Influenza, a viral infection, illness that can range from mild to life-threatening

Influenza, commonly known as "the flu," is a viral infection of the respiratory tract that affects the nose, throat, and sometimes lungs.

 tend to happen annually, at about the same time every year. This period is commonly referred .

However, each outbreak may be caused by a different subtype or strain of the virus, so a different flu vaccine is needed to prevent the flu each year.

For most people, a bout of flu is an unpleasant but short-lived illness.

For others, however, flu can pose serious health risks, particularly if complications such as pneumonia develop.

Every year, thousands of Americans die from the flu. According to the Centers for Disease Control and Prevention (CDC), the number of deaths caused annually by flu in the United States ranged from 3,000 to 49,000 between 1976 and 2006, with an annual average of 23,607 flu-related deaths.

The best way to avoid getting the flu is to get an annual flu vaccination, encourage the people you live and work with to do likewise, stay away from people who are sick, and wash your hands frequently.

Influenza, a viral infection, illness that can range from mild to life-threatening

Influenza, commonly known as "the flu," is a viral infection of the respiratory tract that affects the nose, throat, and sometimes lungs.

 tend to happen annually, at about the same time every year. This period is commonly referred .

However, each outbreak may be caused by a different subtype or strain of the virus, so a different flu vaccine is needed to prevent the flu each year.

For most people, a bout of flu is an unpleasant but short-lived illness.

For others, however, flu can pose serious health risks, particularly if complications such as pneumonia develop.

Every year, thousands of Americans die from the flu. According to the Centers for Disease Control and Prevention (CDC), the number of deaths caused annually by flu in the United States ranged from 3,000 to 49,000 between 1976 and 2006, with an annual average of 23,607 flu-related deaths.

The best way to avoid getting the flu is to get an annual flu vaccination, encourage the people you live and work with to do likewise, stay away from people who are sick, and wash your hands frequently.

11 Struggles Every New Runner Understands

I've never been one of those people. You know the kind, the ones who wake up in the morning or lace up in the evening and "go for a run."

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I've always been envious of my roommates, who can sneak in a jog with ease and carry on with their day, as if they had done something casually simple like taking the trash out. So, I made a vow to give running another chance. After all, the exercise has been shown to make you happier, reduce your risk for disease and even increase longevity.

While group classes and long walks will probably always be more my speed, I did find that I was enjoying running more than I ever did in the past. However, that doesn't come without a few hiccups. Below are a handful of struggles all new runners can probably relate to.

Getting winded in the first few minutes.

Probably one of the most discouraging elements of getting into a running routine is realizing that you're not as in shape as you thought you were. I continuously find myself doing more walking or jogging than actual running. But just because you need those intermittent breaks doesn't mean you aren't a runner. In fact, research shows that walking intervals during your run can help you maintain your overall pace.

Two words: Sore. Muscles.

The second-day pain is real. If you're experiencing those achy muscles, try one of these post-run remedies. Just make sure you're checking in with your body as you establish your routine. A little soreness is OK, but if the pain is more intense you may have sustained a running-related injury.

 

 

Feeling overwhelmed by the copious amount of races.

Color runs, beer runs, zombie runs, princess half marathons... the list is seriously endless. However, there are some perks to picking a race. Signing up for one helps you set a goal as you get into a routine, plus there's an opportunity to turn it into a social event by participating with your friends.

If your goal is to become a marathon runner (and props to you!), there are also some benefits there: Research shows consistent long-distance running can improve cardiovascular health and lower the risk for other organ disorders, the Wall Street Journal reported.

The jolting agony of waking up at 6 a.m.

My sleepy brain is constantly telling me my bed feels better than running (and often, the bed wins). If you need a little extra motivation, try one of these hacks to help you jumpstart your morning workout.

The boredom.

Part of the reason I never got into a routine in the first place was because the exercise itself seemed extremely dull to me (the treadmill is my arch-nemesis). Once I discovered more running-path options, I started to have more fun. However, that's not to say that I don't get a little bored sometimes — and that's OK.

Note: If you still just can't get excited by the process most of the time, you may want to try a more entertaining workout option instead. Exercise should be engaging, not mind-numbing.

Trying to find your perfect route.

Finding your favorite place to run is like finding a good apartment: It feels elusive until one day you hit the lottery. Whether you're into lush scenery or a skyline, it's important to find the routes that work for you in order to make the exercise entertaining.

The joy of picking out new workout clothes.

Sleek tanks! Compression pants! Neon shoes!

Running toward (multiple) "finish lines."

If you've ever uttered to yourself just one more pole, you're not alone. In fact, picking out an arbitrary finish line on your run can improve your performance. Research shows those who stare at a target in the distance go faster and feel less exertion than those who don't concentrate on anything, The Atlantic reported.

 

 

Bargaining with yourself on your run.

If you run five more blocks, you can binge-watch Scandal when you get home, I tell myself. Chances are I'd probably do it anyway — but at least it encourages me in the moment.

Creating a playlist that will consistently keep you motivated.

No, a simple music-streaming app won't do when your lungs are on fire and your legs feel weak. You need that one specific song that will inspire you to keep going (shout out to all my Shake It Off comrades). If you're looking for a playlist to spice up your run, check out some of these.

Eating Well As You Age

Looking in the mirror for changes as you age? A healthy diet helps to ensure that you'll like the reflection you see. Good nutrition is linked to healthy aging on many levels: It can keep you energized and active as well as fight against slowing metabolism and digestion and the gradual loss of muscle mass and healthy bone as you age.

Making healthy diet choices can help you prevent or better manage chronic conditions such as high blood pressure, high cholesterol, and diabetes. It's never too late to adopt healthier eating habits.

Strategies for Healthy Eating as You Age

Replace old eating habits with these healthy approaches:

  • Eat every three or four hours. “This keeps energy levels high and keeps appetite hormones in check to avoid overeating,” says Kim Larson, RD, of Total Health in Seattle and a spokesperson for the Academy of Nutrition and Dietetics.
  • Eat protein at each meal. Aim for 20 to 30 grams to help maintain muscle mass. Choose fish at least twice a week as a source of high quality protein. Other good sources of protein include lean meat and poultry, eggs, beans, nuts, and seeds.
  • Choose whole grains. Replace refined flour products with whole grains for more nutrients and fiber.
  • Choose low-fat dairy. Cutting out the saturated fat may help lower your risk for heart disease.
  • Learn about portion sizes. You may need to scale back on the serving sizes of foods to control your weight.
  • Choose nutrient-rich whole foods over empty calories. Whole foods are those closest to their natural state. Empty calories are typically processed foods with added salt, sugar, and fat. For example, snack on whole fruit instead of cookies.
  • Eat a “rainbow” of foods. “Eat five to seven servings of fruits and veggies each day to keep antioxidants like vitamins A, C, and E high,” Larson says. Choosing fruits and vegetables of different colors provides your body with a wide range of nutrients. According to research published in the May 2012 issue of the Journal of the American Geriatric Societyexercise coupled with higher fruit and vegetable intake led to longer lives. Fruits and veggies also fill you up with fiber, which cuts down on snacking and helps control weight, Larson says.
  • Choose healthy cooking techniques. Try steaming, baking, roasting, or sautéing food rather than frying it to cut back on fat.
  • Cut down on salt. If you’re over 51, national recommendations are to eat less than 1,500 milligrams of salt per day. Look for low-sodium foods and season your meals with herbs and spices rather than salt.
  • Stay hydrated. “Dehydration can cause irritability, fatigue, confusion, and urinary tract infections,” Larson says. Be sure to drink plenty of water and other non-caffeinated liquids throughout the day.
  • Ask about supplements. You may have changing nutrient needs as you get older and might benefit from vitamins B12 and D, calcium, and omega-3 fatty acid supplements, Larson says. Ask your doctor or a dietitian for guidance.

Overcoming Challenges to Healthy Eating

Eating a healthy diet can be complicated by changes you may face as you age, such as difficulty eating or a limited budget. There are strategies you can try to solve these common challenges:

  • If you've lost your appetite or sense of taste: Try new recipes and flavors — adding spices, herbs, and lemon juice can make foods more appealing. If you take medication, ask your doctor if appetite or taste changes are side effects and if switching to another drug might help.
  • If you have a hard time swallowing or chewing: Choose foods that are moist and easy to eat, such as nutritious soups made with beans and vegetables, Larson says.
  • If affording groceries is difficult: Shop from a list — careful planning can help you make the healthiest and most cost-effective food choices. Use coupons or shop on days when discounts are offered. Buying fruits and veggies when they’re in season and frozen produce in bulk can also help control expenses.
  • If you have trouble preparing meals: Consider buying healthy prepared or semi-prepared meals or at least pre-cut ingredients to cut down on energy-draining prep time.

Larson believes in the importance of enjoying your food. Make healthy-diet changes step by step and have fun experimenting to find new tastes and cooking styles. Eat slowly and pay attention to the experience. “Create a pleasant eatingenvironment," she says. "Sit by a window and enjoy every bite.”

What You Need to Know About Hyperpigmentation

Even small skin traumas like a pimple or bug bite can leave you with complexion-busting dark spots. “This is one of the most common ailments that patients come to see me about,” explains Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “It’s an annoying condition that affects all skin types, but the good news is that it’s fairly easy to treat.”

Find out how Dr. Downie helps patients treat and avoid marks on their complexions.

Everyday Health: What causes hyperpigmentation?

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Jeanine Downie: Any trauma or inflammation to the skin — either from acne, pimples, bug bites, or simply a bump, cut, or scratch — disrupts the surface layers where you have melanin, responsible for skin’s color. As the skin heals, it leaves behind residual pigmentation and dark spots.

 

 

 

EH: Is there anything you can do to prevent it?

JD: Unfortunately, if you’re prone to these dark spots, it’s tough to prevent them. Still, picking or scratching at an irritation will further traumatize the area, so hands off! You’ll also want to be vigilant about wearing sunscreen. As your skin gets darker, so will those hyperpigmented areas — it’s not like a tan is going to even out the color. Obviously, daily sunscreen wear is a must anyway, but this is just one more reason to protect your skin from UV rays.

EH: What steps can you take to treat it?

JD: The sooner you start taking care of your wound, the better it’ll look once healed. I recommend keeping the wound covered, especially if the skin is broken, and applying a topical healing ointment.

 

 

For large cysts or cuts, you may even want to see your dermatologist for a treatment plan. Once the pimple or cut has healed, apply 2% hydroquinone cream, which is available over-the-counter, or 4% hydroquinone, available by prescription from your doctor.

If the topical creams don’t quite do the trick, talk to your dermatologist about chemical peels or laser treatments to completely eliminate more stubborn discoloration.

EH: Is hyperpigmentation more common in people with darker complexions?

JD: No matter your skin color, everyone is susceptible to hyperpigmentation. Still, those with darker complexions seem to hold on to those spots for much longer because they have more melanin in their skin. It also means those hyperpigmented areas are going to be darker and more visible as well. Pregnancy and certain medications can increase your body’s production of melanin, and lead to hyperpigmentation as well.

6 Ways to Prep Your Skin for Summer

Scheduling vacation plans and buying a new swimsuit will mentally prepare you for summer, but your skin may need some help getting ready, too. For gorgeous, smooth skin you'll feel ready to bare, you need to take a few simple steps. Try this head-to-toe refresher to take your skin out of hibernation.

1. Reveal Glowing Skin

Regular exfoliation can be a part of a healthy skin regimen no matter the season; as long as your skin is not sensitive, exfoliation can help you achieve smooth, healthy-looking skin that makes you look more glowing and youthful. “But it must be done with care,” says Doris Day, MD, a dermatologist in New York City. “The goal is to lift off the outer layer of skin cells that are ready to be sloughed off without stripping the skin.”

 

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Brushes, polishing cloths, and scrubs offer easy ways to smooth away rough spots. Rotating cleansing brushes work by physically buffing off the dead skin cells. Exfoliating cloths, microdermabrasion kits, and scrubs with granular ingredients also operate the same way. “For the body, look for a scrub that contains coarse particles that dissolve over time, like sugar, so you don’t irritate the skin,” says Dr. Day.

Products that chemically exfoliate the skin contain ingredients such as glycolic, salicylic, or polyhydroxy acids that cause the skin to shed its outer layer and reveal the newer layer.

2. Remove Hair Without Irritation

If your summer forecast calls for sunny days at the beach or poolside, you may be putting some effort into removing unwanted hair. But once you rip off the wax strip, it’s also important to care for the skin that’s newly exposed to the elements.

