Midwifery Support During Menopause

By Susan Hudson, MSN, CNM, Owner

Menopause is a time of change far more complex than just hot flashes, sleeplessness and mood changes. Frequently menopause coincides with children leaving home, changes in sexual desire, relationship concerns, career changes, and signs of aging – in your parents
and in yourself. At WellSPRing Women’s Health, we listen to our clients talk about all aspects of their life and help women bring balance to body, mind, and spirit.

Perimenopause and menopause are characterized by hormonal shifts that result in the end of menstruation. While the average age of menopause is age 51, some women’s periods will end in their early 40’s, others will continue in their late 50’s. Given that this change can occur at any point over a two-decade period, anticipatory midwifery guidance is an important way to help women prepare for changes that are inevitable. We speak with each woman about the challenges they are facing, what is normal, what might require additional
support, and how they can most naturally alleviate symptoms. Effective herbal and homeopathic remedies may ease troublesome discomforts long before hormone replacement is called for. Hormone testing of blood and saliva can be used to identify hormonal imbalances and guide you in your decision to use hormone replacement or not.

It’s never too early to learn and plan for this event, which is far more comprehensive than hormone changes alone. Menopause is also a time to look at bone health, heart health, breast health, and general nutrition and fitness, all with an emphasis on prevention. We have available a wide range of collaborators that support your midwifery guidance. We may direct you to such therapies as meditation, yoga, herbs, acupuncture, psychotherapy,
bioidentical hormone therapy, and more. Because of our close relationships with other integrative practitioners we have a comprehensive and cutting edge knowledge of holistic wellness strategies.

We believe that moving through menopause can be a very empowering experience. Many women use this juncture to take better care of themselves after prioritizing the needs of others. Here at WellSPRing, we will offer you education and support through the pleasures and challenges of menopause. We look forward to being here for you at each stage of life… including menopause!

We honor the normalcy of women’s life-cycle. We believe in:
• Watchful waiting and non-intervention in normal processes
• Appropriate use of interventions and technology for current or
   potential health problems
• Consultation, collaboration and referral with other members of
   the health care team as needed to provide optimal health care

The “Magic Age”: What You Need to Know About Social Security Claiming Strategies

Presented by Jonathan S Merckens, CFP ®

You may have heard that choosing the right social security claiming strategy can help you and your spouse maximize your benefits. But which strategy is best? What’s the appropriate age to claim? What about spousal benefits? If you’re wondering which path to take, these social security basics may help you get started.

Choosing the Right Age to Claim
Retirees can apply for social security anytime between ages 62 and 70. Claiming as early as age 62, however, can permanently reduce not only your benefits but your spouse’s survivor benefits. On the flip side, delaying until age 70 rewards the worker with the maximum benefit and locks in the highest possible benefit for a widow or widower. Of course, retirees who wait until age 70 to claim benefits may need to bridge the income gap by drawing down their retirement portfolio. So, what is the “magic age” to claim?

Until you or your spouse reaches your full retirement age (FRA), you won’t be able to take full advantage of social security claiming strategies. For many of today’s retirees (those born between 1943 and 1955), FRA is 66. If you fall into this category and claim your
benefits prior to age 66, you will automatically apply for both your worker benefit and any additional benefits you qualify for as a spouse, assuming your spouse is already receiving benefits. If you wait until your FRA to claim, however, you can elect to take one benefit or the other, switching them at a later date if advantageous. In addition, once you reach your FRA, social security benefits are no longer offset by earned income from work.

It’s worth noting that the magic age doesn’t have the same effect on spousal survivor benefits. A surviving spouse can claim either his or her own benefit or the survivor benefit independently (even prior to FRA), then switch to the other benefit after FRA. In other words, by claiming prior to FRA, the spouse isn’t deemed to have claimed both the survivor benefit and his or her own worker benefit.

