10 Facts about A [little] Fib that May Surprise You

Atrial fibrillation, also called AF or AFib, is the most common type of heart rhythm disorder. People with this condition are at higher risk for serious medical complications, such as dementia, heart failure, stroke, or even death. Too many of those affected by the condition don’t realize that they have it, and many who have it don’t realize the seriousness of the affliction. All too often, healthcare providers may also minimize the effects of the condition.

September is Atrial Fibrillation Awareness Month, designated to help patients and healthcare providers learn more about this complex condition. In addition to stroke prevention, additional know-how can improve the overall wellness of those suffering from AFib. Often, those with AFib have a lower quality of life than those who have suffered a heart attack. And, unfortunately, some healthcare providers may not know about treatment options that can essentially put a stop to the condition.

For those who have AFib, seeking information about the ailment and  finding early treatment are imperative. The longer someone has AFib, the more likely they will convert from intermittent AFib to enduring it all the time, making it much more difficult to stop or cure.

What is atrial fibrillation?

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.  A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present — like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib occurs when the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Why is AFib associated with a five-times-greater risk for stroke?

When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.

Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. Learn more about stroke risks with the CHA2DS2–VASc tool.

If I don’t have these symptoms, should I be concerned?

There are people who have atrial fibrillation that do not experience noticeable symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.

However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life.  Many may experience one or more of the following symptoms:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure

Are there different types of AFib?

The symptoms are generally the same; however, the duration of the AFib and underlying reasons for the condition help medical practitioners classify the type of AFib problems.

  • Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
  • Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
  • Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
  • Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
  • Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.

Over a period of time, paroxysmal fibrillation may become more frequent and longer lasting, sometimes leading to permanent or chronic AFib. All types of AFib can increase your risk of stroke. Even if you have no symptoms at all, you are nearly 5 times more likely to have a stroke than someone who doesn’t have atrial fibrillation.

How are heart attack symptoms different from AFib symptoms?

Fluttering and palpitations are key symptoms of AFib and are the key differences, but many heart problems have similar warning signs. If you think you may be having a heart attack, DON’T DELAY. Get emergency help by calling 9-1-1 immediately. A heart attack is a blockage of blood flow to the heart, often caused by a clot or build-up of plaque lodging in the coronary artery (a blood vessel that carries blood to part of the heart muscle). A heart attack can damage or destroy part of your heart muscle. Some heart attacks are sudden and intense — where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

People living with AFib should know the Warning Sings

As stated earlier, having atrial fibrillation can put you at an increased risk for stroke. Here are the warning signs that you should be aware of:

Heart Attack Warning Signs

Chest Discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in Other Areas of the Upper Body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of Breath

With or without chest discomfort.

Other Signs

May include breaking out in a cold sweat, nausea or lightheadedness.

Stroke Warning Signs

Spot a stroke F.A.S.T.:

  • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
  • Arm Weakness : Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Call 9-1-1 immediately if you notice one or more of these symptoms, even if they are temporary or seem to disappear.

10 ATRIAL FIBRILLATION FACTS THAT MAY SURPRISE YOU

  1. AFib affects lots of people.  Currently as many as 5.1 million people are affected by AFib — and that’s just in America. By 2050, the number of people in the United States with AFib may increase to as many as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to AFib.  In addition, people over the age of 40 have a one in four chance of developing AFib in their lifetime.
  2. AFib is a leading cause of strokes.  Nearly 35 percent of all AFib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, AFib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, AFib strokes are fatal nearly three times as often as other strokes within the first 30 days. And according to a recent American Heart Association survey, only half of AFib patients understand that they have an increased risk of stroke.
  3. The U.S. Congress recognizes the need for more AFib awareness. StopAfib.org, along with several other professional and patient organizations, asked Congress to make September AFib Month. On September 11, 2009, the U.S. Senate declared it National Atrial Fibrillation Awareness Month.
  4. Barry Manilow has AFib. In 2011, Manilow spoke to Congress about AFib, urging the House of Representatives to pass House Resolution 295, which seeks to raise the priority of AFib in the existing research and education funding allocation process. The resolution does not seek any new funding. Other celebs with AFib include NBA legends Larry Bird and Jerry West, politicians George H. W. Bush and Joe Biden, Astronaut Deke Slayton, Billie Jean King, music mogul Gene Simmons and Helmut Huber, the husband of daytime TV star Susan Lucci.
  5. Healthcare professionals often minimize the impact of AFib on patients.  According to recent research in the Journal of Cardiovascular Nursing, “Compared with coronary artery disease and heart failure, AFib is not typically seen by clinicians as a complex cardiac condition that adversely affects quality of life. Therefore, clinicians may minimize the significance of AFib to the patient and may fail to provide the level of support and information needed for self-management of recurrent symptomatic AFib.”
  6. AFib patients may go untreated.  AFib can fly under the radar as some patients don’t have symptoms and some may only have symptoms once in a while. Thus, patients may go for a year or two undiagnosed, and sometimes not be diagnosed until after they have a stroke or two. Because some health care professionals perceive that AFib doesn’t affect patients’ everyday lives, a common approach is to just allow patients to live with the condition. But…
  7. The quicker the treatment, the greater the chance AFib can be stopped.  For those who have AFib, information about the ailment and treatment options are imperative. The longer someone has AFib, the more likely they will convert from intermittent to constant AFib, which means it’s more difficult to stop or cure.
  8. AFib changes the heart.  Over time, AFib changes the shape and size of the heart, altering the heart’s structure and electrical system. Research at the University of Utah shows that this scarring (fibrosis) from long-term remodeling is correlated with strokes.
  9. Treatments continue to rapidly evolve.  For years, the standard treatment for AFib patients was to send them home with medications, some of which caused harm. Now there are additional options for stopping AFib, including minimally invasive ablation procedures performed inside and outside the heart. For stubborn and long-lasting AFib, open-heart surgery may provide a cure.
  10. You can make a difference in an AFib patient’s life.  This month, forward a link to someone you may know who could have the condition. Attend an AFib awareness raising event or webinar. Or share StopAfib.org siteand ALittleFib.org with patients and friends.  Something as simple as that can help someone become free of AFib.

Prevention and Risk Reduction

Although no one is able to absolutely guarantee a stroke or a clot is preventable, there are ways to reduce risks for developing these problems.

After a patient is diagnosed with atrial fibrillation, the ideal goals may include:

  • Restoring the heart to a normal rhythm (called rhythm control)
  • Reducing an overly high heart rate (called rate control)
  • Preventing blood clots (called prevention of thromboembolism)
  • Managing risk factors for stroke
  • Preventing additional heart rhythm problems
  • Preventing heart failure

Getting Back on Beat

Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.

Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.

“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”

AFib Treatment Saves Lives & Lowers Risks

If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.

If you think you may have atrial fibrillation, here are your most important steps:

  1. Know the symptoms
  2. Get the right treatment 
  3. Reduce risks for stroke and heart failure

Finding the right physician who gets your AFib, understands all the options for treatment, and will openly collaborate with you in your care is key.  Use our first of its kind healthcare ecosystem to find one near you.

As a patient, you can take control of your healthcare.  Go to HealthLynked.com, right now, to sign up for Free!

 

Sources:

Heart.org

Aug 29, 2012 | ArticlesDoctor’s Voice | 12  |

 

 

Top 10 Hidden Hazards to Baby’s Safety at Home

This year, we had the great privilege of being introduced to our first grandbaby.  She’s an incredibly beautiful bundle of energy who will soon be moving about to explore on her own.  Luckily, our home has always been “baby proofed”, but feeling this great responsibility for her wellbeing, and not having had a baby around in quite a while, it is time to seriously think about what else needs to be done.

September is Baby Safety Month, sponsored annually by the Juvenile Products Manufacturers Association (JPMA), so there is no better time than now to survey the safety of your abode.

The Basics

Ideally, the best time to babyproof is early in your pregnancy, before you register, so you can include needed safety items on your registry list.  The best way to babyproof? Get down on your hands and knees and think like a baby! This is a great activity for both mom and dad, as males and females may look for and inspect different aspects of the home and safety measures in general.

Take care of all the obvious hazards, such as exposed electrical sockets and blind cords, but be on the lookout for those not-so-obvious items – empty dishwashers, hanging tablecloths that can be easily pulled down, and poisonous plants.  Remember,  babies at any age are curious explorers and want to touch, feel, lick, smell, and listen to everything and anything they can get their little hands on. Your job is to make your home as safe as possible so they can roam without worry. After all, this new addition is not a temporary guest and should be able to safely investigate every space in your home.

Consider child-proofing an ongoing process.  Monitor your child’s growth and development and always try to stay one step ahead. For example, don’t wait until your baby starts crawling to put up stairway gates. Install them in advance so the entire family gets used to them and baby doesn’t associate his new-found milestone with barriers.

If you are preparing for baby #2 or #3, don’t underestimate your “seasoned” approach to babyproofing from the first time around. In fact, having an older sibling creates additional hazards – you should be aware of small parts from toys and your toddlers’ ability to open the doors, potty lids, and cabinets you have so ingeniously secured.

Top Hidden Hazards

  • Magnets — Small magnets can be easily swallowed by children. Once inside the body, they can attract to each other and cause significant internal damage. Keep magnets out of your child’s reach. If you fear your child has swallowed magnets, seek medical attention immediately.
  • Loose Change — Change floating around in pockets or purses may wind up on tables around the house, where curious children may be attracted to the shiny coins and ingest them. A wonderful way to ensure this doesn’t happen is to assign a tray or jar for loose change and keep it out of a child’s reach.
  • Tipovers — Tipovers are a leading cause of injury to children and the best way to avoid them is to make sure all furniture and televisions are secured to the wall.
  • Pot Handle Sticking Out from Stove — When cooking, it is best that pot handles turn inward instead of sticking out from the stove where little ones may reach up and grab the hot handle. In addition, if holding a child while cooking, remember to keep the handles out of the child’s reach.
  • Loose Rugs or Carpet — Area rugs or carpet that is not secured to the floor causes a tripping hazard for little ones who may already be unstable on their feet. Make sure that all corners are taped down and bumps are smoothed out.
  • Detergent Pods — It is estimated that thousands of children have been exposed to and injured by detergent pods. Easily mistaken by children as candy, these pods pose a risk to the eyes and, if ingested, to their lives. It is important to keep these items out of reach of children.
  • Hot Mugs — A relaxing cup of coffee or tea can quickly turn into an emergency if hot mugs are left unattended or are placed to near the edge of tables where little hands can grab them.
  • Cords — Cords can pose strangulation hazards to children, whether they are connected to blinds, home gym equipment or baby monitors. It’s important to keep cords tied up and out of reach of children. In addition, remember to keep cribs away from cords that the child may reach while inside the crib.
  • Button Batteries — Button batteries are flat, round batteries that resemble coins or buttons. They are found in common household items such as flashlights, remotes or flameless candles.
  • Recalled Products — Make sure you’re aware if a product you own has been recalled. In addition, check that any second-hand products you own have not been recalled. The best ways to ensure your products are safe is to fill out your product registration card as well as check for recalls at recalls.gov.

How to Choose and Use Products

Choose a baby carrier or sling made of a durable, washable fabric with sturdy, adjustable straps.  Use a carrier or sling only when walking with your baby, never running or bicycling.

Choose a carriage or stroller that has a base wide enough to prevent tipping, even when your baby leans over the side.  Use the basket underneath and don’t hang purses or shopping bags over the handles because it may cause the stroller to tip.

Choose a swing with strong posts, legs, and a wide stance to prevent tipping.  Never place your swing or bouncer on an elevated surface such as sofas, beds, tables or counter tops.

When choosing a changing table, before leaving home, measure the length and width of the changing area available on the dresser and compare to the requirements for the add-on unit before purchasing. Check for attachment requirements.  When changing baby, always keep one hand on baby and use restraints.

It is vital the car seat/booster is appropriate for a child’s age, weight, and height.  Always follow the manufacturer’s instructions for both the vehicle and the seat.  As of this writing, the American Academy of Pediatrics used to recommend rear-facing seats for children until at least age 2. Now, the organization is updating its guidelines and wants parents to keep their children in rear-facing seats until they reach the seat’s maximum height and weight limit — even if they’re older than 2. Under the new guidelines, most kids would keep using rear-facing seats until they’re about 4 years old.

Choose a crib mattress that fits snugly with no more than two fingers width, one-inch, between the edge of the mattress and the crib side.  Never place the crib near windows, draperies, blinds, or wall-mounted decorative accessories with long cords.

Choose the right gate for your needs. Before leaving home, measure the opening size at the location the gate will be used.  Gates with expanding pressure bars should be installed with the adjustment bar or lock side away from the baby.

Use waist and crotch strap every time you place a child in the high chair to prevent falls from standing up or sliding out.

And, consider these things when introducing products to your inventory:

  • Safest Option – Keep in mind that new products meeting current safety standards are the safest option.
  • Second-Hand Products – It is recommended secondhand products should not be used for baby. However, if it is necessary to use older products, make sure all parts are available, the product is fully functional, not broken, and has not been recalled.
  • Register your products — Through product registration, parents can establish a direct line of communication with the manufacturer should a problem arise with a product purchased. This information is NOT used for marketing purposes.

Fun Tips and Tricks for New Parents

  • Trying to lose the baby weight? Cut down on late night snacks by brushing your teeth after you put the kids to bed so you won’t be likely to ruin clean teeth.
  • Keep allergens away from your toddler and older children simply by changing their pillow. Don’t know when the last time you changed it was? Buying a new one every year on their birthday is an easy way to remember!
  • While nursing or feeding baby #2, encourage your toddler or older children to read stories to the new baby. Even just telling a story through the pictures keeps your toddler in site and occupied during this already special time.
  • For toddlers working on mastering stairs, install a child safety gate two or three steps up from the bottom stair to give your child a small, safe space to practice.
  • If the sight of blood terrifies your child, use dark washcloths to clean up cuts and scrapes. Better yet, try storing the cloths in plastic bags in the freezer  the coldness will help with pain relief.
  • Keep baby happy and warm during baths. Drop the shampoo and soap in the warm water while you are filling the tub. When it’s time to lather baby, the soap won’t be so cold.
  • Cranky teething baby? Wet three corners of a washcloth and stick it in the freezer. The rough, icy fabric soothes sore gums and the dry corner gives them a “handle”.
  • Having a tough time getting baby to stay still while diaper changing? Wear a silly hat or bobble headband. As a reward for staying still, be sure to let your baby or toddler wear the hat when finished!
  • Before baby #2 arrives, put together a “fun box” for the older sibling that she is only allowed to play with when you nurse or feed baby #2. Inexpensive toys, coloring books, and snacks are all great ideas to include. Be sure to refresh the items once a week to keep an active toddler interested.
  • Put a plastic art mat underneath the high chair while they learn to eat to contain the mess.
  • Tape pics of family members or animals to the ceiling or wall near of your changing table so baby has something to look when diaper changing.
  • Baby or kid yogurt containers make great snack cups on the go. Some yogurt containers cannot be recycled, so why not wash and reuse? They are perfect snack size portions, easy for little hands to grab and even fit in the cup holders of stroller trays. They can also hold just the right amount of crayons for on the go coloring!
  • Can’t get little ones to sit still while you brush or style hair? Put a sticker on your shirt and tell them to look at the sticker. As they get older, make it a game and see if they can count to 50 before you can get those ponytails in!

