FEATURE
She is the nursing director of the new neuro-vascular critical care unit at NCH Baker Hospital and of NCH’s cardiovascular units. But first and foremost, she says, she is a nurse.
​
“I was born to be a nurse,” says Maria Kessler. “I always knew that’s what I would do. I think I knew it when I was in my mom’s belly,” she laughs.
​
Kessler isn’t just any nurse. She’s what she calls a “real” nurse, driven by passion and compassionate care.
​
When she interviews nurse applicants for the specialist units she heads, she knows intuitively if the candidate fits NCH’s culture of excellence.
​
“You have to be in it for the right reasons, and the patients will know the difference. We’re training our nurses to be very specialized in stroke and neurosurgery cases,” she says about the new 16-bed unit. “We can train you, but we can’t train your character.”
​
Born in Manila, Philippines, her aunt was also a “real” nurse. Kessler would wait for her aunt to return home. She was her inspiration.
​
“She was always helping people. She would tell me about her day, and she looked so nice in her white uniform,” Kessler recalls.
​
Lifelong Education
Excellence in education was the cornerstone of her family life. It’s the only thing Kessler’s mother required of her.
​
“You use your education to free yourself from oppression in a Third-World country,” Kessler says, noting that the American Dream is alive and well in her birth country.
“We can train you, but we can’t train your character.” ~ Maria Kessler
She finished an accelerated education program and went straight on to earn her Bachelor of Science in nursing (cum laude) at age 17. She worked in a local operating room, an ICU and ultimately gained experience managing a ward.
​
At 21, she was recruited to work as a nurse at Montefiore Mount Vernon Hospital in New York. She traveled to the U.S. on her own, worked, lived in the nurse’s dormitory and studied for her NCLEX (R.N. nursing boards), often falling asleep in the library.
​
“I had no life skills,” she laughs as she recalls the transition. As her mother wished, her entire life had been focused on being an honor student. “I had no responsibilities. I had to learn how to balance a checkbook. We had maids in the Philippines.” She pauses to laugh. “The first time I did laundry in New York, all my sweaters shrunk. I had to wash my own stockings.” And that’s when she discovered static cling.
​
Career and Family
She moved to her aunt’s home in Southwest Florida in 1987 and began her career at NCH: working the night shift as an R.N. Within the first year, she earned her CCRN (certified critical-care nurse), and when NCH opened its heart unit in 1992, she applied that certification and the skills she’d mastered in the heart ICU in the Philippines.
Maria Kessler with graduating twins Brennan and Stephanie
Kessler met her “knight in shining armor,” Paul, formerly an NCH x-ray technician. Married in 1998, the happy couple learned they were expecting twins a couple of years later. When Kessler was given bed-rest orders, she took a few years off from NCH and brought twins Stephanie and Brennan into the world.
​
“It was the first time I didn’t have a job in my whole life!” the self-professed workaholic says.
​
The family moved to Pennsylvania to care for her in-laws. Paul took care of the twins while Kessler completed her master’s degree. The family then returned to Southwest Florida. She returned to NCH, Paul became a contractor and the twins are working toward their college degrees locally.
​
She was married before and had four children, born in 1982, 1987, 1988 and 1991. There’s a decade difference in age between the twins and her older children, and the mother of six is equally proud of her older children and the professional and military paths they have taken.
​
“Paul is the only reason I can take care of these things,” Kessler says of her advanced degree and duties today at NCH as director of nursing for three acute-care units. “I have a very stable home life,” she says, “and my husband is 200% supportive.” Kessler’s is a story of passion: passion for family and career.
​
“My dream when I was young was to have no children and have a professional career. That didn’t happen, did it?” she laughs. “My children, my family and my dogs, Macy and Maya, lift me up every day.”
​
Her message is clear: Never forget your goals. Today, she trains nurses to be the best they can be so that patients are cared for at NCH instead of elsewhere.
​
Her advice is to find the fire that drives you, follow through and don’t let go.
