Caring for our ageing skin

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“Years of exposure to the sun for lengthy periods may lead to age spots, melasma, dryness and wrinkles,” says dermatologist Thanisorn Thamlikitkul. Photo/Reuters
October 27, 2016 01:00
By THANISORN THAMLIKITKUL MD
Special to The Nation

Inguinal hernias: Diagnosis and treatment

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October 25, 2016 01:00
By DR PAKPONG WATHANAORAN
Speical to The Nation

Zika: frequently asked questions

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October 17, 2016 05:34
By DR ON-UMAR BANPAMAI

Mononucleosis: benign but not always

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October 11, 2016 01:00
By DR GERARD LALANDE

Special to The Nation

Dealing with the most common DIY emergencies

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October 11, 2016 01:00
By TOM NEBE

DEUTSCHE PRESSE-AGENTUR

Hunched posture can lead to numbness in arms

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Poor back posture can not only cause back pain, but also numbness in the arms and the legs, a group that promotes spinal health is warning the slumped and the slouched among us.

A severe hunch from curled-up sitting or standing for long periods leads in time to a deformation in the thoracic vertebrae. If that affects nerves in the area, the affected person may feel tingling or numbness in their extremities, says the German Spinal League.

In such cases, the doctor will not send you home to rest on the couch to cure the numbness. Instead, patients will be prescribed physiotherapy or urged to do healthy core-strength sports, like swimming, Nordic walking or pilates.

Skin care reduces pregnancy stretch marks; fading later is slow

JANA ILLHARDT

DEUTSCHE PRESSE-AGENTUR

Stretch marks annoy many pregnant women: they are often hard to avoid, even if you moisturise the skin every day, and whether or not a particular woman gets them will depend on her individual body.

“They appear on about 70 per cent of all pregnant women,” says Stefanie Montag, a member of the Association of German Dermatologists.

“Stretch marks happen when the deep layer of skin, the so-called dermis, tears,” says Sven von Saldern, a doctor who specialises in cosmetic and plastic surgery.

“They are a sign that the skin’s connective tissue is under too much stress and superficial skin cells can no longer keep up,” adds gynaecologist Christian Albring. Stretch marks are most frequent in the lower abdomen and the breasts.

“We also often see them on the hips, the backside and the thighs,” Montag says. The larger the woman’s belly, the more likely it is that she will get stretch marks.

“Cosmetic care can counter their effects, but they can still emerge,” von Saldern says. Still, you should apply oil to moisturise the skin and keep it elastic.

Albring recommends doing that before the stretching gets so bad that the skin cannot keep up.

You do not need special oils, but Montag suggests properly moisturising the skin once or twice a day.

The best preventive care is gaining weight at a gentle pace.

“Pregnant women who were very thin at the beginning of their pregnancy may put on 10 to 15 kilograms,” Albring says. Women who already had more rounded figures when they started the process should not gain more than 6 to 10 kilograms, the expert says.

Albring also recommends moving.

“Taking a half-an-hour walk every day is the minimum. Doing a little bit of sport besides that would be advisable,” he says. Having a healthy diet that is rich in vitamins and drinking lots of water and no coffee should also help prevent stretch marks.

“These are all just assumptions, however,” Albring stresses. “Although all these tips make sense and are healthy, there is no proof of their effects on the firmness or the elasticity of connective tissue,” he admits.

So what can you do about stretch marks once you get them?

“At first, the layer of fat below the dermis, which has a good supply of blood, appears reddish under the skin,” says Montag. Those are the marks, but they fade over time. “The body’s repair mechanisms make stretch marks turn white.” However, that process can last a year.

Stretch marks will not go away completely, but with the right care you can make them less evident, says von |Saldern.

“With laser treatment, you can punch many little holes in the tissue, which will heal and tighten the skin so the stretch marks are less visible.” Such procedures are expensive, however.

So-called micro-needling is based on the same principle. “It employs a device that contains little needles. These are used to cause tiny injuries in the skin, which causes regeneration,” Montag explains.

