Dreaming

ACORN Dreaming of acorns predicts pleasant things & that much gain is to be expected.
For a woman to dream of eating acorns denotes that she will rise to a position of ease & pleasure.

To dream of shaking acorns from a tree means that you will rapidly attain your wishes in business or love.

AIRPORT In a dream the sight of a busy airport represents the desire for freedom and/or travel.

If the airport is empty and deserted your own travel plans will be changed or delayed.

ALMONDS If you see almonds in your dream you'll have a temporary sorrow.

If you ate and enjoyed them, you'll be lucky, but if they tasted bitter, you should delay any contemplated changes for as long as possible.

ANGELS A favorable dream forecasting success, protection, happiness, and rewarding friendships.
BABY To see a baby in your dream signifies innocence, warmth and new beginnings. A love affair may be blooming for you in your near future. You will also make new and fun friends.

If a woman dreams she is nursing a baby, she will be deceived by the one she trusts the most


BALLOON Seeing balloons in your dream indicates a dashing of hope on any and all fronts, business or love, as well as a general falling off of all kinds of businesses you may be involved in.

If you are ascending in a balloon this is an omen of especially frustrating conditions in your life.

BEAR To dream of killing a bear foretells liberation from entanglements.
BED To dream of a clean, white bed denotes the end of worries.

If a woman dreams of making a bed, there will soon be a new lover in her life.

BICYCLE To dream of riding a bicycle uphill signifies bright prospects.

To dream of riding downhill calls for care - misfortune is near.

BIRDS Flying birds are a sign of prosperity to the dreamer.
BIRTH If you dream of death it's a sign of a birth, if you dream of birth, it's a sign of death.
BUTTERFLY To see a butterfly among flowers indicates prosperity.

To see butterflies flying around denotes news from absent friends by letter or from someone who has seen them.

CANDLES To see candles burning with a clear and steady flame denotes the constancy of those around you and a well-grounded fortune.
CATS Dreaming of a cat is a generally unfortunate omen and it shows treachery as well as a run of bad luck.

Cats attacking you represent enemies; if you succeed banishing them you will overcome great obstacles and rise in fortune and fame.

CROW Seeing a crow in your dream means disappointment in everything, grief and misfortune.
CROWN To dream of a crown predicts a change in your life. The dreamer will travel a long distance from home & form new relationships.
DEATH
If you dream of death it's a sign of a birth, if you dream of birth, it's a sign of death.
DANCING To dream that you are dancing means that some unexpected good fortune will come to you.
DECEASED PERSON If you should dream of a deceased person and this person speaks only to you, pay close attention to what the spirit is telling you as it could be very important to you.

To dream of seeing a deceased person is normally a dream of warning, and it tells you that the influences around you at this time do not bode well for your affairs, and you should not enter into any binding contracts or verbal agreements.

DIAMONDS To dream of owning diamonds is a very promising dream signifying great honor and recognition from high places.
DOG To dream about a dog indicates great gain and constant friends.

To hear the barking of dogs foretells news of depressing nature. Difficulties are more likely to follow.

DRAGONFLY If you dream that a dragonfly lands on your body then you will have excellent news from someone far away from home.

If you see a dead dragonfly, then the news will be bad.

A dragonfly perched gracefully on some other object shows that you will soon be having guests that may be hard to get rid of.

DRIVING If you dream that you are driving a vehicle it is a sign that you should be careful to take no chances with your money, such as gambling, in the next two weeks or so.

If someone else is doing the driving you will find yourself in luck, money wise.

FACE To dream of a smiling face signifies pleasant new friends, experiences, and/or financial gains.

To dream of unpleasant or grotesque (unless amusingly so) faces portend loss.

To dream you are washing your face denotes a necessity to atone for some past indiscretion; better make amends!

To see the faces of strangers signifies an approaching change of residence.

FALLING To dream of falling indicates a loss of emotional equilibrium or self-control. It may represent your insecurity, a lack of self-confidence, a fear of failure or an inability to cope with a situation.

If you fall a long distance in your dream and get hurt, be prepared for really hard times ahead; but if you fall and are not injured your upsets will be minor and temporary.

Death can appear in dreams

Death

Death can appear in dreams in many forms ranging from the near-death experience to wish-fulfillment projected on others. It may seem to be terrifying, or almost joyful in its sense of power.
The near-death experience can be either a psychological phenomenon or a physical one. The physical phenomenon comes from lucid dreaming in a nightmare condition. You may become aware of the body paralysis of the REM state and feel powerless to defend yourself in the dream. This can create an overwhelming sense of vulnerability to the threatening circumstances of the dream and a near-death experience.

The psychological facet is part and parcel of feeling endangered by your circumstances. This danger may be tangible or merely sensed in the dream. If it is tangible, the source of the danger is the area for interpretive work (whom, why, how, and what has endangered your life?). If the danger is merely sensed, it may symbolize ambivalence concerning a soul's transition into facets of self-awareness you may not want to completely embrace.

There is also a spiritual near-death experience. People who participate in actively seeking out-of-body experiences in dreaming may feel themselves unable to, or prevented from, returning to the body. These dreams are powerful images of how we sense the cosmos or spiritual realities impacting upon our lives.

Was the death a sudden deprivation of life or a release from the struggles of it? Moreover, as you became aware of dying, was it threatening or peaceable?

Death of self, loved one, or stranger. Dying in a dream is not too unusual, though if it happened with regularity our waking lives would probably begin to feel a little unstable. Often, derealization (see movies) accompanies death so your dream can continue with your observation. Otherwise, death is the wake-up point.

