Health Connection - December 2019

Tips for Avoiding Common Holiday Health Issues

From shopping and decorating to celebrating and traveling, most of us try to pack a lot into the already-busy holiday season. The hectic pace of the holidays can be stressful, and the added stress makes it easy to push healthy habits aside until after the New Year. But did you know that some health conditions are more common during the holidays? And overindulging in unhealthy food or drinks, skipping exercise, sacrificing sleep, or not taking time to relax can put you at increased risk for these problems. That’s why it’s so important to make your health a priority and to help avoid these medical conditions that could derail your holiday plans.

Heart attacks. According to a study published by the American Heart Association, the risk of heart attack is highest in December and January, when heart-related deaths increase by five percent. People tend to delay seeking care during the holidays, and are more likely to mistake symptoms such as chest pain for heart burn or acid reflux. Heart disease progresses over time, but increased stress and poor dietary choices during the holidays can make the heart work harder, and result in a cardiac event. If you have cardiovascular disease or are at risk, take time to meditate and relax no matter how busy you are, get a little exercise every day, and save your holiday indulgences for the occasional special treat. Above all, don’t ignore the warning signs of a heart attack. If you or a loved one experience any symptoms, call 911 immediately.

Gallstones. Gallstones can strike anybody at any time, but eating large, high-fat meals or enjoying too many sugary treats during the holidays can be a recipe for gallbladder disaster. Gallstones are present in 15-20% of adults, and often just stay in the gallbladder and don’t cause any harm. But when gallstones block the tubes that drain from the gallbladder and liver into the intestine, they can cause serious problems and may require surgery. Symptoms include sudden onset of pain in the upper abdomen, most often with nausea or vomiting. Reduce your risk of painful gallstones and a trip to the ER during the holidays by drinking lots of water, eating a colorful variety of fruits and vegetables, and limiting consumption of high-fat and sugary foods. Try to take a brisk 30-minute walk daily to keep your digestive system moving. If you do experience severe abdominal pain that lasts more than two hours, or if it is accompanied by nausea, vomiting, fever, or yellowing of your skin or the whites of your eyes, seek immediate medical attention.

Falls at home. The Consumer Products Safety Commission reports that 12,000 – 15,000 people end up in the ER every year as a result of falls from holiday decorating alone. Falls from ladders are particularly dangerous, and can result in broken bones and serious head injuries. Avoid falls by exercising common sense and knowing your limits. Make sure your ladder is solid and steady, have someone hold the ladder for you, and leave the decorating to someone else if you have balance concerns or feel unsteady. Find additional resources for preventing falls here.

Alcohol related injuries. Drunk driving is the cause of nearly half of all holiday accidents and fatalities on the road. While a glass of champagne with family and friends can add to the festivities, two or more drinks can easily impair your judgment and make you a danger to yourself and others if you get behind the wheel of a car. Set limits on how much you will drink before heading out to any celebration, and make arrangements for safe transportation ahead of time. And remember that alcohol-fueled accidents aren’t just limited to the roads. About a quarter of all accidents in the home are caused by alcohol, including burns, cuts, and falls, so limit alcohol consumption while cooking or using appliances with sharp or moving parts. Learn about Alcohol Use Disorder here.

Depression. Even if you normally enjoy the holidays, the added demands and anxiety that come with the season can leave you feeling a bit down. The “holiday blues” can strike when you are lonely or have no plans, but also if you have too many plans and are feeling overwhelmed. Financial stress, increased food and alcohol intake, and trying to keep up with expectations and deadlines can all exacerbate low mood. Often, these feelings stop as the holidays end – but if the sadness sticks around for weeks or months, or if your mood interferes with your daily activities, talk to your doctor. Some ways to avoid depression during the holidays include taking time for yourself to relax and recharge, saying “no” to invitations that feel more like obligations, and practicing gratitude for the positive people and experiences in your life. Learn about suicide prevention here.

Remember that it’s important to enjoy the holiday season with friends and family, and missing an occasional workout or enjoying a special meal or treat shouldn’t be a problem. Stick to your wellness routine most of the time, and make healthy choices whenever you can, then relax and enjoy the festivities. You’ve earned it, and the New Year is right around the corner.