Give your skin some time to recover before rolling out your beach towel or getting active outdoors. “I advise clients to stay out of the sun or heat for at least 48 hours after any hair-removal process,” says Cindy Barshop, owner of Completely Bare spas. “Follicles are vulnerable to irritation, and skin may be sensitive due to any heat or friction from lasers, waxing, or shaving.”

Since most of us don’t plan our hair removal that far in advance, buffer your tender skin with an oil-free sunscreen, wait for it to dry (about 5 minutes), and dust on some talc-free baby powder, says Barshop. To prevent ingrown hairs, it’s helpful to wear loose-fitting clothing and use an after-waxing product that contains glycolic and salicylic acids, which team up to prevent dead skin cells from causing bothersome bumps.

 

 

3. Fight UV Rays With Food

All the work you put into making your skin look good won’t be worth it unless you guard it from the sun’s damaging rays, which are strongest during the summer. Surprisingly, you can protect yourself from the inside, too. “In addition to usingsunscreen, eat cooked tomatoes every day if you know you’re going to be in the sun,” says Jessica Wu, MD, assistant clinical professor of dermatology at USC Medical School. According to research, cooked tomatoes are rich in lycopene, an antioxidant that helps fight the effects of UV rays such as redness, swelling, and blistering from sunburn. If you plan to spend a lot of time outdoors, you may benefit from consuming tomato sauce, grilled tomatoes, or even Bloody Marys. “This doesn’t replace sunscreen, but the habit could give you additional protection if you can’t reach your back and miss a spot,” Dr. Wu adds.

4. Clear Up Body Breakouts

It’s no better to have acne on your body than on the face, especially in the heat, when hiding and covering up isn’t an option. The approach to treating acne on the back, chest, and elsewhere on the body is the same as treating facial acne: “Exfoliate regularly, don’t pick, and treat with effective ingredients,” says Day.

Washing with products that contain salicylic acid helps slough off the dead skin cells; a treatment product with micronized benzoyl peroxide can also help by penetrating the skin and killing off the bacteria that cause acne.

If your skin is sensitive, investing in an acne-treating blue light tool may be worth the cost. “You simply wave the light wand over skin for five minutes daily and it helps kill bacteria,” says Leslie Baumann, MD, a dermatologist in Miami. If you have severe body acne, see a dermatologist.

5. Erase Cellulite

First, the good news: Some products may be able to smooth out the undesirable dimples and unevenness of cellulite. The bad news: They won’t get rid of cellulite forever. The smoothing and toning effect, like many good things in life, is fleeting. Still, it may be worth slathering on a toning body lotion to make your skin look and feel tighter for a day at the beach or a special event.

“Products that contain caffeine and theophylline temporarily dehydrate fat cells,” says Dr. Baumann. “However, it’s the massage and the application of the cream that does the work.” The best course of action long-term is to exercise regularly, coupled with targeted massage, suggests Baumann.

Another way to hide cellulite is to apply a fake tan. Take advantage of the newest self-tanners, which have come a long way from the strong-smelling streaky creams or sprays of yesteryear. “There has been so much progress in the formulations — the colors are natural, there’s no streaking, and the scent is so much better,” says Day.

6. Treat Your Feet

If you’ve stuffed your feet inside boots all winter, they probably could use a little TLC for sandal weather. Jump-start your program with a salon pedicure, or if you’re short on time, you can heed Day’s DIY tip, which will help soften feet while you sleep. First, remove thicker skin with a foot file. Apply a rich emollient cream or ointment, then cover the feet in plastic wrap and cotton socks. Leave on overnight. Repeat every day until you achieve smooth skin, then once a week to maintain soft skin.

7 Healthy Habits of the 2016 Presidential Candidates

The New Hampshire primary's in full swing, and if there’s one thing all the presidential hopefuls can agree on, it’s that running for office is the ultimate endurance challenge. They’re canvassing across the country with little time to exercise or sleep, and it doesn’t help that at every stop they’re tempted by unhealthy foods like pizza, pork chops, and pies. So how do the presidential candidates stay healthy and keep their energy levels up during the grueling primary season? Read on to find out!

What Is Guillain-Barré Syndrome?

Guillain-Barré syndrome (GBS) is an illness that can result in muscle weakness or loss of muscle function in parts of the body.

In people with Guillain-Barré syndrome (pronounced GHEE-yan ba-RAY), the body's own immune system attacks the peripheral nervous system.

The peripheral nervous system includes the nerves that connect the brain and spinal cord to the limbs. These nerves help control muscle movement.

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 or 2 out of every 100,000 people develop GBS each year in the United States.

Anyone can get GBS, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS each year.

Causes and Risk Factors

Doctors don't know what causes Guillain-Barré syndrome.

Many people with GBS report a bacterial or viral infection (such as the flu) days or weeks before GBS symptoms start.

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.

Types of GBS

There are several types of Guillain-Barré syndrome, which are characterized by what part of the nerve cell is damaged.

The most common type of GBS is called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

In AIDP, the immune system mistakenly attacks the protective nerve covering that helps transmit nerve signals from the brain to other parts of the body.

Guillain-Barré Syndrome Symptoms

The first symptoms of Guillain-Barré syndrome often include feelings of tingling or weakness in the feet and legs. These feelings may spread to the arms and face.

The chest muscles can also be affected. Up to a quarter of people with GBS experience problems breathing.

In very severe cases, people with GBS may lose all muscle function and movement, becoming temporarily paralyzed.

Signs and symptoms of Guillain-Barré syndrome may include:

  • Pricking or tingling "pins and needles" sensations in the fingers, toes, ankles, or wrists
  • Muscle weakness that starts in the legs and spreads to the upper body
  • Unsteady walking
  • Difficulty with eye or facial movements (blinking, chewing, speaking)
  • Difficulty controlling the bowels or bladder
  • Rapid heart rate
  • Difficulty breathing

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.

Some risk factors for binge eating disorder include:

  • A history of anxiety or depression
  • A history of dieting (especially in unhealthy ways, such as skipping meals or not eating enough food each day)
  • Painful childhood experiences, such as family problems

Symptoms of Binge Eating Disorder

People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.

Binge eating episodes are associated with three or more of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you're not feeling hungry
  • Eating alone, because you feel embarrassed about how much you're eating
  • Feeling extremely disgusted, depressed, or guilty after eating

Some people also display behavioral, emotional, or physical characteristics, such as:

  • Secretive food behaviors, including hoarding, hiding, or stealing food
  • Feelings of anger, anxiety, worthlessness, or shame preceding a binge
  • Feeling disgusted with your body size
  • A strong need to be in control, or perfectionist tendencies

Binge Eating Disorder Treatment

If you have binge eating disorder, you should seek help from a specialist in eating disorders, such as a psychiatrist or psychologist.

There are several treatments available for BED. Treatment options may include:

 

10 Varicose Veins Myths

If you have ropy, blue blood vessels in your legs, you may think that they’re unsightly but don't cause any overt symptoms. Yet for some people, varicose veins can cause skin damage and, even worse, lead to dangerous blood clots.

They’re incredibly common: Varicose veins affect about one in four U.S. adults, or about 22 million women and 11 million men between ages 40 and 80.

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Your leg veins face an uphill battle as they carry blood from your toes to your heart. Small flaps, or valves, within these vessels prevent blood from getting backed up on this journey, and the pumping action of your leg muscles helps push the blood along. 

But if these valves weaken, blood can pool — primarily in the veins of your legs — increasing pressure in the veins. As a result of this increased pressure, your body tries to widen the veins to compensate, causing them to bulge and thicken, and leading to the characteristic twisted appearance of varicose veins.

 

 

To help you learn the facts about these enlarged veins, we've set the record straight on 10 sometimes confusing pieces of information, including who gets varicose veins and why, health problems they can cause, and treatment options.

Myth 1: Varicose Veins Are Only a Cosmetic Issue

“A lot of people are told by primary care doctors or others that varicose veins are a cosmetic issue only, when oftentimes they can be much more than that,” saysKathleen D. Gibson, MD, a vascular surgeon practicing in Bellevue, Washington.

“A significant percentage of patients with varicose veins will eventually develop symptoms,” says Pablo Sung Yup Kim, MD, assistant professor of surgery at Mount Sinai's Icahn School of Medicine in New York City. “The most common include dull achiness, heaviness, throbbing, cramping, and swelling of the legs.” Other symptoms include severe dryness and itchiness of the skin near varicose veins. People with varicose veins are also at an increased risk for a dangerous type of blood clot known as deep vein thrombosis.

Other not-so-common signs and symptoms, found in less than 10 percent of patients, include bleeding, skin discoloration, skin thickening, and ulcer formation — all due to varicose veins, says Kim. Unfortunately, once you have skin damage, it’s usually permanent.

“It’s very important to seek medical advice if you have varicose veins and experience symptoms — before changes in the skin are irreversible,” he says.

Myth 2: Varicose Veins Are an Inevitable Sign of Aging

Aging definitely worsens varicose veins, though not everyone gets them. “It's a degenerative process that gets worse and more prominent as we age,” says Dr. Gibson. But young people can get varicose veins, too. While the average age of patients treated in Gibson’s practice is 52, she and her colleagues have treated patients as young as 13.

If you've got varicose veins, it may run in your family. “The cause of varicose veins is primarily genetic,” Gibson explains.

Changes in hormone levels also come into play as a risk factor for varicose veins. “Your risk can be made worse, especially by pregnancy,” she adds.

Myth 3: Varicose Veins Are Strictly a Women’s Issue

While varicose veins are more common in women, men get them, too. About one-quarter of adult women have some visible varicose veins, compared to 10 to 15 percent of men.

Steve Hahn, 51, of Kirkland, Washington, first noticed in his twenties that he had varicose veins in his left leg after he sprained his ankle playing basketball. When he injured his knee about 10 years ago, he noticed that the varicose veins had become more extensive.

“After about five years of thinking about it, I finally had them treated,” he says. “Both of my legs felt very heavy all of the time at this point, as opposed to just after walking a golf course or playing tennis or basketball.”

After treatment, Hahn says, “I feel like I have new legs.” The heaviness is gone, as is the ankle swelling, which he didn't know was related to the varicose veins. And as a side benefit, he adds, he looks better in shorts.

Myth 4: Running Can Cause Varicose Veins

Exercise — including running — is usually a good thing for your veins. “Exercise is always good for the circulation,” Kim says. “Walking or running can lead to more calf-muscle pumping and more blood returning to the heart.”

“Being a runner doesn’t cause varicose veins,” adds Gibson, though there's controversy about whether exercise makes them worse or not.” Compression stockings can help prevent blood from pooling in your lower legs during exercise. “For patients who haven't had their varicose veins treated and are running, I recommend compression. When you’re done running and are cooling off, elevate your legs,” she says.

Myth 5: Varicose Veins Are Always Visible

While the varicose veins you notice are right at the surface of the skin, they occur deeper in the body, too, where you can't see them. “It really depends on the makeup of the leg,” Gibson says. “If you've got a lot of fatty tissue between the muscle and the skin, you may not see them. Sometimes surface veins are the tip of the iceberg and there's a lot going on underneath.”

Myth 6: Standing on the Job Causes Varicose Veins

If you have a job that requires you to be on your feet a lot — as a teacher or flight attendant, for example — you may be more bothered by varicose veins. But the jury's still out on whether prolonged standing actually causes varicose veins. “People tend to notice their varicose vein symptoms more when they’re standing or sitting,” Gibson explains.

RELATED: Steer Clear of These 9 Artery and Vein Diseases

Myth 7: Making Lifestyle Changes Won't Help

Your lifestyle does matter, because obesity can worsen varicose veins, and getting down to a healthy weight can help ease symptoms. Becoming more physically active is also helpful. “Wearing compression stockings, doing calf-strengthening exercises, and elevating your legs can all improve or prevent varicose veins,” saysAndrew F. Alexis, MD, MPH, chairman of the dermatology department at Mount Sinai St. Luke's and Mount Sinai Roosevelt in New York City.

Myth 8: Surgery Is Your Only Treatment Option

The only treatment available for varicose veins used to be a type of surgery called stripping, in which the vein is surgically removed from the body. That’s no longer the case. While this procedure is still the most commonly used varicose vein treatment worldwide, according to Gibson, minimally invasive procedures that don't leave scars have become much more popular in the United States.