To die yourself is very troubling. Most people have not invested much emotional energy in preparation for death and feel that death is a strong enemy to be avoided. Being confronted with death is a place that is uncomfortable. By the way, how did you die in your dream and do you assign responsibility to anyone for your death? These are important questions.

The death of a loved one may be the result of numerous factors. You may feel genuine anxiety for that person's well-being. The death may be more symbolic than that as you struggle with the reality of your love for that person as weighed against repressed anger towards them. Finally, it may herald the passing of the relationship if the loved one is romantic and not familial in connection.

The death of a stranger can be the development or transition of different aspects of the self. Consequently, it is often useful to decide how you knew the stranger and whether you seemed deeply moved or only casually concerned with the death. It may be that the randomness of life in the central concern. In this case, looking at who else in the dream is concerned with the stranger's death and your connection to the fellow mourners is important. The death of a stranger may symbolize stereotypes that need to be rethought or explored as a means to a greater self-understanding. Are you being confronted with situations where your attitudes about others are being challenged?

The interpretation of the dream of death could be one of many things

The interpretation of the dream of death could be one of many things. Most people think right off the bat dreaming of death is a bad thing, but in most cases it is not bad at all. Death means in most cases the ending to something in one’s life. It could be the end of a long family battle or the end of a long sickness. It is a very common dream. Something that perhaps has been dragging along in one’s life, such as the coming to an end of a career could finally be ending with the dream of death. Other things it could possibly be would be an ending to a relationship. In most cases the relationship or career is making the person unhappy or not a good situation.


Other possibilities of the interpretation of death could be the ending to one thing with the beginning of another. Things could be a relationship again or a career, with the

start of something new and fresh. The symbolism of death is most always a positive thing. There are a few cases when it really means that death is going to happen, but usually it means the rebirth of something better. It could also mean that it could be the end of a person’s worries. The worries will die in a sense. The cause of the worry will cease to exist. Another possible meaning could be of prosperity and longevity.



There could be some negative possibilities however. Dreaming of death could mean a person has a fear of losing something. Not necessarally a person or pet though. It

could be the loss of a relationship or a job. Also the just fear of having already lost something. It could be a personal item of great sentimental value or again a relationship or a job. Dreaming of death could be a sign of pet up anger towards a person. In this case the person needs to address the anger and realize why they are angry and at whom. Negative feelings about someone or something could also the result of dreaming of death.


In any case, dreams are a person’s subconscious way of talking to the inner self. If the dreams bother a person or they are reoccurring, they should be looked into and

addressed. If the dream is simply ignored, there is a loss of self-awareness.

Healthy Dating & Relationship Tips

Healthy Dating & Relationship Tips

Grab your partner!

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Healthy Dating and Relationship Tips?
Ann Landers? Dear Abby?
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Ever have a little difficulty with dates - -finding them, keeping them, communicating with them? Or how about relationships in general – how to tell if you’re in a good one or bad one? Or maybe you know someone else who struggles with these issues?

How about any of the issues below? Ever have to deal with them?

• A is for Acceptance Issues – You wish you could change someone. Or they want to “change” you.
• B is for Burnout Issues – You wonder about how to carry out romance long-term…
• C is for Compatibility Issues – Opposites attract, don’t they?
• D is for Dependable – Friend should be dependable, right?
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Let’s face it. There’s an old saying about a dog being “man’s best friend.” So getting along with another human being is rated second, at best.

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- You both disagree 180-degrees on important issues; politics, religion, state of the economy, etc. But “love conquers all,” right?

- You apologized for being late on the first date, re-scheduling the second date, scheduling the reservation at the wrong time on the third date….but “love is blind,” right? The other person should have endless patience?

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1. All we need is love. Fact or Fiction?

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Evaluating Health Information:A Guide for Health Professionals

Evaluating Health Information:
A Guide for Health Professionals

Books, magazines and the Internet are three major sources of information about health, but just because the information is published doesn’t mean that it’s reliable. Sometimes a book or web site that looks trustworthy is based on opinions rather than facts, and sometimes the information is just plain wrong! With so much information out there, how do you decide what to believe? This guide is designed to help you examine health information so you can decide whether or not the information is reliable or not.

1. Question the source of the information-Here are some questions to help you decide if the information is biased:

Who created the information? Are they trying to promote a product or idea?
Is there advertising presented along with the information? Is a variety of information presented, or just one point of view?
Is the information from a medical or health-related organization? If not, what is the author or organization’s reason for publishing health information?
2. Information seems unbiased but is it reliable?-Other things to consider:

Is it easy to find out who created the information? The author and/or organization should be clearly identified, and contact information should be available. Is the site professionally managed and reviewed by experts in the field?
Is the information clearly organized? If you are looking at a web site, do the links work?
Is the information up-to date? Look for a date of publication. Health information and treatments change all the time, so old information may no longer be accurate.
Who is the information created for? Information should be age appropriate. For example, if intended for teens, it should be teen friendly and at a much lower reading level than if created for adults.
Does the site have sponsors? All sponsorship, advertising, or commercial interests should be clearly stated.
3. Check links and more links-Not only do you want to be sure that the links work, it is very important to know where the link goes to. Some sites provide a direct connection with sites that in turn link to inappropriate sites. Rule of thumb is to check 3 generations of links.

4. Don’t be fooled by web sites claims-Be alert to web sites that credit themselves as the only source of the information or if the site blatantly discredits other sources of information.

5. Use common sense-If the information appears unprofessional or sketchy, it probably is. Compare the information you find on a web site with information from other reputable sites.

6. Don’t recommend web sites that you haven’t visited-Take the time to check out a reference before recommending it. In the long run, it’s important to know if the advice you are giving is credible. Your best bet is to look for information that is published by medical societies, health care organizations, or nonprofit organizations that are devoted to helping people.

