Turning the Page…By Terry Polanin, APRN

The Telomere Effect—Aging, Longevity, “Canaries in the Coal Mine”

As I write this last newsletter article for the Couri Center, I am very proud to have been a part of a practice whose very foundation is about promoting healthy lifestyles for women.  It has been a privilege guiding our patients through our integrative lifestyle focus to embrace a future full of beauty in themselves and their surroundings and finding moments to appreciate joy and peace.

That said, I would like to share with you some recent scientific research about our telomeres. Being able to see a future bright and healthy, does require some effort on our part, preserving our telomeres. For the past 40 years in nursing, I have seen many changes in healthcare and the health of our American people.  I am grounded in the belief that staying healthy, emotionally and physically, can help to “turn back time” and most of my passion in this profession has been promoting healthy habits and lifestyles.

As you know, it is not an easy path for many of us as we navigate our way through the multitude of “diets” and exercise recommendations available today.  I was enlightened recently by a speaker at a national conference discussing The Telomere Effect, a theory on cellular aging impacted by lifestyle factors and stress.  Telomeres are the end caps of our DNA.  When telomeres critically shorten, the end of the DNA is exposed to damage, and the cell dies.  Telomerase is a cellular enzyme that rebuilds telomeres and has additional non-telomeric roles in cell survival.  Who doesn’t want their cells to survive or thrive for that matter?  Telomeres typically shorten as we age.  Many studies have shown that life stress, or perceived life stress (if you feel like the things happening to you are stressful) can shorten telomeres.  Shorter telomeres will increase cortisol (stress hormone) and over time increase inflammation in our bodies.  Adverse childhood events will shorten telomeres, even stress exposure intrauterine (babies in the uterus) can reduce the telomeres as we age.  Dr. Couri was one of the first physicians in the Peoria area to integrate the philosophy of adrenal health and stress management, into western medicine at the Couri Center practice in early 2010.

The good news is cell aging by telomere loss can be reversed with telomerase!  Several studies have shown that accelerated telomere loss can be reversed within 4 weeks by reactivating telomerase.  This raises the question—can molecular aging be reversed? That answer seems yet to be determined, but many studies are showing promising results.  In the book, The Telomere Effect (Eppel and Black, 2017), the research they have performed suggests favorable measures to improve the telomeric effect on our bodies.  Such as:

1) Regular exercise

2) Dietary “Restraint.” Eat a more plant-based diet, with less processed and sugar-laden foods.

(See research from Dr. Ornish Lifestyle Study published in Lancet, 2008)

3) Vitamin C, D3, E, folic acid in foods or vitamin supplements (See our Couri Center store for quality brands such as Xymogen or Metagenics, or Nordic Naturals)

4) Omega 3 fatty acids-Fish oil (We suggest Nordic Naturals for quality fish oil)

5) Social Support

6) Mindfulness, Meditation, Yoga

7) Stress Management (Such as time for yourself, a walk/hike in the woods, weekend get-a-ways)

8) Statins (Yes, this was on the list and suggested for lowering cholesterol and its anti-inflammatory properties)

9) Estrogen (Yes!! Especially if started in early menopause.  Talk with your provider for further information)

10) Sleep

11) Anti-depressants (Yes, it was on the list, and of course, many of the measures mentioned above will also naturally boost your mood if actively done regularly in our lives)

Unfavorable measures on our telomeres were: obesity, insulin resistance (Pre-Diabetes), elevated homocysteine levels (a measure of inflammation), and cigarette smoking. Have your labs checked!

If you need assistance in improving your lifestyle habits and reducing the telomeric effect, please see your Couri Center health care provider and/or Leslie Bayer, our Registered Dietician, who will help navigate you.  It has been my pleasure to work with Leslie, over the years, as she has been a vital component of the integrative health care we provide at the Couri Center.

And now, please bear with me as I reflect back on the 44 years I have spent fulfilling my childhood dream of becoming a nurse, and the 39 years as a Nurse Practitioner/Advance Practice Registered Nurse.  I am feeling melancholic, as my retirement in March 2019 draws near.  I honestly cannot put into words the joy I have received through the patients that I have met along the way who trusted and allowed me into their personal lives as a health care provider.  You have really taught me much more than I did you, I am sure.

My journey began in the late 70s when I was teaching Nursing at OSF at the time, and we were asked to continue our education.  The request was honored by obtaining a Master’s Degree in Nursing. This was a time when very few nurses had Bachelor’s Degrees, and the University of Illinois had just opened their graduate school at the Peoria School of Medicine.  I was accepted and asked to consider starting a new, expanded role for the nurse. Mind you, at this time in Peoria there were very few female physicians and certainly no nurses who would provide health care, other than at the hospital bedside, under the Doctor’s orders.   It was a “man’s world” in medicine, but a concept that intrigued me (the women’s movement was also gaining momentum) and the University of Illinois was preparing to lead the way in this new concept for medicine and nursing.  We decided to call ourselves Nurse Practitioners, but we were still practicing under our RN license and signing the physicians’ name to prescriptions.

