If you’re a fan of the Game of Thrones books by George R.R. Martin, you’ll recognize “Winter is Coming” as the motto of the House of Starks. As Lords of the North, they know that they have to be ready for the hardships winter will bring. For those of us in the real world, our hardships might include colder temperatures, snow and a lot less sunshine. This change in our environment can cause us to feel down, or depressed, sometimes so much that our quality of life can be affected. This change in mood is called Seasonal Affective Disorder, or SAD.
Symptoms of SAD may include:
- Increased appetite with weight gain
- Loss of interest in work or other activities
- Less energy and ability to concentrate
- Unhappiness and irritability
- Increased sleep
- Sluggish movements
- Social withdrawal
Instead of hibernating this winter, take action to lessen the impact that SAD has had on you in the past. Consider these great suggestions by Alex Orlov, a writer for Life by DailyBurn, in his article, “9 Ways To Cope With Seasonal Affective Disorder:”
1. Soak up morning sunshine.
According to Kalayjian, winter blues will be worst in the mornings when you’re rousing yourself from bed. She tells clients to open curtains as much as possible to get exposure to natural light right when the body is waking up.
2. Maintain your routine.
“The most helpful thing is to try to keep up everyday activities,” says Rohan. Once daylight savings time occurs, don’t neglect your favorite hobbies just because winter spurs an impulse to hibernate. You’ll feel better knowing you’re still making it to your weekly book club, basketball game or brunch with friends.
3. Work it out.
During a killer gym session, the brain works hard to override the temporary feelings of discomfort by telling the body to keep pushing. You’ll naturally release endorphins, which will make you feel happier and even euphoric. A meta-review published in the American College of Sports Medicine Journal in 2013 suggested that, for some individuals, exercise might be comparable to therapy or anti-depressants as an effective treatment for depression.
4. Flip a switch.
Research suggests that light boxes can help up to 50 percent of people who suffer from SAD. The bright light emitted from these devices helps the body awaken in the morning and decreases the hormone melatonin that keeps us asleep at night. And for those seeking a quick fix: Studies show that light therapy can spur a mood lift in just several days. “Based on the literature, [light therapy] is a very effective treatment,” says Rohan. However, since the FDA does not regulate light boxes, she recommends consumers pursue light therapy under the supervision of a professional. “It takes some trial and error to get it just right,” she says, emphasizing that timing, positioning and potential side effects should all be discussed with an expert before you begin treatment.
5. Ditch the sugar.
It’s common knowledge that too much of the sugary stuff will make us gain weight and puts us at risk for developing diabetes and certain cancers. And research shows that sugar has a sour effect on mental health, too. Countries that consume the most sugar have higher rates of depression, and scientists hypothesize that it hinders the body’s ability to cope with stress and can worsen anxiety. Many people crave sweet and starchy foods in the wintertime because they provide a temporary energy boost, but these treats will ultimately leave you just as sluggish as before. Instead, opt for eating complete meals with good sources of protein and fiber.
6. Get outside.
Both Rohan and Kalayjian recommend breathing in some fresh air each day. Studies confirm that spending time outside can relieve stress, so bundle up and brave the cold for at least five minutes to lift your spirits. “It turns out that going for a walk in the morning after sunrise can be especially effective,” says Rohan. “It gets light to the retina, but it’s also physical activity.” Two birds, one stone!
7. Develop wintertime interests.
Bummed that you can’t play beach volleyball every weekend? Rohan recommends finding substitutes for the mood-enhancing activities you enjoy in the summer. “Having fun is central to having a good mood,” she says. “What are things to do in winter that are fun to do?” Strap on some snowshoes, check out a new fitness class, take a spin on an ice rink or step up your game in the kitchen — you just might find a new passion.
8. Practice relaxation.
Some down dog could help you get out of the dumps. Practicing yoga, studies show,can alleviate symptoms of depression and anxiety. Plus, preliminary research on meditation reveals that breathing exercises and mindfulness exercises can actuallychange neural networks and decrease stress. Kalayjian also recommends progressive relaxation, a technique that promotes body awareness by tensing and relaxing muscle groups throughout the body.
