Monday, July 27, 2020

A lump in my throat.

Back maybe 10 or 15 years ago, I had a large bump appear on my throat. It was mostly fluid and around my thyroid so it was drained, tested, and deemed fine. No mention was ever made about follow up. About 2 years ago, I noticed my skin seemed drier than normal, and my eyebrows disappeared. A number of other symptoms led me to an endocrinologist and some nodules were found. Again, tested and found benign, so blood work was done the following year and this year, an ultrasound was added. The nodules hadn't changed, but I noticed my TSH had jumped up, and when I brought up concerns about at what point do we take action, my concerns were glossed over and I was told they'll recheck in 6 months, if needed. At this point, I found a new endocrinologists office, one with staff that actually listen to what you have to say, answer your questions, and explain everything. Here, they did a test called thyroid peroxidase antibodies (TPO). Since my number was high, that meant I was currently having a bout of Hashimoto's disease (HD). Being an autoimmune disease, that is, a disease that causes the body to attack itself, it can come and go, so a negative TPO may just mean that HD is not currently active. Women are particularly prone to HD,  and it is the leading cause of hypothyroidism. Symptoms include dry skin and hair, weight gain, slowed heart beat, heavy or irregular periods. The other autoimmune disease that effects the thyroid is Grave's disease (GD). In the case of  GD, you tend towards hyperthyroidism with fatigue, weight loss, and trouble sleeping being some of the symptoms. I'm still in watch and wait mode, but I understand when to be concerned and what the next steps will be. Since women tend more towards thyroid issues than men, their concerns were often dismissed as normal changes. So if things don't feel quite right, ask your doctor about checking out your thyroid. And don't let them tell you it's all in your head.

Thursday, March 12, 2020

Muh-Muh-Muh-My Corona

Covid-19 is all over the news, and I'm not going to repeat all those how-to-stay-healthy tips (and you should have been doing those things all along anyway). Being someone who works from home, I have the drill down pretty well. But thousands of people are being thrown into telecommuting situations without even a life vest. So let's look at the basics. You will need at least a decent internet connection and a device to connect with. Since you may be spending many hours on this device, a laptop or desktop may be more comfortable for you than your phone or tablet. If you'll be doing phone conferencing, invest in a headset and bone up on proper etiquette. For a videoconference, there are additional things to remember (and really, really remember others can see you. I was once on a videoconference and the moderator occasionally lost the battle of the eyeroll, if you know what I mean.)

 If you don't have internet at home, then you need to find a place with free wi-fi from which to work. Libraries are great places for that (and also for people who don't have laptops at home, but you'll have to check your local library to see what their rules are for reserving a computer and how long a stretch you can use one.) There are also plenty of cafes out there with wi-fi, just be polite and buy something, don't just tie up their seating. If this is going to be a long-term arrangement or you will be doing a lot of phone conferences, you may want to look into co-working spaces, and your company may agree to pay the cost. It's much cheaper than renting office space and there are no long-term contracts. Plus, someone conducting a business meeting or conference on their computer in a public place can be really annoying to the other folks in that space.

Once you have all the nuts and bolts worked out, you need to work on your attitude. When you're in an office, your brain is in at-work mode. Now you need to transfer that attitude to an environment that will have more distractions and temptations to draw you away. Inc. has some great tips for telecommuters. If you're the boss, or you want to score some points with the boss, Fast Company offers these strategies for setting up work-at-home during the corona crisis. And since work is also a social place, these companies have found ways to keep up the social vibe.

You may find you enjoy working from home, so keep good records to show how productive you are and maybe you'll be able to telecommute more often. Keep healthy folks, and stock up on some limes to go with that Corona.

Thursday, January 30, 2020

Dem Bones

I belong to a group of cancer survivors that works out at the local YMCA. We have a regular group workout twice a week, which is great time to share information. Two members of the group had questions about calcium supplementation and, being the good medical librarian that I am, I said I would send them some articles to share with their doctors so that they could find out what is best for their individual health. And I must say, calcium is quite the can of worms, when you get right down to it. One person was wondering if there were guidelines on how much calcium you should get from supplements as opposed to the food you eat. Short answer: no. The Mayo Clinic has good information on what foods are high in calcium; combinations of calcium and medicines or other foods that don't work well, and the risks of too much calcium. Of course, your body most readily absorbs calcium from foods, with dairy products being the easiest to absorb. But each body is different; maybe you're lactose intolerant so avoid dairy, or you can't eat enough dark leafy veggies. So there is no set percentage, but getting as much of your calcium as possible from your diet is best. There's also the question of Vit D. It helps the body absorb calcium, which is why most milk has Vit D added. So you may be getting enough calcium, but if your body is not producing enough Vit D, you may not be absorbing all of it. A physical often includes a blood test that provides your level of calcium and Vit D, which is a good place to start when talking with your physician about supplements.

