African Rejuvenation Medicine(Ajidewe)

African Rejuvenation Medicine(Ajidewe)

Looking younger than your age should not be that difficult.Babalawo Obanifa will in this work reveal one of the herbal prepration in Yoruba herbal medicine for age and body body rejuvenation.
Rejuvenation medicine are preparation that aid and facilitate reversal of aging process in human beigns.Rejuvenation is  complete
reversal of aging.This can be achieve biologicaly through herbs and spiritualy through spiritual preparation.It is one of the herbal preparation for this purpose that we are concern with in this work. What rejuvenation medicine do for you is that it extend your life span.It make you look so much younger than your age, You can be fifty -five and still look Thirty,that is how it work. Now let proceed to one of the remedy that can be use for this purpose:


• Ewe kuti(No English or scientific name availiable for this leave)Eepo ope eyin,(bark stem of palm tree with scientific name Elais Guineensis),ewe Ela tabi Awayeiku(Leaves of
Calyptrochilum chrristyan),egbo ako ibepe(root of male flowering pawpaw with scientific name carica papaya)Abeyo ogede( sprout shoot of already cut Banana tree).,Odidi atare kan(One full pod of alligator pepper with scientific name aframomum melegueta). Grind it together and mix with soap,then
pound it together.. Uses: Bath with the soap once a month.and use twelve time annualy.
By using this work it will be difficult for any body not related or close to you to know your age.it work.tested and proof. Herein
documented for next generation.

Copyright :Babalawo Pele Obasa Obanifa, phone and whatsapp contact :+2348166343145, location Ile Ife osun state Nigeria.

IMPORTANT NOTICE : As regards the article above, all rights reserved, no part of this article may be reproduced or duplicated in any form or by any means, electronic or mechanical including photocopying and recording or by any information storage or retrieval system without prior written permission From the copyright holder and the author Babalawo Obanifa, doing so is considered unlawful and will attract legal consequences

Version en español

Medicina de rejuvenecimiento africano (Ajidewe)


Parecer más joven que tu edad no debería ser tan difícil.Babalawo Obanifa en este trabajo revelará una de las preparaciones a base de hierbas en la medicina herbal Yoruba para la edad y el rejuvenecimiento corporal.

La medicina de rejuvenecimiento es una preparación que ayuda y facilita la reversión del proceso de envejecimiento en los seres humanos. El rejuvenecimiento está completo

Reversión del envejecimiento. Esto se puede lograr biológicamente a través de las hierbas y la espiritualidad a través de la preparación espiritual. Es una de las preparaciones herbales para este propósito que nos preocupa en este trabajo. Lo que la medicina de rejuvenecimiento hace por ti es que amplía tu vida. Te hace ver mucho más joven que tu edad, puedes tener cincuenta y cinco y seguir pareciendo Treinta, así es como funciona. Ahora pasemos a uno de los remedios que se pueden usar para este propósito:



• Ewe kuti (no hay nombre científico o inglés disponible para esta licencia) Eepo ope eyin, 7 (tallo de palmera con nombre científico Elais Guineensis), oveja Ela tabi Awayeiku (hojas de Calyptrochilum chrristyan), egbo ako ibepe (raíz de macho) papaya floreciente con nombre científico carica papaya) Abeyo ogede (brote de brote de árbol de plátano ya cortado)., Odidi atare kan (Una vaina completa de pimienta de cocodrilo con nombre científico aframomum melegueta). Muela y mezcle con jabón, luego

Golpearlo juntos. Usos: Baño con el jabón una vez al mes. Use doce veces al año.

Al usar este trabajo, será difícil para cualquier persona no relacionada o cercana a usted conocer su edad. Es un trabajo probado y comprobado. Aquí en

documentado para la próxima generación.


Copyright: Babalawo Pele Obasa Obanifa, teléfono y contacto de whatsapp: +2348166343145, ubicación Ile Ife osun state Nigeria.


AVISO IMPORTANTE: Respecto al artículo anterior, todos los derechos reservados, ninguna parte de este artículo puede reproducirse o duplicarse de ninguna forma ni por ningún medio, electrónico o mecánico, incluidas fotocopias y grabaciones, ni por ningún sistema de almacenamiento o recuperación de información sin previa autorización por escrito Del propietario de los derechos de autor y del autor Babalawo Obanifa, hacerlo se considera ilegal y tendrá consecuencias legales


Versão Portuguesa

Medicina de Rejuvenescimento Africano (Ajidewe)


Olhando mais jovem do que sua idade não deve ser tão difícil.Babalawo Obanifa irá neste trabalho revelar uma das preparações de ervas na erva Yoruba para a idade e rejuvenescimento do corpo corporal.

Medicina de rejuvenescimento são a preparação que ajudam e facilitam a reversão do processo de envelhecimento em seres humanos. O rejuvenescimento está completo

reversão do envelhecimento. Isso pode ser conseguido biologicamente através de ervas e espirituais através de preparação espiritual. É uma das preparações a base de plantas para este propósito que nos preocupamos com este trabalho. O medicamento de rejuvenescimento faz por você é que ele amplia sua vida. Isso faz com que você pareça muito mais novo do que sua idade, você pode ter cinquenta e cinco anos e ainda parece Trinta, é assim que funciona. Agora, avance para um dos remédios que pode ser usado para esse fim:



• Ewe kuti (Nenhum nome em inglês ou científico disponível para esta licença) Eepo ope eyin, 7 (talho de palmeira com nome científico Elais Guineensis), ovelha Ela tabi Awayeiku (folhas de Calyptrochilum chrristyan), egbo ako ibepe (raiz de floração masculina pawpaw com nome científico carica papaya) Abeyo ogede (broto de árvore de banana já cortada)., Odidi atare kan (Uma vagem completa de pimenta de jacaré com nome científico aframomum melegueta). Junte-a e misture com sabão, então

batalhe juntos .. Usos: Banho com sabão uma vez por mês. E use doze vezes anuais.

Ao usar este trabalho, será difícil para qualquer organismo não relacionado ou perto de você conhecer seu age.it work.tested e proof.Herein

documentado para a próxima geração.


Direitos de autor: Babalawo Pele Obasa Obanifa, telefone e contato whatsapp: +2348166343145, localização Ile Ife osun state Nigeria.


AVISO IMPORTANTE: No que diz respeito ao artigo acima, todos os direitos reservados, nenhuma parte deste artigo pode ser reproduzida ou duplicada de qualquer forma ou por qualquer meio, eletrônico ou mecânico, incluindo fotocópias e gravação ou por qualquer sistema de armazenamento ou recuperação de informações sem permissão prévia por escrito. O detentor dos direitos autorais e o autor Babalawo Obanifa, fazendo isso, são considerados ilegais e atrairão consequências legais

Version française

Médecine africaine de rajeunissement (Ajidewe)


Regarder plus jeune que votre âge ne devrait pas être si difficile.Babalawo Obanifa dans ce travail révélera l'une des préparations à base de plantes en phytothérapie Yoruba pour l'âge et le rajeunissement du corps.

Les médicaments de rajeunissement sont des préparations qui facilitent et facilitent le renversement du processus de vieillissement chez les humains. Le rajeunissement est terminé

Cela peut être réalisé par les herbes et la spiritualité grâce à la préparation spirituelle.Il est l'une des préparations à base de plantes à cet effet que nous sommes concernés par ce travail. Ce que la médecine de rajeunissement fait pour vous, c'est qu'il prolonge votre durée de vie. Cela vous donne l'air beaucoup plus jeune que votre âge, vous pouvez avoir cinquante-cinq ans et toujours regarder Trente, c'est comme ça que ça marche. Maintenant, passons à l'un des remèdes qui peuvent être utilisés dans ce but:



• Ewe kuti (Pas d'anglais ou nom scientifique disponible pour ce congé) Eepo ope eyin, 7 (tige de palmier avec nom scientifique Elais Guineensis), brebis Ela tabi Awayeiku (feuilles de Calyptrochilum chrristyan), egbo ako ibepe (racine de malefloweringpawpaw avec le nom scientifique carica papaya) Abeyo ogede (pousse de pousses de bananier déjà coupé)., Odidi atare kan (Une gousse complète de poivre alligator avec le nom scientifique aframomum melegueta). Grincer ensemble et mélanger avec du savon, puis

piler ensemble .. Utilise: Bain avec le savon une fois par mois.et utiliser douze fois par an.

En utilisant ce travail, il sera difficile pour tout organisme non apparenté ou proche de vous de connaître votre âge.

documenté pour la prochaine génération.


Copyright: Babalawo Pelé Obasa Obanifa, téléphone et whatsapp contact: +2348166343145, localisation Ile Ife osun état Nigeria.


AVIS IMPORTANT: En ce qui concerne l'article ci-dessus, tous les droits réservés, aucune partie de cet article ne peut être reproduit ou dupliqué sous quelque forme ou par quelque moyen, électronique ou mécanique, y compris la photocopie et l'enregistrement ou tout système de stockage ou de récupération d'informations. détenteur du droit d'auteur et l'auteur Babalawo Obanifa, ce faisant est considéré comme illégal et entraînera des conséquences juridiques

Deutsche Version

Afrikanische Verjüngungsmedizin (Ajidewe)


Suchen Sie jünger als Ihr Alter sollte nicht so schwierig sein.Babalawo Obanifa wird in dieser Arbeit eine der Kräuterpräpration in Yoruba Kräutermedizin für Alter und Körperverjüngung offenbaren.

Verjüngung Medizin sind Vorbereitung, die helfen, Umkehrung des Alterungsprozesses in menschlichen beigns zu erleichtern. Verjüngung ist abgeschlossen

Umkehrung des Alterns.Dies kann biologisch durch Kräuter und spirituelle durch spirituelle Vorbereitung erreicht werden.Es ist eines der pflanzlichen Vorbereitung für diesen Zweck, dass wir uns mit in dieser Arbeit beschäftigen.Welche Verjüngung Medizin für Sie tun, ist, dass es Ihre Lebensdauer verlängern. Es macht Sie so viel jünger aussehen als Ihr Alter, Sie können fünfundfünfzig sein und immer noch dreißig aussehen, so funktioniert es. Lassen Sie jetzt zu einem der Mittel, die für diesen Zweck verwendet werden können:



• Ewe kuti (Kein englischer oder wissenschaftlicher Name verfügbar für diesen Urlaub) Eepo ope eyin, 7 (Barckstamm der Palme mit wissenschaftlichem Namen Elais Guineensis), Mutterschaf Ela tabi Awayeiku (Blätter von Calyptrochilum chrristyan), egbo ako ibepe (Wurzel der männlichen Blütepawpawwith wissenschaftlicher Name Carica Papaya) Abeyo ogede (Sprossenschießen von bereits geschnittenem Bananenbaum)., Odidi atare kan (Eine volle Schote von Alligatorpfeffer mit wissenschaftlichem Namen aframomum melegueta) .Grind es zusammen und mit Seife mischen, dann

Pfund es zusammen .. Verwendet: Bad mit der Seife einmal im Monat.und verwenden Sie zwölf Mal jährlich.

Durch die Verwendung dieser Arbeit wird es für jeden Körper, der nicht mit Ihnen verwandt oder nah bei Ihnen ist, schwierig sein, Ihr Alter zu kennen.Es ist work.tested und proof.Herein

für die nächste Generation dokumentiert.


Urheberrecht: Babalawo Pele Obasa Obanifa, Telefon und WhatsApp Kontakt: +2348166343145, Standort Ile Ife Osun Staat Nigeria.


WICHTIGER HINWEIS: In Bezug auf den obigen Artikel, alle Rechte vorbehalten, darf kein Teil dieses Artikels in irgendeiner Form oder mit irgendwelchen Mitteln reproduziert oder vervielfältigt werden, sei es elektronisch oder mechanisch, einschließlich Fotokopieren und Aufzeichnen oder durch Informationsspeicherung oder Abrufsystem ohne vorherige schriftliche Genehmigung. Inhaber und der Autor Babalawo Obanifa, dies zu tun, gilt als rechtswidrig und wird rechtliche Konsequenzen ziehen


Русская версия

Африканская медицина омоложения (Ajidewe)


Глядя моложе своего возраста, не должно быть так сложно. Бабало Обанина в этой работе покажет одно из травяных препариентов в лекарстве от йорубы в возрасте от возраста и омоложения тела.

Омолаживающая медицина - это подготовка, помогающая и способствующая изменению процесса старения у человека. Омоложение завершено

отмена старения. Это может быть достигнуто биологическим путем через травы и духовность посредством духовной подготовки. Это одна из травяных приготовлений для этой цели, к которой мы относимся в этой работе. Какое лекарство для омоложения делает для вас, так это то, что оно продлевает вашу жизнь. Это заставляет вас выглядеть намного моложе вашего возраста. Вы можете быть пятьдесят и по-прежнему выглядеть тридцать, вот как это работает. Теперь перейдите к одному из средств, которые могут быть использованы для этой цели:



• Ewe kuti (нет английского или научного названия, доступного для этого отпуска) Eepo ope eyin, 7 (стержень барка с пальмовым деревом с научным названием Elais Guineensis), ewe Ela tabi Awayeiku (листья Calyptrochilum chrristyan), egbo ako ibepe (корень мужской цветной кожи с научным имя carica papaya) Abeyo ogede (побегите побег уже отрезанного бананового дерева)., Odidi atare kan (Один полный стручок аллигатора с научным названием aframomum melegueta). Поймите его вместе и смешайте с мылом, затем

фунт его вместе. Использует: Ванна с мылом один раз в месяц. И использовать двенадцать раз в год.

Используя эту работу, для любого тела, не связанного или близкого вам, будет сложно узнать ваш возраст. Работа. Проверено и доказано.

документированы для следующего поколения.


Авторское право: Babalawo Pele Obasa Obanifa, телефон и whatsapp контакт: +2348166343145, местоположение Ile Ife osun государство Нигерия.


ВАЖНОЕ ЗАМЕЧАНИЕ. Что касается вышеприведенной статьи, то все права защищены, никакая часть этой статьи не может быть воспроизведена или дублирована в какой-либо форме или любыми средствами, электронными или механическими, включая фотокопирование и запись или любую систему хранения или поиска информации без предварительного письменного разрешения. и автор Бабалаво Обанифа, делая это, считается незаконным и будет привлекать юридические последствия



非洲复兴医学（Ajidewe）


比你年龄小看起来应该不会那么困难。巴巴拉沃·奥班尼法（Babalawo Obanifa）将在本作品中揭示约鲁巴草药中的一种草药制剂，用于年龄和身体的年轻化。

回春药是帮助和促进逆转人类老化过程的准备。回春完成

老化的逆转，这可以通过药草和灵性通过精神准备来实现，这是我们在这项工作中所关心的草药准备之一。复兴药物为你做的是延长你的寿命。它使你看起来比你年龄年轻得多，你可以是五十五岁，仍然看起来是三十岁，这是如何工作的。现在让我们来看看可以用于这个目的的补救措施之一：



Ewe kuti（这个假期没有英文或学名）Eepo ope eyin，7（学名为Elais Guineensis的棕榈树干），母羊Ela tabi Awayeiku（Calyptrochilum chrristyan叶），egbo ako ibepe（malefloweringpawpawwithscientificname番木瓜（carica papaya）），阿巴约·奥杰德（已经切好的香蕉树的芽苗），Odidi atare kan（学名为aframomum melegueta的鳄鱼胡椒的一个完整的豆荚）。

将它们一起捣碎..用途：每月一次用肥皂洗澡，每年使用十二次。

通过使用这项工作，任何与您无关的身体都很难知道您的年龄，这些工作经过了测试和证明。Herein

记录下一代。


版权：Babalawo Pele Obasa Obanifa，电话和WhatsApp的联系方式：+2348166343145，地址Ile Ife osun州尼日利亚。


重要通知：关于上述文章，保留所有权利，未经事先书面许可，不得以任何形式或任何手段复制或复制本文的任何部分，电子或机械的，包括影印和录制，或通过任何信息存储或检索系统。提交人Babalawo Obanifa认为这样做被认为是非法的，将会招致法律后果


अफ़्रीकी कायाकल्प चिकित्सा (अजदीव)


आपकी उम्र से छोटी दिखना मुश्किल नहीं होनी चाहिए। बाबालो ओबनिफा इस काम में एक आयुर्वेदिक आयुर्वेदिक आयुर्वेदिक आयुर्वेदिक औषधि और आयुर्वेदिक शरीर के कायाकल्प के लिए एक हर्बल prepration प्रकट करेगा।

कायाकल्प दवा तैयारी है कि मानव बीन्स में वृद्धावस्था की प्रक्रिया का समर्थन और सहायता की सुविधा है। पुनरुद्धार पूरा हो गया है

बुढ़ापे के उलट। यह आध्यात्मिक तैयारी के माध्यम से जड़ी-बूटियों और आध्यात्मिकता के माध्यम से जीवशास्त्रीय प्राप्त कर सकते हैं। यह इस प्रयोजन के लिए हर्बल तैयारियों में से एक है कि हम इस काम में चिंतित हैं। आपके लिए कायाकल्प दवा क्या है कि यह आपके जीवन काल का विस्तार करे। यह आपको अपनी उम्र की तुलना में बहुत छोटा दिखता है, आप पचास-पांच हो सकते हैं और अब तीस लग सकते हैं, इस तरह वह काम करता है। अब इस उपाय के लिए एक उपाय के लिए आगे बढ़ें:



• ईवे कुटी (कोई भी अंग्रेजी या वैज्ञानिक नाम इस अवकाश के लिए उपलब्ध नहीं है) ईपो ओपे आईिन, 7 (खजूर के पेड़ का वैज्ञानिक नाम एलैस गिनेंन्सिस के साथ), ईए इला टॅबी अवएक्यू (कैल्प्ट्रोक्लुम क्रिस्टियन की पत्तियां), एबो एबिप (नर फ्लायरिंगपॉपीवाविथ साइंसनाम के रूट) कैरीया पपीता) अबेओ ओगेडे (पहले से ही केला के पेड़ को काटते हैं), ओडिडी अतर कान (एलियगेटर का काली मिर्च का एक पूरा पोड, वैज्ञानिक नाम एफ़राममम मेलेगुएटा)। इसे एक साथ मिलाकर साबुन के साथ मिश्रण करें, फिर

इसे एक साथ मिलाएं .. उपयोग: महीने में एक बार साबुन से स्नान करें। और बारह बार वार्षिक उपयोग करें

इस काम का उपयोग करके यह मुश्किल हो सकता है कि किसी भी शरीर से संबंधित न हो या आप के पास अपनी उम्र जानना मुश्किल हो। कामकाजी और साक्ष्य। हायरिन

अगली पीढ़ी के लिए प्रलेखित।


कॉपीराइट: बाबलावो पेले ओबासा ओबिनीफा, फोन और व्हाट्सएप संपर्क: +2348166343145, स्थान Ile Ife osun राज्य नाइजीरिया


महत्वपूर्ण सूचना: जैसा कि ऊपर दिए गए आलेख के संबंध में, सभी अधिकार सुरक्षित हैं, इस लेख का कोई भी हिस्सा किसी भी रूप में या किसी भी तरह से, इलेक्ट्रॉनिक या मैकेनिक सहित फोटोकॉपी और रिकॉर्डिंग या किसी भी जानकारी भंडारण या पुनर्प्राप्ति प्रणाली द्वारा पूर्व लिखित अनुमति के बिना दोहराया जा सकता है। लेखक बाबालाओ ओबानिफा, ऐसा करने से गैरकानूनी माना जाता है और कानूनी परिणामों को आकर्षित करेगा

أفريكان ريجوفناتيون مديسين (أجيديوي)


أبحث أصغر من عمرك لا ينبغي أن يكون من الصعب.بالاو أوبانيفا سوف في هذا العمل تكشف واحدة من بريبراتيون العشبية في الطب العشبية اليوروبا لعمر والجسم تجديد الجسم.

تجديد الطب هي إعداد التي تساعد وتسهيل عكس عملية الشيخوخة في بيغنز الإنسان.تجدد اكتمال

عكس الشيخوخة.هذا يمكن تحقيق البيولوجية من خلال الأعشاب و سبيريتوالي من خلال التحضير الروحي.أنها واحدة من إعداد العشبية لهذا الغرض أننا قلقون في هذا العمل. ما تجديد الطب تفعل بالنسبة لك هو أنه يمتد حياتك. انها تجعلك تبدو أصغر بكثير من عمرك، يمكنك أن تكون خمسين خمسين ولا تزال تبدو ثلاثين، وهذا هو كيف work.Now السماح المضي قدما في واحدة من العلاج التي يمكن استخدامها لهذا الغرض:



• إيوي كوتي (لا يوجد اسم إنجليزي أو علمي متاح لهذه الإجازة) إيبو أوب إيين، 7 (الجذع الشوكي من شجرة النخيل مع الاسم العلمي إليس غينينسيس)، النعجة تابي أوايايكو (أوراق كاليبروتشيلوم كريستيان)، إيبو أكو إبيب (جذر ماليفليرينغباوباويثسسينتيفيكاميكاريكا البابايا) أبيو أوجيد (برعم تبادل لاطلاق النار من قطع شجرة الموز بالفعل).، أوديدي أتار كان (واحد كامل جراب من التمساح الفلفل مع الاسم العلمي أفراموموم ميليغويتا) .Grind معا وتخلط مع الصابون، ثم

الجنيه معا .. الاستخدامات: حمام مع الصابون مرة واحدة في الشهر. واستخدام اثني عشر مرة سنويا.

باستخدام هذا العمل سيكون من الصعب على أي هيئة لا علاقة أو قريبة منك أن تعرف work.it الخاص بك work.tested والإثبات. هيرين

موثقة للجيل القادم.


حقوق الطبع والنشر: بابالاو بيلي أوباسا أوبانيفا، الهاتف واتساب الاتصال: +2348166343145، موقع إيل ايف ولاية أوسون نيجيريا.


ملاحظة هامة: فيما يتعلق بالمادة أعلاه، جميع الحقوق محفوظة، لا يجوز نسخ أو نسخ أي جزء من هذه المادة بأي شكل من الأشكال أو بأي وسيلة إلكترونية أو ميكانيكية بما في ذلك التصوير الضوئي وتسجيل أو عن طريق أي نظام تخزين المعلومات أو استرجاعها دون إذن خطي مسبقفرومثكوبيريغولدراندث الكاتب بابالاو أوبانيفا، القيام بذلك يعتبر غير قانوني وسوف تجلب العواقب القانونية

Do You Live with Anxiety? Here Are 11 Ways to Cope

Medically reviewed by Timothy J. Legg, PhD, CRNP on December 19, 2018 New — Written by Ally Hirschlag
Intro
Quick coping methods
Long-term strategies
Anxiety red flags
When to see a professional


Breathe: There are ways to calm your anxiety

Know that feeling of your heart beating faster in response to a stressful situation? Or perhaps, instead, your palms get sweaty when you’re confronted with an overwhelming task or event.

That’s anxiety — our body’s natural response to stress.

If you haven’t recognized your triggers yet, here are a few common: your first day at a new job, meeting your partner’s family, or giving a presentation in front of a lot of people. Everyone has different triggers, and identifying them is one of the most important steps to coping and managing anxiety attacks.

Identifying your triggers can take some time and self-reflection. In the meantime, there are things you can do to try to help calm or quiet your anxiety from taking over.

5 quick ways to cope with anxiety

If your anxiety is sporadic and getting in the way of your focus or tasks, there are some quick, homeopathic remedies that could help you take control of the situation.

If your anxiety is focused around a situation, such as being worried about an upcoming event, you may notice the symptoms are short-lived and usually subside after the anticipated event takes place.

Question your thought pattern

Negative thoughts can take root in your mind and distort the severity of the situation. One way is to challenge your fears, ask if they’re true, and see where you can take back control.

Practice focused, deep breathing

Try breathing in for 4 counts and breathing out for 4 counts for 5 minutes total. By evening out your breath, you’ll slow your heart rate which should help calm you down.

The 4-7-8 technique is also known to help anxiety.

Use aromatherapy

Whether they’re in oil form, incense, or a candle, scents like lavender, chamomile, and sandalwood can be very soothing.

Aromatherapy is thought to help activate certain receptors in your brain, potentially easing anxiety.

Go for a walk or do 15 minutes of yoga

Sometimes, the best way to stop anxious thoughts is to walk away from the situation. Taking some time to focus on your body and not your mind may help relieve your anxiety.

Write down your thoughts

Writing down what’s making you anxious gets it out of your head and can make it less daunting.

These relaxation tricks are particularly helpful for those who experience anxiety sporadically. They may also work well with someone who has generalized anxiety disorder (GAD) when they’re in a bind too!

However, if you suspect you have GAD, quick coping methods shouldn’t be the only kind of treatment you employ. You’ll want to find long-term strategies to help lessen the severity of symptoms and even prevent them from happening.

6 long-term strategies for coping with anxiety

If anxiety is a regular part of your life, it’s important to find treatment strategies to help you keep it in check. It might be a combination of things, like talk therapy and meditation, or it might just be a matter of cutting out or resolving your anxiety trigger.

If you’re not sure where to start, it’s always helpful to discuss options with a mental health professional who might suggest something you hadn’t thought of before.

Identify and learn to manage your triggers

You can identify triggers on your own or with a therapist. Sometimes they can be obvious, like caffeine, drinking alcohol, or smoking. Other times they can be less obvious.

Long-term problems, such as financial or work-related situations, may take some time to figure out — is it a due date, a person, or the situation? This may take some extra support, through therapy or with friends.

When you do figure out your trigger, you should try to limit your exposure if you can. If you can’t limit it — like if it’s due to a stressful work environment that you can’t currently change — using other coping techniques may help.

Some general triggers:

a stressful job or work environment
driving or traveling
genetics — anxiety could run in your family
withdrawal from drugs or certain medications
side effects of certain medications
trauma
phobias, such as agoraphobia (fear of crowded or open spaces) and claustrophobia (fear of small spaces)
some chronic illnesses like heart disease, diabetes, or asthma
chronic pain
having another mental illness such as depression
caffeine
Adopt cognitive behavioral therapy (CBT)

CBT helps people learn different ways of thinking about and reacting to anxiety-causing situations. A therapist can help you develop ways to change negative thought patterns and behaviors before they spiral.

Do a daily or routine meditation

While this takes some practice to do successfully, mindful meditation, when done regularly, can eventually help you train your brain to dismiss anxious thoughts when they arise.

If sitting still and concentrating is difficult, try starting with yoga.

Try supplements or change your diet

Changing your diet or taking supplements is definitely a long-term strategy. Research shows certain supplements or nutrients can help anxiety reduction.

These include:

lemon balm
omega-3 fatty acids
ashwagandha
green tea
valerian root
kava kava
dark chocolate (in moderation)
However, it can take up to three months before your body is actually running on the nutrition these herbs and foods provide. If you’re taking other medications, make sure to discuss herbal remedies with your doctor.

Keep your body and mind healthy

Exercising regularly, eating balanced meals, getting enough sleep, and staying connected to people who care about you are great ways to stave off anxiety symptoms.

Ask your doctor about medications

If your anxiety is severe enough that your mental health practitioner believes you’d benefit from medication, there are a number of directions to go, depending on your symptoms. Discuss your concerns with your doctor.

When is my anxiety harmful?

Identifying what sort of anxiety you’re dealing with can be somewhat challenging because how one’s body reacts to perceived danger can be entirely different compared to another person.

It’s likely you heard anxiety as a blanket term for that general feeling of worry, nervousness, or unease. It’s often a feeling grown in response to an upcoming event that has an uncertain outcome.

Every person deals with it at one time or another, because it’s part of our brain’s response to a perceived danger — even if that danger isn’t real.

That said, there are times anxiety can get serious and turn into anxiety attacks that initially feel manageable and then gradually build up over a few hours. (This is different from a panic attack, which is out of the blue and subsides.)

Signs of an anxiety attack

These are some of the more common mental and physical symptoms of anxiety:

feelings of danger, panic, or dread
nervousness or restlessness
rapid heart rate
sweating
trembling or chills
tiredness or weakness
gastrointestinal problems
difficulty focusing
hyperventilation
It’s also possible to experience an anxiety and panic attack simultaneously. The quick coping strategies mentioned above may also help with a panic attack.

Other mindful strategies to cope with panic attacks include focusing on an object, repeating a mantra, closing your eyes, and going to your happy place.

Symptoms of a panic attack

fear of dying
feeling like you’re losing control
a sense of detachment
heart palpitations
shortness of breath
chest pains or tightness
nausea
feeling lightheaded or dizzy
numbness or tingling in your extremities
feeling hot or cold

I Don’t Like Meditating. Here’s Why I Do It Anyway

Medically reviewed by Timothy J. Legg, PhD, CRNP on March 25, 2019 New — Written by Jason Brick
I don’t like meditating. But when I do it regularly, life is better. Stress is lower. My health improves. Problems seem smaller. I seem bigger.

As much as I’m loath to admit it, I’m not a fan of meditation. It comes unnaturally to me, despite my 36 years of martial arts study and interest in self-improvement, health-hacking, and general enlightenment.

I realize this speaks poorly of me as a person, kind of like my opinions on aikido, jazz music, pumpkin pie, and “A Prairie Home Companion.” That I’m not fond of them doesn’t mean they’re bad, it means I’m not as good as I could be


Worse yet, when I do regularly meditate, I find my life is better. Stress is lower, my health improves. I can focus more on my work, and am less likely to say things I regret to my friends, colleagues, and loved ones. Problems seem smaller. I seem bigger.

And I’m not alone. Over the past few decades, a host of researchTrusted Source has supported the conclusion that meditation is good for us, and that we should all meditate a few minutes each day.

Meditation has been found again, and again (and again) to reduce stress, with all the physical, social, and emotional benefits that provides.
Multiple studies have found meditation can reduce feelings of depressionTrusted Source and anxietyTrusted Source.
In 2003, researchers learned that regular meditation helped to boost immune function.
Meditation can help control pain, according to several studies, including these in 2016 and 2017Trusted Source.
That’s just the tip of that particular iceberg. Bottom line: meditation is good for me, and for you, no matter how much we might not want to do it. Kind of like eating a vegetarian meal once or twice a week.

So, from one resistant but learning meditator to others, here’s what I’ve learned about meditation and how to make it part of improving your life.

You don’t have to just sit around


Non-practitioners sometimes imagine meditation to be boring — and perhaps if not done a certain way, it can be. But there’s more than one kind of meditation available, so you can easily find one that suits you. Here are just a few alternatives:

Walking meditation calms your mind when you focus on your strides and movement of taking steps (rather than, say, focusing on your breath). Walking in a labyrinth is a centuries-old practice of contemplation common among many spiritual faiths, including Catholicism.
Kata is the formal practice of martial arts, including tai chi. The motions of this practice are so complex it becomes impossible to think of other things, allowing for profound meditative focus. See also yoga.
Listening mindfully to music,  especially music without lyrics, produces the same impacts of meditation by allowing you to be transported by the sounds, away from stray and extraneous thoughts.
Daily task meditation iswhere you take the process of a task — like doing dishes, cooking a meal, or getting dressed — and focus on it the way a kung fu master might focus on her forms.
Those are just a few examples. Other options for meditation include loving-kindness meditation, guided relaxation, breathing meditation, zazen sitting meditation, awareness meditation, Kundalini, pranayama…

The point is there’s a kind of meditation that works well with your needs, tastes, and general outlook. It’s just a matter of finding the right match.

Your brain might mess with you

Meditating is supposed to be a quieting of the mind, where you think about nothing in particular (or nothing other than the actions of the meditation) to allow that background noise to filter out and let you rest. That’s why exercise can be meditative: at a certain point you’re only able to think about the exercise.

But along the way, throughout each session of meditation, your thoughts are going to keep zooming in and trying to distract you. This happens all the time in the beginning, but here’s a secret: It happens all the time to the masters, too.

The trick with meditation isn’t to totally eliminate those stray thoughts. It’s to let them pass through your mind without you grabbing hold of them.

In the first stages of learning, you’ll fail a lot of the time. You’ll be meditating for a while and suddenly realize you stopped somewhere along the way to think about your to-do list and what you’re making for dinner that night.

Eventually, that will happen less and less, and you’ll start distracting yourself by getting frustrated that the thoughts intrude at all. You will ultimately be able to let them pass through and over you without taking root, so you can continue your meditation for as long as you wish.

Speaking of “as long as you wish….”

It doesn’t have to be for very long

Yes, I read the stories about Gichin Funakoshi (aka The Father of Modern Day Karate) meditating for an entire day while standing under a waterfall, and about retreats where people spend the entire weekend in some kind of a trance. And probably, some of those stories are true.

No, they don’t mean you have to meditate for hours to get anything out of meditation.

The studies I mentioned above had subjects meditate for less than an hour, in most cases less than 15 minutes, and even those sessions resulted in significant improvements to physical, emotional, and psychological health.

Some of the masters I’ve personally spoken with go one further, advising us to start with just one minute of meditation per day. That won’t be enough to reap huge, long-lasting benefits, but it has two advantages:

You will succeed. Anybody can meditate for a minute, no matter how busy or distractible they are.
You’ll be pleasantly surprised how much of a difference it makes for the next 10 minutes of your life.
I personally found those two factors combined to be an excellent motivator. Under the powerful motivation of immediate success and feeling the short-term impact of that minute, I committed more fully to learning how to meditate.

You don’t have to be a certain ‘type’ of person to meditate

Meditation has shed the new age or ‘hippie’ reputation it once had. Anyone can do it. Here’s an incomplete list of groups that actively practice meditation or encourage their people to meditate regularly:

professional athletes in the NFL, NHL, and UFC
actors including Hugh Jackman, Clint Eastwood, and Arnold Schwarzenegger
SEAL Team Six and other special forces branches of U.S. and worldwide militaries
an impossibly long list of CEOs and entrepreneurs like Richard Branson and Elon Musk
If Randy Couture and the guy who plays Wolverine meditate, you can do it too. It only takes a minute — literally — and you can start today.

Jason Brick is a freelance writer and journalist who came to that career after over a decade in the health and wellness industry. When not writing, he cooks, practices martial arts, and spoils his wife and two fine sons. He lives in Oregon.


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The Difference Between VLDL and LDL

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on January 3, 2019 New — Written by Diana Wells
VLDL
LDL
Testing
Lower VLDL and LDL
Overview

Low-density lipoproteins (LDL) and very low-density lipoproteins (VLDL) are two different types of lipoproteins found in your blood. Lipoproteins are a combination of proteins and various types of fats. They carry cholesterol and triglycerides through your bloodstream.

Cholesterol is a fatty substance that’s necessary for building cells. In the body, it’s most commonly created in your liver through a complex pathway. Triglycerides are another type of fat that’s used to store extra energy in your cells.

The main difference between VLDL and LDL is that they have different percentages of the cholesterol, protein, and triglycerides that make up each lipoprotein. VLDL contains more triglycerides. LDL contains more cholesterol.

VLDL and LDL are both considered types of “bad” cholesterol. While your body needs both cholesterol and triglycerides to function, having too much of them can cause them to build up in your arteries. This can increase your risk for heart disease and stroke.

1. Find out your recommended cholesterol level.

VLDL definition

VLDL is created in your liver to carry triglycerides throughout your body. It’s made up of the following componentsTrusted Source by weight:

Main components of VLDL Percentage
cholesterol 10%
triglycerides 70%
proteins 10%
other fats 10%
The triglycerides carried by VLDL are used by cells in the body for energy. Eating more carbohydrates, or sugars, than you burn can lead to excessive amounts of triglycerides and high levels of VLDL in your blood. Extra triglycerides are stored in fat cells and released at a later time when needed for energy.

High levels of triglycerides are linked to the buildup of hard deposits in your arteries. These deposits are called plaques. Plaque buildup increases your risk for heart disease and stroke. Experts believe this is due to:

increased inflammation
increased blood pressure
changes in the lining of blood vessels
low levels of high-density lipoprotein (HDL), the “good” cholesterol
High triglycerides are also associated with metabolic syndrome and nonalcoholic fatty liver disease.

LDL definition

Some VLDL is cleared in the bloodstream. The rest is transformed into LDL by enzymes in the blood. LDL has less triglycerides and a higher percentage of cholesterol than VLDL. LDL is largely made up of the following componentsTrusted Source by weight:

Main components of LDL Percentage
cholesterol 26%
triglycerides 10%
proteins 25%
other fats 15%
LDL carries cholesterol throughout your body. Too much cholesterol in your body leads to high LDL levels. High LDL levels are also associated with the buildup of plaque in your arteries.

