(Editor’s note: This is the third story in a four-part weekly series on meditation, including its benefits for pain management, mental health and overall well-being. The first article in the series is Do You Meditate? Here’s Why You Might Want To; the second article is How Meditation Can Help with Chronic Pain; and the fourth article is Could Meditation Benefit Cognitive Function?)
Four months after becoming sick, my husband took his last breath and my life changed completely as I went from “we” to “me” and began the inevitable, intense journey of grieving.
Soon after, a friend invited me to meditate with a group of women. But the timing wasn’t right for me. Grief takes away your ability to focus, and my mind wasn’t ready to settle down for quiet contemplation.
As a writer and journalist, I followed my instinct, researching tools that might help. Of course, it’s impossible to get a magic pill or learn something new that will remove the heartache. But mindfulness and meditation were recurring words in my research.
Mindfulness Is About Staying in the Moment
I was introduced to mindfulness through an organization in my community offering support for anyone who had lost a loved one during the one-year period after their passing.
I attended a session billed as a mindfulness practice. It involved visualization with instruction to close your eyes and think about the worst possible thing you had been through, focusing on the details of the event.
As you can guess, this didn’t go well for a woman who had just buried her husband, and flight won over fight as I bolted from the room sobbing hysterically. It was the last time I wore mascara for two years.
"When we're talking about mindfulness as it relates to grief, you have to make sure that we are thinking of the most important part of mindfulness, which is compassion for self."
Soon after the session, I learned my initial experience wasn’t exactly the goal of mindfulness.
“Mindfulness is about being awake and present to what's unfolding moment to moment,” says Heather Stang, a mindfulness speaker and author of Mindfulness & Grief: With Guided Meditations To Calm Your Mind & Restore Your Spirit. “But when we're talking about mindfulness as it relates to grief, you have to make sure that we are thinking of the most important part of mindfulness, which is compassion for self.”
Stang refers to a quote by Jon Kabat Zinn, the founding director of the University of Massachusetts Medical School Center for Mindfulness: “In Asian languages, the word for mind and the word for heart are the same word.”
“When we're grieving, we're suffering,” says Stang, who is also a yoga therapist. “I view it as grieving mindfully. You have to be tuned into how you’re doing in the moment. Mindfulness gives us that true insight into ‘How am I right now?’ And it gives us the power to choose: ‘Is the present safe for me right now?’”
In retrospect, the supposed mindfulness experience I took part in wasn’t safe for me in the moment. Lesson learned.
Meditation Is about Focus
Grief has its own complexity, because your mind is going back and forth between past and present at lightning speed, making it almost impossible to harness your thoughts. But I persevered.
Once I started focusing on being mindful in the moment, I became calmer. At that point, I felt I was ready to try meditation, and accompanied my friend to a small group of women who gathered at someone’s home once a week.
The practice was to sit for 20 minutes focusing on the breath — breathe in, breathe out — in silent contemplation, followed by 10 minutes of walking meditation, then another 20 minutes of sitting meditation.
Turns out, I wasn’t going to get this down pat without practice. I was unable to sit without fidgeting, and focusing on my breath was a challenge. These are both common for meditation novices. But for the grief stricken, in quiet times, our minds float to our deepest sorrows. I spent several evenings melting on the bathroom floor in a puddle of silent tears and tissues.
The Mindfulness-Meditation Connection
It turns out there is a connection between mindfulness and meditation, and combining them can have some wonderful benefits.
Mindfulness meditation “is a mental training practice that … brings you and your thoughts into the present, focusing on emotions, thoughts and sensations that you're experiencing ‘in the now,’" according to Verywellmind.com.
The website says that “while it can be initially difficult to quiet your thoughts, with time and practice you can experience the benefits of mindfulness meditation, including less stress and anxiety” — and, I’ll add, grief.
It also helped that I formed a bond with the women I meditated with. One woman had brain cancer and eventually passed away. Instead of being the storyteller, I was the listener, as her friends shared stories about their friendship with this special person and her impact on others.
Slowly, I incorporated meditation into my daily life as well, taking short breaks to breathe in and out and steady myself. It took some time but, eventually, I was able to tame my mind. Now, I can sit daily for 30 minutes meditating, focusing on my breath, accepting when my mind wanders off, and bringing it back to my breath again.
It wasn’t an easy journey, but learning to meditate, truly living in the moment instead of worrying what will happen tomorrow, plus focusing on the positive, helped me control my mind instead of allowing my thoughts to control me.
How Meditation Can Help With Grief
For people who are grieving, Stang sums up several ways meditation can help:
• In the early days of loss, focus and concentration meditation can help give your mind a much-needed break from thinking.
• Mindfulness-based meditation practices will help you cultivate a calm and steady presence as you open to your experience of grief.
• Compassion meditation will help you soften to your own experience and feel more connected to those around you.
• As you begin to reengage in your life after loss, more contemplative practices will help you acknowledge the ways that you have changed and rewrite your post-loss story.


