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Here’s to Your Health

An Action Plan for Health – New Year New You

Step one of a successful resolution?

Put it in writing!

Make out an Action Plan.

What are your New Year resolutions? Write them down, share them with friends and family who are great cheerleaders. (Along with making realistic and achievable goals -see tomorrow’s post on making resolutions that stick), going public and finding others to cheer you along as they pursue their resolutions is right up there as a component in achieving success.

Don’t worry if you don’t start January 1, set another start date. The Russians celebrate the Old New Year January 14th, the Chinese New Year is February 8th, or perhaps set a date special to you?

What should you include in your Action Plan?

Include your long-term goals, how you will measure your success in those areas, what your goal for this month is, and what actions you will take this week to achieve this short term goal.

Below are the  basic components of the action plan:

1. Long-term goals
Establish your short-term and long-term goals so that they have a tangible reward as well as the loftier health goals and write those on the top of your action plan.
 While we’re often motivated to make resolutions because of a recent medical diagnosis, like high cholesterol, the actual goals often tap into emotional and spiritual health. Consider barriers to achieving your wellness goals.

2. Make an appointment with your health and keep it.

If your plan states that you’re going to go to the gym or take the dog for a walk don’t cancel that appointment for another function because it seems less important. You have an appointment with your health, and that IS important.

The action plan asks you to identify when and how much of something you plan to do. Are you more likely to get up in the morning and walk? If you put off the exercise until the evening will it never happen?

3. Be specific about how much time and energy will go into meeting your weekly goal.

A concrete example – you set a goal to eat a more balanced diet, but then don’t actual turn that intention into action. Be very detailed in the action plan. Write into the plan a dedicated time to plan meals and snacks, to shop for fresh produce and to prepare the produce in one sitting so that you can use it for those planned healthy meals.

I think about the fruit salad in a little lemon juice my own mother always seems to have in the fridge ready to go, or my friend Trish who keeps salad fixings chopped and cleaned ready in separate clear storage containers to be tossed together at a moment’s notice for a healthy meal.

Addressing what will appeal or work for the individual is key. If those fresh veggies and fruits already prepared and ready to eat are they less likely to end up rotting in the veggie draw and then making their way to the compost?

4. Be realistic and flexible about your action plan. Allow wiggle room to be successful.

A crucial part of the action plan is reflecting on the steps you plan to take and being realistic about whether you’re going to attain that. If you know that week after week you say you’re going to track what and how much you eat, after all you know this is a successful strategy for many, yet week after week you fail- reassess!

What is your confidence level that you could track for one day out of seven on a scale of one to 10?


Good. How about two days?

An eight or nine.

What about three days of tracking?

Once your confidence level dips below a seven rethink your goals.

The emphasis is on being successful and that success breeds success. If you can be successful for three days this week maybe next week or the week after your confidence will be higher so that you can accomplish four days of tracking.

A sample action plan:

My long-term goal:  Improve my cardiovascular health
Why? To be there and be healthy for my children and see them become adults

Measurements of success

ex. Climb five flights of stairs without getting out of breath, reduce cholesterol:
1. Reduce total cholesterol level (I have one measurement from about a year ago. Time to schedule a doctor’s appointment)

2. Improve time at the Saguaro East 5K walk

3. Get stronger and more flexible. Perform squats with good form and perform basic sun salutation with ease.

4. Lose 10 pounds

Goal for the Month:

Address overeating challenge & up physical activity (After reflection I realize part of my weight gain over the past few years is due to a change in eating habits, growing portion sizes, late night snacking, and finishing my children’s food AND a reduction in physical activity)

Steps I can take to accomplish my monthly goal:

1. Address late night snacking by addressing thirst with water and tea rather than food
2. Increase number of steps by going on family walk in the evening (Family New Year’s Resolution)
3. Reduce going back for seconds by slowing down eating, increasing water intake

Week 1

This week I will: when feeling tempted after my evening meal to snack, I will drink a cup of herbal tea and/or water and if still feeling like a snack, have a piece of fruit.

