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Archive for May, 2009

BACK TO THE PRESENT

How to live in the moment and appreciate your surroundings every day

Life happens in the present. But so often, we let time rush past, unobserved and unseized. We worry about the future and ruminate about the past while precious seconds of our lives slip away. We’re so focused on what’s next that we neglect what’s now. There is an alternative. Living in the moment – What psychologists call mindfulness – means fully experiencing the here and now. It means you stop doing and focus on just being. It means placing your attention on what’s happening at this moment. If you can do that, you’ll see it changes everything. Here are some practical tips to help you get mindful now.

MEDIATE

Meditating is nothing more than focusing on the present moment. The easiest way to meditate is to simply focus on your breath – not because your breath has some magical quality, but because it’s always there with you. The challenge is to keep your attention on your breathing. Inevitably, your mind will wander and thoughts will arise – and that’s fine. When it happens, just let go of the thought and bring your attention back to the present by focusing once again on your breath.

REMINDERS

Use a reminder of the string-around-your-finger variety. Wear your watch upside-down, put a quarter in your shoe, or put a smudge on one of the lenses of your glasses. When you notice it, let that serve as a reminder for you to notice your surroundings, become aware of your senses and your bodily sensations, and bring your focus into the present. If you get to the point where you’re going entire days without noticing it, switch up the reminder.

SLOW DOWN

Attend to the subtleties of experience in the here and now. Get a handful of raisins. Eat one – but don’t just pop it in your mouth. Instead, imagine you’ve never seen a raisin before. Look it over carefully. Consider its shape, weight, color, and texture. Rub the raisin gently across your lips, noticing how it feels. Now put the raisin in your mouth, and roll it around slowly with your tongue. Notice how it feels in your mouth. Take a small bite, noting the flavor. Next, chew the raisin slowly, focusing on its taste and texture. Then swallow, and follow its path down your throat as far as you can. You can have a few more but remember to focus on what each one looks, tastes, and feels like on your lips, in your mouth, and down your throat.
Make it new.

When you’re performing music, giving a presentation, or even just recounting a favorite story, try to make it new in subtle ways, delivering it in a way you’ve never done before. Rather than performing it by rote, take a risk and try something different – use different words, add a pause, try to express a particular emotion to the audience. Not only will you enjoy it more yourself, but studies find that audiences prefer such performances too. Somehow mindfulness seems to leave an imprint on everything we do.

MIND THE GAP

Whenever you find yourself waiting – for the checkout line to move, for the traffic light to change, for the Web page to load – get present. Instead of being impatient and wishing things would go faster, be grateful for the gift of a respite – For The 30 seconds or a minute or two minutes during which you have no Obligations.

MOVE YOUR TOES

Here’s a good trick to return to mindfulness if you feel angry or aggressive. Shift all your attention to the soles of your feet. Move your toes slowly, feel the weave of your socks and the curve of your arch. Breathe naturally and focus on the soles of your feet until you feel calm. Practise this exercise until you can use it wherever you are, and whenever you find yourself, feeling verbally or physically aggressive.

FOCUS THE SENSES

When you observe your surroundings without judging them – Good or bad – you naturally nudge your awareness into the present moment. Close your eyes and focus on your sense of scent and mentally list the smells – the restaurant downstairs, the wet pavement outside, the perfume of a co-worker. Next, list all the sounds you hear – the ventilation system, cars in the distance, the hum of your computer, typing. Then open your eyes and list the things you see – the rustling of the trees, the faces in the crowd, the wrinkles on your palm. Finally, list the things you can sense that you appreciate – the way a beam of sunlight hits the brick building across the street, the welcome sight of a friend’s smile, the smell of cookies baking. Remember, you’re not looking for things to appreciate – you’re appreciating the things you sense. With luck, this exercise will put you in a state of relaxed attention that reduces anxiety and makes you feel alive.

(Source: WebMD, January 19, 2009 – http://www.webmd.com/balance/features/back-to-present?ecd=wnl_can_052609&em=amVubnlobzczMThAeWFob28uY29t)

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Moms who give their kids ginger ale to soothe upset tummies may find this as no surprise – Ginger may help relieve the nausea of cancer chemotherapy.

In the largest study to date evaluating the benefits of ginger for patients undergoing chemotherapy, as little as one-quarter of a teaspoon of ginger cut symptoms of nausea by 40%.

Despite the use of traditional anti-nausea drugs, about 70% of people who undergo chemotherapy experience nausea and vomiting, according to Researcher Julie Ryan, PhD, Assistant Professor of Dermatology and Radiation Oncology at the University of Rochester who discussed the findings on 14May 2009 at a news briefing sponsored by the American Society of Clinical Oncology (ASCO).

