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Tag: fatigue

Ten Commandments of Good Health


Many years ago a desert dweller climbed a mountain and talked to a bush on fire.  What resulted was a set of laws that was to revolutionize mankind’s behavior.  These were not ten suggestions formulated by a long range planning committee nor were they ten proposals put forth by a strategic consultant, they were commandments from a Holy God.  These laws have become almost universally accepted, even by divergent religions, as wise and worthy of adopting. 

     With all humility and a sincere desire to be unpretentious (I am not even worthy enough to scrape the grasshoppers from Moses’ designer goat skin sandals), I propose the Ten Commandments of good health to serve as a lamppost for your journey down fitness lane.  It seems unfair to hurry through these guidelines, so I will opine in both this month’s and next month’s column to cover them all.

                                                      Commandment One

You Shall Exercise:

Live Longer, Reduce Stress, and Grow Your Brain

     Exercise is the elusive fountain of youth.  If you are heavy, harried or hormonal, moving with purpose is a critical part of the solution. Everyone knows exercise is good for you, but few of us follow through. Exercise begins above the neck with a commitment to self and family.  Part of this motivation lies in the hidden benefits of exercise that are not common knowledge such as the prevention of breast and prostate cancer,  reduction in the onset and progression of Alzheimer’s disease, and as a cure for clinical depression.  Start with a simple walking program and free yourself from the “couch of doom”.

Commandment Two      

You Shall Rest:

A Nap a Day May Keep the Doctor Away

     We live in a hurry-up culture where “Just Do It” supplants “Let It Be”. Busyness has be­come a virtue that is without merit.  Idle hands are the devil’s playthings only in those who haven’t learned the discipline of relaxation.  Certainly there is a place for goal setting and industrious behavior, but there is also a purpose in rest and play. Relaxing on purpose is healthier than just doing something aimlessly. A major area of our lives that is most affected by this culture of chaos is sleep. The average adult requires eight hours of restful sleep a night to function best the next day.  The average adult actually gets around six hours of sleep a night.  This obvious disconnect leads to chronic fatigue and foggy thinking.  40% of Americans (100 million people) are moderately to severely sleep-deprived!

Commandment Three     

You Shall Not Worry:

Make Stress Work For You

     Stress is the little yapping dog biting at the heels of our health.  It is generally an annoyance, but, if it goes on long enough, can become a festering wound.  There are a number of books and counselors that provide a wealth of guidance on effective stress management in a world that oozes anxiety.   Studies indicate that up to 75% of visits to doctors are related to anxiety.  Stress is simply a perception of an internal or external event and thereby can be influenced by our thoughts.  One person’s stress is another person’s opportunity.  You will never be without stress, but you can control and minimize the adverse effects. 

Commandment Four 

You Shall Get Checkups:

                                          Prevention Pays Lifelong Dividends

     A healthy mind and body is dependent on action and education, not passivity and ignorance.  You must be an advocate for you and your family’s well-being by embracing prevention.  Men are especially negligent in this arena, and often decisions regarding family health are delegated (by default) to women in the household.  Seventy percent of health decisions involving the family are made by mom, which includes checkups, vaccines, nutrition, and screening tests.  Most importantly, the woman, by her actions and decisions, sets the tone for current and future health decisions.  A major health care crisis today is not cancer, AIDs, or heart disease, but people not making healthy, proactive lifestyle decisions.  We have to transform a system based on sick care to one that truly embraces well care, and that can only be achieved by practicing individual, responsible prevention.

Commandment Five

You Shall Not Be Gluttonous:

Eat Your Way to Good Health

     

     We are often called a society of consumption.  The talking heads are referring to consumerism; however, the real consumption issue is what we eat.  Our diet has more of an impact on our health and longevity than almost any other activity.  Content and quantity are the evil twins of gluttony.  There are four simple guidelines that, if followed consistently, will provide a foundation of healthy nutrition that will build a legacy of wellness.  Simply stated, eat balanced, low fat, low sugar, and high fiber meals. It is possible to alter the health inheritance of our kids and grandkids by changing how we think about food.  You can spring the family from the prison of poor nutrition and not be held captive by your genetics through a simple and doable eating plan.  We truly are what we eat. 

