39 million people in the U.S. have migraine disease – and it’s 3x more common in women than men.
Most people with the disease get 2-4 migraine attacks/month on average.
Types of migraine
Migraine without aura
This is sometimes called common migraine because about 3 in 4 people with migraine experience this type.
Some symptoms may include:
Throbbing pain on one or both sides of the head
Moderate to severe head pain that gets worse with normal physical activity
Nausea and/or vomiting
Sensitivity to light, sound and smell
Migraine with aura
About a quarter of people with migraine get a warning sign, called an aura, that an attack is coming. This can occur 5-60 minutes before a migraine attack.
Symptoms include:
Seeing flashing lights, wavy lines, bright dots or zigzags
Trouble seeing
Tingling or “pins and needles” feeling
Trouble speaking clearly
Weakness
Head pain
Migraine without head pain
Also known as a silent migraine, this is migraine with aura but without head pain. It affects about 4% of people with migraine overall, but may become more common for people with migraine as they approach midlife.
About 4 of 10 people who have migraine with aura will have aura without head pain later in life.
Symptoms include:
Seeing flashing lights, wavy lines, bright dots or zigzags
Trouble seeing
Tingling or “pins and needles” feeling
Trouble speaking clearly
Weakness
Vestibular migraine
Vestibular migraine involves vertigo (dizziness) in addition to head pain. It’s most common in people with a history of motion sickness and migraines.
Symptoms include:
Dizziness that lasts from minutes to hours (or even days)
Balance problems
Throbbing head pain, usually on one side of the head
Nausea and/or vomiting
Sensitivity to light, sound and smell
Retinal migraine
Retinal migraine causes visual disturbances in one eye. It is rare and typically affects women of childbearing age .
Symptoms include:
Seeing twinkling or flashing lights in one eye
Decreased or lost vision in one eye
Head pain that may be present from the onset or start up to an hour later
Chronic migraine
A person has chronic migraine if they have headache pain for 15+ days (with migraine symptoms for at least 8 of them), 3 months in a row. If you have migraine attacks fewer than 15 days a month, it’s called episodic migraine.
Symptoms may include:
Frequent moderate or severe headache attacks
Pain on one side of the head or both
Throbbing, pulsing or pounding head pain
Nausea and or vomiting
Sensitivity to light, sound and smell
Menstrual migraine
This migraine is linked to hormone changes during the menstrual cycle. Attacks usually hit just before or when your period starts, and are often worse and last longer than at other times during your cycle.
Symptoms may include:
Throbbing head pain, often on one side of your head
Nausea and/or vomiting
Sensitivity to light, sound and smell
Chills and sweating
Sore or sensitive scalp
Hemiplegic migraine
This rare migraine type involves weakness on one side of the body, sometimes with an aura and not always with head pain. Because of these symptoms, this type of migraine attack is sometimes mistaken for a stroke and should be checked by a healthcare provider (HCP).
Symptoms include:
Weakness on one side of the body
Head pain
Vision changes
Numbness
Tingling
Trouble speaking
Coordination issues
Nausea and/or vomiting
Sensitivity to sound and light
Concerned about migraine? Talk to your HCP.
This educational resource was created with support from Pfizer.
39 millones de personas en EE.UU. tienen trastornos de migrañas y son 3 veces más frecuentes en mujeres que en hombres.
La mayoría de personas que padecen este trastorno tienen de 2 a 4 episodios de migrañas al mes en promedio.
Tipos de migrañas
Migraña sin aura
Se denominan a veces migrañas comunes porque afectan aproximadamente a 3 de cada 4 personas que tienen migrañas.
Algunos síntomas podrían incluir:
Dolor palpitante en uno o ambos lados de la cabeza
Dolor de cabeza moderado a grave que empeora con actividades físicas normales
Náuseas o vómitos
Sensibilidad a la luz, a los sonidos y a los olores
Migraña con aura
Aproximadamente un cuarto de las personas que padecen migrañas tienen una señal de alerta, denominada aura, que indica que va a ocurrir un episodio. Puede ocurrir de 5 a 60 minutos antes de un episodio de migrañas.
Los síntomas incluyen:
Ver luces destellantes, líneas onduladas, puntos brillantes o líneas en zigzag
Dificultades con la vista
Sensación de cosquilleo o de “alfileres y agujas”
Dificultad para hablar claramente
Debilidad
Dolor de cabeza
Migraña sin dolor de cabeza
También conocida como una migraña silenciosa, es una migraña con aura pero sin dolor de cabeza. Afecta a aproximadamente el 4% de personas que padecen migrañas en general, pero podría volverse más frecuente para personas que padecen migrañas a medida que se aproximan a la mediana edad.
Aproximadamente 4 de cada 10 personas que padecen migrañas con aura tendrán aura sin dolor de cabeza en etapas posteriores de sus vidas.
