Q: I read that belly fat is dangerous. I have a potbelly. What can I do to lose it?
A: Belly fat is dangerous because it is associated with type 2 diabetes, heart disease and hypertension. It is not possible to lose just belly fat.
You need to reduce your intake of calories, (eat 75 per cent of what you are eating now), reduce carbohydrate and increase the fruit and vegetable content of your diet. You also need to exercise — jog, run, walk or swim for at least 40 minutes, five to six days a week. Also, women need to ensure that their waists are smaller less than 35 inches and men less than 40 inches.
Q: I go for a 40-minute walk every morning, but I feel exhausted at the end of it.
A: Your body probably needs some fuel before your walk, but not a full meal. Eat a banana a half hour before you leave the house. It will provide calories, which are released slowly during the exercise. It also contains potassium and other nutrients that will help with the fatigue.
Q: I am 65 years old. I had a hysterectomy around 15 years ago. Last night, I saw blood in my urine. There is no fever or pain.
A: Painless haematuria (blood in the urine) is a sinister symptom at your age. Most of the harmless causes like stones or infection cause pain and/or fever. Do a routine urine analysis to make sure it really is blood and not some dye you ingested
in the food or vegetables like beetroot. If there is blood then please consult a urologist for further treatment.
Q: I got up awkwardly and my knee started to pain. There is no obvious swelling.
A: Rest the knee for two or three days, apply ice packs for 10 minutes every 3-4 hours, bandage the knee with an elastocrepe bandage, and take a paracetemol (500 mg) if the pain is severe. If it is not better after two days, you need to consult an orthopaedic surgeon to see if there is anything seriously wrong with your knee.
Q: I am on medication for epilepsy and want to stop to become pregnant.
A: If you stop treatment, you might have a seizure while pregnant. This can adversely affect the baby. If you are worried about congenital malformations, the statistics are reassuring. In the general population, the risk for congenital malformations is 2-4 per cent. With anti-epileptic medication the risk is marginally higher, 4-6 per cent. Work closely with your obstetrician and neurologist and follow their advice.
Q: My right eye twitches and I am unable to control it. This happens several times during the day. Is it dangerous?
A: This involuntary twitching is usually harmless and will eventually stop by itself. It may be caused by fatigue, stress or excessive caffeine. Rarely, it may be due to inflammation of the eyelids, light sensitivity or conjunctivitis. If it lasts more than two weeks, consult an ophthalmologist.
Q: My teeth are stained light brown. What do I do?
A: All kinds of things can stain the teeth — tea, coffee, carbonated drinks, fruits like pomegranate, betel leaf (pan) and tobacco. You could try brushing your teeth twice a day and rinsing out your mouth thoroughly after eating.
Parents, please note — want to know where your child is suffering from bipolar disorder? It’s simple for a study says that irritability should be considered when diagnosing for the condition.
Researchers at Bradley Hospital in Providence have found that some kids with bipolar disorder experience manic episodes without extreme elation — one of the hallmarks of the disorder — and are diagnosed based on irritable mood.
“Our findings confirm that while irritable-only mania is uncommon, it does exist — particularly in younger children — and should be considered in a bipolar diagnosis,” Jeffrey Hunt, who led the study, said in a statement.
For their study, the researchers quantified frequency and severity of manic symptoms — including irritability and elation — in 361 children, all between the ages of 7 and 17, already diagnosed with bipolar disorder.
The researchers found 10% of children were irritable-only and about 15% were elated-only. Nearly three-quarters experienced both elation and irritability, the findings revealed.
When events over which people feel they have no control occur, or when they are inevitable but unpleasant, people say, “I am depressed.” They feel down and out. Depression can be medically diagnosed not merely when changes in outlook and mood negatively affect behaviour, thinking and normal functioning, but only if they have lasted two weeks or longer.
Depression appears to be a nebulous entity, “all in the head”, and is often summarily dismissed as just that. In a way it is true, because medically, depression occurs when the neurotransmitters — chemicals responsible for carrying messages in the brain — are unbalanced and out of sync. It can start in childhood, but usually becomes obvious between the ages of 25 and 44. This is a time when the external stresses of life are at their peak. It probably results from a combination of genetic, biochemical, environmental and psychological factors.
The onset of depression appears with the insidious onset of vague sadness, irritability, anxiety, fatigue, loss of energy, altered eating habits with weight gain or loss and decreased concentration. Physical symptoms like headache, digestive symptoms and vague aches and pains may set in. None of these, on investigation, entail identifiable diagnostic abnormalities, nor do they respond to conventional medical treatment. Subconscious attempts by the individual to artificially boost one’s mood may manifest as drug or alcohol abuse. It may remain unrecognised by family, peers and society until there’s a suicide attempt.
The Greeks had a name for long lasting depression. They called it “dysthymia”, a diagnostic term still in use. The symptoms of dysthymia are mild and last from 3-5 years. Affected people are always sad, pessimistic, socially withdrawn and unproductive. Major depression, on the other hand, shows negative mood changes that may be overwhelming. This, if untreated, can last from six months to one and a half years. A combination of stressful situations leads to a type of depression called an “adjustment disorder”. Manic-depression or bipolar disorder results in extreme mood swings, alternating between sadness and withdrawal and reckless mood elevation, insomnia, increased libido and grandiose ideas.
