A. The symptoms like irritability, tiredness and behavioural changes are common indications of insomnia. You’re right—napping in the afternoon is not advisable, as it leads to further disturbance in your sleep cycle. In your case, most likely your sleeplessness is due to unresolved feelings and thoughts related to the loss of your spouse that disturb your mind when you sleep, which disrupts your sleep cycle. Try incorporating a consistent sleep routine to help you improve the quality of your sleep. I recommend exercising and doing yoga regularly, and eating nutritious, wholesome meals. Yoga can also help you manage stress more effectively. Focus on correcting the problem, rather than looking for quick fixes like sleeping pills. Sleeping pills ought to be your last resort; however I do not recommend taking them as they can be addictive.

Q. I am 50 years old and suffer from obesity and high blood pressure. I have been taking medication for the high blood pressure; but in spite of my doctor changing my medication recently, my blood pressure remains high. Also, my wife complains that I snore loudly during the night. What’s more, I tend to get up often in the night to pass urine, and in the morning I wake up feeling heavy-headed. Sometimes, during the day, I have an uncontrollable urge to sleep. Can you please tell me what can be the cause of this?

A. Snoring, urge to pass urine in the night, and feeling heavy-headed in the morning can all be symptoms of sleep apnoea, given the fact that you have obesity. Sleep apnoea is a sleep disorder in which your breathing stops temporarily due to the blockage of the upper airways. These pauses in breathing interrupt your sleep, leading to frequent awakenings each hour. Most people who have this sleep disorder may not remember waking up in the night; however, they may feel tired, irritable and depressed, or see a decrease in productivity. Other symptoms of sleep apnoea include:

• frequent pauses in breathing
• gasping, snorting or choking
• feeling tired and sleepy during the day, no matter how much time you spent in bed
• waking up with shortness of breath, chest pains, headaches, nasal congestion or a dry throat.

If untreated, sleep apnoea can lead to serious health disorders like hypertension, diabetes, heart disease, lung problems, and depression.

Q. I get funny sensations in both my legs while I sleep. It feels as though insects are crawling over my legs. Of late, I have also started getting cramps in my legs when I sleep. Plus, my husband complains that I move my legs a lot in my sleep which disturbs his sleep. During the day, however, I don’t experience these problems. I don’t know what’s happening to me. What should I be doing?

A. These symptoms are suggestive of Restless Leg Syndrome [RLS]. RLS is a sleep disorder that is characterised by an almost irresistible urge to move your legs.

Common signs and symptoms of RLS include:

• uncomfortable sensations in the legs or arms, accompanied by a strong urge to move them
• the sensations are triggered by rest and get worse at night
• sensations temporarily get better when you move, stretch, or massage the affected limb
• repetitive cramping or jerking of the legs during sleep.

The causes of RLS are unknown. However, it may be indicative of an iron deficiency, or underlying neurological disorders like Parkinson’s disease or peripheral neuropathy. Alcohol intake and sleep deprivation tend to worsen the symptoms of RLS. Talk to your doctor for further information and treatment of your problem.

The post Do you feel tired even after sleeping the whole night? appeared first on Complete Wellbeing.

What are the risks associated with metabolic syndrome?

Syndrome X increases your risk of coronary heart disease and stroke by four times, and of developing diabetes by as much as 6 – 8 times. Those with the syndrome are also more likely to suffer from sleep disorders, back pain and joint problems. Women affected by this syndrome are at a higher risk of developing polycystic ovarian disease [PCOD] and infertility.

How common is metabolic syndrome?

In the last decade, this syndrome has become much more common in India. It is estimated that about 30 per cent of adults or one in 3 – 4 adults have it; the syndrome is more common in women than in men.

Syndrome X increases your risk of coronary heart disease and stroke by four times, and of developing diabetes by as much as 6 – 8 times

How is metabolic syndrome diagnosed?