These deposits can eventually lead to atherosclerosis. Atherosclerosis occurs when deposits of plaque have hardened and narrowed the artery. This increases your risk for having a heart attack and stroke.

Recent guidelines from the American Heart Association now focus on the overall risk for developing heart disease, rather than individual cholesterol results.

Your levels of total cholesterol, LDL, and HDL, along with a variety of other factors, determine which treatment options are best for you.

Talk to your doctor about your cholesterol and how you can lower your risk for heart disease with diet, exercise, lifestyle changes, and medication, if needed.

Testing VLDL and LDL

Most people will get their LDL level tested during a routine physical exam. LDL is usually tested as part of a cholesterol test.

The American Heart Association recommends all individuals over the age of 20 get their cholesterol checked every four to six years. Cholesterol levels may need to be followed up more frequently if your risk for heart disease is high or to monitor any treatment.

There’s no specific test for VLDL cholesterol. VLDL is usually estimated based on your triglycerides level. Triglycerides are also usually tested with a cholesterol test.

Many doctors don’t do the calculations to find your estimated VLDL level unless you ask for it specifically or have:

other risk factors for cardiovascular disease
certain abnormal cholesterol conditions
early onset heart disease
Risk factors for cardiovascular disease include:

increased age
increased weight
having diabetes or high blood pressure
having a family history of cardiovascular disease
smoking
lack of regular physical activity
unhealthy diet (high in animal fat and sugar and low in fruits, vegetables, and fiber)
How to lower VLDL and LDL levels

The strategies for lowering your VLDL and LDL levels are the same: increase physical exercise and eat a healthy variety of foods.

Quitting smoking and decreasing alcohol consumption can be beneficial as well. Your doctor is the best place to start for recommendations on heart-healthy lifestyle changes tailored for you.

Tips

Eat nuts, avocados, steel-cut oatmeal, and fish rich in omega-3 fatty acids, like salmon and halibut.
Avoid saturated fats, which are found in foods like beef, butter, and cheese.
Exercise at least 30 minutes a day.

What Happens When You Crack Your Back?

Medically reviewed by William Morrison, MD, specialty in orthopedics, on July 29, 2019 New — Written by Tim Jewell
The spine
How it happens
Risks
How to
Takeaway
You know that feeling when you first stand up and stretch after you’ve been sitting for too long, and you hear a symphony of pops and cracks in your back, neck, and elsewhere? It feels good, doesn’t it?

But what’s behind all that popping? Should you be worried?

Generally, no. When you “crack” your back, nothing’s actually cracking, splintering, or breaking. There’s even a technical term for it: crepitus.

Spinal manipulation, or an “adjustment,” can be done by yourself or by a professional, such as a chiropractor or other joint and spine specialist.

Let’s look at why backs make that “cracking” noise, some downsides to adjusting your back, and how to do it for the benefits.

A look at the spine

Before we dive into how back cracking works, let’s talk a little bit about the anatomy of your spine. The spine consists of several major components:

Spinal cord: The spinal cord is a long, thin bundle of nerves that connects your brain to the nerves throughout your body.

Meninges: These are membranes around the spinal cord and brain that absorb impact to the spine. They contain a fluid called cerebrospinal fluid (CSF), which serves many other functions.

Spinal column: Also called the vertebral column, the spinal column is made up of 33 vertically stacked pieces of bone called vertebrae, running from just below your skull to the tailbone (coccyx). Each vertebra can move independently of each other, allowing your back to be flexible. Each vertebra is divided from the next by soft spinal discs. These discs are filled with a jelly-like fluid called nucleus pulposus. This provides a cushion between the vertebrae so they don’t hit or scrape  each other.

Now that you have a good working knowledge of the spine, let’s move on to what’s happening when you adjust your back.

What’s happening when your back “cracks”?

Theory #1: Synovial fluid and pressure

The most popular theories propose that adjusting a joint releases gas — no, not that kind of gas.

Here’s one process that many experts think is occurring:

Cracking your back stretches squishy capsules on the outer edges of the vertebrae around joints called facet joints.

Stretching these capsules allows the synovial fluid inside them to have more space to move around, releasing pressure on your back joints and muscles and moving your facet joints.

When the pressure is released, synovial fluid becomes gaseous and makes the cracking, popping, or snapping sound. This quick change of state is called boiling or cavitation.

Theory #2: Other gases and pressure

An alternative explanation also involves gas. Some experts believe that gases like nitrogen, carbon dioxide, and oxygen build up between your joints over time, especially if your joints aren’t properly aligned and swell from poor posture like being hunched over or sitting for long periods of time.

When you stretch the joints out or move around in certain ways, the gas is released.

Why does it feel good?

This release of pressure is supposedly what makes back adjustments feel so good to lots of people.

Back cracking also causes endorphins to be released around the area that was adjusted. Endorphins are chemicals produced by the pituitary gland that are meant to manage pain in your body, and they can make you feel super satisfied when you crack a joint.

But there may be another, less physiological and more psychological process at work here.

A 2011 study suggests that you might associate the sound of cracking your back with a positive feeling of relief, especially when a professional chiropractor does it. This is true even if nothing actually happened to the joint — a placebo effect at its finest.

What are the risks?

Before we move on, just remember that any back adjustments you or a professional make shouldn’t cause you any major pain.

Adjustments may be uncomfortable, especially if you stretch yourself too far or if you’re not used to the feeling of a chiropractor manipulating your joints. But you shouldn’t feel intense, sharp, or unbearable pain.

Here are some possible risks of adjusting your back incorrectly:

Cracking your back too quickly or forcefully can pinch nerves in or near your spinal column. A pinched nerve can hurt. A lot. And some pinched nerves can stay pinched and limit your mobility until you have them examined and treated by a professional.

Cracking your back forcefully can also strain or tear muscles in and around your back, including your neck muscles near the top of the spine and your hip muscles near the bottom. Strained muscles can be difficult or painful to move, and severe muscle injuries may require surgery.

Cracking your back frequently over time can stretch back ligaments. This permanent stretching is called perpetual instability. This increases your risk of getting osteoarthritis as you get older.

Cracking your back too hard or too much can injure blood vessels. This can be dangerous because many important vessels run up and down your back, many of which connect to your brain. One possible complication of this is blood clotting, which can cause strokes, aneurysms, or other brain injuries.

How to do it safely

The safest way to crack your back by yourself is by stretching your back muscles.

Many experts recommend yoga or pilates led by a trained professional for the best results, but you can also just do a few back exercises at home for a quick adjustment.

Some of these exercises can also help reduce chronic back pain or increase your range of motion if you do them consistently.

There are several ways to do this that you can make a part of your daily routine. Try one or more of these and see which ones work best for you.

Knee-to-chest

Lie on your back and use your hands to pull your knee up toward your chest, one leg at a time. Relax your back and neck into the stretch as you pull with your arms.

Repeat 2–3 times.

Try this move twice a day.

Variations on hand placement include:

putting your hand on your knee, below the kneecap

holding on to the back of your thigh, behind your knee

hooking your leg over your forearm

Lower back rotation

Lie on your back and raise your knees up so they’re bent.

Keeping your shoulders still, move your hips to one side so that your knees are touching the ground.

Hold this position for 10 seconds, or for 2 deep breaths in and out.

Slowly return your knees to their previous position and repeat in the other direction.

Do this 2–3 times, at least twice a day.

Bridge stretch

Lie on your back.

Bring your heels back toward your butt so that your knees are pointed up.

Pressing your feet into the floor, lift your pelvis up so that your body forms a straight line from your shoulders to your knees.

Another version of this, as shown above, involves placing your feet higher up; instead pressing your feet into the floor you place them onto a wall and perform the same pelvic lift. This provides different leverage and stretching for your back. It can put more pressure on your upper back or shoulders.

Seated lower back rotation

While you’re sitting down, bring your left leg over your right leg.

Put your right elbow on your left knee, then rotate your upper body to the left.

Hold this position for 10 seconds, or 3 breaths, then return to your normal position.

Repeat this on the opposite side with your right leg over your left leg and turning to the right.

Unless you’re a professional chiropractor or licensed to adjust joints, don’t try to manipulate individual back joints or discs by yourself — this can cause injury or damage.

The takeaway

Adjusting your back is generally safe if you do it carefully and not too often. Most of all, it should not hurt.

And while there’s nothing wrong with regular stretches, compulsively cracking your back a few times a day or more, or doing it too suddenly or forcefully, can be harmful over time.

See a doctor, physical therapist, or a chiropractor if you experience persistent discomfort or pain when you adjust your back, after adjusting (and it doesn’t go away), or if you have long-term back pain in general. These could all be signs of a back condition that needs medical treatment.

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4 Fixes for Rounded Shoulders and Better Posture

Medically reviewed by Stacy Sampson, DO on July 29, 2019 New — Written by Sarah Kester

Back stretch

Chest stretch

Breathwork

Awareness

Causes

Takeaway

If you work in a job that requires sitting for prolonged periods of time, then your shoulders have likely rounded forward at some point. This is especially the case for office workers and truck drivers.

If your shoulders have shifted forward, there are simple fixes for rounded shoulders. It mostly requires remembering and repeating certain exercises.

These exercises can help you gain back the upper hand on your posture and overall well-being.

1. Cat-cow pose

The Cat-Cow Pose is a common yoga pose. You can practice yoga in guided classes or on your own. Most basic yoga poses can be done at home.

This particular pose helps target the back and chest. These are the areas that are primarily affected by rounded shoulders.

To do this:

Begin by kneeling on all fours on a mat or the floor.

To ensure proper alignment, position your hands directly under your shoulders, your hips shoulder-width apart, and your spine in a neutral position.

Your feet should be plantar-flexed, meaning that you point your toes away from your body. To do this, the top of your foot will touch over the floor.

To move into the upward cat phase of the exercise, exhale and push your spine up as far as it will comfortably go towards the ceiling.

Meanwhile, your chin will tuck in towards your chest.

Hold this position for 5 to 10 seconds.

Next, transition into the downward cow phase by first inhaling. Slowly relaxing the back and letting your abdomen dip towards the floor.

This should move your shoulder blades together and cause your back to arch.

Hold this for 5 to 10 seconds and then return to the starting neutral position.

Repeat 2 to 3 times.

2. Above the head chest stretch

You may have noticed a tighter-than-normal chest from rounded shoulders.

This is likely caused by the slightly forward posture of rounded shoulders that causes muscles of the chest to shorten and become tighter.

This chest stretch will help to open up the front body.

To do this:

Start either seated or standing with your arms raised, elbows bent, and your hands interlocked on the back of your head.

Imagine a tennis ball is sitting between your shoulder blades as you gently squeeze the shoulder blades together to hold it in place.

Hold this stretch for 15 to 30 seconds. Remember to breathe.

Repeat 2 to 3 times.

Make this move more comfortable by adjusting the height of your hands. For example, you can place your hands on top of your head or even a few inches above your head to get a different stretch.

For a deeper stretch, try doing this after a warm shower or after light exercise like walking, when your muscles are warmed up.

3. Deep breathing

This fix incorporates something we all know how to do: breathe!

When our shoulders and upper back round forward, this can affect breathing by making it harder for the breathing motion of the diaphragm and the rib cage to occur, making breaths feel shallow.

Posture affects breathing, and you can use breathing to change your posture. As a bonus, some people find breathing practices a great way to reduce stress.

To do this:

Start by finding a comfortable space that has minimal distractions.

While your posture doesn’t need to be perfect, it should be upright enough that your chest feels open.

Place a hand above your navel and another on your heart.

Close your eyes.

Close your mouth and take a deep breath in through your nose. You should feel your abdomen expanding underneath your hand.

Hold for 2 to 4 counts.

Breathe out through either the mouth or nose for another 2 to 4 counts.

Repeat this same process for at least 60 seconds.

If you’re new to deep breathing, start with really short sessions. As you get more comfortable, you can gradually add more time to your practice.

4. Posture awareness checks

Reverse habits by adopting posture awareness. You can do this by implementing a “posture check” into your day.

It’s a quick and effective way to retrain your body to naturally adjust into the positions that promote proper alignment.

To do this:

Start by standing against a wall. Your head, shoulder blades and butt should touch the wall. Your heels should be 6 inches away from the wall.

Since the goal is to have less than 2 inches between your neck and the wall and your back and the wall, measure the spaces to ensure they meet this requirement. First, between your neck and the wall and then your back and the wall.

In the beginning weeks of doing these exercises, aim to do a posture check as often as you can. To really get into the habit, try doing it once an hour for a few days.

Once your posture improves over time, you can reduce the frequency of these checks while continuing to practice body awareness.

It may take several weeks to see major improvements in posture.

What causes rounded shoulders?

Rounded shoulders usually happen from repetitive movements and poses. “Text neck” is a similar posture-related issue. This term gets its name from the position your spine and shoulders make when you bend your neck forward and down. This happens when you do things like read a text, check Twitter, or try to beat your high score on Candy Crush.

Posture-related issues aren’t the only causes of rounded shoulders. Other potential causes include:

thoracic kyphosis, also known as roundback, which can occur in osteoporosis

scoliosis, an abnormal side to side curvature of the spine

muscle weakness

extra weight

muscle imbalance, which can come from neglecting certain muscles during exercise

carrying around heavy objects

The takeaway

If your rounded shoulders are caused by posture-related issues, such as sitting at a desk or constantly looking down, these exercises can help improve your posture. Doing these exercises, along with regular posture checks, can also help with other aspects of your health, including your breathing and muscle weakness.

What Is Solitary Play?

Medically reviewed by Karen Gill, MD, specialty in pediatrics, on July 29, 2019 New — Written by Jane Chertoff

Age

Examples

Benefits

Concerns

Takeaway

Going it alone already?

As your little one starts to play with toys and explore objects around your home, they may do so interacting with you at times, and at other times, go at it alone.

Solitary play, sometimes called independent play, is a stage of infant development where your child plays alone. While that may seem sad at first — is your baby already preparing to leave the nest? — rest assured that they’re learning important skills.

Solitary play teaches babies how to entertain themselves — undoubtedly helpful when you need to get things done — and also fosters their future independence.

Solitary play is often first seen in children ages 0–2, before they start interacting and playing with other kids. Independent play is also a stage that older preschoolers and children choose to engage in after they know how to play with others, proving just how valuable this skill is.

How solitary play fits into the 6 stages of play

Solitary play is considered the second of Mildred Parten Newhall’s six stages of play. Here’s where it falls, if you’re keeping track:

Unoccupied play. Your baby is just starting to take in the world around them without much interaction beyond observation. Their surroundings are fascinating!

Solitary play. Much to your delight, your baby starts reaching for and interacting with objects. Sure, they’re playing alone — but it’s delightful to see the wonderment at this stage. They don’t yet understand or care that others around them may be playing, too.

Onlooker play. Your child observes others, but isn’t playing together with them. You may notice your little one pausing in their play to watch you as you do things around a room.

Parallel play. Your child plays at the same time as others in the general vicinity, but doesn’t interact with them. Think of a busy call center where rows of telemarketers are all making their own phone calls. (On second thought, don’t think of that.)

Associative play. Your child plays next to or alongside other kids doing similar activities. They start to adorably talk to or interact with one another but won’t organize or synchronize activities.

Cooperative play. Makin’ you proud — when your child plays with others cooperatively and is interested in both the other kids and the activity.

When babies typically enter this stage

Your baby may start playing — we use the term a little loosely at this age — independently as young as 2 or 3 months, or as soon as they can start seeing bright colors and textures.

As they grow a little more, they’ll take a bigger and bigger interest in toys and objects around them. This may occur from 4–6 months. You can set them up on a mat or blanket on the floor and watch them take an interest in toys, objects, or a play gym without your help.

Solitary play will continue beyond babyhood. Most toddlers and preschoolers around ages 2–3 start to take an interest in interacting and playing with other children, but that doesn’t mean solitary play stops. It’s healthy for your child to play alone from time to time.

If you’re concerned about your little one’s play habits or worried they’re playing alone too often, talk to an amazing resource you have — your child’s pediatrician.

Examples of solitary play

Solitary play for infants is downright adorable and may include:

looking at colorful pictures in board books

sorting and stacking nesting bowls

interacting with their play gym

playing with blocks

Examples of solitary play for toddlers/preschool-aged children — who may choose to play alone even when they are able to play with others — include:

“reading” or flipping through books on their own

working on a project like a Lego set

putting together a puzzle

coloring or painting on large sheets of paper or in coloring books

playing with wooden blocks or a train set

playing in their play kitchen

And because we could all use some additional ideas, here are some more solitary play options for your toddler/preschool-aged child if they’re upset to have no playmates around:

Give your child a “Where’s Waldo” or “I-Spy” book they can look at by themselves.

Watch your child play on a hopscotch board outside they can jump through without your help.

Give your child age-appropriate matching card games they can play on their own.

Look for age-appropriate sets of toys your child can put together on their own, like magnetic wooden blocks, Lego Duplo, or Magna-Tiles.

Benefits of solitary play

Fosters independence

When your child is a newborn, you do everything for them — even hand them a toy. As they grow into the solitary play stage, they’ll start to reach for things nearby on their own. Even though they’re still so young, babies entering this phase start to develop independence.

It may be hard to see now, but they’ll eventually figure out how to problem solve, build, or do a new toy on their own. If you let them be without interfering, you’re allowing your child to become more independent later on. We know, it’s bittersweet.

Helps develop preferences and interests

When your baby is playing independently, they’re also developing their own preferences and interests. Later on, they may be part of a group of children who all like similar toys and activities.

For now, they’re deciding whether they like the red or green ball best. This is a must for understanding what they like and don’t like in the world, research shows.

Develops creativity and imagination

You can set out toys for your little one, but it’s up to them what they decide to play with during solitary play. Their focus is on the objects of their play only, and babies may even become upset if you try to join in or direct the play with the objects in front of them.

Don’t take it personally — developing a mind of their own and laying the foundation for future imagination is a good thing!

Develops powers of concentration, persistence, and completion

Research shows that later on, when your toddler or preschooler chooses to engage in solitary play, they’re in charge of their actions. This allows them to focus on what they want to do and learn to work through problems. They also learn to complete a task.

If this sounds pretty far off for your tiny baby currently playing alone in their play gym and not even able to sit up independently, give yourself a pat on the back anyway — you’re helping to ensure that they’ll be taskmasters before you know it.

Common concerns about solitary play

Solitary play has so many benefits for your child. But around preschool age, if your child hasn’t started interacting or playing with other kids, you may be concerned.

You and your child’s caregivers can slowly start to encourage them to interact with other children who may have similar interests. Keep in mind, all children develop at their own pace, so your kid may start to play with others slightly later. That’s OK.

You can always talk to your child’s pediatrician about any concerns you have about their development. They can recommend a child psychologist or counselor, if needed.

The takeaway

Remember, even when your little one is playing alone, that doesn’t mean you don’t need to supervise them. Sit back and let your young child have their playtime while continuing to keep an eye on them. But try not to interfere unless it’s necessary.

One final note: Try to separate independent or solitary playtime from screen time. They aren’t the same thing. Excessive screen time for toddlers may interfere with healthy development, research shows.

Transthyretin Amyloid Cardiomyopathy (ATTR-CM): Symptoms, Treatment, and More

Medically reviewed by Payal Kohli, MD on July 29, 2019 New — Written by Nancy Moyer, MD

Symptoms

Causes

Diagnosis

Treatment

Risk factors

Outlook

Bottom line

Transthyretin amyloidosis (ATTR) is a condition in which a protein called amyloid is deposited in your heart, as well as in your nerves and other organs. It may lead to a heart disease called transthyretin amyloid cardiomyopathy (ATTR-CM).

Transthyretin is the specific type of amyloid protein that’s deposited in your heart if you have ATTR-CM. It normally carries vitamin A and thyroid hormone throughout the body.

There are two types of transthyretin amyloidosis: wild type and hereditary.

Wild-type ATTR (also known as senile amyloidosis) isn’t caused by a genetic mutation. The protein deposited is in its non-mutated form.

In hereditary ATTR, the protein is formed incorrectly (misfolded). It then clumps together and is more likely to end up in your body’s tissues.

What are the symptoms of ATTR-CM?

Your heart’s left ventricle pumps blood through your body. ATTR-CM can affect the walls of this chamber of the heart.

The amyloid deposits make the walls stiff, so they can’t relax or squeeze normally.

This means your heart can’t effectively fill (reduced diastolic function) with blood or pump blood through your body (reduced systolic function). This is called restrictive cardiomyopathy, which is a type of heart failure.

Symptoms of this type of heart failure include:

shortness of breath (dyspnea), especially when lying down or with exertion

swelling in your legs (peripheral edema)

chest pain

irregular pulse (arrhythmia)

palpitations

fatigue

enlarged liver and spleen (hepatosplenomegaly)

fluid in your abdomen (ascites)

poor appetite

lightheadedness, especially upon standing

fainting (syncope)

A unique symptom that sometimes occurs is high blood pressure that slowly gets better. This happens because as your heart becomes less efficient, it can’t pump hard enough to make your blood pressure high.

Other symptoms you might have from amyloid deposits in other parts of the body besides your heart include:

carpal tunnel syndrome

burning and numbness in your arms and legs (peripheral neuropathy)

back pain from spinal stenosis

WHEN TO SEE THE DOCTOR

If you have chest pain, call 911 immediately.

Seek medical attention right away if you develop these symptoms:

increasing shortness of breath

severe leg swelling or rapid weight gain

rapid or irregular heart rate

pauses or slow heart rate

dizziness

fainting

What causes ATTR-CM?

There are two types of ATTR, and each has a unique cause.

Hereditary (familial) ATTR

In this type, transthyretin misfolds because of a genetic mutation. It can be passed from parent to child through the genes.

Symptoms usually start in your 50s, but they can begin as early as your 20s.

Wild-type ATTR

Protein misfolding is a common occurrence. Your body has mechanisms to remove these proteins before they cause a problem.

As you age, these mechanisms become less efficient, and misfolded proteins can clump and form deposits. That’s what happens in wild-type ATTR.

Wild-type ATTR isn’t a genetic mutation, so it can’t be passed down through the genes.

Symptoms usually start in your 60s or 70s

How is ATTR-CM diagnosed?

Diagnosis can be difficult because the symptoms are the same as other types of heart failure. Tests commonly used for diagnosis include:

electrocardiogram to determine if the heart walls are thick from the deposits (usually the electrical voltage is lower)

echocardiogram to look for thick walls and assess heart function and look for abnormal relaxation patterns or signs of increased pressure in the heart

cardiac MRI to look for amyloid in the heart wall

heart muscle biopsy to look for amyloid deposits under a microscope

genetic studies looking for hereditary ATTR

How is ATTR-CM treated?

Transthyretin is mainly produced by your liver. For this reason, hereditary ATTR-CM is treated with a liver transplant when possible. Because the heart is often irreversibly damaged when the condition is diagnosed, a heart transplant is usually done at the same time.

In 2019, the Food and Drug Administration (FDA)Trusted Source approved two medications for the treatment of ATTR_CM: tafamidis meglumine (Vyndaqel) and tafamidis (Vyndamax) capsules.

Some of the symptoms of cardiomyopathy can be treated with diuretics to remove excess fluid.

Other medications usually used to treat heart failure, such as beta-blockers and digoxin (Lanoxin), can be harmful in this condition and shouldn’t be routinely used.

What are the risk factors?

Risk factors for hereditary ATTR-CM include:

a family history of the condition

male gender

age over 50

African descent

Risk factors for wild-type ATTR-CM include:

age over 65

male gender

What is the outlook if you have ATTR-CM?

Without a liver and heart transplant, ATTR-CM will get worse over time. On average, people with ATTR-CM live 2.5 to 4 yearsTrusted Source after diagnosis.

The condition can have an increasing effect on your quality of life, but treating your symptoms with medication can help significantly.

The bottom line

ATTR-CM is caused by a genetic mutation or is age-related. It leads to symptoms of heart failure.

Diagnosis is difficult because of its similarity to other types of heart failure. It gets progressively worse over time but can be treated with a liver and heart transplant and medication to help control symptoms.

If you experience any of the symptoms of ATTR-CM listed earlier, contact your doctor.

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Here’s What You Need to Know About Popping in Pacifiers to Soothe Newborns

Medically reviewed by Karen Gill, MD, specialty in pediatrics, on July 29, 2019 New — Written by Noreen Iftikhar, MD

When to start

During sleep

Benefits

Risks

Pacifier tips

Weaning off pacifier

Takeaway

Why are pacifiers such a big deal?

As with most things related to newborns, using a pacifier can come with pluses and minuses. If your newborn is taking one (some don’t!), it’s probably their favorite go-to accessory. And while thoughts of braces in your baby’s future run through your head, you’re probably more than a little thrilled that it soothes their crying.

Ahh, enjoy that silence. But then worry pops back into your head because you wonder if this carefree sucking might be habit-forming or interfering with feedings.

Your baby loves the pacifier, but is it healthy?

Go ahead and pop that pacifier back into junior’s mouth. Not only is it super cute to see baby sucking away, the paci is also good for them — and you — in more ways than one.

Pacifiers have endless nicknames including soothers, dummies, binkies, soo soos, and buttons. But whatever you call them, you’re probably aware that pacifiers can bring joy to your little bundle of joy (read: more joy to you). As the names suggest, pacifiers help soothe and calm babies.

Sucking is a normal reflex in newborn babies. In fact, it begins even before birth. It helps your baby practice feeding from the breast or a bottle. Sucking without feeding — called non-nutritive sucking — is also natural for babies.

So pacifiers are popular for good reason. In Western countries, up to 75 percent of babies use binkies at some point.

When can my newborn start using a pacifier?

There’s no right or wrong answer about how soon you should give your newborn a pacifier. But if you’re breastfeeding, the American Academy of Pediatrics (AAP)  generally recommends waiting until you and your baby have a nursing routine down pat. This may mean waiting up to four weeks for your baby to avoid nipple confusion.

What on earth is nipple confusion, and why didn’t they tell you about this in the hospital? Well, sucking on a nipple is different — clearly from your side of things, but also for baby — than sucking on a pacifier.

Some newborns may find it easier to suck on the pacifier. This can make it more difficult for them to latch on for breastfeeding. Or, they may use their energy to suck on the pacifier and then fall asleep or be less interested in breastfeeding when feeding time comes.

Breastfeeding can be even more difficult for preterm babies. This is because they may have smaller sucking muscles. Your nurse or doctor may recommend waiting to use a pacifier. However, every baby is different.

A 2013 AAP study suggested that offering pacifiers may help babies breastfeed only. The research followed babies in a newborn unit who were breastfed with and without also being offered pacifiers:

Almost 79 percent of babies with pacifiers available were breastfed only without being given any formula feedings.

By contrast, after restricting pacifiers, about 68 percent of babies breastfed only.

So, one theory is that pacifiers may help keep babies content and distracted between breastfeedings. Without them, some mothers may offer the bottle between breastfeeding sessions. But it’s hard to say conclusively, and more research is needed, so talk to your doctor.

If you baby is exclusively bottle-feeding from the start, you should be able to give a soothing pacifier right away.

Is it OK for my baby to have a pacifier during sleep?

Even if your little one isn’t crying, sucking a pacifier may help them fall asleep and stay asleep longer — which means more sleep for you, too.

What’s even better? Pacifiers are also linked to lowering the risk of sleep-related death in babies. Sudden infant death syndrome (SIDS) is the most common  cause of death in babies between 1 month and 1 year.

Several medical studies have found that giving your baby a pacifier while they sleep may be associated with a reduced risk of SIDS, possibly by more than half.

Medical organizations are taking note, too. The AAP’s safety guidelines against SIDS advises that pacifiers help even if they fall out after your baby nods off. So go ahead — pop the pacifier in your newborn’s mouth and rest a little easier.

Why do pacifiers make sense at night?

Pacifiers may help protect your baby from SIDS and suffocation during sleep for several reasons. They might make it harder for your baby to roll over onto their stomach. Tummy time is great under your watchful eye, but sleeping on the stomach is the riskiest position for SIDS.

A pacifier also blocks your baby’s face from accidently getting too close to the mattress, a pillow, or blanket. (That being said, your infant’s crib should be as empty as a florist shop the day after Valentine’s Day — no pillows, blankets, or stuffed animals inside it.)

Other researchers think that sucking on a pacifier might help babies develop better nerve reflexes and breathing muscles.

Give your baby their favorite pacifier as you lay them down (on their back) for sleep or a nap. If the pacifier falls out mid-sleep, it’s perfectly OK. If they wake up or cry, try popping the pacifier back in.

Benefits of pacifiers

Pacifiers are as important as baby wipes — and arguably have just as many benefits. Keep a few on hand to give to your newborn: at home, in your car, and in your purse.

Rest assured that a pacifier is less habit-forming than sucking on a thumb, and habits are unlikely to form before 6 months of age, period.

During sleep and nap time, pacifiers help:

babies fall asleep and stay asleep

babies relax and self-soothe back to sleep if they wake up

Pacifiers may also help:

prevent SIDS in newborns

your baby exclusively breastfeed, if that’s what you want

your baby stay content between feedings longer

Pacifiers help soothe and distract babies:

during general fussiness

from general anxiety or fear

when they’re sick or colicky (heaven forbid, but it happens)

when they’re getting a check-up or shots

when they’re being bathed but before they take to the water

During flights and travel a pacifier may:

help ease anxiety

help relieve ear pain from air pressure changes

Risks of pacifiers

There are a few risks to keep in mind with pacifiers.

Nipple confusion can occur if a pacifier is used too soon, and your baby may:

prefer the pacifier to latching onto your breast

get tired and breastfeed for short periods only

They can also be habit-forming, but generally only over the age of 6 months. If this happens, your precious little one might:

become dependent on a pacifier to self-soothe while awake

wake up and cry if the pacifier falls out during sleep

Illness can also occur if the pacifier isn’t cleaned often and adequately. They may:

spread germs

increase the risk of ear infections (more common after the age of 6 months)

And finally, using a pacifier for too long can famously interfere with your baby’s incoming teeth. They can cause baby teeth to grow in slightly crooked.

Pacifier manufacturers have developed new shapes and sizes to combat this, and also keep in mind that baby teeth aren’t permanent. (The tooth fairy will be draining your pockets before you know it.)

Tips for using a pacifier to keep everyone happy

Use one-piece pacifiers that can’t come apart. This reduces the risk of choking.

Look for pacifiers that are made from natural rubber and other safe materials.

Avoid pacifiers that contain harmful chemicals like bisphenol-A (BPA).

Clean pacifiers by boiling in sterile water for a few minutes.

It’s even OK to suck your baby’s pacifier clean sometimes — this might help prevent allergies later on.

All good things must come to an end

When your baby (or toddler) starts using their pacifier as a chewing toy or teether, it might be time to wean him off of it. One sign that your baby is chewing the pacifier rather than sucking it is nonstop drool.

As with toilet-training, there are several different ways to cut the proverbial umbilical cord to baby’s pacifier. Try these tips to find out what works for your little one:

take it away cold turkey (and brave the tantrums)

give them the pacifier only at certain, consistent times — the slow and steady approach

limit the pacifier to one place, such as their crib

offer your child other ways to self-soothe — like a favorite blanket or toy

The takeaway

Pacifiers are safe for your newborn. When you give them one depends on you and your baby. You might prefer to have them practically come out of the womb with a pacifier and do just fine. Or it may be better to wait a few weeks, if they’re having trouble latching onto your breast.

Pacifiers have pros and cons. A very important benefit is that they are associated with lowering the risk of sleep-related deaths in newborns, especially babies under the age of 4 months.

As for the cons, you don’t have to worry about teething problems or ear infections due to pacifiers just yet if you have a newborn. Baby teeth begin to appear at about 6 months. Ear infections are also more common in babies at this age.

The AAP advises that its best to wean your baby off the beloved pacifier around the age of 1 year. Until then, enjoy every moment!

13 Things to Know Before Getting a Brazilian Wax

Medically reviewed by Cynthia Cobb, DNP, APRN on July 29, 2019 New — Written by Jen Anderson

Brazilian vs. bikini

Benefits

Side effects and risks

Period, pregnancy, and piercings

When you shouldn't wax

Pain

Find a salon

How to prep

During the appointment

Aftercare

Ingrown hairs and irritation

Result longevity

Takeaway

What is a Brazilian wax?

With a Brazilian wax, pubic hair is groomed and removed from the front of the pubic bone, around the external genitals, between the upper thighs, and around the anus.

Depending on your preferences, you can choose to remove all hair in the area or leave a small strip of hair in the front.

How is this different from a bikini line wax or bikini full wax?

Basic bikini line waxes typically clean up hair in the bikini region, wherever hair could poke out from a swimsuit bottom: on the sides of the bikini (or underwear) line and between the belly button and pubic bone.

Bikini full waxes include everything in a bikini line wax, as well as hair removal on the front of the pubic bone. Here, you can choose to leave behind a strip, triangle, or square of hair.

The Brazilian goes a step further by offering complete pubic hair removal: from the front of the pubic bone to the area underneath, called the perineum, to the anus.

Are there any benefits?

Absolutely. Outside of a smoother bikini region, waxing is a form of deep exfoliation.

According to the American Academy of Dermatology, this type of physical exfoliation removes dead skin cells from the top layer of skin to promote collagen production and boost the efficacy of topical treatments.

This form of hair removal is also one of the least irritating to the skin.

If done properly, waxing is less likely to cause an unwanted rash, bumps, or other irritation than using an epilator or shaving.

But that’s not all. Waxing pulls out hair from the root.

When hair grows back in the same place, it’s usually weaker, softer, and thinner than before.

This means that, over time, you’ll have less hair to groom — and the hair that remains will be more manageable.

Are there any side effects or risks to consider?

As with any other form of hair removal, waxing has some potential side effects.

You may notice redness or bumps immediately after your wax — this is incredibly common and should subside within the next 24 hours.

To help with the healing process, you can apply lotions or serums made for the pubic region. These can also help prevent any ingrown hairs.

If you’re not used to pubic hair removal, you may also experience some itchiness.

Resist the urge to scratch! This could cause further irritation or micro-tears in the skin, and you definitely don’t want that.

Instead, apply a topical hydrocortisone cream or aloe vera gel to soothe the area.

Some research suggestsTrusted Source that pubic hair removal of any kind may be associated with an increased risk for sexually transmitted infections (STIs).

Although much less common than redness or itching, waxing can cause small breaks in the skin. This could leave you more susceptible to STIs that are transferred between skin-to-skin contact.

Can you get waxed if…?

Interested in getting a Brazilian but unsure if it’s the right move? There are a few things to consider, depending on your circumstances.

You’re on your period

You may want to consider rescheduling your appointment. When you’re menstruating, the skin around your pubic bone becomes a little more sensitive and you’re more prone to cramping.

If you’re still down to get waxed, make sure you wear a tampon or reusable cup to your appointment. Most professionals won’t wax if you’re using a pad or free flowing.

You’re pregnant

You may want to check with your doctor if you’re in the last trimester. Otherwise, you’re probably in the clear. Just keep in mind that your hormones are changing and this could affect your pain tolerance.

You have genital piercings or tattoos

If you have a tattoo, waxing can actually help exfoliate the area and make your ink appear more prominent.

When it comes to genital piercings, your wax technician will likely ask for you to remove your stud. If you’re unable to remove the piercing, they will simply work around the area. Just know that you might have a few stray hairs near the piercing.

Is there anyone who shouldn’t get a wax?

Your skin might be more sensitive if you’re taking antibiotics, hormone replacements, or hormonal birth control.

You can probably still get waxed, but you should check with your doctor to be sure.

You should also check in with your doctor if you’re taking oral acne medications, such as Accutane, or using topical retinoids, such as Retin-A.

These medications weaken the skin barrier through chemical exfoliation, and waxing could result in painful overexfoliation.

Radiation and chemotherapy can also lead to an uptick in skin sensitivity and dryness, so waxing may not be the most comfortable hair removal method.

How painful is it?

It’s not a walk in the park, that’s for sure. It really depends on what your individual pain tolerance is.

The first appointment is usually the worst in terms of pain, so keep this in mind. The second appointment may feel drastically different.

