Ask the Expert

A: The first thing to know about Kegel exercises is that they’re not for everyone. The famed exercises that strengthen the pelvic floor muscles can help prevent or alleviate a host of pelvic floor dysfunctions, but if a person’s issues are caused by a tightening or tensing of the pelvic floor, Kegels should be avoided.

The second thing to know about Kegels is that if you’re doing them correctly, you could do them in public without anyone knowing. That means that if your face is red or your breathing is labored, you are not doing Kegels correctly.

The third thing to know about Kegels is that it is possible to do too many. Pelvic floor exercises work out the pelvic floor muscles. And like any muscle workout, going overboard can lead to injury and pain.

The pelvic floor can get too tight and develop muscle tension or spasm. This can be from doing too many Kegels, performing Kegels incorrectly, or not training the muscle to go through the full range of motion by lengthening or releasing after contracting.

Lastly, the pelvic floor muscles need coordination training to work with the rest of your body and your breath. They need to turn on at the right intensity and at the right time to meet the demand of any specific activity. 

A pelvic floor physical therapist can help a woman determine if Kegel exercises are right for her – and instruct her how to do it properly. One method that helps is to imagine a zipper running from the anus up to the pubic bone, start at the back of the zipper, and draw up and in to draw it closes. That drawing up contraction should then be held for a few second before being released for the same number of seconds. Do those 10 to 15 times for a set. You will also want to do “quick flicks”, where you do a set of 10 to 15 Kegels as quickly as you can without holding them.

The number of Kegels needed to strengthen the pelvic floor will vary from person to person, but generally 60 to 80 per day is a good target. As with any exercise or therapy, if you have questions, please consult a doctor or specialist.

For more information or to schedule an appointment with the Hoag Pelvic Health Program, call our Newport Beach office at 949-764-7277 or our Irvine office at 949-557-0190.

A:  Postpartum is a season of life marked by new experiences, growth and significant adjustments. Many parents struggle with returning to their workplace after the birth of their child. It can be stressful to figure out how to manage the competing priorities of parenthood, relationships, work, family life, self-care and wellbeing. There are a wide range of emotions that can arise in the context of returning to work, including sadness, guilt, anger, anxiety, excitement and joy. Here are some strategies to help you cope with transitioning back to work.

• Set realistic expectations of the adjustment process. Try not to be too hard on yourself. This is a challenging adjustment for most parents, and it takes time to establish your new routine. It will get easier as you get back into a manageable rhythm. Give yourself some compassion and kindness as you navigate this new chapter of parenthood. Example of self-compassionate statements: “This is difficult, and I am doing the best I can. I will get through it.”
• Cope ahead. Recognizing that returning to work may bring up difficult thoughts and feelings can help us practice useful coping skills ahead of time. Start to think about ways you can take care of yourself and lessen the stress related to this transition. Some examples include noticing and checking in with your emotional state and needs, taking breaks when possible, listening to your favorite music, journaling, deep breathing, mindfulness practices, talking to loved ones about your feelings, body movement, baths and rest.
• Set boundaries. It is important to prioritize your needs as you return to work. Give yourself permission to set boundaries around working overtime, taking your breaks, and your availability outside of work hours. Talk to your human resources team about benefits and protections for working parents. Remember your values and what matters to you.
• Communicate with your support system. Let those around you know that you may need additional support as you return to work. Talk to your partner about splitting up responsibilities and tasks so you are not taking on too much. Express your feelings, remember it is okay to feel overwhelmed and nervous.
• Anxiety about returning to work and separating from your child may emerge as your return-to-work date approaches. This is a normal experience, and it is important to validate your feelings. This is a big transition that may cause you to be nervous. Try to remember that anxious thoughts and feelings are understandable given all the changes you have been through since having your baby. It can be helpful to prepare for the separation by doing trial runs with other caregivers or childcare providers. Start with one to two hours away from your baby, and then gradually lengthen the time away. This can help prepare you for your return to work.
• Seeing the whole picture. There are a wide range of emotions you are likely to experience when returning to work. Although it can be difficult to transition, many parents express some unexpected positive experiences once they return. It can be fulfilling to return to your career and have time with other adults outside of the home. There are going to be difficulties associated with returning to work, but do not discount the potential for positives.
• If you are struggling with overwhelming anxiety and/or low mood, it may be useful to connect with a therapist to support your transition. Although a wide range of emotions is natural, if your feelings and thoughts are getting in the way of daily life, therapy may be a great resource to help you navigate these challenges.

