Blog Posts

Are You SAD in the Summertime?

June 12th, 2018

For most of my life, I lived in Pennsylvania and for a while in Ohio. What these states have in common are the dark, dreary, depressing winter months. For me, they were really depressing because I suffer from SAD, seasonal affective disorder. I even ordered a therapeutic lightbox from Alaska, which I willed to my former officemates in Cleveland when I moved to Florida.

I’m not the only one who gets depressed during the dark months of the year. SAD affects about 4 percent to 6 percent of the US population. People with SAD in the winter typically feel lethargic, sleep a lot, eat more and gain weight, and generally stay inside until spring.

Getting SAD in the winter kinda makes sense, mainly because daylight is sparse and you have no energy to do anything anyway. Amazingly though, about 10 percent of people with SAD get symptoms of depression during the daylight-heavy summer months. It’s called reverse SAD or summer SAD.

People who get SAD in the summer typically have symptoms that are the opposite of those of winter SAD. They generally can’t sleep or don’t need as much sleep, eat less and lose weight and are agitated or anxious instead of lethargic. One thing people with summer SAD have in common with their winter counterparts is the tendency to avoid outside activities, which can lead to isolation. Not good!

Researchers have no definitive answers for what causes summer SAD. There’s been more research done on winter SAD because it’s more common, but studies that have been done on summer SAD point to a few possible reasons for its development.

Dearth of daylight is known to be a culprit in winter SAD. An overabundance of it is thought to contribute to the summer variety. Sunlight affects the production of melatonin, a powerful antioxidant and free radical scavenger that’s an ingredient of the neurotransmitter serotonin, which plays a role in controlling mood.

Messing up melatonin screws up the serotonin levels in the brain, which can lead to mood changes, including depression. Melatonin also affects the sleep-wake cycle, altering sleep patterns.

The higher summer temperatures are suspected of contributing to summer SAD, too. The heat in the summer can be oppressive and agitating to people with SAD. Some research suggests summer SAD has a genetic component. It’s been found that as many as two-thirds of people who suffer with SAD have a family member with a major mood disorder.

Researchers have floated a few other theories as well. Some suggested a link between SAD and allergies. Others are trying to determine if the season you were born in has any impact on the development of a seasonal mood disorder.  Sounds pretty out there to me!

If you get depressed during the summer months, there are some things you can do to help you get through it. Here are a few tips:

Don’t suffer in silence. Consider talking to a qualified therapist to share your struggles and get some management strategies. Another option is a physician or psychiatrist. Medication may be an appropriate treatment for you.

Get enough sleep. You might not feel like sleeping, but not getting enough can trigger symptoms or make them worse. The recommendation for adults is seven to eight hours of sleep per 24-hour period.

Don’t forget to exercise. Summer is a busy time, but take time to get in a workout. Physical activity is known to fight the symptoms of depression. Schedule your exercise for early mornings or evenings when it’s not so hot outside or consider an indoor exercise routine to beat the summer heat.

Don’t overdo dieting. I know you want to fit into that bathing suit, but being on a restrictive diet can make you feel stressed and unhappy. Instead, eat a healthy, balanced diet rich in protein, fruits and vegetables.

Plan ahead. If you currently take medication for a mood disorder, consult your doctor in the spring. He or she may adjust your dose ahead of time to prepare you for the depression of summer SAD that’s coming your way.

If you get SAD during the summer, take heart; fall’s just a few months away!

Stop Suicide

June 8th, 2018

Victims may appear happy when in fact they’re not

In the days just prior to the moment in which she took her own life, world renowned fashion designer Kate Spade was described as happy, jovial and in good spirits by friends and family members.Graphic from istockphoto.com.

Three days later, friends and associates of Anthony Bourdain were saying the same thing after the celebrity chef took his own life while he was on location in France shooting an episode of his CNN TV show, Anthony Bourdain, Parts Unknown.

Mental health experts weren’t surprised to hear that. It’s not unusual they say for suicide victims to mask their true emotions all while displaying a completely different set of feelings while they’re with family and friends.

