Along with this essential goes the need for flexibility from all road trippers. Don’t set your travel plans in stone, especially if you’re focused around outdoor adventuring. That way, if you get weathered out or just plain bored in one area, you can all agree to move on and check out another area. Spontaneity is part of the fun of calling the back of a truck or a van your home for a while, so take advantage of your mobility!

No matter where you’re going, always pack some warm clothes – you just never know where you’ll end up, and nothing is more miserable than shivering all day and night in a cold, damp vehicle or tent. A warm sleeping bag is a definite must as well, as are a swimsuit and towel – who knows when you’re going to find a shower? Maybe your only bathing opportunity for a few days or weeks will be jumping in a river – trust me, after a few days of not showering and playing hard in the dirt, you’ll want to get wet, no matter how cold the water is.

As for food, that’s up to you, but I suggest using large plastic boxes with see-through sides for easy organization and storage. These are available cheap at places like K-Mart and Target, and they sure beat rummaging through grocery bags to find dinner. A large water jug is a necessity as well. And definitely spoil yourself when you’re picking up the plastic boxes by purchasing a nice, off-of-the-ground camp chair. I got one for $13 at K-Mart, and it made hanging out in the evening that much more comfortable.

Finally, don’t forget to carry some cash. You never know where or when your wheels will break down and what you’ll have to do to get out of the mess. I had a pretty scary experience down in Arizona one night long ago when a tire flattened with nary an ATM in sight. Luckily, my partner and I scraped together almost $25 between us and managed to convince a suspicious small-town mechanic to give us a used tire that would get us to a place with cash machines.

What should you leave behind? Well, you can figure out most of that, but I will say that large coolers tend to become more of a pain than anything else, especially if you’re going to be camping anywhere near a river (you can store perishables there). Constantly draining coolers and replacing the ice are no way to spend your rest days.

And please, please don’t bring anything work-related with you on the road. This should be avoided at all costs, unless you’re joining the ranks of those who are permanently on the road. Nothing is more irritating than traveling companions who are chained to their cell phones or computers. Turn that stuff off, sit back and stare and the clouds, and just enjoy your time away from it all. Ahhh, life is good, no?

If it doesn’t, count your blessings, but don’t count out the chance to become more aware of the estimated 50,000 Canadians, whose lives, not to mention their loved ones, are affected by this illness.

Multiple Sclerosis is a complex, neurological disease, hence the difficulty in finding cause and cure. In the simplest of terms, it is a disease that attacks the central nervous system causing an array of symptoms, ranging from mildly disabling to severely so. While there are a number of common symptoms, MS can offer a host of unusual problems, individually unique. Since one of the most unsettling characteristics of this illness is the unpredictability of its progression, a “one day at a time” approach is the best option. Always easier said than done, when it’s your life you’re talking about. Once you learn to live with the illness, and you do, life becomes a challenge of managing symptoms, which can differ from day to day. Then, in the best case scenario, at some point in time, you decide its going to take a lot more than MS to take the wind out of your sails. You move forward, living life to the fullest, although at times this seems to be an impossible feat.

There is no shortage of information on Multiple Sclerosis. As with most chronic illnesses, statistics and information can be gathered from a variety of sources. But the most valuable knowledge is not that which is compiled into pamphlets or other reading material. What I believe to be the most valuable, is the insight, awareness can lead us to. Not so much awareness of the disease itself, but awareness of the lives the disease affects. What is it like to be someone with MS? How does one go about living daily with such limitations acquired simply by the luck of the draw? Yes, if there is one thing essential to understand, it is that illness and misfortune are not choosy predators. Of course, we can stave off many hardships by taking care in the way we live, but never think for one moment, that anyone is immune to the illness and just plain bad luck that shows no favouritism to any race, gender or class of people. The hand of misfortune taps shoulders at random.

While “awareness” months, days, walks, events, etc. are important to bring focus to specific issues, what about the rest of the year? People don’t only have MS in May, cancer in April, heart problems in February (just to name a few). These are all a 365-day reality to many, and that is why awareness is so important. That is why it is so important to learn about the person with MS, CP, MD, or cancer, and not only of their illness. Learn of whom they are, their place in the community and how their life relates to yours, because, in the big picture, they do.