The landscape was changing. With more complex technology, HMOs and evidence-based medicine, and more complicated patients were coming on the horizon, there were a few “broad-minded “physicians that welcomed the concept of “collaborative practice” with an RN willing to expand their role and basically see the healthier, wellness-type patients for routine physical exams and acute care in offices or clinics.

Preventive, patient education was my passion, so I delved into developing diabetic, weight control, hypertension, and chronic disease programs for our patients to complement the physicians’ medical care. (And offered to perform the women’s health exams which were welcomed). There were about six Nurse Practitioners in Peoria at that time striving to advance this new role, which was met with skepticism and some resistance from much of the medical community at the time.  However, by the mid-90s, it seemed that hospitals were starting to expand into primary care and buying physician practices which led to the need for more primary care providers since the growing population of seniors and chronic diseases were over-whelming physician practices.  A perfect opportunity for Nurse Practitioners and Physician Assistants (PAs) (a few PAs had been in the area also at that time) to integrate into the primary care practices, especially pediatrics and family practice.

At that time, I was given the opportunity to become the Coordinator of the Mid Level Provider group (a term I felt confusing to the public and somewhat demeaning to the professions) at Methodist Medical Center, which by this time had about 20 NPs and one PA. This was an opportunity to develop standards of care, position descriptions, and develop collaborative practice incentives.  It was also a time to change our group name, which I fondly called the Advance Practice Providers, now shortened to APPs.

It was an exciting time.  I was given the opportunity to develop a collaborative practice at the Friendship House for Christian Services in an underserved area of Peoria.  Additionally, I was asked to help begin a family practice in a school-based clinic housed in the Valeska Hinton School (with a progressive Principal, Ken Hinton, who believed children and families needed to have health care to be fully able to learn/succeed).    As time progressed, our nurse practice act was amended, and by 2002 we officially became APNs (Advance Practice Nurses) with the ability to sign our own names to prescriptions, based on our credentials, while working collaboratively with a physician(s).

Now, as I look back, I am so amazed and thankful at the progress we have made from the “ghost” provider in the 80s to a respected colleague and an integral part of health care teams in the 21st century.  We’ve come a long way!

This is probably way more than you wanted or did read, but thank you for listening as I “stroll down memory lane” to I look back on the joys and challenges of this “calling” I’ve been privileged to be part of.  And thank you to my patients, over the past 39 years as an APRN (that title recently amended), who have shared your lives with me and taught me about life.  I will never forget you.

Lastly, thank you to Dr. Michele Couri and her husband Tim Couri, who had the vision to bring contemporary women’s health care into the 21st century in central Illinois, with a focus on women, and designed by women.  It has been an honor to work with you and with the marvelous providers and staff that I have spent the past eight years with as colleagues and friends.  As my strong, loving 93-year-old mother always says…God never closes one door that He doesn’t open another.”

As I transition into retirement, I plan to focus on our three amazing children and their spouses. There is so much to look forward to!  We are expecting our first grandchild in May, our daughter’s wedding in October, as well as, a full schedule of international travel with my wonderful husband of 40 years. We also have a new 8-year old rescue bulldog Mack, my elderly 32-year-old horse Copper and my dear 93-year-old mother keeps ME young with lots of shopping!  I hope this keeps my mind off retiring from the Couri Center and the bittersweet close of this door.  So, I will remember the saying as I walk out the door in March, “Don’t cry because it’s over, but smile because it happened.”  I will probably do both.

 

God bless and to your health,

Terry Polanin, APRN

A Glimpse of Bali, Indonesia By Terry Polanin, MS, APRN, FNP-BC

Does anyone remember the musical “South Pacific?”  I’m sure there are some that do. It was one of my favorites, as a child.   I certainly never imagined I would have the opportunity to experience “Bali Hai—is calling…where the sky meets the sea.  A special island.”  Fortunately, due to my husband’s speaking engagements with the International Institute of Welding, I found myself in the South Pacific, “where the skies meet the sea.”  I would like to share some of my impressions as we explored this beautiful island.  I also would like to request prayers for the safety and recovery of the wonderful people in those islands that experienced the earthquakes this past summer.  Everywhere we toured were signs for “Tsunami Evacuation Route” and directions to get to the highest hotel floor or tallest area for safety.