Los síntomas incluyen:
Ver luces destellantes, líneas onduladas, puntos brillantes o líneas en zigzag
Dificultades con la vista
Sensación de cosquilleo o de “alfileres y agujas”
Dificultad para hablar claramente
Debilidad
Migraña vestibular
La migraña vestibular viene con vértigo (mareo) además de dolor de cabeza. Es más frecuente en personas con antecedentes de mareo y migrañas.
Los síntomas incluyen:
Mareo durante minutos u horas (o incluso días)
Dificultad para mantener el equilibrio
Dolor de cabeza palpitante, usualmente en un lado de la cabeza
Náuseas o vómitos
Sensibilidad a la luz, a los sonidos y a los olores
Migraña retiniana
La migraña retiniana causa alteraciones visuales en un ojo. Es infrecuente y comúnmente afecta a mujeres de edad fértil .
Los síntomas incluyen:
Ver luces titilantes o destellantes en un ojo
Reducción o pérdida de la visión en un ojo
Dolor de cabeza que puede estar presente desde el inicio o la aparición de la migraña hasta una hora después
Migraña crónica
Una persona tiene una migraña crónica si tiene dolor de cabeza durante más de 15 días (con síntomas de migrañas durante al menos 8 de ellos), 3 meses seguidos. Si tienes episodios de migrañas menos de 15 días en un mes, esto se denomina migraña episódica.
Los síntomas pueden incluir:
Episodios frecuentes de dolores de cabeza moderados a graves
Dolor en uno o ambos lados de la cabeza
Dolor de cabeza palpitante, pulsante o pulsátil
Náuseas o vómitos
Sensibilidad a la luz, a los sonidos y a los olores
Migraña menstrual
Esta migraña se asocia con cambios hormonales durante el ciclo menstrual. Los episodios usualmente ocurren justo antes o al inicio de tu período menstrual y frecuentemente son peores y duran más que en otros momentos durante tu ciclo menstrual.
Los síntomas pueden incluir:
Dolor de cabeza palpitante, frecuentemente en un lado de la cabeza
Náuseas o vómitos
Sensibilidad a la luz, a los sonidos y a los olores
Escalofríos y sudoración
Cuero cabelludo adolorido o sensible
Migraña hemipléjica
Este tipo infrecuente de migrañas incluye debilidad en un lado del cuerpo, a veces con aura y no siempre con dolor de cabeza. Debido a estos síntomas, este tipo de episodios de migrañas a veces se confunde con un accidente cardiovascular y un proveedor de atención médica (HCP, por sus siglas en inglés) debería evaluarlo.
Los síntomas incluyen:
Debilidad en un lado del cuerpo
Dolor de cabeza
Cambios de la vista
Entumecimiento
Cosquilleo
Dificultades para hablar
Problemas de coordinación
Náuseas o vómitos
Sensibilidad a sonidos y a la luz
¿Estás preocupada por migrañas? Habla con tu proveedor de atención médica.
Este recurso educativo se preparó con el apoyo de Pfizer.
My nurse asked Megan to fill out a simple questionnaire that helps identify whether a person may have depression. Megan’s high score on this questionnaire indicated a possible diagnosis of depression. After looking at her responses, I talked with her. Megan told me she felt a little embarrassed to be admitting out loud that she was struggling. Like many people, she had a hard time explaining exactly what she was feeling. She took several long pauses, but I was careful not to interrupt.
Megan told me that she was feeling both sad and anxious at the same time. “I feel like I’m coming out of my skin,” she said. Although she felt tired all the time, she couldn’t fall asleep at night. She would often toss and turn for hours, usually thinking about past mistakes. Sometimes, she wished she could just disappear. Fortunately, she had not thought about hurting or killing herself.
As Megan talked, I noticed her body language and speech patterns. She fidgeted with her hands a lot, and she looked mostly at the floor. I asked some questions to make sure she was safe and to rule out other things that can make depression worse. Megan said that she was not using drugs or alcohol or engaging in high-risk sexual practices. She said that she felt safe at home and elsewhere, but she wasn’t comfortable talking about her feelings with her parents. I thanked her for having the courage to come in and ask for help. She admitted it had been hard for her.
I let Megan know that it’s common for depression and anxiety to go hand in hand. I explained that they don’t just cause psychological symptoms. They can also affect you physically and cause symptoms like chest tightness, fatigue, headaches, and jitteriness. Since I could tell that Megan held a lot of her feelings in her body, I recommended taking a few minutes each day to put on music and dance. Dancing is a great activity to help relieve tension and improve your mood. I also taught Megan a relaxation technique to use whenever she was feeling anxious. It’s a simple, effective exercise called soft-belly breathing. It involves breathing slowly in through your nose and feeling your belly fill with air before breathing out through your mouth.
In addition to counseling, I prescribed a low dose of an antidepressant for Megan. (Learn more about antidepressants and how to take them safely.) I explained to Megan that it can take several weeks for an antidepressant to start working. Side effects from these medicines usually decrease after a couple of weeks.
