Dr. Barbara Williams — Preventing cardiovascular disease
When Williams' father was diagnosed with coronary disease nine years ago, she was a 37-year-old resident who had fallen out of the habit of exercising and ate three to four servings of red meat a week along with heaping helpings of "comfort foods" such as pasta.
"My plates at home were fairly large, so I was putting on portions that looked appropriate," says the former nurse, now a cardiologist on staff at Parma Community General Hospital. "When I finally started measuring them, they were 1 1/2, maybe two times the serving size that is recommended!"
Her dad's diagnosis served as a wake-up call. Williams replaced roughly half the red meat in her diet with fish and chicken, switched from 2-percent to skim milk, from vegetable oil to more heart-healthy olive oil, and substituted fresh fruit for snacks of cookies and chocolate. Instead of sitting down to a big dinner when she gets home from work around 8 p.m., she pops a Stouffer's Lean Cuisine frozen entree in the microwave around 5 p.m. — an admittedly high-sodium item that forces her to limit her salt intake throughout the day — and eats a light supper or a container of yogurt later in the evening.
Williams also jump-started her exercise program, adding resistance training to her aerobic workout on the stationary bike and elliptical machine to help control her weight, which she now monitors by stepping on the scale once every two weeks. The length and frequency of time spent in the gym, however, varies more than it should, ranging from 10 to 15 minutes twice a week to 30 to 45 minutes five times a week.
"The American College of Cardiology does recommend an hour of exercise a day most days of the week," she notes. "I'm not there yet."
Dr. Paradi Mirmirani — Dealing with adult acne breakouts
The 35-year-old dermatologist has been keeping occasional breakouts in check since she was a 29-year-old resident by applying a pea-sized dab of .025-percent Retin-A cream to her face every night. The prescription-only medication not only reduces the appearance of zits caused by still-oily skin, periods and makeup — an oil-free, supposedly non-irritating, zinc oxide-based sunscreen is the main culprit in her case — but also helps reverse the sun damage she incurred as a tan-happy teen-ager growing up in Southern California.
"It shrinks the oil glands, changes the environment so that the bacteria responsible for acne no longer proliferates, and speeds up [skin-cell] turnover," says Mirmirani, who sees patients at University Hospitals' Chagrin Highlands Medical Center in Orange Village.
But Mirmirani trades in her Retin-A for Azelex, a cream containing azelaic acid prescribed for mild to moderate acne, during pregnancy (she's expecting her third child) and while breast-feeding. "It's a common compound in a lot of nutritional supplements, so it's actually quite safe to use during pregnancy," she says. "It's not quite as strong as Retin-A, but it does the job."
Dr. Amanda Weiss Kelly — Staying motivated to exercise
The director of pediatric sports medicine at Rainbow Babies & Children's Hospital says she's always liked to exercise, an attitude she attributes to the years she spent growing up on military bases overseas — first in Germany, then in Japan — while her father worked for the U.S. Department of Defense.
"We grew up in places where exercise was a part of everybody's life," says Kelly, now 33. "For entertainment on weekends, Germans walked up a mountain and came back down — we did those things. At work, the Japanese did calisthenics as part of their day."
But Kelly also credits her continuing enthusiasm for almost-daily workouts on her varied choice of physical activities. At the gym, she does everything from elliptical training to Pilates. And she plays on both indoor and outdoor soccer teams as well as in two lacrosse leagues during the summer. When she jogs, she often does it with a friend.
"It's hard to bag out on somebody at 6 o'clock in the morning," she explains. "If you run by yourself, it's real easy to turn off the alarm clock."
Dr. Barbara Messinger-Rapport — Stalling the onset of osteoporosis
The Cleveland Clinic Foundation geriatrician has become increasingly dedicated to keeping her own bones healthy as she's watched her mother struggle with osteoporosis, which causes a gradual decrease in the strength, density and quality of bone. The fear of falling and breaking a bone alone has limited 74-year-old Esther Messinger's activities.
"You can't do anything about your genetics," says Messinger-Rapport, 45. "But your lifestyle can postpone the disease process for a long time."