It’s A Fact

Most injuries can be prevented! Parents and caregivers play a huge role in protecting children from injuries.  Choosing the right baby products for your family can be overwhelming, but safety should never be compromised.

What Can You Do?

  1. Choose and use age and developmentally appropriate products.
  2. Read and follow all manufacturer’s instructions, recommendations for use, and warning labels.
  3. Register your products and establish a direct line of communication with the manufacturer.
  4. Actively supervise — watch, listen and stay near your child.
  5. Frequently inspect products for missing hardware, loose threads and strings, holes, and tears.
  6. Monitor your child’s growth and development and discontinue use when needed.

Newborns in your home or on the way?  In addition to getting your home in order, you’ll want to find a great pediatrician you can really connect with….Find one in our first of its kind social ecosystem built for healthcare.  In HealthLynked, you can make appointments with your providers on the go and create your own personal, portable medical records.  You can also create and manage one for baby.

Ready to get Lynked?  Go to HealthLynked.com today, sign up for Free, and take control of your healthcare!

 

Source:  BabySafetyZone.com

 

The Benefits of Breastfeeding for Both Mother and Baby | WebMD


In honor of Breastfeeding Awareness Month, we will be sharing a series of articles promoting breastfeeding.  This next one is about the “ABC’s” of breastfeeding – a brief overview of the basics you should know, republished in full from WebMD.


Breastfeeding Overview

Making the decision to breastfeed is a personal matter. It’s also one that’s likely to draw strong opinions from friends and family.

Many medical experts, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. And breastfeeding for a year at least with other foods which should be started at 6 months of age, such as vegetables, grains, fruits, proteins.

But you and your baby are unique, and the decision is up to you. This overview of breastfeeding can help you decide.

What Are the Benefits of Breastfeeding for Your Baby?

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat — everything your baby needs to grow. And it’s all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding lowers your baby’s risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.

Breastfeeding has been linked to higher IQ scores in later childhood in some studies. What’s more, the physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children. The AAP says breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome). It’s been thought to lower the risk of diabetes, obesity, and certain cancers as well, but more research is needed.

Are There Breastfeeding Benefits for the Mother?

Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster. It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding also lowers your risk of breast and ovarian cancer. It may lower your risk of osteoporosis, too.

Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, it saves you time and money. It also gives you regular time to relax quietly with your newborn as you bond.

Will I Make Enough Milk to Breastfeed?

The first few days after birth, your breasts make an ideal “first milk.” It’s called colostrum. Colostrum is thick, yellowish, and scant, but there’s plenty to meet your baby’s nutritional needs. Colostrum helps a newborn’s digestive tract develop and prepare itself to digest breast milk.

Most babies lose a small amount of weight in the first 3 to 5 days after birth. This is unrelated to breastfeeding.

As your baby needs more milk and nurses more, your breasts respond by making more milk. Experts recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. If you supplement with formula, your breasts might make less milk.

Even if you breastfeed less than the recommended 6 months, it’s better to breastfeed for a short time than no time at all. You can add solid food at 6 months but also continue to breastfeed if you want to keep producing milk.

What’s the Best Position for Breastfeeding?

The best position for you is the one where you and your baby are both comfortable and relaxed, and you don’t have to strain to hold the position or keep nursing. Here are some common positions for breastfeeding your baby:

  • Cradle position. Rest the side of your baby’s head in the crook of your elbow with his whole body facing you. Position your baby’s belly against your body so he feels fully supported. Your other, “free” arm can wrap around to support your baby’s head and neck — or reach through your baby’s legs to support the lower back.
  • Football position. Line your baby’s back along your forearm to hold your baby like a football, supporting his head and neck in your palm. This works best with newborns and small babies. It’s also a good position if you’re recovering from a cesarean birth and need to protect your belly from the pressure or weight of your baby.
  • Side-lying position. This position is great for night feedings in bed. Side-lying also works well if you’re recovering from an episiotomy, an incision to widen the vaginal opening during delivery. Use pillows under your head to get comfortable. Then snuggle close to your baby and use your free hand to lift your breast and nipple into your baby’s mouth. Once your baby is correctly “latched on,” support your baby’s head and neck with your free hand so there’s no twisting or straining to keep nursing.

How Do I Get My Baby to ‘Latch on’ During Breastfeeding?

Position your baby facing you, so your baby is comfortable and doesn’t have to twist his neck to feed. With one hand, cup your breast and gently stroke your baby’s lower lip with your nipple. Your baby’s instinctive reflex will be to open the mouth wide. With your hand supporting your baby’s neck, bring your baby’s mouth closer around your nipple, trying to center your nipple in the baby’s mouth above the tongue.

You’ll know your baby is “latched on” correctly when both lips are pursed outward around your nipple. Your infant should have all of your nipple and most of the areola, which is the darker skin around your nipple, in his mouth. While you may feel a slight tingling or tugging, breastfeeding should not be painful. If your baby isn’t latched on correctly and nursing with a smooth, comfortable rhythm, gently nudge your pinky between your baby’s gums to break the suction, remove your nipple, and try again. Good “latching on” helps prevent sore nipples.

What Are the ABCs of Breastfeeding?

  • A = Awareness. Watch for your baby’s signs of hunger, and breastfeed whenever your baby is hungry. This is called “on demand” feeding. The first few weeks, you may be nursing eight to 12 times every 24 hours. Hungry infants move their hands toward their mouths, make sucking noises or mouth movements, or move toward your breast. Don’t wait for your baby to cry. That’s a sign he’s too hungry.
  • B = Be patient. Breastfeed as long as your baby wants to nurse each time. Don’t hurry your infant through feedings. Infants typically breastfeed for 10 to 20 minutes on each breast.
  • C = Comfort. This is key. Relax while breastfeeding, and your milk is more likely to “let down” and flow. Get yourself comfortable with pillows as needed to support your arms, head, and neck, and a footrest to support your feet and legs before you begin to breastfeed.

Are There Medical Considerations With Breastfeeding?

In a few situations, breastfeeding could cause a baby harm. You should not breastfeed if:

  • You are HIV positive. You can pass the HIV virus to your infant through breast milk.
  • You have active, untreated tuberculosis.
  • You’re receiving chemotherapy for cancer.
  • You’re using an illegal drug, such as cocaine or marijuana.
  • Your baby has a rare condition called galactosemia and cannot tolerate the natural sugar, called galactose, in breast milk.
  • You’re taking certain prescription medications, such as some drugs for migraine headaches, Parkinson’s disease, or arthritis.

Talk with your doctor before starting to breastfeed if you’re taking prescription drugsof any kind. Your doctor can help you make an informed decision based on your particular medication.

Having a cold or flu should not prevent you from breastfeeding. Breast milk won’t give your baby the illness and may even give antibodies to your baby to help fight off the illness.

Also, the AAP suggests that — starting at 4 months of age — exclusively breastfed infants, and infants who are partially breastfed and receive more than one-half of their daily feedings as human milk, should be supplemented with oral iron. This should continue until foods with iron, such as iron-fortified cereals, are introduced in the diet. The AAP recommends checking iron levels in all children at age 1.

Discuss supplementation of both iron and vitamin D with your pediatrician Your doctor can guide you on recommendations about the proper amounts for both your baby and you, when to start, and how often the supplements should be taken.

Why Do Some Women Choose Not to Breastfeed?

  • Some women don’t want to breastfeed in public.
  • Some prefer the flexibility of knowing that a father or any caregiver can bottle-feed the baby any time.
  • Babies tend to digest formula more slowly than breast milk, so bottle feedings may not be as frequent as breastfeeding sessions.

The time commitment, and being “on-call” for feedings every few hours of a newborn’s life, isn’t feasible for every woman. Some women fear that breastfeeding will ruin the appearance of their breasts. But most breast surgeons would argue that age, gravity, genetics, and lifestyle factors like smoking all change the shape of a woman’s breasts more than breastfeeding does.

What Are Some Common Challenges With Breastfeeding?

  • Sore nipples. You can expect some soreness in the first weeks of breastfeeding. Make sure your baby latches on correctly, and use one finger to break the suction of your baby’s mouth after each feeding. That will help prevent sore nipples. If you still get sore, be sure you nurse with each breast fully enough to empty the milk ducts. If you don’t, your breasts can become engorged, swollen, and painful. Holding ice or a bag of frozen peas against sore nipples can temporarily ease discomfort. Keeping your nipples dry and letting them “air dry” between feedings helps, too. Your baby tends to suck more actively at the start. So begin feedings with the less-sore nipple.
  • Dry, cracked nipples. Avoid soaps, perfumed creams, or lotions with alcohol in them, which can make nipples even more dry and cracked. You can gently apply pure lanolin to your nipples after a feeding, but be sure you gently wash the lanolin off before breastfeeding again. Changing your bra pads often will help your nipples stay dry. And you should use only cotton bra pads.
  • Worries about producing enough milk.A general rule of thumb is that a baby who’s wetting six to eight diapers a day is most likely getting enough milk. Avoid supplementing your breast milk with formula, and never give your infant plain water. Your body needs the frequent, regular demand of your baby’s nursing to keep producing milk. Some women mistakenly think they can’t breastfeed if they have small breasts. But small-breasted women can make milk just as well as large-breasted women. Good nutrition, plenty of rest, and staying well hydrated all help, too.
  • Pumping and storing milk. You can get breast milk by hand or pump it with a breast pump. It may take a few days or weeks for your baby to get used to breast milk in a bottle. So begin practicing early if you’re going back to work. Breast milk can be safely used within 2 days if it’s stored in a refrigerator. You can freeze breast milk for up to 6 months. Don’t warm up or thaw frozen breast milk in a microwave. That will destroy some of its immune-boosting qualities, and

it can cause fatty portions of the breast milk to become super hot. Thaw breast milk in the refrigerator or in a bowl of warm water instead.

  • Inverted nipples. An inverted nipple doesn’t poke forward when you pinch the areola, the dark skin around the nipple. A lactation consultant — a specialist in breastfeeding education — can give simple tips that have allowed women with inverted nipples to breastfeed successfully.
  • Breast engorgement. Breast fullness is natural and healthy. It happens as your breasts become full of milk, staying soft and pliable. But breast engorgement means the blood vessels in your breast have become congested. This traps fluid in your breasts and makes them feel hard, painful, and swollen. Alternate heat and cold, for instance using ice packs and hot showers, to relieve mild symptoms. It can also help to release your milk by hand or use a breast pump.
  • Blocked ducts. A single sore spot on your breast, which may be red and hot, can signal a plugged milk duct. This can often be relieved by warm compresses and gentle massage over the area to release the blockage. More frequent nursing can also help.
  • Breast infection (mastitis). This occasionally results when bacteria enter the breast, often through a cracked nipple after breastfeeding. If you have a sore area on your breast along with flu-like symptoms, fever, and fatigue, call your doctor. Antibiotics are usually needed to clear up a breast infection, but you can most likely continue to breastfeed while you have the infection and take antibiotics. To relieve breast tenderness, apply moist heat to the sore area four times a day for 15 to 20 minutes each time.
  • Stress. Being overly anxious or stressed can interfere with your let-down reflex. That’s your body’s natural release of milk into the milk ducts. It’s triggered by hormones released when your baby nurses. It can also be triggered just by hearing your baby cry or thinking about your baby. Stay as relaxed and calm as possible before and during nursing — it can help your milk let down and flow more easily. That, in turn, can help calm and relax your infant.
  • Premature babies may not be able to breastfeed right away. In some cases, mothers can release breast milk and feed it through a bottle or feeding tube.
  • Warning signs. Breastfeeding is a natural, healthy process. But call your doctor if:
  • Your breasts become unusually red, swollen, hard, or sore.
  • You have unusual discharge or bleeding from your nipples.
  • You’re concerned your baby isn’t gaining weight or getting enough milk.

Where Can I Get Help With Breastfeeding?

Images of mothers breastfeeding their babies make it look simple — but most women need some help and coaching. It can come from a nurse, doctor, family member, or friend, and it helps mothers get over possible bumps in the road.

Reach out to friends, family, and your doctor with any questions you may have. Most likely, the women in your life have had those same questions.

SOURCE: WebMD Medical Reference Reviewed by Dan Brennan, MD on December 5, 2017

Sources

 

SOURCES:

News release, American Academy of Pediatrics.

Baker, R. Pediatrics, November 2010.

American Academy of Pediatrics: “Policy Statement: Breastfeeding and the Use of Human Milk.”

American College of Obstetricians and Gynecologists: “Breastfeeding Your Baby.”

CDC: “Proper Handling and Storage of Human Milk.”

National Women’s Health Information Center: “Benefits of Breastfeeding.”

National Women’s Health Information Center: “Questions and Answers About Breastfeeding.”

National Women’s Health Information Center: “How Lifestyle Affects Breast Milk.”

La Leche League International: “How Do I Position My Baby to Breastfeed?”

American Academy of Family Physicians: “Breastfeeding: Hints To Help You Get Off to a Good Start.”

National Library of Medicine: “Overcoming Breastfeeding Problems.”

KidsHealth.org: “Feeding Your Newborn.”

American College of Nurse-Midwives, GotMom.org: “Breastfeeding with Confidence.”

© 2017 WebMD, LLC. All rights reserved.

Breastfeeding saves lives, boosts economies in rich and poor countries


In honor of Breastfeeding Awareness Month, we will be sharing a series of articles promoting breastfeeding.  This one focuses on breastfeeding as the most exquisite form of personalized medicine.


SOURCE:  By Catharine Paddock PhD, Published

The decision not to breastfeed harms the long-term health, nutrition and development of children – and the health of women – around the world, conclude leading experts in a new series of papers on breastfeeding published in The Lancet. They also detail how this loss of opportunity damages the global economy.

The authors say countries should see promoting breastfeeding as an investment that benefits not only their public health, but also their economies. The two-part series is the most detailed analysis of levels, trends and benefits of breastfeeding around the world.

By not being exclusively breastfed for the first 6 months of their lives, and not continuing to receive their mother’s milk for another 6 months, millions of children are being denied the important health benefits of breastfeeding, note the authors.

Figures estimated for the series suggest if all countries were to increase breastfeeding for infants and young children to near-universal levels, over 800,000 child deaths (13% of all deaths in the under-2s), 20,000 breast cancer deaths and $302 billion in costs to the global economy could be prevented every year.

The authors say that by not doing enough to promote and encourage breastfeeding, the world’s nations – both rich and poor – are overlooking one of the most effective ways of improving health of children and mothers.

Cesar Victora, a professor from the Federal University of Pelotas in Brazil and a leading author in the series, says the need to tackle this global issue is greater than ever. She notes:

“There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth. Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike.”

Breast milk is a ‘very exquisite personalized medicine’

The experts say their analyses – comprising 28 systematic reviews of available evidence, 22 of which were prepared for the series – show, for example, that breastfeeding has a significant benefit to life expectancy.

In wealthy countries, breastfeeding reduces sudden infant deaths by over a third, and in low and middle-income countries, breastfeeding halves cases of diarrhea and reduces respiratory infections by a third.
In a podcast interview for the series, Prof. Victora says while we are only “beginning to scratch the surface,” a lot of evidence is emerging about the biology of breastfeeding and the components and properties of breast milk.

He quotes a colleague who likens breast milk to “very exquisite personalized medicine” because it reflects the biological interaction between the mother and her child, “something that formula will never be able to imitate,” he notes.