It is diagnosed when a patient has at least three of the following five conditions:

• Central obesity, which is measured as waist circumference of more than 35 inches in men and more than 32 inches in women
• Fasting blood triglycerides of more than 150 mg/dL or being on medication for high triglycerides
• HDL cholesterol levels of less than 40mg/dL in men and less than 50mg/dL in women
• Blood pressure of more than 130/85 mmHg or being on medication for high blood pressure
• Fasting blood sugar of more than 100 mg/dL or being on medication for high blood glucose.

How is metabolic syndrome treated?

The best way is to lose weight, increase physical activity and modify your diet.  Exercise should be intensified over the time. The ‘exercise prescription’ should be obtained from a qualified exercise specialist. Daily activity should be encouraged. Abnormal cholesterol levels may be controlled with medication.

Metabolic surgery is recommended for individuals who are morbidly obese and are unable to lose weight or keep the lost weight off despite repeated attempts. It also helps individuals who are obese and have developed uncontrolled diabetes, high blood pressure, heart disease or fertility issues.

The best way to treat metabolic syndrome is to lose weight, increase physical activity and modify your diet

If you are suffering from metabolic syndrome, make sure that you:

• Routinely monitor your body weight [especially abdominal girth]. Also monitor blood glucose, lipoproteins and blood pressure
• Get treated for high cholesterol, high blood pressure and high blood glucose
• Adopt an overall healthy lifestyle and take measures to manage your stress.

It’s important to focus on all the components of this syndrome for holistic management.

This was first published in the April 2015 issue of Complete Wellbeing.

The post Are you suffering from syndrome X? appeared first on Complete Wellbeing.

The concept of pre-diabetes evolved out of this necessity to prevent diabetes and its complications and nip them in the bud. That is possible by its early detection and thereby preventing it from becoming full blown diabetes mellitus, commonly known as type 2 diabetes.

What is the blood sugar level for prediabetes?

The following blood sugar levels are indicative of prediabetes:

Fasting blood sugar: 100-125 mg/dl [also called as impaired fasting glucose]
Post meals sugar:  140-200 mg/dl [on doing oral glucose tolerance test]
HbA1c: 5.8 – 6.4%

Pre-diabetes is that grey zone between normalcy and diabetes. Pre-diabetes, as the name indicates, is the stage of diabetes before it becomes overt and needs medical treatment. If your fasting blood sugar levels are more than 125 mg/dl or if your HbA1c is more than 6.4, then, you have diabetes. You may of course be alarmed to get a high reading like this, but the bright side is that you’re in a zone from where you can return back to normalcy and not proceed to develop diabetes. But that is only if you take the necessary precautions and follow your doctor’s advice as suggested.

What are the symptoms of prediabetes?

Now this is the tricky bit, because there are no symptoms seen with pre-diabetes, some people may have signs of insulin resistance like black patches over the neck, armpits or elbows also called as ‘acanthosis nigricans’. Skin tags or warts also indicate that the person may develop diabetes and should be screened. Also, if your weight has been increasing or your triglycerides are high, you are at risk of prediabetes.

Am I at risk of diabetes or prediabetes?

Read this list carefully because it is the give-away on how you can detect this condition in time and reverse it before it’s too late. So get your blood sugars levels checked annually if:

• • You have a family history of type 2 diabetes
  • If you have low level of physical activity
  • If you’re a smoker
  • If you have high blood pressure and/or abnormal blood fats
  • If you have some heart related diseases or blockages in the heart
  • If you’ve had gestational diabetes during pregnancy or polycystic ovarian syndrome [PCOS]
  • If you’re on some anti psychotic medications
  • You have central obesity with a waist circumference of more than 90 cm
  • If you have a BMI higher than 25

What percent of people with prediabetes develop diabetes?

Studies have shown that 15 – 30 per cent of individuals with pre-diabetes will progress to full fledged diabetes within a year, if left untreated. Once you’ve been detected with pre-diabetes or even if you have more than a few of the above mentioned risk-factors, put an action plan in place.

Strategies to reverse prediabetes naturally

Diet to reverse prediabetes

Firstly, reduce all the sources of sugar and transfat from your diet. This includes table sugar, jaggery, honey, fruit juices and processed foods. Indian diet is very carbohydrate centric, but restricting carbohydrates will help. Coconut and coconut oil in the diet should be restricted. Diet high in fibre, fruits and vegetables is advised. Reduce intake of excess sugar, cheese, butter, fried foods, chips, pickles and processed foods.

