Is Hydrogen Water the Key to Gut Health You’ve Been Missing?


One of the biggest trends we’re seeing in the wellness world today is hydrogen water, which is very similar to alkaline water that had its own fifteen minutes of fame a few years ago. The difference? Hydrogen water is definitely here to stay. It’s more than a health buzzword; it’s the key to unlocking a healthy gut microbiome. With more Americans than ever suffering from gut disorders like IBS and leaky gut, or even just bloating, let’s take a deep dive into why hydrogen water is the MVP of gut microbiota.

First, What Is Hydrogen Water? 

Hydrogen water is essentially exactly what we all understand water to be, but with hydrogen gas (H2) added to it. This enhancement is tasteless, odorless, and colorless, which means you get all the benefits of hydrogen water without unpleasant additions – it’s like drinking out of the tap without the risk of chemicals or fluoride. 

Understanding the Function of the Stomach

Your stomach is a critical organ in your body’s digestive system, which is mainly responsible for the mechanical and chemical breakdown of everything you consume. The stomach, located between the esophagus and the small intestine, is something you likely never give much thought to – unless you have chronic gut issues. 

When food enters the stomach, it immediately begins mixing with gastric juices, which are composed of hydrochloric acid and digestive enzymes. It’s here that the stomach and its acids kill bacteria and other potentially harmful pathogens that could have been consumed with your food. Once the initial phases of digestion are completed, the food moves further down to your small intestine where digestion will continue (and nutrient absorption happens too). 

How Hydrogen Water Helps Stomach Health 

Chances are, you’ve only dabbled with hydrogen for your health by pouring hydrogen peroxide in your ears or on wounds, but by consuming hydrogen water, molecular hydrogen enters your body and goes to work as a powerhouse antioxidant to fight off free radicals. Free radicals are the cause of oxidative stress which not only damages your DNA, but increases inflammation – the root of most health issues. 

With molecular hydrogen in your body, there are countless positive effects for virtually every part of the body, but especially your stomach. Studies suggest that molecular hydrogen reduces tissue damage and restores blood flow. This is critical when it comes to conditions of the stomach. 

Main Stomach Benefits 

The benefits of hydrogen water consumption are many when it comes to the stomach, but there are three areas where the most benefits are seen:

  • Promoting Healthy Gut Microbiome: Studies have shown that hydrogen can influence gut microbiota composition, which promotes the growth of beneficial bacteria in the stomach and boosts gut health. A health gut microbiota is essential for proper digestive function and indirectly benefits the stomach by improving digestion as well as nutrient absorption. 

  • Beating Gastritis: Gastritis is a condition where inflammation in the stomach lining is either acute or chronic. The anti-inflammatory properties of hydrogen water mentioned above help reduce the inflammation that’s associated with gastritis which can provide much-need relief from debilitating symptoms. 

  • Reducing Discomfort: While some people deal with symptoms like indigestion, mild abdominal pain and bloating from time to time, others suffer chronically. Hydrogen water is able to alleviate these symptoms due to its ability to reduce inflammation and oxidative stress within the gastrointestinal tract. 

How to Get Hydrogen Water

If incorporating hydrogen water into your daily routine seems intimidating, don’t let it be! There are easy ways to integrate this miraculous water into your lifestyle. You can get a water ionization machine or buy hydrogen water online and in some health food stores. There are even tablets you can add to create hydrogen water at home or on the go. The truth is, drinking hydrogen water is just as easy as drinking from the tap but with all the added benefits for your stomach and overall health!

What Are You Waiting For? 

Whether you suffer from chronic issues with your gut or occasional, the benefits of hydrogen water are so vast, why not invest in a water ionization machine to start living your best life and feeling your best too? For improving your stomach health, hydrogen water is a no-brainer. Its antioxidant properties boost your stomach’s functions, hydration levels and so much more. 



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Cardioverter-Defibrillator: A Treatment for Arrhythmia


A cardioverter-defibrillator (ICD) is a type of medical implant device. It tracks and treats an irregular heartbeat (arrhythmia). It sends an electric current through your heart when needed. The ICD is smaller than a cell phone. It has two main parts: a pulse generator and a lead (wire). The pulse generator monitors your heartbeat. It is like a small computer that runs on a battery. The lead goes from the pulse generator to the inside of your heart. It sends signals and electric currents between your heart and the pulse generator. Some people need multiple leads with their ICD.

Path to improved well being

Your doctor may recommend an ICD to treat your irregular heartbeat. There are many different types of arrhythmias. Treatment depends on what kind you have. An ICD is one form of treatment. You may need an ICD if you have or are at high risk of a life-threatening ventricular arrhythmia. Examples include ventricular tachycardia and ventricular fibrillation. Having a previous heart attack, heart disease, or cardiac arrest are other reasons you may need an ICD.

Ventricular tachycardia is when the bottom chambers of your heart (the ventricles) beat too fast. When this happens, your heart has a hard time pumping blood. As a result, your body and brain don’t get enough blood. This is life threatening.

Ventricular fibrillation is when the bottom chambers of your heart (the ventricles) beat too fast and unevenly. The heart flutters, and little or no blood is pumped to your body and brain. Someone who has this type of arrhythmia is at risk of passing out. Treatment is required within minutes in order to prevent death.