To schedule an appointment or learn more about maternal mental health services for pregnant and post-partum patients, call 949-764-8191 or email us at wellness@hoag.org .

A:  An Integrative Approach to Chemotherapy Relief with Acupuncture

Acupuncture is a 3,000-year-old Eastern practice that uses tiny needles to increase blood flow and circulation throughout the body. 

By stimulating specific points near or on the surface of the skin, these acupuncture points have the ability to alter biochemical and physiological conditions in the body. Acupuncture can specifically offer decreased inflammation and improved pain management, which makes it an effective mechanism of healing for chemotherapy treatment side effects. 

Because acupuncture points are designated areas of electrical sensitivity, inserting needles at these points stimulate neurotransmitters and endorphins, the body’s natural pain-killing hormones thought to be 200 times more potent than morphine. The substances released as a result of acupuncture relax the body, and also regulate serotonin in the brain, which also decreases anxiety and relieves insomnia. Other physiological effects include increased circulation, decreased inflammation, relief of muscle spasms and increased T-cell count, which supports the immune system.

Acupuncture is an effective supplemental treatment for people who experience side effects from treatment of chemotherapy, surgery, radiation therapy and hormone therapy. These symptoms include mental and physical fatigue, pain, anxiety and depression.

Acupuncture also helps with:

• Nausea and vomiting related to chemotherapy
• Hot flashes related to hormone treatment
• Joint pain related to aromatase inhibitor therapy
• Physical pain
• Neuropathy
• Swelling and edema
• Peripheral neuropathy
• Constipation
• Loss of appetite
• Fatigue
• Insomnia and other sleep disorders, dyspnea (breathing difficulties)
• Anxiety
• Depression

For more information or to book your consultation and acupuncture treatment with Christina Nguyen, M.S., L.A.C., call 949-764-7239 or email wellness@hoag.org.

A:  Massage. Such a lovely word. When it comes to a massage, our minds often associate it with relaxation, but a massage also comes with a vast array of modalities. Our specialized massages are proven to be a great addition to ease discomforts experienced by pregnant and postpartum moms, enhance healing and comfort while receiving cancer care, and can promote increased range of motion and flexibility for those living an active lifestyle.

Here are the various modalities Hoag for Her Center for Wellness massage therapists provide:

Swedish
Swedish massage is a Western style massage most often used in spas and for relaxation purposes. It’s often used for those struggling with anxiety, depression and the everyday stress life brings. If you are looking for relaxation at its finest, Swedish is the way to go with your choosing of light, medium to deep pressure to relieve you of all those knots and built-up tension. Receiving a massage monthly is typical unless you and your massage therapist (MT) determine a different plan, or if you have a specific preference of session frequency.

Deep Tissue
Deep Tissue, the Swedish modality’s sister, is often referred to as “Dwedish” for its combination work. A Swedish based deep tissue massage allows for more pressure than a regular Swedish massage by incorporating the massage therapist’s forearms and elbows. Communication and breath work are key for deep tissue massage. Work with your therapist and remember to be vocal about the amount of pressure applied in various areas because a pressure that feels great in one area may not feel too fantastic in another.

Lymphatic
Lymphatic massage, also known as manual lymphatic drainage, relieves swelling that occurs when medical treatment or illness blocks your lymphatic system. Lymphatic massage is much gentler with far less pressure. At Hoag for Her our massage therapists can incorporate lymphatic massage techniques into your session. For clients with more specific needs, Hoag Outpatient Rehabilitation Services offers a specific lymphatic drainage program.