Because: I will feel less guilt about my late night snacking and it’ll probably help with late night heartburn

What: Satisfy thirst with liquid not food

How often & how much: At least 5 evenings/week

When: evening

Confidence level:  1  2  3  4  5  6  7  8  9  10       (confidence level less than 7? Rethink!)

All month we’re providing tips, advice, recipes and inspiration to help you meet your New Year resolutions with the New Year, New You campaign.

Join our New Year New You Giveaway and you might receive even more!

Prizes include A Fitbit Charge HR Wristband, or a nutritional assessment to get you on the path to clean eating, or maybe a exercise assessment to get you on track for success, all with our expert professionals.

Check here for more information.
giveaway, tucson, new year, new you

Perfection is Overrated: Staying Healthy and Sane Over the Holidays

Women, this is not the time to buy that issue of Martha Stewart’s Living, or to pore through the latest issue of Real Simple (it’s not really that simple…)You’ll risk feeling all kinds of inadequate as you read lists of '10 Perfect Holiday Hostess Gifts.' Click To TweetPhotos of elaborate centerpieces will have you eyeing your own cluttered dining room with loathing, or at least guilt.

The best way to hold it together over the holiday season is to keep it simple (with a lower case “s”) and keep your eye on the prize—family, friends, health, happiness.  It’s not about having the perfectly decorated home, the ideal gifts for your kids’ teachers, or a pile of gorgeously wrapped presents for your family.

Rushing around to take photos for your holiday card midway through December? Do a New Year’s greeting instead. Everyone will look happier and more relaxed if the photos aren’t taken under duress. Or forget sending cards altogether. You can break your own rules if they are causing you more stress than pleasure.

If you do host gatherings, focus on being genuine in your hospitality, not “perfect”. Perfection is an unattainable illusion and it takes away from your ability to really be present with people you’ve invited into your home. Our house is typically chaotic, never entirely clean, and undeniably imperfect. Time and again, guests have said that our desire to host parties gives them confidence to host their own, since we don’t wait until everything is “just so” (the kitchen fully painted, the laundry all folded and put away, the weeds pulled) to have people over. At first I wondered if I should be offended that friends commented  this way on the state of our house, but I quickly took it as a true compliment, and I felt proud that I could inspire others to share their homes, their lives, in all their beautiful imperfection.

Reminding ourselves that was are “good enough ‘ (hosts, friends, parents, workers) is important, especially at this time of the year when there is so much pressure to attend and host events, buy or make gifts, and look like we’ve got it under control.  And allowing ourselves to be “real” about what we can and cannot do, what we do and do not feel capable of, serves to remind others that they too are “good enough” just as they are.

10 Tips for Eating Well at Thanksgiving

Are you looking forward to a big Thanksgiving meal?

Are you also worried that you might overeat? If so, try some of the Nutritionista aka Laurie Ledford RD’s  tips to get you through the holiday.
10 tips for eating healthy this thanksgiving
10 Tips from TMC #RegisteredDietitian on eating happy & healthy this #Thanksgiving Click To Tweet

1. Have at least one healthy dish on the table

Whether you are the host or a guest, be sure to prepare (or bring) at least one healthy dish. This will be your go-to food when everyone is reaching for seconds. If it’s full of colorful vegetables, then you can feel good about serving another spoonful of nutrients onto your plate. See our next blog post for tips.

2. Check the size of your plate

Using a smaller sized plate will help you eat less. Try a salad plate or an antique dinner plate, which is usually much smaller than a modern one.

3. Be careful of which part of the turkey you eat

If you choose light meat instead of dark meat turkey, you can save yourself about 60 calories per serving.

4. Don’t eat the skin!

Be sure to remove the skin from your turkey before eating it. The skin is full of saturated fat and calories.

5. Go easy peasy on the gravy

The gravy can also add a lot of fat and calories (and salt).

6. Whole grains over buttery croissants or cornbread

Choose whole grain rolls over croissants or cornbread to spare yourself even more fat and calories.

7. Beware the veggie casserole

Load up on steamed or roasted vegetables instead of vegetable casseroles.

