ATHENA

What, me exercise? You've got to be kidding! I can give you a million good excuses. Let's start with my disability. (I use that one a lot), then there's no time, then there's no one to help me; it's a great list. But I do take my service dog for a walk twice a day, and even though pushing the joy stick on my power chair doesn't give me an aerobic effect, the vibrations I get from wheeling over bumpy roads do seem to increase my circulation a bit. Does that count? You bet. It's amazing what we do that counts, and we don't even know it.

We've named our newsletter Athena for the Greek goddess of wisdom. Living a healthy lifestyle comes down to making wise choices. Sometimes our choices vary in wisdom, depending on our life experience and our current situation. When I have to weigh the cost of my strength, energy, and time against the benefits of exercise, it's exercise that loses. Not so wise. On the other hand, I've been accused of being fanatical about keeping a healthy diet. That's an easy choice, because I firmly believe you are what you eat. Smoking never held an appeal for me since I grew up in a house full of putrid pipe smoke. No tough decisions there. When it comes to going in for a check up though, it's like pulling teeth. Too many traumatic experiences with doctors when I was a kid now make me wait until things get really bad before I venture into their domain.

If I were to look at a list of all the types of healthy behaviors, I'd find that I'm at different levels of wisdom on each one of them. I think that's true for all of us. There seems to be four such levels or stages. The lowest is the "don't bother me" stage. That's when you don't want to be confused with the facts and when you don't like somebody pointing out that what you're doing is bad for you (that's where I am on exercise!). Second is the "maybe" stage. That's when you know its bad and you want to change but you just don't know how or don't think you can. Many people spend years in this second stage thinking about a change. Third is the "okay, I'll do it" stage, when you resolve to give it a try. Fourth is the hardest, the "keep on truckin'" stage. Staying with your new behavior, despite all the excuses that you could call upon, takes the most energy and commitment, but also has the most benefits.

We're going to dedicate the first four issues of Athena to each of these stages. Because we like challenges, we've decided to target some of the behaviors and attitudes that are the hardest to change and women who have the most barriers to overcome. I invite you to come with us on the revolutionary journey to better health. We'll offer some guideposts and a cheering squad along the way. Here's how you get to the first mile marker.

Make a list of all the things you wish you could change in your physical health, your social life, your emotional health, and your spiritual life. Now pick one of these to think about in the next month. For now, think of all the reasons you benefit from not changing. Then think about all the ways you would be better off if you did change. That's all. Just think about it for right now. In the next issue an exercise will guide you in recording and weighing these ideas. Remember, living a healthy lifestyle is your choice. With friends to help you along the way, changing to healthier choices is within your grasp!
 
 

As a Consumer of Health Care,

I am a 46-year old woman with a spinal cord injury and 24-hour attendant care. I'm also a survivor of breast cancer. I've learned some things over the years that might be helpful to other women in similar situations.

For instance, when you're in the hospital, look at the medications the nurses bring. Once I sent some pills back because I knew they weren't written in my chart. They were somebody else's meds. This isn't being nosy, it's called participating. It's crucial for you to be a participating patient in all medical settings. It keeps doctors' malpractice insurance rates down if we stay alive! Medical people helping you will constantly be changing - that's why it's important to know exactly what people are doing to you, and why. Often you are the one who verbally bridges care from one person to another. A good doctor will say you have a responsibility and right to know about what's being given to you and done to you. Certainly, back in the 1970's, the attitude was worse than it is now. Now hospitals acknowledge that patients have rights. All patients.

Coordinate between your pharmacist and doctors so you're sure everybody's on the same page. Have an open relationship with your doctors - one that fosters an exchange of ideas and no hard feelings. When you feel you need one, get a second opinion. You are the captain, the doctor is the co-captain. Get to know nurses - they are often more accessible than doctors and can answer many, but not all, questions.

I consciously do good things for myself. The number one thing is I trust my instincts. If something feels wrong I keep talking until the right person hears and does the right thing. I believe in taking vitamins and keeping my body clean. This is especially important for those with spinal cord injuries. Regular skin checks keep things like sacral ulcers to a minimum. I see my doctor about problems as soon as they arise, or I start doing on my own what I know he would want me to do. Knowing these things is all part of being a participating patient. Knowing what to do to prevent problems is the most important of all, obviously.

I can't feel my feet, but that doesn't stop me from keeping my nails cut properly. Nail health is important; so is good dental hygiene. As I've gotten older, I've gotten bonier and more susceptible to friction breakdowns and bones breaking. I keep myself safe from careless injuries. I live with pain 24 hours a day - there's no sense in bringing on unnecessary pain.

