Alcohol Abuse: How to Recognize the Signs

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Alcohol Abuse: How to Recognize the Signs

Alcohol Abuse: How to Recognize the Signs

You began to drink for fun whenever friends got together for the weekend. The feeling was wonderful and suddenly life felt good. You then liked to drink even when alone, and drink after drink you developed an inclination for more. You knew you were drinking a little too much but were not sure what to do about it. You have known alcohol was bad for health but you often felt sick whenever you tried to cut down on drinking. You are now willing to seek help but do not know how and what actually will help you.

Signs of excess drinking

 Excess of alcohol is harmful to health and can cause warning signs. One may experience an irresistible craving for more and more drinks. One may not be able to stop once drinking is begun. If one does resolve to check drinking, there are symptoms like nausea, tremors, sweating, and confusion that prompt one to drink. One then drinks to keep the symptoms in control. These may be worse in the mornings and one may resort to drinking as the first thing in the morning to control these symptoms. This is called physical dependence. Lastly, one may need to drink more quantities to experience the pleasure or high one gets form alcohol. This is called tolerance. Gradually, due to the compulsion to drink, there may be problems in the house and work place. The alcoholic gets annoyed at any advice to control drinking and prefers to drink in secret. Forgetfulness and black outs may incapacitate life. One seeks pleasure in only drinking rather than in hobbies or work. One may stock up drinks at home or carry one in the car to drink frequently to get the desired feelings and satisfaction.

For family and friends: Signs of alcohol abuse

Friends and family should be watchful for any signs of abuse in a person who is a known alcoholic, so that timely help can be rendered. One should pay attention to the health, habits, behavior, and appearance of the addict. The person may become less conscious about the physical appearance and may keep bad hygiene. There may a blushing face. One may show many behavioral changes. There may be uninhibited talking and abusing. One may become hostile and uncooperative and may refuse to shoulder responsibilities at home. Performance in school or work place may decrease. One may be socially withdrawn, depressed and emotionally unstable, may lack motivation, and become lethargic. There may be periods of hyperactivity, elation, uncontrolled behavior, and high energy. Sleep disturbances are frequent. The addict may express financial problems, may sell away valuables and assets for money, and may like to return home late in the night. The person may drive recklessly, have intense appetite, may smell of alcohol, and keep chewing on gums to mask the smell. The addict stays unhealthy, develops frequent nosebleeds, cold, allergies, sores in mouth, and convulsions. One may vomit, sweat, and have frequent headaches and stomach aches. Many may attempt suicide.

Helping a loved one realize they are drinking too much

Alcohol affects not only the addict but also the family and friends. The near and dears should try and offer help when they see that somebody at home is drinking too much. They should find a calm moment to communicate to the person about the problems that have been added due to the drinking. The person may be motivated to give up on alcohol emphasizing how harmful alcohol is for not only the alcoholic but in general for all at home and also the society. Somebody may accompany the addict to the healthcare professional or for a counseling session. The person should never feel lonely and should be assured constant cooperation of the family in the arduous task of giving up alcohol. The affected person may be encouraged to participate in more social activities and seek help to prevent oneself from drinking again.

Self Help

Any chronic alcoholic will have repeated urges to drink and will need to know how to control them. If one is not able to keep away from drinking, one may try non-alcoholic beer as a short-term substitute. One may keep chewing some gums to keep the mind distracted from alcohol. Green tea, caffeine, chocolate, or any other drink may help. One should avoid being alone and the accompanying friend or family member should know how to remind the addict for not drinking. Exercise has numerous benefits on health and keeping fit. It builds positive thinking and helps to combat the desire for alcohol.

Anybody who is warned by others for the amount and frequency of drinking or remains preoccupied by the thought of drinking needs to seek help. The first help may be a friend or family member in whom one can confide. One should share the problem with honesty and openness. The healthcare provider or doctor may help. Besides education on how alcohol affects health, they may provide useful tips to control the desire to drink. They may guide on how to cut down on drinks as stopping all together may be harmful and nonrealistic. One may be referred to a community alcohol service. Some medicines may be prescribed to control the symptoms of withdrawal. These include drugs like chlordiazepoxide. There are several self-help groups like Alcoholics Anonymous (AA) and groups like Al-Anon Family Groups that offer help to the families of alcoholics. Addaction, Connexions, and Adfam are other groups which offer help and support for treatment of alcoholism and deaddiction. Rehabilitation services are offered by NHS and other centers in the form a residential program of few weeks. Joining one of these groups can help to meet others who have been successful in giving up on the habit.

Outlook

Alcohol is very difficult to quit. A strong resolve and determined approach has helped many to successfully quit alcohol and bring back the joy in life. Life only changes for betterment and the entire effort is worth the try.

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Addictions———–Alcohol

 ADDICTIONS

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Addictions – We would be covering Alcohol,Drugs,Tobacco,and Other Substances

Addictions-Alcohol Points to be covered are 

  • Doctor’s Role In Alcohol Or Drug…
  • Alcoholism
  • Alcohol Abuse: How to Recognize…
  • Alcohol Withdrawal Syndrome
  • Naltrexone for Alcoholism
  • Drinking: It Can Spin Your World..

