Archive for July, 2009

Alternative Solution to Back Pain

July 28th, 2009

1) Acupunc­ture
A study con­ducted at Sheffield Uni­ver­sity in the United King­dom looked at the long-term symp­tom reduc­tion and eco­nomic ben­e­fits of acupunc­ture for per­sis­tent low back pain. An aver­age of 8 acupunc­ture treat­ments were given to 159 peo­ple, while 80 peo­ple received usual care instead.

After one year, peo­ple receiv­ing acupunc­ture had reduced pain and reported a sig­nif­i­cant reduc­tion in worry about their pain com­pared to the usual care group. After two years, the acupunc­ture group was sig­nif­i­cantly more likely to report that the past year had been pain-free. They were less likely to use med­ica­tion for pain relief.

How does acupunc­ture work? Accord­ing to tra­di­tional Chi­nese med­i­cine, pain results from blocked energy along energy path­ways of the body, which are unblocked when acupunc­ture nee­dles are inserted along these invis­i­ble pathways.

A sci­en­tific expla­na­tion is that acupunc­ture releases nat­ural pain-relieving opi­oids, sends sig­nals that calm the sym­pa­thetic ner­vous sys­tem, and releases neu­ro­chem­i­cals and hormones.

An acupunc­ture treat­ment gen­er­ally costs between $60 and $120. Acupunc­ture is tax-deductible (it’s con­sid­ered a med­ical expense) and some insur­ance plans pay for acupuncture.

If you want to try acupunc­ture, plan on going one to three times a week for sev­eral weeks initially.

2) Cap­saicin Cream
Although you may not have heard of cap­saicin (pro­nounced cap-SAY-sin) before, if you’ve ever eaten a chili pep­per and felt your mouth burn, you know exactly what cap­saicin does. Cap­saicin is the active ingre­di­ent in chili peppers.

When it is applied to the skin, cap­saicin has been found to deplete sub­stance P–a neu­ro­chem­i­cal that trans­mits pain–causing an anal­gesic effect.

In one double-blind study, 160 peo­ple were treated with cap­saicin for 3 weeks, while another 160 peo­ple used a placebo. After 3 weeks, pain was reduced by 42% in the cap­saicin group com­pared to 31% in the placebo group. Inves­ti­ga­tors rated cap­saicin sig­nif­i­cantly more effec­tive than placebo.

Cap­saicin cream, also called cap­sicum cream, is avail­able in drug stores, health food stores, and online. A typ­i­cal dosage is 0.025% cap­saicin cream applied four times a day. The most com­mon side effect is a sting­ing or burn­ing sen­sa­tion in the area.

If pos­si­ble, wear dis­pos­able gloves (avail­able at drug­stores) before apply­ing the cream. Be care­ful not to touch the eye area or open skin. A tube or jar of cap­saicin cream typ­i­cally costs between $8 and $25.

3) Vit­a­min D
Chronic mus­cle pain can be a symp­tom of vit­a­min D defi­ciency. Vit­a­min D is found in fish with small bones, for­ti­fied milk and cereal, and expo­sure to sunlight.

Risk fac­tors for vit­a­min D defi­ciency are:

•darker pig­mented skin (e.g. His­panic, African Amer­i­can, Asian) does not con­vert UV rays effi­ciently to vit­a­min D

•diges­tive dis­or­ders, such as celiac disease

•use of glu­co­cor­ti­coid med­ica­tions for con­di­tions such as lung dis­eases and allergies

•min­i­mal sun expo­sure (elderly, insti­tu­tion­al­ized, home­bound, veiled or heavily-clothed individuals)

•lat­i­tude and sea­son — for exam­ple, peo­ple in Boston do not pro­duce vit­a­min D from sun expo­sure between Novem­ber and February

A study by the Uni­ver­sity of Min­nesota looked at the preva­lence of vit­a­min D defi­ciency in 150 peo­ple with chronic mus­cu­loskele­tal pain. Researchers found that 93% of patients had vit­a­min D defi­ciency. All peo­ple with darker pig­mented skin (African Amer­i­can, East African, His­panic, and Native Amer­i­can ori­gin) had vit­a­min D deficiency.

Another inter­est­ing find­ing was that the major­ity of peo­ple with severe vit­a­min D defi­ciency were under 30 years of age. Sea­son was not a sig­nif­i­cant factor.

The researchers con­cluded that all peo­ple with per­sis­tent, non-specific mus­cu­loskele­tal pain should be screened for vit­a­min D deficiency.

4) Music Ther­apy
Music ther­apy is a low-cost nat­ural ther­apy that has been found to reduce the dis­abil­ity, anx­i­ety, and depres­sion asso­ci­ated with chronic pain.

A study eval­u­ated the influ­ence of music ther­apy in hos­pi­tal­ized patients with chronic back pain. Researchers ran­dom­ized 65 patients to receive, on alter­nate months, phys­i­cal ther­apy plus 4 music ther­apy ses­sions or phys­i­cal ther­apy alone.

Music ther­apy sig­nif­i­cantly reduced dis­abil­ity, anx­i­ety, and depres­sion. Music had an imme­di­ate effect on reduc­ing pain, although the results were not sta­tis­ti­cally significant.

5) Vit­a­min B12
Vit­a­min B12 has been found to relieve low back pain. A double-blind Ital­ian study exam­ined the safety and effec­tive­ness of vit­a­min B12 for low back pain. Peo­ple who received vit­a­min B12 showed a sta­tis­ti­cally sig­nif­i­cant reduc­tion in pain and dis­abil­ity. They also used less pain med­ica­tion than the placebo group.

Besides pain, other symp­toms of vit­a­min B12 defi­ciency are numb­ness and tin­gling, irri­tabil­ity, mild mem­ory impair­ment, and depression.

Risk fac­tors for vit­a­min B12 defi­ciency are :

•per­ni­cious anemia

•med­ica­tions (stom­ach acid-blocking medications)

•inad­e­quate intake of meat or dairy products

•infec­tion (small intes­tine bac­te­r­ial over­growth, parasites)

•Diges­tive dis­eases (stom­ach removal surgery, celiac dis­ease, Crohn’s disease

Vit­a­min B12 mus­cle injec­tions are the stan­dard treat­ment for vit­a­min B12 defi­ciency. Stud­ies have found vit­a­min B12 sub­lin­gual tablets (placed under the tongue for absorp­tion) and nasal gel are also effective.

6) Mag­ne­sium
Mag­ne­sium is the fourth most abun­dant min­eral in the body. It’s involved in over 300 bio­chem­i­cal reac­tions in the body.

Mag­ne­sium helps main­tain nor­mal mus­cle and nerve func­tion, keeps heart rhythm steady, sup­ports a healthy immune sys­tem, and keeps bones strong. Mag­ne­sium also helps reg­u­late blood sugar lev­els, pro­motes nor­mal blood pres­sure, and is known to be involved in energy metab­o­lism and pro­tein synthesis.

Symp­toms of mag­ne­sium defi­ciency include mus­cle spasms and pain, pre­men­strual syn­drome, irri­tabil­ity, depres­sion, insulin resis­tance, high blood pres­sure, irreg­u­lar heart rhythms, and heart disease.

A Ger­man study found that min­eral sup­ple­ments increased intra­cel­lu­lar mag­ne­sium lev­els by 11% and was asso­ci­ated with a reduc­tion in pain symp­toms in 76 out of 82 peo­ple with chronic low back pain.

7) Wil­low Bark
The bark of the white wil­low tree (Salix alba) has pain-relieving prop­er­ties sim­i­lar to aspirin. An ingre­di­ent in white wil­low bark, called salicin, is con­verted in the body to sal­i­cylic acid (aspirin is also con­verted to sal­i­cylic acid once in the body). Sal­i­cylic acid is believed to be the active com­pound that relieves pain and inflammtion.

A num­ber of stud­ies have com­pared white wil­low to med­ica­tion or placebo:

•A Uni­ver­sity of Syd­ney study com­pared the effects of wil­low bark extract to refe­coxib, a Cox-2 inhibitor pain med­ica­tion. In the study, 114 patients received a herbal extract con­tain­ing 240 mg of salicin and 114 received 12.5 mg of refe­coxib every day. After four weeks, both groups had a com­pa­ra­ble reduc­tion in pain.

•A study in the Amer­i­can Jour­nal of Med­i­cine exam­ined 191 patients with an exac­er­ba­tion of chronic low back pain. They were ran­domly assigned to receive a wil­low bark extract with either 120 mg (low-dose) or 240 mg (high-dose) of salicin, or placebo. In the fourth week of treat­ment, 39% of peo­ple receiv­ing the high-dose extract were pain-free, 21% receiv­ing the low-dose were pain-free, and 6% of peo­ple receiv­ing the placebo were pain-free. Peo­ple in the high-dose group improved after the first week. Sig­nif­i­cantly more peo­ple in the placebo group required pain medication.

8) Yoga for Back Pain
Yoga cre­ates bal­ance in the body through var­i­ous poses that develop flex­i­bil­ity and strength. A study of peo­ple with chronic mild low back pain com­pared Iyen­gar yoga to back edu­ca­tion. After 16 weeks, there was a sig­nif­i­cant reduc­tion in pain inten­sity, dis­abil­ity, and reliance on pain med­ica­tion in the yoga group. Ben­e­fits were also seen at three month fol­low up assessments.

