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Nurse Bridgid

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Monday, February 28, 2011

Should I be taking fish oil supplements?

Fish oils that are made into supplements are taken from the fatty tissues of fish and they contain Omega-3 fatty acids as well as DHA (docosahexaenoic acids) which both aid in decreasing inflammation and are thought to have numerous other health benefits.  They are currently being studied in the effects of Alzheimer's, clinical depression, anxiety disorders, high blood pressure, and cancer.

Why not just eat a lot of fish?
The fish with the highest amounts of Omega 3 fatty acids and DHA unfortunately are also fish that are at the top of the food chain and at highest risk for high levels of mercury and other toxins.  The fish with the higest amounts are Tuna, Shark, and Swordfish, so the FDA recommends limiting their intake BUT you can take a supplement that will give you the same amount as if you ate one of those fish without the risk of the toxins.

What are the benefits?
Well, it is known that fish oil supplements help to decrease inflammation, so that would be beneficial for athletes and runners.
There were some preliminary studies in Cancer Epidemiology and The European Journal of Cancer Prevention looking at the association between Omega 3 fatty acid intake and cancer reduction for prostate, colorectal, and breast cancers.  One of the studies showed a reduction in the rate with mice, and another showed a decreased risk of breast cancer, but it was a preliminary study with many flaws; even the authors noted that further research was ncessary.
The National Institute of Health (NIH) suggests that people take between 1g-3g of Omega 3's per day to reduce risks associated with coronary artery disease (CAD) and high blood pressure.
A study in the British Journal of Psychiatry found that higher levels of Omega 3's were associated with lower levels of assaults among prisoners.  As well, it has been shown to have a positive effect with those suffering from depression and decreasing suicide rates.
More research is needed but high Omega 3 supplementation seems to have positive effects with Alzheimer patients in allowing for maintained memory status and with Parkinson's patients to delay the cognitive and physical issues that occur.

Are there side effects?
There is an increased risk of bleeding with high amounts of fish oils, possible toxin intake (if taking cod liver oil), and fish burps!!  And, with any supplementation, unless you take one that is FDA approved, you don't fully know what you are ingesting so be sure that you talk to your HCP about the brand and type you are taking.

I suggest talking to your HCP about how much supplement you should take specific to your needs. I suggest taking the odor free fish oil pills from Whole Foods; they are the best fish oils supplement that don't give you fish burps!  As well, the FDA has just approved Lovaza which is an Omega 3 supplement that is prescription only, so you know you are getting a pure form with low risk of toxin ingestion. Also, it is best to actually eat fish as part of your diet, but if you are someone who doesn't like fish or eat very much, then talk to your HCP about taking a fish oil supplement....I take mine every day!!  I know the research is preliminary, but as far as I see it, the benefits way outweigh the risks!!

Yours in Good Health

Friday, February 25, 2011

Do you wake up not feeling so refreshed?

Snoring is a huge issue in peoples lives that can cause marital issues, make you the butt of many jokes, and just cause you to have nights of fitful sleep.  The American Association of Oral and Maxillofacial Surgeons estimate that between 30-50% of the US population has problems with snoring, for some people it's a chronic issue and some people it is sporadic and only when they are completely exhausted, but for some it is a real medical concern because it is actually obstructive sleep apnea (OSA) or central sleep apnea (CSA).  I wanted to let you know what the difference is, how you can make some changes on your own to try to alleviate your symptoms, and what your medical options are.

So why do we snore?
During times of complete exhaustion, after drinking alcohol, or if there is swelling in the throat tissues due to GERD (Gastroesophageal Reflux Disease), the muscles in the roof of your mouth relax which allows them to vibrate, obstruct your airway a little, causing you to create a more forceful airflow through the tissues and the vibrations/airflow force cause you to snore!!

What can I do to try and stop?
There are a bunch of things that you can do to try and stop snoring, and they are really pretty simple lifestyle changes:
Lose weight: as little as 10lbs can make a huge difference, the more weight on your neck as you sleep, increases the required force of airflow through the muscles in your mouth
Avoid/limit Alcohol: it can relax your muscles even further in the roof of your mouth and cause you to snore when you normally wouldn't.
Avoid heavy meals two hours before you go to bed: after a heavy meal, your body is focused on digesting the food in your stomach, so everything else tends to have decreased blood flow and muscles relax.
Lay off Sleeping Pills: They create a form of deep sleep and complete relaxation of your muscles, if you have a tendency to snore, you will snore more with use of sleeping pills.