How is an ICD implanted?

A doctor or surgeon implants an ICD during minor surgery. The pulse generator is placed under your collarbone on the left or right side of your chest, or in your abdomen (stomach area). It can go in a “pocket” under your skin or in a muscle. The doctor inserts one end of the lead (wire) into a vein that goes to your heart. They move the wire through the vein until it reaches the heart. The other end of the wire gets attached to the pulse generator. Once it is implanted, the doctor programs and tests the ICD to treat your heart rhythm problem. The process requires a short hospital stay.

How does an ICD work?

The ICD’s job is to quickly recognize and stop problems. It does this by keeping track of your heart rhythm at all times. If your heartbeat becomes irregular, the ICD delivers the treatment. Your doctor can program the ICD to do several things.

  • Pacing: For mild ventricular tachycardia, the ICD can deliver several pacing signals in a row. These signals cause your heart to return to a normal rhythm.
  • Cardioversion: This is used if pacing doesn’t work. Cardioversion sends a mild shock to your heart to stop the fast heartbeat.
  • Defibrillation: For ventricular fibrillation, the ICD sends a stronger shock. This can stop the fast rhythm and help the heartbeat go back to normal.
  • Pacemaker: The ICD can detect when your heart beats too slow. It can act like a pacemaker and bring your heart rate up to normal.

What does treatment with an ICD feel like?

When the ICD delivers pacing or acts as a pacemaker, you may not feel anything. This is because little energy is used. Some people feel fluttering in their chest. However, there is no pain or discomfort. Cardioversion is stronger. It can feel like a thump in your chest.

Defibrillation is the strongest. Most people say it feels like being kicked in the chest. It often happens all of a sudden. It lasts less than a second. It can make you upset or anxious afterward. However, it’s important to remember that it probably saved your life.

Things to consider

An ICD does not cure an arrhythmia or heart disease. It manages your condition(s) and helps prevent cardiac arrest and death. In addition to ICD, your doctor may prescribe medicine. Follow all instructions and tell your doctor what other medicines you take. Ask your doctor for an ICD wallet ID card. It is important that you carry this at all times. You will need this when you travel and in case of an emergency.

How will an ICD affect my lifestyle?

After you get an ICD, you will need to limit activity. This allows your body to adjust and heal properly. You can slowly go back to your regular lifestyle. Ask your doctor when it is safe to drive a car again. It will vary based on your condition and the local laws. You can expect to be back to normal after a month.

You need to stay away from machines that could interfere with your ICD. Do not work near strong magnetic or electrical fields. The ICD is safe around most home power tools and electric appliances, including microwave ovens. However, make sure that all electric items are properly grounded and in good repair. Your doctor can help you understand what to avoid when you have an ICD. Machines, devices, or procedures that may cause interference include:

  • Security metal detectors
  • Magnets
  • Power-generating equipment
  • Some power tools and electronic devices
  • Electric fences and transformer boxes
  • Electronic mattresses or pillows
  • Anti-theft systems
  • Cell phones
  • Magnetic resonance imaging (MRI)
  • Therapeutic radiation
  • Electrolysis (electric hair removal)

When to see a doctor

Your doctor should test your ICD at regular checkups. Its generator battery can last 5 to 7 years. It can be replaced in outpatient surgery.

Getting an ICD may cause new emotions or depression. Talk to your family and a doctor if this happens to you. The doctor can recommend counseling or a support group.

Questions to ask your doctor

  • Once I have an ICD will I always need it?
  • How do I care for my wound after ICD surgery?
  • How long after getting an ICD can I return to my normal activities?
  • Can I drive?
  • Can I have sex?
  • Can I play video games and use electronics?
  • Will I know when a shock is coming?
  • How do I know if my ICD is working or not?

Resources

National Institutes of Health, MedlinePlus: Implantable cardioverter-defibrillator

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Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.





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HIV Exposure: Advice for Health Care Workers


Path to Improved Health

There are many ways to prevent occupational exposure to HIV. To start, health care workers should treat all body fluids the same way. You should assume they are infected and take precautions:

  • Use protective covering, such as gloves and goggles. You always should do this when dealing with blood and body fluids.
  • Wash your hands and other skin areas right after contact with blood and body fluids.
  • Be careful when handling and disposing of needles and sharp instruments.
  • Use available safety devices to prevent needle stick injuries.
  • Be aware of your employer’s post-exposure processes.

If an exposure does occur, follow these basic steps:

  • For a skin puncture, induce bleeding at the wound site. Do this by applying gentle pressure around the wound as you wash the area with soap and water.
  • For a skin or mucous splash, rinse the area well with water.
  • Get the infected person’s information. This includes name, address, phone number, and HIV status. If they are a patient, get their doctor’s contact information.
  • Notify your supervisor and coworkers. If your place of work has other procedures in place, follow those (incident reporting, etc.).
  • Seek immediate medical care. Go to your employee health unit, emergency department, or personal doctor.

Once you are with medical professionals, they will assess the exposure. If you have a skin puncture or cut, you may also need a tetanus toxoid booster. The following are some questions a doctor may ask about the exposure.