Another study com­pared yoga, con­ven­tional exer­cise, and a self care book for peo­ple with chronic low back pain. Back func­tion in the yoga group was supe­rior to the book and exer­cise groups at 12 weeks. Although there was no dif­fer­ence in symp­toms at 12 weeks, at 26 weeks, the yoga group was supe­rior to the book group.

9) Bowen Ther­apy
Bowen ther­apy is a type of gen­tle body­work that was devel­oped in Aus­tralia by osteopath Tom Bowen (1916–1982). Bowen ther­apy is more widely used in Aus­tralia and Europe, but it has been grow­ing in pop­u­lar­ity in North America.

Bowen ther­a­pists use a series of spe­cial­ized “moves” using their fin­gers and thumbs. The moves typ­i­cally involve the ther­a­pist pulling the skin slack away from the mus­cle, apply­ing pres­sure, and then quickly releas­ing the tension.

These moves are per­formed on pre­cise areas of mus­cles where spe­cial recep­tors are located. Nerve impulses are sent to the brain, result­ing in mus­cle relax­ation and reduc­tion of pain.

The moves are not con­tin­u­ous — the ther­a­pist allows the client to rest for a few min­utes between each move. A typ­i­cal treat­ment is between 30 to 40 minutes.

10) Breath­ing Tech­niques
Breath­ing tech­niques that make use of the mind-body con­nec­tion have been found to reduce pain. These tech­niques inte­grate body aware­ness, breath­ing, move­ment, and med­i­ta­tion. What’s great about breath­ing tech­niques is that you can do them your­self at home at no cost.

One study com­pared 6–8 weeks (12 ses­sions) of breath ther­apy to phys­i­cal ther­apy. Patients improved sig­nif­i­cantly with breath ther­apy. Changes in stan­dard low back pain mea­sures of pain and dis­abil­ity were com­pa­ra­ble to those result­ing from high qual­ity, extended phys­i­cal ther­apy. Breath ther­apy was found to be safe. Other ben­e­fits of breath ther­apy were improved cop­ing skills and new insight into the effect of stress on the body.

11) Mas­sage Ther­apy
When many peo­ple have back aches and pain, the first thing they think of is mas­sage. Stud­ies have found that mas­sage may be effec­tive for sub­a­cute and chronic pain. It has also been found to reduce anx­i­ety and depres­sion asso­ci­ated with chronic pain. Mas­sage ther­apy is the most pop­u­lar ther­apy for low back pain dur­ing pregnancy.

12) Chi­ro­prac­tic
Back pain is one of most com­mon rea­sons peo­ple see a chi­ro­prac­tor. Doc­tors of chi­ro­prac­tic use chi­ro­prac­tic spinal manip­u­la­tion to restore joint mobil­ity. They man­u­ally apply a con­trolled force to joints that have become restricted by mus­cle injury, strain, inflam­ma­tion, and pain. Manip­u­la­tion is believed to relieve pain and mus­cle tight­ness and encour­age healing.

A study pub­lished in the Spine Jour­nal exam­ined manip­u­la­tions com­pared to sim­u­lated manip­u­la­tions in 102 peo­ple with back pain and/or radi­at­ing pain. The researchers found that active manip­u­la­tions were more effec­tive at reduc­ing acute back pain and sci­at­ica with disc protrusion.

13) Alexan­der Tech­nique
Alexan­der tech­nique teaches peo­ple to improve their pos­ture and elim­i­nate bad habits such as slouch­ing, which can lead to pain, mus­cle ten­sion, and decreased mobil­ity. This tech­nique was cre­ated by Fred­er­ick Matthias Alexan­der (1869–1955), an Aus­tralian actor who learned how to cor­rect hoarse­ness in his voice by improv­ing his posture.

You can learn Alexan­der tech­nique in pri­vate ses­sions or group classes. A typ­i­cal ses­sion lasts about 45 min­utes. Dur­ing that time, the instruc­tor notes the way you carry your­self and coaches you with ver­bal instruc­tion and gen­tle touch.

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(Con­tin­ued from Page 2)
10) Breath­ing Tech­niques
Breath­ing tech­niques that make use of the mind-body con­nec­tion have been found to reduce pain. These tech­niques inte­grate body aware­ness, breath­ing, move­ment, and med­i­ta­tion. What’s great about breath­ing tech­niques is that you can do them your­self at home at no cost.

One study com­pared 6–8 weeks (12 ses­sions) of breath ther­apy to phys­i­cal ther­apy. Patients improved sig­nif­i­cantly with breath ther­apy. Changes in stan­dard low back pain mea­sures of pain and dis­abil­ity were com­pa­ra­ble to those result­ing from high qual­ity, extended phys­i­cal ther­apy. Breath ther­apy was found to be safe. Other ben­e­fits of breath ther­apy were improved cop­ing skills and new insight into the effect of stress on the body.
•Breath­ing tech­nique — How to breathe with your belly
11) Mas­sage Ther­apy
When many peo­ple have back aches and pain, the first thing they think of is mas­sage. Stud­ies have found that mas­sage may be effec­tive for sub­a­cute and chronic pain. It has also been found to reduce anx­i­ety and depres­sion asso­ci­ated with chronic pain. Mas­sage ther­apy is the most pop­u­lar ther­apy for low back pain dur­ing preg­nancy.
•Find a mas­sage ther­a­pist
12) Chi­ro­prac­tic
Back pain is one of most com­mon rea­sons peo­ple see a chi­ro­prac­tor. Doc­tors of chi­ro­prac­tic use chi­ro­prac­tic spinal manip­u­la­tion to restore joint mobil­ity. They man­u­ally apply a con­trolled force to joints that have become restricted by mus­cle injury, strain, inflam­ma­tion, and pain. Manip­u­la­tion is believed to relieve pain and mus­cle tight­ness and encour­age healing.

A study pub­lished in the Spine Jour­nal exam­ined manip­u­la­tions com­pared to sim­u­lated manip­u­la­tions in 102 peo­ple with back pain and/or radi­at­ing pain. The researchers found that active manip­u­la­tions were more effec­tive at reduc­ing acute back pain and sci­at­ica with disc pro­tru­sion.
•Find a doc­tor of chi­ro­prac­tic
13) Alexan­der Tech­nique
Alexan­der tech­nique teaches peo­ple to improve their pos­ture and elim­i­nate bad habits such as slouch­ing, which can lead to pain, mus­cle ten­sion, and decreased mobil­ity. This tech­nique was cre­ated by Fred­er­ick Matthias Alexan­der (1869–1955), an Aus­tralian actor who learned how to cor­rect hoarse­ness in his voice by improv­ing his posture.

You can learn Alexan­der tech­nique in pri­vate ses­sions or group classes. A typ­i­cal ses­sion lasts about 45 min­utes. Dur­ing that time, the instruc­tor notes the way you carry your­self and coaches you with ver­bal instruc­tion and gen­tle touch.
•More about Alexan­der tech­nique
14) Pro­lother­apy
Pro­lother­apy addresses dam­aged lig­a­ments (bands of con­nec­tive tis­sue that help keep bones attached to each other) to relieve chronic mus­cu­loskele­tal pain.

How does it work? Ten­dons and lig­a­ments in the back often do not heal com­pletely after injury. Bones of the spine become less sta­ble, which can lead to chronic pain.

Pro­lother­apy involves the injec­tion of a liq­uid solu­tion into soft tis­sues such as lig­a­ments and ten­dons. This trig­gers local inflam­ma­tion and trig­gers the body’s nat­ural heal­ing response which repairs the weak­ened soft tis­sues and relieves pain. Unlike drugs, pro­lother­apy is thought to address the under­ly­ing problem.

After locat­ing the areas that require treat­ment, the doc­tor inserts a thin nee­dle with the solu­tion into the area. There is often mild pain, but it can be reduced by using a local anaes­thetic. A typ­i­cal course of treat­ment is 10 to 25 ses­sions for back pain. Since it is believed to repair the joint, no other treat­ment is necessary.

Pre­lim­i­nary stud­ies have found that back pain, which often involves lig­a­ment injury, responds par­tic­u­larly well to pro­lother­apy. It is the posi­tion of the Amer­i­can Asso­ci­a­tion of Orthopaedic Med­i­cine that pro­lother­apy is a safe and effec­tive ther­apy for the treat­ment of selected cases of low back pain and other chronic myofas­cial pain syn­dromes. Pro­lother­apy injec­tions must be admin­is­tered by a med­ical doc­tor (M.D.), osteopath (D.O.) or by a state-licensed natur­o­pathic doc­tor (N.D.) in cer­tain states.

15) Bal­neother­apy
Bal­neother­apy is one of the old­est ther­a­pies for pain relief. The term “bal­neo” comes from the Latin word, bal­neum, mean­ing bath. Bal­neother­apy is a form of hydrother­apy that involves bathing in min­eral water or warm water.
•A study com­pared bathing in min­eral water to plain tap water in 60 peo­ple with low back pain. They found that min­eral water con­tain­ing sul­phur was supe­rior in reduc­ing pain and improv­ing mobil­ity com­pared with tap water.