​
As a lifelong critical-care nurse and mentor to countless others, Kessler knows firsthand that “Life is precious. Step back and you’ll see that the big picture makes sense in the end.”
FIT FOR LIFE
Compassion Outpaces Sheer Fitness
Woman inspires community support of Pan-Florida Challenge cancer ride
​
by Jessa Gilberto, Pan-Florida Challenge
Laraine Bergmann at the 2021 Pan-Florida Challenge Cancer Ride
Laraine Bergmann is just one rider, but her involvement in the Pan-Florida Challenge Cancer Ride (PFC) has been a driving force behind the nonprofit’s support from the Treviso Bay community in Naples.
​
Eight years ago, Bergmann, now 74, stepped out of church one Sunday morning and came across a PFC sign-up table. She had been recovering from back surgery and grew to love cycling as a low-impact exercise that would benefit her healing.
​
“I had no concept what it was to bike 200 miles in the Florida wind,” Bergmann laughs. “I have a heavier bike, and I was one of the oldest people. But I signed up and did the whole 200!”
​
PFC supports cancer patients of all ages and their families. It sponsors educational programs and partners with organizations like the Cancer Alliance of Naples. PFC also funds groundbreaking research and clinical trials that are having a tremendous impact at Moffitt Cancer Center in Tampa.
​
What the Treviso Bay community loves most about the charity is its effort to distribute nutritious food to undernourished children in Florida. These PFC Power Packs and Family Weekend Backpack Meals are intended to help prevent cancer later in life. With the help of annual fundraisers, grants, sponsorships and benefactors, PFC has been able to provide more than 8 million meals to date.
​
Bergmann says the idea of feeding hungry kids has opened her community to get involved.
​
“Avalon Elementary is right in our backyard,” explains Bergmann, who notes that many residents are amazed there could be such poverty here in Collier County. “They didn’t know, and now they want to help. Any one of us could have been those kids or could be someone with cancer. We feel very blessed, and so we want to give back.”
​
There are many charities to choose from here, but Bergmann believes people are inspired by PFC’s mission and transparency. “Our board really vetted the charity and made sure the money went as they said: to the mission. Treviso Bay is happy to contribute to the cause. It’s a top-of-mind charity here.”
For a decade, Bergmann has completed every PFC ride offered in Naples, each year exceeding the last year’s fundraising goal.
​
She is signed up for this year’s longest of multiple routes (125 miles) and now rides with a group of women from her community, all who have sponsored her in the past.
​
These neighbors have started fundraising with their own events and many volunteer for, if not ride in, the annual PFC. About four years ago, her husband started an annual golf tournament to benefit PFC which raised more than $100,000 in 2021 alone.
​
“It’s more about drive than fitness. The power of one person can really make a difference,” Bergmann explains. “We all have been — or will be — affected by cancer in some way.”
​
Cyclists of all ages and abilities are welcome to join the ride as individuals or teams, choosing from multiple routes in Naples and Tampa on March 25 or 26. To learn more, please visit panfloridachallenge.org.
MIND MATTERS
Women and ADD: The Hidden Disability
What females need to know about attention deficit disorder
​
by Kimberly Blaker
Editor’s note: ADD (Attention Deficit Disorder) is now referred to as “ADHD, inattentive type.” For clarification purposes, we refer to the disorder as ADD in this article.
​
Almost all women find that life today is complex, upsetting or frustrating. That’s what author Sari Solden puts forth in her book “Women with Attention Deficit Disorder.” However, women are still able to meet most of [life’s] demands reasonably well, she writes.
​
“For women with untreated Attention Deficit Disorder (ADD), however, the demands of daily life can be crippling. It cripples their self-esteem, their families, their lives, their work and their relationships.”
​
ADD, also known as Attention-Deficit Hyperactivity Disorder (ADHD), affects between 3-5% percent of the population. But adult ADD — especially as it appears in women — often goes unrecognized.
