All Posts tagged Chouchani MD

Sleep Problems in Women

sleep problemsThe average adult needs 7 to 9 hours of sleep each night to lead a healthy life, assist in their mental health, and boost their physical health. Getting a good night’s sleep helps our mood, immune system, and energy levels. Overall, adult women sleep an average of 11 minutes more than men, but research shows their quality of sleep is lower, which signals sleep problems. One reason for sleep problems could be that women are more likely to interrupt their sleep and its quality to take care of others (such as nursing or waking up to tend to a newborn), but it is also attributed to biological factors like changing hormones during menstruation, pregnancy, and menopause.

Common Sleep Problems, Causes, and Remedies

Insomnia: more than 1 in 4 women in the U.S. suffer from insomnia, having difficulty falling and staying asleep. Though insomnia is more common in people with depression and anxiety—also conditions more likely to affect women—hormonal shifts during menstruation, pregnancy, or menopause affect a woman’s circadian rhythm, resulting in sleeplessness. During menopause, hot flashes and night sweats also disrupt women’s sleep.

Treatment starts from trying to keep a regular sleep schedule, reducing caffeine and alcohol consumption, and improving the sleeping environment. Underlying conditions are, of course, also treated properly with medication and therapy so that chances of them contributing to insomnia can be lessened.

Restless Leg Syndrome: during pregnancy and if taking depression medication, women are more likely to experience RLS, a condition that occurs when lying down and is an uncontrollable urge to move the legs. The risk of it increases from pregnancy to menopause, and women with more children are more like to suffer from it. One possible cause is iron deficiency.

Treatment can include improving sleep habits and the sleeping environment and/or taking iron supplements. Be mindful that about 80% of people with RLS may experience periodic limb movement disorder, which leads to involuntary twitching of the legs every 20 to 30 seconds.

Sleep Apnea: another one of the most common sleep disorders is sleep apnea, and it unfortunately tends to go undiagnosed in women as they report more general symptoms associated with it. Sleep apnea is characterized by pauses in breathing during sleep, leading to snoring, chocking, and gasping sounds that disrupt sleep. The risk for sleep apnea increases in women over 50 and those who may be obese.

Women who may suspect this condition should pay attention to the specific signs of breathing difficulty to report to their doctor. Though CPAP therapy is the most common, it is also likely hormonal treatments will help with the symptoms, or increased exercise and lifestyle changes to reduce fat.

These are a few of the sleep problems that are most common among women, and when reporting to your doctor or healthcare professional it is important to remember that your overall health history is to be taken into consideration when dealing with sleep disorders. Additionally, irregular work schedules or increased duties in women’s lives are factors that increase their chances of suffering from a sleep disorder.

 

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Sunscreen and Skincare 

sunscreenSummer is here and so is the need for sunscreens and skin protection! To safely enjoy your time at the pool, shore, or park, remember there are two types of UV light that can harm your skin: UVA and UVB. Too much exposure can cause skin cancer. UVA light prematurely ages your skin, causing wrinkles and spots, while UVB light leads to sunburns. Though you should avoid the sun during the peak hours of 10 a.m.  to 4 p.m., you should also choose a broad-spectrum sunscreen that protects you from UV light.

What about SPF?

Often, we may think that the higher the SPF, the closer to sun safety. However, high-number SPFs offer the same protection as low-number SPFs. You should use a sunscreen of at least 30 SPF, and keep in mind SPFs greater than 50 provide only a small increase in UV protection. 

Effectiveness

Though it would be ideal, putting on moisturizer with sunblock in the morning does not last the whole day. It can be washed off when swimming, or even sweating, and we tend to not apply a thick enough layer in the first place. Water-resistant sunscreens are not a solution either: they last about 40 minutes in water. High water-resistant products last up to 80 minutes. 

Types of Skin

The biggest question is whether we should use sun lotion/cream or a spray. Here are some basic differences you may want to consider: 

  1. Lotions and creams: if you have dry skin, go for a cream sunscreen, especially on the face. Around your eyes, you can use a stick and for large areas, use a lotion. 
  2. Gel and sprays: gels are very useful in hairy areas, and sprays offer an easy way to put sunscreen on your children. Be generous when spraying so that you end up with a thick coating, but don’t spray around the eyes and nose. 

