Stress is a reality of everyday life. The term “stress” was used first in physics in order to analyze the problem of how man-made structures must be designed to carry heavy loads and resist deformation. With the transition from physics to the behavioral sciences, the usage of the term “stress” changed. Some scholars define stress as word of physics, which refers to the amount of force used on an object and it relates in real life to how certain issues that carry forces applied to humans. Other scholars define stress as a state of mental or emotional strain caused by adverse circumstances.
Certain issues like financial difficulties, health issues, personal conflicts and work issues all carry force or pressure on a ones’ body, mind and spirit. Some of the pressures originate from the environment but most often it emanates from within a person's head in the form of worry, anxiousness, regret, discouragement and low confidence and self-esteem.
The body’s autonomic nervous system controls your heart rate, breathing, vision changes and more. It’s built in stress response, the fight-or- flight response, helps the body face stressful situations. So, when a person has long-term (chronic) stress, continued activation of the stress response causes wear and tear on the body.
Stress affects the physical, emotional, mental and behavioural well-being of someone. Some of the signs and symptoms include;
Acne: This is one of the most visible ways that stress often manifests itself. When some people are feeling stressed out, they tend to touch their faces more often and this can spread bacteria and contribute to the development of acne. On the other hand, several studies have also confirmed that acne may be associated with high levels of stress. This is attributed to hormonal shifts, bacteria, excess oil production and blocked pores while stressed.
Headaches: Many studies have found that stress can contribute to headaches, a condition characterised by pain in the head and neck region. Other common headache triggers include lack of sleep, alcohol consumption and dehydration which mainly happen when one is stressed.
Rapid heartbeat: A fast heartbeat and increased heart rate can also be one of the symptoms of high stress levels. A study measured heart rate reactivity in response to stressful and non-stressful event, and this showed that heart rate was significantly higher during stressful conditions compared to non-stressful times. However, a rapid heartbeat may also be caused by other factors such as high blood pressure, thyroid disease, certain heart conditions, and by drinking large amounts of caffeinated or alcoholic beverages.
Appetite changes: Changes in appetite are common during times of stress. When you feel stressed out, you may find yourself either with no appetite at all or ravenously raiding the refrigerator in the middle of the night. These changes in appetite may also cause fluctuations in weight during stressful periods. However, appetite changes can be caused by other factors such as; use of certain medications or drugs, hormonal shifts and psychological conditions.
Decreased energy and insomnia: Chronic fatigue and decreased energy levels can also be caused by prolonged stress. Stress may also disrupt sleep and cause insomnia, which can lead to low energy. Work related stress can increase sleepiness and restlessness at bedtime and also experiencing a higher number of stressful events is significantly associated with an increased risk of insomnia.
High blood pressure: Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. When you have hypertension, it means the pressure against the blood vessel walls in your body is consistently too high. High blood pressure is often called the SILENT KILLER because you may not be aware that anything is wrong, but the damage is still occurring within your body. High blood pressure can be dangerous if it’s not treated. It can put you at risk for stroke, heart failure and other medical problems. Changing what you eat, exercising more and taking your medications can help you keep your blood pressure where it should be.
Depression: Stress has been found to be associated with depression. For-example stress due to loss of a loved one, loss of a job and others. Depression is a medical condition that affects your mood and ability to function. It can also cause difficulty with thinking, memory, eating and sleeping. Depression types include clinical depression, bipolar, dysthymia, seasonal affective disorder and others. Treatment options here range from counselling to medications to brain stimulation and complementary therapies. Without treatment, depression can get worse and last longer. In severe cases, it can lead to self-harm or death.
Panic attacks: These are sudden un-reasonable feelings of fear and anxiety that cause physical symptoms like a racing heart, fast breathing and sweating. When people are stressed, they are worried about many things and very anxious. Some people become so fearful of these attacks that they develop panic disorders, a type of anxiety disorder. Therapy and anti-anxiety medications can stop panic attacks.
