Life is a Beautiful Mess

Life is a Beautiful Mess

Community Hospital 19/12/2016 0

Our old dog woke me up in the middle of the night…again. Grumbling, I dealt with her and then stumbled back to bed. Eyes wide open I stared at the ceiling, every unfinished project fighting for priority in my head. There’s wrapping yet to do, cards to be sent, the holidays fast approaching in addition to all the other commitments on my to-do list that have yet to be checked off.

Slipping back out of bed, I stepped outside in the crisp air to look at the full moon peaking out from the clouds. I took a deep breath and tried to quiet my mind by reflecting on the stillness of cold nights and bright skies.

If it’s true that the simple things mean the most then I challenge you to take the time for the simple things this season. Find beauty in the night sky. Be grateful for that tail-wagging dog who is happy to see you (even if it’s 3:00 a.m.). There’s a reason you can’t fall asleep. Maybe you haven’t spent enough time saying thank you today and realizing just how blessed you are.

When you get caught up in everything on your to-do list and your mind won’t stop swirling, I think that could possibly be the universe or God or your guardian angels telling you to count your blessings. Take a deep breath, exhale, and whisper “thank you”.

Your life may feel like a mess at times, but it’s a beautiful mess. And out of the mess of ribbons and bows and pretty paper you wrap a gift. Isn’t that the perfect analogy for life? It’s a jumbled mess, but at the end of the struggle of taping the corners just right, there is a gift. Be grateful for the gifts you’ve been given.

Wishing you a blessed Christmas and a new year filled with long walks, fairy tale endings and millions of kisses!

~ Jana, MA, CHWC

Community Hospital Blog Contributor

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The personal side of cancer

Community Hospital 26/10/2016 0

I had the honor of interviewing the physicians at Grand Valley Oncology this summer to write their bios for their website. Of course, education and experience made the cut, but I wanted anyone who read about them to see their softer side. Who they are outside of the cancer center. I quickly found out: who they are outside of the cancer center is exactly who they are at work.

It was universal: they love their job. There may have been different reasons they have chosen their profession and many different avenues got them to their current positions, but there was a collective, “I am exactly where I am supposed to be” theme.

They work hard. They continue to study and to learn in a field that changes daily. They see their patients on this life-altering journey and they walk beside them, helping them find hope. It was Dr. Virgilio who said, “I truly believe that cancer has its bad side but it changes people for the good. The living presence of God: That’s the good.”

What caught my attention was the resounding positive attitude they all have and the need to share that positivity with their patients. Dr. Miller said, “Cancer gives you a different philosophy on life. You can choose to live every day or die every day.”

And then an interesting point came up more than once.

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Ovarian & Breast Cancer: Why your family history is important

Community Hospital 05/10/2016 0

Ovarian & Breast Cancer: Why your family history is important

Get out your teal and pink colored ribbons everyone because September is ovarian cancer awareness month, and October is focused on breast cancer awareness.  There are many different topics that can be spotlighted for cancer awareness.  One that I believe is very important, and can potentially stop a cancer before it begins, is being aware of your family history of cancer.

The presence of breast or ovarian cancer in your family history does not automatically mean that cancer is hereditary.  Being aware of your family history and discussing this with a genetic counselor can help to determine whether you may also have an increased risk for the disease.  Research has shown that about 10% of breast cancers diagnosed are hereditary, and up to 20% of ovarian cancers are hereditary.  By determining if your family falls into the hereditary category you can become proactive in screening and reducing the risk for these cancers.

There are features, or red flags, to be aware of in your family history that may indicate a hereditary cause for breast and/or ovarian cancer.  Some features that are more concerning for hereditary breast and/or ovarian cancer include breast cancer diagnosed under the age of 50, 3 or more individuals diagnosed with breast cancer on the same side of the family, individual with 2 or more primary breast cancer diagnoses, male breast cancer, and ovarian cancer diagnosed at any age.  This is not an extensive list of concerning features.  If you have questions about your family history and risk of cancer speak with a genetic counselor or physician.

If you are interested in discussing your family history of cancer and how it may affect your cancer risks please speak with your doctor about genetic counseling.  If you or a family member are identified as having hereditary cancer risks there are specific actions you can take to reduce your cancer risks or increase surveillance to detect cancer at earlier, more treatable stages.  One of the great benefits of genetic counseling and testing is the ability to change the pattern of cancer in a family going forward.  The cancer that may have affected past generations is not doomed to repeat itself when families become empowered to take action with genetic information!

Katie Lemas, MS, CGC

Genetic Counselor – Grand Valley Oncology





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Roses and Thorns

Community Hospital 30/08/2016 0

Shame spirals are real. They happen when you feel you have failed. When you’ve done something and you find yourself saying, “I’m not good enough.” It then spirals into something like this:

I am not talented enough.