For a skin puncture:

  • Is it shallow or deep?
  • If caused by a needle, what gauge was it? Was the needle solid (suturing) or hollow?
  • If caused by an instrument, what was it?
  • Was there blood or bloody material on the surface of the object?
  • Was the object in prior contact with the infected person’s body fluids?
  • If blood was injected in you, how much?
  • Were you wearing protective covering?

For a skin or mucous splash:

  • What type of body fluid were you exposed to, and how much?
  • On what part of your body were you exposed?
  • What size area was the contact?
  • What was the length of contact time?
  • Was there a break in your skin?
  • Was there a rash, bite, or open wound?
  • Were you wearing protective covering?

About the infected person (source):

  • Is the source HIV negative or positive? They could be infected but not know yet. One in seven people living with HIV are unaware.
  • Has the source had possible exposure to HIV through sex with multiple and/or anonymous partners, condomless sex, anal sex where both partners have a penis, or use of recreational drugs, injection drugs, or methamphetamines?

About yourself:

  • Have you been exposed to HIV before? If so, when and how? What were the results?
  • Are you sexually active?
  • What kind of relationship are you in?
  • Are you pregnant or breastfeeding?
  • Do you have any health conditions?
  • What medicines are you taking?
  • Are you allergic to anything?
  • Do you agree to HIV testing? Do you agree to document the incident?

You and your doctor will decide on the best form of exposure treatment. Your doctor may have you take medicine to reduce your risk of getting HIV. He or she might also prescribe other medicines to protect against hepatitis or other infections. You’ll likely need blood work to check your liver, kidney, and bone marrow function.

Post-exposure prophylaxis (PEP) for HIV is a treatment to suppress the virus and prevent infection after exposure. PEP should be taken within 72 hours of possible exposure to HIV, so it is important to seek treatment quickly. Prophylaxis medicines can have some side effects. Gastrointestinal symptoms are the most common, including nausea, diarrhea, and stomach pain or discomfort.

Until HIV infection is ruled out, you should refrain from blood or organ donation and only engage in low- or no-risk sexual activity, including the use of barrier methods like condoms. If you are breastfeeding, you should switch to feeding your baby formula.





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Depression and Alzheimer’s Disease – familydoctor.org


What is depression?

When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression has symptoms nearly every day, all day, for 2 weeks or longer. These symptoms can include:

  • Feeling sad or numb
  • Crying easily or for no reason
  • Feeling slowed down
  • Feeling restless and irritable
  • Feeling worthless or guilty
  • Trouble remembering, focusing, or making decisions
  • Headaches, backaches, or digestive problems
  • Unplanned weight loss or gain
  • Sleeping too much or having problems sleeping
  • Feeling tired all the time
  • No interest or pleasure in things you used to enjoy, including sex
  • Thoughts about death or suicide

There is a minor form of depression that causes less severe symptoms. Both have the same causes and treatment. An older person who has depression may feel confused or have trouble understanding simple requests.

What is Alzheimer’s disease?

Alzheimer’s disease is the most common type of dementia. Dementia is a group of symptoms caused by damage to brain cells. This can happen because of a tumor, head injury, stroke or disease. Alzheimer’s disease makes it hard for people to remember, learn, and communicate. These changes eventually make it hard for people to care for themselves. It may also cause changes in mood and personality.

Depression is very common among people who have Alzheimer’s disease. In many cases, they become depressed when they realize that their memory and ability to function are getting worse. Together, depression and Alzheimer’s disease can cause other symptoms. They may not want to go places or see people anymore. Their outlook and quality of life can suffer.

Path to improved health

From the outside looking in, it may be difficult to know if your family member is depressed. You can look for some of the typical signs of depression. Your loved one may become angry and agitated or lost and confused. They may refuse help with personal care, such as getting dressed or taking medicines.

Alzheimer’s disease and depression have many symptoms that are alike. It can be hard to tell the difference between them. If you think that depression is a problem for your loved one who has Alzheimer’s disease, talk to their doctor.

Things to consider

There are many things you can do to help someone who has Alzheimer’s disease and depression:

  • Create a pleasant environment. Include people and things that they are familiar with. This can brighten their spirit and help soothe any fear or anxiety.
  • Set realistic expectations of what they can do. Help them with tasks they can’t do alone. Do not expect so much that they become frustrated or upset.
  • Let them help with simple, enjoyable tasks. These could be preparing meals, gardening, or doing crafts.
  • Avoid loud noises, crowded places, or overstimulation. This may cause them to become anxious or act out.
  • Be positive. Frequent praise will help them—and you—feel better.

As the caregiver of a person who has Alzheimer’s disease, you must also take care of yourself. If you become too tired and frustrated, you will be less able to help. Ask for help from family, friends, and local community organizations. Respite care may be available from your local senior citizens’ group or a social services agency. This is short-term care that is given to a patient to provide relief for the caregiver. Look for or ask your doctor about caregiver support groups.

Other people who are dealing with the same problems may have good ideas on how to cope. Adult day care centers may be helpful. They can give your family member a consistent environment and a chance to socialize. Most senior living facilities have programs specific for people who have Alzheimer’s disease.