Back pain: causes and treatment

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Approximately 80 per cent of people are likely to experience some kind of back pain in their lives how much or how little the pain varies with age and for some it might be more general back pain, perhaps due to muscle strain.

For others, however, the culprit could be a herniated disc and if this is the case, patients will finally seek the help of a doctor, as the pain is generally very intense and causes other painful symptoms. These include pain that extends down through either one or both legs, with muscle weakness to the point of being unable to walk properly, inevitably disrupting lifestyle, activities and routines.

The intervertebral discs in the spine are a type of cartilaginous joint, the nucleus of which is made up of a highly flexible, jelly-like substance called mucoprotein gel. The discs are like pads that serve as cushions between the individual vertebrae of the spine.

They serve two primary purposes; they allow spinal movement, and they also act as shock absorbers bearing the impact of weight travelling down through the spine. If a disc is impacted to the point of damage or rupture, the injury can cause some of the inner gel-like substance to bulge or protrude out through the tougher outer ring of the disc, compressing the surrounding nerves and causing pain and discomfort.

A herniated disc is caused by deterioration of the intervertebral disc, most often the result of gradual age-related wear and tear. As you age, the internal gel-like substance of your spinal discs begin to lose their flexibility, causing them to slip out of place more easily and press on the surrounding nerves. An important factor in accelerated disc degeneration is a person’s lifestyle and daily habits. Some people do a lot of heavy lifting in their work and do so using the wrong positions, thus causing the discs to bear the strain of too much weight.

For athletes or those who play sports, a herniated disc can be the result of repetitive motion and heavy impact on the discs or a sudden twist movement. Overweight individuals are also at increased risk of herniated discs due to the additional weight that the discs must support. All of these can be contributing factors for accelerating disc degeneration or causing a tear or rupture of the disc, putting pressure on the surrounding nerves.

If you start to have back pain throughout your entire back and particularly heavy pain in the lower back and waist area that extends down to your legs, and if this is a chronic pain lasting for more than two weeks, you might well have a herniated disc.

In this case, the best course of action is to see a doctor as soon as possible in order to properly and promptly diagnose your symptoms.

A herniated disc is a treatable condition. If the patient’s symptoms are less severe, doctors will first advise medication and physical therapy. If the patient continues to experience severe or acute back pain to the point of being unable to carry out regular daily activities, the doctor may then recommend minimal access microdisectomy for treatment. This type of surgery is known as MIS (Minimally Invasive Surgery), which uses innovative surgical technology that has made ground-breaking and progressive developments in recent years.

The benefits of this type of surgery are far less pain, an incredibly small incision only the size of a fingertip, much lower risk of infection, and most importantly, a much faster recovery rate, eliminating the need for long, drawn out hospital stays. Following surgery, the patient is typically able to return home within 24 to 48 hours.

The best option is always early prevention; you can prevent the likelihood of herniated discs by simply employing proper techniques when moving or using your back.

Some important steps to take follow: avoid lifting heavy objects, if you must sit for long periods of time, try to stretch and change positions frequently, work to develop and maintain core muscle strength (this includes both the back and abdominal muscles). If you know your bones are not particularly strong, try to avoid sports that involve frequent jumping or heavy impact to the spine and take up exercises such as swimming, and other lighter forms of exercise that focus on increased flexibility. All of these changes can help to extend the lifespan of a healthy spine and intervertebral discs and prevent premature disc deterioration.

DR CHALAT WINMOON is a Spinal Surgeon at Samitivej Sukhumvit Hospital. |Call (02) 022 2494-6.

Looking good, FEELING BETTER

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SPECIAL FEATURE

A four-day wellness workshop in Phuket unveils the path to a sustainable healthy lifestyle

IF YOUR immediate reaction to feeling out of balance with yourself is to rush to the gym and start one of those fashionable diets that promise to have you looking slim and feeling great in just a few weeks, take a deep breath and slow down. There are better, not to mention healthier and sustainable, ways of getting back in tune, according to the three leaders of the “reboot and re-energise your body and mind” workshop hosted last weekend by JW Marriott Phuket Resort & Spa.