Aging 

If you want the use of sunscreen to be effective in preventing aging, wrinkles, and sunspots, get in the habit of using it every day. This means, it’s not only for special occasions or only during the summer. Those who use broad-spectrum sunscreen daily show 24% less signs of aging than those who use it intermittently. In addition to the sunscreen, wear protective clothing that covers the arms and chest. Use hats and sunglasses to protect your head and eyes and find shade whenever possible. 

Acne 

One of the most common resistances to sunscreen is that it causes oily or acne-prone skin to break out even more, as it clogs the pores and is, simply, very thick. However, do not let that keep you from protecting your skin from UV rays: there are lightweight, oil-free, and non-comedogenic sunscreens available. Some of them even include lactic acid, perlite, silica control shine and antioxidants to work with oily skin and prevent breakouts while protecting you. 

 

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Chronic Fatigue Syndrome

chronic

Rather more serious than the usual activity-induced fatigue, Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME/CFS) is a chronic illness that is known to affect more than 1 million Americans. Women are four times more likely than men to be diagnosed with it. Keep in mind that it is different from expected fatigue, as it often disables people from doing simple daily tasks such as showering or dressing and may also confine people to bed.

Along with the general description we are provided about chronic fatigue, we know of three key symptoms:

  • ME/CFS is accompanied by fatigue that lasts more than 6 months, and it is not the result of usual effort, nor is it made better when resting
  • Symptoms become worse after mental, physical or emotional effort that would not have caused any issues before the illness
  • Sleep does not get the job done, as people with ME/CFS may be just as tired after a full night’s sleep, not refreshed

Causes

Medical professionals do not yet know exactly what causes ME/CFS, but speculate it is possible there is more than one cause. It is also assumed that there may be a variety of triggers for the condition, such as infections or changes in the immune system. Patients report that CFS starts after flu-like illnesses or a cold/stomach bug, while others also link it to periods of extreme stress—which can of course affect body chemistry. There are no conclusive results yet, but another scientific hypothesis is that ME/CFS is linked to the virus that causes mono, Epstein-Barr.

Treatment

Because of the inconclusive results on what exactly causes ME/CFS, it is difficult for medical professionals to suggest treatment for it, nor is there a CDC approved treatment. However, it is possible to treat certain symptoms to provide relief for some patients. Since it is not a guarantee, unfortunately many people learn to live with it and manage the symptoms to the best of their ability with the support of their family and friends.

Most commonly, healthcare professionals work with patients to address post-exertional malaise and help patients understand, and find, their limits when it comes to physical and mental exertion and create routines as well as “energy envelopes” to manage their fatigue. Sleep problems can also be addressed with either tips for good sleep habits, over the counter medications, or even prescribed sleep medications. Pain of muscles and joints is also addressed in the same manner, and even alternative medicine may be suggested.

Additional symptoms of ME/CFS may include dizziness, loss of memory and/or difficulty concentrating as well as depression and stress. Keep in mind that experiencing individualized or sporadic symptoms listed here is not a conclusive diagnosis for chronic fatigue, and should you suspect, you may be suffering from it, it is best to reach out to your doctor.

 

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Pregnancy Thyroid Conditions

Thyroid conditionsThyroid diseases affect hormone levels and may cause overall hormonal imbalances that ultimately can have an impact on a woman’s fertility. Additionally, women have been found to develop either hyperthyroid or hypothyroid during pregnancy. However, it is untreated thyroid diseases that may have more of a negative impact on a pregnancy and not medicine-regulated thyroid conditions.

What is the difference?

Hyperthyroidism: refers to an overactive thyroid, when your thyroid gland produces too much of the hormone thyroxine. It usually heightens your metabolism, causing an irregular fast heartbeat and often accompanied by unplanned weight loss.

Hypothyroidism: as the name suggests, this is when your thyroid gland is less than regularly active, thus producing less of the hormone thyroxine than your body needs. It may initially not cause any symptoms, but if left untreated hypothyroidism may lead to obesity, infertility, and heart disease.