Many with suicidal thoughts simply do not want to burden their friends or family members with their darkest feelings. Others refuse to share those thoughts out of fear they won’t be taken seriously and will be see as simply seeking attention.

But attention is precisely what anyone experiencing suicidal thoughts needs, and as the recent deaths of Spade and Bourdain suggest, anyone from any walk of life can develop and eventually act on his or her suicidal tendencies.

Simply put, suicidal tendencies do not discriminate. Suicide is the second-leading cause of death among people aged 10 to 24, but people 85 and older have the highest suicide rate among all adults.

Some members of the population are, however, more prone to falling prey to suicidal tendencies. For example, it has long been known that members of the Native American and Alaskan Native communities are more prone to suicide.

The same goes for members of the LGBTQ+ community, and according to a 2016 report by the United States Department of Veterans Affairs in which the records of 55 million veterans were analyzed, 20 veterans take their lives each day.

But suicide is not a problem only for those suffering from depression, such as Spade. In 2016, more than half of the nearly 45,000 suicide victims in the United States had not been previously diagnosed with a mental illness, according to the U.S. Centers for Disease Control and Prevention (CDC).

That’s one reason clinicians are convinced that many potential suicide cases can be prevented, and why most of those clinicians believe that by simply paying attention, friends and family members can do the most to prevent a suicide from happening.

In particular, it’s important to look for significant behavioral changes such as a sudden desire to withdrawal from or avoid social activities involving family and friends, decreases in activity levels and increases in anxiety, agitation or restlessness.

The reason, according to Dr. Dan Reidenberg, executive director of the Suicide Awareness Voices of Education (SAVE), is that suicide is not something that someone typically attempts on a spur of the moment basis.

“It’s not as if one morning someone wakes up and says, Today is the day I’m going to do this,” Dr. Reidenberg told ABC News shortly after Spade died.  “It happens over time and falls on a continuum.”

Dr. Reidenberg added that simply being available to talk to someone who may be contemplating suicide can change that person’s plans and that letting someone know you are always there for them can save a life as well.

The National Institute for Mental Health (NIMH) provides several tips for helping someone who may be contemplating suicide that also apply to anyone who may be going through a crisis that could lead to such thoughts.

They include asking the person if they are thinking about suicide. That may seem to be a rather blunt approach, but studies show that asking someone if they are contemplating suicide does not increase the risk of it happening.

It is also wise for those around someone who may be displaying suicidal tendencies to rid their environment of anything that might be used to commit suicide, such as guns, knives and drugs.

Finally, encouraging someone to seek professional help, be it from a volunteer at a crisis center, a doctor or a spiritual advisor clergyman, can go a long way toward preventing a suicide as well.

It’s also important to remember that, should the crisis pass, it’s wise to continue to keep tabs on a person who may have expressed suicidal thoughts. After all, that person may seem to be happy, jovial and in good spirits, when in fact they are not.

Screen Time Sensibilities

June 3rd, 2018

There is a big debate in this country and others over the effect of screen time on our kids. Some experts say the constant use of tech devices has a negative impact, while others argue tech use has many benefits. My thought is that the use of smartphones, tablets, laptops and more has both. Use just has to be moderated. Let’s look at both sides of the issue before deciding what to do.

The Verge.com ran a great article detailing how this country, especially its parents, are divided on the issue of screen time. In the article, author Lauren Smiley relates how research on screen time with various tech device is actually very limited. Smiley notes further that studies that have been done came to mixed conclusions.

According to The Verge article, some researchers liken the results of using today’s tech with results we already know about, those of an older, well studied technology, TV. Of course, TV watching in excess has been linked to obesity, poorer school performance, social and language delays, sleeping problems and difficulties within the family dynamic.

Some studies link high levels of screen time to mental health problems, including higher rates of depression and anxiety. The results of another study, released in January, backed that up. This study showed that teens who get a lot of screen time are less happy and less satisfied with their lives. The study was a large national survey of eighth, 10th and 12th graders conducted annually since 2012, the year smartphones reached the 50 percent concentration point in the US.