All types of depression are more common in women. Hormonal changes in women — pre-menstrual and during menopause and childbirth — directly alter the neurotransmitter ratios in the brain and make them vulnerable to depression. A particular type, called post partum (after childbirth) depression, is peculiar to women.
Depression is not a normal or inevitable part of ageing. Depression can set in with age, as a result of external causes like financial insecurity, illnesses and loss of a spouse, or physical factors like atherosclerotic blood vessels with compromised blood flow to the brain.
Children and adolescents can also develop depression. They feign illness, refuse to go to school, sulk, get into trouble, or are disruptive, negative and irritable.
Depression must be treated before it spirals out of control. Treatment with psychotherapy (talking) and medication leads to 80 per cent recovery and normal productive lives.
Antidepressants must be taken regularly for three to four weeks before the full therapeutic effect appears. The medication should then be continued for the time specified by the doctor, despite apparent improvement, to prevent a relapse.
If you are depressed:
Feelings of tiredness and hopelessness are part of depression and, even though it may be difficult, go to a therapist and begin treatment.
• Engage in regular physical exercise. The chemicals released during the activity will cross the blood brain barrier and elevate your mood. Physical fitness is a great morale booster.
• Go to a movie, or visit a friend.
• Participate in religious, social or cultural activities.
• Set realistic goals.
• Large tasks may appear formidable and insurmountable, but can be completed if broken into smaller ones, and then prioritised without guilt.
Try to spend time with other people and speak to a trusted friend or relative. Isolating yourself prevents others from reaching out to you.
It is better to postpone life-altering decisions like marriage, divorce or a job change till the depression lifts.
Mood improves gradually. It does not become elevated overnight, nor is it possible to “snap out” of depression. Improvement is often as insidious as the onset. Sleep patterns revert to normal and appetite becomes normal even before the mood lifts. Positive thinking replaces negative thoughts as the depression starts to respond to treatment.
Those around depressed souls also need to be conscious. They can help by listening to them, providing encouragement and not making demands that may heighten their sense of failure. Any reference to suicide is a red flag — an appeal for help and urgent intervention. It must be taken seriously.
For decades, people suffering from chronic fatigue syndrome have struggled to convince doctors, employers, friends and even family members that they were not imagining their debilitating symptoms. Skeptics called the illness“yuppie flu” and “shirker syndrome.”
CLICK & SEE
Donna Flowers was once debilitated by chronic fatigue but has tamed her disease with exercise and treatment.
But the syndrome is now finally gaining some official respect. The Centers for Disease Control and Prevention, which in 1999 acknowledged that it had diverted millions of dollars allocated by Congress for chronic fatigue syndrome research to other programs, has released studies that linked the condition to genetic mutations and abnormalities in gene expression involved in key physiological processes.
The agency has also sponsored a $6 million public awareness campaign about the illness. And last year, it released survey data suggesting that the prevalence of the syndrome is far higher than previously thought, although these findings have stirred controversy among patients and scientists.
Some scientists and many patients remain highly critical of the C.D.C.’s record on chronic fatigue syndrome. But nearly everyone now agrees that the syndrome is real.
“People with C.F.S. are as sick and as functionally impaired as someone with AIDS, with breast cancer, with chronic obstructive pulmonary disease,” said Dr. William Reeves, the lead expert on the illness at the disease control agency, who helped expose its misuse of chronic fatigue financing.
Chronic fatigue syndrome was first identified as a distinct entity in the 1980s. (A virtually identical illness had been identified in Britain three decades earlier and called myalgic encephalomyelitis.) The illness, which afflicts more women than men, causes overwhelming fatigue, sleep disorders and other severe symptoms. No consistent biomarkers have been identified and no treatments have been approved for addressing the underlying causes, although some medications provide symptomatic relief.
Patients say the word “fatigue” does not begin to describe their condition. Donna Flowers of Los Gatos, Calif., a physical therapist and former professional figure skater, said the profound exhaustion was unlike anything she had ever experienced.
“I slept for 12 to 14 hours a day but still felt sleep-deprived,” said Ms. Flowers, 51, who fell ill several years ago after a bout of mononucleosis. “I had what we call ‘brain fog.’ I couldn’t think straight, and I could barely read. I couldn’t get the energy to go out of the door. I thought I was doomed. I wanted to die.”
Studies have shown that people with the syndrome experience abnormalities in the central and autonomic nervous systems, the immune system, cognitive functions, the stress response pathways and other major biological functions. Researchers believe the illness will ultimately prove to have multiple causes, including genetic predisposition and exposure to microbial agents, toxins and other physical and emotional traumas. Studies have linked the onset of chronic fatigue syndrome with an acute bout of Lyme disease, Q fever, Ross River virus, parvovirus, mononucleosis and other infectious diseases.