Endothermal ablation, for example, involves using a needle to deliver heat to your vein, causing it to close and no longer function. While the procedure doesn't leave a scar, it can be painful, and you may have to undergo sedation before being treated. “You have to have a series of injections along the vein to numb it up; otherwise, you wouldn't be able to tolerate the heat,” Gibson explains. You may need to take a day off from work to recover, as well as a few days off from the gym.

Some medications, called sclerosing agents, close a vein by causing irritation. Others are adhesives that seal a vein shut and don’t require the area to be numbed. Gibson and her colleagues have helped develop some of the new technologies and products used in treating varicose veins, including adhesives.

Milder varicose veins can be treated by dermatologists with non-invasive approaches, such as laser therapy and sclerotherapy, says Dr. Alexis. “For more severe cases where symptoms may be involved, seeing a vascular surgeon for surgical treatment options is advised.”

Although treatment for varicose veins means losing some veins, you have plenty of others in your body that can take up the slack, explains Gibson. “The majority of the blood flow in veins in the leg is not on the surface at all; it's in the deep veins within the muscle,” she says. “Those deep veins … are easily able to take over for any veins that we remove on the surface.”

Myth 9: Recovery After Varicose Vein Treatments Is Difficult

 

 

Newer treatments have quicker recovery times. “These procedures can be performed in an office within 20 to 30 minutes with no recovery time. Patients can usually return to work or daily activities on the same day,” Kim says.

Myth 10: Varicose Veins Can Be Cured

Treatments are effective, but they aren't a cure, Gibson says. Sometimes, varicose veins can make a repeat appearance after treatment. “What I tell my patients is it's kind of like weeding a garden,” she says. “We clear them all out, but that doesn't mean there's never going to be another dandelion popping out.”

10 Essential Facts About Ovarian Cancer

Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.

We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.

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Here are 10 essential facts about ovarian cancer that you should know:

1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.

2. You should see your doctor if you experience any of these ovarian cancer symptoms:

  • Vaginal bleeding (especially if you’re past menopause)
  • Abnormal vaginal discharge
  • Pain or pressure in the area below your stomach and between your hip bones
  • Back pain
  • A change in bathroom habits, such as urgently needing to urinate, urinating frequently, or having constipation or diarrhea

It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.

 

 

These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.

3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:

  • Pelvic or abdominal pain
  • Strong urge to urinate or frequent urination
  • Bloating or increased abdominal size
  • Difficulty eating or feeling full early

If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.

4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.

RELATED: Overcoming Ovarian Cancer, Twice

5. Ovarian cancer has several key risk factorsThese include:

  • Women with a family history of ovarian cancer may be at higher risk.
  • Women who have never been pregnant and women who have uninterrupted ovulation due to infertility treatments seem to be at higher risk.
  • Early onset of your period, or having a late menopause, seems to increase risk.
  • Using talcum powder in the genital area may increase risk.
  • Smoking is a risk factor for a type of ovarian cancer known as mucinous ovarian cancer. Quitting smoking seems to reverse the risk back to normal, says Morgan.

6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.

7. Ovarian cancer treatments are evolving and improving all the time.Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.

 

 

8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.

9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.

10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.

How to Prevent Hearing Loss

Do you have trouble following a conversation in a noisy room? Do other people complain that you have the television turned up too loud? If the answer to either of those questions is yes, you may already have some degree of hearing loss.

Hearing loss can start at any age. According to the National Academy on Aging and Society, the number of affected Americans between the ages of 45 and 64 has increased significantly since 1971. But it’s much more common in seniors: Some 40 percent of the 20 million Americans who have hearing loss are 65 or older.

Contrary to popular belief, however, hearing loss is not an inevitable part of aging. Some causes of hearing loss can be prevented, and most types of hearing loss can be helped.

Types and Causes of Hearing Loss

There are three basic types of hearing loss:

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  • Sensorineural hearing loss is caused by damage to the inner ear nerves or the nerves that carry sound to the hearing area of the brain. Once you have this type of nerve damage, the only treatment is a hearing aid. Causes of sensorineural hearing loss include injuries, tumors, infection, certain medications, and excessive noise exposure.
  • Conductive hearing loss is caused by a condition that blocks sound waves from being transferred to the nerves involved in the hearing process. Whereas sensorineural hearing loss usually affects both ears, conductive hearing loss may only affect one ear. Common causes include ear infections, ear wax, ear trauma such as a punctured eardrum, and other diseases that affect the ear canal, the eardrum, or the tiny bones in the middle ear. Unlike sensorineural hearing loss, this type of hearing loss can often be corrected and restored.
  • Mixed hearing loss occurs when someone who has nerve type hearing loss from aging or noise trauma then gets an ear infection or develops a wax impaction, causing their hearing to suddenly get much worse. It’s a combination of sensorineural hearing loss and conductive hearing loss.

Hearing Loss Evaluation

If you are having trouble hearing or develop sudden deafness, you need to get your hearing checked as soon as possible. Sudden deafness is a serious symptom and should be treated as a medical emergency. For many people, though, hearing loss may be gradual and not obvious. Here are seven warning signs to watch out for:

  • You have trouble hearing while on the telephone.
  • You can’t seem to follow a conversation if there is background noise.
  • You struggle to understand women’s or children's voices.
  • People complain that you turn up the TV volume too high.
  • You constantly ask people to repeat themselves.
  • You have a long history of working around loud noises.
  • You notice a ringing, hissing, or roaring sound in your ears.

 

 

If you think you have any kind of hearing loss, the place to start is with your doctor. Whether your hearing loss is gradual or sudden, your doctor may refer you to an audiologist (a medical specialist in hearing loss) or an otolaryngologist (a medical doctor specializing in disorders of the ear).

 

 

Depending on the cause and type of your hearing loss, treatment may be as simple as removing ear wax or as complicated as reconstructive ear surgery. Sensorineural hearing loss can't be corrected or reversed, but hearing aids and assistive devices can enhance most people’s hearing. For those with profound hearing loss approaching deafness, an electronic hearing device, called a cochlear implant, can even be implanted in the ear.

Tips for Hearing Loss Prevention

One type of hearing loss is 100 percent preventable: that due to noise exposure. Noise is measured in units called decibels: Normal conversation is about 45 decibels, heavy traffic may be about 85 decibels, and a firecracker may be about 120 decibels. Loud noise — anything at or above 85 decibels — can cause damage to the cells in the inner ear that convert sound into signals to the brain. Here are some tips for avoiding noise-induced hearing loss:

  • Minimize your exposure to loud noises that are persistent.
  • Never listen to music through headphones or ear buds with the volume all the way up.
  • Wear ear plugs or protective earmuffs during any activity that exposes you to noise at or above 85 decibels.
  • See your doctor about a baseline hearing test, called an audiogram, to find out if you already have some early hearing loss.

You should also see your doctor if you have any symptoms of ear pain, fullness, or ringing, or if you experience any sudden change in your hearing. These symptoms could be early warnings of preventable hearing loss.

Hearing loss or deafness can have a serious effect on social well-being. It can cut you off from the world around you. Know the causes of hearing loss, and practice hearing loss prevention to preserve the hearing you still have.

Regis Philbin Takes on High Cholesterol

The legendary talk-show host is helping raise awareness about heart health and the importance of staying on drug treatment.

Regis Philbin has been entertaining us for more than 50 years — from his legendary morning show with Kathie Lee Gifford and Kelly Ripa to . With his carefree personality and love of the sharp, off-the-cuff one-liner, at age 86 he remains one of America’s favorite television personalities. Seemingly forever young, he got a wake-up call in 1992, when he faced a major health scare that spurred him to lead a more .

Philbin was away from the TV studio and on a trip in Florida when he started to experience sharp chest pains.

“My heart was driving me crazy, I couldn’t believe it, I had these chest pains,” Philbin says. “We did an down there in Florida and my doctor told me my cholesterol levels were at 300. Are you kidding me? Three hundred!”

High blood cholesterol is one of the major markers of heart disease. According to the , a healthy total cholesterol level is less than 200 milligrams per deciliter (mg/dL). Any levels at 240 mg/dL or above — like the levels Philbin had — would be considered significantly high.

Once Philbin was back in New York, his doctor put him on his first , and Philbin, with his wife, Joy, by his side, decided that he would make significant to fight off the progression of his heart disease.

“I think things changed in a hurry,” Philbin says about his approach to his health.

“It shook us both up, it was a wake-up call,” Joy recalls of her husband’s health scare. “Quite frankly, I didn’t give cholesterol a thought myself. I mean, Regis didn’t have the best diet, but I never thought it was that bad. It kind of set him on a new regimen. You really start to feel your mortality. He was only 61 when he had his first event.”

This wouldn’t be his only heart health scare. Philbin had triple bypass surgery in 2007 because of a buildup of .

The ‘Take the Cholesterol to Heart’ Campaign

Right now, the Philbins are raising awareness about heart health through the “” campaign, which they launched in October 2017 in cooperation with Kowa Pharmaceuticals and the American Academy of Family Physicians Foundation. The campaign aims to encourage people to remain on a heart-healthy routine while also seeking out better information and asking questions before considering stopping their . Philbin, who has shared almost everything about his life over decades of being on air, has always been very open about his experiences with and was approached by the campaign to be its public face.

Joy says that what was most stunning to her about being part of the campaign was learning that 50 percent of people who are on statins stop taking the drugs after one year of use. She adds this shocked her because of how helpful the drugs were for her husband’s health.

Statins are drugs that lower blood cholesterol levels by blocking an enzyme that produces cholesterol in the liver. Getting people to maintain their drug regimen is one of the big challenges of treating high cholesterol, says , the president of the Utah Lipid Center and a fellow at the American Heart Association and the National Lipid Association.

“The big question is, why do these people stop taking their statins? One issue is you don’t necessarily feel better or worse when you take a statin; you have to go through testing to know your cholesterol is lower, so you don’t necessarily have a daily reminder every morning telling you you’re getting better,” Brinton says. “Another thing is that some patients will experience , like muscle pain or weakness. They might have stomach pain or a skin rash.

"There’s also a lot of negative and sometimes factually inaccurate information on the web. However, reputable medical sites cite evidence that highlight the positive health benefits of statins and show that these side effects do not occur in anywhere near the high numbers some of these other sites might lead you to believe.”

Reasons to Stay on Your Statins

A looked into the effectiveness of both statin and non-statin therapies for lowering cholesterol. The study reviewed 49 trials from 1966 to 2016 that involved 312,175 people in total. The report’s authors assert that statins should remain at the front of the line in treating cholesterol, but alternative therapies could be just as helpful if a person can’t tolerate statins or is looking for a different source of treatment. These could involve bile acid sequestrants or even a simple .

“I’ll say this up front, . They prevent heart attack and can prevent stroke. But a statin can’t work if you don’t take it,” Brinton stresses.

Brinton says there are a few things people should keep in mind when looking to lower their cholesterol with statin treatment:

Stay informed. To help counter some potentially inaccurate information out there, Brinton says the first person to turn to is your doctor. Beyond that, he says there’s useful information at places like the , the American Heart Association, and the National Lipid Association website, .

Know your options. Brinton says that people who are discouraged by one drug should know that there are multiple statin drugs out there. “A lot of people who stop their statin for whatever reason didn’t talk to or consult their doctor, who then doesn’t have a chance of helping them decide what to do,” he adds. “There are several statins out there, and people need to realize that there are other options if what they try first doesn’t work out.”

Be vigilant. If you’re having a bad experience, your statin medication could be reacting with other medications you are taking. Brinton says it is important that people tell their doctor about other medications or supplements they're on. They could then be prescribed a different statin.

How Regis Stays Healthy in Retirement

This all rings true for the Philbins. After his scare in the early '90s, Philbin started seeing a cardiologist, , and became even more of a “fitness freak,” Joy says.

“When you’re in your thirties, for example, you aren’t running to a doctor. But when you hit your sixties, you become a little more proactive about your health,” Joy says. “If your diet is wrong, you start looking into it. You become more aware.”

Echoing Brinton, Joy says that communication between you and your doctor is key in maintaining the best possible heart health.

“Some people avoid going to the doctor; they’re afraid of bad news,” she adds. “It’s important to maintain that [relationship]. You get closer to your doctor as you age, it’s one of the things you do. That’s crucial. It was so important for Regis.”

For his part, Philbin is doing everything he can to stay healthy in retirement. The talk-show host with the gift of gab is more than happy to share his heart health journey.

“I’ve been dealing with this for 25 years. It’s been a long time,” Philbin says. “I'm always more than happy to talk about this. For me, it’s everything.”

