♪ >> HELLO.

I AM SHELLEY IRWIN.

WELCOME TO COMMUNITY CONNECTION.

TODAY'S EDITION IS FOCUSED ON ALL THINGS WOMEN'S HEALTH, SO THOSE INVOLVED ON THE SUBJECT GET THEIR INTRODUCTIONS SO HELLO TO YOU DR. DENISE LOGAN, BLUE CROSS-BLUE SHIELD OF MICHIGAN.

DR. ROBIN HUBBARD FROM GRAND RAPIDS WOMEN'S HEALTH AND MARY FREE BED REHABILITATION.

LADIES HERE WE ARE.

OF COURSE, MEN ARE ALLOWED TO BE INVOLVED AS WELL.

LET'S ZONE IN ON YOUR RESPONSIBILITIES.

DR. LOGAN, TELL US BUT.

>> OH.

I HAVE BEEN WITH BLUE CROSS-BLUE SHIELD OF MICHIGAN BLUE CARE NETWORK SINCE 2011.

YES.

MY DALE RY ACTIVITIES INCLUDE ONE PROVIDING PREAUTHORIZATIONS FOR REQUESTED PROCEDURES OR REQUESTED HOSPITALIZATION AND I HAVE A PART OF MY JOB WHERE I AM INVOLVED WITH CLINICAL ASPECTS AND CLINICAL CONCERNS THAT ARE PHYSICIAN PROVIDERS WHO ARE CONTRACTED WITH US MAY HAVE.

>> THANK YOU.

DR. ARMSTRONG.

HOW ABOUT YOUR?

OK.

I AM REHABILITATION SPECIALIST AT MARY FREEBOARD AND BEEN HERE SIX YERS AND SEE PATIENTS WITH DIFFERENT ABILITY AND CONDITIONS THAN YOU CLAUDE A SMALL PRACTICE IN WOMEN'S HEALTH SPECIFICALLY TO PUBLIC AND AD BE A NOM DAL.

>> DR. ROBIN HUBBARD.

YOU HAVE DELIVERED MANY BABES ABOUT OVER THE LAST 30 I DAS.

>> AXLEY.

IT?

IS A BABY BOOM.

SO LOTS OF BABIES.

>> THERE WE ARE.

>> TELL US ABOUT IT.

WHAT IS YOUR NICHE.

OBVIOUSLY OB/GYN.

I AM OBSTETRICIAN GYNECOLOGIST SO I TAKE WOMEN OF ALL AGES.

MOST PUBERTY THROUGH END OF LIFE.

PRACTICE WITH GRAND RAPIDS WOMEN'S HEALTH WE DO OUR DELIVERIANCE SURGERIES THROUGH SPECTRUM HEALTH AND BUTTERWORTH AND I ABLE LEADERSHIP AND THE DEPARTMENT CHAIR OF OB STRICT AND GIN CONTROL GY THERE.

>> GREAT.

LET'S GET THIS ELEPHANT OUT OF THE ROOM.

COVID-19.

WHAT HEALTH CHALLENGES FOR WOMEN EXISTS WITH THIS, DR. LOGAN?

>> WELL.

OF COURSE.

WELL, OF COURSE, BECAUSE COVID-19 IS ACTUALLY INFLAMMATORY RESPONSE THAT THE VIRUS TAKES ON, ANY WOMAN JUST LIKE ANY PERSON WHO GETS COVID-19 WITH ANY COMORBIDITIES THAT IS INCREASED OAKS POSH SURE.

SOME LITERATURE HAS TALKED ABOUT VITAMIN D DEFICIENCY BUT I FOUND SOMETHING MORE RECENTLY AND I REALLY PUT A LOT OF CREDIBILITY ON IT WHERE THEY TOOK A CERTAIN POPULATION AND TRIED TO GIVE THEM HIGH DOSES OF VITAMIN D TO DETERMINE IF IT WAS GOING TO BE EFFECTIVE, SO WOMEN JUST AS EVERYONE ELSE FOR COVID-19 CAN BE EFFECT ITCH USUALLY FOR PNEUMONIA BUT BECAUSE IT IS SUCH A NOVEL OR NOVICE VIRUS.

WE ARE STILL LEARNING MORE AND MORE ABOUT IT AND SOME OF THE ADVERSE EFFECTS OR COME HICATIONS THAT OCCUR AFTERWARDS, SO EVERYONE CAN BE EFFECTED.

NOT JUST SOMETHING WE CAN FOCUS ON AND SAY IT ONLY AFFECTS WOMEN BECAUSE IT AFFECTS ALL OF US.

>> YES.

DR. ARMSTRONG IN REHABILITATION SETTING, WHAT CHANGES HAVE BEEN MADE OVER THE LAST YEAR?

>> YEAH.

WE HAVE SEEN PATIENCE UNALL SORTS OF DIFFERENT CAPACITIES THEN RESULTS IN THE DIGS ABILITY BECAUSE OF IT.