•A sys­tem­atic review and meta-analysis pub­lished in the jour­nal Rheuma­tol­ogy assessed spa ther­apy and bal­neother­apy for low back pain. The researchers found that the data sug­gest ben­e­fi­cial effects com­pared to con­trol groups. They con­cluded that the results were encour­ag­ing and that large-scale tri­als were war­ranted.
Dead Sea salts and other sulphur-containing bath salts can be found in spas, health food stores, and online.

Peo­ple with heart con­di­tions should not use bal­neother­apy unless under the super­vi­sion of their pri­mary care provider.

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Menstrual Pains — Ideas & Remedies

July 27th, 2009

menstrual

Men­strual peri­ods can be light and easy for some teens and young women, but for oth­ers, they can be heavy or accom­pa­nied by painful cramps. Cramps can be a big rea­son why girls are absent from school, why they miss sport prac­tices, and why they may avoid social events with their friends. How do you know if you should be con­cerned? Read on to learn more about painful peri­ods and what you should do if you have them.

What is Dysmenorrhea?

Dys­men­or­rhea (pro­nounced: dis-men-o-ree-a) is a med­ical term that means “dif­fi­cult or painful peri­ods”. There are two types of dys­men­or­rhea, pri­mary and secondary.

Pri­mary dys­men­or­rhea is the most com­mon kind of dys­men­or­rhea. Cramp­ing pain in the lower abdomen (belly) can start from 1–2 days before your period comes and can last 2–4 days, which may include lower back pain.

Sec­ondary dys­men­or­rhea is when cramps and for some, lower back pain are a result of a med­ical prob­lem such as endometrio­sis or pelvic inflam­ma­tory dis­ease.

What causes men­strual cramps?

Men­strual cramps are caused by uter­ine con­trac­tions (when your uterus tight­ens and relaxes allow­ing blood to leave your uterus). The lin­ing of your uterus releases spe­cial chem­i­cals called “prostaglandins”. These sub­stances can increase the inten­sity of the con­trac­tions espe­cially if the lev­els rise. High lev­els of prostaglandins may also cause nau­sea and lightheadedness.

Is it nor­mal to have some mild cramps dur­ing your period?

Yes, it is nor­mal to have mild cramps dur­ing your period because of uter­ine con­trac­tions. The uterus is a mus­cle that tight­ens and relaxes which can cause jab­bing or cramp-like pain. How­ever, if the dis­com­fort is not relieved with over the counter med­ica­tions and causes you to miss school or other daily activ­i­ties, it could mean that there is another rea­son for your symptoms.

When you first get your period, it is com­mon for you not to have reg­u­lar peri­ods and you may not ovu­late for a few months, or even for a few years. So you may not have men­strual cramps when you first begin your period. After one or two or three years, when your hor­mone sys­tem is more mature, you might have more severe men­strual cramps.

What other symp­toms do girls have dur­ing their periods?

In addi­tion to cramp­ing dur­ing their peri­ods, some girls may have other symptoms.

 *Symp­toms may be mild to mod­er­ate and can include:

  • Nau­sea (feel­ing like you want to throw up)

  • Vom­it­ing (throw­ing up)
  • Loose bowel movements/diarrhea

  • Con­sti­pa­tion

  • Bloat­ing in your belly area

  • Headaches

  • Light­head­ed­ness– feel­ing faint

Are men­strual cramps the same as PMS (Pre-Menstrual Syndrome)?

Men­strual cramps are not the same as PMS. Symp­toms of PMS such as bloat­ing, weight gain, and mood­i­ness hap­pen before a woman’s period begins, and get a lot bet­ter when her period starts. On the other hand, with dys­men­or­rhea, cramps usu­ally get worse the first day or two of a woman’s period and have a dif­fer­ent cause and treatment.

What med­ica­tions can I take for my men­strual cramps?

If you are hav­ing men­strual cramps, talk with your par­ents or health care provider about your options. If your men­strual cramps are painful, you may think about tak­ing some type of the over-the-counter med­ica­tion for one to two days. These med­ica­tions are “anti-prostaglandins”. They help relieve the dis­com­fort, make your flow lighter, and cause your uterus to cramp less. Look for over-the-counter med­ica­tions that con­tain Ibupro­fen or naproxen. Take this med­i­cine when you first start to feel uncom­fort­able, and con­tinue tak­ing it every 4–6 hours or as rec­om­mended by your health care provider. Since this kind of med­i­cine can upset your stom­ach, you should take it with food. Make sure you read the label as to how much and how often you should take the med­ica­tion. You should not take these prod­ucts if you are aller­gic to aspirin-like med­i­cine or have stom­ach prob­lems. It is impor­tant not to take more med­i­cine than is rec­om­mended or prescribed.

Is there any­thing else I can do to help my men­strual cramps?

Nat­ural reme­dies like a microwav­able warm pack or a heat­ing pad placed on your abdomen (lower belly) may help. Soak­ing in a warm bath may also relieve uncom­fort­able cramps. Some teens find that increas­ing their phys­i­cal activ­ity helps; oth­ers find that rest­ing qui­etly for short peri­ods of time helps.

 Acupunc­ture is an alter­na­tive treat­ment that is some­times rec­om­mended to treat dys­men­or­rhea. You should also eat a healthy diet, drink lots of flu­ids, and get plenty of rest. You can try dif­fer­ent treat­ments to find out what works best for you.

What if noth­ing helps my men­strual cramps?

If your men­strual cramps are not relieved by over-the-counter med­i­cine, make an appoint­ment to see your health care provider (HCP). It is help­ful to bring a “pain diary” (that you have kept for a cou­ple of months) to show your HCP. A pain dairy is a tool to help you keep track of your pain; when it comes, the loca­tion of the pain, how long it lasts, and what relieves it.

For exam­ple: You had pain in the lower area of your belly that lasted for 4 hours. menstrual1You took 2 Motrin (200 mg) with good relief and you used a heat­ing pad that helped.

Is it okay to exer­cise when I have my period?

Exer­cis­ing is a good way to stay fit and healthy. Some girls like to exer­cise when they have their period because it helps lessen their cramps. Other girls are uncom­fort­able exer­cis­ing when they have their period. You should find what works best for you. Talk to your coach or gym teacher if exer­cis­ing is uncom­fort­able dur­ing your period.

What if I have big clots of blood dur­ing my period?

Dark, chunky clots of blood can be per­fectly nor­mal. Many women get them dur­ing their period when they have days of heavy cramp­ing and heavy bleed­ing. Your body usu­ally makes things called “anti-coagulants,” that keep your blood from clot­ting as it moves to your vagina and out of your body. But dur­ing days of heavy bleed­ing and cramp­ing, your body is push­ing blood so quickly out of you that your body does not have time to release these anti-coagulants. Your blood then clots. If you have clots that are big­ger than a quar­ter, it is a good idea to talk with your health care provider.

What if I get spots of blood on my under­wear between my periods?

Bleed­ing in the mid­dle of your cycle could mean dif­fer­ent things. Some women bleed a lit­tle bit dur­ing the mid­dle of their cycle, when they ovu­late (when a mature egg is released from your ovaries). This is noth­ing to worry about. Other times, “spot­ting” occurs because of an infec­tion such as a sex­u­ally trans­mit­ted dis­ease (if you are hav­ing sex­ual inter­course). Some­times, “spot­ting” can be because of a cer­vi­cal polyp (a tumor that may need to be removed sur­gi­cally). But this is not very com­mon! You should talk to your health care provider if you have bleed­ing when you don’t have your period.

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Carpal Tunnel Syndrome, What is that?

July 23rd, 2009

tunnel

What is carpal tun­nel syn­drome?
Carpal tun­nel syn­drome is a painful dis­or­der of the wrist and hand. The carpal tun­nel is a nar­row tun­nel formed by the bones and other tis­sues of your wrist. This tun­nel pro­tects your median nerve. The median nerve gives you feel­ing in your thumb, and index, mid­dle and ring fin­gers. But when other tis­sues in the carpal tun­nel, such as lig­a­ments and ten­dons, get swollen or inflamed, they press against the median nerve. That pres­sure can make part of your hand hurt or feel numb.

What causes carpal tun­nel syn­drome?
Doing the same hand move­ments over and over can lead to carpal tun­nel syn­drome. It’s most com­mon in peo­ple whose jobs require pinch­ing or grip­ping with the wrist held bent. Peo­ple at risk include peo­ple who use com­put­ers, car­pen­ters, gro­cery check­ers, assembly-line work­ers, meat pack­ers, musi­cians and mechan­ics. Hob­bies such as gar­den­ing, needle­work, golf­ing and canoe­ing can some­times bring on the symptoms.

Carpal tun­nel syn­drome is linked to other things too. It may be caused by an injury to the wrist, such as a frac­ture. Or it may be caused by a dis­ease such as dia­betes, rheuma­toid arthri­tis or thy­roid dis­ease. Carpal tun­nel syn­drome is also com­mon dur­ing the last few months of pregnancy.

Symp­toms of carpal tun­nel syndrome

* Numb­ness or tin­gling in your hand and fin­gers, espe­cially the thumb and index and mid­dle fingers.

* Pain in your wrist, palm or forearm.

* More numb­ness or pain at night than dur­ing the day. The pain may be so bad it wakes you up. You may shake or rub your hand to get relief.

* More pain when you use your hand or wrist more.