8. Get wrapped up in conversations

The more time you spend talking, the less opportunity you will have for mindless eating.

9. Get the recipe

If you try a dish and think it’s the best thing you’ve ever tasted, and you feel you have to eat more, more, more… Stop, savor the last few bites, and then ask for the recipe. If you know you can have it any time you want, there’s no need to overeat now.

10. Allow yourself to enjoy dessert

(Or whatever your indulgence of choice happens to be). This is a festive time, so you shouldn’t have to feel deprived; however, you should still remember that all good things should be enjoyed in moderation.

Did Aunt Betty bring the best dressing ever to #Thanksgiving? Don't stuff yourself! Ask for the recipe. More… Click To Tweet

Do you believe this Breast Cancer Treatment Myth? TMC One’s breast oncology surgeon weighs in on cancer diagnoses

Throughout the month of October, Breast Cancer Awareness Month, we tapped into the expertise of Dr. Michele Boyce Ley, TMC One’s  board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. We’ve shared information with you including how to assess your breast cancer risk, asked her to weigh in on breast cancer myths about breast screening including mammography and self-breast exams and had her tell us what to do – and consider – if you find a lump in your breast.

To round out this blog series, we asked her opinion on a story that was recently released by the Susan G. Komen organization titled: Debunking Five Common Myths About Breast Cancer Treatment.

We decided to focus on the three Dr. Boyce Ley thought would be the most meaningful.

Breast Cancer Treatment Myth #1

I don’t have time to get a second opinion because I must begin treatment as soon as possible.

BDP36480First – that second opinion issue. “Second opinions are important for a couple of reasons,” said Dr. Boyce Ley. “Maybe the physician you initially went to isn’t a breast specialist. Or maybe they’re just not a good fit for you. Women need to know that it’s OK to find another doctor! Don’t worry about offending your current doctor or the person who referred you to them. It’s your health. People need to feel empowered to get multiple opinions.” Dr. Boyce Ley added that second opinions are also great because perhaps the first time around, you didn’t quite understand all of the information. Or maybe one physician has a treatment option that another doctor didn’t offer you.

Second – how soon after diagnosis should treatment start? The National Breast and Cervical Center Early Detection Program guidelines recommend starting treatment within 60 days of being diagnosed. Dr. Boyce Ley said that timeframe is readily accepted by most people – that two months is the maximum amount of time a patient should wait before starting therapy. She added that most patients in Southern Arizona begin therapy within a month of being diagnosed. “I think this is really hard for patients,” she said. “They feel like it’s an emergency, but realistically, it takes years for the cancer to grow. A couple of weeks in the life of breast cancer doesn’t change the outcome. Even a patient with an aggressive cancer will usually start therapy within a week or two.”

Breast Cancer Treatment Myth #2

Everyone diagnosed with breast cancer dies from breast cancer or everyone diagnosed with breast cancer survives.

Dr. Boyce Ley stressed that breast cancer is not a death sentence. With modern treatment, an estimated 90 percent of women with early-stage breast cancer will go on to live five or more years after diagnosis without it recurring. Of course survival rates vary based on what stage the cancer is in and what kind of behavior the breast cancer has. According to the National Cancer Institute, there are about three million breast cancer survivors in the United States. However, more than 40,000 women and more than 400 men still die from breast cancer every year. The reality is that while most people will survive breast cancer, unfortunately some patients will not.

Breast Cancer Treatment Myth #3

Chemotherapy and radiation therapy are more harmful than helpful.

Decades of breast cancer research have proven that chemotherapy and radiation therapy saves lives. “We know that these are two things that contribute to better survival,” said Dr. Boyce Ley. “Historically, doctors have gone from giving no chemotherapy to giving too much chemotherapy and now we’re working hard to give patients just the right amount.”