AND WE HAVE UNPATIENT SERVICE THAT WAS DEVOTED TO IT WHEN THE NUMBERS WERE HIGHER IN THE COMMUNITY NOW ACTUALLY FORMED OUTPATIENT REHAB PROGRAM THAT IS MULTIDISCIPLINARY AND INCLUDES OCCUPATIONAL THERAPISTS, NUTRITIONALLISTS, SPEECH PATHOLOGIES AND PHYSICIANS TO SORT OF LEAVE THAT TEAM AND DIFFERENT PRESENT TAGSES AND AFTER THE LONG HAUL THAT PEOPLE TALK ABOUT AFTER EXPERIENCING THE ILLNESS, SO WE ARE TAKING PATIENTS ON A REGULAR BASIS IN THAT CATEGORY.

>> DR. HUBBARD, IN THE, LAST BUT NOT LEAST, BABIES, WELL, THEY DON'T KNOW.

THEY DON'T CARE COVID-19 IS OUT.

I TRUST YOU ARE DELIVERING SAFE AND GOOD PROCEDURES.

>> YEAH.

DEFINITELY.

SO AT THE BEGINNING WHEN THE HOSPITAL WENT INTO SHUTDOWN LAST MARCH IT WAS INTERESTING BECAUSE EVEN THE EMERGENCY ROOM HAD SIGNIFICANT DECREASE IN VOLUME, BUT OF COURSE, THE BABIES KEPT COMING AND COULDN'T PLAN AHEAD FOR THAT AND SO WE HAVE STAYED BUSY THROUGHOUT AND HAVE DEAN GREAT JOB OF KEEPING OUR PATIENTANCE OUR STAFF AND THE BABIES SAFE AND THE GOOD NEWS IS, ALTHOUGH, PREGNANT WOMEN ARE AT SLIGHT INCREASED RISKS OF HAVING MORE SERIOUS DISEASE WITH COVID AND INCLUDING THE NEEDING HOSPITA ADMISSION, ET CETERA, AND THERE IS ALSO A HIGHER RATE OF BLOOD CLOTS THAT WE HAVE BECOME AWARE OF SOIREES TRYING TO USE BLOOD THINNERS IN PATIENTS THAT ARE GETTING COVID INFECTIONS, MOST MOMS THAT GET PREGNANT DO WELL AND SO DO BABIES SO THAT IS REALLY GREAT NEWS AND FOR ALL OF THE PREGNANT WOMEN THAT HAVE BEEN AFFECTED BUT THE ISSUE NOW THAT IS THE ORIGINAL STUDIES OF THE TWO FIRST VACCINES THAT CAME OUT, THE PFIZER AND MODERNA WERE NOT DONE INCLUDING PREGNANT WOMEN OR BREASTFEEDING WHICH, WHICH IS A BIG AREA OF MEDICINE THAT IS ALWAYS A PROBLEM.

WE NEED TO UNDERSTAND WHAT HAPPENS IN PREGNANCY AND HOWEVER, WE HAVE LEARNED THAT THERE IS A LOT OF WOMEN WHO ARE RECEIVING THE VAC SEN AND THE GENERAL CONSENSUS AND QUITE SAFE IN THE ONGOING STUDIES SHOWING THAT OF THOSE HUNDREDS 6 THOUSANDS OF WOMEN WHO HAVE BEEN PREGNANT AND RECEIVED THE VACCINE THEY AND THEIR BAB BUTS ARE DOING WELL AND DECREASE THE RISKS DURING THEIR PREGNANCIES SO THERE IS A LOT OF THATP HAPPENING.

FEEL LIKE EVERY DAY THERE IS SOMETHING NEW.

>> YES, DR. ARMSTRONG, TALK ABOUT WE'LL HEALTH PROGRAMS IN SA REHABILITATION NET WHAT ARE YOU SEEING?

>> YEAH.

WOMEN'S HEALTH PROGRAM PROGRAMS CAN ADDRESS WE'LL ISSUES ACROSS LIFE SPAN HE WE HAVE A REHAB PROGRAM THAT SPECIFIC TO SORT OF HELPING PATIENTS REHAB AND RECOVER FRIDAY WHAT PREGNANCY DOES TO ALL OF THE BODIES SO ONE THING WE WOULD LOVE TO DO IS SORT OF A POPULATION HEALTH DRIVE TO GIVE PATIENCE EXERCISES IN THE HOSPITAL TO BE ABLE TO BE SAFE AT A CERTAIN POINT AFTER PREGNANCY IS RESOLVED SO THAT IS MAYBE HOME HOPEFULLY SOME DAY IN THE COMMUNITY WE'LL GET THAT GOING.

WE ALSO HAVE A CANCER REHAB FLAM ADDRESS SORT OF, DIFFERENCE OF ABILITIES THAT RESULT FROM CANCER TREATMENT, A LOT OF DIFFERENT TYPES OF SYMPTOMS LIKE FATIGUE, NEUROPATHY, THING LIKE TO.