* Trou­ble grip­ping objects.

* Weak­ness in your thumb.

How is carpal tun­nel syn­drome diag­nosed?
Your doc­tor will prob­a­bly ask you about your symp­toms. He or she may exam­ine you and ask you how you use your hands. Your doc­tor may also do these tests:

* Your doc­tor may tap the inside of your wrist. You may feel pain or a sen­sa­tion like an elec­tric shock.
* Your doc­tor may ask you to bend your wrist down for 1 minute to see if this causes symp­toms.
* Your doc­tor may have you get a nerve con­duc­tion test or an elec­tromyo­g­ra­phy (EMG) test to see whether the nerves and mus­cles in your arm and hand show the typ­i­cal effects of carpal tun­nel syndrome.

How seri­ous is carpal tun­nel syn­drome?
Carpal tun­nel syn­drome usu­ally isn’t seri­ous. With treat­ment, the pain will usu­ally go away and you’ll have no last­ing dam­age to your hand or wrist.

How is carpal tun­nel syn­drome treated?
If carpal tun­nel syn­drome is caused by a med­ical prob­lem, your doc­tor will prob­a­bly first treat that problem.

Your doc­tor may ask you to rest your wrist or change how you use your hand. Your CARPTUNdoc­tor may also ask you to wear a splint on your wrist. The splint keeps your wrist from mov­ing but lets your hand do most of what it nor­mally does. A splint can help ease the pain of carpal tun­nel syn­drome, espe­cially at night.

Putting ice on your wrist, mas­sag­ing the area and doing stretch­ing exer­cises may help too.

Tips on reliev­ing carpal tun­nel syndrome

* Prop up your arm with pil­lows when you lie down.
* Avoid using your hand too much.
* Find a new way to use your hand by using a dif­fer­ent tool.
* Try to use the other hand more often.
* Avoid bend­ing your wrists down for long periods.

Can I pre­vent carpal tun­nel syn­drome?
Yes. See the box below for some tips on pre­vent­ing carpal tun­nel syndrome.

Many prod­ucts you can buy–such as wrist rests–are sup­posed to ease symp­toms of carpal tun­nel syn­drome. No one has proven that these prod­ucts really pre­vent wrist prob­lems. Some peo­ple may have less pain and numb­ness after using these prod­ucts, but other peo­ple may have increased pain and numbness.

Things that may help pre­vent carpal tun­nel syndrome

* Lose weight if you’re over­weight.
* Get treat­ment for any dis­ease you have that may cause carpal tun­nel syn­drome.
* If you do the same tasks with your hands over and over, try not to bend, extend or twist your hands for long peri­ods.
* Don’t work with your arms too close or too far from your body.
* Don’t rest your wrists on hard sur­faces for long peri­ods.
* Switch hands dur­ing work tasks.
* Make sure your tools aren’t too big for your hands.
* Take reg­u­lar breaks from repeated hand move­ments to give your hands and wrists time to rest.
* Don’t sit or stand in the same posi­tion all day.
* If you use a key­board a lot, adjust the height of your chair so that your fore­arms are level with your key­board and you don’t have to flex your wrists to type.

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Hypertension or High Blood Pressure…? Why…?

July 22nd, 2009

What is high blood pres­sure? What causes high blood pressure?

Blood pres­sure is the force of blood push­ing against blood ves­sel walls. The heart pumps blood into the arter­ies (blood ves­sels), which carry the blood through­out the body. High blood pres­sure, also called hyper­ten­sion, is dan­ger­ous because it makes the heart work harder to pump blood to the body and it con­tributes to hard­en­ing of the arter­ies or ath­er­o­scle­ro­sis and the devel­op­ment of heart failure.

What Is “Nor­mal” Blood Pressure?

There are sev­eral cat­e­gories of blood pres­sure, including:

* Nor­mal: Less than 120/80
* Pre­hy­per­ten­sion: 120–139/80–89
* Stage 1 high blood pres­sure: 140–159/90–99
* Stage 2 high blood pres­sure: 160 and above/100 and above

Peo­ple whose blood pres­sure is above the nor­mal range should con­sult their doc­tor about meth­ods for low­er­ing it.
What Causes High Blood Pressure?

The exact causes of high blood pres­sure are not known. Sev­eral fac­tors and con­di­tions may play a role in its devel­op­ment, including:

* Smok­ing
* Being over­weight or obese
* Lack of phys­i­cal activ­ity
* Too much salt in the diet
* Too much alco­hol con­sump­tion (more than 1 to 2 drinks per day)
* Stress
* Older age
* Genet­ics
* Fam­ily his­tory of high blood pres­sure
* Chronic kid­ney dis­ease
* Adrenal and thy­roid disorders

Essen­tial Hypertension

In as many as 95% of reported high blood pres­sure cases in the United States, the under­ly­ing cause can­not be deter­mined. This type of high blood pres­sure is called essen­tial hypertension.

Though essen­tial hyper­ten­sion remains some­what mys­te­ri­ous, it has been linked to cer­tain risk fac­tors. High blood pres­sure tends to run in fam­i­lies and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pres­sure, although the gap begins to nar­row around age 44. After age 65, black women have the high­est inci­dence of high blood pressure.

Essen­tial hyper­ten­sion is also greatly influ­enced by diet and lifestyle. The link between salt and high blood pres­sure is espe­cially com­pelling. Peo­ple liv­ing on the north­ern islands of Japan eat more salt per capita than any­one else in the world and have the high­est inci­dence of essen­tial hyper­ten­sion. By con­trast, peo­ple who add no salt to their food show vir­tu­ally no traces of essen­tial hypertension.

The major­ity of all peo­ple with high blood pres­sure are “salt sen­si­tive,” mean­ing that any­thing more than the min­i­mal bod­ily need for salt is too much for them and increases their blood pres­sure. Other fac­tors that have been asso­ci­ated with essen­tial hyper­ten­sion include obe­sity; dia­betes; stress; insuf­fi­cient intake of potas­sium, cal­cium, and mag­ne­sium; lack of phys­i­cal activ­ity; and chronic alco­hol consumption.

Sec­ondary Hypertension

When a direct cause for high blood pres­sure can be iden­ti­fied, the con­di­tion is described as sec­ondary hyper­ten­sion. Among the known causes of sec­ondary hyper­ten­sion, kid­ney dis­ease ranks high­est. Hyper­ten­sion can also be trig­gered by tumors or other abnor­mal­i­ties that cause the adrenal glands (small glands that sit atop the kid­neys) to secrete excess amounts of the hor­mones that ele­vate blood pres­sure. Birth con­trol pills — specif­i­cally those con­tain­ing estro­gen — and preg­nancy can boost blood pres­sure, as can med­ica­tions that con­strict blood ves­sels.
Who Is More Likely to Develop High Blood Pressure?

* Peo­ple with fam­ily mem­bers who have high blood pres­sure.
* Peo­ple who smoke.
* African-Americans.
* Women who are preg­nant.
* Women who take birth con­trol pills.
* Peo­ple over the age of 35.
* Peo­ple who are over­weight or obese.
* Peo­ple who are not active.
* Peo­ple who drink alco­hol exces­sively.
* Peo­ple who eat too many fatty foods or foods with too much salt.

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Be Healthy & Energized

July 14th, 2009

Every day, 2.2 mil­lion Amer­i­cans com­plain of being tired. Most of us chalk it up to hav­ing too much to do and not enough time to do it in, espe­cially dur­ing extra-busy peri­ods. But often the true cul­prits are our every­day habits: what we eat, how we sleep, and how we cope emo­tion­ally. Read on for some sim­ple, recharg­ing changes that can help you tackle all of the energy stealer in your life.

Ener­gize Your Diet

Why is it that fill­ing up on pasta or Chi­nese food for lunch leaves us snacky and sleepy an hour later? Or that falling short on flu­ids makes us for­get­ful and foggy? Fact is, eat­ing habits play a pow­er­ful role in how well we func­tion on every level. Below, six top fatigue-fighting nutri­tion strate­gies to chew on.

* Have break­fast… even if you don’t feel hun­gry. You’ll be a lot perkier: Stud­ies show that peo­ple who eat break­fast feel bet­ter both men­tally and phys­i­cally than those who skip their morn­ing meal. British researchers at Cardiff Uni­ver­sity even found that spoon­ing up a bowl of break­fast cereal every morn­ing is asso­ci­ated with lower lev­els of the stress hor­mone cortisol.

* Eat every three to four hours. Hav­ing three small­ish meals and two snacks through­out the day can keep your blood sugar and energy lev­els sta­ble all day long, says Roberta And­ing, R.D., a spokesper­son for the Amer­i­can Dietetic Asso­ci­a­tion (ADA). Note the word “small­ish.” Super sized meals demand more of your energy to digest, which can leave you feel­ing lethar­gic. At each mini-meal, get a mix of car­bo­hy­drates (which the body uses for energy), pro­tein (which helps sus­tain energy if needed), and healthy fats like those found in fish, nuts, and olives — these fats and pro­tein con­tribute to meal sat­is­fac­tion, so you don’t go hunt­ing for sweets an hour later and wind up with a short-lived sugar high and sub­se­quent crash. A few meal ideas: a low-fat yogurt par­fait with berries and a cou­ple of table­spoons of whole-grain gra­nola; salmon over mixed greens with whole-grain crack­ers; and beef ten­der­loin with a baked sweet potato and asparagus.

