I'm a 22-Year-Old With Fibromyalgia—and Some Days I Wish I Could Detach Myself From My Body

The pain started when I was 16 years old. It began in my finger joints, the aching dull one moment and sharp the next. Soon the pain became more widespread. It circumnavigated to what seemed like every joint in my body. (Later I would learn that these were tender points surrounding the joints rather than the joints themselves.) Every time I took a step, I felt a sharp jab in response.

I was a high school junior in New York. The SATs, AP classes, school sports, the school musical, and college counseling took up the majority of my time. I ignored the pain because I simply didn’t have the energy or time to deal with it. When I allowed myself time to focus on it, I would turn to Google. These late night symptom-checking sessions usually left me convinced I was about to die. I told my parents that something felt wrong, but they shrugged and told me to go to the doctor.

In and out of waiting rooms

The first time I explained my joint pain to the family doctor I'd been seeing for years, I said that I thought it might be arthritis or leukemia. (At least, that’s what Google had told me.) My doctor wasn’t so sure. He told me I was stressed and needed to relax. He asked me if I ever felt depressed or anxious. I nodded, even though a large part of my anxiety stemmed only from my unexplained pain. He sent me away with a Zoloft prescription and didn’t recommend any specialists.

I’m not sure why doctors seem to prescribe Zoloft first. Whenever I talk to friends who have also been prescribed SSRI antidepressants, we exchange dark glances, remembering our first trial runs on Zoloft before we found the prescriptions that actually worked for us. I can still remember the constant feeling of electricity coursing through my head, the way the drug made me fixate on certain things rather than allow the anxiety to fade away. I lived like this for over a year.

All the other physician visits I went to seemed to blur together. I remember going to one with the same complaint I had for my first doctor, and he told me it was due to stress. He patted my shoulder and wished me the best of luck with my college search. He was kind, but he clearly thought the pain was in my head. I insisted on tests—for Lyme disease, blood work—anything that would tell me what was wrong with my body. They all came back negative.

I went away to college in Boston. During my first semester, I took the train back home twice to see my doctor. The pain was now so bad, I was unable to sit in the library to study without being assaulted by aches. Google searches worried me, as these symptoms—combined with the headaches, fatigue, and insomnia I was now experiencing—led me to believe something serious was going on. I went into my doctor’s office again and again feeling like my body had betrayed me.

Finally a diagnosis

The next year, I transferred to the University of Virginia and was now farther away from my hometown and doctor. I called him a few times on the phone with complaints, but ultimately the rush of new experiences at school distracted me from the pain, even though it was always there in the background.

I didn’t tell most people about the pain that followed me daily. This was probably because I didn’t want to seem weak or pitiable, but also because I refused to give it a name or a voice. If I didn’t acknowledge the pain, I reasoned, then maybe it didn’t exist after all. Maybe it was, as my doctor kept insisting, just stress.

One fall, an ex-boyfriend convinced me to wean myself off Zoloft. My anxiety was getting worse—enough to noticeably affect my relationships and friendships—so I agreed that a change in medication might be a good idea. I went to my doctor’s office that winter break.

As I sat perched on the chair in his exam room that December day, I remember him asking me more questions about my anxiety and stress levels. He applied pressure to my joints and asked where the pain was located. Eventually, he sighed and said it looked like I had fibromyalgia, but he had not suspected it before because I was so young.

What is fibromyalgia?

The word was long and unfamiliar. Fibromyalgia. I didn’t even know how to spell it.

What I later found out, though, is that fibromyalgia is an elusive and confusing diagnosis. The condition is thought to affect the way the brain processes pain signals, amplifying their intensity and thereby causing chronic, debilitating pain, according to Mayo Clinic.

Fibromyalgia also mimics many other conditions, including arthritis, lupus, and cancer, which is why it often takes years to get a diagnosis. There's no definitive test for it; it's diagnosed by a process of elimination when other conditions are ruled out. For years, it was even considered a mental-health disorder. It was only in 2007 when medication became available to treat symptoms and side effects. (Fibromyalgia currently has no cure.)

My doctor told me that I was one of 3.7 million Americans living with the condition, the majority of which are middle-aged women. He didn’t know why fibromyalgia affected me, especially since I am decades younger than the average person diagnosed. Though fibromyalgia may be genetic, no one in my family has it. It might also be caused by physical or emotional trauma. Yet at the time I developed it, I was in high school, living a relatively carefree life of dancing in my school musical, running to soccer practice, and studying for the SATs.

Man dies from eating more than a bag of liquorice a day, for weeks

We know the dangers of sweet foods to our health, but in the case of liquorice, it turns out it may be worse for us than we ever thought, doctors say.

This is after one man’s love for the confectionery turned sour when he suffered cardiac arrest, according to a case published in the New England Journal of Medicine this month. 

Doctors wrote that the 54-year-old man, a construction worker in the US state of Massachusetts, ate about one-and-a-half bags of black liquorice every day for a couple of weeks. 

“The patient had been in a fast-food restaurant when he gasped suddenly and lost consciousness,” the report reads.

He was revived after emergency responders performed CPR, but reportedly died the next day.

How did this happen?

“Even a small amount of liquorice you eat can increase your blood pressure a little bit,” said Dr Neel Butala, a cardiologist at Massachusetts General Hospital who described the case in the New England Journal of Medicine.

In their paper, they explain that black liquorice contains a compound, known as glycyrrhizic acid, that can be toxic in large doses.

Dr Elazer Edelman, one of the authors of the paper, explained that studies have shown that glycyrrhizic acid could cause "hypertension, hypokalemia [dangerously low potassium levels], metabolic alkalosis, fatal arrhythmias, and renal failure" – all of which were seen in this patient.

Apart from this, the patient was also reported to have had a poor diet. 

The doctors also noted that the patient had recently changed the type of sweets he was consuming – a few weeks prior to his death, he switched from red fruit-flavoured twists to a different type made with black liquorice.

Another doctor, Dr Andrew Lundquist, also wrote that the liquorice was to blame: "Further investigation revealed a recent change to a liquorice-containing candy as the likely cause of his hypokalemia," Lundquist wrote.