I try to maintain the right weight. Since I'm not into "rabbit" foods, I try to eat small portions of the things I like, like meat and potatoes.

I'm not perfect, believe me. I should be eating healthier food. I could drink more water to help prevent so many kidney stones. My housekeeping and laundry keep me limber but I could use more exercise. I've tried, believe me; I've been there, done that and got the t-shirt!

On days when I feel overwhelmed, primal screams into my pillow help. So does venting to attendants and a disabled friend. When I feel like it, I cry. Knowing I'm in God's hands helps tremendously, and my family's support - that's more important than financial support.

My advice is don't let your disability keep you from pursuing your dreams. If you want to be a nurse or doctor, go to school. Teach if that's your strength, but don't sit out because you think you can't compete. And never be afraid to ask questions of medical personnel.
 
 

Is Your Diet Right for You?
by Mary Pat Bolton, RD, MS

Diet and nutrition are hot topics these days. In fact, there's so much information available that it can seem overwhelming and confusing. Just what should we be eating? Is there one ideal diet, and if so, what is it? Answers to questions about nutrition are particularly critical for women with disabilities because results from the National Health Interview Survey show that they are more likely to be significantly overweight or underweight compared to women without disabilities.

We don't have all the answers, because researchers are still learning about the many ways that diet affects health. But based on current knowledge, one strong theme is becoming clear: a moderately low-fat diet based around plant foods - whole grains, vegetables, fruits, and legumes - seems to offer the most benefits.

Scientists have known for many years that this type of diet can reduce your risk of heart disease, but there's also evidence that people who eat plant-based diets have a lower incidence of cancer. Now we are beginning to learn why.

A new group of compounds has been identified in plants which actually help the body resist cancer and infection. Called phytochemicals, they are distinct from the vitamins and minerals which plant foods also supply. Phytochemicals are widespread in fruits, vegetables, grains, legumes, seeds, nuts, and herbs, and they provide a virtual arsenal for fighting disease. Here are some rich sources of these powerful plant chemicals.

Vegetables: onions, garlic, leeks, chives, broccoli, cabbage, Brussels sprouts, cauliflower, kale, mustard greens, spinach, tomatoes, peppers, cucumbers, radishes, celery, parsnips, carrots
Fruits: oranges, grapefruit, lemons, limes, cantaloupe, peaches, apricots, red grapes, strawberries, raspberries, cherries, watermelon, guava Dried beans and peas: all types, including split peas, lentils, garbanzo beans, and pinto beans
Whole grains: all types, including whole wheat bread, wheat germ, wheat bran, oatmeal, oat bran, brown rice, and barley
Soy foods: soybeans, soy protein, soy milk, soy flour, and tofu
Nuts and seeds: sesame seeds, flax seeds, all types of nuts
Herbs: parsley, cilantro, mint, caraway, turmeric, ginger, cumin, dill, fennel, basil, oregano, thyme, sage, and rosemary
Beverages: black and green tea, red wine, red grape juice

Hopefully, you are already eating many of these foods, but for most Americans, adopting a plant-based diet requires some substantial changes. Altering well-established dietary patterns takes patience and commitment. It helps to remember that our eating habits are what psychologists call learned behaviors. In other words, they're not genetic traits! That means we can choose to develop new habits and preferences - and the key word here is choose. Rather than thinking about what you shouldn't eat, realize that you have an empowering opportunity to make food choices which can improve your health and help protect you from disease. Each small step you take - just adding a salad at dinner, for example, or a piece of fruit at lunch - brings you closer to a healthy eating style. Over time, you may discover that the foods you most enjoy are also the foods that are best for you.

Are You are "Participating Patient?"
by Margaret A. Nosek, PhD
Michele Arnold

Article to come.