Changes in libido: Our bodies react to stress by releasing hormones of adrenaline and cortisol. Chronic stress, in particular, can interfere with your body’s hormone levels, and results in a low libido. The arteries can also narrow and restrict blood flow in response to stress, which can also lead to erectile dysfunction. Stress can also reduce your libido by distracting you and taking your mind off sexual desires.
Muscle tension and jaw clenching: A person may clench their jaw or grind their teeth without noticing it, when stressed, and over time this can cause the muscles to tighten up and it comes on suddenly or gradually and it can last for long periods. Stress can also cause a person to clench their fists or lead to tension in the shoulder and neck muscles. If stress is getting in the way of daily life, talk to your healthcare provider about the best treatments, practice natural ways to relieve stress.
Fortunately, there are many ways to help relieve stress. These include; practicing mindfulness, doing exercises & yoga, taking a walk, reducing your caffeine intake, spending time with friends and family, listening to music, dancing, laughing it off, developing a positive self-talk habit, eating a balanced diet, meditate, doing breathing exercises and many others.
We need to know that stress is unavoidable as taxes and death, however, we can always manage stress.
Pregnant
women and their partners often wonder if it's safe to have sex during
pregnancy. Will it cause a miscarriage? Will it harm the unborn baby? Are
there sex positions to avoid? Here's what to know.
Is
Sex Safe During Pregnancy?
Yes! As long as you're having a normal pregnancy without complications, sex during pregnancy is safe until your water breaks or you go into labor.
Sex
is a natural, normal part of pregnancy if you're having a normal pregnancy.
Penetration and intercourse’s movement won't harm the baby, who is protected by
your abdomen and the uterus’ muscular walls. Your baby is also
cushioned by the amniotic sac’s fluid.
The contractions of orgasm aren't
the same as labor contractions. Still, as a general safety precaution,
some doctors advise avoiding sex in the final weeks of pregnancy, believing
that hormones in semen called prostaglandins can stimulate contractions.
One
exception may be for women who are overdue and want to induce labor. Some doctors believe
that prostaglandins in semen actually induce labor in a full-term or past-due
pregnancy since the gel used to "ripen" the cervix and induce labor
also contains prostaglandins. But other doctors think that this semen/labor
connection is only a theory and that having sex doesn't trigger labor.
When
Not to Have Sex During Pregnancy
Talk
with your doctor about whether it’s safe to have sex while you’re pregnant.
They may advise you not to have sex if you have any of the following types of
high-risk pregnancy:
You're at risk for miscarriage or a
history of past miscarriages
You're at risk for preterm labor (contractions before 37
weeks of pregnancy)
You're having vaginal bleeding,
discharge, or cramping without a known cause
Your amniotic sac is leaking fluid
or has ruptured membranes
You're expecting twins, triplets,
or other "multiples"
You're having an incompetent cervix or if it has dilated.
You or your partner has sexually transmitted disease.
Keep
in mind that if your doctor says "no sex," that may include anything
that involves orgasm or sexual arousal, not just intercourse. Discuss it so
you’re clear on what they mean.
Call
your doctor if you have unusual symptoms during or after sex, such as:
Pain
Bleeding
Fluid or discharge
Significant discomfort
Contraction
Pregnancy
Sex
All
woman's experiences during pregnancy are different -- including how they feel
about sex.
For
some, desire fades during pregnancy. Other women feel more deeply connected to
their sexuality and more aroused when they're pregnant.
During
pregnancy, it's normal for sexual desire to come and go as your body changes.
You may feel self-conscious as your belly grows. Or you may feel sexier with
larger, fuller breasts. Not having to worry about birth control is another
perk.
Here's
a common pattern of libido during pregnancy:
First trimester. Nausea, fatigue,
or breast tenderness may kill your sex drive. But don’t
worry; it will come back.