How Meditation Can Ease the Path of Grieving

Suzanne Boles

“Thank you for the intervention. Friends and family came to be with me. I agreed to be admitted to hospital. Am waiting for a bed. I had a horrible breakdown. I am sorry for worrying you.”
This was my message posted on Facebook to friends on October 19, 2014. It was over a year since my husband, Bob, passed away. Every day since he died on June 8, 2013 was like walking through thick, muddy water with a constant fog clouding my head.
I was a willing participant in the loss and grief cycle from day one. I had no interest in the future. The past was painful, the present bleak. Every day I woke up crying, for days, weeks, months, and soon a year passed. Depression is part of the initial journey. Many people feel like they can’t survive without their loved one. The agony is enormous, but the pain starts to diminish with time.
It is natural to experience intense grief after someone close dies, but complicated grief is different.
My story was different. The depression was pervasive and continued, even escalated. I journaled the experience, intermittently, in a blog. Posting my thoughts gave me temporary relief. Then I’d go down the rabbit hole again. What I didn’t realize was that I was experiencing something more than a normal grief journey. Though not diagnosed, researching my symptoms led me to what’s known as Complicated Grief.
The Intensity of Complicated Grief
According to The Center for Complicated Grief (CG) “[it] is a form of grief that takes hold of a person’s mind and won’t let go. It is natural to experience intense grief after someone close dies, but complicated grief is different. Troubling thoughts, dysfunctional behaviors or problems regulating emotions get a foothold and stall adaptation. Complicated grief is the condition that occurs when this happens.
“People with complicated grief don't know what’s wrong. They assume that their lives have been irreparably damaged by their loss and cannot imagine how they can ever feel better. Grief dominates their thoughts and feelings with no respite in sight.”
According to the Mayo Clinic, CG can be determined “when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose CG when the grieving continues to be intense, persistent and debilitating beyond 12 months ... Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done.”
The Diagnosis That Probably Saved My Life
I had seen several therapists. They tried to help, under the assumption that I was grieving as any woman would after the death of her husband. What I didn’t tell them was that my sadness had escalated to suicide ideation.
On the evening of Saturday October 18, 2014, I posted on Facebook: “Please take care of my cats.” My cry for help wasn’t a mystery to friends who were following my downward spiral. Phone calls went out from people in several cities to friends who lived near me who came to my house, then later family. Despite my uncharacteristic reaction screaming at everyone who entered the door and yelling at them to leave, I eventually calmed down and agreed to be taken to the hospital.
I was put in a room with no windows and a security guard. Some family members came in. The doctor followed and told me the medication I’d been taking for many years to control my clinical depression wasn’t working. When that happens, ironically, it can make you more depressed.
That diagnosis rocked me to the core and probably saved my life. Every day had been torture. And now I had someone who was telling me they could help me and life could actually get better.
I agreed to be admitted to hospital and new medication was prescribed by a hospital psychiatrist. I stayed there just over a week, eventually getting day passes, then a weekend pass. After my release, I was closely monitored to ensure my medication was doing what it should have done. I started seeking other ways to help me out of the dark pit and took part in several Cognitive Behavioral Therapy (CBT) programs, or what I refer to as retraining the brain to focus on the positive.
Live in the Moment
Today, I lead what those newly grieving are told is “the new normal life” because, when our loved ones die, life as we knew it is inevitably changed forever and will never go back to what we thought was our normal life. As Buddhist monk and peace activist, Nhat Hanh, said, “It is not impermanence that makes us suffer. What makes us suffer is wanting things to be permanent when they are not.”
The new life can be good if we come to terms with our losses; remember them with loving kindness; embrace our family, friends, and new people who come into our lives and accept that nothing is ever permanent in life. The biggest lesson I learned is to truly live in the moment and enjoy each precious day as a gift.
If you, or someone you know, has been suffering with extreme grief symptoms for over a year it might be time to seek help.
Coping with Grief and Loss
While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief and eventually, find a way to pick up the pieces and move on with your life. Here are some suggestions from Help Guide: 
1. Acknowledge your pain.
2. Accept that grief can trigger many different and unexpected emotions.
3. Understand that your grieving process will be unique to you.
4. Seek out face-to-face support from people who care about you.
5. Support yourself emotionally by taking care of yourself physically.


Coping With Complicated Grief

Is there such a thing as male menopause? "Male menopause is a catchy name but it is definitely not a medical diagnosis," Raevti Bole, MD, a urologist at the Cleveland Clinic, says. 
"Low testosterone levels can cause low energy, decreased concentration, difficulty putting on muscle or losing fat, depression and low sex drive.""On average, testosterone levels in men drop about 1% per year after their 40s."
"In popular culture, it's used to refer to the symptoms of decreasing testosterone and general aging in men." However, since the term male menopause may be confusing and misleading, Bole says, "I recommend using testosterone deficiency, to be most accurate."
"On average, testosterone levels in men drop about 1% per year after their 40s," Bole adds. "Even so, most men do not develop a low testosterone. So, while testosterone levels naturally decline with age, not all men drop low enough to be diagnosed with testosterone deficiency (where their testosterone level is causing symptoms and is lower than threshold)."
Bole estimates that between 10 and 30% of older men have low testosterone levels. Be aware that variations in testosterone testing can affect the correct numbers.
What Are The Symptoms?
Low testosterone levels can cause low energy, decreased concentration, difficulty putting on muscle or losing fat, depression, low sex drive and worsening erections, Bole says. 
"Most of these symptoms have other causes that are also common such as obesity, diabetes, chronic stress, poor sleep and several others," she adds.
Diagnosis
Stanton Honig, MD, a urologist at the Feinberg School of Medicine at Northwestern University, reports that because physicians don't screen for low testosterone, diagnosis is based on reported symptoms.
While testosterone levels naturally decline with age, not all men drop low enough to be diagnosed with testosterone deficiency.
Suppose a man suspects he has low testosterone or is experiencing symptoms. In that case, he should visit his primary care physician for evaluation so the doctor can check for other factors contributing to the signs. 
"For example," Bole explains, "if you have untreated sleep apnea or poorly controlled diabetes, these need to be addressed." 
Then, the doctor can check the testosterone level to see whether it's low. If it is, they can refer the patient to a urologist.
On Fertility and Sperm
"Menopause in women is universally defined as 12 months after a women's last period, and usually occurs around age 51," Bole notes. After that, the ovaries no longer produce estrogen nor release eggs. In contrast, men don't usually stop making sperm at a definite age. 
"While menopause ends a woman's ability to get pregnant naturally, in men, there's no such universal drop in loss of fertility," Bole says.
Does Weight Play A Role?
"Weight gain is associated with testosterone deficiency," Bole says. "Yet, cause and effect are complicated – weight gain can be associated with other conditions like diabetes as well as lifestyle and diet." Nonetheless, men designated as obese are five times more likely to have low testosterone than non-obese men.
According to Honig, if men experience weight gain, it can be challenging to determine which came first – the weight gain causing low testosterone or the low testosterone causing the weight gain.
"If your testosterone is low, it can be harder to gain lean muscle and lose fat even while you are eating right, exercising and controlling your other medical conditions," says Bole. 
"In this case, it would make sense to replace testosterone," she continues. "But, nevertheless, if your testosterone is normal then the weight gain is probably from something else, and increasing your testosterone is unlikely to help you."
"Fat cells contain an enzyme that converts testosterone to estrogen, so losing fat can help boost testosterone levels," Bole says. "But we need more long-term studies to examine this relationship."
Treatment for Low Testosterone
There are a few treatment options available. "Testosterone replacement therapy (TRT) for low testosterone can include injections, patches, gels, pellets and newer formulations like oral medication. Be aware that TRT can affect fertility," Bole explains.
Testosterone injection is generally the most reliable way to get the medication into your body, at least when starting out.
Before a prescription is given, a physician should find out if the patient is interested in having children, according to Honing, because "a man who takes testosterone suppresses sperm production and fertility."
Newer TRT formulations, such as oral medication and a nasal gel, must be taken several times a day. "Testosterone injection is generally the most reliable way to get the medication into your body, at least when starting out," says Bole. An injection is also more likely to be covered by health insurance.
Honig and Bole agree that supplements do not help treat low testosterone. "Supplements are not tested by the FDA (Federal Drug Administration), so it's hard to know what's in them," Bole cautions. "A healthy diet and good quality multivitamin are good to have," she adds.
How to Manage Low Testosterone
Here's what you can do to manage low testosterone, as recommended by Dr. Raevti Bole:
See your primary care doctor to control any other medical conditionsDo cardiovascular exercise a few times each weekGet enough sleepEat a healthy dietIf you have a lot of stress in your life, strategies like meditation or seeing a therapist can help