I am not smart enough.

I am not organized enough.

I am not thin enough.

I am not enough.


Stop the shame spiral!

I was visiting with an old friend who is both a successful writer and landscaper. (I share he’s a landscaper because I think his analogy fits him perfectly. Keep reading. You’ll figure it out.)

I was in a shame spiral – feeling unworthy. And he shared this gem:

“I picture roses and thorns. For every thorny thought, I force myself to find the positive thought, to find the rose.”

Wow. Pretty simple but very poignant.

Often times, when we are spiraling down, we just keep pricking ourselves with the thorns. I can feel I have failed at something one day and then I manage to remember every failure I have encountered since I was ten years old. It goes something like this:

“Darn it, I missed my dentist appointment. I am a loser. There is a Lego tsunami in the living room and the breakfast dishes aren’t done. I didn’t exercise this morning…”

The spiral continues until I end here:

“Remember when I spelled the word ‘envelope’ wrong in the 5th grade spelling bee and lost the competition to Bennett, the annoying boy who sat behind me?



Today, I do roses & thorns.

“The breakfast dishes aren’t done because I was busy building the Lego zoo to house our new dinosaur (that retails at $1.99 but we spent $40 at Chuck E. Cheese to win). Rose!

Chris made breakfast and I didn’t have to do it. Rose!

I can get my exercise by cleaning up the Legos. Rose?”

(Okay, sometimes you have to stretch to see the rose but you get my point.)

Stop focusing on the thorns that hurt you today and find the rose. Then stop and really see it. Embrace it. Enjoy it.

Wishing you a bouquet of roses!

~ Jana, MA, CHWC

Community Hospital Blog Contributor






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Fuel Your Workouts

Community Hospital 18/08/2016 0

There’s a lot of information out there from people and organizations telling you what you should and shouldn’t eat if you want to lose weight, gain weight, or get healthy. All of that contradictory information makes it difficult to know what you should actually do. Maybe all you need to do is get back to basics. 

When it comes to weight loss nutrition is key and calories are king! If you are trying to lose weight it is as important to make sure you are getting enough calories as it is to make sure you aren’t getting too many. People like to throw around 1200 like it is a magic one size fits all number, but that’s not the case. Every body is unique and an ACSM certified personal trainer or exercise physiologist can help you figure out how many calories you should be eating every day.  

What is a calorie anyway?  A calorie is a unit used to measure energy, specifically a calorie is the amount of energy needed to raise the temperature of 1 kilogram of water 1 degree celsius. A calorie can be thought of as fuel that comes from macronutrients: carbohydrates, proteins, and fats.  

According to the 2010 Dietary Guidelines put out by the federal government: between 45 and 65 % of your daily calories should come from carbohydrates, 10 to 35 % from protein, and 20 to 35 % from fat.  

As an example: if an individual consumes 2000 Calories per day their daily macronutrient allowance may look something like this –  

2000 calories X 60% carbohydrate = 1200 calories of carbohydrate per day
1200 calories / 4 calories per gram = 300 grams of carbohydrate per day 

2000 calories X 20% protein = 400 calories of protein per day
400 calories / 4 calories per gram = 100 grams of protein per day 

2000 calories X 20% fat = 400 calories of fat per day
400 calories / 9 calories per gram = 44 grams of fat per day 

Following these basic rules should help get you to the healthiest weight for you. These guidelines will fuel your workouts and fuel your life. There is no reason to change your diet to compensate for your exercise routine unless you are an athlete training at high intensity for several hours per week – in which case your coach and athletic trainer will provide you with all of the nutritional guidance necessary. 

  • Always contact your primary care provider for guidance before making any significant changes to your diet.   For more information: and

Anne, B.S. Exercise Physiology

Community Hospital Blog Contributor


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Preventing Cardiovascular Disease

Community Hospital 18/07/2016 0

Probably every person has a story about how cardiovascular disease has affected their lives. Heart disease is the leading cause of death in the United States even though many of the known risk factors for developing cardiovascular disease are modifiable. Prevention is key, and that includes prevention of further damage once you’ve been diagnosed. It is never too late to live heart healthy!

Physical activity is arguably the most important modifiable risk factor to developing cardiovascular disease. The American Heart Association is a great resource for physical activity recommendations for adults and children Recommendations for physical activity specifically to prevent cardiovascular disease include 150 minutes of moderate intensity physical activity (50-70% of maximum heart rate) or 75 minutes of vigorous intensity physical activity (70-85% of maximum heart rate) per week.  

To calculate your maximum heart rate simply subtract your age from 220. For example, a 45 year old individual will take 220 – 45 to get a maximum heart rate of 175 beats per minute.  