“Patients undergoing chemotherapy often ask if there is anything more they can do,” said ASCO incoming President Douglas Blayney, MD, of the University of Michigan.

“Here’s a simple intervention that can be used along with standard [nausea drugs],” he told WebMD.

Ginger Taken Before Chemo to Improve Absorption

Previous, smaller studies assessing the benefit of ginger for chemotherapy-related nausea had inconsistent results. They also did not look at ginger supplementation before initiating chemotherapy, which allows for earlier absorption by the body, Ryan said.

The new National Cancer Institute-funded study involved 644 people who had experienced nausea after one cycle of chemotherapy and had at least three more cycles to go. Most were women, and two-thirds had breast cancer.

Participants were randomly assigned to receive a placebo or 0.5 grams, 1.0 grams, or 1.5 grams of ginger in capsule form once a day for six days, starting three days before the first day of a chemotherapy cycle.

Everyone also took Zofran or Kytril, traditional drugs used to manage the nausea associated with chemotherapy.

Participants rated their nausea on a 7-point scale — where 1 equals no nausea and 7 equals the worst possible nausea — four times a day for the first four days of chemotherapy.

Ginger Relieves Nausea

By the end of the first day, patients who took the two lower doses of ginger which contains the equivalent of one-quarter and one-half teaspoon of fresh or dry ginger – rated their nausea as 1 or 2 points, meaning they had no or very slight nausea.

In contrast, those who took a placebo rated their nausea as 4 to 5 points, meaning they had a lot of nausea.

The higher dose of ginger also worked, though not as well. The benefits were maintained for the four days of the study.

Researchers expect the effects will last even longer. People tend to experience the most unpleasant nausea on the first day of chemotherapy and are less likely to have nausea on subsequent days if they don’t have it on the first day.

“So will ginger ale or ginger snaps do the trick?” Ryan said that theoretically, as long as they contain one-quarter to one-half teaspoon of fresh or dry ginger. But if it’s ginger flavoring, that wouldn’t work. Scientists don’t know why ginger relieves nausea.

(Source: WebMD, May 14, 2009)

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Hormonal therapy for menopause, already linked to an increase in breast cancer and strokes, also strongly increases the risk of death among women who develop lung cancer, new research has shown.

The findings are based on secondary analysis of a study of 16,608 menopausal women in good health by the US government known as the Women’s Health Initiative.

Researchers sought to evaluate the effects of Prempro, a combination of estrogen and progestin (a synthetic form of progesterone), sold by the US pharmaceutical Wyeth.

The analysis focused on the incidence of the most common form of lung cancer and its mortality rate over a period of nearly 5.5 years comparing women who followed the hormonal treatment and another group that took placebos.

There was no significant difference between the two groups in the rate of lung cancer but the mortality rate after the diagnosis was two times higher among the women that were following hormonal therapy.

But menopausal woman who got lung cancer and followed hormonal treatment had a 61 percent higher chance of dying from the disease than the other women in the study.

Researchers headed by Rowan Chlebowski, an oncologist at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, presented the findings here at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO), the biggest global cancer conference.

While breast cancer is the most common cancer in US women, lung cancer is the leading cause of cancer death among US women.

“We already know that combined hormone therapy has more risks than benefits,” said the study’s lead author Chlebowski.

The increase of risk of death among women who smoke and then follow hormone therapy “raises particular concerns,” added Chlebowski.

(Source: AFP, May 30, 2009)

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Most of us know about the emotional symptoms of depression. But you may not know that depression can cause physical symptoms, too.

In fact, many people with depression feel pain or other physical symptoms. These include:

(1) Headache
These are fairly common in people with depression. If you already had migraine headaches, they may become worse if you’re depressed.
(2) Back Pain
If you already suffer with back pain, it may get worse if you become depressed.
(3) Muscle Aches and Joint Pain
Depression can make any kind of chronic pain worse.
(4) Chest Pain
Obviously, it’s very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But chest pain is also associated with depression.
(5) Digestive Problems
You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.
(6) Exhaustion and Fatigue
No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
(7) Sleeping Problems
Many people with depression can’t sleep well anymore. They wake up too early or can’t fall asleep when they go to bed. Others sleep much more than normal.
(8) Change In Appetite Or Weight
Some people with depression lose their appetite and lose weight. Others find they crave certain foods — like carbohydrates — and weigh more.
(9) Dizziness Or Lightheadedness
Many depressed people never get help, because they don’t know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.

These physical symptoms aren’t “all in your head.” Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.

Treating Physical Symptoms:

In some cases, treating your depression with therapy or medicine or both will resolve your physical symptoms.

But make sure to tell your health care provider about any physical symptoms. Don’t assume they’ll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.

Since pain and depression go together, sometimes easing your pain may help with your depression.