As a general rule, hard waxes tend to hurt less than soft waxes.

If you’re worried about pain levels, try finding a salon that uses hard waxes.

How do you find a reputable salon?

Do your research! Look up salons in your area and see which ones have the best reviews.

You’ll also want to make sure your salon doesn’t double dip applicators or skip out on wearing gloves.

Reputable salons will usually have you fill out a client questionnaire or do a quick consultation to get to know you and your health history beforehand.

If anything, talk to your friends and see where they’ve gone. Sometimes, word of mouth is the best way to figure out where go.

What should you do before your appointment?

Check in with yourself before the appointment to make sure you’re ready. You should:

Make sure your hair is at least ¼-inch long — about the size of a grain of rice. If it’s longer than ½ inch, you may want to trim it slightly so the wax is able to grip better.

Gently exfoliate with a buffing mitt or wash cloth a couple days before your appointment to help prevent ingrown hairs.

Avoid tanning for at least 24 hours before your appointment, as this can cause the skin to be more sensitive.

Cut down on alcohol and caffeine the day of your appointment. Both can cause your pores to tighten and make waxing more painful.

Wear breathable, cotton underwear or loose bottoms to your appointment for maximum comfort.

Take an over-the-counter pain reliever about 30 minutes before your appointment to help lessen pain.

Arrive at least 10 minutes early to your appointment so you can check in and use the bathroom, if needed.

What happens during the appointment?

Your first appointment will probably take around 30 minutes to an hour, depending on how much hair you have and how much you want to get removed during your session.

Here’s what you can expect:

Your wax technician will ask you to get undressed from the waist down and hop up on the table.

Before the technician does anything, they’ll likely ask you for your preferences. Let them know if you want a bikini line wax, bikini full, full Brazilian, or any strips of hair left.

Next, the tech will do some cleansing to ensure that the wax has a clean surface to stick to.

Once the area is clean, they’ll go in with a pre-wax treatment, usually an oil or powder, to ensure that the skin is protected.

Then, the waxing! Depending on the type of wax, your technician will either use paper or cloth to remove your hair. Smaller strips might be used underneath and around the anus while larger strips will be used on the front of the pubic bone.

If the technician misses any hairs, they’ll clean it up with tweezers.

Finally, they’ll rejuvenate the area with a serum or cream to soothe irritation and prevent any ingrown hairs.

When you go to pay, make sure to tip at least 20 percent. This is the standard for most salons.

What should you keep in mind immediately after your appointment?

Immediately after your appointment, make sure that you’re treating the area with a little more TLC than normal:

If there’s any tenderness or redness, apply a hydrocortisone cream or a cool compress.

Avoid sexual activity for at least 24 hours. This will give any micro-tears time to heal before engaging in any genital-to-genital contact.

Avoid strenuous activity, like a medium- or high-impact workout class, and soaking in water for at least 24 hours. A shower is fine, but a bath might cause irritation.

Avoid tanning for at least 24 hours afterward. The deep exfoliation can make the pubic area more susceptible to sun damage.

Resist the urge to shave or otherwise remove any stubble or errant hairs that pop up. This removal can increase the risk of ingrown hairs before your next waxing appointment.

What can you do to minimize ingrown hairs and other bumps?

Ingrown hairs are a major pain — no pun intended.

To help prevent any from popping up, do a gentle exfoliation a few days before your appointment.

Steer clear from harsh physical or chemical exfoliants. All you need for a gentle exfoliation is a washcloth.

If you end up with ingrown hairs, don’t pick! This will only cause further irritation and potential scarring.

Instead, apply a bikini-safe treatment like fur Ingrown Concentrate or Anthony Ingrown Hair Treatment to help heal, soothe, and repair the skin around the trapped hair.

How long will the results last?

This depends on how fast your hair grows and how dark your hair is.

Typically, it lasts around three to four weeks. Once the hair is at least ¼-inch long, you can go in for another wax.

In the meantime, be careful to resist shaving — it can lead to more itchiness, irrit

In the meantime, be careful to resist shaving — it can lead to more itchiness, irritation or ingrown hairs.

If you stick to a monthly waxing schedule, you’ll likely find that waxing becomes easier and less painful over time.

If you don’t keep up with a schedule, you’ll disrupt the hair growth cycle and have to start from scratch all over again. Unfortunately, this means it will be more painful the next time you go.

The bottom line

When it comes to bikini waxes, a Brazilian might not be the most comfortable, but it could be the perfect fit for your lifestyle.

The most important thing to remember is that if you don’t enjoy your wax, there’s no requirement to keep doing it.

Talk to a doctor, do your research, and experiment with different methods until you find the one that works best for you.

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How To Manage the ‘Period Flu’ (Yes, It’s a Thing)

Medically reviewed by Meredith Wallis, MS, CNM, ANP on July 29, 2019 New — Written by Adrienne Santos-Longhurst

Symptoms

Cause

Pregnancy

Treatment

See a doctor

Takeaway

The period flu isn’t a legit medical term, but it sure does sum up how crummy some people feel during their period.

Flu-like symptoms such as headache, nausea, and even fever are just some of the complaints that have people wondering if they’re getting sick or going crazy during that time of the month.

The good news: You’re not crazy or alone — period flu is definitely a thing, based on anecdotal evidence. And it has nothing to do with the actual flu, so there’s that.

The bad news: It’s still poorly understood and not always acknowledged in the medical community.

Read on to learn more about why you might feel like you have the flu before or during you period and what symptoms warrant a visit to a doctor.

What are the symptoms?

The wild ride caused by hormones can vary greatly from one person to another. Some people experience period flu symptoms in the days just before their period that are part of what’s called premenstrual syndrome (PMS). Others feel lousy throughout their period.

The symptoms are pretty varied, too, and can include:

nausea

headache

dizziness

diarrhea

constipation

fatigue

muscle aches

cramps

fever or chills

Why does it happen?

Experts aren’t totally sure about what causes this phenomenon, but hormone fluctuations throughout your menstrual cycle are the most likely culprit.

Before your period, prostaglandins, which are hormone-like fatty acids, are produced to help your uterus shed its lining.

Excess prostaglandins make their way into your bloodstream, which can cause a whole bunch of period symptoms, like cramps, period poop, and farts — don’t pretend you don’t know what I’m talking about.

Cyclic changes in your sex hormones, mainly estrogen, can also cause you to feel run down, along with causing your more run-of-the-mill period symptoms, like cramps, breast tenderness, and mood swings.

Chemical changes in your brain, such as fluctuations in serotonin and other chemicals related to mood states, may also trigger some PMS symptoms, according to the Mayo Clinic. These include fatigue, sleep problems, food cravings, and depression.

Could it mean I’m pregnant?

Feeling queasy and fatigued as you wait for your period to turn up could set off alarm bells and have you running to the drugstore for a pregnancy test.

Early symptoms of pregnancy and PMS  cause many of the same symptoms, like nausea, bloating, fatigue, and breast swelling and tenderness.

But unless your period is late, there’s no link between common period flu symptoms and pregnancy.

Is there anything I can do?

Period flu symptoms can make it hard to function, but there are several things you can do for relief. Certain lifestyle changes and therapies can also help you prevent or at least minimize future symptoms.

To get relief now

Here are some things you can do to ease your symptoms:

Take an over-the-counter (OTC) pain medication. OTC anti-inflammatories, such as ibuprofen (Advil), can ease muscle aches, cramps, headaches, and breast pain. Taking an anti-inflammatory before your period starts may lessen pain and bleeding.

Use a heating pad. A heating pad  can help relieve cramps and muscle aches. Place a heating pad over your lower abdomen for 15 minutes at a time as needed throughout the day.

Take an antidiarrheal drug. OTC medications for diarrhea, including loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol), can stop diarrhea. Pepto-Bismol can also help with other tummy issues, such as nausea and upset stomach.

Stay hydrated. Drinking enough water is always important, but even more so if PMS is making you want to eat all the food, including salty snacks. Staying hydrated can help keep headaches at bay and prevent compulsive eating before your period.

To prevent future bouts

Here are some things you can start doing to improve your periods and prevent, or at least reduce, those icky period flu symptoms during your next cycle:

Exercise regularly. Exercise has been shown to improve a lot of the discomfort associated with periods, including cramps, depression, and lack of energy.

Eat healthy foods. Eating healthy is always a good idea, but making healthier choices in the two weeks leading up to your period can reduce PMS symptoms. Cut back on your alcohol, sugar, salt, and caffeine intake.

Quit smoking. ResearchTrusted Source shows that smoking worsens PMS symptoms. A 2018 study also linked smoking to irregular periods and early menopause. If you currently smoke, talk to a healthcare provider about a smoking cessation program to help you quit.

Get enough sleep. Aim to get at least seven hours of sleep every night. Sleep deprivation has been linked to depression, anxiety, and mood swings. Not getting enough sleep can also cause food cravings and compulsive eating, and trigger headaches.

Get more calcium. Calcium may help to reduce the severity of PMS symptoms. You can take a calcium supplement or add more calcium-rich foods to your diet.

Take vitamin B-6. Vitamin B-6 can help ease some period-related symptoms, including moodiness, bloating, and irritability. You can take a B-6 supplement or get B-6 through foods such as poultry, fish, fruit, and potatoes.

When to see a doctor

Some discomfort during your period is normal, but symptoms that interfere with your daily activities should be discussed with your healthcare provider. They could be a sign of an underlying condition that needs treatment.

Period symptoms you shouldn’t ignore  include:

heavy periods

missed or irregular periods

painful periods

unexplained weight loss

pain during sex

The bottom line

While it’s not recognized as an official diagnosis, the period flu appears to be very real for some people. It isn’t totally clear what causes it, but hormonal fluctuations likely play a big role.

While lifestyle changes and home treatment can usually help, talk to your healthcare provider if your symptoms are getting in the way of your daily life.

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How to Try CBD for Depression

Medically reviewed by Zara Risoldi Cochrane, PharmD, MS, FASCP on July 29, 2019 New — Written by Kimberly Holland

Benefits

Research

CBD vs. antidepressants

For anxiety

Side effects

How to use

Where to buy

Takeaway

Cannabidiol (CBD) is a type of natural compound known as a cannabinoid. Cannabinoids are found in the plant Cannabis sativa. This is the same plant that produces marijuana.

CBD, however, does not cause psychoactive effects like marijuana does. The “high” or euphoria caused by marijuana is the result of another type of cannabinoid, tetrahydrocannabinol (THC).

CBD can also be derived from the hemp plant, a cousin of the marijuana plant.

CBD has seen a surge in popularity in recent years, as new research explores its potential health benefits. Some research suggests that CBD oil and other CBD products may be beneficial for symptoms of depression.

How can it help?

If you’re looking into using CBD for therapeutic purposes, it’s important to understand that the research around CBD is limited. There have been a lot of studies in the last decade, but most of them were done using animals.

That means the possible benefits of CBD oil for depression in humans are mostly speculative right now.

Still, CBD does appear to have some benefits for depression, especially for dealing with:

anxiety

cognitive impairment

discomfort before public speaking

CBD oil may also be helpful for conditions potentially related to depression, such as chronic painTrusted Source.

What does the research say?

Experts believe that CBD’s potential benefits for depression are related to its positive effect on serotonin receptors in the brain.

Low serotonin levels are likely connected to depression. CBD doesn’t necessarily boost serotonin levels, but it may affect how your brain’s chemical receptors respond to the serotonin that’s already in your system.

A 2014 animal study found that CBD’s effect on these receptors in the brain produced both antidepressant and anti-anxiety effects.

A more recent 2018 reviewTrusted Source of existing studies concluded that CBD has anti-stress effects, which may reduce depression related to stress.

As mentioned, this is an area that’s still being actively studied, and new research and reviews are published every year. As researchers begin to better understand CBD oil and its potential benefits or concerns, information about how to most effectively use the product will continue to change.

How does it compare to antidepressant medications?

When it comes to treating depression, CBD does appear to have some benefits over antidepressant medications.

Most antidepressant medications take weeks to start working. However, a 2019 animal studyTrusted Source found that CBD has a fast and sustained antidepressant-like effect.

CBD may also result in fewer side effects than antidepressant medication. Insomnia, sexual dysfunction, mood swings, and agitation are common side effects of antidepressants. CBD has not shown similar issues.

Caution

While CBD may offer some benefits over antidepressant medications, it isn’t a replacement. Never stop taking prescribed medication, especially antidepressants, without talking to your healthcare provider first.

Abruptly stopping medication that’s been prescribed to you can cause serious side effects. If you want to stop taking medication, work with your healthcare provider to come up with a plan for gradually decreasing your dosage.

What if I also have anxiety?

Depression and anxiety commonly occur together, and people with one are more likely to have the other. CBD does appear to help with both.

One studyTrusted Source found that people who took 600 milligrams (mg) of CBD experienced significantly less social anxiety than people who took a placebo. Another studyTrusted Source used a smaller dose of 300 mg, which still reduced levels of anxiety.

Anxiety may also have a link to low serotonin, so CBD’s effect on serotonin receptors might partly explain these beneficial effects.

Does it cause any side effects?

So far, CBD doesn’t appear to cause many side effects. But some people may be more sensitive to it and experience:

diarrhea

dry mouth

nausea or vomiting

fatigue

irritability

changes in weight or appetite

It’s hard to know if CBD causes any long-term side effects due to a lack of research. So far, experts haven’t identified any major long-term risks.

Keep in mind that this doesn’t mean there aren’t any. It simply means that researchers haven’t encountered any yet.

In a 2017 reviewTrusted Source, the World Health Organization concluded that CBD is generally safe. They noted that adverse effects may be caused by interactions between CBD and medications.

To minimize your risk of side effects, make sure to talk to your healthcare provider before trying CBD if you regularly take medication, including over-the-counter medications and herbal supplements.

How do I use it?

CBD is available in four formulations:

Oral. This includes tinctures, capsules, sprays, and oils. These mixes can be taken as they are, or they may be used in other preparations, such as smoothies or a coffee.

Edible. Drinks and foods, such as CBD-infused gummies, are now widely available.

Vaping. Vaping with CBD oil is one way to quickly ingest the compounds. However, there’s some debate over the long-term safety of this method. In addition, it can also cause coughing and throat irritation.

Topical. CBD-infused beauty products, lotions, and creams are a big business right now. These products incorporate CBD into things you apply directly to your skin. However, this formulation is likely best for pain, not mental health uses.

Where do I buy CBD?

Hemp-derived CBD is legal in most U.S. states. Marijuana-derived CBD, however, isn’t as widely available.

If you want to try CBD, you’ll need to find a reputable seller. Hemp-derived CBD is widely available in most areas. You may even find it in some health food stores. Marijuana-derived CBD is only sold in dispensaries in states where marijuana is legal for medicinal or recreational use.

Keep in mind that the Food and Drug Administration (FDA) does not regulate CBD oil or any CBD products. Like other supplements, CBD is often not inspected for quality, safety, or purity.

If you’re interested in buying CBD, look for brands that are reputable and trustworthy. You can usually determine if a brand is reputable by checking if they conduct third-party lab testing of their products.

The bottom line

CBD is becoming an increasingly popular remedy for a range of health issues, including depression. If you’re interested in trying CBD oil, talk with your healthcare provider.

While studies show the compound is generally safe, it may interact with medications. It’s a good idea to review medications and other supplements you’re taking before you begin using CBD.

Homemade Bug Spray Recipes for Your Skin, Home, and Yard

Medically reviewed by Vincent J. Tavella, MPH on July 29, 2019 New — Written by Jandra Sutton

Natural bug repellents

Safety

DIY recipe for skin

DIY recipe for home

DIY recipe for plants

More prevention tips

Bottom line

Not everyone is comfortable using synthetic chemicals and pesticides to ward off bugs. Many people are turning to natural, environmentally friendly remedies for repelling insects, and homemade bug sprays are an easy solution. Not only are they typically safe for human use, they’re generally effective too.

This article will take a closer look at some of the natural ingredients that may help keep bugs at bay, and how you can use these ingredients to make your own bug spray.

What natural ingredients help repel bugs?

While the Environmental Protection Agency (EPA) requires most skin-applied insect repellants to be registered for both human safety and effectiveness, the agency has also listed several natural ingredients as minimum risk pesticides.

It’s important to note that while these ingredients are safe for human use, the EPA does not evaluate them for effectiveness.

Here are some popular natural ingredients that may help repel bugs in your home and yard.

Citrus oils

Citronella and citrus oils like limonene are popular and well-known insect repellents. Studies suggest citronella helps repel mosquitoes, and it may also be effective  against kissing bugs, fleas, aphids, mites, and flies.

Garlic oil

ResearchTrusted Source suggests that garlic oil may help with repelling ticks. Plus, the Centers for Disease Control and Prevention (CDC)Trusted Source lists garlic oil as a natural tick repellent for use in yards and gardens.

Thyme essential oil

A 2005 studyTrusted Source suggest that thyme essential oil helps repel mosquitoes. However, thyme oil isn’t considered safe for use on your skin unless diluted.

Oil of lemon eucalyptus

A 2016 reviewTrusted Source concluded that oil of lemon eucalyptus is an effective natural mosquito repellent. Plus, according to the CDC, products containing oil of lemon eucalyptus are effective against mosquitoes.

Oil of lemon eucalyptus shouldn’t be confused with lemon eucalyptus essential oil which isn’t effective at repelling mosquitoes.

Dill essential oil

Looking to repel bugs indoors? One studyTrusted Source concluded that dill effectively repels cockroaches. However, the oil should be diluted before using it on your skin.

Cinnamon oil

If mosquitoes are a major concern, cinnamon oil may be a good option to consider. One studyTrusted Source concluded that cinnamon oil helped repel mosquitoes both in a lab setting and outdoors. Another studyTrusted Source suggested cinnamon oil may be effective in killing mosquito larvae as well.

However, cinnamon oil can cause skin reactions, so be sure to dilute it before using it on your body, or stick to using it in the yard.

Lavender essential oil

Lavender oil isn’t only helpful for relaxation and sleep. It can also be effectiveTrusted Source at repelling mosquitoes. Plus, lavender is usually considered safe for topical use without diluting it.

Peppermint oil

Studies suggest that peppermint oil works to both kill and repel mosquitoes. Plus, another study concluded that peppermint oil may be effective at keeping spiders away as well.

Safety tips

Many of these ingredients are considered natural and safe for human use. However, it’s important to remember that not all essential oils are safe for topical use. If you’re planning to use essential oils on your skin, you may need to dilute them with a carrier oil.

Certain essential oils, like citrus oils, can be phototoxic when applied directly to the skin. This means that sun exposure may cause severe burns and even skin cancer.

Homemade bug spray recipe for your skin

When it comes to making a bug spray recipe that’s safe on your skin, make sure that you’re choosing essential oils that are safe and effective for topical application.

For an easy and natural mosquito repellent  for your skin, you’ll need the following:

glass spray bottle

oil of lemon eucalyptus or lavender essential oil

witch hazel

Then, follow these steps:

Mix 1 part oil of lemon eucalyptus or lavender essential oil with 10 parts witch hazel in the bottle. (For each drop of oil, use 10 drops of witch hazel.)

Shake gently to mix.

Spray to apply.

Homemade bug spray recipe for your home or yard

You can also create a homemade bug spray to use around your house or yard. Remember, while many essential oils are safe and effective for repelling insects, that doesn’t mean they’re safe for topical use.

For a DIY indoor/outdoor bug spray, you’ll need the following:

glass spray bottle

lavender essential oil

oil of lemon eucalyptus

citronella essential oil

distilled water

white vinegar

Then follow these steps:

Mix 10 to 20 drops of each essential oil with 2 ounces distilled water and 2 ounces of white vinegar.

Shake gently to mix.

Spray to use.

Homemade bug spray recipe for plants

While some homemade bug sprays can help keep bugs away from your plants, others — like cinnamon essential oil — can cause damage to the plants themselves.

For a DIY recipe that won’t harm your plants, try diluting a few drops of thyme essential oil with distilled water. Mix in a glass spray bottle and spritz on your plants.

Other tips to prevent bug bites

No one likes dealing with bug bites. Besides using a bug spray or repellant, there are other steps you can take to help protect yourself.

Wear light-colored, loose-fitting clothing, especially when you’re outdoors.

Make sure your clothing covers your arms, legs, ankles, and feet.

To avoid mosquito bites, try to stay indoors at dusk and dawn.

Use citronella candles when you’re outdoors for additional protection.

Avoid wearing scented lotions and perfumes outside.

Get rid of standing water in gutters, birdbaths, planters, pots, and wheelbarrows.

Keep any food or drinks covered.

The bottom line

Although synthetic insect repellents are considered safe for human use, natural alternatives are growing in popularity. While studies suggest that many natural ingredients may be effective in repelling insects, more research is needed.

If you want to make a homemade bug spray, make sure you know about the safety of the ingredients you’re using. Even natural ingredients can be unsafe in certain situations.

The Benefits of Wide Pushups and How to Do Them

Medically reviewed by Daniel Bubnis, MS, NASM-CPT, NASE Level II-CSS, specialty in fitness, on July 29, 2019 New — Written by Emily Cronkleton

Benefits

How to

Safety

Variations

When to do

Bottom line

Wide pushups are a simple yet effective way to build your upper-body and core strength. If you’ve mastered regular pushups and want to target your muscles a little differently, wide pushups are a good option.

By positioning your hands further apart, wide pushups target your chest and shoulder muscles more than standard pushups. They offer other benefits, too.

To do wide pushups, you don’t need any gear besides your own body weight. This means you can do them anywhere and anytime you want.

In this article, we’ll take a closer look at the benefits of wide pushups, how to do them, and variations you can try.

What are the benefits of a wide pushup?

According to the American Council on Exercise, wide pushups can increase muscle strength and endurance in your:

chest (pectoralis)

shoulders (anterior deltoid)

upper arms (triceps)

A 2016 studyTrusted Source found that doing pushups with a wider hand placement can also work your serratus anterior muscle harder than a standard pushup.

This often neglected muscle, which spans your upper ribs, helps you move your arms and shoulders. It also provides support to your neck and back muscles.

According to the Mayo Clinic, wide pushups are also a beneficial core stability exercise. Having strong core muscles can enhance your balance and posture, protect your back from injury, and make almost any movement easier.

Additionally, according to the National Academy of Sports Medicine, changing hand positions doesn’t only provide variety, it also allows you to use a different range of motion, which can help prevent overuse injuries.

How to do a wide pushup

As with all exercises, it’s important to use proper form. Doing so can help you reap the most benefits and avoid injury.

To do a wide pushup with correct form, keep these pointers in mind:

Keep your shoulders, spine, and hips in a straight line.

Lengthen your spine to keep your back straight.

Make sure your hips don’t sag down or point upward.

Look at a spot on the floor ahead of you as you keep your neck neutral.

Engage your core and gluteal muscles when you do the exercise.

Once you’re ready to start, follow these instructions:

Start in plank position with your hands wider than your shoulders.

Face your fingers forward or slightly to the outside.

Slowly bend your elbows out to the side as you lower your body toward the floor.

Pause when your chest is just below your elbows.

Engage your core as you press into your hands to lift your body back to the starting position.

Do 1 to 3 sets of 8 to 15 repetitions.

If you have good upper-body strength, you can build up to do 3 to 4 sets of 20 to 30 repetitions.

The key is to start slowly and gradually increase the number of sets and repetitions as you get used to this exercise.

Safety tips

Be sure to warm up before doing a set of wide pushups. Try doing some dynamic stretches, like arm circles or arm swings, to get your muscles warmed up and relaxed.

Do wide pushups with caution, especially if you have any injuries or have had an injury in the past. This is especially important for shoulder, back, or wrist injuries.

If you aren’t sure if a wide pushup is safe for you, talk to your doctor, physical therapist, or a certified personal trainer before trying it.

To avoid muscle strains, don’t push yourself beyond your limits. Stop immediately if you experience pain.

You can avoid repetitive injuries by cross-training, or doing exercises that target other muscle groups.

Variations of a wide pushup

Easier variation

If you’re a beginner, you can try doing this exercise on your knees instead of your toes. This may help you pay attention to your form and the proper alignment of your shoulders, back, and hips.

Once you have the correct form down, and have built up your strength, you can transition to the regular wide pushup.

More challenging variation

To make a wide pushup more challenging, try one of the following:

Place your feet on an elevated surface, such as a bench, step, or box.

Place one foot on a basketball or volleyball and the other foot on the floor.

Put both feet on a ball.

Place a weight plate on your back.

Another option is to try staggered-hand pushups by placing one hand in the usual position, below your shoulder, and your opposite hand out wide. This can work one side of your chest at a time.

What’s the best way to add a wide pushup to your workout?

Wide pushups are a versatile exercise. You can do them:

as part of your warmup routine, after doing dynamic stretches

mixed into your cardio or strength-training workout

at the end of a weightlifting session

Aim to do wide pushups 3 to 4 times per week, allowing for at least 1 full day of rest in between sessions to help your muscles recover.

Proper form is more important than how many wide pushups you do. It’s better to do fewer repetitions with perfect alignment than more repetitions with poor form.

The bottom line 

Wide pushups offer a challenging upper-body workout that targets the muscles in your chest, shoulders, and upper arms. This pushup variation can also help build your core strength, and it may help protect your back, too.

Alternating wide pushups with standard pushups may also be a good way to prevent overuse injuries.

Always work within your limits and avoid overexerting yourself. Start slowly and have patience as you build your strength and endurance.

How and When to Include Static Stretching in Your Workout

Medically reviewed by Gregory Minnis, DPT, specialty in physical therapy, on July 29, 2019 New  — Written by Emily Cronkleton

Vs. dynamic stretching

Benefits

Safety

Examples

Bottom line

It’s no secret that when you’re in a hurry to get a workout done, you may neglect stretching — but you shouldn’t.

Stretching can make a difference in how well your muscles recover after exercise. It can also affect your flexibility and exercise performance.

Here’s a look at the benefits of static stretching, how it differs from dynamic stretching, and examples of static stretches you can add to your workout.

What’s the difference between static stretching and dynamic stretching?

Dynamic stretching is typically done before you start your workout, and involves active movements that help get your muscles warmed up and ready for exercise.

These movements are often similar to the type of activity you’ll be doing during your workout. For instance, a swimmer may move their arms in circles and a runner may jog in place before starting their run.

Static stretching, on the other hand, is done at the end of your workout, and involves stretches that you hold in place for a period of time, without movement. This allows your muscles to loosen up, while increasing flexibility and range of motion.

What are the benefits of static stretching?

If you’re tempted to ditch stretching after your workout, you may miss some of these benefits.

Greater flexibility and range of motion

Stretching at the end of your workout, once your muscles are warmed up, can help increase the range of motionTrusted Source in any joint you target. Range of motion is how far a joint, like your hip or knee, can comfortably move in a particular direction.

Having greater flexibility and range of motion can help you move with more comfort and ease. This can make everyday tasks and exercises easier.

Less pain and stiffness

Having tense, tight, or overworked muscles can cause pain and discomfort. Research has shown that static stretching is an effective way to reduce stiffnessTrusted Source in tight muscles. This, in turn, can also lead to reduced pain, which may help you tackle your daily tasks more easily.

Decreased stress

High levels of stress can cause your muscles to feel tense and tight. Stretching your muscles can help them relax and, when combined with mindful breathing exercises, it can also reduce mental tension and anxiety.

Increased blood flow

A 2018 studyTrusted Source on animals found that daily stretching can also improve circulation. Increased blood flow may help your muscles recover more quickly after you’ve exercised.

Improved performance

Boosting the flexibility of your muscles can enhance your agility, speed, and muscle strength. This may help you perform at a higher level when you work out or play a sport.

Safety tips 

To keep your stretches safe and effective, keep these tips in mind.

Don’t stretch beyond what’s comfortable. A slight degree of discomfort is normal, but you shouldn’t feel any pain while you’re stretching. Stop right away if you feel sharp pain.

Be gentle. Use smooth, slow movements. Avoid jerking or bouncing movements while you’re holding a stretch. Be extra cautious if you’re recovering from an injury.

Don’t forget to breathe. Breathing can help relieve stress and tension in your body, and may also help you hold a stretch for longer.

Start slowly. Start with just a few stretches at first, and add more repetitions and stretches as you build your flexibility.

Examples of static stretches

A sample static stretching routine at the end of your workout may involve the following moves.

1. Overhead triceps stretch

This stretch targets your triceps and the muscles in your shoulders.

Stand with your feet hip-width apart, and roll your shoulders back and down to release any tension.

Reach your right arm up to the ceiling, then bend your elbow to bring your right palm down toward the center of your back.

Bring your left hand up to gently pull your right elbow downwards.

Hold this stretch for 20–30 seconds before switching arms.

Repeat on both sides 2 or 3 times, attempting to get a deeper stretch with each repetition.

2. Biceps stretch

This stretch targets your biceps as well as the muscles in your chest and shoulders.

Stand up straight, place your hands behind your back and interlace your hands at the base of your spine.

Straighten out your arms and turn your hands so your palms are facing down.

Then, raise your arms as high as you can until you feel a stretch in your biceps and shoulders.

Hold this stretch for 30–40 seconds.

Repeat 2 or 3 times.

3. Cobra Pose

This stretch helps to relieve tightness in your abdominals, chest, and shoulders.

Lie on your stomach with your hands directly under your shoulders, fingers facing forward, and arms drawn in tightly next to your chest.

Press into your hands and squeeze your elbows into your torso as you lift your head, chest, and shoulders.

You can lift your torso partway, halfway, or all the way up.

Keep your elbows slightly bent.

You can let your head drop back to deepen the pose.

Hold this position for 30–60 seconds.

Repeat 1 or 2 times.

4. Seated butterfly stretch

4. Seated butterfly stretch

This stretch targets your inner thighs, hips, and lower back.

Sit on the floor with your back straight and your abs engaged.

Place the soles of your feet together in front of you. Let your knees bend out to the sides.

Place your hands on your feet as you pull your heels toward you, letting your knees relax and inch closer to the floor.

Take a deep breath, and hold this pose for 10 to 30 seconds.

5. Head-to-knee forward bend

Use this stretch for the muscles in your back, groin, hamstrings, and calves.

Sit on a yoga mat or other comfortable surface.

Extend your left leg out in front of you, and place the sole of your right foot to the inside of your left thigh.

Inhale and lift your arms overhead.

Exhale as you lengthen your spine and bend forward at your hips.

Rest your hands on your foot, legs, or the floor.

Hold this pose for up to a minute.

Repeat on the opposite side.

The bottom line 

Although it can sometimes be tempting to skip stretching after a workout, there are many reasons not to overlook it.

Not only can static stretching improve your flexibility and range of motion, it can also help your muscles recover faster after a workout, leading to less pain and stiffness.

Static stretching is also a great way to release stress and tension in your muscles, which can help you feel more relaxed.

Talk to your doctor if you have any health concerns about stretching, especially if you have an injury or medical condition.

Is E-Stim the Answer to Your Pain?

Medically reviewed by Gregory Minnis, DPT, specialty in physical therapy, on July 29, 2019 New  — Written by James Roland

What it is

Types

How it works

Cost

When it's used

Risks

Outlook

Alternatives

Takeaway

Whether you’re recovering from an injury or stroke or dealing with the pain of fibromyalgia or another condition, you may benefit from a physical therapy procedure called electrical stimulation, or e-stim.

E-stim sends mild electrical pulses through the skin to help stimulate injured muscles or manipulate nerves to reduce pain.

E-stim may not be appropriate for everyone, but for many people this painless procedure is accelerating recovery and providing relief from painful or uncomfortable symptoms.

What is e-stim?

E-stim uses electrical pulses to mimic the action of signals coming from neurons (cells in your nervous system). These mild electrical currents target either muscles or nerves.

E-stim therapy for muscle recovery sends signals to targeted muscles to make them contract. (Flexing your biceps is a form of muscle contraction.) By causing repeated muscle contractions, blood flow improves, helping repair injured muscles.

Those muscles also improve their strength through repeated cycles of contraction and relaxation. E-stim can also “train” muscles to respond to the body’s natural signals to contract. This is an especially helpful benefit for stroke survivors who must essentially relearn basic motor functions.

The type of e-stim that focuses on pain relief sends signals on a different wavelength so they reach the nerves, rather than the muscles. Electrical stimulation can block pain receptors from being sent from nerves to the brain.

What are the main types of e-stim?

The two main types of e-stim are transcutaneous electrical nerve stimulation (TENS) and electrical muscle stimulation (EMS).

TENS

TENS may be used for chronic (long-term) pain as well as for acute (short-term) pain. Electrodes are placed on the skin near the source of the pain. Signals are sent through nerve fibers to block or at least reduce the pain signals traveling to the brain.

EMS

EMS uses a slightly stronger current than TENS to get muscles to contract. The unit’s electrodes (also placed on the skin near the affected muscles) cause rhythmic contractions. This can improve muscle strength if the user attempts to contract the muscle simultaneously.

Other e-stim types

In addition to EMS and TENS, your doctor or physical therapist may recommend other e-stim treatments.

OTHER TYPES OF E-STIM

One of the following similar e-stim treatments may help you, depending on your condition:

Electrical stimulation for tissue repair (ESTR) helps reduce swelling, increase circulation, and speed up wound healing.

Interferential current (IFC)  stimulates nerves to reduce pain.

Neuromuscular electrical stimulation (NMES)  stimulates the nerves in muscles to restore function and strength, prevent muscle atrophy, and reduce muscle spasms.

Functional electrical stimulation (FES) involves a unit implanted in the body to provide long-term muscle stimulation aimed at preserving function and motor skills.

Spinal cord stimulation (SCS) uses an implantable device to relieve pain.

Iontophoresis helps deliver ionically charged medication  to tissue to help speed up healing.

You may have seen TV and online advertisements for home e-stim systems. If you’re interested in one of these products, talk with your doctor or a physical therapist. Be sure to get proper instruction on its use before trying it out.

As part of a physical therapy program, you may be provided a battery-powered unit to use at home. Make sure the unit’s settings are correct before using it on your own.

How does e-stim work?

E-stim uses small electrodes placed on the skin. The electrodes are small, sticky pads that should come off with little discomfort at the end of the session.

Several electrodes are placed around the area receiving treatment. Wires from the e-stim device are attached to the pads.

Steady streams of electrical pulses are delivered through the wires from the e-stim unit. The unit may be small enough to fit in your hand or larger, like a landline phone and answering machine.

For muscular stimulation, the pulses will reach the muscles, signaling them to contract.

Pulses aimed at the nervous system block the transmission of pain signals from reaching the spinal cord and brain. The pulses also stimulate the body to produce more natural pain-relieving chemicals called endorphins.

WHAT TO EXPECT DURING E-STIM

Electrodes are placed around the site receiving therapy.

The electrical current will begin on a low setting and increased gradually.

You’ll get a tingly, “pins and needles” feeling at the site.

Depending on the type of e-stim, you may feel a muscle twitch or contract repeatedly.

Each e-stim therapy session may last 5 to 15 minutes, depending on the condition being treated.

How much does e-stim cost?

When e-stim is part of an overall physical therapy program, your insurance may cover it like other physical therapy treatments.

Check with your insurance provider first, however. The nature of your condition will often determine coverage. For example, an insurance provider may cover e-stim for scoliosis in serious cases, but not if the curvature is less than 20 degrees.

Home TENS or EMS systems can start at $20 for simple, starter units. Higher-end systems that are more durable and offer more features can cost several hundred dollars.

What does it treat?

E-stim may be appropriate for the following conditions:

back pain

cancer-related pain

dysphagia (trouble swallowing)

fibromyalgia

joint pain

arthritis

muscle conditioning (mostly for athletes, such as long-distance runners)

muscle injury from trauma or disease

nerve inflammation

poor muscle strength

urinary incontinence

spinal cord injury

stroke

surgery recovery

Researchers are also working on ways to use e-stim to help people with advanced multiple sclerosis walk again.

Risks of e-stim

The most common risk of e-stim is skin irritation where the electrodes are placed.

However, there’s a much more serious risk to heart health. For people with a pacemaker or other implantable heart device, e-stim may be dangerous and isn’t recommended.

E-stim is also not recommended for those who are pregnant. But in some supervised circumstances, e-stim has been used to help relieve labor pains.

What’s the outlook for people who use e-stim?