Doctor’s Role in Alcohol or Drug Abuse Recovery

Your doctor plays an important role in your recovery from alcohol or drug abuse.  The decision to stop using alcohol or other drugs is of utmost importance to your health. So, is it not advisable to work in close cooperation with your doctor who can not only treat any medical problems during your recovery, but can also give you emotional support and increase your chances of having long term sobriety?

SIGNS OF ADDICTION

The uncontrollable need/urge to have a drug or a substance is the most obvious sign of addiction in an individual. Psychological signs of addiction may include use of drugs or alcohol to forget problems or to relax, being withdrawn and keeping secrets from family and friends, loss of interest in activities considered important in the past, anxiety/ anger/depression or mood swings. Physical signs of addiction may include changes in the sleeping habits, changes in eating habits (weight loss/gain), feeling sick or shaky while attempting to stop the habit of abuse. Medical problems such as stomach and heart problems, high blood pressure, and psychological illnesses such as depression, anxiety, sleep disorders, and sexual dysfunctions could indicate alcohol or substance abuse in an individual.

HELP FROM THE FAMILY DOCTOR

It is very common for individuals to not be honest with their family doctor regarding information such as duration and frequency of alcohol intake or drug abuse. Also, he/she may be uncomfortable revealing the truth on abuse of prescription medicines in the past. It is always advisable for an individual to inform the family doctor of his/her decision to stop alcohol intake or use of other drugs. No matter what the past relationship with the doctor, the individual needs to be open and honest in his future relationship once he/she has decided to stop alcohol or drug abuse. This is important as the individual needs to work together with the doctor to ensure long-term recovery. The doctor can then provide the much needed emotional support and also help treat any medical problems the individual may suffer from during the period of recovery.

NEED TO INFORM

The doctor can help the individual deal with mood changes such as irritability, anger, depression, anxiety, insomnia, and sexual problems that are very common during the first few months of recovery. An individual may need help from the doctor during the recovery period in adjusting doses of blood pressure medicines that he/she was taking while on the habit of alcohol intake or drug abuse. Also if the individual has been abusing prescription medications in ways that were not intended, the doctor can exercise caution while in prescribing them if ever needed.

SAFETY OF MEDICINES DURING RECOVERY

It is recommended that during recovery from alcohol or drug abuse, an individual should try treatment options such as physical therapy, ice or heat therapy, or massage therapy for relief from pain, anxiety, or insomnia. Use of relaxation techniques such as deep breathing and meditation can help in the relief of feelings of stress and anxiety. However, the doctor may prescribe non opiate pain medicines that are not addictive for relief of pain, if the other methods mentioned earlier do not work. However as a rule intake of medicines for anxiety or pain is discouraged as they can increase the risk of a relapse. Tranquilizers, muscle relaxants, such as benzodiazepines, barbiturates and meprobamate, narcotic medicines (pain killers, analgesics and opiates) should be all avoided, especially if the individual has previously abused a narcotic such as heroin, codeine, morphine or oxycodone.

SAFETY OF ANTIDEPRESSANTS

Depression is one of the major issues an individual faces during recovery from alcohol or drug abuse. Major depression is a serious medical condition that requires appropriate treatment with an antidepressant. However, intake of antidepressants in an individual recovering from alcohol or drug abuse can be a matter of concern. It is therefore important that the individual seeks the advice of his/her doctor who will decide if the individual needs an antidepressant based on his/her recovery status. Intake of an antidepressant when appropriately prescribed does not carry a risk of relapse. However, it is recommended that before restoring to antidepressants an individual may participate in self help support group programs such as Alcoholics Anonymous or Narcotics Anonymous to help with his/her feelings of depression during the first few months of recovery.

SEEK HELP!

Substance abuse gradually paves the way for addiction, be it physical, psychological or both. While defining an addiction can be tricky handling it and recovering out of it is even harder. Overcoming an addiction may feel impossible, but it is not. Recovery starts when the person admits that he/she has a problem. In addition to the treatment programs available it is better to seek professional help from the family doctor. In the process of recovery honesty and strict attention to the process of recovery are among the keys to long-term success. The individual needs to be open with the doctor about how much, how often and how long he/she used alcohol or other drugs. The doctor can help the individual with any medical or psychological illnesses that he/she may face during the process of recovery. The individual needs to work together and in close cooperation with the family doctor who can not only provide medical support but can also give the emotional support and understanding needed for long-term recovery.

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Food-And-Nutrition—Eating-Healthy–Healthy Meal Planning

Essential required nutrients
Healthy Meal Planning
Healthy Meal Planning
Most of you reading this might think that planning a meal is simple, and wonder why the whole issue about planning. You might have planned what to cook for the day or sometime even planned the whole week’s meal for your family. But have you ever spent time or thought about how healthy is the food that we eat? Does it satisfy all the essential required nutrients to the body in a balanced amount? Does it help your family grow and stay healthy? If not, then start thinking right now. No rocket science, it’s simple! Change your normal meal plan to Healthy meal plan.

Serving size
As the popular saying goes “Too much of anything is good for nothing”, similarly eating too much of food also proves adverse. It is very important that you know the exact amount of food you need to have per every meal. Perfect amount of servings varies for every person as it depends on their age, sex, how physically active they are, and also their health condition. Serving size on the food product is a guide to help you know how much calories or nutrients are in a specific quantity of food. A healthy meal plan is your personal guide to help you plan daily meals. It helps you to include healthy nutritive and balanced food. A properly followed meal plan proves effective in people who wish to keep a track of their daily calorie intake.