When to see the doctor

Contact your doctor if you recognize Alzheimer’s disease and/or depression symptoms in yourself or a loved one. The American Academy of Family Physicians (AAFP) recommends that adults be screened for depression.

The doctor may prescribe medicine to treat some symptoms. Antidepressant medicines can be helpful. These medicines help improve emotional and mental symptoms. They also can help with eating and/or sleeping problems. Antidepressant medicines are not habit-forming.

Questions to ask your doctor

  • Do depression and Alzheimer’s disease run in families? Am I at risk?
  • What types of medicines treat depression and Alzheimer’s disease? Are there any side effects?
  • Will depression go away?
  • Are there any lifestyle changes that help improve the symptoms?
  • Can you recommend a support group for people who have these conditions and their caregivers?

Resources

U.S. Department of Health and Human Services: Eldercare Locator





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Locations of Head and Neck Cancer



Where does head and neck cancer occur?

Head and neck cancer is cancer in the head or neck region.

Head and neck cancers make up about 4% of all cancers in the United States.

Men are more likely to get head and neck cancer, but it’s also seen in women and never smokers.

There are several different locations where head and neck cancer can occur.

Voice Box (Larynx)

Laryngeal cancer = the voice box (larynx)

Throat (Pharynx)

Hypopharyngeal cancer = the lower throat (next to and behind your voice box)

Oropharyngeal cancer = the middle section of your throat, including your tonsils, soft palate and back of tongue

Nasopharyngeal cancer = the space behind your nose

Mouth

Oral cancer = the mouth, cheeks, lips, front of your tongue and the roof of mouth

Nose and sinuses

Nose (nasal cavity) = the openings behind the nostrils

Sinus (paranasal sinus) cancer = the air-filled spaces around or near the nose

Salivary glands

Salivary gland cancer = the salivary glands, the organs in your mouth and throat that produce saliva

Neck

Head and neck cancers can spread to the lymph nodes in the neck, causing a mass.

Catching head and neck cancer early is important. The survival rate of people with stage 1 or stage 2 head and neck cancer is between 70% and 90% .

If you have questions about head and neck cancer, talk to your healthcare provider.

This educational resource was created with support from Merck.



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Stool Soiling and Constipation in Children


Things to consider

There are many reasons your child may not want to use the bathroom for a bowel movement. They may be scared of being alone in the bathroom. They may be scared of the toilet. Some children just don’t want to stop playing to go to the bathroom.

If bowel movements have been painful in the past, your child may “hold” their stools when they have the urge to pass one. They do this to avoid the pain. This can lead to constipation. Constipation may occur if:

  • Your child is not eating enough high-fiber foods, drinking enough water, or getting enough exercise.
  • Your child has an illness that causes them to have a fever and not to eat much. This problem can remain even after the illness goes away.

In many children, the cause for constipation cannot be found.

Children who have constipation may have soft or liquid stools leak from the anus (the opening to the rectum). This is caused by a mass of stool stuck in the lower bowel. This happens because the amount of stool can become so large that it leaks out of the anus, causing soiling. These stools have a very bad smell.

Symptoms of constipation include:

  • Extreme straining during a bowel movement
  • Abdominal pain and bloating
  • Crankiness
  • Tiredness
  • Loss of appetite between bowel movements
  • Wetting during the day or night
  • Extreme reluctance to use the toilet

If your child doesn’t have a bowel movement for 3 or 4 days in a row, call your doctor. They may want to remove the stool that has collected in the lower bowel. Your doctor can do this in the office by giving your child an enema or a suppository. This is medicine that is inserted into the anus. Your doctor also may have you give your child laxatives to remove the stool.

After the stool has been removed, it is important to be sure that your child can have bowel movements easily. Easy bowel movements will help prevent another large collection of stool. Treatment may include changing your child’s diet to include more fluids and fiber-rich foods, having your child sit on the toilet several times a day, and giving your child daily laxatives to help soften the stools.





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El diagnóstico de cáncer de mama de Olivia Munn es una señal de alerta para todas las mujeres



Cuando la actriz Olivia Munn, de 43 años, publicó en Instagram que recibió un diagnóstico de una forma agresiva de cáncer de mama, no solo recibió mucho apoyo, sino que usó su estatus de celebridad para concientizar acerca de una prueba poco conocida que salvó su vida.

El año anterior, Munn estaba realizando pruebas que tenía planificadas antes de ir a Alemania para la filmación de su nueva película de ciencia-ficción. Se sometió a su mamografía anual e incluso a pruebas genéticas para detectar la mutación BRCA. Ambas pruebas mostraron resultados normales. Pero cuando su doctor tomó el paso adicional de usar la herramienta de evaluación de riesgo de cáncer de mama (BCRAT, por sus siglas en inglés) que tiene varias preguntas acerca de antecedentes familiares y salud reproductiva, el riesgo de Munn fue del 37%. Fue lo suficientemente alto para que su doctor recomendara la RM que detectó su cáncer.