Beauty of Bali

Aside from the threat of earthquakes and tsunami waves that they have lived fearing for years, the beauty is magnificent.  Bali is just one of many Indonesian Islands in the Indian Ocean and the Bali Sea. White beaches, tropical palm trees, Hindu temples on every corner, and friendly people abound.  We had the opportunity to stay in some beautiful hotels, the first was the Nusa Dua Hotel and Spa, the oldest on the island.  They had planted trees and palms to shade the beach for the preservation of natural beauty rather than umbrellas over the chairs for shade.  The bottled water, which was all that we drank due to the lack of sanitation services on the island, was in glass bottles (see photo above) very colorfully decorated with flowers typical of the scenery.  The flowers were magnificent in the hotels and along the streets.  Many begonia and tropical flowers.  One of the hotels that we stayed in had a jungle-like atmosphere with a swim-up pool and steps going onto the patio and the room, surrounded by beautiful trees and plants.

Economics in Bali

The country is stricken with poverty, as are many countries outside the United States. The average salary for one month’s work in Bali is about 200 American dollars with the average rent of a two-bedroom apartment being around $50.  Some people work for the hotels or drive taxi cabs for a living, such as the young man who took us on a full day tour in a nice vehicle (similar to Uber) only charging us $55 and would not accept a gratuity.  The people seem to appreciate the positive aspects of their life, not focusing on the things they don’t have.   We were continually impressed with the spirituality and kindness of the Balinese people, as well as the noted lean-ness of the people. We, in the bountiful USA, could take some lessons.

A Foundation of Faith and Family

In talking with the native Balinese, it seemed obvious that their faith and family were uppermost in their lives.  The Balinese do have minorities of Christian, Muslin, and Buddist religions, but primarily most of the Balinese people practice Hinduism.  Balinese Hinduism, called Agama Hindu Dharma, originated from Java and Shivaism and Buddism.  It’s a combination of Indian philosophy with indigenous Balinese beliefs that nature is “power” and each element is subject to influence from the spirits.  Ancestor worship is common while spirits and ancestors are treated with respect.  They are housed in a shrine and given “offerings” made from agricultural products, such as rice and flowers.  Each home, each place of business, often cars, and certainly temples will have “offerings” in front of them as you walk along.  They are little boxes made of bamboo with objects “offered” to the spirits and Gods for protection against evil.  Hinduism is built on five pillars of faith:  a Supreme God; belief in the soul as the universal principle of life; belief in the fruition of one’s deeds (giving and helping others), and belief in the ultimate release (moksa—like heaven). The community revolves around family and religion.  The family worships common ancestors in the family shrine of each household.  Temples are built inside homes, as well as in the community.  It is not uncommon to see temples in the middle of a home or just in the middle of a business area.  The family “compound” is bordered by brick or a fence to protect the family from dangerous “influences.”  The children are taught family household chores and religious practices.  Often outside the compound is a fruit garden. We also saw very few “homeless” people on the streets as you see in America.  Gede, our guide, said it is because the government goes into homes to evaluate if the family needs help with food, shelter, or schools.  Then they are given the help they need and help to find a job.  They try to “take care of one another,” he explained.   Again, going along with the necessary foundation focusing on family and religion, taught in homes throughout the country.  Probably a reason that crime is so low in Bali, as well.

There are many statues and symbols of their  “Gods” who are protecting them from evil spirits.  In the temples, one of the Hindu faith only would enter the temple to find “balance” and leave from an exit door with positive feelings, leaving evil spirits behind.  Rice is applied to their foreheads after one prays to give “positive energy” to your soul. The Balinese offer prayer three times daily for protection, asking for a good day and good fortune.

Balinese Culture and Employment

Most of the Balinese still work in the agricultural sector which includes wet and dry rice fields, cattle and poultry farming, and fisheries.  They work communally organizing themselves from planting time to harvesting in their small communities.  Their work is labor-intense, and their food is primarily vegetables, rice, and fish.  We were impressed by the lean-ness of society.  It was very rare to see anyone from Bali that was overweight or considered obese.  Their culture promotes a more active lifestyle, often out of necessity, as well as lean, healthy foods in the vegetables and “sticky rice” being staples, as well as fish and chicken.  I saw a book entitled, Food and Life, The Art of Nourishment, by Dr. Nadia Volf, which I felt conveyed their spirit of nourishment, so obvious in the people.  “All our life is thus exalted by the magic power of art—for each of our five senses, man has created art.  For the taste buds and taste, cookery—the art of preparing foods offered by nature.  Art that bears us off into dreams, allows us to touch everyday beauties, insists unceasingly on the simple happiness of existing, and wakes in us infinite, previously unimagined possibilities.”  The buffets that we enjoyed were often multi-cultural with cuisine from China, Japan, India, Bali, and Western.

