Each year 185,000 women in this country learn that they have breast cancer. Because less than a quarter of them have genetic or other known risk factors, the diagnosis often comes as a devastating surprise. The emotional turmoil that results can affect women's physical health as well as their psychological well-being. This question-and-answer fact sheet explains how psychological treatment can help these women harness the healing powers of their own minds.
What impact does a breast cancer diagnosis have on psychological well-being?
Receiving a diagnosis of breast cancer can be one of the most distressing events women ever experience. And women may not know where to turn for help.
Distress typically continues even after the initial shock of diagnosis has passed. As women begin what is often a lengthy treatment process, they may find themselves faced with new problems. They may find their personal relationships in turmoil, for instance. They may feel tired all the time. They may be very worried about their symptoms, treatment and mortality. They may face discrimination from employers or insurance companies. Factors like these can contribute to chronic stress, anxiety and depression.
Why is it important to seek psychological help?
Feeling overwhelmed is a perfectly normal response to a breast cancer diagnosis. But negative emotions can cause women to stop doing things that are good for them and start doing things that are bad for anyone but especially worrisome for those with a serious disease. Women with breast cancer may start eating poorly, for instance, eating fewer meals and choosing foods of lower nutritional value. They may cut back on their exercise. They may have trouble getting a good night's sleep. And they may withdraw from family and friends. At the same time, these women may use alcohol, cigarettes, caffeine or other drugs in an attempt to soothe themselves.
A breast cancer diagnosis can also lead to more severe problems. Researchers estimate that anywhere from 20 to 60 percent of cancer patients experience depressive symptoms, which can make it more difficult for women to adjust, participate optimally in treatment activities and take advantage of whatever sources of social support are available. Some women become so disheartened by the ordeal of having cancer that they refuse to undergo surgery or simply stop going to radiation or chemotherapy appointments. As a result, they may get even sicker. In fact, studies show that missing as few as 15 percent of chemotherapy appointments results in significantly poorer outcomes.
How can psychological treatment help women adjust?
Licensed psychologists and other mental health professionals with experience in breast cancer treatment can help a great deal. Their primary goal is to help women learn how to cope with the physical, emotional and lifestyle changes associated with cancer as well as with medical treatments that can be painful and traumatic.
For some women, the focus may be on how to explain their illness to their children or how to deal with a partner's response. For others, it may be on how to choose the right hospital or medical treatment. For still others, it may be on how to control stress, anxiety or depression. By teaching patients problem-solving strategies in a supportive environment, psychologists help women work through their grief, fear, and other emotions. For many women, this life-threatening crisis eventually proves to be an opportunity for life-enhancing personal growth.
Breast cancer patients themselves aren't the only ones who can benefit from psychological treatment. Psychologists often help spouses who must offer both emotional and practical support while dealing with their own feelings, for instance. Children, parents and friends involved in caretaking can also benefit from psychological interventions.
The need for psychological treatment may not end when medical treatment does. In fact, emotional recovery may take longer than physical recovery and is sometimes less predictable. Although societal pressure to get everything back to normal is intense, breast cancer survivors need time to create a new self-image that incorporates both the experience and their changed bodies. Psychologists can help women achieve that goal and learn to cope with such issues as fears about recurrence and impatience with life's more mundane problems.
Can psychological treatment help the body, too?
Absolutely. Take the nausea and vomiting that often accompany chemotherapy, for example. For some women, these side effects can be severe enough to make them reject further treatment efforts. Psychologists can teach women relaxation exercises, meditation, self-hypnosis, imagery or other skills that can effectively relieve nausea without the side effects of pharmaceutical approaches.
Psychological treatment has indirect effects on physical health as well. Researchers already know that stress suppresses the body's ability to protect itself. What they now suspect is that the coping skills that psychologists teach may actually boost the immune system's strength. In one well-known study, for example, patients with advanced breast cancer who underwent group therapy lived longer than those who did not.
Research also suggests that patients who ask questions and are assertive with their physicians have better health outcomes than patients who passively accept proposed treatment regimens. Psychologists can empower women to make more informed choices in the face of often-conflicting advice and can help them communicate more effectively with their health care providers. In short, psychologists can help women become more fully engaged in their own treatment. The result is an enhanced understanding of the disease and its treatment and a greater willingness to do what needs to be done to get well again.
What type of psychological treatment is helpful?
A combination of individual and group treatment some-times works best. Individual sessions with a licensed psychologist typically emphasize the understanding and modification of patterns of thinking and behavior. Group psychological treatment with others who have breast cancer gives women a chance to give and receive emotional support and learn from the experiences of others. To be most effective, groups should be made up of women at similar stages of the disease and led by psychologists or other mental health professionals with experience in breast cancer treatment.
Whether aimed at individuals or groups, psychological interventions strive to help women adjust to their diagnoses, cope with treatment and come to terms with the disease's impact on their lives. These interventions offer psychologists an opportunity to help women better understand breast cancer and its treatment. Psychologists typically ask women open-ended questions about their assumptions, ideas for living life more fully and other matters. Although negative thoughts and feelings are addressed, most psychological interventions focus on problem-solving as women meet each new challenge.
A breast cancer diagnosis can severely impair a woman's psychological functioning, which in turn can jeopardize her physical health. But it doesn't have to be that way. Women who seek help from licensed psychologists with experience in breast cancer treatment can actually use the mind-body connection to their advantage to enhance both mental and physical health.
Rabu, 19 Maret 2008
Colds and the Flu: (What to Do If You Get Sick)
Be Aware of Common Flu Symptoms
The flu usually comes on suddenly and may include these symptoms:
• High fever
• Headache
• Tiredness/weakness (can be extreme)
• Dry cough
• Sore throat
• Runny nose
• Body or muscle aches
• Diarrhea and vomiting also can occur, but are more common in children.