She added that doctors these days have lots of ways to analyze a patient’s cancer to identify more clearly what treatment would benefit the patient. This allows a treatment plan to be tailored to that specific patient. “We have ways to identify which patients are going to benefit from which targeted therapies,” said Dr. Boyce Ley. “The same can be said for targeted radiation. We have the ability to target one part of the breast where the cancer is and avoid radiation damage to the heart and lungs. Those are things we didn’t have available to us 15 years ago.”

Dr. Boyce Ley is located at TMC One, 2424 N. Wyatt Drive #100, on the TMC campus. Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
(520) 324-1286 to review qualifications and schedule an appointment.

You’ve found a lump in your breast. Now what?

WhattodoifyoufindalumpDr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program, has shared her expertise with us over the past few weeks about how to assess your breast cancer risk. She also helped us clarify some myths about breast screening including mammography, while stressing the importance of being aware of changes in your body. Having a good gauge on what your breasts normally feel like will help you know when something isn’t quite right.

So – what if you find something?

1. Connect with your primary care physician

Dr. Boyce Ley said your best bet is to start with your primary care physician. Don’t have one? Chances are you’ll find one you totally connect with at TMC One. Your physician will typically order breast imaging. A mammogram and ultrasound can solve many questions without escalating it to a breast specialist.

2. Determine if it is time for a breast specialist

When should your first call be to a breast specialist? If you notice changes with your nipple or if your breast has suddenly changed color, size, shape or texture. Dr. Boyce Ley said she often sees women who, upon finding an abnormal mass in their breast, instantly jump to a worst case scenario – “who will take care of my kids when I die?” She advises women in this situation to keep this in mind: “Most of the time, it’s not going to be cancer,” said Dr. Boyce Ley, “but that still means you should pursue it. Even if you have an abnormal screening mammogram, the chance of finding a cancer is very small. A majority of the time, we may need to do further testing but oftentimes it turns out to be something benign like a cyst or overlapping breast tissue. Those are the two most common things we find.”

The take away message: Statistically, it’s unlikely that the mass you feel is going to be cancer.If it is cancer, it’s likely small and easily treatable.

3. Get a second opinion

If the initial imaging shows the mass is benign, but your physician recommends a biopsy, Dr. Boyce Ley said it’s not a bad idea to get a second opinion before getting a biopsy. Sometimes the recommendation to biopsy may differ from physician to physician and some things can be followed with imaging and exams. You may feel an urgency to get an answer but taking your time to make a good choice is important. However, Dr. Boyce Ley cautioned that if a biopsy is recommended for you, follow through with it because it could save your life.

4. Take a little time to assess and make a game plan

“So many women come in with ideas that they’ve gotten from their friends and neighbors instead of medical professionals. They’ve already decided that they’re dying or that they need a double mastectomy. As a breast surgeon, it can be very hard to unwind that thinking. Is it important to get into someone quickly? Yes. But breast cancer is not an emergency. A difference of one or two days – even a week – is not going to make a difference with your treatment. In the age of quick information that we live in, while it’s possible to find information easily, it’s not necessarily helpful.”  Dr. Boyce Ley gave this advice: “Get the facts. Figure out your options. And then come up with a game plan that’s best for YOU.”

Dr. Boyce Ley is accepting new patients!
She is located at TMC One, 2424 N. Wyatt Drive #100, on the TMC campus.
Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
(520) 324-1286 to review qualifications and schedule an appointment.

Screening and mammography myths – what’s your “normal?”

BDP36471We are continuing our weekly blog series with Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. Last week she shared with us highly valuable information about how to figure out if you’re really at high risk for breast cancer or not.

This week we’re focusing on how to sort out truths vs. myths when it comes to screening and mammography.

As women, we’re told to do our self-breast exam “when we pay our rent.” Or “on the same day every month as our birthday.” There are even apps to remind you. Most of us know we should do them. But the reality is, we don’t.

Are self-exams encouraged? And should you really be doing them? “Absolutely,” said Dr. Boyce Ley. “We want women to become really self-aware when it comes to their breast health. We want them to do monthly self-exams so that they become familiar with what their normal is. If they do regular checks and know what their breasts feel like, it’s easier to discover when something feels out of the ordinary. If you’re aware of it, you can monitor it and get in to see a breast specialist if necessary. When it comes to self-exams, it’s best to do it the first week after your menstrual cycle.”