To find your target heart rate, simply multiply your maximum heart rate by the maximum heart rate percentage you’re aiming for. For example, if the 45 year old individual is wanting to exercise at a moderate intensity, or 50 – 70% of their maximum heart rate, they would simply multiply 175×0.5=88 for the lower range and 175×0.7=123 for the upper limit. Then monitor your heart rate during exercise to try to keep it in that target range.  

These recommendations are a great place to start. If you’re looking for a more personalized approach to fitness and heart disease prevention, visit any gym with ACSM certified personal trainers or contact your primary care provider for resources.

In addition to healthy amounts of physical activity, a sensible diet and maintaining a healthy weight are both very important components to living heart healthy.  

As always, check with your primary care provider before beginning any exercise program. More on living a heart healthy lifestyle can be found at:

~ Anne, B.S., Exercise Physiology


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Genetic counselor…What is that?

Community Hospital 21/06/2016 0

Picture this.  You are at a friendly get together mingling with new people.  You are engaged in polite small talk and a familiar question comes up, “So, what do you do?”  For me the answer is, “I am a genetic counselor.”  95% of the time the response I receive is a polite smile followed by a bit of a blank stare and then, “What is that?”  So what exactly is a genetic counselor?  You are about to find out.

Let’s start by breaking down the title genetic counselor.  Genetic is something to do with genes or heredity, and counselor is a person trained to give guidance.  Therefore, a genetic counselor gives guidance relating to genes or heredity.  This sounds pretty straight forward, but being a genetic counselor is much more than guiding a person’s genes. The National Society of Genetic Counselors, an organization that promotes and supports genetic counselors, describes genetic counselors as healthcare providers who help “…understand and adapt to the medical, psychological and familial implications of genetic contributions to disease.”  This is a great description, one definitely well-crafted from a reputable organization.  I like to provide a more basic description of genetic counselors as genetics nerds who really like puzzles and helping people.  So why would a puzzle loving nerd who likes human interaction become involved in your medical care?  There are several reasons, and the list continues to grow.

Genetic counselors appeared about 20 years after the discovery of the structure of DNA in the 1950’s.  With this discovery genes, (a unit of heredity transferred from parent to offspring that determines some characteristic of the offspring), were identified and their effects on health began to be recognized.  Genetics was and continues to be a complex field that only becomes more complicated with new discoveries and technology.  Currently there are thousands of genetic tests offered by hundreds of genetic testing laboratories.  Determining what these tests are and how the results can affect health and patients’ lives is where genetic counselors become a crucial part of the care team.  Genetic counselors guide patients, their families and other healthcare providers through the complex world of genetic testing providing education, advocacy, and support so that patients can make difficult decisions and live the best life for themselves.  Whether this means learning about risks to an unborn child, increased personal risks for cancer or heart disease, or obtaining a difficult diagnosis for a family member genetic counselors help patients to be supported and empowered throughout the process.  Genetic counselors do not make designer babies or have the ability to tell the future.  We do try to make a complex field less intimidating and support people and families along the way.

If you are interested in learning more about genetic counselors please check out this YouTube video for more details of what a genetic counselor is and how they can become involved in your care.

~ Katie Lemas, MS, CGC

Genetic Counselor

Grand Valley Oncology


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Summer is Here~ Slow Down!

Community Hospital 15/06/2016 0

Slow down.

Last year I wrote an article for our second daughter who was graduating from high school. If you can relate to this rite of passage, check out “Dear Daughter” below via the “Read More” link.

Today I am thinking about us—the parents. Whether you have a future graduate in the class of 2031 or a young adult daughter beginning the graduate school process, my advice is the same:

Slow down.

These moments will pass before you have a chance to breathe. So slow down and be present.

Let’s face it; summer is cool! It’s a time when we barbecue, watch the game in the stands or sign up for a race or two (or in my husband’s case: ten.) We figure out where to travel with the family and how to get there. We try to fit it all in. And that’s the problem.

At our house alone we are figuring out how to juggle the teenagers’ part-time job schedules, our work schedules, which camps everyone is going to, the family summer vacation and of course, Chris’ ten races. It’s all great stuff—don’t get me wrong. But I write this advice with our family in mind as well as yours: slow down this summer.

We took Andrew on a hike yesterday and I am embarrassed to admit, I was slightly frustrated with the little guy. Didn’t he know I was trying to get my cardio in while I took him on the hike? Didn’t he understand that we needed to keep the pace moving? Of course not! We found the buried treasure just ten feet from the parking lot—who knew treasures were so easy to find?! We then proceeded to study every gecko, every ant, every fascinating rock (that would be all rocks to Andrew) and there was a game of hide-and-seek in there as well. No, my heart rate didn’t soar into its target zone but my imagination soared as we pretended to be passed by dinosaurs of all shapes and sizes.