Bladder Leaks: More Common Than You Might Think

By Robert C. Chan, MD

Bladder leakage and urinary incontinence are subjects that rarely come up in conversations, yet

maybe they should. Approximately one out of three women over the age of 45, and one out of every two women over 65, have stress urinary incontinence. Incontinence tends to become more common as people get older. However, it can affect both men and women of all ages.

It can be temporary, such as when caused by a urinary infection, or ongoing, such as when changes occur in the nerves or muscles around the bladder.

Wanting to call attention to these common but typically embarrassing issues, celebrities Kris Jenner, Samuel L. Jackson, and Kate Winslet have decided to share their experiences with the world.

Kate Winslet, 44, shared on The Graham Norton Show how she suffered from a form of bladder leakage―stress urinary incontinence―associated with activities such as coughing, laughing, lifting, or running. “I can’t jump on trampolines anymore, I wet myself,” Winslet said.

Samuel L. Jackson, 70, was initially embarrassed to talk about his experiences, but has been quoted saying, “I realized that this was a problem that millions of Americans deal with every day.”

On an episode of Keeping up with the Kardashians, Kris Jenner, 64, talked about a urinary incontinence incident that occurred at a restaurant after Khloe Kardashian didn’t let her out of the booth to get to the bathroom.

Patients often feel embarrassed or nervous about talking about their conditions with their physicians. Often, they no longer leave their house, exercise, or go out to dinner or the movies for fear of having accidents.

Types of Incontinence

1. Stress Incontinence: This is leakage associated with activities such as lifting, coughing, sneezing, or running. Many women who have had children develop this, as well as men who have had prostate surgery.
2. Urge Incontinence: With this type of leakage, patients complain they have a strong urge to go to the bathroom, but begin leaking before they can make it in time. It is caused by a bladder contraction that happens when patients aren’t trying to go to the bathroom.
3. Overflow Incontinence: This happens when the bladder fills up, doesn’t empty, and the urine overflows beyond what the bladder can hold.

How is urinary incontinence diagnosed?

Diagnosis of urinary incontinence starts with a physical exam and discussion of your health. Your liquid consumption—how much, when, and what you drink—will be important to the discussion. Many patients are asked to keep a “bladder diary” for a few days before their appointment. Other tests may include a urinalysis, and a bladder stress test (if leaks occur when you cough, sneeze or laugh). Further testing may include X-rays, ultrasound, or additional diagnostic testing, especially if surgery is being considered.

What are some treatments for urinary incontinence?

Treatments range from conservative management to more invasive forms of therapy.

Conservative management may include medications, devices such as a pessary, physical therapy with Kegel exercises, and biofeedback. Using behavioral techniques to train the bladder such as holding your urine for longer periods of time between trips to the bathroom, emptying the bladder more completely, or scheduling your bathroom visits are effective treatments. Reducing liquids, especially alcohol or caffeine, losing weight, and increasing your physical activity can also help.

An array of over-the-counter “hygiene products” are also available to help you manage issues with bladder leakage or incontinence. These include pads, liners, disposable underwear, and reusable underwear to absorb moisture.

If more aggressive treatment is needed, your physician may recommend sling surgery, peripheral nerve stimulation, Botox injections, and bladder nerve stimulators.

If celebrities can talk about it, so can you. Seek the help you need. Don’t let your bladder stop you from living the life you want. Bladder leakage and incontinence are treatable conditions that no longer have to limit people’s lives.

Robert Chan, MDis a Board Certified Urologist at MarinHealth Urology.

Take a Deep Breath – Essential Oils to Calm Anxiety at Home or in the Hospital

We’ve all experienced those moments where a certain scent suddenly takes us back to another time and place. Perhaps it’s the aroma of fresh-baked cookies. Or maybe it’s a passerby’s perfume or a whiff of wood smoke on a cool fall day. Whether a scent takes you back to a specific memory, calms you down, or cheers you up, there’s a link between our sense of smell and our emotions that cannot be denied.

The power of certain scents to calm, relax, uplift, or invigorate us is the basis for the ancient art of aromatherapy. Aromatherapy uses essential oils―aromatic liquids extracted from plants, flowers and trees―to reduce the symptoms of mental, physical and emotional distress. The oils capture the “essence” of the plant's scent. Clinical evidence has shown that the natural chemicals found in these concentrated extracts have positive effects on the body, mind and spirit.

