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Stress: You Don’t Have to Live With It

Have you ever found yourself with sweaty hands before a big meeting or felt your heart pound before getting on a roller coaster? You are experiencing stress.

Stress is an automatic response our bodies have to unexpected or challenging circumstances. Your nervous system kicks into high gear, flooding your body with hormones that elevate your heart rate, increase your blood pressure, boost your energy and prepare you to deal with the problem.

Stress is often useful for helping us to focus on a task and perform at a higher level. But the constant pressures of life ─ such as working long hours, traffic jams, money problems and tensions at home ─ can cause your body’s alarm system to stick in the “on” position. This is chronic stress. Over time, it can interfere with your ability to live a normal life and can contribute to serious health issues, including obesity, heart disease, diabetes, depression, gastrointestinal problems and asthma.

Recognize the symptoms of stress

How do you know when daily stress has become chronic stress? Look for these symptoms:

  • You become easily upset, frustrated and moody; feel overwhelmed, like you are losing control; have difficulty relaxing and quieting your mind; feel lonely, worthless, and depressed; and avoid others.
  • You have low energy, headaches, upset stomach (including diarrhea, constipation and nausea), chest pain and rapid heartbeat, tense muscles, insomnia, frequent colds and infections, loss of sexual desire and/or ability, nervousness and shaking, cold or sweaty hands and feet, clenched jaw and grinding teeth.
  • You experience constant worrying, racing thoughts, forgetfulness and disorganization, inability to focus, being pessimistic or stuck in negative thoughts.

How stressed are you? Take this quick test to find out.

Take steps to de-stress

Even if you are experiencing high levels of stress, you don’t have to stay that way. You can choose to make changes in your life and learn techniques to feel better now and lower the possibility of stress-related health issues in the future.

  1. Breathe deeply. Just a few minutes of deep breathing can calm you and tame your physical response to stress. You can do it anywhere, such as at your desk or in a parked car. As you breathe out, relax a specific muscle group. Start with the muscles in your jaw. On the next breath out, relax your shoulders. Move through the different areas of your body until you’re feeling calm.
  2. Focus on the moment. When you’re stressed, you’re probably worried about what to do next or regretful about something you’ve already done. Distract yourself from worry by focusing on what you’re doing right now. If you’re walking, feel the sensation of your legs moving. If you’re eating, focus on the taste and the sensation of the food. Practice being in the moment.
  3. Keep your problems in perspective. We get stressed when we focus so much on a specific problem that we lose perspective. You need to remind yourself of the ways in which you’re lucky — that you have family and friends, that you have a job and good health. Counting your blessings helps you put your problems back into perspective.
  4. Identify what’s stressing you. If you feel stressed, write down the cause, your thoughts and your mood. Once you know what’s bothering you, develop a plan for addressing it. That might mean setting more reasonable expectations for you and others or asking for help with household responsibilities, job assignments or other tasks.
  5. Build strong relationships. Relationships can serve as stress buffers. Reach out to family members or close friends and let them know you’re having a tough time. They may be able to offer practical assistance and support, useful ideas or just a fresh perspective as you begin to tackle whatever’s causing your stress.
  6. Get enough rest. 7-8 hours of sleep each night is a powerful antidote for stress. Try cutting back on caffeine and alcohol, remove distractions such as television or computers from your bedroom, and go to bed at the same time each night.
  7. Learn relaxation techniques. Meditation or yoga helps with stress management. Getting good at them will take a little time and practice, but the long-term result is an improved mood and better health.
  8. Get active. Regular exercise is key to long-term stress management. People who exercise tend to have better moods and more energy than people who don’t. Regular exercise will also lower your risk for many health problems.

Doing these things will help calm you down and lift you up. But if you continue to feel stressed, talk to your doctor. Your doctor can help you learn how to manage stress effectively or, if needed, refer you for additional care.

Dr. Sneha Sheth sees patients in MPCP’s Arundel Mills office. She received her medical degree from St. George`s University, School of Medicine, and completed her residency program in Family Medicine at Robert Wood Johnson Medical Center. She is certified by the American Board of Family Medicine.

Fad Diets and Holiday Weight Loss

By: Janice Rutkowski, M.D.

The holiday season is approaching, filled with parties, family and, for many of us, a few extra pounds. If you stand on the bathroom scale January 1 and see a higher number, you may resolve to take off those pounds ─ fast.

If that’s the case, be careful how you do it. There are fad diets on the market that promise quick weight loss, but many of them take an unbalanced approach to diet and nutrition. Some tell you to avoid “bad” foods, such as carbohydrates or fats, while others restrict you to just a few foods.