Grains
The grain category includes food such as rice, crackers, bread, cereals, and pasta. Grain servings are measured in ounce equivalents. Now you must be wondering what an ounce equivalents is. Relax! It is nothing but a simple measurement that is equal to 1 slice of bread, ½ cup of cooked oats or rice or pasta and 1 cup of dry cereals.

Different Age Group

Serving Size

4-8 Years Kid

4-5 Ounce Equivalent / Day

9-18 Years (Girl)

5 Ounce Equivalent / Day

9-18 Years (Boy)

6 Ounce Equivalent / Day

Adult (Female)

6 Ounce Equivalent / Day

Adult (Male)

8ounce Equivalent / Day

Make sure that atleast half of these grain servings include whole grain foods such as wheat or multiple grain breads, crackers, readily available whole wheat pasta, and oatmeal.

Vegetables
Vegetables are must in your meal plan. The perfect servings of vegetable are measured in cups. Daily recommended servings of vegetable are:

Different Age Group Serving Size
4-8 Years Kid 1 ½ Cup / Day
9-13 Years (Girl) 2 Cups / Day
9-13 Years (Boy) 2 ½ Cups / Day
For Adults 2-3 Cups / Day
Make it a point to eat 1 cup of vegetables or drink vegetable juice, eat 2 raw carrots, 1 big sweet potato or 1 medium white potato or 2 cups of leafy vegetables every day.

Fruits
Fruits are generally a healthy option, and are considered a complete pack of fiber and many essential nutrients. Fruits can be consumed as whole, canned, dried or you can also prefer fruit juice. Daily recommended intake of fruit is:

Different Age Group Serving Size
2-18 Years (Both Male & Female) 1 To 1 ½ Cup / Day Or 1 Whole Medium Sized Fruit
Adults (Both Male & Female) 2 Cups / Day
1 serving of fruit is equal to 1 small apple, 1 big banana, and 1 cup of fruit juice or ¼ to ½ cup of dry fruits. Rely only on 100% fruit juice as it has more nutrients, and less sugar.

Milk and milk products
Calcium rich foods are very essential for stronger bones. Milk product includes yogurt, milk, cheese and icecreams. Note that cream, butter, and cream cheese are not under the list of milk products as they do not provide enough calcium. The recommended amount of milk and milk products for different age group are:

Different Age Group Serving Size
2-8 Years Kid 2 Cups / Day
9-18 Years (Both Male & Female) 3 Cups Of Milk Or Milk Product / Day
Adults (Both Male & Female) 3 Cups Of Milk Or Milk Product / Day
Always prefer low fat or non-fat milk and yogurt and cheese prepared from skimmed milk as they have low fat. You can have other calcium equivalent foods like yogurt, cheese, orange juice also.

Meats & beans
This category of food includes chicken, beef, pork, turkey, and fish they also include other protein rich foods such as beans, lentils, peanuts, and egg. Servings of these foods are measured in ounce equivalents. One ounce equivalent is equal to ½ cup of cooked dry beans, 1 egg, 1-2 tablespoon of peanut butter, and about a handful of nuts. The daily recommended servings are:

Different Age Group Serving Size
2-8 Years Kid 2 To 4 Ounce / Day
9 -13 Years (Both Male & Female) 5 To 6 Ounce / Day
Adults (Both Male & Female) 5 To 6 Ounces / Day
It is good if you choose lean meat, fish, beans, and peas as often as possible, as they are low in fat. Remove visible fat from the meat, and avoid frying them.

Food exchanges
If you are on dieting or on some restricted diet plan, you must be bored by eating the same food day after day. Food exchange list provides you with options where you substitute one food for the other. The American Diabetes Association has published a food exchange list that groups food with approximately same amount of nutritive value and compares the serving size and nutritive value of one group of food with another, and substitutes it with other food choices containing the same nutritive value. The exchanged list of food equals approximately the same amount of calories, proteins, fat, and carbohydrate that is present in the substituted food. The food exchange list has 3 main categories

Carbohydrate group
Meat and meat substitutes group
Fat group
For instance consider,
½ cup of cooked carrots, broccoli, or cabbage
1 cup of raw vegetables or green salad
½ cup vegetable juice
All the above mentioned food contains 25 calories and 5 grams of carbohydrate. Now you can shuffle your choice of food between these, as all contains equal amount of nutrition in it. Similarly, meat food group includes very lean, lean, medium-fat, and high fat meat. Food like 1 ounce of fish fillet or shellfish, and 2 egg whites contains 35 calories, and 1 gram of fat per servings.

Carb counting
Carb counting tracks the amount of carbohydrate you consume everyday, and helps you control the calories you get from it. Counting carbs in a meal is easier than trying to figure out what type of carbohydrates you should take. It also helps to adjust the amount of carbohydrates as per you needs. Consult your physician about the right meal plan. It is important that you control fat and cholesterol level along with carb counting. Foods that are rich in carbohydrates are bread, cereals, rice, fruit, yogurt, milk, potatoes, corn, dry beans, fruit, juice, cakes, cookies, and candies.