7. Encourage teens and parents to discuss information they have found online-Assist adolescents and their families to identify the resources they have used to gather information. This will help you to understand their attitudes about their illness and treatment plan. Provide reliable information that is clear and easy to understand. Be sure to reinforce that the information they read should not replace ongoing communication with their health care provider!

Headaches: tension

Headaches: tension

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Tension headaches usually begin with a dull, aching pain on both sides of the head that gradually increases in severity. A tension headache is often described as, "My head feels like it is in a vise." The pain is usually worse at the back of the head. Tension headaches may recur for many days on end and are often triggered by stress, fatigue, or noise.
These headaches are quite common. It is not easy to determine just what causes them in any one person. Muscle tension plays a role, as do the day-to-day pressures of life. Researchers now believe changes in the levels of certain chemicals in the brain can cause tension headaches.

Tension headaches may be triggered by:

tiredness or fatigue
eating too little or too much
work stress
eyestrain
poor posture
noise
lack of exercise
major life changes
depression or anxiety or
injury, such as a car accident
Over-the-counter medicines may be used to relieve the pain, however, carefully review the label directions and precautions for other health considerations before taking these medications. Contact your physician before taking any pain relievers if you have high blood pressure.

It is important to relieve tension and remove the stressors from your life. If simple self-care measures do not help, a healthcare provider can prescribe a medication that may help control the pain associated with a tension headache. Unusually severe headaches, or headaches associated with changes in nerve or muscle function, should be evaluated right away.

Self-care to prevent and relieve muscle-tension headaches:

identify and avoid those things that cause you stress
rest in a quiet setting until symptoms improve
avoid tobacco and alcohol use
eat regular, healthy meals
get regular exercise and adequate sleep
learn to use relaxation techniques and
take time out for fun
One or more of these will usually help. More often, we must learn ways to cope with preventing a tension headache.

What are the treatment options for girls with PCOS?

What are the treatment options for girls with PCOS?

The most common form of treatment for PCOS is the birth control pill.Even if a young woman is not sexually active, her health care provider may prescribe birth control pills because they contain the hormones that her body needs to treat her PCOS. The birth control pill may be prescribed continuously or cyclically. The birth control pill works by:

Correcting the hormone imbalance
Lowering the level of testosterone, which will improve acne and lessen hair growth
Regulating her menstrual periods
Lower the risk of endometrial cancer (which is higher in young women who don’t ovulate regularly)
Preventing an unplanned pregnancy, if she is sexually active
Are there any other medications used to treat PCOS?

Yes. A relatively new medicine which helps the body lower the insulin level is called metformin. It is particularly helpful in girls who have high levels of insulin or have pre-diabetes or diabetes. It is necessary for a young woman to have her kidney and liver function checked before taking this medication. Since this medicine isn’t appropriate for everyone, it is important to encourage a young woman to ask her doctor whether this medicine is right for her. Because a young woman may ovulate while on this medication, she will also need to use birth control if she is sexually active. Alcohol should be avoided when taking metformin. Some young women may be treated with both metformin and birth control pills at the same time.

What about treating excess hair growth?

Treatment is individually based. Options may include bleaching, waxing, depilatories, spironolactone, which is a prescription anti-hair growth medication, electrolysis, and laser treatment. A young woman may require help finding a local salon that provides high quality, cost-effective services that can help her to choose the right option for her.

Are there any special treatments for acne associated with PCOS?

There are various ways to treat acne in general, including the birth control pill, topical creams, oral antibiotics, and other medications. These treatments are not necessarily specific to PCOS. Studies have shown that when insulin and glucose levels are controlled and ovulation resumes, acne and other skin conditions may improve greatly.

What about weight loss plans?

Losing excess weight when someone is overweight may reduce some of the symptoms of PCOS. It is often beneficial for a young woman with PCOS to talk to her health care provider or nutritionist about healthy ways to lose weight and increase her exercise. Following a nutrition plan that helps manage insulin levels may help girls with PCOS manage their weight too. It also keeps the heart healthy and lowers a girl’s risk of developing diabetes. Encourage the young woman with PCOS to:

Choose nutritious, high-fiber carbohydrates instead of sugary carbohydrates
Balance carbohydrates with protein and healthy fats
Eat small meals and snacks throughout the day instead of large meals
Exercise regularly to help manage insulin levels and your weight
Is it normal for a young woman with PCOS to feel concerned about her health?

When a teen or a young woman is initially diagnosed with PCOS, she often feels confused. It is a difficult diagnosis to comprehend and the symptoms are distressing. Girls may also feel frustrated and/or sad if they are having a hard time losing weight, dealing with acne, excess body hair, and menstrual irregularities. When a health care provider takes the time to explain what PCOS is and offers treatment options, a young woman may feel relieved that at last there is an explanation and treatment for the problems she has been suffering with. Having a diagnosis without an easy cure can be difficult. However, it is important for girls with PCOS to know they are not alone. Finding a doctor who knows a lot about PCOS and who they feel comfortable talking to is very important. Keeping a positive attitude and working on a healthy lifestyle even when results seem to take a long time is very important too! Many girls with PCOS tell us that talking with a counselor about their concerns can be very helpful. Other girls recommend Internet chats such as: www.youngwomenshealth.org/chat.html

Is there anything else I should know?

It is important that girls with PCOS follow-up regularly with their doctor and take their medication. The prescribed treatment will regulate her periods and lessen her chance of getting diabetes and other problems. Because young women with PCOS have a slightly higher chance of developing diabetes, her doctor may suggest that she have her blood sugar tested once a year or have a glucose challenge test every few years. Girls who are on hormonal pills to treat PCOS and who smoke should receive counseling on smoking cessation.

