Cancer on my mind is an article written by Dr. Albert Lim Kok Hooi, a consultant oncologist. He opens his article by saying:

As a doctor, I am interested in how the human mind works. As an oncologist, I am interested in the lure of alternative medicine. And so I have tried to understand why, in spite of all the scientific evidence at hand, there are many amongst us who do not want to undergo conventional cancer treatment – surgery, radiotherapy, chemotherapy and targeted therapy – but instead risk being treated by unproven and potentially dangerous alternative therapies.

He goes on to say that this happens because sometimes science is not very well understood. He talks about confirmed bias, a phenomenon in cognitive science, the science of how the mind works. He describes it as a person that -- notices the hits and ignores the misses in support of his own beliefs. So, basically someone might have a strong bias against chemotherapy, for no other reason than what they have seen on television, without really knowing the true facts.

I was going to write a blog later in my series of blogs on toxins and stress and disease from the studies that I have been reading for the last month. But since a comment was made about stress and whether it has a correlation to disease to the previous blog I wrote on toxins and stress creating disease in our bodies, I will jump ahead and share some research I found on the relation of stress and disease. A relation to stress and disease has been researched by many doctors, psychologists, and medical research facilities and conclusions are that stress does several things to the body causing it to shut down in areas that can effect the body with disease and illness.

Do the common phrases, Tension Headache, Upset Stomach, Shaky Nerves, Tight Chest, ring a bell? Studies showed that work place stress has created an increase in heart disease and high blood pressure as well as making the body more susceptible to flu and viruses. It also has shown that stress can be related to Type 2 Diabetes as well as obesity. "Stress in general can disrupt the body's ability to process glucose, especially in people whose genetics make them vulnerable", said Richard Surwit of the Duke University Medical Center in a research article in the November/December issue of the journal Psychosomatic Medicine.

I'm a good runner when it comes to the right state of mind and the right weather. I have to feel a spark of motivation to know I'll succeed at running, and I prefer cool temperatures. Something in the low 70s or below is perfect. When it's hot and steamy and humid in my Florida town, I tend to struggle. Like I did today.

I set out for a three-mile run with my head in the game. The air was a bit too warm for my liking, but I pushed myself anyway. For a good long time, I did well. With loud music blaring on my MP3 player and a steady pace, I conquered about 75 percent of my goal. Then something happened. I felt my body slow, and my feet wanted to stop. They almost did. Instead of giving in and giving up, though, I pushed myself to finish. In the end, it felt good.

My advice to you today is this: just when you feel you are fading, fading, fading -- don't quit. Try to get through the moment and you'll likely find some energy to keep plugging away.

You can receive many benefits when you practice relaxation techniques. Some of these include lowering your blood pressure, reducing muscle tension, enhancing the immune system, better balance, improved memory and increased energy. It can also potentially improve concentration and cause you to be more efficient in daily activities.

1. Yoga -- is defined by Wikpedia -- its ultimate goal is the attainment of an eternal state of perfect consciousness. I find it to be a great relaxation technique to try. It really seemed to clear my mind by the breathing and concentrated movements. It brings yourself into a state of relaxation by blocking everything out and concentrating on what your body is doing.
2. Tai-Chi -- This type of relaxation technique is something that I have never tried. MayoClinc.com describes --Tai chi as a noncompetitive, self-paced system of gentle physical exercise. To do tai chi, you perform a defined series of postures or movements in a slow, graceful manner. Each movement or posture flows into the next without pausing.
3. Music -- We know how music can induce many emotions to surface. Emotions from the past for instance, can't some songs just bring you back to how you felt in that past moment? It makes sense to me that forms of music can calm and relax.
4. Exercise -- This relaxation technique can mean anything from cardio, weight training and low impact exercises. It really depends on the individual, some will get lots of stress relief when a training consists of higher impact workouts. Don't forget walking -- its one thing we can all try to do more of.
5. Meditation -- I'm no expert on meditation but I have listened to a few relaxation technique tapes after my breast cancer diagnoses. It seemed to help me relax. I never stuck with it though for some reason. I look at meditation as something that can be found in your own special way. I thought you had to just sit still and listen to music and try not to think -- not a very simple task as I'm sure we all know. I find a nice bath with a book and glass of wine as my form of mediation. You can find yours too.
6. Hypnosis --Again this type of relax technique is one that I have never experienced. It is said to be able to put a person into a deep relaxation stage very quickly and can relieve stress.
7. Massage -- This technique I'm happy to say that I indulge. Especially foot massages, it relaxes my whole body. Its a way to give yourself a much needed gift.