These symptoms are usually referred to as "flu-like symptoms." A lot of different illnesses, including the common cold, can have similar symptoms.
Cold Versus the Flu
The flu and the common cold are both respiratory illnesses caused by different viruses. Because these two types of illnesses have similar symptoms, it can be difficult to tell the difference between them. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.
General Steps to Take If You Get Sick
If you develop flu-like symptoms, and you are not at high risk for complications from the flu:
• Get plenty of rest
• Drink a lot of liquids
• Avoid using alcohol and tobacco
• Consider taking over-the-counter medications to relieve the symptoms of flu (but never give aspirin to children or teenagers who have flu-like symptoms)
• Stay home and avoid contact with other people to protect them from catching your illness
• Cover your nose and mouth with a tissue when you cough or sneeze to protect others from your germs.
Most healthy people recover from the flu without complications.
Look Out for Emergency Warning Signs
There are some “emergency warning signs” that require urgent medical attention.
In children, some emergency warning signs that need urgent medical attention include:
• High or prolonged fever
• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Changes in mental status, such as not waking up or not interacting; being so irritable that the child does not want to be held; or seizures
• Flu-like symptoms improve but then return with fever and worse cough
• Worsening of underlying chronic medical conditions (for example, heart or lung disease, diabetes)
In adults, some emergency warning signs that need urgent medical attention include:
• High or prolonged fever
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest
• Near-fainting or fainting
• Confusion
• Severe or persistent vomiting
Seek medical care immediately, either by calling your doctor or going to an emergency room, if you or someone you know is experiencing any of the signs described above or other unusually severe symptoms. When you arrive, tell the receptionist or nurse about your symptoms. You may be asked to wear a mask and/or sit in a separate area to protect others from getting sick.
Special Concerns for People at High Risk for Complications from the Flu
Some people are at increased risk to develop complications of flu. This group includes:
• People 65 years of age and older
• Children 6-23 months of age*
• People of any age with chronic medical conditions (for example, heart or lung disease, asthma, diabetes, or HIV infection)
• Pregnant women
If you are in a group that is considered to be at high risk for complications from the flu and you get flu-like symptoms, you should consult your health-care provider when your symptoms begin.
Some of the complications caused by flu include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children also may get sinus and ear infections.
*Children 6-23 months of age are at increased risk for influenza-related hospitalization.
Coping with HIV and AIDS
Acquired Immune Deficiency Syndrome (AIDS) is caused by the Human Immunodeficiency Virus (HIV). The virus attacks and eventually destroys certain white blood cells, which are a part of the body’s immune system that we need to fight off infections. The immune system makes antibodies to combat the HIV virus. Their presence in the blood can be measured. If a person has antibodies, they are called “HIV positive” because they have been infected with the HIV virus. However, the person may remain healthy for a long time, even many years. AIDS is the late stage of the illness known as HIV disease, and occurs when so many white blood cells have been destroyed that the immune system cannot do its job well. The person with AIDS develops infections, even from unusual organisms (opportunistic infections) and various malignancies. HIV virus also can affect the brain and nerves.
There are medications to control the infections and malignancies. There are also medications to slow the growth of HIV. However, right now there is no cure and no vaccination to prevent infection. The disease is fatal. However, many new treatments are being developed and there is hope that medical research will rapidly find better forms of treatment and prevention. HIV is spread through the transmission of contaminated body fluids—such as semen, vaginal secretions and blood—into the body of another person. The entry occurs through broken skin and mucous membranes (tissues that line the mouth, vagina, rectum, and urethra). Any activity where one partner—either heterosexual or homosexual—penetrates another sexually can spread the illness. Any cutting into the body with contaminated
instruments can cause infection; this includes needles used by IV drug abusers, unsterilized medical and dental equipment, as well as ear piercing, tattooing, and manicure equipment. Take precautions. Always ask if equipment used in medical, dental or cosmetic procedures is sterilized, new, or disposable. Always practice safe sex. Mothers infected with HIV should also know that they can pass the infection to their children during pregnancy and breast feeding. However, the virus is not spread by casual contact, such as hugging, holding hands, close conversation, sharing a meal, etc. Don’t assume AIDS can’t happen to you or your loved ones. It can. The only absolute treatment is prevention. We must try hard not to stigmatize and isolate those who are infected with HIV or have developed AIDS. If you have questions about what is safe, consult your physician.
Should I be tested for HIV antibodies?
It is important that you know your HIV antibody status. There are many places where you can take a test anonymously and where no record is kept of your results. Taking the test is also important because early diagnosis and treatment of HIV disease may prolong life and reduce disability. Those who engage in high-risk behavior—i.e., those who may become infected or infect others through IV drug use or unprotected (without a condom) hetero or homosexual intercourse—should consider taking the test immediately. In addition, anyone who received blood or blood products prior to screening of the blood supply in 1985 may have been exposed to the HIV virus.
You should never take the test without careful preparation and counseling, however. You should consider the emotional, social, legal, financial, and insurance consequences. It often helps to bring along a knowledgeable person whom you trust to help you ask questions that will get you the information you need to make an informed decision in the event you test positive. It is a good idea as well to have an expert with whom you can discuss your results.
What should I do with my test results?
If you are HIV positive, find a physician who knows about HIV disease and with whom you feel comfortable. You will need to work together very closely and will want someone who cares what happens to you.
If you are HIV negative, consult your physician about the need for future testing and about lifestyle changes you may need to make in order to stay HIV negative.
