Author Archives: Monica

Moles and Your Skin

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There are several skin lesions that are very common and benign (non-cancerous). These conditions include moles, freckles, skin tags, benign lentigines, and seborrheic keratoses.

Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups.

Most moles appear in early childhood and during the first 30 years of a person’s life. It is normal to have between 10-40 moles by adulthood. As the years pass, moles usually change slowly, becoming raised and/or changing color. Often, hairs develop on the mole. Some moles may not change at all, while others may slowly disappear over time.

What Causes a Mole?

Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may darken after exposure to the sun, during the teen years, and during pregnancy.

Types of Moles

Congenital nevi are moles that are present at birth. Congenital nevi occur in about one in 100 people. These moles may be more likely to develop into melanoma (cancer) than are moles that appear after birth. A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDEs of melanoma (see below).

Dysplastic neviare moles that are typically larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These nevi are more likely to become melanoma. In fact, people who have 10 of more dysplastic nevi have a 12 times higher chance of developing melanoma, a serious form of skin cancer. Any changes in a mole should be checked by a dermatologist to evaluate for skin cancer.

How Do I Know if a Mole Is Cancer?

The vast majority of moles are not dangerous. Moles that are more likely to be cancer are those that look different than other existing moles or those that first appear after age 30. If you notice changes in a mole’s color, height, size, or shape, you should have a dermatologist (skin doctor) evaluate it. You also should have moles checked if they bleed, ooze, itch, or become tender or painful. Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of the skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, and ears.

If a mole does not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, talk to your dermatologist.

The following ABCDEs are important characteristics to consider when examining moles. If a mole displays any of the signs listed below, have it checked immediately by a dermatologist. It could be cancerous.
•Asymmetry. One half of the mole does not match the other half.
•Border. The border or edges of the mole are ragged, blurred, or irregular.
•Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red.
•Diameter. The diameter of a mole is larger than the eraser of a pencil.
•Evolution. The mole is changing in size, shape, or color.

#moles

Hamstring Strains

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Unfortunately, hamstring strains are both common and painful. They strike athletes of all sorts — including runners, skaters, and football, soccer, and basketball players.

But what is a hamstring?

It isn’t actually a single ”string.” It’s a group of three muscles that run along the back of your thigh. They allow you to bend your leg at the knee.

During a hamstring strain, one or more of these muscles gets stretched too far. The muscles might even start to tear. You’re likely to get a hamstring strain during exercise that involves a lot of running and jumping or sudden stopping and starting.

Getting a hamstring strain is also more likely if:
•You don’t warm up and stretch before exercising
•The muscles in the front of your thigh (the quadriceps) are a lot stronger than your hamstrings
•You’re a teenager going through a growth spurt

What’s the Treatment for a Hamstring Strain?

Luckily, minor to moderate hamstring strains usually heal on their own. You just need to give them some time. To speed the healing, you can:
• Rest the leg. Avoid putting weight on the leg as best you can. If the pain is severe, you may need crutches until it goes away. Ask your doctor or physical therapist if they’re needed.
• Ice your leg to reduce pain and swelling. Do it for 20-30 minutes every three to four hours for two to three days, or until the pain is gone.
• Compress your leg. Use an elastic bandage around the leg to keep down swelling.
• Elevate your leg on a pillow when you’re sitting or lying down.
• Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) will help with pain and swelling. However, these drugs may have side effects, such as an increased risk of bleeding and ulcers. They should be used only short term, unless your doctor specifically says otherwise.
• Practice stretching and strengthening exercises if your doctor recommends them. Strengthening your hamstrings is the best protection against hamstring strain.

In severe cases where the muscle is torn, you may need surgery. The surgeon will repair the muscles and reattach them.

When Will a Hamstring Strain Feel Better?

Recovery time depends on how badly you injured the hamstring. Keep in mind that people heal at different rates. While you get better, you should strengthen the hamstring with a new activity that won’t aggravate the strain. For instance, runners could try doing laps in a pool.

Whatever you do, don’t rush things. Don’t even try to return to your old level of physical activity until:
•You can move your leg as freely as your uninjured leg
•Your leg feels as strong as your uninjured leg
•You feel no pain in your leg when you walk, jog, sprint, or jump

If you start pushing yourself before the hamstring strain is healed, you could re-injure the hamstring and develop permanent muscle weakness.