Remember before doing any exercises or relaxation techniques please talk to your doctor to make sure its safe -- especially if you have any medical conditions.

When I read something powerful -- a quote, a story, a reflection -- I write it down or cut it out or make a copy of it and drop it into a file folder I've titled inspiration. This file, among others, has been on many a moving van and has traveled with me all over the East coast, from city to city, house to house. And every once in a while, when I need a lift, this is my go-to file -- I go to it, pluck something out, and refresh my mind and spirit.

This file has been with me since at least 1997 -- the date on a photo-copied Ann Landers column I have sitting before me. It's 10 years old, but there's nothing dated about the words printed on this single sheet of paper. They are as touching and moving and relevant now as they were when I first read them. They may be even more meaningful today, because of the thread of cancer that is now woven throughout my days.

These are life lessons, offered by a publisher of the Mount Pleasant News in Iowa, for students about to graduate from high school. They go like this:

Dear Graduates:

There is the kind of education you get in school and the kind you get afterward. Both are important. Put them together, and you have wisdom. The trouble is, life is generally half over before you figure out what is going on.

Graduating seniors can save 25 years of trial, error, and hard knocks by memorizing the lessons of life listed below.

On the average, you learn about one big lesson per year after you leave high school. In really tough years, you learn two or three. Some years, you don't learn anything. After 40, you forget things and have to learn them again.

Some of this information is borrowed. Some is stolen. Some may even be original, but that's doubtful. It's pretty hard to be original in a world as old as this one.

25 Things You'll Need To Know After High School

1. Don't sweat the small stuff, and remember, most stuff is small.
2. The most boring word in any language is "I."
3. Nobody is indispensable, especially you.
4. Life is full of surprises. Just say "never" and you'll see.
5. People are more important than things.
6. Persistence will get you almost anything eventually.
7. Nobody can make you happy. Most folks are as happy as they make up their minds to be.
8. There's so much bad in the best of us and so much good in the worst of us that it doesn't behoove any of us to talk about the rest of us.
9. Live by what you trust, not by what you fear.
10. Character counts. Family matters.
11. Eating out with small children isn't worth it, even if someone else is paying.
12. If you wait to have kids until you can afford them, you probably never will.
13. Baby kittens don't begin to open their eyes for six weeks after birth. Men generally take 26 years.
14. The world would run a lot smoother if more men knew how to dance.
15. Television ruins more minds than drugs.
16. Sometimes there is more to gain in being wrong than right.
17. Life is so much simpler when you tell the truth.
18. People who do the world's real work don't usually wear neckties.
19. A good joke beats a pill for a lot of ailments.
20. There are no substitutes for fresh air, sunshine, and exercise.
21. A smile is the cheapest way to improve your looks, even if your teeth are crooked.
22. May you live life so there is standing room only at your funeral.
23. Mothers always know best, but sometimes fathers know too.
24. Forgive your friends and your enemies. You're all only human.
25. If you don't do anything else in life, love someone and let someone love you.

I just received my University of Florida alumni magazine and right smack in the middle of the publication is a story about cancer. The gist of the article is that there's an explosion of effort and activity in cancer research at this institution -- much like all over the nation -- and featured are all sorts of new cancer techniques and strategies and treatments. But one thing in particular stood out to me. What I read -- in the space of just two short sentences -- jumped off the page and really made me think.