WE HAVE A FLAM ADDRESS THAT'S THE HIGHEST PROPORTION OF PATIENTS IN THAT PROGRAM ARE PATIENTS THAT EXPERIENCED BREAST CANCER AND GOING THROUGH TREATMENT FOR THAT SO THAT IS AS WELL.

THEN ANOTHER FLAM WE HAVE IS SA BONE HEALTH PROGRAM SO PATIENCE UNDERGOING OSTEOPOROSIS AND THE TREAM AND MANAGEMENT AND HELP WITH MAINTAINING THAT BONE HEALTH AND PREVENTING BONE LOSS SO WE FOCUS ON THAT AS WELL AND SPECIFIC TO WOMEN'S HEALTH.

>> DR. LOGAN, WHAT DOES BLUE CROSS-BLUE SHIELD OF MICHIGAN OFFER WHEN IT COMES TO THE MENTAL HEALTH NEEDS?

>> OH, OF COURSE.

WITH THE COVID-19 WHAT WE HAVE SEEN IN THE ASSURANCE ARENA IS THAT WE HAVE MORE PROVIDERS AND ALSO MORE PARTIES PANNINGS OR MEMBERSHIP AND PARTICIPATING INTEL LE HEALTH SO WE DO HAVE THE ABILITY EVEN TO PROVIDE MENTAL HEALTH SERVICES FOR THOSE WITH NEED IT WITH A TELEHEALTH APP.

SO THAT IS QUITE USEFUL AND IN THOUGH LITERATURE IT SAYS THAT IS QUITE USEFUL WHAN THE POPULATION THAT THEY CAN REACH MORE ESPECIALLY, TOO, REMEMBER WE NOT ONLY HAVE THOSE PEOPLE IN OUR MEMBERSHIPS IN THE CITY AREA, BUT SUBURBAN, BUT ALSO, OUT IN THE RURAL AREA, SO THIS REALLY SEEMS TO MAKE GOOD IMPACT ON THAT SO WE DO SEE AND THINK THAT MENTAL HEALTH IS VERY IMPORTANT AND WE TRY TO REACH OUT AND DO AS MUCH AS CAN, TO PROMOTE IT, OF COURSE, WE COVER IT.

>> DR. HERBERT, WE PRAISE YOU FOR BRINGING NEW LAV INTO THE WORLD WHEN SHOULD MENTAL HEALTH COME UP WITH YOUR CARE?

>> WELL, I WOULD HAVE TO SAY, AT EVERY VISIT, SO MENTAL HEALTH IS A HUGE PART OF WOMEN'S HEALTH.

THAT WAS WHAT I DO EVERY DAY, WHETHER THE PATIENT IS PREGNANT OR NOT.

AND THAT I THE RATES OF MENTAL HEALTH CONCERNS ARE SIGNIFICANTLY INCREASED AND I THINK FOR ALL OF US, IT HAS BEEN DESCRIBED AS THE COVID PANDEMIC HAS BEEN TRAUMA.

NOT JUST STRESSFUL OR ANXIETY ROW VOKING REN, SO THE REPERCUSSIONS OF THAT FOR EVERYONE NO MAT ARE HOW HAVE YOU BEEN AFFECTED IS SIG CONDITION AND SO I ADDRESS MENTAL HEALTH WITH ALL PATIENTS AND I FIND THAT INTERESTINGLY FOR WOMEN'S HEALTH A LOT OF TIMES HORMONAL TRANSITIONS ALSO THAT IS PUBERTY, OR PMS, RIGHT BEFORE YOUR PERIOD WHEN YOU ARE HAVING HORMONE CHANGES OR PREGNANCY, OR MENOPAUSE, AND SEEM TO BE VERY VULNERABLE TIMES FOR WOMEN, BE WHERE THEY MAY HAVE A LITTLE BIT OF HARDER TIME STRUGGLING WITH DEPRESSION, ANXIETY, IRRITABILITY, AND IT IS REALLY IMPORTANT THAT YOU REACH OUT, SEEK SOME HELP, TALK TO YOUR PROVIDER TO SEE IF THERE IS SOMETHING THAT YOU CAN DO, MANY PEOPLE FEEL LIKE, IT MAY JUST BE NORMAL, BUT A LOT.

TIES THERE IS THINGS THAT WE CAN DO, SUPPORT GROUPS, COUNSELING, MDCATION, PERHAPS, TO HELP IMPROVE THE POSITION THAT YOU FEEL YOU ARE IN.

IN A THINK A LOT OF PROVIDERS ARE STRUGGLING, TOO, PROVEERED BURNOUT IS AT ALL-TIME HIGH WITH THE STRESSES OF THE PANDEMIC.

>> YES.