We met a young man who took us around the island for several days, and when asked about their religion and culture, he replied:  “Everybody tries to be friendly.  We know we have one life and want to do good.  We want to be happy with family and friends.  That is the way in Bali.  Try not to get angry, but be patient with one another.  Helps protect us from evil spirits.”  A philosophy I will never forget…

Happy, healthy holidays to you,

 

Terry Polanin, MSN, APN

Family Nurse Practitioner

MedPax: Custom Monthly Supplements

Dr. Michele Couri, FACOG, ABIHM has personally created several customized MedPax™ (individualized daily supplement dosing packs) based on the most common symptoms and conditions patients discuss with Couri Center providers.

Couri girl MedPax™ are available for:

  • Bone Health (Osteopenia and Osteoporosis)
  • Heart Health (elevated cholesterol)
  • Menopause Relief
  • PMS Management
  • Gut Health
  • Mood and Anxiety
  • Stress and Sleep Issues
  • Hair, Skin and Nails
  • Inflammation and Joint Pain
  • Diabetes
  • Athletic Performance

MedPax™ are able to be further customized to each patient’s individual supplement needs to maximize effectiveness and affordability. So, if you have a certain medical issue or constellation of symptoms (other than the ones listed above) that you want resolved, we can customize MedPax™ just for you.

How it works:

After reviewing your medical history and any pertinent lab work, we will make recommendations for appropriate supplements for you. After we meet with you, we will input our recommendations for your personalized MedPax™ securely online to Xymogen®. You will then receive your supplements shipped directly to your house.

MedPax™ Benefits:

  • MedPax™ is convenient. You can easily take your nutritional supplements on the go.
  • It takes the guesswork out of organizing and remembering if you took your supplements.
  • MedPax™ clearly tells you when to take your next dose.
  • You don’t have to ever worry about running out. Your MedPax™ can be automatically sent to you every 30 days.

If you would like to find out if Couri girl MedPax™ are right for you, email info@couricenter.com or call 692-6838 to set up an appointment to learn more. Or if you are tired of buying several different bottles and brands of supplements to achieve optimal results, switch to MedPax™ and let us make it easier and more effective for you to achieve your goal. And our Earth will thank you — less bottles in our beautiful oceans!

 

Why We Recommend an Annual Well-Woman Exam By Terry Polanin, MSN, APN, Certified Family Nurse Practitioner

“Is it true I no longer need an annual pap smear?” This is a very common question of many people, especially since the American College of Obstetrics and Gynecology is not recommending an annual pap smear IF the patient has had NORMAL screening Pap smears in years past. We want our patients to know that the Couri Center does recommend the yearly well-woman visit and exam. Often people think that the “yearly gynecology or well-woman exam” is only about the Pap smear. It is not.

At the Couri Center, we have long believed in providing integrative women’s health care. It is the heart and soul of our practice. To accomplish this, we believe in addressing concerns involving the “whole person” which is far more than just the lab test called the “ Pap smear.” Certainly, we believe that the Pap smear is important and has saved many lives by detecting abnormal cells and HPV (human papillovirus), which can lead to cervical cancer. The incidence of cervical cancer in the United States has been greatly reduced since the development of pap smears in the l940s. So, we are still doing many pap smears for women, especially if they have had abnormal paps in the past. The frequency for women with “normal pap” results has been reduced from yearly to every 3-5 years depending on your age and circumstances. (See article by Dr. Kaleb Jacobs in the Couri Center newsletter). We, at the Couri Center, believe that you should have a yearly well-woman visit and then, if you fall into the guidelines of normal routine screening, we would recommend that your pap smear and HPV virus test (the virus believed to cause cancer of the cervix) be performed every 3 years, at the time of your annual exam. However, if you wish to have an annual Pap smear with the office visit, please inform us when scheduling. We suggest that you talk with your insurance provider to be sure they are covering the actual annual Pap smear. While most cover the yearly exam, some are following the ACOG guidelines for routine screening suggesting less frequent Pap smear testing.

So, what does the yearly “well-woman gynecology visit” include? The American College of Obstetrics and Gynecology (ACOG) has developed guidelines for these visits, depending on the woman’s age. (Well woman task force: Components of the well-woman visit. Obstet Gynecol 2015) Certainly, each visit will include a height, weight, body mass index (BMI to determine the risk for being overweight/obesity), blood pressure, thyroid, breast exam, abdominal exam, skin exam, and pelvic exam (pap smear as indicated). These are areas of the exam that help us to screen for health or medical problems such as hypertension, overweight issues, assistance with smoking cessation as needed, thyroid problems, breast lumps or problems, abnormal skin issues, and gynecological pelvic problems such as an enlarged uterus, ovaries, prolapsed (sagging) pelvic organs causing incontinence, and vulvar /vaginal skin problems. In addition to the physical exam, and depending on your age, we will discuss other areas pertinent to your health such as your lifestyle habits, home/work/family/self “balance”, exercise and eating habits to help assist with normal weight levels, hormone imbalances, and other areas that may be concerning you at the time of the visit.

