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Stress is how the brain and body respond to any demand. Every type of demand or stressor such as exercise, work, school, major life changes, or traumatic events, can be stressful. Some stress can be beneficial at times; it can provide the drive and energy needed to help people get through situations like exams or work deadlines. Stress can also be life saving in some situations. For example, in response to danger, our bodies react by releasing stress hormones (adrenaline and cortisol) into the blood, which helps us prepare to face a threat or flee to safety.
However, if someone experiences an extreme amount of stress or when the source of stress is constant, then health problems could develop. Untreated chronic stress can result in serious health conditions including, high blood pressure, heart disease, obesity and a weakened immune system. Stress can also contribute to the development of other major illnesses, such as anxiety and depression. It is important to tackle the causes of stress in your life if you can. Avoiding the problems rather than facing them can make things worse. Sometimes it may not be possible to change a stressful situation, so you may need to accept that there is nothing you can do about it and refocus your energies elsewhere. CAUSES Some common causes of stress include:
SYMPTOMS OF STRESS You may feel: Overwhelmed, irritable, anxious or fearful, tired all the time, depressed You may have: Racing thoughts, constant worrying, difficulty concentrating, difficulty making decisions You may experience: Headaches, muscle tension or pain, dizziness, sleep problems You may begin to:
STRESS MANAGEMENT By finding positive, healthy ways to manage stress as it occurs, many of the negative health consequences can be reduced. Below are a few tips to help you manage and reduce stress. Tip#1: Talk with family and friends, and ask for help. Keep in contact with friends and family. A daily dose of friendship is great medicine and talking with someone who cares may be helpful. Also, do not be afraid to ask for help from your spouse, friends, and family. Tip#2: Engage in daily physical activity Regular physical activity can improve your mood and relieve physical tension. Physically active adults have lower risk of depression and loss of mental functioning. It can also be a great source of pleasure too; try walking, swimming, biking or dancing every day. Tip#3: Get enough sleep Inadequate or poor quality sleep can negatively affect your mood, mental alertness, energy level, and physical health. Try to get at least six hours of sleep each night. Tip#4: Slow down and get organized
Tip#5: Give up bad habits Too much alcohol, cigarettes or caffeine can increase your blood pressure. If you smoke, you should make the decision to quit. If you do drink alcohol, do so in moderation. Also, try to maintain a healthy diet. Tip#6: Try not to worry Accept that there are some things that are out of your control, and that you can only do so much about a particular situation. Also, the world won't end if you do not get certain things done as planned, so try not to overthink too much. Tip#7: Learn relaxation techniques Doing things you enjoy is a natural way to relieve stress.
Tip#8: Practice Positive Self-talk Negative self-talk increases stress, while Positive self-talk can help you to calm down and control stress. Practice positive self-talk everyday. For example: Negative to Positive
Tip#9: Try Emergency stress stoppers These are actions to help you defuse stress in the moment. Here are some examples.
Tip#10: Psychological Therapy If you've tried “self-help techniques” and they are not working, or if you have suicidal thoughts, are overwhelmed or are using drugs or alcohol to cope, then you may benefit from psychological therapies like cognitive behavioral therapy (CBT). See a health care provider who may be able to provide a recommendation you. . I hope that these tips on STRESS MANAGEMENT were helpful; Remember, YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgements: American Heart Association National Institute of Mental Health Stress Management Society Visit http://www.stress.org.uk/ for more information
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Uterine Fibroids are tumors or lumps made of muscle cells and other tissue that grow in the wall of the uterus (womb). They are also called leiomyomas or myomas. Fibroids are almost always benign (meaning not cancerous). They can grow as a single tumor, or there can be many of them. The size, shape, and location of fibroids can vary also. A single fibroid can be less than 1 inch in size or can grow to 8 inches across or more. They may be present within the uterus wall, inside the uterus, on its outer surface or attached to it by a stalk-like structure (see image below). Uterine fibroids can grow very slowly or enlarge quite rapidly. Experts still do not know what causes uterine fibroids but they have been linked to the hormones