Next month…what else but six through ten!

Too Pooped to Play

“I’m sick and tired of being sick and tired!” 

“I just have no energy.”

     One of the most common problems of the 21st century woman is fatigue.  I am not exaggerating by stating that well over 40% of women I see in my office complain at some stage of their life of excessive tiredness.  Lack of energy is not a local phenomenon either (in spite of the claims of one woman who was sure that SRS had something to do with her low energy level.  Of course this was the same gal who had been nabbed by aliens and forced to watch reruns of “Geraldo”).  National statistics are equally as impressive.  One study even went as far to claim that 30.3 % of adolescents experienced excessive fatigue (PEDIATRICS Vol. 119 No. 3 March 2007, pp. e603-e609) 

   The classification of fatigue runs the gamut from a transient mild tiredness to a debilitating lack of energy.  One of the inherent problems in studying a condition such as this is the subjectivity of the diagnosis.  Those who suffer with chronic fatigue are often perceived as malingerers and patronizingly dismissed.  There is still reluctance on the part of many medical practitioners to legitimize chronic fatigue syndrome, the most extreme form of tiredness, as a genuine entity; however, this appears to be an area where the science is finally catching up with the clinical observation.  As with any medical problem that is poorly understood, the treatment of excessive fatigue is varied, sometimes unconventional, and often unsuccessful.  It is important to distinguish chronic fatigue syndrome from “garden variety” tiredness as they differ in numbers of symptoms and degree of disability.  For many sufferers it comes down to how much the lack of energy interferes with normal day to day activities.  The Center for Disease Control in Atlanta has set down certain criteria for physicians and researchers to use in making the diagnosis of chronic fatigue syndrome.  A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

  • cognitive dysfunction, including impaired memory or concentration
  • exhaustion and increased symptoms for more than 24 hours following physical or mental exercise
  • unrefreshing sleep
  • joint pain (without redness or swelling)
  • persistent muscle pain
  • headaches of a new type or severity
  • tender lymph nodes
  • sore throat

  You can see from these symptoms that there is tremendous overlap with other common problems.  We all may experience some of these problems some of the time. The key is the persistence and intensity of the problem and, importantly, no other medical or emotional troubles that serve as a cause.

   There is hope!  Since becoming a more universally defined syndrome, additional research has been done on ways to thwart this bothersome illness.  Many of these treatments and suggestions also apply to the woman who has only mild symptoms.  So whether you are unable to get out of the bed or just collapse at the end of a busy day, these pointers may be worthwhile pursuing.

     First and foremost, get a good checkup by your doctor.  Many medical conditions such as hypothyroidism, menopause, Lupus, depression, anemia, and sleep apnea have fatigue as a primary symptom.  If you check out well with your doc, consider the following:

1.  Check your sleep habits.  We are a culture of sleep deprivation.  It makes logical sense that if we don’t sleep restfully we will be tired the next day.  I am amazed at the number of folks that forget this simple connection.  Improve your sleep and your energy will rebound.

2.  Force yourself to get off the couch.  Multiple studies show the positive effect of exercise on energy level.  You may be saying, “I would exercise if I wasn’t so darn tired!” It is tough, but forcing yourself to do something, even a good walk, will, over time, improve your energy level.

3.  Garbage in equals energy gone.  We are what we eat, and this applies to energy level.  In fact, energy derives from the body’s ability to metabolize food.  If we put molasses in our car’s gas tank, it won’t go far.  If we put junk in our gas tank, we won’t go far!