Give these a try and see if your snoring disappears or decreases, most likely then your only issue is snoring, and it isn't more serious....although you should still discuss this problem with your HCP to be safe and make sure that they don't want to do further sleep studies!

How do I know if it is OSA or CSA?
You may have:
- Excessive daytime sleepiness (barely able to keep your eyes open in the afternoon)
- Difficulty staying asleep
- Extremely loud snoring
- Waking up gasping for breath
- Reports from a significant other/seeping partner that you stop breathing
- Morning headaches
- Waking up frequently with a sore throat
**If you have any of these, you need to go see your HCP and tell them about your symptoms.  OSA and CSA need to be treated!

What are the complications from OSA and CSA?
Heart attack, stroke, decreased libido, inability to concentrate, irregular heartbeats, high blood pressure, mood problems (due to lack of sleep), irritability, ruin relationships/marital strain, memory problems, and impotence.

What puts me at risk?
- Being overweight (although thin people can have the disorder too)
- Neck circumference >17" for men and >16" for women
- Smoker
- High blood pressure
- Use of Alcohol/Sleeping Pills
- Narrow throat (you might not know unless you've had surgery before)
- Male
- Family History
- Age >60 years old
-Prolonged sitting (people who primarily sit can have fluid shifts from their legs to the rest of their bodies when they lay down at night to rest)

What are the treatments?
After talking to your HCP, and getting some sleep testing done, you will be officially diagnosed and there are various treatments that will be suggested, usually to try medical treatments first, then surgical.
- Continuous Positive Airway Pressure (CPAP): Basically a little machine that gives sir pressure through your nose into your airway while you sleep and allows you to keep your airway open and not obstruct. It prevents snoring, and while the little contraption looks like it would be really uncomfortable, people who use these machines to treat sleep apnea, say it gives them the best night sleep, and they love it!
-Bilevel Positive Airway Pressure (BPAP): similar to CPAP but gives different pressures during inhalation and exhalation based on what works best for you.
- Oral appliances: there are oral appliances that can pull the tongue and lower jaw forward to keep the soft palate (muscles of the roof of the mouth) tight.

Surgical treatments:
- Uvulopalatopharyngoplasty (UPPP): The tissues from the back  and top of your throat are removed to prevent the vibrations that cause snoring and obstructions.
- Maxillomandibular Advancement: Your jaw is moved forward allowing for more space near the soft palate and makes obstruction less possible.
- Tracheostomy: For SEVERE apnea in which you constantly obstruct at night; a plastic tube is inserted into your neck to allow for free air passage, below the areas that obstruct. You can keep it covered during the day, but open while you sleep to keep your airway open.
- Sometimes nasal polyps can be removed to aid the problem or fix a deviated septum (a curvature in the structure of the nose)

It is estimated that 1 in 5 US adults has some form of sleep apnea, so if you are a snorer please go try to make some changes and talk to your HCP, there is no need to live with the side effects of poor sleep, and while some of the treatments seem pretty extreme, they will keep you living longer, healthier, and happier!!  Plus, your significant others will thank you!! So go get checked out, and talk to your HCP about your options, and get on the road to better sleep and a better life!!

Yours in Good Health

Thursday, February 24, 2011

Meth: The real deal

I know that Crystal Meth is making this name for itself as a "soccer mom" drug, a drug that moms are doing so that they have the energy to work, be full time moms, trek their kids around, and get diner on the table....which kind of makes it seem like a drug that isn't a big deal to do.  In a word?  FALSE!  It is very addictive and has some pretty crappy long term health effects.  As well, it can make you age and all of your teeth rot into little nubs....not a good look!  The DEA has estimated that 10 million Americans have tried Crystal Meth at least once!!
What is Crytsal Meth?
It is methamphetamine (basically an "upper") mixed with ephedrine (from cold medicine also an "upper") and phosphorous and iodine to bind the chemicals together, and make it into a crystal like substance, hence crystal meth.  Methamphetamines are legal drugs, with a prescription, used for ADD and ADHD, but when mixed with these other compounds and either smoked, snorted, injected, or inserted into the anus or urethra can give a 12 hour euphoric high.  It also increases alertness, energy, and decreases fatigue and appetite.