estrogen and progesterone, which are produced by the ovaries. Fibroids usually develop during a woman's reproductive years (age of 16 to 50) when estrogen levels are at their highest. They tend to shrink when estrogen levels are low, such as after the menopause. It is also thought that fibroids occur more often in overweight or obese women because being overweight increases the level of estrogen in the body. Uterine fibroids are common, appearing in up to 70% of women by age 50. Black women are three to five times at greater risk; they develop fibroids more often and at a younger age than women of other ethnic groups. Persons with a family history of fibroids are at increased risk, whereas women who have children appear to be at a lower risk. SYMPTOMS Most fibroids do not cause any symptoms, but some women with fibroids can have:
TREATMENT The most common method used to diagnose fibroids is ultrasound. If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor may monitor you occasionally to see if they have grown. For women who have symptoms, treatment may depend on the woman’s age, the size of the fibroids and whether or not she wants to become pregnant. MEDICATION 1. Over the counter pain medication such as Ibuprofen and Paracetamol can be use by women with mild abdominal pain. 2. Birth control drugs can be used to help control symptoms in women who experience moderate to severe pain and heavy menstrual bleeding. These may include:
3. Tranexamic acid, Mifepristone and Ulipristal acetate (Ella/Esmya) are also medication used to treat heavy menstrual bleeding in women with fibroids. 4. Gonadotropin-releasing hormone agonists (GnRHa) are drugs that stop the menstrual cycle and can shrink fibroids. They are sometimes used before surgery to reduce the risk of bleeding. Because GnRHa have many side effects, they are used only for short periods (less than 6 months). After a woman stops taking a GnRHa agonist, her fibroids usually return to their previous size. SURGERY For women with moderate to severe symptoms, surgery may be the best form of treatment. 1. Myomectomy Myomectomy is surgery to remove the fibroids from the wall of the uterus. It removes only the fibroids and leaves the healthy tissue of the uterus in place. It is best for women who still wish to have children after treatment or who wish to keep their uterus for other reasons. You can become pregnant after a myomectomy. The surgery can be performed in many ways; it can be major surgery (involving cutting into the abdomen) or performed with laparoscopy or hysteroscopy. After myomectomy it is still possible for new fibroids to grow. 2. Hysterectomy Hysterectomy is a major surgical procedure in which the entire uterus is removed. This surgery is the only sure way to cure uterine fibroids. It is done when a woman's fibroids are large, if she has heavy bleeding, if she is near or past menopause, or if she does not want children. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. NON-SURGICAL TREATMENT 1. Endometrial Ablation is a procedure that destroys the lining of the uterus. It is used to treat women with small fibroids (less than 3 centimeters). It is not often recommended for women who want to have children. 2. Uterine Artery Embolization (UAE) is a procedure where tiny particles (about the size of grains of sand) are injected into the blood vessels that lead to the uterus. The particles cut off the blood flow to the fibroid and cause it to shrink. UAE can be performed as an outpatient procedure in most cases. The effects of this procedure on fertility are uncertain. Click the link below to learn more about fibroid treatment. https://www.youtube.com/watch?v=eSJ-ztQ97Og (you may skip to 16:52) Tip#1: Maintain a healthy weight, because high levels of body fat are associated with elevated levels of estrogen. Tip#2: Exercise regularly, as this may lower your chances of uterine fibroids. Tip#3: Maintain a healthy diet. Eat a low-fat diet and try to minimize your consumption of red meat and poultry, which may build up fat in the body that could then be used to produce more estrogen. Try to occasionally replace meat with beans and legumes instead. Tip#4: Eat more cruciferous vegetables (these are green leafy vegetables such as arugula, broccoli, cabbage, cauliflower, collard greens, kale and turnip greens), and try not to over cook them. Cruciferous vegetables are rich in nutrients, including several carotenoids and vitamins, and they are a good source of fiber. They may also have a protective effect against fibroids. Studies show that these vegetables contain a group of substances (called glucosinolates), which may have anti-cancer effects as well. Tip#5: For more information about Fibroids and fertility, click the link below. https://fertilityinstitute.com/2016/08/24/do-uterine-fibroids-affect-your-fertility-and-pregnancy/ I hope these tips on UTERINE FIBROID were helpful; Remember, YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgement The American College of Obstetrician and Gynecologists The Fertility Institute Visit https://www.acog.org/Patients/FAQs/Uterine-Fibroids for more information.  