According to The Guardian, Jeff Beckman, a spokesman for the Hershey Company which produces the Twizzlers liquorice twists, said that “all of our products are safe to eat and formulated in full compliance with FDA regulations”, and that all foods, including candy, “should be enjoyed in moderation”.

Previous case report also linked to liquorice

In a 2015 case study, published in the BMJ Case Reports, a 45-year-old woman was reported to have experienced hot flushes, sweating, and headaches for four months.

Tests revealed that she had been suffering from hypertension that was induced by liquorice tea. Doctors wrote that she had been drinking up to six cups of liquorice tea per day, and that once she stopped consuming the drink, her hypertension, and hypokalaemia entirely resolved.

Since the patient had chosen the tea as a substitute for caffeinated tea and fruit-based infusions, the doctors wrote that “clinicians need to be continually vigilant of the impact that dietary choices may have on patient health”. 

In 2017, the Food and Drug Administration (FDA) warned that eating two ounces (56g) of black liquorice per day for at least two weeks could lead to irregular heart rhythm (arrhythmia) in people 40 years and older.

Ohio Woman Is Tased and Arrested After Refusing to Wear Mask at Middle-School Football Game

A mother in Ohio was captured on video being tased and arrested after refusing to wear a face mask during an away middle-school football game.

According to police, at a Wednesday night game in Logan, a woman who wasn't wearing a face mask in the bleachers was asked several times to either put on her mask or leave. When she refused and resisted arrest, she was tased and handcuffed, according to Logan police.

The incident was caught on video and uploaded to social media. In the video, the woman, later identified as Alecia Kitts, can be seen telling a Logan police officer "don't touch me" after reportedly refusing to put on her face mask, which appears to be in her back pocket.

After the officer tells Kitts to put her hands behind her back and she refuses, he can been seen tasing her before handcuffing her. Kitts was charged with criminal trespassing and released at the scene. Additional charges are pending on Kitts and another female subject involved in the incident, according to police.

"It is important to note, the female was not arrested for failing to wear a mask, she was asked to leave the premises for continually violating school policy. Once she refused to leave the premises, she was advised she was under arrest for criminal trespassing, she resisted the arrest, which led to the use of force," police said in a statement.

Kitts is a Marietta City Schools parent, the Marietta Times reports.

“The governor and the [Ohio] health department have made it very clear that masks are required indoor and outdoor at sports facilities. They’re just part of the expectation,” MCS Athletic Director Cody Venderlic said in a statement to the paper. “They’re one of the requirements the OHSAA [Ohio High School Athletic Association] brought down and said that if we’re going to be able to have fall sports we’re going to have to social distance and we’re going to have to wear masks.”

On Thursday, Logan-Hocking schools were placed on lockdown after receiving threats related to the previous night's incident. Logan police are investigating the arrest. Attorney information was not available for Kitts.

Study recommends combo of Mediterranean diet and intermittent fasting for the heart

In a world where overconsumption of meat and processed foods has become a serious health threat, many have turned to simpler diets rich in plant-food with less red meat.

One of these popular diets is the Pesco-Mediterranean diet, rich in olive oil, seafood and a variety of vegetables. Another popular way of eating is intermittent fasting where adherents only eat during a certain period of the day, technically fasting for 12 to 16 hours a day. Apart from other benefits, this can also help you lose weight.

Best diet

A review of literature, published in the Journal of the American College of Cardiology, looked at a hypothetical diet as part of a healthy lifestyle that could be beneficial for heart health.

Research has shown that plant-based diets are better for cardiovascular health in societies that eat too much meat, but a complete vegan diet has other drawbacks and nutritional deficits due to the lack of animal protein. The vitamins specifically lacking are B12 and vitamin D, which come solely from animal products, forcing one to take supplements.

"Thus, although many individuals will benefit from a reduction in the consumption of meat, especially processed meat, modest amounts of wholesome animal-based foods such as fish and fermented dairy products continue to play an essential role in the ideal diet," write the authors.

More vegetables, less red meat

This is where the Pesco-Mediterranean diet comes into play. The basis of the diet is vegetables, fruits, nuts, seeds, legumes, whole grains, extra-virgin olive oil with seafood (not fried) and fermented dairy products. You can only drink water, coffee or tea, although, if you want alcohol, they advise only one glass of red wine a day.

The diet is inspired by the Mediterranean people, who also incorporate intermittent fasting into their traditional eating habits. Studies have proven many times that their diet can reduce all-cause and cardiovascular disease (CVD) mortality, as well as ailments like coronary heart disease, diabetes, Alzheimer’s disease, depression and overall cancer mortality.

Compared to vegetarians, pescatarian and lacto-ovo-vegetarians reduced coronary artery disease mortality by 34% compared to regular meat-eaters, while it decreased by less than 25% in vegans and occasional meat-eaters.

"However, selection bias and confounding, which may be accounting for some of these findings, are pervasive issues in diet-health studies and may undermine the validity of some findings," warn the authors.

Fish, dairy, pasta and eggs

Fish also has many heart benefits and is a major source of omega-3 fatty acids, but it's important to choose low-mercury fish. Health boards around the world promote it as the ideal diet for its health benefits. 

Dairy products are also important for protein, minerals, probiotics and vitamin D.

"Although there is no clear consensus among nutrition experts on the role of dairy products in CVD risk, they are allowed in this Pesco-Mediterranean diet. Fermented low-fat versions, such as yoghurt, kefir, and soft cheeses, are preferred; butter and hard cheese are discouraged, because they are high in saturated fats and salt."

They also allow eggs in the diet, although no more than five a week. In terms of pasta, pizza and rice, the authors note that these are fine as long as they are prepared at home and in the traditional Mediterranean way.

Intermittent fasting benefits

Then there's intermittent fasting, which has grown in popularity, which can help you lose weight, decrease intra-abdominal adipose tissue and reduce free-radical production.