9. Book a trip.
Prepare for takeoff, because quality vacation time will certainly boost your mood. Those that suffer from seasonal depression will benefit from additional sunshine if they head south, but taking a break from work is important for anyone’s mental health. Studies show that people even experience pleasure from anticipating trips. “Across the board, SAD patients will tell you they feel better [after vacation],” says Rohan. But she cautions against depending on getaways for happiness. “I think it’s important to learn to tolerate the place where you live instead of jumping on a plane.” While you count down the days ’til your beach holiday, find ways to get joyous about the winter wonderland in your own backyard. (See full article here.)
Winter is coming. Be Ready!
Martin, George R.R. Game of Thrones. New York: Bantam Books, 1996. Print.
I think we’ve all been talked to to death about protecting our skin from getting burned and overexposed to the sun. If you’re at least 35 or older, you may even remember the days of baby oil mixed with iodine as the way to get a great tan. And the more tan you are, the more beautiful you are, right?
Except when you over do it and look like leather.
I confess I still like the look of sun-kissed skin; however, I now attempt to get it out of a self-tanning lotion.
We had a scare in our family recently that makes me even more leery of getting too much sun. Last year my younger sister found a spot on her upper arm that wouldn’t go away. She thought it was just some type of pimple. It wasn’t a scary looking black color, it was flesh-colored. It wasn’t larger than a pencil eraser or asymmetrical. The only thing that bothered her was that it wasn’t clearing up. She went to her primary care doctor for something else, and “by the way, what do you think about this thing on my arm?” Luckily, her doctor did not blow her off, but removed it and sent it for biopsy. About a week later, he called her to say it was melanoma.
That news was unexpected, and threw us all for a loop. If you start reading about melanoma, you realize that the odds aren’t good for survival. She had to go to a specialist who removed more skin in that area, looking at the cells under a microscope as he went, until he got to clear cells. That was a good sign, that he was able to get to normal cells instead of continually finding more cancer cells. Thankfully, my sister is cancer-free; she will be monitored on a regular basis for any recurrence for the next few years.
I’m sharing this story with you because I read an article today that says melanoma is on the rise in our teenagers. While our kids are still in our homes, we need to harp on them to use sunscreen, no matter how annoying we are. We also need to be good parents and slather our little kids (6 months and older) with sunscreen anytime they’re out in the sun. At the pool, the sunscreen has to be on at least 15 minutes before getting in the water for it to work, and reapplied often. Teach them at an early age that wearing sunscreen is important. But for those of us who grew up in the age of baby oil and iodine, it’s too late to reverse the sun damage that’s already happened. So, we have to keep an eye on our skin with regular checks of our largest organ, our epidermis.
What makes you more prone to developing skin cancer?
- If you had blistering sunburns as a teenager
- If you had outdoor summer jobs for 3 or more years as a teenager
- If you have pale skin that doesn’t tan easily (burns instead)
- If you have red or blonde hair
- If you have blue eyes
- If you have many moles or freckles
- If you have HIV or any condition that makes your immune system not work well
- If you are taking immunosuppressants
- If you have a family history of melanoma.
- If you are older than 65 years of age.
People who are non-medical may feel they can’t tell if something is normal or abnormal. In school, I was taught this way to remember how to tell if a skin lesion could be a concern:
The A-B-C-D-Es of Skin Cancer
Anytime you find a spot that concerns you, please go see your healthcare provider to get it checked out.
It’s a good idea to have your skin checked out once a year, especially if you fall into any of the at-risk categories. In the meantime, use your sunscreen with SPF of 30 or higher, limit your time out in the sun, especially between 10am to 4 pm, and dress in protective clothing such as a hat and sunglasses when you are outside. Take care of yourself. ¡Salud!
Up until I hit about 30 years old, I was not much on physical fitness. I really didn’t have much trouble with gaining too much weight, or feeling like I had a real weight problem (meaning, I felt like I might be happy to lose 5 lbs, but didn’t feel motivated to do so since I was at a normal weight). I ate pretty much what I wanted to and stayed at the same size. That is, until I gave birth to my first child.