* Fill up on more fiber. Fiber has a time-releasing effect on carbs, so they enter your blood­stream at a slow and steady pace, giv­ing your energy stay­ing power, says And­ing. When choos­ing your mini-meals (see above), include fiber-filled options that add up to the daily rec­om­mended 25 to 30 grams of fiber (the aver­age per­son gets only between 10 and 15 grams). Some sug­ges­tions: a bowl of raisin bran (5 grams of fiber per cup); black beans and cheese wrapped in a multi-grain tor­tilla (beans have 7.5 grams per 1/2 cup; one tor­tilla has 5 grams); air-popped pop­corn (3.6 grams per 3 cups); an apple with the skin (3.3 grams); and whole-wheat spaghetti (6.3 grams per cup).

* Fuel your brain with omega-3s. Found in fatty fish (such as tuna and salmon), wal­nuts, and canola oil, these essen­tial fatty acids play a role in keep­ing brain cells healthy and help­ing you feel men­tally alert. Another poten­tial bonus: Omega-3s encour­age the body to store carbs as glyco­gen — the stor­age form of glu­cose (blood sugar) and the body’s main source of stored fuel — rather than as fat.

* Stay hydrated. Water makes up the major­ity of your blood and other body flu­ids, and even mild dehy­dra­tion can cause blood to thicken, forc­ing the heart to pump harder to carry blood to your cells and organs and result­ing in fatigue. Also, ample flu­ids keep energy-fueling nutri­ents flow­ing through­out the body, says Nancy Clark, R.D., author of Nancy Clark’s Sports Nutri­tion Guide­book. To gauge your hydra­tion, Clark rec­om­mends mon­i­tor­ing how often you uri­nate. You should be going every two to four hours, and your urine should be clear or pale yel­low in color. Tip: Besides drink­ing more, you can also con­sume foods that nat­u­rally con­tain water, such as yogurt, broc­coli, car­rots, and juicy fruits, like water­mel­ons, oranges, and grapefruits.

* Watch caf­feine intake after noon. Typ­i­cally, con­sum­ing a mod­er­ate amount of caf­feine — 200 to 300 mg, the amount found in two to three cups of cof­fee — can make you more ener­getic and alert in the hours fol­low­ing, says Anthony L. Komaroff, M.D., a pro­fes­sor of med­i­cine at Har­vard Med­ical School. But when caf­feine is con­sumed in large quan­ti­ties — or any­time in the after­noon or evening — the qual­ity of your sleep that night can take a nose­dive, leav­ing you with heavy eye­lids the next day. One cau­tion for those who are highly sen­si­tive to caf­feine: Although switch­ing to a decaf latte in the after­noon sounds like the answer, researchers at the Uni­ver­sity of Florida found that out of 22 decaf­feinated cof­fee bev­er­ages tested, all but one con­tained some caffeine.

Ener­gize Your Spirit

* We’re all famil­iar with phys­i­cal exhaus­tion, but men­tal strain — sad­ness, bore­dom, worry, anger, and gen­eral stress (the big­gie) — can take an even heav­ier toll on vital­ity, com­pletely wear­ing you out. Life hap­pens, and these dif­fi­cult emo­tions will, too. But if you react wisely, your brain and body will rebound — along with your vim and vigor.

* Splash some water on your face or take a shower when you’re feel­ing burned-out. Some 55 per­cent of study par­tic­i­pants reported using these types of “water ther­apy” to suc­cess­fully increase their energy, accord­ing to find­ings in the Jour­nal of Per­son­al­ity and Social Psy­chol­ogy. Appar­ently, a lit­tle H 2 O refresher can instantly help take the edge off when you’re feel­ing overwhelmed.

* Suit up in a “power” out­fit to beat the blahs. Fight the ten­dency to throw on sweats when you’re feel­ing slug­gish. Although it may seem coun­ter­in­tu­itive to slip into the skirt you save for spe­cial occa­sions, it helps to look in the mir­ror and see an ener­giz­ing image — not a deflat­ing one that con­firms and rein­forces your inter­nal state, says Alice D. Domar, Ph.D., founder and exec­u­tive direc­tor of the Domar Cen­ter for Com­ple­men­tary Health­care in Waltham, MA. Dress­ing for suc­cess will give you a big men­tal boost every time you catch sight of your reflec­tion (or receive a com­pli­ment) through­out the day.

* Vent your feel­ings. Keep­ing fear, anx­i­ety, and stress pent up inside may seem like a grown-up way to deal with these emo­tions. But dis­cussing neg­a­tive feel­ings with another per­son can ease them far bet­ter than keep­ing them bot­tled up; by air­ing them, you reduce their abil­ity to sap your sta­mina, says Komaroff, who is also the editor-in-chief of the Har­vard Health Let­ter.
* Turn on some tunes. Lis­ten­ing to music is one of the most effec­tive ways to change a bad mood, decrease ten­sion, and increase energy. Con­sider this: Run­ners in one study who lis­tened to music while on the tread­mill ran faster than those who jogged in silence — no mat­ter how loud the vol­ume or how fast the tempo, accord­ing to new find­ings in the jour­nal Ergonom­ics. Other research sug­gests that music effec­tively dis­tracts you from feel­ing fatigue. Try burn­ing a CD of your favorite songs and play­ing it any­time you need a pick-me-up. (If you exer­cise, so much the bet­ter — but the music will move you either way.)

* Let go of grudges. Nurs­ing a grudge prompts your mind and body to react as if they’re under chronic stress, increas­ing your heart rate and blood pres­sure and poten­tially result­ing in an impaired immune sys­tem and exhaus­tion over time, accord­ing to a study in the jour­nal Psy­cho­log­i­cal Sci­ence. On the other hand, prac­tic­ing empa­thy and for­give­ness after you’ve been wronged makes you feel as if you’re back in con­trol, which keeps the body’s stress responses in check. The next time you find your­self har­bor­ing ill feel­ings, repeat a stress-relieving mantra to your­self, such as, “For­give­ness makes me a hap­pier and stronger person.”

* Take belly breaths. When we’re under stress, we’re prone to take “chest breaths” — short, shal­low ones, says Domar. Chest breath­ing brings less air into the lungs and reduces the sup­ply of ener­giz­ing oxy­gen to the body and brain, leav­ing you phys­i­cally and men­tally drained. The goal is deep, diaphrag­matic breath­ing — like that of a sleep­ing infant: When you breathe in, your belly should round and fill like a bal­loon; on an exhale, your belly should slowly deflate. Of course, remem­ber­ing to prac­tice deep breath­ing isn’t the first thing on your mind when you’re under the gun, so as a visual reminder, try post­ing a tran­quil pic­ture (such as a pool of water or your kids smil­ing) with the word “breathe” next to your com­puter, or any­where you tend to feel on edge.

* De-clutter a cor­ner. Go through that tee­ter­ing pile of papers or over­flow­ing closet and clear it out. Clut­ter can make you feel out of con­trol and over­whelmed, espe­cially when you’re already feel­ing stressed or down. Plus, sim­ply accom­plish­ing a goal, no mat­ter how seem­ingly minor, can be ener­giz­ing, says Domar.

* Do some good. Acts of altru­ism can lend a lit­tle pep to your step. In fact, one study in the Jour­nal of Health and Social Behav­ior found that vol­un­teer work can boost your energy in six ways: It enhances hap­pi­ness, life sat­is­fac­tion, self-esteem, sense of con­trol over life, phys­i­cal health, and mood.

Get a Restora­tive Rest

When you have a lot to do (um…always), usu­ally the first thing to get squeezed off your agenda is sleep. But miss out on shut-eye and your energy, pos­i­tiv­ity, pro­duc­tiv­ity, and mem­ory are sure to suf­fer. And nearly a quar­ter of Amer­i­can adults aren’t get­ting enough rest, which has led to an epi­demic of day­time sleepi­ness, accord­ing to a poll by the National Sleep Foun­da­tion. The key to buck­ing this trend is to brush up on sleep hygiene. Try these steps for starters.

* Cut back on TV and com­puter time after 8 p.m. If you’re already a night owl (you go to bed late and sleep in on week­ends), the bright light emit­ted from tele­vi­sion and com­puter screens can make falling asleep at a decent hour even harder. The rea­son: Light sup­presses the pro­duc­tion of mela­tonin, a hor­mone secreted at sun­set that tells the brain that it’s night­time, explains John Her­man, Ph.D., direc­tor of the train­ing pro­gram in sleep med­i­cine at the Uni­ver­sity of Texas South­west­ern Med­ical School at Dal­las. And when mela­tonin lev­els are low, your brain is fooled into think­ing that it’s still day­time — and remains rar­ing to go. When­ever pos­si­ble, wait until the next morn­ing to tune in and/or log on. If you must use light-emitting tech­nol­ogy at night, try to turn it off an hour or two before hit­ting the sack.