Second trimester. Your libido may kick into high
gear. In fact, increased blood flow throughout your body can
enhance your orgasms.
Third trimester. Sex may feel uncomfortable as
birth approaches.
Tell
your partner what you're feeling and what works. You may need to play with
positions, especially later in pregnancy, to find one that's both comfortable
and stimulating for you. If something doesn't feel right for either of you,
change what you're doing and talk to your OB about any physical problems.
Avoid
lying flat on your back in the "missionary position" for sex after the
fourth month of pregnancy. That way, you can avoid the weight of the growing
baby constricting major blood vessels.
Get
on top or lie on your side, with your partner behind. Or get on your hands
and knees, with your partner kneeling behind. These positions reduce
pressure on your belly.
Enjoy intimacy in
other ways. Cuddle, kiss, or massage each other. Enjoy a bubble bath
together.
As
always, if you're not absolutely sure about your partner's sexual history, use
condoms. Pregnancy doesn't protect against sexually transmitted infections --
such as HIV, herpes, genital warts, or chlamydia -- and those infections can
affect your baby.
The
first six weeks after delivery are called the postpartum period. Sex during
this time may be the last thing on your mind. You may have less desire because
of:
Emotional issues, such as
postpartum blues, anxiety over parenting, or
relationship issues with the father.
Intercourse is generally safe after any
incisions have fully healed and you feel the delicate tissues of your vagina have
healed. This healing usually takes several weeks. You can ask your doctor what
they recommend. Most doctors will say to wait at least 6 weeks after delivery
before intercourse. Equally important is feeling emotionally ready, physically
comfortable, and relaxed.
After
pregnancy, some women notice a lack of vaginal lubrication. A water-based
lubricant can ease the discomfort of vaginal dryness during sex.
For
both you and your partner, patience is a virtue. Given the realities and
stresses of early parenthood, it can take up to a year for a couple's normal
sex life to return in full bloom.
Can I Get Pregnant Again
if I Am Breastfeeding?
Women
who breastfeed have a delay in ovulation when an egg is released
from the ovary and menstruation. But ovulation will happen before you
start having periods again. So, you can still get pregnant during this time.
Follow your health care provider's recommendations on birth control.
What are the common myths or misbeliefs of sex during pregnancy?
You may have heard several warnings about how harmful is sex during pregnancy. But the truth is, most of those warnings are mere myths and misconceptions. A lot of couples do not really know what they should and should not do regarding sex during pregnancy.
As a result of incorrect knowledge, many couples refrain from sex as they do not want any risks but sex during pregnancy has no risks. Rarely, some women may suggest avoiding sex during pregnancy due to their complicated pregnancy but for others, you need not hold your sex desires. Here are the common myths and misbeliefs about sex during pregnancy
Sex during pregnancy is harmful
Sex can harm the baby
Sex during pregnancy can cause miscarriage
You do not need to use condoms
Avoid sex to keep pregnancy healthy
Women have low sex drive during pregnancy
Pregnancy sex is painful
All pregnancy sex positions are not good
Different positions will influence the sex of the baby.
Diabetes happens when your body isn't able to take up sugar (glucose) into its cells and use it for energy. This results in a build-up of extra sugar in your bloodstream.
Poorly controlled diabetes can lead to serious consequences, causing damage to a wide range of your body's organs and tissues – including your heart, kidneys, eyes, and nerves.
Why is my blood glucose level high? How does this happen?
The process of digestion includes breaking down the food you eat into various different nutrient sources. When you eat carbohydrates (for example, bread, rice, pasta), your body breaks this down into sugar (glucose). When glucose is in your bloodstream, it needs help – a "key" – to get into its final destination where it's used, which is inside your body's cells (cells make up your body's tissues and organs). This help or "key" is insulin.
Insulin is a hormone made by your pancreas, an organ located behind your stomach. Your pancreas releases insulin into your bloodstream. Insulin acts as the “key” that unlocks the cell wall “door,” which allows glucose to enter your body’s cells. Glucose provides the “fuel” or energy tissues and organs need to properly function.