“It’s unlikely that this big cluster of people who fit the symptoms all have the same triggers,” said Kimberly McCleary, president of the Chronic Fatigue and Immune Dysfunction Syndrome Association of America, the advocacy group in charge of the C.D.C.-sponsored awareness campaign. “You’re looking not just at apples and oranges but pineapples, hot dogs and skateboards, too.”
Under the most widely used case definition, a diagnosis of chronic fatigue syndrome requires six months of unexplained fatigue as well as four of eight other persistent symptoms: impaired memory and concentration, sore throat, tender lymph nodes, muscle pain, joint pain, headaches, disturbed sleeping patterns and feelings of malaise after exertion.
The broadness of the definition has led to varying estimates of the syndrome’s prevalence. Based on previous surveys, the C.D.C. has estimated that more than a million Americans have the illness.
Last month, however, the agency reported that a randomized telephone survey in Georgia, using a less restrictive methodology to identify cases, found that about one in 40 adults ages 18 to 59 met the diagnostic criteria — an estimate 6 to 10 times higher than previously reported rates.
Many patients and researchers fear that the expanded prevalence rate could complicate the search for consistent findings across patient cohorts. These critics say the new figures are greatly inflated and include many people who are likely to be suffering not from chronic fatigue syndrome but from psychiatric illnesses.
“There are many, many conditions that are psychological in nature that share symptoms with this illness but do not share much of the underlying biology,” said John Herd, 55, a former medical illustrator and a C.F.S. patient for two decades.
Researchers and patient advocates have faulted other aspects of the C.D.C.’s research.
Dr. Jonathan Kerr, a microbiologist and chronic fatigue expert at St. George’s University of London, said the agency’s gene expression findings last year were “rather meaningless” because they were not confirmed through more advanced laboratory techniques.
Kristin Loomis, executive director of the HHV-6 Foundation, a research advocacy group for a form of herpes virus that has been linked to C.F.S., said studying subsets of patients with similar profiles was more likely to generate useful findings than Dr. Reeves’s population-based approach.
Dr. Reeves responded that understanding of the disease and of some newer research technologies is still in its infancy, so methodological disagreements were to be expected. He defended the population-based approach as necessary for obtaining a broad picture and replicable results. “To me, this is the usual scientific dialogue,” he said.
Dr. Jose G. Montoya, a Stanford infectious disease specialist pursuing the kind of research favored by Ms. Loomis, caused a buzz last December when he reported remarkable improvement in 9 out of 12 patients given a powerful antiviral medication, valganciclovir. Dr. Montoya has recently completed a randomized controlled trial of the drug, which is approved for other uses, but the findings have not been released.
Dr. Montoya said some cases of the syndrome were caused when an acute infection set off a recurrence of latent infections of Epstein Barr virus and HHV-6, two pathogens that most people are exposed to in childhood. Ms. Flowers, the former figure skater, had high levels of antibodies to both viruses and was one of Dr. Montoya’s initial C.F.S. patients.
Six months after starting treatment, Ms. Flowers said, she was able to go snowboarding and take yoga and ballet classes. “Now I pace myself, but I’m probably 75 percent of normal,” she said.
Many patients point to another problem with chronic fatigue syndrome: the name itself, which they say trivializes their condition and has discouraged researchers, drug companies and government agencies from taking it seriously. Many patients prefer the older British term, myalgic encephalomyelitis, which means “muscle pain with inflammation of the brain and spinal cord,” or a more generic term, myalgic encephalopathy.
“You can change people’s attributions of the seriousness of the illness if you have a more medical-sounding name,” said Dr. Leonard Jason, a professor of community psychology at DePaul University in Chicago.
Sleep deprivation can alter your levels of thyroid and stress hormones, which play a part in everything from your memory and immune system to your heart and metabolism. Over time, lack of sleep can lead to:
Fortunately, there are many steps you can take to get the sleep your body craves. Here are 10 to start with (and the link below has 14 more):
1. Sprinkle just-washed sheets and pillowcases with lavender water, and then iron them before making your bed. The scent is proven to promote relaxation.
2. Hide your clock, so that its glow won’t disturb you and make sure there is no light coming from other sources including your windows as this will seriously impair your body’s ability to produce melatonin.
3. Choose the right pillow — neck pillows, which resemble a rectangle with a depression in the middle, can enhance the quality of your sleep and reduce neck pain.
4. Paint your bedroom sage green, or another soothing color, which will provide a visual reminder of sleep.
5. Move your bed away from outside walls, which will help cut down on noise.
6. Kick your dog or cat out of your bedroom — studies have shown that they snore!
7. Take a hot bath 90 to 120 minutes before bedtime; it increases your core body temperature, and when it abruptly drops when you get out of the bath, it signals your body that you are ready for sleep.
8. Keep a notepad at your bedside — if you wake in the middle of the night with your mind going, you can transfer your to-do list to the page and return to sleep unworried.
9. Put heavier curtains over your windows –– even the barely noticeable light from streetlights, a full moon, or your neighbor’s house can interfere with the circadian rhythm changes you need to fall asleep.
10. Eat a handful of walnuts before bed — they’re a good source of tryptophan, a sleep-enhancing amino acid.