Prof. Victora cites as an example the effect that receiving breast milk has on the development of the microbiome – the trillions of friendly bacteria that live in and on our bodies and play a key role in our health.
He says we are also beginning to understand that breast milk has epigenetic effects – that is, it influences the expression of genes that control cell activity and development. And, another recent discovery is that breast milk contains stem cells.

There is evidence, the authors note, that breastfeeding increases intelligence and may protect against obesity and diabetesin later life. And for mothers, breastfeeding for longer reduces their risk of breast cancer and ovarian cancer.

Promoting breastfeeding makes economic sense

The authors say countries should see promoting breastfeeding as an investment that benefits not only their public health, but also their economies.  They estimate that loss to economies due to impact of not breastfeeding on intelligence amounted to $302 billion in 2012, or 0.49% of world gross national income.

Prof. Victora and colleagues also calculate that if rates of breastfeeding in babies under 6 months were to increase to 90% in the US, China and Brazil, and to 45% in the UK, they would save these countries $2.45 billion, $223.6 million, $6.0 million and $29.5 million, respectively, due to reductions in treating common childhood illnesses like pneumonia, diarrhea and asthma.

This loss of opportunity to boost public and economic health is further highlighted by the fact that worldwide rates of breastfeeding are low, particularly in wealthy countries – for example the UK, Ireland and Denmark have some of the lowest rates of breastfeeding at 12 months in the world (under 1%, 2% and 3%, respectively).

Prof. Victora remarks that breastfeeding is one of the few “positive health behaviors” that is more prevalent in poor countries than in wealthy countries. Also, in poor countries, it is the poorer mothers that practice it more. He notes:

“The stark reality is that in the absence of breastfeeding, the rich-poor gap in child survival would be even wider.”

He urges policymakers to take note of this and be reassured that promoting breastfeeding provides a rapid return on investment that takes less than a generation to come to fruition.

Aggressive formula marketing undermines breastfeeding promotion

One of the papers also touches on the effects that aggressive marketing of “formula” or breast milk substitutes is having, despite countries attending the World Health Assembly in 1981 adopting the World Health Organization (WHO) International Code of Marketing of Breast-Milk Substitutes, which the authors note has not been enforced effectively.

The multi-billion dollar breast milk substitute industry must be reined in, they urge, or it will continue to undermine breastfeeding as the best feeding practice in early life.

The WHO recommend babies start breastfeeding within 1 hour of life, are exclusively breastfed for 6 months. After this, there should be gradual introduction of adequate, safe and properly fed complementary foods with babies continuing to breastfeed for up to 2 years of age or more.

The authors note that global sales of breast milk substitutes are expected to reach $70.6 billion by 2019, as co-author Dr. Nigel Rollins, from the Department of Maternal, Newborn, Child and Adolescent Health at the WHO in Geneva, explains:

Saturation of markets in high-income countries has caused the industries to rapidly penetrate emerging global markets. Almost all growth in the foreseeable future in sales of standard milk formula (infants <6 months) will be in low-income and middle-income countries, where consumption is currently low,…”

He cites the example of the Middle East and Africa, where estimates show per-child consumption of breast milk substitutes will likely grow by over 7% in the period 2014-2019.  And in wealthy nations, growth in breast milk substitutes will be largely driven by sales of follow-on and toddlers milk, which are set to increase by 15% by 2019, he notes.

Breastfeeding must become a key public health issue

The authors say governments and international organizations have to show powerful political commitment and provide the financial backing needed to protect, promote and support breastfeeding at all levels – national, community, family and workplace.

In an accompanying comment paper, leading experts in the field – including Frances Mason from Save the Children UK and Dr. Alison McFadden from the School of Nursing and Health Sciences at the University of Dundee, UK – say world leaders must not repeat the mistake of leaving out breastfeeding from the Millennium Development Goals when it sets the Sustainable Development Goals later this year.

They plead for breastfeeding not be tagged onto the child nutrition agenda but to be treated as a key public health priority that reduces disease, infant deaths and inequity, and also urge leaders at all levels to “end promotion of products that compete with breastfeeding.”

Prof. Victora concludes:  “There is a widespread misconception that breast milk can be replaced with artificial products without detrimental consequences.”
In October 2015, Medical News Todaylearned of a report from the Centers for Disease Control and Prevention (CDC) that shows while breastfeeding support at US hospitals has improved since 2007, there are still many ways it could be better. Improved hospital care could increase breastfeeding rates nationwide, it concludes.


If you are looking for a physician to care for you along your birthing journey or to support you in your efforts to breastfeed, you might connect with them in HealthLynked.  WE are the first of its kind social ecosystem designed specifically for physicians and patients to collaborate in the efficient exchanges of health information.

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13 [HealthCare] Leadership Lessons from the Lady with the Lamp

“What nursing has to do is put the patient in the best condition for nature to act upon them,” said Florence Nightingale.  The mother of modern nursing was born May 12, 1820 in Florence, Italy, and passed on this day, August 13, 1910 in London England.   As the founder of the science, her philosophy of managing the patient changed the face of nursing forever.

Today, the 108th anniversary of her death, marks a wonderful time to reflect upon the life and work of the woman who more than anyone else can also be properly credited with building the framework for modern healthcare leadership. In her groundbreaking work in Crimea, the “Lady with the Lamp” crafted guidelines for hospital administration and the use of statistics which still serve as the basis for clinical leadership today.

In a very real sense, her innovative approaches make Nightingale the architect of the modern hospital. With the exception of high-tech medicine evolution over the past half century, virtually every department in today’s hospitals and every clinician office can trace the roots of their standards back to those first introduced by Florence Nightingale.

History

In 1853, the Crimean War broke out….The British Empire was at war with the Russian Empire for control of the Ottoman Empire.  During this time of open conflict, no fewer than 18,000 soldiers were admitted into military hospitals across the war zone.  The English were in an uproar about the neglect of their soldiers, who not only lacked sufficient medical attention due to under-staffing, the conditions in these hospitals were appalling, inhumane and unsanitary.

In late 1854, Florence Nightingale was a highly regarded superintendent living in London when she received an urgent letter from the Secretary of War, Sidney Herbert.  He requested she organize a corps of skilled nurses to tend their sick in Crimea.

Nightingale rose to the call, assembling a team of 34 nurses.  Though they we’re made aware of the horrid conditions, not one was truly prepared for the reality of what they faced upon arriving in Scutari – the base hospital in Constantinople.

The hospital was built on a large cesspool which contaminated the water and the hospital itself.   Patients were lying in their own feces on stretchers strewn throughout the hallways.  Rodents and bugs scurried over them.  More soldiers were dying from controllable infectious disease, like typhoid and cholera, than from their injuries.

The no nonsense Nightingale quickly set to work.  She and her team procured scrub brushes and cleaned every surface within Scutari.  She then spent every waking moment caring for the sick, and, at night, moved through the halls carrying a lantern ministering to patient after patient.  The soldiers who were inspired, comforted and healed by her compassion took to calling her the “lady with the lamp”.  To others, she became me known as “The Angel of Crimea”.

Her work reduced the hospital’s deaths by two-thirds.  In addition to vast improvements in cleanliness, Nightingale also created many patient programs that significantly contributed to a healthy, healing environment – both physically and psychologically – using the application of statistics.

13 Leadership Lessons from the Lady with the Lamp

Follow Your North Star

Born into wealth, Florence could easily have settled into a life of Victorian ease at her family’s country mansion; instead, she chose a path of arduous commitment to caring for others. Nightingale found something more than just a job to do – she was on a mission.  She did not inquire about pay and benefits before leading her team of young nurses off to the Crimea, where they endured working conditions that would be beyond intolerable in today’s world.

Her devotion to her calling changed the work of healthcare forever while ensuring she never experienced burnout.  Her legacy reminds us caring for the sick is more than just a business – it’s a mission, and that being a caregiver is more than just a job – it should be a calling. The first duty of healthcare leadership is inspiring this commitment, beginning with our own examples.

Many of the problems in today’s healthcare system stem from the fact too many clinics and hospitals focus more on their business plans rather than on their missions, and far too many healthcare professionals have jobs rather than a calling. Nightingale might encourage a re-commitment to the things that really matter – those passions that hopefully attracted our idealistic younger selves into healthcare in the first place.  Create a compelling mission for your team, and lead others with that mission front of mind at all times.

PERSIST RELENTLESSLY

Nightingale was courageous and unstoppable. She did not allow opposition from the British aristocracy or the antiquated views of military leaders to prevent her from doing her work. When she ran into a wall, she found a way around or over, even to the extent of going directly to the English public for funding support and to the Queen for political backing.

With a never ceasing, never ending single minded focus to Exceed Expectations, it is always important to remain resolute and thrive, even when facing challenges or obstacles.  If the mission is compelling enough and routinely rallied around, you Will ensure your ongoing efforts lead to ultimate success.

Build a Culture of Discipline

Less well-known than Nightingale’s contributions to hospital and nursing practice was her pioneering work in the field of medical statistics. Her painstaking efforts to chart infection and death rates among soldiers at Scutari gave weight to her demands for improved sanitary conditions first at military hospitals, and later in civilian institutions. She demonstrated that if you want to be effective, it’s not enough to know that you’re right – you must be able to demonstrate that you’re right with the facts.

Be Truly Present

Long before Daniel Goleman coined the phrase “social radar” in his book Emotional Intelligence, Nightingale appreciated that awareness and empathy are central to quality patient care (and to effective leadership). In Notes on Nursing, she wrote: “The most important practical lesson that can be given to nurses is to teach them what to observe – how to observe… If you cannot get the habit of observation one way or another you had better give up being a nurse, for it is not your calling, however kind and anxious you may be.”

In today’s fast-paced healthcare environment, it’s important that caregivers  and healthcare leaders stop for a moment for a quick mental reminder to really be in the moment with patients and team members, and not mentally off onto the next chore.   It is critical leaders apply the “social radar” principle when interacting with everyone.

Set the Stage

Nightingale’s environmental theory was “the act of utilizing the environment of the patient to assist in recovery”.  This involves the nurse’s initiative to configure the environmental settings appropriate for the gradual restoration of a patient’s health and acknowledges external factors associated with the patient’s surroundings affect life and biological and physiologic processes and development.

Just as important is creating a work environment for your staff that encourages peak performance.  Without doubt, the greatest influence in life is our environment – it affects our moods, our ability to perform, our effectiveness, our health, our peace of mind, our sense of wellbeing, and our beliefs.  Our environment impacts everything.

It is critical leaders create an environment where the teams they guide are challenged, supported and more energized than ever before.  Build a workplace that reinforces the mindset of peak performance, which empowers the team to drive the results you want, and routinely encourages everyone to take the necessary steps to create remarkable success.  Take the initiative to set the stage and configure physical and psychological environments that unleash greatness.

Maintain Mutual Respect

Nightingale cared passionately about the nurses under her wing and the soldiers under her care. As one example, she was adamant, in her hospital, triage would be performed on the basis of the patient’s medical condition and not his rank in the military, social standing, or religion – a precept that was quite radical in Victorian England. Many of the specific techniques in her ground-breaking work Notes on Nursing are now outdated, but her absolute commitment to patient dignity and a spirit of mutual respect in the workplace remains essential.

Choose your Attitude

Nightingale would have agreed with the statement, “Attitude is everything”. She had an intuitive understanding that emotions are contagious, and would never have tolerated the gossip, complaining, and other forms of toxic emotional negativity prevalent in many work environments today. Toxic negativity is the emotional and spiritual equivalent of cigarette smoke, and, in its own way, just as harmful.

To promote a more positive and productive workplace culture, we must raise our attitudinal expectations and lower our tolerance for deviation from those expectations. Even in the horrendous circumstances that prevailed at Scutari, Nightingale insisted people be treated with dignity.  One thing is certain: she would never have tolerated, much less condoned, the gossip and the complaining hallways and in the “Coffee-Clutch” today. In one of the many letters she delivered to newly graduated nurses from the Nightingale School of Nursing, Florence wrote:

“Prying into one another’s concerns, acting behind another’s back, backbiting, misrepresentation, bad temper, bad thoughts, murmuring, complaining. Do we ever think of how we bear the responsibility for all the harm that we cause in this way?”

Guide with Encouragement

In her quiet and dignified manner, Nightingale was a cheerleader devoted to encouraging qualified young women to enter her profession – even though the work was hard and the pay was low. One suspects she would have had harsh words for doctors and nurses of our era who are telling the next generation to stay out of healthcare because they themselves are working too hard, not making enough money, and not having enough fun.

Aspire to Improve Passionately

Nightingale never rested on her laurels; instead, she continuously raised the bar. After proving a more professional approach to nursing care would improve clinical outcomes, she helped found the first visiting nurses association, chartered the first modern school of professional nursing, created a blueprint for the modern hospital, and used her writings to create professional standards for hospital management.

She remained active until the end of her life at the age of 90. Her commitment to never-ending improvement shines like a lamp across more than a century, inspiring us to work our way through the challenges of today and never lose sight of the better world we need to create for tomorrow.

Create and Model Loyalty

 Nightingale was a team-builder who cared passionately about the nurses under her wing and the soldiers under her care. She was a demanding leader, but also showed uncompromising commitment to the people she led.

Upon her return to England from Scutari she personally endeavored to make sure that every nurse who had served with her there would find employment upon their return home. Her legendary loyalty to the soldiers she served was reflected in the fact that when she was buried, her coffin was escorted by octogenarian veterans of the Crimean War honoring their debt to the lady with the lamp.

Introduce Humor

 

Nightingale’s contemporaries reported she had a wonderful sense of humor and was often able to defuse tense situations with the light touch of laughter.   She might reflect, if she could laugh in the hell-on-earth environment of the Scutari Barrack Hospital, then no matter what the world throws at us, we can’t forget the restorative and healing power of laughter.

Maintain Open Collaboration

 We are constantly hearing about the “healthcare crisis”, and we are likely to be hearing those two words in sound bites for decades to come.  What would Nightingale tell us about dealing with this perennial drain on our wellbeing?  Sara Rutledge, a nurse who’s a character in Joe Tye’s book The Florence Prescription: From Accountability to Ownership, put it this way: “We need to see opportunities where others see barriers. We need to be cheerleaders when others are moaning doom-and-gloom. We need to face problems with contrarian toughness because it’s in how we solve those problems that we differentiate ourselves from everyone else.”

Difficulty is the common thread woven into every great achievement.  To encourage innovation and accountability, foster open collaboration and even embrace contrarian opinions.  We will always achieve far more working together.  When we are fully transparent with one another, facilitate a culture of trust and mutual respect and make room for and learn from opposing ideas, we will grow.  Together, we must support the mission and growth of the team at all times.

Display and Encourage Initiative

 Nightingale attributed her success to the fact she “never gave or took any excuse.” When told there was no money to repair a burned-out wing of the Scutari Barrack Hospital that was scheduled to receive hundreds of new casualties, she hired a Turkish work crew and before anyone could stop her, had the wing refurbished. The acid test of an “empowering” workplace is whether people – regardless of job title – can take the initiative to do the right thing for patients and coworkers without seeking permission or worrying about recrimination.

A concluding thought

Equip, enable, empower and encourage your people.  They will take care of the patients and customers, and that will take care of the results.  In this way, we can create a better healthcare world, confidently confront the challenges we face with courage and determination, and ensure we are making wellness a priority for all.

And here is another cool way to make wellness a priority.  Go to HealthLynked.com and signup for free, today!  There, you will be able to connect and collaborate more closely on the efficient exchange of health information.