If I’m HIV positive, should I tell other people?
It is important to tell those whom you may have exposed through sexual contact, needle sharing or other risky behavior. They need to be tested and have the knowledge that allows them to seek medical are. This can be very difficult to do and counseling can help. You will profit from a network of helpful and supportive people. However, you do need to be careful about whom you tell. Some people have very strong reactions. Telling your boss and coworkers can have financial and legal ramifications. It is best to start with a few friends or family with whom you feel close and whom you can trust not to tell others. Developing a community of support is a process and takes time. There may be HIV-positive support groups in your area or HIV hotlines that provide education and helpful support.
How does it feel to be HIV positive?
It is normal to have strong reactions such as fear, anger, and a sense of being overwhelmed. Some people even have suicidal thoughts. It is understandable that you might feel helpless and fear illness, disability and death. Other reactions might include:
Denial
Often, people who find out they are HIV positive will handle the news by denying that it is true. This denial may come up soon after the diagnosis is made. Denial can be helpful: it can give you time to get used to the idea of infection. It can, however, cause problems for oneself and others if one engages in risky behavior. And if it goes on too long it can get in the way of your getting the assistance and medical attention you need.
Guilt
It is not unusual for people to blame themselves for illness and to feel it is punishment. This guilt can be worsened by society’s prejudice and ignorance about HIV and AIDS. It is important, if you are HIV positive, to seek out those who are accepting and supportive.
Sadness
HIV disease means life changes and losses of one kind or another. Sadness is an understandable reaction. Sadness lifts for most people as they adjust. On the other hand, it can turn —sometimes slowly and subtly, sometimes quickly—into a more serious problem, called Depression.
If you are feeling depressed, it is important that you talk your feelings out. Your physician— as well as knowledgeable and supportive friends and loved ones—can help. Remember that there is always help through counseling, and any strong and lasting reaction calls for some kind of assistance.
What other psychiatric reactions are possible with HIV disease?
Many people with HIV disease do not develop serious emotional illness. However, if you develop any if the following reactions, it is important that you seek treatment. Depression—Characterized by prolonged periods of sadness and crying, feeling low or despairing, feelings of guilt and lowered self-esteem, a tendency to see only the negative side of things; also, fatigue, decreased ability to concentrate, loss of pleasure in activities, changes in appetite and weight, trouble sleeping, and, sometimes, thoughts of suicide.
Anxiety disorders—Characterized by excessive worry, feelings of being always on edge, muscle tension, restlessness; and other physical symptoms such as shortness of breath, sweating, rapid heart rate, nausea and diarrhea. They may also appear as sudden attacks of intense anxiety.
Mania—Characterized by an abnormally and persistently elevated mood or great shifts of mood, often with marked irritability. There is decreased desire for sleep, overactivity, rapid talking, poor concentration, and racing thoughts. People with this disorder may also have grand and sometimes bizarre ideas about themselves and impossible schemes for making money and becoming famous. They
may engage in spending sprees and other impulsive behavior. They may become very disorganized in their thinking and behavior and be unable to take care of themselves.
Psychotic symptoms—People may develop hallucinations, seeing things or hearing things that other people do not. They also may become “delusional,” developing strange, unrealistic, and very unlikely ideas. For example, they may think that even their closest friends are plotting to harm them or that secret organizations are spying on them, bugging their telephone or sending messages by television or radio. These are just a few examples of the many forms psychosis can take.
Alcohol and drug abuse—Some people may try to numb their feelings by abusing drugs and alcohol. At times, the person has a history of such problems. At other times, they begin to abuse drugs and alcohol after they learn they are HIV positive or develop symptoms of AIDS.
Difficulties with memory and thinking
Infections, malignancies, and nutritional deficiencies that are the results of AIDS can affect brain functioning. Some medications used to treat HIV infection or its complications can also have these effects. HIV itself can infect the brain, causing a condition doctors call AIDS Dementia Complex. Symptoms that might be a signal of trouble include:
-Forgetfulness
-Confusion
-Difficulty paying attention
-Slurred or changed speech
-Sudden changes in mood or behavior
-Clumsiness or difficulty walking
-Muscle weakness or strange sensations, like numbness or tingling
-Slowed thinking and difficulty finding words
If you have any of these problems you should discuss your concerns with your physician. He or she may suggest the help of a psychiatrist or other mental health specialist.
How can a psychiatrist help me?
A psychiatrist will talk with you and take a history in which he or she will ask about your current problems and how you managed in the past. He or she will need to know about any past or present alcohol or drug abuse and whether there is any family history of emotional problems or substance abuse. The psychiatrist, who is a medical doctor, will need to speak with your other physicians and review your medical history. The psychiatrist will ask specific questions to test memory, attention, and other aspects of thinking and problem solving. Your psychiatrist will tell you and your physician what he or she thinks is the nature of your problem, and will make recommendations for treatment. With your agreement, he or she may provide the recommended treatment if the expertise of a psychiatrist is required.
What treatments are available?
Various forms of psychotherapy may be useful, alone or in combination with medications which can help people with HIV disease express and understand their emotional reactions and find better ways to cope. Some problems can be treated with medications. There are anti-anxiety medications and antidepressants, including psycho-stimulants, that are safe and effective for use in people with HIV disease. People with Mania may need a mood stabilizing medication and those with psychotic symptoms may need an antipsychotic medication. There is substance abuse counseling for those with alcohol or drug abuse problems. In some areas of the country, there may be support groups or AA groups for people who have both HIV and substance abuse problems.
Are there other forms of help?