ONE OF THE NICHES, DR. ARMSTRONG, IS PELVIC AND BE A DOLL NAL REHABILITATION.

BRING US HERE.

YES.

>> SO, THAT IS A REALLY BIG UMBRELLA TERM FOR A LOT OF DIFFERENT TYPES OF CONDITIONS.

I SPOKE BRIEFBLY THERAPY OFFERED AFTER BODY CHANGE THROUGH PREGNANCY OR SOMETHING LIKE THAT.

IT A PLIES TO ALL SORTS OF DUFF RENT ISSUES.

SO ONE COMMON ONE WOULD BE URINARY INCONTINENCE SO SO MANY WOMEN LIVING DIE DAY WITH DIF DIFFICULTIES WHEN BETWEEN URINATION AND SORT OF THAT UNCOMFORTABLE SOCIAL SITUATION THAT HAPPENS.

ONE THING THAT I LET PATIENTS KNOW, IT IS NOT NECESSARILY NORMAL FOR WOMEN TO BE INCONTINENT AND THROUGHOUT THEIR LIFETIME AND I THINK THAT IS COMMON MISCONSENSUAL THE WORLD THAT IT IS JUST NORMAL.

I HAD THREE TY KIDDS.

THAT IS HOW LIFE IS.

SIGNED LIKE TO PUT IT THROUGHOUT.

THERE IS HELP FOR THAT.

THERE IS ALL SORTS OF DIFFERENT REASONS FOR THAT TO HAPPEN.

DR. HUBBARD PROBABLY KNOWS QUITE A BIT ABOUT LOTS OF THOSE REASONS AS WELL BUT WORKING IN A TEAM TIME!

SOMETIMES WITH THE OB, GYNECOLOGIST WORKS NICELY TO HELP WITH MUSCULAR CONTROL OF THOSE AREAS IN TRYING TO PREVENT THAT WEAKENING FROM HAPPENING.

THE OTHER AREA THAT WE FOCUS ON IS THAT OF PAIN.

AND SO PELVIC PAIN IS NOT NECESSARILY A NORMAL RESPONSE TO HAVING CHANGES IN PREGNANCY OR CHANGES IN LATER UNLIFE.

HORMONE ASSOCIATED CHANGES CAN HAPPEN ONCE THE CAUSE CAME AS WELL.

SOL THAT MAY MEAN PAIN WITH INTERCOURSE, PAIN AROUND THE TIME TIME OF THIS PERIOD WHERE SO WE WORK ON CHANGING A THE WHOLE TONE, CHANGING FLEXIBILITY.

THINGS LIKE THAT THROUGH PUBLIC THE FOY HELP WITH JUST MODIFYING THOSE SYMPTOMS.

WE SEE PATIENTS WHO HAD BIG AC ARE BE A SAB DOM NAL SURGERIES FOR THINGS LIKE CANCER OR HERNIA AND RELATED TO WHAT NEEDS TO BE DONE AND SO SOMETIMES IT TAKES THINGS LIKE SCAR TISSUE RELIEF OR CHANGES IN THE WAY THE MUSCLES ARE CONTROLLED BY THE WAIVE EXERCISE TO HELP WITH THAT PAIN.

SOL THAT PELVIC AND REHAB PROGRAM REALLY SORT OF ENCOMPASSES THAT REGION OF THE BODY AND ALL SORTS OF DIFFERENT DIF CANTITION WOMEN HAVE RESULTING FROM WHAT HAPPENED TO US.

>> THANK FOR THAT.

LET'S TALK ON FEW HEALTH CHALLENGES ON WHO IT COMES TO LIFE-STYLE.

BACK TO YOU DR. DENISE LOGAN WITH BLUE CROSS-BLUE SHIELD OF MICHIGAN.

THE STATE OF WOMEN WITH, WELL, ALWAYS FIGHTING OUR WEIGHT, OBESITY.

ARE WE IN AN EPIDEMIC?

HOW ARE WE FIGHTING THIS HEALTH ISSUE?

>> THAT IS INTERESTING QUESTION.

I SAY THAT BECAUSE IF WE START TO TAKE A LOOK AT THE STATIS STATISTICS, AND WE TAKE A LOOK AT CARDIOVASCULAR DISEASE.

SAY THAT BECAUSE CARDIOVASCULAR DISEASE, CANCER AND COVID WERE THE HIGH CAUSES OF DEATH FOR THE YEAR 2020 BUT WE REALLY DON'T HAVE ALL THE STATEDS YET ON THE CORONAVIRUS AND THERE IS REASON WE DON'T HAVE THAT BECAUSE THERE IS A LOT OF MISQUOTING, A LOOK OF CODING, THERE IS A LOOK OF CERTAIN STATES PROVIDING THAT INFORMATIONING TO THE CDC.

SOME THE NUMBERS THAT YOU SEE RIGHT NOW, I KNOW WE JUST HEARD ABOUT 500,000.