What are the immediate effects?
Increased energy
Increased libido (sexual drive)
Increased blood pressure and heart rate
Agitation and irritability
Loss of appetite
Insomnia (people will go days without sleeping)
Muscle clenching
Intense alertness and concentration
Psychosis (from the drug AND lack of sleep)

With Chronic use:
Increased tolerance (needing more to get the same high)
Severe withdrawal symptoms when stopping (intense depression)
Temporary weight loss
Rotten teeth (due to vein constriction- it kills blood supply to the teeth and they die)
Psychosis can last for months to years after the drug is stopped...
Long Term effects?
People with chronic meth use can have severe depression, suicidal tendencies, anxiety, violent behavior, and have a much higher rate of Parkinson's Disease. As well, the drug can kill off certain parts of your brain which will cause decreased memory, impaired attention, and can have long term schizophrenia.

How do people die?
Due to the increased blood pressure and heart rate at such intense levels, most people who overdose or have other medical issues, go into sudden cardiac arrest, have strokes, OR can go into severe hyperthermia (elevated temperature) which will cause immediate death.

What are the street names?
Ice, Meth, glass, tweak, yaba, Tina, quartz, speed, stove top, and numerous others!!

Other Meth issues:
Crystal Meth is a public health issue because adding the chemicals together to make the compounds, is highly excitable and can cause major explosions.  It is so dangerous.

As well, the vapors and gases from cooking the drug up can seep into the walls and flooring and drug families living in the same building, plus put them at risk for the possible explosions from the noxious gases.  In many states, it is now required to test the structure of buildings for meth presence before purchasing a home, which is a sad statement for the US, but good to know that you are not being exposed unbeknownst to you in your own home.

Also due to the hyper sexuality that is caused by the drug, there is an increased risk of STDs/HIV and transmission with meth users due to a lack of use of protection.

Crystal Meth is illegal in all forms worldwide, and transporting, buying, production, and use will get you put in jail if you are caught.

Honestly, based on all of the physical effects, I really don't think it's worth it.  The whole Meth Mouth would be enough for me not to try it, along with the risk of schizophrenia-type effects for the long term after using.  There are plenty of other ways to get a boost in energy that are legal (like caffeine).  Please stop using and get help if you use Crystal Meth, and if you have friends who use, please help them stop!  It is bad for you AND the community at large.  Please be safe and get healthy.

Yours in Good Health

Wednesday, February 23, 2011

Blood Donation: Should I do it?

According to the American Red Cross, one person out of every 10 that is admitted to the hospital requires a blood transfusion, and each transfusion contains about 3 pints of blood.  I was shocked about the statistics that only about 38% of the US population is able to donate, and of that, only a very small portion actually donates.  Type O blood is the universal donor type blood, meaning that Type O blood can be given to anyone, so after a trauma or in the case of a major blood loss requiring transfusions, if we don't know someone's blood type, we give them O until we figure out otherwise.  Type AB is the universal recipient, in that they can receive any kind of blood without having a transfusion reaction.

Should I donate?
If you can, YES!! You are eligible to donate red blood cells every 56 days and platelets every 7 days, and you can save hundreds, of not thousands of lives, by donating.  It is a donation, as in you are not paid for it, you are doing out of sheer good will for others...which is an AMAZING thing to do!

What are the criteria to donate whole blood cells?
In most states, you must be 17 years old, at least 110lbs, and be in good health (normally it jut means that you are feeling well, and if you have a chronic condition that it is being treated and medically managed i.e. diabetes).  If you are on antibiotics, as long as you are at the end of the course of treatment, you can still donate.  As well, if you have had vaccinations, usually within 4-8 weeks after treatment, you can donate.  Check out the Red Cross's web site for specifics.   There are other criteria related to lifestyle (STDs, piercings/tattoos), living/traveling outside the US, and receiving blood from outside the US (specifically parts of Africa after 1977 and in the UK after 1980).  One criteria that I disagree with completely, is that if you are a man who has ever had sex with a man, you are considered high risk and unable to donate...I see no need for this criteria, but it has been generally accepted in the medical field as a rule out for donation.  Also, if you have any form of Hepatitis, HIV, or exposure to CJD (mad cow disease) you will be unable to donate.