Don’t be afraid to understand. Sometimes, perhaps, we worry that if we look too long or take too much notice, we might somehow tempt the cruel hand of fate to turn in our direction. I believe the opposite is true. The more we know, the less we need to fear.

Please bask in the knowledge that everyday you can make a difference by simply being aware. Let the desire for awareness become a challenge to attain a better understanding of life around you, and not just within your circle. Look to the left and the right, and really take notice of some of the less pleasant, but very real possibilities of life. Once you begin to really see these possibilities, you will also begin to recognize and understand the opportunities you have to make a difference, and that is when real awareness begins. That is when awareness becomes a gift.

Everyone has seen those slick little diagrams of circles indicating the over lapping of certain events in our lives. They explain how the effects are not singular events or isolated incidences. I think those round colored bubbles are far too harmless and innocent-looking to represent life. Those relationship circles should have teeth on them, like gears in a machine. The machine of our lives.
It doesn’t matter where you live or what kind of work you do. It doesn’t matter how reserved and detached you might try to keep yourself from the world at large. We are all still immersed in relationships. Some of them last for relatively short periods of time like the relationship between you and your waitress at the local dinner. Others are life long i.e., your family relationships, you and your parents, you and your kids, you and your spouse. Some relationships, like your career, may not last your whole life but they are still smack dab in the middle of it for a large number of years.

I guess you are beginning to see that that out lives are filled with relationships. To make life a more comfortable, harmonious place it is best to have the gears of these relationships well oiled and meshed together. If we can’t do that, those very same gears can shred us into confetti.

Keeping the job balanced with romance or family life and keeping the different relationships within the family spinning smoothly to everyone’s benefit can be tough thing to do.

The ability to keep all those gears turning in a safe, productive fashion sometimes seems to take the skills of a mechanic and a magician. It is not easy to handle both the physical and much more esoteric emotional needs of those in our lives. Whether it is a polite hello and thank you for that harried waitress at lunch that you may only know for thirty or forty-five minutes; taking the time to sit with your kid and listen to the story of how they got the part in the school play, being picked even over Mary Stover who is way more popular; you’re going to hear one of my favorite remedies … cures if you will, for almost every relationship and societal ill: Be Nice.

If you want to hear some complimentary words tossed in your direction, give a few out once in a while. You want to have somebody do something nice for you? Do something nice for somebody else. Give your spouse some respect; hand out a little independence and dignity to your kids. Bend over and give the family pet a quick pat.

If you work for somebody, show up for work on time more than twice this week, it puts your boss in a better mood. Show up for work on time everyday. He’ll probably be so stunned he’ll give you that raise next time you ask.

If people work for you, don’t expect them to work late every night, studies show that working smarter, not longer, increases productivity. Give your employees a chance to go home and talk to their families. Maybe they’ll show up on time tomorrow.

Being nice isn’t the fix all tool for keeping those relationship gears running, but it darn sure acts as the grease to smooth the action. Do you want to see the gears in a relationship slow to a grind? Well, the next person that walks through your door, look up at them, frown and say, “What do you want?”

You’ve had it happen to you before haven’t you? It does not promote a warm working relationship. So be nice.

While I’m thinking about it, smile at me next time you see me on the street, because I’ll be smiling at you. It’s all part of my effort to get off work on time next Friday to see my kid in a school play.

Tumors can be benign or malignant.

A benign tumor is one that may grow to very large proportions if left untreated yet will not spread to other parts of the body and should not kill the patient. Many benign tumors do not grow significantly and do not require any treatment at all. Benign bone tumors are seen in children (most common are osteochondromas, hemangiomas, unicameral bone cysts, aneurysmal bone cysts, osteoid osteomas, and chondroblastomas) and in adults (most common are giant cell tumors and enchondromas). There are many other types of benign bone lesions and other causes of abnormalities seen on radiographs such as bone islands, bone infarcts and degenerative cysts that usually do not require surgery or a biopsy for treatment.

Malignant bone tumors (bone cancers) include bone sarcomas, lymphoma of bone, multiple myeloma, and metastatic carcinoma. The main types of bone sarcomas are Osteosarcoma, Ewing’s, Chondrosarcoma and malignant fibrous histiocytoma of bone. Osteosarcoma and Ewing’s occur mostly in adolescents and young adults while chondrosarcoma and malignant fibrous histiocytoma occur in adults. These malignant sarcomas require aggressive management with surgery, chemotherapy (exception is chondrosarcoma) and sometimes radiation (especially Ewing’s).