Gallstones are hard solid matter usually formed inside the gallbladder. The gallbladder is a small saclike organ in the upper right part of the abdomen. It is located under the liver, (just below the front rib cage on the right side). It stores bile, which helps to digest fatty foods. Bile contains several different substances, including cholesterol and bilirubin; it is stored in the gallbladder until needed. When we eat a high-fat meal the gallbladder contracts and injects bile into the small intestine. Gallstones are thought to develop because of an imbalance in the chemical make-up of bile, (they may also form if the gallbladder doesn’t empty itself completely). There are two main types of gallstones: Cholesterol stones and Pigment stones. Cholesterol stones are more common (80%) and they are made up of cholesterol; pigment stones are made of bilirubin (which is a waste product of the breakdown of red blood cells). Some persons have a single stone while others have multiple. Some stones are as small as a grain of sand and others can be the size of a golf ball. SYMPTOMS Most persons who have gallstones never experience any symptoms (up to 70% of persons). Gallstones usually cause symptoms when they move from the gall bladder into the bile ducts (the tubes that lead from the gall bladder to the intestine). (See image below) Biliary colic is the most common symptom of gallstones. It occurs when gallstones get stuck in the narrow neck of the gall bladder, which can cause severe pain. The pain is felt at the top of the abdomen, either in the middle or just under the ribs on the right hand side. The pain may spread to the right side or behind to the right shoulder blade. It is generally a continuous pain but may come in waves; the pain could last for minutes to hours and then goes away. Some persons may experience sweating and vomiting as well. Biliary colic may occur at any time, but some persons notice it more at evening time and after having a “fatty meal”. The pain may be so severe that it sometimes wakes persons out of their sleep at night. Some persons with gallstones may develop fever, jaundice (yellowing of the skin and whites of the eyes), cholecystitis (inflammation of the gall bladder) and pancreatitis (inflammation of the pancreas). RISK FACTORS You’re more likely to get gallstones if you:
TESTS Your doctor may recommend blood tests to look for signs of infection and to check if the liver is working normally. Gallstones are confirmed using an abdominal ultrasound scan. This can give the location, number and size of the stones, which will determine the best kind of treatment. TREATMENT Treatment for gallstones is usually only necessary if they are causing symptoms. Surgery Most cases of gallstone disease are easily treated with surgery. Once you have one “gallbladder attack”, the chance of having another one is high (up to 70%). You can wait to see if the problem resolves itself, but it may be best to remove the gallbladder to prevent future attacks. You can lead a perfectly normal life without a gallbladder. Your liver would still produce bile to digest food, but the bile would drip continuously into the small intestine (rather than build up in the gallbladder). If your gallbladder is irritated or inflamed, most doctors will want to take it out right away. The surgery is most often laparoscopic surgery. This means that small tools are inserted into small incisions in the abdomen to remove the gallbladder. The surgery is safe and effective and it limits your hospital stay to about 1 day. Without surgery, the gallbladder could get infected; it might even burst open, causing further problems. Very severe cases can be life threatening; however, deaths from gallstone disease are generally rare. Endoscopic Retrograde Cholangiopancreatography (ERCP) This is a procedure that can be used to find and remove stones in the common bile duct. (Click the link below to learn more) https://www.sages.org/publications/patient-information/patient-information-for-ercp-endoscopic-retrograde-cholangio-pancreatography-from-sages/ Dissolving Stones Gallbladder stones can sometimes be dissolved by a chemical (Ursodiol or Chenodiol), which comes in pill form. (Click the link below to learn more) https://medlineplus.gov/druginfo/meds/a699047.html Tip#1: Maintain a healthy weight. Obesity increases the risk of gallstones. Work to achieve a healthy weight, and then try to maintain that weight by continuing a healthy diet and continuing to exercise. Tip#2: Lose weight slowly. There's evidence that rapid weight loss can disrupt your bile chemistry and increase your risk of developing gallstones. A more gradual weight loss plan is recommended. Tip#3: Reduce your intake of fats. Avoid greasy and fried foods. Choose low-fat foods whenever possible, but do not avoid fats completely. Tip#4: Ensure a Healthy Diet. Your diet should contain lots of fruits, vegetables, whole grains and nuts (including peanuts and cashews); this may reduce the chances of getting gallstones. I hope these tips on GALLSTONES were helpful; Remember YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgements American Gastroenterological Association Medicine.net (For image) Visit https://www.gastro.org/practice-guidance/gi-patient-center/topic/gallstones for more information.  