BUT REMEMBER, THAT IS FROM THE TIME IT WAS HERE.

THAT WAS SINCE LAST YEAR, CERTAINLY, WE JUST DIDN'T GET 500,000 FROM JANUARY UNTIL NOW.

SO WHEN YOU HEAR THOSE NUMBERS, THINK OF ONE THE NUMBER RINSE YET.

THEY WILL NOT BE FINALIZED UNTIL THE THIRD QUARTER OF THIS YEAR AND SOP THAT ALL THE STATES WILL HAVE PROVIDED THAT INFORMATION.

BUT I GO TO THAT AND I SAY THAT BECAUSE LIFE-STYLE CHANGES.

2009 WERE PLATEAU FOR HEART DISEASE.

OBESITY, OBESITY, INCREASED BY 13%.

AND DIABETES INCREASED BY 2 OPINION%.

SO THERE IS A DIRECT RELATIONSHIP WITH THAT, LIFESTYLE CHANGES ARE NOT TEMPORARY.

THEY ARE ACTUALLY PERMANENT.

AND IT IS A JOURNEY, REMEMBER, YOU NEVER GOT THAT WAY WITH ALL THE OBESITY ISSUES, LIKE OVERNIGHT.

IT WAS A GRADUAL PROCESS.

AND WITH A LIFESTYLE CHANGES THAT ARE NEEDED AND THAT IS INCREASING YOUR EXERCISE, DECREASING YOUR PORTION SIZE, AND TRYING TO ELIMINATE OR DIMINISH YOUR FATTY FOODS SO YOU WILL DECREASE YOUR CHOLESTEROL, LOOK AT THOSE CALORIES.

START READING.

START READING THE LABELS.

DECREASE THE CALORIC INTAKE.

LOOK AT THE AMOUNT OF FAT THAT IS IN THERE.

THOSE ARE ALL BAD THINGS.

SO ALL OF THAT IS INCLUDED IN THE LIFE-STYLE CHANGE.

WITH CORE LEAN IN, THAT HAS TO BE ALMOST AL JOKE BECAUSE EVERYONE IS SEDENTARY DUE TO CREST CREST IS THAT READY TO GET OUT.

IT HAS READY TO HAVE PEOPLE COME IN, OF COURSE, YOU DON'T WANT THAT TO HAPPEN, BUT THAT IS ALSO PART OF THE CHANGES THAT WE HAVE TO MAKE WITH THE LIFE-STYLE CHANGES SO CREATE SOME TYPE OF ACTIVITY.

SOME TYPE OF ACTIVE ACTIVITY EVEN IF IT IS JUST SITTING AT YOUR DESK WORKING AND MOVING YOUR FEET UP AND DOWN.

REMOVING YOUR, YOU KNOW, YOUR KNEENESS ALL.

KNOW DR. ARMSTRONG IS SAYING GO, GIRL.

NOW SEE?

YES.

WHAM DO YOU HAVE TO FOLLOWP ON THAT DR. ARMSTRONG?

>> WELL, TO ITLY AGREE WITH WHAT THREE WAS SAYING.

THE LIFE SOMETIME CHANGES ARE SO IMPORTANT, BOTH IN PREVENTION CRON UK DISEASE SHE WAS TALKING ABOUT, BUT ALSO, WE SEE THAT PATIENTS THAT HAVE A HEALTHY LIFE-STYLE ARE LESS ACCESSIBLE TO SERIOUS DISEASE WITH COVID.

IT IS IMPERATIVE FOR EVERYONE TO BE AS GOOD AS THEY CAN BE WITH MAKING LIFE-STYLE MODIFICATIONS THAT ARE HEALTHY CHANGES.

WE HAVE A LIFE-STYLE MEDICINE PROGRAM AT MARY FREE BED.

IT IS NOT ROCKET SCIENCE BUT ADDRESS THE THING SPECIFICALLY TO PEOPLE'S LIFESTYLES WHICH THEY CURRENTLY HAVE AND MORE INDIVIDUALIZED PROGRAM TO LOOK AT WHAT ARE THE THINGS YOU ARE DOING NOW.

WHAM ARE SMALL CHANGES WE CAN MAKE TO START SEEING BUYING BIG CHANGES DONE THE ROAD AND LONG TUTED NAL THING WE HAVE TO AS PATIENTS AND INDIVIDUALS TO MAKE BIG CHANGES.

GREAT.

DR. ROBIN HUBBARD.

I HAVE A QUESTION FOR YOU ON BEHALF OF FACEBOOK.

AS A NEW MOM.

WHY CAN'T I SLEEP?

>> WELL, ASIDE FROM THE OBS YU, THE BABY IS WAKE UP ALL THE TIME.

THINK THAT THERE IS A COUPLE OF FACTORS.

ONE IS PROBABLY HORMONAL.

SO WHEN YOU ARE POSTPARTUM, YOUR HORMONES ARE CHANGING RAPIDLY.