Cure is possible and is more likely in patients without metastatic spread of disease and when the tumors are small and surgically resectible.

If untreated these tumors will spread to vital organs and kill the patient.

Despite our best treatment modalities, almost half of patients with high grade sarcomas will progress and die of their disease.

Research is being focused on improving our understanding of metastatic potential, mechanisms and prevention.

The ’staple’ items we suggest getting from the grocery store are mostly non-perishable, or at least, have a very long-shelf life, but they’re really good for you.

-canned tuna (both in water and oil)
-pita pockets
-apricots and other dried fruit (figs, dates)
-sun dried tomatoes
- Daniel bars
-long-lasting fruits and vegetables(Granny Smith and Fuji apples, winter squash, jicama, grapefruit, bananas)
-amaranth
-couscous
-baby food (yup we’re serious)
-dried legumes(garbanzo, pinto, navy, white, kidney, chickpeas)
- whole wheat bread
-cheese, grated and blocks of cheese
-pre-packaged and sorted raw salad greens (spinach, arugula, endive, lettuces)
-baby carrots
-apple cider, orange juice (all unsweetened in family-size tetra packs)
- avocadoes (Haas variety)

A great many canned foods, such as pineapple, corn and soups, have a great deal of sugar, salt, EDTA (preservative) and other additives in them. The items we suggest have few preservatives but are readily accessible to dorm residents.

Canned tuna is great with mayonnaise/plain yogurt plus olive oil with lettuce in pita pockets. It’s packed full of protein that’ll keep you awake so you can cram for that nasty exam, and the fats in tuna are good for you while making you feel fuller for a longer time.

Pita pockets are useful for leftovers from frozen dinners (reheated in microwave) and canned one-container meals such as Stagg chili. We suggest getting whole wheat pitas which have extra fiber; great for your digestive system, your heart and your blood sugar levels, and it makes you feel fuller longer.

Apricots and other dried fruit can be added to that standby, Rice-a-Roni. They can be eaten alone, as a snack when included in a ’study hall mix’ with peanuts and chocolate chips, or when you’re nervous and need something to chew on. They’re also great when added to amaranth, as you’ll see below.

Sun-dried tomatoes with olive oil can be included in pitas, microwave dinners, in sandwiches or eaten alone for a loaded source of Vitamin A, C and E.
Daniel bars are made with whole grains, and it’s done using the microwave. Try out our recipe for an energy bar or snack better than the average pricey granola bar you find at the store.

Our interview with Kate when she went hiking has a nice rundown of the long-lasting fruits and veggies. We suggest buying a grater, a small cutting board and a paring knife so you can have lots of raw salads (cheddar turnips, squash ‘n’ beets, apple-jicama salad with hummus) with stuff you can make in a microwave, like our dorm-hummus recipe. Winter squash (small) can be cut into flat slices or chunks and microwaved with cheese and a spice mix. You can read up on squash and get a couple of recipe ideas in our Food Market. The fiber, energy and vitamins and minerals will do you good.

Amaranth and couscous are grains that can be found in most bulk food sections or on the shelf near rolled oats. With really hot water (or hot cider, hot chocolate, hot chicken broth) you just stir in the whole grain, let it sit for five minutes for amaranth, ten for couscous, and eat up. Super-easy and pretty cheap, too.

Baby food, the on-the-shelf kind for 6-months old babies and up are packed with nutrients and taste quite good. We love using it as a spread for whole wheat crackers here at HTT.

Beans are a great source of protein, vitamins and minerals and make a complete protein when eaten with brown rice, or with squash and corn. Dried beans can be flash-revived in the microwave after you soak them overnight in a plastic container, covering the beans with two inches of water. Add a large pinch of baking soda to “degas” the beans. Pour hot water over the beans and let sit, then microwave on high for 20 minutes, taking it out to stir once in awhile. Then let it sit covered for one hour, and your beans are ready to drain and eat or add to one of those awful cans of condensed soup for some nutrient value. They can also be mushed up with fresh parsley, plain yogurt, mixed dried spices and lemon juice for a dip.