The January study found that adolescents’ psychological wellbeing decreased the higher the number of screen hours. In addition, the teens’ correlation between happiness and screen activities was negative, while the correlation between happiness and non-screen activities, such as sports and person-to-person interaction, was positive.

A little older study, in 2015 in the UK, recorded the tech use activities of more than 800 14-year-olds. They then analyzed these students two years later using the UK’s standard secondary education testing protocol. The study results found that those kids spending an extra hour a day on screens earned 9.3 fewer points on the test, the equivalent of dropping a grade in two subjects.

The results of the January study were not all anti-screen time. The researchers found that teenagers who get a small amount of screen time, between one and five hours a week, are happier than those who get none at all. The happiest teens, they say, are those who are above average at face-to-face social interaction and below average in social media use.

There are other positive arguments made by the defenders of technology. For one, students have access to more information than ever before. Instead of having to trek to the library to do research, they have a library of information at their fingertips. They can find what they need in less than ten seconds. As a result, our kids are learning more and getting smarter.

Not only does technology make getting information easier, it makes learning more fun. Our kids are spending time online, and they’re learning at the same time. The tech devises are just another way of taking in information. Kids using them don’t even see it as learning; they view it as having fun. The new tech fills in the knowledge gaps.

Defenders argue against those who say the tech devices are acting as a crutch to our younger generation by making so much information available to them in an instant. Defenders say by looking something up, the kids have no choice but to absorb what they’re reading and actually learn it. They’re passively learning.

The question everyone seems focused on is how much screen time is appropriate for kids, and there are no distinct rules to follow. This leaves parents to decide how much screen time their children can have each day. There are a few general thoughts on the subject to take into consideration.

For one, a Harvard clinical psychologist and school consultant studied the impact of digital technology on infant brain development. She concluded there is no productive role for technology in the life of a baby under two years. Others agree with this assessment.

In 2016, the American Academy of Pediatrics released its updated guidelines, suggesting no screens before age 18 months, with the exception of video chatting with family members. They also suggest kids ages two to five should be limited to one hour a day with exceptions for educational programming. They leave it up to the parents to limit screen time for kids over five.

Tech Advisor, a company in the UK, agrees with the AAP’s guideline for children under two and those two to five. They go further, however, and recommend kids five through 18 get no more than two hours of screen time per day. This does not include time at school if their school uses tablets for student education or for homework. It includes leisure activities on tech devices.

Any parent will tell you it’s a constant battle getting their kids, particularly teens, to give up their tech devices, especially their smartphones. But common sense suggests you balance your kids’ screen time with screen-free activities. Here are a few tips for a sensible screen time plan for your family:

  • Check access and availability. Don’t let your kids have TVs, computers or any other device with a screen in their bedrooms.
  • Set rules. Set screen time protocols for your family, and create media-free zones in your home.
  • Explain the reasons for limiting screen time. Discuss the dangers of excessive screen time with your children. They’ll be more open to limits if the dangers are clearly pointed out.
  • Be a role model. Set the example. Limit your own use of computers and smartphones. Your kids won’t be willing to reduce their time on tech devices if you’re constantly using yours.
  • Take breaks. Screen time often leads to over-stimulation. Have your kids take breaks to calm down their brains.
  • No screens before bedtime. Most screens use LCDs that emit a blue light that inhibits sleep and the circadian rhythm. Leave an hour or so after screen use before bedtime.

There are more tips on the second page of this article, as well as some ideas for alternatives to screen time. There are no hard-and-fast rules about screen time, but there are a few guidelines. Still, it’s up to you to decide how much screen time your kids get each day. Use your best judgment.

Safe at Work

June 3rd, 2018

Every day, nearly 13,000 Americans are injured on the job. The more startling fact is that all these injuries are preventable. Workplace safety is a main point of focus for the Nation Safety Council, and not just during National Safety Month in June. Businesses and employees must be aware of potential safety hazards all twelve months of the year.Safe at Work

Workplace safety involves a vast number of concerns. Some of the more commons are hazardous chemicals, drug use in the workplace, and slips and falls. Of course, I can’t cover all safety topics here, so I’m going to take a brief look at three that the Safety Council and other organizations have chosen as priorities this year.