Exercise

If you’ve always had a sedentary lifestyle, just deciding or knowing that you need to exercise is not going to help. You’re going to have to take a more committed step towards your health. Engage a personal fitness trainer, or find an exercise buddy who is more motivated than you are. If you know you can’t rely on yourself to be regular at this, share the responsibility with another person.

Moderate physical activity like swimming or brisk walking for 30 minutes is good enough to result in weight loss of 5 – 10 per cent which can reverse prediabetes and normalise your blood sugar. If you are obese, it is recommended to increase the physical activities to 60 minutes per day. Remember, losing weight and maintaining it for long term is most important to prevent diabetes. Seek help to reduce your smoking frequency and limit alcohol intake to only 1 – 2 units per week.

Lifestyle management for reversing prediabetes

Since this is a lifestyle disease, to reverse it too, you have to tweak your lifestyle to make it more favourable towards your health and wellbeing. Allow your physician to decide whether or not you may require any medication too, in order to accelerate the process of reversal of sugar levels to normal. This may be needed particularly for those with heart problems, morbid obesity or strong family history of diabetes. Drugs like metformin and acarbose can be used to normalise blood sugars. Other goals should be to keep blood pressure around 130/80mmHg

Total cholesterol levels should be below 200 mg/dl, LDL should be less than or equal to 100 mg/dl and HDL cholesterol should be more than 40 mg/dl in men and 50mg/dl in women.

Other strategies to reverse prediabetes

Apart from lifestyle and diet changes the only other recommended strategy to reverse pre-diabetes is bariatric surgery which is done only in obese patients who have failed to lose weight despite repetitive attempts or extremely obese patients. These patients tend to have other complications of obesity, pre-diabetes being one of them.

I’d like to reiterate that to have pre-diabetes is good news. Good news because early detection will drive you to be motivated, control your food habits and exercise to get your blood sugars to normal. So go for it!

 This was first published in the January 2013 issue of Complete Wellbeing.

The post What Is Prediabetes and How to Reverse It appeared first on Complete Wellbeing.

Hygiene measures

Hepatitis A is a viral liver disease that can cause mild to severe illness. It is spread by faecal-oral transmission when a person ingests food or drink contaminated by an infected person’s stool. The disease is closely associated with poor sanitation and a lack of personal hygiene habits such as hand-washing.

Food hygiene

• Take precautions especially if you are travelling in rural or underdeveloped areas with poor sanitation.
• Avoid consuming untreated tap water including ice cubes. When outside, have canned or bottled drinks. You can also boil water if there is doubt regarding canned waters.
• Avoid eating uncooked fruits and vegetables, especially ones that cannot be peeled. Foods with thick skins might be safe once peeled. Clean all foods thoroughly.
• Order meat and seafood well-done. Avoid having raw clams, oysters, mussels and other shellfish.
• Avoid having mayonnaise, cheese, yogurt and other creamy products.
• Avoid fishing or eating fish from potentially polluted waters.
• Avoid having food bought from street vendors.

Personal hygiene

• Always wash hands after using the toilet and before eating or handling food. Wash hands with warm, running water and a mild, preferably liquid, soap. Toilets must be kept clean.
• Rub hands together vigorously until a soapy lather appears and continue for at least 15 seconds ensuring all surfaces of the hands are covered. Dry hands with a hand dryer or clean towel [preferably paper].
• Discard disposable towels in a bin. Bins with foot-pedal operated lids are preferable.
• Avoid sharing with anyone razors, toothbrushes or other implements, which could become contaminated with blood.
• Minor cuts, open or weeping skin lesions and abrasions should be covered with waterproof or other suitable dressings.
• Nappies and sanitary towels must be burnt in an incinerator or securely bagged and sealed and disposed of according to local guidance.

The post Hygiene and nutrition to prevent hepatitis appeared first on Complete Wellbeing.