E-stim targeting the nerves for pain relief can be effective in treating a range of conditions causing nerve and musculoskeletal pain as well as pain that doesn’t respond to traditional treatments, according to 2019 researchTrusted Source.

However, the researchers note e-stim isn’t always a first-line treatment. Rather, it’s part of a broader set of options available to physical therapists.

Depending on your condition, you could start to feel better after one e-stim session. You may need multiple sessions, depending on the severity of your condition and symptoms.

In a small 2019 studyTrusted Source, researchers found that 36 NMES sessions over a 16-week period improved muscle function in people with rheumatoid arthritis.

E-stim is still considered an alternative therapy. There are some health experts who are skeptical of its long-term effectiveness.

There’s also some disagreement about which conditions are best suited for e-stim treatment.

Generally speaking, e-stim is most effective at working weakened or atrophied muscles and healing muscles after an injury or surgery.

As a pain reliever, e-stim (especially TENS therapy) can be effective in treating many conditions, though typically as part of a broader pain-management program.

Are there alternatives to e-stim?

While e-stim can be an effective tool in physical therapy and rehabilitation, it’s just one of many strategies employed by physical therapists, sports medicine physicians, and orthopedists.

Other forms of therapy include:

muscle-strengthening exercises using weights, resistance bands, machines, and a person’s own body weight

massage

range-of-motion exercises

stretching and flexibility exercises

ice and heat treatments

The takeaway

E-stim treatments have become standard parts of physical therapy for many conditions.

When used as part of injury or surgery recovery, e-stim should be used as a prescribed, supervised treatment, though home use may be appropriate in many cases.

Just be sure to tell your healthcare provider if you have a heart condition or are pregnant.

Sharing your medical history and a list of medications and supplements you take is always a smart and safe approach, too.

If you’re interested in e-stim as a tool for muscle conditioning or pain relief, talk with your doctor about your options and how to proceed safely.

10 Things to Know About the Wheelbarrow Sex Position

Medically reviewed by Janet Brito, PhD, LCSW, CST, specialty in sex therapy, on July 29, 2019 New — Written by Jen Anderson

Overview

Skill level

Who can try

Benefits

How to

Tips and tricks

Standing vs. sitting

Other modifications

Advanced techniques

Other moves to try

Takeaway

What is it?

The wheelbarrow position allows for rear entry, or “back door,” penetrative sex.

In this position, the giving partner stands while holding the receiving partner’s legs.

The receiving partner is usually on the floor, using their hands to balance in a plank-like position.

As you might have guessed, this move gets its name from the wheelbarrow-like shape the two partners create.

The person with their hands on the ground looks like the wheelbarrow, while the person standing looks like they’re pushing the, ahem, contraption.

Is it as hard as it sounds?

We’re not going to lie — it takes a little finessing to get the right angle.

And for the receiving partner, it takes a lot of abdominal strength, arm strength, and willpower.

It may be tempting to sink into the floor once your partner gets going, but that’s the fastest way to bring your pleasure to a hard stop.

If you’re a fan of rear-entry positioning and you’re already pretty comfortable with other forms, you may find that this move is easier than it looks.

Who can do it?

Like other forms of rear-entry penetration, this position is popular as a technique for penile-vaginal sex.

If your partner doesn’t have a penis, you can still give this a go with a dildo or other wand toy.

You can even switch up the entry point, allowing either partner to experiment with deep anal penetration.

With this variation, the receiving partner can enjoy intense G spot or prostate  stimulation — potentially triggering a full-body orgasm unlike anything they’ve experienced before.

What benefits does it offer?

This versatile move is all about those hard-to-reach erogenous zones.

If you find it difficult to orgasm from vaginal penetration alone, which is normal by the way, the wheelbarrow may introduce you to a couple of pleasure points that provide a much-needed boost.

Due in part to its deep penetration, this move offers better access to the elusive G spot.

Although the G spot is only about 3 inches from vaginal opening, missionary and other front-facing positions often lack the elevation and angle needed to really dive in.

It also brings the A spot into view. Officially known as the anterior frontal cortex, the A spot sits closer to the cervix.

When massaged just so, it’s been known to elicit a powerful vaginal ejaculation.

On the flip side, the position may also offer access to anal — specifically prostate, in some cases — orgasms.

How do you do it?

To get in position, the giving partner should remain standing with their legs slightly parted and knees slightly bent.

The receiving partner should then bend over and place their hands on the ground, bed, or a prop as if in a plank.

You may find it helpful to start on all fours and move through a pushup to get into position.

The giving partner can then lift the receiving partner’s legs and gently guide them to each side of their waist.

There are a couple of options here.

The standing partner can hold onto the bottom partner’s legs — usually mid-thigh — or move their grip to the bottom partner’s waist.

From here, the bottom partner can completely wrap their legs around the giving partner’s waist for more grip — or leave their legs long to introduce a new angle.

The latter is more advanced, so you may have to work up to this.

This variation works best when the bottom partner is able to wrap their legs completely around the standing partner instead of leaving them long.

Once you’re in alignment, the giving partner can slowly enter the receiving partner and begin thrusting.

Is there anything that can make this smoother?

This position might feel a little awkward at first, so it’s important to get as comfortable as possible before penetration begins.

When it comes to potential lightheadedness, it’s always better to be proactive than reactive.

Shift positions every so often so that the bottom partner can lift their head above their heart and allow their circulation to return to normal.

If the bottom partner’s arms are quick to tire, they can lean on their forearms for more support. Keep a pillow or blanket handy for added cushioning.

Depending on how you’re positioned, the standing partner can rest their lower back against a countertop or lean against a wall for added support.

Do you have to do it standing up?

Absolutely not! Depending on what you’re in the mood for, one or both partners can be seated.

Though less strenuous — it’s sometimes referred to as the “lazy wheelbarrow” — this variation requires a bit more teamwork to keep things moving.

Instead of standing, the top partner can sit on the edge of the bed or chair.

The receiving partner has more options here. They can take advantage of the lower height and rest more comfortably on their forearms while planking, or find a seated position of their own.

The lower the receiving partner’s hips, the more coordination is needed to thrust back and forth.

Keep in mind that this penetration may not be as deep as in the standard variation, so if that’s what you’re looking for, you may want to alternate between sitting and standing.

In either approach, the receiving partner’s legs should still drape on either side of the giving partner.

Are there any other modifications?

If you or your partner are used to lying down, this Kama Sutra position is the perfect one for you: plough position.

This wheelbarrow variation takes the same concept to the bed.

The receiving partner will lie stomach down and extend their legs behind them, dangling off the bed.

The giving partner will stand between the bottom partner’s legs and lift them into position. Unlike the standard wheelbarrow position, this variation gives you a similar angle and the same deep penetration without the exhaustion or discomfort that comes from thrusting in a plank.

Is there anything else you do to take it to the next level?

Of course! There’s always room to explore other erogenous zones — and get more of a workout in the process.

If you want to add clitoral stimulation into the mix, you can slide a hand down below or guide a vibrating toy to just the right spot.

But if relying on one arm to support your overall position sounds daunting, take a moment to reexamine your strengths.

Wrapping your legs around your partner or gripping tighter with your inner thighs can free up one of the standing partner’s hands so that they can do the deed for you.

They can also experiment with hair tugging, spanking, and other erotic touch.

What can you try once you’ve mastered the wheelbarrow?

You may want to check out other positions that focus on G-spot stimulation. A few of our favorites:

Closed missionary position

This variation of the classic missionary position might not offer the deepest penetration, but it definitely provides more friction for the G spot.

In contrast to standard missionary, the bottom partner closes their legs. The person on top can then straddle the bottom partner’s legs and enter, allowing for a tight squeeze.

Spooning

Who knew cuddling could be this hot? Big spoon, meet little spoon. Literally.

Both the rear entry and tighter squeeze allow for more G-spot stimulation and deeper penetration — plus more control over the speed.

The bottom line

Wheelbarrow isn’t the easiest sex position to nail down, so you may want to save this one for a partner you’re already comfortable with.

But no matter who you’re with, leave room to laugh at your inevitable meet-cute with the floor. We’ve all been there, so dust your knees off and shimmy back into position to try again.

It may take a few tries to find the angle that works best for you and your partner — or to realize that today just isn’t the day and try something else.

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What’s Causing My Baby’s White Tongue?

Medically reviewed by Karen Gill, MD, specialty in pediatrics, on July 29, 2019 New — Written by Valencia Higuera

Thrush

Milk residue

When to see a doctor

Prevention

Takeaway

Open wide and say ‘ahhh’

The fragility of a newborn can be one of the most intimidating things in the world. And naturally, you’ll do everything in your power to protect this tiny human from anything that brings worry.

You ever-so-gently lay them down, support their head, dress them lightly, and check every square inch of their body for any unusual signs. And then you notice it: Instead of being perfectly pink, your baby’s tongue looks like it has a white coating on it.

This coating can seem to appear out of nowhere. But here’s the good news — a white tongue in babies isn’t unusual. It’s typically caused by either an overgrowth of yeast — very treatable — or by something as simple as milk residue.

It could be thrush

Thrush is a yeast infection caused by an overgrowth of the fungus Candida — yes, the very same type that causes vaginal yeast infections and diaper rashes.

In the case of oral thrush, though, the infection forms on parts of the mouth involved in sucking. This includes your baby’s lips, tongue, and inner cheeks.

And though we know you put baby first, and you second, you should also know that thrush can spread to the object of your baby’s sucking if you’re breastfeeding: your nipples. Conversely, yeast on your nipples (that you may not even know you have) can contribute to thrush in your baby’s mouth.

The tell-tale signs and symptoms of thrush

Not every white tongue is caused by thrush. So here’s a good rule of thumb: If you’re able to wipe or brush off a white coating, thrush isn’t the culprit. Yeast hangs on for dear life.

Also, if your baby has thrush, it’s unlikely for the white to only appear on their tongue. If you open their mouth, you’ll see a cottage-cheese coating over other areas, too, like inside their cheeks.

If you notice these symptoms, don’t panic. But thrush isn’t something to ignore, even if it’s mild and doesn’t seem to cause any problems. There’s always the chance of the infection getting worse, and if it does, your baby may have pain or discomfort that makes it harder for them to feed or latch onto your breast — and if baby’s not happy, no one’s happy.

Causes of thrush

You might wonder why many babies get oral thrush while it’s rarely a problem for adults. The answer is simple: A baby’s young immune system isn’t always strong enough to fight off germs and infections. And because of their weaker immune system, it’s much easier for yeast to grow on some parts of their little body.

But a weak immune system isn’t the only culprit. If your baby takes an antibiotic to treat another infection — say, one of those pesky ear infections — this drug can kill off good bacteria, also encouraging the growth of yeast.

Treatment for thrush

Hearing that your baby has any type of infection can cause a range of emotions. But there’s no need to worry with this one — thrush is very common and easily treatable.

Your baby’s doctor will likely prescribe a liquid antifungal that you’ll apply directly to white patches. For the medicine to work, you’ll want it to sit on their tongue or inside their mouth for as long as possible. So give your baby treatments at least 30 minutes before feedings.

Once the medicine is in their system, you can expect the infection to clear in a few days.

Additional considerations if you’re breastfeeding

To be clear, thrush happens in babies who are bottle-fed and breastfed. If you breastfeed, though, know that it’s possible for you and your baby to spread yeast to each other.

This might be a lesser known problem, but it does happen and it’s called nipple thrush. Signs include:

sore, painful nipples after pain-free breastfeeding

cracked, itchy, or blistered nipples

achy breasts after feedings

If you also have thrush, it isn’t enough to treat your baby. Sure, medicine will clear their infection. But if you don’t clear your own infection, you’ll continue to spread thrush back and forth. There are a lot of things you and baby will share over a lifetime — this shouldn’t be one o. Sure, medicine will clear their infection. But if you don’t clear your own infection, you’ll continue to spread thrush back and forth. There are a lot of things you and baby will share over a lifetime — this shouldn’t be one of them.

Applying a topical antifungal cream — available over the- counter in the form of yeast infection creams and others — on and around your nipples after each feeding is usually enough to kill the fungus.

It’s possible that you might need a prescription antifungal for a particularly stubborn infection. Since yeast likes warm, moist areas, let the skin of your breasts air dry as much as possible before putting your bra back on.

Don’t forget to wash off any leftover residue of the cream before nursing. Your symptoms will also clear up in a few days.

It could be milk residue

It’s completely normal to worry about your baby. And, honestly, you should never let anyone tell you that your worries are foolish. If you see a white coating on your baby’s tongue, you might immediately think it’s thrush and call the pediatrician — and there’s nothing wrong with that.

But there’s also a chance that what you believe to be yeast is only milk residue.

Distinguishing between the two can be tricky, as they have similar appearances. One of the easiest ways to tell the difference is to try and wipe off the residue with a warm, damp cloth.

If the residue comes off or becomes less noticeable, you’re dealing with milk residue and not thrush. Keep in mind that milk residue is more noticeable after feedings and only appears on the tongue.

What causes this buildup of milk? Simply put, a lack of saliva.

A newborn’s mouth is different from an adult’s mouth in that babies don’t produce a lot of saliva during the first few months after birth. (That is, until they are about 4 months. Then it’s time for a months-long vacay in droolville.) The less saliva, the harder it is for their mouths to wash away milk.

Milk residue may be more likely to occur if your baby has tongue tie, a condition that restricts movement of their tongue. Your baby’s tongue might be unable to touch the roof of their mouth, in which case the lack of friction causes a buildup of milk residue.

This can also happen if your baby has a high palate, and their tongue can’t reach the roof of their mouth.

Regardless of cause, though, milk residue isn’t permanent, nor a reason for concern. A white tongue goes away once your baby’s mouth produces more saliva, or when they start to eat solid foods.

In the meantime, you can consider gently wipe off the residue using a soft, damp cloth after feedings, though this may not be necessary.

When to see a doctor for a white tongue

Just because thrush is common in babies doesn’t mean you should ignore the problem. Untreated thrush can cause pain and discomfort, and if so, you’ll have a fussy baby on your hands.

See a doctor if your baby develops any creamy, white lesions in their mouth, especially if you can’t remove the whiteness with a damp cloth. It’s likely thrush, but a pediatrician can run tests if they suspect something else.

If your baby has thrush, see your own doctor if your nipples or breasts become sore. It’s important that you’re treated at the same time to stop the spread of the infection.

 How to prevent a white tongue?

Gently wiping or brushing your baby’s tongue after each feeding can help prevent a white tongue caused by milk.

As far as thrush goes, your best weapon is to sterilize all equipment used for feedings. This includes bottles, nipples, and your breast pump. You can take it a step further and sterilize pacifiers and any toys your baby puts in their mouth.

If you have thrush on your nipples, prevent recurrent infections by frequently changing your breast pads, and washing your breastfeeding bras in hot water.

Also, if you express or freeze your breast milk with thrush, consider giving this milk to your baby while you’re both being treated. If you give this milk to your baby after the infection clears, there could be a greater chance that the thrush could return.

The takeaway

If you see a white coating on your baby’s tongue, know that it happens and it’s not because you’re doing something wrong. It could be thrush, or it may be something as simple as milk residue.

In the event of thrush, these yeast infections are easily treatable, so see your pediatrician. Your sweet baby will be sticking their perfectly pink tongue out at you before you know it!

10 Reasons You Might Miss a Period

Medically reviewed by Meredith Wallis, MS, CNM, ANP on July 29, 2019 New — Written by Corinne Osborn

Stress

Weight changes

Exercise

PCOS

Hormonal birth control

Perimenopause

Early menopause

Thyroid issues

Chronic conditions

Pregnancy

Takeaway

No period this month? Try not to freak out. It’s normal miss a period once in a while. It could just be your body’s response to stress or changes in your eating or exercise habits. But sometimes, it can also be a sign of a larger issue.

Here’s a look at 10 potential reasons why Aunt Flo might leave you hanging.

1. You’re stressed out

Your body’s stress-response system is rooted in a part of your brain called the hypothalamus. While you may no longer be running from predators, your body is still hard-wired to react as if you were.

When your stress level peaks, your brain tells your endocrine system to flood your body with hormones that switch on your fight-or-flight mode. These hormones suppress functions that aren’t essential to escaping an imminent threat, including those of your reproductive system.

If you’re under a lot of stress, your body can stay in fight-or-flight mode, which can make you temporarily stop ovulating. This lack of ovulation, in turn, can cause missed periods.

2. You’ve lost or gained weight

Severe changes in body weight can lead to a condition known as secondary amenorrhea, which means missing your period for three months or more. This is particularly common when your BMI  undergoes a rapid change.

Extreme increases or decreases in body fat can lead to a chaotic hormonal imbalance that causes your period to come late or stop entirely.

In addition, severe calorie restriction affects the part of your brain that “talks” to your endocrine system, giving instructions for the production of reproductive hormones. When this communication channel is disrupted, hormones can get really out of whack.

3. You’ve upped your workout intensity

A strenuous exercise regimen can also cause missed periods. This is most common in those who train for several hours a day. It happens because, whether intentionally or not, you’re burning way more calories than you are taking in.

When you burn too many calories, your body doesn’t have enough energy to keep all its systems running. This can lead to a hormonal imbalance that throws off your menstrual cycle, leading to missed or late periods.

Periods typically go back to normal as soon as you stop training so hard or increase your caloric intake.

4. You have PCOS

Polycystic ovary syndrome (PCOS) is a set of symptoms caused by an imbalance of reproductive hormones. People with PCOS don’t ovulate regularly. As a result, your periods may be lighter than normal, arrive at inconsistent times, or disappear altogether.

Other PCOS symptoms can include:

excess or coarse facial and body hair

acne on the face and body

thinning hair

weight gain or trouble losing weight

dark patches of skin, often on the neck creases, groin, and underneath breasts

skin tags in the armpits or neck

infertility

5. You’re using hormonal birth control

Many love the pill because it makes their periods so regular. But it can sometimes have the opposite effect, especially during the first few months of use.

Similarly, when you stop taking the pill, it can take a few months for your cycle to get back to normal. As your body returns to its baseline hormone levels, you may miss your period for a few months.

If you’re using another hormonal birth control method, including an IUD, implant, or shot, you might stop getting your period altogether.

6. You’re in perimenopause

Perimenopause is the time leading up to menopause. It typically starts in your mid- to late forties. Perimenopause lasts for about four years before your period stops completely.

For many, missed periods are the first sign of perimenopause. You may skip a period one month and be back on track for the following three. Or, you may skip your period three months in a row and find that it arrives unexpectedly, often lighter or heavier than you are accustomed to.

7. You’re in early menopause

Early menopause, also known as premature ovarian failure, happens when your ovaries stop working before you turn 40.

When your ovaries aren’t working the way they should, they don’t produce enough estrogen. As estrogen levels drop to all-time lows, you will begin to experience the symptoms of menopause.

Late or missed periods may be an early sign. You may also experience hot flashes, night sweats, and trouble sleeping.

Other signs of premature ovarian failure include:

vaginal dryness

trouble getting pregnant

decreased sexual desire

trouble concentrating

8. You have a thyroid condition

Your thyroid is a butterfly-shaped gland in your neck that produces hormones that help regulate many activities in your body, including your menstrual cycle. There are several common thyroid conditions, including hypothyroidism and hyperthyroidism.

Both hypothyroidism and hyperthyroidism can affect your menstrual cycle, causing irregularity, but hyperthyroidism is more likely to cause late or missed periods. Sometimes, your period may disappear for several months.

Other symptoms of a thyroid issue include:

heart palpitations

appetite changes

unexplained weight changes

nervousness or anxiety

slight hand tremors

fatigue

changes to your hair

trouble sleeping

9. You have another chronic condition

Certain chronic health problems, especially celiac disease and diabetes, are sometimes associated with menstrual irregularities.

Celiac disease is an autoimmune disease that affects your digestive system. When people with celiac disease eat gluten, their immune system reacts by attacking the lining of the small intestine.

When the small intestine is damaged, it impairs the body’s ability to absorb nutrients from food. Subsequent malnourishment affects normal hormone production and leads to missed periods and other menstrual irregularities.

Those with type 1 and type 2 diabetes might also experience a missed period in rare cases. This tends to only happen when blood sugar levels aren’t managed at ideal levels.

10. You’re pregnant

If there’s a chance you may be pregnant and your cycles are typically regular, it may be time to take a pregnancy test. Try to do this about one week after your period was supposed to start. Taking a test too early can result in a false negative.

If your periods are typically irregular, it can be harder to find the right time to take a pregnancy test. You may want to take a few over the course of several weeks or talk to your healthcare provider to be sure.

Other early symptoms of pregnancy to watch for include:

tender, painful breasts

swollen breasts

nausea or vomiting

fatigue

The bottom line

Missing a period can be alarming, but there’s usually a simple explanation. Still, if your period hasn’t arrived for more than 40 days, it’s best to make an appointment with your healthcare provider to see what’s going on.

What Causes Vulvar Pain During Your Period and How to Treat It

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on July 29, 2019 New — Written by Ann Pietrangelo

Causes

Medical treatment

Home remedies

See a doctor

Takeaway

It’s not uncommon to have vulvar discomfort, itching, or pain at some point, especially during your period.

The vulva is the outer part of the genitalia in people with a vagina. It includes the outer labia (labia majora) and inner labia (labia minora). The mound made by the pubic bone, the clitoris, and the openings of the urethra and vagina are also part of the vulvar area.

In this article, we’ll take a look at some causes of vulvar pain, how they’re diagnosed, and what you can do about them.

Causes of vulvar pain

Common causes of vulvar pain Less common causes of vulvar pain

vulvodynia Bartholin’s gland cyst

yeast infection vaginismus

bacterial infection vulvar cancer

folliculitis chronic pain conditions, such as fibromyalgia, interstitial cystitis, or irritable bowel syndrome

trichomoniasis

Vulvodynia

Vulvodynia is chronic vulvar pain, burning, or other irritation that lasts at least three months. Vulvodynia is idiopathic, meaning there’s no clear cause. Symptoms can be unprovoked or provoked by touch.

Cyclic vulvodynia, or cyclic vulvitis, tends to change according to where you are in your menstrual cycle. The pain may get worse around your period, especially when you try to insert a tampon. In some cases, pain improves during the period.

Although the exact cause of vulvodynia isn’t known, these may be contributing factors:

previous vaginal infections

allergies and skin sensitivities

injury to the nerves around the vulvar

hormonal changes

pelvic floor weakness

certain genetic disorders

Vulvodynia is estimated to affect up to 16 percentTrusted Source of women.

Yeast infection

About 75 percentTrusted Source of women will have at least one vaginal yeast infection in their lifetime. It’s caused by an overgrowth of yeast. Some potential causes are:

hormonal changes due to pregnancy or oral contraceptives

antibiotics or topical antimicrobial agents

douches or harsh feminine hygiene products

wearing tight or poorly ventilated underwear or clothing

unmanaged diabetes

It can hurt when you urinate, during intercourse, or when you try to insert a tampon. It can also involve a thick, white discharge.

Bacterial infection

A bacterial infection, or bacterial vaginosis, develops when your pH is out of balance. This can happen when you change sexual partners or if you douche. It can also cause foul-smelling discharge and burning during urination.

Folliculitis

Folliculitis is when small red bumps develop from infected hair follicles. It tends to occur on the outer labia.

Bartholin’s gland cyst

A Bartholin’s gland cyst can form on either side of the vagina when a gland becomes blocked. A painful cyst usually indicates infection.

Trichomoniasis

Trichomoniasis is a common sexually transmitted infection (STI) caused by a parasite. Symptoms can include abnormal discharge with a strong odor, painful urination, and pain with intercourse or tampon use. In some cases, there’s also lower abdominal pain.

Vaginismus

Vaginismus is a painful involuntary spasm around the muscles of the vagina. This may happen during sexual intercourse, during a vaginal exam, or when you try to use a tampon. Some potential contributing factors are anxiety or a history of sexual abuse or trauma.

Vulvar cancer

Vulvar cancer is rare and slow-growingTrusted Source. Some risk factors may include having:

vulvar intraepithelial neoplasia

human papillomavirus (HPV) infection

history of genital warts

Vulvar cancer can cause other symptoms such as:

itching

bleeding, even outside of your period

changes to skin color or thickness

lumps, bumps, or ulcers

Chronic pain conditions

In 2012, researchers foundTrusted Source that those who have vulvodynia are more likely to have a one or more other chronic pain conditions such as:

fibromyalgia

interstitial cystitis

irritable bowel syndrome

Can those in perimenopause and postmenopause experience vulvar pain?

Anyone with a vulva can experience vulvar pain. It’s not uncommon for symptoms to appear in midlife or after menopause and for many of the same reasons it happens earlier.

In addition, vulvar pain in perimenopause or after menopause may have to do with low estrogen levels. Other symptoms can include vaginal dryness and vulvar atrophy.

Medical treatment

Treatment for pain during your period depends on the cause.

For vulvodynia

Your doctor can treat vulvodynia with local anesthetics or hormone creams that can be applied directly to the skin. In some cases, antidepressants or antiseizure drugs can help ease symptoms.

For yeast infections

Yeast infections are treated with antifungal medications. Many are available over-the-counter (OTC) in the form of creams, tablets, and suppositories.

If you’ve never had a diagnosed yeast infection, see your doctor before trying OTC medications. Antifungals won’t work on other causes of vulvar pain.

For bacterial infections

Antibiotics are generally used to treat bacterial infections.

Both types of infection can and should be treated during your period. If you’re using vaginal creams or suppositories for a yeast infection, tampons can make the medication less effective, so you should switch to pads.

For folliculitis

Folliculitis usually clears up on its own. Your doctor can drain a troublesome Bartholin’s gland cyst. In the meantime, warm compresses may help ease pain or discomfort.

For trichomoniasis

Trichomoniasis may be treated with a single dose of an oral medication called metronidazole. It’s important that you and your sexual partners are treated to prevent transmitting the disease again.

For vaginismus

Some ways to treat vaginismus include:

Kegel exercises to strengthen and help control vaginal muscles

using a vaginal dilator to help your muscles become more flexible and to increase your comfort level

therapy or counseling with a mental health professional

For vulvar cancer

Vulvar cancer treatment can involve:

surgery

topical therapies

chemotherapy

biologic therapy

radiation

Home remedies

If you have vulvar pain during your period, try switching from tampons or menstrual cups to pads to see if that helps. If you already use pads, switch brands to see if you have a sensitivity to a specific product.

Here are some other tips for dealing with vulvar pain:

Make sure your underwear is loose and has a breathable, cotton crotch.

Avoid tight pants or shorts.

Use a cold compress or a cool gel pack to lessen pain and itching.

Avoid activities like cycling or horseback riding that put pressure on the vulva, particularly if you’re extra sensitive during your period.

Don’t use hot baths or hot tubs, which can make matters worse. Instead, soak in a sitz bath. You can do this for 5 to 10 minutes several times a day, even if you’re menstruating.

Don’t use douches, genital deodorants, or perfumed feminine hygiene products.

Don’t use irritating shampoos or soaps.

Wash your genital area with plain water. Gently pat dry.

After your shower, you can apply plain petroleum jelly or other emollient with no preservatives. Be sure to only use these on outer areas.

You can use a lubricant prior to having sex, but stay away from products that contain harsh ingredients such as alcohol or flavorings. Don’t use products that are designed to get warmer or cooler.

When to see a doctor

It’s important to see a doctor for vulvar pain, especially if you also have other symptoms. Vulvar pain is often easily treated. But without proper treatment, fungal infections, STIs, and other causes of vulvar pain can lead to serious complications.

After hearing about your symptoms and medical history, your doctor will probably perform a pelvic exam to look for abnormalities. A swabbing of the vagina and vulva can determine if you have a bacterial or yeast infection. The results of these tests will guide the next steps.

The takeaway

While often treatable, chronic vulvar pain may affect your quality of life.

Whether associated with your period or not, you should see your doctor if you experience vulvar pain. It’s likely due to an easily treatable condition, but it’s also important to rule out a few potentially serious causes.

I Was Nervous to Try Mobility Devices — and Uncovered My Own Ableism in the Process

 Written by Jackie Zimmerman on July 29, 2019 New

“Will you end up in a wheelchair?”

If I had a dollar for every time I heard someone say that since my multiple sclerosis (MS) diagnosis 13 years ago, I’d have enough cash to buy an Alinker. More on that later.

Despite 13 years of anecdotal proof from knowing many people living with MS who aren’t using wheelchairs, the general public always seems to think that’s where this whole MS journey leads.

And the term “end up” in a wheelchair is less than favorable, right? Like the same way you “end up” doing chores on a Sunday afternoon, or how you “end up” with a flat tire after hitting a pothole.

Yikes, man. It’s no wonder that people with MS, like myself, live our lives with this fear wrapped in disdain topped with judgement when it comes to the idea of needing a mobility device.

But I say screw that.

I don’t currently need a mobility device. My legs work just fine and are still pretty strong, but I’ve discovered that, if I use one, it has a huge impact on how far I can go or how long I can do whatever I'm doing.

Despite 13 years of anecdotal proof from knowing many people living with MS who aren’t using wheelchairs, the general public always seems to think that’s where this whole MS journey leads.

And the term “end up” in a wheelchair is less than favorable, right? Like the same way you “end up” doing chores on a Sunday afternoon, or how you “end up” with a flat tire after hitting a pothole.

Yikes, man. It’s no wonder that people with MS, like myself, live our lives with this fear wrapped in disdain topped with judgement when it comes to the idea of needing a mobility device.

But I say screw that.

I don’t currently need a mobility device. My legs work just fine and are still pretty strong, but I’ve discovered that, if I use one, it has a huge impact on how far I can go or how long I can do whatever I'm doing.

It’s made me start thinking about mobility devices, even though it feels icky — which is the scientific term for something that society has taught you to fear and be ashamed of.

The “ick” is what I feel when I think about how my self-worth could be affected if I start using a mobility device. Then it gets amplified from the guilt I have for even thinking such an ableist thought.

It’s shameful that even as an activist for disability rights, I can’t always escape this ingrained hostility toward people with physical disabilities.

So, I’m giving myself permission to test out mobility aids without my own judgement — which is actually enabling me to not care about anyone else’s, either.

It’s kind of this amazing experience where you dabble in the thing you might need in the future, just to see how it feels while you still have the choice.

Which brings me to the Alinker. If you’ve been keeping up on MS news, you know by now that Selma Blair has MS and she’s beboppin’ around town on an Alinker, which is a mobility bike to be used in place of a wheelchair or walker for those who still have full use of their legs.

It’s completely revolutionary when it comes to mobility aids. It puts you eye level and provides support to keep your own weight off your feet and legs. I really wanted to try one, but these babies aren’t sold in stores. So, I contacted Alinker and asked how I could test one.

And wouldn’t you know, there was a lady who lives 10 minutes away from me that offered to let me borrow hers for two weeks. Thanks, Universe, for making exactly what I wanted to have happen, happen.

I got on the Alinker, which was too big for me, so I put on some wedges and hit the road — and then I fell in love with a walking bike that’s $2,000.

My husband and I like to take walks at night, but depending on the day I’ve had, sometimes our walks are much shorter than I’d like them to be. When I had the Alinker, my fatigued legs were no longer a nemesis, and I could keep pace with him for as long as we wanted to walk.

My Alinker experiment got me thinking: Where else in my life could I use a mobility aid that would enable me to do things better, even though I can still technically use my legs regularly?

As someone who currently straddles the line between able-bodied and disabled, I spend a lot of time thinking about when I may need physical support — and the discriminatory shame storm follows not far behind. It’s a narrative I know I need to challenge, but it isn’t easy in a society that already can be so hostile toward disabled folks.

So, I decided to work on accepting it before this becomes a permanent part of my life. And that means being willing to be uncomfortable as I test mobility aids, while also understanding the privilege I have in this scenario.

The next place I tried was at the airport. I gave myself permission to use a wheelchair transport to my gate, which was at the end of the earth, aka the farthest gate from security. I recently saw a friend do this, and it’s something that honestly never crossed my mind.

However, a walk this long usually has me on empty by the time I get to my gate, and then I have to travel and do it all over again in a few days to come home. Travel is exhausting as it is, so if using a wheelchair can help, why not try it?

So I did. And it helped. But I almost talked myself out of it on the way to the airport and while I was waiting for them to pick me up.

In a wheelchair, I felt like I was about to amplify my “disability” to the world, putting it out there for everyone to see and judge.

Kind of like when you park in the handicapped spot and the second you get out of your car, you feel like you have to start limping or something to prove you really do need that spot.

Instead of wishing a broken leg on myself, I remembered I was testing this out. This was my choice. And immediately I felt the judgement I had manifested in my own head start to lift.

It’s easy to think of using a mobility device as giving in, or even giving up. That’s only because we’re taught that anything other than your own two feet is “less than,” not as good. And that the moment you seek support, you also show weakness.

So, let’s take that back. Let’s dabble in mobility devices, even when we don’t need them every day.

I still have quite a few years ahead of me before I really need to consider regularly using a mobility device. But after testing a few, I’ve realized that you don’t need to lose complete control of your legs to find them useful. And that was powerful for me.

Jackie Zimmerman is a digital marketing consultant who focuses on nonprofits and healthcare-related organizations. Through work on her  website, she hopes to connect with great organizations and inspire patients. She began writing about living with multiple sclerosis and irritable bowel disease shortly after her diagnosis as a way to connect with others. Jackie has been working in advocacy for 12 years and has had the honor of representing the MS and IBD communities at various conferences, keynote speeches, and panel discussions.

5 Ways to Find Joy in Moving Your Body, for Every Body

 Written by Anna Lee Beyer on July 29, 2019 New

Yes, “exercise” can and should be joyful.

Exercise is...

something I have to do to lose weight

for athletes

hard and sweaty

not fun

prescribed by my doctor

something I’m not good at

embarrassing

I didn’t “sport” as a kid.

I really wanted to be with my friends on the tennis team in high school, but no one could tease any skill out of me. When they gave up trying to teach me, I went back inside to my books.

A few decades have passed, along with many gym memberships, group classes, and 30-day “get fit quick” programs.

There are people who thrive on intense workouts, crave them. I wanted to lift weights like an Olympian, too; I wanted to kick-box fear into the hearts of creepy man-shaped punching bags; I wanted to run a marathon so I could put a “26.2” sticker on my bumper.

But did I really? Finding motivation was never effortless, and “no pain, no gain” was never my mantra.

In our Instagram/CrossFit/before-and-after culture, exercise is a thing we push ourselves to do — to earn treats, to prove worth, to change our bodies.

Joyful movement is something different: It’s supposed to feel good. With joyful movement, the focus of physical activity is on pleasure instead of results.

When I learned about joyful movement, I asked myself, “What activities are fun? What do I want to do?”

Then a miracle happened. I found activities that felt good — that I craved — and it opened my mind to how many different ways there are to move that aren’t punishing.

Movement that’s powerful just because it feels good.

5 ways to find joy in movement, no ‘should’ or shame allowed

1. Remember a favorite childhood activity

I have a minitrampoline in my home office. I used to jog on it, but wow, that was boring.

Exercise is...

something I have to do to lose weight

for athletes

hard and sweaty

not fun

prescribed by my doctor

something I’m not good at

embarrassing

I didn’t “sport” as a kid.

I really wanted to be with my friends on the tennis team in high school, but no one could tease any skill out of me. When they gave up trying to teach me, I went back inside to my books.

A few decades have passed, along with many gym memberships, group classes, and 30-day “get fit quick” programs.

There are people who thrive on intense workouts, crave them. I wanted to lift weights like an Olympian, too; I wanted to kick-box fear into the hearts of creepy man-shaped punching bags; I wanted to run a marathon so I could put a “26.2” sticker on my bumper.

But did I really? Finding motivation was never effortless, and “no pain, no gain” was never my mantra.

In our Instagram/CrossFit/before-and-after culture, exercise is a thing we push ourselves to do — to earn treats, to prove worth, to change our bodies.

Joyful movement is something different: It’s supposed to feel good. With joyful movement, the focus of physical activity is on pleasure instead of results.

When I learned about joyful movement, I asked myself, “What activities are fun? What do I want to do?”

Then a miracle happened. I found activities that felt good — that I craved — and it opened my mind to how many different ways there are to move that aren’t punishing.

Movement that’s powerful just because it feels good.