Things like toxic chemicals and boxes blocking exits are obvious safety hazards, but we might not think of fatigue as a safety risk. One thing you’ve got to realize is that fatigue is more than just being tired. Fatigue is a whole-body weariness that includes feeling tired, but also feeling reduced energy and needing to put more effort into doing everyday tasks at the level you desire.

The truth is people who feel this way let down their guard, and their safety performance decreases, so does their job performance. It’s estimated that fatigued workers cost employers $136 billion annually in health-related lost productivity.

Eating right, exercising and getting an appropriate amount of sleep can all help ward off fatigue. According to the National Safety Council, adults need seven to nine hours of sleep each day to reach peak performance at work. However, 30 percent of workers report averaging less than six hours. It’s time to get some sleep and be safer at work, and everywhere else.

Here’s another interesting fact from the National Safety Council. They say two million American workers report being victims of workplace violence every year. The US Bureau of Labor Statistics says that in 2014, 409 people were fatally injured in attacks at work, about 16 percent of the total workplace deaths that year.

Here are some more recent statistics. A 2016 publication reported that workplace violence and deaths occurred in most every type of occupation, even ones you wouldn’t suspect. They noted that there were 4,460 injuries and 65 deaths in professional and business services. Who’da thunk it!

The National Institute for Occupational Safety and Health divides workplace violence into four categories: criminal intent, customer/client, worker-on-worker and personal relationship. Women are most often the victims of personal relationship violence at work. Of course, there’s the active shooter situation. That would fall under the criminal intent category.

There are a few steps employers and businesses can take to help curb and prevent violence on the job. First of all, they need to create a violence prevention plan and make it an essential part of their strategic health and safety plan.

A few things they can include in their plans are making sure the workplace is secure and their employees know whom to call in an emergency, doing background checks on new employees and providing active shooter training. There are other suggestions in this article.

It’s likely the next workplace hazard plays a role in both fatigue and violence. It’s work-related stress. Research has found that 45 percent of lost work days are due to stress, anxiety or depression. That comes out to 11.7 million days. What’s more, the cost of lost productivity due to a stressful work environment is staggering. It totals $500 billion annually.

An in-depth survey done in 2017 by Mental Health America noted that overstressed people add to unhappiness in the workplace, which has an indirect effect on everyone else. That means that stressed-out people who dread coming to work contribute to productivity losses. Those losses are often not reflected in the calculated numbers, so that annual cost figure could actually be higher.

We know stress affects us emotionally. It can lead to disorders such as anxiety and depression. But stress has a negative effect on us physically as well. According to the American Institute of Stress, there are few diseases in which stress doesn’t play an aggravating role. Some of the conditions linked to stress are heart attack, stroke, high blood pressure and an increased susceptibility to infections. To learn more about the symptoms and effects of stress, read this.

Reducing stress at work can be challenging, but it’s important for your mental and physical health. There are many articles on the net with helpful tips, and this is one of them. Among the tips in is this article are: try medication and contemplation, balance your work and professional lives, learn to say “no,” and write down and remember the things that you’re grateful for.

There’s so much more to know about workplace safety, but your best bet is to be aware. Know your surroundings, take the proper precautions and always be safety-conscious.

Rip Currents: More Menacing Than You Think

June 3rd, 2018

The traditional dawn of summer here in Florida brings with it the dawn of storm season, a months-long period in which heavy afternoon thunderstorms are the norm and conditions are ripe for the development of tropical storms and hurricanes.

Gusty winds, lightning strikes and flash floods are among the most common byproducts of these intense summer storms. But so too are rip currents. That’s why the American Red Cross always chooses the first week of June as Rip Current Awareness Week.

The National Weather Service defines rip currents as “strong narrow currents that move away from shore.” They can occur at any beach where there are breaking waves, and they are often swift enough to drag away even the strongest of swimmers.