4. Reduce stress.  Stress magnifies everything!  The more stress, the more your lack of energy.  It’s as if the body tries to shut down to save itself from the stress. The more you can minimize stress, the more energy you will have.

  I realize this is a very superficial treatment of very complex solutions, but maybe it can stimulate you to investigate these approaches on your own. 

   

Fatigue

“I’m sick and tired of being sick and tired!” 

“I just have no energy.”

     One of the most common problems of the 21st century woman is fatigue.  I am not exaggerating by stating that well over 40% of women I see in my office complain at some stage of their life of excessive tiredness.  Lack of energy is not a local phenomenon either (in spite of the claims of one woman who was sure that SRS had something to do with her low energy level.  Of course this was the same gal who had been nabbed by aliens and forced to watch reruns of “Geraldo”).  National statistifatiguecs are equally as impressive.  One study even went as far to claim that 30.3 % of adolescents experienced excessive fatigue (PEDIATRICS Vol. 119 No. 3 March 2007, pp. e603-e609) 

   The classification of fatigue runs the gamut from a transient mild tiredness to a debilitating lack of energy.  One of the inherent problems in studying a condition such as this is the subjectivity of the diagnosis.  Those who suffer with chronic fatigue are often perceived as malingerers and patronizingly dismissed.  There is still reluctance on the part of many medical practitioners to legitimize chronic fatigue syndrome, the most extreme form of tiredness, as a genuine entity; however, this appears to be an area where the science is finally catching up with the clinical observation.  As with any medical problem that is poorly understood, the treatment of excessive fatigue is varied, sometimes unconventional, and often unsuccessful.  It is important to distinguish chronic fatigue syndrome from “garden variety” tiredness as they differ in numbers of symptoms and degree of disability.  For many sufferers it comes down to how much the lack of energy interferes with normal day to day activities.  The Center for Disease Control in Atlanta has set down certain criteria for physicians and researchers to use in making the diagnosis of chronic fatigue syndrome
.  A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

  • cognitive dysfunction, including impaired memory or concentration
  • exhaustion and increased symptoms for more than 24 hours following physical or mental exercise
  • unrefreshing sleep
  • joint pain (without redness or swelling)
  • persistent muscle pain
  • headaches of a new type or severity
  • tender lymph nodes
  • sore throat

  You can see from these symptoms that there is tremendous overlap with other common problems.  We all may experience some of these problems some of the time. The key is the persistence and intensity of the problem and, importantly, no other medical or emotional troubles that serve as a cause.

   There is hope!  Since becoming a more universally defined syndrome, additional research has been done on ways to thwart this bothersome illness.  Many of these treatments and suggestions also apply to the woman who has only mild symptoms.  So whether you are unable to get out of the bed or just collapse at the end of a busy day, these pointers may be worthwhile pursuing.

     First and foremost, get a good checkup by your doctor.  Many medical conditions such as hypothyroidism, menopause, Lupus, depression, anemia, and sleep apnea have fatigue as a primary symptom.  If you check out well with your doc, consider the following:

1.  Check your sleep habits.  We are a culture of sleep deprivation.  It makes logical sense that if we don’t sleep restfully we will be tired the next day.  I am amazed at the number of folks that forget this simple connection.  Improve your sleep and your energy will rebound.

2.  Force yourself to get off the couch.  Multiple studies show the positive effect of exercise on energy level.  You may be saying, “I would exercise if I wasn’t so darn tired!” It is tough, but forcing yourself to do something, even a good walk, will, over time, improve your energy level.

3.  Garbage in equals energy gone.  We are what we eat, and this applies to energy level.  In fact, energy derives from the body’s ability to metabolize food.  If we put molasses in our car’s gas tank, it won’t go far.  If we put junk in our gas tank, we won’t go far!

4. Reduce stress.  Stress magnifies everything!  The more stress, the more your lack of energy.  It’s as if the body tries to shut down to save itself from the stress. The more you can minimize stress, the more energy you will have.