 

#hamstring

Couch to 5k

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5K Training Plan

Picking a 5K — 3.1 miles — as a route back to fitness is smart. Many exercise experts agree, and you’re not alone in thinking that training for your first 5K may propel her on the road to lifetime fitness.

It’s among the most popular of road racing event distances, says Jean Knaack, executive director of the Road Runners Club of America, a national association of running clubs and events. “The boom is in the 5K and the half marathon,” .

”I think the 5K is a great distance for beginning runners,” Knaack says. Or even walkers, as many 5K events are now billed as run/walks.

Why? The 5K is doable, Knaack says, even if you’ve spent many more hours in front of the TV than on a treadmill, if you train appropriately.

Here, experts talk about how you can go from the couch to the 5K course, paying attention not only to your physical training but also your mental attitude. In three months or less, you could go from couch spud to fitness star. (It’s always recommended, especially for adults over 50, that sedentary people check in with their doctor before starting to train.)

Psych Yourself Up — and Off the Couch

While most people focus on the physical training — at least feeling comfortable jogging or walking 3 miles or so before the big event — mentally preparing is just as important, says Fabio Comana, an exercise physiologist for the American Council on Exercise in San Diego. Step one, he says, is not thinking about the 3 miles, which can be intimidating, but the steps it takes to get there. ”Think about the process,”‘ Comana tells WebMD. That breaks down what might seem intimidating — run 3+ miles when you have yet to run 1 — into manageable chunks.

For instance, you may tell yourself: “Long term, I am getting ready for a 5K. But for the next two weeks, my process goal is to be able to get off the couch and jog or walk at a reasonable pace. I will try 1K.”

When you have worked up to a 1K, Comana suggests, “Do a self-evaluation.” Ask yourself what words come to mind when you finish. If you are thinking pain and fatigue, he says, you’re probably doing too much. “If you feel energized,” he says, “it’s a good indication you will continue.”

Each time you meet a ”process” goal, reward yourself, he suggests. “Go see a movie, buy yourself some training gear.”

You can also focus in on the intrinsic rewards of exercise, such as your newfound joy of movement, your gratification at meeting a goal, your sense of accomplishment.Write down the reasons you want to do the 5K, Comana suggests. It might be to improve your health, lose weight, look better in your clothes. Then list the obstacles, such as: you have to get up earlier to squeeze in the training, you need to buy a good pair of running shoes. The pros probably outweigh the cons, which is motivating.

Don’t try to play catch-up if you miss a workout If you miss one of your walks, you don’t suddenly go from 2 miles to 4 miles.

Play ‘Mind Games’ No matter how jazzed you may be at the beginning, when motivation wanes, you need help fast.

If getting out of bed in the morning early enough to train is the problems, lay out everything you need to wear the night before. Put your gear by the coffee pot.

As you lull yourself to sleep, repeat a mantra such as “Feet, alarm, coffee.” You are formatting your brain for action. The plan: feet hit the floor, turn off the alarm, head for the coffee pot. As you are brewing your coffee, you are getting dressed, then walking out the door.

The principle here is, the body in bed wants to stay in bed. The body in motion wants to stay in motion.

Refer back to your pro-con list, Comana suggests, when motivation lags.

Couch-to-5K-Training-Program-a

#couchto5k

Is the Season Getting You Down?

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Shine the Light on Winter Blues

In northern climates when the heavy snows fall and the sun moves south, many people find their moods shift from upbeat to downright depressed. The severe form of winter depression–called seasonal affective disorder, or SAD–affects at least two million North Americans. Another thirty-nine million experience milder symptoms of moodiness and extended sleep patterns that somewhat resemble hibernation.

Overeating, sleeping for prolonged periods, mood swings, carbohydrate cravings, and weight gain during winter months may be more than just symptoms of cabin fever. They can suggest a biochemical reaction caused by a lack of exposure to sunlight.

Like all living things, we humans are sensitive to the seasons and sunlight. We secrete a hormone called melatonin, which helps us sleep at night and stay awake during the day. Melatonin production is directly linked to sun exposure. So, as the days get shorter during the winter, our bodies produce more and more melatonin and we can literally feel like going into a cave and hibernating.