I didn’t gain over 28 lbs with that pregnancy, but I didn’t lose the last 8lbs before getting pregnant with my second. With him, I gained 33 lbs and was at a high weight (for me), 164 lbs, about 40 lbs over my normal weight. I didn’t like my body at that weight, my clothes didn’t fit, and I was going to have to actually work to get the weight off.
My 10 year anniversary celebration was the same year I gave birth to my second. We planned on going on a cruise that October, so I had to lose about 20 lbs before that. I had managed to get down to about 145 naturally. I began exercising at 6 weeks postpartum, right after my check up, doing some aerobic exercise video tapes (Jane Fonda, I think!) with a friend. I weaned my son from breastfeeding at the end of July; I planned on restricting my calorie intact and knew this wasn’t a good idea while nursing. I had decided that running was the easiest and cheapest way to exercise and lose weight. I only needed shorts, t-shirt, socks and running shoes. No gym membership required!
My first time out, my goal was to keep going for 15 minutes, walking or running. I found I could only jog for about 2 minutes before getting out of breath (did I mention I had 5 weeks of bedrest with both pregnancies? Yeah.) Slowly, over the course of 3 weeks, I was finally able to jog for the entire 15 minutes!
In the meantime, I was using the Slim Fast plan as my eating plan. I added in some extra carb calories (maybe 200-300) to keep hunger at bay. The pounds started coming off and this inspired me to keep going. Instead of emphasizing how far I went on my runs, I went by minutes. After I made it jogging straight for 15 minutes, the next week, I went 17 minutes three days that week. The next week, it was 19 minutes for three days, and so on, until I was able to jog without stopping for 30 minutes. After that, I actually started taking my car out after my runs to clock the mileage (oh, the days before affordable GPS!)
When my husband and I left for our cruise, I had gotten back down to about 125, my pre-pregnancy weight. I hadn’t seen that number for about two and a half years and I really felt great! Our trip was fantastic and we had a memorable anniversary. After we got back home, I continued with my running. The next year, I decided that maybe a marathon wasn’t a crazy lunatic idea after all, and decided to train for the St. Jude Memphis Marathon. I had a great running buddy, Dianne, who would run part of my long runs with me, then bike beside me (and around me) as I finished up my mileage. I was following the training schedule in Jeff Galloway’s Book on Running for a 4 hour marathon finish time. I highly recommend his book. I finished my first marathon in 4 hours, 14 minutes and 19 seconds, a little off my goal, but I finished!!
I’m telling my story to you because I really didn’t believe that I could ever be a runner. A marathon sounded like an incredible feat of physical endurance that only crazy people wanted to accomplish. I didn’t like running (it hurt), I wasn’t athletic (I quit track in junior high because one girl was faster than me). After that first marathon, I would look back and think about the years before my kids were born, all the time I wasted that I could have been so involved in a running club! Runners are fun people, they’re nice, they encourage each other. You’re making an effort to be healthy, races usually raise money for a good cause, having a race as a goal keeps you motivated to get out there and train.
If you’re looking for something to get into, don’t want to spend a lot of money and are willing to put the time in, I would encourage you to try running. Even if you have to walk/run like I did, get out there. Time spent moving your body will reap rewards in lower cholesterol, lower blood sugars, muscle building and fat loss. It’s amazing, too, the psychological benefits of knowing that you can run a mile without stopping.
So, that’s my story of how I got started with my running. If I could do it, you can, too. Let your stubborn, willful self take over and get you out the door. You can do it. No think about it.
Stress plays a big part in many of our lives. I’ve always heard that a certain amount of stress can be healthy, leading us to get things done or change a bad behavior. It’s when stress is a constant part of your life that it can affect your health. Stress has been linked to causing or worsening heart disease, high blood pressure, obesity, diabetes, a weakened immune system, and psychosomatic illnesses.
A psychosomatic illness is an illness that begins with emotional stress or damaging thought patterns, and progresses with physical symptoms. For instance, have you heard of “nervous stomach” or someone breaking out in hives because of stress?
