Under stress

The timetable of a working mother makes one tired just by looking at it. A typical day would start at 6 a.m. and end after dinner time. The hard work can be compounded by the presence of demanding in-laws, children’s illnesses and deadlines to be met at work.

A woman in this situation always feels guilty that she is not doing enough for her children and her family, suffers from a feeling of inadequacy and is also found wanting by colleagues and bosses at work, and husband and in-laws at home.

The children feel that their mother is not at home for them. Colleagues are usually unsympathetic. The husband often feels that he is being neglected. Classically, housework is not considered work at all, but just something a woman does, naturally; so it is rare that anybody in the family appreciates what the woman is doing for the home and understands why she is tired and irritable.

Working women are in a state of constant stress which manifests itself in symptoms like feeling weak, tired, irritable, having a headache, body ache, hyperacidity, pain in the abdomen and other gastro-intestinal problems.

These complications take them to various doctors and specialists who usually prescribe symptomatic treatment without realising that the basic problem is excessive stress. As a result there is no lasting improvement. Clearly, the malady lies not in the body but in the stressed mind.

The most common symptoms are: Weakness and fatigue: Identifying stress as the problem behind weakness and fatigue can be difficult because any other physical disease may cause exactly the same symptoms. The doctor would usually prescribe non-specific treatment if no obvious cause is found, missing the actual problem.

Aches and pains: These symptoms may lead to the doctor asking the patient to get herself tested for a whole range of possible conditions without any clear diagnosis. Headache: Any headache that continues for several days needs to be evaluated, but all headaches are not a sign of serious medical problems.

Headaches resulting from tension are very common. Patients go from one doctor to another for eye-check ups and ENT examinations and may be finally referred to a neurologist. Gastric problems: This group constitutes the most common illness resulting from stress.

Hyperacidity, abdominal pain and frequent bowel movements are a possibility and patients try out several specialists without any abnormality being detected. Neither the patient nor the doctor recognise the problem. It is almost never focused on when the patient is telling the doctor her medical history.

The treatment of all these ailments does not lie in mere symptom-targeting medication. This may cause transient improvement but does not cure the patient. When nothing specific is found, many patients are labelled neurotic or hypochondriac, imagining themselves to be ill when there is no illness. They then get even less care from the family and the medical fraternity.

Medicines are not the answer to the problem. The real treatment is to reduce the burden on the working mother. Measures need to be taken to reduce the level of stress of working women. Here the family, especially the spouse, obviously plays the most crucial role in this. Helping the working woman out with domestic chores and sharing the burden of parenting can often do away with her hyperacidity.

Giving her time to relax, going out for a walk, meeting her friends, and forgetting the home for a while can be an enormous stress-reliever. The medical fraternity too should recognise the working mother syndrome and consider this aspect when treating her. If the real cause is detected quickly, cures can result not from medicine but from changes in lifestyle.

Body image and sexual function after cancer

by Dr. R. A. R. Perera,

Consultant Psychologist

For many cancer survivors, anxiety over having a life threatening disease, adjusting to the changes that have occurred in their sexual functioning, body image and in their intimate relationships can be difficult.

They might have problems like negative emotions such as anger, resentment, grief and unresolved conflicts.

Cancer patients, particularly those who are older, are often reluctant to discuss the topic of sex and because of this, doctors may incorrectly assume they have no concerns. Often a consultation with their doctor is the only legitimate place where a patient is able to bring up their sexual difficulties.

In eastern societies like in Sri Lanka there are numerous barriers that may make, taking a sexual history in any patient (specially cancer patients) difficult.

The psychosexual impact of cancer and its treatments is influenced not only by the physical changes that affect body image sexual function, but also by other factors such as whether the person is in a current sexual relationship, and to a certain extent the person’s age. Cancers that potentially have the greatest impact on body image and sexual function are

* Breast and gynaecological

* Prostate and testicular

* Head and neck

* Colorectal (intestinal cancers)

Treatments for cancer including surgery, chemotherapy, radiation and hormonal therapy, can all negatively impact on sexual functioning.

It has been estimated that approximately half the women who survive breast cancer report sexual problems. After a mastectomy (removal of breast) women are particularly vulnerable, with younger women being twice as likely to experience sexual problems than older women.

Women who are given hormonal treatment for breast cancer have decreased circulating sex-hormones (estrogens), which can cause loss of sexual desire, vaginal dryness and painful sexual intercourse.

In male, even with a successful surgery for prostate cancer, impaired sexual function may still be a significant problem, particularly over time. There is also a risk of urinary incontinence, though this improves over time for the majority of patients.

It has been estimated that about 70% of men and women experience sexual dysfunction after surgery for intestinal cancers (colorectal cancer).

Psychosexual dysfunction is higher in patients with a urinary or stools bag, compared to those with intact urinary or stools sphincters (valves).

It should be recognised that many drugs and medications for cancer therapy would influence sexual performance.

