NOW Is the Right Time to Quit Smoking

By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists

For people who smoke, kicking the habit is one of the healthiest things you can do for yourself. Cigarette smoking kills about 178,000 women each year in the US, shaving an average of 14.5 years off the lives of female smokers.
Each puff of cigarette smoke exposes users to 2,500 chemicals and cancer-causing agents, including nicotine, tar, and carbon monoxide. Smoking causes 87% of lung cancer deaths and increases the risk of developing cervical and other cancers. Smokers are more likely to experience heart attack, stroke, emphysema, bronchitis, osteoporosis, rheumatoid arthritis, cataracts, and infertility than non-smokers are.
Pregnant women who smoke put their babies at a higher risk for preterm birth, low birth weight, sudden infant death syndrome, poor lung function, asthma, and bronchitis. The harmful chemicals in cigarette smoke are also passed through breast milk to babies. Smokers who quit can stop or reverse the damage caused by cigarettes. In the days and months after you quit, your heart rate and blood pressure drop to healthier levels, and your breathing, circulation, and sense of smell and taste may improve. Heart attack risk decreases by 50% within the first year after quitting, and the chances of developing lung cancer, heart disease, and other ailments fall to nearly that of a nonsmoker in the first few years.
Nicotine withdrawal and cravings derail 70% to 90% quit attempts. If you are thinking about quitting, nicotine replacement products—such as patches, gum, lozenges, inhalers, and nasal spray—or doctor-prescribed medications, such as bupropion or varenicline, can help curb cravings and may increase your chances of quitting successfully.
Smokers can call 800-QUIT-NOW, a free national smoking cessation hotline, to speak with trained counselors who will help develop individualized quit plans. Support groups, such as Nicotine Anonymous, and other local smoking cessation resources may also be a great place to start.
Set a quit date when you will throw away all your cigarettes and clean your clothes to get rid of the smoky smell. You may want to schedule your quit date for November 17, 2011, to coincide with the Great American Smokeout. Keep busy
on your quit day—exercise, go to the movies, take a long walk, etc.—get plenty of water, and ask your friends and family to help keep you honest.
According to the American Cancer Society, more than 75% of women say they want to stop smoking. It takes most smokers several tries to finally quit for good. If your first attempt is not successful, don’t get discouraged. Get some help and get back on track. For more information on smoking cessation, go to www.cancer.org/.

Reducing Your Risk of Breast Cancer

By James N. Martin, Jr, MD
President, the American Congress  of Obstetricians and Gynecologists

Every three minutes, a woman is diagnosed with breast cancer in the US. While it may seem as if you have no control over cancer, research has shown that there are certain lifestyle choices that can reduce your chances of developing the disease.
The American Institute for Cancer Research estimates that almost 40% of breast cancer cases in the US—roughly 70,000 cases per year—could be prevented if women stayed within a healthy weight range, exercised more, and cut down the amount of alcohol they consumed. The good news is that every woman has control over these factors.
Maintain a healthy weight. Women who gain excess weight, especially after menopause, are more prone to breast cancer. Extra body fat produces estrogen, which can fuel certain cancers, such as some breast and endometrial cancers. Find out your ideal body mass index (BMI)—a measure of body fat in comparison to your height and weight—at nhlbisupport.com/bmi.
Get active. Women who exercise
regularly have a 20-30% reduction in breast cancer risk. Physical activity helps keeps weight in check and may have a positive effect on harmful factors that can raise the risk of cancer, such as inflammation and excess hormones.
Just 30 minutes of moderate exercise, such as brisk walking, every day is a good start and may be enough to provide some protection. As your strength and stamina increase, add more time, intensity, and variety to your workout schedule to gain added benefit.
Drink less. Despite the often-touted cardiovascular benefits of moderate alcohol consumption, drinking has been linked to a higher risk of breast cancer. If you choose to drink, limit it to one drink per day. That translates into 5 ounces of wine, 1.5 ounces of hard liquor, or one 12-ounce beer.
Eat Healthier. Aim to eat a balanced diet rich in a wide variety of colorful fruits and vegetables, whole grains, lowfat dairy, and lean protein. By filling your plate with healthy whole foods, you have less room for foods that are high in fat, sodium, and processed sugar.
National Breast Cancer Awareness Month is the perfect time to learn about the factors that may raise your risk, and then try your best to reduce them. To learn more, go to nbcam.org.