"Unlike modern humans, our ancient ancestors did not have access to an unlimited supply of food throughout the year. Nor did they routinely eat three large meals plus snacks on a daily basis.

"Instead, they were typically engaged in a daily struggle to hunt and gather food, often in harsh milieus with sparse resources and seasonal scarcity. These environmental challenges were the grist for the evolutionary mill, whereby Homo Sapiens became genetically adapted to respond to intermittent fasting by becoming more resistant to stress."

In this proposed diet, you can eat between 09:00 and 18:00, fasting for the rest of the time. During these hours, the body uses up the available energy resources and starts accessing fatty acids from adipose cells for fuel. It can also lower blood pressure and resting heart rate.

"However, the evidence regarding time-restricted eating remains preliminary, mostly based on animal models and observational human studies," the authors add.

There are also some instances where intermittent fasting won't work for everyone, i.e. if you're recovering from an eating disorder, doing an intense training programme, have diabetes and if you're pregnant.

While this proposed diet requires more study, it might be a good proposition for someone with a high risk of heart disease.

Listen up, ladies! Steer clear of these 6 skincare ingredients during your pregnancy

Pregnancy is one of the most memorable milestones in a woman’s life; a time when she nourishes another life in her womb. And as we know, with great power comes great responsibility. So when you’re expecting a baby, you need to be even more cautious about everything you do, eat and use! 

You must have heard a ton of advice about what to eat, and what not to do during your pregnancy. But has anyone told you about some skincare ingredients that could cause harm to you and your baby?

So, before you buy your next skincare product, check the label for the following ingredients:

1. Retinol

Vitamin A derivatives such as retinol are considered essential for the growth of your baby, but high doses can prove to be dangerous. Research has shown a link between excess vitamin A and birth defects. Therefore, it is better to be safe than sorry.

2. Chemicals in your sunscreen

Sunscreens are often loaded with chemicals, some like avobenzone and oxybenzone that aren’t pregnancy-friendly. These chemicals affect the growth of your fetus, and in some cases, disrupts your hormonal balance.

3. Added fragrance

When a product is high on fragrance, it is clear that it is loaded with chemicals.

Generally, fragrances contain harmful components like aldehydes and parabens, which can pose serious health risks. So, try opting for fragrance-free products to be on the safer side.

4. Benzoyl peroxide and salicylic acid

These ingredients are largely used in anti-acne products. While the external application causes no harm, if consumed orally during pregnancy, it can have complications during the birth of your baby.

5. De-pigmentation chemicals

Many women experience skin pigmentation, and use products that contain a chemical called ‘hydroquinone’. But ladies, if this chemical is present in any product, it’s best to stay away from it, as it can cause severe allergies, and can react to sensitive skin.

Moreover, about 40-45% of the chemicals are absorbed in your bloodstream, which is not very healthy, both for you and your baby.

6. Parabens

Parabens are one of the most common ingredients present in cosmetic products. They not only get easily absorbed in the skin, but also disrupt hormones.

A study published in the Journal of Chemistry found that prenatal exposure of BPA, which is also a form of paraben, is linked to many serious complications including miscarriages, and impaired fetal growth.

So ladies, be extremely careful when you buy skincare products during pregnancy!

WHAT DOES SCIENCE TELL US ABOUT MUSIC AND INSOMNIA?

In our hectic world, a good night’s sleep is worth its weight in gold when it comes to improving physical and mental well-being. Much more than a basic method of energy conservation, sleep is a state during which muscle and bone are generated and repaired, and memories and learning systems are updated.

Sleep also allows the body and brain to clear out the toxic byproducts of the day’s waking activity that might otherwise build up and cause harm. In short, good sleep is a cornerstone of human health.

Sadly, not all of us are blessed with the bounty of a good night’s slumber after a long and often tiring day. Around 30% of adults experience chronic insomnia at some point in their life – where sleep is disrupted for more than a month. Estimates are even higher in older populations and those who experience regular stress.

Insomnia can be devastating, and has been linked to cognitive deficiencies – such as memory lapses, psychological problems including mood and anxiety disorders, and long-term health concerns including obesity and dementia. The most severe cases of chronic insomnia can even increase the risk of mortality.

The cost of insomnia goes well beyond just health. According to the National Sleep Foundation, insomniacs are two to four times more likely to have an accident – with over 72,000 traffic accidents a year in the US alone linked to sleep deprivation. Insomnia also costs US companies an estimated $150 billion in absenteeism and reduced productivity, every year.

Given our need for regular and deep sleep, it is no surprise then that people with insomnia often reach for the medicine cabinet. Pharmacies in the UK regularly dispense more than 15.3m prescriptions for sleep aids. But this is not the safest route to a good night’s slumber, as the use of over the counter and prescription sleep aids can lead to harmful side effects, dependency and withdrawal.

Music for sleep?

Research has shown that listening to “self-selected” music – music of your choice – can actually shorten stage two sleep cycles. This means people reach restful REM sleep – the restorative part of our sleep – more quickly.

In the study, students who listened to 45 minutes of music before bedtime for three weeks saw a cumulative positive effect on multiple measures of sleep efficiency with similar effects reported in older citizens in Singapore. Following all this evidence, the NHS now recommends “listening to soft music” before bedtime as a method to prevent insomnia.

With all this in mind, our research unit, along with colleagues from the Sleep and Cognition Laboratory at the University of Lincoln and Goldsmiths, University of London, has embarked on a new music sleep project, to find out what people listen to when they are nodding off – and why people believe music helps their sleep.

The first phase of our music sleep survey has been completed by 651 people, who have told us a great deal about the music that helps them to sleep. We discovered the top rated composer of sleep music in our sample is Johann Sebastian Bach. He was followed by Ed Sheeran, Wolfgang Amadeus Mozart, Brian Eno, and Coldplay.

Aside from those few top rated artists, there was an enormous variety of individual choices – with 14 different genres and 545 different artists named. And it is this data which will give us the basis to examine the features of effective sleep music. Using computer programs we will be able to pin down the consistent musical features that support sleep among these many diverse musical sounds.