When a person starts taking medicine to treat depression, there is a risk of increased suicidal thoughts, particularly in young people. Although this is rare, I discussed the risk with Megan and made sure she had a plan, just in case. She already knew about suicide hotlines that are accessible by phone, text, or online (for example, the National Suicide Prevention Lifeline at 1-800-273-8255). She also identified a friend to call if she had thoughts about hurting herself. I assured her that she could always call her counselor or my office, or go to an emergency room if she needed help right away.
I asked Megan to come back for a follow-up visit in 1 week so I could see how she was tolerating the antidepressant. She told me it was a relief to talk about her feelings. She felt hopeful that her symptoms would improve over time. As Megan’s family doctor, I’ll continue to guide her treatment for depression and provide needed care and support.
Reach Out for Help
People who have depression sometimes think about suicide. If you have thoughts about hurting yourself, tell someone. Tell your doctor, your friends, or your family. You can also call a suicide hotline, such as the National Suicide Prevention Lifeline at 988.
Get help right away. There are people who can help you. Depression can be successfully treated.
Vivir con esclerosis múltiple significa que tendrás que hacer algunos cambios en tu vida, incluyendo administrar tus cuidados personales. ¡Estos son tan importantes como tu tratamiento médico!
Según la neuróloga
Le Hua, M.D., entre más pronto abordes los asuntos relacionados con tu estilo de vida, más fácil será controlar tus síntomas o incluso reducir la velocidad de su progreso.
Nutrición
Una nutrición sana promueve alimentos saludables y limita los que no son tan sanos, tales como alimentos procesados con alto contenido de grasa y de azúcar. Hua recomienda la dieta mediterránea como un buen plan alimenticio para la mayoría de personas con EM. No solo se enfoca en alimentos saludables, sino que también es considerablemente asequible. Los alimentos recomendados son, entre otros:
Frutas
Vegetales
Productos lácteos bajos en grasa
Pastas, cereales y panes integrales
Frijoles
Frutos secos y granos
Alimentos marinos y aves de corral
Aceite de oliva
Ejercicio
Podría parecer que hacer ejercicio o incrementar la actividad física aumentaría el cansancio que se produce por la EM. Sin embargo, el ejercicio de hecho reduce la fatiga e incrementa tus endorfinas, las hormonas que “te hacen sentir bien”. Lo que debes hacer después de tu diagnóstico de EM depende del nivel de estado físico que tenías antes de dicho diagnóstico. Si solías participar en maratones y si vas al gimnasio todos los días, seguir con ese nivel es útil. Si nunca has hecho ejercicio, empieza a realizar actividades físicas en forma gradual. Incluso caminar alrededor de la cuadra es útil. Recuerda, trabajar en el torso es útil para el equilibrio y reduce las caídas. Algunas actividades que pueden mejorar el estado físico de tu torso son:
Yoga
Pilates
Ejercicios con bandas de resistencia
Estiramiento
Sueño
Muchas personas con EM sienten mucho cansancio. No dormir suficiente causa incluso más fatiga, pero los problemas de sueño debido a EM pueden tener diferentes causas:
Angustia, especialmente justo después del diagnóstico
Dolor
Levantarse frecuentemente para orinar
Cosas que puedes hacer para promover un mejor sueño:
No uses dispositivos electrónicos, no veas televisión, no hagas ejercicio ni participes en actividades que estimulen tu cuerpo o mente de dos a tres horas antes de ir a la cama.
Haz algo relajante, tal como escribir un diario, colorear o cualquier actividad que te dé calma.
Toma siestas estratégicas que no duren más de 15 a 20 minutos.
Habla con tu doctor si el dolor o ir con frecuencia al baño hace que te mantengas despierta.
Controla tu peso
El tejido adiposo, también conocido como células grasas, es inflamatorio. Esto incrementa los síntomas de la EM. La pérdida de peso debería basarse en cómo te sientes, dijo Hua, no en lo que muestra la balanza. Así que no te enfoques en eso. Enfócate más en mejorar tu nutrición y en el ejercicio. Comunícate con un nutricionista para obtener orientación y apoyo si es necesario.
Deja de fumar
Fumar empeora los síntomas y resultados de la EM, así que dejar el hábito del tabaco es importante. Fumar incrementa la inflamación de tu cuerpo y también afecta negativamente a los medicamentos para la EM. Dejar de fumar puede reducir la tasa de progreso de la EM y disminuir las recaídas. Pide ayuda a tu doctor o comunícate con grupos de apoyo. Podría tomar varios intentos, pero cada vez, estarás un poco más cerca de tu meta.
Cuida tu salud mental
Ya sea que escribas un diario, que medites o que hables con un profesional o grupo de apoyo de la salud mental, el cuidado de tu salud mental es una parte importante de vivir bien con EM.