THAN CAN IMPACT YOUR SLEEP CYCLES JUST DIRECTLY.

IT CAN ALSO IMPACT THE MOODS AS WE HAVE DISCUSSED WHICH HAS AN EFFECT DIRECTLY ON INSOMNIA.

AND ANXIETY, I SEE A LOT OF ANXIETY IN THE POSTPARTUM PERIOD THAT AFFECTS WOMEN'S ABILITY TO SLEEP, SO THE MIND STARTS RACING.

I THINK WE HAVE EXPERIENCED THIS, WHERE YOU LANE BED.

I AM SO TIRED.

I CANNOT TURN MY MINE OFF.

THEM CAN BE A LOT OF DIFFERENT FACTORS, BUT I WOULD SAY, FOR THE PERSON THAT WROTE WIN ON FACEBOOK, IT WOULD BE GOOD TO BRING THAT UP WITH THE OB/GYN.

IT DOESN'T MAT ARE HOW FAR OUT YOU ARE.

THE RELATIONSHIP DOESN'T END.

YOU COULD BE A WEAK OAR YEAR OUT FROM THE DELIVERY AND TALK A LITTLE BIT ABOUT WHAT IS HAPPENING.

HOW YOU ARE STRUGGLING.

THERE ARE LOTS OF DIFFERENT THINGS LIFESTYLE CHANGES AND EVEN COUNSELING A STUDY RECENTLY SHOWED THAT COGNITIVE BEHAVIOR THERAPY CAN IMPROVE INSOMNIA RATES BETTER THAN SOME MEDICATION WHICH IS GREAT BECAUSE WE RETRAIN OUR BRAIN TO NOT KIND OF PANIC LIKE, OH, NO I HAVE TO LAY DOWN.

KNOW THAT I AM NOT GOING TO BE ABLE TO FALL ASLEEP THEN YOU GET MORE WORRIED THEN YOUR BRAIN STARTS SPINNING EVEN MORE.

SO THAT IS SOMETHING I WOULD JUST SUGGEST MAYBE TALKING TO YOUR PROVIDER ABOUT.

A YES.

I KNOW YOU ARE ALL MOMS VOW BEEN THERE, DONE THAT.

DR. ARMSTRONG, DO YOU WANT TOP THAN THE.

>> YEAH.

I MEAN, I AM LIVING THAT LIFE RIGHT NOW MYSELF.

I HAVE KIDS THAT ARE AGES TWO, FOUR AND SIX SANZ UNDERSTAND HOW A PERSON WOULD FEEL LIKE THEY ARE NOT ABLE TO GO TO SLEEP.

THINK SOMETIMES THOSE BEHAVIOR CHANGES ARE SOME OF THE MOST IMPORTANT CHANGES THAT YOU CAN DO.

PUTTING YOUR PHONE DOWN.

ALL OF ON THE PHONES PRIOR TO BEDTIME.

WE KNOW AS THIS BLUE LIGHT THAT EMITS FROM THE PHONES FINE TURN ON THE FILTER FORGETTING RID OF THE BLUE LIGHT.

IT IS STILL EKE EFFECTS THE BEEN AND KEEPS THOSE NEUROCHRONIC CONNECTIONS THAT LEAD TO THAT CLOSE TO BED TIME.

EVEN PUTTING YOUR PHONE DOWN AN HOUR EARLIER THAN DID YOU BEFORE PRIOR TO GOING TO BED CAN HELP WITH THAT.

ATOTALLY AGREE.

MANAGEMENT OF DEGRESSION CAN BE A BIG THING WE MAY NOT BE THINKING ABOUT THAT REALLY CHANGES OUR SLEEP.

WONDERFUL.

QUESTION FOR US ALL.

BACK TO YOU THE STATE OF WOMEN'S HEALTH AND RATION AND EQUITIES AND I WILL BEGIN WITH YOU DR. LOGAN.

>> WELL.

THAT IS NOT SOMETHING NEW.

IT THAT BEEN AROUND FOR A VERY, VERY LONG TIME.

IT IS USUALLY RELATEDDED TO THE ECONOMY.

IT IS USUALLY RELATED TO HOUSING AND THE ECONOMY ALSO INCLUDE IN THAT AND I ACTUALLY INCLUDE EMPLOYMENT.

I ALSO INCLUDE IN THAT IS EDUCATION, BUT IT IS INTERESTING BECAUSE BECAUSE THERE IS EARLIER STUDIES THAT I HAVE REVIEWED QUITE SOME TIME AGO, AND EVEN WITH THE EDUCATIONAL PROCESS FOR DR. BE HUBBARD, EVEN, WHAT I SAW IN THAT WAS KIND OF AMAZING AND KIND OF SURPRISING BECAUSE THE PROCESS FOR BECOMING PREGNANT AND HAVING A BABY ACTUALLY STARTS BEFORE THE PREGNANCY AND SO YOU NUTRITIONAL STATUS IS IMPORTANT BEFORE YOU GET PREGNANT AND THOSE ARE SOME, TOO, OF THE DISPARITIES THAT WE SEE, THE NUTRITIONAL OUTLOOKING AND OUTPUT AND NUTRITIONAL FOODS THAT ARE AVAILABLE ARE NOT AVAILABLE AND THE INNER CITY AND SO THAN ALSO AFFECTS THE DISPARITY SO THEY ARE JUST SO MANY THINGS HERE.