6 Steps to Calming Anger

Your anger is important.

This fiery emotion is an appropriate reaction to injustice, betrayal, loss, hurt, trauma, or violation. It’s essential to acknowledge and honor this fierce feeling so that we can attend to the harm that has been caused. When we deny or suppress our anger we often cause ourselves further suffering. And, when we don’t slow down to find the ground and get clear when our anger is ablaze, we end up hurting others.

So the next time anger arises, here are six steps to meet the moment with curiosity and inspire a constructive response.

1 | Notice where there’s tension in your body.

Anger shows up physically in the body. Notice if you’re clenching your fists, tightening your jaw, heating up, or feeling sensations in the belly. You may also notice an impulse to run, fight, or withdraw.

Take some space to be with whatever is coming up for you. While it may be uncomfortable, remember that no feeling is permanent. Observe how the physical manifestations of anger naturally shift and change with time.

2 | Slow down and tend to the wisdom of your body.

Anger often comes with a sense of urgency. You may be thinking, “We must figure this out now!” or “ We must get justice now!” While it’s important to address what’s happened, our words and actions usually don’t yield the outcome we’d like when we’re still in the intensity of the emotion. So, it’s crucial first to slow down and take care of yourself.

If you’re noticing physical tension, then invite relaxation into that body part. If you’re heating up, place an ice pack on your neck. If you’re feeling the impulse to run, give yourself permission to walk away for a bit and collect your thoughts (you can always say something like, “I need some time to digest what just happened, I’d like to come back to this tomorrow”). If you’re withdrawing, you might not feel safe, give yourself permission to leave and do something that helps you feel safe and connected (maybe reach out to a friend, meditate or go spend some time in nature). If you feel the desire to fight, find a way to move that energy (maybe go for a run, cook dinner, or do some jumping jacks).

3 | Take long soothing breaths.

The experience of anger is stressful and takes a lot out of us. Breathing deeply and slowly can help reset the nervous system. Take at least five deep breaths as a way to settle the mind and body.

4 | Meet yourself with compassion.

Anger is destabilizing, uncomfortable, and painful. Be kind to yourself. Place your hands over your heart and offer yourself soothing affirmations like, “You don’t deserve to be treated like this.” or “That wasn’t fair.” Or, try saying to yourself, “Wow! This is a lot to process and manage. I’m sorry things feel so hard right now.”

5 | Notice if there are any feelings underneath the anger.

Take as much time as you need in steps one through four. Once you’re feeling calmer, investigate what else might be going on for you. Sometimes anger can serve as protection for other feelings that may be even more challenging to feel. For example, many of us weren’t taught how to deal with feeling disappointed, so anger sometimes arises to shield us from a deeper sadness. Diving beneath the surface of a big emotion and exploring the complexity of our experience can help inform our next steps.

6 | Give yourself time to respond rather than react to the situation.

A reaction happens in an instant; it’s informed by the past and fueled by emotions. A response takes a little longer; it includes the present and is empowered by awareness and clarity. Reactions are more likely to cause harm or bring up feelings of regret. Responses are thoughtful and tend to take into consideration everyone involved and future consequences.

Due to the intensity of anger it’s hard to see clearly and feel our feet on the ground. Generally, it’s helpful to sit with your reaction and give yourself space to feel the feeling and understand the bigger picture. For a steadier, calmer, and more compassionate space, you can decide how to respond. There are many options at this point, including standing up for yourself, having a tough conversation, creating a boundary, ending the relationship, forgiveness, taking a time out, or seeking additional support.

Foods That May Block DHT and Fight Hair Loss

1. Green tea

Derived from the Camellia sinensis plant, green tea is one of the most popular drinks worldwide.

During production, green tea leaves are steamed — and not fermented as is often the case with oolong and black tea leaves — which maintains more of the tea’s natural compounds 

This includes one of green tea’s primary plant chemicals called epigallocatechin gallate (EGCG), which has been associated with health benefits like weight loss, heart health, and brain health ).

EGCG has also been shown to protect hair follicles — the part of your skin that grows hair — from hair loss caused by DHT (7Trusted Source).

When applied to the scalps of three men for 4 days, an alcohol extract of EGCG stimulated hair growth by preventing the death of cells that regulate the growth and development of hair caused by DHT 

While this study has many limitations related to its small sample size and short treatment duration, it helps pave the way for further research on the topic.

Green tea extract supplements commonly contain standardized amounts of EGCG but have not been shown to combat hair loss caused by DHT. They have also been linked to liver damage in certain populations.

Ultimately, additional studies in humans are needed to better determine whether drinking green tea or taking EGCG or green tea supplements blocks DHT and fights hair loss.

2. Coconut oil

Coconut oil comes from the kernel or meat of coconuts.

It’s commonly used for cooking thanks to its ability to withstand high cooking temperatures. The oil also has various applications in beauty, skin care, hair care, and overall health.

Coconut oil contains a high percentage of fat from medium-chain triglycerides (MCTs), primarily in the form of lauric acid, which has been shown to block DHT production in test-tube and animal studies when provided orally.

While these types of studies — known as preclinical studies — help researchers identify whether a specific treatment may be effective or safe, their results can’t be translated to humans.

As such, clinical studies in humans are needed before coconut oil can be recommended for preventing or treating hair loss.

3. Onions (and other foods rich in quercetin)

White onions add a sweet yet sharp flavor to an abundance of dishes.

They contain few calories but boast a high content of antioxidants like quercetin.

In preclinical studies, quercetin has been shown to inhibit the production of DHT from testosterone by blocking the action of the enzyme alpha-5 reductase and decreasing oxidative stress.

For example, when combined with a commonly prescribed medication to treat hair loss, quercetin was shown to decrease DHT production in rats.

Despite these promising results, no studies have investigated the effects of eating onions or taking quercetin supplements on DHT levels in humans.

Other fruits and vegetables rich in quercetin include asparagus, spinach, kale, apples, and berries.