Reminding girls with PCOS about the benefits associated with good nutrition and physical exercise is the first step in helping them take charge of their health. Understanding and learning more about PCOS will help you to be supportive to the many teens and young women dealing with this challenging health problem. Offering resources such as educational websites and monitored Internet chats can provide much needed support

A Guide for School Nurses, Health Educators, and Others

Understanding Polycystic Ovary Syndrome (PCOS) in Teens:
A Guide for School Nurses, Health Educators, and Others

Polycystic Ovary Syndrome (PCOS) is the most common reproductive endocrine disease among women of childbearing age. Although this condition has not received much publicity, it impacts many young women. In fact 5-10% of teens and young women have this diagnosis. The most common symptoms are irregular periods, weight gain, acne, and excess facial and body hair. The severity of the symptoms varies from girl to girl. Most young women are generally distressed with how the symptoms impact their life and self esteem. Having an understanding of this disease, the etiology, current trends in medical treatment, and the important role of good nutrition and exercise will help you to support teen girls with PCOS.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. The name “Poly”, meaning “many”, and “Cystic”, meaning “cysts”, refers to the fact that those with PCOS may have enlarged ovaries that contain many very small cysts. These small cysts also called follicles develop in the ovary but the eggs are only rarely released. The outer wall of the ovaries thickens giving the ovary a polycystic appearance. These cysts are not cancerous and do not need to be surgically removed. It is not uncommon for girls with PCOS to have normal appearing ovaries but still have an imbalance in their hormone levels. Generally, symptoms of PCOS begin during the teenage years around the start of menstruation and can be mild or severe. The extent of symptoms and their severity varies significantly among young women. What most health care providers will agree on is that young women with this disorder have irregular menstrual cycles and they have higher than normal levels of androgens (male hormones) in their blood.

What are the signs of PCOS?

Young women with PCOS commonly have one or more signs. Some of the most common signs include:

Irregular periods—periods that come every few months, not at all, or too frequently
Hirsutism—extra hair on the face or other body parts
Acne
Weight gain and/or trouble losing weight, and in some cases, obesity
Patches of dark skin on the back of the neck and other areas, called “acanthosis nigricans”
Infertility or impaired fertility due to irregular periods or lack of ovulation
Other less common signs/symptoms may include:

Hair thinning (on the top of the head)
Skin tags under the armpits or neck area
High total cholesterol and/or low HDL “good cholesterol”
High blood pressure
Pre-diabetes or in some cases, diabetes
Can you tell if a young woman has PCOS?

If a teen or young woman you know has 2 or more of the above symptoms, she could have PCOS. There can be other reasons for these symptoms and therefore only a health care provider can tell for sure. If the young woman is distressed about the symptoms she is experiencing, you should suggest that she see her primary care provider. While she is waiting for her appointment, you can advise her to keep a log of her menstrual cycles and symptoms. She should bring the log with her when she meets with her provider. After an initial evaluation is completed, she may be referred to an adolescent gynecologist, or an endocrinologist for further testing.

What causes PCOS?

PCOS is caused by an imbalance in the hormones secreted by the pituitary gland that in turn affects the ovaries. Many girls with PCOS also have higher than normal levels of insulin from the pancreas. PCOS usually happens when the luteinizing hormone (LH) levels or the insulin levels are too high, which results in extra testosterone production by the ovary.

Stress is defined as a feeling of emotional or physical tension

Stress is defined as a feeling of emotional or physical tension. Emotional stress usually occurs when situations are considered difficult or unmanageable. Therefore, different people consider different situations as stressful.

Physical stress refers to a physical reaction of the body to various triggers. The pain experienced after surgery is an example of physical stress. Physical stress often leads to emotional stress, and emotional stress is frequently experienced as physical discomfort (e.g., stomach cramps).

Stress management refers to various efforts to control and reduce the tension that occurs in stressful situations (see also Stress in Childhood).

Information Return to top

Stress management involves making emotional and physical changes. The degree of stress and the desire to make the changes will determine the level of change that will take place.

ASSESSING THE EXISTENCE OF STRESS

Attitude: The attitude of an individual can influence whether a situation or emotion is stressful or not. Having a negative attitude can predict stress in a person, because this type of person will often report more stress than would someone with a positive attitude.

Physical well-being: A poor diet places the body in a state of physical stress and a weakened immune system. As a result, the person can be more susceptible to infections. A poordiet can be related to unhealthy food choices, not eating enough, or an unpredictable eating schedule. A nutritionally unbalanced eating pattern can result in not getting enough nutrients.

This form of physical stress also decreases the ability to deal with emotional stress, because malnutrition will affect the way our brain processes information.

Physical activity: Not enough physical activity can result in a stressful state for the body. Physical activity has many benefits. A consistent program of physical activity can contribute to a decrease in depression, if it exists. It also improves the feeling of well-being.

Support systems: Most everyone needs someone in their life whom they can rely on when they are having a hard time. Minimal or absent support systems make stressful situations more difficult to deal with.

Relaxation: People with no outside interests, hobbies, or means of relaxation, may be unable to handle stressful situations because they have no outlet for stress.