La vida de Munn se convirtió repentinamente en una pesadilla y, en vez de ir a Alemania, se sometió a cirugías importantes en un período de 10 meses, incluyendo una mastectomía doble, una disección de ganglios linfáticos, una cirugía reconstructiva y una mastectomía con conservación del pezón. En febrero de 2024, hizo que se remuevan sus ovarios y útero para evitar que el cáncer reaparezca.

Cuando Munn divulgó al público en general lo que su diagnóstico de cáncer implicó para ella, atribuyó la detección temprana a que su doctor usó la BCRAT. “Soy afortunada. Lo detectamos suficientemente temprano para tener opciones. Deseo lo mismo para cualquier mujer que tenga que enfrentar esto algún día”, publicó en Instagram.

Según Mary Jane Minkin, M.D., una ginecóloga de Yale New Haven Hospital y miembro del consejo de asesoría de HealthyWomen, las mujeres deberían someterse a mamografías todos los años desde que cumplen 40 años. Sin embargo, tal como ocurrió con Munn, someterse a una mamografía no siempre es suficiente.

“Las mamografías no detectan del 10 al 15% de los cánceres. No son infalibles en lo que se refiere a la salud mamaria. En esos casos es cuando la herramienta de evaluación de riesgo es útil”, dijo Minkin, quien explicó que si detectas un cáncer de mama en forma temprana, tal como lo hizo Munn, la tasa de supervivencia es muy alta.

Cómo funciona la herramienta de evaluación de riesgo de cáncer de mama

La BCRAT usa la información personal de una mujer para estimar el riesgo de desarrollar cáncer de mama invasivo en los siguientes 5 años y hasta la edad de 90 años. “Básicamente se asegura de que las personas que tienen un mayor riesgo se sometan a pruebas en forma regular”, dijo Minkin.

Según el Instituto nacional de cáncer, la herramienta evalúa:

  • La edad
  • La edad en la que tuviste tu primer período menstrual
  • La edad en que tuviste tu primer parto de un niño nacido con vida
  • El número de parientes de primer grado con cáncer de mama
  • El número de biopsias previas de mama
  • La presencia de células precancerosas en la mama

“Ser mujer es el mayor factor de riesgo. Entre más envejecemos, mayor es el riesgo”, dijo Minkin. Pero hay muchos otros factores que deben considerarse. “Si tenías 9 o 10 años cuando empezaste a tener períodos menstruales, tienes un mayor riesgo que alguien que empezó a tener períodos menstruales a los 15 años”, explicó.

El número de hijos que tienes y la edad a la que los tuviste también puede ser un factor de riesgo. Tener varios hijos antes de cumplir 35 años, reduce tu riesgo.

La genética también juega un papel importante. Entre más parientes en primer grado, es decir, tu madre, hijas o hermanas, hayan recibido diagnósticos de cáncer de mama, mayor será tu riesgo.

Lee: A mi hermana, a mi mamá y a mí nos diagnosticaron cáncer de mama en un plazo de 18 meses >>

Entre más biopsias de mama hayas tenido, más elevado será tu riesgo también. Incluso si las biopsias tienen resultados negativos, el hecho que se requirieron sugiere que algo sospechoso está ocurriendo en tu mama.

La BCRAT, que está disponible en línea y en la oficina de tu proveedor de atención médica, analiza toda tu información y proporciona una puntuación de la evaluación del riesgo. Personas con una puntuación de más del 20% deberían someterse a mamografías anualmente y a RM de seno desde que cumplen 30 años.

Limitaciones de la BCRAT

Aunque la BCRAT puede salvar vidas, tiene limitaciones. La herramienta no reemplaza pruebas genéticas y no puede detectar en forma precisa el riesgo de mujeres que portan las mutaciones BRCA1 y BRCA2. Tampoco puede evaluar el riesgo de mujeres que tienen antecedentes de cáncer de mama.

Según la Susan G. Komen Foundation, la herramienta evalúa el riesgo a nivel grupal y no a nivel individual. Esto significa que proporciona el riesgo promedio de cáncer de mama para un grupo de mujeres con factores de riesgo similares, así que no puede predecir si una mujer tendrá cáncer de mama en forma individual.

Además, la BCRAT no usa todos los riesgos conocidos establecidos para cáncer de mama, tales como el cigarrillo, la dieta y la obesidad, lo cual puede limitar sus predicciones.

El modelo original solo usaba datos recolectados de mujeres de raza blanca, pero ahora puede estimar el riesgo para mujeres de raza negra, asiática, mujeres de las islas del pacífico e hispanas. Sin embargo, es posible que no pueda evaluar en forma precisa a otros grupos raciales y étnicos.

Conoce tus opciones

Si usas la herramienta en línea, habla de los resultados con tu proveedor de atención médica para asegurarte de que los estás leyendo correctamente. Si tienes un riesgo alto, encuentra a un experto de confianza que defienda tus intereses para que te sometas a pruebas apropiadas y para que obtengas la atención que necesitas.

Si tienes una puntuación alta en la BCRAT, eso no significa que necesites una mastectomía. “Hay medicamentos que pueden usarse para reducir el riesgo y hay cosas que las personas pueden hacer por sí solas”, dijo Minkin. Reducir el consumo de alcohol, hacer ejercicio en forma regular, mantener un peso saludable y no fumar puede ayudar. “Independientemente de cuál sea tu riesgo, mantente al tanto de lo que ocurre en tus mamas”. Si ves algún cambio, no lo ignores.