* Hide your alarm clock. Watch­ing the clock to see how long it’s tak­ing you to drift off or how much time you have left before your alarm goes off can result in a poor night’s sleep, says Kelly A. Car­den, M.D., med­ical direc­tor of the Sleep Health Cen­ter Affil­i­ated with Hall­mark Health at Med­ford in Med­ford, MA. This hyper­vig­i­lance keeps the brain awake and alert and pre­vents you from slip­ping into deep, restora­tive sleep. The easy fix: Set your alarm clock, then either face the num­bers away from you or put it on the floor, in a drawer, or across the room.

* Give your pet his own sep­a­rate sleep­ing space. At night, pets snore, jig­gle their tags, move around a lot, and even hog the cov­ers and bed space. It’s no won­der that 53 per­cent of pet own­ers who sleep with their pets in the bed­room have some type of dis­rupted sleep every night, accord­ing to a study from the Mayo Clinic Sleep Dis­or­ders Cen­ter in Rochester, MN. Con­sider relo­cat­ing your furry friend’s sleep­ing quar­ters to another area, even if it’s just his own bed in your bedroom.

* Lower the ther­mo­stat. For a good night’s sleep, make sure your room is com­fort­ably cool — enough so that you need a light blan­ket. This ensures that your envi­ron­ment is in sync with your body’s inter­nal tem­per­a­ture, which nat­u­rally drops dur­ing the night, accord­ing to the National Sleep Foun­da­tion. Stud­ies sug­gest the ideal sleep­ing tem­per­a­ture is between 54 and 75 degrees; any­thing cooler or warmer may cause you to wake up.

* Skip the night­cap. Alco­hol depresses the ner­vous sys­tem — the sys­tem of cells, tis­sues, nerves, and organs that con­trols the body’s responses to inter­nal and exter­nal stim­uli. So while sip­ping a glass of wine before bed may help you nod off, the seda­tive effects wear off as your body metab­o­lizes the alco­hol, which may cause you to wake up in the mid­dle of the night and have trou­ble falling back to sleep. Alco­hol has also been shown to inter­fere with the body’s nat­ural 24-hour bio­rhythms, caus­ing blood pres­sure to rise and heart rate to race at night when it’s nor­mally calm and relaxed. You don’t have to give up that evening cock­tail entirely to achieve sound sleep — just try to avoid alco­hol within two to three hours of bedtime.

* Get your exer­cise. While sci­en­tists don’t yet under­stand why, aer­o­bic exer­cise has been proved to help you fall asleep faster at bed­time, spend more hours in deep sleep, and wake up less often through­out the night, says Komaroff. At the same time, vig­or­ous exer­cise can act like a stim­u­lant (which is a great day­time ener­gizer), so sched­ule your work­outs in the morn­ing or after­noon, when you need a boost the most.

* Fol­low the 15-minute rule. If you can’t fall asleep, or if you wake up and can’t get back to sleep within about 15 min­utes, get out of bed and do some­thing relax­ing that will help clear your head, such as read­ing, med­i­tat­ing, or knit­ting (but not watch­ing TV or surf­ing the Web). Then, once you feel sleepy again, go back to bed. If you stay put and fret about being awake, you’ll only make your­self more anx­ious — and less likely to catch the z’s you need.

* Write down your wor­ries. Dur­ing the day, jot down any stres­sors that are weigh­ing on you, says Car­den. Then, do some men­tal problem-solving before your head hits the pil­low — or, if you’re falling short on solu­tions, tuck your list away and resolve to brain­storm ideas dur­ing your morn­ing shower or com­mute to work. Just know­ing you’ve estab­lished a plan for tack­ling your to-do’s will make you feel like you’ve made some progress, allow­ing you to relax, drift off — and wake up the next morn­ing ready to take on the day.

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Being Tired…? Why…

July 10th, 2009

tired1Some days you’re so low on energy that you’re drowsy by lunchtime and in need of a nap by mid after­noon. What’s mak­ing you so tired all the time? Stress, poor eat­ing habits, over­work, even med­ical treat­ments can wear you down and cause fatigue.

Fatigue isn’t the same thing as sleepi­ness, although it’s often accom­pa­nied by a desire to sleep — and a lack of moti­va­tion to do any­thing else.

In some cases, fatigue is a symp­tom of an under­ly­ing med­ical prob­lem that requires med­ical treat­ment. Most of the time, how­ever, fatigue can be traced to one or more of your habits or rou­tines. Chances are you know what’s caus­ing your fatigue. And with a few sim­ple lifestyle changes, it’s likely that you have the power to put the vital­ity back in your life.

Tak­ing a quick inven­tory of the things that might be respon­si­ble for your fatigue is the first step toward relief. Three gen­eral areas cause most cases of fatigue:

  • Lifestyle prob­lems. Feel­ings of fatigue often have an obvi­ous cause, such as sleep tired2depri­va­tion, over­work or unhealthy habits.
  • Psy­cho­log­i­cal prob­lems. Fatigue is a com­mon symp­tom of men­tal health prob­lems, such as depres­sion and grief, and may be accom­pa­nied by other signs and symp­toms, includ­ing irri­tabil­ity and lack of motivation.
  • Med­ical prob­lems. Unre­lent­ing exhaus­tion may be a sign of an under­ly­ing ill­ness, such as a thy­roid dis­or­der, heart dis­ease or diabetes.

Com­mon causes of fatigue include:

  • Acute liver failure
  • Alco­hol use or abuse
  • Ane­mia
  • Anx­i­ety
  • Caf­feine use
  • Can­cer
  • Chronic fatigue syndrome
  • COPD
  • Depres­sion (major depression)
  • Emphy­sema
  • Exces­sive phys­i­cal activity
  • Grief
  • Heart dis­ease
  • Hyper­thy­roidism (over­ac­tive thyroid)
  • Hypothy­roidism (under­ac­tive thyroid)
  • Inac­tiv­ity
  • Kid­ney fail­ure, chronic
  • Lack of sleep
  • Med­ica­tions, such as anti­his­t­a­mines, cough and cold reme­dies, pre­scrip­tion pain med­ica­tions, heart med­ica­tions, blood pres­sure med­ica­tions, and some antidepressants
  • Obe­sity
  • Preg­nancy
  • Recov­ery from major surgery
  • Rest­less legs syndrome
  • Sleep apnea
  • Stress
  • Type 1 diabetes
  • Type 2 diabetes
  • Unhealthy eat­ing habits
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Why am I so Tired?

July 7th, 2009

Get­ting plenty of sleep but still exhausted? Before you blame your multi-tasking, super-woman lifestyle, learn more about what might be at the root of your unex­plained fatigue.

We are in the midst of a global energy cri­sis but it has noth­ing to do with oil. The prob­lem is unex­plained fatigue.

“I’m so tired; I just can’t do what I used to do.”

“I’d love to go but hon­estly, I just don’t have the energy.”

“Sex? You mean right now?”

If you’re like most women, these phrases have become mantras, the echo of our col­lec­tive yawn grow­ing louder every day.

“The sin­gle biggest com­plaint I hear from my patients, day in and day out, is fatigue,” says car­di­ol­o­gist Nieca Gold­berg, MD, Direc­tor of the NYU Med­ical Cen­ter Women’s Heart Pro­gram and asso­ciate pro­fes­sor at the NYU School of Medicine.

Of course, for some of us the prob­lem is sim­ply multi-tasking to the max and not get­ting enough sleep, or good qual­ity sleep. “If you’re con­tin­u­ally log­ging in just 5 or 6 hours a night, it’s going to catch up with you, no mat­ter your age,” says Rebecca Amaru, MD, clin­i­cal instruc­tor of obstet­rics and gyne­col­ogy at the Mount Sinai Med­ical Cen­ter in New York City.

But if you are get­ting a healthy 7 to 8 hours a night and you’re still tired, Gold­berg says it’s time for a check-up to uncover the causes for fatigue.

“If your fatigue goes on for more than a week and there is no expla­na­tion for feel­ing tired, then yes, see your doc­tor,” says Goldberg.

While occa­sion­ally fatigue may be a sign of a seri­ous ill­ness, experts say most often it’s caused by a minor prob­lem, with a rel­a­tively easy fix.

To help you zero in on why you can’t stop yawn­ing, here are 7 hid­den causes of fatigue — poten­tial health prob­lems you should dis­cuss with your doctor.

Fatigue Cause # 1: Anemia

“If you are in your repro­duc­tive years, and par­tic­u­larly if you expe­ri­ence heavy men­strual cycles, have fibroid tumors or uter­ine polyps, or if you’ve recently given birth, the blood loss may have caused you to develop ane­mia — a lead­ing cause of fatigue in women,” says Amaru.

Prob­lems occur, she says, when the bleed­ing leads to a defi­ciency of hemo­glo­bin, the iron-rich pro­tein in red blood cells that car­ries oxy­gen from the lungs to other parts of your body. When your tis­sues and organs don’t get enough oxy­gen, she says, the result is fatigue.

Other causes of ane­mia include inter­nal bleed­ing, or a defi­ciency of iron, folic acid, or vit­a­min B12. Ane­mia may also be caused by chronic dis­eases like kid­ney dis­ease, for exam­ple. Symp­toms can include dizzi­ness, feel­ing cold, and irritability.

To con­firm a diag­no­sis of ane­mia, your physi­cian will give you a blood test. Treat­ment, she says, usu­ally con­sists of iron sup­ple­ments if iron defi­ciency is the cause, and adding iron-rich foods — such as spinach, broc­coli, and red meat — to your diet.