Thyroid Risks & Pregnancy

You may be at a higher risk for a thyroid condition during pregnancy if:

  • You are currently being treated for a thyroid condition.
  • Have already had a thyroid condition or have had a child with a thyroid condition.
  • Have a family history of thyroid autoimmune conditions, such as Graves’ disease or Hashimoto’s disease.
  • Have an autoimmune condition or Type 1 diabetes.

Hyperthyroid and Pregnancy

Untreated or inappropriately treated hyperthyroidism can lead to the following issues during pregnancy, especially affecting the baby:

  1. Premature birth, before the 37th week of pregnancy.
  2. Low birthweight, with the baby being born under 5 pounds.
  3. Goiter, the abnormal enlargement of the thyroid gland as well as general thyroid problems.
  4. Miscarriage or stillbirth.

Hypothyroid and Pregnancy

Some of the problems untreated hypothyroid can cause for the baby are the same as in the case of untreated hyperthyroid—such as thyroid problems, miscarriage or stillbirth—but there are a few that are different:

  1. Problems with nervous system developmenta and brain growth, especially when untreated hypothyroid happens during the first trimester.
  2. Infantile myxedema, which is linked to severe hypothyroid can lead to dwarfism (when an adult person is less than 4ft tall) as well as lower-than-average intelligence and a lack of skills necessary for daily life. 

Thyroid Medicine

Whether you are experiencing hyperthyroid or hypothyroid, thyroid medicine is meant to balance thyroid hormones in your body and keep them at the right level. If you are taking thyroid medicine and planning to become pregnant, consult with your doctor for possible adjustments. If you are taking medicine and become pregnant, do not stop taking your medication—as untreated thyroid problems lead to more severe issues than taking the medicine—but do get in contact with your doctor as soon as possible to ensure your and your baby’s health.

Remember that since thyroid diseases are a hormonal imbalance, lack of medicine and proper treatment is what leads to severe, or even fatal, issues during pregnancy; thyroid medication is not likely to harm an expectant mother or her baby.

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Anti-Aging Skincare

anti-aging

In a youth-obsessed world, where “perfection” of skin and body is heavily promoted by popular media, women often find themselves struggling to find anti-aging treatments. Though the expectation to stop time and its effects on the body and skin is far from realistic, an increasing number of both men and women invest a lot of time, energy, and money in anti-aging treatments and, often, invasive procedures. A different perspective, however, may suggest that the wish to remain young-looking does not have to do so much with appearances, as with keeping your body and skin healthy.

Skin and Face

A lot of focus is placed on how healthy and rejuvenated one’s face skin looks; ergo, the following anti-aging tips may help you take care of one of the most exposed parts of your body.

  • Use a cleanser: the first important step to keep your face looking clean is to use a cleanser that agrees with your skin. Try to avoid abrasive products and be mindful of whether your chosen product is either drying your skin too much, or leaving you feeling oily even after washing. Keep in mind that depending on where you are on your menstrual cycle, you may need to use different products.
  • Find a serum: serums are concentrated products that you rub onto your skin, using a circular motion to open up the pores and relax your muscles. They usually consist of a combination of vitamins and nutrients, most commonly hyaluronic acid to increase skin elasticity, as well as vitamins C and E for skin rejuvenation. Serums also contain antioxidants. Some of the serum ingredients can be light sensitive, so be careful which one you use during the day or at night!
  • Moisturizers and sunscreen: though it may seem simple, just like with the cleansers you want to make sure you are using a moisturizer that agrees with your complexion and adequately protects your skin. If you are prone to acne, you want to be especially careful with your choice of moisturizer, opting for a more natural-based face cream. Contrary to popular belief, sunscreen ought to be used every time you are exposed to the sun and not only during the summer or at especially sunny places. In fact, sun reflecting off white snow or sun exposure at higher altitudes can be much more damaging.