Este recurso educativo se preparó con el apoyo de Daiichi Sankyo y Merck.

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Insulin Therapy – familydoctor.org


When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly. Because of this, the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood and not enough in your cells can lead to serious health problems.

All people who have type 1 diabetes and some who have type 2 diabetes need to take insulin. It helps control their blood sugar levels. The goal is to keep your blood sugar level in a normal range as much as possible. Insulin is usually taken by injection (a shot). It can also be taken using a pen or a pump.

Path to improved health

How often will I need to take insulin?

You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 shots a day for good blood sugar control. Some people need 3 or 4 shots a day.

Do I need to monitor my blood sugar level?

Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you don’t already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You then insert the strip into a machine called a glucose meter. The results will tell you whether your blood sugar is in a healthy range

There are newer devices that can monitor your blood sugar without pricking your finger. Some of these work by wearing a sensor on your arm or abdomen. The sensor will read your glucose levels from fluids just underneath your skin. The information is then transmitted to a reader or an app on your phone.

Your doctor will help you decide which method is best for you.

When should I take insulin?

You and your doctor should discuss when and how you will take your insulin. Each person’s treatment is different. Some people who use regular insulin take it 30 to 60 minutes before a meal. Some people who use rapid-acting insulin take it just before they eat.

Types of insulin:

  • Rapid-acting insulin (such as insulin lispro, insulin aspart, and insulin glulisine) starts working in about 15 minutes. It lasts for 3 to 5 hours.
  • Short-acting insulin (such as regular insulin) starts working in 30 to 60 minutes and lasts 5 to 8 hours.
  • Intermediate-acting insulin (such as insulin NPH) starts working in 1 to 3 hours and lasts 12 to 16 hours.
  • Long-acting insulin (such as insulin glargine and insulin detemir) starts working in about 1 hour and lasts 20 to 26 hours.
  • Premixed insulin is a combination of 2 types of insulin (usually a rapid- or short-acting insulin and an intermediate-acting insulin).

What is rapid-acting insulin? How can it help control my blood sugar level?

Rapid-acting insulin starts working more quickly than other types of insulin. It begins working within 15 minutes and leaves your body after 3 to 5 hours.

To keep your blood sugar level steady throughout the day, your doctor may also prescribe a longer-acting insulin. Or they may prescribe another drug for you to take each day in addition to rapid-acting insulin.

When do I take rapid-acting insulin?

You should inject rapid-acting insulin no more than 15 minutes before you eat. Your doctor will tell you how much insulin to inject. Remember, you should not wait more than 15 minutes to eat after you take this insulin shot.

Rapid-acting insulin can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 60 minutes before eating. Many people find it hard to time their meals around regular insulin injections. Sometimes they end up eating too soon or too late. Then they don’t achieve the best blood sugar control. Since rapid-acting insulin is taken so close to mealtime, it may help you control your blood sugar more effectively.

Can I mix rapid-acting insulin with other types of insulin?

You can mix a rapid-acting insulin with an intermediate-acting insulin, according to your doctor’s instructions. Rapid-acting insulin should always be drawn into the syringe first. This will keep the intermediate-acting insulin from getting into the rapid-acting insulin bottle. After mixing rapid-acting insulin in the same syringe with an intermediate-acting insulin, you must inject the mixture under your skin within 15 minutes. Remember to eat within 15 minutes after the injection.

How do I prepare the correct dose of insulin?

You may take insulin using a syringe that you fill from a vial or using a dosing pen that contains the insulin. If your rapid-acting insulin comes in a pen, your doctor or their office staff can show you how to use it correctly. Follow the directions carefully.

  • Wash your hands.
  • Take the plastic cover off the new insulin bottle. Wipe the top of the bottle with a cotton swab that you have dipped in alcohol. It’s best for rapid-acting insulin to be at room temperature before you inject it.
  • Pull back the plunger of the syringe. This draws air into the syringe equal to the dose of insulin that you are taking. Then put the syringe needle through the rubber top of the insulin bottle. Inject air into the bottle by pushing the syringe plunger forward. Then turn the bottle upside down.
  • Make sure that the tip of the needle is in the insulin. Pull back on the syringe plunger to draw the correct dose of insulin into the syringe. The dose of insulin is measured in units.
  • Make sure there are no air bubbles in the syringe before you take the needle out of the insulin bottle. Air bubbles can cut down the amount of insulin that you get in your injection. If air bubbles are present, hold the syringe and the bottle straight up in one hand, tap the syringe with your other hand and let the air bubbles float to the top. Push on the plunger of the syringe to move the air bubbles back into the insulin bottle. Then withdraw the correct insulin dose by pulling back on the plunger.
  • Clean your skin with cotton dipped in alcohol. Grab a fold of skin and inject the insulin at a 90-degree angle. (If you’re thin, you may need to pinch the skin and inject the insulin at a 45-degree angle.) When the needle is in your skin, you don’t need to draw back the syringe plunger to check for blood.