Many areas have community groups that provide services such as food preparation, housing, buddy networks, hotlines, and information on how to access medical care. There are also self-help support groups where people with HIV or AIDS can meet with others coping with the same or similar problems. Groups are also available to provide support and services for friends and family members.
If you are HIV positive, are there things you can do to help yourself?
It is important that you see your doctor regularly, and that you follow his or her recommendations. You can help by making some lifestyle adjustments. It is important to maintain good nutrition and to get enough rest. If you smoke, try to stop. It is helpful to stop or reduce alcohol use. It is very important to develop social contacts and to enlist the support and help of friends and family. If you feel that you are alone, it is important to recognize that help and companionship are available. A local community group or hotline that specializes in helping those with HIV disease and AIDS can be a good place to start.
What sort of reaction should I expect from family and
friends when I tell them I’m HIV positive?
Your family and friends will be affected by the consequences of your HIV infection, too. They may also experience feelings of denial, anger, fear, and grief. Some, unfortunately, will suffer from the same misunderstandings and prejudices that exist in society at large concerning people with HIV disease. They may also have questions about how they can prevent the spread of the infection, as well as questions about what is to be expected as the consequence of infections. Discussion with your physician can be helpful. It is important to remember that counseling— including couples and family counseling—is available and can be useful. There are also support groups for spouses, partners, and close friends of those with HIV disease.
There are medications to control the infections and malignancies. There are also medications to slow the growth of HIV. However, right now there is no cure and no vaccination to prevent infection. The disease is fatal. However, many new treatments are being developed and there is hope that medical research will rapidly find better forms of treatment and prevention. HIV is spread through the transmission of contaminated body fluids—such as semen, vaginal secretions and blood—into the body of another person. The entry occurs through broken skin and mucous membranes (tissues that line the mouth, vagina, rectum, and urethra). Any activity where one partner—either heterosexual or homosexual—penetrates another sexually can spread the illness. Any cutting into the body with contaminated
instruments can cause infection; this includes needles used by IV drug abusers, unsterilized medical and dental equipment, as well as ear piercing, tattooing, and manicure equipment. Take precautions. Always ask if equipment used in medical, dental or cosmetic procedures is sterilized, new, or disposable. Always practice safe sex. Mothers infected with HIV should also know that they can pass the infection to their children during pregnancy and breast feeding. However, the virus is not spread by casual contact, such as hugging, holding hands, close conversation, sharing a meal, etc. Don’t assume AIDS can’t happen to you or your loved ones. It can. The only absolute treatment is prevention. We must try hard not to stigmatize and isolate those who are infected with HIV or have developed AIDS. If you have questions about what is safe, consult your physician.
Should I be tested for HIV antibodies?
It is important that you know your HIV antibody status. There are many places where you can take a test anonymously and where no record is kept of your results. Taking the test is also important because early diagnosis and treatment of HIV disease may prolong life and reduce disability. Those who engage in high-risk behavior—i.e., those who may become infected or infect others through IV drug use or unprotected (without a condom) hetero or homosexual intercourse—should consider taking the test immediately. In addition, anyone who received blood or blood products prior to screening of the blood supply in 1985 may have been exposed to the HIV virus.
You should never take the test without careful preparation and counseling, however. You should consider the emotional, social, legal, financial, and insurance consequences. It often helps to bring along a knowledgeable person whom you trust to help you ask questions that will get you the information you need to make an informed decision in the event you test positive. It is a good idea as well to have an expert with whom you can discuss your results.
What should I do with my test results?
If you are HIV positive, find a physician who knows about HIV disease and with whom you feel comfortable. You will need to work together very closely and will want someone who cares what happens to you.
If you are HIV negative, consult your physician about the need for future testing and about lifestyle changes you may need to make in order to stay HIV negative.
If I’m HIV positive, should I tell other people?
It is important to tell those whom you may have exposed through sexual contact, needle sharing or other risky behavior. They need to be tested and have the knowledge that allows them to seek medical are. This can be very difficult to do and counseling can help. You will profit from a network of helpful and supportive people. However, you do need to be careful about whom you tell. Some people have very strong reactions. Telling your boss and coworkers can have financial and legal ramifications. It is best to start with a few friends or family with whom you feel close and whom you can trust not to tell others. Developing a community of support is a process and takes time. There may be HIV-positive support groups in your area or HIV hotlines that provide education and helpful support.
How does it feel to be HIV positive?
It is normal to have strong reactions such as fear, anger, and a sense of being overwhelmed. Some people even have suicidal thoughts. It is understandable that you might feel helpless and fear illness, disability and death. Other reactions might include:
Denial
Often, people who find out they are HIV positive will handle the news by denying that it is true. This denial may come up soon after the diagnosis is made. Denial can be helpful: it can give you time to get used to the idea of infection. It can, however, cause problems for oneself and others if one engages in risky behavior. And if it goes on too long it can get in the way of your getting the assistance and medical attention you need.
Guilt
It is not unusual for people to blame themselves for illness and to feel it is punishment. This guilt can be worsened by society’s prejudice and ignorance about HIV and AIDS. It is important, if you are HIV positive, to seek out those who are accepting and supportive.
Sadness
HIV disease means life changes and losses of one kind or another. Sadness is an understandable reaction. Sadness lifts for most people as they adjust. On the other hand, it can turn —sometimes slowly and subtly, sometimes quickly—into a more serious problem, called Depression.
If you are feeling depressed, it is important that you talk your feelings out. Your physician— as well as knowledgeable and supportive friends and loved ones—can help. Remember that there is always help through counseling, and any strong and lasting reaction calls for some kind of assistance.
What other psychiatric reactions are possible with HIV disease?