5 ways to find joy in movement, no ‘should’ or shame allowed

1. Remember a favorite childhood activity

I have a minitrampoline in my home office. I used to jog on it, but wow, that was boring.

When someone told me all of the great things rebounding (the grown-up word for jumping on a trampoline) can do for the body, I was excited to try it again. I had no idea I could just bounce on it like a kid at a trampoline park and feel happy, warm, tired, and clear-headed all at once.

Was there something you liked to do as a kid just because it was fun? Running through the sprinklers, dancing with music videos, or bouncing a ball off the side of your house? Channel your childhood self and give it a try again. Think of all the fun things you could do if feeling old and silly didn’t get in the way!

2. Get a friend involved — even long distance!

In 2019, my friend L. and I will mark 25 years since we met. Unfortunately, we’ve spent most of that time living in different states and saying, “If we only lived in the same town, we would walk/swim/try new things together every day.”

Friends have a way of amplifying motivation while mitigating self-consciousness. Even though there are 1,053 miles between us (San Antonio, Texas, to Athens, Georgia), L. and I do our best to walk “together.” We share pictures from the trail or sidewalk, commiserate when one of us has bad weather, wax poetic when the skies clear.

We remind each other as often as possible how good it feels to be grounded on the earth so we’re motivated to keep getting out there.

Would a buddy give you the courage to try something new? Pick a friend and make a plan. If you don’t have fun, on to the next thing!

3. Find something that feels liberating

Running behind a stroller was one of the most empowering, freeing experiences I’ve ever had. I got so used to pushing a stroller that I felt off-balance without it. Where do my arms go? My water bottle?

Those stroller days are behind me, and so is running for now. I don’t get the same joy from it now as I did when I was learning the streets of my neighborhood, showing the world to an infant who thrived on the rhythm and sunshine.

New motherhood, a new job, a precarious financial situation: So many life events can leave you feeling out of control or stuck. Sometimes we’re even bogged down by a lack of change.

Running took me out of my house and out of my head when I felt trapped at home with an infant and postpartum anxiety.

Is there a way you can create some space around you? Look for fresh air, sunshine, and enough space to scan the horizon. Then move freely.

4. Yoga is everywhere and for everyone (including kids)

I literally do yoga with Joy — she’s been my yoga teacher on and off for the last five years. Even when yoga hurts, when it brings up anger and trauma, I have a built-in reminder that “joy” is still part of the formula.

A few years ago, I discovered a new element of joy in yoga: my daughters’ curiosity and participation. I’m not a playground type of parent, playing chase or going down the giant slide. But I do try to sneak in some yoga while my children are underfoot, and they naturally join in. You don’t know cute if you haven’t seen a wobbly 3-year-old in Tree Pose.

Children are proof that yoga isn’t just something you learn in a studio. The way you sit on the floor, the way you stretch after a nap, the way you broaden your stance to invoke power — you’re already doing yoga.

If you don’t have money or confidence for a class, but you still feel drawn to the practice, get a book from the library or find a video on YouTube.

5. Swimming without laps

I spent high school in my friend’s backyard pool, but we weren’t “swimming.” We were horsing around, floating, disregarding sun protection, doing flips off the diving board. If I could recreate those days right now, I’d do it in a second.

But swimming for exercise? I thought if I wasn’t doing laps with a perfect crawl stroke and breathing rhythm, my swimming didn’t “count.” It felt indulgent to float around the pool on vacation, staring up at the sky.

It was indulgent. And what’s wrong with that?

Recently, I discovered a new joy in swimming — splashing in the kiddie pool with my small children. We all pretend to be Moana characters and end up happily drained and resting in the late afternoon.

Feel at home in the water but aren’t sure what to do with yourself? My advice is to do what you want: play, float, bob, do a headstand.

It’s been a lifelong challenge to do the activities I was supposed to do — for health, fitness, weight loss. I’ve accepted a new challenge to do things that don’t suck joy from me.

When you find what those activities are for you, you can borrow my new mantra:

Exercise Movement…

… is fun.

Anna Lee Beyer writes about mental health, parenting, and books for Huffington Post, Romper, Lifehacker, Glamour, and thealth, parenting, and books for Huffington Post, Romper, Lifehacker, Glamour, and others. Visit her on Facebook and Twitter.

Where Do Nonbinary People with Breast Cancer Find Support?

 Written by Miri Mogilevsky, LISW on July 29, 2019 New

“Everyone keeps talking about how the one remotely positive thing about having breast cancer is the survivor community, but that just doesn’t feel like something I get to have.”

Q: I’m nonbinary. I use they/them pronouns and consider myself transmasculine, although I don’t have any interest in hormones or surgery. Well, lucky me, I may end up getting top surgery anyway, because I also have breast cancer.

The experience has been very alienating. Everything about it, from treatment itself to support groups to the gift shop at the hospital, is obviously meant for cis women, especially straight and traditionally feminine ones.

breast cancer.

The experience has been very alienating. Everything about it, from treatment itself to support groups to the gift shop at the hospital, is obviously meant for cis women, especially straight and traditionally feminine ones.

I have supportive people in my life, but I wonder if I need to connect with other survivors, too. While the support groups I’ve been encouraged to go to all seem to be full of nice people, I worry it’s just because they see me as a woman, too. (There’s also a support group for men with breast cancer, but I’m not a man with breast cancer, either.)

Honestly, the people in my trans and nonbinary support groups on Facebook, and the trans folk I know locally, have been much more helpful as I go through this, even though none of them have had breast cancer. Is there anything I can do to feel more supported?

Everyone keeps talking about how the one remotely positive thing about having breast cancer is the survivor community, but that just doesn’t feel like something I get to have.

A: Hey there. I want to first of all validate how extra difficult and unfair this is. Advocating for yourself as a nonbinary person is always hard work. It’s especially hard (and unfair) when you’re doing so while going through cancer treatment!

I could go on a whole rant about the sexualization and gender essentialism that’s shaped breast cancer advocacy and support for decades, but none of that helps you right now. I just want to acknowledge it’s there, and there are starting to be more and more survivors, co-survivors, advocates, researchers, and medical providers who are aware of this and pushing back against it.

I think there are two pieces to your question, and they’re somewhat separate: one, how to navigate treatment as a nonbinary person; and two, how to seek support as a nonbinary survivor.

Let’s talk about the first question. You mentioned lots of supportive folks in your life. This is really important and helpful when it comes to navigating treatment. Does anyone accompany you to appointments and treatment? If not, could you recruit some friends or partners to come with you? Ask them to speak up for you and back you up as you set some boundaries with your providers.

Make a list of things your providers need to know to refer to you correctly. This could include the name you go by, your pronouns, your gender, the words you use for any parts of your body that might trigger dysphoria, how you want to be referred to besides your name and pronouns (i.e., person, human, patient, etc.), and anything else that might help you feel affirmed and respected.

There’s no reason why a doctor, introducing you to their assistant, can’t say something like, “This is [your name], a 30-year-old person with an invasive ductal carcinoma on the left side of their chest.”

Once you have your list, share it with any receptionists, nurses, PCAs, doctors, or other staff you interact with. Receptionists and nurses may even be able to add notes to your medical chart to make sure other providers see and use your correct name and pronouns.

Your support people will be able to follow up and correct anyone who misgenders  you or otherwise misses the memo.

Of course, not everyone is comfortable setting these kinds of boundaries with healthcare providers, especially when you’re fighting a life-threatening illness. If you don’t feel up to it, that’s completely valid. And it doesn’t make it your fault that you’re being misgendered or referred to in ways that don’t work for you.

It’s not your job to educate medical professionals. It’s their job to ask. If they don’t, and you have the emotional capacity to correct them, that could be a really helpful and ultimately empowering step for you. But if you don’t, try not to blame yourself. You’re just trying to get through this as best you can.

Which brings me to the second part of your question: seeking support as a nonbinary survivor.

You mentioned the trans/nonbinary people you know locally and online are really supportive, but they’re not survivors (or, at least, they’re not survivors of the same cancer you have). What kind of support are you looking for that you might need from breast cancer survivors specifically?

cI just ask because, while cancer support groups can be really helpful, they’re not right or necessary for everyone. I think a lot of us end up feeling like we “should” go to a support group during treatment because it’s the “thing to do.” But it’s possible that the social and emotional support needs you have are already being met by your friends, partners, and trans/nonbinary groups.

Given that you’ve found these folks more helpful than the other cancer survivors you’ve met, maybe there isn’t actually a cancer support group-shaped hole in your life.

And if that’s the case, it kind of makes sense. While I was in treatment, I was often stunned by how much I had in common with people who had gone through all kinds of completely noncancer things: concussions, pregnancy, loss of a loved one, invisible illness, ADHD, autism, Lyme disease, lupus, fibromyalgia, severe depression, menopause, and even gender dysphoria and gender-affirming surgery.

One of the things causing you the most pain right now is cissexism, and that’s an experience that everyone in any trans group is going to resonate with. No wonder you feel more supported there.

If you do want to find some resources more specific to trans or nonbinary cancer survivors, though, I recommend taking a look at the National LGBT Cancer Network.

I dearly wish there were more out there for you. I hope you’re able to carve out the space you need for yourself.

No matter what, though, I see you.

Just as your gender isn’t determined by the body parts you were born with, it’s not determined by which of those body parts cancer happens to strike.

Yours in tenacity,

Miri

Miri Mogilevsky is a writer, teacher, and practicing therapist in Columbus, Ohio. They hold a BA in psychology from Northwestern University and a master’s in social work from Columbia University. They were diagnosed with stage 2a breast cancer in October 2017 and completed treatment in spring 2018. Miri owns about 25 different wigs from their chemo days and enjoys deploying them strategically. Besides cancer, they also write about mental health, queer identity, safer sex and consent, and gardening.

-I Endured Multiple Miscarriages — and I’m Stronger Because of Them

 Written by Anna Crollman on July 29, 2019 New

Those losses, however painful, have shaped who I am today.

The news of our first positive pregnancy test was still sinking in as we drove to Wilmington for my mother-in-law’s wedding.

Earlier that morning, we had taken a beta test to confirm. As we waited for a phone call from the doctor to let us know the results, all I could think about was sharing the news and all the baby planning ahead.

I’d been off my hormone-blocking breast cancer medication for exactly six months; we were excited it had happened so fast. I was only allowed two years off my medication, so time was of the essence.

We had dreamed of becoming parents for years. Finally, it seemed cancer was taking a back seat.

But as we sped along the familiar route, pain started to course through my abdomen.

Having struggled with gastrointestinal issues ever since chemotherapy, I laughed it off at first, thinking it was just a bad case of gas pains. After the third bathroom stop, I weakly stumbled to the car, shaking and sweating.

Ever since my mastectomy and subsequent surgeries, physical pain triggers my anxiety. The two become so intertwined it’s hard to differentiate the physical pain from the anxiety symptoms.

My ever logical husband, meanwhile, beelined for the closest Walgreens, desperate for pregnancy-safe medication to alleviate my pain.

While waiting at the counter, my phone rang. I answered, expecting my favorite nurse Wendy’s voice on the other line. Instead I was met with my doctor’s voice.

Normally matter-of-fact, her quiet, soothing tone sent up an immediate warning. I knew what followed would break my heart.

“Your numbers are dropping,” she said. “That, combined with your pain, has me very concerned.”

In a daze, I stumbled to the car, processing her words. “Monitor the pain closely. If it worsens, go right to the emergency room.” At that point, it was too late to turn around and head home, so we continued toward what was supposed to be a joyful family weekend.

The next few hours are a blur. I remember arriving at the condo, collapsing on the floor, crying in pain and waiting in agony for the ambulance to arrive. For many cancer survivors, hospitals and doctors can trigger a host of negative memories. For me, they’ve always been a source of comfort and protection.

On this day it was no different. Though my heart was breaking into a million pieces, I knew those ambulance medics would care for my body, and in that moment, it was the only thing that could be controlled.

c

Four hours later, the verdict: “It’s not a viable pregnancy. We have to operate.” The words stung me like I had been slapped in the face.

Somehow the words carried a sense of finality. Though the physical pain was under control, I could no longer ignore the emotions. It was over. The baby couldn’t be saved. Tears stung my cheeks as I sobbed uncontrollably.

Before the ectopic pregnancy, my hope was unwavering. Despite my cancer diagnosis three years prior, hope for my future family guided me forward.

I had faith our family was coming. While the clock was ticking, I was still optimistic.

Following our first loss, though, my hope was shattered. I had trouble seeing beyond each day and felt betrayed by my body. It was hard to see how I could carry on in the midst of such pain.

I would be challenged many more times by grief before finally reaching our season of joy.
Little did I know that around the next bend, a successful frozen embryo transfer was waiting for us. This time around, while we had a little longer to revel in the joy, that hope, too, was ripped from us with the dreaded words, “There is no heartbeat,” at our seven-week ultrasound.

Following our second loss, it was my relationship with my body that suffered most. My mind was stronger this time around, but my body had taken a beating.

The D and C was my seventh procedure in three years. I began to feel disconnected, like I was living in an empty shell. My heart no longer felt a sense of connection to the body I moved in. I felt fragile and weak, unable to trust my body to recover.

So, how on earth did I heal from this nightmare? It was the community around me that gave me the strength to carry on.

Women from around the world sent me messages on social media, sharing their own stories of loss and the memories of the babies they once carried but never got to hold.

I realized that I, too, could carry the memory of these babies forward with me. The joy of the positive test results, the ultrasound appointments, those gorgeous photos of the tiny embryo — each memory stays with me.

Four hours later, the verdict: “It’s not a viable pregnancy. We have to operate.” The words stung me like I had been slapped in the face.

Somehow the words carried a sense of finality. Though the physical pain was under control, I could no longer ignore the emotions. It was over. The baby couldn’t be saved. Tears stung my cheeks as I sobbed uncontrollably.

Before the ectopic pregnancy, my hope was unwavering. Despite my cancer diagnosis three years prior, hope for my future family guided me forward.

I had faith our family was coming. While the clock was ticking, I was still optimistic.

Following our first loss, though, my hope was shattered. I had trouble seeing beyond each day and felt betrayed by my body. It was hard to see how I could carry on in the midst of such pain.

I would be challenged many more times by grief before finally reaching our season of joy.

Little did I know that around the next bend, a successful frozen embryo transfer was waiting for us. This time around, while we had a little longer to revel in the joy, that hope, too, was ripped from us with the dreaded words, “There is no heartbeat,” at our seven-week ultrasound.

Following our second loss, it was my relationship with my body that suffered most. My mind was stronger this time around, but my body had taken a beating.

The D and C was my seventh procedure in three years. I began to feel disconnected, like I was living in an empty shell. My heart no longer felt a sense of connection to the body I moved in. I felt fragile and weak, unable to trust my body to recover.

So, how on earth did I heal from this nightmare? It was the community around me that gave me the strength to carry on.

Women from around the world sent me messages on social media, sharing their own stories of loss and the memories of the babies they once carried but never got to hold.

I realized that I, too, could carry the memory of these babies forward with me. The joy of the positive test results, the ultrasound appointments, those gorgeous photos of the tiny embryo — each memory stays with me.

From those around me who had walked this path before, I learned that moving on didn’t mean I was forgetting.

Guilt, though, still lived in the back of my mind. I struggled to find a way to honor my memories while also moving on. Some choose to plant a tree, or celebrate a significant date. For me, I wanted a way to reconnect to my body.

I decided a tattoo was the most meaningful way for me to reestablish the bond. It wasn’t the loss I wanted to hold on to, but the memories of those sweet embryos that once grew within my womb.

The design honors all my body went through as well as symbolizing my body’s ability to heal and once again carry a child.

Now behind my ear those sweet memories remain, staying with me as I build a new life filled with hope and joy. These children I lost will always be a part of my story. For anyone who has lost a child, I’m sure you can relate.

Slowly but surely, I learned to live with both guilt and hope intertwined. Then, too, came the small moments of joy.

Little by little, I started enjoying life again.

The moments of joy started small and grew with time: sweating out the pain in a hot yoga class, late-night snuggles with my hubby watching our favorite show, laughing with a girlfriend in New York when I got my first period following the miscarriage, bleeding through my pants in the line to a NYFW show.

Somehow I was proving to myself that despite all I lost, I was still me. I may never be whole again in the sense that I knew before, but just like I did after cancer, I’d continue to reinvent myself.

We slowly opened our hearts to start thinking about a family again. Another frozen embryo transfer, surrogacy, adoption? I began researching all our options.

In early April, I started getting impatient, ready to try another frozen embryo transfer. Everything hinged on my body being ready, and it didn’t seem to be cooperating. Every appointment confirmed my hormones weren’t yet at the desired baseline.

Disappointment and fear began to threaten the relationship I had rebuilt with my body, hope for the future waning.

I had been spotting for two days and was convinced that my period had finally arrived. We were headed in on Sunday for another ultrasound and blood check. My husband rolled over on Friday night and said to me, “I think you should take a pregnancy test.”

I pushed the idea from my head, too scared to even acknowledge the possibility of a natural pregnancy.


was so focused on Sunday’s next step toward our frozen embryo transfer, the thought of natural conception was the furthest thing from my mind. Saturday morning, he pushed me again.

To appease him — with no doubt it would be negative — I peed on a stick and went downstairs. When I returned, my husband was standing there, holding the stick with a goofy grin.

“It’s positive,” he said.

I literally thought he was joking. It sounded impossible, especially after all we’d been through. How on earth did this happen?

Somehow all that time I thought my body wasn’t cooperating, it was doing exactly what it was supposed to do. It had healed from my D and C in January and the subsequent hysteroscopy in February. It somehow managed to form a beautiful baby all on its own.

While this pregnancy has been riddled with challenges of its own, somehow my mind and body have carried me forward with hope — hope for the strength of my body, my spirit, and most of all, for this baby growing inside me.

Fear may have threatened my hope time and time again, but I refuse to give up. There’s no doubt that I have changed. But I know I’m stronger for it.

Whatever you’re facing, know you’re not alone. While your loss, despair, and pain may seem insurmountable now, there will come a time when you, too, will find joy again.

In the worst moments of pain following my emergency ectopic surgery, I never thought I would make it to the other side — to motherhood.

But as I write to you now, I’m in awe of the painful journey I’ve faced to get here, as well as the power of hope as it carried me forward.

I now know that everything I went through was preparing me for this new season of joy. Those losses, however painful, have shaped who I am today — not just as a survivor, but as a fierce and determined mother, ready to bring new life into this world.

If I’ve learned anything, it’s that the path forward may not be on your timeline and it may not be exactly as you’d planned. But something good is waiting for you just around the bend.


Anna Crollman is a style enthusiast, lifestyle blogger, and breast cancer thriver. She shares her story and a message of self-love and wellness through her blog and  social media, inspiring women around the globe to thrive in the face of adversity with strength, self-confidence, and style.

The Ultimate Guide to Traveling with Anxiety: 5 Tips to Know

Medically reviewed by Timothy J. Legg, PhD, CRNP on July 29, 2019 New — Written by Meagan Drillinger
Having anxiety doesn’t mean you have to be homebound.
Raise your hand if you hate the word “wanderlust.”

In today’s social media-driven world, it’s nearly impossible to go more than 30 minutes without being oversaturated with images of gorgeous people in gorgeous places doing seemingly gorgeous things.

And while that may be great for them, there seems to be a complete disregard for the people out there who aren’t going anywhere because they have anxiety.

It turns out that anxiety disorders are the most common mental illness in the United States, affecting 40 million adults (18.1 percent of the population) each year. Anxiety disorders are highly treatable, but less than 40 percent of folks with anxiety actually receive treatment.

So kudos to those of you out there living #thathashtaglife. But for a significant portion of people, that life seems woefully out of reach thanks to anxiety.

The good news is that it’s entirely possible to get out and see the world — yes, even when you have anxiety. We’ve reached out to experts who have given their professional tips and tricks on how to travel when you have anxiety.

1. Recognize the trigger(s)

As with any anxiety or fear, the first step to overcoming it, or coping with it, is to recognize where it comes from. Say its name out loud and you take away its power, right? Just like any fear, the same is true for travel anxiety.

Some anxiety is triggered by the unknown. “Not knowing what will happen or how things will go can be very anxiety-provoking,” says Dr. Ashley Hampton, a licensed psychologist and media strategist. “Researching what it is like to go to the airport and go through security is important,” she recommends.

Traveling can also trigger anxiety because of a previously bad travel experience. “I have had clients tell me they no longer like to travel because they were pickpocketed and now feel like they’re unsafe,” Hampton adds.

She recommends that instead of dwelling on the one negative instance, focus on all the many, many instances that were positive. “We also talked about strategies to implement that can help to prevent them from being pickpocketed again,” Hampton says. Sometimes bad things happen, she adds, and those things can happen to anyone.

Is a fear of flying itself triggering anxiety? For many people, travel anxiety comes from the physical act of being on a plane. For this, Hampton recommends deep breathing and a combination of counting when the plane is taking off and climbing into the sky.

“I also try to sleep, as time sleeping is less time for me to spend worrying,” Hampton says. If the flight is in the middle of the day, distractions are positive tools that can help reduce anxiety, like reading a book or listening to music.

Figuring out your anxiety triggers is a good way to help anticipate it and ultimately help you through to the other side.

2. Work with your anxiety, not against it

Speaking of distractions, these can be some of the most effective ways to fill those anxiety-fraught moments while either in transit or on the trip itself.

First, if traveling alone is too much, there’s no reason to not travel with a friend to help share some of the responsibilities. In fact, traveling with a friend could make the whole experience downright fun.

“Share your concerns, your coping strategies, and how they can support you if you become anxious,” says George Livengood, assistant national director of operations at Discovery Mood & Anxiety Program.

“If you are traveling by yourself, let a friend or family member know that you might reach out to them if in distress, and coach them on the ways they can provide support over the phone,” he says.

It can help to accept, expect, and embrace the fact that you’ll be anxious, too. Often trying to push away the feelings of anxiety can make it worse.

“By embracing the fact that they will be anxious and preparing for what it will be like, they can actually reduce the likelihood of the anxiety happening, or, at least, reduce the severity of the symptoms,” says Tiffany Mehling, a licensed clinical social worker.

For example, being prepared with the thought “I will be anxious if there is turbulence” and visualizing how you’ll respond — maybe with mindfulness or breathing techniques that can slow down the psychological reaction — can be effective.

It can even be as simple as, “When I get butterflies, I’m going to order a ginger ale as soon as possible.”

3. Come back to your body

Anyone with anxiety can tell you that anxiety isn’t just mental.

Dr. Jamie Long, a licensed clinical psychologist, offers seven easy steps when trying to mitigate travel anxiety by tending to your body:

The night before your travels, drink plenty of water and nourish your body. Anxiety can diminish your appetite, but the brain and body need fuel to combat anxiety.
Once through security, buy a cold bottle of water — and be sure to drink it. Our thirst increases when we’re anxious. The cold bottle of water will come in handy.
In the boarding area, do a 10-minute guided meditation, preferably one intended for travel anxiety. There are many meditation apps you can download to your phone. Most apps have meditations intended for different situations.
A few minutes before boarding, go to the bathroom or a private corner, and do a few jumping jacks. Intense exercise, even for just a few moments, can calm a body revved up by emotion.
Walking down the gangway, do four-count paced breathing. Breathe in for four seconds, hold for four seconds, exhale for four seconds, and repeat.
While in your seat, give your anxious thoughts a competing task. Bring something to read, have something to watch, or even say the alphabet backward. Giving your brain a focused task keeps it from dress-rehearsing a catastrophe.
Practice compassionate and encouraging self-talk. Tell yourself, “I can do this. I am safe.”
While traveling, it’s also important to be thoughtful about food choices. The foods we put in our bodies can directly affectTrusted Source our ability to regulate our moods, including the amount of anxiety we feel.

Be cautious of spiking caffeine, sugar, or alcohol intake if you’re looking to manage your symptoms. And stay nourished, especially if your travels involve a lot of physical activity.

4. Set your own pace

There’s no “wrong” way to travel. If you’re active on social media, you might be led to the conclusion that there are “right” and “wrong” ways to travel, based on your peers who are semi-preaching YOLO and not “traveling like a tourist.”

The truth is, as long as you’re respectful of the places you visit, there’s absolutely no wrong way to travel. So, set your own pace to what feels comfortable. You aren’t doing it wrong.

“I like to recommend clients spend some quiet time transitioning to being in a new space once they arrive at their destination,” says Stephanie Korpal, a mental health therapist with a private practice. “It can be critical to slow down and let our emotional selves catch up to our physical selves.”

She recommends a few minutes of deep breathing or meditating once you arrive at your accommodation.

It can also be helpful to be aware of the pace while traveling. It can be easy to get caught up in the idea of packing every minute with activities and sightseeing.

“If you suffer from anxiety, that pace might actually prevent you from soaking up the experiences,” Korpal says. “Be sure, instead, to incorporate downtime, relaxing at your place of lodging, or maybe reading at a coffee shop so you don’t get physiologically overstimulated.”

5. Don’t confuse anxiety with excitement

Ultimately, some anxiety is normal. We all need anxiety to function. And often, anxiety and excitement can have similar signals.

They both increase heart rate and breathing, for example. “Don’t let your mind trick you into thinking you must be anxious because your heart rate has increased,” Livengood says. There’s no need to psych yourself out!

The excitement, after all, can be what makes travel worthwhile. It’s part of the fun and part of the reason you want to travel in the first place! Don’t lose sight of that.

And remember, anxiety doesn’t mean you’re resigned to being homebound.

With some creative thinking and preparation — and, if needed, some professional support — you can learn how best to travel on your own terms.


Meagan Drillinger is a travel and wellness writer. Her focus is on making the most out of experiential travel while maintaining a healthy lifestyle. Her writing has appeared in Thrillist, Men’s Health, Travel Weekly, and Time Out New York, among others. Visit her blog or Instagram.


Why Is My Anxiety Worse at Night?

Medically reviewed by Timothy J. Legg, PhD, CRNP on July 29, 2019 New — Written by Leah Campbell
“When the lights are out, the world is quiet, and there are no more distractions to be found.”

Why Is My Anxiety Worse at Night?

Medically reviewed by Timothy J. Legg, PhD, CRNP on July 29, 2019 New — Written by Leah Campbell
“When the lights are out, the world is quiet, and there are no more distractions to be found.”


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It always happens at night.

The lights go out and my mind spins. It replays all the things I said that didn’t come out the way I meant. All the interactions that didn’t go the way I intended. It bombards me with intrusive thoughts — horrific videos that I can’t turn away from, playing over and over in my head.

It beats me up for mistakes I’ve made and tortures me with worries I can’t escape.

What if, what if, what if?

I’ll sometimes be up for hours, the hamster wheel of my mind refusing to relent.

And when my anxiety is at its worst, it often follows me even into my dreams. Dark, twisted images that seem haunting and all too real, resulting in restless sleep and night sweats that serve as further proof of my panic.

None of it’s fun — but it’s also not entirely unfamiliar. I’ve been dealing with anxiety since my tween years and it’s always been the worst at night.

When the lights are out, the world is quiet, and there are no more distractions to be found.

Living in a cannabis-legal state helps. On the nights that are the worst, I reach for my high-CBD vape pen and that’s usually enough to soothe my racing heart. But before legalization in Alaska, those nights were mine and mine alone to get through.

I would have paid anything — given everything — for a chance to escape them.

Understanding what’s happening

I’m not alone in this, according to clinical psychologist Elaine Ducharme. “In our society, individuals spend billions of dollars to rid themselves of anxiety,” she tells Healthline.

She explains that the symptoms of anxiety, though, can often be life-saving. “They keep us alert to danger and assure survival.” She’s talking about the fact that anxiety is basically our body’s fight or flight reaction — in practice, of course.

The problem for those suffering [from] anxiety is that usually there is no need for the anxiety. The physical danger is not real and there is no need to fight or flee.”

And that’s my problem. My worries are rarely life and death. And yet, they keep me up at night all the same.

Licensed mental health counselor Nicky Treadway explains that, during the day, most people with anxiety are distracted and task-focused. “They’re feeling the symptoms of anxiety, but they have better places to land them, moving from point A to B to C throughout the day.”

This is how I live my life: keeping my plate so full that I don’t have time to dwell. As long as I have something else to focus on, the anxiety seems manageable.

But when thenighttime anxiety sets in, Treadway explains that the body is shifting into its natural circadian rhythm.

“The light is going down, the melatonin production in the body is going up, and our body is telling us to rest,” she says. “But for someone who has anxiety, leaving that place of hyperarousal is difficult. So their body is kind of fighting that circadian rhythm.”

Ducharme says that panic attacks occur with the greatest frequency between 1:30 and 3:30 a.m. “At night, things are frequently quieter. There is less stimulation for distraction and more opportunity for worry.”

She adds that we may have no control over any of these things, and they’re often made worse by the fact that help is less available at night.

After all, who are you supposed to call at 1 in the morning when your brain is putting you through a marathon of worries?

The worst of it

In the darkest moments of night, I convince myself that everyone I love hates me. That I’m a failure at my job, at parenting, at life. I tell myself that everyone who’s ever hurt me, or left me, or spoken ill about me in any way was absolutely in the right.

I deserved it. I’m not enough. I never will be.

This is what my mind does to me.

I see a therapist. I take meds. I try hard to get enough sleep, to exercise, to eat well, and to do all the other things that I’ve found help keep the anxiety at bay. And most of the time, it works — or at least, it works better than doing nothing at all.

But the anxiety is still there, lingering on the edge, waiting for some life event to occur so that it can seep in and make me question everything I’ve ever known about myself.

And the anxiety knows it’s at night when I’m most vulnerable.

Fighting the demons

Ducharme cautions against using marijuana as I do in those darkest moments.

“Marijuana is a tricky issue,” she explains. “Though there is some evidence that marijuana can relieve anxiety in the short term, it is not recommended as a long-term solution. Some people actually become more anxious on pot and may develop paranoid symptoms.”

For me, that isn’t issue — perhaps because I don’t rely on marijuana on a nightly basis. It’s only those few times a month when my regular meds just aren’t doing the trick and I need sleep.

But to avoid having those nights altogether, Treadway suggests developing a sleep routine that can help with the transition from day to night.

This might include taking a 15-minute shower every night, using lavender essential oils, journaling, and meditating. “That way we’re more likely to shift into sleep, and to have better quality sleep.”

I’ll admit, this is an area I could improve. As a self-employed freelance writer, my bedtime routine often includes working until I feel too tired to type another word — and then shutting the lights off and leaving myself alone with my broken thoughts.

But after over two decades of dealing with anxiety, I also know she’s right.

The harder I work to take care of myself and stick to routines that help me relax, the easier my anxiety — even my nighttime anxiety — is to manage.

There is help

And perhaps that’s the point. I’ve come to accept that anxiety will always be a part of my life, but I also know there are things I can do to help keep it under control, which is something Ducharme is passionate about making sure others are aware of.

“People need to know that anxiety disorders are highly treatable,” she says. “Many respond very well to treatment with CBT techniques and medication, learning to stay in the moment — not in the past or future — even without meds. Others may need meds to calm themselves enough to learn and benefit from CBT techniques.”

But either way, she explains, there are methods and medications available that can help.

As for me, even though I’ve committed 10 years of my life to extensive therapy, there are some things that are ultimately really difficult to escape. That’s why I try my hardest to be kind to myself — even to the part of my brain that sometimes likes to torture me.

Because I am enough. I am strong and confident and capable. I am a loving mother, a successful writer, and a devoted friend.

And I am equipped to deal with any challenge that comes my way.

No matter what my nighttime brain tries to tell me.

For the record, you are too. But if your anxiety is keeping you up at night, talk to a doctor or therapist. You deserve to find relief, and there are options available to achieve that.


Leah Campbell is a writer and editor living in Anchorage, Alaska. She’s a single mother by choice after a serendipitous series of events led to the adoption of her daughter. Leah is also the author of the book “Single Infertile Female” and has written extensively on the topics of infertility, adoption, and parenting. You can connect with Leah via Facebook, her website, and Twitter.


Get Bowled Over by This Quinoa and Roasted Sweet Potato Recipe
 Written by Tiffany La Forge on July 29, 2019 New

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Illustration by Brittany England
Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

Ah, grain bowls — a current favorite lunchtime craze.

So why aregrain bowls so popular?

First, they’re perfect for meal prep. You can cook a big batch of grains, roast some veggies, or even utilize leftovers from dinner the night before — and voilà! you have a grain bowl.

Constructing the perfect grain bowl goes like this:

Choose your grains — brown rice, quinoa, barley, millet, etc.
Pick your protein.
Add in the fixin’s — veggies, seeds, nuts, and other healthy fats.
Add dressing.
The star of this meatless grain bowl is quinoa, a nutritious gluten-free grain high in protein, fiber, and antioxidants. Quinoa is higher in protein than most grains and contains all nine essential amino acids, making it a great choice for plant-based protein.

Topped with heart-healthy greens, crunchy veggies, antioxidant-rich sweet potatoes, and a Greek yogurt dressing (for even more protein), this hearty lunch is 336 calories per serving.

Quinoa and Roasted Sweet Potato Bowls with Lemon Yogurt Recipe

Servings: 4

Cost per serving: $2.59

Ingredients

For the quinoa

1 tsp. olive oil
2 cloves garlic, minced
1 cup quinoa
2 cups vegetable stock
1/2 tsp. salt
3 tbsp. chopped fresh cilantro
For the bowls and sauce

1 large sweet potato, cubed
1 bunch of asparagus, trimmed and cut into thirds
1 tbsp. + 2 tsp. olive oil, divided
1 cup plain Greek yogurt
1 lemon, zested and juiced
3 tbsp. chopped fresh parsley
4 radishes, thinly sliced
2 cups baby kale or spinach
sea salt and pepper, to taste
Directions

Preheat the oven to 450°F.
Toss the cubed sweet potato with a teaspoon of olive oil and the salt and pepper. Roast on a parchment-lined baking sheet until golden brown and tender, about 20–30 minutes.
Toss the asparagus with a teaspoon of oil, salt, and pepper, and roast until tender for the last 10–15 minutes that the potatoes are baking.
In the meantime, cook the quinoa. To do this, rinse the quinoa and heat the olive oil in a medium stock pot. Cook the minced garlic until fragrant and softened, but not browned. Add the quinoa and toast until nutty, about 1–2 minutes. Add the stock and salt and bring to a boil. Once boiling, cover and turn down the heat to a steady simmer. Cook 15 minutes. Remove from heat and let stand 5 minutes. Uncover, fluff with a fork, and mix in the chopped cilantro.
Make the yogurt sauce by whisking 1 tablespoon olive oil, the Greek yogurt, lemon juice, lemon zest, and chopped parsley. Season to taste with salt and pepper.
Assemble the bowls. Divide the quinoa between 4 bowls or meal prep containers. Top with the roasted sweet potato, asparagus, sliced radish, and baby kale. Drizzle with yogurt sauce.
Enjoy!
PRO TIP
To save even more money, use water in place of vegetable stock when making the quinoa and feel free to change up the veggies in this bowl for whatever’s on sale or in season.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

Dig Into This Affordable Kale, Tomato, and White Bean Soup Lunch Recipe

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge

Written by Tiffany La Forge

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Illustration by Brittany England
Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

Soup makes for a great meal prep option — especially when it’s as straight-forward as this kale and white bean soup recipe.

At just about $2 per serving, this soup highlights the wonder that is canned beans. Canned beans are convenient, an excellent source of protein, and cheap!

Garbanzo beans (chickpeas), for example, are high in protein, fiber, folate, iron, and magnesium. This soup also utilizes a generous amount of antioxidant-rich kale which, along with the tomato, adds plenty of vitamin C.

One serving of this soup has:

315 calories
16 grams of protein
high amounts of fiber
Whip up a batch of this soup on Sunday to last you through the whole work week. You can also make this soup completely vegan by skipping the grated cheese.