Varicose veins are swollen and enlarged veins that usually occur on the legs and feet. They may be blue or dark purple, and are often lumpy, bulging or twisted in appearance. These abnormal veins typically do not cause any problems. There are usually no symptoms, however some persons may experience: discolored skin in the area around the vein, itchy and thin skin over the affected vein, swollen feet and ankles, burning or throbbing in the legs. Heaviness and muscle cramps may be felt also. In worst cases, varicose veins could even cause skin ulcers, blood clots and inflammation of the veins in the legs; these require timely medical treatment. The symptoms are usually worse during warm weather or if you have been standing up for long periods of time. They may improve with walking or if you rest and raise your legs. CAUSES Varicose veins develop when the small valves inside the veins stop working properly. Normally (in a healthy vein), blood flows smoothly in one direction to the heart. The blood is prevented from flowing backwards by a train of tiny valves that open and close to let blood through. If the valves weaken or become damaged, then blood can flow backwards and collect in the vein, eventually causing it to become swollen and enlarged. (See image below) Risk factors for developing varicose veins include:
TYPES OF VARICOSE VEINS (see images below) Spider veins (also called Telangiectasia) These are blue or red veins that are very small, measuring around 0.5 to 1mm in diameter. They are harmless and can occur any where on the skin including the face. Reticular varicose veins These may be grouped close together in a network. They are deeper veins, slightly bigger (measuring 1 to 3mm diameter) and are commonly blue in color. Trunk varicose veins These are much larger veins, which are thick, long and lumpy and can often look unpleasant. TREATMENT COMPRESSION STOCKINGS Compression stockings (or socks) may first be recommend for up to 6 months, along with regular exercise and elevation of the legs when resting. These stockings exert pressure on the ankles and legs compressing the surface veins; this helps the valves to function properly and prevents back flow of blood. RADIOFREQUENCY AND ENDOVENOUS LASER ABLATION These methods involve passing a probe through the skin into the varicose vein, using ultrasound to guide the position. A device at the tip of the probe uses laser or radiofrequency energy to heat up the inside of the vein and close it off. SCLEROTHERAPY This uses a liquid/chemical that is injected into the vein to cause irritation and scarring inside, which eventually closes it off. This procedure is often used to treat smaller varicose veins and spider veins, and may require several treatments to completely close the vein off. SURGERY Surgery (Vein stripping and ligation) is normally done as a last resort or in severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin. It is done as an outpatient procedure and the recovery time is about 1 to 4 weeks. Tip#1: Avoid standing or sitting still for long periods. Take regular breaks throughout the day and try to move around. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. Tip#2: Elevate the legs often above the level of your heart about 3 or 4 times a day for about 15 minutes at a time. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms. Tip#3: Exercise regularly; this can improve circulation and help maintain a healthy weight. Weight loss may result in significant improvement of varicose veins. Tip#4: Avoid wearing tight clothes, especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can restrict blood flow and may make varicose veins worse. Tip#5: Avoid wearing high heels for long periods. Lower heeled shoes can help tone your calf muscles, which can help to improve blood flow in the veins. Tip#6: Wear compression stockings if you have large varicose veins. They can be effective if worn everyday, especially on days when you would be standing for very long periods. Putting them on early at mornings right after getting out of bed and removing them just before bedtime may see substantial improvement in symptoms. I hope these tips on VARICOSE VEINS were helpful; Remember, YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgements National Heart, Lung and Blood institute Mark O’Donnell vascular surgery (for image) St. Bartholomew Hospital/ Science photo library (for image) Visit https://www.nhlbi.nih.gov/health-topics/varicose-veins for more information. |
AuthorDr. J. Lawarna Matthew Archives
January 2021
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