Many people with HIV disease do not develop serious emotional illness. However, if you develop any if the following reactions, it is important that you seek treatment. Depression—Characterized by prolonged periods of sadness and crying, feeling low or despairing, feelings of guilt and lowered self-esteem, a tendency to see only the negative side of things; also, fatigue, decreased ability to concentrate, loss of pleasure in activities, changes in appetite and weight, trouble sleeping, and, sometimes, thoughts of suicide.
Anxiety disorders—Characterized by excessive worry, feelings of being always on edge, muscle tension, restlessness; and other physical symptoms such as shortness of breath, sweating, rapid heart rate, nausea and diarrhea. They may also appear as sudden attacks of intense anxiety.
Mania—Characterized by an abnormally and persistently elevated mood or great shifts of mood, often with marked irritability. There is decreased desire for sleep, overactivity, rapid talking, poor concentration, and racing thoughts. People with this disorder may also have grand and sometimes bizarre ideas about themselves and impossible schemes for making money and becoming famous. They
may engage in spending sprees and other impulsive behavior. They may become very disorganized in their thinking and behavior and be unable to take care of themselves.
Psychotic symptoms—People may develop hallucinations, seeing things or hearing things that other people do not. They also may become “delusional,” developing strange, unrealistic, and very unlikely ideas. For example, they may think that even their closest friends are plotting to harm them or that secret organizations are spying on them, bugging their telephone or sending messages by television or radio. These are just a few examples of the many forms psychosis can take.
Alcohol and drug abuse—Some people may try to numb their feelings by abusing drugs and alcohol. At times, the person has a history of such problems. At other times, they begin to abuse drugs and alcohol after they learn they are HIV positive or develop symptoms of AIDS.
Difficulties with memory and thinking
Infections, malignancies, and nutritional deficiencies that are the results of AIDS can affect brain functioning. Some medications used to treat HIV infection or its complications can also have these effects. HIV itself can infect the brain, causing a condition doctors call AIDS Dementia Complex. Symptoms that might be a signal of trouble include:
-Forgetfulness
-Confusion
-Difficulty paying attention
-Slurred or changed speech
-Sudden changes in mood or behavior
-Clumsiness or difficulty walking
-Muscle weakness or strange sensations, like numbness or tingling
-Slowed thinking and difficulty finding words
If you have any of these problems you should discuss your concerns with your physician. He or she may suggest the help of a psychiatrist or other mental health specialist.
How can a psychiatrist help me?
A psychiatrist will talk with you and take a history in which he or she will ask about your current problems and how you managed in the past. He or she will need to know about any past or present alcohol or drug abuse and whether there is any family history of emotional problems or substance abuse. The psychiatrist, who is a medical doctor, will need to speak with your other physicians and review your medical history. The psychiatrist will ask specific questions to test memory, attention, and other aspects of thinking and problem solving. Your psychiatrist will tell you and your physician what he or she thinks is the nature of your problem, and will make recommendations for treatment. With your agreement, he or she may provide the recommended treatment if the expertise of a psychiatrist is required.
What treatments are available?
Various forms of psychotherapy may be useful, alone or in combination with medications which can help people with HIV disease express and understand their emotional reactions and find better ways to cope. Some problems can be treated with medications. There are anti-anxiety medications and antidepressants, including psycho-stimulants, that are safe and effective for use in people with HIV disease. People with Mania may need a mood stabilizing medication and those with psychotic symptoms may need an antipsychotic medication. There is substance abuse counseling for those with alcohol or drug abuse problems. In some areas of the country, there may be support groups or AA groups for people who have both HIV and substance abuse problems.
Are there other forms of help?
Many areas have community groups that provide services such as food preparation, housing, buddy networks, hotlines, and information on how to access medical care. There are also self-help support groups where people with HIV or AIDS can meet with others coping with the same or similar problems. Groups are also available to provide support and services for friends and family members.
If you are HIV positive, are there things you can do to help yourself?
It is important that you see your doctor regularly, and that you follow his or her recommendations. You can help by making some lifestyle adjustments. It is important to maintain good nutrition and to get enough rest. If you smoke, try to stop. It is helpful to stop or reduce alcohol use. It is very important to develop social contacts and to enlist the support and help of friends and family. If you feel that you are alone, it is important to recognize that help and companionship are available. A local community group or hotline that specializes in helping those with HIV disease and AIDS can be a good place to start.
What sort of reaction should I expect from family and
friends when I tell them I’m HIV positive?
Your family and friends will be affected by the consequences of your HIV infection, too. They may also experience feelings of denial, anger, fear, and grief. Some, unfortunately, will suffer from the same misunderstandings and prejudices that exist in society at large concerning people with HIV disease. They may also have questions about how they can prevent the spread of the infection, as well as questions about what is to be expected as the consequence of infections. Discussion with your physician can be helpful. It is important to remember that counseling— including couples and family counseling—is available and can be useful. There are also support groups for spouses, partners, and close friends of those with HIV disease.
Women and Diabetes
• In the U.S., 9.1 million women have
diabetes and 3 million of them don't
even know it.
• Women who have diabetes are more
likely to have a miscarriage or a baby
with birth defects.
• Women with diabetes are more likely
to be poor which makes it harder to
manage the disease.
Heart Disease
and Stroke
• Women with diabetes are more likely
to have a heart attack and have it at a
younger age.
• Most people with diabetes die from
heart attack or stroke.
Are You at Risk for Diabetes?
Are you overweight?
Do you get little or no exercise?
Do you have high blood pressure
(130/80 or higher)?
Do you have a brother or sister with
diabetes?