Kale, Tomato, and White Bean Soup Recipe

Servings: 6

ngredients

2 tbsp. olive oil
4 cloves garlic, minced
1 leek, white and light green part only, diced
1 small yellow onion, diced
3 stalks celery, diced
4 medium carrots, peeled and diced
1 28-oz. can diced tomatoes
1 cup diced and peeled Yukon gold potatoes
32 oz. vegetable broth
1 15-oz. can garbanzo beans, drained and rinsed
1 15-oz. can cannellini beans, drained and rinsed
1 bunch Lacinato kale, stemmed and chopped
1 tbsp. fresh rosemary, chopped
2 tsp. fresh thyme, chopped
sea salt and freshly ground pepper, to taste
grated Parmesan, for serving (optional)
Directions

Heat 2 tablespoons of olive oil in a large stock pot over medium heat.
Add in the garlic, leek, onion, celery, and carrots. Season with sea salt and freshly ground pepper. Cook the vegetables, stirring occasionally until softened, about 5–7 minutes.
Add in the diced tomato and cook another 5 minutes. Add in the potatoes and vegetable broth. Bring to a simmer.
Mash half of the cannellini beans. Once simmering, add in the kale and the beans. Lower the heat, cover, and cook for about 15–20 minutes, until the potatoes are tender. Stir in the herbs.
Serve with freshly grated Parmesan, if desired.
PRO TIP
Making your own vegetable broth at home is a great way to save money. Freeze clean carrot peelings, onion skin, leek tops, and vegetable ends in a freezer-safe bag and make a batch of broth when you have enough.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

This Affordable Mediterranean Tuna Pasta Salad Is the Perfect Lunch Option

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge


Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

It’s true, tuna pasta salad gets a bad rap. It can spark mental images of an unappetizing bowl of overcooked pasta, mushy peas, and way-too-much-mayo that’s sat in a grocery store deli case for far too long.

But this tuna pasta salad is different. We promise.

Per serving, this pasta salad has:

425 calories
high amounts of fiber and iron
24 grams of protein
With the satiating trifecta of fiber, protein, and healthy fats, you may find you’re full until dinner.

Inspired by Mediterranean flavors, this salad trades mayonnaise for a light and zesty vinaigrette and is loaded with herbs and fresh veggies. Jarred ingredients like marinated artichokes, roasted red peppers, and olives add a ton of flavor without a ton of dollars.

The tuna in this recipe is — and should be — the highest cost per serving ingredient

Bonus: This colorful salad is a great meal-prep lunch idea, as it tastes even better the next day!

Mediterranean Tuna Pasta Salad Recipe

Servings: 4

Cost per serving: $2.80

Ingredients

8 oz. whole grain rotini pasta
1 small shallot, minced
3 tbsp. olive oil
1 tsp. Dijon mustard
1 tbsp. lemon juice
1/2 tsp. lemon zest
1 tbsp. red wine vinegar
1/2 tsp. dried oregano
1 Persian cucumber, diced
4 oz. grape tomatoes, halved
1/4 cup kalamata olives, chopped
1/2 cup roasted red peppers, chopped
4 oz. marinated artichokes, chopped
1/2 cup crumbled feta
1 can tuna
1/2 cup fresh parsley, chopped
sea salt and pepper, to taste
Directions

Cook the pasta according to package directions, in generously salted water until al dente. Drain the pasta and rinse under cold water, toss with a drizzle of olive oil, and set aside to cool completely.
Make the dressing. In a mason jar, combine the minced shallot, olive oil, Dijon, lemon juice and zest, vinegar, oregano, and salt and pepper to taste. Shake vigorously until emulsified.
Toss the cooled pasta with the cucumber, tomatoes, olives, red peppers, artichokes, feta, tuna, and parsley. Pour in the dressing and mix until combined. Taste and adjust seasoning, adding salt and pepper as desired.
Let the pasta sit in the refrigerator overnight, or for at least 4 hours. Enjoy!
PRO TIP
When making pasta for salads, toss the drained pasta immediately with a little olive oil to avoid it from sticking together as it cools.

that’s sat in a grocery store deli case for far too long.

But this tuna pasta salad is different. We promise.

Per serving, this pasta salad has:

425 calories
high amounts of fiber and iron
24 grams of protein
With the satiating trifecta of fiber, protein, and healthy fats, you may find you’re full until dinner.

Inspired by Mediterranean flavors, this salad trades mayonnaise for a light and zesty vinaigrette and is loaded with herbs and fresh veggies. Jarred ingredients like marinated artichokes, roasted red peppers, and olives add a ton of flavor without a ton of dollars.

The tuna in this recipe is — and should be — the highest cost per serving ingredient.

Bonus: This colorful salad is a great meal-prep lunch idea, as it tastes even better the next day!

Mediterranean Tuna Pasta Salad Recipe

Servings: 4

Cost per serving: $2.80

Ingredients

8 oz. whole grain rotini pasta
1 small shallot, minced
3 tbsp. olive oil
1 tsp. Dijon mustard
1 tbsp. lemon juice
1/2 tsp. lemon zest
1 tbsp. red wine vinegar
1/2 tsp. dried oregano
1 Persian cucumber, diced
4 oz. grape tomatoes, halved
1/4 cup kalamata olives, chopped
1/2 cup roasted red peppers, chopped
4 oz. marinated artichokes, chopped
1/2 cup crumbled feta
1 can tuna
1/2 cup fresh parsley, chopped
sea salt and pepper, to taste
Directions

Cook the pasta according to package directions, in generously salted water until al dente. Drain the pasta and rinse under cold water, toss with a drizzle of olive oil, and set aside to cool completely.
Make the dressing. In a mason jar, combine the minced shallot, olive oil, Dijon, lemon juice and zest, vinegar, oregano, and salt and pepper to taste. Shake vigorously until emulsified.
Toss the cooled pasta with the cucumber, tomatoes, olives, red peppers, artichokes, feta, tuna, and parsley. Pour in the dressing and mix until combined. Taste and adjust seasoning, adding salt and pepper as desired.
Let the pasta sit in the refrigerator overnight, or for at least 4 hours. Enjoy!
PRO TIP
When making pasta for salads, toss the drained pasta immediately with a little olive oil to avoid it from sticking together as it cools.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

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Add Some Crunch to Your Lunch with This Lentil and Barley Salad Recipe

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge


Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

At less than $2 per serving, this sweet and savory grain salad is a winner.

The stars of this salad are the lentils and barley, two budget-friendly ingredients that bring considerable nutritional value to the table.

Lentils are made up of 25 percent protein and are an excellent source of fiber, B vitamins, zinc, and potassium.

Like lentils, barley is also rich in fiber, vitamins, minerals, and beneficial plant compounds.

Meanwhile, pomegranate and apple not only add sweetness to this salad, but a punch of antioxidants with anti-inflammatory benefits.

You can also feel free to experiment with whatever grains you have on hand. Here are some of our favorites.

Lentil and Barley Salad with Pomegranate and Feta Recipe

Servings: 4

Cost per serving: $1.86

Ingredients

3/4 cup dry green lentils
1/2 cup dry pearled barley
2 garlic cloves, minced
1 tbsp. minced shallot
1 1/2 tsp. Dijon mustard
1 tsp. honey
2 tbsp. apple cider vinegar
1/4 cup olive oil
1/2 cup pomegranate seeds
1/3 cup crumbled feta
1 cup shredded radicchio or red cabbage
1/4 cup chopped fresh parsley
1 apple, peeled and diced
1/4 cup chopped almonds
sea salt and pepper, to taste
Directions

Combine the lentils and barley with 5 cups of water, 2 cloves of garlic, and sea salt. Bring to a boil and then cover. Reduce to a simmer and cook until the lentils and barley are done (this takes about 25 minutes).
Drain, discard garlic cloves, and set aside to cool.
Make the dressing by combining the shallot, Dijon mustard, honey, apple cider vinegar, olive oil, and salt and pepper (to taste) in a mason jar. Shake vigorously until emulsified and combined.
Assemble the salad. Combine the cooled barley and lentils with the pomegranate, feta, radicchio, parsley, apple, and almonds.
Dress with the vinaigrette and toss thoroughly to combine.
Serve cold or at room temperature.
Pro tip Make this dish dairy-free and replace the feta with olives to keep that tangy flavor.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.


Dress up Your Lunchtime Salad with This Wild Rice and Chicken Kale Recipe

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge


Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

This wild rice salad is a great way to use leftover chicken. It’s packed with protein, fiber, and healthy fats, and clocks in at about 400 calories per serving.

Although wild rice is more expensive than typical rice, look to wild rice blends that include other varieties such as brown, long grain, and red rice, as these tend to be less expensive.

This salad features kale, juicy grapes, ripe tomatoes, crunchy veggies, almonds, and a quick and easy vinaigrette made with pantry staples.

You may already know the many nutritional benefits kale can offer, but just in case you need a reminder: Kale is among the most nutrient-dense foods in the world and boasts a generous amount of vitamins (K, A, and C), fiber, and antioxidants.

Wild Rice and Chicken Kale Salad Recipe

Servings: 4

Cost per serving: $2.78

Ingredients

3 tbsp. balsamic vinegar
1/4 cup + 2 tsp. olive oil
1 tbsp. honey
1 tbsp. Dijon mustard
1/4 tsp. dried thyme
1 bunch kale, stemmed and chopped
1 1/2 cups cooked chicken, diced
1 cup grape tomatoes, halved
2 cups red seedless grapes, halved
1 cup shredded carrots
3 stalks celery, sliced
1/4 cup chopped parsley
1/4 cup sliced toasted almonds
1 1/2 cups cooked wild rice blend
sea salt and pepper, to taste
Directions

Make the dressing by combining the balsamic, olive oil, honey, Dijon, and thyme in a mason jar and shaking vigorously to combine. Season with salt and pepper.
In a large bowl, toss the chopped kale with 2 teaspoons of olive oil and salt and pepper to taste. Massage the kale for a few minutes, until the leaves turn noticeably darker green in color and tenderize.
Toss the kale with the chicken, tomatoes, grapes, carrots, celery, parsley, almonds, and cooked wild rice.
Add in the dressing and toss to combine. Enjoy!
PRO TIP
If you can splurge or find it on sale, goat cheese makes for a delicious addition to this salad. Just crumble about a tablespoon on top for each serving.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

Put a Twist on Your BLT with This Budget-Friendly Panzanella and Turkey Bacon Salad

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge


Affordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

Think of this recipe as a more nutritious — but still delicious — deconstructed BLT sandwich.

In case you’ve never heard of panzanella, it’s a salad that features dressing-soaked bread that’s tossed with veggies and herbs.

In this version, we combine whole-grain bread cubes with turkey bacon, crunchy romaine lettuce, ripe tomatoes, avocado, and the quickest lemony dressing you’ve ever made.

It’s a great way to get some midday fiber, healthy fats, and fresh veggies to keep you feeling full and energized up through 5 p.m.

And, best of all, it’s under $3 per serving!

One serving of this BLT salad is:

480 calories
14 grams of protein
high amounts of fiber
And did we mention how delicious it is?

BLT Panzanella Salad with Turkey Bacon

Servings: 2

Cost Per Serving: $2.89

Ingredients

1 cup crusty whole grain bread, cubed
1 tsp. olive oil
4 slices turkey bacon
1 cup cherry tomatoes, halved
1/4 cup fresh basil, chopped
1 ripe avocado, diced
2 cups romaine lettuce, chopped
1 garlic clove, minced
2 tbsp. avocado oil
1 tbsp. lemon juice
sea salt and pepper, to taste
Directions

Preheat the oven to 400°F.
Toss the bread cubes with the olive oil and a pinch of salt and pepper. Toast the bread on a baking sheet until golden, about 10–15 minutes. Remove and let cool.
Place the turkey bacon on a parchment-lined baking sheet and cook until crisp, about 15 minutes. Crumble the bacon.
Toss the cooled bread cubes with the crumbled bacon, tomatoes, basil, avocado, and romaine lettuce.
In a small bowl, whisk together the minced garlic, avocado oil, and lemon juice. Season with sea salt and pepper and toss to coat the salad. Enjoy!
PRO TIP
Don’t throw away that bread or unwanted end pieces! This salad is the perfect way to use up stale bread.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.


Shake Things up with These Affordable Chickpea Taco Lettuce Wraps

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on July 29, 2019 New — Written by Tiffany La Forge

ordable Lunches is a series that features nutritious and cost effective recipes to make at home. Want more? Check out the full list here.

For a delicious, meatless Taco Tuesday at the office, pack these chickpea taco lettuce wraps for lunch.

These are one of the most straight-forward lunches you can make, and they’re extremely customizable. The beauty of these tacos is that you can really top them with anything you desire — or anything that’s in the fridge.

The nutrient-dense chickpeas in this recipe are packed with protein and fiber. In fact, one serving of this recipe contains a whopping amount of daily recommended soluble fiber.

And because this recipe makes 2 servings, it’s perfect to make for dinner and then pack half away for lunch the next day.

Chickpea Taco Lettuce Wraps Recipe

Servings: 2

Cost per serving: $2.25

Ingredients

1 tbsp. olive oil
1/2 cup onion, diced
2 cloves garlic, minced
1 15-oz. can garbanzo beans, drained and rinsed
1 tbsp. taco seasoning
6 large bibb or romaine lettuce leaves
1/4 cup shredded cheddar cheese
1/2 cup salsa
half an avocado, diced
2 tbsp. pickled jalapeno, chopped
2 tbsp. fresh cilantro, chopped
1 lime
Directions

Heat a sauté pan with the olive oil. Once hot, add the onion and cook until softened.
Stir in the garlic and the chickpeas. Season the mixture with the taco seasoning and cook until golden.
Spoon the chickpea mixture into lettuce wraps and top with shredded cheese, salsa, avocado, pickled jalapeno, fresh cilantro, and a squeeze of lime juice. Enjoy!
PRO TIP
Pack the chickpea mixture and the lettuce and toppings in separate containers so you can heat the chickpeas before assembling.

Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

13 Ways to Get a Doctor to Take You (Very, Very) Seriously When You’re in Pain
 Written by Ash Fisher on July 29, 2019 New
Are you sure you aren’t lying, though?

ow we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

Let’s say you’ve been suffering from pain for a while, perhaps years.

Thinking, ever so naively, that being in constant pain for months on end isn’t normal, you go to your doctor. He orders blood work and maybe an X-ray or a sonogram. All results come back normal, so your doctor dismisses your concerns.

Maybe he accuses you of being a drug seeker, since the only people with “real” pain are either dying or lying.

I get it. It took me 32 years to get a doctor to take my pain seriously — and to get a diagnosis with a connective tissue disease I was born with that no doctor ever noticed my obvious symptoms of, whoops.

I don’t want you to wait decades for answers, though. So here are some expertly curated tips and tricks to get your doctor to listen to you, take your pain seriously, and — gee-whiz-gosh-golly! — maybe even help.

1. Say “I am in pain.” Be ignored or dismissed, because it can’t be that bad. Leave with your tail between your legs, you wascally wabbit.

2. Say “I am in severe pain.” This time your doctor will respond! With an eye roll. Followed by a reminder that all your blood work is negative and you don’t “look sick.” Leave the doctor’s office, you dramatic exaggerator, you!

3. Wear a button that says, “Friendly reminder: I Am in Pain.” Pin it to your shirt that says, “REAL BAD PAIN, DOC.” Make sure he looks at your throat so when you stick your tongue out and say “ah,” he’ll see your new tongue tattoo that says: “YOU TOOK AN OATH.”

4. Bring a polygraph machine to your next appointment. Make sure you’re hooked up to it when you remind your doc that you’re in severe, daily pain. He’ll acknowledge that while the machine claims you aren’t lying, your insurance doesn’t cover polygraph tests, and thus, he can’t take the results into account when determining your treatment plan, which is yoga.
5. When your doctor suggests yoga, solemnly inform him that your pain is so bad you can’t even do yoga. So, if he could just help with this widespread joint and muscle pain that is slowly, steadily debilitating you more and more each week — whether that be physical therapy or pain meds or a specialist or just, you know, something — you promise to take a yoga class.

6. Write a guide called “A 30 Second Primer on Basic Human Decency” and anonymously mail it to your doctor the week before your appointment. He won’t read it — that is the catch-22 of the decency primer.

13 Ways to Get a Doctor to Take You (Very, Very) Seriously When You’re in Pain
 Written by Ash Fisher on July 29, 2019 New
Are you sure you aren’t lying, though?


Share on Pinterest
Illustrations by Brittany England
How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

Let’s say you’ve been suffering from pain for a while, perhaps years.

Thinking, ever so naively, that being in constant pain for months on end isn’t normal, you go to your doctor. He orders blood work and maybe an X-ray or a sonogram. All results come back normal, so your doctor dismisses your concerns.

Maybe he accuses you of being a drug seeker, since the only people with “real” pain are either dying or lying.

I get it. It took me 32 years to get a doctor to take my pain seriously — and to get a diagnosis with a connective tissue disease I was born with that no doctor ever noticed my obvious symptoms of, whoops.

I don’t want you to wait decades for answers, though. So here are some expertly curated tips and tricks to get your doctor to listen to you, take your pain seriously, and — gee-whiz-gosh-golly! — maybe even help.

1. Say “I am in pain.” Be ignored or dismissed, because it can’t be that bad. Leave with your tail between your legs, you wascally wabbit.

2. Say “I am in severe pain.” This time your doctor will respond! With an eye roll. Followed by a reminder that all your blood work is negative and you don’t “look sick.” Leave the doctor’s office, you dramatic exaggerator, you!

3. Wear a button that says, “Friendly reminder: I Am in Pain.” Pin it to your shirt that says, “REAL BAD PAIN, DOC.” Make sure he looks at your throat so when you stick your tongue out and say “ah,” he’ll see your new tongue tattoo that says: “YOU TOOK AN OATH.”

4. Bring a polygraph machine to your next appointment. Make sure you’re hooked up to it when you remind your doc that you’re in severe, daily pain. He’ll acknowledge that while the machine claims you aren’t lying, your insurance doesn’t cover polygraph tests, and thus, he can’t take the results into account when determining your treatment plan, which is yoga.


Share on Pinterest
5. When your doctor suggests yoga, solemnly inform him that your pain is so bad you can’t even do yoga. So, if he could just help with this widespread joint and muscle pain that is slowly, steadily debilitating you more and more each week — whether that be physical therapy or pain meds or a specialist or just, you know, something — you promise to take a yoga class.

6. Write a guide called “A 30 Second Primer on Basic Human Decency” and anonymously mail it to your doctor the week before your appointment. He won’t read it — that is the catch-22 of the decency primer.

7. Get your hands on a traffic light costume. Cut out two red felt circles and sew them over the yellow and green lights. When it’s time for your next appointment, don you now your pain apparel. The doctor will take in your costume of three red lights and begin to ask “Why?” This is when you chime in with, “Why are they all stop lights? Glad you asked! So you’ll STOP ignoring my pain.”


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8. Bring your corgi for sympathy because that wily pup with those big brown eyes can get any human to do anything for her, up to and including persuading medical professionals to take her mother’s pain seriously. If you don’t have a corgi, you can borrow mine.

9. Dress like a clown. Cry, cry your big, sad clown tears. “Doc,” you’ll plead, “they say clowns only cry in secret. But look at me go!” Your doctor will diagnose you with “Crocodile Tear-Itis” and likely give you a psych referral before officially dropping you from his practice. That night you’ll ruminate in your rocking chair, still clad in your clown costume, muttering to yourself as you try to figure out where it all went wrong, “But... everybody loves a clown.”


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10. Bribery is
. Bribery is a solution that never backfires! Your doctor may be rich in money, but you’re rich in pain! Bake him a cake of pain. Or get one of those novelty buzzers your elementary school teachers hated and shock him when he shakes your hand. When he hollers, explain, “Now you know how I feel! Let’s talk pain management solutions.”

11. Get your partner or a friend to come with you wearing an altered “I’m With Stupid” shirt so it says, “I’m with My Loved One Who Is Suffering and I Want You to Listen to Her and Stop Making Her Life Harder.” Make sure they position themselves so that the arrow points to you.

12. Go to medical school and become a doctor, figure out the source of your pain, cure it with an outrageous, newfangled, revolutionary, Nobel Prize–winning new treatment. You’re now pain-free, but don’t lose focus! Make sure you rub it in your doctor’s face and never forget that you didn’t do all this to cure your pain, but to spite him.

13. Die in front of your doctor, with fingers crossed (to increase the chances of resuscitating you). If you don’t die, he will probably say you were exaggerating.


-If you die, congratulations! Your pain was real, you were very sick, and everyone who doubted you is very sorry. We wish you lots of success in the afterlife.


Ash Fisher is a writer and comedian living with hypermobile Ehlers-Danlos syndrome. When she’s not having a wobbly-baby-deer-day, she’s hiking with her corgi, Vincent. She lives in Oakland. Learn more about her on her website.



Sublocade (buprenorphine)

Medically reviewed by Lindsay Slowiczek, PharmD on July 29, 2019 New — Written by Helen Marshall, BPharm, MRPharmS
About
Generic
Sublocade vs. Suboxone
Withdrawal
Dosage
Side effects
Alternatives
Sublocade vs. Vivitrol
FAQs
Uses
Use with other treatments
Sublocade and alcohol
Interactions
Cost
How it’s given
How it works
Pregnancy
Birth control needs
Breastfeeding
Precautions
For professionals
FDA warning

FDA warning: Risk of serious harm or death with injection into a vein
This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A alerts doctors and patients about drug…

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What is Sublocade?

Sublocade (buprenorphine) is a brand-name prescription medication. It’s used in adults to treat moderate to severe opioid use disorder (formerly called opioid abuse). An opioid is a powerful type of drug often prescribed to treat pain.

Sublocade helps prevent cravings and withdrawal symptoms that you may get if you stop taking opioid drugs. These drugs include prescription pain relievers such as morphine, oxycodone, and fentanyl, and illegal drugs such as heroin.

For your doctor to prescribe Sublocade, you must first use a form of buprenorphine that you take under your tongue or inside your cheek. (You keep the buprenorphine in your mouth until it dissolves.) You’ll need to take a dose that controls your withdrawal symptoms for at least seven days. Then your doctor may switch you to Sublocade.

The buprenorphine in Sublocade is part of a class of drugs called partial opioid agonists. A class of drugs is a group of medications that work in a similar way.

Sublocade is given as an injection in your belly just under your skin (subcutaneous). A healthcare provider will give you the injection once a month in a clinic. You’ll also have counseling and other support as part of your treatment. These services are meant to help you to cope with emotional challenges or social situations that might lead you to use opioids again.

Effectiveness

Sublocade has been found to be effective at reducing opioid use.

A 24-week clinical study looked at people with opioid use disorder. About 30% of people who took Sublocade and had counseling didn’t use other opioids for at least 80% of the study. This was compared to 2% of the people who took a placebo (no treatment).

Is Sublocade a controlled substance?

Yes, Sublocade is a Schedule III controlled substance. This is a type of drug that has a high chance of misuse and a high risk of becoming dependent on using it. Because of these risks, the U.S. government has special rules for prescribing and dispensing Schedule III drugs.

Doctors who prescribe Sublocade to treat opioid use disorder must have special training and then be certified by the U.S. government.

Sublocade is a drug that’s banned in competitive sports. Traces of the drug may remain in your blood for 12 months or longer after you stop Sublocade treatment.

Sublocade generic

Sublocade is available only as a brand-name medication.

Sublocade contains one active drug ingredient: buprenorphine. The form of buprenorphine that’s in Sublocade is injected in your belly just under your skin, and it’s not available as a generic. However, other forms of buprenorphine are available as generics.

Sublocade vs. Suboxone

You may wonder how Sublocade compares to other medications that are prescribed for similar uses. Here we look at how Sublocade and Suboxone are alike and different.

Sublocade contains just buprenorphine, while Suboxone contains buprenorphine and naloxone.

Uses

The Food and Drug Administration (FDA) has approved Sublocade to treat opioid use disorder (formerly called opioid abuse).

For your doctor to prescribe Sublocade, you must first use a form of buprenorphine that you take under your tongue or inside your cheek. (You keep the buprenorphine in your mouth until it dissolves.) You’ll need to take a dose that controls your withdrawal symptoms for at le

For your doctor to prescribe Sublocade, you must first use a form of buprenorphine that you take under your tongue or inside your cheek. (You keep the buprenorphine in your mouth until it dissolves.) You’ll need to take a dose that controls your withdrawal symptoms for at least seven days. This is called induction treatment.

Then your doctor may switch you to Sublocade, which is used for maintenance treatment. This is when you have long-term treatment with buprenorphine to help keep your cravings and withdrawal symptoms under control.

Sublocade is used as part of a treatment program that involves counseling and other support.

Suboxone is FDA-approved to treat opioid dependence. This is another name for opioid use disorder. Suboxone is used to reduce withdrawal symptoms when you first decrease or stop your use of opioids. This is the induction phase of treatment.

Suboxone is also used in the maintenance phase of treatment. This is when you keep taking Suboxone on a long-term basis. The drug helps keep your withdrawal symptoms and cravings in check as you go through your treatment program. The program will also involve counseling and other support. These are meant to help you to cope with emotional challenges or social situations that might lead you to use opioids again.

Drug forms and administration

Sublocade is given as an injection in your belly just under your skin (subcutaneous). A healthcare provider will give you the injection in a clinic.

Sublocade is available in two strengths: 100 mg/0.5 mL and 300 mg/1.5 mL.

You’ll receive Sublocade injections once a month.

Suboxone comes as an oral film that dissolves under your tongue (sublingual) or between your gums and cheek (buccal). Each film contains two drugs: buprenorphine and naloxone. The naloxone has little effect when you take the film by mouth. It’s included to discourage the misuse and abuse of Suboxone.

If you were to try to inject Suboxone, the naloxone would block the effects of any opioids in your body. This would cause instant withdrawal symptoms if you were dependent on opioids.

Suboxone films come in four strengths:

2 mg buprenorphine and 0.5 mg naloxone
4 mg buprenorphine and 1 mg naloxone
8 mg buprenorphine and 2 mg naloxone
12 mg buprenorphine and 3 mg naloxone
You’ll take Suboxone once a day.

Side effects and risks

Sublocade and Suboxone both contain buprenorphine. Suboxone also contains naloxone, although your body will absorb very little naloxone when you take Suboxone by mouth. Both Sublocade and Suboxone can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Sublocade, with Suboxone, or with both drugs (when taken individually).

Can occur with Sublocade:
pain, itching, or redness at the injection site
Can occur with Suboxone:
opioid withdrawal symptoms, such as body aches, belly cramps, and rapid heart rate
sweating
redness in your mouth
swollen or painful tongue
insomnia (trouble sleeping)
blurred vision
back pain
Can occur with both Sublocade and Suboxone:
constipation
headache
nausea
vomiting
feeling tired or sleepy
dizziness, especially when getting up from sitting or lying down
Serious side effects

These lists contain examples of serious side effects that can occur with Sublocade, with Suboxone, or with both drugs (when taken individually).

Can occur with Sublocade:
few unique serious side effects
Can occur with Suboxone:
severe opioid withdrawal symptoms if you inject the drug
Can occur with both Sublocade and Suboxone:
severe allergic reactions
respiratory depression (slowed breathing) and coma
liver damage
adrenal gland problems such as low hormone levels
physical dependence* (your body gets used to having the drug) that can lead to drug-seeking behavior and drug misuse or abuse
* With Sublocade, physical dependence can lead to withdrawal symptoms weeks to months after you stop treatment. (See the “Sublocade and withdrawal” section below for more information.) With Suboxone, physical dependence can lead to withdrawal symptoms within days if you suddenly stop taking the drug.
Effectiveness

The only condition that both Sublocade and Suboxone are used to treat is opioid use disorder (formerly called opioid abuse). Sublocade is used only for maintenance treatment (to help keep your cravings and withdrawal symptoms under long-term control). Suboxone can be used for induction treatment (to control your withdrawal symptoms when you first stop taking other opioids) and maintenance treatment.

These drugs haven’t been directly compared for maintenance treatment yet. However, a clinical study of the two drugs is due to start in 2019. The American Society of Addiction Medicine  recommends buprenorphine as a treatment for opioid use disorder.

Costs

Sublocade and Suboxone are both brand-name drugs. There are currently no generic forms of Sublocade. But there are generic forms of Suboxone. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Sublocade generally costs more than Suboxone. The actual price you’ll pay for either drug will depend on your insurance plan and your location.

Sublocade and withdrawal

Your body can become physically dependent on Sublocade, and it’s possible to have mild withdrawal symptoms after stopping treatment.

However, you may not have withdrawal symptoms until a few weeks or months after your last injection. Each injection of Sublocade provides a steady level of the drug for a month. After your last injection, the level of the drug in your body will start to slowly lower.

At some point, you and your doctor may agree that it’s time to stop treatment with Sublocade. When this happens, you should be monitored for withdrawal symptoms for a few weeks to months after your last injection. These symptoms may include:

shaking
goose bumps
muscle aches
sweating
feeling hot or cold
runny nose
watery eyes
diarrhea
vomiting
It’s important to talk with your doctor about what to do if you have withdrawal symptoms. Sometimes other medications can help ease such symptoms.


Sublocade dosage

The following information describes Sublocade dosages that are commonly used or recommended. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Sublocade is given as an injection in your belly just under your skin (subcutaneous). A healthcare provider will give you the injection in a clinic.

Sublocade is available in two strengths: 100 mg/0.5 mL and 300 mg/1.5 mL.

You’ll receive Sublocade injections once a month.

Dosage for opioid use disorder

The usual dose of Sublocade is a 300-mg injection once a month for two months. This will be followed by a 100-mg injection once a month for as long as your doctor recommends. In some cases, the 100-mg dose may not be effective. So your doctor may increase the dose to 300 mg once a month.

There should be at least 26 days between your doses.

What if I miss a dose?

If you miss an appointment to have an injection of Sublocade, call your doctor right away to reschedule. You should have the injection as soon as possible. If you have the injection within two weeks of missing your dose, there shouldn’t be any problems. However, if you have the injection later than this, you could start to have symptoms of withdrawal.

To help you remember your appointments, put them in a calendar. You can also set a reminder on your phone.

Will I need to use this drug long term?

This depends on your personal circumstances. Treatment for opioid use disorder is usually long term. If you and your doctor determine that Sublocade is safe and effective for you, you can keep using it long term as part of your treatment program. You and your doctor will decide together when you might be ready to end your treatment with Sublocade.

Sublocade side effects

Sublocade can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Sublocade. These lists do not include all possible side effects.

For more information on the possible side effects of Sublocade, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Sublocade can include:

constipation
headache
nausea
vomiting
pain, itching, or redness at the injection site
feeling tired or sleepy
dizziness, especially when getting up from sitting or lying down
Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Sublocade aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects, explained in more detail below under “Side effect details,” can include the following:

severe allergic reactions
respiratory depression (slowed breathing) and coma
liver damage
adrenal gland problems
physical dependence* (your body gets used to having the drug) that can lead to drug-seeking behavior and drug misuse or abuse
* Physical dependence can lead to withdrawal symptoms weeks to months after you stop taking Sublocade. See the “Sublocade and withdrawal” section above for more information.
Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Sublocade. But it’s not known how often people have allergic reactions after they’ve taken Sublocade. Symptoms of a mild allergic reaction can include:

skin rash
itchiness
flushing (warmth and redness in your skin)
A more severe allergic reaction is rare but possible after having a Sublocade injection. Symptoms of a severe allergic reaction can include:

hives
swelling of your face, typically in your eyelids

Serious side effects

Serious side effects from Sublocade aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects, explained in more detail below under “Side effect details,” can include the following:

severe allergic reactions
respiratory depression (slowed breathing) and coma
liver damage
adrenal gland problems
physical dependence* (your body gets used to having the drug) that can lead to drug-seeking behavior and drug misuse or abuse
* Physical dependence can lead to withdrawal symptoms weeks to months after you stop taking Sublocade. See the “Sublocade and withdrawal” section above for more information.
Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Sublocade. But it’s not known how often people have allergic reactions after they’ve taken Sublocade. Symptoms of a mild allergic reaction can include:

skin rash
itchiness
flushing (warmth and redness in your skin)
A more severe allergic reaction is rare but possible after having a Sublocade injection. Symptoms of a severe allergic reaction can include:

hives
swelling of your face, typically in your eyelids, lips, tongue, mouth, or throat
trouble breathing
feeling dizzy or faint
One type of severe allergic reaction that may occur with Sublocade is called anaphylaxis. In addition to the symptoms above, anaphylaxis can cause a low pulse rate, rash, and sudden drop in blood pressure.

Call your doctor right away if you have a severe allergic reaction to Sublocade. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Feeling tired, drowsy, or sleepy

While you receive Sublocade, you may feel drowsy, sleepy, or tired, or have slow reaction times. These are common side effects, especially:

in the first few days after your first injection of Sublocade
if your doctor increases your dose
if you take other medications that can make you sleepy
In a clinical study, sleepiness was reported in 4.9% of people who took 300 mg of Sublocade, followed by 100 mg of Sublocade once a month. Sleepiness occurred in 2% of people who took 300 mg of Sublocade throughout the study. This was compared to 0% of people who took a placebo (no treatment).

In the same study, fatigue (lack of energy) was reported in 3.9% of people who took 300 mg of Sublocade, followed by 100 mg of Sublocade once a month. Fatigue occurred in 6% of people who took 300 mg of Sublocade throughout the study. This was compared to 3% of people who took a placebo.

Until you’re certain that Sublocade isn’t making you tired, don’t drive, operate machinery, or do other activities that may be dangerous.

If you’re concerned about feeling tired while taking Sublocade, talk with your doctor. They can suggest treatments that may help.

Constipation

You may get constipated during your Sublocade treatment. In clinical studies, constipation occurred in about 9.4% of people who took 300 mg of Sublocade, followed by 100 mg of the drug once a month. Constipation occurred in 8% of people who took 300 mg of Sublocade throughout the study. This was compared to 0% of people who took a placebo.

If you’re concerned about constipation while taking Sublocade, talk with your doctor. They can suggest treatments that may help ease the condition and ways to help avoid constipation.

Respiratory depression and coma

If you take too much Sublocade or take it too often, you may develop respiratory depression. This is a condition in which your breathing becomes slow, shallow, weak, and may even stop.

You may also develop central nervous system (CNS) depression, a condition in which your brain activity slows. CNS depression can lead to delirium (sever)

ad to delirium (severe confusion about what’s real) and coma. Both respiratory depression and CNS depression can be fatal.

It’s not known how often people develop respiratory or CNS depression during Sublocade treatment.

Symptoms and risks

Symptoms of respiratory depression or CNS depression can include:

slow, shallow breathing
extreme sleepiness
confusion
slurred speech
problems with coordination
dizziness or fainting
If you’re taking Sublocade and have symptoms of respiratory depression or CNS depression, call your doctor or 911 right away.

Drinking alcohol or taking certain other drugs while you’re receiving Sublocade injections can increase your risk for respiratory and CNS depression, loss of consciousness, and death. Some of these drugs include:

benzodiazepines
sleeping pills
other tranquilizers or sedatives
opioids
muscle relaxants
certain antidepressants
antihistamines that cause drowsiness
Avoid drinking alcohol or taking these drugs while receiving Sublocade, unless your doctor says that it’s fine. You should also avoid these drugs for a few months after you stop treatment with Sublocade. This is because the drug can stay in your body for a few months after your last injection. (For more details about interactions that can cause respiratory depression or coma, see the “Sublocade interactions” section below.)

Liver damage

Liver problems, such as hepatitis (liver swelling) and jaundice, have been reported in people who took Sublocade. Tell your doctor if you have symptoms of liver problems, which can include:

yellowing of your skin or the white of your eyes
dark urine
pale stools
abdominal (belly) pain
nausea
loss of appetite
Liver damage can also reveal itself by releasing certain liver enzymes into your blood. In a clinical study, up to 12.4% of people who took Sublocade had high levels of these enzymes in their blood. This was compared to 1% of people who took a placebo (no treatment).

Your doctor will check your blood for these enzymes on a regular basis with a liver function test. If your test results show damage to your liver, you may need to stop taking Sublocade.

If you’re concerned about liver damage while taking Sublocade, talk with your doctor.

Adrenal gland problems

Taking opioid medications such as Sublocade for longer than a month can affect your adrenal glands. But it’s not known how often people develop problems with their adrenal glands during Sublocade treatment.

Adrenal glands make and release hormones, and opioids can cause the glands to stop making enough of a hormone called cortisol. This is called adrenal insufficiency, and its symptoms can include:

nausea
vomiting
loss of appetite
fatigue (lack of energy)
weakness
dizziness
low blood pressure
If you have any of these symptoms, tell your doctor. You may need to take a steroid medication to help treat problems with your adrenal glands. You may also have to stop taking Sublocade.


