Janet Horn - The Smart Womans Guide to Midlife and Beyond: A No Nonsense Approach to Staying Healthy After 50

We would first like to thank the two people whose confidence in our book and in us was essential, Sharlene Martin and Melissa Kirk. Ms. Martin, our agent, immediately saw the potential and need for a book geared to our target audience. She reflects what characterizes this group in her intelligence, tenacity, and success. Ms. Kirk, our acquisitions editor, also saw the potential of this book and has guided us with patience, expertise, and insight throughout the project. New Harbinger Publications, with its very creative staff, has been a pleasure with which to work; thanks go to Kayla Sussell for her copyediting expertise, Amy Shoup for the wonderful cover, Earlita Chenault, Leyza Yardley, Janice Fitch, and Julia Kent for help with promotion, and Jess Beebe for editing assistance early on. We thank Dr. Joanne Perron and Dr. Lori Taft Sours for sharing personal stories with us, as well as those of our patients who allowed us to use their medical stories. We especially thank all of our patientspast and presentfor being our best teachers and the reason for our work..

Janets acknowledgments: My husband Alan has always supported my professional efforts, and he enthusiastically did so again with this project. Being the feminist he is, he saw the potential in this book from the very beginning. I thank my parents, who gave me every imaginable opportunity, and only wish they were still here to enjoy this books publication. My brother Ron encouraged and supported me in my personal and professional endeavors from my childhood on, as did my brother Howard, who was an invaluable consultant for this book. I greatly appreciate the encouragement and advice I received from Joan Cornblath, Jim Magruder, Nan and Craig Duerling, and Anne Fischer. For the chats and laughs in the midst of their work with me, thanks go to Jim Turnbull and Jessica Wescott. My book group, the Literary Ladies of Grafton, provides endless inspiration, great discussions, and laughs. I thank everyone at the Shepherds Clinic for making it the medical oasis it is; there, against all odds, medicine continues to be practiced the way it should be. Finally, after having been a bridesmaid in Robins wedding in 1986, Im thrilled that we could have another collaborative project after twenty-two years, particularly one as significant as this is.

Robins acknowledgments:I would like to acknowledge the support and patience of my beautiful family, my husband Dr. Peter Adesman (an endless source of laughs and information about the GI tracthis specialty), and my sons, David and Brian. In addition, I would like to thank my wonderful dogs, Tally and Lucy, who were great company throughout the whole writing process, keeping me calm and forcing me to go out and exercise! I am grateful for the advice and encouragement of Jennifer Carr, Dianne Oceana, Doris Roser, Wendy Enneking, Dee Gillen, and Wendy Ortiz. I am grateful to my parents, Burt and Aileen Miller, who have been behind me and supporting me 100 percent (through the process of writing this book as well as through life), along with my brother, Jim, and sister, Janet Cohen. I thank my clinic partners at Asante Health System, who have helped me to create a wonderful work environment, and my many mentors at the National Association of Medical Communicators, including Kate OBrian, as well as Patsy Smullin, President and owner of KOBI-5 TV, who helped me to find my voice. Finally, thanks to Janet, who has been a great partner, sounding board, and fearless leader in this project.

Janet Horn, MD, is board-certified in internal medicine and infectious diseases, with training in obstetrics and gynecology. Much of her career was spent in solo private medical practice. For many years, she was a full-time faculty member at the Johns Hopkins University School of Medicine. Dr. Horn has authored many medical journal articles and several medical textbook chapters. Currently, she divides her time between medical writing and practicing medicine at the Shepherds Clinic, which serves the uninsured.

Dr. Horn has been recognized by Baltimore Magazine and The Consumers Guide to Top Doctors as one of the top doctors in Baltimore and in the United States. The Maryland Daily Record named her one of the top 100 women in Maryland in 1999.

Robin H. Miller, MD, is a board-certified internist and integrative medicine specialist who trained with Dr. Andrew Weil at the University of Arizona. She is founder and medical director of Triune Integrative Medicine, an innovative medical clinic in Medford, OR. Dr. Miller is also clinical assistant professor of medical informatics at the Oregon Health and Science University in Portland, OR. She is author of Kids Ask the Doctor.

Dr. Miller is an award-winning medical correspondent for KOBI, the NBC affiliate in southern Oregon and northern California, and can be seen on the Patient Channel on MSNBC.com. She writes a medical column for the Daily Courier in Grants Pass, OR, and a quarterly column for Ashland Magazine.

Visit the authors website and blog at www.smartwomanshealth.com

Chapter 1

Lets start with a story. You just got home from a busy day of (choose one): work/running errands. Youve taken off your purple leather gloves (you got a great deal on them from QVC), and youre busily looking through the mail. Suddenly, your cell phone plays its usual I Cant Get No Satisfaction, and propping it between your ear and your shoulder while you continue going through the huge stack of letters and catalogs, you answer. Its your (choose one): daughter/best friend excitedly telling you what happened when she asked her boss for a raise today.

As youre listening and looking through the mail, you notice that the table on which youre placing the mail is very dusty. You grab the glove you put there earlier and begin vigorously dusting. The next letter pops up in your stack of mail; you recognize the handwriting on the envelope. The address is printed in block letters written in red ink. Its from your high school crush. At the same time you recognize the handwriting, your daughter/best friend is saying that perhaps she shouldnt have worn the red plaid miniskirt to her meeting with her boss. Suddenly, you realize theres no sound coming from the phone. You go blank. Who were you talking to? How can you not remember who you were just on the phone with? And what was the love of your lifes name, anyway, the heartthrob who always printed all his/her letters in red? And, wheres your other purple glove? You think, This cant be happening to meof all peopleIm a world-class multitasker!

Sound familiar? Were sure you have your own versions of this story; forgetting why you went into a room once you get there, blanking out the name of your best friends husband at a party, walking out of a movie and being unable to recall the title, no matter how hard you try. We also know the first thoughts that come into your head after a few of these occurrences: Am I getting senile? Is this early Alzheimersdisease?Do I have early dementia? One thing is for sure about your concerns: Youre not alone. These days, one of our biggest health concerns is the fear of losing our functioning brains, or literally losing our minds, due to Alzheimers disease (AD) or other types of dementia. Or at the very least, we fear losing parts of our mental functioning, such as memory or our ability to reason.

Today, because medical science has advanced so much during our lifetimes, we know more about diseases of the brain than our predecessors knew. And, happily, much of it is good news. For instance, we now know that the deterioration of our brainpower, known for years as senility, is not a necessary consequence of aging. In fact, the lessening of our brain function as we age is not inevitable. Surprised? Read on.