The good news: With effec­tive treat­ment, your fatigue should begin to lift in thirty days or less.

Fatigue Cause # 2: Under­ac­tive thy­roid (hypothyroidism)

If you are gen­er­ally slug­gish, run down, and even a lit­tle depressed, Gold­berg says the prob­lem may be a slow thy­roid, also known as hypothy­roidism. The thy­roid is a small, but­ter­fly shaped gland that sits at the base of your neck and con­trols your metab­o­lism, the speed at which your body operates.

“I believe that undi­ag­nosed thy­roid dis­or­der is one of the major female health prob­lems in this coun­try. I think it is even more wide­spread than any­one real­izes,” says Goldberg.

Accord­ing to the Amer­i­can Thy­roid Foun­da­tion, by age 60 approx­i­mately 17% of all women will have a thy­roid dis­or­der and most won’t know it. The most com­mon cause, they say, is an autoim­mune dis­or­der known as Hashimoto’s thy­roidi­tis. This con­di­tion causes the body to destroy the cells respon­si­ble for pro­duc­ing thy­roxin and other hor­mones secreted by the thy­roid gland. The result is hypothy­roidism, or a slow metabolism.

Blood tests known as T3 and T4 will detect thy­roid hor­mones. If these hor­mones are low, Gold­berg says syn­thetic hor­mones can bring you up to speed and you should begin to feel bet­ter fairly rapidly.

Fatigue Cause # 3: Undi­ag­nosed Uri­nary Tract Infec­tion (UTI)

Although most women asso­ciate a uri­nary tract infec­tion with symp­toms such as burn­ing or urgency, Gold­berg says in some instances fatigue may be your only clue.

“Not every woman has obvi­ous symp­toms of a UTI. Some have no symp­toms or mild symp­toms that go unno­ticed, except for the fatigue,” she says.

In most instances, a UTI is caused by bac­te­ria in the uri­nary tract, often the result of improper bath­room hygiene (wip­ing back to front, for exam­ple). Sex­ual inter­course can increase the risk because it can push bac­te­ria from the vagina into the urethra.

If your physi­cian sus­pects that you have a UTI, your urine will be tested. Treat­ment is quick and easy, and usu­ally involves an oral antibi­otic med­ica­tion. Gold­berg says the fatigue will lift within a week or less.

If your symp­toms return, get tested again, she says, because in some women, UTI’s are chronic. If this is the case, talk to your doc­tor about pre­ven­tive care, includ­ing low dose antibiotics.

Fatigue Cause # 4: Caf­feine Overload

Many of us grab a cof­fee or cola for a quick burst of energy, but for some women, caf­feine can have the oppo­site effect.

In an arti­cle pub­lished in the jour­nal US Phar­ma­cist, author W. Stephen Pray, PhD, RPh, reports that caf­feine is a stim­u­lant, but if you take too much, the tables can turn.

“In some patients, con­tin­ued abuse results in fatigue,” accord­ing to Pray. And if you think this means you sim­ply require more caf­feine to get the kick, this isn’t the case. “Any attempts to solve the prob­lem by increas­ing caf­feine intake causes the fatigue to worsen,” he says.

The solu­tion: Elim­i­nate as much caf­feine from your diet as pos­si­ble. This means not only cut­ting out cof­fee. Choco­late, tea, soda and even some med­ica­tions also con­tain caf­feine and could be caus­ing unex­plained fatigue.

Fatigue Cause # 5: Food Allergies

While food is sup­posed to give us energy, some doc­tors believe hid­den food intol­er­ances — or aller­gies — can do the oppo­site. Accord­ing to Rudy Rivera, MD, author of Your Hid­den Food Aller­gies Are Mak­ing You Fat, even mild food intol­er­ance can leave you feel­ing sleepy. Eat the offend­ing food long enough and you could find your­self feel­ing con­tin­u­ally exhausted.

“Evi­dence indi­cates food intol­er­ance as a cause of fatigue, and even sug­gests that fatigue may be an early warn­ing sign of food intol­er­ance,” he says.

If you sus­pect that food may be behind all that yawn­ing, Rivera says to start with an elim­i­na­tion diet, cut­ting out foods that cause you to feel sleepy within 10 to 30 min­utes of eat­ing them. You can also talk to your doc­tor about a food allergy test — or invest in a home test such as ALCAT — which may help you iden­tify the offend­ing foods.

Fatigue Cause # 6: Sleep Apnea

If you’re not get­ting enough sleep, it stands to rea­son you’ll be tired. But what if you don’t know that you aren’t get­ting suf­fi­cient sleep? This is often the case with a con­di­tion called sleep apnea — a sleep dis­or­der that causes you to momen­tar­ily stop breath­ing, often many times dur­ing the night. Each time you stop breath­ing, you awaken just long enough to dis­rupt your sleep cycle, usu­ally with­out being aware of it. Your only clue, says Gold­berg, is that you expe­ri­ence con­stant fatigue no mat­ter how many hours you sleep each night.

Accord­ing to Gold­berg, sleep apnea, which is caused by an upper air­way obstruc­tion, often occurs in women who are over­weight or obese. Snor­ing is often a sign of sleep apnea. Diag­no­sis requires a visit to a sleep lab, or to a doc­tor spe­cial­iz­ing in sleep apnea.

If you have sleep apnea, your physi­cian will rec­om­mend lifestyle changes, includ­ing los­ing weight and quit­ting smok­ing. Med­ical treat­ment includes devices that keep air­way pas­sages open while you sleep. In extreme cases, surgery may be nec­es­sary to ensure proper air­way flow. Left untreated, sleep apnea can increase your risk of stroke or heart attack.

Fatigue Cause # 7: Undi­ag­nosed Heart Disease

If you find your­self becom­ing exhausted after activ­ity that used to be easy, it may be time to talk to your doc­tor about the pos­si­bil­ity of heart disease.

Accord­ing to Gold­berg, when over­whelm­ing fatigue sets in after ordi­nary tasks — such as vac­u­um­ing the house, doing yard work, or com­mut­ing from work each day — your heart may be send­ing out an SOS that it needs med­ical attention.

“This doesn’t mean that you should panic every time you yawn,” says Gold­berg. “Most of the time, fatigue is not the first sign of heart dis­ease, and it’s usu­ally linked to some­thing far less serious.”

At the same time, Gold­berg points out that heart dis­ease is the lead­ing cause of death in women. “If fatigue fol­low­ing activ­ity is sig­nif­i­cant, and no other pos­si­ble rea­son comes to mind, see your doc­tor for a check-up,” she advises. If your fatigue is related to your heart, med­ica­tion or treat­ment pro­ce­dures can usu­ally help cor­rect the prob­lem, reduce the fatigue, and restore your energy.

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What is Stress?

July 6th, 2009

stress_2Stress can come from any sit­u­a­tion or thought that makes you feel frus­trated, angry, or anx­ious. What is stress­ful to one per­son is not nec­es­sar­ily stress­ful to another.

Anx­i­ety is a feel­ing of appre­hen­sion or fear. The source of this uneasi­ness is not always known or rec­og­nized, which can add to the dis­tress you feel.

Alter­na­tive Names

Anx­i­ety; Feel­ing uptight; Stress; Ten­sion; Jit­ters; Apprehension

Con­sid­er­a­tions

Stress is a nor­mal part of life. In small quan­ti­ties, stress is good — it can moti­vate you and help you be more pro­duc­tive. How­ever, too much stress, or a strong response to stress, is harm­ful. It can set you up for gen­eral poor health as well as spe­cific phys­i­cal or psy­cho­log­i­cal ill­nesses like infec­tion, heart dis­ease, or depres­sion. Per­sis­tent and unre­lent­ing stress often leads to anx­i­ety and unhealthy behav­iors like overeat­ing and abuse of alco­hol or drugs.

Emo­tional states like grief or depres­sion and health con­di­tions like an over­ac­tive thy­roid, low blood sugar, or heart attack can also cause stress.

Anx­i­ety is often accom­pa­nied by phys­i­cal symp­toms, including:

  • Twitch­ing or trem­bling
  • Mus­cle ten­sion, headaches
  • Sweat­ing
  • Dry mouth, dif­fi­culty swallowing
  • Abdom­i­nal pain (may be the only symp­tom of stress, espe­cially in a child)

Some­times other symp­toms accom­pany anxiety:

  • Dizzi­ness
  • Rapid or irreg­u­lar heart rate
  • Rapid breath­ing
  • Diar­rhea or fre­quent need to urinate
  • Fatigue
  • Irri­tabil­ity, includ­ing loss of your temper
  • Sleep­ing dif­fi­cul­ties and nightmares
  • Decreased con­cen­tra­tion
  • Sex­ual problems

Anx­i­ety dis­or­ders are a group of psy­chi­atric con­di­tions that involve exces­sive anx­i­ety. They include gen­er­al­ized anx­i­ety dis­or­der, spe­cific pho­bias, obsessive-compulsive dis­or­der, and social pho­bia.

Com­mon Causes

Cer­tain drugs, both recre­ational and med­i­c­i­nal, can lead to symp­toms of anx­i­ety due to either side effects or with­drawal from the drug. Such drugs include caf­feine, alco­hol, nico­tine, cold reme­dies, decon­ges­tants, bron­chodila­tors for asthma, tri­cyclic anti­de­pres­sants, cocaine, amphet­a­mines, diet pills, ADHD med­ica­tions, and thy­roid medications.