Ten Reasons Why You Should Have an Annual Well-Woman Examination *

  • Birth Control: Learn about choosing the right birth control method for you, if you are in need of birth control.
  • Cancer Screening: Learn more about breast cancer, colon cancer, and other types of cancer.
  • Vaccinations: Talk with your provider about vaccines against the human papillomavirus (HPV), and other pertinent vaccines for prevention of diseases.
  • Health Screening: Discuss screening for high blood pressure, diabetes, bone density for osteoporosis and more.
  • Depression Screening: Depression is a common but serious illness. The yearly visit is a time to talk with your health care provider about any concerns you may have about depression, anxiety and situational stresses in your life.
  • Sexually Transmitted Infection Screening: Sexually transmitted infections (STI) such as chlamydia, gonorrhea, trichomonas, and genital herpes are infections spread by sexual contact, which can be screened during your pelvic exam at your visit.
  • Concerns about Sex: Discuss questions or concerns you may have about sexual intercourse, painful intercourse, or hormone changes that may alter your response to sex or interest.
  • Weight Control: Learn about ways to control your weight, prevent obesity, exercise, and prevent problems associated with being overweight. (Our dietitian, Leslie Bayer, coordinates our TLC™-Total Lifestyle Programs-at the Couri Center. Ask about a free consultation).
  • Issues With your Menstrual Period: Discuss PMS, painful periods, your first period, heavy bleeding or irregular periods.
  • Preconception Counseling: If you are planning a pregnancy, talking with your provider about ways to have a healthy pregnancy or plans for conception which will include healthy eating, exercise, avoiding cigarette smoking/alcohol/drugs, past pregnancies, and prenatal vitamins. (We, at the Couri Center, do not provide obstetrical care any longer but can refer you to others that do.) *ACOG 2015

Other Reasons: Get help with hormones, menopause issues, (our harmonié hormone pellet therapy) urinary incontinence, (our Emsella treatment) vaginal dryness, (our MonaLisa Touch™ laser for vaginal health), hair and skin issues (laser hair removal, free aesthetician consultations available), medical-grade skin products (NIA24® now available).

So, the next time someone says “you don’t need your yearly pap smear any longer”—you are now better equipped to explain to them the value of a yearly well woman exam and the pap smear routine screening guidelines and the many reasons that your annual visit is very important.

Have a happy, healthy summer!

 

Terry Polanin, MSN, APN, Certified Family Nurse Practitioner

Couri Girl Spring 2018

At the Couri Center, we specialize in women’s health.  With years of advanced medical training and decades of experience, our success is easily measured in volumes of patient praise.  From traditional gynecology & surgical procedures, integrative health programs & aesthetics, take comfort in knowing you can trust the Couri Center with:

  • Well-Woman Exams
  • Urinary Incontinence
  • Menopausal Management
  • Family Planning
  • Contraception
  • Pap Smears
  • Pelvic Ultrasounds
  • Treatment of Heavy Menstrual Bleeding and/or Fibroids
  • Treatment of Abnormal Pap Smears
  • da vinci® Robotic Surgery
  • MonaLisa Touch™ Vaginal Laser
  • harmonié Bioidentical Hormone Replacement Therapy
  • Food Sensitivity Testing
  • Customized Nutritional Supplements
  • TLC™ Integrative Lifestyle Programs
  • Weight Loss Programs
  • Infrared Sauna Therapy
  • Aesthetic Studio:  Laser Hair Removal, Wrinkle/Age Spot Removal, Scar & Stretch Mark Removal, Rosacea & More
  • Injectables:  BOTOX®  & KYBELLA®
  • LATISSE®
  • Pro-Niacin® Skincare by NIA24®

New patients welcome!  Schedule today: 692-6838  

Exciting News for Hormone Therapy By Terry Polanin, MSN, APN

The year 2017 brought us exciting news for menopausal and perimenopausal hormone replacement therapy. We have all heard, over and over, the results of the WHI (Women’s Health Initiative) study from the early 2000s, which brought with it many negative statements about menopausal hormone replacement therapy (HRT). Many of those results, found in older women on specific synthetic hormone therapy, were incorrectly extrapolated and applied across the board, to women of ALL ages, which resulted in many women unfairly frightened and inappropriately removed from their hormones!  Since then, many studies have shown the positive impact of HRT on the quality of life and health benefits for perimenopausal and menopausal women. Most recently, in July of 2017, the North American Menopause Society (NAMS) has issued a Position Statement on Hormone Therapy affirming the effectiveness and safety of hormone replacement therapy.