After our hike, I was racing around until my head hit the pillow and so it didn’t hit me until the next morning: Those are the moments that matter. The days are coming when I won’t have my college kid and my preschooler on a hike together with me. I can focus on my target heart rate then.

Part of taking care of your health is taking care of your heart. Go ahead and do your cardio and strength training. But don’t forget the other ways you take care of your heart. Breathe in the beauty that makes up your day. Smile at the imaginary dinosaurs that cross your path. Slow down and be present in the simple moments. Come on, we are just grown up kids, so grab an icy pop (blue’s my favorite) and enjoy your summer!

~ Jana, MA, CHWC

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Health Hazards of Exercise

Community Hospital 31/05/2016 0

Everyone is probably aware that exercise is a vital component of a healthy life. But with any physical activity there is an inherent risk of injury that may intimidate even those with the best of intentions out of starting a fitness program. All physical activity runs the obvious risks of muscle strain and joint injuries, even walking across the lawn can be hazardous for your ankles! However when you’ve got a complicated medical history, have been inactive for a long period of time, or have family history of some diseases, risk with activity increases somewhat.

One piece of good news is that the association between physical activity and health has been thoroughly researched and continues to be researched today. Exercise professionals are able to use relatively simple and very sensitive questionnaires, such as the commonly utilized Physical Activity Readiness Questionnaire (PAR-Q), to identify individuals for whom a medical evaluation and physician consent is advisable prior to beginning an exercise program.

Additionally, the risk of serious injury or medical complication is very small and the benefit far outweighs the risk for almost every situation. This risk vs benefit as it applies to different activity levels is represented in the graph below. As vigorousness increases the risk is increased slightly, but the benefit is significant. This association continues until a certain point where overtraining can become an issue, however this tip in the risk vs benefit relationship tends to occur in individuals training at very high intensity for extended periods of time.

Benefits and risks related to levels of physical activity figure

Figure 1 (Click to View): Risk and benefit relationship as it relates to various levels of physical activity. From van Sluijs, Verhagen, van der Beek, van Poppel, van Mechelon, 2003, Risks of physical activity. In Perspectives on health and exercise, edited by J. McKenna and C. Riddoch (United Kingdom: Palgrage Macmillan), 112. Adapted by Anne Back, BS.

As always, check with your primary care provider before beginning any exercise program. More on the risks of injury with physical activity can be found at:

Howley, E. T., & Thompson, D. L. (2012). Fitness Professional’s Handbook. Champaign, IL.

Lavie, C. J., Milani, R. V., Marks, P., & de Gruiter, H. (2001). Exercise and the heart: Risks, benefits, and recommendations for providing exercise prescriptions. The Ochsner Journal, 207-212.

Powers, S. K., & Howley, E. T. (2012). Exercise Physiology: Theory and Application to Fitness and Performance . New York, NY: McGraw-Hill.

Anne, B.S. Exercise Physiology

Community Hospital Blog Contributor

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What’s the big deal about Blood Pressure?

Community Hospital 02/05/2016 1

There’s a lot of talk about blood pressure and as many as 1 in 3 adults have high blood pressure, only half of whom have their condition under control. But why does it matter? According to the Centers for Disease Control and Prevention high blood pressure (BP of 140/90 mmHg or higher) is named as a primary or contributing cause for almost 1000 deaths per day. When blood pressure goes up you may have few or no symptoms, so it is important to check it regularly.

Several risk factors contribute to the development or worsening of hypertension. Some modifiable risk factors are obesity, tobacco use, activity level, eating diets high in sodium and low in potassium, and alcohol use. Other non-modifiable risk factors include certain medical conditions like diabetes, family history, advanced age, and gender.

The good news is if you do have high blood pressure, or if it is starting to creep up, you have several options. Simple things like adjusting your diet can bring systolic (top number) and diastolic (bottom number) blood pressure down by as much as 5 and 3 mmHg respectively (USDA guidelines recommend the DASH diet for reducing cardiovascular risk factors, lowering risk of metabolic syndrome, and maintaining a healthy body weight:

Likewise, lifestyle changes such as quitting smoking, losing weight, limiting alcohol intake, and getting active can make a big difference! Adding a moderate-intensity endurance exercise program has been shown to improve blood pressure. And of course if any of these changes aren’t quite adequate pharmaceuticals are always an option.

As with any medical condition, be sure to consult with your primary care provider before making changes.

For more resources visit:
Howley, E. T., & Thompson, D. L. (2012). Fitness professionals handbook. Champaign, IL.
Powers, S. K., & Howley, E. T. (2012). Exercise physiology: Theory and application to fitness and performance. New York, NY: McGraw-Hill.

~ Anne, B.S. Exercise Physiology

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