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Winter is Coming

winter

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.

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
  • Hopelessness
  • 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.)

snow

My Winter Wonderland!

 

Winter is coming. Be Ready!

¡Salud!

Sources:
http://www.nlm.nih.gov/medlineplus/ency/article/001532.htm
http://www.huffingtonpost.com/2014/12/06/seasonal-affective-disorder_n_6255780.html
Martin, George R.R. Game of Thrones. New York: Bantam Books, 1996. Print.

 

Your Largest Organ

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?Patricia Krentcil

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.

slideshow-trio

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.whaleskin

 

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

abcde-of-melanoma

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!

Under Pressure

stressed

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?

StressSymptoms

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!

relax

 

Sources: http://stress.about.com/od/stressmanagementglossary/g/psychosomatic.htm

Do You Have a Midnight Train to Nowhere?

social_snoring

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
  • Stroke
  • Heart failure, irregular heart beats, and heart attacks
  • Diabetes
  • Depression
  • 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.

snore

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!

Sources: http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea,          http://www.sleepfoundation.org/sites/default/files/2005_summary_of_findings.pdf

CAGE yourself

CAGE

Have you ever wondered if you drink too much? The CAGE questionnaire is a screening tool that can be used by yourself or your healthcare provider to see if you have a problem that needs evaluation. It’s not used to diagnose alcoholism, only as a way to see if a person possibly needs help or support.

The questions are:

  1. Have you ever felt you should cut down on your drinking?
  2.  Have people annoyed you by criticizing your drinking?
  3. Have you felt bad or guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves
    or get rid of a hangover (eye-opener)?

If you answer “yes” to 2 or more questions, that’s an indication of an alcohol problem.

There are the different levels of misuse:

  • Risky or hazardous use–having more than 4 drinks in one day for men or more than 3 drinks in one day for women
  • Harmful use–drinking that causes physical or mental harm (i.e. falls, high blood pressure, unclear thinking)
  • Alcohol abuse–drinking that causes a person to lose his job or have decreased work or school performance, neglect home responsibilities, driving while drunk, and/or have legal or social problems
  • Alcohol dependence (alcoholism)–a craving for alcohol, physical dependence (get the shakes without a drink), loss of control over drinking, and a need to drink an increased amount to feel the effect.

For those with a positive screen that fall under the “Risky or hazardous use”or “Harmful use” categories, brief counseling with more than one session has been found to be effective. For those who fall in the “Alcohol abuse” or “Alcohol dependence” categories, brief counseling hasn’t been shown to work well; a treatment program with ongoing support would be more effective.

I’ve noticed that a lot of my patients are really not aware of what is considered “drinking in moderation.” For men, this would be no more than 2 drinks a day or no more than 14 drinks per week. For women, moderate drinking is no more than one drink a day or no more than 7 drinks per week. A drink is considered to be 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor.

drink

Please see your healthcare provider if you have questions or concerns about your alcohol use.

Source: http://www.uspreventiveservicestaskforce.org/uspstf12/alcmisuse/alcomisart.htm

Get Your Pound of Cure

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.

86million_preventive

Services for Adults include screenings for:

  1. Abdominal Aortic Aneurysm
  2. Alcohol Misuse
  3. Aspirin use
  4. Blood pressure
  5. Cholesterol
  6. Colorectal Cancer
  7. Depression
  8. Type 2 Diabetes
  9. Diet
  10. HIV
  11. Immunizations
  12. Obesity
  13. Sexually Transmitted Infections
  14. Syphilis
  15. Tobacco Use

For more detailed information: http://www.healthfinder.gov/HealthCareReform/Adults.aspx

Services for Women and Pregnant Women include screenings for:

  1. Anemia (pregnancy)
  2. Bacteriuria (pregnancy)
  3. BRCA
  4. Breast Cancer Mammography
  5. Breast Cancer Chemoprevention
  6. Breastfeeding
  7. Cervical Cancer
  8. Chlamydia Infection
  9. Contraception
  10. Domestic and Interpersonal Violence
  11. Folic Acid
  12. Gestational Diabetes (pregnancy)
  13. Gonorrhea
  14. Hepatitis B (pregnancy)
  15. HIV
  16. HPV DNA Test
  17. Osteoporosis
  18. Rh Incompatibility (pregnancy)
  19. Sexually Transmitted Infections
  20. Syphilis
  21. Tobacco Use
  22. Well-woman Visits

For more detailed information: http://www.healthfinder.gov/HealthCareReform/Women.aspx

Services for children include screenings for:

  1. Alcohol and Drug Use
  2. Autism
  3. Behavioral
  4. Blood Pressure
  5. Cervical Dysplasia
  6. Congenital Hypothyroidism
  7. Depression
  8. Developmental
  9. Dyslipidemia
  10. Fluoride Chemoprevention
  11. Gonorrhea
  12. Hearing
  13. Height, Weight, and Body Mass Index
  14. Hematocrit or Hemoglobin
  15. Hemoglobinopathies
  16. HIV
  17. Immunization
  18. Iron
  19. Lead
  20. Medical History
  21. Obesity
  22. Oral Health
  23. PKU
  24. Sexually Transmitted Infections
  25. TB
  26. Vision

For more detailed information: http://www.healthfinder.gov/HealthCareReform/Children.aspx

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