Whole wheat bread is great with a spread that doesn’t need refridgeration. There “are” some out there, including Skippy peanut-jam stripes, powdered wasabi and condensed milk, or plain maple syrup or honey.  Cliff likes his pb sandwiches with honey, cinnamon and banana slices. Give it a try to maximize the nutrition you get.

Cheese is useful because it works in salads, sandwiches, pitas, microwave dinners, as a snack on its own and to thicken up soups. The other suggestions we have can just be rinsed and eaten as they are, maybe with lemon juice added or better yet, a vinegar dressing (vinegar mixed with lemon zest - that grater comes in handy again - and five spice powder or chillies you nuked in the microwave). We also insist on flavour-enhancing condiments that can be kept on the shelf, such as chipotle chilies in adobo, roasted garlic (done in the microwave), and powdered herbs and dried spices. Dried dill does wonders for the ‘dorm hummus dip’.

And here’s a sample recipe:

Dorm Hummus Dip

2 cans chickpeas, drained
half can tomato puree
1 16 oz. container plain yogurt
dried dill (optional)
1 or 2 chipotle chilies in adobo
1 garlic clove
2 tablespoons olive oil

Let plain yogurt drain for at least 20 minutes, pour liquid that gathers from the bowl. Mash chickpeas and mince chilies and garlic, or mash all ingredients in a blender. Use in tuna pita pockets, on crackers, cheese or to jazz up Granny Smith apple slices.

If you’re in a dorm now and planning to transfer to a house that has a refrigerator, check out our grocery list to maximize nutrition while minimizing cooking time and money spent!

We’ve been asked for another Dorm Food article. Ah yes, freshmen moving into their dormitories, all wailing about the food that sucks. We won’t give you lollipops to soothe your pain, but we will give out one suggestion that will help with those bouts of homesickness.

Electric pancake griddles can be real lifesavers. Sometimes you really do need simple carbohydrates for energy, and throwing some pancake batter bought from the store onto the griddle with some dried fruit chopped into it is a good solution. As long as your dorm room’s got an electrical outlet, plug ‘er in, add water to the pancake mix, and don’t leave out the berries!

Dried cranberries, chopped apricots, almond slivers and dried or dessicated coconut flakes can be stored for a long time, and they add much needed flavor without the excess sugar courtesy of maple syrup or spray-on toffee. Just about every griddle comes with a nonstick coating nowadays, but we still suggest using a bit of cooking spray (butter or popcorn flavor is good) to make cleanup less of a chore.

If your friends or parents really think it’s necessary to give you a college go-away present, a pancake griddle is a great long-term investment. Great nutrition, too. Buckwheat or whole wheat pancake mix is widely available for most of our readers. (And you’ll be an instant hit with your dorm mates.)

An alternative idea is to invest in an electric indoor grill. When you add the microwave in the dorm common room to this multi-purpose appliance, you’ve almost got a whole “kitchen”! It may sound strange, but these appliances are also ideal for single people who aren’t living in dorms. It fits right on your countertop, and you can cook meat, vegetables, brown rice, pancakes and toast bread in the same appliance. Since there are tons of models out there with different brand names, we’re not going to mention any specific names but we will give you the features we recommend instead.

- Does it come with a cover?
The cover should be connected by a hinge and there should be grid ‘lines’ and the same non-stick cooking surface as the bottom half of the grill. When the heat source comes from above and below the food, everything will be cooked twice as fast compared to having only one heat source at the bottom. The non-stick grid should also be removable for gentle washing.

- How large is the cooking surface?
If you spread your fingers wide, then place your hands beside each other, the cooking surface should be at least as wide as that, plus half a handspan to make 2 and 1/2 hands in all. Instead of having to keep a close eye on the grill and prepare your meals in batches, you can place all the food on it at once, and turn the heat up or down as needed after removing the cooked foods to your plate.

- And speaking of temperature control, there should be at least three settings, High, Medium and Low, or Temperature settings in Farenheit or Celsius. Meat usually requires the High setting but vegetables will overcooked on the outside and undercooked inside at this temperature setting. The timer, we’ve found, is more annoying than helpful, since the grill and food heat up and cooks so quickly.