How should I prepare to give blood?
Really, you don't need to do anything special, but stay hydrated, if you are someone who gets nervous around needles, I suggest keeping some candy or a soda close by to keep your blood sugar up, so hopefully you won't pass out, eat a low fat meal, and try to bump up your iron a few days before(like eat some red meat!!) Also make sure to eat some treats after donation to keep your blood sugar up.

What to expect at time of donation?
When you arrive you will need to show two forms of ID (usually)
A brief physical exam
A health history and questionnaire
A quick sample of blood will be taken (to check your red blood and iron levels)
A needle will be inserted (as long as you are an acceptable donor) and one unit of blood cells will be taken, then the needle removed, and you are asked to sit for 10 minutes and eat some snacks!
The whole process should take under an hour!!

How do I donate?
Check out the American Red Cross web site and pop in your zip code and they will tell you the closest place to donate and when.
You can set up your own blood drive!!  Contact the American Red Cross and they will help you to organize at our school, office, etc.

So for under an hour of your time, you can help to save a life, and you might even need those blood stores one be a good samaritan and donate today and encourage your friends and family to do the same!!!

Yours in Good Health

Monday, February 21, 2011

Can pretty smelling pits cause cancer?

There has been a rumor out there since I was in elementary school that antiperspirants and deodorants caused breast cancer, and many people that I know still live and die by that statement.  I have always thrown caution to the wind with this one, as an athlete and as someone who sweats a lot, to keep my friends and people close to me happy and smelling nothing but goodness!

First of all, there is a difference between deodorant and antiperspirant: deodorant merely covers the scent of sweat, whereas antiperspirant prevents the amount of underarm sweat.  Both preparations are absorbed through the pores in the skin, and specifically in women, the theory is that these preparations can be absorbed in larger amounts through possible cuts in the skin from shaving, also that certain ingredients (mainly aluminum gets the most press) can be absorbed so close to breast tissue which is said to increase the risk of breast cancer.  But is it?  The aluminum based products clog the sweat pore up, not allowing sweat to come out, and possibly be absorbed and have estrogen-like effects (some breast cancers are hormone sensitive and grow bigger with higher levels of estrogen).  (from the Journal of the National Cancer Institute 2000, Journal of Applied Toxicology 2003, and Journal of Inorganic Biochemistry 2005).

So what are the results??
In shocking news: the results are mixed!!!  In a 2002 study by the National Cancer Institute, which was a study performed on around 1600 women in the US, and found no correlation between use of antiperspirant and deodorant or shaving using a regular razor or electric.

In 2003,  a study from the European Journal of Cancer, looking at 437 breast cancer survivors found that the age of breast cancer diagnosis was much earlier in women who used antiperspirants/deodorants and shaved frequently, and in those that started using these products under the age of 16.

A study in 2006 in the Eastern Mediterranean Health Journal found that in around 100 subjects there was no association with breast cancer and antiperspirant/deodorant use but it was related to family history (which is undoubtedly true) and oral contraceptives (needs further investigation but there is a very weak link).

What does Nurse Bridgid say?
These studies are all pretty weak, they are based on interviews with subjects after the fact, and the first two studies don't really take other exposures and family history into account.  If this is something that you are really worried about, you can try all natural deodorants or powders that don't contain aluminum.  If you have a strong family history for breast cancer, then you should take every precaution and talk to your HCP about ways to prevent breast cancer and get BRCA1-2 testing done (genetic testing for risk of breast cancer).  Otherwise, I say deodorant and antiperspirant it up!!  No need it make others smell your pits if they don't need to!!  So keep up the good hygiene!!

Yours in Good Health

Sunday, February 20, 2011

Can I get YOUR help?