Any diet that restricts certain foods or strictly limits calories can lead to initial weight loss. But fad diets rarely bring long-term results because people return to their poor eating habits when the diet ends.  Also, people who use these extreme diets may not be getting all the nutrients they need to stay healthy.

Let’s examine five fad diets to avoid in 2017. Then we’ll give you tips for the right way to control your weight during the holidays.

  1. The Five-Bite Diet

The Five-Bite Diet encourages you to count bites instead of calories. You skip breakfast and then eat five bites of whatever food you want at lunch and dinner. The problem with this approach: even if you choose high-calorie foods for your five bites, you may only take in about 800 calories a day, which is less than half of the recommended daily amount. This diet won’t provide you with the key vitamins, minerals and nutrients your body needs, and may cause deficiencies that lead to anemia, bone loss, decreased cognitive function, and low energy.

  1. The Raw Food Diet

The Raw Food Diet teaches that cooking food destroys nutrients and natural enzymes, so you should only eat raw fruits, vegetables and grains. Since raw foods are often low in calories and fat, you’ll probably lose weight and get some nutrients on this diet. The downside is you’ll also miss some important nutrients, including protein, iron, calcium and minerals.  Also, cooking food has some benefits, such as killing bacteria and making food easier to digest. Eating only raw foods can also lead to bloating, indigestion, constipation, malnutrition and a lowered immune system.

  1. The Baby Food Diet

The Baby Food Diet is an Internet phenomenon that cuts calories and controls portions by having you replace one or two meals a day with baby food, which ranges 25-75 calories per jar, and then eat a healthy dinner. This diet has several notable drawbacks. It is very low in fiber, which can lead to digestion problems. It is low in fat and protein, which will leave you hungry in an hour or two and increase your chances of binge eating. Also, since baby food is very bland and there’s little chewing, you will probably feel unsatisfied and crave something else.

  1. The Blood Type Diet

The Blood Type Diet is based on the assumption that the foods you eat react with your blood type, so your blood type dictates what you should eat. If your blood type is A, for example, you should have a mainly vegetarian diet; type O’s should consume meats and avoid grains; type B’s can eat a variety of foods; and if you’re type AB you can eat anything on the A and B lists. But research has not supported this diet’s claims, and following it can deprive you of vital nutrients. For example, people with type A blood may not get the proteins and carbohydrates they need for good health.

  1. The Master Cleanse

Master Cleanse claims to rid the body of harmful “toxins” and promote weight loss. It is a liquid diet that lasts three to 10 days and features a special lemonade drink made of lemon juice, maple syrup and cayenne pepper. This concoction is a diuretic that will cause you to shed water weight. The problems with the Master Cleanse are shared by all “cleansing” regimens. First, its claim that it rids the body of toxins is questionable since your liver and kidneys do that on a continual basis. Second, once you stop the diet, the water weight will return. Third, the diet only gives you 600-1,200 calories a day, well below the recommended daily amount. And finally, because of the lack of nutrients and calories, you may experience fatigue, nausea, dizziness and dehydration.

Now that we’ve looked at wrong ways to deal with weight gain, here are 10 good tips to help you enjoy the holidays while keeping your weight under control:

  1. Be realistic. Instead of trying to lose pounds during the holidays, try to maintain your current weight.
  2. Plan time for exercise. A moderate increase in exercise can help offset holiday eating. Try walking briskly 10-15 minutes twice a day.
  3. Before a party, eat a light snack like raw vegetables or a piece of fruit to curb your appetite.
  4. At a party buffet, take small portions of a variety of foods, including vegetables and fruits.
  5. Eat until you are satisfied, not stuffed. Chew your food slowly and enjoy the flavor.
  6. Limit the amount of alcoholic beverages you drink. They can lessen your inhibitions and induce overeating.
  7. If you overeat at one meal, eat less at the next to balance out your calorie intake.
  8. Plan group activities with family and friends that aren’t all about food. Try playing games or going on a walking tour of decorated homes.
  9. Bring your own healthy dish to a holiday gathering.
  10. Prepare favorite dishes that are lower in fat and calories. Here are some tasty, healthy holiday recipes to get you started.

 

Janice Rutkowski, M.D.Dr. Janice Rutkowski is an MPCP partner and is certified by the American Board of Internal Medicine. She sees patients at the Arundel Mills office.

Important Facts About That Cough You Have

Cough is a frequent symptom seen in medical offices at this time of year. It can be a source of aggravation, frustration and anxiety for many patients. A cough falls into one of the following categories based on its duration: it can be acute, lasting less than 3 weeks; subacute, lasting from 3 to 8 weeks; or chronic, which lasts over 8 weeks.