Este recurso educativo se preparó con el apoyo de Novartis.
Natural family planning (NFP) is a form of pregnancy planning. It does not involve medicine or devices. NFP helps people observe their body’s fertility signs to know when to have sexual intercourse. It can be used if you are trying to achieve or avoid pregnancy. It involves keeping track of a person’s bodily changes throughout the menstrual cycle. People may choose NFP for religious or personal reasons, or because they are concerned about the side effects of artificial means to achieve or avoid a pregnancy.
Path to improved health
Pregnancy can occur if sexual intercourse takes place right before or after ovulation. Ovulation is when the ovaries release an egg. It usually happens at around the same time each month. The egg moves toward the uterus through the fallopian tubes. This is where conception takes place. An unfertilized egg may live for up to 12 hours. The body will shed the egg during the menstrual period if it isn’t fertilized.
There are several methods of natural family planning.
The mucus or ovulation method. A woman checks and tracks her cervical mucus. During ovulation, your cervical mucus is stretchy, clear, and slick. It looks and feels like an uncooked egg white. You will write down your mucus’ consistency each day.
The sympto-thermal method. A woman takes her daily basal body temperature (BBT) using a BBT-specific thermometer. You can take it in your mouth, vagina, or rectum. A regular BBT is between 97° and 98°F. At the time of ovulation, your BBT will rise between .5 and 1 degree. You should take your BBT in the morning before you get out of bed. Ideally, it should be the same time of day. You should use the thermometer the same way each day to get accurate results.
The sympto-hormonal method. This planning method relies on at-home urine tests to monitor hormone levels that can predict fertility. An electronic fertility monitor measures the hormone level in urine. When combined with cervical mucus observations, this method can indicate fertility at 94 to 98%.
The rhythm method. It is based on the calendar dates of a person’s previous menstrual cycles. This method can be more difficult and is not as reliable. It doesn’t allow for changes in the menstrual cycle, which are common. A normal menstrual cycle is between 28 to 32 days. The day a person starts their period is considered to be cycle day 1. Ovulation often occurs around day 14 of the menstrual cycle.
The standard days method. This is similar to the rhythm method but designates a covers a longer period of fertility. The standard days method assumes fertility on days 8 through 19 of every menstrual cycle. This means that to prevent pregnancy, you would not have sexual intercourse on these days.
The lactational amenorrhea method. This method is for people who are still breastfeeding an infant who is younger than 6 months of age. It can sometimes be used for longer than 6 months but it less reliable. For this method to work, the parent must not have had a period since giving birth and is not supplementing her baby’s feeding (feeding them only by breast/with breastmilk).
Sometimes, people combine the approaches. In all of the methods, it is recommended that you use a calendar or chart to track the data and changes. This predicts when you ovulate, so you can have or avoid sex. You may notice other symptoms you can track. These include bloating, backache, tender breasts, or pain in your ovaries. It generally takes 3 to 6 cycles of charting to get an accurate idea of your ovulation pattern.
Things to consider
You may choose to find someone who teaches NFP methods. You can ask your doctor for a recommendation. When you follow NFP methods to prevent pregnancy, the success rate is about 90%. When you follow NFP methods to conceive, on average, 2 out of 3 couples who don’t have fertility problems become pregnant. If you do not follow instructions completely, NFP will be less effective.
There are benefits and risks of NFP. It is free, or less expensive compared to the use of birth control or condoms, which can be expensive. NFP doesn’t have side effects. It meets certain religious guidelines. You can stop NFP at any time and it won’t affect your menstrual cycle. On the other hand, NFP requires you keep a constant schedule. If you veer from it or aren’t careful, you may not be successful. You may need to use back-up contraceptives. NFP can be hard if you have abnormal menstrual cycles or are breastfeeding. It is also worth noting that other methods of birth control (pills, condoms, an intrauterine device), when used as directed, tend to offer more protection against pregnancy than NFP.
Questions to ask your doctor
Are there any health conditions that may prevent me from using natural family planning?
What should my cervical mucus look and feel like when I’m not ovulating compared to when I am?
How long should it take for me to rely on NFP?
Do you recommend working with an NFP teacher?
Resources
American Pregnancy Association: Fertility Awareness
National Institutes of Health, MedlinePlus: Pregnancy – identifying fertile days
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.
A lot of exercise advice is geared at people who work out at the gym. Many men, though, either can’t belong to a gym or choose not to. If you don’t have a gym membership, you shouldn’t feel limited or helpless. There still are plenty of ways to get and stay fit outside of the gym. Follow these tips and ideas below.
Path to improved health
According to the Centers for Disease Control and Prevention (CDC), adults should get at least 150 minutes of cardio per week. This breaks down to 30 minutes of fitness 5 times a week. The CDC also says adults should do strength training at least two days a week. Routine exercise can prevent certain health conditions. These include heart disease, diabetes, and some cancers. People who exercise are less likely to be overweight, get injured, or fall in old age.