Glycemic index (GI)
How fast a food can raise your blood glucose level is measured by Glycemic index. Different carbohydrate foods have different effects on your body. Few foods increase your blood glucose level immediately, and few do it gradually. The different effects of foods are prioritized according to their effect on blood glucose level. This difference is shown by a value called Glycemic index. A food with low GI Value tends to increase the blood sugar levels slowly. High GI value foods cause a drastic increase in blood sugar levels. Choosing low GI carbs is the long term secret of maintaining a healthy heart, normal blood glucose level, and weight control. Shift your diet to foods that are with low GI value, such as oats, barley, bran, whole grains, sour dough, stone ground flour, pasta, noodles, basmati rice, and lots of vegetable salads.

Fats
Fats are very important part of a healthy diet. Fats like saturated and transfat are harmful to health, but other fats like monounsaturated and polyunsaturated fat are healthy fats that lower the level of bad cholesterol. Eating excess fat diet may result in heart disease, excess weight, type-2 diabetes, high blood pressure, and certain types of cancer. Maintaining a low fat diet is essential for healthy living. It is recommended that in adults fat should contribute only 25-30% of the total calories that we consume every day, which equals 56 to 77 grams of fat.

Fats like olive oil, peanut oil, canola oil, sesame oil, and sunflower oil are rich in monounsaturated fat; and polyunsaturated fat is found in vegetable oil, sunflower oil, corn oil, safflower oil, soy and cottonseed oil. Include vegetables, fruits, whole grains, skimmed milk, and cholesterol free protein in your diet as they are low in fat. Limit yourself to 6 ounce of meat per day. And importantly, make physical activity a part of your daily schedule to burn out calories.

Sugar substitutes
If you have a sweet tooth and always love eating sweets but you want to cut down the complications that these sweet things can bring, then it is better to go for a sugar substitute. Sugar substitutes are chemical or natural substances that tastes as good as sugar but with less or no calories at all. Using sugar substitute helps you to control calorie intake and it is helpful in controlling the blood glucose level. The US Food and Drug Administration has listed the ‘daily acceptable intake’ of these sugar substitutes. It has also approved that sugar substitutes are safe to use and they do not result in any disease as they are proved to be 100 times milder than the amount that is required to cause any health concern. It has also been shown that people using sugar substitute intake less calories and they do not over eat.

Quick tips for healthy meal planning
Plan up a simple, healthy, and manageable diet, and slowly shift yourself to healthy meal plan
Eat little but see that you have a balanced diet of all required nutrients
Fill your plate with colorful fruits and vegetables at every meal
Prefer whole grains, as oats and grains are rich in insoluble fiber and are digested slowly, and fall lower in the Glycemic index that helps in maintaining blood glucose level.
Include foods which contain monosaturated fat and polysaturated fat like peanut oil, olive oil, almonds, pecans, pumpkin, and sesame seeds, corn, soy beans, flaxseed oil etc
Include different source of protein diet in your meal plan chick pea, beans, cow’s milk, boiled egg, peanuts, cheese, brown rice, broccoli, potatoes, lentils etc.
Include calcium and vitamins in your diet. Food rich in calcium are fortified cereals, soy beverage, spinach, cowpeas, white beans, soy beans.
Limit the amount of sugar, salt, and processed food.
Healthy diet plan requires perfect planning and proper interpretation. The battle for healthy meal plan can be won only if you have a perfect healthy meal plan, well-stocked kitchen, healthy snacks and book of quick, easy, and healthy recipes.

Eat healthy and stay healthy

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Toxoplasmosis in Pregnancy

Toxoplasmosis in Pregnancy

Infection, infection everywhere! Infection is quite common and most of us get infected with some kind of microbes at some point of time in our life. Few infections are very frequent and general they disappear on their own or by medications, but there are few life threatening infections that might result in very serious complications. The only way to avoid infection is to stay away from the causative agents. One such infection, which infects a woman during your pregnancy and threatens the life of the unborn child, is called as Toxoplasmosis. To know more about Toxoplasmosis go on with the article.

About Toxoplasmosis

The infection, toxoplasmosis is caused by a parasite called as Toxoplasma gondii. The culprit may be the neighbor’s cat. The parasite Toxoplasma gondii grows in the intestine of cats. The egg-cyst of the parasite is dropped out in the cat’s feces, mainly in the litter box or in the garden soil. The parasite may catch hold of you when you handle the litter box or do gardening or walk barefoot in the soil that has the infected cat’s feces. Sometime you can get infected with Toxplasma gondii when you eat raw or uncooked beef, pork, chicken, and goat; as these animals acts as intermediate host for the parasite. They grow in their muscles and get into their milk. Other modes of infection are consuming contaminated, unwashed, unpeeled vegetables, fruits, and unpasteurized milk. Few people are born with the infection as their mother would have had the infection during pregnancy and passed it on to her child. Although, it is very rare, it is said that you can also be infected during blood transfusion or organ transplantation if the donor is already infected.

Know whether your cat is infected

The primary host of Toxoplasma gondii is the cat family. If your cat is infected with the parasite it usually doesn’t show any symptoms of infection. But it excretes as many as 10 million egg-cysts in its feces everyday for 3 weeks, until the acute infection period lasts. After excretion, it takes almost 1-21 days for the egg-cyst to become infectious. The egg-cysts are so minute that they are invisible to your naked eyes and they can survive in the soil for almost about a year. If you somehow get these egg-cysts in your hand you can be infected by handling food or inhaling the cyst. Flies also help these egg-cysts by carrying it on their legs and transferring it on your food.