Black Women’s Mental Health Needs an Intervention

 

There’s no time like the present to talk about mental health. We’re in the middle of one of the biggest pandemics in modern human history and experts are worried that prolonged shelter-in-place orders and uncertainty may lead to more depression, anxiety, and stress. Stay-home orders also mean it’s harder to visit your therapist, psychiatrist, or other mental health-care professional, and that is doubly true for Black women, who already faced barriers to mental health care pre-Coronavirus. In fact, in a 2016 study, researchers found that Black patients were less likely to even receive a call back from potential therapists to schedule an appointment. Rather it be money, time, or stigma, there are still barriers standing in the way of Black women accessing adequate mental health care. So the question stands: How can Black women make their mental health a priority and access mental health care?

Your location impacts mental health care

We know there are barriers to mental healthcare for BIPOC (Black, Indigenous, and people of color)—there have been numerous studies sharing the many different ways Black and brown women miss out on crucial care. But when you stop and think about it, even something as seemingly innocuous as an address makes a difference. To Charmaine Williams, PhD, Vice-Dean of Students at the School of Graduate Studies, University of Toronto, location could be a deterrent for Black women accessing care. “I did a study and the travel times that people [Black women and women of color] were undertaking to get to help were astonishing,” says Dr. Williams. In a 2018 study, 46 percent of respondents had to drive an hour round trip or more to access mental health services. Systematically racist policies such as gerrymandering and redlining negatively impact access to mental health services for people of color. Additionally, Dr. Williams says we have to look at the professions of potential patients and how restrictive traditional therapist’s office hours are. A potential patient may be unable to leave work and meet a practitioner in the middle of the day; and many offices close at 5 p.m.

These obstacles can make the case for telemedicine, says Tichianaa Armah, MD, Medical Director and Vice President of Behavioral Health at Community Health Center, Inc. “I’ve been very much a proponent of telehealth, even before Covid-19 happened,” Dr. Armah says. “Some of my patients would have to take two or three buses before they can get here, so we [the Community Health Center] had actually been piloting this for several months already.”

Due to Coronavirus, there may be more opportunities to engage with telehealth, or some of the digital mental health providers, like Talkspace or Cerebral. These services are also significantly less expensive than traditional therapy, which can be anywhere between $50 to $250+ per private session.

The Black community still has stigmas we need to break through

There is this idea that millennials are the “therapy generation,” and that we’re more open about attending therapy, but that’s not necessarily the case for BIPOC millennials. “We need more black people sharing their [mental health] experience,” Dr. Armah laments. “People are suffering and they get care and then they feel better—while all of that’s happening, largely people don’t know about it. You never find that with my white patients—they’re sharing that info with each other.” Talking about therapy and mental health remains a taboo in so many BIPOC communities, and the National Alliance on Mental Illness (NAMI) says this stigma may stem from personal shame, and can even be familial stigma passed down through generations. Black people in particular are hesitant to “air family business,” aka share these issues with an outside party, and you may carry that notion with you far into adulthood.

Breaking away from those beliefs can be a major turning point for Black women seeking mental health care. In turn, you may be helping others. “Being open [about mental health care], can help you relate to a friend or family member; that really speaks volumes that we can be more open about pursuing help, “ says Dr. Armah.

Why Time—Not Just Money—Needs To Be Part of the Conversation About How To Make Wellness More Accessible

 

In an ideal world, Amber Nash would love to go to therapy once a month. She’d also be thrilled to take a 30-minute daily walk outside and lift weights three times per week. But as an entrepreneur and mother of three—including an infant—she simply doesn’t have time to consistently fit basic wellness practices like these into her life. Having her kids home full-time due to the COVID-19 pandemic is only making her feelings of time poverty worse, despite the fact that she’s fortunate enough to have part-time child care four days per week.

“I feel panicky and overwhelmed daily because I have no time for wellness or me-time and I’m just 5 months postpartum,” says Nash. “Because I’m nursing my new baby and working around meetings, I have only lifted weights once in August and once in July. It’s my go-to wellness activity.” Although she compensates by walking on a mini-treadmill at her desk, she knows she’s not feeling as well as she could if she were able to lift. And although she did make a therapy appointment months ago for postpartum issues, she ultimately wasn’t able to fit it in around work and parenting duties.

Nash’s story illustrates a reality that studies have confirmed for years: Time is a luxury, and many people don’t have enough of it to make wellness a regular practice. For instance, one 2018 survey showed that 35 percent of workers named time as the biggest barrier to sticking to wellness-related New Year’s resolutions. Another study, published in 2010, indicates that time may be more important than money when it comes to creating a regular exercise routine. That said, time poverty often goes hand-in-hand with financial poverty. If someone works multiple low-wage jobs, lacks access to transportation or childcare, or can’t afford time-saving solutions such as a dishwasher or grocery delivery, they’ll naturally have less free time available to focus on their own well-being.

Clearly, time needs to be part of the conversation when we talk about making wellness more accessible. Yet it’s largely been absent from the discussion up until this point, to the detriment of those who arguably need wellness practices the most. “Men and women who have been wellness geeks for years are not the ones that need help learning about self care, yet we continue to see a lot of solutions being created for the same self-selecting audience,” says Sabrina Mason, MPH, co-founder of hormonal health support platform Pollie. “What about single parents that work two shift jobs and don’t have enough money for proper child support? How do we reach them?”

COVID-19 has exacerbated the effects of time poverty, even among higher-wage earners. This is especially true for parents and other caregivers, many of whom are devoting extra time to their dependents in the face of school closures and social distancing. In a June survey, 67 percent of caregivers said that they or their partner were the family’s sole source of childcare that month. What’s more, caregivers who have lost childcare due to COVID-19 reported higher rates of stress and anxiety than those with childcare. A growing number of people are also caring for older family members due to the pandemic. In 2019, nearly 44 million Americans provided unpaid health-related care for their loved ones, but that number is believed to have doubled since COVID-19 hit the U.S.

Fortunately, a growing group of wellness entrepreneurs is creating platforms and programming with time poverty in mind. Some are creating A.I. tools that streamline the time-consuming process of finding and partaking in health care. Others are hosting bite-sized, virtual wellness workshops that can be accessed any time, any place. All are fueled by a desire to bring self care and health care to those without time privilege—and to ultimately make the industry more accessible for all.