Many SAD sufferers manage their seasonal depression with daily exposure to full-spectrum lamps or light boxes. By getting daily doses of natural light, they can fool their brains into thinking it’s summertime, and their need to sleep decreases.

Recent research shows that timing these light therapy sessions to our natural biological clocks is even more beneficial than usage during the day. Exposure to natural spectrum bright light for thirty minutes on awakening is twice as effective as evening sessions, and one study found this practice actually had an 80 percent chance of sending SAD into remission.

If winter blues are getting to you, consider investing in a full spectrum lamp and use it first thing in the morning–because SAD is for the bears.

#winterblues

Hyponatremia

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What is hyponatraemia?
Although we’re often urged to cut down on salt in our diet, salt or sodium is essential for many of the body’s functions including fluid balance, blood pressure management and the nervous system.

Hyponatraemia is a low level of sodium or salt in the blood. Symptoms are not usually very specific and can include changes to a person’s mental state, headache, nausea and vomiting, tiredness, muscle spasms and seizures.

Hyponatraemia may be caused by drinking too much water, for example during strenuous exercise, without adequate replacement of sodium.

It may also be due to a loss of sodium and body fluid.

Severe hyponatraemia can lead to coma and can be fatal.

Treatment of hyponatraemia involves intravenous fluid and electrolyte replacement, medicine to manage the symptoms of hyponatraemia, as well as any treatments for any underlying cause.

What causes hyponatraemia?
A low sodium level in the blood may result from excess water or fluid in the body, diluting the normal amount of sodium so that the concentration appears low. This type of hyponatraemia can be the result of chronic conditions such as kidney failure (when excess fluid cannot be efficiently excreted) and congestive heart failure, in which excess fluid accumulates in the body. SIADH (syndrome of inappropriate anti-diuretic hormone) is a disease whereby the body produces too much anti-diuretic hormone (ADH), resulting in retention of water in the body.

Hyponatraemia can also result when sodium is lost from the body or when both sodium and fluid are lost from the body – for example, during prolonged sweating and severe vomiting or diarrhoea.

Medical conditions that can sometimes be associated with hyponatraemia are adrenal insufficiency, hypothyroidism, and cirrhosis of the liver. The eating disorder anorexia can also cause a sodium imbalance.

Some medicines can lower blood sodium levels. Examples of these include diuretics (water tablets), desmopressin, and sulfonylureas.

What are the symptoms of hyponatremia (low blood sodium)?
When sodium levels in the body are low, water tends to enter cells, causing them to swell. When this occurs in the brain, it is referred to as cerebral oedema. Cerebral oedema is particularly dangerous because the brain is confined in the skull without room for expansion, and the swelling can lead to brain damage as the pressure increases within the skull.

In chronic hyponatraemia, in which the blood sodium levels drop gradually over time, symptoms are typically less severe than with acute hyponatraemia (a sudden drop in blood sodium level). Symptoms can be very nonspecific and can include:
Headache
Confusion or altered mental state
Seizures
Decreased consciousness which can proceed to coma and death.

Other possible symptoms include:
Restlessness
Muscle spasms or cramps
Weakness, and tiredness

Nausea and vomiting may accompany any of the symptoms.

How is hyponatraemia diagnosed?

The symptoms of hyponatraemia are not specific, so a blood test measuring the sodium level is needed to confirm the diagnosis of hyponatraemia. Sometimes the medical history (such as prolonged vomiting or excessive sweating) will help a doctor with the diagnosis. In other cases, further blood tests, urine tests, and imaging studies may be needed in order to determine the exact cause of the hyponatraemia.

How is hyponatraemia treated?
Mild chronic hyponatraemia may not require treatment other than adjustments in diet, lifestyle or medication. For severe or acute hyponatraemia, treatment often involves intravenous (IV or drip) fluids and electrolytes. In this case medication is often needed to treat the underlying cause of the hyponatraemia as well as medication to manage the accompanying symptoms.

#salt

Chickenpox (Varicella)

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Chickenpox (varicella) is a contagious illness that causes an itchy rash and red spots or blisters (pox) all over the body. Chickenpox can cause problems for pregnant women, newborns, teens and adults, and people who have immune system problems that make it hard for the body to fight infection.

Chickenpox usually isn’t a serious health problem in healthy children. But a child with chickenpox needs to stay home from school. And you may need to miss work in order to care for your child.