The Benefits of Exercise During Pregnancy

By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists

It’s no surprise that pregnancy causes many changes to a woman’s body. Extra weight, changing balance, and fatigue can all make sitting on the couch seem a very attractive proposition. But staying active can provide multiple benefits to you and your baby, making pregnancy an excellent time to adopt and stick to an exercise program.
During pregnancy, exercise can reduce backaches, constipation, bloating, and swelling; oost mood and energy; promote muscle tone, strength, and endurance; and improve sleep quality. It can reduce the risk of gestational diabetes. Pregnant women who exercise may also have an easier time with labor and delivery and weight loss after childbirth.
Talk to your doctor before beginning or continuing an exercise program to be sure that you don’t have any health problems that would limit your activity. Women with certain forms of heart and lung disease, cervical problems, a multiple pregnancy that is at risk of preterm labor, vaginal bleeding, preterm labor, placental problems, and high blood pressure caused by pregnancy (preeclampsia) should avoid exercise. For most pregnant women, however, 30 minutes of moderate intensity exercise on most, if not all, days of the week is recommended.
Be mindful of the changes in your body when choosing your activity. Pregnancy hormones can cause the ligaments that support your joints to stretch and your balance shifts as you gain weight in the front of your body. These changes can lead to more injuries, less stability, and the increased likelihood of falling. The extra weight is also more taxing on your heart. If you can’t talk at normal levels at all times, you may be working too hard.
Gentle exercise such as walking, swimming, cycling, or low-impact or water aerobics is suitable for exercisers of all levels. However, you should avoid any sports or activities that could injure your abdomen or that have a high risk for contact such as ice hockey, soccer, or basketball. Skip activities that come with a high risk of falling such as downhill skiing, horse-back riding, or vigorous racquet sports. Stop exercising and call your doctor if you experience dizziness or faintness, increased shortness of breath, uneven or rapid heartbeat, chest pain, trouble walking, vaginal bleeding, calf pain or swelling, headache, uterine contractions that continue after you rest, fluid gushing or leaking from your vagina, or decreased fetal movement.
Be sure to wear comfortable clothes and a supportive bra and shoes. Drink plenty of water to avoid dehydration and overheating. Most importantly, get out, get moving, and have fun!
For more information, the ACOG Patient Education Pamphlet “Exercise during Pregnancy” is available at www.acog.org/publication/ patient_education.

Do your part to make surgery a success

By Richard N. Waldman, MD, President, The American Congress of Obstetricians and Gynecologists

Millions of people in the US have surgical procedures each year. Being prepared for surgery beforehand can help ease anxiety, improve peace of mind, and pave the way to a smoother recovery. Have a surgery coming up? Keep these tips in mind:

Find Out Basic Information
Your doctor will explain how the procedure is performed, why you need to have it, the risks of the surgery vs. the risk of no treatment, and alternative treatments that may be available. You may also want to ask:

When and where will the surgery take place (hospital, your doctor’s office, surgical center, or clinics)? Will you need any pre-surgical tests or exams? Who will be a part of your surgical team (doctors, anesthesiologists, nurses, etc)? Is any special preparation involved? What type of care will you need following surgery?

Before Your Surgery
If you smoke, quitting will decrease the risk of problems related to anesthesia and post-operative lung infections, and will help wounds to heal faster. Any period of not smokinghelps, but aim to quit at least two weeks before the operation.

Make a list of all of the medications you take (both prescription and over-the-counter such as pain killers, vitamins and other supplements) and share it with your doctor. Find out if it’s okay to continue taking them.
On the day before your surgery, follow any diet regimens suggested by your doctor, such as fasting or drinking only clear liquids. Don’t drink alcohol within 24 hours of your scheduled start time.
If you are a diabetic, keep your blood sugar well-controlled.
Consider preparing a “living will” or appointing a health care power-of-attorney. These measures help ensure that you will receive the type of care you want if you are unable to make medical decisions for yourself.

Surgery Day
At home, shower, wash your hair, and remove nail polish or acrylic nails. Don’t wear makeup and leave any valuables at home. Be sure you have your insurance card.
If you’ll be staying overnight, bring only essential items, such as a case for contact lenses, or dentures.
Arrive at the surgical facility early.
You will be asked to sign a consent form describing the details of your upcoming procedure and verifying that you were involved in the decision-making process with your doctor. Before signing, read it carefully and ask questions if there is anything that you don’t understand.
Be prepared to answer questions about your health history, current medications, and allergies.

For more information, the Patient Education Pamphlet “Preparing for Surgery” is available at www.acog.org/publications/
patient_education. ♀