Already widely popular in Europe, aromatherapy is the fastest growing integrative healing art in U.S. hospitals today. At MarinHealth Medical Center, our care team uses essential oils to help patients relax. Patients interested in trying aromatherapy are offered a choice of the following:

• Bergamot – A relaxing yet uplifting scent that decreases grief and anxiety.
• Lavender – Widely used to reduce anxiety, stress or fear. Promotes relaxation and sleep.
• Lemon – Emotionally uplifting, lemon helps to relieve tension related headaches and pain and promote sleep.
• Orange – Evokes feelings of joy and happiness.

As part of our hospital-wide patient satisfaction initiative, our Perioperative Services nursing team recently launched an initiative to study the use of Integrated Healing Arts (IHA) to help reduce stress and anxiety in pre-operative patients. Nurses used an IHA combination of caring presence, gentle touch, focused breathing, and essential oils to help patients relax.

Participants in this nursing-led study were pre-operative patients over the age of 13. On the day of their procedure, nurses used an anxiety assessment tool to measure the patient’s anxiety levels before and after the use of essential oils. Anxiety levels were rated based on a standard anxiety scale ranging from 0 (no anxiety) to 10 (high anxiety).

The study’s preliminary findings indicate that the use of essential oils had a statistically significant impact on pre-operative anxiety, with bergamot and lavender having the most pronounced effects.

• Bergamot showed a large average reduction in mean anxiety from 5.0, prior to the use of essential oils, to 2.4, after the use of essential oils.
• Lavender, the most popular choice, also reduced anxiety significantly, from an average of 3.56 to 1.81.

MarinHealth will continue to explore the benefits of aromatherapy on pre-operative anxiety using a larger patient group. Future studies will take into consideration the brands of essential oils used, as well as gender differences in how people respond to essential oils.

Aromatherapy has also been shown to reduce anxiety and promote relaxation at home or in the workplace. Some people also find aromatherapy to be an effective sleep aid. If you are interested in trying aromatherapy at home, keep in mind that most essential oils are very concentrated, and should be diluted with a carrier oil such as olive oil or sweet almond oil prior to applying it to the skin. Always do a patch test on a small area of skin first to ensure you don’t have an adverse reaction. Or, try putting a few drops in a special diffuser to lightly scent―and calm―an entire room.

The Joy of Giving

Just as practicing gratitude can make us happier, supporting important causes and helping those in need can lift our mood and bring more meaning to the holidays. Studies have shown that giving to others or volunteering our time in meaningful ways can make us happier, reduce stress and anxiety, and boost overall life satisfaction. When we help others, dopamine is released in the brain, which improves mood and triggers good feelings. In fact, the Mayo Clinic reports that volunteering has many health benefits, including decreasing depression risk, increasing physical activity, and even helping reduce chronic pain.

Giving to organizations with missions that align with your personal passions is a good thing to do, but do take some time to research and ensure that your contribution will be used appropriately. If you need help finding a worthy charity or want to ensure that your donation is utilized effectively, visit www.charitynavigator.org. This is an easy way to assess an organization and find one that matches up well with your interests.

While all types of giving are appreciated, you may be able to increase the joy and satisfaction you personally experience with these tips:

• Give to specific projects where you know your donation will make a difference in a very tangible way, such as providing meal delivery and companionship to elderly people during the holidays.
• Consider giving smaller donations on a regular basis throughout the year, so you know you are making a consistent difference.
• Give for the pure joy of giving, regardless of any rewards, incentives, or recognition involved.
• Give to specific people or groups with situations or goals that resonate with you emotionally. If the story of a local family who lost everything in a fire brings tears to your eyes, providing help or support to them is sure to bring more joy to your heart.

Of course, if you have time to volunteer, you’ll likely meet new people, make new connections, and see first-hand how your time and talents can help change lives. From working with refugees trying to acclimate to a new country to helping neglected pets find loving homes, the opportunities to give back within the community are practically limitless. If you’re not sure how or where you want to help, this website is a good place to start.

And, if improving health and well-being throughout Marin is a goal you want to support, learn more about the MarinHealth Foundation or opportunities to volunteer at MarinHealth Medical Center.

Finally, remember that giving back doesn’t have to require a lot of time or money. Living with a spirit of generosity – no matter how much you have to give – is all it takes to make you more aware of daily opportunities to make a difference in the community.