Is Physical Activity for You?
by Hedi Thompson-Torrence, MSEd

You probably have not thought too much about exercise, but maybe you should. Sometimes, just doing the simple things you need to do each day makes you feel tired. The more tired you are, the less likely you will want to do anything else physically active. However, when you choose to become more physically active, you will actually feel less tired. You will have more energy to meet your daily needs, and you will have a more positive view on life. Physical activity is good for you! There are many health benefits of physical activity, including decreasing your risk for heart disease, high blood pressure, diabetes, certain cancers, osteoporosis, and obesity. You will lower your cholesterol and body fat. The risk of injury to your joints and muscles will decrease. You will feel less depressed, anxious, and fatigued. In addition, you will increase your strength and endurance, which will help you get through your day with less effort and more energy. It may seem difficult at first to add more physical activity to your life, but the rewards will make it all worthwhile! Adding physical activity to your life does not mean that you need to join a gym or begin an exercise program. In fact, you may already be more active than you think! There are many physical activities you can choose to do to become more healthy, including gardening, cleaning house, walking or wheeling, dancing, and swimming, just to name a few. You can even combine interests to make these activities more enjoyable. For instance, if you like photography, you can walk or wheel with your camera and take interesting pictures. Your interest in photography adds to the enjoyment of walking. Physical activities can be done alone, or with family and friends. Getting others involved is more fun, and you will be more likely to stick to it if you have people to join you and encourage you. To get the health benefits described above, there are two "catches".

Whatever activity you choose to do, it must be done often, and at a level that causes your heart rate and breathing to increase. For example, if you enjoy gardening, garden two or three times per week, and work at a level that challenges you. Gardening is already physically active. To make it more so, use a watering can instead of a hose. You get stronger lifting the weight of the can, and water your plants at the same time. It is easy to add more activity to your life, especially if you do something you enjoy. Don't shy away from becoming more physically active because you don't think it will help you. It will! You will feel better, and will have fun doing it!

Are You Being Pressured to Quit Smoking?
by Patricia Dolan Mullen, DrPH

Most people know that smoking is a killer. Lung cancer has surpassed breast cancer as the #1 cause of death for women. The warnings on cigarette ads and packages list other health consequences of smoking for ourselves and those who live and work with us. And, the health risks are even greater for women with disabilities. Yet many women still smoke; the rate is even higher among young women with disabilities.

At the same time, smokers are feeling pressured by others not to smoke. Since smoking is increasingly restricted in public places, smokers report that they feel more frustrated, irritated, and self-conscious than ever. Moreover, they say that they find themselves having to defend their right to smoke when challenged by family, friends, doctors, and co-workers. It is easy to view comments from others as criticism rather than as concern for the smoker's health. This can result in feelings of resentment and more insistence on the right to smoke.

We suggest having a serious talk with people in your life who are pressuring you to quit. Explain to them that you are aware of their views but that quitting is a personal decision. Tell them to ease up. Only you can decide if and when you want to quit. Nagging doesn't help. Positive support does. Once pressures ease up, you may begin to take a more balanced view of smoking.

Researchers have gathered information about the ways smokers defend themselves when they feel pressured to stop smoking. Some smokers say they'll quit "some day." Some who have been demoralized after a failure say, "I've tried everything" or "I don't have enough willpower." Others say quitting is possible, but in their view, "It's the only thing I have to help deal with stress" or I don't smoke that much" or "The damage is done." For some women with disabilities, smoking may also provide relatively inexpensive entertainment when they are stuck in the house.

With less pressure to stop smoking, it is easier to look at some of these statements. For example, experts now agree that will power is often NOT enough to break nicotine's powerful grip. In fact, nicotine replacement products (gum or patches) that have recently been approved for sale without a doctor's prescription are now recommended for smokers who decide to quit.

If you are open to considering both the costs and benefits of smoking, in the next newsletter, you'll get an opportunity to take a look at where you stand in this decisional balance.

RESOURCES

Need more information about improving your health? Take a look at these:

Check Your Health: Consumer Screening Manual and Forms: Health Screening for Adults with Disabilities Related to Physical Impairments by Tom Seekins, Ph.D., Kaye Norris, Ph.D., Quincy-Robyn Young, M.A., and Craig Ravesloot, Ph.D. Available from: Research and Training Center on Rural Rehabilitation Services
Rural Institute on Disabilities
University of Montana, Corbin Hall, Room 52, Missoula, MT 59801
To order, call toll-free 1-800-732-0323

Charting Your Course to Health and Wellness: A Health Promotion Packet for Women with Physical Disabilities
Includes booklets on lifestyle assessment, preventing and managing secondary conditions, enhancing relationships, leisure, managing stress and healthy eating.
Available from:
Temple University College of Health, Physical Education, Recreation, and Dance
316 Seltzer Hall, Box 062-62, Broad and Cecil B. Moore Avenue, Philadelphia, PA 19122
Voice: (215) 204-7213 Fax: (215) 204-1455

Nutrition Fact Sheet: Fruits and Vegetables: It's Easy to Take the "5-A-Day Challenge"
Available from:
National Center for Nutrition and Dietetics
216 West Jackson Blvd.
Chicago, IL 60606-6995

Please check the CROWD web page for additional information on wellness and women with disabilities: www.bcm.tmc.edu/crowd/