Prenatal and Postnatal
Pregnancy is often depicted as a joyful nine months, but the physical reality often includes a surreal number of changes to a mother’s body. Prenatal massage assists with alleviating low back pain, leg pain, reducing labor pains during birth, reducing anxiety and stress, improving mood, and easing insomnia. Massages will be adjusted as one progresses through each trimester along with any recommendations from your OB.

During the postnatal period, there are changes physically and mentally as you transition from carrying your baby in your tummy to caring for your baby in your arms. These new habits can lead to new tension in your body, which is normal, but can come with pain and cause some discomfort. Receiving massage regularly will assist in alleviating any unwanted stress keeping you refreshed and ready while caring for your little one. Check with your OB and  massage therapists for their recommendation for you to have the best results after birth.

Sports
As an athlete or individual who generally leads an active lifestyle, the most important issue is trying to refrain from receiving any injuries. As a former and current athletic individual, I can relate. This is a difficult objective to accomplish, but accidents happen. A sports massage allows for increased range of motion (ROM) and flexibility, while reducing pain and decreasing stress. Depending on your lifestyle, this will also determine how often you may need to receive a sports massage, and this could range from a few times a week to monthly.

Trigger Point
Trigger point therapy is a nonpharmacological approach to reduce chronic and acute muscular pain. Myofascial trigger points are painful or tense areas that are found in muscles. Each body carries different holding patterns, which may result in needing anywhere from two visits a week to biweekly sessions.

Now that you know the different massage modalities, it is time to give it a try. Our licensed therapists can incorporate multiple modalities into each session, based on your body’s specific needs.

If you are ready to schedule a massage, give us a call at 949-764-7239 or email us at wellness@hoag.org.

Gratuity is not accepted.

A: 

A Dietitian’s Perspective: Postpartum Nourishment for Breastfeeding Moms

Determining nutrition needs during the postpartum period can be difficult because each woman’s birth story is different. What remains a constant is that your body will require more calories during breastfeeding than prepregnancy.

Early Postpartum – “First 40 Days”

The first two weeks postpartum are considered the acute recovery phase which is the most nutritionally demanding. Just as in pregnancy, lactation places high demands on your energy and protein stores.

After the first two weeks, hunger and appetite are often at peak levels as your body aims to heal itself. During this time, nutrient-dense meals are recommended. Your body needs extra calories and protein for the processes of wound and incision healing, tissue healing and milk production.

Although some moms may feel inclined to reduce calories to expedite postpartum weight loss, calorie counting is not recommended during the first 40 days. Instead, focus on these postpartum guidelines:

1. Listen to your hunger and fullness cues to guide your energy needs. Our bodies are wired to assist us in regulating our intake. It is normal to experience an increase in hunger postpartum. Do not place judgement or a timeline on your larger appetite–your body is recovering!

2. Maximize nutrients and repletion instead of focusing on foods to avoid. Incorporate nutrient-dense foods in your diet to help you heal and recover. Attempting to avoid foods and suppressing your appetite can take away from your body’s ability to repair itself.

3. Adopt a flexible, “all foods fit” approach to eating. “All foods fit” is used to emphasize that no single food has the power to heal or hurt postpartum. Foods should not be labeled “good” vs. “bad” foods. Nutrition is synergistic—combining different foods promotes optimal health.

4. Practice body respect. Body respect involves acknowledging pregnancy and birth without focusing on weight, shape or size. Nourish your postpartum body as it heals and recovers instead of focusing on fixing or controlling your body.

To help meet your nutrient needs, try eating six small meals per day or small meals every two to three hours. Feel free to order food in and accept the generosity of friends and family offering to help with meal preparation. Do not feel pressured to eat perfectly; instead, focus on getting nutrition and rest.

After the “First 40 Days”

After your six-week postpartum check-up, your clinician may allow you to begin gentle to moderate exercise. This timeline can vary based on your birth experience and whether you had a vaginal delivery or C-section.

The Institute of Medicine estimates that breastfeeding women with a healthy prepregnancy weight need 330-400 additional calories per day than prepregnancy. Heavily restricting calories will affect your milk supply.

