When therapist Rene D. Czerwinski, LMHC, NCC, learned that almost half of transgender Americans attempt suicide in their lifetimes, her strong commitment to providing excellent care to transgender patients was reconfirmed. “That’s way higher than the national average for any other group. It’s a shocking number,” she says.
Rene’s practice at Pacific Medical Centers is underpinned by a key message: you are not alone, and there is support. Rene has pursued specialized training and certification in transgender care. At PacMed, she works with other health care providers who are open to continuous professional learning and committed to team care for their patients.
Rene works with transgender people as well as their parents. Parents of transgender children need to know they are not alone and that there are people out there who understand what they are going through.
The Need for Unified Services
In an international study published by the National Institutes of Health,* the rate of attempted suicide by transgender persons ranges from 32 percent to 50 percent around the world. Transgender people also face increased risk of discrimination, bullying, and violence, plus the loss of their support systems if rejected by family, friends, and the larger community. The police, health care providers, and other service providers often don’t have training or knowledge to provide high quality care to transgender people. All of these, of course, can influence the well-being of transgender people.
Rene sees a need for transgender services, a care area that she feels is not well understood. “Being transgender is not an illness,” she says. She explains that the emotional struggles of people who are transgender are often related to social anxiety, fear of rejection, self-image, and body image. This is part of what Rene helps patients, family, and communities understand. Rene knows firsthand what family members might need to know during transition: her child is transgender.
Respectful Mental Health Support
For clients who are transgender or exploring, Rene emphasizes that being transgender doesn’t mean anything is wrong with you. “We need to remove the stigma that being transgender is a mental health issue or an illness,” Rene says. “By doing so, we can see that the anxiety and depression that get attached to being transgender are related to the fears about how others will react or how sometimes our bodies don’t match what we want them to be.”
Clients who are considering transitioning, with treatments ranging from hormones to surgeries, may need the services of not only physicians, surgeons, and a counselor, but also a psychiatrist. Together, these professionals can make sure that insurance qualifications are met and provide letters and other documentation. They can help research support resources and care options and provide guidance during the process.
Your Body, Your Choice
Rene’s experience and training has heightened her awareness of how to create an accepting space for her patients. “It’s important for a caregiver to come on board with the patient—to not try to tell them how or what to feel,” she explains.
Therapy is a place to explore where a person is now and their desires for the future. Transgender care encompasses everything from small changes to big shifts. A transgender person doesn’t—and shouldn’t—have to know their destination immediately to receive excellent care.
“I remind my patients that everybody is going to look different. We don’t have to know that this is exactly how we want to look. Maybe you want to be somewhere in the middle,” says Rene. “We’ll find what works best for you because it’s your body, your choice.”
The Care at PacMed
Transgender people get to choose the right path for their personal journey. They need physicians who support them through the process—“in whatever stage you’re in and whatever stage you want to go to,” adds Rene.
Happy summer! The Living Well Alliance™ (LWA) would like to remind you of our favorite wellness programs.
Our team continues to help local companies reach their employee wellness goals by providing complimentary services – including biometric screenings, health fairs and one wellness class each year. Don’t forget to schedule your LWA programming soon, as fall will be here before you know it!
With our 2018 webinar subscription program, you can offer your organization more wellness initiatives on a regular, monthly basis! Because we are now halfway through 2018, we’ve prorated our monthly subscription to just $200 for 6 webinars for your whole company to enjoy. What a deal!
Lastly, we’d like to share some of our most popular summer wellness topics:
- Fight with Food: Nutrition for Cancer Prevention. Nearly 50% of most common cancers can be prevented! In this class, you will learn what cancer is and the common types, review risk factors to avoid, and gain positive lifestyle interventions that have been shown to lower your risk.
- Brain Boost. With all the fresh produce available in our area, it’s easy to choose foods that energize and protect the brain. You can choose to include a cooking demo at no additional cost other than food supplies.
- Food for Thought. This class reviews the importance of mindful eating in our busy summer lives and offers a good basis for thinking about long-term health goals.
- Plant Forward Nutrition. Want to understand different plant-based diets? We will review the research on these diets and the different types out there. Want to taste some plant-focused foods? Add in a cooking demo at no additional cost other than food supplies.
Classes from the Living Well Alliance help you provide wellness programming to your employees. These 45-minute, in-person classes are interactive, fun and current—an easy fit for your worksite.