Other treatments can also help with painful symptoms. Certain types of focused therapy like cognitive behavioral can teach you ways to cope better with the pain.

(Source: WebMD – http://www.webmd.com/depression/recognizing-depression-symptoms/physical-symptoms?ecd=wnl_day_052909&em=amVubnlobzczMThAeWFob28uY29t)

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Sometimes, the pressure of caring for someone who is elderly or who has a chronic illness can lead to stress and a condition called “Caregiver Burnout.” To prevent this, it’s essential to know how to manage your stress.

WHAT IS STRESS?
Stress is a reaction to changes that require you to adjust or respond. Our bodies are designed to feel stress and react to it. Not always a bad thing, stress keeps us alert and ready to escape danger.

It’s not always possible to avoid change or the situations that can cause stress; as a result, you can begin to feel overwhelmed and unable to cope. When it persists, stress can affect the body’s immune system, leading to illness. The key to coping with stress is to identify the causes of stress in your life, then learn healthy ways to deal with them. It’s important to remember that stress comes from how you respond to stressful events. Therefore, you have some control over stress and how it affects you.

WHAT CAUSES STRESS?
Stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental, and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. Becoming a caregiver is a common source of stress for many people.

When you are not sure of the exact cause of your stress, it may be helpful to know the warning signs. Once you can identify these signs, you can learn how your body responds. Then you can take appropriate steps to reduce the stress.

WHAT ARE THE WARNING SIGNS OF STRESS?
Your body sends out physical, emotional, and behavioural warning signs of stress.

Emotional Warning Signs:
• Anger
• Inability to concentrate
• Unproductive worry
• Sadness
• Frequent mood swings

Physical Warning Signs:
• Stooped posture
• Sweaty palms
• Tension headaches
• Neck pain
• Chronic back pain
• Chronic fatigue
• Weight gain or loss
• Problems with sleep

Behavioural Warning Signs:
• Over-reacting
• Acting on impulse
• Using alcohol or drugs
• Withdrawing from relationships
• Changing jobs often

What Can I Do to Reduce Stress in My Life?
Finding ways to reduce stress will help lessen the long-term emotional and physical toll of care-giving. Tips for managing stress include:

• Keep a positive attitude. Believe in yourself.
• Accept that there are events you cannot control.
• Be assertive instead of aggressive. “Assert” your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
• Learn to relax.
• Exercise regularly. Your body can fight stress better when it is fit.
• Stop smoking.
• Limit yourself to moderate alcohol and caffeine intake.
• Set realistic goals and expectations.
• Get enough rest and sleep. Your body needs time to recover from stressful events.
• Don’t rely on alcohol or drugs to reduce stress.
• Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.

Coping Mechanisms:
Most people don’t have a plan for coping with stress. Fortunately, there are a number of techniques that you can use to help deal with stress, such as:

• Two-minute relaxation – Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
• Mind relaxation – Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word “one,” a short word such as “peaceful,” or a short phrase such as “I feel quiet.” Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
• Deep breathing relaxation – Imagine a spot just below your navel. Breathe into that spot, and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.
• Guided imagery – Guided imagery is a meditative technique that involves focusing on a particular sensory image to create a specific physical reaction. Guided imagery (also called guided meditation) is a form of mind-body therapy that can bring about deep relaxation and positive focus, the state of mind and body most conducive to healing. Guided imagery also can be used to release tension, anxiety, and stress.
• Biofeedback – Biofeedback helps a person learn stress-reduction skills by providing precise, immediate information about muscle tension, heart rate, and other vital signs as a person attempts to relax. It is used to learn total body relaxation and also to gain control over certain physiological functions that cause tension and physical pain.
• Behavioural changes – Changing certain thought patterns and behaviours can help you better manage difficult situations and stress. Examples include checking your assumptions, sharing your expectations with others, being assertive, exercising and eating healthy, focusing on positive relationships, forgiving, communicating feelings, listening, and rewarding yourself and others.

By recognizing your warning signs and taking steps to reduce the stress in your life, you should be able to cope more easily with the pressures of being a caregiver.

(Source: WebMD – http://www.webmd.com/healthy-aging/caregiving-insights/handle-stress)

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Diabetes is spiraling in Asia but – unlike the West – those affected are relatively young and less likely to be struggling with obesity, a new study shows.

Research published in the Journal of the American Medical Association on Wednesday said the disease has turned into a global problem, with the number of victims expected to grow from 240 million in 2007 to 380 million in 2025.

More than 60 percent of those will be in Asia, the world’s fastest growing region, with low- and middle-income countries hardest hit.

India will see its numbers grow from 40 million to nearly 70 million; China 39 million to 59 million; and Bangladesh 3.8 million to 7.4 million, the authors wrote, citing figures from the International Diabetes Federation. Indonesia, the Philippines, Malaysia, Vietnam and others will also see their figures skyrocket.