AN INDIVIDUAL STRESS MANAGEMENT PROGRAM

Positive thinking.
Refocus the negative to be positive.
Make an effort to stop negative thoughts.
Plan some fun. Take a break.
Physical activity:

Start an individualized program of physical activity. Most experts recommend doing 20 minutes of aerobic activity 3 times per week.
Decide on a specific time, type, frequency, and level of physical activity. Make this dedicated time fit into your schedule so it can be part of your routine.
Find a buddy to exercise with -- it is more fun and it will encourage you to stick with your routine.
You do not have to join a gym -- 20 minutes of brisk walking outdoor will do the trick.
Nutrition:

Plan to eat foods that improve health and well-being. For example, increase the amount of fruits and vegetables you eat.
Use the food guide pyramid to help make healthy food choices.
Eat an appropriate amount of food at a reasonable schedule.
Social support:

Make an effort to interact socially with people. Even though you feel stressed, you will be glad to have gone out to meet your friends if only to get your mind off of things.
Reach out to individuals.
Nurture yourself and others.
Relaxation:

Learn about and try using one or more of the many relaxation techniques, such as guided imagery, listening to music, or practicing yoga or meditation. One or more should work for you.
Take time for personal interests and hobbies.
Listen to your body.
Take a mini retreat.

A healthy weight for a healthy back

A healthy weight for a healthy back
Experts agree that the best way to achieve and maintain a healthy weight level is through a balanced diet and exercise. For people with many types of back problems, regular exercise and, when necessary, weight loss, can help ease existing back problems and prevent future ones.

Obesity and extra weight can cause low back pain
Along with other health issues that arise from having an unhealthy weight level, obese and overweight patients have an increased risk for back pain, joint pain and muscle strain (1). In particular, overweight patients are more likely to experience problems in their low back than patients at a healthy weight level. This is especially true for people with extra weight around their midsection as the extra weight pulls the pelvis forward, strains the low back and creates low back pain.

In addition to muscle strain, spinal structures such as the discs can be negatively impacted by obesity. Patients with significant excess weight also may experience sciatica and low back pain from a herniated disc or from a pinched nerve if the discs have been damaged from compensating for the extra weight (2).

Weight loss can lower risk for other back problems
Managing weight through nutrition, diet and exercise not only reduces existing back pain, but can also help prevent certain types of back problems in the future. For example, overweight and obese patients have an increased risk for osteoarthritis. The additional strain on the joints from the excess weight can cause arthritis in patients whose Body Mass Index (BMI) is too high. For patients who already have osteoarthritis, weight loss is one of the recommended treatments (3).

In addition, successful recovery from back surgery may also be affected by a patient’s weight because obese patients run a higher risk of complications and infections from surgery (3). As a result, overweight or obese patients may consider weight loss before major surgery in order to improve their outcome as well as to avoid contributing to further back problems.

For more information about how obesity affects back health and tips for weight loss, please see Weight loss for back pain relief.

Exercise helps with weight loss and back pain
Maintaining a healthy weight usually helps patients to be more consistent with exercise. This is because overweight patients often have fatigue, difficulty breathing or shortness of breath as they exercise, which may cause them to avoid regular physical activity (3).

As a general rule, many patients with back problems believe that they should avoid all exercise in an effort to protect their back from further injury or back pain. However, in reality, inactivity and lack of exercise can actually contribute to future pain and worsen existing problems. Patients are often unaware that movement through gentle exercise stimulates healing and a flow of nutrients within the spine. This is especially important for the discs in the spine. Physical activity causes the discs to swell with water and then squeeze it out, which exchanges nutrients between the discs and other spinal structures. When the patient does not engage in enough physical activity, the spinal discs are deprived of the nutrients they need to stay healthy and functional. The importance of physical activity is explained further in Exercise and fitness to help your back.

Developing a safe weight loss, diet and exercise program
The key to a healthy diet and good nutrition is balance. Patients should consume adequate amounts of vitamins and nutrients but should avoid exceeding the daily intake recommendations for some. Consuming a balanced amount of recommended vitamins and nutrients is also important because certain nutrients and vitamins work in concert while others work against each other. A balanced diet should include a range of healthy foods and, if appropriate, nutritional supplements.

Because of the complexities of developing a healthy diet, exercise and weight loss program, patients should always consult a health professional before starting an exercise routine, changing their diet or taking nutritional supplements. The health professional should help the patient determine any potential limitations and guidelines to follow specific to his or her back problem. With attention to the nutritional content and quantities of food consumed, combined with gentle exercise to control weight, patients will enjoy better back health as well as improved overall health.

Composition of a high-quality mattress

Composition of a high-quality mattress
Understanding mattress features
Choosing a new mattress that is comfortable, supportive, high-quality and high-value is important for patients with low back pain. Major sales, rebates, promotions, special features and advertising can make shopping for the right mattress a challenge.

However, by understanding the physical composition of a mattress, patients can accurately evaluate and compare mattresses. Some mattress stores will offer cutaway views of mattress interiors, a good way to gauge mattress quality. When this option is not available, patients should be prepared to ask questions about the interior of the mattress.

Key components of a good mattress
The following physical components are the important features of most high-quality mattresses.

