Featured Guest Columnist

Midnight Madness: From Sweet Dreams to Nightmares

Sleep is good medicine
Sleep is one of the body's basic needs. It restores and preserves our health. Too little sleep puts us at risk for health problems such as high blood pressure and heart disease. Immunity to sickness declines, and tolerance for stress plummets.

When we don't have a well-rested body and mind, every aspect of our waking day is affected. Yet statistics show that as many as 70 percent of Americans are sleep-deprived.

Of course, some of those exhausted Americans are women in midlife. In fact, according to the National Sleep Foundation, women who report the most sleep problems are those dealing with perimenopause through postmenopausal. Their symptoms include hot flashes, mood disorders, insomnia, and sleep-disordered breathing. Such sleep problems are often accompanied by depression and anxiety.

Many women don't realize just how important sleep is, so they put it at the very bottom of the "to do" list. We tend to squeeze every hour out of every day. We cram our schedules with professional, social, and family activities, rarely leaving time to relax and get to bed on time. But sleep is when the body renews and recharges itself with energy and strength for the next day.

When your head finally hits the pillow at the end of the day, your mind is probably still racing, and your inner dialogue may sound something like this:

I'm so tired. How come I can't relax? I've got to get to sleep – I have a million things to do tomorrow. I've got to finish that report and get Mom to her doctor's appointment. And I can't remember, does Jessie need a ride home after soccer practice? I can't keep up. I'm just not feeling right these days. Oh, I hope I don't have hot flashes tonight.

If you have trouble falling or staying asleep, you may have a problem that needs medical attention. During midlife, it's important to sort out whether a sleep problem is related to menopause symptoms or is that's called a "primary" sleep disorder, a condition that creates sleep problems but has nothing to do with menopause.

Is nighttime a bad dream?
Menopause itself doesn't cause difficulty sleeping, but its symptoms certainly can. As we've discussed, hot flashes occur more frequently at night, causing interrupted sleep and tiredness the next day. In addition, our daily stresses and concerns with physical changes during menopause tend to "turn on" when the lights go off. Our minds go into overdrive and we ruminate.

In addition, menopause-related anxiety depression, and mood swings can keep thoughts churning long past bedtime. For some women, the physical and psychological changes they experience during the menopause years can feel like a bad dream that won't go away.

Here's a hopeful note. Although we can't treat sleep problems with hormone therapy, we can use it to treat menopause symptoms that deprive you of the rest you need. Often, restoring hormone balance with low-dose, short-term hormone therapy will help you get a good night's sleep. Women who prefer not to take hormone therapy can discuss alternative options with a women's health doctor. And if you have a primary sleep problem, there are many excellent treatments available today.

But before you can rest easy, you and your doctor will need to figure out whether your symptoms are related to menopause or a sleep disorder.

Watch for these signs
Whether related to menopause or not, sleep problems show up in a number of different ways that may include:

  • Trouble falling asleep
  • Difficulty staying asleep
  • Waking too early and being unable to get back to sleep
  • Finding it hard to wake up on time
  • Being tired during the day
  • Sleeping too much

These could indicate one or more of the following problems:

Problem: Hot flashes and night sweats that frequently disrupt sleep.
Solution: Depending on how severe your hot flashes are, you may benefit from alternative remedies (discussed in Chapter 7) or hormone therapy. Otherwise, try these tips to keep cool at night:

  • Wear loose clothing to bed
  • Keep your bedroom cool and well ventilated
  • Avoid taking hot showers or baths before bed
  • Sleep with your socks on to help regulate body temperature

Problem: Physical discomfort. Menopause symptoms that can set you up for a poor night's sleep include hot flashes, itchy skin, a dry vagina – any physical irritation that is bothering you.
Solution: If you had a pounding headache, you’d probably take a pain reliever to alleviate it. Why wouldn't you treat menopause symptoms so that you can rest at night? Use various treatments discussed throughout this book to care for your symptoms and sleep is likely to come much more easily.

Problem: Mood swings, depression, or anxiety.
Solution: Natural ways to improve your mood include eating right, exercising regularly, and practicing relaxation techniques to restore balance. You can also try taking vitamin B, which is believed to boost mood because it restores elements involved in different aspects of brain chemistry.

But if you remain depressed or anxious for more than two weeks, it's important to see a doctor. Only a physician can properly determine whether your case calls for a prescription to treat depression or anxiety.

Problem: Stress. Most of us don’t have an "off button" that allows us to erase the day's stressors when we retire at night. Instead, thoughts of family, work, and personal affairs churn in our heads as soon as we turn off the lights. We lie in bed and worry and think.