How Behavioral Science Can Help Your Clients Stick to Their Goals

 

Does this sound familiar? You land a new client and they are eager and excited to train with you. They enjoy the workout you designed for them and then collaborate to determine some next steps they can do at home to support their progress. You feel good about the session, hopeful that you are going to be able to support change with this client, only to discover the following week that they have not done a single thing they said they would do. Each week you work together to come up with unique and important new positive steps to take, but it is no use; they aren’t doing any of it. You (and your client) may be feeling like you are running up against a brick wall and start to wonder, “Why won’t they just do what they say they are going to do?”

You are not alone. This is a common frustration for people in the health and fitness industry. It can lead to judgments about the client’s willpower, discipline or commitment to health and fitness. Understanding human behavior and why someone does or doesn’t do something can help both you and your clients move forward in a productive way. 

The Information-Action Fallacy

In his book Tiny Habits, Dr. BJ Fogg talks about the “Information-Action” fallacy. Most people think that if you offer people the right information it will change their behaviors. This is not true. Information alone does not reliably change behavior. If it did, everyone would eat a diet consisting only of nutrient-dense whole foods and always get adequate amounts of daily exercise.

When we make assumptions about a client’s lack of commitment, we are missing an opportunity to ask better questions. What you really want to know is “What is getting in the way of you being able to do this behavior?”

Fogg offers a reliable formula that will tell us whether or not someone is going to create—and stick to—a new behavior. Fogg purports that no behavior happens without this formula Behavior = Motivation + Ability + Prompt (B = MAP). In this model, a behavior only happens when the motivation, ability and prompt converge in the correct way. 

First, start by asking the “Discovery Question.” For example, “What is making this behavior hard to do?” You want to deconstruct any barriers to their successful completion of the behavior. For example, perhaps your client wants to walk four times a week for 30 minutes. Seems easy enough, but they aren’t doing it. Instead of giving up and moving on to a new behavior, first understand what is getting in the way. Really dig deep here—is it time? Ability? Weather? Routine? Desire? Once you understand what is getting in the way, you can work together to remove those barriers.

Creating Supportive Environments

After you have identified the barrier, it’s time to create the environment that supports the behavior the client wants to create. Does the envirnoment need to be altered to better support the behavior? Or does the behavior need to be adjusted to better support the environment?

Using the example of walking four times per week, altering the environment might include things like mapping out the specific route so the client knows where they’re headed, or getting a treadmill at home if walking outside is uncomfortable. Other possibilities include waking up 30 minutes earlier to fit in a walk or laying out exercise clothes the night before as a reminder. The key here is understanding what is getting in the way of walking consistentlyand adjusting the environment to fit the behavior.

If the client cannot adjust the environment, can they adjust the behavior? For example, the walking goal could be completed by breaking up the walk into three 10-minute walks to make the behavior easier to accomplish, or by doing two 10-minute walks on six days per week instead of four 30-minute walks per week. Again, understanding the barriers is the most important factor.

The next time you find yourself feeling frustrated about your client’s apparent lack of discpiline or willpower, try asking better questions. By understanding what might be getting in the way of completing the behavior, the client can adjust either the behavior or the environment to better suit their needs.

Prevention by Reducing Mosquito Bites

Prevention of mosquito bites is another way of preventing disease. The adult mosquitoes like to bite inside as well as around homes, during the day and at night when the lights are on. To protect yourself, use insect repellent on your skin while indoors or out, mosquito traps or mosquito nets. When used properly, repellents are safe for kids and adults alike. Keep in mind that even though some of them are classified as pesticides by the Environmental Protection Agency (EPA), repellents don't kill mosquitoes. So you may still see these annoying insects buzzing about. Repellents simply make it more difficult for mosquitoes to find you.

Common insect repellents include:

DEET (N,N-diethylmetatoluamide) blocks a mosquito's ability to find people who've applied it. Apply repellent with a 10% to 30% concentration of DEET to your skin and clothing. Choose the concentration based on the hours of protection you need — the higher the concentration of DEET, the longer you are protected. A 10% concentration protects you for about two hours. Keep in mind that chemical repellents can be toxic, and use only the amount needed for the time you'll be outdoors. Don't use DEET on the hands of young children or on infants younger than age 2 months.

Picaridin. This repellant, also called KBR 3023, offers protection that's comparable to DEET at similar concentrations. It also blocks a mosquito's ability to find people who've applied it. Picaridin is nearly odorless, which may make it a good alternative if you're sensitive to the smells of insect repellents.

Oil of lemon eucalyptus. This plant-based chemical may offer protection that's comparable to low concentrations of DEET. Don't use this product on children younger than 3 years.

Others. Shorter acting repellents that may offer limited protection generally contain plant-based oils such as oil of geranium, cedar, lemon grass, soy or citronella.

When possible, wear also long sleeves and pants for additional protection. Also, make sure window and door screens are secure and without holes. If available, use air-conditioning (see also prevention for travelers.

Clothing tips to keep in mind include:

- Wear long-sleeved shirts;

- Wear socks;

- Wear long pants and consider tucking your pants into your socks;

- Wear light-colored clothing, since mosquitoes are more attracted to darker colors;

- Apply mosquito repellent to your clothing, shoes, and camping gear and bed netting;

- Wear a full-brimmed hat to protect your head and neck;

- Consider wearing a mosquito net to cover your head and face or torso

Probiotic yogurt

Probiotics are the helpful bacteria that live in the human gut and improve digestion and overall health.

Some research from 2011 suggested that eating probiotic yogurt could improve cholesterol levels in people with type 2 diabetes. This could help lower the risk of heart disease.

One review study suggested that consuming probiotic foods may reduce inflammation and oxidative stress, as well as increase insulin sensitivity.

People can choose a natural yogurt, such as Greek yogurt, with no added sugar. A probiotic yogurt will contain live and active cultures called Lactobacillus or Bifidobacterium.

