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Essential Things to Know About Being a Parent of Multiples

By Rachel Franklin, M.D., M.O.M.*

Your Family Doc

• Be Organized: life is much easier when everyone is on the same schedule of eating, sleeping, diaper changing and so on
• Ask for Help: especially in the first few months of life, you will need a break; enlist your parents, friends, or a babysitter for a few hours a week to help you get rest, do the housework or shop for the groceries
• Prioritize: decide what is essential and what is important and let everything else slide; you will be too busy and too tired to worry about the laundry or the house being “just so.”  Be glad you and the kids have clean clothes to wear.
• Encourage Individuality: many people around you may group your multiples (“the twins,” and so on), but they are distinct children with their own personalities.  Encourage their individuality and educate those around you to do so as well.
• Respect their Union: your multiples have a special bond with each other that they will never have with anyone else on Earth.  If they should choose to dress alike, prefer to play with each other, or share a special language, allow it when it doesn’t interfere with their social development.
• Advocate for Them: schools may want to separate them before they are ready or to keep them together after they have tired of so much closeness; advocate for what you believe to be best for them at school, at home and in the society around them.
• Guard their Privacy: multiples are frequently the subject of random comments from complete strangers and may become embarrassed or shy as a result; you may feel your privacy has been invaded by intrusive questions about how the twins, triplets or more were conceived; speak out in your own defense and by so doing, show the children that their privacy is also valued
• Take Some Time Out: multiples require a lot of energy, especially in the first few years, and you and your partner need time to reconnect; ask for help and take time out for adult relationship-building
• Enjoy Them: multiples are a special blessing; take a deep breath in one of those rare quiet moments and reflect on how far you have come with them, how hard you worked to get them here safely, and how much you love them

*Mother of Multiples

Dr. Rachel Franklin is the author of “Expecting Twins, Triplets and More: A Doctor’s Guide to a Healthy and Happy Multiple Pregnancy” (St. Martin’s Griffin).

Preventing Hypertension

By Rachel Franklin, M.D., "Your Family Doc"

OU Physicians Family Medicine

In the last post I talked with you about preventing heart attacks.  This time, I want to focus on high blood pressure, or hypertension.    Hypertension is defined as a blood pressure reading higher than 140 on the top number (called systolic) or higher than 90 on the bottom number (called diastolic).  Like the plumbing in our houses, our arteries can be damaged - and even break apart - when the pressure inside them is too high.  This can lead to heart attacks, strokes, kidney and heart failure and other significant problems.

Hypertension is called the "silent killer" because you won't feel its effects until it's too late.

To prevent high blood pressure, you must first know your risks, and work to eliminate or reduce those that are preventable.  The top risk factors for high blood pressure are:

• Smoking.
• Sedentary lifestyle.
• Being overweight.
• Getting older.
• Having a family history of high blood pressure.

Next, be sure and get a regular checkup with your Family Doc.  Most adults should have their blood pressure tested at least every 3 years.  Your doctor can help you identify your lost important risk factors and watch for early signs of hypertension.  She may also advise you on specific ways you can reduce your risks.

For starters, begin to prevent hypertension by following these simple steps:

• Exercise. At least 30 minutes every day.
• Eat better. Start by avoiding fats that are solid at room temperature.  Next, consider following a diet like the DASH plan that has been shown to lower blood pressure and reduce the risk of heart disease.  (Visit www.dashdiet.org</a> for more info)
• Lose weight. You only have so many blood vessels.  Giving them less body to serve helps them not to work as hard
• Stop smoking. I know I'm harping on a theme here.  Sorry, but it's the truth.

If you already have high blood pressure, follow the above steps and keep seeing your doctor.  Take your medicines as prescribed and talk to your doctor about taking a daily aspirin to reduce your risk of heart attack.  Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you'd like to read about in this column.  Here's to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women's and children's health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

Your Guide to a Healthier Heart

By Rachel Franklin, M.D., "Your Family Doc"

OU Physicians Family Medicine

You have the power to reduce your risk of having a heart attack by up to 75% with these simple strategies.

First, the bad news.  Over one million Americans will suffer a heart attack this year.  Despite the amazing advances in medical and surgical cardiac care that you hear about in fancy TV and radio ads, the fact is that one in three Americans will not survive their first heart attack, and for those who do survive, many will suffer from heart failure, irregular heart beats, decreased energy, depression and a host of other problems for the rest of their lives.