So if you don’t work out at a gym, where do you exercise? The answer is anywhere. You can be active at home or at work, inside or outside. You can exercise by yourself, on a team, or with your family.
A range of activities is available. You can do traditional exercise, such as walking, running, or bicycling. You can play a sport, like basketball or softball. You also can get fitness equipment to use at home or follow video or online exercise programs, such as P90X. You can buy your own hand weights to use or do moves that use your body weight.
It may not always be simple, but these tips will help:
Get motivated. Set small goals that you know you can achieve. Small successes lead to big changes. They’re also what help to change bad habits into good habits. Be specific with your goals. Men are more likely to commit when they sign up for an event. One example is training for a race, such as a 5K or marathon. Once you’ve met a goal, reward yourself!
Switch it up. Varying your fitness routine is crucial. Your body begins to adjust to exercise after a certain amount of time. Change up your speed, weight, or moves. Try new activities, like yoga, or other forms of exercise. Cardio helps with endurance by keeping your heart rate up. Strength training builds muscle. Both cardio and strength training burn calories and are needed to round out your fitness.
Step it up. Aim to get a set number of steps per day. Use an activity tracker to keep track of your steps. Try to take the stairs or park farther away. Go for an evening walk by yourself or take your kids and/or dogs.
The more, the merrier. Find a friend or group of people to exercise with. This is common for men who run or cycle. It helps you stay on track and push yourself.
Make a fitness date with yourself. Some people benefit from marking their calendar or setting a phone alarm.
Be well rounded. You already know you need cardio and strength training. Rotate activities and moves that target your whole body. This means your upper body, lower body, and core.
Things to consider
When you exercise at home, it’s easy to get distracted. Work out in an environment where you can succeed. Your mental outlook also plays a big part. It’s important to stay focused and not take too many rest breaks.
If you’re new to a certain exercise, it’s important to start slow. Build up your speed, reps, or weight as you go to prevent injury or burnout. Talk to your doctor before starting a new fitness routine. They may want to perform an exam, discuss health risks, or monitor your progress.
What you put in your body is just as important as what you do with your body. Eat nutritious foods that provide fuel to exercise and stay healthy. Learn how to read nutrition labels to see what you’re eating. If you are active, you’ll need to eat more to keep up your metabolism. You still should maintain proper portion control. Staying fit also means staying hydrated. Drink plenty of water throughout the day and as you exercise.
Don’t forget to rest and recover from your workouts. You can do this by stretching before and after you exercise. Build in a day of rest from fitness. Make sure you get enough sleep at night to recharge your body and your brain.
Questions to ask your doctor
How can I prevent injuries working out at home?
Are there certain types of exercise I should avoid?
Should I take any vitamins or supplements?
Resources
Centers for Disease Control and Prevention: Physical Activity Basics
Men’s Fitness: 25 Fitness Tips and Strategies From the Experts
United States Department of Agriculture: MyPlate.gov
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When you have diabetes, you have special concerns you need to manage to stay healthy. When you are pregnant and have diabetes, you also are faced with unique challenges. But it is possible to have a healthy pregnancy, even with diabetes. You just need to take extra care before and during your pregnancy.
What is diabetes?
Diabetes is a disease that occurs when your body doesn’t make or use the hormone insulin properly. It causes too much blood glucose (sugar) to build up in the blood. This can cause serious health problems, such as heart disease, kidney failure, or blindness. The 3 most common types of diabetes are:
Type 1. This occurs when your body doesn’t produce enough insulin. You must take insulin to control it.
Type 2. This occurs when your body doesn’t produce enough insulin or doesn’t respond to insulin as it should. It can sometimes be controlled through diet and exercise. Some people need to take insulin or medicine to manage it.
Gestational diabetes. This is a special kind of diabetes that some women develop during pregnancy. It usually goes away soon after the baby is born. It is different than having diabetes before you are pregnant. However, it can put you at higher risk for developing Type 2 diabetes in later years.
How does diabetes affect a pregnant woman?
When diabetes is managed properly and blood sugar levels are controlled, you shouldn’t see many problems. However, if blood sugar levels are not well-controlled, diabetes can lead to problems for a pregnant woman, including:
Making some long-term diabetes problems worse. These include eye problems and kidney disease.
Increasing the risk of developing preeclampsia. This is when you develop high blood pressure and too much protein in your urine. It can cause serious or life-threatening problems for you and your baby.
Increasing the risk of having a miscarriage or stillbirth. A miscarriage is the loss of a baby before 20 weeks. A stillbirth means the baby dies in the womb sometime after 20 weeks.
Increasing the likelihood you will need a Caesarean section. Also called a C-section, this is when surgery is done to deliver the baby through the mother’s belly. It takes longer for the mother to recover and comes with risks of complications, as in any surgery.
How does diabetes affect a developing baby?