THEY ARE DIFFERENT FAVORABLES SO WE CANNOT SAY BECAUSE BUT GET EDUCATION.

YOU DON'T HAVE THOSE DISPARITIES.

YOU DON'T THEME.

JUST BECAUSE YOU ARE POSITIVE, THERE ARE CERTAIN OTHER THINGS THAT HAPPEN, TOO, IN REGARDS TO THOSE DESPAIRS AND THAT HAPPENED EVEN BEFORE, BEFORE YOU BECAME ECONOMICALLY SUCCESSFUL.

SO THERE ARE A LOT OF FAVORABLES FOR THAT DISPARITY AND YES, IT DEBTS OCCUR IN WOMEN BUT ALSO OCCURS IN MEN SO I CANNOT EXCLUDE THEM BUT I KNOW I AM NOT SUPPOSED TO BE TALKING ABOUT MEN TODAY.

A WOMAN, NEED OUR MEN.

DR. HUBBARD, WHAT IS YOUR ANSWER TON THIS PLATFORM?

>> IT IS SUCH A COMPLEX ISSUE.

AND WE KNOW FOR WOMEN'S HEALTH AND PREGNANCY RELATED HEALTH, BE THAT RATION DESPAIRS HAVE PERSISTED FOR A LONG TIME AS THE DOCTOR SAID.

THERE IS A LOT MORE AWARENESS AND ATTENTION TO IT RECENTLY WHICH I THINK IS FANTASTIC AND MORE ATTENTION EVEN WITHIN THE WALLS OF THE HOSPITAL AT SPECTRUM HEALTH WITH DIVERSITY AND EQUITY, COMMITTEES LOOKING AT HOW TO BETTER SERVICE THE COMMUNITY AND INCLUDE PEOPLE WITH BLACK AND BROWN SKIN TO INCLUDE OUR MORE DIVERSE AREAS OF THE COMMUNITY THAT IT IS HARDER TO REACH THAT HAVE DIFFERENT ACCESSES TO HEALTH CARE, BIN PREGNANCY, MATERNAL OUTCOMES ARE POOR FOR PEOPLE THAT HAVE DIFFERENT RACES AND IT IS UNFORTUNATE AND WE NEED TO FIGURE OUT HOW TO PENETRATE THE COMMUNITY AND THAT IS NOT JUST BY TALKING ABOUT IT.

WE HAVE TO MAKE REAL STRIDES IN OUR COME TIN AND A LOT OF PEOPLE ARE LOOKING AT RESEARCH SAN DIRECTING EDUCATION TOWARD COMMUNITY LEADERS WITHIN THE POPULATION.

AND I THINK THAT IS SOMETHING THAT IS VITALLY IMPORTANT TO TRY TO PENETRATE THE COME IN THE WITH PEOPLE THAT THERE IS TRUST BUILT IN SO WE CAN PROVIDE RESOURCES HELP WEDCATION AND NUTRITION AND IMPROVE THOSE DY DISPARITIES BECAUSE IT IS NOT RIGHT THERE SHOULD BE DIFFERENT PREGNANCY OUTCOMES ORBITER SUCCESS MATERNAL MORBIDITY RATES BASED ON THE COLOR OF YOUR SKIN.

>> YES.

>> DR. ARMSTRONG, YOUR FINAL COMMENT ON THAT, THEN WE'RE READY FOR CONTACT INFORMATION, 1:00 TELL US YOUR THOUGHTS.

>> YEAH.

SO I ACTUALLY WOULD SPEAK TO THIS FROM MY PERSPECTIVE AS ITCATOR WITHIN THE MICHIGAN STATE MEDICAL SCHOOL.

ACTUALLY WORK PART TABLE MEDICAL SCHOOL SOIL GET TO INTERWALK THE MOST DIVERSE CLASS OF MEDICAL STUDENTS EACH YEAR IN THE COUNTRY AND STRY TO FILL OUR CLASSES WITH ALL DIFFERENT TYPES OF PEOPLE AND ONE THING THAT I NOTICED THAT IS WE REALLY TRIED TO MAKE A PUSH FROM THE ADMINISTRATE IFLEVEL IN OUR CURRICULUM ABOUT THE HEALTH DY ARE DISPARITIES THAT PIX THEN TAKING THE NEXT STEP TO PUSH THEM TOLL TRY TO CHANGE THING!