This one thing is what I am about to share, and I'm calling it my Thought for the Day. It's a great morsel of information -- short, sweet, easy to digest, and perfectly powerful -- and so I invite you to read on, let this string of words sink into your mind, think about it over the course of the day, and then determine how you might use it in your own life. And then come back tomorrow, when another Thought for the Day will await you.

Think about this:

More than half of all cancer deaths can be prevented by maintaining a healthy lifestyle. Poor nutrition, obesity, physical inactivity, and cigarette smoking together account for 63 percent of all cancer deaths.

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!

Thanks to Bev, my brainy friend, for this story tip!

From houseplants to raised beds, to plant a seed, tend the soil, and watch a plant grow is one of the most inspiringly hopeful of activities. In hopefulness is found a kind of healing. According to the American Horticultural Therapy Association, horticulture therapy is defined as "a process utilizing plants and horticultural activities to improve social, educational, psychological and physical adjustment of persons thus improving their body, mind, and spirit." The American Cancer Society offers a list of some of horticulture therapy benefits one can expect from gardening that include:

• Feelings of hope.
• Stress reduction.
• Social interaction.
• Pain relief.
• Improved muscle tone, flexibility, and cardiopulmonary capability.
• Creativity and self-expression.
• Enhanced self-esteem and improved mood.
• Motor skill development.
  

As the New Year arrives, so do the gardening catalogs in the mail. Interested in receiving gardening catalogs but not certain where to start? Cyndi's Catalog of Garden Catalogs lists over 2,000 mail-order gardening catalogs for the home gardener.

Two of my favorite gardening websites and online catalogs are found at Seeds of Change and Seed Savers Exchange.

At Seeds of Change, you can find garden seeds, seed collections, cover crops, seedlings, fruit trees, garden tools, kitchen items, and a bookstore. All organic. In addition, Seeds of Change publishes a newsletter.

Seed Savers Exchange is a nonprofit organization that saves and shares heirloom seeds. According to Seed Savers Exchange, "Our organization is saving the world's diverse, but endangered, garden heritage for future generations by building a network of people committed to collecting, conserving and sharing heirloom seeds and plants, while educating people about the value of genetic and cultural diversity."

But, wherever you start, once you catch the gardening bug, you will understand why horticulture therapy is becoming an integrated part in healing programs adopted at some of the medical centers across the country.

This past summer, a man in the business of helping smokers quit, was diagnosed with inoperable lung cancer. Just months later, anti-smoking guru Allen Carr lost his battle with cancer. On November 29th, Carr died at his home in Malaga, Spain.

A heavy smoker for 33 years before quitting 23 years ago, Carr claimed to have found an easy way to quit smoking. From that discovery, he founded The Easy Way to Stop Smoking Program, which would eventually grow into 70 clinics in 30 countries. In addition, his company publishes how-to quit smoking books, CDs, tapes and DVDs.

Using cognitive therapy, Carr told smokers interested in quitting that they could do it without willpower, without suffering withdrawal and without gaining weight. The celebrity endorsements for his program include Sir Anthony Hopkins, Sean Bean, Marie Helvin, Johnny Cash, George Harrison, Lisa Stansfield, Sir Richard Branson, Britney Spears, Susannah York, Bruce Oldfield, Stefano Gabbana and Julie Christie.

Carr is credited with helping over 25 million people to quit smoking.

An Easy Way to Stop Smoking Program clinic spokesperson was quoted as saying, "Allen spent many years in smoke-filled rooms after he quit, while treating smokers for addiction. He is certain that had he not quit, he would have died 20 years ago." Near the time of his death, Carr wrote a letter to Tony Blair urging his government and NHS to accept the easy method program. Carr was 72.

Nabilone, known as Cesamet, a synthetic imitation of an active ingredient found in marijuana, has been shown successful in treating cancer patients experiencing nausea, pain, anxiety and depression, according to University of Toronto researchers who conducted a study on the effectiveness of the synthetic drug.