Studies show that rip currents have at times attained speeds of eight feet per second. That’s faster than Olympic swimmers can swim and in terms of danger, they are a greater menace to swimmers than tornadoes are to non-swimmers.

Since 2013, when the National Weather Service first began keeping data on them, rip currents have been responsible for an average of 65 deaths per year, which is more than the number of deaths reportedly caused by tornadoes and lightning strikes over that period.

In addition, the United States Lifesaving Association says that rip currents are the reason for 80 percent of all beach rescues in the United States, where the NWS says Florida ranks first in rip-current related deaths the past four years.

Rip currents are known to have a quick-sand-like effect on their victims as disaster often strikes as a result of a swimmer attempting to swim back towards the shore, against the stronger pull of the outward-bound current.

That’s a natural instinct, but swimming into the current will quickly tire out even the best of swimmers, which can result in drowning. It’s recommended then that swimmers caught in a rip current instead swim parallel to the shore line until they reach the end of the current.

For more tips on how to survive being caught in a rip current, check out this safety video courtesy of the American Red Cross. And keep in mind that a wicked storm doesn’t have to be immediately present to create a rip current.

Storms that are well offshore can produce rip currents as well, which is why it’s wise to always keep track of local weather conditions, including checking the NWS’s rip current forecast, before heading out to the beach.

 

A Message About Men’s Health

June 3rd, 2018

This blog may be about men’s health, but women need to read it, too. Women have to encourage the men in their lives to pay more attention to their health. June is Men’s Health Month, and it’s the perfect time to review a few of the biggest health issues men face.Message About Men’s Health

Since forever, women have lived longer than men. The US Centers for Disease Control and Prevention report that on average, women today live more than five years longer than men, and that gap is getting wider. Men have higher rates of death in most of the top ten causes of death. They also tend to have higher rates of complications from many disorders.

According to a report from the World Health Organization, men have higher death and complication rates for conditions like coronary heart disease, high blood pressure, diabetes and cancer. Yet, many of the risk factors for those diseases that have increased in the past few years aren’t male-specific and are preventable. These include increases in smoking, alcohol consumption, sedentary lifestyles and obesity.

According to WHO, there’re other factors that can contribute to a poorer life expectancy for men. For instance, men generally have greater exposure to occupational hazards such as physical or chemical hazards. They tend to engage more often in behaviors involving risk-taking, they’re less likely to see a doctor when they’re sick, and when they do, they’re less likely to fully report their symptoms.

A board member of the Men’s Health Network notes that certain conditions common in men, such as high blood pressure and high cholesterol, have no detectable symptoms. Many cancers also have few detectable symptoms in their early, most treatable, stages, so health care monitoring is crucial.

That’s where women can come in. We can help our men be aware of screenings, adopt healthy eating habits and promote exercise by setting an example and doing it with them. We can also encourage them to see the doctor when they complain of not feeling well or show signs of illness. They’re protecting the family by staying healthy.

So, what are the big health issues facing men? I read a couple of articles that listed the Top 10 or Top 5 Men’s Health Issues, but I’m going to condense the list to three big ones. You can read more at these three sites:

Still high on the list is cardiovascular disease. The American Heart Association tells us that one in three men have some form of cardiovascular disease. It’s the leading cause of death for men in the US, responsible for one of every four male deaths. Another condition that’s common in men and can contribute to cardiovascular disease is high blood pressure, which slowly damages the heart and blood vessels over time. These disorders can be controlled if detected early.

Here’s one you might not have thought of but is a growing problem. It’s skin cancer. Men 50 and older are at high risk for developing skin cancer, more than twice as likely as women. The reason is because men have generally had more sun exposure and tend to have fewer visits to the doctor for skin checks. More men than women die of melanoma, a lethal form of skin cancer. Regular skin checks can catch skin cancer in its early stages.

Diabetes is a problem in itself, and it can result in a whole bunch of other problems. It can lead to erectile dysfunction and lower testosterone levels. Low testosterone also decreases a man’s muscle mass and energy level. Low blood glucose can cause depression and anxiety, as well as damage to the nerves and kidneys and lead to heart disease, liver disease, stroke and vision issues. Routine blood work can monitor blood glucose levels and detect pre-diabetes.