Signs of toxoplasmosis

Toxoplasmosis usually doesn’t show any symptoms in infected humans. If at all symptoms do appear they just resemble a simple flu with swollen lymph glands, muscle pain, fever, and headache that lasts for several months. Severe toxoplasmosis can affect your eyes, brain, and other organs. Other symptoms include reduced or blurred vision, redness of eyes, and sometime tearing.

Risk during pregnancy

Toxoplasmosis infection during pregnancy can put your unborn child in great risk. The risk in unborn child arises if you are infected for the first time after conceiving, particularly during your first and second trimester. If you had toxoplasmosis infection before 6 months of conception, then the risk of infection in your unborn child reduces as your body already has the antibodies to fight against another infection. If you are pregnant and are infected with toxoplasmosis, then of course your baby is at risk of getting infected with toxoplasmosis as the parasite crosses the placenta. Such infants are said to have “congenital toxoplasmosis”. Babies born with congenital toxoplasmosis may have medical complications, which include problems with brain, eyes, heart, kidney, blood, liver, and spleen. Few longterm effects of congenital toxoplasmosis are seizures, cerebral palsy, deafness, mental retardation, and blindness. But many infected infants will have no problem at birth but they develop complications later in their life, therefore if you had toxoplasmosis infection before or during your pregnancy it is better to contact your doctor and get your baby checked.

Diagnosis

The only effective diagnostic test for detecting toxoplasmosis is blood test, which detects previous and current infection. Most often the blood test detects the presence of antibodies against the parasite.

Prenatal diagnosis detects the presence of parasite using amniotic fluid (fluid around the baby in womb), fetal blood, and placental tissue. A level II ultrasound can detect any morphological abnormality in the fetus such as hydrocephalus (large head) and hydrops (fluid accumulation in the body cavity). But an ultrasound is not an efficient technique to detect parasite infection.

Treatment

You do not require any treatment even if you are diagnosed with toxoplasmosis unless and until you are pregnant or have a very weak immune system. Symptoms of toxoplasmosis usually go away after few days without any treatment. If you are pregnant, then your health care provider might consult an infectious disease expert and suggest a treatment plan to control the infection. It is shown that treating mother actually doesn’t prevent the passing of infection to the unborn but for sure it reduces the severity of the complications in new-born. In children with congenital toxoplasmosis doctor may prescribe few anti-toxoplasmosis medicines in various combination. If your kid has a weak immune system then he need to be hospitalized and treated and kids with AIDS need to take anti-toxoplasmosis medication for their entire life.

Preventing a toxoplasmosis infection

The best way to protect a child from complications of toxoplasmosis is to prevent an infection in mother. Few steps to prevent toxoplasmosis infection are

  • During pregnancy you can ask someone else to clean the cat litter box
  • Use gloves if you are cleaning the litter box and also while working in garden
  • Keep the litter box clean and dispose the excretion everyday
  • Train you cat to defecate in one particular place
  • Do not feed your cat raw meat
  • Wash your hand with soap and disinfectant solutions
  • Avoid consuming raw meat and unwashed vegetables and fruits
  • Wash or/and peel fruits and vegetables before eating them
  • Cook meat up to 160°F or until it is no longer pink in color. Do not taste the meat before it is fully cooked
  • Avoid eating raw egg and consuming unpasteurized milk
  • Freezing the meat before cooking greatly reduces the risk of infection
  • Keep your utensils clean, wash the chopping board and knives with soap solution after use
  • Take steps to control cockroaches and flies
  • Do not drink untreated water

 

Conclusion

Everyone likes to have a pet and all of us love our pet. But sometime these lovely creatures become the reason for our illness. Petting cats can be quite a risk. But this doesn’t mean that you should get rid of your cats, this actually means that you need to take extra care in preventing the infection. However, you cannot prevent your cats from getting toxoplasmosis therefore it is important that you follow few precautions to avoid being infected. In case if you suspect that you might have the infection it is advisable that you check it with your doctor.

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Understanding gestational diabetes

A guide to gestational diabetes

Pregnancy is the time when a woman has to take extra care about herself to avoid any harm to the growing fetus and herself too.  Among the many conditions to keep a watch on, diabetes during pregnancy is the most important. A high blood sugar is harmful to the pregnant woman and the growing baby, and may complicate the pregnancy and the birth process.

Understanding gestational diabetes

During pregnancy, the fetus gets all the nourishment from the mother through placenta, a structure which connects the baby with the uterus of the mother. Placenta also secretes various hormones, which may interfere with the normal functions of other hormones in the mother. Usually, pancreas secretes hormone insulin that helps the body use sugar for production of energy. In pregnant women, the hormones from placenta may interfere with function of insulin, thereby elevating the levels of blood sugar. As a result, a woman who was non-diabetic before pregnancy, may develop high blood sugar when pregnant. This condition is called gestational diabetes. Gestational diabetes, if untreated is harmful to the mother as well as the fetus. The sooner the treatment starts the better it is for the health of the mother and child. In most of the cases, the gestational diabetes disappears once the child is born.