What is Male Menopause?

Debbie L. Miller

After 50, weight gain, fatigue and loss of strength serve as not-so-pleasant aging reminders. The good news is we can control more of our body changes than we think we can.
Weight Gain and Belly Fat
Take weight gain, for example. Men and women find themselves gaining weight at a rate of one to two pounds per year between early adulthood and middle age, according to the Centers for Disease Control and Prevention (CDC).
Women particularly tend to gain belly fat after menopause. Although going through menopause is often considered an expected part of aging, research shows that it does not cause a woman to gain weight. A review by the International Menopause Society found that, although weight gain is not caused by menopause, hormonal changes during this time can, however, lead to more belly fat. Environmental and lifestyle factors are largely to blame for the weight gain itself, scientists concluded.
"Our cells become resistant to insulin as we age," says Dr. Kathryn A. Boling, primary care provider and family medicine specialist at Mercy Personal Physicians at Lutherville, Md. "This can lead to weight gain around the belly, especially in women."
In insulin resistance, fat, muscle and liver cells do not respond normally to insulin. As a result, liver cells do not absorb glucose (blood sugar) easily from the bloodstream, a situation that can keep blood sugar levels higher than normal and increase the risk of type 2 diabetes.
What you can do: To decrease weight gain and reduce your risk of developing type 2 diabetes, Boling recommends cutting back on refined carbohydrates, such as white flour and sugars, desserts, sweets and breads. Swap out sugar carbs for vegetables, fruit and whole grains to cut calories and keep blood sugar levels in check. In addition, keeping a food journal can help you lose weight. A 2008 study of nearly 1,700 subjects shows keeping a food diary can double weight loss when compared to people who do not track their food.
Metabolism Changes and Weight
Another factor contributing to weight gain is a drop in metabolism, which begins to decline in your 30s.
"Metabolism is down between 10 and 15 percent by age 50," says Boling. Loss of muscle contributes largely to a decrease in metabolism, since muscle burns more calories at rest than fat.
"Muscle loss is one of the most underrated health issues after 40 and 50," says Suzette Pereira, researcher with Abbott Nutrition, Columbus, Ohio, specializing in muscle health and muscle loss associated with age. "Thirty to 40 percent of our body is muscle. Muscle loss occurs slowly but accelerates over time."
Feeling weaker or fatigued after a walk may be signs of muscle loss, Boling says. Muscle atrophy also relates to weaker bones and can contribute to osteoporosis over time.
A survey by AARP and Abbott of nearly 1,500 people found that although 73 percent of survey participants recognize they naturally lose muscle with age, only 13 percent know the importance of maintaining muscle mass with age.
"It's not about abs and biceps," says Pereira. "It's about fat burning and maintaining your posture and also dealing with health setbacks."
According to the survey, more than a third of respondents reported being hospitalized after 50 due to chronic disease; loss of strength and muscle were among their greatest recovery concerns.
"Your body burns through muscle when you're sick," says Pereira. The term "sarcopenia" refers to the decline of muscle tissue associated with the aging process. "Sarcopenia puts you at high risk of losing your independence," says Pereira. Muscle loss is one of the biggest causes of overall functional decline in older adults, according to the National Institutes of Health.
In addition to changes in muscle, ligaments and tendons (which attach muscle to bone), also change. As a result of these changes (which include increased dehydration and "brittleness"), adults over 50 experience increased healing time. Injuries such as tendonitis become more likely over time. Specifically, tendons and ligaments of the shoulder (rotator cuff), Achilles, elbows and knees often become more fragile and susceptible to damage in active people over 50. By the age of 80 many people lose up to 50 percent of muscle mass.
What you can do: Resistance training is the gold standard to preserve muscle and strength, says Periera. "And keep in mind it's never too late to start. Your muscles have plasticity, meaning they can become strong again," she notes. Although three out of four people in the AARP/Abbott survey said they exercise three times a week, they mostly focused on cardio, not strength training, Periera says. "Only 24 percent said they do strength training."
Experts agree that exercise goes a long way toward reducing the severity and consequences of many bodily changes that happen as we age. A regular workout program that includes strength training keeps muscles healthy, says Pereira. "You don't have to go to a gym. Home workouts are fine." Try DVDs or check out YouTube videos by qualified trainers to ensure you're using the right, safe form.
And be sure to include enough protein, a building block of muscle. "We become less efficient at utilizing protein as we get older," says Boling, who recommends 30 grams of protein per meal.
Above all, be consistent with your efforts. "Yes, change happen with aging," says Boling, "but you can keep yourself at a place where you're active and healthy despite these changes."
 