Obesity Linked to 13 Types of Cancer

There's a link between obesity and 40 percent of all the cancers diagnosed in the United States, health officials reported Tuesday.

That doesn't mean too much weight is causing all these cancer cases, just that there's some kind of still-to-be explained association, according to the U.S. Centers for Disease Control and Prevention.

Still, the study findings suggest that being obese or overweight was associated with cancer cases involving more than 630,000 Americans in 2014, and this includes 13 types of cancer.

"That obesity and overweight are affecting cancers may be surprising to many Americans. The awareness of some cancers being associated with obesity and overweight is not yet widespread," Dr. Anne Schuchat, CDC deputy director, said during a midday media briefing.

The 13 cancers include: brain cancer; multiple myeloma; cancer of the esophagus; postmenopausal breast cancer; cancers of the thyroid, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus and colon, the researchers said.

Speaking at the news conference, Dr. Lisa Richardson, director of CDC's Division of Cancer Prevention and Control, said early evidence indicates that losing weight can lower the risk for some cancers.

According to the new report from the CDC and the U.S. National Cancer Institute, these 13 obesity-related cancers made up about 40 percent of all cancers diagnosed in the United States in 2014.

RELATED: U.S. Cancer Death Rate Continues to Fall

Although the rate of new cancer cases has decreased since the 1990s, increases in overweight and obesity-related cancers are likely slowing this progress, the researchers said.

Of the 630,000 Americans diagnosed with a cancer associated with overweight or obesity in 2014, about two out of three occurred in adults aged 50 to 74, the researchers found.

Excluding colon cancer, the rate of obesity-related cancer increased by 7 percent between 2005 and 2014. During the same time, rates of non-obesity-related cancers dropped, the findings showed.

In 2013-2014, about two out of three American adults were overweight or obese, according to the report.

For the study, researchers analyzed 2014 cancer data from the United States Cancer Statistics report and data from 2005 to 2014.

Key findings include:

Of all cancers, 55 percent in women and 24 percent in men were associated with overweight and obesity.
Blacks and whites had higher rates of weight-related cancer than other racial or ethnic groups.
Black men and American Indian/Alaska Native men had higher rates of cancer than white men.
Cancers linked to obesity increased 7 percent between 2005 and 2014, but colon cancer decreased 23 percent. Screening for colon cancer is most likely the reason for that cancer's continued decline, Schuchat said.
Cancers not linked to obesity dropped 13 percent.
Except for colon cancer, cancers tied to overweight and obesity increased among those younger than 75.
The new report was published online Oct. 3 in the CDC's Morbidity and Mortality Weekly Report.

Dr. Farhad Islami is strategic director of cancer surveillance research for the American Cancer Society.

He said it's "important to note that only a fraction of the cancers included in the calculation in this report are actually caused by excess body weight."

According to Islami, "many are attributable to other known risk factors, like smoking, while for many others, the cause is unknown. Obesity is more strongly associated with some cancers than others."

The World Cancer Research Fund estimates that "20 percent of all cancers in the United States are caused by a combination of excess body weight, physical inactivity, excess alcohol, and poor nutrition. The American Cancer Society is currently doing its own extensive calculation of the numbers and proportions of cancer cases attributable to excess body weight, the results of which will be published soon," he said.

The Role of Genetics in Depression

These new genetic discoveries may someday lead to new depression treatments.

 death thoughts, and more — you might ask yourself, "Why me?" Scientists are trying to answer that question.

Researchers know from twin and family studies that genetics does play a role in depression: You don’t actually inherit depression, but you may inherit genes that predispose you to the condition. If you have a parent or sibling with major depressive disorder, you are two to three times more likely to develop depression than someone with no family history. The risk is higher if family members developed depression early in life or experienced recurrent episodes of depression.

Risk Factors for Depression Vary

Having a genetic predisposition doesn’t mean you’ll become depressed. Environmental factors are also very important, says Mary Fristad, PhD, director of research and psychological services in the division of child and adolescent psychiatry at the Ohio State University in Columbus.

“Even if someone is ‘genetically loaded’ because they have multiple relatives with depression — and their partner is equally genetically loaded — raising a child in a calm, predictable, loving, nurturing, limit-setting household with good nutrition, plenty of exercise, adequate sleep, and participation in enjoyable activities might either prevent or delay the onset of depression,” she says.

Dr. Fristad doesn’t recommend genetic testing for depression. “The simplest and least expensive genetic test at present is to ask if anyone on either side of the family has depression,” she says.

But Chris Aiken, MD, director of the Mood Treatment Center and a clinical psychiatry instructor at the Wake Forest University School of Medicine, both in Winston-Salem, North Carolina, says one particular type of gene has been implicated in the development of depression — information that may be helpful to some people. It’s called the serotonin transporter (SERT); serotonin is a neurotransmitter that helps regulate levels of anxiety, depression, and irritability.

RELATED: How to Tell If It’s a Bad Mood or Depression

“You can have genes for either a short or long version of SERT,” says Dr. Aiken. “These genes predict whether people will get depressed in the face of stress. For people with the long-arm version of the gene, the risk of depression doesn't rise even after a major life stress, like divorce, grief, or job loss. For those with the short-arm version, the rate of depression goes up with each new stress."

“What's interesting is that people have the same rate of depression when they aren't under any stress — regardless of which version of SERT they have,” Aiken says. “It's only after major stress or childhood trauma that the two groups start to look different.”

Having the long form of the gene raises the risk of experiencing depression after stress, but you won’t automatically become depressed if you have that gene and undergo stress. Similarly, you can still get depressed with the short-arm gene after a stressful life event (i.e., having the gene is not totally protective). In a nutshell, having a particular form of the gene raises the risk of depression after stress but cannot 100 percent predict or prevent it.

According to Aiken, the short-arm SERT isn’t unique to depression: It’s also been linked to post-traumatic stress disorder, fear responses, and alcoholism.

New Genetic Markers for Depression Revealed

In a study published in July 2015 in Nature, scientists reported finding two genetic markers that appear to be clearly linked to major depression. Researchers sequenced DNA from about 10,600 Chinese women, half of whom had depression. Of that half, 85 percent had a severe type of depression called melancholia, described as a gloomy, foreboding feeling that robs people of their joy. They found two genetic sequences that seemed to be linked to depression and confirmed these correlations in an additional 6,000 subjects and controls.

Norman Sussman, MD, a psychiatrist and director of the Treatment Resistant Depression Program at NYU Langone Medical Center in New York City says the results of this study help validate the fact that depression really is an illness, not a psychosomatic disorder or weakness of character.

RELATED: The Real Monthly Cost of Depression

“I tell patients, depression is a medical disease," says Dr. Sussman. "Instead of [showing] physical symptoms (which they can also have), it primarily manifests through abnormalities in cognition and mood. You see things in a negative, hopeless way.”

The Nature findings also offer potential opportunity for treatment. Sussman says if we understand the mechanics of depression, it opens new pathways for drug development. Furthermore, says Aiken, knowing your genotype can also help you avoid wasting time with medications that are less likely to work. For example, people with short-arm SERT genes are less likely to respond to selective serotonin reuptake inhibitors, the most common type of antidepressant, but they may respond to other medications.

How You Can Prevent Depression Symptoms

There’s no medical test to diagnose depression, so health professionals rely on patients or family members to report symptoms. The American Psychiatric Association’s diagnostic guidelines say patients should not be diagnosed with depression unless they exhibit a persistently low mood or loss of interest in activities once deemed pleasurable or enjoyable, in addition to four or more symptoms of depression.

Depression symptoms might include loss of interest in activities once deemed pleasurable or enjoyable, significant weight loss or gain, lack of energy, feelings of worthlessness, or repeated thoughts of death or suicide.

RELATED: 5 Things Psychologists Wish Their Patients Would Do

At least 10 percent of Americans will eventually experience an incidence of major depressive disorder, the most serious type of depression. Other people have low-grade, chronic depression. “The difference is severity,” says Sussman. “People with chronic depression know they should be happier than they are.” 

The important thing to keep in mind is that depression is not inevitable — even if you’re genetically predisposed — and it is treatable.

“Studies show that people whose environments are loving, nurturing, structured, physically active, and have good social networks and friendships are protective for children with genetic risks for depression,” says Aiken.

Online screening tools, such as the Depression Wellness Analyzer and the Patient Health Questionnaire (PHQ-9), can help you evaluate whether you may have depression. Discuss the results with your physician so you can seek treatment if appropriate.

Fewer Diabetes Cases Being Missed

Although the number of people diagnosed with diabetes is still on the rise, the good news is that most people with the disease know they have it, a new study shows.

The research suggests that over the past two and a half decades, the percentage of undiagnosed cases has dropped significantly.

"If you're going to your doctor, you probably don't have to worry about undiagnosed diabetes," said study author Elizabeth Selvin, a professor of epidemiology at Johns Hopkins University's Bloomberg School of Public Health.

Selvin explained that previous estimates suggested that over a quarter to 30 percent of people with diabetes probably didn't know it. But those estimates assumed that doctors were only doing one test for diabetes and not following up with a confirmatory second test, as the American Diabetes Association recommends.

However, "we found that's not consistent with how diabetes is diagnosed in clinical practice. In practice, an abnormal finding is confirmed with a second test for the diagnosis. When you use two tests, we see that we're doing a good job with screening and diagnosing diabetes," Selvin said.

In fact, the two-test method seems to capture about 90 percent of all diabetes cases, the researchers noted.

Selvin and her colleagues used data from U.S. National Health and Nutrition Examination Surveys done from 1988 to 1994 and from 1999 to 2014.

RELATED: 9 Types of Medication That Help Control Type 2 Diabetes

The surveys showed that when the research began in 1988 to 1994, there were about 10 million adults with diabetes and confirmed undiagnosed diabetes (that means people who just had one test and didn't get a follow-up test). By 1999 to 2014, there were 25.5 million adults with diabetes or undiagnosed diabetes.

The new research revealed that the number of undiagnosed cases as a percentage of all diabetes dropped from more than 16 percent to slightly less than 11 percent over 26 years.

People who were undiagnosed were more likely to be overweight or obese, older, or a racial or ethnic minority. They were also less likely to have health insurance or access to health care, the study found.

"What we need to figure out is how to target our screening and prevention efforts to the group that actually is undiagnosed. Some of the people being missed have very high [blood sugar levels] and the efforts should be concentrated on getting those people to the clinic," Selvin said.

The findings were published Oct. 23 in the Annals of Internal Medicine.

Dr. Anne Peters is director of the clinical diabetes program at the University of Southern California Keck School of Medicine in Los Angeles. She wrote an editorial that accompanied the study.

"I think there are fewer undiagnosed cases than we used to think, but there are still a lot of people who are undiagnosed," Peters said.

"People with risk factors need to get tested. But people get afraid of the stigma. They get afraid of the disease. But diabetes doesn't have to be awful. People don't have to give up. We need a lot more public awareness and a lot more prevention," she said.

And that doesn't mean you have to lose 100 pounds. "Losing 15 pounds can make a big difference. Just walking 30 minutes a day, five days a week is incredibly beneficial. Take diabetes on in bite-sized pieces," Peters advised.

"There are so many new ways to treat diabetes. Almost everything has changed in the past 30 years. But the earlier you start treatment, the better. Some things are better to face," she said.

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6 Things I Didn't Know About Depression Until It Happened to Me

If you or a loved one has been diagnosed with depression, these insights from people who are successfully managing their own depression may help you.

Depression can make you feel alone and isolated, but in reality you aren't. Many other people live with depression every day, and you can learn a lot from them. Here, three people diagnosed with depression share insights they’ve gained along the way.

1. It's Not Your Fault

For the longest time, "I felt like something was wrong with me," says Marisa McPeck-Stringham, 37, a social worker in Ogden, Utah, who blogs about her life, including her depression, as Iron Daisy. She first noticed as a teen that she was sometimes down in the dumps, but she wasn't diagnosed until age 20, she says. Before the diagnosis, she would ask herself: What's wrong with me? She knew she had a good family, a good home, and great parents. "I didn't know it was a mental illness," she says. "I didn't know it was a problem with my brain chemistry."

That reaction is a common one, says Michelle B. Riba, MD, associate director of the University of Michigan Comprehensive Depression Center in Ann Arbor and past president of the American Psychiatric Association. Patients often tell her they think they did something to bring on the depression, and that they could have been stronger.