During the study of 139 participants, a survey was conducted to rate how well the synthetic drug alleviated the adverse side-effects most commonly associated with chemotherapy. According to the study, cancer patients who were prescribed Cesamet indicated less pain, anxiety and depression.

A prescription drug approved for cancer patients who do not respond to traditional anti-nausea treatments, lead investigator Dr. Vincent Maida stated, "This is not a pot pill and has absolutely no street value."

The trouble with the synthetic drug, which is legal, is the stigma attached to marijuana use in general, even on the part of some physicians, who are said to be hesitant to prescribe a version of marijuana even if it is not marijuana. In our modern society, marijuana is sometimes associated with counter-culture populations, addiction and even as a gateway to more addictive drugs.

I would say I just do not get it when it comes to the denial of making cancer treatment for a cancer patient a little easier, but The Scientific American published a brief history of marijuana that brings us from ancient China to the present with, "In 1937 the U.S. Congress, against the advice of the American Medical Association, passed the Marijuana Tax Act, effectively banning use of the drug by making it expensive and difficult to obtain. Ever since, marijuana has remained one of the most controversial drugs in American society. Despite efforts to change its status, it remains federally classified as a Schedule 1 drug, along with heroin and LSD, considered dangerous and without utility."

As anyone who has undergone the grueling ordeal of chemotherapy can tell you, getting high is the last thing on their mind. However, alleviating the debilitating side effects of chemotherapy is critical.

Other medical marijuana-related posts include:

• Montel Williams: poster child for pot
  
• Medical marijuana pot pill approved for chemotherapy
• Breast cancer has made me a criminal patient story
• FDA rejects medical marijuana use
• Guru of Ganja: medical marijuana advocate faces new pot charges

My own oncologist did it just two days ago. He checked in on my mental health, asked how I was surviving, and eased my fear of cancer recurrence and possible death. He reached beyond the medical scope of our relationship -- literally. He placed a hand on my shoulder. He offered me a hug. He cared.

Yet many doctors refrain from reaching too far into the lives of the patients they treat. They stay at a distance. They focus on merely replacing illness with health. This is, after all, the purpose of medicine -- to fix people.

Dr. Jeremy Geffen, author of The Journey Through Cancer: Healing and Transforming the Whole Person, shares in his book that "at present, doctors focus primarily on the physical characteristics of their patients -- bones and organs, tissue samples, test results, height, weight, and age. Yet in each of us, there is a rich mental, emotional, and spiritual reality that influences, even directs the course of our lives."

Conventional medicine responds to cancer patients with surgery, chemotherapy, radiation, and other treatment protocols to essentially get rid of the cancer. Physical signs, symptoms, and responses are carefully monitored -- while other areas of patients' lives receive little attention.

A whole component of true medical care is missing -- as doctors may feel unprepared to address emotional issues, and time restraints allow for limited interaction between doctor and patient.

Geffen believes the ultimate purpose of medicine is to help all beings "experience unbounded love, joy, and inner peace, and to know this is the essence of who we truly are." This purpose, he believes, deserves as much attention as the purpose of treating symptoms and curing disease.

And so Geffen created a program based on his Seven Levels of Healing -- a program that includes both the relative and ultimate purposes of medicine, both the doing and the being.

Level One: Education and Information -- provides basic information about cancer and treatment options and encourages patients to actively participate in and obtain benefit from their care.

Level Two: Connection with Others -- explores the importance of reaching out to others for comfort and support on the journey through cancer.

Level Three: The Body as Garden -- invites patients and family members to see the human body as growing and evolving, as a complex garden rather than a machine. This level touches on good nutrition, exercise, massage, acupuncture, and a variety of complementary and alternative approaches to healing.

Level Four: Emotional Healing -- enters the realm of the human heart, shedding light on fear, pain, anger, self-love, and forgiveness.

Level Five: The Nature of Mind -- examines how life with cancer is influenced by our thoughts, beliefs, and the meanings we give events.

Level Six: Life Assessment -- delves into aspirations, goals, and purposes of our lives.

