimizing bodies for pregnancy holistically, Dr. Renée and Chef Omar recently launched a new private community: The Naturela Connection: A Community for Complete Well-being & Fertility Support. They will be launching their personalized 12-week program, “From Plate to Pregnancy: The Ultimate Fertility Nutrition Program,” and their soon-to-be-published book, “From Plate to Pregnancy: Boost Fertility Through Diet: Preparing Your Body for Pregnancy: A Nutrition and Chef-Inspired Food Guide.” The free masterclass will be offered in the fall, which will introduce the 12-week program to the community.

Join our masterclass by signing up here and joining The Naturela Connection.

For questions or media relations, please contact us at moc.e1787908788vitce1787908788llocs1787908788secca1787908788eht@t1787908788roppu1787908788s1787908788 or moc.l1787908788iamg@1787908788ydeme1787908788r.ale1787908788rutan1787908788. 

We look forward to connecting with you and supporting your journey to optimal fertility!

Dr. Renée and Chef Omar

Holistic Approaches for Managing Stress in Women

By Dr. Malathi Acharya
Integrated Medicine and Integrative Oncology specialist.
Founder and Chief Medical Officer at Ayur Integrative Medicine

Understanding Stress

Ladies, have you ever felt overwhelmed by the daily grind, juggling work, family, and personal commitments, only to find yourself feeling drained and anxious? You’re not alone. Stress is a common experience for many women, impacting our well-being in profound ways. Understanding stress and how to manage it effectively can make a world of difference in our lives.

Stress comes in different forms:

• Eustress: The “good” stress that motivates you, like preparing for a big presentation or planning a special event. It makes you feel energized and resilient.
• Tolerable Stress: Uncomfortable but manageable stress, such as dealing with a busy schedule or a temporary setback. With support and coping strategies, you can get through it.
• Toxic Stress: Overwhelming stress that feels unmanageable, often due to a lack of support or chronic stressors. It can take a serious toll on your mental and physical health.

Stress manifests in various ways, including:

• Psychological Symptoms: Forgetfulness, negative thinking, insomnia, anxiety, depression, inability to focus, and loss of creativity.
• Emotional Symptoms: Tearfulness, anger, irritability, frustration, and defensiveness.
• Physical Symptoms: Headaches, palpitations, fatigue, constipation, frequent infections, teeth grinding, and muscle aches.
• Behavioral Symptoms: Decreased exercise, increased alcohol consumption, social withdrawal, self-neglect, absenteeism from work or school, poor time management, smoking, and drug use.

Consequences of Chronic Stress

Chronic stress can lead to severe health issues, including an increased risk of heart disease and strokes, obesity, inflammation, suppressed immune function, and mental health conditions such as depression.

Holistic Approaches to Managing Stress

Embracing a holistic approach to managing stress is crucial for women, as it considers the interconnectedness of our minds, bodies, and spirits, offering comprehensive and effective strategies to support our overall well-being. Here are the key areas to focus on:

Nutrition

A predominantly plant-based whole foods diet is essential for managing stress and maintaining optimal health. Incorporate whole unrefined grains like brown rice and quinoa, beans and legumes such as lentils and chickpeas, and a variety of colorful vegetables and fruits like spinach, bell peppers, blueberries, and carrots. Nuts and seeds, including almonds and flaxseeds, offer healthy fats and protein. Use healthy fats like canola oil, avocado oil, and olive oil. Soy-containing foods like tofu and edamame can help regulate hormone levels, while oily fish rich in omega-3 fatty acids, such as salmon and sardines, support brain function and reduce stress-related inflammation. By incorporating these nutrient-dense foods into your diet, you can better manage stress and promote overall well-being.

Movement

Regular physical activity is crucial for managing stress and can be easily integrated into daily life. Exercise boosts the production of brain-derived neurotrophic factor (BDNF), which supports brain health, enhances cognitive function, and builds resilience to stress. Think of BDNF as a fertilizer for your brain that helps it grow and adapt.

Incorporating movement into your routine doesn’t mean you have to hit the gym every day. Simple activities like taking a brisk walk during your lunch break, dancing to your favorite music, or playing with your kids at the park can make a significant difference. Physical activity also releases endorphins, often referred to as “feel-good” hormones, which elevate your mood, improve sleep, and act as natural painkillers. Finding enjoyable ways to stay active can transform how you cope with stress and improve your overall quality of life.

Mind-Body Techniques

Mind-body practices are highly effective in managing stress. Techniques such as breathwork, meditation, yoga, and tai chi activate the parasympathetic nervous system and the vagus nerve, helping to balance the effects of stress by lowering heart rate, blood pressure, and breathing rate. These practices promote a state of relaxation, enhance mindfulness, and improve emotional regulation. Regularly engaging in mind-body techniques can significantly reduce stress levels, improve mental clarity, and foster a sense of well-being.