Healthy Living

Time takes its toll on the human body, and as much as many of us would like to rewind the clock we need to remember there is no quick fix. Skin care definitely helps us look youthful, but the real secret comes with following a healthy lifestyle: stay hydrated by drinking plenty of water, exercise appropriately for your body and age, consume nutritious foods and follow a diet that agrees with your body type and your body’s needs, and be cautious of promising schemes that claim to reverse the aging process—it’s not that simple!

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Vaginal Infections

vaginal infectionsVaginitis and bacterial vaginosis are both equally common vaginal infections. While the symptoms experienced may be either completely the same or very similar, the treatments for the two are very different. It may help to understand that bacterial vaginosis is a type of vaginitis, along with yeast infections and trichomoniasis. Additionally, there are some slight differences as far as the symptoms are concerned which may help you distinguish what it may be, should you experience abnormal discharge.

Vaginitis

It is caused by a change in the normal levels of vaginal bacteria or by an infection. It may also be caused by some skin disorders or reduced estrogen levels (usually after menopause). Overall, it is an inflammation of the vagina that can lead to itching and discharge, as well as pain during intercourse and urination. It may also lead to vaginal bleeding or spotting.

Vaginosis

Overgrowth of vaginal bacteria cause this vaginal inflammation, which results in discharge of gray, white, or even green color. Itching and pain during urination are also common symptoms, as is foul-smelling vaginal odor. Keep in mind that many people with bacterial vaginosis may not experience any symptoms. It can affect any age, but it is more common on women of reproductive ages.

Diagnosis

Any doctor will probably begin by looking into your medical history and, of course, take into consideration your sexual history to determine risk factors—especially if you have multiple sex partners or a new sex partner. The existence of previous vaginal infections is also a risk factor, as are your hormonal levels. Performing a pelvic exam to check for vaginal inflammation and discharge is also standard procedure. If your doctor is suspecting bacterial vaginosis, it is also likely that they will check your abdomen and pelvic organs for any indication of disease. Taking a sample for lab testing and examination of vaginal secretions and pH helps reach a more detailed diagnosis as well.

Treatment

Depending on the type of vaginitis diagnosed, your doctor will assign different treatments. Yeast infections are the easiest to treat with over-the-counter (OTC) medications, usually anti-fungal creams. Keep in mind that though OTC are convenient and cost-effective ways to treat vaginal abnormalities, the wrong medication can lead to more complications and delay proper diagnosis and treatment.

Bacterial vaginosis may be treated by prescribing Metronidazole, which can be taken orally or as a gel applied into the vagina. Other treatments include: Tinidazole, a prescribed oral medication and Clindamycin, a vaginal gel. Note that vaginosis can spread between female sexual partners, and it is especially important for pregnant women to be treated to avoid early birth or low birth weight.

There is also non-infectious vaginitis to keep in mind, which may be caused by other sources of irritation such as a new soap or laundry detergent, tampons, or sanitary napkins.

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Varicose and Spider Veins

VaricoseOne of the most common concerns of aging women is the appearance of varicose veins on their legs. Varicose veins and spider veins are swollen, twisted veins that are mostly found on the legs and appear more in women because pregnancy tends to increase the risk of having them. Additional factors are older age and obesity. Both types of veins are usually painless, don’t cause health problems, and can be treated for cosmetic purposes. Some people report experiencing aching pain and discomfort, while varicose veins sometimes lead to more serious problems.

What is the difference?

Varicose veins are red, blue, or skin colored and seem to have a rope-like texture, while they also tend to cause the skin to bulge out. They are often on the thighs and calves, as well as the inside of the leg near the ankles and feet. During pregnancy they can also happen in the lower pelvic area and the buttocks.

Spider veins are smaller than varicose veins, and predominantly red. They can be seen under the skin, but they do not make the skin bulge. They can from tree-like designs or look like spider webs (hence their name). Most commonly, they are seen on the legs and face.

Symptoms

Other than simply appearing under your skin, you may experience an achy feeling on your legs, muscle cramping, or swelling on your lower legs. Another sign may be worsened pain after either sitting or standing for an extended period of time. Itching or skin discoloration around veins may also be indicative of varicose veins forming.