Dr. Riba tells her patients, "It's a medical condition and has to be treated like a medical condition." Anyone diagnosed with depression must be evaluated to see which treatment or combination might work for them, Riba says.

2. Being Depressed Takes a Lot of Energy

Elizabeth Moon, 70, of Austin, who wrote Crown of Renewal and other books, was diagnosed in the early 1980s. She didn't understand until after she got a diagnosis and was treated how exhausted she had been from trying to keep up with her life. "I didn't realize how long I had been depressed," she says.

"I was active, very physically active," says Moon. "I didn't think of myself as depressed; I didn't realize I was sliding into depression."

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“Not everyone fits the stereotype of sitting on the couch," unable to do anything, she says. "If you’re feeling worthless, like you have no future — even if you appear to be healthy and holding down a full-time job, get checked out.”

"People may not pinpoint [depression symptoms] right away," Riba says of those who get depressed. They may think they’re sleep deprived, for instance, or just have some temporary issues balancing responsibilities.

3. Exercise Has Been Proven to Help With Symptoms

Often, the last thing you want to do if you’re depressed is go out and get some exercise. But those who’ve been there understand the value of exercise, and say it often helps. "If I don't get out and exercise, I have to really watch myself and make sure I’m not sliding," Moon says. "I do much better if I’m active. I have much less chance of sliding into another episode."

RELATED: The Real Monthly Cost of Depression

Exercise ''readjusts our brain chemistry," says McPeck-Stringham. She includes exercise as part of her "self-care" routine. Her workouts also become valuable "me" time, she finds.

And there is good evidence that exercise improves your mental health. A study published in 2014 in JAMA Psychiatry found that exercise does lower your chance of becoming depressed. And in people who already have depression, exercise helps lift depressive symptoms.

4. Writing Helps You Sort Out Your Emotions

Keola Birano, 33, of Hilo, Hawaii, is a full-time writer who also works for his wife's clothing business. Diagnosed at age 19, he soon learned the power of writing — not for his livelihood, but for his depression. First, he wrote a letter to his father and ''without giving it to him," burned it. "It released whatever [negative] feeling I may have held onto," he says.

He has continued writing, both for his blog, Keola Birano Reimagined, and for personal growth. "When you write, it opens up parts of your brain you didn't know were there,'' he says. "I try to do 10 minutes a day on autopilot, to let the feelings out."

5. Managing Depression Is an Ongoing Effort

"It takes a lot of significant work to keep yourself strong," Birano says. "You have to keep working on it. Once you start thinking you have it beat, you set yourself up for failure."

Moon agrees. "I can go downhill in 30 seconds,'' she says. "I've learned to have a plan in place when that happens," she says. Part of her plan is to keep tabs on her mental health before that slide downhill. "At least five times a year, I take the Beck Depression Inventory [a tool used by mental health experts] and see where I am. If I’m coming up [on the score], I need to be very careful. If the score doesn't go back down, I may need meds."

RELATED: 10 Foods I Eat Every Day to Beat Depression

For her, the best approach has been to take medications when needed and then taper off them, she says, but she doesn’t claim this is best for everyone. It’s important to remember that decisions to stop or start medications should always be done in conjunction with your physician.

6. Having a Depression Relapse Doesn’t Mean You Failed

"Right now, I’m in between episodes," Moon says. "I know another one may come and it isn't a disaster when it does come. It doesn't mean you’ll end up committing suicide either."

Figuring out what works for you to stay on an even keel is critical, Moon says. The most important thing for anyone who's depressed? "Recognize when you’re falling off the cliff," she says. Then go get the help you need and deserve.

8 Ways to Maximize Your Depression Treatment

Tailor Your Depression Treatment

Although depression can make you feel like you’re alone, the truth is that you’re not: Major depression affects nearly 15 million adults in the United States every year, according to the Depression and Bipolar Support Alliance (DBSA). However, depression treatment can be different for everyone. "Depression is unique to the individual," says Steve Koh, MD, MPH, chair of the American Psychiatric Association Scientific Committee and an assistant clinical professor of psychiatry at the University of California, San Diego. That’s why it’s important to work with your doctor to find the right depression treatment plan. Although medication is a mainstay of treating and managing depression, it’s not the only answer — and it can take time to find just the right treatment for you. "Medication can have different effects, good and bad, so you should have good communication with your doctor to ensure that it’s not only working well, but that it’s also not causing any side effects," Dr. Koh says. Consider these tips to help increase your chances of successful depression treatment.

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The 1-Hour Workout That Gets Ciara THIS Bod

The singer — who gave birth to a son in May — recently appeared on MTV’s House of Style and continues to work with Degree Women for the brand’s Do More campaign. Users can search for fitness classes and view behind-the-scenes rehearsal footage on Degree’s web site

“As a hardworking woman, I’m always trying to figure out how I can get better and improve at everything I do," explains Ciara. "I really love being able to share this message with other women and encourage them to keep pursuing their dreams.”

 

 

 

 

At a Degree Women press event, Ciara gave Everyday Health the scoop on how she stays fit, healthy, and gorgeous while trying to juggle a packed schedule. 

On her fitness regimen: “I work out an hour a day. That’s all you need — the rest of it’s all about how you eat,” says Ciara. “When I train with Gunnar [Peterson], we do a mix of plyometric moving and weight training because you want a good balance of cardio, while still maintaining your muscle.”

 

 

 

On eating right: “For breakfast, I love an egg white omelet with spinach and turkey. I’ll also have a side of fruit and wheat toast,” she says. If she gets a late-night craving, Ciara satiates herself with chocolate Ensure protein shakes. “Sometimes I get hungry before I go to bed — I’ll drink one of these and it holds me over until the morning.” 

On how she motivates herself before a performance: “I think about what it is that I want to do onstage and how great I want the show to be,” she says. “I pray, stretch, jump, and move around to get my body warmed up.”

On maintaining her glow: “When I wake up, I wash my face with my dermatologist’s [Dr. Sabena Toor] foaming cleanser, which is made with organic ingredients,” says Ciara. “Then I put vitamin C and Revisions tinted moisturizer all over my face. I do that twice a day.”

Overly Controlling Moms Lose Out, Study Says

Helicopter parents, take note: A mother has a better relationship with her child if she respects the youngster's need for independence at a young age, a new study suggests.

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Mothers who allowed children more freedom at age 2 were viewed more positively by their children later in childhood, according to the University of Missouri study.

The study included more than 2,000 mothers and their children. The researchers observed how much the mothers controlled the children's play at age 2 and then interviewed the children at fifth grade to assess how they felt about their mothers.

"When mothers are highly controlling of small children's play, those children are less likely to want to engage with them," Jean Ispa, co-chair of the department of human development and family studies, said in a university news release.

 

 

Respect for independence is important both for children's growth and for creating positive parent-child relationships, she said. "We found that mothers who supported their children's autonomy were regarded more positively by their children than mothers who were highly directive," she said.

RELATED: Being a Good Parent Without Judging Other Parents

"Mothers who are very directive when their children are toddlers often tend to still be controlling when their children enter adolescence," Ispa noted.

Mothers with small children mostly use physical controls, she said, but when children are older these directives become more verbal and psychological -- not allowing kids to speak their mind, for instance. "It's not surprising that their children begin to view them in a negative light," Ispa said.

The findings, published online recently in the journal Social Development, don't mean that parents should not establish and enforce rules or offer advice, Ispa said. She noted that behavioral rules -- such as teaching children to check for cars before crossing the street -- did not have a negative impact on mother-child relationships.

It was psychological control -- such as inducing guilt or telling children what to think and feel, or to play in certain ways -- that damaged mother-child relationships, the study found.

 

 

"Many times, parents think that employing these controlling behaviors is the 'right way' to raise children, but our research shows that really does not work," Ispa said.

"Allowing children age-appropriate levels of autonomy to make safe decisions is very good for kids, and they usually will make wise decisions when they have been taught about safe choices as well as consequences," she added.

"A good place for parents to start would be to have open discussions and allow their children to express their own points of view," she suggested. "When giving children instructions, explain reasons for decisions rather than simply saying, 'Because I said so.' "

How to Protect Yourself During a Mass Shooting

No one thinks they could be in this situation, but here's advice from safety experts if it happens.

Thursday, April 03, 2014

The headlines appear with unnerving frequency about mass shootings somewhere in the United States -- at a movie theater, a shopping mall, a school, a sporting event. Yesterday, a shooting tragedy took place at the Fort Hood military base in Texas, the second at this site since November 2009.

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Precisely how often mass shootings have occurred depends somewhat on interpretation. The Congressional Research Service, which defines a mass shooting as one that takes place in a relatively public place and results in four or more deaths, not including the shooter, identified 78 such shootings in the United States from 1983 to early 2013. A report by researchers at Texas State University, done after the killings at Sandy Hook Elementary School in Connecticut, used different parameters and identified 84 mass shootings from 2000 to 2010 by people whose main motive appears to have been mass murder.

Though the precise number of mass casualty shootings may be hard to determine, there's no disagreement that people today need to think about their safety whenever they go out in public, said Dennis Krebs, a retired captain and paramedic with the Baltimore County Fire Department and author of "When Violence Erupts, A Survival Guide for Emergency Responders" and the "Special Operations Mission Planning Field Guide." 

“If you at least think about what you would do if you were confronted with such a situation, it gives you an edge,” Krebs said. 

Life-Saving Tips in the Event of a Mass Shooting

Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University, said that people don’t need to panic or even fear going to public places to avoid mass casualty shootings. He does agree with Krebs though: In 2014, it’s worth giving some thought to how to protect yourself during a mass shooting. 

 

 

What you can do if faced with a mass shooting depends greatly on the situation and your physique and physical capabilities, Dr. Redlener noted. “If you’re small and alone or with your 1-year-old or your 14-year-old, it’s going to be different,” he said. “Everything about survival guidelines is dependent on the details of the particular situation.” 

However, experts in public safety do have advice on how to protect yourself and your loved ones in the event of a mass shooting.

Pay attention to your surroundings. No matter where you go, "be aware of your environment," Redlener said. "If you see something that looks suspicious or out of place, or you notice an unusual gathering of people, you can begin taking action prior to the event occurring." By being aware, you may be able to avoid the scene and not walk into trouble. “Situational awareness is something that police officers and the military are taught and trained to do,” he said. When you go to a mall or a movie, know where the nearest exits are. 

RELATED: Media Exposure to Traumatic Events Can Be More Stressful Than Being There

Flee if you can. If you’re caught in a mass shooting, “you want to get outside of the building as quickly as you possibly can," Krebs said. A lot of people freeze, but "that's the last thing you want to do,” he said. Urge any people you're with to come with you, but don’t waste precious time trying to persuade them to get out while you can. 

 

"If you see something... suspicious or out of place...you can begin taking action prior to the event."

Irwin Redlener, MDTWEET

 

David Reiss, MD, a San Diego psychiatrist, said that some training in the martial arts can help prepare you to deal with your body’s natural fight-or-flight response and not be paralyzed when faced with traumatic events from which you should flee. “To be aware of that response and have some training in dealing with it can be useful without going overboard,” he said. 

Leave your belongings behind. Drop whatever stuff you have with you -- packages, luggage, purse, or backpack. It will make your exit easier. Nothing is more important than your life, Krebs said. Video of the mass shooting at the Los Angeles airport in November 2013 showed people fleeing with their suitcases, but, as Krebs said, "there's nothing in that piece of Samsonite that’s worth your life." 

If you can’t run, hide. “You want to be in an area that allows you to be protected from the gunman or further mischief by the armed perpetrator,” said Stephen Hargarten, MD, MPH, professor and chairman of emergency medicine and director of the Injury Research Center at the Medical College of Wisconsin. Lock and barricade the doors to your hiding place. In one recent mass shooting at a mall, a store clerk was able to protect some shoppers by hitting the button for a gate in front of the store, sealing everyone inside, Krebs said. 

Once in hiding, be quiet. Shut off your cellphone. Instinct may tell you to keep it on and try to call for help, but a ringing phone could be dangerous if it attracts the shooter's attention, Krebs said. Call 911 for help only if and when it’s safe to do so. 

 

 

Try to avoid confronting the shooter. According to the U.S. Department of Homeland Security, taking any action against the shooter should be a last resort -- something you do only if your life is in imminent danger. But, if there's no other option, yell, act aggressively, or look around for something that might work as a weapon. 

Afterwards, exit carefully. Once the shooting has stopped and you are able to leave the building, go out with your hands up. Drop whatever you are carrying. “Police may not have a description of the suspect they’re after," Krebs said, "and if you come running out the door with something in your hand, you could end up getting hurt." 