- Grills should come with non-stick handles as well as a non-stick pan to catch fat drippings (yes, it *is* possible to have bacon in your dorm on Saturdays!)and liquids.
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These should fit very close to and under the grilling surface so that you won’t accidentally cause an accident while you reach for a pen and your homework nearby.

There are two things you can do with outdoor grills that you shouldn’t try with your indoor grill (unless you really want to set the smoke alarms off):

- Rubbing the grilling surface with small herb flakes, spice powders or chili flakes. This is likely to start a fire. The cookbook most grills come with will tell you this as well.

- Since there’s very little ventilation in the dorm room, we suggest NOT adding whole chilies or other foods to the grill.

Indoor grills should be available near the rice cookers in kitchen gadgets department of a supermarket near you.

We’ve suggested purchasing a crockpot before, but several readers have asked for more details. Here are the features we recommend:

A removable liner
The stoneware pot should have a coated interior and should be removable for ease of cleaning. Watch out because it gets very hot! A 5-quart pot gives you and your dorm mates plenty to share. Crockpots are convenient for students and busy singles because you can put the ingredients in, leave it at a temperature setting, cover it, then forget about it till you get back. By then, your dorm will be filled with the pleasant aroma of dinner waiting for you.

An auto-change temperature setting
Every crockpot comes with Low, Medium and High temperature settings, but the crockpots worth your money also come with an Auto Change setting. With an internal thermometer set at 80 C, the crockpot will automatically lower or increase the heat so the contents of your crockpot are not overcooked.

Bakelite or heat-proof handles
So you can lift the crockpot and put it away in the cupboard or under the bed when you need room for the unbelievably thick textbooks.

Invite your classmates “home” for lunch with this nutritious and filling set-it-and-forget-it recipe (it uses ingredients you can store in your room without a fridge):

Crockpot Back-to-School chunky soup

1 cup macaroni shells
1 cup macaroni elbows
4 hot dogs, cut to chunks
1 teaspoon olive oil
1/2 teaspoon garlic powder or soy sauce
half 1 green pepper, chopped
half 1 red pepper, chopped
2 tomatoes, diced
half of 1 onion, chopped
1 can mushrooms, drained
1 can baby corn, drained
1 pepperoni, diced
2 cups low-sodium broth (chicken, vegetable, beef, or other)
5 tablespoons grated cheese
Place all ingredients in the crockpot and set on low for 3 or 4 hours when you leave for class in the morning, and you’ll have lunch and dinner waiting for you. Garnish with some cheese and dried parsley when ready to serve.

Dorm food has a pretty bad reputation - both for making people gain weight and for bad tasting, low-nutrient stuff. True, the rumors are a bit exaggerated, but for those who’ve experienced dorm food, you do get used to the bad stuff. If you’re concerned, you ought to get answers to these questions when choosing a college:

1) What kind of meal choices do I get?

Exam stress and illness should be accomodated. Heavy and oily lasagnas are out during exam time, as we’ve said in our previous articles, and you should have mostly fluids when you’re down with a cold, flu, fever or worse. Does HFS allow for short notice changes to the requested menu due to illness? Does HFS make digesting food easier during exam time? There should be more white meats, more soups, steamed vegetables and nutrient-packed foods for exam stress. Is herbal tea such as mint available as an alternative to coffee to make you alert after an all-nighter? What about religion, celiac disease or diabetes?

Remember, you should be able to obtain widely-available foods such as fruit-flavored yogurt with Lactobacillus (for better digestion and immunity), honey, echinacea tea and Ziplock bags free from HFS.

2) Does HFS take into account dietary restrictions such as calorie and protein intake, as well as extra nutrient-rich foods if I request it?

Many students are combining exercise or amateur sport competitions with their studies. A great way to keep your brain alert, but you also have to watch that your body is able to make the repairs and 3) What kind of meat is used for dishes like meatloaf?

Get around to asking if the meat is leftover meat, meat left on students’ plates or freshly bought meat. The most you can really expect is leftover meat, but meat and other stuff left on plates is unacceptable.

4) Does HFS provide the option of “to-go” breakfasts such as smoothies?

You’re paying tons already for your meal card and tuition. Why should you have to pay extra for pricey smoothies off campus? HFS is sure to have overripe bananas, apples and individual cans of pineapple chunks lying around. Ask for smoothies or canned fruit if you’re in a rush.