Making the Most of Spousal Benefits
It’s a common assumption that, if both spouses delay claiming social security until age 70, they can maximize their monthly benefits. That’s not always the case, however. To help ensure that you don’t leave money on the table, here are a few strategies to consider. (Note that, for a couple to take advantage of these strategies, at least one spouse must have reached FRA.)

• Claim the spousal benefit when one spouse reaches FRA. You can only earn delayed retirement credits on your own worker benefit, not by delaying the spousal benefit. If your spousal benefit will always be greater than your own benefit, it makes sense for you to take advantage of the spousal benefit sooner rather than later.

• “Claim now and claim more later.” With this popular strategy, you apply for social security at FRA but suspend payments until age 70. This allows your spouse to submit a restricted application for spousal benefits if he or she has also reached the magic age. In the meantime, both of you will continue to earn delayed retirement credits on your own worker benefits. Then, when each of you reaches ages 70, you can apply for your maximized benefits. (Keep in mind that only one spouse can file and suspend so that the other can claim spousal benefits; it’s not possible for both spouses to file and suspend.)

• Claim the lower benefits first. Cash flow needs may require you to turn to social security before both spouses reach FRA. But, if your budget permits, there’s still an opportunity to enhance your overall social security strategy. Here’s how it works: The spouse with the lower benefit claims as early as age 62; meanwhile, the other spouse waits until his or her FRA and files a restricted application for spousal benefits, which will amount to half of the lower-earning spouse’s full retirement benefit. Then, at age 70, the one receiving spousal benefits switches to his or her own worker benefit, which has accumulated delayed retirement credits. Once the spouse with the higher earning history claims his or her retirement benefit, the other spouse can switch to the spousal benefit if it’s higher.

Beyond the Basics
It’s important to note that many social security claiming strategies seek to provide a larger cumulative benefit over a couple’s lifetime rather than generating a greater benefit today. If you and your spouse have shortened life expectancies, a delayed claim may shortchange you, possibly lowering your current standard of living or depleting retirement assets that could pass to your heirs.

Clearly, when it comes to determining the optimum social security claiming strategy, numerous variables are at play. Your financial adviser can help you evaluate the benefits of different strategies and find the option best suited to you and your unique situation.

Do You Suffer From Incontinence or Pelvic Prolapse?

MetroHealth Advanced Gynecology Experts Offer State-of-the-Art Care for Sensitive Issues.

Millions of women experience involuntary loss of urine, referred to as urinary incontinence. Unfortunately, this condition occurs when you least expect it and the slightest cough, giggle or physical activity sends you to the nearest restroom. Whether it’s the loss of a few drops of urine or the frequent and strong urge to urinate, the symptoms are bothersome and often debilitating. Incontinence can halt your life, while causing emotional distress and decreased body image.

Pelvic organ prolapse is a weakening in the pelvic muscles. When these muscles become weak, the surrounding organs, such as the bladder, uterus, rectum or intestines, can protrude through the vagina and cause pain, urination and bowel movement problems as well as sexual issues. Fortunately, there are treatment options for women suffering from this condition.

While incontinence is common, it is not normal and any woman experiencing pelvic pain, urine loss or any other gynecologic health issue does not need to suffer in silence. The team at MetroHealth’s Center for Advanced Gynecology is sensitive to your issues and offers innovative, non-invasive treatment options. Some issues can be resolved with medications, exercises or dietary changes; however, if surgery is necessary, options include outpatient minimally invasive procedures, which allow for faster recovery and less pain and scarring than traditional surgery.

The physicians at the MetroHealth Center for Advanced Gynecology help many women return to their normal lifestyles as quickly as possible. Dr. Sarah Kane recently treated an active mother for her stress urinary incontinence. This patient enjoyed attending her kids’ sporting events, but often experienced urine loss when she jumped up to cheer. After undergoing a minimally invasive sling procedure to help cure her issue, this active mom enthusiastically supports her favorite teams – without any embarrassing repercussions.