Postpartum Guidelines and Tips for Meal Planning:

· Plan ahead: Prepare healthy proteins in advance so you can easily add protein to each meal. For example, grilled chicken breast is easy to add to salads, wraps and skillet dishes. Grill chicken breasts to use later in the week or even freeze grilled chicken for the following week.

· Calcium is essential for mom and baby: The daily recommended calcium intake is 1,000 mg. For those who are lactose intolerant, use calcium fortified non-dairy products. Additional sources of calcium include leafy greens, fortified cereals and tofu. Speak with your healthcare provider or dietitian if you have concerns about meeting the recommended calcium intake.

· Aim for variety in your diet! Eat foods rich in nutrients like vitamin C, zinc and selenium to help keep your immune system strong. Choosing different types of fruits, vegetables, whole grains and seasonings will expose your infant to diverse flavors and tastes.

· Add fiber in your diet: Start your day with fiber in conjunction with protein for the perfect combo of energy and sustenance. Fiber is an essential nutrient to help with post-labor constipation. The recommended daily amount of fiber is ~30 grams.

· Stay hydrated all day long: Drink up to three liters of water daily. · Curb your caffeine intake: While the small amount of caffeine that passes from you to the baby through breast milk is not known to adversely affect your infant, the CDC recommends sticking to 300 mg or less per day.

· Minimize empty calories: Minimize foods that are high in added sugar, sodium and saturated fat, including fried foods, soft drinks and desserts. · Avoid high-mercury fish: Some seafood and fish such as tuna, king mackerel, orange roughy, marlin, shark, swordfish and tilefish are high in mercury. Healthier options include salmon, shrimp, cod, tilapia, trout and halibut. · Continue prenatal vitamins: Breastfeeding mothers should continue to take prenatal vitamins or a vitamin specific to postnatal mothers.

· Remember weight loss is ideally slow and gradual: If you’re trying to lose weight while breastfeeding, the Academy of Nutrition and Dietetics says a slow weight loss of one pound per week or four pounds per month is ideal.

· Limit alcohol while breastfeeding: Although many women decide to avoid alcohol while breastfeeding, if you choose to drink, limit it to after breastfeeding or wait two to three hours after having a drink to breastfeed.

Sample One-day Meal Plan

The one-day meal plan below is about 2,200 calories. You can add calories to this by including additional snacks or remove calories by reducing portion sizes. Remember to honor your hunger and fullness cues.

Breakfast

• 2 eggs
• 1 slices wheat toast
• 1 tbsp peanut butter
• 1 cup strawberries

AM Snack

• 1 serving overnight oats

Lunch

• 2 cups chicken, lentil, vegetable soup
• 1 slice toast
• ½ avocado

PM Snack

• ½ cup trail mix (think variety – nuts, seeds, dried fruit, granola)

Dinner

• 6 oz baked salmon or BBQ tempeh
• 1 cup brown rice
• 2 cups salad greens with vinaigrette

Bedtime Snack

• 1 oz dark chocolate
• 1 medium banana

To modify this meal plan for a plant-based diet:

· For breakfast, eliminate the eggs and enjoy two slices of wheat toast with peanut butter

· Eliminate the chicken in the soup and double the lentils

· Choose BBQ tempeh at dinner

If you are breastfeeding and would like to establish a personalized nutrition plan with a dietitian at the Hoag for Her Center for Wellness, call 949-764-7239 to schedule a consultation.

References:

1. NF Butte, A Stuebe, “Maternal nutrition during lactation” March 2022. UpToDate.

2. L Poston, “Gestational weight gain” March 2022. UpToDate.

3. NIH Dietary Reference Intakes – https://ods.od.nih.gov/HealthInformation/Dietary_Reference_Intakes.aspx

4. J Linardon, L Susanto, H Tepper, M Fuller-Tyszkiewicz, “Self-compassion as a moderator of the relationships between shape and weight overvaluation and eating disorder psychopathology, psychosocial impairment, and psychological distress”. Body Image. April 2020. 5. Intuitive Eating – http://www.intuitiveeating.org/ 6. La Leche League – https://www.llli.org/

• Sense of poor sleep quality or non-restorative sleep.
• Daytime sleepiness.
• Regular difficulty sleeping despite adequate opportunities for sleep. 