I have been nominated as a Best Health Blog!  If you enjoy my blog, please click on the link below and vote for me, NurseBridgid!

Thank you for reading and for your support!!

Yours in Good Health

Friday, February 4, 2011

Want a SmartMouth??

I was told about this mouthwash by a friend, and was totally skeptical that it kept your breath fresh for 12 hours at a clip, but I am a total believer after trying it and I seriously can't live without it now! I seriously have fresh breath even after drinking tea AND after working a night shift....that's impressive!  Plus, if I don't work a night shift, and actually sleep like a normal human being overnight, I still wake up with fresh breath. I read up on it, like the actual science behind why it works, and I thought I would share it with you guys so that you too can give bad breath a permanent kiss off!

What causes bad breath?
Bad breath can be caused by eating or drinking strongly smelling substances like garlic/onions or coffee/tea.  But it can also be caused by a build up of gram negative anaerobic bacteria which eats up oxygen and creates a sulphur rich compound that gives off a rotten egg- like sulphur smell, which is why when you are sleeping you wake up with not so fresh breath...there is a bacteria war at night!

How does Smart Mouth work?
It is two different solutions: the first one contains sodium florite which kills off the sulphur rich compounds to flush them out of your mouth, thus ridding your mouth of the stank, then the second solution contains zinc which reacts with the sodium florite and leaves tons of free zinc radicals in your mouth to block the gram negative bacteria from staying in your mouth, therefore preventing the sulphur rich compounds from forming and making stinky breath.  So your mouth stays fresh and clean!  I must say, the one thing that it takes a little getting used to is that your mouth feels a little different for the first two days of use just because you are getting used to the fact that you have high concentrations of zinc in your mouth- it makes your tongue feel a little fuzzy, but you get over it.  I promise, the two days of weirdness are worth it!!

 Honestly, if I had read this I wouldn't believe it either, but I use it daily and it is AMAZING!  And, it really does work for 12 hours....try it out!  If you go to the Smart Mouth web site, you can get a $2.00 off coupon to try it out. Let me know what you think!

Yours in Good Health

Thursday, February 3, 2011

Hoodia: does it really completely curb your appetite?

There are all these claims out there about diet pills with Hoodia that stop your appetite and make you never feel hungry in a natural healthy way, so you lose weight.  A couple of things are wrong with this claim: A) Not eating is the WORST way to lose weight B) There is nothing healthy about diet pills!  But, I did want to explain further about hoodia gordonii because it has been used by the San Bushmen in the Kalahari Desert for years to prevent hunger and thirst during long hunting journeys, so that they could travel and hunt for food, water, etc without the physical/emotional pains of hunger and thirst to weaken them. And, people seem to be taking this supplement like crazy to try and lose weight. But, is that the same stuff that is in the diet pills?

What is Hoodia gordonii?
It is called a cactiform plant (i.e. a cactus like plant) that is technically a succulent plant that has large purple flowers that grows in desert like areas in Angola and South Africa.  It is also a plant that is on the list of plants at risk for endangerment/extinction if they are over farmed, and are being watched by international conservation groups.  Hoodia gordonii is the only plant in its group to contain the glycoside p57 which is thought to prevent the hunger/thirst drive.

What forms is it sold in?
Hoodia is sold in liquid, pills, and powder forms by numerous diet pill companies.

Is it worth the hype?
Well, here's the deal, when eaten in nature, it does stave off hunger and thirst, it has been shown time and time again, even on 60 Minutes Leslie Stahl tried it when in Africa, and she said that she didn't feel hungry or thirsty the rest of the day, but it has also been studied since the 1930's by various scientists worldwide.  And Phytofarm, a pharmaceutical company, did a clinical trial involving 18 people showing that they eat took in over 1000 less calories a day when using their product BUT it was never published so there is no way to look at any side effects or why the study was limited to so few people before being stopped...but it isn't a good sign, if it was all positive that study would be published everywhere.  Also, there have been plenty of reviews from consumers of various hoodia products saying that they have had none of those effects.

Side Effects:
It truly has not been studied enough, but there are preliminary reports that the p57 has some harsh effects on the liver, that were not a problem for the San Bushmen but it won't be approved by the FDA for that reason!!