5)Ask students living in dorms what they’ve been getting, and how satisfied they are with the food. Don’t be surprised if you hear lots about “Ramen”, “puffed wheat squares”, “triscuit with peanut butter and sugar” and “Rice-a-Roni”. That’s considered gourmet food in dorms when you alternate between these three. Consider a grocery pool; students on one floor of a dorm wing each chips in $0.20 for a bag of 16 grapefruit from the grocery store. Or pears, sweet potatoes or Fuji apples - stuff that’ll keep for awhile without refrigeration. For the grocery pool everyone should take turns going to the supermarket for stuff so that it doesn’t burden one person. It’s helping everyone to eat healthy for more effective studying, cramming and exam-writing, after all.

6) Speaking of refrigeration, do the dorm wings have one mini-fridge at least? Can you get a fridge for your dorm room at all?

Yes, dorm food is unpleasant, as bad as plane food sometimes. But it doesn’t have to be the death knell to your health. Keep fruit and whole grain breads in plain sight, and the money you waste on extra stuff (with service taxes) will be kept to a minimum.

This medication should only be bought after a doctor has prescribed it. The medication can be purchased in a variety of dosages: 2.5 mg, 5 mg, 10 mg and 20 mg. This medicine has the same formula and potent substances like the branded medicine. The medication has the equivalent potency of the branded one, in every way. In just a few minutes it begins to have an effect which lasts up to four hours. While it stays in the blood, the persons using it can reach and keep a better erection with a higher level of satisfaction. The muscles of the penis are allowed to relax by increasing the flow of blood during sexual intercourse with this medication. It goes without saying, the medication has improved the life of countless men afflicted with erectile dysfunction or impotency.

If considered along with other anti-impotency medicine, this can be found at cheaper prices. As for Vardenafil, you can purchase it online. Due to the increasing interest in anti-impotency medications such as Vardenafil, many pharmacies have begun to sell them on the Internet. In addition to offering affordable medications, online stores provide specific product descriptions to aid you in their proper usage. It is true that this medicine brings very good results, but similar to other medicines, there is a possibility that common side effects such as headaches, feeling nauseous, unclear vision, back pain, and overextended erection time, might happen. If side effects occur, patients are cautioned to halt usage of the medication and check with their physicians immediately.

Purchase Vardenafil from botwmeds.com which has a ready supply of excellent brand name and generic drugs. This is the best way to purchase Vardenafil online at the cheapest cost.

* Heart rate: The original ACOG guidelines were to keep maternal heart rate under 140 beats per minute. You can estimate your heart rate by taking a six-second count, then adding a zero to your result. With the added demands and blood flow in your body, you may find that your heart rate increases far more quickly than before exercise. Some lenience is generally given to women who were highly active prior to pregnancy, but ask your doctor for their specific guidelines relative to you. Current guidelines suggest exercising at 50-60% of your Maximum Heart Rate.

* Overheating: It is incredibly important not to overheat, especially in first trimester. There is a risk of damage to the baby if your core temperature overheats, and this will happen far faster during pregnancy than before. You can help avoid overheating by exercising indoors or in cooler times of day, staying cool and setting your pace so you don’t overheat. Drink plenty of cool liquids, track your heart rate and stay well ventilated. You should never go into a sauna or steam room during pregnancy for the same reason.

* Hydration: Drinking plenty of water is always important during exercise, but it’s especially important when you’re pregnant. The extra cool fluids are important not only for replenishing your body, but also as a cooling mechanism to prevent overheating.

* Proper breathing techniques: It’s important to keep the flow of oxygen going to the baby at all times. During aerobic activity, be sure to breathe deeply and regularly, and decrease your intensity if you find yourself winded. During weight lifting, avoid maneuvers that require the “vasalva maneuver” — grunting exertion to lift a weight. Decrease your weight or avoid those specific moves altogether while pregnant.

* Impact Avoidance: Avoid sports with high impact/risk of falling (such as skiing, water skiing, horseback riding, racquetball, scuba diving and other activities with risk of falling or contact sports)

* Muscle Relaxation: During pregnancy, your hips spread and joints relax. Use caution when exercising as this may affect your overall balance and increase your potential for joint injuries.