Alternatives to Sublocade

Other drugs are available that can treat opioid use disorder. Some may be better suited for you than others. If you’re interested in finding an alternative to Sublocade, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs used to treat opioid use disorder include:

Opioid agonists such as:
methadone (Dolophine, Methadose)
buprenorphine sublingual  tablets
buprenorphine implant (Probuphine)
buprenorphine and naloxone sublingual tablets/films (Bunavail, Suboxone, Zubsolv)
Opioid antagonists such as naltrexone (Vivitrol)
Sublocade vs. Vivitrol

You may wonder how Sublocade compares to other medications that are prescribed for similar uses. Here we look at how Sublocade and Vivitrol are alike and different.

Sublocade contains buprenorphine, which is a type of drug called an opioid partial agonist. It prevents cravings and withdrawal symptoms that you get when you stop taking other opioids.

Vivitrol contains naltrexone, which is a type of drug called an opioid antagonist. It blocks the effect of opioids.

Uses

The Food and Drug Administration (FDA) has approved Sublocade to treat opioid use disorder (formerly called opioid abuse).

For your doctor to prescribe Sublocade, you must first use a form of buprenorphine that you take under your tongue or inside your cheek. (You keep the buprenorphine in your mouth until it dissolves.) You’ll need to take a dose that controls your withdrawal symptoms for at least seven days. Then your doctor may switch you to Sublocade.

Sublocade is used as part of a treatment program that involves counseling and other support. This is to help you to cope with emotional challenges or social situations that might lead you to use opioids again.

Vivitrol is FDA-approved for treating opioid dependence, which is another name for opioid use disorder. The medication is used to help keep people from using opioids after they’ve stopped taking these drugs.

Vivitrol is also FDA-approved to treat alcohol dependence, which is another name for alcoholism. The drug is used to help keep people from consuming alcohol after they’ve quit drinking.

Vivitrol is also used as part of a treatment plan that includes counseling and other support.

Drug forms and administration

Sublocade is given as an injection in your belly just under your skin (subcutaneous). A healthcare provider will give you the injection in a clinic.

Sublocade is available in two strengths: 100 mg/0.5 mL and 300 mg/1.5 mL.

Vivitrol is given as an injection in a muscle (intramuscular). A healthcare provider will give you the injection in a clinic.

Vivitrol comes in one strength: 380 mg/4 mL.

Both Sublocade and Vivitrol injections are given once a month.

Side effects and risks

Sublocade contains buprenorphine, and Vivitrol contains naltrexone. These medications can cause some different and some similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Sublocade, with Vivitrol, or with both drugs (when taken individually).

Can occur with Sublocade:
constipation
nausea
vomiting
feeling tired or sleepy
dizziness (such as when getting up from sitting or lying down)
Can occur with Vivitrol*:
symptoms of colds, such as a stuffy or runny nose, sore throat, or cough
toothache
insomnia (trouble sleeping)
high blood pressure
Can occur with both Sublocade and Vivitrol:
pain, itching or redness at the injection site
headache
* Side effects described for Vivitrol are those seen when the drug is used to treat opioid use disorder.
Serious side effects

These lists contain examples of serious side effects that can occur with Sublocade, with Vivitrol, or with both drugs (when taken individually).

Can occur with Sublocade:
respiratory depression (slowed breathing) and coma
adrenal gland problems, such as low hormone levels
physical dependence* (your body gets used


Common questions about Sublocade

Here are answers to some frequently asked questions about Sublocade.

Does Sublocade have naloxone in it?

No, Sublocade injections contain only the drug buprenorphine.

Naloxone is a drug that blocks the effects of opioids. It’s used to treat opioid overdose. Naloxone is included in some buprenorphine medications that you take by mouth, such as Suboxone, Bunavail, and Zubsolv. When you take these drugs by mouth, your body absorbs very little of the naloxone. The naloxone is included in these medications only to help prevent people from misusing them.

Sublocade doesn’t contain naloxone because the injections are given only by your healthcare provider. So there’s very little chance that anyone else could obtain the drug and misuse it.

Where will I be given Sublocade treatments?

The only way to receive Sublocade injections is from a healthcare provider at certain clinics. The clinic must be certified by the Sublocade REMS program (Sublocade Risk Evaluation and Mitigation Strategy Program). This drug safety program restricts access to Sublocade to help prevent the drug from being misused. (See the “FDA warning” section at the top of this article to learn more.)

If you have questions about where to receive your Sublocade injections, ask your doctor.

If I’m taking Sublocade, can I use pain relievers during an emergency or if I’m having surgery?

While you’re receiving Sublocade, it’s fine to use non-opioid medications to relieve pain. These include acetaminophen and anti-inflammatories such as ibuprofen.

However, you should avoid taking opioids to relieve pain whenever possible. Opioids can increase your risk for respiratory depression (slowed breathing), loss of consciousness, and death. Opioids can also be less effective than usual at relieving pain if you’re taking Sublocade.

In an emergency or if you’re having surgery, tell the medical staff that you’re taking Sublocade. (You can also have your family give the staff this information.) Opioid pain relievers should be used only under the supervision of medical staff who know that you’re dependent on an opioid. They’ll need to monitor your breathing while the opioid is in your body.

This also applies for a few months after you stop receiving Sublocade. You’ll still have Sublocade in your body for a few months after your last injection.

Sublocade uses

The Food and Drug Administration (FDA) approves prescription drugs such as Sublocade to treat certain conditions.

Sublocade for opioid use disorder

Sublocade is FDA-approved to treat moderate to severe opioid use disorder in adults. (Opioid use disorder was formerly called opioid abuse.) Sublocade is used after you’ve started treatment with buprenorphine tablets or films that dissolve under your tongue or inside your cheek. Your doctor will adjust your dose of this oral buprenorphine until it controls your withdrawal symptoms and cravings for at least seven days. After this, you’ll switch to injections of Sublocade.

You’ll also have counseling and other support as part of your treatment. These are meant to help you to deal with emotional challenges or social situations that might lead you to use opioids again. The type of counseling and other support offered depends on your personal circumstances. It might include:

individual or group counseling sessions
cognitive behavioral therapy, which helps you adjust your negative thoughts to better deal with problems
family therapy
access to support groups
help with social issues such as employment or housing
With opioid use disorder, your body and mind depend on and crave opioid drugs. Opioid drugs are sometimes called opiates or narcotics. They include prescription pain relievers such as morphine, fentanyl, oxycodone, and tramadol, and illegal drugs such as heroin.

Sublocade affects the same parts of your brain as opioids do, so Sublocade helps reduce your cravings for opioids. Sublocade also helps prevent the physical withdrawal symptoms you m

brain as opioids do, so Sublocade helps reduce your cravings for opioids. Sublocade also helps prevent the physical withdrawal symptoms you may get when you stop using opioids. This should make it easier for you to stop abusing other prescription or illegal opioids.

Effectiveness

Researchers have looked into how effective Sublocade is in helping treat opioid use disorder.

Results from a 12-week study

Sublocade was found to reduce the rewarding effects of other opioids in a 12-week study. Researchers looked at 39 people with opioid use disorder. First, these people were given two injections: one of an opioid called hydromorphone  and one placebo (no treatment). The people were asked to rate how much they liked the effects of each injection on a visual-analog scale. This is where personal feelings are described next to a number.

Then the people were given buprenorphine taken under the tongue  (Suboxone films). After this, they were given an injection of Sublocade, followed by another Sublocade injection four weeks later.

While the Sublocade was in the people’s systems, they were given an injection of hydromorphone once a week. They were also given a placebo injection once a week. The people were asked to rate how much they liked the effects of each injection on the same scale as before.

Before Sublocade was given, the hydromorphone injection produced much more rewarding effects than the placebo injection. While the people had Sublocade in their body, the rewarding effects of hydromorphone weren’t significantly different from those of the placebo.

Results from a 24-week study

In a 24-week clinical study, Sublocade was found to be effective at reducing opioid use. Researchers looked at 489 people with opioid use disorder. For 7 to 14 days, these people were first treated with a form of buprenorphine that you place under your tongue. Then they were split into three groups:

Group 1 was given 300 mg of Sublocade once a month for six months.
Group 2 was given 300 mg of Sublocade once a month for two months. This was followed by 100 mg of Sublocade once a month for four months.
Group 3 was given a placebo (no treatment) once a month for six months.
In addition to their monthly injections, people in all three groups had counseling at least once a week. Each week, researchers checked their urine for evidence of opioid use.

People in groups 1 and 2 who were given Suboxone and counseling had more weeks during which they didn’t use other opioids. This was compared to people in group 3, who received a placebo and counseling. About 30% of people in groups 1 and 2 (the Suboxone groups) didn’t use other opioids for at least 80% of the 24-week study. This was compared to 2% of the people in group 3 (the placebo group).

Sublocade use with other treatments

It’s important that Sublocade is used as part of a complete treatment program for opioid use disorder. Along with your Sublocade injections, you’ll be given counseling and various forms of emotional or behavioral therapy, or support with social issues. This aims to help you avoid or cope with situations that might lead you to use opioids again.

The type of therapy or support offered depends on your personal circumstances. It might include:

individual or group counseling sessions
cognitive behavioral therapy, which helps you adjust your negative thoughts to better deal with problems
family therapy
access to support groups
help with social issues such as employment or housing
If you’re taking Sublocade and have questions about counseling or other forms of support, talk with your doctor.

Sublocade and alcohol

You should avoid drinking alcohol while you’re receiving Sublocade. Drinking alcohol can increase your risk for serious side effects such as:

slowed breathing
severe drowsiness
slow reaction time
loss of consciousness
coma
death
If you drink alcohol, talk with your doctor about the possible risks and whether Sublocade is right for you.

Sublocade interactions

Sublocade can iSublocade interactions

Sublocade can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Sublocade and other medications

Below is a list of medications that can interact with Sublocade. This list doesn’t contain all drugs that may interact with Sublocade.

Before taking Sublocade, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Sublocade and benzodiazepines

Taking benzodiazepines with Sublocade can increase your risk for serious side effects. (Benzodiazepines are drugs for anxiety or insomnia.) These side effects include respiratory depression (slowed breathing), severe sleepiness, loss of consciousness, coma, and death.

Examples of benzodiazepines that can increase the risk of serious side effects if taken with Sublocade include:

alprazolam (Xanax)
clonazepam (Klonopin)
diazepam (Valium)
lorazepam (Ativan)
Avoid taking benzodiazepines while you receive Sublocade and for a few months after you stop Sublocade treatment. You should use a benzodiazepine drug only if your doctor has prescribed it and knows that you’re receiving Sublocade.

Sublocade and sleeping pills

Taking sleeping pills with Sublocade can increase your risk for serious side effects. These include respiratory depression (slowed breathing), severe sleepiness, loss of consciousness, coma, and death.

Examples of sleeping pills that can increase the risk of serious side effects if taken with Sublocade include:

eszopiclone (Lunesta)
zaleplon (Sonata)
zolpidem (Ambien)
Avoid taking sleeping pills while you receive Sublocade and for a few months after you stop Sublocade treatment. You should use sleeping pills only if your doctor has prescribed them and knows that you’re receiving Sublocade.

Sublocade and other opioids

Taking other opioids with Sublocade can increase your risk for serious side effects. These include respiratory depression (slowed breathing), severe sleepiness, loss of consciousness, coma, and death. Sublocade may also make opioid pain relievers less effective at relieving pain.

Examples of other opioids that can increase the risk of serious side effects if taken with Sublocade include:

codeine
dihydrocodeine
fentanyl (Abstral, Fentora, and others)
heroin
hydrocodone (Vicodin)
methadone
morphine (Kadian)
oxycodone (Percocet)
tramadol (Ultram, Conzip)
Avoid taking opioids while you receive Sublocade and for a few months after you stop Sublocade treatment. You should use an opioid pain reliever only if your doctor has prescribed it and knows that you’re receiving Sublocade.


Sublocade and certain antidepressants

Taking certain antidepressants with Sublocade can increase your risk for serotonin syndrome.

Some antidepressants increase levels of serotonin in your brain. (Serotonin is a chemical that’s involved in passing messages between nerve cells.) Sublocade also increases the level of serotonin in your brain. High levels of serotonin increase your risk for a rare but serious side effect called serotonin syndrome.

Examples of antidepressants that can increase the risk of serotonin syndrome if taken with Sublocade include:

selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine  (Prozac), paroxetine (Paxil, Pexeva, Brisdelle), and sertraline (Zoloft)
serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine  (Cymbalta) and venlafaxine (Effexor XR)
tricyclic antidepressants, such as amitriptyline, desipramine  (Norpramin), and imipramine (Tofranil)
monoamine oxidase inhibitors (MAOIs),* such as phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine (Parnate)
mirtazapine
If you’re taking an antidepressant, talk with your doctor before you start receiving Sublocade. They may switch you to a different antidepressant.

* MAOIs can also cause respiratory depression (slowed breathing) and severe sleepiness if taken with Sublocade.
Sublocade and certain antihistamines

Taking antihistamines that can cause sleepiness with Sublocade might increase your risk for extreme sleepiness and respiratory depression (slowed breathing).

Examples of antihistamines that can cause sleepiness with Sublocade include:

chlorpheniramine (Chlor-Trimeton)
diphenhydramine (Benadryl)
hydroxyzine (Atarax)
Avoid taking these drugs with Sublocade unless your doctor has prescribed them.

Sublocade and certain antifungals

Taking certain antifungal drugs with Sublocade can raise the level of buprenorphine in your body. (Antifungals treat infections caused by a fungus.) This can increase your risk for side effects such as sleepiness, respiratory depression (slowed breathing), constipation, nausea, and dizziness. However, the risk for this interaction is greater with antifungals taken by mouth than with antifungals applied to the skin.

Examples of antifungals that can increase buprenorphine levels when taken with Sublocade include:

itraconazole (Sporanox)
ketoconazole
posaconazole (Noxafil)
voriconazole (Vfend)
In some cases, you may need to take one of these antifungals during your Sublocade treatment. If you have slow and shallow breathing, severe sleepiness, confusion, slurred speech, or problems with coordination, tell your doctor right away.

Sublocade and certain antibiotics

Taking certain antibiotics with Sublocade can raise the level of buprenorphine in your body. (Antibiotics treat infections caused by bacteria.) This can increase your risk for side effects such as sleepiness, respiratory depression (slowed breathing), constipation, nausea, and dizziness.

Examples of antibiotics that can increase buprenorphine levels when taken with Sublocade include clarithromycin (Biaxin) and telithromycin (Ketek).

In some cases, you may need to take one of these antibiotics during your Sublocade treatment. If you have slow and shallow breathing, severe sleepiness, confusion, slurred speech, or problems with coordination, tell your doctor right away.

Sublocade and linezolid

Taking the antibiotic linezolid (Zyvox) with Sublocade can increase your risk for a rare but serious side effect called serotonin syndrome. (Serotonin is a chemical that’s involved in passing messages between nerve cells.) Serotonin syndrome can occur if your serotonin levels get too high. Both linezolid and Sublocade can increase your serotonin levels.

If you’re taking linezolid, talk with your doctor before you start receiving Sublocade. They may switch you to a different antibiotic.

Sublocade and certain drugs for HIV infection

Taking certain HIV medications with Sublocade can raise the level of buprenorphine in your


buprenorphine in your body. This can increase your risk for side effects such as sleepiness, respiratory depression (slowed breathing), constipation, nausea, and dizziness.

Examples of drugs for HIV that can increase buprenorphine levels when taken with Sublocade include:

atazanavir (Reyataz)
cobicistat (Tybost)
darunavir (Prezista)
fosamprenavir (Lexiva)
indinavir (Crixivan)
lopinavir/ritonavir (Kaletra)
nelfinavir (Viracept)
ritonavir (Norvir)
saquinavir (Invirase)
Many of these drugs also come in combination products, so be sure to tell your doctor about all of your medications.

In some cases, you may need to take one of these HIV medications during your Sublocade treatment. If you notice any of the side effects mentioned above, tell your doctor right away.

Sublocade and certain drugs for tuberculosis

Taking certain treatments for tuberculosis (TB) with Sublocade can reduce the level of buprenorphine in your body. This could make Sublocade less effective or cause withdrawal symptoms.

Examples of TB drugs that can reduce the level of buprenorphine in your body when taken with Sublocade include:

rifabutin (Mycobutin)
rifampin (Rifadin)
rifapentine (Priftin)
If you’re taking a drug to treat TB, talk with your doctor before you start receiving Sublocade. They may switch you to a different TB medication.

Sublocade and certain drugs for seizures

Taking certain seizure medications with Sublocade can reduce the level of buprenorphine in your body. This could make Sublocade less effective or cause withdrawal symptoms.

Examples of seizure drugs that can reduce the level of buprenorphine in your body when taken with Sublocade include:

carbamazepine (Carbatrol, Equetro, Tegretol)
fosphenytoin (Cerebyx)
oxcarbazepine (Trileptal)
phenobarbital
phenytoin (Dilantin, Phenytek)
primidone (Mysoline)
If you’re taking a drug to treat seizures, talk with your doctor before you start receiving Sublocade. They may switch you to a different seizure medication.
Sublocade and certain drugs for migraine

Taking triptan medications for migraines  with Sublocade could increase your risk for a rare but serious side effect called serotonin syndrome. (Serotonin is a chemical that helps transmit messages between nerve cells.) Serotonin syndrome can occur if your serotonin levels get too high. Triptan medications and Sublocade can both increase serotonin levels.

Examples of triptan medications that could increase your risk for serotonin syndrome if taken with Sublocade include:

almotriptan (Axert)
eletriptan (Relpax)
frovatriptan (Frova)
naratriptan (Amerge)
rizatriptan (Maxalt)
sumatriptan (Imitrex)
zolmitriptan (Zomig)
If you’re taking a triptan medication for migraines, talk with your doctor before you start receiving Sublocade. They may switch you to a different migraine drug.

Sublocade and herbs and supplements

Some herbs and supplements have been specifically reported to interact with Sublocade.

Sublocade and St. John’s wort

Avoid taking St. John’s wort, which is also called Hypericum perforatum, while receiving Sublocade. St. John’s wort can reduce the level of buprenorphine in your body. (Buprenorphine is the drug in Sublocade.) This could make Sublocade less effective or cause withdrawal symptoms.

Taking St. John’s wort with Sublocade can also increase your risk for a rare side effect called serotonin syndrome. (Serotonin is a chemical that helps messages travel between nerve cells.) Serotonin syndrome can occur if your serotonin levels get too high. St. John’s wort and Sublocade can both increase serotonin levels.

Sublocade and herbs and supplements that cause sedation

Taking herbs or supplements that cause sleepiness while you’re also using Sublocade might increase your risk for sedation (extreme sleepiness). Examples of these supplements include:

kava
melatonin
valerian
Be sure to check with your doctor or pharmacist before using any herbs and supplements while taking Sublocade.

Sublocade cost

As with all medications, the cost of Sublocade can vary. To find current prices for Sublocade in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay will depend on your insurance plan and your location.

Financial and insurance assistance

If you need financial support to pay for Sublocade, or if you need help understanding your insurance coverage, assistance is available.

Indivior, the manufacturer of Sublocade, offers a copay assistance program called INSUPPORT. For more information and to find out if you’re eligible for this program, call 844-467-7778 or visit the program website.

How Sublocade is given

A healthcare provider will give you Sublocade as an injection in your belly just under your skin (subcutaneous). For each injection, they’ll choose a different spot on your belly. You’ll go to a clinic to receive the injections.

After you have an injection of Sublocade, you may develop a lump in the injection area. This is because Sublocade reacts with your body’s fluids to form a solid mass. Over the next month, the mass will get smaller as the drug is absorbed into your bloodstream. Keep in mind these helpful tips

Don’t rub or massage the lump or injection site.
Don’t try to remove the lump.
Avoid wearing clothing with tight waistbands or belts that may rub the injection area.
If you have any concerns about the lump after your Sublocade injection, talk with your doctor.

When to take

Your healthcare provider will give you an injection of Sublocade once a month. The injections should be given at lease 26 days apart.

Make sure you keep your appointments to have your injections of Sublocade. To help you remember, write down your schedule on a calendar or set a reminder in your phone.-



How Sublocade works

An opioid is a powerful type of drug often used to treat pain. Opioids include prescription pain relievers such as oxycodone, fentanyl, hydromorphone, and tramadol, and illegal drugs such as heroin.

Opioids work by acting on special areas in your brain called mu opioid receptors. This has a strong pain-relieving effect, but it also produces the high feeling that opioids can cause. These feelings can make you crave opioids.

Repeated use of opioids can also make your body dependent on the drugs. So if you stop taking opioids, you may have symptoms of withdrawal, such as muscle aches, sweating, or diarrhea.

What Sublocade does

Sublocade contains an opioid called buprenorphine, which is widely used in treatment programs for opioid use disorder. The aim of treatment is to replace other opioids with buprenorphine, and then wean off buprenorphine over time.

Buprenorphine is a type of drug called a partial opioid agonist. It acts on your mu opioid receptors, but it doesn’t stimulate them as much as full opioid agonists, such as heroin or morphine.

This means that buprenorphine helps you stop craving opioids, but it doesn’t produce the same high feeling you may get from other opioids. Buprenorphine also helps prevent withdrawal symptoms that you may have after you stop taking other opioids.

Sublocade is an extended-release or long-acting form of buprenorphine, which means that it works over a long time. After Sublocade is injected, it reacts with your body’s fluids to form a solid mass. This mass will slowly break down over the next month, steadily releasing the drug into your bloodstream.

Over time, you’ll have a steady level of buprenorphine in the mu receptors in your brain. This can stop other opioids from acting on the receptors. So if you take other opioids during your treatment, they may not give you a high feeling.

Two phases of treatment

Opioid use disorder is treated in two phases: induction and maintenance. In the induction phase, you’ll take a form of buprenorphine under your tongue or inside your cheek. This will help reduce withdrawal symptoms as you take less or stop using other opioids.

Once your cravings and withdrawal symptoms are under control, you can move to the maintenance phase of treatment. First, you’ll stop taking the form of buprenorphine by mouth. Then you’ll start using Sublocade to help keep your withdrawal symptoms under long-term control. Sublocade may also help curb your cravings for other opioids and help prevent you from using them during your treatment.

How long does it take to work?

Sublocade starts to work right away. So your cravings and withdrawal symptoms should start to feel under control after your first Sublocade injection.

Sublocade and pregnancy

Some animal studies have looked at the inactive ingredients in Sublocade injections. The studies suggest that using Sublocade during pregnancy may harm the baby.

The active ingredient in Sublocade is called buprenorphine. In studies, using other forms of buprenorphine during pregnancy doesn’t appear to increase the risk of birth defects.

However, using any form of buprenorphine during pregnancy can cause your baby to be born with opioid withdrawal symptoms. This is a condition called neonatal opioid withdrawal syndrome. Symptoms can include:

feeling irritable (easily upset or frustrated)
shaking
crying much more than usual
trouble sleeping
diarrhea
vomiting
not gaining weight
If you’re pregnant and are dependent on opioids, talk with your doctor. They can help you decide on the best treatment plan for you and your baby, both during and after your pregnancy.

Buprenorphine and birth control

It’s not known if Sublocade is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Sublocade.

Sublocade and breastfeeding

Clinical studies have showed that the active drug in Sublocade (buprenorphine) can pass into breast milk in small amounts. Serious problems haven’t been reported in women who took Sublocade while breastfeeding.

It’s important to talk with your doctor about the best way to feed your child.

If you do decide to breastfeed while having Sublocade injections, keep a close eye on your child. If they’re much sleepier than usual, have trouble breastfeeding, or aren’t gaining weight, tell your doctor.

And call 911 right away if your child:

has trouble breathing
has slow or shallow breathing
becomes limp
can’t be woken up
Sublocade precautions

This drug comes with several precautions.

FDA warning: Risk of serious harm or death with injection into a vein

Sublocade has a boxed warningTrusted Source. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Sublocade must not be injected into a vein because the drug becomes a solid mass after it’s injected. If Sublocade is injected into a vein, the mass that forms can move through your bloodstream and cause tissue damage. The mass can also block the blood supply to vital organs, such as the lungs, resulting in serious harm or death.

Because of these possible risks, you can get Sublocade only from your doctor through the Sublocade REMS program. If you have questions about the program, you can visit its website or call 866-258-3905. You can also ask your doctor.

Other warnings

Before taking Sublocade, talk with your doctor about your health history. Sublocade may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

Lung disease

You’re more at risk for severe breathing problems while using Sublocade if you have a condition that affects your breathing. These include chronic obstructive pulmonary disease (COPD), asthma, and sleep apnea. Ask your doctor what treatment is right for you.

Underactive adrenal glands (Addison’s disease or adrenal insufficiency)

Sublocade can sometimes cause problems with your adrenal glands, which make and release hormones. So if these glands aren’t currently producing enough hormones, you may not be able to use Sublocade. Ask your doctor what other treatments may be better for you.

Liver disease

Sublocade can cause liver problems and worsen any liver problems that you already have, including hepatitis. So if you have moderate or severe liver problems, you may not be able to use Sublocade. Ask your doctor what other treatments may be better for you.

Recent head injury or brain problem

Sublocade can increase the pressure of the fluid in your spinal cord and brain. This can be dangerous if you already have a head injury or brain condition.

Sublocade can alsoshrink your pupils and make you sleepy. If your doctor can’t look at your eyes properly and you’re not fully awake, it’s harder for them to monitor you. So if you have any head injuries or brain problems, you may not be able to use Sublocade. Ask your doctor what other treatments may be better for you.

Gallbladder problems

Sublocade can worsen gallbladder  problems. So if you currently have a gallbladder problem, you may not be able to use Sublocade. Ask your doctor what other treatments may be better for you.

Allergic reactions to buprenorphine

If you’ve ever had an allergic reaction to buprenorphine (the active drug in Sublocade), you shouldn’t take Sublocade. And if you don’t know whether you’ve had an allergic reaction to buprenorphine, talk with your doctor.

Abnormal heart rate or rhythm

If you or an immediate family member has had a type of abnormal heart rhythm called long QT syndrome, you shouldn’t take Sublocade. (Long QT syndrome can run in families.) You also shouldn’t use Sublocade if you’re taking medication for an abnormal heart rate or rhythm. Ask your doctor what treatment may be a better choice for you.

Pregnancy

Babies born to mothers treated with Sublocade during pregnancy can have opioid withdrawal symptoms. For more information, please see the “Sublocade and pregnancy” section above.

Breastfeeding

Sublocade can pass into breast milk and may harm breastfeeding babies. For more information, please see the “Sublocade and breastfeeding” section above.

Note: For more information about the potential negative effects of Sublocade, see the “Sublocade side effects” section above.

Professional information for Sublocade

The following information is provided for clinicians and other healthcare professionals.

Indications

Sublocade is approved to treat moderate to severe opioid use disorder in adults. Treatment must not be started until patients have been taking transmucosal buprenorphine, with dose adjustment to control withdrawal symptoms and cravings, for at least seven days.

Sublocade must be used in conjunction with counseling and psychosocial support as part of a structured program.



Mechanism of action

Buprenorphine acts as a partial opioid agonist at the mu receptor. It acts as an opioid antagonist at the kappa receptor.

Pharmacokinetics and metabolism

Sublocade injection contains buprenorphine dissolved in the Atrigel delivery system. This solidifies on contact with body fluids, forming a solid mass that gradually dissolves over a month, delivering buprenorphine at a controlled, constant rate.

The time to reach maximum blood concentration of buprenorphine is a median of 24 hours after injection of Sublocade. Steady-state is reached after four to six months of monthly injections.

Approximately 96% of buprenorphine is bound to plasma proteins.

Buprenorphine is primarily metabolized by CYP3A4. Its major metabolite is norbuprenorphine, which is further transformed to its glucuronidated form. The majority of metabolites are excreted in the feces and a small amount in the urine. The elimination half-life is 43 to 60 days.

Buprenorphine may still be detected in plasma for 12 months or longer after treatment with Sublocade is stopped.

Age, sex and race do not significantly affect the pharmacokinetics of buprenorphine. Clearance is significantly reduced in moderate and severe hepatic impairment. The effect of renal impairment was not studied.

Contraindications

Sublocade is contraindicated in patients known to be hypersensitive to buprenorphine or the Atrigel delivery system, which is made up of a 50:50 poly(DL-lactide-co-glycolide) biodegradable polymer with a N-methyl-2-pyrrolidone (NMP), a biocompatible solvent.

Misuse and dependence

Buprenorphine is a Schedule III controlled drug. It has potential for abuse and can cause physical and psychological dependence. Patients who are prescribed buprenorphine should be monitored for diversion, misuse, and addictive behaviors.

Misuse of Sublocade by intravenous injection can cause thromboembolic events resulting in serious harm or death.

The potential for diversion, misuse, and abuse is minimized by the Sublocade Risk Evaluation and Mitigation Strategy Program (REMS). Sublocade can only be supplied to healthcare professionals by pharmacies certified by the REMS program. Sublocade can only be administered by a healthcare professional at a healthcare setting certified by the REMS program.

Storage

Sublocade injection should be stored in a refrigerator at 35.6° to 46.4°F (2° to 8°C) before use. It can also be stored in the original packaging at room temperature of 59° to 86°F (15° to 30°C) for up to seven days.

It should be removed from refrigeration 15 minutes before administering the injection to allow it time to warm up.

Do not administer Sublocade if it has been kept at a room temperature for more than seven days.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.


9 Home Remedies Backed by Science

Medically reviewed by Deborah Weatherspoon, PhD, RN, CRNA on July 29, 2019 New — Written by Rosa Escandon
Turmeric
Chili
Ginger
Shiitake
Eucalyptus
Lavender
Mint
Fenugreek
Magnesium
Takeaway



Overview

Chances are you’ve used a home remedy at some point: herbal teas for a cold, essential oils to dull a headache, plant-based supplements for a better night’s sleep. Maybe it was your grandma or you read about it online. The point is you tried it — and perhaps now you’re thinking, “Should I try it again?”

It’s not clear exactly what makes a home remedy do the trick. Is it an actual physiological change in the body or more of a placebo effect? Thankfully, in recent decades, scientists have been asking the same questions in a lab, and are finding that some of our plant-based remedies aren’t just old wives’ tales.

And so, for the skeptic who needs more than a placebo to feel well, we got your back. Here are the home remedies backed by science:

Turmeric for pain and inflammation

Who hasn’t heard of turmeric by now? Turmeric has been used, primarily in South Asia as a part of Ayurvedic medicine, for almost 4,000 years. When it comes to proven medicinal purposes, the golden spice may be best for treating pain — specifically pain associated with inflammation.

Several studies have found that curcumin is responsible for turmeric’s “wow” factor. In one study, people with arthritis pain  noted that their pain levels were more reduced after taking 500 milligrams (mg) of curcumin than 50 mg of diclofenac sodium, an anti-inflammatory drug.

Other studiesTrusted Source back up this pain relief claim as well, noting that turmeric extract was as effective as ibuprofen for treating painTrusted Source in patients with knee osteoarthritis.

Don’t go grinding turmeric — which stains heavily! — for immediate relief though. The amount of curcumin in turmeric is at most 3 percent, meaning you’re better off taking curcumin supplements for relief.

That’s not to say a soothing turmeric latte won’t help. It’s suggested that 2 to 5 grams (g) of the spice may still provide some benefits. Just be sure you add black pepper to boost the absorption.

Drink a cup per day

Turmeric is about the long game. Consuming 1/2 to 1 1/2 tsp. of turmeric per day should start providing noticeable benefits after four to eight weeks.
Chili peppers for pain and soreness

This active component of chili peppers has a long history of use in folk medicine and has slowly become more accepted outside of homeopathy. Now, capsaicin is a popular topical ingredient for managing pain. It works by causing an area of the skin to get hot, before eventually turning numb.

Today, you can get a prescription capsaicin patch called Qutenza, which relies on very high level of capsaicin — 8 percentTrusted Source — to work.

So, when it comes to sore muscles or generalized body pain that won’t leave you alone, and you have some hot peppers or cayenne pepper on hand? Make some capsaicin cream.

DIY capsaicin coconut oil cream

Mix 3 tbsp. of cayenne powder with 1 cup of coconut.
Heat the oil on a low simmer until it melts.
Stir the mixture thoroughly for 5 minutes.
Remove from heat and pour into a bowl. Let it firm up.
Massage onto skin when cooled.
For an extra fancy feel, whip your coconut oil with a hand mixer so that it becomes light and fluffy.

It’s important to test your reaction to the compound before using too extensively. You may also use jalapeño peppers, but the amount of heat may vary depending on the pepper. Never use this cream around the face or eyes, and be sure to wear gloves during application.


Ginger for pain and nausea

It’s almost law to try ginger when you have a cold, sore throat, or are experiencing morning sickness and nausea. Making a cup is pretty standard: Grate it in your tea for a stronger effect. But the other benefit of ginger that goes less noticed is its effectiveness as an anti-inflammatory.

The next time you feel a little queasy and have a headache, try ginger. Ginger works differently than other pain relievers that target inflammation. It blocks the formation of certain types of inflammatory compounds and breaks down existing inflammation through an antioxidant that interacts with acidity in the fluid between joints. Its anti-inflammatory effects come without the risks of nonsteroidal anti-inflammatory drugs (NSAIDs).

Ginger tea recipe

Grate half an inch of raw ginger.
Boil 2 cups of water and pour over ginger.
Let sit for 5 to 10 minutes.
Add juice from a lemon, and add honey or agave nectar to taste.
Shiitake mushrooms for the long game

Lentinan, also known as AHCC or active hexose correlated compound, is an extract of shiitake mushrooms. It promotes antioxidant and anti-inflammatory effectsTrusted Source at a cellular level.

A petri dish studyTrusted Source suggests that AHCC can help with inhibiting breast cancer cells, and its interaction with the immune system might help fight cancerTrusted Source by improving chemo-weakened immune systems.

If you’ve found bone broth to be comforting, throw in a few chopped shiitake mushrooms next time. One studyTrusted Source found that eating 5 to 10 g of shiitake mushrooms every day helped boost human immune systems after four weeks.

Eucalyptus oil for pain relief

Eucalyptus oil has a component called 1,8-cineole, which may help relieve pain. The component has a morphine-like effect when tested on miceTrusted Source.

And for the essential oils fans, you’re in luck. Eucalyptus oil has been shown to relieve body pains even after inhalation. For lovers of Vick’s VapoRub, who have been inhaling it as a home remedy for congestion, well, eucalyptus oil is your magic ingredient.

However, inhaling eucalyptus oil isn’t for everyone. This oil can trigger asthma and may be harmful to pets. It may also lead to respiratory distress in infants.

Lavender for migraine and anxiety

Migraine attacks, headaches, anxiety, and general feelings of (dis)stress? Inhaling lavender can help with that. Studies shows that lavender helps with:

migraine
lowering anxiety or restlessness
memory troubles when stressed and sleepTrusted Source
Drinking lavender tea or keeping a satchel around for times of high stress is one way to reduce anxiety and relax the mind and body.

As an essential oil, it can also be combined with other plant oils for aromatherapy. One studyTrusted Source found that in combination with sage and rose, lavender was helpful in relieving premenstrual syndrome (PMS) symptoms.

CAUTION
While lavender is a powerful plant, it can come with side effects. Directly applying essential oil without diluting it may irritate the skin or potentially affect hormone levels. Always diffuse and dilute essential oils before use.

Mint for muscle pain and digestion

Mint, as common as it sounds, isn’t simple. Depending on the type, it can provide different uses and benefits.

For pain, you’ll want to look for wintergreen, which has methyl salicylate, a compound that may work similarly to capsaicin. Applying it can feel like a cool “burn” before the numbing effect takes place. This effect helps with joint and muscle pain.

The other mint type that’s commonly used in folk medicine is peppermint. An ingredient in many different cures, peppermint has been found to be especially effective in helping treat irritable bowel syndrome (IBS) symptoms.

Studies show that along with fiber, it helps reduce spasmsTrusted Source, as well as diarrhea and abdominal painTrusted Source associated with IBS. Peppermint activates an anti-pain channel in the colon, which reduces inflammatory pain in the digestive tract. This most likely accounts for its effectiveness in treating IBS.