Body Changes After 50: How Much Can You Really Control?

Linda Melone, CSCS

I'm one of about 44,000 people who've been enrolled in the Pfizer BioNTech COVID-19 Phase 3 vaccine trial. I'm no hero, just a 59-year-old who desperately wants to see my kids who live an airplane flight away; resume my vacations and indoor dining and basically get on with my life.
I felt ecstatic when the news broke Nov. 18 that the Pfizer vaccine was 95% effective in preventing COVID-19 without serious side effects in people who had no previous signs of the disease. Since then, Pfizer has applied to the Food and Drug Administration (FDA) for emergency access. If that's approved, the vaccine will be given to the public.
My First Injection
Here's what it's been like for me, and a few others I've interviewed who are in Pfizer and Moderna COVID-19 vaccine trials:
That evening, I smiled. My arm hurt.
Back on Sept. 1, I reported to the Yale Center for Clinical Investigation in New Haven for my first visit. After meeting with an infectious disease doctor and answering numerous questions to consent to the study, I got my first injection of either the SARS Co-V2 vaccine or a saline placebo. Half of the participants are getting the vaccine and half the placebo.
I have a couple of typical health problems for people my age: hypertension and osteoporosis. (My husband, who's 67 and a bit healthier, is also participating in the study. Neither of us was excluded based on our age or diagnoses.)
My initial visit took three hours because the "dose" needed to be thawed before administration. Nurses offered me coffee, trail mix and other snacks while I waited, and paid me $100 through a gift card.
Dr. Onyema OgbuaguThat evening, I smiled. My arm hurt. To me, that meant that I got the live vaccine and not the placebo. But I won't know for sure because the study is "blinded," meaning no one knows who's getting what until the study ends. If I did get the placebo, I'll be offered the vaccine once the study is unblinded.
The day after I got injected, I felt sluggish and tired, with body aches. I duly noted these symptoms in the app that the vaccine trial participants are required to put on our phones. (My husband had no soreness or fatigue.)
My Second Injection
About three weeks later, I received a second injection. Again, my arm felt sore, looked red at the injection site and I had body aches and fatigue. (At a meeting with Centers for Disease Control and Prevention advisers Monday, doctors urged the agency to be upfront about side effects some people may have after receiving the first dose of a COVID-19 vaccine, including muscle pain, chills and headaches.)
Three weeks after that, my blood was drawn and tested for antibodies to COVID-19. The director of the study, Dr. Onyema Ogbuagu, wouldn't comment about this.
My next appointment is in March for more blood tests.
Overall, the study is supposed to last 26 months. It will continue even if the vaccine gets approved because researchers need more safety data and long-term efficacy data over a period of time, said Laurie Andrews, a nurse working on the Yale study.
Have I been scared to be in the vaccine trial? No. I know that by the time a drug gets to Phase 3, it's deemed safe for testing in humans. So, I feel like the risk of participating is small.
Unlike some vaccines, this one doesn't contain the whole virus or those parts of the virus that can make you sick. Instead, it contains part of the virus' genetic code — the RNA — surrounded by fatty particles. Your own cells then produce some of the spike protein seen on the outside of the virus. This spike protein helps your body produce antibodies to fight COVID-19.
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Dr. Kathryn Boling, 62, a family medicine specialist in Lutherville, Md., also entered a Pfizer trial. She's hoping to set an example for her patients who may be hesitant to take the vaccine when it's approved.
What Other COVID-19 Vaccine Trial Participants Told Me
"The risk of doing nothing was that I could get COVID and die from it," she said. "But the benefit is that I might be able to protect myself and tell my patients how I felt after getting the vaccine."
Boling said she knows that many of her patients are afraid of the vaccine.
"If it works out, I could reassure them. Or if it didn't, I could warn them. That was my thinking," she said.
"I wanted to be one of the first people to get it and I could be proof that it works."
Boling's arm felt sore after the first shot, too. But she suffered intense body aches after the second injection.
Danielle PlummerAs an experiment, she later had her medical assistant inject her with saline, which is what is used as the placebo in the Pfizer study. She felt nothing after the saline shot.
Hospital pharmacist Danielle Plummer, 48, is in the Moderna study in Las Vegas. Moderna reported its vaccine to be 94% effective.
"When COVID took over the world, I knew there had to be something more than wearing masks or washing our hands. This [a vaccine] is going to be fundamental to getting society back to normal," Plummer said. "I really wanted to get the vaccine because I am exposed to (COVID) patients at work. I wanted to be one of the first people to get it and I could be proof that it works."
Plummer has administered thousands of vaccines over the years and knows that no vaccine is 100% safe.
She believes she got the placebo because she felt no body aches or other symptoms after the injection. As with my Pfizer trail, Moderna participants who got the placebo will be offered the vaccine at the end of the study.
As an African American, Ashley Nealy, 32, wanted to participate in the Pfizer study because COVID-19 has hit the Black community hard and she wanted to be a part of the solution.
Ashley NealyBut she took a lot of flak for enrolling in the study in Atlanta. After being interviewed by a local TV station, Nealy's story received more than 650 comments on its Facebook page, many of them negative.
"People asked if I'm not aware of the Tuskegee experiments," Nealy said. (Those were the U.S. government's syphilis study of 600 Black men who did not provide consent for it.)
"All these negative comments, it shows the mistrust of the medical establishment in the Black community. Somebody even mentioned me possibly growing a third ear in ten years," said Nealy.
Like me, Nealy experienced fatigue and soreness after the shots.
"I enrolled in the study because I wanted to help us get out of this pandemic a little sooner," Nealy said.
She worries, however, that many Americans won't get a COVID-19 vaccine if it is approved.
Everybody in a COVID-19 vaccine trial has their own reason for entering it. I'll admit I wanted to get the vaccine to help reduce my chances of getting the coronarivus. But I also believe in doing what you can to help, when you're able.
I know that I can't cure COVID-19. But I can do this one small thing to help the cause.