 

 

 

Adapted from the following works:

100 Day Challenge, by Gary Ryan Blair

10 Leadership Lessons from Florence Nightingale, by Joe Tyre

 

 

7 Health Benefits of Holding Hands and Its Potential for Healing Society


There’s something special about holding hands with another human being. All of us are innately conscious of how this simple act can stir an instant intimacy, heighten our awareness and express a deep connection. This alchemy of two hands touching has so deeply captured our collective imagination, it’s been the subject of our highest artistic achievements, from the ceiling of the Sistine Chapel, to the poetry of Romeo and Juliet, to the lyrics of the Beatles.

But what is it about holding hands, exactly, that makes it so powerful? In partnership with Dignity Health, The Huffington Post explored what science can tell us about this ubiquitous, mysterious gesture and how it can affect our brains and physical well-being, as well as our relationships. Holding hands, we learn, has the power to impact the world.

Holding Patterns

Human beings are hardwired to seek out each other’s touch before we are even born. If you’ve ever touched the palm of a newborn baby, then you’ve likely witnessed (and been treated to) one of the earliest instinctual responses to manifest in humans: the “grasping reflex.” Known to science as the palmar grasp reflex, the instinct makes a baby grab your finger and squeeze it tight.

Humans share this trait with our primate ancestors; it can still be observed in species of monkeys, notably in the way newborns cling to their mothers, unsupported, so the mother can transport the two, hands-free.

Human fetuses have been observed displaying this behavior weeks before full-term delivery. They will clutch their umbilical cord, place their hand in their mouth, or suck their thumb. Twin fetuses are known to hold hands, as poignantly captured in a Kansas family’s moving sonogram image, in which one twin is healthy and the other is critically ill.

Babies may relinquish the grasping reflex over time, but the importance and vitality of touch remain essential.

Touch, A Necessity Of Life

Quantifying the power of touch can be challenging for researchers — measuring the outcome of, say, depriving a child from human contact is unethical. But an unsettling episode in Romania offered scientists some telling insights into what can happen when we are denied the nurturing that touch can provide.

Charles Nelson, professor of pediatrics at Harvard Medical School and author of the book Romania’s Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery, led a study that measured the developmental progress of hundreds of children raised in poorly run Romanian orphanages. They had endured years without being held, nuzzled or hugged, according to a Harvard Gazette report. Many of the children had physical problems and stunted growth, despite receiving proper nutrition.

The same appears to hold true through adulthood. Adults who don’t receive regular human touch — a condition called skin hunger or touch hunger — are more prone to suffer from mental and emotional maladies like depression and anxiety disorders.

As psychologists Alberto Gallace and Charles Spence point out in the journal Neuroscience and Biobehavioral Reviews, “touch is the first of our senses to develop” and “our most fundamental means of contact with the external world.” It’s more than just a comforting sensation; touch is vital to human development and life.

The ‘Love Hormone’ 

Clearly, we humans live to touch. But how does it sustain us? What’s happening in our bodies and minds when what we touch is another person’s hand?

Multiple studies — including one conducted at the University of California Los Angeles (UCLA) — show that human touch triggers the release of oxytocin, aka “the love hormone,” in our brain. Oxytocin is a neurotransmitter that increases feelings of trust, generosity and compassion, and decreases feelings of fear and anxiety.

Dr. Tiffany Field, director of the Touch Research Institute (TRI) at the University of Miami/Miller School of Medicine, says that holding hands is one of the most powerful forms of touch in part because the skin is a sense organ and needs stimulation, just as the ears and the eyes do.

Touch is our most fundamental means of contact with the external world.

Psychologists Alberto Gallace and Charles Spence

“When the fingers are interlaced and someone is holding your hand, they’re stimulating pressure receptors [that trigger] what’s called vagal activity,” Field says. “When there’s pressure in the touch, the heart rate goes down, the blood pressure goes down, and you’re put in a relaxed state. When people interlace their fingers, they get more pressure stimulation than the regular way of holding hands.”

Physical touch — and especially holding hands — is commonly associated with “feeling good.” Which raises the question, is there more hand-holding can do for us?

With Touch Comes Toleration

As we’ve seen, humans are not only creatures of habit, we’re also creatures of comfort. We gravitate toward situations and people who make us feel as content and secure as possible.

In the scientific study “Lending A Hand,” neuroscientists from the University of Virginia and the University of Wisconsin studied the effect the simple act of a human touch has on people in stressful situations. In this case, the participants underwent the threat of electric shock. The researchers came to the conclusion that a “loving touch reassures.”

On a physiological level, participants were able to better cope with pain and discomfort when they were holding hands because the act of holding hands decreased the levels of stress hormones like cortisol in their body. In other words, if stress is contagious, apparently a feeling of calm is contagious, too.

The Societal Imprint Of Human Touch 

Scientific research correlates physical touch with well being in  several important areas of life. Multiple studies at TRI concluded physical touch can affect pain management, lower blood pressure, decrease violence, increased trust, build a stronger immune system, create greater learning engagement and enhance overall well-being.

TRI is mining the potential of touch through a range of current studies, including how massage may help premature babies to grow, and if it can reduce depression in pregnant women such that they’re less likely to deliver prematurely.

“If every preemie was massaged in the U.S.,” Field suggests, “in one year that would save about $4.8 billion in hospital costs, because on average they get out of the hospital six days earlier.”

Field and her colleagues at TRI treat people with hip pain, typically from arthritis, and work to reduce depression and sleep problems in veterans who suffer from PTSD.  “Touch reduces pain because of the serotonin that’s released, and with the pressure on receptors during physical exercise, you get more deep sleep,” Field says.

Human Touch: More Important Now Than Ever

Science indicates that there’s a social argument to encourage hand-holding. What’s holding us back from embracing this? Today’s growing preoccupation with digital media over personal physical contact may unintentionally affect people negatively.

Though small in scope, another Touch Research Institute study suggests that American teenagers touch each other less than French teenagers do, and are more prone to aggressive verbal and physical behavior. Other data supports this claim that American youth is more violent and more prone to suicide than youth in other countries. Field’s hypothesis is that it has to do with ours being a “touch-phobic society.”

Oh please, say to me / You’ll let me be your man / And please, say to me / You’ll let me hold your hand

The Beatles, “I Wanna Hold Your Hand”

“With this taboo of touch in the school system, children are getting touched less,… less than when I was a kid, certainly,” Field says. “We’re so concerned about kids being touched the wrong way that we’ve basically banned it from the school system, and I think that’s really unfortunate.”

What can we do to shift this paradigm? It may be as simple as instilling in ourselves the mindfulness to outstretch a hand more often to those in our lives who matter most to us.

Here is a summary of seven documented benefits of holding hands:

  1. Holding hands is a great stress reliever

Holding hands with your significant other decreases the level of a stress hormone called cortisol. Even the touch of a friend or a teammate can make us feel more content, connected, or better about ourselves. When we are stressed out, a light touch on our hand can help ease the strain, both physically and mentally. Our skin also gets more sensitive when cortisol is rushing through our bloodstream, so the touch of a helping hand will have a significantly larger impact. The largest concentration of nerve endings is actually contained inside the hands and fingertips.

So, next time you’re having a really tough day, get together with your partner or a friend and ease the stressful day with them.

  1. Holding hands boosts love & bonding

Oxytocin is the hormone behind this benefit. Oxytocin strengthens empathy and communication between partners in a relationship, which is proven to be a contributing factor for long-lasting, happy relationships. Holding hands with your partner will improve your relationship and create a bond that will impact the quality of your relationship significantly.

Couples who have happy relationships hold hands automatically, sometimes without even noticing, because of a habit developed by their nervous systems. Holding hands produces the oxytocin, which makes us feel happier and more loved.

  1. Holding hands is great for your heart

Besides relieving stress, holding hands with your partner lowers your blood pressure, which is one of the major contributors to heart disease. When we’re clasping fingers with our loved ones, we’re not just easing stress and improving our relationships – we are providing a comfortable sensation that helps our heart. The power of a warm touch goes beyond the health benefits to the heart; a study from Behavioral Medicine backs up this claim.

  1. Holding hands relieves pain

While enduring pain, humans have the natural reflex to tighten their muscles. Think of childbirth – husbands are typically inside the delivery room holding their wife’s hand while she’s going through labor. The reflex to grasp our partner’s hand comes as second nature: It’s always easier to endure pain while holding hands with your soulmate.helping hand

  1. Holding hands fights fear

Remember that horrible scene in the last horror movie you saw that made you want to jump out of your chair? Luckily, your darling was with you to hold your hand and make you feel safe. The human brain responds to sudden stimulation using adrenaline; this stimulation gets our blood pumping and releases high levels of cortisol throughout our body.

During these moments, our natural reaction is to hold hands with someone we trust. It varies from person to person, but a large portion of women will instantly grab their partner’s hand. That’s the intuitive way to fight off nerve

  1. Holding hands provides a sense of security

Simple hand holding is a source of safety and comfort for young children. Remember when your parents taught you to how to cross the street or walked you down a crowded sidewalk? Or when you were learning to ride a bicycle? Insecurity disappears when we have a hand to hold and allows us to more easily conquer obstacles. The security that parents provide their children by holding hands shapes their children’s behavior and their way of thinking.

Additionally, the sensation of safety goes both ways; parents also feel safer when their children are within their grasp.

  1. Holding hands is just plain comfortable

Everybody loves comfort. The sensation of holding hands often provides a comfy feeling while talking a walk with your loved one. A great example is holding hands inside a jacket pocket to warm them up on those cold December nights when you decide to take a stroll in the snow with your partner. Even with gloves, we love to hold hands. It bonds us; it provides lovely sensations and gives us quality time with people we care about.

Conclusion

One thing is certain: our entire bodies, from our nerves to our brains, respond positively to touch and crave it from the time we’re born. Whether it’s due to instinct, comfort, intimacy or love, touch brings us closer to each other both physically and emotionally — and is a necessity for our overall well-being.

This tiny, commonplace behavior triggers chemical reactions in our minds that make us feel loved, happy, cared for, and respected.  Holding hands is one of the fundamental ways we can positively impact our lives and the lives of others.

When we hold hands, the nerves in our skin communicate with our core nervous system, producing hormones that make us feel pleasant and warm. There’s much more to it, of course, and new studies continue to explore the positive psychological effects of human touch today.



As AT&T used to say, “Reach out and Touch Someone”, but not through the phone.  Be present.  Put down the phone.  Hold hands.

Looking for a physician that understand the importance of compassionate care?  At HealthLynked, we are connecting patients and physicians in ways never before possible.  We have built a social ecosystem designed to bring you and your care givers closer than ever before to Improve HealthCare.

Ready to get Lynked?  Get connected today for free by going to HealthLynked.com.


Adapted from the following Sources:

By HuffPost Partner Studio.  The Science Behind The Profound Power Of Holding Hands |

A touching tribute. May 20, 2016

Kvrgic, Dejan.  Study Discovers 7 Surprising Benefits of Holding Hands.  LifeHack.com

 

 

 

21 Health Benefits and 6 Cool Facts About Zucchini

A staple at many markets and bountiful in backyard gardens during this time of year, zucchini can range in color from yellow to deep green. It has a tender texture with a slightly sweet flavor and, at just 21 calories per cup, it makes a welcome addition to a calorie-controlled diet.

Today, August 8th, is National Zuchinni Day and Sneak Some Zucchini on Your Neighbors’ Porch Day, so let’s take a look at all the potential benefits of this SuperFood.

What Is Zucchini?

Often known globally as courgette, zucchini is a summer squash native to the Americas. It belongs to the species Cucurbita pepo, along with a few other types of squashes and pumpkins. Zucchini boasts a rich nutritional profile, and it offers many health benefits thanks to its phytonutrients, mineral and vitamin content, including:

Vitamin C

Zucchini serves as a good source of vitamin C. A water-soluble antioxidant, vitamin C dissolves in your body fluids and protects your cells from free radicals, which are highly reactive compounds that oxidize your DNA, lipids and proteins, causing cellular damage. Getting enough vitamin C in your diet also aids in nerve cell communication, helps your body metabolize cholesterol and keeps your tissues strong. A cup of chopped zucchini contains 22 milligrams of vitamin C, which is 24 percent of the recommended daily intake for men and 29 percent for women, set by the Institute of Medicine.

Lutein and Zeaxanthin

Zucchini also provides you with lutein and zeaxanthin, two phytonutrients that belong to the carotenoid family, which is the same nutrient family that includes beta-carotene, a source of vitamin A. Lutein and zeaxanthin promote healthy eyesight. They filter light rays as they enter your eye, helping to ensure that harmful rays can’t damage your eye tissues. While, as of September 2013, the Institute of Medicine has not set a recommended daily intake for lutein and zeaxanthin, the American Optometric Association notes that intakes of at least 6 milligrams per day can reduce your risk for age-related macular degeneration, an eye disease that causes blindness. A cup of chopped zucchini provides 2.6 milligrams of lutein and zeaxanthin, or 43 percent of this intake goal.

 Manganese

Consuming zucchini also boosts your intake of manganese, an essential mineral. Like vitamin C, manganese protects your tissues from harmful free radicals. It supports the function of glycosyltransferases, a family of proteins that promote healthy bone tissue development. Manganese also helps your body produce collagen essential for efficient wound healing. Each cup of chopped zucchini boasts 0.22 milligram of manganese. This provides 12 and 10 percent of the Institute of Medicine’s recommended daily intake for women and men, respectively.

 Other Cool Zucchini Facts

  • One zucchini is called zucchina.
  • The world’s largest zucchini was 69 1/2 inches long and weighed close to 30 kilos.
  • Zucchini is the only fruit that starts with the letter Z.
  • The most flavorful of zucchinis are usually small and have darker skin.
  • Even the flower of the zucchini plant is edible. You can fry the zucchini blossoms into a delicacy.
  • And lastly, the word zucchini comes from ‘zucca’, which is the Italian word for squash.

Benefits Of Zucchini

  1. Zucchini Benefits For Weight Loss

It’s super low in calories, making it the perfect light side dish for a heavy meal; one cup of sliced zucchini has about 19 calories. That’s 40 to 50% lower than the same serving size for other low-cal green veggies like broccoli and Brussels sprouts. And because it’s so versatile, you can enjoy this low-calorie food in so many different recipes, from baked fries to pesto roll-ups. Of course, you can always grill zucchini with herbs for some savory flavor, too.

Zucchini is a low-starch fruit, low in carbohydrates and high in fiber. It will fill you up and discourage overeating.

The fruit also has a high water content which can keep you full for longer periods. It is one of those foods with a low glycemic index. Increased intake of fruits and vegetables and low-fat foods has been linked to healthy weight loss and weight maintenance.  Another benefit of high-fiber foods is they require more chewing – an individual, therefore, takes more time to eat and is typically unable to gorge on a large number of calories in a brief period.

  1. Improves Heart Health

Zucchini has a good amount of potassium: 295 milligrams per cup, or 8% of your recommended daily value. According to the American Heart Association, potassium can help control blood pressure because it lessens the harmful effects of salt on your body. Studies suggest boosting your potassium intake (while also curbing sodium) can slash your stroke risk and may also lower your odds of developing heart disease.

Because it is high in the antioxidant vitamin C, zucchini may help the lining of your blood cells function better, lowering blood pressure and protecting against clogged arteries. One cup of sliced zucchini has 20 milligrams, or about 33% of your daily value.