Where do I inject the insulin?

Insulin is injected just under the skin. Your doctor or their office staff will show you how and where to give an insulin injection. The usual places to inject insulin are the upper arm, the front and side parts of the thighs, and the abdomen. Don’t inject insulin closer than 2 inches from your belly button.

To keep your skin from thickening, try not to inject the insulin in the same place over and over. Instead, rotate injection places.

Things to consider

If you’re going to use rapid-acting insulin, you need to be aware of insulin reactions and how to treat them. Rapid-acting insulin begins to work very quickly. So while you and your doctor are working to find the right dosage of this insulin, you may have some insulin reactions.

Hypoglycemia is a condition in which the level of sugar in your blood is too low. If you use insulin, your blood sugar level can get too low if you exercise more than usual or if you don’t eat enough. It also can get too low if you don’t eat on time or if you take too much insulin. Most people who take insulin have insulin reactions at some time. Signs of an insulin reaction and hypoglycemia include the following:

  • Feeling very tired
  • Yawning frequently
  • Being unable to speak or think clearly
  • Losing muscle coordination
  • Sweating
  • Twitching
  • Having a seizure
  • Suddenly feeling like you’re going to pass out
  • Becoming very pale
  • Losing consciousness

People who have diabetes should carry at least 15 grams of a fast-acting carbohydrate with them at all times in case of hypoglycemia or an insulin reaction. The following are examples of quick sources of energy that can relieve the symptoms of an insulin reaction:

  • Non-diet soda: ½ to ¾ cup
  • Fruit juice: ½ cup
  • Fruit: 2 tablespoons of raisins
  • Milk: 1 cup
  • Candy: 5 Lifesavers
  • Glucose tablets: 3 tablets (5 grams each)

If you don’t feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

Teach your friends, work colleagues, and family members how to treat hypoglycemia, because sometimes you may need their help. Also, keep a supply of glucagon on hand. Glucagon comes in a kit with a powder and a liquid that you must mix and then inject. It will raise your blood sugar level. If you are unconscious, or you can’t eat or drink, another person can give you a shot of glucagon. Talk to your doctor to learn when and how to use glucagon.

You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or their office staff can teach you how to use the monitor. You’ll need to write down each measurement and show this record to your doctor. They will use this information to decide how much insulin is right for you.

Blood sugar measurements can vary depending on your lifestyle. Stress levels, how often you exercise, and how fast your body absorbs food can affect measurements. Hormonal changes related to puberty, menstrual cycles, and pregnancy can, too. Illness, traveling, or a change in your routine may mean that you have to monitor your blood sugar level more often.

Questions for your doctor

  • Do I need insulin to control my type of diabetes?
  • What type of insulin should I take?
  • How often do I need to check my blood sugar?
  • How can I know how much insulin to take?
  • What if insulin doesn’t seem to lower my blood sugar?
  • What should I do to keep my insulin from getting too low overnight?

Resources

National Institutes of Health, MedlinePlus: Insulin Injection

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Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.





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Hospice Care – familydoctor.org


What is hospice care?

Hospice care is a special program for patients who are ill and dying, and their families. Hospice care is a form of palliative care. It is meant for people who have 6 months or less to live. Hospice is not focused on curing an illness. Instead, it aims to:

  • Make the patient comfortable
  • Ease pain and other symptoms
  • Support the family through a sad and difficult time

Hospice care tries to provide the best quality of life for dying patients. This is done through a holistic approach. It offers spiritual, mental, emotional, and physical comfort to the patients, their families, and their caregivers.

A hospice team is a group of people who understand the specific goals of hospice care. The team helps patients live out their final days with dignity and as much comfort as possible. It can include:

  • Doctors
  • Nurses
  • Social workers
  • Spiritual counselors
  • Home health aides
  • Bereavement counselors
  • Other volunteers

Path to well being

Hospice care can occur wherever patients are spending their final days. This includes a home, hospital, nursing home, or hospice facility. Members of the hospice team try to help patients be as pain-free and comfortable as possible. They also try to help them be at peace with themselves and their illness. At the same time, the team provides support, education, and counseling to family members and friends. If the patient is in a nursing home, the team will offer support to staff and other residents as well.

There are several services included in hospice care. These include:

  • Providing nursing care
  • Training family members in patient care, if needed
  • Offering spiritual and emotional support for the patient and the family
  • Helping with practical matters related to terminal illness, such as wills, finances, and end-of-life directives
  • Providing speech, occupational, and physical therapies
  • Coordinating care with the patient’s family doctor
  • Managing pain and other symptoms
  • Offering grief and death support groups for families

For specific questions about what hospice care includes, ask your hospice care representative. Your family doctor can provide you with information on contacting the right person.

Things to consider about hospice care

Bereavement support helps people cope with the loss of a loved one. Grief is a normal emotion for people to have in relation to death. It is common for family, friends, and caregivers when a loved one passes away. There is no timetable or calendar for grief. People experience grief in different ways. Many people feel anger, loneliness, guilt, confusion, and fear when a loved one dies. It helps to talk about these feelings and the person who passed away.