If you have diabetes:
Your pancreas doesn’t make any insulin or enough insulin.
Or
Your pancreas makes insulin but your body’s cells don’t respond to it and can’t use it as they normally should.
If glucose can’t get into your body’s cells, it stays in your bloodstream, and your blood glucose level rises.
What are the different types of diabetes?
The types of diabetes are:
Type 1 diabetes.
This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people have diabetes have Type 1.
It’s usually diagnosed in children and young adults (but can develop at any age). It was once better known as “juvenile” diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes.
Type 2 diabetes.
With this type, your body either doesn’t make enough insulin, or your body’s cells don’t respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it “having a touch of sugar.”
Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
Gestational diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you're at higher risk of developing Type 2 diabetes later on in life.
Less common types of diabetes include:
Monogenic diabetes syndromes: These are rare inherited forms of diabetes accounting for up to 4% of all cases. Examples are neonatal diabetes and maturity-onset diabetes of the young.
Cystic fibrosis-related diabetes: This is a form of diabetes-specific to people with this disease.
Drug or chemical induced diabetes: Examples of this type happen after organ transplant, following HIV/AIDS treatment, or are associated with glucocorticoid steroid use.
Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.
Who gets diabetes? What are the risk factors?
Factors that increase your risk differ depending on the type of diabetes you ultimately develop.
Risk factors for Type 1 diabetes include:
Having a family history (parent or sibling) of Type 1 diabetes.
Injury to the pancreas (such as by infection, tumor, surgery, or accident).
Presence of autoantibodies (antibodies that mistakenly attack your own body’s tissues or organs).
Physical stress (such as surgery or illness).
Exposure to illnesses caused by viruses.
Risk factors for prediabetes and Type 2 diabetes include:
Family history (parent or sibling) of prediabetes or Type 2 diabetes.
Being African-American, Hispanic, Native American, Asian-American race, or Pacific Islander.
Being overweight.
Having high blood pressure.
Having low HDL cholesterol (the “good” cholesterol) and high triglyceride level.
Being physically inactive.
Being age 45 or older.
Having gestational diabetes or giving birth to a baby weighing more than 9 pounds.
Having polycystic ovary syndrome.
Having a history of heart disease or stroke.
Being a smoker.
Risk factors for gestational diabetes include:
Family history (parent or sibling) of prediabetes or Type 2 diabetes.
Being African-American, Hispanic, Native American, or Asian-American.
Being overweight before your pregnancy.
Being over 25 years of age.
SYMPTOMS AND CAUSES
What causes diabetes?
The cause of diabetes, regardless of the type, is having too much glucose circulating in your bloodstream. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.
Causes of Type 1 diabetes
This is an immune system disease; Your body attacks and destroys insulin-producing cells in your pancreas. Without insulin to allow glucose to enter your cells, glucose builds up in your bloodstream. Genes may also play a role in some patients. Also, a virus may trigger an immune system attack.
Cause of Type 2 diabetes and prediabetes
Your body’s cells don't allow insulin to work as it should to let glucose into its cells. Your body's cells have become resistant to insulin. Your pancreas can’t keep up and make enough insulin to overcome this resistance. Glucose levels rise in your bloodstream.
Gestational Diabetes: Hormones produced by the placenta during your pregnancy make your body’s cells more resistant to insulin. Your pancreas can’t make enough insulin to overcome this resistance. Too much glucose remains in your bloodstream.
What are the symptoms of diabetes?
Symptoms of diabetes include:
Increased thirst.
Weak, tired feeling.
Blurred vision.
Numbness or tingling in the hands or feet.
Slow-healing sores or cuts.
Unplanned weight loss.
Frequent urination.
Frequent unexplained infections.
Dry mouth.