After you have had chickenpox, you aren’t likely to get it again. But the virus stays in your body long after you get over the illness. If the virus becomes active again, it can cause a painful viral infection called shingles.

Chickenpox is caused by the varicella-zoster virus. It can spread easily. You can get it from an infected person who sneezes, coughs, or shares food or drinks. You can also get it if you touch the fluid from a chickenpox blister.

A person who has chickenpox can spread the virus even before he or she has any symptoms. Chickenpox is most easily spread from 2 to 3 days before the rash appears until all the blisters have crusted over.

You are at risk for chickenpox if you have never had the illness and haven’t had the chickenpox vaccine. If someone you live with gets chickenpox, your risk is even higher because of the close contact.

The first symptoms of chickenpox usually develop about 14 to 16 days after contact with a person infected with the virus. Most people feel sick and have a fever, a decreased appetite, a headache, a cough, and a sore throat. The itchy chickenpox rash camera.gif usually appears about 1 or 2 days after the first symptoms start.

After a chickenpox red spot appears, it usually takes about 1 or 2 days for the spot to go through all its stages. This includes blistering, bursting, drying, and crusting over. New red spots will appear every day for up to 5 to 7 days.

It usually takes about 10 days after the first symptoms before all blisters have crusted over. This is when the person with chickenpox can return to day care, school, or work.

#chickenpox

Degenerative Disc Disease

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Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).

The changes in the discs can result in back or neck pain and/or:
•Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions joints.
•Herniated disc, an abnormal bulge or breaking open of a spinal disc.
•Spinal stenosis, the narrowing of the spinal canal camera.gif, the open space in the spine that holds the spinal cord.

These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.

What causes degenerative disc disease?
As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people. These age-related changes include:
•The loss of fluid in your discs. This reduces the ability of the discs to act as shock absorbers and makes them less flexible. Loss of fluid also makes the disc thinner and narrows the distance between the vertebrae.
•Tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.

These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting). People who are obese are also more likely to have symptoms of degenerative disc disease.

A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.

As the space between the vertebrae gets smaller, there is less padding between them, and the spine becomes less stable. The body reacts to this by constructing bony growths called bone spurs (osteophytes). Bone spurs can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.

What are the symptoms?
Degenerative disc disease may result in back or neck pain, but this varies from person to person. Many people have no pain, while others with the same amount of disc damage have severe pain that limits their activities. Where the pain occurs depends on the location of the affected disc. An affected disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttock, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.

The pain may start after a major injury (such as from a car accident), a minor injury (such as a fall from a low height), or a normal motion (such as bending over to pick something up). It may also start gradually for no known reason and get worse over time.

In some cases, you may have numbness or tingling in your leg or arm.

How is degenerative disc disease diagnosed?
Degenerative disc disease is diagnosed with a medical history and physical exam. Your doctor will ask about your symptoms, injuries or illnesses, any previous treatment, and habits and activities that may be causing pain in the neck, arms, back, buttock, or leg. During the physical exam, he or she will:
•Check the affected area’s range of motion and for pain caused by movement.
•Look for areas of tenderness and any nerve-related changes, such as numbness, tingling, or weakness in the affected area, or changes in reflexes.
•Check for other conditions, such as fractures, tumors, and infection.

If your exam reveals no signs of a serious condition, imaging tests, such as an X-ray, are unlikely to help the diagnosis. Imaging tests may be considered when your symptoms develop after an injury, nerve damage is suspected, or your medical history suggests conditions that could affect your spine, such as bone disease, tumors, or infection.

How is it treated?
To relieve pain, put ice or heat (whichever feels better) on the affected area and use acetaminophen (such as Tylenol) or nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen. Your doctor can prescribe stronger medicines if needed.

If you develop health problems such as osteoarthritis, a herniated disc, or spinal stenosis, you may need other treatments. These include physical therapy and exercises for strengthening and stretching the back. In some cases, surgery may be recommended. Surgery usually involves removing the damaged disc. In some cases, the bone is then permanently joined (fused) to protect the spinal cord. In rare cases, an artificial disc may be used to replace the disc that is removed.

 

#disk

Helping Veterans and Wounded Warriors

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This nation’s military veterans and wounded warriors continue to fight, long after they come off the battlefields. They fight to be whole again and to reclaim their physical and psychological health. Many forms of massage and bodywork can help them do just that.