The chances of getting gestational diabetes is more in people who are overweight, who are above 25 years of age, who have a family history of diabetes, who are Asian American, Hispanic/Latino, African American, American Indian or Pacific islander because of genes susceptible to gestational diabetes in these ethnic races, who have given birth to a baby before that was weighing more than nine pounds and who have a previous history of gestational diabetes, miscarriage and repeated infections.

 There are different tests that are done to diagnose gestational diabetes. The fasting blood sugar test is done when the patient is fasting, drinking only water for 8 hours. The random blood sugar test is done anytime of the day. In the screening glucose tolerance challenge test, the patient is given a sugary drink and then the blood glucose level is checked after an hour. This test can be done anytime of the day.

Another test for diagnosing gestational diabetes is the Oral glucose tolerance test. You are asked to fast for 8 hours before the testing. The blood is taken for the test during fasting. Thereafter, you would be asked to drink sugar water, and then blood sugar is tested every hour for 3 hours. A fasting blood sugar above 95mg/dl, at 1 hour above 180mg/dl, at 2 hours above 155mg/dl and at 3 hours above 140mg/dl, indicates gestational diabetes. All diagnostic tests are done generally between 24 to 28 weeks of pregnancy which is the time when gestational diabetes can occur in pregnancy.

Managing gestational diabetes

To manage gestational diabetes, firstly modifications in diet are essential. With the help of a dietician, a well balanced diet plan to lower the blood sugar has to be made. Foods rich in sugars like cookies, desserts, sweets, candies and sweet juices have to be avoided. Carbohydrates foods like pasta, bread, potatoes, cereal, and rice are good for the mother and the baby. They should however be taken in limited quantities. Eating many small meals at regular intervals are recommended to avoid rise in blood sugar level. Apart from diet planning, careful monitoring of sugar level is essential. You can use a home blood sugar monitoring device to check your blood sugar at least four times daily or as advised by your physician.

 In addition, physical activity is important to maintain normal blood glucose levels. Swimming and walking are good exercises and you can do them after the approval of your doctor. If the mother has any complications, then only upper body exercises are advised by the doctor that can be performed sitting on the chair. Aerobics in water is also a good exercise that is relaxing and fun.

Apart from diet planning and physical exercise some women with gestational diabetes will need to take insulin shots or oral medications depending on the test results. Insulin is not harmful to the baby and is given under doctor’s supervision.

Complications of untreated gestational diabetes

Untreated gestational diabetes leads to complications in the mother as well as the baby.  In mothers it may lead to a condition called preeclampsia, where there is excess protein lost in the urine, and high blood pressure that occurs in the 20th week of pregnancy. Due to excess sugar in urine, mothers with gestational diabetes have more chances of getting urinary tract infections than mothers in normal pregnancies. Mothers with history of gestational diabetes may develop it again during second pregnancy or may get diabetes in later years.

During pregnancy, the mother having gestational diabetes has more sugar in the blood which crosses the placenta and reaches the baby. The pancreas of the baby then starts producing more insulin to counter the glucose resulting in overgrowth of the baby. This condition is called macrosomia. Delivery of such large babies may need a caesarean section. 

The babies after birth may develop low blood sugar which may result in seizures of the baby. Careful monitoring and intravenous glucose are administered by the doctor under such circumstances. The infant’s blood sugar levels are carefully monitored by conducting blood sugar tests. If the infant is diagnosed with low blood sugar, then sugar water or glucose is administered to the baby intravenously or through a tube into the vein of the infant. Untreated gestational diabetes may result in birth of a baby with breathing problem which continues till the lungs become stronger. The baby in later life has a high risk of developing diabetes and obesity. The baby may also develop problems in walking and balancing. There can be disorders like hyperactivity or inattentiveness. If bilirubin (the yellowish pigment found in bile produced by liver) level is found to be high, then it is treated with light therapy. In this treatment the baby is placed under blue green spectrum of light that changes the structure of bilirubin molecules which are then easily excreted out in urine and stool of the baby. Plastic shield filters are used to protect the baby against any harmful rays. The baby is also given eye patches for eye protection during the therapy. The baby wears a diaper only during the treatment.

Your bundle of joy

By following the doctor’s advice and taking all the necessary precautions you can get over gestational diabetes. Awareness regarding gestational diabetes removes all fears and apprehensions regarding the safety of your baby. The health and safety of your ‘bundle of joy’ is in your hands!

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Pregnancy-Induced Hypertension (PIH)


 

Pregnancy-Induced Hypertension (PIH)

If you are pregnant and have been detected with high blood pressure readings on more than one occasion, don’t ignore it. Remember that if you have pregnancy induced hypertension (PIH) and it is left untreated, there are high chances of you winding up with a preterm baby, a still born baby, or a baby with growth retardation not to mention the effects on your health.

Sounds serious, isn’t it? But rest assured. Not only can PIH be detected early during regular antenatal visits but there are treatment options that can help in controlling your blood pressure and help prevent serious complications.

Understanding PIH

Pregnancy induced hypertension (PIH) refers to the high blood pressure disorders seen in pregnancy. The four different levels of hypertensive disorders in pregnancy are chronic hypertension (high blood pressure present for some time before pregnancy and detected prior to 20 weeks of gestation), gestational hypertension (high blood pressure during the second half of pregnancy), preeclampsia (high blood pressure affecting all organs of the body), and eclampsia (occurrence of seizures due to severe preeclampsia).