Conceptualised and put together by the resort’s spa director, Linda Overman three years ago, this fourth wellness workshop saw the return of three Phuket-based practitioners – vitality performance coach Hayden Rhodes from RPM Health Club, nutritional specialist Craig Burton, and yoga practitioner Kim White.

“What we’re doing here is taking a look at the big picture of health, and health requires different segments – nutrition, movements and mindset,” Australian nutritionist with sports science background, Craig Burton, told XP.

“I think the word holistic sums up what we do very nicely, but these days ‘holistic’ is used very broadly and misleadingly for commercial gain. That’s why I prefer to use the word ‘function’. We all want to restore function to our bodies, to have more energy, to feel better and to look better. For me, clinical data like blood work are great indicators of what’s been happening in someone’s life. I believe in individuality, that everyone is different, and everyone needs a different diet and different movements.” Burton continued.

Our group of a dozen or so participants scanned the programme looking for the usual health retreat suspects like detox juice breakfast, daily colonics, raw diet lunch and fasting for dinner and to our relief, found nary a one.

“It’s the combination of mind, body and spirit.” New Zealander Hayden Rhodes, a performance coach and nutritionist who has worked with many professional athletes and celebrities, explained. “You have to look at your lifestyle and whatever is happening in your life to see what affects these three. You can’t focus on only one. As someone who has been through a lot of trauma, both physical and emotional, I can assure you that physiology is important but the mindset is equally as important. You can’t be happy if you’re not healthy, and how can you be healthy if you’re not happy?

“What we are doing is grounded in science, and complements modern Western medicine. Hospital doctors are usually overwhelmed by the number of patients they have to see and don’t have the time or the energy to go through the details of your life to identify the causes of your problem and work through it with you. Actually we are hoping to partner up with physicians who understand what we do and prescribe yoga or new diet plans instead of pills and supplements.”

A private consultation with Burton was the first workshop activity and he had us ticking boxes and answering several questions our lifestyle and diet. Each morning, Rhodes and White took turns hosting “gentle rise and shine” sessions using various movement techniques including a sunrise stroll along the beach and yin yoga, a slow-paced from of the ancient exercise regime focusing on stretching connecting tissues and joints.

“Over the years I’ve learned other aspects of yoga which go beyond the physical, and as a teacher I teach people to have a better idea of what yoga can do for them,” said White, who hails from South Africa. “Yoga is completely different for everybody. We all have different bodies, different abilities and different ideas of what we want to get out of yoga. I try to make people fall in love with the yoga that is good for them, to balance out their life from a yogi point of view. I give them guidelines so that they practise by themselves every day. Yoga is not difficult and everyone can do it.”

Totally refreshed and nicely stretched, we walked over to Ginja Cook, the resort’s Thai restaurant, where executive chef Dietmar Spitzer awaited with a nutritious and tasty breakfast. We fuelled up for the day with simple and healthy dishes like hummus and vegetables, nuts, muesli, rice milk, omelettes, fresh fruits and fresh fruit and vegetable juice.

“I don’t believe in fusion cuisine,” Spitzer explained. “Food should be straight forward. When the plate arrives, you should recognise what’s on it. Very often the simplest food is the best, especially when you have good quality ingredients. We work very closely with the local fishermen who bring their catch to our kitchens every day. We believe in local products and import very little and only when necessary.” The importance of a healthy breakfast was further underlined in a session led by all three experts, during which they suggested dishes both easy and quick to prepare.

A series of talks were held over the weekend. Burton explained how the ups and downs in cortisol – the stress hormone – affects our bodies in terms of weight gain, blood sugar imbalance, gastrointestinal problems and inflammation. In another talk he addressed the importance of hormonal balance which, when off kilter, leads to various health conditions including obesity.