Simple measures such as use of vaginal lubricants, local estrogen creams or products to facilitate erectile function may be all that is required for most of the patients. More complex situations will require psychological assessment and psychotherapy.

The patient may express a range of beliefs, attitudes and feelings about sex, and about having cancer.

It is important that the patient feels they are supported in a holistic approach, which focuses on their quality of life, their intimate relationships, and their social situations.

Smoking links to hearing loss

Smoking and obesity could both cause permanent hearing damage, say scientists. Either could threaten blood flow to the ear, they say, with damage levels clearly linked to the level of obesity or the length of a smoking habit. However, the Antwerp University-led study found that high levels of work noise remained the biggest risk. In a separate study, smoking in middle age was linked to worse memory, which could hasten the arrival of dementia.

A link between smoking and hearing problems has been suggested by others, but the conclusions of the latest research, involving more than 4,000 men and women aged between 53 and 67, offer the most convincing evidence to date.

All the study participants were given a hearing test, then asked about their lifestyle and where they worked. Dr. Erik Fransen, of the University of Antwerp in Belgium, one of the lead researchers, said that the ability to pick out high frequency sounds was damaged in smokers and the obese, although to not as great an extent as those exposed to very loud noise in the workplace.

He said: “The hearing loss is proportional to how much you smoke and your body mass index (BMI). “It starts getting worse once you have smoked regularly for more than one year.” He said that, unlike some parts of the body, once damage had occurred, there was no prospect of recovery.

“Once the damage is done, it’s done. It does not repair.” Blood flow The theory behind the hearing damage is similar to the reason smoking and obesity can harm other organs.

Both can disrupt the flow of blood around the body, and Dr. Fransen suggested that the resulting lack of oxygen, coupled with the failure to remove toxic waste from the ear, can be damaging. Amanda Sandford, from the pressure group Action on Smoking and Health (ASH), said There are so many young people who think that they can give up in middle age and escape some of the other diseases associated with smoking. “In this case, some of the damage may already have been done.”

The study was part-funded by the Royal National Institute for the Deaf (RNID), and Dr. Mark Downs, from the charity, said that, with an ageing population, age-related hearing loss could be a major problem. “Losing your hearing in later life can make it harder to maintain contact with friends and families and lead to isolation and depression, so making small concessions now could have an enormous effect in the long term.”

A separate research project involved more than 5,000 civil servants, who completed memory and reasoning tests and then repeated them five years later. It found that smoking in middle age was linked to a decline in memory and verbal reasoning ability. Memory problems at this age have been linked to a swifter onset of the symptoms of dementia. - BBC NEWS

Oral health:

Tips for proper dental care

Don’t take your smile for granted. Maintain good oral health by practising regular dental care habits and reporting problems to your dentist promptly. Clean your teeth daily and see your dentist one to two times a year to prevent gum disease and other oral health problems.

Tips on how to brush your teeth:

* Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste.

* Use a soft-bristled toothbrush ? it’s gentler on your gums.

* To brush properly, hold your toothbrush at a slight angle against your teeth and use short back-and-forth motions.

* Brush the inside and chewing surfaces of your teeth.

* Brush your teeth for about two minutes each time you brush.

* Brush your tongue.

* Avoid vigorous or harsh scrubbing, which can irritate your gums.

* Replace your toothbrush every three or four months, or sooner if it becomes frayed.

* Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well. Flossing for oral health a toothbrush can’t reach all the tight spaces between your teeth or the areas under your gumline. That can allow plaque to build up, threatening your oral health. Flossing, though, removes those particles and improves oral health.

Tips on how to floss your teeth:

* When you floss, gently ease the floss between your teeth.

* Pull the ends of the floss against the front and back surface of a tooth so that the floss forms a “C” as it wraps around the tooth.

* Gently pull the floss from the gumline to the top of the tooth to scrape off plaque.

* Floss the backs of your teeth.

* Use fresh floss as you progress through your teeth.

* If you have trouble getting floss through your teeth, try waxed floss. *If it’s hard to manipulate the floss, try using a floss holder. Other oral health care tips Brushing and flossing are the mainstays of good dental care and oral health. In addition to those, you may also want to consider these oral health tips:

* Use an interdental cleaner, such as a dental pick or dental stick specially designed to clean between your teeth.

* Use a mouth rinse to help reduce plaque between your teeth.

* Use oral irrigators, or devices that aim a stream of water at your teeth, to remove food particles.

* Don’t use toothpicks or other objects that aren’t made to clean your teeth. Oral health problems to report to your dentist Call your dentist promptly if you develop any of the following signs and symptoms that may suggest oral health problems:

* Red, tender or swollen gums

* Gums that bleed when you’re regularly brushing and flossing

* Gums that are pulling away from your teeth, which may make your teeth seem longer

* Pus around your teeth and gums when you press on the gums

* A bad taste in your mouth

* Loose teeth

* Changes in the way your top and bottom teeth touch

* Changes in the feel of your dentures

* Sensitivity to hot and cold