Men face many more health issues that affect them not just physically, but mentally as well. This month, encourage the men in your life to take advantage of screenings, get regular physicals, lead a healthy lifestyle and see the doctor when necessary. Help them take control of their health and live longer.

“Brain Attack” Can Strike Anyone, Anytime

May 31st, 2018

Strokes don’t just happen to the elderly. They can disable or kill men and women of working age, too. That fact is just one of the awareness-raising messages the American Heart Association/American Stroke Association is spreading during May, which is American Stroke Month.

A stroke or “brain attack” happens when blood flow to part of the brain is cut off. As a result, brain cells are deprived of oxygen and begin to die, which threatens the abilities controlled by that area of the brain, such as muscle control, speech or memory.

Someone who suffers a minor stroke may have only temporary challenges, such as slurred speech or weakness of an arm or leg. But more serious strokes may lead to permanent paralysis or inability to speak. More than two-thirds of stroke survivors are left with some form of disability.

The faster a stroke victim receives treatment, the better the chances for survival and recovery. For each minute a stroke goes untreated and blood flow to the brain is blocked, the patient loses about 1.9 million neurons, which are nerve cells that transmit information throughout the body.

Be alert for these common symptoms of a stroke and call 9-1-1 immediately if they occur. Also, note the time the first symptom appears, because that can affect treatment decisions.

  • Sudden numbness or weakness in the face, an arm or a leg, especially on one side of the body;
  • Sudden confusion, difficulty speaking or understanding what’s going on or being said;
  • Sudden difficulty seeing out of one or both eyes;
  • Sudden trouble walking, dizziness or loss of balance or coordination;
  • Sudden severe headache with no known cause.

There are two types of “brain attacks” classified as strokes. A hemorrhagic stroke happens when a brain aneurysm bursts or a weakened blood vessel leaks. An ischemic stroke is caused by a blood clot that blocks a vessel carrying blood to the brain.

A transient ischemic attack, commonly known as a TIA, can mimic stroke-like symptoms and lasts less than 24 hours. A TIA occurs when blood flow to part of the brain stops for a short period of time. While they generally don’t cause permanent brain damage, TIAs are a serious warning sign of a future stoke and shouldn’t be ignored.

Some risk factors for strokes can’t be controlled, including age, gender or family history. But people can minimize other things that make them more susceptible, such as high blood pressure and/or cholesterol, smoking, drug and/or alcohol abuse, poor diet and lack of physical activity.

The bottom line: Up to 80 percent of strokes can be prevented.

Here, courtesy of the National Stroke Association and the American Heart Association, are other stroke facts by the numbers:

  • A stroke happens every 40 seconds.
  • Nearly 800,000 people experience a new or recurrent stroke every year.
  • Stroke is the leading cause of adult disability in the United States.
  • Stroke is the No. 3 cause of death in women and the fourth leading cause of death of men in this country. Some 185,000 people die from a stroke each year.

Women have higher risk of fatal strokes

May 29th, 2018

Some 55,000 more women than men have a stroke each year, and more women die as a result, according to the American Heart Association, which has deemed May as American Stroke Month.

Women share many of the same risk factors as men, such as high blood pressure, irregular heartbeat, diabetes, depression and emotional stress. But for women, hormones, reproductive health, pregnancy and childbirth also can influence how likely they are to suffer a stroke.

For instance, stroke risk increases during a normal pregnancy because of natural changes in the body such as increased blood pressure and stress on the heart. And women who have preeclampsia, or high blood pressure that develops during pregnancy, double their risk of a stroke later in life.

Women who have more than one miscarriage may be at greater risk for blood clots, which in turn increases their stroke risk.

Taking birth control pills, meanwhile, may double the risk of stroke, especially for women with high blood pressure.

Many women undergo hormone replacement therapy to relieve menopause symptoms, including hot flashes, night sweats and pain during sex. Once thought to lower stroke risk, hormone replacement therapy actually slightly increases it.