Level Seven: The Nature of Spirit -- embraces the spiritual aspects of the healing process.

As a physician, Geffen aims to bring his vision of medicine and healing to cancer patients everywhere. And he uses his book as an instrument of communication -- so readers can participate in his vision, so they can learn to settle for nothing less than medical care that centers on the whole person. And not just the parts.

To read previous posts on the same topic, visit:
The Journey Through Cancer: Introduction
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for:
The Journey Through Cancer: Beverly Is Every One Of Us

It was his father's death from stomach cancer -- and the cold, impersonal, clinical manner in which his father was treated leading up to his death -- that inspired Dr. Jeremy Geffen to become the kind of oncologist he wished had been available for his father -- "someone who could look into the mind, heart, and spirit of a human being as intently as he could gaze at an MRI scan or pathology report; someone who provided love, support, wisdom, and hope."

For the 20 years that have followed his father's death, Geffen's inspiration has led him in exactly this direction. He credits education and a strong network of mentors for preparing him for the path less traveled, for allowing him to achieve his vision for comprehensive, integrative medical care.

Geffen founded the Geffen Cancer Center and Research Institute in 1994, and directed it until 2003. It was one of the first cancer centers in the United States created specifically to provide complete, holistic care for people with cancer and their loved ones.

After working closely with cancer patients over the years, Geffen observed that every single question and concern encountered on the journey through cancer falls precisely into one of seven different yet interrelated domains.

Geffen wrote down these domains -- he calls them the Seven Levels of Healing -- and began sharing them with his patients and staff who remarked that the levels perfectly mirrored their own experiences. And so Geffen kept them fresh in his mind and over the course of time developed them into a formal program that became the foundation for the standard of care offered to his patients and their loved ones.

Geffen's book -- that brings life to the Seven Levels of Healing -- is called The Journey Through Cancer: Healing and Transforming the Whole Person. It is a result of his own personal journey that began the day his father left a dreaded string of words on his answering machine. "Oh, Jeremy. I think I've got a little problem. I had an endoscopy today and the doctor said I have a tumor in my stomach. Unfortunately, it's malignant. Maybe you could give me a call."

Geffen was in medical school when his father recorded these words. Now he is an accomplished oncologist, author, public speaker. He is the father of the Seven Levels of Healing -- soon to be revealed right here on The Cancer Blog.

To read previous post on the same topic, visit:
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for:
The Journey Through Cancer: What Is The Purpose of Medicine?

I love it when seven of something lands before me, offering me potential material for the Sunday Seven series. In fact, it just happened. And I can't wait to start writing about the Seven Levels of Healing common to cancer patients and those who love them.

I have a new book. It's called The Journey Through Cancer: Healing and Transforming the Whole Person by Jeremy Geffen, MD.

Dr. Geffen knows cancer. He lost his father just three months after a stomach cancer diagnosis. He became an oncologist. He founded a cancer research center. He travels and speaks and writes about health and wellness. And inside the pages of his newly revised and updated paperback, he details the Seven Levels of Healing -- a blend of conventional and complementary principles-- and the true stories of cancer patients who have directly experienced them.

It occurred to me while first flipping through this book that I might read it in its entirety and then write a review of the material. Then I determined it would take much too long for this approach. With two small children, a few jobs, an exercise routine I must revisit, and all the other bits and pieces of life that keep me occupied, this would be quite an undertaking -- the actual reading, the remembering, the writing. Somehow, this would be too much to manage. But small steps. I think I can handle small steps. So this is how it's going to work.

I will present to you in this post the Seven Levels of Healing. I don't know much about them yet -- although by title alone, I am sure I have lived most of them in my own cancer journey. So I will simply lay the groundwork. And then I will start reading. And as I read, I will write. This will be my own one-woman book club -- with an open invitation for new members. Read my posts and reflect on them. Agree. Disagree. Leave comments. Buy your own book. Read with me. Apply what you learn to your own life. Share what you learn with others. The possibilities are endless as I journey my way through this new book in search of peace, clarity, and comfort -- all of which flow from these seven levels.