Therapeutic Massage
With its ability to meld body and mind, massage is an excellent way for veterans to reintegrate. Not only can this kind of therapeutic touch address the physical wounds, it can help bring a sense of normalcy back into daily life. “Gratifying physical experiences, such as massages … may be experiences that patients build up that are not contaminated by trauma, and which may serve as a core of new gratifying experiences,” writes Bessel van der Kolk, author of Traumatic Stress.

Research on massage and veterans, funded by the National Institutes of Health, has shown considerable promise for this hands-on therapy. An initial 2014 study found that veterans reported significant reductions in physical pain, physical tension, irritability, anxiety/worry, and depression after massage. As a result, researchers are hoping to show in Phase 2 of their study that massage could diminish our veterans’ needs for opiods for pain management, a significant concern for the US Department of Defense and the veterans themselves.

Many of our military personnel returning from battle zones come home less than whole. In cases of amputation, massage can help control edema, deal with neuromas, improve skin health, and loosen scar tissue. For more on this topic, read “David’s Heroes” in the November/December 2014 issue of Massage Bodywork magazine. Find it online at www.massageandbodyworkdigital.com/i/398416.

When visiting a massage therapist for the first time, expect a comprehensive intake process to facilitate your session. If you are a veteran or wounded warrior, your therapist will want to discuss the extent of your injuries with you, the medical procedures you’ve undergone, and any ongoing health issues, as well as medications you’re currently taking. All of these questions help inform the therapist how to work most effectively and safely with you, so be honest and forthcoming in your responses. As with any massage, be sure to let your therapist know if anything makes you uncomfortable during your session–whether it’s that the room temperature is too hot or the massage pressure is too deep. At any time, you can end the session if the work is too intense or you need a break.

Craniosacral Therapy
Craniosacral therapy (CST) has shown considerable promise in helping military veterans and other posttraumatic stress disorder (PTSD) sufferers. The developer of CST, the late John E. Upledger, DO, OMM, believed this subtle hands-on therapy could make a difference. When he invited veterans to be part of intensive CST programs in 1999, he found that their depression and anxiety levels dropped considerably after the therapy was administered, and that feelings of hopelessness, which had once been pervasive, quickly dissipated.

Further evidence for CST came in 2004-2005, when military personnel returning from duty in combat regions were exposed to the therapy at California’s Naval Hospital Lemoore. “The results were absolutely profound,” says retired commanding officer Sandy DeGroot, who oversaw the program. “It’s very hard for [those returning from active combat zones] to come back fully and be in the present moment. The CST work allowed them to release trauma held in the body.”

Reflexology
According to author Paula Stone, reflexology is a highly effective therapy for PTSD, a condition that affects more than 5.2 million Americans every year. “Acute sustained stress erodes the very fabric of our being, while acute trauma can tear it. Whether prolonged or sudden, traumatic life experiences wound a person in body, emotions, mind, and soul, and can result in PTSD. Compassionate bodywork, including reflexology, can help heal the body and the person.”

She says two benefits of using reflexology for clients with PTSD are (1) it can be utilized when massage and other touch therapies cannot and (2) the client remains clothed. “Reflexology improves the client’s sense of well-being, improves sleep, reduces anxiety, and often reduces the need for pain medications, especially following surgery or cancer treatments.” Stone says foot reflexology improves the function of all body systems. “Immediately noticeable are improvements in the flow of bioelectrical energy, blood, lymph, and nerve impulses. Reflexology also works energetically by balancing the body’s energy systems. It works in harmony with a broad spectrum of energy therapies, such as polarity therapy and Asian medicine.”

Finding Help
Other modalities that have offered relief for members of our nation’s military include breath work, Healing Touch, myofascial release, reiki, Therapeutic Touch, trauma touch therapy, and even yoga. More are being added to the list every day.

If you or someone you know is a veteran or wounded warrior, and is suffering, reach out. Contact your local Veterans Affairs offices, visit the Wounded Warrior Project (www.woundedwarriorproject.org) or Comfort for America’s Uniformed Services (CAUSE; www.cause-usa.org), and make an appointment with your massage therapist or bodyworker.

For more information on PTSD, visit the National Center for PTSD, US Department of National Veterans Affairs, at www.ptsd.va.gov.
#ptsd