Buyer beware:
It has been estimated by News Target that around 80% of hoodia products on the market are either fake or contaminated!  They are not FDA regulated, and seeing as the actualy plant is a scarce resource currently, and heavily regulated, the chances of all these hundred of companies selling "100% Pure Hoodia" is highly unlikely.  I guess the old adage holds true that if it seems to good to be true, it is.

My best advice is to save your money, and do it the old fashioned what you eat, and if you want an appetite suppressant, eat and apple with a glass of water- the pectin will fill you up and stave off hunger pains!!

Yours in Good Health

Wednesday, February 2, 2011

Do you smoke...even one cigarette while drinking?

So I know a ton of people, and see lots of patients, that always say "no, I don't smoke" and I know that they believe it, but when you go out on the weekends, have a few beverages, and bum a cigarette off of someone.  There are still health detriments like and increased risk of lung cancer and an increased risk of blood clots for women on birth control!!  It's not a good idea, in general, to smoke at all (obvious advice coming from an HCP) and I wanted to give some ways to quit, medical and homeopathic, and lifestyle changes to ensure that you stay off the hooch!!

Where to begin?
Making the decision to quit is a HUGE step and a major part of the process, so you need to be proud of yourself just for making that decision.  In order to stand by your decision, you need to lay some groundwork:
1. Set a quit date and mark it on a calendar
2. Tell your friends, family, coworkers, etc and ask them for their support.
3. Write a list for yourself of how your life will improve, and focus on the positive (i.e. save money, fresher breath, wont smell like smoke, will breathe easier, etc)
4. Look at the monetary benefits that you have to gain: write down how much you spend daily/weekly/monthly/annually on tobacco products and set up a savings account.
5. Set a goal that if you haven't touched the hooch by your anniversary of your quit date, then clean out your savings account and treat yourself!!!

What can I do to make the process easier??
1. Try to prevent cravings: nicotine gives your body a bit of a sugar rush, so you get headaches from lack of the stimulant rush and the sugar that it is used to, so prepare for the headaches that you will get and drink some coffee/tea/green tea with honey or sugar, and be prepared that you will have a heartier appetite so be ready to treat yourself with comfort foods!  (Not often a statement you will hear from me) And be ready with sugar-free gum, mints, and other things to keep your oral cravings satisfied.
- Be ready that after a meal if you normally smoke after meals, prepare with a fruit dessert, gum, etc.
- If you previously smoked when you drink, realize that your cravings will be strong then, so stick to non-smoking bars, friends homes where you can't smoke, or don't drink alcohol (gasp!) until the cravings subside
- If you only smoke socially, then make sure that you don't hang with the friends that you normally smoke with, and let them know why...if they want to hang without tobacco products then keep them around!
-Keep yourself busy, so that you don't have idle time to crave the nicotine, and change your lifestyle so that you aren't tempted.
- Drink lots of water to keep your mouth active with a no calorie and healthy alternative!
- Stay active to keep off excess pounds that may pop on and keep your mind active so that you feel better and don't want to smoke.
-Keep a craving journal so you can read back and see what you were doing when you had a craving and what you did to prevent it

2. Medication therapy: there are nicotine and non-nicotine medications to prevent cravings and to help ease tobacco out of your life and your HCP can help you to decide which is best for you
- Nicotine replacement: gum, inhaled nicotine, the patch, etc. so you get small amounts of constant amounts of nicotine to stave off the physical need for tobacco.
- Non-nicotine medications such as Zyban and Chantix. Bupropion (Zyban) is a drug used as an antidepressant that is taken twice a day (orally) and it helps to reduce the physical and mental cravings for tobacco.  Varenicline (Chantix)is a drug that prevents the brain from feeling the pleasant results of nicotine (the stuff the gets you addicted).  Some people can become suicidal from this medication  and have almost schizophrenic like side effects (hear voices, etc)and you need to call your HCP immediately and stop taking the medication.  If you are suicidal call 911 (or emergency services wherever you are).