​
CHARACTERISTICS OF ADD IN WOMEN
The symptoms of ADD are many. Some more commonly seen symptoms in women are opposite of the more recognized symptoms seen in men. And that makes detection and diagnosis more complicated. While there are many characteristics, most women with ADD don’t have every symptom, but each has a mixture severe enough to impair some areas of life.
​
Mental vs. physical disorganization – Disorganization is typical and often a severe problem for women struggling with ADD. They may be unable to organize their homes, offices or lives.
​
Other women with ADD find clutter and disorganization an incredible distraction, which can lead to mental disorganization. The disorganized brain struggles to store, weed out and organize logically. For these women, being tidy and organized equals survival.
​
Hyperactivity vs. hypoactivity – Women with ADD can be hyperactive or hypoactive (underactive).
​
Hyperactive women may go at full speed until they crash, often missing important life events. Hypoactive women with ADD are often unable to muster the energy to do much of anything.
​
Inattention vs. hyperfocusing – Women with ADD struggle with the inability to regulate attention. It doesn’t mean they can never maintain attention, but their ability to focus is based on interest and whether the activity is stimulating. Many women daydreamed through school when they were younger. Yet the subjects or activities they found fun, interesting or exciting didn’t pose such a problem. Adult life with ADD is often the same.
​
Hyperfocusing, which is the opposite of inattention, also poses problems and can coexist with symptoms of inattention. While it may be challenging to focus on some things, a woman may hyperfocus on what interests her and be unable to shift her attention. Hyperfocusing can last for hours, days or longer, which makes it difficult to break for important matters. Meals may be forgotten, and family members can carry on conversations without being heard.
​
If a hyperfocused woman does manage to break away from what she's engrossed in, she may wander aimlessly and forget what she's doing.
​
Impatience and impulsivity
Women with ADD may be impatient, either visibly or internally. Minor nuisances can cause significant agitation, expressed or not.
Women with ADD may also be impatient about life and events, going into things full swing rather than step by step. Impulsiveness is often noted in spending, new relationships (even marriage), interrupting conversations or blurting things out they later regret.
​
Mood – Mood swings, being overemotional or easily frustrated is another problem for some women with ADD, which can lead to a misdiagnosis of bipolar disorder, though the two can coexist.
​
Depression in the ADD woman may stem from a lack of self-worth or feeling overwhelmed because of attention issues. Though not a symptom of ADD, depression often coexists or is a result of the disorder.
​
MISDIAGNOSIS
There are reasons women with ADD often go undiagnosed, including hormonal fluctuations, diagnosing depression and anxiety caused by ADD and misdiagnosing hyperactive women with bipolar disorder.
​
WHERE TO FIND HELP
Be informed, as an accurate diagnosis and appropriate treatment are essential. Compile a list of questions to ask your provider. If you don't feel comfortable with a physician's responses, seek help elsewhere.
​
TREATMENT OPTIONS
Because ADD is neurobiological, therapy and coaching work best in conjunction with medication.
RECENT REFERENCE BOOKS
-
​Women with ADHD: The Indispensable Guide to Overcome the Struggles of Living with ADHD and Embrace Neurodiversity (2022) by Grace Monroe
​
-
Help for Women with ADHD: My Simple Strategies for Conquering Chaos (2017) by Joan Wilder
​
-
Adult Woman With ADHD: The Unconventional Guide to Coping With Neurodiversity With Tips for Avoiding Distractions, Managing Emotions and No Longer Feeling Like a Failure, Turning Into a Superwoman (2023) by Pansy Bradley
​​
-
THE HIDDEN FLOWER: A Life-Changing Guide for Today’s Women With ADHD (2022) L. William Ross-Child
EXPERT OPINION
Reimagining Women’s Health Care
This could, and should, be the year of prioritizing women’s health
​
by Michelle Carnahan
I believe that 2023 may become a watershed year that will further move the needle on women’s health and health care. With women making up more than half of the U.S. population, it’s time for women’s health to be considered more than a niche market.