Disaster Preparedness With Children 

Parents with young children should follow the same advice that flight attendants give passengers: Take care of yourself first because, if you don’t, you won’t be able to help your children, Dr. Hargarten said.

Before you're faced with a traumatic event, talk with your children about the best ways to handle such situations. What you say will depend on their age, but whatever you say, try not to frighten them unnecessarily. Emphasize that in an emergency situation like that, they would need to follow your directions, no questions asked. If you have to scream at your children, it could attract the attention of the shooter. 

As part of your family's disaster preparedness plan, decide where to meet if you get separated in an emergency -- even if it's a place you've been many times before. 

Dr. Reiss said you can’t anticipate mass casualty shootings and should not spend your days fretting over what you would do if you were caught up in one. “If you expect emergencies every moment of your day, it will ruin your life,” he said. It’s best to give it some thought but not let it overwhelm you

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.

Some risk factors for binge eating disorder include:

  • A history of anxiety or depression
  • A history of dieting (especially in unhealthy ways, such as skipping meals or not eating enough food each day)
  • Painful childhood experiences, such as family problems

Symptoms of Binge Eating Disorder

People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.

Binge eating episodes are associated with three or more of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you're not feeling hungry
  • Eating alone, because you feel embarrassed about how much you're eating
  • Feeling extremely disgusted, depressed, or guilty after eating

Some people also display behavioral, emotional, or physical characteristics, such as:

  • Secretive food behaviors, including hoarding, hiding, or stealing food
  • Feelings of anger, anxiety, worthlessness, or shame preceding a binge
  • Feeling disgusted with your body size
  • A strong need to be in control, or perfectionist tendencies

Binge Eating Disorder Treatment

If you have binge eating disorder, you should seek help from a specialist in eating disorders, such as a psychiatrist or psychologist.

There are several treatments available for BED. Treatment options may include:

 

8 Things Your Dentist Knows About You Just By Looking In Your Mouth

You flossed right before your appointment—and that’s the only time.

Sorry, but you can’t fool your dentist into thinking you floss daily by doing it the night before or morning of your visit. 

“The gums of people who only floss right before a visit are bleeding or look damaged,” says Timothy Stirneman, D.D.S., of All Smiles Dental in Algonquin, Illinois. “Healthy gums are nice and tight and pink.”

Santa Monica-based dentist Kenneth Wong, D.D.S., is on to you, too. “When patients floss right before coming in for a cleaning, I can see the slices where the floss cut at the gum because they were overzealous,” he says. 

Conquering Depression and Obesity

By the time David Clark was in his early thirties, he owned a chain of 13 retail stores that reported $8 million a year in sales, and he was married with three children. “I should be happy,” he recalls thinking. But he wasn’t.

He was depressed. “I couldn’t find simple joy in anything, and had thoughts of stepping in front of a bus to end it,” he says. The depression caused him to eat massive amounts of fast food and drink recklessly, he says, and that led to obesity. At his heaviest, the nearly 6-foot-tall Clark, from Lafayette, Colorado, weighed 320 pounds.

Clark was not alone in suffering from depression and obesity. Nearly half of all adults who live with depression — 43 percent — are obese, and adults with depression are more likely to be obese than adults who aren’t depressed, according to the Centers for Disease Control and Prevention.

Whether depression or obesity comes first can vary from person to person, says Kim Gudzune, MD, MPH, assistant professor of medicine at Johns Hopkins Medicine in Baltimore. “But if you have one condition, you’re more likely to have the other,” she says.

Depression and obesity are often linked because of the stigma of obesity. Some who are obese have a poor body image and can become depressed as a result, Dr. Gudzune says, and others eat to drown their sorrows.

In addition, “there may be shared neural pathways between obesity and depression that may place individuals at risk for both,” says Leslie Heinberg, PhD, director of behavioral services for the Bariatric and Metabolic Institute at the Cleveland Clinic in Ohio.

How Clark Turned His Life Around

After his weight gain, Clark was at risk for high blood pressure and was borderline diabetic.

He says he overcame both of his health conditions essentially on his own. One morning, when he was 34, Clark says he woke up and realized how close to death he was. He knew that if he didn’t change, his children would be fatherless.

“I didn’t want my kids to see their father drink himself to death,” he says, so he joined Alcoholics Anonymous and followed the group's 12 steps to stop drinking. “I went on a spiritual journey to make peace with my path,” says Clark, who grew up poor and homeless. As a kid, he and his dad had roamed the country in the back of a pickup truck, he says.

RELATED: 6 Ways to Set Goals You’ll Actually Achieve

He also began running. And running. Some years earlier, he'd seen the New York City Marathon on television and always had it in the back of his mind that that was something he might do. Eventually, Clark became an ultra-marathon runner. Now 44, he runs at least 80 to 100 miles a week and competes in some of the most challenging endurance races on the planet, including across Death Valley in California.

At first, it was painful to run, but he says the pain was also motivating. “I knew the stakes had to be pretty high to make such a dramatic change in my life," he says.

Running: A Low Cost Mood Booster

After Clark revamped his diet to be plant-based, stopped drinking alcohol, and began running regularly, his weight began to drop. It took him 18 months, but he got down to a healthy 180 pounds. When he switched to competitive running, he lost another 20 pounds and has stayed at 160 for years now, he says.

The running also improved his mood, says Clark, who chronicles his journey in the book Out There: A Story of Ultra Recovery. Exercise releases endorphins — hormones that reduce your perception of pain and improve your mood, according to Harvard Medical School in Boston.

Clark advises others who struggle with obesity and depression to do like he did and “draw a line in the sand” to say, “I’m not going to live this way anymore — I’m going to move on to a better place.”

What You Can Do

Though Clark lost weight on his own, not everyone can. So if you're struggling, consider working with a nutritionist or your doctor to find a weight-loss program. The key is to make low-calorie, healthy choices and exercise more so that you burn more calories than you consume, according to the National Institutes of Health. If you're extremely overweight, your doctor might suggest medication to curb your appetite, or weight-loss surgery.

Exercise and eating well may also help treat your depression. You can work with a therapist who can help you find the right treatment plan. That could include individual or group therapy, stress-reduction techniques, medication, or some combination of these.

Treatment can be difficult, because a side effect of some depression medications is weight gain, Gudzune says. But treating depression and weight issues simultaneously, Heinberg says, can be beneficial because if people who are depressed are able to lose weight, that could benefit their depression.

potting Between Periods: Should You Worry?

leeding between your periods, or “spotting,” can occur for many reasons.

The cause is usually benign; for example, hormonal fluctuations that occur at the very beginning of your reproductive life cycle (menarche, the onset of periods) or toward the end (menopause, when periods stop) are often likely culprits.

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But “spotting is never normal," says Joyce Gottesfeld, MD, an ob/gyn at Kaiser Permanente Colorado in Denver. "It doesn't necessarily mean that something bad is going on, but it's not normal.” So if you do notice spotting, it's worth a call to your physician to get it checked out.

When investigating why you’re spotting, healthcare providers consider your age and whether you’re pregnant, have been having unprotected sex, or recently started using a hormonal contraceptive.

 

 

If you’ve started taking the birth control pill or gotten a progesterone implant, it’s not unusual to experience irregular bleeding. If spotting doesn't taper off, talk to your doctor. “You're probably going to want to change birth control pills, because nobody wants to deal with that all the time,” Dr. Gottesfeld says.

Skipping a pill or two may also bring on spotting. “If you're on birth control pills and you missed a pill, that can also make you have bleeding between your cycles, and I wouldn't be so worried,” says Anne C. Ford, MD, associate professor of obstetrics and gynecology at the Duke University School of Medicine in Durham, North Carolina.

Spotting in the Early Years

Spotting can mean different things at early versus later stages of your reproductive cycle.

When you first start having your period, it may be quite irregular for months or even years. This is because your brain, ovaries, and uterus are still working on getting in sync hormonally. Unless your bleeding is excessively heavy or prolonged, it's usually not a problem, according to Dr. Ford.

Once you become sexually active, spotting after intercourse raises a red flag. This is especially true if you’re having unprotected sex or have just started having sex with a new partner.

Bleeding can signal a sexually transmitted infection (STI), such as chlamydia orgonorrhea, that should be treated promptly, Ford says. “Often, the cervix can be very friable [eroded] or just bleed very easily from the infection,” she explains.

Another condition that can lead to post-sex bleeding is cervical entropion, in which the fragile glandular cells lining the cervical opening grow on the surface of the uterus.

Much more rarely, post-sex spotting can be a sign of cervical cancer. Your doctor can take a Pap smear, a sample of cells from your cervix — the opening of the uterus at the top of the vagina — to test for STIs and abnormal precancerous or cancerous cells.

Mid-cycle bleeding could also mean that you’re pregnant and could be miscarrying, although spotting during pregnancy doesn't always mean the pregnancy will be lost. Ectopic pregnancy, in which a fertilized egg grows outside of the uterus (usually within the fallopian tubes), can also cause bleeding, according to the American Congress of Obstetricians and Gynecologists (ACOG). 

Spotting may also be due to vaginal trauma. “The vagina and the cervix are very vascular [they have a lot blood vessels], so they bleed very easily,” says Lisa Dabney, MD, an ob/gyn in the division of urogynecology at Mount Sinai West in New York City. “A scratch in the vagina will always bleed more than a scratch in your regular skin would.”

Bleeding Between Periods in the Middle Years

Once you reach your thirties, the chance that spotting could indicate endometrial cancer, a type of cancer of the uterus, increases. Obesity also boosts your risk of endometrial cancer, even if you’re a younger woman. “We're seeing more and more endometrial pathology like that because of the obesity epidemic. We have to worry about that in very obese women, even if they're younger,” Ford says.

Spotting “definitely becomes more worrisome after the age of 35, because it could be an early sign of endometrial cancer,” Dr. Dabney says. “Hormonal changes, fibroids, and polyps are far more common than endometrial cancer. It's probably one of those things, but unless you have it evaluated, you don't know if you're that one in 1,000 people who has the cancer.”

Fibroids, benign growths that can form in your uterus, are more likely to cause irregular bleeding if they grow into the uterine lining. Polyps, another type of benign growth, can also grow in the uterus or on the cervix and may cause bleeding. Bothfibroids and polyps can be removed surgically.

Endometrial hyperplasia, in which the lining of the uterus grows too thick, can also cause abnormal bleeding. While this condition is benign, it can be a precursor to cancer in some cases, according to ACOG.

If your doctor suspects you may have endometrial cancer, he or she will take a sample of tissue from the endometrium so that the cells can be examined under a microscope. Other tests, such as an ultrasound, may be used to determine if bleeding is related to polyps or fibroids.

The long march toward menopause — which officially occurs when a woman has not menstruated for a full year — begins for most women during their fourth decade. As your ovaries begin winding down egg production, your period is likely to become irregular. You may skip a cycle here or there, have your periods unusually close together, or experience heavy bleeding.

 

 

“As people's ovaries start to age, you can see mid-cycle spotting,” Ford says. “That's very normal and it comes from fluctuating hormone levels.” It can be hard to tell what's normal and what's not during this tricky time of life, according to Ford. “If your normal period was 3 to 5 days and now you're bleeding 7 to 10 days and it's heavy, then it's probably not a normal period.”

For Pain, It Matters Which Doctor You See

As a physician anesthesiologist, I know how challenging it can be to treat patients who are in pain. For most people, pain is temporary. But for more than 100 million Americans, there is no end to pain.

Chronic pain can be broad or focused, dull or sharp, distracting or excruciating, and in many cases, debilitating.

Your likelihood of experiencing chronic pain increases with age. Gender can also influence how much pain you have. In general, women report having more pain than men.

The Serious Effects of Pain

Living with chronic pain can affect your life in many ways:

Mental health changes. According to a 2006 survey from the American Academy of Pain Medicine, almost two-thirds of people living with chronic pain have reported a decrease in overall happiness and 77 percent reported feeling depressed.
Increased fatigue. Pain can affect your daily functioning, resulting in decreased concentration, diminished energy levels, and difficulty falling or staying asleep.
Decreased job performance. Chronic pain costs the U.S. more than cancer, heart disease, and diabetes. Health economists estimate that the cost of chronic pain may be as high as $635 billion a year, according to a report published in the Journal of Pain. We can only guess how many people have been limited in their professional advancement because of pain.
Which Doctor Is Best at Treating Pain?