3. Non-Medication treatments: other therapies that can help to ease the physical and mental cravings of tobacco and nicotine.
- Hypnosis can be used to help you to straighten your need to quit and increase a negative attitude towards nicotine subconsciously.
- Acupuncture can be used to stimulate your natural endorphins and can help to manage your withdrawal symptoms, like easing headaches and irritation that may occur.
- Behavior Therapy helps you to learn a new way of living your life, and doing your normal behaviors without being reliant upon nicotine.

So, you what??
Well, you have that special anniversary treat to look forward to!  Also, you can make a healthy life change like work out more, or pick up a new hobby...something that makes your healthy lifestyle change seem worth it.  On average people gain 3-4lbs after they quit, so try to pick up a hobby where you might prevent that.  And remember, you are not a failure if you slip up, but toss out the rest of the pack, and realize what your trigger is; empower yourself to not let nicotine guide you, you guide you!

Decide to be healthier and make this change...and I hope that these tips encourage you and help you!!  Remember, talk to your HCP about what is the best route for you to take, some people swear by cold turkey, but for those who want to ease out of the grips of nicotine, talk to your HCP!!

Yours in Good Health

Tuesday, February 1, 2011

hair, hair, everywhere....falling out of my head?

I wanted to talk to people about something that can be a difficult topic to bring up: hair loss, both for men and women.  The medical term is alopecia, but most people just think it is a nightmare.  There are a bunch of treatments out there, some are appropriate for you, and some may not be.  The key is having a good relationship with your barber/stylist/significant other/friends so that they will be open with you if they see some thinning (the back of the head can be impossible to see on your own, unless to are snapping pics all the time!)  Then making the decision wether you want to just let it ride and grow old gracefully, or make the decision to treat and having the knowledge of the treatments available, (which I will be giving you).  Finally, having an open relationship with your HCP to bring up the issue and talk about treatments and what might work best with your lifestyle and hair loss diagnosis will help you to get the right treatment for it medication, surgery, a hair piece, or a nice hat!

What is the definition of baldness/balding?
It is an excessive hair loss from your scalp due to either a medical condition, genetics, or medications and it can be present in anyone: men, women, children!!  There is permanent hair loss (fe/male pattern baldness, scarring baldness after burns) and temporary hair loss (from medications, stress, vitamin deficiency).

How does hair grow?
Based on hormonal changes, damage or irritation (over processing with colors, sun damage, scars/trauma, etc) to the hair shaft, some areas of your head may have hair with shorter growth periods, or it will only grow to a shortened length.  Your scalp hair goes through a period of growth called anagen, where the hair grows about 1/2 inch (1cm) per month for about 2-3 years, then the hair will stay dormant, a phase known as telogen, for 3 to 4 months, then it will fall out and the process restarts.  The average person looses 50-100 hairs per day  and has a total of 100,000 hair shafts on their head, so it is barely noticeable, but people with darker hair tend to see theirs more, and I think it leads to more unnecessary freak outs!  But gradual thinning of the hair is part of the aging process, the problem arises when the telegen phase is more common than the anagen phase and you lose more hair than is growing at any given time.

What causes hair loss?
Pattern Baldness (androgenetic alopecia): occurs in both men and women, in which the growth time of hair shortens and the hairs are not as thick and not as deeply rooted, so they fall out easier.  Heredity and genetics plays a major role, and determines the age and rate that you lose your hair and the speed at which it falls out.

Cicatrical (scarring) alopecia: occurs when inflammation causes damages and scars the hair follicle and doesn't allow new hair to grow.  I can be caused by different disease processes such as lupus.

Alopecia Areata: an autoimmune disease in which the disease is not well understood. It is a disease in which you may lose all your hair and then it grows back completely, this may happen a few times throughout your life.  It usually occurs in otherwise healthy people, and some HCP's believe that it may be related to environmental changes or hormonal changes.
Telogen Effluvium: A sudden change in your hair growth cycle, usually due to either a physical or emotional shock.  Hair roots are pushed prematurely into the resting state, then fall out.  Within a month or two, the growth process starts all over normally again.  It usually occurs after a death of someone close, excessive weight loss, high fevers, extreme diets, nutritional deficiencies, or surgery.  Once the issue is corrected or after a period of time and shock wears off, the hair re-grows.
Traction Alopecia: From excessive hairstyling that pulls the hair back or down, it can cause damage and scarring to the roots, then the hair is unable to grow back.