​
Women’s health covers so much more than just reproductive health, but, for too long, it’s been viewed that way. The ability to make real progress hinges on health care leaders listening to women to identify their challenges and address them in meaningful ways.
​
Here’s the shortlist of focus areas I feel deserve the greatest amount of attention:
​
Broadening maternal and reproductive health care
The U.S. Supreme Court’s decision to reverse Roe v. Wade wasn’t just a historic and far-reaching decision. It also highlighted the country’s maternal mortality crisis. It’s a stark reality that the maternal mortality rate in the U.S. is more than three times higher than in 10 other high-income countries, including Canada, the United Kingdom and Germany. Black women are nearly three times more likely to die from pregnancy-related complications than white women.
​
There’s a lot of work to be done, as the majority of pregnancy-related deaths in the U.S. are preventable.
​
Having access to a regular doctor or place of care is essential to ensure good health outcomes for women. Access to affordable contraception, family planning and maternal health care are essential needs for women across the U.S.
​
Expanding access to mental health resources
COVID-19 generated a surge in mental health concerns that disproportionately affect women, with women reporting higher rates of anxiety and depression. This makes sense, given that women generally faced greater stress and responsibilities during the pandemic, adjusting to school closures and children’s needs while managing their own work and their family’s responses to the evolving pandemic.
​
Even as the pandemic began to wind down in 2022, the country’s mental health crisis continued. According to the American Psychological Association, demand for treatment remained high for trauma and stress-related disorders and substance abuse. Nearly half of all mental health care providers have been unable to meet the demand for treatment.
​
In 2023, I hope to see more solutions to tackle the variety of mental health challenges that women face. As companies leverage technology to develop solutions, it’s become clear that partnering with and listening to mental health experts is what will lead to making patient safety a priority. Also needed: addressing the severe shortage of behavioral health providers, including expanding mental health services in the workplace and improving the integration of behavioral health into primary care.
Normalizing aging
Women deserve to age how they age. Women often hit the peaks of their careers just as they begin to experience menopause, forcing them to manage a range of invisible and visible symptoms, including hot flashes, mood changes and sleep issues.
​
In a 2022 study exploring the stereotypes associated with menopause published in the Harvard Business Review, both full-time workers and college students considered a hypothetical coworker described as a “menopausal woman” to be less confident and less emotionally stable than one described as a “middle-aged woman.”
​
But the researchers also found an effective strategy to overcome this bias: When a woman said that her hot flashes were caused by menopause, she was seen as “more confident, stable and leader-like.” Simply put, normalizing menopause at work by talking about it can help boost perceptions of competence and leadership potential.
​
This requires employers to build psychologically safe workplaces in which women feel comfortable to discuss issues and ask for the support they need without fear of discrimination or retribution.
​
Health care reimagined
Women make up 60% of America’s workforce. As consumers, they make more than 80% of health care decisions — researching, analyzing and deciding on the best course of health care for themselves as well as for their partners, children and aging parents.
​
As someone who has worked hard to remove unnecessary barriers to health care throughout my career, I say it’s time to reimagine health care in a way that delivers what women truly need. I’m confident that we will see more progress in this direction in 2023, but achieving that goal requires addressing long-standing gender bias, prioritizing women’s health and expanding equitable access to health care for all women, regardless of their race, income, class or sexual orientation.
​
Imagine decreasing the maternal mortality rate, broadening access to reproductive care options, reducing anxiety and depression, and normalizing menopause so women can live longer, healthier and more fulfilling lives.
​
The result will ultimately be better outcomes for women.
Michelle Carnahan is president of Thirty Madison, a health care company for people living with chronic conditions. Her background in strategy, marketing and operations at Sanofi and Eli Lilly allowed her to see how having access to the care patients needed changed their lives for the better.
THE HEART OF THE MATTER
The Subtleties of Heart Disease in Women
Know the signs, what to do and how to prevent it
​
by Kimberly Blaker
February is American Heart Month, a time to focus on cardiovascular health.