A poor diet – for exam­ple, low lev­els of vit­a­min B12 — can also con­tribute to stress or anx­i­ety. Per­for­mance anx­i­ety is related to spe­cific sit­u­a­tions, like tak­ing a test or mak­ing a pre­sen­ta­tion in pub­lic. Post­trau­matic stress dis­or­der (PTSD) devel­ops after a trau­matic event like war, phys­i­cal or sex­ual assault, or a nat­ural dis­as­ter. Peo­ple with gen­er­al­ized anx­i­ety dis­or­der expe­ri­ence almost con­stant worry or anx­i­ety about many things on more than half of all days for 6 months. Panic dis­or­der or panic attacks involve sud­den and unex­plained fear, rapid breath­ing, and increased heartbeat.

In very rare cases, a tumor of the adrenal gland (pheochro­mo­cy­toma) may be the cause of anx­i­ety. The symp­toms are caused by an over­pro­duc­tion of hor­mones respon­si­ble for the feel­ings of anxiety.

Home Care

The most effec­tive solu­tion is to find and address the source of your stress or anx­i­ety. Unfor­tu­nately, this is not always pos­si­ble. A first step is to take an inven­tory of what you think stressmight be mak­ing you “stress out”:

  • What do you worry about most?
  • Is some­thing con­stantly on your mind?
  • Does any­thing in par­tic­u­lar make you sad or depressed?
  • Keep a diary of the expe­ri­ences and thoughts that seem to be related to your anx­i­ety. Are your thoughts adding to your anx­i­ety in these situations?

Then, find some­one you trust (friend, fam­ily mem­ber, neigh­bor, clergy) who will lis­ten to you. Often, just talk­ing to a friend or loved one is all that is needed to relieve anx­i­ety. Most com­mu­ni­ties also have sup­port groups and hot­lines that can help. Social work­ers, psy­chol­o­gists, and other men­tal health pro­fes­sion­als may be needed for ther­apy and medication.

Also, find healthy ways to cope with stress. For example:

  • Eat a well-balanced, healthy diet. Don’t overeat.
  • Get enough sleep.
  • Exer­cise regularly.
  • Limit caf­feine and alcohol.
  • Don’t use nico­tine, cocaine, or other recre­ational drugs.
  • Learn and prac­tice relax­ation tech­niques like guided imagery, pro­gres­sive mus­cle relax­ation, yoga, tai chi, or med­i­ta­tion. Try biofeed­back, using a cer­ti­fied pro­fes­sional to get you started.
  • Take breaks from work. Make sure to bal­ance fun activ­i­ties with your respon­si­bil­i­ties. Spend time with peo­ple you enjoy.
  • Find self-help books at your local library or bookstore.

Call your health care provider if

Your doc­tor can help you deter­mine if your anx­i­ety would be best eval­u­ated and treated by a men­tal health care professional.

Call 911 if:

  • You have crush­ing chest pain, espe­cially with short­ness of breath, dizzi­ness, or sweat­ing. A heart attack can cause feel­ings of anxiety.
  • You have thoughts of sui­cide.
  • You have dizzi­ness, rapid breath­ing, or rac­ing heart­beat for the first time or it is worse than usual.

Call your health care provider if:

  • You are unable to work or func­tion prop­erly at home because of anxiety.
  • You do not know the source or cause of your anxiety.
  • You have a sud­den feel­ing of panic.
  • You have an uncon­trol­lable fear — for exam­ple, of get­ting infected and sick if you are out, or a fear of heights.
  • You repeat an action over and over again, like con­stantly wash­ing your hands.
  • You have an intol­er­ance to heat, weight loss despite a good appetite, lump or swelling in the front of your neck, or pro­trud­ing eyes. Your thy­roid may be overactive.
  • Your anx­i­ety is elicited by the mem­ory of a trau­matic event.
  • You have tried self care for sev­eral weeks with­out suc­cess or you feel that your anx­i­ety will not resolve with­out pro­fes­sional help.

Ask your phar­ma­cist or health care provider if any pre­scrip­tion or over-the-counter drugs you are tak­ing can cause anx­i­ety as a side effect. Do not stop tak­ing any pre­scribed med­i­cines with­out your provider’s instructions.

What to expect at your health care provider’s office

Your doc­tor will take a med­ical his­tory and per­form a phys­i­cal exam­i­na­tion, pay­ing close atten­tion to your pulse, blood pres­sure, and res­pi­ra­tory rate.

To help bet­ter under­stand your anx­i­ety, stress, or ten­sion, your doc­tor may ask the following:

  • When did your feel­ings of stress, ten­sion, or anx­i­ety begin? Do you attribute the feel­ings to any­thing in par­tic­u­lar like an event in your life or a cir­cum­stance that scares you?
  • Do you have phys­i­cal symp­toms along with your feel­ings of anx­i­ety? What are they?
  • Does any­thing make your anx­i­ety better?
  • Does any­thing make your anx­i­ety worse?
  • What med­ica­tions are you taking?

Diag­nos­tic tests may include blood tests (CBC, thy­roid func­tion tests) as well as an elec­tro­car­dio­gram (ECG).

If the anx­i­ety is not accom­pa­nied by any wor­ri­some phys­i­cal signs and symp­toms, a refer­ral to a men­tal health care pro­fes­sional may be rec­om­mended for appro­pri­ate treatment.

Psy­chother­apy such as cognitive-behavioral ther­apy (CBT) has been shown to sig­nif­i­cantly decrease anx­i­ety. In some cases, med­ica­tions such as ben­zo­di­azepines or anti­de­pres­sants may be appropriate.

Ref­er­ences

Muller JE, Kohn L, Stein DJ. Anx­i­ety and med­ical dis­or­ders. Curr Psy­chi­a­try Rep. 2005 Aug;7(4):245–51.

White KS, Far­rell AD. Anx­i­ety and Psy­choso­cial Stress as Pre­dic­tors of Headache and Abdom­i­nal Pain in Urban Early Ado­les­cents. J Pedi­atr Psy­chol. 2005.

Lubit R, Rovine D, Defran­cisci L, Eth S. Impact of trauma on chil­dren. J Psy­chi­atr Pract. 2003; 9(2): 128–138.

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The Struggling Grant System

July 1st, 2009

Grants have been intended to fur­ther research in all realms, most notably the can­cer world, although the past 40 years have demon­strated an obvi­ous decrease in grant fund­ing, lead­ing to fewer research break­throughs in the indus­try. Top fed­eral can­cer offi­cials have noted that the grant sys­tem needs to be changed because of the cau­tious steps, which the many can­cer insti­tutes take when fund­ing research, but steps have yet to be imple­mented to curb this fact.

Many top sci­en­tists and researchers have come up with novel ideas that can either lead to devel­op­ing more drugs to com­bat can­cer, or lead to a fur­ther under­stand­ing of the causes of can­cer. How­ever, many grant pro­grams refuse to fund such endeav­ors because they don’t con­tribute whole­heart­edly towards win­ning the fight against can­cer. Many of these indus­tries are still hop­ing to dis­cover an over­ar­ch­ing cure for can­cer, and devote more time and money to this sin­gle endeavor. Addi­tion­ally, even some of the stud­ies that can prove to be help­ful in the can­cer world are denied because of the lack of fur­ther research; these sci­en­tists can­not receive the proper research with­out grants and many are there­fore caught in this catch-22 of sorts.

Can­cer research was sup­posed to have been much more devel­oped than it is when this type of fund­ing orig­i­nally began 40 years ago, though it was hard to pre­dict the mas­sive impact can­cer has had through mod­ern soci­ety. With the many dif­fer­ent forms and many dif­fer­ent muta­tions, it has become increas­ingly dif­fi­cult to develop an over­ar­ch­ing “cure” for can­cer. Many of the break­throughs in the indus­try have come about as a result of out­side mon­e­tary fund­ing and donors who con­tribute large amounts to spe­cific causes. Most of the fund­ing for major grant sites addi­tion­ally come from walkathons and memo­r­ial dona­tions rather than a larger indus­try. The grant review com­mit­tees are also becom­ing increas­ingly cau­tious with their money because of the small amount of funds they have to sub­mit for research; if they do not see notice­able promise in spe­cific research ven­tures, they will reject the plan. This has hin­dered many fur­ther steps in can­cer research because of the smaller projects that can help towards gain­ing a bet­ter insight into the sus­cep­ti­bil­ity of can­cer.

While there are many ven­tures through­out the nation that require more funds than the can­cer indus­try does at a faster pace, there should at least be addi­tional fund­ing that sup­ports these endeav­ors. For a dis­ease, which has afflicted thou­sands of Amer­i­cans over the past decades, we have yet to make the can­cer indus­try a top pri­or­ity in any gov­ern­ment fund­ing. This may not change any time soon, but rec­og­niz­ing the fact that research is not mov­ing at a fast pace due to this lack of funds for grants is impor­tant towards gain­ing a bet­ter sys­tem to sup­port this research.

This post was con­tributed by Megan Jones, who writes about the nurs­ing col­leges. She wel­comes your feed­back at Meg.Jones0310@gmail.com

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