People can add berries and nuts to yogurt for a healthful breakfast or dessert.

Citrus fruits

Research has shown that citrus fruits, such as oranges, grapefruits, and lemons, have antidiabetic effects.

Eating citrus fruits is a great way to get vitamins and minerals from fruit without the carbohydrates.

Some researchers believe that two bioflavonoid antioxidants, called hesperidin and naringin, are responsible for the antidiabetic effects of oranges.

Citrus fruits are also a great source of:

• vitamin C
• folate
• potassium

The dietary approach to stop hypertension (DASH) plan

The DASH plan was originally developed to help treat or prevent high blood pressure (hypertension), but it may also reduce the risk of other diseases, including diabetes. It may have the additional benefit of helping you lose weight. People following the DASH plan are encouraged to reduce portion sizes and eat foods rich in blood pressure-lowering nutrients, such as potassium, calcium, and magnesium.

The DASH eating plan includes:

lean protein: fish, poultry

plant-based foods: vegetables, fruits, beans, nuts, seeds

dairy: fat-free or low-fat dairy products

grains: whole grains

healthy fats: vegetable oils

People with diabetes on this plan are advisedTrusted Source to reduce their sodium intake to 1,500 milligrams per day. The plan also limits sweets, sugary beverages, and red meats.

The Mediterranean diet

The Mediterranean diet is inspired by traditional foods from the Mediterranean. This diet is rich in oleic acid, a fatty acid that occurs naturally in animal and vegetable-based fats and oils. Countries that are known for eating according to this diet pattern include Greece, Italy, and Morocco.

A Mediterranean-type diet may be successful in lowering fasting glucose levels, reducing body weight, and reducing the risk of metabolic disorder, according to a study in Diabetes Spectrum.

Foods eaten on this diet include:

Protein: poultry, salmon and other fatty fish, eggs

Plant-based foods: fruits, vegetables like artichokes and cucumbers, beans, nuts, seeds

Healthy fats: olive oil, nuts such as almonds

Red meat may be consumed once per month. Wine may be consumed in moderation, as it may boost heart health. Remember to never drink on an empty stomach if you are on medications that raise the level of insulin in the body.

The paleolithic (paleo) diet

The paleo diet centers on the belief that modern agriculture is to blame for chronic disease. Followers of the paleo diet eat only what our ancient ancestors would have been able to hunt and gather.

Foods eaten on the paleo diet include:

Protein:meat, poultry, fish

Plant-based foods: nonstarchy vegetables, fruits, seeds, nuts (excluding peanuts)

Healthy fats:olive oil,avocado oil, coconut oil, flaxseed oil, walnut oil

The paleo diet may be a good option for people with diabetes as long as the person does not have kidney disease. According to a three-month study in the Journal of Diabetes Science and TechnologyTrusted Source, a paleo diet may improve glycemic control in the short term for people with type 2 diabetes.

The gluten-free diet

Gluten-free diets have become trendy, but for people with celiac disease, eliminating gluten from the diet is necessary to avoid damage to the colon and body. Celiac disease is an autoimmune disorder that causes your immune system to attack your gut and nervous system. It also promotes body-wide inflammation, which could lead to chronic disease.

Gluten is a protein found in wheat, rye, barley, and all foods made from these grains. According to the American Diabetes Association, 10 percent of those with type 1 diabetes also have celiac disease.

Ask your doctor for a blood test for celiac disease. Even if it comes back negative, you could still be intolerant to gluten. Talk with your doctor about whether a gluten-free diet is right for you.

While anyone with diabetes can take up a gluten-free diet, it may add unnecessary restrictions for those without celiac disease. It’s also important to remember that gluten-free is not synonymous with low carb. There are plenty of processed, high-sugar, gluten-free foods. There is usually no need to complicate meal planning by eliminating gluten unless you need to.

Vegetarian and vegan diets

Some people with diabetes focus on eating vegetarian or vegan diets. Vegetarian diets typically refer to diets where no meat is eaten, but animal products like milk, eggs, or butter can be consumed. Vegans will not eat meat or any other type of animal product, including honey, milk, or gelatin.

Foods that are healthy for vegetarians and vegans with diabetes include:

beans

soy

dark, leafy vegetables

nuts

legumes

fruits

whole grains

While vegetarian and vegan diets can be healthy diets to follow, those who follow them may be missing out on vital nutrients if they aren’t careful.

Some nutrients vegetarians or vegans may need to obtain through supplements include:

Calcium. Found largely in animal products like dairy, calcium is an important nutrient that contributes to the health of bones and teeth. Broccoli and kale can help provide necessary calcium, but supplements may be needed in a vegan diet.

Iodine. Required for metabolizing food into energy, iodine is predominantly found in seafood. Without these animal products in their diets, vegetarians and vegans may have trouble getting enough of the necessary iodine. Supplements can be beneficial.

B-12: Since only animal products have vitamin B-12, a supplement may be necessary for those following a strict vegetarian diet.

Zinc: The main source of zinc comes from high protein animal products, and a supplement may be advised for those on a vegetarian diet.

8 Causes of Night Sweats

Doctors often hear their patients complain of night sweats. Night sweats refer to excess sweating during the night. But if your bedroom is unusually hot or you are wearing too many bedclothes, you may sweat during sleep, and this is normal. True night sweats are severe hot flashes occurring at night that can drench your clothes and sheets and that are not related to an overheated environment.

It is important to note that flushing (a warmth and redness of the face or body) may be hard to distinguish from true night sweats.

There are many different causes of night sweats. To find the cause, a doctor must get a detailed medical history and order tests to decide what medical condition is responsible for the night sweats. Some of the known conditions that can cause night sweats are:

Menopause. The hot flashes that accompany menopause can occur at night and cause sweating. This is a very common cause of night sweats in women.

Idiopathic hyperhidrosis. Idiopathic hyperhidrosis is a condition in which the body chronically produces too much sweat without any identifiable medical cause.