Reasons why you develop PIH could be attributed to preexisting high blood pressure, placental involvement, underlying disease, or hormonal factors. In simpler terms, you have PIH, if during pregnancy your blood pressure goes up, you retain water, and there is presence of protein in your urine.

You are at an increased risk of PIH, if you have a past history of high blood pressure or kidney disease. It is seen to be more common during your first pregnancy. You are also at an increased risk if your mother or sister had PIH. Your risk of PIH is increased if you are a teenage mother, or are over 40 years of age, and are carrying multiple babies.

Symptoms

If you are developing PIH you may be able to notice some symptoms. You may gain weight rapidly almost 4 to 5 lbs in a week. You may experience severe headaches, blurry vision, spots in your eyes, and severe pain over your stomach under your ribs, with decrease in your daily urine output. However, it is very likely that you may miss these symptoms and mistake them as normal worries of pregnancy. It is, therefore, very important that you keep your regular prenatal appointments wherein your doctor will screen you for any overt signs and aid in early detection of PIH.

Diagnosis

There is no one test that can detect or confirm whether you are suffering from PIH. Your doctor will look for signs of high blood pressure (140/90 mm Hg or greater on more than two occasions), persistent swelling over your face, ankles and feet, with rapid weight gain of over 4 to 5 pounds in a week. However, none of these symptoms as a standalone are indicative of PIH.

Your doctor may order for a urine test to look for the presence of and amount of protein in your urine. Your doctor may also order for blood tests to assess your kidney and liver functions, and clotting factors. Fetal ultrasound (high-frequency sound waves that create images of your baby on a monitor) may be recommended for close monitoring of your baby’s growth.  ADoppler scan will additionally help to measure efficiency of blood flow to the placenta. In order to ensure that your baby is getting enough oxygen and nourishment, a non stress testmay be done to check how your baby’s heart rate reacts when your baby moves.

Treatment

Your doctor will decide on the best option of management of your PIH based on how close you are to your due date. If you are close to your due date then the best way to protect you and your baby is delivery of your baby as soon as possible.  If PIH is detected very early in your pregnancy, management may include bed rest, lying on your left side (to take the weight off your major blood vessels), salt restriction, and medicines to lower your blood pressure until delivery of your baby. Your physician may also prescribe aspirin and calcium supplements to prevent complications of PIH.

If you are having severe preeclampsia your doctor will prescribe corticosteroids to temporarily improve your liver and platelet functioning and also to help your baby’s lungs become more mature (prepares a premature baby for its life outside the womb in as little as 48 hours). The most important part of your management is to see your doctor regularly to check your blood pressure, urine protein levels and your baby’s well being.

On the other hand, if your PIH is severe and you are almost close to your due date your doctor may recommend induction of labor right away. Whether you will have a normal labor or a caesarean section will depend on the readiness of your cervix (whether it’s beginning to open, thin out, and soften). If the PIH or preeclampsia is severe, and there is need to deliver your baby immediately it may not be possible to consider your baby’s gestational age or the readiness of your cervix. If your doctor feels that it is not possible to wait then he/she may induce labor in you or schedule a C-section at the earliest.

Complications

PIH can affect both you and your baby. High blood pressure prevents the placenta (that gives air and food to your baby) from getting enough blood resulting in your baby getting less air and food. This affects your baby and can cause premature birth, low birth weight, and still birth.

High blood pressure may affect your kidneys and other organs. If you develop the more serious form known as preeclampsia, it can affect the placenta, your kidneys, liver and brain. You may experience seizures due to its effects on your brain.  You may have to deliver prematurely due to the complications and risk to the baby and yourself. PIH has long lasting effects and also places you at a higher risk of developing coronary artery disease in the future.

Outlook

PIH is a serious illness that is characterized by high blood pressure during pregnancy. While many women with high blood pressure during pregnancy have healthy babies without serious problems, it can nevertheless be dangerous to both the mother and baby if left untreated. The positive side of PIH is that it can be detected early during regular antenatal visits. So, if you have developed PIH it is of great importance that you are followed closely by your medical practitioner to initiate appropriate treatment and help prevent prematurity/death of your baby and other severe complications. Treatment options range from dietary changes, exercise, rest, medicines, to deciding to deliver the baby in the most severe cases.  Always keep in mind that w

orking with your doctor to control your blood pressure level will help you in minimizing your risk and improve your chances of having a healthy baby.

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My Health and Wellness Prenatal Diagnosis: Amniocentesis and CVS

Prenatal Diagnosis: Amniocentesis and CVS

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Nothing is as devastating, for a child bearing parent, as the discovery that a long-awaited child has birth defects. In such situations, a reaction of shock, disbelief, and grief accompanied with feeling of guilt and responsibility is experienced. The shattered hopes of parents are usually accompanied with spiritual feelings like – Why me? What wrong did I do to be punished in such a way? Or some people might take things positively and accept things as they are. In earlier days, any defect in the unborn baby was detected only after the baby was born, but ever since new advancement in the field of medical genetics and diagnostic technologies have started assisting reproduction, the growth of this field has become non-stoppable. These advancements have created choice and control in human reproduction by helping to detect any defect in the baby before it is born.  Procedures that help to detect birth defect prenatally (before birth) are called as prenatal-diagnosis.