Mattress springs and coils provide back support. A common type of mattress contains spring coils in various arrangements to give firmness for back support. The wire in the coils comes in different thicknesses, where a lower gauge number denotes thicker, stiffer wire and a firmer mattress (2). More steel coils may indicate a higher-quality mattress, but patients should still use their own judgment for what mattress is best suited to provide support and help alleviate their low back pain.
Mattress padding provides comfort. In addition to the spring coils in a mattress, the padding on top of the mattress is another factor that can indicate quality. Mattress padding is usually made of materials including polyurethane foam, puffed-up polyester or cotton batting (2). Extensive mattress padding is often more expensive, but patients may find it more comfortable and more effective in alleviating their low back pain.
Middle padding in a mattress: This type of mattress padding is just below the quilted top layer and is usually made with foam. When looking at a cross-section of the mattress, softer foams feel almost moist to the touch while firmer foams won’t spring back as quickly (1). The next layer of mattress padding is made of cotton batting that may vary in thickness across different mattresses and even within one mattress. This causes the mattress to feel firmer in some areas rather than others, such as increased firmness in the middle of the mattress (2).
Insulation mattress padding: Thispaddinglies on top of the coil springs so that they cannot be felt from on top of the mattress and also protects the coils from damaging the top layers of the mattress (2).
Mattress ticking and quilting: The outer layer of a mattress consists of ticking, which is usually a polyester or cotton-polyester blend in a good-quality mattress. The mattress quilting attaches the ticking to the top layers of padding. Shoppers should examine the quality of stitching on the mattress quilting, looking for consistent, unbroken stitches (2).
Mattress foundations: The mattress foundation or box spring adds another level of back support to the mattress. Foundations usually consist of a wooden or metal frame with springs. A plain wooden frame may make mattresses feel harder than a frame with springs. A wood mattress foundation should only be purchased if the wood has no cracks and is straight. The Better Sleep Council recommends that purchasing a foundation and mattress as a set maximizes the life of the mattress (1).
Foam mattresses: Other types of mattresses are constructed from memory foam or latex foam. They can be purchased in different densities. Some foam mattresses are made of multiple layers of foam adhered together while others have a foam core in the center. Foam mattresses come in various degrees of firmness to give patients greater selection for back support and back comfort.
Asking questions, requesting written product information and examining each mattress thoroughly will help patients become more educated consumers. By following the practical guidelines for selecting a new mattress, patients will be well-equipped to find the best mattress for sleep comfort, back support and reducing low back pain.

Understanding osteoarthritis of the spine

Understanding osteoarthritis of the spine
Arthritis and osteoarthritis introduction
“Arthritis” is a general term that describes many different diseases causing tenderness, pain, swelling, and stiffness of joints as well as abnormalities of various soft tissues of the body. Of the combined term, “arthros” means a joint and its attachments, and “–itis” means inflammation. Various forms of arthritis affect nearly 50 million Americans and contribute to the majority of all physical disabilities. Although arthritis is ultimately associated with a wearing out of joints, nearly a half million children are also affected.

Of the several varieties of arthritis, the most common, the most frequently disabling, and often the most painful is osteo- (meaning bone) arthritis, mostly affecting the weight bearing joints (hips and knees) plus the hands, feet and spine. Normal joints are hinges at the ends of bones usually covered by cartilage and lubricated inside a closed sack by synovial fluid. Normally, joints have remarkably little friction and move easily. With degeneration of the joint, the cartilage becomes rough and worn out, causing the joint halves to rub against each other, creating inflammation with pain and the formation of bone spurs. The fluid lubricant may become thin and the joint lining swollen and inflamed.

Osteoarthritis is also known as degenerative joint disease and affects up to 30 million Americans, mostly women and usually those over 45 or 50 years of age. All races in the U.S. appear to be equally affected. This article focuses on osteoarthritis of the spine, particularly on facet joint arthritis.

Where osteoarthritis occurs
Cartilage is a form of usually slick, slightly elastic, connective tissue that covers the ends of the bone joints. In part, cartilage serves as a protective shock absorber to minimize the impact of bouncing, jumping and other types of daily activities on the joints – and is thus subjected to considerable wear and tear during life. Indeed, heavy work, sports, repeated injuries and obesity take a heavy toll on the joints of the limbs and spine. To be healthy, all joints should be exercised, but if this is excessive, joint damage may accumulate slowly. In addition to the hips, knees and lower back, arthritis commonly occurs in the neck, small finger joints, the base of the thumb, and the big toe. In the fingers, nodes (masses of bone and cartilage) can form on either side of the nail bed or the margins of joints to become reddened, tender and swollen. Cartilage breakdown in the hips and knees can be severe enough to require joint replacement. Osteoarthritis found in other joints, such as the hinge of the jaw, is often due to injury or stress.

Osteoarthritis of the spine
Spinal arthritis is one of the common causes of back pain. Spinal arthritis is the mechanical breakdown of the cartilage between the aligning facet joints in the back portion (posterior) of the spine that quite often leads to mechanically induced pain. The facet joints (also called vertebral joints or zygophyseal joints) become inflamed and progressive joint degeneration creates more frictional pain. Back motion and flexibility decrease in proportion to the progression of back pain induced while standing, sitting and even walking. Over time, bone spurs (small irregular growths on the bone also called osteophytes) typically form on the facet joints and even around the spinal vertebrae. These bone spurs are a response to joint instability and are nature’s attempt to help return stability to the joint. The enlargement of the normal bony structure indicates degeneration of the spine. Bone spurs are also seen as a normal part of aging and do not directly cause pain, but may become so large as to cause irritation or entrapment of nerves passing through spinal structures, and may result in diminished room for the nerves to pass (spinal stenosis).

Osteoarthritis in the spine is anatomically divided into:

Lower back (lumbar spine) osteoarthritis, sometimes called lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and pelvis).

Neck (cervical spine) osteoarthritis, sometimes called cervical spondylosis (spondy- implies the spine, and –osis is an abnormal condition), which can cause stiffness and pain in the upper spine, neck, shoulders, arms and head.