Other causes:
Nutritional deficits (low iron, protein, fad diets/crash diets, etc)
Medications (drugs for arthritis, depression, heart disease, blood pressure, and birth control)
Disease (diabetes, lupus, psoriasis)
Medical treatments (chemo, radiation)
Hormonal changes (pregnancy, childbirth, stress, menopause, thyroid issues)
Hair treatments (overprocessing with dyeing hair, straightening, perms)
Scalp infections (ringworm- a fungal infection)
Trichotillomania ( a mental disorder in which people have an irresistible urge to pull out their hair, can be eyebrows/head hair/etc, and the excessive pulling causes patchy areas without hair and over time can lead to scarring)

How will my HCP test me?
Your HCP will ask for a full medical history and ask about any lifestyle or emotional changes recently, about any diet changes, and will do a physical exam.  They may pull out a few hairs to inspect the root and hair shaft itself, inspect the scalp, they may do a biopsy of the skin, and they may draw some blood to test for thyroid disease, etc.

What are treatment options?
I just want to let you know that most types of baldness can never be cured, but treatments can help.
Minoxidil (Rogaine): treatment for androgenetic alopecia and alopecia areata and it comes in 2% and 5% forms right over the counter in foam or liquid form to rub into your scalp.  It can either regrow hair with hair thinner than your baseline OR just slow/stop hair from falling out (person dependent).  It can take new hair 12 weeks of use to start growing, so be patient with it, but as soon as you stop using the product, the hair will fall back out.  The only side effect is that your scalp can become irritated from use, so it may not be worth it if you don't have much response.

Finasteride (Propecia): is a prescription pill to treat male pattern baldness, and needs to be taken daily to allow for a slowing of hair loss and a possible hair regrowth.  It stops the conversion of testosterone to dihydotestosterone (DHT) which shrinks hair follicles, due to this though, it can decrease sex drive.  It CANNOT BE USED BY WOMEN!  Pregnant women cannot even touch this medication because it causes severe birth defects in male fetuses.

Corticosteroids: injections in the scalp can help with alopecia areata. And new hair grows within 4 weeks of starting the injections, which occur monthly.  There are creams and ointments as well but they are not as effective.

Anthralin (Dritho-scalp): A cream or ointment that is a tar like substance that you put on and wash off daily that is used to treat psoriasis but it can stimulate hair growth and new hair can be seen in 12 weeks. It is a prescribed treatment.

Using your existing hair to cover areas that are missing hair.
Hair transplant  little grafts of skin containing hair are taken from an area with larger amounts of hair and implanted in an area with less hair. Several transplantations are usually required to get the desired results due to continued hair loss (not of transplanted hair but of your baseline hair).

Scalp Reduction The name is just as it seems, the skin on your head is more pliable and stretchy than it seems, and stretching it out to remove areas of baldness makes the appearance of more hair. They can also create "flaps" and fold an area of skin bearing skin over an area of bald skin.  This technique can be combined with hair transplantation to create the ultimate coiffe!!

Of course, there is always the option of wigs and hair pieces that can can be worn over your scalp and cover up, naturally looking, the areas of balding.  And, there are tons of hair pieces that aren't the toupees of the 70's where nothing matches or blends it, it gets pretty high tech and some aren't even noticeable, but they can be pricey!!

How can I prevent hair loss?
Eat a well balanced diet
Try to cope with stress in an appropriate way (talk to your HCP about support groups or therapy)
Avoid tight hairstyles and over-processing
Don't pull at your hair or if you notice you do, talk to your HCP
Talk to your HCP early about hair loss of it is a concern and you are genetically predisposed

There are tons of options these days to treat hair loss for men and women. As a woman, I can totally understand wanting to treat balding in any way, but I don't  think always have to treat it, what's wrong with a nice bald head?  I say nothing.  Maybe that is sexist of me, but I don't think that there is anything to be embarrassed about!  I hope this gives you all some insight into how balding occurs and ways to prevent and treat, and also clears up some rumors about treatments and gives you the ability to talk to your HCP about options!

Yours in Good Health