My Experience in a COVID-19 Vaccine Trial

Alix Boyle

You may have seen news reports or social media posts calling for people to sew medical masks to help protect health care professionals from contracting COVID-19.
If you’ve been thinking of joining the sewing brigade or organizing a mask collection effort, there are some things you should know before cutting your fabric or threading your machine.
Helping makes us feel good, but if we don’t help in a way that is needed, our hard work and efforts can be for nothing.
Who Is Asking for Homemade Masks?
People on the front lines or who directly work with COVID-19-positive patients require special masks called N95 respirators. These are firm, rounded masks that offer a higher level of protection than the standard paper or fabric surgical masks most people are familiar with. People who are at lower risk of exposure to the virus but who still need or want protection use the surgical masks.
But there’s a shortage of personal protective equipment (PPE), including masks, in various parts of the country. This is why there have been appeals for homemade masks. Others asking for homemade masks are those who work at long-term care facilities or stores, as well as people who must interact with the public. And as of April 3, the CDC has made the recommendation that all individuals wear cloth masks when they go out.
Regardless of where the masks are to be used, it's important to verify what type of mask the receiving facility or organization needs.
“The CDC [Centers for Disease Control] has said basically if you [a health care professional] don't have anything, wear a thin bandana,” said Kathryn A. Boling, a family physician with Mercy Medical Center in Baltimore. “So for people in areas where they have shortages to the point where they're considering wearing a bandana, a hand-sewn mask that fits a little bit more snugly would be a godsend to them.”
For health care providers who must wear an N95, which really should only be used once, a home-sewn mask can be used over the top of the N95 and then taken home and washed. This allows the N95 respirator to be used for an extended period.
Boling emphasized, however, that these masks are only a stopgap measure until proper supplies arrive. “At that point, no one will need the homemade masks because they just aren’t going to protect you as well as those that are specifically made to protect you,” she noted.


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Following Guidelines From Experts
Regardless of where the masks are to be used, it’s important to verify what type of mask the receiving facility or organization needs. There are many patterns available online, but not all are appropriate or even comfortable to use. Here in Minnesota where Next Avenue is based, these are suggested patterns from Allina Health: mask pattern for beginner sewers and mask pattern for advanced sewers.
Some patterns call for using hair elastics as earpieces, but these may be too tight for some people. Other patterns suggest inserting vacuum bag filters between the fabric, which could be bulky and uncomfortable.
“If [the masks] are not comfortable, people aren't going to wear them,” said Mary Beth West, a public health nurse in Nashville. “And you put all this effort into something, and then we can't use it.”
West started collecting masks for her colleagues when she heard about the shortages from friends across the country. “If people aren't sure about a pattern, I encourage them to go to a medical website for a tutorial, like this one from Vanderbilt Medical Center. I know they have a pattern and a lot of other ones do," said West. "Don't go to Pinterest. Go to the medical websites and read what they are specifically asking for.”
Sewing Masks Gives Us a Feeling of Helping Out
Quilting guilds often participate in community projects, and the call for masks has spread quickly among them.
Jane Laughlin Sweeney, a small business owner in Seabrook, Texas, is a member of the Lakeview Quilters Guild, which responded to a personal request for masks for their local hospital. A former member of the guild works in the women and baby unit there, but the hospital didn’t have any masks for its workers in that department since they aren’t considered high risk.
The pattern the quilters received uses two layers of tightly woven cotton with a pocket so staff can insert their hospital masks inside. This would allow them to reuse the hospital mask and launder the sewn one.
“It's just snowballed since then,” Laughlin Sweeney said. “Adolescent homes and nursing homes have asked for masks. They know the masks don’t offer one hundred percent protection, but they do make the residents feel a little better, and it will protect them to some degree.”
Laura Laing, a writer in Baltimore, began sewing masks for her community because she felt helpless.
“Several hospitals in my area, including Johns Hopkins, are collecting homemade masks. I'm not certain what they're being used for, but they have asked for the masks,” she said. “I like to sew, and I need to feel like I'm doing something. I know that my little masks are not adequate protection. But if they can be used in some settings, freeing up N95 masks for really critical situations, then I've done something worthwhile.”
"I like to sew, and I need to feel like I'm doing something."
Other Needs That Can Be Sewn

Masks aren’t the only thing medical professionals need during the pandemic. Some facilities are asking people who sew to make gowns to be worn over clothing; others are asking for surgical caps and cotton drawstring bags. At the end of their shift, nurses and others can strip off their uniforms and place them directly into the bag — all to be thrown into the wash separate from other laundry.
Hand-sewn medical masksSome nurses have also asked for headbands with a large button sewn on each side at ear height. They can then put the mask-ear elastics around the buttons instead behind of their ears, which are starting to get raw and sore from wearing the masks for such long periods.
If You Want to Help
Here are some tips if you want to use your sewing or organizational skills to help out during the COVID-19 pandemic:
If you get an appeal to make masks, make sure the facility named in the appeal really wants/needs them.Check to see if the facility has other needs, like the gowns or headbands.Use a recommended pattern and requested materials. This is particularly important because not all fabrics are equal. If the facility doesn’t have a recommended pattern, search for patterns that other facilities are using.If you’re organizing the drive, find out the best place for a drop off. In some communities, it may be the local fire hall or police station; in others, it may be the hospital itself.If you try the items on yourself to check for fit, wash them before donating.Check to see if your local fabric stores are offering fabric and elastic for making masks. They may have discounts or donations.The late Fred Rogers famously said his mother told him to watch for the helpers when something bad happened. Helpers can be anyone. They can be they first responders, firefighters, doctors or nurses, but they can also be grocery store cashiers, truck drivers and even volunteers who want to sew masks for those who need them.