​
Heart disease is the leading cause of death among women in the United States. According to the Centers for Disease Control and Prevention (CDC), it accounts for 20% of female deaths.
​
Coronary artery disease, also commonly known as coronary heart disease or atherosclerosis, is the most common type of heart disease. More than 6% of women age 20 and older are afflicted by it, which can lead to a heart attack or heart failure. (That’s one in 16 women, the CDC reports.)
​
Heart conditions for which women are at higher risk than men include cardiac syndrome X (an ischemic heart disease most prevalent in perimenopausal and postmenopausal females), angina (chest pain) and broken heart syndrome (stress-induced cardiomyopathy). Women can also be affected by several other heart conditions. These include heart failure, heart valve disease, arrhythmia (irregular heartbeat) and atrial fibrillation (AFib).
​
Prevention
Although several risk factors for heart disease cannot be modified, like family history, race, gender, age and menopause, many risk factors can be changed, according to Cleveland Clinic. Take these actions to reduce your risk for disease:
​
-
quit smoking
-
lower your total cholesterol, LDL and triglycerides
-
increase your HDL (good) cholesterol
-
reduce your blood pressure, if it is high
-
keep diabetes under control
-
maintain a healthy body weight
-
eat heart-healthy foods
-
exercise regularly
-
reduce your stress
​
A drink a day may offer some benefit to your heart by increasing your HDL cholesterol, but medical experts caution against more than one drink per day. Studies have found high alcohol consumption can damage the heart. Although some studies suggest alcohol may be beneficial in moderation, others have shown the opposite. Cleveland Clinic recommends if you don’t already drink alcohol, not to begin.
​
Heart attack signs
While women can experience all the same symptoms as men, they often experience heart attacks differently. Most notably, women don’t always experience crushing chest pain. Instead, they may feel tightness or pressure in the chest. As a result, symptoms can go unnoticed or are easily brushed off.
Take notice if the pain or discomfort goes away and then comes back or lasts for more than a few minutes, it could be a symptom. Other symptoms include:
​
-
shortness of breath
-
pain, discomfort, weakness or heaviness in either arm
-
discomfort in the neck, jaw, upper back, shoulders or stomach
-
indigestion, nausea or vomiting
-
cold sweats
-
fatigue
-
sleep disturbance
-
dizziness or lightheadedness
​
What to do if you’re having a heart attack
Call 911 immediately and have them dispatch emergency medical services (EMS). This can be faster than having someone drive you to the hospital.
​
Also, if you’re in a public place, a defibrillator may be available. Ask whoever you see first to check. Defibrillators come with easy instructions and could save your life.
​
Finally, take an aspirin, says Anthony Komaroff, MD, editor-in-chief of "Harvard Health Letter." He recommends a standard dose of 325 mg that isn’t coated. “Chew it, and then swallow it with a glass of water,” says Komaroff, to quickly get it into your system. This can slow blood clotting and limit damage to your heart.
​Kimberly Blaker is a freelance writer. She also owns an online store, Sage Rare & Collectible Books, specializing in out-of-print, scarce, signed and first editions and fine bindings at sagerarebooks.com
CHAPTER 121
Women’s Health
Caring for yourself is the greatest act of love
This month, we draw attention to your health, the greatest gift of love you can give yourself and those dear to you.
​
We feature the life and passions of Maria Kessler, NCH’s nursing director of three critical-care units, including the new 16-bed neurovascular unit, and we learn about 74-year-old Laraine Bergmann, who’s about to set out for the ride of her life to benefit Pan-Florida Challenge.
​
Since it’s heart month, Kimberly Blaker reviews the subtle differences and signs of heart disease in women. This author also brings us an overview of ADD/ADHD in women and how it can be overlooked as a primary disorder.
​
To round out our Women’s Health issue, health care expert Michelle Carahan presents her views as to why 2023 can and should be the year for women’s health care reform.
​
Let’s keep in mind that 1970s commercial’s famous tagline:
“When you’ve got your health, you’ve got just about everything.”