Having high blood sugar can harm your baby as soon as it starts developing. These problems can include:
Birth defects.The baby’s organs form during the first 2 months of pregnancy. Uncontrolled blood sugar can affect those organs and cause birth defects. These include defects in the brain, spine, and heart.
A large baby.When your blood sugar is high, the baby’s is too. This causes the baby to grow to a larger-than-normal size. It can lead to problems during delivery for both the mother and the baby. Large babies are also more likely to be obese or have diabetes when they are older.
Preterm birth.This is when the baby is born too early. Babies born early have a higher chance of having problems with their breathing, heart, intestines, and vision. Women with diabetes are more likely to have their babies early.
Low blood sugar.When a mother doesn’t control her diabetes during pregnancy, the baby’s blood sugar can dip very low after birth. This can be serious and must be treated quickly.
Path to improved health
When diabetes is well-controlled and blood sugar levels stay within a healthy range, you increase your chance of having a healthy baby. Follow these steps to have a healthy pregnancy when you have diabetes.
Plan ahead
Make an appointment with your doctor before you become pregnant. They will probably run tests to see how diabetes has affected your body. They will help you get your blood sugar levels under control and make sure it is safe for you to become pregnant.
See your doctor
When you have diabetes, you need to see your doctor more often than if you didn’t have diabetes. Go to all your prenatal appointments and follow your doctor’s instructions. Ask your doctor if you should see an ophthalmologist (eye doctor) or nephrologist (kidney specialist) during your pregnancy.
Eat healthy
See a dietitian if you don’t have one already. They can help you create a healthy meal plan that will help keep your blood sugar levels under control. Follow the plan and eat a healthy diet to help your baby be healthy.
Exercise
Exercise is an important part of diabetes management, especially when you’re pregnant. It helps balance food intake and keeps your blood sugar under control. Aim for at least 30 minutes of exercise 5 days a week.
Take your medicine
Whether its vitamins, diabetes pills, or insulin, take your medicine as your doctor prescribes. They may adjust what you take once you become pregnant. Some women with both type 1 and type 2 diabetes may need to take insulin during pregnancy. For others, diabetes can be controlled with oral medicines. Even if you were taking insulin before becoming pregnant, the amount you need will change when you are pregnant. Be sure to follow your doctor’s instructions. Medicine amounts may change as your pregnancy progresses.
Monitor your blood sugar often
Your blood sugar levels can change very quickly when you are pregnant. Follow your doctor’s instructions and check your sugar levels often. This will allow you to see how exercise, diet choices, insulin, or other medicines affect your blood sugar. That way you can adjust as they are needed. It will also allow you to see when your levels are getting too low before you have a severe reaction. Stress and illness also can affect your blood sugar levels.
Follow other healthy pregnancy guidelines
As with any pregnancy, there are certain things you should do for the best health for you and your baby.
Don’t smoke.It can increase your chance of having a preterm or stillborn baby. It can also increase diabetes-related health problems, such as eye, heart, or kidney disease.
Avoid alcohol.Alcohol can lead to serious problems in your baby that could affect it for the rest of its life.
Take your vitamins.Folic acid is an important vitamin to take during pregnancy. You should start taking it before you become pregnant and continue throughout the pregnancy. Ask your doctor how much folic acid you should be taking, or if there are any other vitamins you should take.
Things to consider
Your body goes through many changes when you are pregnant. Any of these changes can affect your blood sugar at any time. They also can affect how you manage your diabetes. Even if your diabetes has been well-controlled in the past, you may need to change your habits. This includes your meal plan, your exercise routine, and the medicines you take. As your pregnancy progresses, you may need to change your management plan again. Be flexible and listen to your doctor. Follow their instructions. Take care of yourself and monitor your blood sugar levels to strive for a healthy pregnancy.
Postpartum
After you give birth (usually in the hospital) a pediatrician will check your baby for low blood glucose. Your baby was getting blood glucose from you (and making extra insulin to compensate) and will need time to readjust.
Your insulin needs will also decline—drastically—which puts you at risk for hypoglycemia too. Within just a few hours, your blood glucose levels might be back to the levels they were at before you were pregnant.
See your doctor within two weeks for a checkup. If you have type 2 diabetes and weren’t previously using insulin, you might be able to switch back to an oral medication, though some women prefer to stay on insulin longer because it doesn’t get into breast milk.
Whatever treatment you opt for, breastfeeding is strongly recommended by most health care providers. It helps lower your blood glucose and children who are exclusively breastfed have a lower incidence of type 2 diabetes. Not only that, but studies have found that mothers with gestational diabetes have a lower risk of developing type 2 in the future if they breastfeed.
Note that nursing requires a lot of energy. To prevent dangerous low blood sugar, remember to check your blood glucose before you breastfeed and, unless it’s already high, eat a snack.