• Prioritizing sleep. 
• Limiting naps to the early afternoon.
• Keeping your routine consistent, with the same wake and bedtime.
• Unplug from electronics 30 to 60 minutes before bed.
• Allow 30 minutes to wind down with soft music, light stretching, reading and/or relaxation exercises. 
• Sleep in a dark, cool and quiet space. 

• Control: Becoming more aware of our body can give us more control over our body mechanics, especially our bad habits. 
• Breath: The natural expansion and contraction of the rib cage and chest during full breath cycles support and improve spinal elongation. 
• Concentration: Take care and focus while doing postural exercises to receive maximum, lasting benefits.
• Centering: This refers to the importance of centering of spinal alignment as well as centering the mind and body with the exercises being performed. 
• Flowing Motion: When the spine has more mobility, suppleness, and strength within proper alignment then our body can move with more flow and ease. 
• Precision: Practicing good posture frequently with precision on execution will bring forward steady improvement. 

A: While the weather in Southern California is almost always perfect for hiking, now is an especially great time to enjoy physical activity outside. As always, follow your health care provider’s recommendations on the intensity and duration of exercise and be sure to hydrate and protect your skin. Three local hiking trails come to mind as my top recommendations ranging from family friendly to moderate intensity, and all with a beautiful ocean view. Happy exploring!

Hikes in OC with an Ocean View

Bolsa Chica Wetlands, Huntington Beach
If you are looking for a flat trail with ocean views and bird watching, this is the trail for you. The wetlands are right across PCH, so you get an ocean view the entire time! There’s no elevation on this trail. You can make it a family friendly walk or go for a jog. Starting from the free parking lot on PCH the trail runs in between the wetlands providing views on both sides. After about .5 mile, you can either loop around to the park area with benches or follow the trail to the right for an open stretch of trail leading towards the surrounding neighborhoods. Pending your route this can be a 1–3+ mile outing. If you are enjoying a run on the trail and want to extend your time you can always repeat the loop. Be sure to keep your eyes peeled for local birds as they dive into the water to fetch their food – it is quite a show! This flat trail doesn’t offer any shade, so I recommend planning a sunset trip and be sure to bring sunscreen and a hat. The Bolsa Chica Conservancy Team is a great resource for any questions you have about the trail and wildlife. They offer guided tours and events to keep the community connected to this wonderful outdoor resource.

Click here for a map of the Bolsa Chica Wetlands.

Santiago Creek Trail(s), Orange 
This is a choose your own adventure hike! There is ample parking at the trailhead ($5 fee), with restroom access. The hike is both dog friendly and open to mountain bikers, there is also a rattlesnake warning so keep your eyes open. The start of the hike is shaded by oak trees and has a view of one of the first dams in Orange County. After about .5 mile you can choose from one of the incline trails to the top. After about a mile of steady incline you will reach the top to catch a view of the Pacific Ocean. If you look closely, you can even spot Hoag in the distance! Follow the trail to Barham Ridge (another ~1 mile), and you will find views of the ocean on one side and the mountains on the other. Be sure to keep an eye out for hawks soaring overhead. From here you can extend your hike by taking one of the many trails or head back onto the trail to the parking lot. There are a lot of trails leading back to the entrance, so it can be a little tricky. We ended up doing a little exploring on some of the side trails as we made our way back to the parking lot, and our hike ended up being about 4.5 miles, 890 feet of elevation and taking just over 2 hours. Be sure to bring sunscreen and a hat, as after the first .5 mile you are in the sun for the rest of the hike.

Click here for a map of the Santiago Creek Trail(s).