Founded in 1989, The North American Menopause Society (NAMS) is North America’s leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging. Its multidisciplinary membership of 2,000 leaders in the field – including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education – allows NAMS to be uniquely qualified to provide information that is both accurate and unbiased, not for or against any point of view. The NAMS research and recommendations are highly respected and endorsed by numerous notable organizations.

Hot flashes and night sweats are very common symptoms of menopausal women. But they may also be seen in women in peri-menopause (time prior to menopause). These symptoms may impact the quality of life and will often bring them to our office seeking guidance and relief. Moderate to severe vasomotor symptoms (flashes, night sweats) affect a high percentage of women and may last for years. Using an evidence-based research approach, the NAMS issued guidelines for treatment in 2017.

Systemic hormone therapy, specifically estrogen therapy, is recommended as long as a person has no contraindications. The NAMS recommends hormone therapy for women, most favorably, starting HT prior to the age of 60 and /or within 10 years from the onset of menopause. For a woman with a uterus, it is necessary to also give progesterone to prevent any postmenopausal bleeding or other serious complications when using systemic estrogen hormone therapy. If a woman does not have a uterus, then it is acceptable to give estrogen therapy alone to provide relief, but progesterone can also be given if symptom relief is not obtained from estrogen alone.

At the Couri Center, we believe our harmonié pellet program provides optimum relief for menopausal and peri-menopausal women. We also discuss other bio-identical hormones (hormones most like your own natural hormones) for relief of hormone imbalance and menopausal symptoms. People often ask if there is a limit to the duration a person can use HRT—currently, there is no evidence to support routine discontinuation at a specific age or length of time, based on the most recent research and evidence.

Vaginal dryness, vaginal or vulvar irritation, painful intercourse and sometimes vulvar burning or pain with urination (now commonly referred to as Genitourinary Syndrome of Menopause), are also very prevalent symptoms of peri- and menopausal women. Dr. Jacobs, in our January/February newsletter, wrote an article about this syndrome and some of the current remedies to relieve symptoms. The NAMS Position Statement recommended low dose vaginal estrogen, preferably estradiol, as well as vaginal moisturizers and nonprescription lubricants. At the Couri Center, we also recommend the use of coconut oil daily and prior to intercourse, but first test on your arm (and your partner) prior to using in the genital area. Often, systemic hormone estrogen therapy will help to relieve vaginal dryness and other GSM symptoms. Optimal relief will likely be from the vaginal estrogen, preferably Estrace (estradiol) cream, Vagifem (estradiol) vaginal tablets, or compounded Estriol cream.

The recent Position Statement is a reaffirmation of the effectiveness and safety of hormone replacement therapy when helping people with vasomotor symptoms (hot flashes, night sweats) and for genitourinary symptoms (overactive bladder, bladder leakage, incontinence with laughing or sneezing).

If you are suffering with any of these symptoms, please contact your health care provider at the Couri Center and schedule an appointment for evaluation and to discuss treatment options. Together, let’s make you the best you can be and feel for a positive, healthy 2018.

 

To your health,

Terry Polanin, MSN, APN

 

Reference: Menopause 2017 Jul: 24:728

Welcoming NEW Gynecology Patients

 

Welcome to the Couri Center for Gynecology & Integrative Women’s Health.  We are accepting NEW patients and look forward to meeting you!

At the Couri Center we specialize in women’s health.  With years of advanced medical training and decades of experience, our success is easily measured in volumes of patient praise.  From traditional gynecology & surgical procedures to integrative health programs and aesthetics, take comfort in knowing you can trust the Couri Center.

LEARN MORE ABOUT THE COURI CENTER HERE

If you would like to schedule your new gynecology visit with one of our providers, please call 309-692-6838.  To expedite your appointment process, please complete the below forms and return them to us. 

What do I need to bring to my appointment?

To allow us to better serve you, and expedite your check-in process, we have included the below forms for you to fill out at your convenience at home:  Patient Information Form, Gynecologic Questionnaire and Medical Release. Also, please include a copy of the front and back of your insurance card. Please complete and return all forms to:  Couri Center, 6708 North Knoxville Avenue, Suite 1, Peoria, Illinois, 61614 or email to info@couricenter.com.  Unfortunately, if we do not receive these forms two weeks prior to your appointment, we will ask you to reschedule. We take pride in providing the utmost in compassionate and comprehensive gynecologic care and your paperwork helps us do just that right from the start.