Infections. Tuberculosis is the infection most commonly associated with night sweats. But bacterial infections, such as endocarditis (inflammation of the heart valves), osteomyelitis (inflammation in the bones), and abscesses can cause night sweats. Night sweats are also a symptom of HIV infection.

Cancers. Night sweats are an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, people who have an undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fevers.

Medications. Taking certain medications can lead to night sweats. Antidepressant medications are a common type of drug that can lead to night sweats. From 8% to 22% of people taking antidepressant drugs have night sweats. Other psychiatric drugs have also been associated with night sweats. 

Medicines taken to lower fever, such as aspirin and acetaminophen, can sometimes lead to sweating. 

Many other drugs can cause night sweats or flushing.

Hypoglycemia. Low blood sugar can cause sweating. People who are taking insulin or oral diabetes medications may have hypoglycemia at night that is accompanied by sweating.

Hormone disorders. Sweating or flushing can be seen with several hormone disorders, including pheochromocytoma, carcinoid syndrome, and hyperthyroidism.

Neurologic conditions. Uncommonly, neurologic conditions including autonomic dysreflexia, posttraumatic syringomyelia, stroke, and autonomic neuropathy may cause increased sweating and may lead to night sweats.

As a consumer can I use public health services?

• Yes! Most local and state health departments offer services such as vaccinations at discounted cost.
• Check their websites or visit your local health department to obtain a listing of all services offered.

What public health consumers can observe/ask:

If you are taking advantage of services offered through your local or state health department:

• Make sure public healthcare providers are cleaning their hands before and after touching you, even if they will be wearing gloves. It’s okay to ask them to clean their hands if you have not seen them do so.
• During visits where you or your loved one may get vaccinations remember to ask if the needle and syringe have been newly opened for you; syringes and needles should only be used one time and on one patient.
• If you are having dental work done at the local health department, ask how the instruments are cleaned between uses.
• Ask about other services the health department provides that may help you maintain a healthy lifestyle.

If you are given an antibiotic by a public healthcare provider, be sure to ask the following questions:

• “Do I really need an antibiotic?”
• “Can I get better without this antibiotic?”
• “What side effects or drug interactions can I expect?”
• “What side effects should I report to you?”
• “How do you know what kind of infection I have? I understand that antibiotics won’t work for viral infections.”

What family members or other visitors can do in the public health setting:

• Family members accompanying you and other visitors to the public health department should wear a mask to cover their nose and mouth if they have signs of a respiratory infection.
• Practice good hand hygiene while in the public health department.
• Make sure to cover your mouth when coughing or sneezing and promptly clean hands.

Super-Foods for New Moms: Salmon

There's no such thing as a perfect food. But salmon is pretty close to it when it comes to a nutritional powerhouse for new moms. Salmon, like other fatty fish, is loaded with a type of fat called DHA. DHA is crucial to the development of your baby's nervous system. All breast milk contains DHA, but levels of it are higher in the milk of women who get more DHA from their diets.

The DHA in salmon may also help your mood. Studies suggest it may play a role in preventing postpartum depression.

One caution: The FDA recommends that breastfeeding women, women who are pregnant, and women who might get pregnant limit how much salmon they eat. The guidelines recommend an average of 12 ounces, or the equivalent of two main servings, per week. The reason is to limit the amount mercury your new child is exposed to.

The mercury level in salmon is considered low. Some other fish, such as swordfish or mackerel, have a high amount of mercury and should be avoided altogether. The 12 ounces are an average. Eating more in 1 week -- such as having three servings instead of two -- won't hurt as long as you eat less the following week.

Diagnosing Mild Cognitive Impairment in Women

Memory slip-ups can be a normal part of getting older. They can also be side effects of medications, a temporary consequence of menopause, or early signs of dementia.

So, how can doctors tell what’s normal? New research suggests it depends on your sex.

“Women have a verbal memory advantage over men that may allow them to compensate for Alzheimer’s-related brain changes for longer than men,” says Erin Sundermann, PhD, a researcher at University of California-San Diego and author of the new study.

Cognitive tests, which include remembering as many words as possible from a list, help doctors determine whether changes in a person’s memory are cause for concern. If you score below a certain threshold, you might have mild cognitive impairment, or MCI. That’s a decline in thinking skills beyond just normal aging. MCI can, but not always, progress to dementia.

The problem with the memory tests is that cut-off scores for MCI don’t reflect that women tend to have stronger verbal memory than men.

In a study of 985 older adults, based on standard scoring, a quarter of the women and nearly half the men had MCI. But, based on sex-specific averages, just more than a third of both women and men had MCI.

To figure out which scoring method gave the correct diagnosis, the researchers looked for plaque deposits in the brain that signal the presence of Alzheimer’s. Women who had MCI based on sex-specific scores, but not based on standard scoring, had Alzheimer’s-related plaques in their brains. Men who were normal by sex-specific standards had no plaques in their brains.

Want Brighter, Whiter Teeth?

Have your pearly whites lost their luster because of dingy gray or yellow stains? Stained teeth can occur as we age, but some common foods, drinks, and even mouthwashes can stain teeth. Do-it-yourself remedies can help whiten teeth, and avoiding substances that stain teeth can stop further discoloration. Use these secrets to whiter teeth to restore your bright smile.

Do-It-Yourself Teeth Whitening

You may be able to get rid of superficial stains by yourself. A number of at-home tooth-whitening products -- kits, strips, toothpastes, and rinses-- may lighten stains. There are even some old-fashioned remedies you can try. Tooth-whitening products available on drugstore shelves use mild bleach to brighten yellow teeth. Toothpastes use abrasives and chemicals to remove surface stains. For deep stains, you may need a dentist's help.

Tooth-Whitening Kits

A home tooth-whitening kit contains carbamide peroxide, a bleach that can remove both deep and surface stains and actually changes your natural tooth color. If you have coffee-stained teeth, a tooth-bleaching kit can help. With some kits, you apply a peroxide-based gel (with a small brush) to the surface of your teeth. In other kits, the gel is in a tray that molds to the teeth. The tray must be worn daily (for 30 to 45 minutes) for a week or more.