The acute cough is mostly a result of upper respiratory tract infections and acute bronchitis. Most of the time, these are due to viruses and do not require the use of antibiotics. Fever may or may not be present and phlegm can be discolored. Pertussis, or whooping cough, is on the rise in the United States and may manifest by violent coughing and should be treated with an antibiotic. Approximately 15% of users of commonly prescribed blood pressure medications, lisinopril or zestril, may develop a cough, which usually begins within a week of beginning the medication. Treatment is stopping the offending medication and waiting 1-4 weeks for resolution, which you’ll want to coordinate with your primary care provider so you can get on an appropriate replacement medication. Lastly, pneumonia may also cause you to develop a cough. Depending on what incites coughing, therapy is supportive with cough medication, antihistamines, decongestants, antibiotics (if needed), and possible inhalers if asthma-like signs are present.

A subacute cough is most commonly a result of a prior upper respiratory infection. It can also be caused by asthma, postnasal drip, gastric acid reflux (even if heartburn is not present) or a primary lung disease. At this time, a chest X-ray should be obtained, especially for smokers or former smokers. Specific therapy is suggested depending on the cause.

Finally, chronic cough should be evaluated by requesting appropriate tests which may include sinus imaging, CAT scans, cardiac or gastroenterologic evaluations. A referral to a specialist may be needed.

If you or a loved one is suffering with a cough, particularly one that has lasted for more than 3 weeks, see your primary care provider, who can then determine an appropriate course of treatment.

 

Janice Rutkowski, M.D.Janice Rutkowski, M.D. is an MPCP partner and is certified by the American Board of Internal Medicine. She sees patients at the Arundel Mills office.

Respiratory Illnesses: Nothing To Sneeze At

Do you know the number-one reason people come to their doctor this time of year? If you’re sneezing or coughing as you read this, you already have a pretty good idea: respiratory illnesses are the chief reason for doctors’ visits.

Some respiratory conditions are fairly mild, but others can be life-threatening. And cold weather can make them worse.

You are probably most familiar with the common cold and seasonal flu, which are prevalent this time of year.  Caused by viruses, colds and flu have respiratory symptoms that may include runny nose, congestion and cough. Symptoms can usually be treated with over-the-counter medications, but your doctor may prescribe antiviral medications such as Relenza® or Tamiflu®. You can also reduce your chances of getting the flu with an annual vaccine, available at MPCP offices.

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough with phlegm or pus, fever, chills and difficulty breathing. A variety of organisms, including bacteria, can cause pneumonia. For treatment, your doctor may prescribe antibiotics, which are often effective.

Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to your lungs. Bronchitis is very common and often develops from a cold or other respiratory infection, or is caused by smoking. People with bronchitis often cough up thickened mucus, which can be discolored.

Bronchitis may be either acute or chronic. Acute bronchitis usually improves within a few days, and can be treated with rest, drinking lots of fluids, avoiding smoke and fumes, and possibly a prescription for an inhaled bronchodilator and/or cough syrup. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. In some cases, oral steroids to reduce inflammation and/or supplemental oxygen may be necessary.

Asthma affects people of all ages, but it often starts during childhood. It is a chronic disease that inflames and narrows your lungs’ airways. Symptoms of asthma include bouts of wheezing, chest tightness, shortness of breath and coughing. Most people who have asthma have allergies, but some people develop asthma because of contact with chemicals or industrial dusts in the workplace.

Many things can trigger asthma symptoms:

  • Allergens from dust, animal fur, mold and pollens from trees, grasses and flowers
  • Irritants such as cigarette smoke, air pollution and sprays, such as hairspray
  • Medicines such as aspirin or other nonsteroidal anti-inflammatory drugs
  • Sulfites in foods and drinks
  • Viral upper respiratory infections, such as colds
  • Physical activity, including exercise

Doctors treat asthma with two types of medicines: long-term control and quick-relief. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief or “rescue” medicines relieve asthma symptoms that may flare up.

Emphysema is a chronic disease that gradually damages the air sacs in your lungs, making you progressively more short of breath. Smoking is the leading cause of emphysema. See your doctor if you’ve had unexplained shortness of breath for several months, especially if it’s interfering with your daily activities.

Emphysema can’t be cured, but treatments can help relieve symptoms and slow the progress of the disease. Your doctor might prescribe bronchodilators to relax constricted airways or inhaled steroids to relieve shortness of breath. You may also need pulmonary rehabilitation to reduce breathlessness or supplemental oxygen.

If you have questions about any of the conditions described in this article, an MPCP physician would be glad to discuss them with you.

 

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Dr. Sneha Sheth practices in MPCP’s Arundel Mills office and is certified by the American Board of Family Medicine. She received her medical degree from St. George`s University, School of Medicine and completed her residency program in Family Medicine at Robert Wood Johnson Medical Center.