It can be difficult to avoid stress; there are pressures to pay bills, do well at your job, keep your job, volunteer at your kid’s school, take on responsibility at church, etc. You may be raising teenagers or trying to work things out with your spouse or dealing with the serious illness of a family member. Life just tends to throw things our way, and we have to deal, right?
Knowing that I need to develop better techniques myself, I went in search of tips for dealing with stress. I found a great article listing 25 stress relievers by Elizabeth Scott, M.S. and I wanted to share it with you. Go and take a look at the article, then try to use a couple every week until you find one that really does it for you.
Be good to yourself! ¡Salud!
So, your significant other begs to be allowed to fall asleep first. You avoid camping or sharing a room with anyone because when you fall asleep, you’ve been told that you saw logs. You could have sleep apnea. Sleep apnea is when you stop breathing repeatedly during sleep, and is considered a serious disorder.
If left untreated, sleep apnea can result in a number of health problems, including:
- High blood pressure
- Heart failure, irregular heart beats, and heart attacks
- Worsening of ADHD
Untreated sleep apnea may also be responsible for poor performance in everyday activities, such as at work and school, car accidents, underachievement at school in children and adolescents, and having to sleep on the couch…or elsewhere.
A sleep study, or polysomnogram, is needed to diagnose sleep apnea. This is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. Most of the time, this study is done at a sleep disorder clinic or sleep lab.
If your sleep apnea is mild, you may be asked to:
- Lose weight
- Avoid alcohol and sleeping pills
- Change sleep positions to improve breathing
- Stop smoking. Smoking can increase the swelling in the upper airway, which may worsen both snoring and apnea.
- Avoid sleeping on your back
Sometimes sleep apnea is severe enough that other measures are needed. Continuous Positive Airway Pressure, or CPAP, may be prescribed. This involves a mask that you wear over your mouth or nose. It’s hooked to a machine that blows air into your airway. This way your airway stays open, preventing you from snoring or holding your breath. Depending on the person, a dental device may be a better option, or even surgery, if an anatomical problem is causing the airway to be blocked.
Consider these questions:
- Are you a loud, habitual snorer?
- Do you feel tired and groggy on awakening?
- Are you often sleepy during waking hours and/or can you fall asleep quickly?
- Are you overweight (BMI > or = 35) and/or do you have a large neck (> or = to 16in)?
- Have you been observed to choke, gasp, or hold your breath during sleep?
If you or someone close to you answers “yes” (or plays you a recording of your snoring!) to any of the above questions, you should talk to your healthcare provider about getting tested for sleep apnea. ¡Salud!
Have you been told that your blood pressure is a little high? Maybe you’ve been given a blood pressure medicine by your healthcare provider, but you’ve resisted taking it. The most common thing I hear is, “I don’t want to have to take a medicine every day.” So what lifestyle changes could you try to keep from taking a medicine for your blood pressure?
Besides getting at least an hour and a half of exercise in per week and losing weight, cutting back on your salt intake could make a difference. Salt may make our food taste better, but too much can have bad effects on our health. It can raise blood pressure, make the kidneys work harder, cause swelling in the tissues, and make us at higher risk for heart disease. Educating yourself on the foods that have more salt than others may help you lower your intake of salt by making better choices.
Foods that are typically higher is sodium are
- Fast foods,
- Canned foods,
- Frozen meals,
- Snack foods like chips, pretzels, crackers and nuts,
- Marinades and flavorings, especially Teriyaki sauce and Soy Sauce, and
- Packaged deli meat.
Read the nutrition label for how much sodium per serving a product contains and how many servings are in the container or package to see how much sodium you’re taking in when eating the above types of food. It might be an eye-opener!
The American Heart Association recommends no more than 2300 mg a day of sodium for most people. For those age 51 years and older, and those of any age, including children, who are
- African American (more salt sensitive than other races) or
- have high blood pressure,
- diabetes, or
- chronic kidney disease,
should limit their intake to 1,500 mg of sodium per day.
Sometimes, even with lifestyle changes, you may still need a blood pressure medicine; family history can play a strong role in whether you’ll develop it. I’m usually willing to allow my patients at least 3 months of lifestyle changes before putting them on a medicine. So–get out there and exercise, drop a few pounds, and cut back on your salt! ¡Salud!