You and Your Sewing Machine Can Help Fight COVID-19

Marijke Vroomen Durning

Do you have trouble understanding your doctor's instructions, finding accurate health information, or working through health insurance forms? If so, you're not alone.
"Nearly half of adults in the U.S. demonstrate limited health literacy skills," says Michael Wolf, Ph.D., Director of the Center for Applied Health Research on Aging at the Feinberg School of Medicine at Northwestern University. "Nine out of ten people may struggle with some aspect of navigating health information and services."
"Nine out of ten people may struggle with some aspect of navigating health information and services."What is Health Literacy?
The Health Resources & Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, defines health literacy as "the degree to which individuals can obtain, process, and understand basic health information needed to make appropriate health decisions."
Health literacy is defined as a shared responsibility between patients and providers where both must communicate in ways the other can understand.
Helen Osborne, a health literacy consultant in Natick, Massachusetts, defines health literacy as "a shared responsibility between patients (or anyone receiving health information) and providers (anyone providing health information). Each must communicate in ways the other can understand."
Why Aren't We Health Literate?
Several things can stand in the way of our lack of health proficiency. First, medical language can be confusing. Filling out forms and recalling your medical history can be difficult. 
In addition, health and medical information are not always written in plain English and doctors may not speak to patients simply enough. 
Physicians may not have time to explain things as well as you'd like. Keeping track of multiple medications may be confusing, as well.
Older Adults & Health Literacy
Older adults are among the groups with low health literacy. "Adults, particularly those over seventy, have higher rates of limited health literacy," Wolf says. "The confluence of greater health care needs in older age at a time when many of us are becoming somewhat cognitively compromised sets the stage for significant health literacy concerns." 
Older adults often have one or more chronic health conditions and because of this, they often need more care than when they were younger. "Similarly, the age-related cognitive decline also accelerates in our later years, impacting how quickly we can process information, recall instructions, and multitask," Wolf adds.
Osborne cites factors that may affect how we understand health issues, like "an increased prevalence of disease, drug interactions, and declining abilities to see, hear, think, and remember." 
Likewise, aging adults may also "be facing life situations such as losing a spouse, moving from their home, or transitioning from being the caregiver of a family to now being cared for by their family."
Health Literacy Skills
The U.S. Department of Health and Human Services (HHS) says health literature includes the following skills:
Navigating health care systemsUnderstanding prescription drug instructions and consent formsFollowing pre-surgery instructionsCheck a nutrition label to ensure an item is safe for someone with a food allergyCalculating the correct dose of a medicine, among others"Health communication often requires more advanced skill sets, like understanding risks of a procedure or comparing two treatment options," Wolf says. "Health literacy also entails communicating effectively to healthcare providers."
Tips for Patients
Osborne has some tips for patients in her book, "Health Literacy from A to Z: Practical Ways to Communicate Your Health Message":
Take note of your symptoms. That includes when they started, how often they occur, and what they feel like to you. It can help to describe symptoms using both words (such as describing pain as “achy” or “sharp”) and numbers.Invite family members or friends to act as advocates. This is extra important when anticipating difficult medical conversations.Overcome communication barriers. Wear your glasses, use needed hearing aids, and let providers know when you cannot understand important words, concepts, and instructions.Create your medical record. Again, you are the expert on yourself. It helps a lot to keep your records and be willing to share these when needed by others involved with your care.Teamwork Helps
Suzanne McCoy, 65, and her mother, Rafaela McCoy, 95, of Brooklyn, New York, work together on managing Rafaela's medications and medical care. 
Suzanne, a two-time breast cancer survivor, describes her health literacy as good. "I'm very good about bringing a list of questions to my doctors," Suzanne says. "I always ask about the possible results of my tests and plan of action for each. As a result, I was much more health literate for my second bout of breast cancer at age 62 than during my first bout at 39."
What did she do differently the second time? "I asked questions and wrote down the answers. Then, I joined cancer support groups to share information with others," she explains. 
"I asked questions and wrote down the answers. Then, I joined cancer support groups to share information with others."
"I did my research when I was prescribed anti-hormone medication," Suzanne adds. She had adverse side effects from the medication and asked her doctor to prescribe the brand name drug, which her research indicated would cause fewer side effects. 
She even found a pharmacy in another state with more affordable prices for the expensive drug.
Rafaela McCoy has several health issues, including high blood pressure, atrial fibrillation (a-fib), gastric concerns, anemia, and thyroid issues. "I can't hear too well and have to rely on my daughter to be there or make or receive calls from doctors regarding medical issues and prescriptions," she explains. 
"Also, I take a lot of medicine, and it's hard to keep track of them — some I take in the morning and some I can't take too close together."
The two have a system to keep track of medicines Rafaela has taken and which ones need to be taken. "My mom came up with a system," Suzanne says. "She lines up the bottles on her table with the caps facing up, in the correct order of when to take each. Then, once she takes each medicine, she turns the bottle cap-down." 
Recently, two new medicines were added, bringing the total to eight, and one of the two has to be taken before the other. "I separated those two bottles and put them to the left of the other six because they're the first ones she has to take in the morning," says Suzanne.
Additional Suggestions to Improve Health Literacy 
Ask your doctor about tests, medicines, and medication side effectsIf you don’t understand what your doctor says or if they talk too fast, let them knowAsk doctors to repeat information clearly and then repeat what you hearBring a friend or relative to doctor appointments and ask them to take notesEvery time you visit your doctor, bring your medications, including OTC (over-the-counter) onesBring a list of questions to ask so you don’t forget during the visit

Improve Your Health Literacy

On busy days, it can be tough to make time to attend an hour-long yoga class or get to the gym. The convenience of DVDs and online workouts can’t be beat.
 