Pacific Ridge Trail (via Crystal Cove), Newport Beach 

For the adventure seekers looking for a challenging hike with great views, this is the trail for you! This hike was referred to me by one of our Hoag Pelvic Floor PT’s, Heather Lapaglia, and is a moderate out and back trail leading to the ocean. You can find free parking at Ridgeline Park, where you will also find a map indicating the start of the trailhead. Start on the main path as you descend and head towards the Crystal Cove parking lots via the Muddy Canyon Entrance. When you are within about a mile of the beach your breathtaking ocean views begin. The trail ends at the Crystal Cove Ranger Station Headquarters, where Ranger Linda recommends you stop in to ask questions before you take the tunnel down to the beach. Be sure to bring snacks and water so you can relax on the beach before you begin your climb to the top. Once you have had your fill at the beach, you can start your climb back to top. This is about a 9-mile round trip hike, with a 4.5-mile descent to start, and a 4.5-mile climb to get back to the trailhead. Be sure to bring your sunscreen and hat, as there is no shade.

Click here for a map of the Ridge Trail.

A:

6 Tips to Ward Off Holiday Stress

When we think of the holidays, thoughts of fun, joy and happiness fill our minds until the realities of seasonal demands set in. These six tips from Danielle Dawson, M.A., L.M.F.T., will help you manage the stress that comes with extra shopping and running more errands, going to holiday parties and relatives visiting.  

Expectations of a fun, joyful and happy holiday season often add pressure to keep a smile on our face, only to increase our negative thoughts and feelings. But with a few helpful tips to make it through the season, you can feel more prepared and confident to handle what is coming.

1. Create or keep healthy habits
   Three of the best ways to keep stress to a minimum is eating healthy (even at holiday parties), getting plenty of sleep and staying physically active. If you already have a healthy daily routine, continue what you are doing and add the holiday obligations into your life – do not give up the things that make you feel good. If you haven’t started creating healthy habits, now’s a wonderful time to start a new routine.

2. Plan ahead
   Between family, friends and co-workers, holiday event commitments start to grow. Make sure to plan so you do not overcommit. If you are hosting a holiday event, organize your party, create a menu and plan for what needs to be done. Getting things done early and asking for help alleviates last minute stress. 

3. Learn to say no
   Often, you overcommit your time because ‘tis the season. Decide what is most important for you, where you want to go and protect your time. If you have a clear idea of what you want for your holiday season, you can easily say no to the things you do not want to do.

4. Make a holiday spending budget
   Finances are one of the biggest stressors in your life. Planning early with a financial budget and sticking to it will help elevate stress around purchases for loved ones. Plus, it helps you make informed decisions on gifts, so you are not paying them off the rest of the year.

5. Take a break
   Don’t forget to take care of what your mind and body need. Take a nap, watch a silly movie, read a good book, take a short walk outside, listen to uplifting music, or light some scented candles. Remember laughter relaxes the mind and body, releasing physical tension and stress. Listening to music and citrus scents boost feelings of well-being. Getting some vitamin D from a walk outside continues to boost happiness.

6. Enjoy the season
   Be mindful. Once you are at an event, cooking a holiday meal and even shopping with crowds, make sure you slowdown in each of those moments and use all your senses to be present to create memories that remind you of how much you enjoy the season.

Remember the holidays are meant to be enjoyed with family and friends. These tips can help relieve holiday stress and ensure you make the most of this time of the year.

To schedule an appointment or learn more about our counseling services, call 949-764-7239.

A: When we think of the holiday season, it’s often associated with happiness and excitement, but let’s face it — the reality is that it may bring a level of stress as well. The holidays may be a time of high emotion and demands, which can leave us feeling overwhelmed and exhausted. For some people, particularly during times of Covid-19, the upcoming holidays may look very different. It can be a period of loneliness, sadness, anxiety and depression, which we can refer to as the “holiday blues.” For these reasons, self-care is essential to getting through the season.