“I just feel so tired all the time.” I hear this usually once, if not two or three times a day from different patients. Depending on who I’m looking at, here are a few of the conditions I consider:
- Hypothyroidism–A blood test is used to determine if the thyroid is functioning the way it should. Besides fatigue, it can also cause constipation, cold intolerance, and dry skin.
- Iron Deficiency Anemia will cause fatigue in men and women. Women who have heavy periods are at risk for this. For men, a blood count, or hematocrit, of less than 40 is generally considered low, and should be seen by a Gastroenterologist (GI) for evaluation of possible bleeding in the gut. Women who have stopped menstruating , but are anemic, should also be considered for referral to a GI doctor.
- B12 Deficiency Anemia— Most B12 deficiencies are caused by not eating enough foods with B12 in them, such as meat, fish, poultry, shellfish, eggs and dairy products. A blood test is used to find out the B12 level in the blood; lower than 300 ng/ml means a deficiency. The quickest way to replace B12 is through an injection once a week for four weeks, then once monthly after that. Any person who has any kind of gastrointestinal disease, such as Crohn’s or Celiac Disease, or who has had any part of their gut removed such as with gastric bypass or colon resection, will need to replace their B12. Alcoholics also need B12 replacement.
- Diabetes— High blood sugars cause fatigue. Any person who is obese, has high blood pressure, high cholesterol or a family history of diabetes should be screened for this.
- Depression— There are two questions used to screen for depression:
- “In the past two weeks, have you felt down or sad on more days than not?”
- “In the past two weeks, have you lost interest or pleasure in doing things you used to enjoy?”
If the answer is “yes” to either of these two questions, than a more thorough evaluation for depression is done. If depression is diagnosed, treatment options would be counseling, medication, or a combination of these. A healthy lifestyle is also encouraged as mood can be affected by diet and exercise.
If you think that you are more tired than you should be, or than you used to be, please see your healthcare provider to see if you need to be screened for these common conditions. ¡Salud!
Keep in mind, this is not meant to be a comprehensive list, and each patient’s assessment is based on his/her health history and physical exam.
The question of what to do with leftover medications is a good one. As a healthcare provider, I need to know the answer for my patients, and wanted to pass the information I found on the FDA’s website along to my readers.
- Medicine Take-Back Programs On April 27, 2013, there will be a National Prescription Drug Take-Back Event. Follow this link for your state information: http://www.deadiversion.usdoj.gov/drug_disposal/takeback/
- Disposal in Household Trash If no Take-Back Program is available, follow these steps to get rid of your unwanted meds:
- Mix medicines (do NOT crush tablets or capsules) with an unpalatable substance such as kitty litter or used coffee grounds;
- Place the mixture in a container such as a sealed plastic bag; and
- Throw the container in your household trash.
- Before throwing out a medicine container, such as a pill bottle, remember to scratch out all information on the prescription label to make it unreadable.