Thank you so much, we look forward to meeting you!

Regards,

The Couri Center for Gynecology

If you are a NEW PATIENT: Please plan on arriving 15 minutes early.

Please complete the below (3) forms as follows:

A.  Print all (3) forms and fill in by hand. Then either:

  1. Mail to our office.  Or
  2. Scan completed documents and email to info@couricenter.com.

OR

B. Complete forms online as .pdf:

  1. Please open each form and save it on your computer, preferably add your last name to the file name while saving
  2. Open the saved documents and complete each fill in form
  3. Save completed documents.
  4. Email completed documents as attachments to:  info@couricenter.com

 

Lessons from the Japanese by Terry Polanin, MSN, APN

Last summer I had the privilege of traveling to China and Japan with my husband who attended an international conference. I felt compelled to share some of my impressions of the Japanese culture, as we Americans can learn much from their healthy, gentle, well-ordered customs.

Our time in Japan was limited to Tokyo, one of the most modern cities in the world. We toured the city and took the “bullet train”, traveling about 200 mph, up to Mount Fuji. We were able to view many smaller towns outside of Tokyo, taking a small boat trip and gondola ride up a mountain. The people were friendly, clean, and very polite in welcoming us Americans. I reflected back to the early 1940s and the conflict, violence, and disruption that both our countries experienced to now, nearly 80 years later, our allegiance.

During our travels, I was continually in awe of the health of this society, and its culture of rich traditions grounded in gentleness, respect, and yet mixed with futuristic technologies. The Japanese people are lean- walking or biking most everywhere (other than public transportation) and they seem to be a peaceful, well-ordered society, appreciating the rich traditions of their forefathers.

The Japanese faith has 3 religions: Shinto, Buddhism, and Christianity. We had the opportunity to visit both a Buddhist and Shinto temple. Both temples had many rooms of ornate, gold architecture and “gods” which they worship. Shinto is the indigenous and oldest faith of the Japanese, as old as Japan. This religion is deeply engrained in the Japanese culture. Religious preaching is not common though the Japanese architecture and pop culture tend to utilize Shinto philosophy for inspiration. Shinto is about kami or sacred spirits. These sacred spirits or gods take on many forms such as animals, plants, lakes, trees, and rivers. Shinto views humans as basically good kami and evil in the world as bad kami. The whole purpose of the Shinto religion is to keep evil spirits away. We took part in two “purifications”—one was a pool to drink from (or just wash ones hands) for the protection of your physical health. The other, a ritual we performed, was to protect and promote emotional health.   Shintologists worship and appreciate nature with the belief that carrying symbols for good fortune and good health will provide good luck to their family and friends. The Japanese are a superstitious culture with many ornate shrines for various kami that they worship. The shrines and temples certainly projected a calm, peaceful presence that is appreciated in Japan by natives and tourists alike.

It’s no surprise to me, after observing the way Japanese eat and take care of themselves, that they not only age well, but experience profound longevity with the average age of death being 87 for females and 84 for males. The Japanese elderly are held in high esteem and highly respected into their senior years- another custom, I believe contributing to healthy aging. A popular book, “Japanese Women Don’t Get Old”, identifies the value of healthy aging in Japan and mentions eating breakfast as a contributing factor as well. Breakfasts and dinners are very similar and usually include many cooked (not fried) vegetables, grilled fish, white (not brown) rice, sushi and fruits. It was very rare to see any native in the area of Tokyo we visited that would be considered overweight or obese. It was also rare to see fast food restaurants, although the “Golden Arches” were in both China and Japan. In Tokyo, “fast food” vendors consisted of mostly small, unrefrigerated carts on the streets or in the open-air store fronts, often with meats (hip bones, etc.), vegetables, and “dumpling” stands.

Healthy aging in Japan can be directly contributed to their lifestyle.  They enjoy healthy, lean, non-processed diets, daily physical activity, rituals of spirituality, and meditative habits. They maintain well-ordered lives and educate youth to value the wisdom of the elders, and focus on family life.  We Americans could re-visit these habits and learn from the Japanese.

Navesta,

Terry Polanin, MSN, APN

Family Nurse Practitioner

 

 

 

Sage Advice By Terry Polanin, MSN, APN

I know there have been many proud parents of graduates this spring and in years past. Recently, I had the blessing of attended my daughter’s graduation as a Physical Therapist and was so impressed with the speech from the Chairman of the Board of Trustees at Bellarmine University in Kentucky, that I wanted to share some insights I gleaned.