THINGS TO GIVE US IDEAS HOW WE CAN CHANGE THINGS THEN SO, SOBS THAT YOU JUST REALLY ENCOURAGING TO SEE, THINK IT IS A PROBLEM AS DR. HUBBARD SAID, IT IS SO COMPLEX AND HARD TO PINPOINT ONE INDIVIDUAL THING AND BUT IT IS VERY IMPORTANT TO KEEP OUR EYES WIDE OPEN AND TO KEEP LISTENING LARNING AND MAKE CHANGES BASED ON THE THINGS WE IDENTIFY.

>> DR. KELLY ARMSTRONG.

HOW DO WE FIND OUT MORE INFORMATION ABOUT YOUR WORK?

SO EASIEST PLAY FLIES GO IS MARY FREE BED.COM.

WE HAVE ROBUST WEBSITE THAT GIVES TRICK AND TRICKS.

EDUCATIONAL CONTENT LISTEN TO AS WELL AS CONTACT INFORMATION FOR ANY PROVIDER.

WONDERFUL.

WHAT DO YOU LEAVE US WITH?

POOH WELL, GRAND RAPIDS, WOMEN'S HEALTH.COM OR 616-5881200.

>> I AM GLAD WE DIDN'T GET A CALL.

YOU DIDN'T GET A CHANNEL LAST 29 MINUTE, RIGHT?

LEAVE US, DR. HUBBARD, WITH A TAKE JEM MESSAGE.

>> WELL, WOMEN'S HEALTH IS VITALLY IMPORTANT AND AS A WOMAN YOU HAVE SO MANY RESPONSIBILITIES WHERE OFTEN WE ARE CARING FOR OUR PARENTS, OUR SIGNIFICANT OTHER, OUR CHILDREN, AND IT IS REALLY IMPORTANT THAT YOU PUT YOURSELF AT THE FOREFRONT AND UNTIL YOU TAKE CARE OF YOURSELF, YOU ARE NOT GOING TO BE AS EQUIPPED TO TAKE CARE OF OTHERS.

SO REACH OUT.

ADDRESS THE CONCERNS THAT YOU MAY HAVE ABOUT YOUR WELL-BEING BE IT PHYSICAL OR MENTAL AND TAKE CARE OF YOU.

YOU DESERVE IT.

>> GREAT.

DR.

SLOGAN, I LEAVE THE LAST MINUTE TO YOU, PLEASE.

>> I HAVE TO APPLY WHAT DR. HUBBARD JUST SAID IN A ALWAYS SAY THAT.

YOU HAVE TO PUT YOURSELF UP THERE AT THE TOP OF THE PRIORITY LIST AND I KNOW THAT WOMEN DO LEAD THE HEALTH CIR AND THEIR FAMILY THEY DICTATE AND DETERMINE WHO AND WHEN SOMEONE IS GOING TO SEEK ANY KIND OF HEALTH CARE SO WOMEN, YOU HAVE A LOT OF CONTROL.

BUT, YOU STILL MUST TAKE CARE OF YOURSELF FIRST IN ORDER TO BE ABLE TO DAIK ARE TAKE CARE OF OTHERS.

YOU CAN, OF COURSE, ACCESS US THROUGH BLUE CROSS BLUE SHIELD OF MICHIGAN AND WE HAVE SPECIFIC OFFICE OF HEALTH AND HEALTH CARE DISPARITIES.

>> THANK YOU FOR THAT.

THAT IS A GO ED RED FOR WOMEN PIN ON YOU DR. LOGAN.

OF COURSE, IT IS.

>> REMEMBER.

>> YES.

>> HEART-TO-HEART.

FOR THIS YEAR AND THEN, WE ARE ACTUALLY PROMOTING THE INFORMATION IN REGARDS TO YOUNGER WOMEN ARE ALSO EFFECTED BY CARDIOVASCULAR DISEASE, HEART DISEASE AND STROKE.

SO IF YOU GUYS CAN.

TAKE A LOOK AT THE AMERICAN HEART ASSOCIATION AND HEART TO HEART.

THERE IS A GREAT VIDEO ON THERE.

AND I WILL SEN IT TO YOU.

I JUST SPRINTED A COUPLE OF WEEKS AGO FOR OUR ORGANIZATION AND IN REREADIES TO HEART HEALTH AND I IT DID FOR MEALS AND MAIL MALES AND FEE MATES.

IT IS ALL GOOD.

GOOD-BYE, LADIES THANK FOR YOUR CONVERSATION.

>> THANK.

>> BYE.

THANK YOU.

OK, BYE.

>> IF YOUR ORGANIZATION WOULD LIKE TO BE CAN BE ARE CONSIDERED IF A COMMUNITY CONNECTION SECT AND EVENT THAT YOU WOULD LIKE TO BE ADDED TO THE COMMUNITY CALENDAR.

E-MAIL YOUR INFORMATION TO IRWIN