Marcia Noyes, 54, of San Antonio, Texas, credits her improved posture, increased flexibility and broader range of motion from following a gentle yoga DVD for several months.
 
“I can bend and move so much better as I’m painting a 3,500-square-foot house, an ongoing project for the past year,” Noyes says.
 
Check out these popular DVDs and find one that’s right for your goals and fitness level. (Always check with a physician before starting any new exercise program.)
 
Leslie Sansone Walking Series
Known as America’s No. 1 walking expert, Leslie Sansone is a nationally recognized fitness guru and creator of the Walk at Home program. Her DVDs include 4 Mile Power Walk, Burn Body Fat, Ultimate 5 Day Walk Plan and many more. You walk in place and perform simple moves, such as stepping side-to-side and leg lifts, all without leaving your living room. Videos are broken out into various mileages from one to five miles so you can choose one to match your fitness level, from beginner on up.
(MORE: Stretch Out and De-Stress With Restorative Yoga)
 
Rodney Yee’s Yoga
Gentle yoga and stretches are a great way to ease into a daily workout routine (this is the routine Marcia Noyes mentioned). Rodney Yee offers a variety of yoga DVDs, ranging from beginner to energy and stress relief, a Power Yoga collection as well as a Daily Yoga and A.M. and P.M. DVD, all of which get four and five stars consistently on Amazon.
 
Stronger Seniors Chair Exercise Program and Workout Program
Stronger Seniors series ranks highest on Amazon for senior exercise DVDs with hundreds of five-star reviews. The instructor’s (Anne Pringle Burnell) vibrant personality and ability make the exercises fun and easy to follow, even for those with health limitations such as osteoarthritis. People who prefer to exercise seated or who have limited mobility feel stronger, more balanced and more flexible. 
 
BoneJuvenate
Geared toward preventing and treating osteoarthritis, BoneJuvenate consists of a 30-minute exercise program designed to strengthen bones and muscles, work the core, enhance balance and flexibility and correct common postural problems. A certified trainer, a chiropractor and an internist specializing in osteoporosis designed this compilation of exercises, a gentle and relaxing approach to weight bearing and balance.
(MORE: 7 Exercises to Never Do After 50)
 
Healing Movements System
Joe Pinella broke his neck and back in a catastrophic car accident and was diagnosed quadriplegic. It took him seven years to recover and regain the use of his arms and legs. He now teaches people over 50 exercise programs designed to heal their own injuries. His Healing Movements System is a Western version of Qi Gong and Tai Chi gentle martial arts and is ideal for beginners and those with aches and pains. “It is easy for anyone to do and can be used to get back into shape after long periods of sedentary living,” Pinella says. “It’s also great for arthritis.”
 
Functional Fitness with Suzanne Andrews
An occupational therapy practitioner (a licensed medical professional who specializes in function), Suzanne Andrews’ line of fitness DVDs specifically targets people over 50 and includes a new Arthritis Walking Workout line. For those with arthritis, Andrews demonstrates the same therapeutic exercises she teaches in her practice to help people decrease joint pain; for osteoporosis, she provides specific exercises to increase bone density. A variety of DVDs can be found on Amazon.
(MORE: Walking 20 Minutes a Day Might Save Your Life)
Weight Watchers Series
From Yoga for Weight Loss for Beginners, to 10-Minute Belly workout, a Yoga Starter Kit and 7-Day Tone & Burn, the Weight Watchers DVD series caters to beginners on up, making them perfect if you’re looking to start with a gentle workout. Top instructors include Lisa Wheeler, who uses hand weights in an hour-long total body workout that includes upper and lower body plus core, abs and butt.
 
Element: AM & PM Yoga for Beginners
The best-selling yoga brand at Walmart, the Element Yoga series offers programs that target weight loss; morning and evening workouts and yoga for belly, butt and thighs, with a focus on strength and flexibility. Instructors include Ashley Turner, one of the top yoga teachers in Los Angeles and Elena Brower, a certified Anusara Yoga teacher and founder of Virayoga in New York City.
Next Avenue contributor Linda Melone is a California-based freelance writer specializing in health, fitness and wellness for women over 50.
 