Do you have a parent with diabetes?
Are you a woman who had diabetes
when you were pregnant OR have you
had a baby who weighed more than 9
pounds at birth?
Warning Signs
Going to the bathroom a lot
Feeling hungry or thirsty all the time
Blurred vision
Lose weight without trying
Cuts/bruises that are slow to heal
Feeling tired all the time
Tingling/numbness in the hands or feet
Most people with diabetes do not notice any
signs.
thke Time To Care…
What is
Diabetes?
• Diabetes changes the way your body
uses food. In your body, the food you
eat turns to sugar.
• Your blood takes this sugar all over the
body. Insulin helps get sugar from the
blood into the body for energy.
• Your body does not get the fuel it
needs, and your blood sugar stays high.
• High blood sugar can cause heart and
kidney problems, blindness, stroke, the
loss of a foot or leg, or even kill you.
Fats
Protein
Cholesterol
Fiber (fruits, vegetables, beans, breads,
and cereals)
• Be active at least 30 minutes a day
most days of the week.
• Exercise helps your body's insulin work
better. It also lowers your blood sugar,
blood pressure and cholesterol.
Use Medicines
Wisely
• Sometimes people with diabetes need to
take pills or take a shot (insulin). Be sure
to follow the directions.
• Ask your doctor, nurse or pharmacist
what your medicines do, when to take
them, and if they have any side effects.
Check Your Blood
Sugar and Know Your
ABCs
• Help prevent heart disease and stroke
by controlling your blood sugar, blood
pressure, and cholesterol.
• Make a plan with your doctor, nurse or
pharmacist.
• Check your blood sugar using a meter
(home testing kit). This tells what your
blood sugar is so you can make wise
choices.
• Ask your doctor for an A-1-C (A-onesee)
blood test. It measures blood
sugar levels over 2-3 months.
• Talk to your health team about your
ABC's:
A - 1 - C
Blood pressure
Cholesterol
Types of Diabetes
• Type 1 - The body does not produce any
insulin. People with type 1 diabetes must
take insulin every day to stay alive.
• Type 2 - The body does not make
enough, or use insulin well. Most people
with diabetes have type 2.
• Some women get diabetes when they
are pregnant.
Watch What You Eat
and Get Exercise
• There is no one diet for people with
diabetes. Work with your team to come
up with a plan for you.
• You can eat the foods you love by
watching serving sizes. Carbohydrates
raise your blood sugar the most.
• The “Nutrition Facts” label on foods can
help. Many packaged foods contain
more than 1 serving.
• The foods we eat are made up of:
Carbohydrates (fruits, vegetables, breads,
juices, milk, cereals and desserts)
The Good
News…You Can
Manage Diabetes
Watch what you eat and get
exercise, use medicines wisely
and check your blood sugar.
diabetes and 3 million of them don't
even know it.
• Women who have diabetes are more
likely to have a miscarriage or a baby
with birth defects.
• Women with diabetes are more likely
to be poor which makes it harder to
manage the disease.
Heart Disease
and Stroke
• Women with diabetes are more likely
to have a heart attack and have it at a
younger age.
• Most people with diabetes die from
heart attack or stroke.
Are You at Risk for Diabetes?
Are you overweight?
Do you get little or no exercise?
Do you have high blood pressure
(130/80 or higher)?
Do you have a brother or sister with
diabetes?
Do you have a parent with diabetes?
Are you a woman who had diabetes
when you were pregnant OR have you
had a baby who weighed more than 9
pounds at birth?
Warning Signs
Going to the bathroom a lot
Feeling hungry or thirsty all the time
Blurred vision
Lose weight without trying
Cuts/bruises that are slow to heal
Feeling tired all the time
Tingling/numbness in the hands or feet
Most people with diabetes do not notice any
signs.
thke Time To Care…
What is
Diabetes?
• Diabetes changes the way your body
uses food. In your body, the food you
eat turns to sugar.
• Your blood takes this sugar all over the
body. Insulin helps get sugar from the
blood into the body for energy.
• Your body does not get the fuel it
needs, and your blood sugar stays high.
• High blood sugar can cause heart and
kidney problems, blindness, stroke, the
loss of a foot or leg, or even kill you.
Fats
Protein
Cholesterol
Fiber (fruits, vegetables, beans, breads,
and cereals)
• Be active at least 30 minutes a day
most days of the week.
• Exercise helps your body's insulin work
better. It also lowers your blood sugar,
blood pressure and cholesterol.
Use Medicines
Wisely
• Sometimes people with diabetes need to
take pills or take a shot (insulin). Be sure
to follow the directions.
• Ask your doctor, nurse or pharmacist
what your medicines do, when to take
them, and if they have any side effects.
Check Your Blood
Sugar and Know Your
ABCs
• Help prevent heart disease and stroke
by controlling your blood sugar, blood
pressure, and cholesterol.
• Make a plan with your doctor, nurse or
pharmacist.
• Check your blood sugar using a meter
(home testing kit). This tells what your
blood sugar is so you can make wise
choices.
• Ask your doctor for an A-1-C (A-onesee)
blood test. It measures blood
sugar levels over 2-3 months.
• Talk to your health team about your
ABC's:
A - 1 - C
Blood pressure
Cholesterol
Types of Diabetes
• Type 1 - The body does not produce any
insulin. People with type 1 diabetes must
take insulin every day to stay alive.
• Type 2 - The body does not make
enough, or use insulin well. Most people
with diabetes have type 2.
• Some women get diabetes when they
are pregnant.
Watch What You Eat
and Get Exercise
• There is no one diet for people with
diabetes. Work with your team to come
up with a plan for you.