Solution: Relaxation techniques are an important part of slowing down at the end of the day. Establish a bedtime ritual like taking a warm bath, reading a favorite book, or writing in a journal to set the mood for sleep. Consider the hour before your bedtime as "you time."
Cleveland Clinic  1- 800.223.2273
Cleveland Clinic is a non-profit academic medical center.

 

 

Laser Skin Resurfacing

Laser resurfacing is a newer laser treatment to reduce facial wrinkles and skin irregularities. The procedure also evens skin pigmentation and removes lesions, both benign (non-cancerous) and malignant.

The laser technique directs short, concentrated pulsating beams of light at irregular skin. Laser skin resurfacing removes skin very precisely, layer-by-layer, resulting in fewer problems with hypopigmentation (lightening of skin). This popular procedure is known by several other names, including lasabrasion, laser peel, or laser vaporization.

Who is a good candidate for laser skin resurfacing?
You may be an ideal candidate for laser skin resurfacing if you have:

Scars from acne
Uneven skin pigmentation
Non-responsive skin after a facelift
Fine lines or wrinkles around or under the eyes, forehead, or mouth

You may not be an ideal candidate if you have active acne or if you have very dark skin.

How does laser skin resurfacing work?

The two types of lasers traditionally used in laser resurfacing are carbon dioxide (CO2) and erbium. Each laser vaporizes superficial, damaged skin cells. Both types of lasers reduce the risk for the patient because they limit the amount of heat absorbed by the skin. The newest type of laser used for resurfacing is a fractionated CO2. This method emits numerous narrow, columns of laser light, allowing for small islands of normal skin to remain intact.

CO2 laser resurfacing - Recovery time: Allow up to 2 weeks.

This method has been used for years to treat different benign and malignant skin conditions. A newer generation of CO2 laser resurfacing uses very short pulsed light energy (ultrapulsed) or continuous light beams that are delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures.

CO2 laser resurfacing has been successfully used to treat wrinkles and scars as well as other benign skin growths such as warts, birthmarks, rhinophyma (enlarged oil glands on the nose), and other skin conditions.

The field of CO2 laser resurfacing is rapidly changing and improving. CO2 laser resurfacing is yet another treatment in the toolbox that includes such options as Retin-A® products, vitamin C lotion, alpha hydroxy acids, chemical peels, dermabrasion, collagen, hyaluronic acid or fat augmentation, and botulinum toxin (trade name Botox®). Patients should look for surgeons with documented training and experience in laser skin resurfacing.

Erbium laser resurfacing - Recovery time: Allow 1 full week.

Erbium laser resurfacing is designed to remove superficial and moderately deep lines and wrinkles on the face and should require only local anesthetic. This laser can also be used on your hands, neck, or chest. One of the benefits of erbium laser resurfacing is minimal injury of surrounding tissue. This laser causes minimal side effects, such as swelling, bruising and redness, so your recovery time should be more rapid.

If you have a darker skin tone, erbium laser resurfacing may work better for you. Your doctor will determine which laser is best for you after a full evaluation of your medical history, current physical condition, and desired results.

Fractional laser resurfacing - Recovery time: Allow 1 full week.

The use of a fractional laser with ablative settings delivers many narrow columns of laser light to the skin. This induces the formation of many zones of thermal damage referred to as microscopic thermal zones (MTZs). The technique allows undamaged skin surrounding the MTZs to serve as a reservoir for tissue to regenerate faster than traditional ablative lasers. Complications, as seen below, appear to be less severe and less frequent with the fractional laser resurfacing.

What can be expected during and after laser skin resurfacing?

In general, all forms of laser resurfacing discussed are performed on an outpatient basis, using local anesthesia in combination with orally or intravenously administered sedative medications. Wrinkles around the eyes, mouth, or forehead may be treated individually, or a full-face laserabrasion may be performed. Here is what to expect during and after resurfacing:

  • Areas of the face to be treated are numbed with a local anesthetic. General anesthesia may be used when the entire face is treated. A partial-face laserabrasion takes 30 to 45 minutes, and the full-face treatment takes 1-1/2 to 2 hours.
  • Following laser resurfacing, a nonstick dressing is applied to the treatment sites for 24 hours. The patient then cleans the treated areas 2 to 5 times a day with saline or a diluted vinegar solution (see instructions below). An ointment such as Vaseline®, Eucerin®, or Aquaphor® is then applied. This wound care is intended to prevent any scab formation. In general, the areas heal in 5 to 21 days, depending on the nature of the condition that was treated, and type of laser used.
  • Once the areas have healed, makeup may be worn to camouflage the pink to red color that is generally seen after laser skin resurfacing. Green-based makeups are particularly suitable for this camouflage since they neutralize the red color. Oil-free makeups are recommended after laser resurfacing. The redness in the laser-treated sites generally fades in 2 to 3 months but may take as long as 6 months to disappear. The redness generally persists longer in blondes and redheads.