Other symptoms
In women
Dry and itchy skin, and frequent yeast infections or urinary tract infections.
In men
Decreased sex drive, erectile dysfunction, decreased muscle strength.
Type 1 diabetes symptoms
Symptoms can develop quickly – over a few weeks or months. Symptoms begin when you’re young – as a child, teen, or young adult. Additional symptoms include nausea, vomiting or stomach pains and yeast infections, or urinary tract infections.
Type 2 diabetes and prediabetes symptoms
You may not have any symptoms at all or may not notice them since they develop slowly over several years. Symptoms usually begin to develop when you’re an adult, but prediabetes and Type 2 diabetes is on the rise in all age groups.
Gestational diabetes: You typically will not notice symptoms. Your obstetrician will test you for gestational diabetes between 24 and 28 weeks of your pregnancy.
What are the complications of diabetes?
If your blood glucose level remains high over a long period of time, your body’s tissues and organs can be seriously damaged. Some complications can be life-threatening over time.
Complications include:
Cardiovascular issues include; coronary artery disease, chest pain, heart attack, stroke, high blood pressure, high cholesterol, atherosclerosis (narrowing of the arteries).
Nerve damage (neuropathy) causes numbing and tingling that starts at toes or fingers then spreads.
Kidney damage (nephropathy) can lead to kidney failure or the need for dialysis or transplant.
Eye damage (retinopathy) can lead to blindness; cataracts, glaucoma.
Foot damage includes nerve damage, poor blood flow, and poor healing of cuts and sores.
Skin infections.
Erectile dysfunction.
Hearing loss.
Depression.
Dementia.
Dental problems.
Complications of gestational diabetes.
In the mother: Preeclampsia (high blood pressure, excess protein in the urine, leg/feet swelling), risk of gestational diabetes during future pregnancies, and risk of diabetes later in life.
In the newborn: usually, High birth weights more than the normal are realized, low blood sugar (hypoglycemia), higher risk of developing Type 2 diabetes over time, and death shortly after birth occurs.
DIAGNOSIS AND TESTS
How is diabetes diagnosed?
Diabetes is diagnosed and managed by checking your glucose level in a blood test. There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test, and A1C Test
Fasting plasma glucose test: This test is best done in the morning after an eight-hour fast (nothing to eat or drink except sips of water).
Random plasma glucose test: This test can be done any time without the need to fast.
A1c test: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months.
This test measures the amount of glucose attached to hemoglobin, the protein in your red blood cells that carries oxygen. You don’t need to fast before this test.
Oral glucose tolerance test: In this test, the blood glucose level is first measured after an overnight fast. Then you drink a sugary drink. Your blood glucose level is then checked at hours one, two, and three.
Gestational diabetes tests: There are two blood glucose tests if you are pregnant. With a glucose challenge test, you drink a sugary liquid and your glucose level is checked one hour later. You don’t need to fast before this test. If this test shows a higher than normal level of glucose (over 140 ml/dL), an oral glucose tolerance test will follow (as described above).
Type 1 diabetes: If your healthcare provider suspects Type 1 diabetes, blood and urine samples will be collected and tested. The blood is checked for autoantibodies (an autoimmune sign that your body is attacking itself). The urine is checked for the presence of ketones (a sign your body is burning fat as its energy supply). These signs indicate Type 1 diabetes.
Who should be tested for diabetes?
If you have symptoms or risk factors for diabetes, you should get tested. The earlier diabetes is found, the earlier management can begin and complications can be lessened or prevented. If a blood test determines you have prediabetes, you and your healthcare professional can work together to make lifestyle changes (e.g. weight loss, exercise, healthy diet) to prevent or delay developing type 2 diabetes.
Additional specific testing advice based on risk factors:
Testing for Type 1 diabetes: Test in children and young adults who have a family history of diabetes. Less commonly, older adults may also develop Type 1 diabetes. Therefore, testing in adults who come to the hospital and are found to be in diabetic ketoacidosis is important. Ketoacidosis is a dangerous complication that can occur in people with Type 1 diabetes.