- Flushing of Certain Medications Some medicines could be so harmful to others if taken that the best thing is to flush them down the toilet. These medications are:
|Abstral (PDF – 1M), tablets (sublingual)||Fentanyl|
|Actiq (PDF – 251KB), oral transmucosal lozenge *||Fentanyl Citrate|
|Avinza (PDF – 51KB), capsules (extended release)||Morphine Sulfate|
|Daytrana (PDF – 281KB), transdermal patch system||Methylphenidate|
|Demerol, tablets *||Meperidine Hydrochloride|
|Demerol, oral solution *||Meperidine Hydrochloride|
|Diastat/Diastat AcuDial, rectal gel [for disposal
instructions: click on link, then go to “Label information”
and view current label]
|Dilaudid, tablets *||Hydromorphone Hydrochloride|
|Dilaudid, oral liquid *||Hydromorphone Hydrochloride|
|Dolophine Hydrochloride (PDF – 48KB), tablets *||Methadone Hydrochloride|
|Duragesic (PDF – 179KB), patch (extended release) *||Fentanyl|
|Embeda (PDF – 39KB), capsules (extended release)||Morphine Sulfate; Naltrexone Hydrochloride|
|Exalgo (PDF – 83KB), tablets (extended release)||Hydromorphone Hydrochloride|
|Fentora (PDF – 338KB), tablets (buccal)||Fentanyl Citrate|
|Kadian (PDF – 135KB), capsules (extended release)||Morphine Sulfate|
|Methadone Hydrochloride, oral solution *||Methadone Hydrochloride|
|Methadose, tablets *||Methadone Hydrochloride|
|Morphine Sulfate, tablets (immediate release) *||Morphine Sulfate|
|Morphine Sulfate (PDF – 282KB), oral solution *||Morphine Sulfate|
|MS Contin (PDF – 433KB), tablets (extended release) *||Morphine Sulfate|
|Nucynta ER (PDF – 38KB), tablets (extended release)||Tapentadol|
|Onsolis (PDF – 297KB), soluble film (buccal)||Fentanyl Citrate|
|Opana, tablets (immediate release)||Oxymorphone Hydrochloride|
|Opana ER (PDF – 56KB), tablets (extended release)||Oxymorphone Hydrochloride|
|Oxecta, tablets (immediate release)||Oxycodone Hydrochloride|
|Oxycodone Hydrochloride, capsules||Oxycodone Hydrochloride|
|Oxycodone Hydrochloride (PDF – 100KB), oral solution||Oxycodone Hydrochloride|
|Oxycontin (PDF – 417KB), tablets (extended release) *||Oxycodone Hydrochloride|
|Percocet, tablets *||Acetaminophen; Oxycodone Hydrochloride|
|Percodan, tablets *||Aspirin; Oxycodone Hydrochloride|
|Xyrem (PDF – 185KB), oral solution||Sodium Oxybate|
This information was taken from the Federal Drug Administration’s website. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flushing_list
For anyone concerned about about the impact on the environment, the FDA makes this statement:
“We are aware of recent reports that have noted trace amounts of medicines in the water system. The majority of medicines found in the water system are a result of the body’s natural routes of drug elimination (in urine or feces). Scientists, to date, have found no evidence of harmful effects to human health from medicines in the environment.
Disposal of these select, few medicines by flushing contributes only a small fraction of the total amount of medicine found in the water. When a medicine take-back program isn’t available, FDA believes that any potential risk to people and the environment from flushing this small, select list of medicines is outweighed by the real possibility of life-threatening risks from accidental ingestion of these medicines.”
Remember to never share your prescription meds with another person.
Now, have a good day and annoy others with your newfound knowledge!
Did you know that the Affordable Care Act requires health insurance plans to cover preventive services with no cost sharing? This means your health insurance can no longer charge a co-pay, co-insurance, or deductible when you see an in-network provider for these services.
Services for Adults include screenings for:
- Abdominal Aortic Aneurysm
- Alcohol Misuse
- Aspirin use
- Blood pressure
- Colorectal Cancer
- Type 2 Diabetes
- Sexually Transmitted Infections
- Tobacco Use
For more detailed information: http://www.healthfinder.gov/HealthCareReform/Adults.aspx
Services for Women and Pregnant Women include screenings for:
- Anemia (pregnancy)
- Bacteriuria (pregnancy)
- Breast Cancer Mammography
- Breast Cancer Chemoprevention
- Cervical Cancer
- Chlamydia Infection
- Domestic and Interpersonal Violence
- Folic Acid
- Gestational Diabetes (pregnancy)
- Hepatitis B (pregnancy)
- HPV DNA Test
- Rh Incompatibility (pregnancy)
- Sexually Transmitted Infections
- Tobacco Use
- Well-woman Visits
For more detailed information: http://www.healthfinder.gov/HealthCareReform/Women.aspx
Services for children include screenings for:
- Alcohol and Drug Use
- Blood Pressure
- Cervical Dysplasia
- Congenital Hypothyroidism
- Fluoride Chemoprevention
- Height, Weight, and Body Mass Index
- Hematocrit or Hemoglobin
- Medical History
- Oral Health
- Sexually Transmitted Infections
For more detailed information: http://www.healthfinder.gov/HealthCareReform/Children.aspx