Come join us at our Federal Way clinic (Aug. 8) from 5:30-7:30pm or Canyon Park clinic (Aug. 25) from 12-2 pm. We have lots of free fun planned—like door prizes, face-painting, games and snacks. And while supplies last, we will give away school backpacks at Federal Way and lunch bags at Canyon Park to children. Come have fun and meet some of our providers!
Eating healthy while camping can be a challenge since most nutritious foods tend to need refrigeration. Being a regular camper myself, I’ve learned some tricks to packing a cooler with vitamin-rich foods. 1) Choose hardy vegetables that last longer such as carrots and dark leafy greens like kale, broccoli and collards. 2)Put all foods in sealed plastic baggies or water-tight containers, including precooked meats, cheeses and dips like hummus. 3) Avoid taking raw meats (or eat them at the beginning of your trip to avoid contamination). 4) Layer your drinks at the bottom making a flat shelf for the foods on top. 5) Be prepared to restock ice halfway through your trip to prevent food borne illness. —PacMed dietitian Christy Goff, RDN
Who wants to make a four-course, fresh meal in the woods?! Try this simple, vegetable-laden quesadilla, being sure to keep perishable ingredients chilled until dinnertime. For even simpler preparation, precut/prechop vegetables, measure and store together in a sealed container or baggie. Consider adding a salad or carrot sticks!
Participating in a school sports programs is a great way for adolescents to develop muscular strength, boost confidence and inspire camaraderie. When participating in sports on any level, eating the right balance of nutrients is essential.
For athletes looking to build muscle and strength, understanding caloric intake and proportions of different macronutrients (carbohydrates, fats and protein) is key. Young athletes, in general, need more calories than adult athletes because of their faster growth and metabolic rates. Eating regular, well-balanced meals each day helps the body get nutrition, balances blood sugar levels and provides the foundation for a strong, healthy body.
Carbs Fuel Explosive Power.
Carbohydrates are the main source of energy for an athletes’ explosive power. About 45-65% percent of the athlete diet should be whole forms of carbohydrates, such as whole grains, quinoa, legumes (beans and lentils), fruit, and starchy vegetables, such as sweet potatoes. Carbohydrates that come naturally with fiber, such as oats and winter squash, help control blood sugar for long-term energy.
Healthy Fats Are Critical to Endurance.
During the first two minutes of high-intensity exercises, all energy generated comes from carbohydrates. As exercise time increases, however, the calories the body burns start to transition from carbohydrate stores to the fat stores—meaning that it’s important for athletes to also include healthy fats in their diet. At most, 30 percent of total caloric intake should come from healthy fats such as nuts, salmon, avocado, omega-3 eggs and grass-fed meats. All of these also help with inflammation and are good for joint health.
Protein Builds and Repairs Muscle.
In our western diet, protein deficiency is generally not an issue; we eat plenty of protein. Also keep in mind that protein is not the main energy source for the body, unlike carbohydrates so young athletes should not overdo protein in hopes of gaining muscle faster. For young athletes up to age 18, protein should comprise 10–30% of total energy intake. Some good sources of protein are lean meat and poultry, fish, eggs, dairy products, and beans and nuts.
Healthy Fluids Oil the Machine.
For the most part, it is a myth that sports drinks keep athletes hydrated better than water. Generally, sports drinks should be considered only for high-endurance and high-intensity sports in which the participant is sweating heavily and exerting themselves for greater than 90 minutes. Otherwise, water is enough to hydrate … plus it’s cheap and readily available! And while some youth often think that sugary or caffeinated beverages will give them an energy boost, these in fact can cause a rapid rise in blood sugar, which can lead to a subsequent energy crash.
A good rule of thumb? Drink when you are thirsty. If properly hydrated, urine should be very light yellow to clear in color. If it’s yellow or dark yellow, you need more fluids.
Without proper fuel and nourishment, the body cannot attain its full athletic potential and is more susceptible to fatigue and injury. To learn more, the dietitians at PacMed are available to support your young athlete. Should any of the athletes in your family experience injury, the doctors in our Sports Medicine department can help diagnose and treat them.
As summer slips away, children may experience a range of emotions for the coming school year—excitement, nervousness, anxiety. The new school year presents many unknowns for a child: Will my teacher be strict? Will I get picked on? Will I make the sports team? Here are proactive steps you can take to combat back-to-school anxiety, including knowing the signs of bullying.