Dr. Michele Boyce Ley Board-Certified, Breast Surgical Oncology Medical Director, TMC Breast Health Program

Dr. Boyce Ley explained that there is chatter in the medical world that monthly self-exams may cause unnecessary imaging and biopsies. One of the many challenges, she explained, is that while there are a lot of risk factors we know about, there are also a lot of risk factors we don’t know about. It can be difficult to definitively decide that a 35-year-old, for example, should have a mammogram. “That’s when it’s appropriate for that patient to see a breast specialist,” she said. “If you’ve tried to figure out if you’re considered high risk or not, and you’re still unsure, or if you just need guidance to sort it all out, have a breast specialist help you,” she said. If a woman is identified as high risk, then imaging starts earlier.

What about the risk of being exposed to so much radiation during a mammogram?

It may be recommended that younger people who are identified as high risk get mammograms every other year instead of annually at first. Or perhaps your doctor wants to combine a mammogram with an MRI. “Generally, radiation risks aren’t any higher than they were with regular film screen mammograms from 15 years ago,” said Dr. Boyce Ley. “MRI is a test without any radiation.”

There are 2D and 3D mammograms. How do I figure out which kind I need?

Film screen mammography is a thing of the past. These days, all mammography is done digitally. A 2D, or standard mammogram, captures all of the layers of the breast tissue stacked on top of each other. During a 3D mammogram, the x-ray camera rotates around the breast, getting a picture of multiple layers of the breast. Those layers can then be separated out for an even more precise view. For a majority of patients, standard digital mammography is still very good. Doctors have found, however, that for all patients, especially those with dense breasts, 3D mammography allows them to do fewer call backs. That means that there is a smaller chance that you’d have to be called back in for a follow-up mammogram or ultrasound. “The detection rate for cancer is higher with 3D mammography, as it allows us to find more small cancers,” explained Dr. Boyce Ley. “The downside is it can cost more.”

At TMC for Women’s Breast Center, both 2D and 3D mammography is performed. If you’re considering a 3D mammogram, be sure to check with your insurance first to see what it covers.

I have breast implants. Do I have to do anything differently?

No. The screening recommendations are the same. Dr. Boyce Ley said that implants can distort the breast tissue. In some cases, implants can make it easier to find a lump by feeling the breast tissue during a monthly self-exam. On the flipside, in some cases, it may make it harder to find a lump by imaging since the breast tissue is being pushed around by the implant. It can be difficult to visualize all the breast tissue since the implant often distorts it.

Does where I get screened matter?

Yes, according to Dr. Boyce Ley. Before you schedule your mammogram, do your research. Ask if your scan is going to be reviewed by a breast imaging specialist or radiologist with a specific focus who is able to give you an accurate interpretation. “You want to have your breast imaging read by someone who almost exclusively does mammographic imaging,” said Dr. Boyce Ley. “There are so many changes in technology and what we learn about the breast. It’s important to have someone who is highly experienced.”

Dr. Boyce Ley recommends asking a few questions when you call to schedule your appointment. Ask things like, “Can you tell me about your radiologist? Can I look them up online? Are they fellowship trained in breast imaging or are they a general radiologist? What percentage of their time do they read mammograms?”

At TMC for Women’s Breast Center, all of our radiologists are trained as general radiologists and then receive specialized training in breast imaging. Additionally, our lead radiologist, Dr. Matthew Bell, as well as Dr. Shayna Klein are both fellowship trained in breast imaging. All of our radiologists must keep their training current, so you can be confident that if you get a mammogram at TMC for Women’s, it’s being read by clinicians who are specially trained in reading mammograms.

Dr. Boyce Ley is accepting new patients!
She is located at TMC One, 2424 N. Wyatt Dr. #100, on the TMC campus.
Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075.

Spread the word about screening mammograms and the FREE screening mammograms available to uninsured women with our latest photo contest.