• You can eat the foods you love by
watching serving sizes. Carbohydrates
raise your blood sugar the most.
• The “Nutrition Facts” label on foods can
help. Many packaged foods contain
more than 1 serving.
• The foods we eat are made up of:
Carbohydrates (fruits, vegetables, breads,
juices, milk, cereals and desserts)
The Good
News…You Can
Manage Diabetes
Watch what you eat and get
exercise, use medicines wisely
and check your blood sugar.
If You’re Overweight, Slim Down for Better Health
Overweight people have an increased risk of high blood pressure, heart disease, and other illnesses. Losing weight reduces the risk.
Ask Your Doctor About Sensible Goals
Your doctor or other health worker can help you set sensible goals based on a proper weight for your height, build and age.
Men and very active women may need up to 2,500 calories daily. Other women and inactive men need only about 2,000 calories daily. A safe plan is to eat 300 to 500 fewer calories a day to lose 1 to 2 pounds a week.
Exercise 30 Minutes
Do at least 30 minutes of exercise, like brisk walking, most days of the week.The idea is to use up more calories than you eat. You need to use up the day’s calories and some of the calories stored in your body fat.
Eat Less Fat and Sugar
This will help you cut Calories. Fried foods and fatty desserts can quickly use up a day’s calories. And these foods may not provide the other nutrients you need.
Eat a Favorite Rich Food, Sometimes
That may keep you from craving it. But eat only a small amount. Make sure your other foods that day are low in fat and calories.
Eat a Wide Variety Of Foods
Variety in the diet helps you get all the vitamins and other nutrients you need.
Watch Out for Promises of Quick And Easy Weight Loss
Fad diets aren’t good because they often call for too much or too little of one type of food. As a result, you may not get important nutrients you need daily.
Remember, if it sounds too good to be true, it probably isn’t true.
What About Diet Pills?
Diet pills you buy without a Prescription won’t make a big difference in how much you lose each week or how long you keep the weight off. If you do use them, read the label carefully. Because of possible side effects, like high blood pressure, never take more than the listed dose. Also, be careful about taking cough or cold medicines with diet pills you buy without a prescription. These medicines may contain the same drug used in diet pills, or a similar drug with the same effects. If you take both products together, you may get too much of the same type drug. This can hurt you. Skim
Milk Prescription diet pills may help some people. If you use them, follow the doctor’s directions carefully.
Ask Your Doctor About Sensible Goals
Your doctor or other health worker can help you set sensible goals based on a proper weight for your height, build and age.
Men and very active women may need up to 2,500 calories daily. Other women and inactive men need only about 2,000 calories daily. A safe plan is to eat 300 to 500 fewer calories a day to lose 1 to 2 pounds a week.
Exercise 30 Minutes
Do at least 30 minutes of exercise, like brisk walking, most days of the week.The idea is to use up more calories than you eat. You need to use up the day’s calories and some of the calories stored in your body fat.
Eat Less Fat and Sugar
This will help you cut Calories. Fried foods and fatty desserts can quickly use up a day’s calories. And these foods may not provide the other nutrients you need.
Eat a Favorite Rich Food, Sometimes
That may keep you from craving it. But eat only a small amount. Make sure your other foods that day are low in fat and calories.
Eat a Wide Variety Of Foods
Variety in the diet helps you get all the vitamins and other nutrients you need.
Watch Out for Promises of Quick And Easy Weight Loss
Fad diets aren’t good because they often call for too much or too little of one type of food. As a result, you may not get important nutrients you need daily.
Remember, if it sounds too good to be true, it probably isn’t true.
What About Diet Pills?
Diet pills you buy without a Prescription won’t make a big difference in how much you lose each week or how long you keep the weight off. If you do use them, read the label carefully. Because of possible side effects, like high blood pressure, never take more than the listed dose. Also, be careful about taking cough or cold medicines with diet pills you buy without a prescription. These medicines may contain the same drug used in diet pills, or a similar drug with the same effects. If you take both products together, you may get too much of the same type drug. This can hurt you. Skim
Milk Prescription diet pills may help some people. If you use them, follow the doctor’s directions carefully.
SMOG AND YOUR HEALTH
The Issue
Smog can cause damage to your heart and lungs – even when you can’t see or smell it
in the air around you.
Background
When we hear the word smog, many of us picture the chemical “soup” that often appears as a brownish-yellow haze over cities. But smog isn’t always visible. It’s a mixture of air pollutants, including gases and particles that are too small to see. Smog often begins in big cities, but smog levels can be just as high or higher in rural and suburban areas. We all need to protect our health against potential damage from smog.
Types and Sources of Air Pollution
The scientists who study smog are most concerned about the following types of air
pollution:
Type: Particulate Matter – or PM.
This is the name given to microscopic particles that pollute the air. They vary in size and chemical make-up.
Sources: Industrial and vehicle emissions, road dust, agriculture, construction and wood burning.
Type: Ground-level Ozone.
This gas is the result of a chemical reaction when certain pollutants are combined in the presence of sunlight. Ground-level ozone shouldn’t be confused with the ozone layer in the sky, which protects us from ultraviolet radiation.
Sources: Ground-level ozone comes mostly from burning fossil fuels for transportation and industry. Ozone levels peak between noon and 6 p.m. during the summer months.