Also know that postpartum depression is common in women with diabetes. Combine managing your diabetes, caring for a newborn, lack of sleep and major hormonal shifts, and you have a recipe for a potentially serious mood disorder. If your “baby blues” don’t improve after two weeks, or if you’re overcome by feelings of sadness or have thoughts of harming yourself or your baby, call the 988 Suicide and Crisis Lifeline. When you do checkups with your doctor, tell them so you can get treated and start feeling better.
Questions to ask your doctor
How can I control my blood sugar?
How often should I check my blood sugar?
Do I need to take diabetes pills or insulin?
Is it safe for the baby to take diabetes medicine?
Do I need to take any vitamins or supplements?
Should I see a dietitian?
Should I see an ophthalmologist?
What exercises can I do to stay active while I’m pregnant?
Will I be able to breastfeed my baby?
Resources
American Diabetes Association: Diabetes and Pregnancy
Centers for Disease Control and Prevention, Diabetes and Pregnancy
National Institute of Diabetes and Digestive and Kidney Diseases, Pregnancy if You Have Diabetes
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Echinacea is a flowering plant that grows in the U.S. and Canada. It is also called coneflower. It is a member of the daisy family of plants. Echinacea has been a popular herbal remedy for centuries. Today, it is often used to prevent or treat viruses that cause colds, sore throats, or the flu.
You can find echinacea products in most drug stores or health food stores. It comes in teas, capsules, pills, liquid extracts, or dried herbs. It is one of the most popular herbs in the United States.
Path to improved health
Many people use echinacea as a dietary supplement for infections such as the common cold. They believe it stimulates the immune system. This helps the body do a better job fighting the infection. This can result in the sickness not lasting as long. Some people take it when they are well to prevent getting an infection.
If you want to treat your cold or flu with echinacea, talk to your family doctor first. Also, make sure you do your research. The FDA does not have to approve dietary supplements before they are sold. In some supplements, the ingredients do not match what the label says. Find a company that quality tests its products. Then you will know you are taking the right thing.
Read the package label carefully. Echinacea can come in many different strengths and dosages. It can also come mixed with other supplements. Follow the directions on the package. Only take the recommended dosage. Taking more than the recommended amount can be dangerous.
Most brands say you should avoid taking echinacea on an empty stomach. They recommend taking it with food or a large glass of water. Don’t take echinacea for more than a few weeks. The long-term safety has not been studied thoroughly.
Talk to your doctor before taking echinacea or other supplements. They can tell you if it will interfere with any other medicines you take. They can also recommend what dosage you should take.
Store all herbal products out of reach and out of sight of young children. Keep them in a cool, dry place so they do not lose effectiveness. Do not store them in bathrooms, which get hot and humid.
Things to consider
Does it work?
Many studies have been done on echinacea’s effect on the common cold. So far, researchers have not found conclusive evidence on its effectiveness. They don’t believe that taking it after you come down with a cold will shorten the time you are sick. Taking it when you are well may slightly reduce your chances of catching a cold.
What are the side effects?
Echinacea can cause minor side effects. These can include an upset stomach, nausea, and dizziness. Serious side effects include allergic reactions such as rash, swelling, and difficulty breathing. It can also worsen asthma symptoms. Talk to your doctor right away about any side effects you are having.
Some people are allergic to plants in the daisy family. These could include daisies, ragweed, marigolds, or chrysanthemums. This may put you at more risk of having an allergic reaction to echinacea.
Who should not take echinacea?
Echinacea is generally safe, but not for everyone. Do not take echinacea if you have any of the following conditions:
In addition, you should not take echinacea if you take immunosuppressants. It may interact with these medicines.
Talk to your doctor before taking echinacea if any of the following apply to you.
You take other medicines regularly or are being treated for a chronic condition (echinacea may interact with other medicines and reduce their effectiveness or cause unwanted side effects)
You drink alcohol, smoke, or use illegal drugs (these substances may affect the way echinacea works)
You are pregnant or breastfeeding
Questions to ask your doctor
Will echinacea help my cold?
Is it safe for me to take it?
What is the best dosage for me?
How long should I take it?
What else can I do to ease my symptoms or shorten the duration of my cold?
Resources
National Center for Complementary and Integrative Health: Echinacea
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.
Exercise can make a real difference for people who have diabetes. Exercise can help control your weight and lower your blood sugar level. It also lowers your risk of heart disease. Heart disease is a condition that is common in people who have diabetes. Exercise can also help you feel better about yourself and improve your overall health.
Path to improved health
Talk to your doctor about what kind of exercise is right for you. The type of exercise you can do will mainly depend on whether you have any other health problems. Most doctors recommend aerobic exercise. This type of exercise makes you breathe deeply and makes your heart work harder. Examples of aerobic exercise include walking, jogging, aerobic dance, or bicycling. If you have problems with the nerves in your feet or legs, you may need to choose other exercises. Your doctor may want you to do a type of exercise that won’t put too much stress on your feet. These exercises include swimming, bicycling, rowing, or chair exercises.