Prenatal diagnosis

As mentioned above, prenatal diagnosis is the way through which the doctor finds any defect in the yet to be born baby. Mostly prenatal diagnosis helps to detect genetic defects (any change in the normal 46 chromosomes) such as Down syndrome, Turner syndrome etc. The two important and widely used prenatal-diagnoses are Amniocentesis and Chrionic villus sampling (CVS). Some parents are at higher risk of having a baby born with genetic defect, if any one or both parent suffers from any genetic abnormalities. Therefore, they might prefer going for prenatal diagnosis to make sure that they baby is growing healthy. Prenatal diagnosis helps parents to decide about the health care to be provided for the infant. Some diseases can be treated before the baby is born and some right after delivery. But some cannot be treated, in such case the parent need to take decision whether to continue the pregnancy or not.

It is predicted that about 20 – 25% of perinatal (after delivery) deaths occur due to congenital anomalies (birth defects). Prenatal diagnosis helps to

  • Plan the coming weeks of pregnancy
  • Know the outcome of the pregnancy
  • Plan for predicted complications in fetus
  • Know the problem in unborn fetus
  • Decide whether to continue the pregnancy
  • Know problems in future pregnancy

Prenatal diagnosis as a routine

Although, in many healthcare center prenatal diagnosis is offered as a part of routine prenatal care it is not mandatory that every pregnant women should have a prenatal diagnosis. Prenatal diagnosis is mostly considered, in one of the following cases

  • In couples who are high risk of having a baby with genetic defect
  • If the women is 35 years or above
  • Previous child with any birth defects such as Down syndrome or spina bifida
  • Abnormal results of screening test done during the first or second trimester. Screening tests include blood test and ultrasound scanning
  • If any one of the parent is a known carrier (carries a defective gene but do not show any signs) of cystic fibrosis (a genetic disease affecting the exocrine glands)

Amniocentesis

Amniocentesis is usually performed during the 15th week of pregnancy of after 15th week. Amniocentesis is aimed at viewing the fetal chromosome, which requires fetal cells. The most common procedure for obtaining fetal cell is by amniocentesis. During amniocentesis, a thin needle is inserted into the uterus through mother’s abdomen under ultrasound guidance and a small amount of amniotic fluid (fluid surrounding the baby) is aspirated out. The amniotic fluid contains fetal cells from fetal skin, lungs, and urinary tract. The aspirated fluid is then sent to laboratory for karyotype analysis (arranging chromosome according to structure and size). During the procedure, the baby will not be hurt and the body will replace the amount of amniotic fluid aspirated. Sometime, during or after the procedure some women may feel cramping, in such case doctor will ask them to rest. Normally, women can return back to normal daily activities the next day itself. Amniocentesis detects genetic defects like Down syndrome, sickle-cell anemia, cystic fibrosis, and Tay-Sachs disease (inherited disorder of lipid metabolism).    

Risks involved in amniocentesis
Very rarely amniocentesis carries the risk of miscarriage. The estimated value is 1:200, that is 1 in every 200 amniocentesis may result in miscarriage. Early amniocentesis also increases the risk of foot deformity called as club foot. In such case CVS is considered safer than early amniocentesis. In women, complications like abdominal cramp, amniotic fluid leakage, or spotting from vagina is noted. Fortunately, most of these complications resolve. Infection like fever and chills should be reported to doctor immediately.

Chrionic villus sampling (CVS)

CVS is performed during the 10-13 weeks of pregnancy. CVS provides information similar to the results obtained by amniocentesis. Parents who are willing to go for CVS should have an ultrasound done 2 weeks before CVS is performed to confirm fetal age and fetal viability. CVS involves taking out small sample of the early placenta (chorion frondosum) by inserting a sterile speculum inside the vagina to allow clear visibility of the cervix. Under ultrasound guidance, the catheter is used to remove a small sample of early placenta for genetic analysis. Trans-vaginal CVS is performed when the placenta is low but if the placenta is placed higher the chronic villus sample is removed by inserting a thin needle into the uterus through abdomen. This procedure is similar to amniocentesis. The patient can start doing activities right after the procedure but vigorous activities should be avoided.

Risks involved in CVS
CVS also involves risk of miscarriage, which range from 1:100 to 1:200. If the obtained sample was not sufficient for testing, CVS or amniocentesis should be repeated again. The major risk associated with CVS is limb defect in fetus. However, the risk of limb defect decreases if CVS is performed after 9 weeks of pregnancy as the process of limb development is over.

Amniocentesis Vs CVS

Both the tests have their own pros and cons. There are some situations where amniocentesis is considered better than CVS. Amniocentesis detects neural tube defect, which CVS does not. If the result of other tests like alpha-fetoprotein is abnormal then amniocentesis is preferred. In case if prenatal diagnosis has to be done during the first trimester of pregnancy then CVS is the best option than early amniocentesis.

Conclusion

Prenatal diagnosis is, of course, a major advancement in the field of reproductive genetics. But however, many women who receive confirmed result that the baby has no abnormality cannot rely on the result as no prenatal test can guarantee the birth of a healthy child even after normal results. If the results of prenatal diagnosis are positive then immediate discussion with the physician and counselor is recommended. Discussing the significance of the result with doctor, genetic counselor, and family members is very important to take further decision. Carrying on with the pregnancy or dropping it is up to the parents.

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