Patients with darker skin tones have a greater risk of healing with darker pigmentation (hyperpigmentation). This may be minimized by use of a bleaching agent after laser skin resurfacing.

How should I prepare for laser skin resurfacing?

  • Avoid tanning or heavy sun exposure and use a broad-spectrum sunscreen daily for 4 weeks prior to treatment.
  • Avoid deep facial peel procedures for 4 weeks prior to the treatment (for example, aggressive chemical peels, laser resurfacing, dermabrasion).
  • Do not use medications that cause photosensitivity (such as doxycycline, minocycline) for at least 72 hours prior to treatment.
  • If you have a history of herpes (oral cold sores, genital) or shingles in the treatment area, let your doctor know and start your antiviral medication (valacyclovir, acyclovir) as directed (usually 2 days prior to treatment and continue for 3 days after treatment).
    Cleveland Clinic  1- 800.223.2273
    Cleveland Clinic is a non-profit academic medical center.

Are you able to communicate calmly and clearly with your teenager regarding relationship problems?

Do you encourage positive behaviors in your teenager on a daily basis?

Are you able to negotiate emotional conflicts with your teenager and work toward a solution?

Are you able to calmly set limits when your teenager is defiant or disrespectful? Are you able to set limits on more serious problem behavior such as drug use, if or when it occurs?

Do you monitor your teenager to assure that he or she does not spend too much unsupervised time with peers?

Tips On How To Talk To Your Healthcare Provider

How can I describe my pain to my health care provider?

Describing your pain accurately and thoroughly may help your health care provider find the cause of the pain and treat it.

Information that is helpful to your doctor includes:

  • How long you have had your pain
  • Where you feel the pain
  • Whether your pain is in one spot or spread out
  • How the pain feels and how severe it is
  • Whether pain is constant or comes and goes
  • What activities make pain worse or improve it
  • How your pain limits what you can do
  • How often the pain occurs and how long it lasts
  • Anything that triggers the pain

Keeping a pain diary or record of your pain is a good way to track your pain triggers as well as symptoms over time. Be as specific as possible. Some words that can help you describe the way your pain feels include:

  • Aching
  • Cramping
  • Fearful
  • Gnawing
  • Heavy
  • Hot or burning
  • Sharp
  • Shooting
  • Sickening
  • Splitting
  • Stabbing
  • Punishing or cruel
  • Tender
  • Throbbing
  • Tiring or exhausting

Tips On How To Talk To Your Healthcare Provider

How can I describe my pain to my health care provider?

Describing your pain accurately and thoroughly may help your health care provider find the cause of the pain and treat it.

Information that is helpful to your doctor includes:

  • How long you have had your pain
  • Where you feel the pain
  • Whether your pain is in one spot or spread out
  • How the pain feels and how severe it is
  • Whether pain is constant or comes and goes
  • What activities make pain worse or improve it
  • How your pain limits what you can do
  • How often the pain occurs and how long it lasts
  • Anything that triggers the pain

Keeping a pain diary or record of your pain is a good way to track your pain triggers as well as symptoms over time. Be as specific as possible. Some words that can help you describe the way your pain feels include:

  • Aching
  • Cramping
  • Fearful
  • Gnawing
  • Heavy
  • Hot or burning
  • Sharp
  • Shooting
  • Sickening
  • Splitting
  • Stabbing
  • Punishing or cruel
  • Tender
  • Throbbing
  • Tiring or exhausting


Are you able to communicate calmly and clearly with your teenager regarding relationship problems?

Do you encourage positive behaviors in your teenager on a daily basis?

Are you able to negotiate emotional conflicts with your teenager and work toward a solution?

Are you able to calmly set limits when your teenager is defiant or disrespectful? Are you able to set limits on more serious problem behavior such as drug use, if or when it occurs?

Do you monitor your teenager to assure that he or she does not spend too much unsupervised time with peers?

Are you able to communicate calmly and clearly with your teenager regarding relationship problems?

Do you encourage positive behaviors in your teenager on a daily basis?

Are you able to negotiate emotional conflicts with your teenager and work toward a solution?

Are you able to calmly set limits when your teenager is defiant or disrespectful? Are you able to set limits on more serious problem behavior such as drug use, if or when it occurs?

Do you monitor your teenager to assure that he or she does not spend too much unsupervised time with peers?

Best Strategies To Help You Fight Seasonal Affective Disorder

Expert tips on how you can have a brighter mood this winter

For many people, the gray days of winter can mean gray moods. If you feel sad, can’t sleep and feel as if all you want to do is lie on the sofa, eat bad food and watch cable for days on end, you might have seasonal affective disorder.