The other member had a more complicated issue. The orthopedist recommended doubling calcium from 1000 to 2000 due to osteopenia; the internist said no, calcium supplementation increases the risk of heart attack. There are a lot of studies looking at the pros and cons of calcium supplements. This article has a good summary of the current research. Again, this is not a question with a yes or no answer. The research is not strong enough to definitively say that calcium supplementation increases your risk of heart attack, or that it increases your risk of kidney stones, nor does it definitively say it will prevent osteoporosis. It depends on an individuals health and an individuals needs. That's why educating yourself about your health issues is important. It allows you to ask the questions so that you can make informed decisions about your health, no bones about it.

Tuesday, December 17, 2019

Damsel in Distress

The last half of 2019 has been a doozy, as I have experienced loss in family, friends, and work. There is lots of information on the stages of grief, which most people associate with the death of a loved one . But those stages, in some form, are associated with any kind of grief, such as a divorce, job loss, flunking out of school, etc. Piling on a number of incidents makes it hard to process as you may be in one stage for loss A but just starting with loss B; it gets complicated. People deal with emotional distress in a number of ways (chocolate and rose tea is my favorite for simpler things), but one method that has helped people who are not only experiencing grief, but who may regularly experience depression, anxiety, and a number of other psychological problems is DBT (dialectical behaviour therapy). Originally developed to help people with borderline personality disorder, DBT is now used to help people deal with almost any negative emotional problem. Some people may be more familiar with CBT (cognitive behavioural therapy), also known as talk therapy. CBT is short-term and focuses on the present; DBT looks at the long-term, offering lifestyle changes to get you through future trials.

DBT looks at four life skills: distress tolerance, emotional regulation, mindfulness, and interpersonal effectiveness. You learn to recognize and label your emotions; react without impulse; be attentive to the present moment, being aware of yourself and others; and interact assertively so you can navigate through conflicts. Therapy can be one-on-one, in a group, or a combination, depending on the therapists available in your area.To find a trained DBT therapist, search the DBT-Linehan certification site. You can also search for  group DBT sessions, if you prefer working with a group rather than one-on-one. Give yourself permission to seek out help and feel what your are feeling. I am, and am stronger for it.

Wednesday, November 20, 2019

SAD but True

When the September equinox hits, I know it's time to plug in the light therapy box because the days will be getting shorter. Yes, seasonal affective disorder, SAD, is a reality in our household. What is SAD? It's a form of depression, so not something you want to self-treat without speaking to a doctor first. Some folks call it the winter blues because it generally starts in the fall and goes through until the days start getting longer again, although there is a form that occurs spring and summer. You may feel worthless, sluggish, lose interest in things, find your appetite has changed, symptoms similar to depression.

Your doctor will possibly run some lab tests and conduct a physical and psychological evaluation to determine what is going on. There are a variety of treatments, depending on what the exam finds. Lifestyle changes include psychotherapy to teach you coping skills, and mind-body therapy to help you relax. Exercise is also a good way to raise your spirits, particularly if you have a goal to work towards (mine is doing an unassisted chin up). Some folks find they need medication, and your doctor may prescribe an antidepressant.

There are also those that find a light therapy box helpful. Although these are not prescription items, it is still best to talk it over with your doctor before purchasing one. Those with bipolar disorder, eyes that are vulnerable light damage, conditions that make your skin sensitive to light, or are on medications that cause sensitivity to sunlight may not be able to use light therapy. If your doctor gives you the OK, be sure to purchase a light that is low in UV emissions and has at least 10,000 lux of light. And like SAD, timing is everything. Starting at the fall equinox helps keep your body on a more even keel, rather than starting when symptoms start, as it can take 4 to 6 weeks to really do any good. Time of day is important; you want to turn your light on within the first hour of waking up in the morning and you want to sit there for 20 to 30 minutes. It's a great excuse for that second cup of coffee or taking the time to finish your crossword puzzle. And if you want to work that mind-body connection, do like I do and pretend you're enjoying the sun on a tropical beach.

Saturday, October 19, 2019

Stop the World, I want to Get Off.