Risk Factors

  • Age: the older you get, the more chances there are of getting varicose veins. Wear and tear on the valves of your veins is normal with age, and eventually the blood may collect back into your veins instead of flowing up to your heart.
  • Sex: as stated above, women are more likely to develop varicose veins. Hormonal changes may play a role, as they tend to relax vein walls. Additionally, hormone treatments increase the risk of varicose veins.
  • Pregnancy, family history, and obesity are other risk factors you should take into consideration if you are worried about varicose veins in older age.

Prevention

Though you cannot completely prevent varicose or spider veins, as they have to do with normal wear and tear of your vein valves and strength of muscles, there are some ways to minimize the risk of getting them or avoid getting more. Improving your circulation and muscle tone through exercising, watching your weight, lowering salt intake, avoiding high heels, elevating your legs, and avoiding sitting down or standing up for a long time are all ways which may help reduce the risk of varicose veins.

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Benefits of Breastfeeding

Benefits of Breastfeeding

If you are an expecting or new mother, you are probably finding yourself wondering about the benefits of breastfeeding, the required—or suggested—length of time for breastfeeding your baby, as well as about storage options and solutions. In this amalgamation of information, one thing is for sure: the decision on whether to breastfeed or not, and for how long, is to be made between you and your baby.

According to the American Academy of Pediatrics, exclusive breastfeeding should take place for six months and continue after solid foods are introduced at least until one year of age. The World Health Organization extends this even further, recommending breastfeeding until two years old or even longer. As far as the beginning of breastfeeding is concerned, both AAP and WHO suggest as early as one hour after birth.

Benefits of breastfeeding

  • Important Nutrition and Antibodies: In the first days after birth, you will produce a thick and yellowish fluid high in protein and low in sugar, full of beneficial compounds, colostrum. It is the ideal milk for a newborn’s digestive tract and as the baby grows, your breasts produce more and more milk. Additionally, it contains high amounts of immunoglobulin and other antibodies which help your baby fight off viruses and bacteria. Formula does not provide antibody protection.
  • Reducing Disease Risk and Promoting Healthy Weight: Because of the existence of antibodies, breast milk helps prevent most common diseases that affect babies, such as ear and respiratory infections, colds, gut infections and intestinal tissue damage, bowel diseases, and even SIDS, diabetes and childhood leukemia. Since breastmilk promotes the development of different gut bacteria, it also helps prevent obesity and weight gain. A bonus to that is that babies self-regulate their milk intake when breastfeeding, so they are more likely to develop healthy eating habits.

Keep in mind that there are benefits to breastfeeding for mothers as well, linked to lower chances of contracting diseases, helping your uterus contract, as well as burning more calories and helping you lose weight after pregnancy. Probably the most interesting of all is that breastfeeding can tremendously help new mothers with post-partum depression.

Storing and Handling

Before handling breast milk, make sure you thoroughly wash and sanitize your hands. If using a pump to express milk, ensure it is clean and replace any tubing that may seem moldy or suspiciously unclean.

Freshly expressed breast milk should be stored in either breast milk storage bags, or food-grade containers with tight fitting lids. Avoid BPA-containing bottles. Store the milk at room temperature for four hours or less or keep it in the refrigerator for up to four days. Though you can keep it in the freezer indefinitely, it is suggested that you store it for up to six months for best use but 12 months is also acceptable.

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Seasonal Allergies

seasonal allergies

 

Seasonal allergies can be exacerbated during pregnancy. It’s not always the seasonal allergens that cause your body to react, as pregnancy hormones can also be the cause of unexpected, atypical, or more severe histamine production. Pregnancy is already stressful and physically challenging at times: worrying about what you can and cannot eat, consume or drink, and which activities should be avoided. But as far as allergies are concerned, there are plenty of antihistamine remedies available during a healthy pregnancy.

Seasonal Allergies & Your Baby

Even if you never experienced any seasonal allergy symptoms prior to your pregnancy, but are allergically reacting to something, rest assured your baby will not be the slightest bit uncomfortable—despite what you may be experiencing. More importantly, your reactions don’t indicate that your child will be born with allergies.