Hospice care is committed to helping people who are grieving. Hospice teams offer warm, professional support to help family members. Teams may provide emotional healing or assist with lifestyle changes. Hospice respects the natural dying process. It provides patients and family members with an opportunity for spiritual growth during this final phase of life.

Questions to ask your doctor

  • When does hospice care become an option?
  • Where do you recommend hospice care occur?
  • Who will be a part of my care team?
  • What will my hospice care include?
  • How much does hospice care cost and does my health insurance cover it?

Resources

American Cancer Society: What is Hospice Care?

National Institute on Aging: What Are Palliative Care and Hospice Care?

Family Doctor Logo

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.





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After a Traumatic Vaginal Birth, I Live with Bladder Leakage



This educational resource was sponsored by Poise, a brand of Kimberly-Clark.

As told to Nicole Audrey Spector

I’m small in stature. But you wouldn’t guess that I’m a petite woman if you went only by my sneeze, the sound of which resembles the war cry of a goose. And observers don’t get to hear just one sneeze. They’re met with at least a few — one after the other. A proper gaggle.

My mom has the same loud sneeze, and as a kid, I’d make fun of it — not so much the chandelier-rattling sound that went with her achoos, but the side effects of her sneezing.

Every time my mom had a sneezing fit, she peed herself. It wasn’t a secret.

“Oh, god, I peed!” she’d scream, then gallop to the bathroom, laughing. The same would happen when a coughing fit befell her. “I peed!!!”

She never seemed to be embarrassed, but I was embarrassed for her.

Now, at 41, I can relate to what my mother has been going through.

When I sneeze or cough, I often pee a little. Sometimes more than a little, if I already “have to go.”

Bladder leakage is a fairly new issue for me. It started after I gave birth to my son, Timothy, in 2022. It was my first time carrying a pregnancy full-term. And my first time having a creature with a head in the 100th percentile vacuumed out of my birth canal, after said head got stuck.

After having Timothy, it took a couple days for me to pee on my own. For the first day, I had a catheter. The second day, I walked to the bathroom by myself and sat on the toilet for what felt like a million minutes, unable to feel anything south of my belly button. It was important, a nurse said, that I pee on my own, without the catheter. When I finally achieved this, my nurse clapped for me. I cheered along, even though I really couldn’t feel the urine coming out, and surely couldn’t turn the stream off and on like I’d been able to before.

When I was released from the hospital after the standard 48 hours, I was sent home with a stockpile of hospital-issue mesh underwear and pads seemingly designed for elephants.

I thought the pads were just there to capture the discharge that would spill out in the first few postpartum days, but it turned out they were catching urine, too, as many a too-late, too-soiled trip to the bathroom revealed.

“A little urinary incontinence after a vaginal birth is normal,” my OB-GYN told me in an email, after I pinged her about two weeks later. I’d emailed her asking about whether the bladder leakage was to be expected.

I told my friend, Sophie, a yoga teacher who does a lot of great work with pregnant and postpartum women about the bladder leakage.

She told me I probably had a pelvic floor injury and she told me to go to a pelvic floor therapist “sooner than later” to address the problem.

Instead of consulting with a pelvic floor therapist as she advised, I did nothing.

Looking back, I think I was really just too tired to believe that anything was wrong or unusual. What’s more, I didn’t feel like “me.” I felt like an alien had taken host in my body. I was a total mess, and I just didn’t want things to be messier than they already were by bringing some certified expert into the mix to be like, “What a mess!”

This was nearly two years ago. The bladder leakage has lessened from what it was right after giving birth, but it’s not gone away. Not at all. What has gone away, however, is my shock about it. I’ve gotten used to peeing a bit when I sneeze, cough or even, sometimes, laugh.

Though I never leak to the extent that I saturate myself completely, I do dribble, and this is enough to motivate me to bring a spare pair of underwear in my bag when I go out. If I leak, I usually just throw out the soiled pair and change into the fresh ones.

It’s not an ideal solution (it’s bad for both the planet and my wallet), but I have yet to come up with something better. Unlike my mother, I don’t find peeing myself particularly humorous. It’s embarrassing, especially when I’m out in public.

And I still wonder, “Is this normal?”

I’ve talked with other moms who’ve had vaginal births, and they all say they can relate. They usually pee a little when they sneeze, cough or laugh a lot, too. Additionally, I recently learned that up to 1 in 2 women experience urinary incontinence.

Does the fact that bladder leakage is so common among women make it “normal”? Is there anything I can do to make this stop? I’ve tried Kegels, per the advice of Sophie and many mom blogs, but I have no clue if I’m doing them correctly and they have yet to make any difference that I can feel.

I’ve reached a breaking point: I need to know if bladder leakage is just a way of life for women like me. Right now, I’m looking for a pelvic floor therapist, and, honestly, wishing I’d done so sooner.

In the meantime, I’m going to explore products like pads or disposable underwear to make urinary incontinence less of a hassle. Throwing panties out in restaurant bathrooms isn’t a good long-term solution — nor is feeling bad about myself all the time

*Names have been changed for privacy.

Resources

National Association for Continence

Poise Incontinence Pads

This educational resource was sponsored by Poise, a brand of Kimberly Clark.

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Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.


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