Remember when as a kid, we delighted in those playground merry-go-rounds that could make us so dizzy we walked drunk for the next five minutes? Funny how that same feeling is no longer a joy. When you get older, it gets lumped under the term dizziness. You may feel faint, like you're going to pass out, or you may have vertigo, the feeling that the world is spinning around you. Either way, your sense of balance is off, and that can be a scary thing, particularly in older people. I had my first bout of vertigo about 15 years ago or so. They sent me in for a VNG, and I'm telling you now, be sure you have a ride home arranged because you won't be driving, or walking straight, anytime soon after that. It did show that my problem was not in the brain, but in my ears. It went away on its own, and I did not have much trouble with it until recently.

The body just seems to know when you have a vacation planned and decides what can I throw at you now. I was getting the spins, and since I was getting my weekly allergy shot, I mentioned it and the doctor checked out my ears for wax, which was a negative, and set me up with a physical therapist. That may sound odd at first, but these are therapists that are trained in maneuvers that help reposition little crystal-like particles called otoliths. It's what is called benign paroxysmal positional vertigo, or BPPV. There are other causes of vertigo, and your doctor will determine which it is, but in my case, this is the culprit. What does the therapist do? Canalith repositioning is one procedure, Eppley maneuver is another. Some therapists will show you a modified home version, but mine does not for fear of someone doing it incorrectly and making a bad situation worse. After the first session, I can see what she meant. I felt miserable and needed someone to drive me home. Being a glutton for punishment, and since the therapist needed to repeat the sequence, which she could not do the first visit because of said misery, I came back next morning. That went much more smoothly, and one more visit should do it, I hope.

Some folks suffer from motion sickness, and that is generally helped by medication If it's not too bad, over-the-counter medications like Bonine or Dramamine usually work. But some people need something stronger. That's where a Transderm Scop comes in. These are good for three days coverage and say the are less likely to cause drowsiness.

To an extent, the body adapts to a new normal, learning ways to bend over while keeping your head up, not turning rapidly, etc. I guess my playground days are over, but I know I'll find new ways to dizzy up the girl.

Thursday, October 3, 2019

I Would Gladly Pay You Tuesday... .

I don't pay much attention to the fast food market, but friends who recently became vegetarian are all over the new kids on the block, the Impossible Burger and its ilk. First, some disclosure: I am an omnivore, but I don't hold vegetarianism or veganism against anyone. Having raised kids in this day and age, I have become accustomed to asking about dietary restrictions before making anyone any food. I understand the avoidance of certain foods due to allergies, religious convictions, and  health considerations. I'm all for sustainability and for watching my environmental footprint not only in food matters, but other ways. What I can't get my head around is, if you have given up meat by choice, i.e. no allergies, religious bias, or health consideration, why would you consider yourself healthier and a better person because you eat what is basically Frankenmeat? Yes, I know, these knew products taste and bleed just like the real thing, but have you sat down and read the label? Although they are made from proteins such as soy or pea, the first ingredient is water, and the long list after the protein generally includes oils, sweeteners, and binders, all of which need to undergo some kind of processing to make them usable by the human body. Even those soy beans and peas have been processed to isolate the protein, and whatever vitamins were in there have to be added back in because the processing stripped them away.

Raising meat of any kind takes energy. You need a food supply and water for the animals. You need to properly dispose of the waste stream. And you need to process, package, and distribute the meat, all of which uses energy. Raising vegetables and fruits also requires food in the way of fertilization and water. You need to properly dispose of the waste stream, and you need to process, package, and distribute the produce. Beyond Meat had the University of Michigan conduct a "cradle to consumption" analysis comparing the Beyond Burger to a beef burger. According to their research, Beyond was more environmentally friendly overall when compared to the generalized beef industry. What they did not look into, nor were they charged to do, is what impact eating highly-processed food has on humans. That, we actually know already, hence the obesity epidemic in our country.

The NIH has a very simple formula for a healthy diet. If you don't want to eat meat, eggs, or dairy, you then need to find substitutes for the nutrients our body needs that may come from these foods. Protein can be found in beans and nuts, calcium in dark leafy greens, good fats come from things like olives or seeds. Rather than swapping out a highly processed beef frank for a highly processed meatless frank, we need to go back to doing more of the processing ourselves and purchasing what we eat as locally as possible. It's good for the environment, good for our body, and good for the soul. We are much like Wimpy (from Popeye cartoons, for those too young to know), wanting to pay down the road for that burger today. What happens when Tuesday comes? Do we pay with our health, our planet, or do we find a middle road? Food for thought, indeed.