Testing for type 2 diabetes: Test adults age 45 or older, those between 19 and 44 who are overweight and have one or more risk factors, women who have had gestational diabetes, children between 10 and 18 who are overweight and have at least two risk factors for type 2 diabetes.
Gestational diabetes: Test all pregnant women who have had a diagnosis of diabetes. Test all pregnant women between weeks 24 and 28 of their pregnancy. If you have other risk factors for gestational diabetes, your obstetrician may test you earlier.
MANAGEMENT AND TREATMENT
Managing Diabetes
How is diabetes managed?
Diabetes affects your whole body. To best manage diabetes, you’ll need to take steps to keep your risk factors under control and within the normal range, including:
Keep your blood glucose levels as near to normal as possible by following a diet plan, taking prescribed medication, and increasing your activity level.
Maintain your blood cholesterol (HDL and LDL levels) and triglyceride levels as near the normal ranges as possible.
Control your blood pressure. Your blood pressure should not be over 140/90 mmHg.
You hold the keys to managing your diabetes by:
Planning what you eat and following a healthy meal plan. Follow a Mediterranean diet (vegetables, whole grains, beans, fruits, healthy fats, low sugar) or Dash diet. These diets are high in nutrition and fiber and low in fats and calories. See a registered dietitian for help understanding nutrition and meal planning.
Exercising regularly. Try to exercise for at least 30 minutes most days of the week. Walk, swim or find some activity you enjoy.
Losing weight if you are overweight. Work with your healthcare team to develop a weight-loss plan.
Taking medication and insulin, if prescribed, and closely following recommendations on how and when to take it.
Monitor your blood glucose and blood pressure levels at home.
Keeping your appointments with your healthcare providers and having laboratory tests completed as ordered by your doctor.
Quitting smoking (if you smoke).
You have a lot of control – on a day-to-day basis – in managing your diabetes!
PREVENTION
Can prediabetes, Type 2 diabetes, and gestational diabetes be prevented?
Although diabetes risk factors like family history and race can’t be changed, there are other risk factors that you do have some control over. Adopting some of the healthy lifestyle habits listed below can improve these modifiable risk factors and help to decrease your chances of getting diabetes:
Eat a healthy diet, such as the Mediterranean or Dash diet. Keep a food diary and calorie count of everything you eat. Cutting 250 calories per day can help you lose ½ pound per week.
Get physically active. Aim for 30 minutes a day at least five days a week. Start slow and work up to this amount or break up these minutes into more doable 10 minute segments. Walking is great exercise.
Lose weight if you are overweight. Don’t lose weight if you are pregnant, but check with your obstetrician about healthy weight gain during your pregnancy.
Lower your stress. Learn relaxation techniques, deep breathing exercises, mindful meditation, yoga and other helpful strategies.
Limit alcohol intake. Men should drink no more than two alcoholic beverages a day; women should drink no more than one.
Get an adequate amount of sleep (typically 7 to 9 hours).
Quit smoking.
Take medications – to manage existing risk factors for heart disease (e.g., high blood pressure, cholesterol) or to reduce the risk of developing Type 2 diabetes – as directed by your healthcare provider.
If you think you have symptoms of prediabetes, see your provider.
Can Type 1 diabetes be prevented? No. Type 1 diabetes is an autoimmune disease, meaning your body attacks itself. Scientists aren’t sure why someone’s body would attack itself. Other factors may be involved too, such as genetic changes.
Can the long-term complications of diabetes be prevented?
Chronic complications are responsible for most illnesses and death associated with diabetes. Chronic complications usually appear after several years of elevated blood sugars (hyperglycaemia). Since patients with Type 2 diabetes may have elevated blood sugars for several years before being diagnosed, these patients may have signs of complications at the time of diagnosis.