The doctor makes sure she gets the 1,200 milligrams of calcium and 800 to 1,000 units of vitamin D ("Without the vitamin D, your body doesn't absorb the calcium very well") perimenopausal women need each day by taking a supplement to augment her intake of plain yogurt and fortified soy milk, orange juice and breads. "I try to keep a mental record during the day of whether I've taken in enough," she says. She also exercises for 60 to 90 minutes every morning. In good weather, she'll ride her bike 20 miles before breakfast. In bad weather, she retreats to the gym.
"The bones are actually very dynamic," she says. "You may think of them as being solid and thick, but in fact they're in constant movement and interaction with the bloodstream. Exercise, especially weight-bearing exercise, does help retard the course of osteoporosis." The most dramatic example of what happens to bones in the absence of such activity, she adds, is the effect of weightlessness on astronauts in space for long periods of time. "If you don't put weight on your bones, your body will actually start to reabsorb them."
Dr. Lizabeth Brooks — Maintaining a healthy weight during pregnancy and getting back in shape after giving birth
The 33-year-old first-time mother and ob/gyn at Fairview Hospital has only 12 more pounds to lose after giving birth to 7-pound-6-ounce Isabella Rene two weeks ago, an accomplishment she credits primarily to gaining no more than the recommended 25 to 35 pounds during her pregnancy instead of using it as "a license to eat" as some of her patients do. She ate four small meals a day instead of the usual three to help control hunger and nausea at the end of her pregnancy and only gave in to her cravings for Mitchell's mint chocolate-chip ice cream a half-pint at a time.
"As long as I could taste what I was craving, I didn't necessarily have to have the entire portion that was served to me," she says.
Breast-feeding is helping melt away the remaining pounds. "A lot of calories are being burned when you're producing adequate breast milk," she explains. But the 5-foot-6 Brooks, who hasn't worked out for two years, concedes that she'll have to hit the home gym to get down to her pre-pregnancy weight of 135 pounds. She plans to begin light aerobic workouts, ideally 30-minute sessions on the elliptical machine three times a week, after her first postpartum checkup — when time permits, that is.
"I typically write out a schedule for the day," she says.
Dr. Nancy Cossler — Managing the symptoms of menopause
At the age of 51, the residency director for University Hospitals' department of obstetrics and gynecology is still taking oral contraceptives. Therefore, she has yet to experience the hot flashes, mood swings and sleep disturbances many of her older patients have described. Her mother, she adds, went through menopause without developing any of the classic symptoms.
"I may not have any difficulties," Cossler says hopefully.
But if Cossler does develop the symptoms of the "change of life" after going off the birth-control pill at the recommended age of 52, she plans to start hormone-replacement therapy, despite the much-publicized link between estrogen and an increased risk of breast cancer (see page 118 for more information on this controversial topic). She points to a 2002 Women's Health Initiative trial funded by the National Institutes of Health in which women who took estrogen and progesterone — the combination therapy usually prescribed for those who still have all their reproductive organs — suffered only a slightly increased incidence of breast cancer. Women who took estrogen only — the treatment recommended for those who have had a partial hysterectomy (removal of the uterus) — showed no increased risk whatsoever.
Dr. Helen Torok — Keeping rosacea in check
The 57-year-old dermatologist at Trillium Creek in Medina relies on a number of products to control her rosacea, a skin disorder characterized by flushing of the cheeks and nose and breakouts of the face aggravated by extreme changes in temperature. The problem is commonly mistaken for acne.
"One out of 20 Americans has rosacea," Torok says, "but a lot of them don't know that they actually have it."
Torok washes her face with Rosanil, a gentle prescription cleanser containing sulfur that helps clear patches of flaking skin known as seborrhea, a skin disorder caused by a yeast organism suffered by 50 to 60 percent of all rosacea patients. First on the face morning and night is an application of MetroGel, a prescription-only preparation that reduces the inflammation of rosacea. "It's not a cure," Torok says, "but as long as you continue using it, you don't break out as much." That's followed by a touch of fragrance-free Neostrata moisturizer, a light over-the-counter lotion that contains a form of glycolic acid that doesn't sting or burn her rosacea-sensitive skin.