Causes of osteoarthritis and spinal arthritis
There are a number of reasons why some people are particularly disposed to osteoarthritis. However, as with nearly all abnormal conditions affecting the body, it is likely that a combination of risk factors work together to cause osteoarthritis. As indicated above, repetitive trauma to the spine from repetitive strains caused by accidents, surgery, sports injuries, poor posture, or work-related activities are common causes of spinal arthritis. Therefore, athletes and people with jobs that require repetitive, and particularly heavy, motion have been found to be at greater risk. Other known risk factors for developing spinal arthritis include:

Aging: steady and advanced aging of spinal structures, beginning in the 30’s, often work-related

Gender: osteoarthritis being more common in post-menopausal women (although below age 45, it is more common in males)

Excess weight: causing more stress on weight-bearing joints and the spine, particularly during the middle age years

Genetics: having a family history of osteoarthritis or congenital defects of joints, spine, or leg abnormalities

Associated diseases: the presence of other associated diseases, infections, diabetes, and various other forms of circulating arthritis, such as rheumatoid arthritis or gout

When a specific cause of the osteoarthritis is unknown, as it is in most cases, it is referred to as primary osteoarthritis, which appears to be mostly due to aging. Aging leads to changes in cartilage and synovial fluid - the tissue water content increases as the protein content decreases. Long term repetitive joint use has been shown to lead to joint inflammation with associated joint pain and swelling, eventually leading to the loss of cartilage.

When the cause of the osteoarthritis is known, it is referred to as secondary osteoarthritis, caused by a particular disease or condition, such as obesity, trauma or surgery to the joints, or abnormal joints at birth.

Patients with osteoarthritis who take an active role in their own treatment can prevent additional joint damage and usually will be able to continue with most of their normal activities. The key to managing the condition is to get an accurate diagnosis and start early, proactive treatment. Most osteoarthritis treatments are focused on reducing the pain and inflammation associated with osteoarthritis and maintaining the joint mobility and flexibility needed to continue with necessary and desired activities. It is clear that a combination of proper exercise, joint mobility, weight control, nutrition and use of appropriate medication is required to control osteoarthritis

Choosing the best mattress for low back pain

Choosing the best mattress for low back pain

Benefits of a good mattress
Sleeping on the wrong mattress has negative consequences for low back pain. A mattress lacking in back support reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which can increase low back pain. The patient also sacrifices sleep comfort if they do not choose a mattress that matches their individual preferences. A mattress that provides both sleep comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

With the variety of mattresses on the market, choosing the right mattress for sleep comfort and back support can be a confusing decision. For people with low back pain, it’s definitely worth it to take time to select the best mattress for their back.

The best mattress for patients with low back pain
The following practical guidelines are designed to help patients with low back pain choose the best mattress for back support and sleep comfort.

Personal preference should ultimately determine what mattress to purchase. Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. There is no single mattress that works for all people with low back pain. Patients should choose the mattress that meets their standards for comfort and support and allows them to get a good night’s sleep.

Understand and inquire about the physical components of the mattress. The coils or inner springs inside a mattress provide back support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress provides comfort and comes in many different thicknesses. Mattresses depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by the patient’s preferences for back support and sleep comfort.

Find a mattress with sufficient back support to reduce low back pain. A good mattress should provide support while allowing for the natural curves and alignment of the spine. Proper back support from the mattress also helps the patient avoid muscle soreness in the morning. A recent study indicates that medium-firm mattresses usually provide more back pain relief than firm mattresses. See Study on the best types of mattress for back support for more information.

Achieve a balance between back support and sleep comfort when buying a mattress. Overall comfort while sleeping on the mattress is equally important as sufficient back support. Sleeping on a mattress that is too firm can cause aches and pains on pressure points. A medium-firm mattress may be more comfortable because it allows the shoulder and hips to sink in slightly. Patients who want a firmer mattress for back support can get one with thicker padding for greater comfort. Choosing a good pillow is another important factor for sleep comfort.

Know when it’s time to get a new mattress. If an old mattress sags visibly in the middle or if the patient is no longer sleeping comfortably on the mattress, it is probably time to purchase a new one. Putting boards under a sagging mattress is only a short-term fix and may cause more back problems and low back pain in the long run. If the old mattress is still comfortable for the patient, he or she may choose to wait before buying a new one.

Shop for the best value and quality of the mattress rather than for price. Finding a high-quality mattress is usually worth the investment, considering the effect a mattress can have on low back pain and sleep comfort. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive. However, a higher price is no guarantee that the mattress is more comfortable or more supportive than a less expensive mattress. Mattress stores often have sales and promotions, so it may pay off to comparison-shop for the best price after finding the right mattress.

Be aware of mattress advertising gimmicks. Claims that a mattress is “orthopedic” or “medically-approved” should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual patient must determine whether or not extra features on a mattress make it more comfortable or supportive for the back.

Give the mattress a test-run before buying. Patients can try sleeping on different makes and models in hotels or at other people’s homes before going to a mattress store. When shopping at the store, shoppers should lay on the mattress with their shoes off for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress. Testing a variety of mattresses is necessary because mattress companies use different ratings of firmness and padding.

Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, removal of old mattresses and especially the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).

Take good care of the new mattress. It is recommended that owners reposition their mattress every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises that putting a mattress on a box spring/foundation that is not made to go with the mattress may decrease the life of the new mattress (1).

Breast-fed babies are better able to cope with stress later in life than babies who are bottle fed

Breast-fed babies are better able to cope with stress later in life than babies who are bottle fed, according to a U.K. study.

Researchers analyzed data on almost 9,000 children at birth, and at ages 5 and 10. The information about the children was gathered from parents, teachers, health workers and midwives.

When the children were 10 years old, their teachers were asked to rate the children's anxiety levels, and their parents were interviewed about major family disruption -- such as divorce or separation -- that occurred when the child was between 5 and 10 years old.

Not surprisingly, high anxiety levels were more common among children whose parents had divorced or separated. However, those who had been breast-fed were much less likely to be anxious than those who had been bottle-fed.

The study found that breast-fed children whose parents had divorced or separated were almost twice as likely to be highly anxious, while bottle-fed children where more than nine times as likely to be highly anxious than other children.