It’s never too late to seek treatment options. Recently, a patient in her eighties, who suffered for years from severe vaginal prolapse, sought treatment. After an outpatient procedure to repair her prolapse, this patient is now cured and was back to gardening within days. Fighting back tears, this woman’s one regret was waiting so long to address her issue.

This expert team of physicians at MetroHealth’s Center for Advanced Gynecology consists of Jeffrey Mangel, MD, Robert Pollard, MD, and Sarah Kane, MD. They specialize in providing advanced care for endometriosis, uterine fibroids, pelvic/bladder pain, pelvic prolapse, and incontinence and bowel control. They also have expertise in minimally invasive gynecological surgery for a wide range of procedures such as hysterectomies.

The specialists see patients in have locations throughout Northeast Ohio. To schedule an appointment, please call 216-778-5890. Metrohealth.org/advancedgyn

Do you Know How to Keep Your Children Safe Online?

By Jesse Weinberger

What exactly do kids DO online?
Your 9 year old daughter is “quietly playing” on the internet in her bedroom. Your 14 year-old son is talking to his virtual army platoon via his Xbox Live videogame. Your 7 year-old son is battling other villages on his IPod Touch or IPad while playing Clash of Clans or Minecraft. Your 17-year old grandson is constantly taking photos and texting (sometimes during family meals).

Other than the texting during dinner example (which is equal parts disrespectful and infuriating), these scenarios seem fairly benign. Would it surprise you to know that every of these examples are wrought with potential risks?

Internet: Gateway to the World
Having access to the Internet is a necessary part of a modern child’s life. Global accessibility is what makes the Internet so incredibly useful and powerful, but it is also the very thing that makes it so potentially dangerous to a child.

Anytime children use a device which is Internet connected (laptop, tablet, gaming console, cell phone, camera, IPod Touch, etc.), you are inviting the entire universe into your home. You might as well go to bed with all of your windows and your front door wide open.

Playing quietly in the bedroom
Children should never have computers in their bedrooms, particularly if the laptop or computer has a webcam attached. Children as old as 13 years should be using devices in a public space in the home.  Cyberbullying and sexual predation flourish in the dark. You should be able to read over your child’s shoulder without her seeing you coming. Moreover, make it clear that you have the right and the responsibility to review and overrule her behavior at any time.

Online and LIVE Gaming
Consoles like Xbox Live, which encourage playing with friends via an Internet connection, have the potential to connect strangers to your child. There have been many cases of attempted abductions after a child (thinking he is playing against another child) arranges to meet an online playmate IRL (in real life).  Sexual predators groom these children over months and months, use voice modulators to make them sound young, and get to know your child before proposing an IRL meeting.

Gaming apps and the very young
Parents often make the mistake of providing their very young children (4-10) with Wi-Fi enabled devices such as an IPad or IPod Touch. There is a game called Clash of Clans, which is currently popular among this younger set. The game itself is quite benign: you build clans and cities and stage great battles. One of the main features of the game (building a clan) is open chat with clan mates.  Young children are being asked for their address and personal information via this chatting feature. These children do not have the emotional or intellectual maturity to understand that their “clan mate” may want to do them harm.

Photos, sexting, and long-term impact
Sexting has become an enormous problem with children as young as 11 years old sending provocative and naked photos of themselves to friends. Our current generation of parents cannot relate to child pornography in any way. Just know that these children perceive these photos as “no big deal.” They do not understand that a child can be charged with creation of child pornography even when the photo is of himself. If that child sends that photo to a friend, he can be then charged with distribution of child pornography. Make no mistake, children are being charged and prosecuted as felons as a result of sexting. High school and college students have lost scholarships and college acceptances as a result.  Some of these children have even been listed on child sex predator registries.

What to do?
As a parent, your single line of defense is education. In order to monitor effectively you must become educated in the devices, apps, and risks that your child is facing on a daily basis. The web offers infinite possibilities for education, socialization, and outreach; just make sure that your child is traveling through every part of her/his world safely.

Jesse Weinberger, www.overnightgeekuniversity.com/women/