Different Seasonal Allergies & Pregnancy

There are two types of seasonal allergies during pregnancy: typical spring allergens that begin as early as February, and summer allergies that last until late fall. Pollen is the culprit for seasonal symptomatic reactions. Ragweed, grass, mold, tree pollen, and other regional pollen-producers can thankfully be avoided and there are healthy ways to soothe your symptoms.

Other pregnancy-related reactions are not caused by your environment: a condition called “Rhinitis of Pregnancy,” usually experienced during the third trimester, is caused by hormone level changes that mimic reactions to seasonal pollens. If you experienced season allergies prior to pregnancy, they may potentially worsen while pregnant. Fortunately, there are many safe ways to treat the reactions.

Treating Seasonal Allergies in Pregnancy

First, stay informed by checking your local pollen forecasts on weather and news apps. You may know some pollens to avoid, but your body can react to new irritants. Wear protective masks while doing outdoor activities like gardening or mowing, and make sure to shower and change clothes once inside. Stay indoors when pollen counts are highest, usually between 5am and 10am.

If you’re experiencing symptoms, saline nasal spray is a safe, effective treatment. It’s important to not use them more than three days in a row, as overuse can worsen nasal congestion. Wearing nasal strips at night opens breathing pathways and leads to a better night’s rest.

Avoidance is always the best form of treatment, but there are over the counter safe medications:

  • Benadryl (diphenhydramine) is most recommended
  • Zyrtec (cetirizine)
  • Claritin (Loratadine)
  • ChlorTrimeton (Chlorpheniramine)

Allergy shots, if begun prior to pregnancy, are usually safe to continue. It’s best not to start any allergy treatment during your pregnancy if you aren’t sure how your body will react. As always, should you experience abnormal symptoms of allergies—or severe reactions to allergy medications—while pregnant, reach out to your doctor.

 

 

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Safety Measures for School

Safety Measures

 

As schools begin to increase the amount of in-person instruction, safety measures should still be in place. Experts advise that we keep COVID-19 precautions meticulously, so we may be seeing the next school year starting with necessary safety measures.

Explaining Safety Measures to your Kid

  1. Teach them about COVID: Kids are more likely to follow safety measures if they understand why: what the virus is, how it spreads, and its seriousness. You should use kid-friendly language to explain a global pandemic, and school kids should understand the virus is something dangerous that goes from one person to another, consists of invisible particles, makes people sick, and can be transmitted from an asymptomatic person.
  2. Model Behavior: Remember that your kids see you as a role model: it matters more what you do than what you tell them to do. Practice safety habits at home and set an example that your kids are likely to follow even when you are not around or supervising them.
  3. Promote Mask Wearing: Though this may be taken for granted, we need to remember that children experience masks differently from adults. Definitely teach your children how to wear a mask properly, but keep in mind, to them a mask is a nuisance or an item to play with. Consider letting your children choose their masks so they feel they are participating and let them decorate their masks—a practice that makes them feel proud of the results, and therefore increases the chances of them taking care of their masks.
  4. Encourage Safe Distancing: Children are naturally drawn to social interactions and if they like experiencing the world in tangible ways the risk of infection is augmented. You can promote group activities and sports that make social distancing easier, while still maintaining comradeship: bike riding, hopscotch, skateboarding or an obstacle course are some suggestions.

Integrating Changes

The safety measures outlined above combine the “new reality” under COVID with elements kids are used to. Just like adults, children can adjust their perspective through understanding the necessity for new habits. As far as the return to school is concerned, since there are so many new elements to get used to, you can alleviate some of the stress by keeping a semblance of normalcy in the following standard, i.e. pre-Covid, ways.

  • Prepare for the first day of school by purchasing school supplies, becoming familiar with the school and classrooms, attending orientations, and getting to know the teachers (probably virtually).
  • Practice the school route with your kid: whether that is driving them, walking them, biking with them, or preparing them to do the route alone in the future, do a few trial runs with your kid before the big day.
  • Consider implementing the school sleep schedule earlier than usual, so that if there are home-school or half days your child’s routine is not terribly disrupted.

 

 

 

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