Thinking pink for October and assessing your breast cancer risk

October is recognized as Breast Cancer Awareness month, and with so much information readily available under the “pink cloud,” we agree with you that sometimes it all can be overwhelming. So your grandma and your aunt had breast cancer – but your mom didn’t. Are you considered high breast cancer risk or not? What is the magic age for a mammogram these days – is it still 40? What’s this I hear about starting at age 35? And with all the attention about Angelina Jolie’s recent double mastectomy, is that really the only way to ensure that you never fall victim to this devastating disease? With an overload of information available at your fingertips about breast cancer, what’s the best way to dissect it all?

We sat down with TMC One’s new breast oncology surgeon Dr. Michele Boyce Ley. She’s a board-certified breast cancer surgeon and medical director of TMC’s Breast Health Program. Dr. Boyce Ley brings high-level, compassionate specialty care to TMC’s well established and respected program. We asked her to break down the most important things you should know about breast cancer and we’re going to share her thoughts in a new post each week throughout the month of October.

First up: that high-risk question.

As women, we are all at risk of getting breast cancer. Yes, men are also at risk. But simply being a woman is the number one risk factor. Others include:

∙ getting older
∙ family history
∙ not having children or having children after age 35
∙ receiving hormone replacement therapy
∙ obesity
∙ lack of exercise
∙ more than four alcoholic drinks a week

Let’s focus on that family history for a bit. Dr. Boyce Ley explains the key here is if multiple people from multiple generations in your family have been diagnosed, then you’re considered high-risk. “If your aunt had breast cancer when she was 65, for example, it’s probably not as important as if your mom had breast cancer at age 45,” she said.

Additionally, there are some easy-to-use scoring methods online to help you figure out if you’re high-risk or not. Dr. Boyce Ley is a fan of the bright pink website that offers a user-friendly tool. TheNational Cancer Institute also offers an online assessment. Still not sure? It’s best to get established with a breast specialist to assess your risk and what to do about it. A breast specialist can also help you figure out your breast density which oftentimes can be another risk factor.

Genetic testing is also an option, but proceed with caution. It’s not for everybody, and there are lots of caveats to it. Dr. Boyce Ley says it really needs to be done by a breast health specialist. Testing used to be limited to just testing for the BRCA 1 and 2 genes. Now there are numerous companies which offer genetic testing for up to 25 different markers. Certainly good information to have, but oftentimes it turns into a case of “We have this info. Now what do we do with it?”

While these mutations have been identified, it takes a highly trained team of clinicians to know how to interpret the results. Genetic testing can make a big difference in the treatment planning but it’s not a one-size-fits-all approach. “The testing can be helpful, but it’s not helpful in the same way for every person,” said Dr. Boyce Ley.

“I always tell my patients who want to pursue genetic testing this: Let’s think this through. If you get the testing done, and you get these results, what are you going to do about it? Your motivation might be to protect yourself or simply to help your children figure out their risk.”

Dr. Boyce Ley warns, however, that testing can have implications for an entire family. “Sometimes there is guilt associated with it if people realize they have passed this gene on to their kids. This isn’t like getting a blood test and finding out you have high cholesterol. It’s a bit more complex than that,” she said. That’s why it’s important to sit down and talk with an expert. Insurance coverage of genetic testing has gotten measurably better with the exception of Medicare, which is more restrictive in covering the cost.

Bottom line: Have a plan before you get genetic testing done.

Doctors continue to develop a better understanding about what characteristics constitute a high-risk patient, and there are an assortment of new drug therapies in the pipeline that work to reduce a patient’s risk. “Just because you’re identified as high-risk doesn’t necessarily mean you need an invasive procedure,” Dr. Boyce Ley said.

Something super simple you can do that isn’t talked about much? Exercise and manage your weight. “It’s been shown over and over again that maintaining a healthy weight and exercising more than four times a week reduces the risk of breast cancer. Those are things you don’t need to see a doctor for. They’re not easy, but they’re free!” she said.