If you  are experiencing pain, your first stop should be to visit your primary care physician. A 2010 analysis of a national medical database found that 13 percent of all doctors visits were to discuss pain. Of these visits, 45 percent were at a primary care physician's office. Less than 1 percent of those surveyed sought help from a specialized pain physician.

Specialized pain physicians are underused by patients, probably because the specialty is relatively new and people don't know about it. These physicians are trained to treat difficult pain conditions using the most advanced treatments.

I like to compare pain physicians to football players. The goal of all of these doctors is the same — to relieve pain — but the role they play varies:

Anesthesiologists spend four years of their training managing anesthesia and pain control in surgical patients. Most pain specialists are anesthesiologists, and they can offer a full array of pain treatments.
Neurologists focus on targeting the neural, or nerve, aspects of pain. Treatments include medications and procedures to treat nerve-related pain.
Physical medicine and rehabilitation physicians focus on relieving pain and improving their patients' day-to-day functioning via physical therapy and physical reconditioning.
The Future of Pain Treatment

Recently, the American Society of Anesthesiologists analyzed dozens of peer-reviewed medical journals from the past year to create its first Women’s Pain Update. Highlights from the report include:

Success with alternative pain-relief methods such as music, yoga, and rose oil.
Breast cancer research that found the type of anesthesia used during breast cancer surgery can affect how quickly and comfortably you recover.
New research has also led to the development of medications that can decrease nerve irritation and depression caused by pain. Similarly, there are several new procedures that can treat pain.

For example, pain specialists can use X-ray or ultrasound imaging guidance to provide relief through steroid injections that target specific nerves and areas of the spinal cord. The procedure is fairly low risk when administered by a physician specifically trained in interventional pain treatments. All three major pain societies, the American Pain Society, the American Society of Interventional Pain Physicians, and the American Academy of Neurology, state that epidural steroid injections are best suited for those with a pinched or inflamed nerve root (also called radiculopathy).

However, we still have a lot to learn about steroid procedures. Studies have shown that any type of epidural injection — including saline — can relieve pain. In fact, such injections provide twice the pain relief of intramuscular steroid injections, without the associated risks.

Don't resign yourself to a life  in pain. If you are one of the millions of people lacking an effective remedy for your pain, a trained pain medicine physician may be able to help you achieve your pain management goals.

Mindfulness Therapy May Help Ease Recurrent Depression

Review of 9 studies suggests it helps patients better cope with troubling thoughts and emotions.

Mindfulness therapy may help reduce the risk of repeated bouts of depression, researchers report.

One expert not connected to the study explained the mindfulness approach.

"Mindfulness-based cognitive therapy enhances awareness of thoughts and emotions being experienced, and enables development of skills to better cope with them," said Dr. Ami Baxi, a psychiatrist who directs adult inpatient services at Lenox Hill Hospital in New York City.

In the new study, a team led by Willem Kuyken, of the University of Oxford in England, analyzed the findings of nine published studies. The research included a total of almost 1,300 patients with a history of depression. The studies compared the effectiveness of mindfulness therapy against usual depression care and other active treatments, including antidepressants.

After 60 weeks of follow-up, those who received mindfulness therapy were less likely to have undergone a relapse of depression than those who received usual care, and had about the same risk of those who received other active treatments, the team reported.

The study authors also believe that mindfulness therapy may provide greater benefits than other treatments for patients with more severe depression.

The study was published online April 27 in the journal JAMA Psychiatry.

"Mindfulness practices were not originally developed as therapeutic treatments," Richard Davidson, of the University of Wisconsin-Madison, wrote in an accompanying editorial. "They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue," he explained.

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

"The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage," according to Davidson.

While this review is the most comprehensive analysis of data to date, it "also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research," Davidson concluded.

However, another psychologist said she is already using mindfulness therapy in her practice.

"I have increasingly incorporated mindfulness based-interventions into my work with children, adolescents and adults, and I've seen how it has improved treatment outcome and overall well-being in my clients," said Jill Emanuele. She is senior clinical psychologist at the Child Mind Institute in New York City.

Emanuele said there is growing evidence that the approach brings patients "increased awareness of emotions and thoughts, and the ability to more effectively regulate and cope with them."

6 Ways to Prep Your Skin for Summer

Scheduling vacation plans and buying a new swimsuit will mentally prepare you for summer, but your skin may need some help getting ready, too. For gorgeous, smooth skin you'll feel ready to bare, you need to take a few simple steps. Try this head-to-toe refresher to take your skin out of hibernation.

1. Reveal Glowing Skin

Regular exfoliation can be a part of a healthy skin regimen no matter the season; as long as your skin is not sensitive, exfoliation can help you achieve smooth, healthy-looking skin that makes you look more glowing and youthful. “But it must be done with care,” says Doris Day, MD, a dermatologist in New York City. “The goal is to lift off the outer layer of skin cells that are ready to be sloughed off without stripping the skin.”

 

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Brushes, polishing cloths, and scrubs offer easy ways to smooth away rough spots. Rotating cleansing brushes work by physically buffing off the dead skin cells. Exfoliating cloths, microdermabrasion kits, and scrubs with granular ingredients also operate the same way. “For the body, look for a scrub that contains coarse particles that dissolve over time, like sugar, so you don’t irritate the skin,” says Dr. Day.

Products that chemically exfoliate the skin contain ingredients such as glycolic, salicylic, or polyhydroxy acids that cause the skin to shed its outer layer and reveal the newer layer.

2. Remove Hair Without Irritation

If your summer forecast calls for sunny days at the beach or poolside, you may be putting some effort into removing unwanted hair. But once you rip off the wax strip, it’s also important to care for the skin that’s newly exposed to the elements.

Give your skin some time to recover before rolling out your beach towel or getting active outdoors. “I advise clients to stay out of the sun or heat for at least 48 hours after any hair-removal process,” says Cindy Barshop, owner of Completely Bare spas. “Follicles are vulnerable to irritation, and skin may be sensitive due to any heat or friction from lasers, waxing, or shaving.”

Since most of us don’t plan our hair removal that far in advance, buffer your tender skin with an oil-free sunscreen, wait for it to dry (about 5 minutes), and dust on some talc-free baby powder, says Barshop. To prevent ingrown hairs, it’s helpful to wear loose-fitting clothing and use an after-waxing product that contains glycolic and salicylic acids, which team up to prevent dead skin cells from causing bothersome bumps.

 

 

3. Fight UV Rays With Food

All the work you put into making your skin look good won’t be worth it unless you guard it from the sun’s damaging rays, which are strongest during the summer. Surprisingly, you can protect yourself from the inside, too. “In addition to usingsunscreen, eat cooked tomatoes every day if you know you’re going to be in the sun,” says Jessica Wu, MD, assistant clinical professor of dermatology at USC Medical School. According to research, cooked tomatoes are rich in lycopene, an antioxidant that helps fight the effects of UV rays such as redness, swelling, and blistering from sunburn. If you plan to spend a lot of time outdoors, you may benefit from consuming tomato sauce, grilled tomatoes, or even Bloody Marys. “This doesn’t replace sunscreen, but the habit could give you additional protection if you can’t reach your back and miss a spot,” Dr. Wu adds.

4. Clear Up Body Breakouts

It’s no better to have acne on your body than on the face, especially in the heat, when hiding and covering up isn’t an option. The approach to treating acne on the back, chest, and elsewhere on the body is the same as treating facial acne: “Exfoliate regularly, don’t pick, and treat with effective ingredients,” says Day.

Washing with products that contain salicylic acid helps slough off the dead skin cells; a treatment product with micronized benzoyl peroxide can also help by penetrating the skin and killing off the bacteria that cause acne.

If your skin is sensitive, investing in an acne-treating blue light tool may be worth the cost. “You simply wave the light wand over skin for five minutes daily and it helps kill bacteria,” says Leslie Baumann, MD, a dermatologist in Miami. If you have severe body acne, see a dermatologist.

5. Erase Cellulite

First, the good news: Some products may be able to smooth out the undesirable dimples and unevenness of cellulite. The bad news: They won’t get rid of cellulite forever. The smoothing and toning effect, like many good things in life, is fleeting. Still, it may be worth slathering on a toning body lotion to make your skin look and feel tighter for a day at the beach or a special event.

“Products that contain caffeine and theophylline temporarily dehydrate fat cells,” says Dr. Baumann. “However, it’s the massage and the application of the cream that does the work.” The best course of action long-term is to exercise regularly, coupled with targeted massage, suggests Baumann.

Another way to hide cellulite is to apply a fake tan. Take advantage of the newest self-tanners, which have come a long way from the strong-smelling streaky creams or sprays of yesteryear. “There has been so much progress in the formulations — the colors are natural, there’s no streaking, and the scent is so much better,” says Day.

6. Treat Your Feet

If you’ve stuffed your feet inside boots all winter, they probably could use a little TLC for sandal weather. Jump-start your program with a salon pedicure, or if you’re short on time, you can heed Day’s DIY tip, which will help soften feet while you sleep. First, remove thicker skin with a foot file. Apply a rich emollient cream or ointment, then cover the feet in plastic wrap and cotton socks. Leave on overnight. Repeat every day until you achieve smooth skin, then once a week to maintain soft skin.

The Link Between Depression and Debt

Too often, depression and debt are connected — and together, they can spiral out of control. Try these strategies to regain your footing.

Mental problems and money problems often go hand in hand. For one, debt is an increasingly common stressor that can trigger depression. Indeed, people who live with debt are more likely than their peers to be depressed and even contemplate suicide, according to a report on the health effects of debt published in 2014 in BMC Public Health. They're also less likely to take good care of their health. On the other hand, the researchers found that debt management programs can help stave off depression. Here's what else you need to know.

How Debt Leads to Emotional Distress

Debt can make you feel helpless, hopeless, and low on self-esteem — and these are all symptoms and risk factors for depression, says Nadine Kaslow, PhD, professor in the department of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta.

Credit card debt, mortgage foreclosure, student loan debt, medical debt, and job loss can all contribute to depression, agree the authors of the BMC Public Health article, adding that you might also experience anger and anxiety. Other factors, such as being the sole breadwinner with dependent children, being elderly and not having much saved for retirement, or having very high interest debts, seem to increase depression risk.

When Depression Leads to Debt

It’s easy to understand how the stress of debt can trigger or worsen depression, but you may not realize that depression can also lead to debt problems.

Symptoms of depression can lead some people to accumulate growing piles of debt, Dr. Kaslow says. "Someone with depression may exhibit behaviors that can lead them into a debt crisis."

"Some people may try to relieve feelings of depression by compulsive shopping. Depression is often associated with destructive and addictive behaviors that can result in overwhelming debt. This type of debt can lead to extreme despair and even to suicide," Kaslow warns.

RELATED: 5 Ways to Ease Unemployment Blues

Compulsive buying, which can lead to debt, is indeed linked to depression, anxiety, and other mood disorders, researchers reported in the American Journal of Addiction in 2013. The researchers note that in addition to depression treatment, support groups using cognitive behavioral strategies can help control compulsive buying.

How to Find Debt and Depression Help

If you find you are dealing with debt and depression, it is important to address both, Kaslow says. Many types of help are available. "If a person is feeling trapped, desperate, and hopeless, they may need help for depression and help getting out of debt," she adds.

Depression is a very treatable disorder. The first step is to recognize the problem and ask your doctor for depression help. Once depression is diagnosed, your doctor might recommend a range of treatment strategies, including talk therapy, medications, and support groups.

For someone with addictive spending behaviors, Debtors Anonymous (DA) is an organization that can be very helpful, says Kaslow. DA has meetings all over the country where people share their experiences with compulsive debt and debt management. There are also online meetings. For help with compulsive debt, check out DA's website.

A good source of advice for getting help with a debt problem can be found via the Federal Trade Commission, which recommends the following strategies:

Develop and closely follow a budget.
Contact your creditors instead of avoiding them.
Know your rights when dealing with debt collectors.
Use a credit counseling or debt management agency.
Seek protection through bankruptcy laws.
Learn about the steps you need to take to repair your credit.
Beware of debt management scams promising an easy fix.

Psoriasis Linked to Higher Risk of Depression

People with psoriasis may be twice as likely to experience depression as those without the common skin condition, regardless of its severity, a new study suggests.

"Psoriasis in general is a pretty visible disease," said study author Dr. Roger Ho, an assistant professor of dermatology at New York University School of Medicine in New York City. "Psoriasis patients are fearful of the public's stigmatization of this visible disease and are worried about how people who are unfamiliar with the disease may perceive them or interact with them."