The Best Workout DVDs for Boomers

Doris pulls me ahead; I trot to keep up. Her tail is sailing, as if atop a mast. I take this as a sign that my 1-1/2 year-old Terrier/Jack Russell mix is happy and brave. Well, slightly braver than she was three months ago when I adopted her from a shelter.
Elaine Soloway and her dog, DorisAs for me, a certified senior at 81, I check my Apple Watch and note my rising heart rate. "Good," I think to myself — exercise and companionship from one 25-pound bundle.
Elaine Soloway and her dog, DorisThe more time I spend with Doris, the more I understand that I have been granted another benefit from our union; I have become braver, too. Unlike Doris' buoyant tail, I have no bodily evidence of this boon; just examples.
Finding Courage at the Dog Park
It's 5 a.m. in Chicago's River North neighborhood; dark, quiet, with only a handful of dog walkers, runners and members of a nearby health club appearing and fading from view. Our target is a dog park, two blocks from our studio apartment. It will likely be deserted at this early hour, but because lights and cameras dot our path, Doris and I are not distressed.
The more time I spend with Doris, the more I understand that I have been granted another benefit from our union; I have become braver, too.
Like always, during our other visits to this park at more reasonable hours, it takes a few minutes to unlatch the iron gate that prohibits the dogs from escape. As the bars squeak and clang, I feel as if we have slipped backward in time, like arena warriors about to enter some dire competition. The image doesn't frighten me; it, in fact, builds my courage.
There is a second locked gate a few feet in, which I more quickly open because I know my pooch is eager to do her bathroom business and perhaps find a pal to chase among the hills and trees.
While she is off-leash, I take a seat on one of the metal chairs, keep an eye on her and then contemplate the change in dog and owner. Along with Doris' adoption papers, she toted a list of fears from her puppyhood in Florida and residences in various shelters. Men, trucks, construction workers, bicycles, scooters, baby strollers, traffic and other big city features kept her tail tucked and hidden. Our daily walks were punctuated by pauses as she confronted each terror.
Now, after four walks a day during these three months, while we still face these disturbances, her fear has lessened. Often, she passes one of these abominations, and hardly gives it a glance from her lovely lashed eyes.
Fighting Childhood Fears
As for Doris' owner, my fears began in childhood. Like many who grew up in the 1940s playing on the sidewalks of old neighborhoods, I at first capered happily. Roller skates (with keys), jump ropes and games of Ring-O-Levio kept us kids giddy until last call to get inside.
Then something happened that shattered that nostalgic picture, leaving me, and other young girls of the time, to cope with lasting trauma. Perhaps little Doris' fears are also remnants from her early life.
The onset of my anxiety began January 7, 1946 when six-year-old Suzanne Degnan was discovered missing from her first-floor bedroom in Edgewater, Chicago. A ladder was found outside her window. Eventually, police discovered Suzanne's dismembered body, a block from the Degnan residence.
After sensational headlines played out for weeks, with vivid descriptions of the child's scattered body parts, William George Heirens, 17, was convicted of the murder of Suzanne Degnan and two other women. (Heirens died in 2012, at the age of 83, after a lifetime of professing fabricated evidence and his innocence.)
Now suppose if at that time, you were an 8-year-old girl who slept on the side of the bed closest to the window, like I did. Our three-room apartment was one floor above our grocery store, easily approachable by a ladder. Although my 11-year-old brother slept on the other side of the bed (remember, this was the 1940s), his presence helped, but didn't mollify my nightly fears.
'Bonded by Our Mutual Trust'
As I grew older, through schools, marriages, parenthood and careers, I became more confident. But this self-assurance never extended to the dark of night. An early riser, I'm happy to be the first to leave a party so I can tuck in by 8 p.m. From the cocoon of my 27th floor apartment, I calmly view the city lights.
At this 5 in the morning, the darkness and silence are as deep as if it were midnight. Doris and I, with our childhood experiences stored high on a shelf of our memories, walk bravely together; one with tail flying, the other with heart bouncing, bonded by our mutual trust.


Lessons in Bravery From a Dog and Her Owner

Elaine Soloway

Last Sunday I received a phone call from Suzanne Gerber, who heads up Next Avenue’s Living & Learning section.
 
She apologized for calling me on the weekend, then told me, in a sober tone, that she had some difficult news to share: Next Avenue gardening writer Leslie Land had passed away. Leslie had been ill for a while, but we hadn’t known that.
 
After letting myself feel the fierce emotional wallop of this “here yesterday but gone now” news, the harshness of the vacancy struck — the experience was akin to looking into the gaping hole a majestic overturned tree leaves behind: all that beauty toppled alongside palpable absence.
 
I said a silent prayer as my mind turned to the interactions I had had with Leslie over the years. 
 
The truth is they weren’t all that numerous, and there were protracted gaps of silence along the way. Yet Leslie’s impact was significant if unspoken. She came into my life in the late ’80s at a very critical time in my career — when I was a young editor at Metropolitan Home magazine just beginning to immerse myself in many of the subjects that, to me, make life worth living.
 
(MORE: Growing and Cooking Summer’s Herbs)
 
Writer (Leslie) and editor (I) began collaborating on gardening and landscaping stories, and as I dug into her work, a world of tumbling vines, moon-kissed white gardens, voluptuous fruit trees and fragrant rosemary and basil opened up.
 
And since Leslie’s first love (and expertise) was cooking — she had been one of the first chefs at Chez Panisse in Berkeley — food became a rich part of our conversations too.
 
She wrote food and gardening articles for numerous outlets (among them the New York Times and Yankee magazine) and published two cookbooks. All the while, she kept expanding her own gardens in Upstate New York and Maine and throwing lavish dinner parties for her many friends. Somehow she found time to write not one but two blogs, “In Kitchen and Garden” and “All Around the House.”
 
Leslie was all about so many other things I value: irreverence, enthusiasm and dedication to what she cared about, clear and well-defined opinions, a fresh and quirky way of looking at things, and a fervent desire to get the most out of nature by sensitively collaborating with her rather than beating her into submission.
 
I admired her gusto and her willingness to experiment and share her exciting discoveries, most of which revolved around lushness, color and form, and flavor.
 
(MORE: Vines Are a Gardener’s Best Friend)
 
Reconnecting With an Old Friend
 
Nearly 25 years had passed since I last worked with Leslie, and when we launched Next Avenue, I suggested to Suzanne that she approach Leslie about writing for us. Over the next year, Leslie wrote a monthly gardening blog for the site, and, as expected, her pieces were eminently practical, expert and brimming with her unique voice.
 
She came to our launch party in May 2012, and it was so delightful to see her in person after such a long time. We went out for drinks afterward, and she regaled us with heartwarming and inspiring tales of her relationship with her husband Bill Bakaitis, a mushroom expert and clearly the center of her life. She also talked about other extraordinary men that she wanted to introduce me to, a lovely gesture. I felt she “got me” more than most and that these connections would be worth my while. Unfortunately, we never made them happen.
 
In reviewing our friendship, it became evident how little sense of a person’s impact we might have unless we take the time to focus on it and consider all its nuances and their magnitude. It also struck me how easily Leslie and I could have never crossed paths again after I left Metropolitan Home and how much we (and our readers) would have missed out on.
 
We truly are sowing seeds with every single action we take at all stages of life, and these will take root and sprout in one way or another, in accordance with the ways in which we nurture them.
 
None of us knows where we will ultimately land, but I’m quite certain that magnificent Leslie Land gardens are being cultivated in many, many spheres and that what she planted here will continue to grow and thrive.


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