Ever heard of DASH diet? Also called the Dietary Approaches to Stop Hypertension, this diet is aimed at improving heart health by lowering hypertension. According to a report published by the National Heart, Lung, and Blood Institute, zucchini is a prominent part of the DASH diet.

Zucchini is low in cholesterol, sodium, and fat, and helps maintain a balance of carbohydrates – a requirement for optimum heart health.

Another reason zucchini works great for the heart is the presence of fiber. High intakes of fiber have been associated with significantly lower risks of developing stroke, hypertension, and heart disease.

Zucchini is also rich in folate, and as per a Chinese study, folate intake is inversely associated with heart disease risk.   The fact that it is rich in other nutrients like potassium and magnesium makes zucchini a superfood for the heart. Research has stated that deficiencies in the two nutrients can be directly linked to heart failure.

Another nutrient in zucchini that is worth your attention is riboflavin, which is a B-complex vitamin essential for energy production. In one study, children with cardiac disease were found to be shockingly deficient in riboflavin, emphasizing on the possible link between riboflavin and heart health.  Another Chinese study has linked riboflavin with alleviated cardiac failure in diabetics.

Riboflavin deficiency is also linked to certain birth defects in pregnant women, especially issues with the outflow tracts in the infant’s heart.

  1. Improves Eye Health

One doesn’t need to be reminded of the importance of vision. That said, zucchini seems to be more than food for your eyes. The fruit is rich in lutein and zeaxanthin, two antioxidants that were found to prevent age-related macular degeneration.

It is shocking to note that certain serious (and often irreversible) eye diseases like glaucoma and age-related macular degeneration have no warning signs.  So, what’s the best approach? Including zucchini in your diet. Zucchini is also a good source of vitamin A, shown to improve eye health.  It is important for eye development and maintenance.  As per a report published by Flaum Eye Institute of the University of Rochester Medical Center, a low-fat diet could be beneficial for the eyes – and zucchini can very well be a part of this diet.

The squash is also a wonderful source of beta-carotene that can improve eye health and offer protection against infections.

  1. Helps Control Diabetes

It is but unfortunate that a household without a diabetic is a rare scene. Well, that’s the sad part. So, is zucchini good for diabetics? Yes, the good part is, zucchini can help.

Non-starchy foods like zucchini can fill you up and aid diabetes treatment.  And the dietary fiber, which zucchini is replete with, can delay glucose absorption and help the patients with type 2 diabetes.  A German study states that insoluble fiber (which zucchini has a good amount of) can be very much effective in preventing type 2 diabetes.  Another study indicates the efficacy of insoluble dietary fiber that has shown to reduce diabetes risk.

Higher fiber intake is also associated with a lower risk of metabolic syndrome, which is one of the factors contributing to diabetes.  According to the University of Maryland Medical Center, soluble fiber can improve glucose tolerance in diabetics. Zucchini contains both soluble and insoluble fiber, by the way.

  1. Helps Lower Cholesterol

Zucchini is one of the few foods that are free of cholesterol, and hence you can include it in your cholesterol-lowering diet.  Soluble fiber has been found to interfere with cholesterol absorption. This helps lower the bad cholesterol or LDL in the blood.

  1. Helps Improve Asthma

In one Iranian study, the high levels of vitamin C in zucchini were thought to even cure asthma.  The anti-inflammatory properties of zucchini also contribute to asthma treatment.

Along with the vitamin C, zucchini also contains copper that is far more effective in treating asthma.

One Finnish study has found the benefits of vitamin C in treating not only asthma attacks, but also bronchial hypersensitivity — a characteristic of asthma.

  1. Protects Against Colon Cancer

The fiber in zucchini is the most important reason it can help in the treatment of colon cancer.  The fiber does multiple things – it absorbs the excess water in the colon, retains enough moisture in the fecal matter, and helps it to pass smoothly out of the body. Though precise knowledge about the subtypes of fiber (soluble or insoluble) in this aspect is important, dietary fiber as a whole has been linked to a reduced risk of colorectal cancer.

As per a Los Angeles study, dietary fiber plays a vital role in regulating the normal intestinal functioning and maintaining a healthy mucus membrane of the intestine. Though the exact amount of fiber and the type is still not clearly known, an expert panel from the study had recommended a fiber intake of 20 to 35 grams per day to prevent colon cancer.

The lutein in zucchini may also reduce the risk of colon cancer.

  1. Enhances Digestion

According to a report published by the University of Rhode Island, green fruits and vegetables, like zucchini, promote healthy digestion.  You can have zucchini as an after-meal snack – simply shred some carrots and zucchini on a quick bread or muffins and relish the taste and health benefits.

In fact, the late Henry Bieler (a prominent American physician who championed the idea of treating disease with foods alone) used to treat digestive issues in his patients with a pureed soup broth made from zucchini.   The dietary fiber in zucchini adds bulk to your diet and aids digestion. However, ensure you introduce fiber in your diet gradually. Increasing dietary fiber in your diet too quickly can lead to bloating, abdominal cramps, and even gas.

It has been found that dietary fiber forms the major components of foods that have low energy value, and hence are of particular importance, especially when it comes to dealing with abdominal issues.  If you are suffering from digestive issues, simply including zucchini in your meal might do the trick. It has been found that the addition of fiber in bread, cookies, breakfast cereals, and even meat products was found to have desirable results.

Zucchini contains both soluble as well as insoluble fiber. The insoluble fiber, also known as ‘the regulator’, accelerates the passage of water through the digestive tract. This reduces the time available for harmful substances to come in contact with the intestinal walls.

Seek out all-natural sources of fiber, and not just zucchini alone. If you are purchasing fiber-rich foods from the supermarket, there is but one ground rule – a good source of fiber is one that has at least 2.5 grams of fiber per serving. Foods having more than 5 grams of fiber per serving are excellent.  Anything lower than 2.5 grams could just be a waste of money.

  1. Lowers Blood Pressure

If you walk down a random street and pick any person you first see, chances are they might be (or is likely soon to be) suffering from high blood pressure.  We are so stressed about everything in life that blood pressure issues have become inevitable…almost.

With zucchini by our side, there is hope for natural relief.  Zucchini, being rich in potassium, is one of the preferred foods to combat hypertension.  Surprisingly enough, zucchini has more potassium than a banana.

Potassium is vasoactive, meaning it can affect the diameter of blood vessels. And hence, the blood pressure as well.  In a London study, potassium supplementation was linked to lowered blood pressure levels.  Though the study talks about certain conflicting results in pertinence to oral potassium supplementation, potassium was never shown to elevate the blood pressure levels.

As per another New Orleans study, potassium intake is mandatory to combat hypertension, especially when the individual is unable to reduce his/her sodium intake.  In addition to controlling blood pressure, potassium also lowers the heart rate and counters the harmful effects of sodium.

According to the National Academies Press, the adequate intake of potassium for adults is 4.7 grams per day.  Echoed by the World Health Organization, this dosage of potassium had the greatest impact on blood pressure levels.  However, dosing might vary depending on the overall health of an individual. Hence, consult your doctor for further details.

So, why is potassium so important with respect to lowering blood pressure? Because the nutrient is one of the principal electrolytes in the human body.  It is required in proper balance with sodium, in a ratio of 2:1. The junk foods we so very lovingly consume every other day have higher levels of sodium than potassium. Which is why they contribute to high blood pressure like no other. Zucchini is a good source of potassium. A medium-sized fruit offers 512 milligrams of the nutrient, which roughly equals 11% of your daily need.

  1. Slows Down Aging

Anti-aging is a big market today – a multi-billion dollar industry. You probably wouldn’t have to contribute much to that segment if you have zucchinis in your kitchen.

Zucchini is a good source of the antioxidants lutein and zeaxanthin. These two carotenoids exhibit powerful anti-aging properties.  They protect the cells of the body and the skin from free radical damage, which may otherwise lead to premature aging. Lutein and zeaxanthin have also been found to lighten the skin and improve its health.

In a study, lutein was found to prevent cell loss and membrane damage.  It also has photoprotective properties that protect the skin from UV damage. Zucchini is also rich in beta-carotene, the low levels of which were found to increase mortality risk in older men.

The riboflavin in zucchini maintains the health of the skin, hair, nails, and mucus membranes. It slows down aging by boosting athletic performance and preventing age-related memory loss and other related conditions like Alzheimer’s disease.  In one study, riboflavin was found to prolong the lifespan of fruit flies – indicating a similar possibility in human beings.

Zucchini, as we have seen, is rich in vitamin C. According to a South Korean study, the vitamin was found to decelerate aging in human heart cells.  Also, vitamin C is found in high levels in the skin layers, and the concentration shows a decline when we age.  Hence, intake of vitamin C appears to be a logical solution to slow down the signs of aging.

  1. Strengthens Bones And Teeth

Green vegetables and fruits, like zucchini, promote stronger bones and teeth,  The lutein and zeaxanthin in zucchini keep the bones and teeth strong. In addition, they also strengthen the blood cells.  Zucchini also contains vitamin K, which contributes to stronger bones.

Magnesium is another nutrient abundant in zucchini.  Most of the body’s magnesium resides in the bones, which helps build strong bones and teeth.  Magnesium also works along with calcium to improve muscle contraction.

The folate in zucchini also protects the bones, as does beta-carotene. Studies show that the body converts beta-carotene into vitamin A, which contributes to bone growth.

Zucchini contains phytochemicals such as indoles, which, according to Rutgers Cancer Institute of New Jersey, maintain strong bones and teeth.  Similar findings have been published by the California Department of Public Health.

  1. Helps Balance Thyroid And Adrenaline Function

Zucchini is rich in manganese, a mineral that promotes the optimal functioning of the thyroid gland.

  1. Helps During Pregnancy

Dark green vegetables are a must during pregnancy, and zucchini is one of them. In the nine months of pregnancy, consuming zucchini offers adequate B-complex vitamins that help maintain the energy levels and mood.

Zucchini is rich in folic acid that has shown to reduce the risk of certain birth defects,  like spina bifida – baby’s spinal chord doesn’t develop properly –  and anencephaly – the absence of a major portion of the brain.  As per a Canadian study, over 50 countries that have fortified their food staples with folic acid saw a dramatic decrease in neural tube defects in pregnant women.

One more reason folate is beneficial to pregnant women is its ability to aid in the production of red blood cells in the body.  This also helps lower the risk of developmental problems in the baby during pregnancy.

It is important to keep in mind that folic acid (or folate) works best when taken before getting pregnant and during the first trimester.  As women need additional folic acid during pregnancy, it is advisable to take a folic acid supplement as well.  Around 400 mcg of folic acid per day is recommended for women in this aspect.

Another reason zucchini is good for pregnancy is its magnesium content. As per an Italian study, magnesium is very important for women with an elevated risk of gestosis or premature labor.

  1. Good For Babies (And Kids)

Diarrhea is one common problem amongst most kids over one year of age. Oh yes, there are medications. But changes in the diet can also help. Bland foods work well in this case, and peeled zucchini can do wonders.

Mashed zucchini can also be a good addition to your baby’s diet.  Since it is soft and bland in taste (and since it comes replete with nutrients), your baby will be able to consume it easily.   NOTE: Never leave a baby alone when he/she is eating. Keep the portions small. And avoid those foods that he/she can easily choke on – these include everything that is hard to chew.

There is likely no need to emphasize the negative effects smoking can have on pregnant women. But, what if a woman has been a smoker for a long time before getting pregnant and just can’t give the habit up? In one Portland study, the intake of vitamin C has been found to prevent lung problems in babies born to pregnant smokers.  Zucchini, being rich in vitamin C, can help in this regard. By the way, this doesn’t mean it is okay to smoke during pregnancy. It simply isn’t.

In another Denmark study, the deficiency of vitamin C was found to impair brain development in infants.  In fact, the importance of vitamin C for infants was discovered way back in the early 1900s.

Studies conducted then stressed the significance of vitamin C in preventing scurvy in infants.  Dr. F.R. Klenner, between 1948-49, cured polio in children with vitamin C, and vitamin C only.  Of course, polio is nearly eradicated today. Both show how important vitamin C has been in the improvement  of population health.

  1. Helps Prevent Gout

Zucchini’s vitamin C grabs the spotlight, yet again. One study has linked vitamin C intake with a lower risk of gout in men.  It achieves this by lowering serum uric acid levels via a process called the uricosuric effect. The vitamin was also found to prevent not just gout, but numerous other urate-related diseases as well.

You can also intake zucchini to complement your gout treatment, especially if your treatment isn’t working well. As with every health concern, dosage is important, so talk to your doctor.

Though gout generally affects men over the age of 40 or anyone with a family history of the disease, it can occur anytime to anyone. It is caused by the excessive build-up of uric acid in the body, leading to its accumulation in tissues in the form of needle-shaped crystals. Apart from taking zucchini and other foods rich in vitamin C, something as simple as drinking 6 to 8 glasses of water daily can prevent gout.

  1. Promotes Prostate Health

When it comes to men’s health, zucchini is one of the vegetables that is often overlooked, but its phytonutrients greatly benefit the prostate.  The high carotenoid content of zucchini also associates it with a reduced risk of prostate cancer.

We have seen that zucchini is rich in beta-carotene and vitamin C. Both of these nutrients, as per a study, were found to be positively associated with prostate cancer.  Vitamin C reduces oxidative DNA damage and hampers the growth and ability of prostate cancer cells.

Lutein is also found in zucchini. As per a report published by the University of California San Francisco, lutein intake is inversely associated with prostate cancer.

Dietary fiber has been found to bind with carcinogens and eliminate them from the body. It also has the ability to prevent prostate cancer progression, and phytonutrients protect the cells from damage.  Both of these healthful compounds are abundant in zucchini, making it a powerful weapon to combat prostate cancer.

  1. Aids Collagen Formation

As we have seen, zucchini contains riboflavin, whose deficiency was found to affect the maturation of collagen.   The vitamin C in the squash plays a major part in the synthesis of collagen, which, as we know, is quite important to maintain the health of joints, cartilage, skin, and blood vessels.  The vitamin also protects the body from cellular damage.  In addition to collagen, vitamin C also helps in the production of elastin, both of which are essential for radiant and healthy skin.

A few other nutrients contribute to collagen formation, like potassium, zeaxanthin, and folate.  Zucchini is replete with these.

  1. Helps In Skin Hydration

Zucchini hydrates the body (and the skin) and helps it deal with the summer heat.

The lutein in zucchini encourages skin health by reducing inflammation responses. But how does that promote skin hydration? Well, here’s the science behind it. When the skin is exposed to sunlight, lutein reduces the inflammation response. This means the sunlight will cause less damage to the skin, and that means less damage to the moisture barrier of the skin as well.  And the result? Well hydrated skin.

Zucchini is 95% water.  This translates to hydrating the skin well. Keep in mind  only about 20% of our daily water intake is met through foods. Hence, it is also important we drink 8-10 glasses of water every day as skin cells need water to function at their best.

  1. Improves Brain Functioning And Memory

Green foods, especially zucchini, are rich in folate and are excellent for brain health.  Folate also helps in the production of DNA and RNA, the body’s genetic material. The nutrient, apart from improving mental health, also enhances emotional health.

The deficiency of folate is linked to megaloblastic anemia, which results in weakness and fatigue. Increased folate intake has been linked to reduced risk of dementia and Alzheimer’s disease in women.