As Dr. W. Patrick Mulloy spoke to the graduating class, his words seemed applicable to not just the graduates, or our children, but to each of us as we walk through the stages of life.

We live in some very tumultuous times in the United States today. We have seen much division in our country and around the world. He challenges us to apply three characteristics that will be required as we go forward in this century:

  1. Be creative. We no longer live in a world where things are black and white. Use your creative brains to develop new techniques, new ideas, new theories, new ways of living and surviving in your personal and professional lives. Don’t be afraid to embrace change and to lead the way for change in your lives.
  2. Be courageous. It will require courage to go out and enhance the world, your professions, and your lives. Have courage to do that.
  3. Be flexible. Be able to adapt to situations, to be flexible when asked to lead or follow. Be flexible in your thinking which may be different than you have thought in the past. Be open to adapting, as you will need to do so in our world today. Always embrace truth.

He also reflected on educating our students, our children. Here are some of the suggestions he spoke of in regards to educating and mentoring our younger generation:

  • Love them. Appreciate them and let them know.
  • Set high expectations for them. They may not always achieve them but they will have tried because you expected them to do so.
  • Hold them accountable. Don’t let them quit. Help them to keep trying and be responsible for their actions.

Personally, I happened to think that this is exactly what good parenting is, as well.

Lastly, he suggested two points for all of us to consider:

  • We must stop the “comfort of opinion”.
  • We must embrace the “discomfort of truth and thought” in order to better our lives and the lives of those living in our country now and for generations to come.

With all that said, as we all go forward in the 21st century, when things seem difficult and uncertain—“Find the eye of the hurricane and go there…give yourself a moment to step back, reflect, think, and find your peace.”

Wishing you all your “eye of the hurricane”, Terry Polanin, MSN, APN

A Vaccine To Prevent Cancer—New Updates By Terry Polanin, MSN, FNP-BC

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For the first time in our lifetime, there is a vaccine to prevent cancer, specifically cervical cancer! I would like to provide an update on the latest advances in the HPV vaccines for the human papillomavirus, commonly known as HPV. Cervical cancer is preventable. HPV infection causes cervical, vaginal, and vulvar cancers in women; cancer of the penis in men, and genital warts in both females and males. HPV is sexually transmitted. The Advisory Committee on Immunization Practices (ACIP) has recommended the vaccination against HPV since 2006. The HPV vaccines are highly effective, safe, and very powerful in preventing HPV infections and HPV-related cancers.

In 2006, the vaccine was approved and licensed for use in the United States for females between the ages of 9 and 26. By 2011, it was also recommended for males ages 9-26.  In those years, the vaccine, Gardasil, targeted four types of HPV viruses while the vaccine Cervarix targeted only two types of HPV viruses. Over the years, most providers recommended Gardasil, as it targeted four types of HPV viruses, two of which were considered high risk for the development of cervical cancer—HPV 16 and 18. As of 2016, there is a “9 valent HPV vaccine” called Gardasil 9, now offered in the United States. Incidentally, I heard a speaker from the Center of Disease Control last fall stating that once fully available, Gardasil 9 would be the only vaccine recommended going forward. The ACIP committee does recommend initiation of the HPV vaccine at ages 11-12, often with a school physical. Administered in the muscle of the upper arm, the vaccine is given to both females and males in a 3-dose schedule. The second injection follows in 1-2 months and the third injection being given 6 months later.

The good news is that the vaccine is now recommended in a 2-dose schedule! If children receive the vaccine under the age of 15, it only requires TWO injections instead of the three previously recommended, unless they have medical reasons such as immune deficiency which would still require 3 doses. The first dose would be given to boys and girls at age 11 -12 (could start as early as 9 years old). The second dose would be given 6-12 months later. Recent studies have found that two doses work as well as three in preventing the HPV infection. If adolescents were 15 and older when they received the first vaccine, they should still follow the 3-dose schedule. The vaccine is not recommended during pregnancy. Check with your insurance company to determine your coverage of the vaccine. Your primary care providers, pediatricians, and local health departments provide the vaccine.

Lastly, please get your screening pap smears to determine if you have the HPV virus or abnormal cells that could lead to cervical cancer. This is the only way to determine if you have the HPV virus. Talk further with your health care provider if you have concerns or questions. Also, please consider having your children and loved ones vaccinated against this virus. Remember that HPV can be prevented if people are educated about the risks of unprotected sexual encounters, the value of abstinence, the use of condoms with sexual activity, and this vaccine that can prevent several types of cancers. Talk to your children about the risks of premarital sex and consequences that can last a lifetime, emotionally and physically.

To your health,

 

Terry Polanin, MSN, FNP-BC