Dr. Boyce Ley is located at TMC One, 2424 N. Wyatt Dr. #100, on the TMC campus.
Call (520) 324-BRST (2778) to make an appointment

Nutrition: Make the Nutrient-Dense Choice

nutrientdenseSeptember is Healthy Aging Month, and it is a good time for all of us to think about how our daily habits will pay off (or hurt us) over the long term. If we want to, we can develop habits that move us toward greater happiness and better health. TMC’s Nutritionista, Laurie Ledford and Wellness Instructor, Michael Urquhart, share a few tips this month to move you in a healthier direction. Can you find a way to work a few of them into your daily life? Today’s post is all about what we consume! As you read ask yourself just how nutrient dense is your diet?

As we age, our bodies require fewer calories. Most of us lose muscle mass, our organs shrink, and we may do less (or less intense) physical activity. Therefore, we need less fuel. If we don’t cut our caloric intake, we’ll gain weight.

Also, some people experience a natural decrease in appetite as they get older, consuming fewer calories without making a conscious effort. Either way, we should try to get the most from the calories we do consume.

When you eat less food, you need to make sure the food you eat is nutrient-dense – that is, it should be full of healthful nutrients but low in calories. These foods will contain lots of vitamins, minerals and often fiber.

Examples include:

  • Colorful fruits and vegetables. They are your healthiest carbohydrate foods. They provide a wide range of vitamins, minerals and antioxidants. Try to limit the amount of starchy vegetables (such as white potatoes and corn) you eat, because these are relatively high in calories.
  • Whole grains. The less processed they are, the more fiber and other nutrients they contain. So choose “whole wheat” bread and pasta instead of white bread and regular pasta. Choose brown rice instead of white rice. Try some other whole grains, such as barley, millet, amaranth and oats.
  • Lean protein foods. Choose lean cuts of beef and pork, skinless poultry and ground meats that have higher lean and lower fat content (for example, 92% lean ground beef). Fish is an excellent source of lean protein. You can also get your protein from non-animal sources, such as beans and soy products.
  • Low-fat or fat-free dairy products. Milk and yogurt provide protein, calcium and other nutrients, which are beneficial to aging bones.

Eating nutrient-dense foods means avoiding “empty calories” from things like candy, cookies, pastries, ice cream, and fried foods. Try making one or two changes each day – switching from an “empty calorie” food to a nutrient dense food from the list above – and you can eventually make it into a healthy daily habit.

Laurie and Mike are part of the Live Well team supporting members of our Tucson community make healthier choices. Check out Mary Kmak’s personal experience with Live Well here.

Women’s health screenings: A “date” with better health

MakeadatewithhealthKarenWomen’s health needs change with age.

The frequency of pelvic exams and mammograms, for example, changes throughout the life cycle. In one decade, you may find yourself wondering about folic acid, while in another, you’re concerned about osteoporosis.

When should you get a shingles vaccine?

What about a colon cancer screeing?

In short: How to keep track of the guidelines?

Karen Narum, nurse practitioner at the TMC for Women Breast Screening Clinic, will help break it down in a conversation on Thursday, May 28 to help women (and the men in their lives) navigate preventive health measures they should take through the decades. The 90-minute conversation starts at 1 p.m. at The Core at La Encantada.

“Sometimes you may hear you need a certain screening at a certain age, but there isn’t a lot of information about why you should,” Narum said. “These screenings are important for prevention. There are certain things we don’t have control over, but there are others that when caught early, can make a huge difference.”

“We’ve been given this awesome machine. We should take care of it – and that’s why ultimately, these screenings are about quality of life.”

Narum noted that these guidelines are just that: Your own healthcare provider will help provide important guidance, given your own health care history and needs. The good news is that most preventive screenings are now covered under your insurance plans.

Narum’s discussion is part of a series celebrating national Women’s Health Month at The Core, which included discussions on everything from hormone therapy to yoga, nutrition and financial fitness.

OhBabyBrookeHerStoryInstagramThe culminating conversation, “Oh baby! What you need to know to keep your new family healthy and well” will take place Friday, May 29 from 2 – 4 p.m., featuring Brooke Casebolt, a registered nurse who is the director of patient experience at TMC for Children.