Rhodes started his body fat talk by addressing common errors we all make trying when to lose weight. These include eating less, self detox, going on a diet, avoiding eating fat, starting running and even blaming our genes. Stress, he pointed out, is at the root of many diseases and therefore we should make every attempt to keep it to the minimum. Only then should we set realistic expectations of what we want to achieve.

“Always start simple and be conscious about the choice you make in creating new eating habit. Learn what food is good for you,” he told the group. After just four days, we did not of course walk out of the workshop looking any different. In fact, it is impossible to spend a few days in a wellness programme and come out completely changed. The way to sustainable healthiness is a life-long journey that demands both a mindful and practical approach, with advice and guidelines from experts, to achieve. And first, you need to really want to make that change.

“There is no cut-off age when it comes to health and well-being.” White said. “Come to us, or any practitioners that you trust, when you are ready to make a change in your life. Come before you get sick or start to have health problems. We don’t want to make you feel like a failure, and a lot of people do feel like failures because they only half want to do this, They’re not really ready, and instead of success they just end up with a bad taste in their mouths.”

The next inspiring wellness workshops will be held in May and September next year at JW Marriott Phuket Resort & Spa. The four-day programme is limited to 20 participants only.

For more information about the wellness workshop, contact Linda Overman, Director of Mandara Spa via email linda.overman@marriotthotels.com

 

Uterine fibroids: prevention and treatment

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HEALTH MATTERS

Uterine fibroids

But although uterine fibroids are extremely common, especially in women of reproductive age, in actuality, this disease may not be as difficult to cure as is generally feared or assumed.

Benign uterine growths or tumours can be in the form of a polyp, or can be a fibroid muscle tissue mass (it may have a stalk or stem-like base), that develops in the muscular wall of the uterus, and can protrude into the uterus itself, as well. This can occur in women of any age, even in younger women, but is most common in women of reproductive age.

Generally speaking, any woman is capable of developing a uterine fibroid, as, again, it is something that can affect women of all ages.

Abnormal vaginal bleeding or discharge is a primary symptoms of uterine fibroids. The kinds of symptoms experienced by patients depend on the location and the size of the tumour. Other common symptoms include pain in the lower abdomen or pelvis, heavy menstrual pain requiring pain medication or pain to the point of being unable to work or function normally, and bladder pressure leading to a frequent urge to urinate. These are all warning signs for which to watch; however, some women may not experience any symptoms or indications whatsoever.

The exact cause of uterine fibroids is still unclear, as it is generally observed that these types of tumours can occur at any time. It does, however, seem that there are some factors contributing to the development of fibroids in the uterus, and one of these is hormones. The female sex hormone, oestrogen, appears to promote the growth of these kinds of tumours, which explains why they occur more frequently in women of reproductive age.

In some cases, if left untreated, uterine fibroids can cause heavy bleeding and possibly infertility.

Currently, the standard treatment option is what is known as a hysteroscopy procedure, during which a hysteroscope, equipped with a miniature camera and light at the end of a tube, only about two millimetres in diameter, is inserted into the vagina in order to examine the cervix and the inside of the uterus. If larger growths are found, a larger diameter camera with a thin electric wire loop attached may then be inserted and an electric current is used to cut the fibroid or polyp into small pieces that can then be removed through the cervix without affecting any other parts of the body.

Treatment of uterine fibroids by using a far safer and more convenient option is the primary benefit. Patients experience minimal pain, and, importantly, a shorter recovery period.

The recuperation period after this type of surgery is just one to days, after which the patient can return to work as usual. Minimally invasive surgery is, therefore, a favoured solution that meets the needs of today’s women who have greater responsibilities, both in the workplace and at home.

For women planning to have children, the issue of uterine fibroids is not one to be complacent about or to leave unattended. Women should undergo regular annual health check-ups, as uterine fibroids can develop at any time.