* Gravity Change: As your body grows larger and you gain weight, your center of gravity shifts so your balance may be off. Adjust your intensity as needed to accommodate your growing body!

* Excessive Exercise: An excessive level of exercise can actually be harmful to you — and your baby — during pregnancy. Failure to gain sufficient weight (per your doctor’s recommendations) is usually a red flag; and you should never exercise with a goal to lose weight during pregnancy. Talk to your doctor about what exercise level is appropriate for you if you have any doubts.

Who Shouldn’t Exercise?

Generally, exercise is contraindicated (not recommended) if you have any of the following conditions:

* Incompetent cervix
* Preterm labor
* Placenta previa
* Vaginal bleeding during pregnancy
* Pregnancy-induced Hypertension.

There are also other conditions your doctor may have concerns about, so be sure to ask your doctor about your specific pregnancy even if you are already an active exerciser.

The Bottom Line

The bottom line is that you should always talk to your doctor about exercise if you’re pregnant, or planning to get pregnant soon. There are many benefits — both physically and emotionally — to moderate exercise during pregnancy. For a small percentage of women, however, the risks far outweigh the benefits and you should be sure that you are not in this category before beginning to exercise. For the vast majority of women, you’ll probably get the green light to continue your current exercise program, or even start a new moderate level program as long as you follow some simple guidelines and listen carefully to your body. So talk to your doctor and find out what’s right for you, and best wishes for a safe and healthy pregnancy!

Actually, the opposite is true, in general. Exercise during pregnancy can help keep you fit and feeling good about yourself. It increases circulation, strengthens muscles, decreases heart rate, decreases insomnia, decreases constipation, helps with back pain and improves self-image. Some studies show a correlation between exercise levels during pregnancy and shorter labors, better maternal stress management, lower intervention/c-section rates and lower risk of premature delivery. Women who exercise during pregnancy also reported an overall lower level of discomfort during pregnancy — always a plus!

So how do you know if it’s okay for you to exercise? And how intense can your exercise routine be? Well, one general rule of thumb is that you shouldn’t start an intense exercise regime during pregnancy. That is to say, if you were a runner before you got pregnant, you can probably keep running — although at a slightly lower intensity level — during pregnancy. If you lifted weights, or did step aerobics, or most other activities, you can probably continue your program, albeit with a few modifications.

So what’s with all of the disclaimers? Why “probably,” “maybe” and “usually”? Well, the fact is that each woman’s pregnancy is different. Your body and your needs may vary from those of every other pregnant woman. While none of us look forward to the inevitable weight gain that comes with pregnancy, it’s a fact of life and if you’re exercising purely to avoid weight gain you may need to re-think your goals. However, if you want to continue an existing exercise routine, or add in some reasonable activity to your life, your doctor will probably give you their blessing.

There are some important reasons to talk to your doctor before starting (or even continuing) an exercise routine during pregnancy, though. As your body responds to the demands of the baby growing within you, the demands upon your body change as well. In general, this means that you have extra blood, an increased heart rate, increased blood pressure, muscle relaxation, changes in your center of gravity, enlarged breasts and uterus, excess stress on your lower back and more.

So what activities are okay during pregnancy? Your doctor will discuss these with you, and you may find that this is a good time to explore some new activities as well. In general, as long as you keep your core temperature down (don’t overheat), stay hydrated and avoid high impact/jolting/traumatic activities, you can stay active as long as your body allows! Many women exercise right up until the day they deliver — albeit with some modifications to accommodate their changing bodies!

Some activities that are popular with pregnant women include cycling, swimming, water aerobics and floor exercise. Non-weight bearing activities are best. Strength training is good for keeping your muscles toned (and great for self-image!), as long as you avoid moves that require the vasalva maneuver (defined below). Squats and lunges can help increase your leg muscle strength and tone, just keep your loosening joints in mind!

Abdominal exercises are not forbidden, as previously thought, rather, moderate abdominal work can actually strengthen your muscles and help you recover more quickly! Be sure not to lie flat on your back after four months (which can compress vena cava, carrying blood to the baby). Side-lying exercises are generally allowed as long as doctor says it’s okay. Check regularly for abdominal separation (a gap between the muscles in your central abdomen) and stop abdominal work immediately if this occurs. Discuss this with your doctor to prevent further injury to this area, which can affect your muscle recovery.

See part II