You may be thinking “who has time for self-care?” as for many, the holiday season means planning and taking care of others. The thought of self-care may even leave you feeling a sense of guilt, but self-care is not selfish. Self-care is a necessity for our own wellness and ability to care for others. For a lot of people, taking care of yourself doesn’t mean me first, it means me too. That leads to our first tip on how to practice self-care during this holiday season:

1. Prioritize time for you!

Self-care doesn’t have to mean an all day ordeal (but if you need to and have the ability, by all means!). It can just mean taking small moments to prioritize you and your wellness. Some ideas might include sitting in silence for 5 minutes, having a cup of tea, taking a moment to engage in deep breathing, strolling through Target alone for an hour (or two), taking a long shower, asking your partner to take on the morning kid duties so you can sleep for an extra hour, talking to friends or family (in person or video call) or going on a walk with the dog. The list can go on and on and look very different for each person. The point is, carving out time (whether that be a few minutes to a few hours) to do things that feel good for you and replenish your energy and spirit no matter how busy we get.

2. Create healthy boundaries with self and others

Boundaries are a form of self-care and essential for our mental well-being. During the holiday season, it can be helpful (even crucial) to set limitations with yourself and others. In general, we can think of boundaries as setting physical, emotional and mental limits. Sometimes that might look like practicing the art of respectfully saying “no,” taking a break when you are feeling overwhelmed, leaving a conversation when someone is nagging you about your personal life, or allowing yourself to feel gratitude and focus on what’s going right versus what’s going wrong. In addition, you may need to set a boundary with yourself on social media usage as it may lead down an ugly path of comparing yourself and your holidays to others around you.

3. Bring it back to basics

If you are questioning when the last time you ate or took a shower was, chances are you may need to spend time on making sure your basic needs are being met. Sleep, nutrition, hydration and movement are important factors that have a huge impact on mental health. When our basic needs are not being met, all the emotions we’re dealing with can feel even worse. Take care of your physical health, try for adequate sleep (when you can), get your body moving, and aim for a balanced diet. However, self-care during the holidays may also mean indulging on your favorite foods and treats from time to time!

To schedule an appointment or learn more about:

Maternal mental health services for pregnant and post-partum patients with Sandy Yokoyama, LMFT, call 949-764-8191

Individual and couples counseling with Danielle Dawson, LMFT, call 949-764-7239

A: As flu season approaches, it is important to take precautions to keep yourself healthy. Unfortunately, many Americans don’t eat enough fresh fruits, vegetables, and other foods we need to keep ourselves healthy year-round. Healthy foods provide many substances including vitamins and minerals to keep us strong and healthy. You can’t just eat an orange or pop a vitamin C pill and expect it to prevent a cold and to boost your immune system. To keep your immune system truly healthy, it’s important to follow a healthy balanced diet over time.

With a few exceptions, it’s best to get your vitamins and minerals from your food rather than in supplements. Here are some of the top vitamins and minerals your immune system needs to perform at its best:

1. Vitamin C

Vitamin C may help prevent infections or shorten the length of your illness. Citrus fruits are a common go-to Vitamin C-rich food, but there are others as well. Consider trying:

• Spinach
• Kiwi
• Bell peppers
• Broccoli
• Strawberries
• Papaya

2. Vitamin D

Vitamin D is one of the most important and powerful nutrients for supporting the immune system. Food sources are limited but include:

• Salmon
• Trout
• Mushrooms
• Sardines
• Vitamin D fortified foods like milk, yogurt, orange juice, and soymilk

In general, it’s best to get most of your vitamins from food, but vitamin D may be the exception. Talk with your doctor and get tested to find out if you need a supplement.