Sleep

Getting enough sleep is essential for managing stress effectively. When we’re sleep-deprived, even minor challenges can feel overwhelming. Think about how much harder it is to handle a busy day at work or deal with family responsibilities when you’re running on just a few hours of rest.

To improve sleep, start by establishing a wind-down routine that signals to your body it’s time to relax. This could include reading a book, taking a warm bath, or practicing gentle stretches. Avoid bright screens before bedtime, as they can interfere with your body’s natural sleep-wake cycle. Keeping a consistent sleep schedule, even on weekends, helps regulate your internal clock. Imagine waking up feeling refreshed and ready to take on the day, rather than dragging yourself out of bed. Prioritizing good sleep hygiene can make a world of difference in how you handle stress and maintain your overall health.

Time in Nature

Spending time in nature has profound stress-reducing benefits. Activities such as hiking, gardening, or simply walking in a park can lower levels of cortisol, the stress hormone, improve mood, and enhance focus. Nature provides a calming environment that allows individuals to disconnect from daily stressors and reconnect with themselves.

Self-Compassion and Self-Care

Practising self-compassion and self-care can be as simple as spending 5-10 minutes daily doing something you enjoy or that relaxes you. This might mean sitting quietly, doing nothing but being present and unwinding. Small acts like savouring a cup of tea, listening to music, or practising brief meditation can make a big difference. Self-compassion enhances empathy and compassion for others, fostering better relationships. Prioritising self-care and self-compassion leads to greater emotional stability, improved resilience, and a positive outlook on life. By taking a few minutes each day for yourself, you build a foundation of well-being that benefits both you and those around you.

By integrating these holistic approaches into your daily life, you can effectively manage stress, paving the way for a healthier, more balanced, and fulfilling life. Small changes can lead to significant improvements in your overall well-being. Remember, it’s essential to find what works best for you and to seek support when needed.

About Dr. Malathi and Ayur Integrative Medicine

Dr. Malathi Acharya is the founder and Chief Medical Officer of Ayur® Integrative Medicine one of the premier practices for integrative medicine in California.  Ayur is dedicated to providing integrative medicine for cancer patients as well as for those who want to optimise their heart and metabolic health. Dr. Malathi  combines conventional treatments with complementary therapies and is dedicated to supporting and empowering you. More info at Ayur Integrative Medicine.

Sexually Transmitted Infections (STI)

By Molly Rad, MD
Board Certified Pediatrician
All Care Pediatrics

Preventing STIs involves practicing safe sex, which includes using condoms consistently and correctly, limiting the number of sexual partners, and getting tested regularly. Communication with your partner about sexual health is also crucial.

Remember, using birth control pills and other forms of hormonal or intrauterine contraception can not protect you against STIs; getting tested is important because we can have STIs without knowing it.

At-home STI testing

Some tests need more than one sample. The benefit of home testing is that you can collect the sample in the privacy of your home without the need for a pelvic exam or office visit.
However, tests done on samples you collect yourself may not always be accurate. If you test positive for an STI on a home test, contact your healthcare provider or a public health clinic to confirm the test results. If your home test results are negative but you have symptoms, contact your provider or a public health clinic to confirm the results.

Molly Rad, MD
Board Certified Pediatrician
All Care Pediatrics

El Camino Hospital Visitor Policy Updates

General information on visitor’s policy

Last updated visitor guidelines from April 1, 2024

All visitors to the hospital must be healthy and without symptoms of infection.  Please read more here.

Since April 1^st, 2024, masking is no longer required of staff, patients, or visitors anywhere in the hospital, though it is encouraged and masks remain available.

As we all know, this pandemic has been through several phases with changing 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 six thousand readers a month worldwide.  Our blog is a helpful vehicle to provide up-to-date information on relevant women’s health issues.  Last quarter an article on paternal age and its relationship to childbearing was again the most-read article on our blog.  More than 8,000 people were interested in the risks of the advanced parental age!  An old article about the gender of the fetus and the science behind it  ‘How can I ensure I get pregnant with a girl (or a boy)’ was read by more than 2000 people.

Also, the article by our guest author Dr. Shyamali Singhal on avoiding cancer-causing chemicals still has a lot of interest and was read by over 1,000 people.  It’s been the most commonly read article in our blog for almost a year.

We update our blog a few times monthly with information on various women’s health issues.  Recent posts have been on the rising of the C-section rates trend in the last 50 years, the early screening for breast cancer and the right recommendations for mammogram, and the great new news about menopausal medicine. 

Follow us on Facebook, LinkedIn, or Instagram to be informed when we post new articles and stay updated on women’s health news.

General Office Information