SAD is a form of depression that generally happens in the late fall, when there is less natural sunlight and the days become shorter and colder. It has been estimated that as many as 9 percent of U.S. adults – about a half-million people – experience symptoms of SAD.

Symptoms of SAD include:

  • Feelings of sadness or a serious mood shift when the seasons change
  • Lack of energy
  • Cravings for carbohydrates
  • Overeating
  • Loss of interest in pleasurable activities (including loss of sexual interest)
  • Difficulty with sleep (either by sleeping too much or experiencing insomnia)

Three-quarters of SAD sufferers are women and it’s more commonly seen in cloudy parts of the country or areas farther to the north or south of the equator. Seasonal affective disorder typically worsens in the winter.

RELATED: Yes, You Really Can Be Allergic to the Cold

Here are three ways you can combat SAD:

  1. Try an exercise program

Most people naturally decrease their activity in the winter because of the harsh weather outdoors.

But if you think you may have SAD, pushing yourself to do physical activity is a good way to combat it, says psychologist Scott Bea, Psy.D.

“Moving your body will compete with that tendency to be sluggish, and can produce good brain chemistry,” Dr. Bea says.

Look for indoor activities that you enjoy, such as yoga or running on a track, or try winter activities like skiing or snowshoeing to take advantage of and enjoy the cold weather.

RELATED: 4 Easy Ways to Stay Fit in Cold Weather

  1. Create social situations

During the wintertime, the cold and lack of regular social interaction can lead you to feel blue, too.

If this is you, Dr. Bea recommends that you try to push yourself to be more social and to connect with others. Often, once you make the effort, the social interaction can lift your spirits.

The key is to get your attention and thoughts away from yourself, he says.

“Creating a new social obligation or inviting people into our homes can motivate us because then there’s an obligation to entertain, or spruce up your house,” Dr. Bea says. “Anything that forces your hand toward activity to be engaged outside of self-awareness would be useful for people with SAD.”

RELATED: How Family Affects Your Heart Health

  1. Use light therapy

Experts believe SAD is triggered by changes in our exposure to sunlight. Research has shown that light therapy, which is sometimes called phototherapy, can help people with SAD.

About 70 percent of people with SAD see improvement when exposed to a therapy light for about a half hour each day, Dr. Bea says.

Light therapy is administered by a device that contains white fluorescent light tubes covered with a plastic screen to block ultraviolet rays. The intensity of light should be 10,000 Lux. Many health professionals treat SAD with 10,000 Lux for 15 minutes to 30 minutes every morning.

“Light therapy is generally safe and well-tolerated, Dr. Bea says. “However, light therapy is not appropriate for some patients – those with conditions such as diabetes or retinopathies or who are taking certain medicines – because of the potential risk of damage to the retina.”

Dr. Bea also recommends eating a well-balanced diet, which includes sufficient amounts of vitamins and minerals. “ This will help you have more energy even though your body is craving those starchy foods and sweets,” he says.
Cleveland Clinic  1- 800.223.2273
Cleveland Clinic is a non-profit academic medical center.

 


Tips On How To Talk To Your Healthcare Provider

How can I describe my pain to my health care provider?

Describing your pain accurately and thoroughly may help your health care provider find the cause of the pain and treat it.

Information that is helpful to your doctor includes:

  • How long you have had your pain
  • Where you feel the pain
  • Whether your pain is in one spot or spread out
  • How the pain feels and how severe it is
  • Whether pain is constant or comes and goes
  • What activities make pain worse or improve it
  • How your pain limits what you can do
  • How often the pain occurs and how long it lasts
  • Anything that triggers the pain

Keeping a pain diary or record of your pain is a good way to track your pain triggers as well as symptoms over time. Be as specific as possible. Some words that can help you describe the way your pain feels include:

  • Aching
  • Cramping
  • Fearful
  • Gnawing
  • Heavy
  • Hot or burning
  • Sharp
  • Shooting
  • Sickening
  • Splitting
  • Stabbing
  • Punishing or cruel
  • Tender
  • Throbbing
  • Tiring or exhausting


Are you able to communicate calmly and clearly with your teenager regarding relationship problems?

Do you encourage positive behaviors in your teenager on a daily basis?

Are you able to negotiate emotional conflicts with your teenager and work toward a solution?

Are you able to calmly set limits when your teenager is defiant or disrespectful? Are you able to set limits on more serious problem behavior such as drug use, if or when it occurs?

Do you monitor your teenager to assure that he or she does not spend too much unsupervised time with peers?

BEST OF HEALTHCARE
MENU