Frank Hu, a Professor at the Harvard School of Public Health, noted the disease is associated with serious complications such as heart disease, stroke and renal failures — all of which are expensive to treat.

Without strong government policy, education and good clinical care, Asia’s escalating epidemic could “erase economic gains made in recent decades,” said Hu, one of the Authors.

Trends of diabetes in the region are influenced by everything from genetic makeup and cultural differences to smoking and degrees of urbanization, the JAMA study showed. But the most startling findings Which tended to vary from country to country related to body mass and age.

Obesity has long been seen as a major factor leading to type 2 diabetes in nations across Europe and North America.

But while Asians still weigh less than their Western counterparts, they’ve gotten fatter around the waist – seen as particularly detrimental with respect to diabetes. It is around the abdomen that fat stores excess energy and releases chemicals that control metabolism and the use of insulin.

So while people from Japan in the east to Pakistan in the west generally have lower body mass indexes, a figure determined by dividing weight by height, “they can have a similar or even higher prevalence of diabetes than Western countries,” the study showed.

Stephen Corbett, a Professor at the School of Public Health at the University of Sydney, said all developing countries that are starting to have relatively stable food supplies and more sedentary Western lifestyles are seeing diabetes in epidemic proportions.

“For thousands of years, most people in China, India, Indonesia, were subsistence farmers,” he said, noting it was a marginal existence for most, with food shortages often occurring several months a year.

“It took 150 or 200 years for Europeans to make the dietary transition that happened in Asia in the last 40 to 50 years,” said Corbett, who is not connected with the study. “I think that the diabetes epidemic is a direct result of that.”

The study also noted while the disease most often affects people between the ages of 60 and 79 in North America and Europe, the age in Asia tends to be disproportionally lower, ranging between 20 years to 59.

This appears to be the result of both low birth weights, which are common in developing countries, and over-nutrition in later life.

The report says this may be partly because Asian women are two- to three-times as likely to have gestational diabetes as their white counterparts.

“Their offspring exhibit early features of metabolic syndrome, thus setting up a vicious cycle of diabetes begetting diabetes,” Hu and the other authors wrote.

The findings were based on analysis of hundreds of articles, data and studies published between January 1980 and March 2009.

(Source: Associated Press, May 27, 2009)

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When a cancer patient from Singapore travelled to the United States last year, he discovered an unusual side effect of his medication: missing fingerprints.

The 62-year-old man was taking capecitabine, or Xeloda, to treat head and neck cancer. Upon arriving in the U.S., immigration officials asked him for his fingerprints. But the drug had caused so much redness and peeling to his fingers that the patient, identified only as Mr. S., had none.

Customs officials held Mr. S. for four hours before deciding he was not a security threat, according to the case published on Wednesday, 27 May 2009, in a letter to the Annals of Oncology Journal.

Capecitabine is a common cancer drug, routinely given to patients with head, neck and kidney cancers as well as lymphomas and leukemias. Doctors said very few patients temporarily lose their fingerprints while on Xeloda, but it does happen.

“Most patients will complain they’re having difficulty holding things or sensing things,” said Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society, who was not linked to the case. “I’ve never had a patient running into a problem with police authorities, but this is not an exaggeration. It could actually happen.”

After returning home, Mr. S. asked his Oncologist, Dr. Eng-Huat Tan at the National Cancer Centre in Singapore, to write a letter certifying he was on capecitabine.

Surprised by Mr. S.’s predicament, Dr Tan recommended in his letter to the Journal that patients taking capecitabine carry a similar doctor’s note if they are travelling to the United States.

Unlike most other countries, American immigration officials take two fingerprints from foreign visitors.

Dr Tan said up to 40 percent of patients on the drug develop a side effect known as hand-foot syndrome, which causes redness, peeling, numbness and tingling. Of those patients, only a small percentage actually lose their fingerprints.

“Patients probably would not notice anything until they travel to the U.S. and discover to their horror that their fingerprints are gone,” Dr Tan said. Mr. S. was Tan’s only patient to report such a predicament, but Dr Tan said a handful of other cases were described on cancer blogs.

Once patients stop taking the drug and apply ice to their hands, their fingerprints will return in about a month.

Brawley guessed that U.S. officials became suspicious because criminals sometimes erase their fingerprints with sandpaper or dip them in acid, which would appear very similar to how Mr. S’s fingers looked.

But he says there are too many side effects from Xeloda, including a weakened immune system and increased cancer risk, that it would be unlikely anyone would take the drug for less-than-honorable reasons.

“No criminal in his right mind would take this drug to try to get rid of his fingerprints,” Dr Tan said.

(Source: Associated Press,May 26, 2009)

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