Also, our brain is 75% water. When there is adequate water in your system, you will be more focused, think quick, and also display greater creativity. More importantly, sufficient water efficiently delivers nutrients to your brain and aids toxin removal. This results in enhanced concentration and mental alertness.  Zucchini, apart from being rich in water, also contains vitamin C, zinc, and omega-3 fatty acids – all of which largely contribute to brain health.

Though not very rich in iron, zucchini contains the nutrient in acceptable amounts. As per a study, early iron deficiency can lead to permanent neurobehavioral problems despite diagnosis and treatment.  Early iron deficiency can even affect the brain’s physical structure. Iron is also important for producing myelin, the fatty sheath that coats the brain’s nerves and accelerates brain communications.

  1. Promotes Hair Growth

Zucchini, being rich in zinc, promotes hair growth.  The vitamin C in zucchini can help heal dry and splitting hair.  It also makes your hair strands strong and supple.  Lack of vitamin C can result in the enlargement of hair follicles, which might eventually stall hair growth.

  1. Enhances Immunity

The vitamin C found in zucchini is an active form of ascorbic acid that boosts the immune system, and it does this in several ways. First, vitamin C helps develop the body’s T cells (a type of white blood cell) into functional T cells that defend against diseases. It also helps you produce more immune cells. The antioxidant properties of vitamin C also prevent cells from dying due to inflammation. The RDA of vitamin C is 90 mg in males and 74 mg in females.

Low levels of vitamin C are linked to increased risk of infection. In fact, high levels of vitamin C are frequently recommended for HIV-positive individuals to enhance their immunity.

In a Switzerland study, vitamin C and zinc were found to enhance immunity, so much that they had even improved the health of patients suffering from certain immune-deficient diseases like malaria and diarrhea.

Potential Side Effects Of Consuming Zucchini

  1. Digestive issues

Zucchini might cause digestive issues in people suffering from Irritable Bowel Syndrome (IBS). In such a case, consume it with caution, or avoid it altogether.  Bitter zucchini might also cause stomach cramps, diarrhea or both,

  1. Allergies

Zucchini might cause allergies in individuals who are sensitive to it. These include nausea, pruritus (severe skin itching), and certain kinds of oral allergies.

  1. Alzheimer’s

Yes, this can be contradictory to what was covered earlier in the article. Iron does help prevent brain ailments. But studies suggest that too much of it can cause neurological conditions like Alzheimer’s.  Though iron is not abundant in zucchini, it still is better to consider its effects.

  1. Excessive beta-carotene

Since zucchini is a very good source of beta-carotene, this could be a concern for certain individuals. Large doses of beta-carotene might be inadvisable for pregnant and lactating women, people who smoke, people who have been exposed to asbestos, and individuals who have undergone angioplasty.

Beta-carotene might also interact with medications – especially those used for lowering cholesterol and other medicines like niacin.

How much of zucchini is too much?

These side effects need not worry you unless you happen to take zucchini in excess. It sure is a super-food, yet there is conflicting information about just how much is too much, so please consult your doctor for more guidance.

 Zucchini – Tips For Selection And Storage

How to select zucchini

Zucchini is usually picked and sold even before it matures. Hence, the seeds and skin are tender, and you can cook it even without peeling. The zucchini must be clean and blemish-free. You must be able to pierce the skin easily with your fingernail.

Also, ensure the zucchini you select is small to medium in size – no more than 6 to 8 inches, and free of pricks and cuts. Some say it is better if it has one inch of stem attached.

How to store zucchini

Zucchini must be stored in a refrigerator. Remember to wrap it tightly.

If you want to freeze zucchini, choose the one with tender skin. Wash and slice it and scald for 3 minutes. Cool and drain and then pack it in a freezer container. You can also freeze shredded zucchini, provided you do it immediately.

If you are planning to grow zucchini in your backyard, you must remember that it grows best when surrounded by mulch, which keeps the soil moist. You also need to add two inches of water every week for the plant to thrive.

How To Prepare Zucchini

  1. As a healthy snack

Simply take raw zucchini sticks or slices and enjoy them with your favorite dip. You can also pack them in your lunchbox for a healthy afternoon snack.

  1. Mashed Zucchini

Wondering what to use as a side dish for your meal? Zucchini! Steam it and mash it. You can then puree this with other root vegetables and serve. Much better (and healthier) than mashed potatoes!

  1. Grilled Zucchini

Who said only meat can be thrown on the grill? Slice zucchini into 1/2-inch thick disks, or cut the zucchini lengthwise, and brush them with cooking oil.  Season as you desire, and grill right on the grate.

  1. Stuffed Zucchini

Pretty simple: Cut the zucchini lengthwise and scoop out the insides. Fill the empty zucchini cups with chopped vegetables, meat, and cheese. Bake for about 40 minutes at 375° F, or until they turn golden brown. Serve while hot.

  1. Use in salads

Make your salad healthier by slicing in zucchini.

Can you eat zucchini skin?

In fact, you should, as zucchini is 95% water. Most of this water is found in the flesh – which means most of the nutrients are found in the skin. Peeling the skin deprives you of vitamins C and K, fiber, potassium, antioxidants, and the other nutrients. Eating zucchini without the skin is almost like drinking plain water – only that you would be chewing in this case.

How To Make Zucchini For Baby

Zucchini can be wonderful for babies. It has a mild flavor. It is soft to chew, and it offers super nutrients.

But, remember this – zucchini, particularly because of its skin, can cause a bit of stomach upset in some individuals. Hence, you must wait till your baby is eating stage 2 foods, which would happen when (s)he is around 8 months old.

In case your child is prone to stomach upsets, peel the zucchini before cooking and observe how your child receives it. If things are alright, try with the skin the next time.

Here is how you can cook zucchini for your child:

  1. Select a zucchini with a firm and shiny skin. It must be free of bruises and any other visible damage. Keep it unwashed in a plastic bag and store it in the refrigerator (until you are ready to cook it, which would usually be up to 4-5 days).
  2. Divide the zucchini widthwise into half. Prepare the zucchini one half at a time. You can keep the second half back in the refrigerator until you want to use it next time.
  3. Slice the end of the zucchini. Wash it thoroughly under a stream of cold water.
  4. Cut it into thin slices.
  5. Fill a saucepan with cold water and bring it to a boil.
  6. Add the sliced zucchini to it. Once the water boils, decrease the heat to medium.
  7. Keep boiling the zucchini until it turns tender – this should take about 10 minutes.
  8. Drain the water and transfer the boiled zucchini into a food processor. Process it until it is completely pureed. You can add a little cold water if it appears too thick.
  9. Wait till the puree cools before you feed it to your little one. You can store the leftovers in a sealed container in the refrigerator for up to 2 days.
  10. You can prepare the other half of zucchini in a similar way.

As always, it is best to consult your baby’s pediatrician before introducing new foods in his/her diet.

Conclusion

Celebrate the  end-of-summer with the super food zucchini . Try grated zucchini in cookies and bread for added moisture, or, stuff between tortillas for a simple veggie quesadilla.  Packed with beneficial nutrients, including Vitamins C and A, potassium, folate, and fiber, zucchini contributes to a healthy heart by decreasing the risk of stroke, reducing high blood pressure, and lowering cholesterol. Get maximum benefits by eating either raw or cooked zucchini and feel free to eat the skin– it’s edible.

And, if you are looking for a physician in your area to advise you on how to take control of your nutritional health, go to HealthLynked.com to find a provider who fits the bill.  We connect providers to Patients and providers to providers to improve overall population health in a novel social ecosystem.

Ready to get Lynked?  Got to HealthLynked.com today to register for free and be entered into our “End of Summer” Contest.

Adapted from the Following Sources:

Tadimalla, Ravi Teja.  21 Amazing Benefits Of Zucchini For Skin, Hair, And Health. Stylecraze, February 20, 2018.

TREMBLAY, MSC, Steve.  The Health Benefits of Zucchini.  LiveStrong.com, OCT. 03, 2017.

 

 

 

 

 

 

 

Help Find the Missing Millions

Hepatitis is an inflammation of the liver. Viruses are the most common cause of hepatitis, but the condition can also be caused by other infections, heavy alcohol use, toxins, certain medications, and autoimmune disease. There are five main virus types that cause hepatitis—type A, B, C, D and E.

Hepatitis A and E are typically caused by ingesting contaminated food or water. Type B commonly occurs through contact with infected blood, semen or other bodily fluid through sex, sharing needles or other drug-injection equipment or from mother to baby at birth. Hepatitis type C is a blood-borne virus that is largely spread by sharing needles or other drug injection equipment. Hepatitis D, which is transmitted through contact with infectious blood, occurs only among people with hepatitis B infection.

Hepatitis B, C, and D afflict more than half a billion people worldwide and are responsible for more than a million deaths a year. Chronic infection with these viruses can lead to cirrhosis of the liver, end-stage liver disease, and liver cancer.

World Hepatitis Day is July 28th and is an opportunity to learn about the global burden of this disease and support efforts to combat viral hepatitis around the world. People can also find out if they should be tested or vaccinated for hepatitis A, B or C by taking CDC’s online Hepatitis Risk Assessment, which is based on CDC recommendations for the United States.

WORLD HEPATITIS DAY 2018 THEME: ELIMINATE HEPATITIS

In 2016, 194 governments adopted WHO’s Global Strategy on Viral Hepatitis, which includes a goal of eliminating hepatitis B and C by 2030, yet only a handful of countries are on track to meet these targets.

We are at a critical juncture. Unless we take action now, our chance to eliminate a cancer-causing illness will be missed. On WHD 2018, we are calling on all individuals and organizations to unite under the theme of “Eliminate Hepatitis” to drive action, build momentum and hold governments accountable. Because only together can we eliminate viral hepatitis by 2030.

WORLD HEPATITIS DAY 2018 CAMPAIGN: FIND THE MISSING MILLIONS

No one should have to live with viral hepatitis without knowing. Yet, globally more than 290 million men, women and children do. Unless there is a massive scale-up in screening, diagnosis and linkage to care, more people will become infected and lives will continue to be lost.

The World Hepatitis Alliance’s (WHA) global campaign – Find the Missing Millions – is a three-year global awareness-raising and advocacy campaign aimed at tackling the main barriers to diagnosis by putting civil society organizations and the affected community at the heart of the solution.

The Disease

The five hepatitis viruses – A, B, C, D and E – are distinct; they can have different modes of transmission, affect different populations, and result in different health outcomes.

  • Hepatitis A is primarily spread when someone ingests the virus from contact with food, drinks, or objects contaminated by feces from an infected person or has close personal contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.
  • Hepatitis B is often spread during birth from an infected mother to her baby. Infection can also occur through contact with blood and other body fluids through injection drug use, unsterile medical equipment, and sexual contact. The hepatitis B virus is common in sub-Saharan Africa, Asia and the Pacific Islands, but also has increased rates in the Amazon region of South America, the southern parts of eastern and central Europe, the Middle East and the Indian subcontinent. The hepatitis B virus can cause both acute and chronic infection, ranging in severity from a mild illness lasting a few weeks to a serious, chronic illness. If infected at birth or during early childhood, people are more likely to develop a chronic infection, which can lead to liver cirrhosis or even liver cancer. Getting the hepatitis B vaccine is the most effective way to prevent hepatitis B. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, followed by 2-3 additional doses. In many parts of the world, widespread infant vaccination programs have led to dramatic declines of new hepatitis B cases.
  • Hepatitis C is spread through contact with blood of an infected person. Infection can occur through injection drug use and unsafe medical injections and other medical procedures. Mother-to-child transmission of hepatitis C is also possible. Hepatitis C can cause both acute and chronic infections, but most people who get infected develop a chronic infection. A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. With new treatments, over 90% of people with hepatitis C can be cured within 2-3 months, reducing the risk of death from liver cancer and cirrhosis. The first step for people living with hepatitis C to benefit from treatments is to get tested and linked to care. There is currently no vaccine for hepatitis C but research in this area is ongoing.
  • Hepatitis D is passed through contact with infected blood. Hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can prevent hepatitis D by getting vaccinated against hepatitis B.
  • Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E usually clears in 4-6 weeks so there is no specific treatment. However, pregnant women infected with hepatitis E are at considerable risk of mortality from this infection.  Hepatitis E is found worldwide, but the number of infections is highest in East and South Asia. Improved sanitation and food safety can help prevent new cases of hepatitis E. A vaccine to prevent hepatitis E has been developed and is licensed in China, but is not yet available elsewhere.

Missing Millions

An estimated 290 million (89%) of the 325 million people living with viral hepatitis B and C are unaware that they are infected (WHO, 2017a), irrespective of gender, age, ethnicity or geography. This puts them at risk of unknowingly transmitting the virus to others and developing extrahepatic manifestations (e.g. autoimmune diseases, diabetes), liver complications, including fatal end-stage liver disease and liver cancer. Without a massive scale-up in awareness coupled with diagnostic services, to ensure that everyone infected gets tested, treatment rates will not increase and infection rates may rise (European Union HCV Collaborators, 2017).

Today, there is now a policy framework to combat and ultimately eliminate viral hepatitis. The United Nations’ Sustainable Development Goals (SDGs), adopted by all countries in 2015, call for combatting viral hepatitis (United Nations, 2015) and in 2016 the World Health Organization (WHO) adopted the Global health sector strategy on viral hepatitis, 2016–2021 (GHSS), which set the goal of eliminating viral hepatitis as a public health threat by 2030 and specifically for 30% of people infected to know their status by 2020 and 90% by 2030 (WHO, 2016). Thus, without  finding these “missing millions” and linking them to care, efforts to eliminate viral hepatitis will fail.

The “Find the Missing Millions” program, initiated by the World Hepatitis Alliance (WHA) in 2018, is a three-year effort intended to assist countries to reach the diagnosis targets they committed to when adopting the WHO viral hepatitis strategy. The program builds on the mission of WHA to “harness the power of people living with viral hepatitis to achieve its elimination” and this white paper highlights how involving civil society and the affected community can strengthen the response. While acknowledging the vast amount of work to date, including viral hepatitis testing guidance from clinical associations and technical agencies (AASLD, 2018; Chávez, 2013; EASL, 2018; Omata, 2016; WHO, 2017b), WHA, working with experts and key partners worldwide, developed a series of complementary recommendations, set out below, focusing on the role civil society and the affected community have in scaling up equitable diagnostic services to  nd the missing millions.

The Importance of Involving Civil Society and the Affected Community in the Response

People living with viral hepatitis and the affected community should be at the heart of every effort to eliminate viral hepatitis. Aside from fulfilling the need for trusted entities that consistently disseminate reliable information, civil society organizations bring fundamentally important perspectives and experiences which greatly enhance the effectiveness of strategies and programs.

In the context of addressing the barriers to diagnosis, a meaningful partnership with the affected community and civil society organizations can, amongst other things, contribute to the delivery of stronger awareness campaigns; strengthen innovative approaches to finding the undiagnosed through peer support services; help identify gaps within action plans which would otherwise be missed; and o er a platform to address stigma and discrimination, ensuring an equitable response so that the most vulnerable and marginalized are not left behind in the effort to eliminate viral hepatitis. As such, policy-makers should harness the voices of those affected by viral hepatitis, recognising them as vital partners in the elimination e ort.

Further, as more people living with viral hepatitis are aware of their diagnosis, they and those in their social environment can be part of the drive to prevent the disease by ensuring access to services, from prevention to testing to treatment and follow-up care, and by encouraging innovation, such as health systems reforms that facilitate new, more people-centered health services.