There is also concern about:
Type: Sulphur dioxide
Sources: Coal-fired power plants and noniron ore smelters
Type: Carbon monoxide
Sources: Mostly from burning carbon fuels (e.g. motor vehicle exhaust)
Potential Health Effects
Since smog is a mixture of air pollutants, its impact on your health will depend on a number of things, including:
• The levels and types of pollutants in
the air
• Your age and general state of health
• The influence of weather
• How long you are exposed
• Where you live
Smog can irritate your eyes, nose and throat. Or it can worsen existing heart and lung problems. In exceptional cases it may result in an early death. The people most at risk are those who suffer from heart and lung problems. Many of these problems are more common in seniors, making them more likely to experience the negative effects of air pollution. Children can be more sensitive to the effects of air pollution because their respiratory systems are still developing and they tend to have an active lifestyle. Even healthy young adults breathe less well on days when the air is heavily polluted. The health effects of ground-level ozone and particulate matter (PM) is also cause for concern. Some studies suggest that long-term regular exposure to PM can increase your risk of early death and perhaps lung cancer. Studies on ozone show that once it gets into
your lungs, it can continue to cause damage even when you feel fine. This is why the federal government, is working to reduce the risks to your health.
Minimize Your Risk
To reduce your exposure to smog and its potential health effects:
• Check the Air Quality index in your community, especially during “smog season” from April to September. Tailor your activities accordingly.
• Avoid or reduce strenuous outdoor activities when smog levels are high, especially during the afternoon when groundlevel ozone reaches its peak. Choose indoor activities instead.
• Avoid or reduce exercising near areas of heavy traffic, especially during rush hour.
• If you have a heart or lung condition, talk to your health care professional about additional ways to protect your health when smog levels are high.
To help reduce the overall levels of smog in the air:
• When possible, use public transportation instead of your car. You could also walk or ride your bicycle, as long as smog levels are not too high.
• Look for alternatives to gaspowered machines and vehicles. Try a rowboat or sailboat instead of a motorboat or a push-type lawnmower instead of one that runs on gasoline.
• Consider fuel efficiency when you buy a vehicle. Keep all vehicles well maintained.
• Reduce energy use in your home. Learn more about alternative energy resources.
• Do not burn leaves, branches or other yard wastes.
• Consider joining a citizens’ committee to advocate for cleaner air in your community.
• Spend time talking with your children about the importance of a sustainable lifestyle.
Smog can cause damage to your heart and lungs – even when you can’t see or smell it
in the air around you.
Background
When we hear the word smog, many of us picture the chemical “soup” that often appears as a brownish-yellow haze over cities. But smog isn’t always visible. It’s a mixture of air pollutants, including gases and particles that are too small to see. Smog often begins in big cities, but smog levels can be just as high or higher in rural and suburban areas. We all need to protect our health against potential damage from smog.
Types and Sources of Air Pollution
The scientists who study smog are most concerned about the following types of air
pollution:
Type: Particulate Matter – or PM.
This is the name given to microscopic particles that pollute the air. They vary in size and chemical make-up.
Sources: Industrial and vehicle emissions, road dust, agriculture, construction and wood burning.
Type: Ground-level Ozone.
This gas is the result of a chemical reaction when certain pollutants are combined in the presence of sunlight. Ground-level ozone shouldn’t be confused with the ozone layer in the sky, which protects us from ultraviolet radiation.
Sources: Ground-level ozone comes mostly from burning fossil fuels for transportation and industry. Ozone levels peak between noon and 6 p.m. during the summer months.
There is also concern about:
Type: Sulphur dioxide
Sources: Coal-fired power plants and noniron ore smelters
Type: Carbon monoxide
Sources: Mostly from burning carbon fuels (e.g. motor vehicle exhaust)
Potential Health Effects
Since smog is a mixture of air pollutants, its impact on your health will depend on a number of things, including:
• The levels and types of pollutants in
the air
• Your age and general state of health
• The influence of weather
• How long you are exposed
• Where you live
Smog can irritate your eyes, nose and throat. Or it can worsen existing heart and lung problems. In exceptional cases it may result in an early death. The people most at risk are those who suffer from heart and lung problems. Many of these problems are more common in seniors, making them more likely to experience the negative effects of air pollution. Children can be more sensitive to the effects of air pollution because their respiratory systems are still developing and they tend to have an active lifestyle. Even healthy young adults breathe less well on days when the air is heavily polluted. The health effects of ground-level ozone and particulate matter (PM) is also cause for concern. Some studies suggest that long-term regular exposure to PM can increase your risk of early death and perhaps lung cancer. Studies on ozone show that once it gets into
your lungs, it can continue to cause damage even when you feel fine. This is why the federal government, is working to reduce the risks to your health.
Minimize Your Risk
To reduce your exposure to smog and its potential health effects:
• Check the Air Quality index in your community, especially during “smog season” from April to September. Tailor your activities accordingly.
• Avoid or reduce strenuous outdoor activities when smog levels are high, especially during the afternoon when groundlevel ozone reaches its peak. Choose indoor activities instead.
• Avoid or reduce exercising near areas of heavy traffic, especially during rush hour.
• If you have a heart or lung condition, talk to your health care professional about additional ways to protect your health when smog levels are high.
To help reduce the overall levels of smog in the air:
• When possible, use public transportation instead of your car. You could also walk or ride your bicycle, as long as smog levels are not too high.
• Look for alternatives to gaspowered machines and vehicles. Try a rowboat or sailboat instead of a motorboat or a push-type lawnmower instead of one that runs on gasoline.
• Consider fuel efficiency when you buy a vehicle. Keep all vehicles well maintained.
• Reduce energy use in your home. Learn more about alternative energy resources.
• Do not burn leaves, branches or other yard wastes.
• Consider joining a citizens’ committee to advocate for cleaner air in your community.
• Spend time talking with your children about the importance of a sustainable lifestyle.
Langganan:
Postingan (Atom)