3. Zinc

Zinc helps your body fight germs and helps make protein to repair your body. Most people can get enough zinc from their diet. However if you are vegetarian or over the age of 50, you may need to supplement. Talk to your primary care provider about taking a zinc supplement. Note that taking zinc supplements for a long period of time or regularly taking cold remedies with zinc can cause copper deficiency or anemia. Some foods that are high in zinc include:

• Oysters
• Peanuts
• Lean meats and poultry
• Baked beans
• Pumpkin seeds
• Yogurt

4. Vitamin E

Vitamin E is a powerful antioxidant that helps your body fight off infection. This important vitamin — part of nearly 200 biochemical reactions in your body — is critical in how your immune system functions. Vitamin E is found in plant-based oils, nuts, seeds, fruits, and vegetables as well as:

• Almonds
• Peanuts/peanut butter
• Sunflower seeds
• Oils such as sunflower, safflower, and soybean oil
• Avocado

5. Vitamin A

Vitamin A stimulates the production and activity of white blood cells to help boost your immune system. It comes in two forms: preformed Vitamin A (in animal foods such as fish, meat and dairy) or from plant carotenoids. Try to get a mix of both to maximize your benefits:

• Green leafy vegetables
• Tomatoes
• Pumpkin or sweet potatoes
• Eggs
• Fish oils
• Milk

6. Iron

Iron helps your body carry oxygen to cells and plays a part in many of the immune system processes. Your body can absorb heme iron the best (aka iron from animal products), but iron is also found in vegetarian foods. Try adding the following to your diet:

• Iron fortified cereals
• Soybeans
• Lentils and beans
• Spinach
• Beef (in moderate amounts)
• Clams

You can also increase the iron content of your foods by cooking in cast iron cookware.

Choose frozen when you can’t get fresh

When selecting produce and high quality animal protein, fresh food is always a go-to. However, as the winter months approach, you can’t always get your hands on high-quality fresh produce. Keep in mind that buying frozen is a good option and can be quite convenient. Frozen food can still boost your immune system because it is usually frozen at its peak ripeness.

In general, eating a healthy diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats throughout the year will give your immune system the biggest boost. If you haven’t been eating as healthy this summer, now is a great time to change things up and start getting those immune boosting benefits!

A: The miraculous changes your body goes through during pregnancy are essential to accommodate your growing baby, but may cause symptoms such as low back pain, hip pain and pelvic pain. Your pelvic floor muscles, located at the base of the pelvic cavity, are now having to work harder to support you and baby, which can sometimes lead to pelvic pain, urinary frequency and/or urinary leakage. If you are experiencing any of these symptoms, don’t let it linger. Seek help from a pelvic floor physical therapist who can assist you in developing an individualized treatment plan to minimize and control symptoms in order to maintain a comfortable and active pregnancy.

Pelvic floor physical therapy can also help prepare you for labor and delivery. We will go over how to get in tune with your pelvic floor muscles, perineal massage techniques to help decrease risk of tearing, breathing techniques to help with pelvic floor relaxation, and laboring positions for comfort.

To schedule an appointment, call our Newport Beach location at 949-764-7277 or our Irvine location at 949-557-0190. Physician referral is required.

A: The FDA recommends at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.

How I break this down with a client depends largely on their lifestyle and what they enjoy doing. For a busy parent, spreading out their workout routine into 15 to 20 minute blocks may be more feasible than doing 45 to 60 minutes all at once. Finding out what time of day works best for your workouts is also key. Are you a morning, midday or evening exercise fan?

Being consistent with your days and times can help you stick with an exercise routine. However, if your schedule is like mine where no two weeks are the same, try blocking off time on your schedule at the beginning of your week to fit in a workout.

Lastly, I always encourage clients to listen to their bodies. The body does a pretty good job of trying to tell you what it wants and doesn’t want. It’s just a matter of how well we’re listening. For example, a client with a very high stress job or someone who is going through a stressful period in their life shouldn’t do super intense cardio or a boot camp class everyday. This will elevate their cortisol levels (stress hormones) higher than they already are and will cause fat loss to come to a crawling speed. Working in a proper workout routine with the right work/rest ratios along with some yoga or Pilates classes would be ideal to get the blood flowing without excessively raising cortisol levels.

Another thing I discuss with my clients is working out when sick. Exercising is great for boosting your immune system, but once you have a cold it is best to rest. Your body needs to focus on fighting off the cold rather than using calories for a workout. I can’t tell you how many times I’ve seen a client try and “sweat out the cold” and then hear from them that the cold got worse.

To learn more about individualized fitness and nutrition sessions, click here