Irregular heartbeat, or atrial fibrillation, quadruples stroke risk and is more common in women than men after age 75.

Strokes also are considerably more common in women who suffer from migraines with aura (flashing or shimmering lights, zigzagging lines or stars) and who also smoke.

Autoimmune diseases such as diabetes or lupus can increase the risk of stroke, too.

Because women generally live longer, a stroke is more apt to negatively impact their lives. They also are more likely to be living alone when they suffer a stroke and to end up in a long-term health care facility, and they have a more difficult recovery, according to the National Stroke Association.

Some stroke symptoms are unique to women, including hiccups, seizures, sudden behavioral change and hallucinations. Those might not be recognized as signs of a stroke, however, which could delay treatment and magnify the damage caused. The most effective stroke treatments are only available if the stroke is diagnosed within three hours after the first symptoms appear.

While strokes typically affect women in their later years, doctors now are focusing on helping women reduce their risk earlier in life. That means more screening for high blood pressure – which is more common in women than in men – along with other health challenges.

Eating right and exercising can help reduce the risk of chronic diseases and improve overall health for anyone. A healthy diet includes vegetables (dark green, red and orange), legumes (beans and peas), fruits (especially whole fruits), grains (at least half of them whole grains), fat-free or low-fat dairy, oils and proteins (seafood, lean meats and poultry, nuts, seeds and soy products). Limiting saturated and trans fats, added sugars and sodium also is part of eating healthier.

As for physical activity, a recent study shows that people can reduce their stroke risk if they exercise five or more times per week.

 

Principles of PHN

May 22nd, 2018

Each year, about one million Americans are affected by shingles, that itchy, burning, blistery and usually very painful rash that can break out anywhere on your body. Shingles is caused by the herpes virus, varicella-zoster, the same bug that causes chickenpox.

So, if you’ve had chickenpox as a kid, that nasty virus can hang around inside your body, hiding in the nerves, and show up again later as shingles. This sneaky germ can lie dormant for decades before reactivating and causing shingles.

For many people who get shingles, the symptoms last from two to six weeks then go away, and you feel better. But an estimated one out of five people ends up with continuing pain after the shingles bout is over. The technical name for this pain complication is postherpetic neuralgia or PHN.

PHN is the result of the virus damaging the nerves of the tissues at the rash site. It’s thought to affect the proper functioning of the nerves that register sensations such as pain, pressure and touch. PHN pain can be rather mild, or it can be excruciating, prompted by the slightest stimulation, such as the touch of clothing or a breeze over the skin.

PHN pain can go away after one month or persist for months and even years after the shingles rash has gone away. No one knows why PHN goes away rather quickly in some people and lasts a long time in others.

There are several factors that increase your risk for getting PHN. They include older age, gender (the risk for longer-lasting PHN is higher in women) and having had shingles that affected the eyes. Having a family history of PHN also puts you at increased risk for developing the painful complication.

Most of the symptoms of PHN occur at the site of the original shingles rash. Some of the things to look out for include an occasional burning, shooting pain and a constant throbbing or aching pain. You may also feel extreme sensitivity to touch and/or temperature. Itching and numbness at the rash site also may occur.

If the nerves that control muscle movement are affected by the PHN, you could experience muscle weakness and even paralysis. Fortunately, this is rare.

Treatment for PHN is not the same for everybody. It is tailored to your specific symptoms and response to medications. There are several types of medications used to treat PHN pain. Your doctor may refer you to a pain management specialist to determine the right medication or combination of treatments that works best for you.

Some of the common medication treatments used for PHN include:

  • Lidocaine or capsaicin pain patches are applied directly to the skin.
  • Pain medications may include non-opioid and opioid drugs.
  • Antidepressants in lower doses than used to treat depression have been shown to help relieve pain.
  • Anticonvulsants traditionally used to treat seizures stabilize abnormal activity of the nerves.

Some people find transcutaneous electrical nerve stimulation, or TENS, beneficial for reducing the pain of PHN. Its effectiveness has not been proven through research, however.