  I realize this is a very superficial treatment of very complex solutions, but maybe it can stimulate you to investigate these approaches on your own. 

   

Ovarian Cancer

For women, ovarian cancer is a frightening malady because of its insidious nature.  It’s been called a silent killer because once symptoms appear, the disease is often widespread.   The key to overcoming this fear is understanding the reality of the disease and dispelling myths.

The American Cancer Society states, “Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 75. Her lifetime chance of dying from ovarian cancer is about 1 in 100.”  Juxtapose this with the most common cancer in women, breast cancer, where a woman’s lifetime risk is 1 out of 8.  Even when you consider total cancer deaths, ovarian ranks low compared to breast, lung, and colorectal.  So indeed ovarian cancer is a fierce adversary, but realistically there is a much lower incidence of this type of cancer than many others.

One reason ovarian cancer is so feared is its delayed presentation of symptoms.  Unlike many illnesses which telegraph their appearance early with notable symptoms, ovarian cancer often doesn’t produce noticeable problems until relatively late in its development.  And when it does, the symptoms are nebulous and rarely initially recognizable as ovarian in nature.  For example, a common symptom of ovarian cancer is abdominal bloating.  Unfortunately, this same symptom can be associated with everything from bad sushi to irritable bowel syndrome.  Common symptoms associated with ovarian cancer include:

Fatigue.

Upset stomach.

Back pain.

Pain during sex.

Constipation.

Menstrual changes.

Abdominal swelling with weight loss

As you can see, virtually all women will experience at least one of these symptoms intermittently. The distinguishing factor often is a persistence or continual worsening of symptoms. 

Unlike the Pap smear for cervical cancer, there are no good screening tests for ovarian cancer.  There is some evidence that a combination of various blood tests and a pelvic ultrasound may suggest an early ovarian cancer, yet these have not yet been shown to be useful enough in a low risk population to be promoted as a screen for everyone.  Certainly these tests (and others like a CT scan) can help steer the diagnosis in someone with unexplained symptoms, but we are still woefully lacking in a universal screening test for ovarian cancer. 

There are some folks who are at a higher risk for this disease and therefore warrant closer monitoring.  Risk factors for ovarian cancer include a family history, menstruating at an early age (before 12), having not given birth to any children, a first child after 30, menopause after 50, and having never taken oral contraceptives (taking birth control pills actually reduces the risk of ovarian cancer).  Of special interest is the genetic relationship between various female cancers like breast and ovarian.  About 10 to 15 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. The most significant risk factor for ovarian cancer is an inherited genetic mutation in one of two genes: breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2). These genes are responsible for about 5 to 10 percent of all ovarian cancers.  Eastern European women and women of Ashkenazi Jewish descent are at a higher risk of carrying BRCA1 and BRCA2 mutations. Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer have an increased risk of ovarian cancer.  These can be detected with a blood test and many insurances will cover this in high risk women.  There is an ethical debate regarding someone who tests positive for these mutations.  Do you prophylactically remove the ovaries as a preventative tool?  There are no clear cut answers at this stage as not everyone who has these mutations will develop cancer.  The utility in this knowledge allows the individual to make a rational decision based on a variety of factors.

Treatment of ovarian cancer is often a combination of surgery and chemotherapy.  Much of the treatment depends on the extent of the disease noted during the surgical removal of the cancerous tissue.  This cancer tends to spread both by local growth in the pelvis and through the bloodstream and lymphatics, so it can metastasize or  reoccur in distant parts of the body.  There have been advances in treatment, especially in chemotherapeutic agents, and one of the most exciting ares of research is in various immunological techniques.  These approaches literally label the cancer cells with tags that allow a chemotherapeutic agent to selectively attack the bad cells while leaving the good cells alone.  Many women are successfully propelled into remission with these and other techniques, so there is expanding hope as research develops.

Ovarian cancer is a serious and scary disease, but it is not the death sentence it once was.