Registration for all events, as well as information about ongoing fitness classes and other lecture series, can be found at The Core at La Encantada’s website. For more information, please call 324-CORE (2673).

Making HerStory – Whether a woman is having her first child or a life-saving surgery, she deserves a welcoming and safe environment with state-of-the-art services and a caring touch. Making HerStory is the campaign for the new Joel M. Childers, M.D., Women’s Center to make this environment a reality at TMC for Women and in our community. 

TMC is Make HerStory donation buttoncommitted to providing a lifetime of care For Women, About Women. Join us in Making HerStory

Just how dense are your breasts? Why keeping abreast of this indicator can help save your life

BreastDensityFlowerWhat kind of question is that?

In recent years it’s become the kind of question that can help health care providers identify breast cancer at earlier stages allowing them to treat women earlier with better results.

What are dense breasts?

The size of our breasts might be the only measurement we’ve thought about when it comes to “the girls,” so what on earth are dense breasts?  The density of breasts is a measurement of fatty tissue compared with fibroglandular tissue. The more fibrogladular tissue you have the more dense your breasts. On a mammogram, this dense tissue shows up as white areas. Levels 3 and 4 in the image below are what we describing as ‘dense breasts’ where more than 50% of the tissue is fibrogladular rather than fat.

Breast Density Categories from American College of  Radiology

Breast Density Categories from American College of Radiology


Why does knowing if you have dense breasts matter?

While having dense breasts is perfectly normal, increased density of fibroglandular tissue makes it difficult to interpret a mammogram. The dense tissue can mask a growth from view. As a result there is a slightly increased risk of not catching a tumor at an easily treatable stage. In younger women, who typically have denser breasts, an aggressive breast cancer may be hidden from detection by the dense fibrogladular tissue. There is also an increased risk of developing breast cancer in tissue that is dense. For women with extremely dense breasts there is a four to six times increase in the rate of breast cancer.


Eek! What if my breasts are dense? Am I going to get breast cancer and not know it because the mammogram was hard to interpret?

Knowing that you have dense breasts can help your care providers determine what is the best screening approach for you. Mammograms are still the primary way breast cancers are detected, but technology is changing rapidly. Digital mammograms have improved the ability to view breast tissue, and  3-D mammograms, also known as digital breast tomosynthesis, have further improved the ability of radiologists to assess dense breasts. There are additional methods that can be applied for women with dense breasts. Read the upcoming post for more information on tomosynthesis here in Tucson.

My breasts aren’t lumpy, I’m not worried.

Before you start trying to manually evaluate whether your breasts are dense (we still encourage monthly self-exams) or comparing them with friends and loved ones, the only way to assess the density of the breast is through mammography. Breast density refers to the appearance of the breasts on a mammogram rather than to breast size or firmness.  Your breasts may feel firm but not appear dense on a mammogram, or feel soft and appear extremely dense on the mammogram.

Once I have dense breasts will it always be that way? Does breast density change?

You may find that your breast density changes from one year’s mammogram to another for a variety of reasons – breast density is related to genetics, hormone levels and age  (all things you can’t control).

Oh no, not the ol’ mammogram!

If you’ve been putting off getting a mammogram, know you are not alone. More than half of Arizona’s women are not up to date on having a mammogram whether they have insurance or not. Perhaps it’s time to read this post about why there is nothing to fear from a mammogram. Whether you have insurance or not, it is time to schedule an appointment. Thanks to support from TMC Foundation, Susan G. Komen of Southern Arizona and an Avon grant many uninsured women can receive a free screening mammogram at TMC for Women.

photo 1 (7)

You’ve got mail!

Last year the Arizona State Legislature passed a law requiring that women whose breasts appear dense (More than 50% dense material – Levels 3 or 4 on the image above) on a mammogram be informed – typically this is done through the results letter sent to the patient – and to encourage them to talk with their health care provider to see whether additional screening is appropriate.

More information: Beyond the Basics – It’s Mammogram Time