Methodology

Available research on the barriers to diagnosis of viral hepatitis and strategies to overcome them is limited to a small number of mainly high-income countries, or speci c regions and populations (Ishizaki, 2017). These studies are also limited with regard to the number and category of respondents. To address these data gaps, WHA conducted a global survey on the barriers to diagnosis of hepatitis B and hepatitis C.

WHA commissioned DJS Research, an independent research agency, to undertake a global consultation, in the form of an online survey that ran from 22 February to 21 March 2018. DJS Research sent approximately 3000 emails in English, French or Spanish to WHA member organizations, people living with viral hepatitis, medical professionals, policy-makers and other stakeholders. An open link to the survey was also provided on websites worldwide, which could be accessed by the wider hepatitis community.  Five hundred and sixty-one surveys were completed.

Following the online survey, telephone interviews were conducted with 17 respondents from Argentina, Australia, Brazil, Canada, Cyprus, Germany, Guatemala, Mali, Portugal, Spain, Switzerland, the United Kingdom and the United States of America. The interviews were designed to gather more detailed views on the barriers that were identified as major within the online survey.

The implications of the overall small sample size are that the data from individual regions can best be regarded as indicative and do not permit comparison or robust conclusions. Further, it is important to note that geographic representation in the survey is not proportionate to the prevalence and incidence of viral hepatitis in the different regions. Nonetheless, the  findings  provide useful avenues for exploration which then need to be adapted to the needs of each individual region. Details on barriers to the diagnosis of viral hepatitis B and C can be found in Find the Missing Millions: Barriers to Diagnosis Global Report (World Hepatitis Alliance, 2018).

The focus of the two-day global stakeholder consultation, held in London on 17–18 May 2018, was to further explore the role that civil society and the affected community can play in overcoming the identified barriers to diagnosis BOX 1 . Participants discussed the barriers to diagnosis identified by the survey and developed a set of recommendations; highlighting the unique role that civil society and the affected community have to play in a sustainable response.

Recommendations

 These recommendations should be considered complementary to WHO guidelines for viral hepatitis testing (WHO, 2017b) and the WHO Global health sector strategy on viral hepatitis, 2016-2021 (WHO, 2016) in that they set out to enhance the role of civil society and the affected community in overcoming the barriers to diagnosing viral hepatitis.

It is important to note that implementing these recommendations requires a multi-stakeholder response and this may mean policy-makers and other stakeholders will need to look beyond current partners. The response will be enhanced by involving not just those already engaged but also anyone who has contact with affected populations or populations at risk. This will vary depending on the setting but potential allies to consider include addiction specialists, nephrologists and hematologists, pharmacists, refugee and migrant support organizations, religious/cultural leaders who have played a role in developing and fostering health services, patient groups representing affected communities such as those with kidney disease, hemophilia or thalassemia and peers in general. Target groups may be different for e orts to combat hepatitis B versus hepatitis C and will likely differ by country or locality.

Overcoming the main barriers to diagnosis requires all stakeholders to engage in three main activities:

1.  Raising Awareness

Lack of public knowledge of the diseases, lack of knowledge among healthcare professionals and stigma and discrimination are all underpinned, in part, by a lack of awareness and so it is recommended that these three barriers should be collectively addressed.

When raising awareness, improving education and combatting stigma and discrimination, different strategies are required for different populations and, as WHO suggests, they will be dependent on the country context and may include promotion through the mass media (WHO, 2017b). In the GHSS it is stated that “Concerted advocacy e orts, particularly by political and community leaders, and a sound communication strategy are required to increase public and political awareness of the public health importance of viral hepatitis… and to mobilize action” (WHO, 2016).

Civil society and the affected community can enhance the response that WHO calls for by:

Partnering with stake holders to advocate for:

  • Health authorities to ensure continuous medical and professional education on viral hepatitis is provided from the early stages of training
  • Enabling frameworks such as anti-discrimination laws and their enforcement and redress of discriminatory acts
  • Decriminalization of drug use and homosexuality as punitive laws hamper public health efforts National governments to join all countries in upholding the commitment made at the 63rd World Health Assembly (2010) to use World Hepatitis Day to improve education and understanding of viral hepatitis

Partnering with stakeholders to take action to:

Promote the use of  findings  from national and/or WHO monitoring and evaluation frameworks to:

  • develop focused awareness strategies which target populations that are being left behind
  •  develop focused awareness strategies which target populations that are being left behind
  • create civil society-led shadow reports highlighting the experiences and expertise of civil society and the affected community to add further weight to national or WHO findings
  • Highlight in campaign materials that viral hepatitis is potentially a cancer-causing disease
  • Highlight that hepatitis can cause severe extrahepatic manifestations
  • Find influencers beyond the usual stakeholders that can help raise awareness (e.g celebrities and political leaders)
  • Create enabling environments where people living with viral hepatitis are able to share their stories in order to humanize the experience of living with viral hepatitis and reduce the stigma around it
  • Contribute to communication and awareness-raising campaigns by helping to formulate culturally speci c messaging to debunk myths, convey a sense of urgency, and reduce stigma
  • To ensure testing for hepatitis B and C is carried out alongside education on viral hepatitis so that awareness is increased in all people tested, not just those with viral hepatitis
  • Use the Find the Missing Millions campaign or other awareness-raising initiatives like World Hepatitis Day and NOhep to promote testing and improve understanding of viral hepatitis

2.  Making Testing More Accessible

The promotion of human rights and equity are core to both the SDGs (United Nations, 2015) and WHO initiatives to eliminate viral hepatitis. In particular these principles are evident within the guidance on access to testing, with WHO calling for testing services to be “accessible to the populations most affected” (WHO, 2017b). WHO further elaborates that: “Rapid expansion of programs to improve coverage should not compromise the quality of services, nor contribute to inequities in access to services and health outcomes” and “Actively engaging affected populations in developing strategies and programs should result in better targeted and acceptable services” (WHO, 2016).

Building on the foundation provided by WHO, civil society and the affected community can help national governments, national health institutions and other stakeholders to make testing more readily available by:

Partnering with stakeholders to advocate for:

  •  Development of a partnership response to viral hepatitis, where people living with the infections are included in ministerial and other global and national advisory structures
  • Better data to shape testing strategies so that they are targeted and client-centered
  • Available and effective testing, integrating both simple and appropriate testing technologies, while incentivizing testing at the primary care level
  • Provision of testing services through new models of care that allow for a “one-stop shop” experience where chronic infection can be confirmed and appropriate linkage to care implemented
  • Gaps in services to be addressed, specifically at sites where testing is not available or where it is underutilized
  • Broad availability of quality-assured rapid tests to screen for viral hepatitis

Partnering with stakeholders to take action to:

  •  Participate in the design of testing policies and strategies at the national level to ensure appropriate considerations that can enhance implementation are accounted for
  • Build the capacity of non-governmental organizations and community-based organizations, including patient groups, to test for viral hepatitis
  • Stimulate political will at all levels of government for increased access to testing
  • Help to ensure an equitable response by setting targets, especially for vulnerable populations, as they are frequently under-represented in testing efforts
  • Recruit peers from the affected communities to conduct testing, act as case managers, provide pre- and post-test counselling, provide reliable information to support those newly diagnosed and address transmission fallacies
Spotlight on peers:

Peer networks span multiple and intersecting groupings and have been successful in community mobilization. For example, peer involvement by community leaders or family members has been shown to promote access and subsequent participation in services for migrant populations, who are often cut o  from services, particularly where language and a fear of using services are barriers (Seedat, 2014; Sweeney, 2015).

The role of peers could extend beyond the current focus on testing and diagnosis to also serve to provide education on viral hepatitis, including how infection/reinfection occurs (Batchelder, 2017). For example, peer-driven testing campaigns for speci c populations such as people living with HIV (PLHIV), men who have sex with men (MSM), and people who inject drugs (PWID) can enable the scale up of diagnosis and treatment, as well as disseminate information on the distinct, available resources for those with a positive diagnosis to prevent stigmatization (Crawforth & Bath, 2013; Meyer, 2015; Scott, 2014; Sharma, 2015).

 3.  Removing Cost Barriers for Viral Hepatitis Testing

The WHA global survey found that out-of-pocket costs to patients were one of the principal barriers to diagnosis. To date, viral hepatitis testing costs have mainly been approached from a provider rather than user perspective in WHO initiatives (WHO, 2017b). However, the 4th strategic direction of the GHSS is: “Financing for sustainability: proposing strategies to reduce costs, improve efficiencies and minimize the risk of  financial hardship for those requiring the services” and the proposed priority actions for countries include reducing  financial barriers to patients by phasing out direct, out-of-pocket payments (WHO, 2016).

A coordinated and decided approach to curb this barrier is needed and civil society and the affected community can contribute by:

Partnering with stakeholders to advocate for:

  •  No, or limited and easily affordable, out-of-pocket costs for patients through inclusion of viral hepatitis services in health insurance schemes
  • Hepatitis testing and treatment to be included in universal health coverage packages, as set out by the Universal Health Coverage Forum in the Tokyo Declaration (2017)
  • The use of central procurement of quality-assured and affordable tests in order to obtain price-volume agreements
  • Leveraging of existing services in order to decrease investment costs for testing infrastructure and personnel, e.g. within HIV or other settings

 

Partnering with stakeholders to take action to:

  • Be a part of multi-stakeholder initiatives at the national level to inform the negotiation of pricing for diagnostic technologies and services
  • Assist in collecting and monitoring pricing data

Get Connected

Need a good doctor to take a peak inside or help you get closer to your microbiome?  Find one fast on HealthLynked.com, where you can build your own personal, portable health record and Connect and collaborate with your care team using our novel ecosystem.

Get Lynked today!  Go to HealthLynked to sign up for Free and start taking control of your medical care.

Sources:  Adapted from

WHA.org

CDC.org

WHO.org

 

References from WHA Whitepaper

American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society  of America (2018). HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis. Last Updated: May 24, 2018. Available from https://www. hcvguidelines.org/sites/default/ les/ full-guidance-pdf/HCVGuidance_ May_24_2018a.pdf, accessed 19 June 2018.

Batchelder AW, Cockerham-Colas L, Peyser D, Reynoso SP, Soloway I, Litwin AH (2017). Perceived benefits of the hepatitis C peer educators: a qualitative investigation. Harm Reduct J;14(1):67.

Chávez-Tapia NC, Ridruejo E, Alves de Mattos A, Bessone F, Daruich J, Sánchez-Ávila JF, et al (2013). An update on the management of hepatitis C: guidelines for protease inhibitor-based triple therapy from the Latin American Association for the Study of the Liver. Ann Hepatol;12 Suppl 2:s3-35.

Crawford S, Bath N (2013). Peer support models for people with a history of injecting drug use undertaking assessment and treatment for hepatitis C virus infection. Clin Infect Dis;57:S75–S79.

European Association for the Study of the Liver (2018). EASL Recommendations on Treatment of Hepatitis C 2018. J Hepatol. pii: S0168-8278(18)31968-8.

European Union HCV Collaborators (2017). Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study. Lancet Gastroenterol Hepatol;2(5):325-336.

Ishizaki A, Bouscaillou J, Luhmann N, Liu S, Chua R, Walsh N, et al (2017). Survey of programmatic experiences and challenges in delivery of hepatitis B and C testing in low- and middle-income countries. BMC Infect Dis.;17(Suppl 1):696.

Meyer JP, Moghimi Y, Marcus R, Lim JK, Litwin AH, Altice FL (2015). Evidence-based interventions to enhance assessment, treatment, and adherence in the chronic Hepatitis C care continuum. Int J Drug Policy;26(10):922-35.

Omata M, Kanda T, Wei L, Yu ML, Chuang WL, Ibrahim A, et al (2016). APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing. Hepatol Int;10(5):681-701

Scott HM, Pollack L, Rebchook GM, Huebner DM, Peterson J, Kegeles SM (2014). Peer social support is associated with recent HIV testing among young black men who have sex with men. AIDS Behav.;18(5):913–20.

Seedat F, Hargreaves S, Friedland JS (2014). Engaging new migrants in infectious disease screening: a qualitative semi-structured interview study of UK migrant community health-care leads. PLoS One; 9(10):e108261.

Sharma M, Ying R, Tarr G, Barnabas R (2015). Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature;528(7580):S77–85.

Sweeney L, Owiti JA, Beharry A, Bhui K, Gomes J, Foster GR, Greenhalgh T (2015). Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals. BMC Health Serv Res;15:97.

United Nations (2015). Sustainable Development Goals. https:// sustainabledevelopment. un.org/?menu=1300 Universal Health Coverage Forum (2017). Tokyo Declaration on Universal Health Coverage: All Together to Accelerate Progress towards UHC. http://www.who.int/universal_health_coverage/tokyo- decleration-uhc.pdf?ua=1 World Health Organization (2016).

Global health sector strategy on viral hepatitis, 2016-2021. WHO: Geneva. http://www.who.int/ hepatitis/strategy2016-2021/ghss- hep/en/World Health Organization (2017a). Global hepatitis report, 2017. WHO: Geneva http://apps. who.int/iris/bitstream/handle/10665/255016/9789241565455- eng.pdf?sequence=1

World Health Organization (2017b).  Guidelines on hepatitis B and C testing. WHO: Geneva http:// apps.who.int/iris/bitstream/handle/10665/254621/9789241549981- eng.pdf?sequence=1

World Health Assembly (2010). 63rd World Health Assembly. Viral hepatitis. 21 May 2010. http://apps. who.int/gb/ebwha/pdf_ les/WHA63/ A63_R18-en.pdf

World Health Assembly (2014). 73th World Health Assembly. Hepatitis. 24 May 2014. http://www.wpro.who. int/hepatitis/wha67_r6-en.pdf

World Hepatitis Alliance (2018). Find the Missing Millions: Barriers to Diagnosis Global Report, http:// www.worldhepatitisalliance.org/ missing-millions/wp-content/ uploads/2018/06/Find-the-Missing- Millions-Survey-Report-FINAL.pdf

 

 

 

Is Diabetes Reaching Epidemic Proportions? Yes, but New Discoveries Offer Hope.

Diabetes has reached epidemic proportions in the U.S. – genetics, sugary diets and the lack of exercise all play a part. In a recent Instagram survey ( it is now the second largest search engine in the world, btw) it was found 97% of us know someone with diabetes.  That number surprised me, as I assumed it would be 100%.

The CDC reports the prevalence of diagnosed diabetes increased from 0.93% in 1958 to 9.40% in 2015. In 2015, 23.4 million people had diagnosed diabetes, compared to only 1.6 million, and it is estimated that number has now risen to above 30 million.   If current disease rates continue, one in three Americans will have diabetes by 2050. Over time, the condition can lead to kidney failure, limb amputations and blindness, among other complications.

The CDC report called the trend alarming, yet there is hope.

A Little History – Insulin Isolated in Toronto

On this day in 1958, at the University of Toronto, Canadian scientists Frederick Banting and Charles Best successfully isolate insulin–a hormone they believe could prevent diabetes–for the first time. Within a year, the first human sufferers of diabetes were receiving insulin treatments, and countless lives were saved from what was previously regarded as a fatal disease.