Some experts believe that PHN can be prevented or its impact lessened if you’re treated with antiviral medication soon after your shingles is diagnosed. Others say the research doesn’t bear this out. Still, it’s often used as a therapy to shorten the course of the shingles outbreak and, hopefully, avoid PHN.

The best way to protect yourself against PHN is to get vaccinated against chickenpox, if you’ve never been, and especially against shingles. The shingles vaccine is not 100 percent effective, but it can greatly reduce the chance of getting the disease and its complications, including PHN.

It is recommended that everyone 50 and older, especially those over 60, get the shingles vaccine to help protect them against an outbreak of shingles and resulting PHN. It’s a little step. You can get the shot at most pharmacies, so it’s readily available.

It’s better to take a few minutes to get a quick shot in the arm than to risk spending months or years in horrible pain. It’s really an easy decision!

Fetal Alcohol Facts

May 15th, 2018

This past February, researchers presented their results of a study, published in JAMA, on the prevalence of fetal alcohol disorders in American children. It was alarming. In their study results, the researchers conservatively estimated 1.1 to 5 percent of kids are affected by alcohol-related disorders, up to five times the previous estimates.Fetal Alcohol Facts

As part of the study, researchers evaluated nearly 3,000 school-aged children in four US communities. They also interviewed children’s mothers about their alcohol use during pregnancy. In all, they identified 222 children who met the criteria of one of the fetal alcohol spectrum disorders.

The results of the February study were immediately challenged by some experts. Opponents cited problems with the study’s design and the reliability of its results. First of all, only 60 percent of eligible families permitted their children to be evaluated. In addition, more than a third of the mothers declined to answer questions about their alcohol use during pregnancy.

The opponents of the study results believed the children not evaluated by researchers likely represented the most high-risk individuals. They also pointed out that mothers were likely unwilling to talk about their alcohol use because admitting to drinking alcohol during pregnancy identifies them as mothers who harmed their babies.

Collectively called fetal alcohol spectrum disorders (FASD), alcohol-related disorders in children include a range of conditions that can cause physical problems as well as problems with behavior and learning. The most severe of the fetal alcohol spectrum disorders is fetal alcohol syndrome or FAS.

FASD are the result of individuals having been exposed to alcohol prenatally. While they’re still growing inside their mothers’ wombs, babies’ livers are not fully developed. They can’t break down the alcohol, so it’s free to travel through the babies’ bodies and damage their brains and other organs.

Among the effects of alcohol in developing babies is it lowers protein-calorie intake, which stunts cell growth. It also causes zinc and iron deficiencies, and alters the healthy level of cholesterol in the blood. In addition, it depletes a chemical that is needed to make an important neurotransmitter in the brain. Neurotransmitters help brain cells relay messages.

It is difficult to pinpoint how many people actually have FASD because some of the symptoms can be subtle. In addition, some symptoms are similar to those of other disorders, including ADHD, making misdiagnosis possible. Some of the more common symptoms of FASD include:

  • Abnormal facial features such as a smooth ridge between the nose and upper lip
  • Small head and body size
  • Learning disabilities and low IQ
  • Hyperactivity
  • Poor memory
  • Speech and language delays
  • Sleep and suckling problems as a baby
  • Problems with the heart, kidneys or bones

Alcohol, including wine and beer, is the leading cause of preventable birth defects in the US. The bottom line is there is no “safe” amount of alcohol to drink during pregnancy, and no “safe” time during pregnancy to drink. The brain develops throughout pregnancy, and even small amounts of alcohol can have a negative effect on that development.

Some women drank during one pregnancy and had healthy babies and think they can drink during subsequent pregnancies with no consequences. Don’t take that chance. FASD can still occur. There’s no way to predict how alcohol will affect your baby, and problems can occur with one baby even though you’ve already had a healthy baby.

The US Centers for Disease Control and Prevention recommends women stop drinking alcohol entirely when they’re pregnant. They even go so far as to warn women trying to get pregnant not to drink because they could be pregnant for three or four weeks before they even know it.

The message is clear: If you want a baby without FASD, don’t drink during pregnancy.

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