Level One: Education & Information
Level Two: Connection with Others
Level Three: The Body as Garden
Level Four: Emotional Healing
Level Five: The Nature of Mind
Level Six: Life Assessment
Level Seven: The Nature of Spirit

And so that's what I have to offer for now. I'm sorry to keep you hanging. But rest assured, I am hanging right along with you, eager to find a moment to dive into this book. To sink my teeth into the words, sentences, paragraphs, chapters. To relay it all to you. I can't wait -- to really understand the Seven Levels of Healing.

Stay tuned for:
The Journey Through Cancer: Introduction

Approximately 3 percent of all new cancers in the United States are linked to obesity, according to the US National Cancer Institute. Stay trim to cut cancer risk, that is what the headline reads. Researchers hypothesis that fat might be preventing apoptosis -- the process in which cancer cells perform a sort of suicide. But it's all untested speculation at this point as to how fat might affect cancer development and growth.

Recently, Rutgers University researchers conducted tests on mice and found leaner mice were less susceptible to developing cancer. Cancer cells in fatter mice died much more slowly, twice as slow as their skinny counterparts. The study is published in the National Academy of Sciences.

In other weighty health-related news, University of Pittsburgh researchers are reporting that overweight middle-aged people who walked briskly for 30 to 60 minutes a day lost 7 pounds in 18 months, while similar adults who didn't exercise consistently gained seven pounds in that time.

During the study, the participants were advised to eat healthy foods but not to restrict the amount of food beyond the norm. Seventy-five percent chose walking as their form of exercise.

Walking is a wonderful exercise for the body, mind and spirit. Most people do not walk alone, and this is a leisurely time to visit and enjoy each other's company. In addition, it's a way to slow down and reconnect with the world around you. Walking is a time to take deep breaths. Living Out Loud author Keri Smith, who blogs The Wish Jar Journal, often blogs about her many observances and adventures in walking and uses it as an exercise in creativity and a renewal of wonder in the every day. Delightfully, she collects things on her walk.

I am a fan of walking. Anyone can walk. During breast cancer treatments (except for the time my red blood cell count dropped so low I didn't have enough steam to make it across the room) walking was something I could do even if I did not have the stamina or will for more formal exercise.

For cancer survivor and Tai Chi, Yoga and Lebed Method teacher Dawn Stasko, her classes lead to more than a physical improvement in balance, a relaxing means of reducing stress, a boost to the immune system and increased energy for participants. It is a place for newly-diagnosed cancer patients, cancer patients undergoing treatments and cancer survivors to bond and find group support. Stasko accepts the initial non-belief of newcomers that Tai Chi and Yoga could possibly make a difference in the quality of their life, and is touched when they discover the classes do help.

"For me it is pure joy to have someone come into my class and say how can this help," she said with tears in her eyes and in a broken voice. "They listen to me and they are kind of hesitant and skeptical, and at the end of the class I get a 'thank you' and that makes the biggest difference in the world."

Valerie Cutshall features the benefits cancer survivors feel they have received by participating in Stasko's classes in Yoga, tai chi classes help cancer patients survive.

Tai Chi is referred to as a graceful form of exercise and described as meditation in motion. Yoga, when used as a form of alternative therapy to enhance flexibility, relaxation or stress relief, is a combination of breathing exercises, physical postures, and meditation. The Lebed Method focuses on healing through a therapeutic exercise and dance movement program designed for women who have had breast cancer, for all cancer patients who have undergone cancer treatments and for lymphedema. For more information, visit the Lebed Method.

The Mayo Clinic has created the Complementary & Alternative Medicine Center that publishes articles about Yoga, Tai Chi and other alternative therapies that can be incorporated to complement conventional cancer treatments.

You can find Tai Chi and Yoga classes in cities throughout the United States. To locate a class in your community, contact the local hospital, community center, community college, the YMCA or YWCA, health club or wellness center.