When it comes to makeup, Torok is hooked on a line by Jane Iredale and sold in doctors' offices and high-end salons as well as over the Internet. The powder foundation, made of inert titanium and zinc oxides, provides a natural SPF-17 protection against the sun and doesn't irritate the skin as its liquid counterparts can.
"When you've got rosacea-sensitive skin, you want to minimize the number of ingredients you're putting on it," Torok notes.
Dr. Jung Jin El-Mallawany — Managing stress
As a psychiatrist, wife and mother, El-Mallawany has found that the best way to handle stress is to avoid getting into situations that produce it. "I know my limits, how much I can do," says the 56-year-old medical director of Marymount Hospital's Behavioral Health Center and chairwoman of the hospital's department of psychiatry. "And when I take on a task, I prioritize. If I do one thing at a time, I will do my best so I don't have regrets later." She also delegates tasks at home. When her two now-grown children were young, she hired a part-time mother's helper to do some of the housework, pick up and drop off the kids at their activities.
"You cannot be a superwoman if you really want to handle your stress," she says. "And we don't have to do that."
What if, despite her best efforts, El-Mallawany ends up in a stressful situation anyway? "The portion that you cannot control, you've got to let go," she says. Sometimes, she'll calm herself by going into an empty room, closing the door and taking a couple of deep breaths. "Some people might say that's meditation," she observes. "For me, it's quiet time."
She unwinds at the end of the day by taking walks, gardening, laughing with friends and family, and watching CNN. The often-grim news of the world, she says, "puts my own stressful situation in perspective."
Dr. Janet Blanchard — Staying young looking without plastic surgery
The Mentor-based plastic surgeon and Lake Hospital System board member, who is in her early 50s, scheduled a series of three microlaser peels over the last year to turn back the clock on her face. "It takes off the outer layer of skin and a portion of the dermis, creating somewhat of superficial burn," Blanchard explains. "It takes off the old, rough layers of skin." The peels, she adds, help tighten the skin and remove or reduce unwanted pigmentation, more commonly known as age spots. She also underwent a trichloroacetic acid peel around her eyes to soften the crow's feet there. While she readily confesses that the trichloroacetic acid peel burns, Blanchard claims that the microlaser peel looks a lot worse than it really is.
"You put on numbing medication," she says. "You just look like it hurts."
Less invasive is Thermage, which Blanchard tried for the first time in February before offering it to her patients. The relatively new treatment uses radio waves administered through a handpiece to immediately tighten the skin on the face by heating the collagen in the underlying dermal layer. The procedure also stimulates production of new collagen, which is lost during the aging process. Blanchard says she required no downtime after the treatment, which she repeated a couple of weeks ago. The desired effects, once achieved, are supposed to last for 18 to 24 months.
Dr. Kathleen Senger — Exercising through fatigue and "the burn"
Forget the fact that she's a general internist who should have known better — the 50-year-old Senger was a couch potato, her exercise program a victim of 12-hour workdays, until she started dating an avid runner three years ago.
"I never dreamt I would be doing a total of 150 miles in two days on a bike," she says of her first-time participation this year in Pedal to the Point, an annual fund-raiser for the National Multiple Sclerosis Society.
But Senger is now one in-shape physician, a woman whose average workout consists of a three-mile run or, when she has more time, a 20- to 50-mile bike ride. The associate director of St. Vincent Charity Hospital's internal medicine residency program says she psyched herself into continuing the trip, despite burning legs and feet, by reciting the prayers she learned while being raised in the Catholic Church.
"Part of dealing with any kind of pain often is distracting yourself from what you're feeling," she says. "Whatever you can do to distract yourself from that physical discomfort is beneficial. For a lot of people, prayer is a way to distract themselves from pain. I find it just gets me out of where my body is at that time. Saying the words repeatedly gets my mind into a different space."