No matter what kind of exercise you do, you should warm up before you start and cool down when you’re done. To warm up, spend 5 to 10 minutes doing a low-intensity exercise such as walking. Then gently stretch for another 5 to 10 minutes. Repeat these steps after exercising to cool down.
When you start an exercise program, go slowly. Gradually increase the intensity and length of your workout as you get more fit. Talk to your doctor for specific advice.
Should I drink more fluids during exercise?
Yes. When you’re exercising, your body uses more fluid to keep you cool. By the time you feel thirsty, you may already be getting dehydrated. Dehydration (not enough fluid in your body) can affect your blood sugar level. Drink plenty of fluid before, during, and after exercise. Make sure you are drinking water or sugar-free drinks so you aren’t raising your sugar levels.
Exercise checklist for people who have diabetes
Talk to your doctor about the right exercise for you.
Check your blood sugar level before and after exercising.
Check your feet for blisters or sores before and after exercising.
Wear the proper shoes and socks.
Drink plenty of fluid before, during, and after exercising.
Warm up before exercising and cool down afterward.
Have a snack handy in case your blood sugar level drops too low.
Things to consider
There are risks to exercising for people who have diabetes, but the benefits far outweigh the risks. Exercise changes the way your body reacts to insulin. Regular exercise makes your body more sensitive to insulin. This could cause your blood sugar level to get too low (called hypoglycemia) after exercising.
Your doctor may tell you to check your blood sugar level before and after exercising. There are two ways you can monitor your blood sugar level each day. It can be done through a blood glucose monitor or a continuous glucose monitoring system. Talk with your doctor about which method is best for you.
If your blood sugar level is too low or too high just before you plan to exercise, wait. It’s better to wait until the level improves. Also, be sure to watch your blood sugar level if you exercise in really hot or cold conditions. Temperature changes how your body absorbs insulin.
When to see a doctor
Your blood sugar may be normal when you begin exercising but quickly drop during your workout. Be sensitive to this. Hypoglycemia usually occurs gradually, so you need to pay attention to how you’re feeling during exercise. If you have any of these symptoms, stop exercising:
A significant change in your heartbeat that doesn’t feel right
If it feels like your heart is skipping a beat or beating irregularly
If you feel shaky or anxious
If you suddenly begin to sweat more than normal
Follow your doctor’s advice about how to treat hypoglycemia. If you begin to feel worse, call your doctor immediately.
Questions for your doctor
Am I healthy enough to begin an exercise program?
What kinds of exercises should I do?
Are there any exercises I should avoid?
Do I have any other health conditions that would affect my ability to exercise?
Am I taking any medication that would interfere with exercise?
How does exercise affect my blood glucose?
How does exercise affect my diabetes?
Resources
American Diabetes Association
Centers for Disease Control and Prevention: Get Active!
National Institutes of Health, MedlinePlus: Diabetes and Exercise
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.
The three most common types of cancer treatment are surgery, radiotherapy, and chemotherapy. Treatment is aimed at removing the cancer cells or destroying them with medicines or by other means.
Some cancers cannot be cured. Some people choose to focus on quality of life and opt not to have treatment. In these cases, they may rely on palliative and hospice care. Palliative care can help provide comfort and treat symptoms. It can begin as early as diagnosis. Hospice care begins nearer the end of life. That is typically when the person is not expected to survive for more than 6 months.
Surgery
Surgery is a way to physically remove the cancer. Surgery can be very successful in treating some kinds of cancer. But it isn’t an option in all cases. It may be possible to safely remove a tumor and any affected surrounding tissue if:
The cancer is in the form of a malignant tumor (a tumor that spreads).
The tumor is still in one place (localized).
Surgery may not be possible if:
The cancer has spread to other areas of the body.
The tumor cannot be removed without damaging vital organs, such as the liver or brain.
Radiotherapy
Radiotherapy uses radiation to damage cancer cells so that they can’t multiply. The radiation is in the form of special X-rays, gamma rays, or electrons. There is usually no pain during this kind of therapy. Depending on the area that is treated, side effects from radiation damage to normal tissues may occur. Your doctor can tell you what to expect. Radiotherapy is sometimes the only treatment needed. It can also be used with other therapies. A combination of surgery and radiotherapy may be used for tumors that grow in one place.
Chemotherapy
Chemotherapy uses strong medicines to attack the cancer cells. This treatment sometimes causes a lot of fear because the side effects can be severe. However, not all people experience severe side effects. The side effects of chemotherapy can often be treated with other medicines.
Chemotherapy is usually used when the cancer has spread to other areas in the body. It can also be used in combination with surgery and radiation. Sometimes the tumor is surgically removed. Then chemotherapy is used to make sure any remaining cancer cells are killed.
Other specialized treatments may be available. Your doctor may talk to you about these treatments if they are an option for you.