Parents can help alleviate young students’ concerns before school begins through consistent emotional and mental support. Some ideas include setting up a bedtime routine at least two weeks before school starts to help ease your student into the school season. Also, take advantage of any scheduled events to meet teachers, classmates and families before the first day; this can help to ease nerves. Finally, be attentive to your child’s concerns. Well before school begins, start having consistent one-on-one conversations about your child’s day. Listen and validate any worries they express. Let them know they can come to you with any issues.
Watching for Bullying
Once school starts, a common source of anxiety for children is bullying. A bully is someone who asserts his or her power by repeatedly being aggressive toward a weaker person. Some types of aggression include physical (such as hitting, stealing and threatening posturing); verbal (such as name calling, public humiliation and intimidation); and behavior focused on relationships (like spreading rumors, social rejection and ignoring).
Here are some signs that can appear in a child who is being bullied:
- Unexplained bruises or other injuries
- Lost or damaged clothing, books or electronics
- Frequent headaches, stomach aches or “invented” illnesses to stay home from school
- Severe anxiety, nightmares, depression
- Bullying younger kids or siblings (bullied children may switch roles and become the bully)
- Weight loss or weight gain
- Inconsistent mood swings, secretive or sullen behavior, temper outbursts
If bullying becomes a recurring issue, don’t hesitate to address the issue directly with the school. Come to the meeting with specific examples, and remember to be respectful as you work together to determine a plan of action.
Keeping Track with a Well-Child Checkup
Now is a good time to get your child in for their annual checkup. Your child’s doctor will check their height and weight, look at other signs of healthy development, screen for childhood diseases, and check for needed vaccinations. If your child has been affected by bullying, you can also talk with their provider about healthy ways to support your child.
We wish you and your children a respectful, healthy and interesting school year.
If you and your family are looking for a primary care provider, please explore the PacMed Family Medicine and Pediatrics providers. We have 10 clinics in neighborhoods around Lake Washington and the south Puget Sound region.
We humans have them, too! How do we avoid skin spots—and which ones are cause for concern? Can nutrition help? What about collagen? Read our 4 newsy bursts below!.
1. Going outside?
We all know the sun is bad for our skin—but hey, we live in cloudy Seattle, right? Wrong! Even on drizzly summer days, 80 percent of the sun’s harmful ultraviolet rays still reach your skin. If you are going to be out for more than a few minutes:
- Always wear a sunscreen with a sun protection factor (SPF) of at least 30 on all exposed skin.
- Cover all the skin you can.
- Avoid the sun between 11 a.m. and 3 p.m., when it is most intense.
- Seek the shade when possible.
2. What’s that spot? When in doubt, check it out.
Many common growths occur on the skin, and it can be difficult to know which lesions may be suspicious. The best bet always is to see your physician when you have questions or concerns.
You also should examine your skin regularly, at least every three months—every square inch! Be proactive about your skin health and watch for new or enlarging pigmented (brown) spots, especially if they are irregular in shape or color. Any new pink or red bumps that persist and enlarge over several months are of concern, especially if they are crusty, bleed or scab easily.
3. Eat your vitamins!
These four antioxidant nutrients can help promote healthy, radiant skin. Try our tips to incorporate foods rich in these nutrients into your daily diet.
- Vitamin A: decreases cell damage and helps the healing process of wounds. Increase your intake of sweet potatoes, carrots, spinach, apricots, cantaloupe and other yellow and orange fruits and vegetables.
- Vitamin E: helps protect against skin damage and plays anti-inflammatory roles in the skin. Try grabbing some sunflower seeds and almonds for your afternoon snack.
- Vitamin C: plays an important role in the synthesis of collagen, a major protein in the skin. Include broccoli, red peppers and green peppers in your favorite dishes, and enjoy oranges, strawberries or kiwi for dessert.
- Omega-3 fatty acids: may include a protective effect against sunburn and premature aging. Your body can’t make them; you have to get them through food. So, make sardines, tuna or salmon for dinner tonight.
4. Instant youth with collagen?
You may be hearing lots of push in advertising for collagen peptide supplements and other skin products. Collagen is a protein in our bodies, particularly the skin, hair, joints and nails. As we age, we gradually lose collagen, and our skin begins to look less moist and full.
So, will using collagen change the effects of time and age? It’s hard to say. Research is tricky when it comes to skin products. It’s hard to isolate whether the product is making an improvement, or whether some other aspect has played a role—like a change in diet, humidity, sleep or hydration.
The jury is still out. Collagen is generally safe and tolerated by most people. In the long run, however, you might do better to save your hard-earned cash and follow the sun-smart tips above for long-term preventive care.