Genetic or biologic factors may also play a role in the link between depression and psoriasis, which requires more research, he said. Either way, the findings mean that all individuals with psoriasis could benefit from screening for depression, Ho said, and their friends and family members should be aware of the connection as well.

The findings were scheduled for presentation Thursday at an American Academy of Dermatology meeting in New York City. They have not yet been published in a peer-reviewed journal and should be considered preliminary.

Most people with psoriasis have red, raised patches of skin covered with silvery-white scales, the researchers noted. These patches usually appear on the scalp, elbows, knees, lower back, hands and feet.

The researchers analyzed the responses of more than 12,000 U.S. adults in the 2009-2012 National Health and Nutrition Examination Survey conducted by the U.S. Centers for Disease Control and Prevention.

Overall, nearly 3 percent of responders reported that they had psoriasis, and about 8 percent had major depression based on their answers to a depression screening assessment. Among those with psoriasis, 16.5 percent had sufficient symptoms for a diagnosis of major depression.

Those with any degree of psoriasis had double the odds of having depression even after taking into account their age, sex, race, weight, physical activity level, alcohol use and history of heart attack, stroke, diabetes and smoking, the researchers said.

Depression is one of several concerns that someone with psoriasis should look out for, said Dr. Delphine Lee, a dermatologist at John Wayne Cancer Institute at Providence Saint John's Health Center in Santa Monica, Calif.

"Patients with psoriasis should be aware that there are several other health issues associated with this condition, including cardiovascular and metabolic diseases, such as diabetes, as well as psychological or psychiatric disorders," Lee said. "To address your health beyond your skin is critical to maximizing a person's quality of life."

Several aspects of dealing with psoriasis may contribute to depression, said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City.

RELATED: 7 Hidden Dangers of Psoriasis

What matters more than its severity is the location of flare-ups, she said. Some of her patients won't wear shorts if it's on their legs or won't go on dates because they're embarrassed about red spots on their skin, she added.

"Also, because it's a chronic illness, you don't know if it's going to get worse and you don't get to take a vacation from it either," Day said. "You're using topical treatments all year long, and as soon as you stop, it comes right back. It's very depressing, and it can affect your self-esteem and your quality of life."

Anxiety about how psoriasis and its treatment may affect your future health might also contribute to depression, Day explained.

"It's unsightly, it can be itchy, people are worried about it spreading to other parts of their body, they worry about the side effects of medication, they worry about psoriatic arthritis, they worry about taking medications when they're pregnant, and they worry about passing it along to their children," she said.

Day recommended that people with psoriasis seek mental health treatment to get to the bottom of their depression.

"It's about that emotional connection and finding out what about this condition is affecting someone in the way that it is," Day explained.

Not seeking help can make matters worse, said Dr. Tien Nguyen, a dermatologist at Orange Coast Memorial Medical Center in Fountain Valley, Calif.

"Psoriasis can cause severe emotional distress," he said, noting some patients may have suicidal thoughts or attempt suicide. "Stress is a known cause of exacerbation of psoriasis, so this will lead to a vicious cycle."

Day added that it's critically important to continue seeing a dermatologist to learn about new medications that become available.

"There are some really amazing new treatments that have a great safety profile that can have excellent clearance with lasting results," Day said.

How to Get Glowing Skin When You Have Psoriasis

Carolyn Jacob, MD, director of Chicago Cosmetic Surgery and Dermatology, doesn’t just treat patients with psoriasis — she manages her own. Dr. Jacob has been living with psoriasis since she was 14 years old.

Jacob’s psoriasis primarily affects her scalp and nails, both of which can be tough to hide. “I hated it when I had scalp involvement, which would show flakes on my clothing and itch constantly,” Jacob says.

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Embarrassed about her nail psoriasis, Jacob used to paint them a color that would mask her symptoms. The National Psoriasis Foundation says that about half of all people with psoriasis will have symptoms affecting the nails, which can include changes in color, thickening of the nails, separation of the nail, and the formation of pits or holes.

An Accessible Skin Care Routine

For healthy skin, Jacob knows she has to keep her skin clear and moisturized as much as possible. She uses CeraVe cleanser, available at many drugstores. “It adds ceramides to the skin, which help to rebalance the natural moisturizing factor in your skin,” she says. She follows that up with CeraVe lotion.

Other daily psoriasis treatment tips that Jacob offers her patients and practices herself include:

  • Cleanse and moisturize your skin just once daily to avoid drying.
  • Use a soft cloth or your hands to lather up with cleanser; never use a loofah on skin that’s actively flaring because the rubbing and scratching could worsen symptoms.
  • If you have psoriasis on your face, Jacob advises against using harsh toners because they can be aggravating.
  • During the frigid Chicago winters, Jacob switches to a cream or moisturizing cream from a lighter lotion because it’s more hydrating for thirsty winter skin.
  • For scalp psoriasis, she recommends over-the-counter favorites like Neutrogena T/Gel, DHS tar shampoos, or those containing salicylic acid (her personal pick is Neutrogena T/Sal.) For something stronger, she likes Clobex, a steroid shampoo that you can get with a prescription from your dermatologist.

When Jacob’s psoriasis flares, she turns to a prescription Avène product called Akérat cream because it contains exfoliators and softeners to soothe the skin.

Daily Psoriasis Treatment Starts from the Inside Out

Jacob knows that psoriasis and its treatments are more than just skin deep. She sticks to a healthy, balanced diet to help keep inflammation down and her symptoms in check. She eats salmon and walnuts for the omega-3 fatty acids, which can help reduce inflammation and promote better heart health. Jacob also takes omega-3 supplements for an extra boost. “They are great for inflammatory conditions, especially psoriasis, and they help balance cholesterol levels and improve your skin texture,” she explains. The heart-healthy supplements can prove particularly beneficial since people with psoriasis have a 58 percent greater chance of suffering a major cardiovascular event like a heart attack, according to the National Psoriasis Foundation.

Stress is also a trigger for psoriasis, so Jacob tries to keep it in check, particularly by exercising. With twin toddlers and a busy schedule, she has to make time to work out. How does she fit it in? “I get up early to exercise so it is done for the day,” she says. It’s a prudent strategy that’s backed by a study from the August 2012 issue of Archives of Dermatology, which found that women who engaged in regular vigorous exercise were less likely to develop psoriasis.

Another of Jacob’s secrets: avoiding alcohol. “It makes stress worse and makes psoriasis worse,” she says. The National Psoriasis Foundation notes that alcohol can interfere with psoriasis treatments and causes side effects when combined with many psoriasis medications. Plus, alcohol can change the way you perceive and manage your stress, according to the National Institute on Alcohol Abuse and Alcoholism.

Find What Works for You

Jacob’s psoriasis is now well controlled with biologic medications, and she says her skin, scalp, and nails stay pretty healthy. Her best advice? Work with your dermatologist to find the right treatment for you.

“The availability of biologic medications was life changing — to not have to deal with other messy medicines that do not work well, to not itch, and to have normal nails is wonderful,” she says. “This type of treatment makes me feel like a normal person again!”

Plastics Chemical Tied to Changes in Boys' Reproductive Development

When expectant mothers are exposed to plastics chemicals called phthalatesduring the first trimester, their male offspring may have a greater risk of infertility later in life, a new study suggests.

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Boys exposed to the chemical diethylhexyl phthalate (DEHP) may be born with a significantly shorter anogenital distance than those not exposed to these chemicals. Anogenital distance is the distance between the anus and the genitals. A shorter anogenital distance has been linked to infertility and low sperm count, the researchers explained.

"We saw these changes even though moms' exposure to DEHP has dropped 50 percent in the past 10 years," said lead researcher Shanna Swan, a professor of preventive medicine and obstetrics, gynecology and reproductive medicine at the Icahn School of Medicine at Mount Sinai in New York City.

"Therefore, we have not found a safe level of phthalate exposure for pregnant women," she contended.

Swan said that this study cannot prove that these boys will have fertility problems as adults or that DEHP causes these problems. However, animal studies have implicated the chemical in male reproductive problems. Based on the data from this study, Swan believes there is a strong association between exposure to DEHP and fertility in human males.

DEHP is used to soften plastics. Most exposure results from eating foods that pick up the chemical during processing, Swan said.

RELATED: 10 Toxic Household Items You Should Throw Away Now

 

 

"Since food is the largest source of DEHP for consumers, it is difficult for pregnant women to minimize exposure," she said. "Eating unprocessed food will likely help. However, eliminating DEHP from food really has to be done by food producers."

The chemical is also found in medical tubing and in a variety of products, including flooring, wallpaper, lacquers and personal care products, Swan said.

The report was published Feb. 19 in the journal Human Reproduction.

For the study, Swan's team collected data on almost 800 pregnant women and their infants.

Specifically, the researchers found that exposure in the womb to three types of DEHP was associated with a significantly shorter anogenital distance in boys, but not in girls.

A group representing the chemical industry took issue with the study, however.

In a statement, the American Chemistry Council (ACC) stressed that the study only examined one type of phthalate, not all versions of the chemical. And it said that phthalates are "one of the most widely studied family of chemicals in use today."

The ACC added that DEHP "is known to break down into its metabolites within minutes after it enters the body. Information collected by the Centers for Disease Control and Prevention over the last 10 years indicates that, despite the fact that phthalates are used in many products, exposure from all sources combined is extremely low -- much lower than the levels established as safe by scientists at regulatory agencies."

 

 

But another expert says phthalate exposure may not be benign. Dr. Kenneth Spaeth, director of the Occupational and Environmental Medicine Center at North Shore University Hospital in Manhasset, N.Y., said, "virtually everyone in the U.S. experiences continual exposure to phthalates."

And, a number of studies have tied the chemicals with changes in developing fetuses. "Phthalates, in particular, have been shown in both human and animal studies to interfere with normal fetal development," he said.

This study supports what has been demonstrated before, that phthalate exposure in the first trimester is linked to male reproductive development, Spaeth said. "This study is an important step forward in establishing this effect because the study included a much larger number of individuals than prior studies and helps identify one particular agent, DEHP, as an important contributor to this effect," he said.

Additionally, this study shows the importance of exposure in the first trimester as a critical window for the effect of phthalates on the male reproductive system. "On the whole, given these features, the authors have contributed important information about the public health risk posed by phthalates," Spaeth suggested.

More Than 1 in 10 Pilots Suffer From Depression, Study Finds

Report highlights need for accurate screening.

More than one-tenth of professional airline pilots may suffer from depression, and a small percentage might experience suicidal thoughts, a new survey reveals.

The findings come in the wake of the Germanwings air crash in 2015. In that tragedy, a co-pilot with depression deliberately crashed an airliner in the French Alps, killing all 150 people onboard.

"We found that many pilots currently flying are managing depressive symptoms, and it may be that they are not seeking treatment due to the fear of negative career impacts," said senior study author Joseph Allen. He is an assistant professor of exposure assessment science at Harvard T.H. Chan School of Public Health in Boston.

"There is a veil of secrecy around mental health issues in the cockpit. By using an anonymous survey, we were able to guard against people's fears of reporting due to stigma and job discrimination," he explained in a Harvard news release.

In the online survey, conducted between April and December of 2015, the researchers asked just over 1,800 pilots in the United States, Canada and Australia about their mental health.

RELATED: 6 Depression Symptoms You Shouldn't Ignore

The findings showed that 12.6 percent of the pilots met the criteria for likely depression and 4 percent reported having suicidal thoughts within the previous two weeks.

Male pilots were more likely than female pilots to report that they had instances "nearly every day" of loss of interest, feeling like a failure, difficulty concentrating and thinking they would be better off dead.

Meanwhile, compared with male pilots, female pilots were more likely to have had at least one day of poor mental health in the previous month, and were more likely to have been diagnosed with depression, according to the researchers.

In addition, depression was more common among pilots who used more sleep aid medications and those who were subjected to sexual or verbal harassment, the investigators found.

According to study first author Alex Wu, the study "hints at the prevalence of depression among pilots -- a group of professionals that is responsible for thousands of lives every day -- and underscores the importance of accurately assessing pilots' mental health and increasing support for preventative treatment." Wu is a doctoral student at Harvard.

The study was published online Dec. 14 in the journal Environmental Health.

About 350 million people worldwide suffer from depression, the researchers said. But less than half receive treatment, partly because of the social stigma, according to the World Health Organization.