Now, I'm not a "bad news" kind of person.  So, here's the good news.  While you can't change your age, your family history or your sex, those "unavoidable" risk factors account for only a portion of your risk of having a heart attack.  You have the power to change the majority of your risk!  Implementing a healthy lifestyle can reduce your risk of heart disease by up to 75%!

Here's the magic formula to reduce your risk of heart attack:

• Stop smoking. The #1 preventable cause of heart disease is smoking.  If you do only one thing, become smoke-free.  No cigars or pipes, either - your heart doesn't care if you inhaled.
• Exercise regularly. Aim for 150 minutes every week of moderate-intensity exercise.  Get a little short of breath and a little sweaty, but pain is not required.  If you can't do 30-60 minutes at a time, exercise for at least 10 minutes several times a day for similar benefit.
• Maintain a healthy weight. You don't have to be a skinny supermodel to help prevent heart disease!  Women with a waist measurement less than 35 inches and men whose waists measure less than 40 inches have a lower risk of heart disease (as well as diabetes, high blood pressure and cholesterol problems) than those with measurements above these numbers.  The closer you can get to your ideal weight, the lower the risk.  Ask your doctor what you should weigh.
• Prevent, or keep tight control of, diabetes. People with diabetes have the same risk of having a heart attack as someone who has already had one. Prevent diabetes to prevent this risk.  If you already have it, work with your doctor and her team to keep your A1C below 7%, your LDL (bad) cholesterol below 100 and your blood pressure below 130/80.  For more explanation of these numbers, please ask your doctor - she wants to help!
• Watch your blood pressure. Normal blood pressure is below 120/70.  Your risk begins to rise when your blood pressure is above 130/80.  If you have been diagnosed with high blood pressure, do all you can to get your numbers in line.  I'll blog more about this later.
• Eat "heart-healthy". The model for a heart-healthy diet is the DASH (Dietary Approaches to Stop Hypertension) diet.  You can find it at www.dashdiet.org</a>.  Low in fat and salt but rich in fruits, vegetables, potassium, magnesium and calcium, DASH has been proven to lower your risk of heart attack even if you don't have high blood pressure.

Think about what we discussed as you were working on resolutions.  Remember that it's not realistic to expect that you'll do everything at once.  Keep this list and aim to do the first two items first.  Work as you can to do the rest and watch your life improve!  Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you'd like to read about in this column.  Here's to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women's and children's health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

Better Health in the New Year, Part 3: Putting Your Plan into Action

By Rachel Franklin, M.D., "Your Family Doc"

OU Physicians Family Medicine

Congratulations!  You have selected a resolution you can stick with, created a plan to succeed and are ready to implement your plan.  Preparing for a resolution may not be as exciting as just giving it a try, but by being prepared you have already significantly increased your chances of success.  Whether you want to eat better, improve your fitness or stop smoking, or you've got another resolution, it's now time to act!

Follow these steps now and as you continue your life-long journey to better health:

• Celebrate. Yes, celebrate before you have finished!  The day your resolution starts, and every day after that, focus your thoughts on how much your success will improve your life and health, and on how good it feels just getting on the right track.
• Maintain focus. Many of us want to expand beyond our initial plans as soon as we've started.  Resist the urge to do more all at once; it's easier to complete a simple task so you can move on to the next phase.
• Reflect. Once each week, take time to review your success thus far.  If you did well, celebrate and commit to continue.  If you stumbled, take time to identify what happened and how you can fix it next week.  Couldn't exercise because your schedule was crazy?  Think about whether you need to exercise at a different time or let other activities drop.  Did you learn that the resolution you selected isn't realistic at this time?  Consider whether to work harder to make it or go back to Part One and pick something else that is more do-able.
• Keep moving forward. Celebrate your successes.  Challenge yourself to succeed in the face of your struggles.  Continue to engage support from others.  And realize that every step in the right direction is a step that strengthens you and makes you healthier!

May this year be the year you reach your goals!  Starting with the next post, I will be writing about selected topics and will give you more specific advice about staying healthy.  Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you'd like to read about in this column.  Here's to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women's and children's health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

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