Annual health check-ups will help to catch and treat this disease in time, and are the best means of prevention. Now that we are more aware of the dangers and treatments of uterine fibroids, we can clearly see that, they need not be as great a source of fear or concern as was once thought.

If or when uterine fibroids occur, medical science is now able to remedy the problem more easily and safely than ever before.

DR SOSAKUL BUNYAVIROCH is an Oncology and Gynaecologic Endoscopic Surgeon attached to the Women’s Health Centre of Samitivej Sukhumvit Hospital. Call (02) 022 2555-6.

Pedalling legs in the air: what people do to relieve low blood pressure

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LIVING WELL

photo: dpa

photo: dpa

It does not take long, and you do not necessarily even need to go to the doctor: you can have your blood pressure measured at many pharmacists’.

The focus is usually on high blood pressure, which can cause a heart attack or a stroke.

However, some people have the opposite: low blood pressure, known as hypotension, which is not always harmless either.

A doctor should establish whether or not there is an organic cause for low blood pressure, says cardiologist Heribert Brueck.

Low blood pressure can be a symptom of a thyroid gland malfunction or a heart disease, such as a myocardial insufficiency. According to the World Health Organization (WHO), a blood pressure of less than 100 over 60 millimeters of mercury (mm Hg) is considered low for women, while the equivalent for men would be anything less than 110 over 70 mm Hg.

Globally, hypotension is believed to affect an estimated five per cent of the population.

“Low blood pressure is not a disease in itself,” Brueck stresses.

It is usually a sign of circulatory problems. Affected people only tend to worry about hypotension if they sometimes get dizzy, feel buzzing in their ears or feel unusually cold.

Pharmacist Ursula Sellerberg points out that older people need to take low blood pressure seriously. For example, if they feel dizzy after getting out of bed, they are at risk of fractures or bruises from fainting.

Hypertense patients are often given drugs to bring their blood pressure down, but the reverse is not usually true.

“Almost no medication is prescribed for low blood pressure,” Brueck says.

Instead, many doctors advise their patients to take better care of themselves.

Christian Dannhart, a spokesman for a group that promotes the healthful effects of alternating hot and cold showers, says, “That is often enough to improve circulation and the supply of oxygen.”

Brueck is however cautious of claims that this improves the cardiovascular system, saying “You should seek a doctor’s advice first.”

Alternating hot and cold is not always a good idea, particularly for people who suffer from certain illnesses including vein problems.

Men and women with low blood pressure should eat food with plenty of salt.

“It is also important to have a diet that is rich in minerals and vitamins, that is, with plenty of fruit and vegetables,” Dannhart says..

Drinking at least 2 litres of water per day is also good for blood circulation. Medicinal plants like rosemary often also have a positive effect on hypotension, by stimulating circulation. Further, exercise can help fight low blood pressure.

“One possibility before you get up in the morning is for instance to stimulate circulation by pedalling your legs in the air in bed,” Sellerberg explains.

“Relaxation techniques such as yoga or breathing exercises can stimulate circulation too and thus improve the brain’s oxygen supply,” Dannhart notes.

Sellerberg offers an even easier tip for the elderly. People with low blood pressure should occasionally “lie down flat and raise their legs higher than the body” to make the blood run to the head.

Drinking plenty of water supports spine |elasticity, expert says

DEUTSCHE PRESSE-AGENTUR

Spinal health and elasticity are impacted by more than just exercise or everyday wear and tear: how much you drink affects the back.

Nutrition also plays a role, according to orthopaedist Reinhard Schneiderhan.

The intervertebral discs, which cushion the spine’s vertebrae and act as a shock absorber, need fluid to stay strong and limber. Even the vertebrae themselves are up to 25-per-cent liquid.

“For a stable, yet elastic spine, it is recommended to drink one and a half to two litres of water per day,” Schneiderhan says.

Two important nutrients for bone health include calcium and phosphorus. Both minerals can be found in milk products, especially in cheeses, or leafy, dark-green vegetables.