Even when the researchers factored in other possible influences, the findings held true. However, the results don't actually prove that breast-feeding itself helps children cope better with stress, the study authors said. They say it may be a marker of some other maternal or parental factors that influence a child's response to stress.

For example, the quality of physical contact between a mother and her baby during the first few days of life may influence the development of the child's neural and hormonal pathways involved in the stress response.

The authors also suggested that breast-feeding may affect the quality of bonding between mother and child and the way they relate to one another. This may have an enduring effect on the child's anxiety levels in stressful situations.

Women & Friendship

Women & Friendship
Friendships between women are special. They shape who we are and who we are yet to be. They soothe our tumultuous inner world, fill the emotional gaps in our marriage, and help us remember who we really are. But they may do even more. Scientists now suspect that hanging out with our friends can actually counteract the kind of stomach-quivering stress most of us experience on a daily basis.

A landmark UCLA study suggests that women respond to stress with a cascade of brain chemicals that cause us to make and maintain friendships with other women. It's a stunning finding that has turned five decades of stress research--most of it on men--upside down.

"Until this study was published, scientists generally believed that when people experience stress, they trigger a hormonal cascade that revs the body to either stand and fight or flee as fast as possible," explains Laura Cousino Klein, PhD, now an assistant professor of biobehavioral health at Pennsylvania State University in State College and one of the study's authors. It's an ancient survival mechanism left over from the time we were chased across the planet by saber-toothed tigers. Now the researchers suspect that women have a larger behavioral repertoire than just "fight or flight "In fact, says Dr. Klein, it seems that when the hormone oxytocin is released as part of the stress response in a woman, it buffers the "fight or flight" response and encourages her to tend children and gather with other women instead.

When she actually engages in this tending or befriending, studies suggest that more oxytocin is released, which further counters stress and produces a calming effect. This calming response does not occur in men, says Dr. Klein, because testosterone--which men produce in high levels when they're under stress--seems to reduce the effects of oxytocin. Estrogen, she adds, seems to enhance it.

The discovery that women respond to stress differently than men was made in a classic "aha!" moment shared by two women scientists who were talking one day in a lab at UCLA. "There was this joke that when the women who worked in the lab were stressed, they came in, cleaned the lab, had coffee, and bonded, "says Dr. Klein. "When the men were stressed, they holed up somewhere on their own. "I commented one day to fellow researcher Shelley Taylor that nearly 90% of the stress research is on males. I showed her the data from my lab, and the two of us knew instantly that we were onto something."

The women cleared their schedules and started meeting with one scientist after another from various research specialties. Very quickly, Drs. Klein and Taylor discovered that by not including women in stress research, scientists had made a huge mistake: The fact that women respond to stress differently than men has significant implications for our health.

It may take some time for new studies to reveal all the ways that oxytocin encourages us to care for children and hang out with other women, but the "tend and befriend" notion developed by Drs. Klein and Taylor may explain why women consistently outlive men. Study after study has found that social ties reduce our risk of disease by lowering blood pressure, heart rate, and cholesterol. "There's no doubt," says Dr. Klein, "that friends are helping us live longer."

In one study, for example, researchers found that people who had no friends increased their risk of death over a 6-month period. In another study, those who had the most friends over a 9-year period cut their risk of death by more than 60%. Friends are also helping us live better. The famed Nurses' Health Study from Harvard Medical School found that the more friends women had, the less likely they were to develop physical impairments as they aged, and the more likely they were to be leading a joyful life.

In fact, the results were so significant, the researchers concluded, that not having close friend or confidante was as detrimental to your health as smoking or carrying extra weight! And that's not all: When the researchers looked at how well the women functioned after the death of their spouse, they found that even in the face of this biggest stressor of all, those women who had a close friend and confidante were more likely to survive the experience without any new physical impairment or permanent loss of vitality. Those without friends were not always so fortunate.

Yet if friends counter the stress that seems to swallow up so much of our life these days, if they keep us healthy and even add years to our life, why is it so hard to find time to be with them? That's a question that also troubles researcher Ruthellen Josselson, PhD, coauthor of Best Friends: The Pleasures and Perils of Girls' and Women's Friendships (Three Rivers Press, 1998). "Every time we get overly busy with work and family, the first thing we do is let go of friendships with other women," explains Dr. Josselson. "We push them right to the back burner. That's really a mistake, because women are such a source of strength to each other. We nurture one another. And we need to have unpressured space in which we can do the special kind of talk that women do when they're with other women. It's a very healing experience."

The Hug Drug

The Hug Drug



It just may be that no drug is more effective than a good, meaningful chat. A British study has demonstrated the healing power of friendship.

A group of chronically depressed women living in London were randomly assigned to receive a volunteer "befriender" or were placed on a waiting list for one. The befrienders were instructed to be confidants to the depressed women, meeting them regularly for chats over coffee or outings.

Tirril Harris, Ph.D., of Guy's, King's and St. Thomas' schools of medicine in London reports in the Journal of Psychiatry that among the women who saw their volunteer friends regularly throughout the year, 72% experienced a remission in depression compared with just 45% in the control group. That's about the same success rate as antidepressants or cognitive therapy, says Harris.

The women who benefited most from the friendship prescription typically experienced some kind of "fresh start": they reconnected or made amends with a person who was estranged from them, or left an unpleasant job for another that seemed more promising.

In one case, Janet, a depressed woman who took part in the study, had been working overtime for no extra pay. Her befriender pointed out that this was unfair and suggested she ask for compensation. Janet approached her boss, who was "amenable and apologetic," Harris recalls. "These types of experiences--an acknowledgment of respect--made the formerly depressed women feel differently about themselves and about the world."