Beyond digestion and stomach troubles, a peppermint oil capsule or tea may also help with headaches, colds, and other body discomfortsTrusted Source.

Fenugreek for breastfeeding

Fenugreek seeds are often used in cooking in the Mediterranean and Asia, but this spice, which is similar to cloves, has several medicinal uses.

When made into a tea, fenugreek can help with milk production for breastfeedingTrusted Source. For people experiencing diarrhea, fenugreek is a great water-soluble fiberTrusted Source to help firm up stools. If you’re constipated, you definitely want to avoid these seeds.

As a supplement, fenugreek has also been found to lower blood sugarTrusted Source, making it a popular aid for people with diabetes. Fenugreek’s role here is due in part to its high fiber content, which can help with improving insulin functionTrusted Source.

Fenugreek in cooking

Fenugreek is often ground and used in curries, dry rubs, and in teas. You can add it to your yogurt for a small savory taste, or sprinkle it over your salads.

Magnesium-rich foods for everything

Feeling muscle pains? Fatigue? More migraine attacks? More likely to slip into a numbed emotional state than usual? It might be a magnesium deficiency. While magnesium is often talked about in terms of the growth and maintenance of bones, it’s also essential in nerve and muscle function.

But studies show that almost half of the U.S. population doesn’t get their required amount of magnesiumTrusted Source. So, if you’ve ever complained of these symptoms and got a slightly terse “eat spinach” response in return, know that it’s not completely unfounded.

Spinach, almonds, avocados, and even dark chocolate are all rich in magnesium. You don’t necessarily need a supplement to treat magnesium deficiency.

When it comes to mood, magnesium may also help. Magnesium works with the parasympathetic nervous system, which keeps you calm and relaxed, suggesting that having a magnesium-rich diet might aid in stress relief.Trusted Source

Foods high in magnesium

lentils, beans, chickpeas, and peas
tofu
whole grains
fatty fish, like salmon, mackerel, and halibut
bananas
Make sure to use home remedies correctly

While most of these natural remedies don’t have any significant side effects, they may be harmful if used in excess amounts.

Certain people may also be more sensitive to dosage amounts, so if you’re on any medication or live with a condition that’s affected by your diet, talk to a doctor before consuming these foods regularly. And if you have an allergic reaction or worsening symptoms from any home remedy, speak to a doctor right away.

Keep in mind that home remedies may not always be safe and effective for you. While these are backed by scientific studies, a single study or clinical trial doesn’t always cover diverse communities or bodies. What research notes as beneficial may not always work for you.

Many of the remedies we listed above are ones we grew up with, ones that families have passed down and brought us up on since we were children, and we look forward to falling back on them when we need the comfort.


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4 Ways People with Mental Illness Are ‘Gaslit’ Into Self-Blame
 Written by Sam Dylan Finch on July 29, 2019 New
“It always seemed to circle back to me and an apparent lack of willpower.”

The first time I told someone that I was mentally ill, they reacted with disbelief. “You?” they asked. “You don’t seem that sick to me.”

“Be careful not to play the victim card,” they added.

The second time I told someone that I was mentally ill, they invalidated me.

“We all get depressed sometimes,” they replied. “You just have to power through it.”

Countless times, I’ve been made to feel like my mental illness is my fault. I wasn’t trying hard enough, I needed to change my perspective, I wasn’t looking at all of my options, I was exaggerating how much pain I was in, I was only looking for sympathy.

If I wasn’t mentally well, they implied, it was obviously an issue with me that had nothing to do with the systems that fail us.

My “failure” to live a functional and happy life had nothing to do with the biological, psychological, and sociological factors that contribute to mental health. Instead, it always seemed to circle back to me and an apparent lack of willpower that kept me down.

For a while, this kind of gaslighting — the denial of my struggles that made me question my own reality — convinced me that my mental illness wasn’t valid or real

Like many mentally ill folks, it was impossible for me to move forward in my recovery until I stopped blaming myself and started seeking out the right kind of support. But it can feel impossible to do this when the people around you are convinced that you’re doing something wrong.

A culture that routinely questions the severity of our illnesses and the sincerity of our efforts — effectively blaming the victim — keeps many of us from accessing the care that we need.

And in my experience, it’s the norm in this society.

I want to unpack those criticisms. The reality is that they harm not just me, but the millions of people that grapple with these illnesses every day.

Here are four ways people with mental health conditions are blamed for what they’re going through — and what we can learn from these harmful assumptions:

1. Expecting us to overcome our illnesses by willpower alone

I remember when my old therapist told me, “If your mental illnesses were just an attitude problem, wouldn’t you have changed it by now?”


The second time I told someone that I was mentally ill, they invalidated me.

“We all get depressed sometimes,” they replied. “You just have to power through it.”

Countless times, I’ve been made to feel like my mental illness is my fault. I wasn’t trying hard enough, I needed to change my perspective, I wasn’t looking at all of my options, I was exaggerating how much pain I was in, I was only looking for sympathy.

If I wasn’t mentally well, they implied, it was obviously an issue with me that had nothing to do with the systems that fail us.

My “failure” to live a functional and happy life had nothing to do with the biological, psychological, and sociological factors that contribute to mental health. Instead, it always seemed to circle back to me and an apparent lack of willpower that kept me down.

For a while, this kind of gaslighting — the denial of my struggles that made me question my own reality — convinced me that my mental illness wasn’t valid or real.

Like many mentally ill folks, it was impossible for me to move forward in my recovery until I stopped blaming myself and started seeking out the right kind of support. But it can feel impossible to do this when the people around you are convinced that you’re doing something wrong.

A culture that routinely questions the severity of our illnesses and the sincerity of our efforts — effectively blaming the victim — keeps many of us from accessing the care that we need.

And in my experience, it’s the norm in this society.

I want to unpack those criticisms. The reality is that they harm not just me, but the millions of people that grapple with these illnesses every day.

Here are four ways people with mental health conditions are blamed for what they’re going through — and what we can learn from these harmful assumptions:

1. Expecting us to overcome our illnesses by willpower alone

I remember when my old therapist told me, “If your mental illnesses were just an attitude problem, wouldn’t you have changed it by now?”

When I hesitated, she added, “I don’t think you’d make yourself suffer this deeply and this much if the solution were that simple.”

And she was right. I was doing everything that I could. My struggles were not due to  a lack of effort on my part. I would’ve done anything if it meant finally getting better.

People who haven’t experienced mental illness personally often buy into the idea that if you try hard enough, mental illness is something you can overcome. With one brushstroke, it’s depicted as a lack of willpower and a personal failing.

Myths like this disempower people because they take the focus away from creating resources to help us, and instead place complete and total responsibility on the person who’s suffering to make solutions appear out of thin air.

But if we could single-handedly ease our suffering, wouldn’t we have already done it? It isn’t fun, and for many of us, it disrupts our lives in significant and even unbearable ways. In fact, mental disorders are a leading cause of disability worldwide.f

My case is exceptional. Most people will take years just to seek out help for the first time, and many will never receive treatment at all.

This gap in care can account for the significant rates of drop-outs, hospitalizations, imprisonment, and homelessness that are a staggering reality for people with mental illness in this country.

It’s incorrectly assumed that if you’re struggling with mental health, a good therapist and a pill or two can easily remedy the situation.

But that’s assuming:

the stigma and cultural norms haven’t discouraged you from seeking help
you have geographically and financially accessible options
treating neurodivergence as an illness is a framework that serves you OR alternatives that resonate with you can be accessed
you have adequate insurance OR access to resources designed for folks without it
you understand how to navigate these systems and can find what you need
you can safely take medications and you respond to the medications prescribed to you
you were accurately diagnosed
you have the necessary insight to recognize your triggers and symptoms and can convey them to a clinician
you have the stamina and time to endure years of testing out different treatments to figure out what works
you have trusting relationships with the clinicians directing your recovery
…which only happens after you’re willing to sit on a waiting list for weeks and even months to see those clinicians in the first place, or can seek out crisis services (like the emergency room) sooner.

Does it sound like a lot? That’s because it is. And this isn’t even a complete list by any stretch.

Of course, if you’re multiply-marginalized, forget it. You not only have to wait for a clinician to see you, but you need a culturally competent one that understands the context of your unique struggles.

This is damn near impossible for many of us, as psychiatry as a profession is still dominated by clinicians who hold a lot of privilege and can replicate these hierarchies in their work.

But instead of addressing the laundry list of reasons why mentally ill people don’t get treatment, it’s just assumed we’re not trying hard enough or that we don’t want to get better.

This is a fallacy designed to prevent us from accessing care and perpetuates a broken system that doesn’t serve us adequately or compassionately.

3. Expecting us to keep a positive attitude

Behind all of the pressure to “keep trying” and all the suggestions that we’re never quite doing “enough” to get better is the implicit message that mentally ill people aren’t allowed to feel defeated.

We’re not allowed to momentarily give up, hang up our gloves and say, “This isn’t working, and I’m tired.”

If we aren’t constantly “on” and working at recovery, it’s suddenly our fault that things aren’t improving. If only we’d just put in the effort, things wouldn’t be this way.

Never mind that we’re human beings and sometimes it’s just too overwhelming or painful to keep going.

A culture that treats mental illness as a lack of effort is a culture that says mentally ill people aren’t allowed to be fully human and vulnerable.

It dictates that the effort is our sole and constant responsibility and that we aren’t allowed moments in which we can grieve, give in, or be afraid. In other words, we can’t be human.

The expectation that mentally ill folks are doing something wrong if they aren’t constantly in motion is an unrealistic and unfair burden to place on us, especially because the level of dysfunction that mental health conditions can present can make it nearly impossible to advocate for ourselves in the first place.

Feeling discouraged is valid. Feeling afraid is valid. Feeling exhausted is valid.

There’s a full-spectrum of emotions that come with recovery, and part of humanizing mentally ill folks requires that we hold the space for those emotions.

Recovery is a discouraging, scary, and exhausting process that can wear down the most resilient among us. This has nothing to do wit
. This has nothing to do with people’s personal failings and everything to do with the fact that these illnesses can be difficult to live with.

If you blame us for not trying harder or trying enough — demonizing those moments when we feel most vulnerable or defeated — what you’re saying is that if we aren’t superhuman and invulnerable, our pain is deserved.

This is untrue. We don’t deserve this.

And we certainly didn’t ask for it.

4. Assuming we’re too functional to be sick or too dysfunctional to be helped

Here’s one of those ways in which mentally ill folks can’t win: We’re either too “functional” by appearances and therefore making excuses for our shortcomings, or we’re too “dysfunctional” and we’re a burden on society that can’t be helped.

Either way, rather than acknowledging the impact mental illness has on us, people tell us that in both scenarios, the problem lies with us.

It personalizes our struggles in a way that’s dehumanizing. We’re seen as either dishonest or insane, and in either case it’s our responsibility to deal with it rather than society’s collective responsibility and ethical obligation to set up systems that allow us to heal.

If we categorically write off people with mental health issues by either invalidating the authenticity of their struggles, or pushing them off to the margins as irredeemably lost, we no longer have to be accountable for what happens when our systems fail them. That’s awfully convenient if you ask me.

Victim-blaming folks with mental illness is not just a matter of stigma — it’s directly harming people with disabilities.

By blaming people with mental illness for their struggles, rather than a system and a culture that consistently fails us, we perpetuate the struggles and stigma that we live with every day.

We can do better than this. And if we want to live in a culture where mental health is accessible to everyone, we’ll have to.

This article originally appeared here.


Sam Dylan Finch is the mental health and chronic conditions editor at Healthline. He’s also the blogger behind Let’s Queer Things Up!, where he writes about mental health, body positivity, and LGBTQ+ identity. As an advocate, he’s passionate about building community for people in recovery. You can find him on Twitter,  Instagram, and Facebook, or learn more at  samdylanfinch.com.

Turmeric for Hair Removal

Medically reviewed by Gerhard Whitworth, RN on July 12, 2019 New — Written by Noreen Iftikhar, MD
Effectiveness
Benefits
DIY
How to
Drawbacks
Where to find
Takeaway
Healthline and our partners may receive a portion of revenues if you make a purchase using a link on this page.

This spice is golden and aromatic, and it’s a popular ingredient in curries, among other savory dishes. But some people also use turmeric in their beauty routines. It’s used as a remedy for skin conditions like acne and dark spots (hyperpigmentation).

Its effectiveness for use in hair removal is mostly anecdotal. And you can find a number of personal reviews and tutorials online. Let’s look at how you can use turmeric to possibly help get rid of hair on the face and body.

Does it work?

It might. Turmeric hair removal is thought to work in two ways:

Natural chemicals in turmeric help to stop or slow hair growth.
Using a turmeric mask or scrub helps to weaken the hair roots and to mechanically pull hair out of the skin.
A 2017 study tested curcuma oil from a plant in the same family as turmeric. The curcuma oil was applied on the underarm area of 60 women for 10 weeks. Researchers found that the curcuma oil reduced or slowed the growth of hair on the area tested.

So, if it works to reduce hair or slow its growth, expect it to work more slowly and less dramatically than waxing or shaving hair off.

Benefits of using turmeric

Usually non-irritating. Using turmeric for hair removal or hair reduction might be a safe, natural way to get smoother skin. It is not known to cause side effects or skin irritation. Therefore, it may also be safe if you have sensitive skin.
Fades spots. Using turmeric on the body may help brighten skin and even out your complexion. The 2017 study that tested curcuma oil for hair removal found that it also reduced pigment cells (melanin) in the body. This may help fade sun spots, age spots, or hyperpigmentation on the skin.
Antimicrobial. Additionally, turmeric has antibacterial, antiviral, and antifungal properties. This may help treat or prevent skin conditions like acne and dandruff.
Gently abrasive. You can also use a turmeric mask as a skin scrub to slough off dead skin cells and unclog pores.
Cost effective. Using turmeric for hair removal may be a cheaper alternative to other methods such as laser hair removal, waxing, and shaving.


Turmeric mask recipes

A turmeric paste or mask is traditionally used for hair removal and for skin remedies. The paste is applied directly on the face for reducing facial hair. It can also be used on other areas of the body.

Turmeric paste recipe #1

Make a turmeric paste by combining:

turmeric powder — the same kind you find in the spice section at a grocery store
water
rose water (optional, for scent)
aloe vera gel (optional, to thicken the paste and soothe skin)
For this recipe, use about one part turmeric powder to about one part water.

Turmeric paste recipe #2

A popular recipe for a turmeric paste adds flour. This is meant to help prevent turmeric from staining your skin a light-yellow shade. Try this recipe for a turmeric skin mask:

1 tsp turmeric
2 tbsp flour (or ground oats)
3 tbps milk (or yogurt)
A few drops of honey
Turmeric paste recipe #3

Another turmeric paste recipe for skin uses only two ingredients:

turmeric powder
whole milk or yogurt
You can add turmeric oil or curcumin oil to your turmeric mask. This boosts the amount of turmeric chemicals that may help remove hair.

For all of the above recipes, mix the ingredients together until the paste has a consistency of toothpaste. The paste should be wet and grainy, so add more water or liquid if it’s too dry. Similarly, add more turmeric powder if the paste is too watery.

Turmeric hair removal steps

Apply the turmeric paste to areas of your face or body where you want hair removed. Consider using a clean makeup brush to apply it to keep your fingers from getting stained.
Leave the turmeric paste on your skin until it dries completely.
Your skin will feel tight as the mask dries — it should start crumbling off as it dries.
At this step some people like to pull up pieces of the mask that flake off easily. In this case, the mask is acting more like a physical hair removal method and might grab a hair here or there.
Splash your skin with lukewarm water and gently rub the mask off with your hands or a face cloth.
Pat dry with a towel.
Downsides to using turmeric

Can stain your skin

A side effect of using turmeric for hair removal is that it can stain your skin. Turmeric has a strong yellow color. Using turmeric paste or turmeric oil may give your skin a slightly yellow or orange stain.

Turmeric stains are temporary.

Wash the area with a mild soap to help remove the yellow coloring. Gently exfoliate the stained skin with a soft, damp towel. Exfoliating removes some of the older skin cells at the top layer of your skin and helps to fade the turmeric staining.

Has a strong odor

The paste also has a strong scent, which some users find unpleasant.

Unknowns remain

It is not yet known whether using turmeric paste for hair reduction is better or the same as using turmeric oil or curcuma oil. The amount of turmeric needed and how long it should be used for is also not known.

More research is needed on using turmeric for hair removal. There are several studiesTrusted Source on the health benefits of turmeric as a food supplement. There are fewer studies on using turmeric on the skin and using turmeric for hair removal.

Choosing turmeric

You can buy turmeric powder from your local grocery store.
You can also go to Middle Eastern, Indian, and Persian grocers in your area. They’ll carry turmeric powder as it’s a key ingredient in these cuisines.
You can also use turmeric or curcumin supplements. Open or crush supplements to get the powder — though this is a much more expensive method.
Look for organic products or well-known spice brands for consistent quality.
Shop for turmeric online.

The takeaway

There isn’t definitive data or studies on the best way to use turmeric for hair removal, but you can still try turmeric masks for hair removal and for its skin benefits.
Does Hookah Smoking Make You High?

Medically reviewed by Alan Carter, PharmD on July 12, 2019 New — Written by Noreen Iftikhar, MD
Getting high
Addiction
Health risks
Takeaway
A hookah is a water pipe used to smoke tobacco. It’s also called a shisha (or sheesha), hubble-bubble, narghile, and goza.

The word “hookah” refers to the pipe, not the contents of the pipe.

The hookah was invented hundreds of years ago in the Middle East. Today, hookah smoking is also popular in the United States, Europe, Russia, and around the world.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, up to 17 percent of high school senior boys and 15 percent of high school senior girls in the United States have used a hookah.

The CDC notes that hookah smoking is slightly higher among college students, with about 22 percent to 40 percent having tried it. This might be because it’s typically a group event and done in special cafes, tea houses, or lounges.

A hookah is made up of a rubber hose, pipe, bowl, and smoke chamber. Tobacco  is heated on coals or charcoal, and it may have flavors added to it, like apple, mint, licorice, or chocolate.

A common myth is that hookah smoking is safer than cigarette smoking. This isn’t true. Hookah smoking won’t get you high, but it does have other health risks and can be addictive.

Can you get high from using a hookah?

A hookah isn’t designed for marijuana or other types of drugs. Hookah smoking won’t get you high. However, the tobacco in it can give you a buzz. You may feel lightheaded, relaxed, dizzy, or wobbly.

Hookah smoking can also make you feel sick to your stomach. This is more common if you smoke too much or smoke on an empty stomach.

The coals used to light a hookah might make some people feel nauseous. Fumes from the coals can cause other side effects, including slight headache pain.

Can you become addicted?

Hookah tobacco is the same tobacco found in cigarettes. This means that when you smoke a hookah, you’re breathing in nicotine, tar, and heavy metals, including lead and arsenic.

Smoking from one hookah for 45 to 60 minutes is about the same as smoking a pack of cigarettes.

Nicotine is the chemical that causes addiction when you smoke or chew tobacco. According to the National Institutes of Health (NIH), nicotine is as addictive as heroin and cocaine.

When hookah smoking, your body absorbs nicotine. It reaches your brain in about 8 seconds. The blood carries nicotine to your adrenal glands, where it triggers the production of adrenaline, the “fight-or-flight hormone.”

Adrenaline raises your heart rate, blood pressure, and breathing rate. It also makes you feel more awake and less hungry. This is why nicotine makes you feel good for a little while.

Over time, nicotine can confuse the brain, causing you to feel sick and anxious if you don’t have it. As a result, smoking cigarettes or other tobacco products with nicotine may make you feel better. This is known as nicotine addiction.

Hookah smoking is often done in social situations. A 2013 survey of 32 people who smoke hookah found that they believed they had a “social addiction” to it. They didn’t believe they were addicted to nicotine.

Health risks of hookah smoking

With hookah smoking, you inhale nicotine and other chemicals from tobacco, as well as chemicals from the fruit flavorings. Tobacco use is linked to almost 5 million  deaths around the world every year.

Hookah smoking also burns coal. This gives off other fumes and chemicals.

An “herbal” hookah may still contain tobacco. You can find tobacco-free hookahs, but they’re not as common. It’s important to know that even if you’re not smoking tobacco, you’re still inhaling chemicals from coal and other substances.

In a hookah, the smoke passes through water before it reaches the hose and mouthpiece. A common myth is that the water filters out harmful substances. This isn’t true.

Lung effects

Researchers in New York City compared respiratory (breathing) health in hookah smokers compared to nonsmokers.

They found that young people who smoked from a hookah only sometimes had several lung changes, including more coughing and sputum, and signs of inflammation and fluid buildup in the lungs.

In other words, even occasional hookah smoking can cause health effects. Like cigarettes, hookahs also give off harmful secondhand smoke.

Heart risks

The same study mentioned above tested the urine of hookah smokers and found that they had some of the same chemicals as cigarette smokers.

Researchers also found other harmful chemicals, like carbon monoxide. These chemicals likely come from the coal that’s used to burn the tobacco.

A 2014 study tested 61 people, including 49 men and 12 women, immediately after hookah smoking in London cafes. Researchers found that hookah smokers had levels of carbon monoxide that were about three times higher than those of cigarette smokers.

Carbon monoxide can lower how much oxygen your body absorbs. This is because it can bond to your red blood cells 230 times stronger than oxygen. Breathing in too much carbon monoxide is harmful, and it might raise your risk of heart disease and other illness.

The researchers also found that study participants had higher blood pressure after hookah smoking. The average blood pressure rose from 129/81 mmHg to 144/90 mmHg.

Over time, hookah smoking may cause chronic high blood pressure, which can also increase the risk of heart disease and stroke.

Infection risk

Hookah smokers typically share one hookah in a group. Smoking from the same mouthpiece can cause infections to spread from person to person. Additionally, some bacteria or viruses may stay in a hookah if it isn’t cleaned properly.

Infections that can spread from sharing a hookah include:

cold and flu
cold sores (HSV)
cytomegalovirus
syphilis
hepatitis A
tuberculosis
Cancer risk

A 2013 review notes that hookah smoking may also be linked to some cancers. Tobacco smoke has more than 4,800 different chemicals, and more than 69 of these are known to be cancer-causing chemicals.

Additionally, hookah smoking may lower your body’s ability to fight some cancers.

That 2013 review also highlights research in Saudi Arabia that found that hookah smokers had lower levels of antioxidants and vitamin C than nonsmokers. These healthy nutrients may help prevent cancer.

Several other studies mentioned in the review link tobacco use to mouth, throat, pancreas, bladder, and prostate cancers.

Other risks

Hookah smoking causes other health effects, including:

low birth weight of babies whose mothers smoked during pregnancy
higher blood sugar levels, which can increase one’s diabetes risk
larynx (voice box) swelling or damage
changes in blood clotting
stained teeth
gum disease
loss of taste and smell
The takeaway

Hookah smoking doesn’t make you high. However, it does have many serious risks and is addictive, much like cigarette smoking. Hookah smoking isn’t safer than cigarette smoking.

If you think you may be addicted to hookah smoking, talk to your healthcare provider about a smoking cessation program to help you quit.

If you’re hookah smoking socially, don’t share mouthpieces. Ask for a sepa
share mouthpieces. Ask for a separate mouthpiece for each person. This may help prevent the spread of infection.
Everything You Need to Know About the Mewing Craze

Medically reviewed by Catherine Hannan, MD on July 12, 2019 New — Written by Kristeen Cherney, PhD
Does it work?
Pictures online are unreliable
How-to
Summary
Mewing meaning

Mewing is a do-it-yourself facial restructuring technique involving tongue placement, named after Dr. Mike Mew, a British orthodontist.

While the exercises seem to have exploded on YouTube and other websites, mewing itself isn’t technically new. In fact, proper tongue alignment is recommended by some orthodontists and other medical professionals as a way to define the jaw, correct speech impediments, and potentially alleviate pain from jaw-related issues.

Despite the hype, mewing has a lot of limitations and may not work like you might see on a YouTube video. If you have medical concerns about your mouth and jaw, you’re better off seeing a doctor for diagnosis and treatment.

oes mewing work?

At the heart of mewing is learning how to reposition your tongue into a new resting place. Supporters of the technique believe that, over time, your tongue position will change your overall facial features, most notably the jawline.

People also believe it may help alleviate jaw pain and provide relief from snoring. Mewing is supposed to work by making your jawline more defined, which can help shape your face and perhaps make it look thinner, too.

While Dr. Mew is credited with popularizing the technique on the internet, these exercises weren’t actually created by the orthodontist. A quick search on YouTube will lead you to videos of others who have tried the technique and have purportedly gotten results. (There are a few videos that debunk the craze, too).

Proponents of mewing also believe that it isn’t the exercise that changes your face, but rather the lack of mewing that can transform your jawline for the worse. It could even possibly provide corrective techniques for children with tongue posture issues that might lead to irregular bites and speech issues, as discussed in one studyTrusted Source.

On the other hand, experts fear that individuals who are in need of surgery or orthodontic work might mistakenly try mewing instead to help fix any issues on their own.

Mewing before and after images are unreliable

YouTube videos, along with numerous before and after pictures, can sometimes persuade viewers into believing that mewing works. However, it’s important to remember that such sources aren’t always reliable.

Many of these online tutorials usually include several weeks or months of practicing mewing, rather than the required years. Additionally, images can be deceiving because of shadows and lighting. The angle at which the people in the photos position their heads can also make the jaw look more defined.

More clinical research is needed to determine the efficacy of mewing.

How to mew

Mewing is the technique of flattening out your tongue against the roof of the mouth. Over time, the movement is said to help realign your teeth and define your jawline.

To properly mew, you must relax your tongue and make sure it’s entirely against the roof of your mouth, including the back of the tongue.

This will likely take a lot of practice, since you’re likely used to relaxing your tongue away from the roof of the mouth without giving it a second thought. Over time, your muscles will remember how to place your tongue in the correct mewing position so it becomes second nature. In fact, it’s recommended that you mew all the time, even when drinking liquids.

As with any DIY technique that seems too good to be true, there is a catch with mewing — it may take yearsto see results. Maxillofacial deformities are typically corrected with surgery or orthodontics, so you shouldn’t assume that you can quickly correct any issues on your own by mewing here and there.

One studyTrusted Source looked at tongue resting positions to see if any muscle groups were engaged as a predictor of long-term memory. In this case, researchers found that the 33 people in the study didn’t exhibit any signs of altered muscle activity.

Takeaway

While not inherently dangerous, there’s not enough evidence available to support the mewing craze for defining your jawline. If you have any pains or cosmetic concerns in the jaw area, see your doctor to discuss treatment options.

You can still try mewing, but be prepared to find little to no results. Until mewing is properly researched as an orthodontic solution, there’s no guarantee that it will work.

4 Driving Hazards Lurking Inside Your Car — and How to Avoid Them

Medically reviewed by J. Keith Fisher, MD  on July 15, 2019 New — Written by Jason Brick
Consider these 4 tips for a healthier and safer driving experience.
You may already know about the hazards of driving that come from outside your car. You probably also know how to avoid them:

Wear your seatbelt.

Don’t drive intoxicated, distracted, exhausted, or while texting.

Drive the speed limit.

Watch out for people who aren’t as careful and responsible as you are.

But fewer of us know about the hazards that come from inside the car. These can either make the consequences of a crash far more dangerous, or contribute to long-term health problems that happen even when you’re no longer behind the wheel.

Here are the four most important and what you can do about them:

1. Keeping a messy car

This one is an exercise in simple math, and you already know how it works if you’ve ever experienced a “tectonic shift” while taking a sharp turn. The stuff inside your car has inertia just like all other matter which can create a serious hazard in a crash.

Let’s run some numbers:

If you rear-end somebody while you’re doing 10 miles per hour (MPH), the pencil you left on the dashboard will roll forward and bounce off the window. Rear-ending somebody at 35 MPH can actually put that pencil through the windshield.

Now, imagine a head-on collision with both cars going over 40 MPH. Think for a moment about what’s going to happen with that bottle directly behind you.

Less dramatic but potentially worse are the soda bottles, take-out wrappers, mildewed clothes, and similar debris lurking in the back of many vehicles. Research has shown that dirty cars can be a serious breeding ground for bacteria of all sorts, and not all of them are harmless.g
Imagine for a moment what might happen if you got nicked by an infected object in even a minor crash.

In short, it’s a good idea to clean up your car (and don’t forget to disinfect!).

2. “Riding” the shift (and other posture mistakes)

We are the sum of our habits. If you spend the American average of 1 hour and 11 minutes per day traveling, how you’re holding your body — posture-wise — matters.

Good posture while driving can help your body, while poor posture carries a lot of potential problems.

Poor posture can result in:

Slouching. This can contribute to lower back pain.
Rolling your shoulders forward. This can cause mobility problems in the shoulders and neck.
Odd leg positioning. This can harm your knees and hips.
“Riding” the shift. By twisting your wrists, shoulders, and elbows too much, this can cause joint issues (mainly an issue for folks who drive a manual car).
Luckily there are some very straight forward ways to avoid these problems. These include:

sitting upright, but relaxed
keeping your hands at 10 and 2 on the steering wheel
keeping your shoulders above your hips and your knees above where your feet go when not pressing a pedal
breathing deeply in this strong posture to relieve stress
3. Not minimizing your commute

We all know commuting can be stressful, but a study in 2008 revealed just how much.

Results of the study found that adding 20 minutes to your commute increased physical symptoms of stress (like cortisol levels and sleep problems) as much as if you had received a 15 percent cut to your salary.

You need to get to work and sometimes driving is unavoidable. That said, you may have some options that could reduce or shift the stress of that commute.

For example, shifting your start and finish times at a flexible job can cut your drive time drastically by letting you miss the worst parts of rush hour. Shifting to a schedule of four longer days — rather than five shorter ones — cuts your commute by 20 percent. The same goes for negotiating telecommuting one or two days per week.

If your working hours aren’t flexible, the study also found that your mode of commute impacts stress. From worst to best, they found buses, driving alone, other public transportation, ride sharing, biking, and walking had drastically different impacts on your stress levels.jo

4. Cranking the tunes

It can get you amped up for a work day to blast your favorite music on your way into work, but the cost may be too much.

Noise-induced hearing loss begins at or above the 85 decibel range. While most standard car stereos max out in the 80 to 95 decibel range, premium sound optimized for volume can reach up to 170, which is more than the front row at a concert.

That’s not to say you shouldn’t listen to your favorite music during a commute. The health benefits of music are numerous and well established. Just resist the temptation to max out what your stereo can do.

While driving might be unavoidable, there are ways to decrease the possibility of negative effects

While driving can have its hazards, we understand that it may be something that’s unavoidable — whether that’s for work or personal reasons.

Using these tips, however, may help to decrease the possibilities of negative long- and short-term effects, from poor posture to hearing loss. That said, if you do find yourself driving for long periods of time on a daily basis, consider doing something that’s going to work your mind or body after you’re done with your long drive, such as taking a walk, hitting the gym, reading your favorite book, or even spending time with family or friends.

And if you can’t do that, look into safe options for working your brain like listening to audiobooks or driving with friends, coworkers, and loved ones.


Jason Brick is a freelance writer and journalist who came to that career after over a decade in the health and wellness industry. When not writing, he cooks, practices martial arts, and spoils his wife and two fine sons. He lives in Oregon.

A Day in My Life with Metastatic Breast Cancer

Medically reviewed by Christina Chun, MPH on July 15, 2019 New — Written by Sarah Reinold


7:00 a.m.

It’s Monday morning. My husband already left for work and I’m lying in my cozy bed with a lovely view of the underside of my eyelids. I’m startled awake by my 2-year-old as he snuggles up under the covers and asks to watch a movie. We decide on “Goosebumps 2.”

7:30 a.m.

My daughter wakes up an hour later than her normal time and comes down the hallway into my room to join her brother and I for our viewing party. We quickly realize that the three of us in one queen size bed, without my morning coffee and with their limited patience, only leads to kicking, arguing, and mommy becoming more ready than ever to get up and make breakfast.

7:45 a.m.

Time for breakfast! Before I do anything, I need to eat. Since starting radiation to my spine, my stomach becomes quite uneasy if I let myself get too hungry. I decide on a simple bowl of Cheerios with milk and a cup of coffee.

8:30 a.m.

After breakfast, I get my kids settled in the living room with a show on Netflix to entertain them long enough for me to take a shower. As soon as I get out, they make their way to the basement to play while I continue getting dressed.

With radiation comes very sensitive skin, so after my shower, I need to lather on a thick layer of lotion to my chest and back, and make sure to wear soft, comfortable clothes. Today I choose a loose-fitting shirt with leggings. The leggings are a must for radiation because they are perfectly form-fitting, so I can sit in the exact position I need to be in for treatment.
sides being a cancer patient, I’m also a wife and stay-at-home mom. Naturally, a Monday morning isn’t complete until I throw in a load of laundry!

10 a.m.

We finally get ourselves out of the house. First stop is the library so we can exchange some books and the kids can play a bit – for free! After the library, we make our way to the grocery store to pick up a few things. Then, we head back home for lunch.
11:45 a.m.

My mom, aka Grammy, comes over to the house to have lunch with us before I head out for my appointments. We’re lucky that we have family close by to help out with the kids. When I have doctor’s appointments and my husband is at work, this helps us save money on daycare expenses and keeps my mind at ease.

12:15 p.m.

I kiss my kids goodbye, thank my mom, and drive to UConn for radiation and infusion. It’s only a 25-minute drive, but I like to give myself extra time to park in the garage and not rush. Most days, radiation isn’t until after my husband gets home from work and I’m usually bolting out the door only to get there five minutes late.

Today, I also have an infusion appointment, so we were able to switch to an earlier radiation slot and take advantage of extra Grammy time.

1:10 p.m.

After changing into my radiation wrap, I go in for radiotherapy treatment to my chest wall and spine. Of course, the day I get there early and have another appointment to get to, they take me in late, but the techs quickly set me up on the table, treat my chest wall, reposition me, and treat my spine. As soon as I’m done, before putting my shirt back on, I spread Aquaphor ointment all over the left side of my chest and back to keep the radiated areas as moist as possible.1:45 p.m.

After taking the elevator up to the fourth floor, I check in with infusion and wait for them to call my name. Once I go in, they check my weight, blood pressure, oxygen level, and temperature. My nurse then comes over to see how I’m feeling and runs through potential symptoms I could be having since my last infusion three weeks ago.

The only complaint I have is side effects from radiation. She proceeds to access my port, and after getting a blood return, she draws blood to send to the lab to monitor various things such as blood cell counts, hemoglobin, and potassium. Then, she puts in the order for the medications I’m receiving today.

2:15 p.m.

My medications are finally ready and my nurse comes over to administer them. At this time, I also put a lidocaine cream on just next to my belly button. This time, the injections lined up with my infusion, which saves me a trip, but also makes my visit more interesting. These injections are very large and very painful, hence the cream.

4:30 p.m.

I’m done with infusion. Time to go home!

5:30 p.m.

While I was at the cancer center all afternoon, my husband was home with the kids cooking dinner. Tonight’s menu consists of steak, potatoes, and Vidalia onions on the grill.

6:40 p.m.

After dinner, I apply another layer of Aquaphor to keep my skin as moisturized as possible and ease some of the burning from radiation.

6:45 p.m.

Metastatic breast cancer cannot get in the way of me being a mom. My two children need me, and they also need baths! Into the tub they go, followed by pajamas, story time, bedtime songs, and lights out by 8 p.m.

8:30 p.m.

Now that the kids are in bed, mostly quiet, I take my magnesium and calcium supplements. Then I climb into my own bed to watch “How To Get Away With Murder” before falling asleep to prepare for what adventures we have in store for us tomorrow.


Sarah is a 28-year-old mother of two. She was diagnosed with stage 4 metastatic breast cancer in October 2018, and has since undergone six rounds of chemotherapy, a double mastectomy without reconstruction, and 28 rounds of radiation. Before her diagnosis, Sarah was training for her first half marathon, but was unable to race due to her life-changing diagnosis. Now that she is done with active treatment, she strives to improve her health and begin running again to achieve that half marathon and live as long as possible for her children. Breast cancer has changed her life in every way imaginable, but by spreading awareness and teaching others about the realities behind this devastating disease, she hopes to become a piece of the influence that cures MBC for good!