Diabetes has been recognized as a distinct medical condition for more than 3,000 years, but its exact cause was a mystery until the 20th century. By the early 1920s, many researchers strongly suspected that diabetes was caused by a malfunction in the digestive system related to the pancreas gland, a small organ that sits on top of the liver. At that time, the only way to treat the fatal disease was through a diet low in carbohydrates and sugar and high in fat and protein. Instead of dying shortly after diagnosis, this diet allowed diabetics to live–for about a year.

A breakthrough came at the University of Toronto in the summer of 1921, when Canadians Frederick Banting and Charles Best successfully isolated insulin from canine test subjects, produced diabetic symptoms in the animals, and then began a program of insulin injections that returned the dogs to normalcy. On November 14, the discovery was announced to the world.

Two months later, with the support of J.J.R. MacLeod of the University of Toronto, the two scientists began preparations for an insulin treatment of a human subject. Enlisting the aid of biochemist J.B. Collip, they were able to extract a reasonably pure formula of insulin from the pancreases of cattle from slaughterhouses. On January 23, 1921, they began treating 14-year-old Leonard Thompson with insulin injections. The diabetic teenager improved dramatically, and the University of Toronto immediately gave pharmaceutical companies license to produce insulin, free of royalties. By 1923, insulin had become widely available, and Banting and Macleod were awarded the Nobel Prize in medicine.

8 Amazing Breakthroughs Giving Us Hope

According to recent research, we’re not entirely sure how many diseases the label ‘diabetes’ covers. But no matter what causes our bodies to struggle with their blood sugar levels, it’s a serious condition that requires daily care.  Scientists have been working hard to find cures, new treatments, and better management techniques for the millions of people worldwide dealing with diabetes.

Here are a few of the latest developments you need to know about.

  1. Insulin producing implants made from stem cells

Clinical trials began last year for testing for ViaCyte’s PEC-Direct device; a credit-card sized implant containing insulin-producing cells derived from stem cells. Previous research had shown the implants could mature and function inside patients. Together with a cohort of volunteers who started testing in January, the new research should tell us soon whether the technology can help people with type-1 diabetes.

  1. Brand new beta cells

Type 1 diabetes develops when a person’s immune system wipes out insulin-producing beta cells in the pancreas. But it turns out that another type of immature beta cell has been hiding in our pancreases all along, and scientists think it might be possible to use these ‘virgin beta cells’ to restore the functionality of the pancreas.

  1. A common blood pressure medication

A drug on the World Health Organization’s list of essential drugs could have another purpose; blocking a molecule implemented in the autoimmune response that can give rise to type-1 diabetes.

Called methyldopa, the compound already has an important job treating high blood pressure in pregnant women and children. It’s left to be seen if it could help reduce the incidence of diabetes in some way, but the fact it’s already being used – rather than being stuck in the lab – makes for a promising find.

  1. A unique transplant

One woman with severe type 1 diabetes has spent a year without insulin injections thanks to an experimental transplant. Doctors implanted insulin-producing cells into a fatty membrane in the stomach cavity, and the success of the operation is paving the way towards more people receiving artificial pancreases.

  1. An extreme diet

A clinical trial conducted on just 298 volunteers in the UK last year found an intensive weight management program could put type-2 diabetes into remission for those who lose a significant amount of weight. The subjects were limited to roughly 850 calories a day for three to five months, consuming mostly soups and health shakes, before having more food introduced.

A similar study conducted on rats last year in the US also showed low calorie diets might help those who can stick to it reverse their condition.

  1. Glucose-monitoring contact lenses

Until we can nail down a cure, there will always been a need to monitor those messy blood glucose levels. Checking your tears for glucose using a smart contact lens, or monitoring your sweat with color changing ink, could be a whole lot less invasive than drawing blood. They’re not new ideas, but constant improvements in miniaturizing technology could mean these kinds of devices aren’t too far off.

  1. Loneliness could make us prone

While we can list a variety of genetic and lifestyle factors that affect a body’s growing resistance to insulin, there’s still a lot to learn. A study published late last year involving nearly 3,000 subjects aged 40 to 75 found there seems to be a significant relationship between social isolation and type-2 diabetes.

It’s not clear what the link might be, but having a few housemates or a local social group could make all the difference.

  1. Mexican cavefish evolved to be diabetic

While developing a resistance to insulin is bad news in humans, the pale, eyeless animal known as a Mexican cavefish evolved a new version of the insulin receptor that makes it harder for the hormone to bind.  This isn’t exactly a problem for the fish, which have also evolved other features to help it compensate. Studying its biology might help shine a light on how diabetes evolved in humans, and maybe even lead to new treatments.

  1. There is a gene for that (?)

By studying one family with rare blood sugar disorders, scientists have identified a gene mutation that can give rise to both high and low blood sugar. This discovery could lead to new treatments for diabetes.

Diabetes is a condition in which the body is unable to produce enough of the hormone insulin, or it cannot use it effectively.  As a result, blood sugar levels become too high.  It is estimated that around 30.3 million people in the United States are living with diabetes. Type 2 diabetes is the most common form, followed by type 1 diabetes.

One of the commonest forms of monogenic diabetes is maturity onset diabetes of the young, which accounts for approximately 2 percent of all diabetes cases in the U.S. among people under the age of 20;   but there are some rarer forms that account for just 1–4 percent of cases in the U.S. These are known as monogenic diabetes, and they arise from a mutation in a single gene that is passed down from one or both parents.  Such mutations impair the function of beta cells, which are cells in the pancreas that secrete insulin.

For this latest study, lead author Prof. Márta Korbonits — of the William Harvey Research Institute at Queen Mary University of London (QMUL) in the United Kingdom — and her colleagues studied a unique family, some members of which had diabetes, while others had insulinomas, or insulin-producing tumors in the pancreas.

Notably, diabetes is characterized by high blood sugar levels, while insulinomas cause blood sugar levels to become too low. How can both of these conflicting conditions run in the same family?  According to Prof. Korbonits and team, a single gene mutation is to blame.

MAFA mutation uncovered

By analyzing the genomes of the family, the researchers were surprised to find a single mutation in the MAFA gene that was present in both the family members with diabetes and those with insulinomas.  The MAFA gene normally regulates the production of insulin in beta cells. A mutation in this gene leads to the production of an abnormal MAFA protein, which seems to be more abundant in beta cells than normal MAFA proteins.

The researchers were able to confirm the presence of the MAFA gene mutation in another family, which also had members with both diabetes and insulinomas.  Overall, the results indicate that a mutation in the MAFA gene may be a cause of both high and low blood sugar levels, but precisely how the mutation causes such conditions remains unclear.

“We believe,” explains first study author Dr. Donato Iacovazzo, also of the William Harvey Research Institute at QMUL, “this gene defect is critical in the development of the disease and we are now performing further studies to determine how this defect can, on the one hand, impair the production of insulin to cause diabetes, and on the other, cause insulinomas.”

These results — now published in the Proceedings of the National Academy of Sciences — represent the first time that a mutation in the MAFA gene has been associated with disease, and the researchers believe that they could pave the way for new treatments for common and rare forms of diabetes.

“While the disease we have characterized is very rare, studying rare conditions helps us understand more about the physiology and the mechanisms underlying more common diseases. We hope that in the longer-term this research will lead to us exploring new ways to trigger the regeneration of beta cells to treat more common forms of diabetes.”

– Study co-author Prof. Sian Ellard, University of Exeter, U.K.

Overall Numbers, Diabetes and Prediabetes

  • Prevalence: In 2015, 30.3 million Americans, or 9.4% of the population, had diabetes.
    • Approximately 1.25 million American children and adults have type 1 diabetes.
  • Undiagnosed: Of the 30.3 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed.
  • Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.2%, or 12.0 million seniors (diagnosed and undiagnosed).
  • New Cases: 1.5 million Americans are diagnosed with diabetes every year.
  • Prediabetes: In 2015, 84.1 million Americans age 18 and older had prediabetes.
  • Deaths: Diabetes remains the 7th leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.

If your system seems to be handling sugar poorly, consider talking to a physician.  You can quickly find and connect with one in the largest ever healthcare ecosystem designed to vastly improve the relationship doctors and patients are meant to enjoy and find great value in….

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Sources

 

Diabetes: Surprising gene discovery could fuel new treatments

Published: Tuesday 16 January 2018 Written by: Honor Whiteman

 

8 Amazing Breakthroughs in Diabetes Research That Are Giving Us Hope

BY SIGNE DEAN & MIKE MCRAE

APRIL 02, 2018

 

 

 

Are We Infertile? Finding Help When Trying to Get Pregnant

Infertility happens when a couple cannot conceive after having regular unprotected sex.  It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Worldwide, 8 to 12 percent of couples experience fertility problems. Between 45 and 50 percent of cases are thought to stem from factors that affect the man.

Treatment is often available.

Causes in men

The following are common causes of infertility in men.

Semen and sperm

Semen is the milky fluid that a man’s penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.

The sperm is produced in the testicles.

When a man ejaculates and releases semen through the penis, the seminal fluid, or semen, helps transport the sperm toward the egg.

The following problems are possible:

  • Low sperm count: The man ejaculates a low number of sperm. A sperm count of under 15 million is considered low. Around one third of couples have difficulty conceiving due to a low sperm count.
  • Low sperm mobility (motility): The sperm cannot “swim” as well as they should to reach the egg.
  • Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. Up to 2 percent of men are thought to have suboptimal sperm.

Abnormal semen may not be able to carry the sperm effectively.

This can result from:

  • A medical condition: This could be a testicular infection, cancer, or surgery.
  • Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
  • Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder
  • Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency.

Other causes may include:

  • Genetic factors: A man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome, as in Klinefelter’s syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm.
  • Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production.
  • Hypospadias: The urethral opening is under the penis, instead of its tip. This abnormality is usually surgically corrected in infancy. If the correction is not done, it may be harder for the sperm to get to the female’s cervix. Hypospadias affects about 1 in every 500 newborn boys.
  • Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra.
  • Radiation therapy: This can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
  • Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

Some medications increase the risk of fertility problems in men.

  • Sulfasalazine: This anti-inflammatory drug can significantly lower a man’s sperm count. It is often prescribed for Crohn’s disease or rheumatoid arthritis. Sperm count often returns to normal after stopping the medication.
  • Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility.
  • Chemotherapy: Some types may significantly reduce sperm count.
  • Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count.
  • Age: Male fertility starts to fall after 40 years.
  • Exposure to chemicals: Pesticides, for example, may increase the risk.
  • Excess alcohol consumption: This may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count.
  • Overweight or obesity: This may reduce the chance of conceiving.
  • Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity.

Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. Women are advised not to use the drug for more than one day.

Causes in women

Infertility in women can also have a range of causes.

Risk factors

Risk factors that increase the risk include:

  • Age: The ability to conceive starts to fall around the age of 32 years.
  • Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
  • Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.
  • Being obese or overweight: This can increase the risk of infertility in women as well as men.
  • Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.
  • Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.
  • Exercise: Both too much and too little exercise can lead to fertility problems.
  • Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man’s scrotum. Some other STIs may also cause infertility.
  • Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.
  • Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Medical conditions

Some medical conditions can affect fertility.

Ovulation disorders appear to be the most common cause of infertility in women.

Ovulation is the monthly release of an egg. The eggs may never be released, or they may only be released in some cycles.

Ovulation disorders can be due to:

  • Premature ovarian failure: The ovaries stop working before the age of 40 years.
  • Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.
  • Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.
  • Chronic conditions: These include AIDS or cancer.

Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.

If the egg does not travel, it can be harder to conceive naturally.

Causes include:

  • Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.

Medications, treatments, and drugs

Some drugs can affect fertility in a woman.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.
  • Chemotherapy: Some chemotherapy drugs can result in ovarian failure. In some cases, this may be permanent.
  • Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems.
  • Illegal drugs: Some women who use marijuana or cocaine may have fertility problems.

Cholesterol

One study has found that high cholesterol levels may have an impact on fertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

However, a survey has suggested that the 3 days most likely to offer a fertile window are the 2 days before ovulation plus the 1 day of ovulation.

Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility.

  • Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.
  • Varicocele: Surgically removing a varicose vein in the scrotum may help.
  • Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
  • Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory.
  • Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked, sperm may not be ejaculated properly.

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

  • Clomiphene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • Metformin (Glucophage): If Clomiphene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
  • Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
  • Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Reducing the risk of multiple pregnancies

Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. The chance of a multiple birth is lower with an oral fertility drug.

Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed. Couples will have to consider the ethical and emotional aspects of this procedure.

Surgical procedures for women

If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

Endometriosis may be treated through laparoscopic surgery. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. It can also help if a man has severe erectile dysfunction.

In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use.

Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.

Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. Fertility treatment with donor eggs is usually done using IVF.

Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to implant into the uterine lining. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. In some women, and especially with age, the membrane becomes harder. This can make it difficult for the embryo to implant.

Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury.

Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

Most people will visit a physician if there is no pregnancy after 12 months of trying.

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.

A doctor can give advice and carry out some preliminary assessments. It is better for a couple to see the doctor together.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Infertility tests for men

The doctor will ask the man about his medical history, medications, and sexual habits and carry out a physical examination. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities.

  • Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Sperm counts can fluctuate, so that several samples may be necessary.
  • Blood test: The lab will test for levels of testosterone and other hormones.
  • Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation.
  • Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it.

Infertility tests for women

A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits.

She will also undergo a gynecologic examination and a number of tests:

  • Blood test: This can assess hormone levels and whether a woman is ovulating.
  • Hysterosalpingography: Fluid is injected into the woman’s uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If a blockage is present, surgery may be necessary.
  • Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.

Other tests include:

  • ovarian reserve testing, to find out how effective the eggs are after ovulation
  • genetic testing, to see if a genetic abnormality is interfering with fertility
  • pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries
  • Chlamydia test, which may indicate the need for antibiotic treatment
  • thyroid function test, as this may affect the hormonal balance

Complications

Some complications can result from infertility and its treatment. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

Some physical effects may also result from treatment.

Ovarian hyperstimulation syndrome

The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops.

Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomiphene and gonadotrophins. It can also develop after IVF.

Symptoms include:

  • bloating
  • constipation
  • dark urine
  • diarrhea
  • nausea
  • abdominal pain
  • vomiting

They are usually mild and easy to treat.

Rarely, a blood clot may develop in an artery or vein, liver or kidney problems can arise, and respiratory distress may develop. In severe cases, OHSS can be fatal.

Ectopic pregnancy

This is when a fertilized egg implants outside the womb, usually in a fallopian tube. If it stays in there, complications can develop, such as the rupture of the fallopian tube. This pregnancy has no chance of continuing.

Immediate surgery is needed and, sadly, the tube on that side will be lost. However, future pregnancy is possible with the other ovary and tube.

Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.

Coping mentally

It is impossible to know how long treatment will go on for and how successful it will be. Coping and persevering can be stressful. The emotional toll on both partners can affect their relationship.

Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation.

It is important to tell a doctor if excessive mental and emotional stress develop. They can often recommend a counselor and others who can offer appropriate support. Online support from organizations such as Resolve can be helpful.

Outlook

For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before.

In 1978, the first baby was born as a result of IVF. By 2014, over 5 million people had been born after being conceived through IVF.

As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time.

Financing fertility treatment can also be costly, but there are programs that can help with this.

Finding Help

HealthLynked is a great platform for connecting and communicating with medical professionals who can guide and counsel you through the issues of infertility.  Create a free profile today and LYNK with physicians in your area immediately.

Ready to get Lynked?  Go to HealthLynked.com to get started for free…right away!

 

Source:

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Infertility in men and women, Medical News Today, 4 January 2018

 

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