What is Rootd? Well, it’s been called “anxiety and panic attack relief in your pocket.”

While there is no doubt that more and more people are opening up about their mental health, and that the stigma surrounding their inner turmoil has lessened over the past several years, there is still much more that we, as a society, need to learn and understand. It is estimated that about 1 in 5 American adults live with a mental illness, while approximately 6 million American adults are affected by anxiety and panic disorders. If you fall into the latter category, Rootd may offer you some welcome relief.

We all feel anxiety in our lives. Our job, family, finances, health, and other factors can send us into a tailspin if something goes awry or amiss. This is common. However, if you find yourself in a situation when you feel like you’re heart is racing, you’re having difficulty breathing, you’re feeling chest and stomach pains, accompanied with sweating, chills, and weakness or dizziness (in short, you think you’re having a heart attack) then chances are you are having a full-on panic attack. The exact causes of panic attacks are unknown although it is felt that genetics, major stress, PTSD, and even low self-esteem can be contributing factors.

Help can be sought through psychotherapy and medications. While undoubtedly both are useful, they are not always available at the time you need help the most. That’s where Rootd can help. Rootd is an app that aims to provide relief for people experiencing anxiety and panic attacks, with tools based on cognitive behavior therapy. Its features include a button you can press for immediate support during panic attacks through prompts, plus breathing exercises, active meditations and nature sounds, and psychoeducation about anxiety. Rootd allows you to keep a record of how you are progressing and how you feel to establish pattern recognition.

Rootd has been featured in Cosmopolitan, Healthline, Bustle, CNET, and more, and is highly rated on both the App Store and Google Play Store. As one satisfied customer raves, “[Rootd is] an excellent tool to help conquer pandemic worries or just anxiety in general, but the support here is also to be commended. Fast response to issues that were of my cause and you can tell this is a team that really cares about their users.

Normally valued at $149, you can get a lifetime subscription to Rootd today for only $59.99.

Prices subject to change.

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A little after a month since they debuted, the Fitbit Sense 2, Versa 4, and Inspire 3 are finally available in India. Off the three, the Inspire 3 is a fitness band while the other two are smartwatches. They still don’t have WearOS 3 but have some improved feature sets that may excite you. Read to know more.

Fitbit Sense 2 features and price

A highlight feature of the Sense 2 is that it can continuously sense your stress thanks to the continuous electrodermal activity (cEDA) sensor. You will be alerted when it thinks you are under high stress and suggest breathing exercises and mindfulness activities.

Speaking of activities, you get up to 40 sports modes. And when you are tired and sleep, the Fitbit Premium sleep profiles present analyses your sleep patterns and assigns a ‘sleep animal’ as your watch face. 

The other things you get with are passive heart rhythm monitoring for atrial fibrillation, a new Tiles UI, and turn-by-turn Google Maps navigation support. 

It is rated to run up to six days on a single charge, and by charging it for 12 minutes, you could get 1 day of battery life.

Fitbit has priced the Sense 2 at INR 24,999, and also bundles a six-month Premium membership for new and returning customers.

Fitbit Versa 4 features and price

Fitbit Versa 4

Fitbit notes the Versa 4 comes with over 40 exercise modes, built-in GPS, and Premium features such as Daily Readiness Score. It is said to run for 6 days on battery and costs INR 20,499. Here too, Fitbit offers a six-month Premium membership for new and returning customers.

Fitbit Inspire 3 features and price

Fitbit Inspire 3

As mentioned already and as you can see in the image above, the Inspire 3 is a fitness band that is advertised to clock 10 days of battery life, and packs in features like automatic step counting, distance covered, activity zones, heart variability rate, SpO2, skin temperature, sleep stages, and more.

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Ever since I moved back to America from Japan in 2020, I have been rethinking life and my own goals moving forward. I decided late last year (2021) that I was going to go back to school and work towards my Masters in Psychology to become a counselor. Well, the more I have been diving into my psych major, the more I have been picking up some helpful tips and tricks that I could easily apply to my life.

On top of that, I find myself stressing out some times while playing competitive games or incredibly difficult titles, so I began to study means by which we can calm our minds as we play video games, ultimately helping us to fully enjoy them.

With that said, the following are some tips and tricks to help you ease your stress while playing. Trust me, I’m a psych major (hehe), and these are all practices with peer reviewed research that I will even source (In APA format, too!) for your convenience.

psych major

Deep Breathing Exercises

One of the most effective and practical tips for calming down is learning deep breathing exercises. These are all relatively simple to learn yet difficult to master, so starting to tackle these breathing techniques now already puts you at a good start, well ahead of most people. While gaming, or honestly doing anything, taking a moment to breathe can be the difference between enjoying yourself and making a poor decision.

According to a study in 2021 (Gopichandran et al., 2021), muscle relaxation techniques and deep breathing exercises help with all types of stresses and anxiety, as well as sleeplessness, tension headaches, and more. It is worth noting that deep breathing stimulates the vagus nerve, which runs from the brain to the abdomen and is in charge of turning off the “fight or flight” reflex, ultimately helping us to get our minds out of the “danger zone” and into a calmer state.

If you are interested in diving into these practices, head on over to this WebMD page on breathing techniques to help with stress relief.

psych major

Meditation

Meditation, similar to muscle relaxation and deep breathing, is a calming technique to center yourself and clear your mind. It is a practice that is thousands of years old, and certain religions, especially Buddhism, perform meditations in all types of profound ways, including Zazen. Maybe this practice is why Japanese players are so good at video games (Okay, I’m kidding, but seriously, though).

Meditation programs and practices have been studied for years and years, and they have found that many of them reduce stress, calm nerves, and cleanse the mind of poor thinking and negative thoughts (Goyal et al., 2014). It is important to understand that meditation is a disciplinary practice and one that takes a lot of time and patience to fully understand and master, so do not be discouraged if your first time meditating is difficult. Just like any helpful action, learning how to turn off your brain, be in the moment, and focus only on breathing will become more natural over time.

If you are interested, there is an excellent 10-minute meditation hosted by Goodful on YouTube. I highly recommend it.

Good Diet & Exercise

Now we step into a very important area, and that is diet and exercise. Many gamers tend to snack and graze for long periods, usually eating and drinking unhealthy things that do more damage than good. As a gamer and a psych major, this has been one of the most life-changing areas of my mental health, and I think all of us need to be more wise about the food we intake and the amount of work we put into exercising.

Not only does good diet and exercise help with stress levels, pumping endorphins that make you feel good, they also contribute in reducing risk for cardiovascular disease (Burg et al., 2017). Essentially, exercise pumps positive chemicals into the brain, and it also strengthens one of our most important organs in the body, the heart.

Diet, also, plays a major role in stress relief. According to Sakano and his team (2020), high fat diets, and ones consisting of many sugars, induce stress. To combat this, committing to a low-fat diet and reducing sugar intake can help to calm nerves and lower stress levels. Again, as a psych major and a gamer, I hate this reality, because I love snacking. However, it is just not good for your mental health.

psych major

Taking Breaks

Another area that stressed out gamers tend to neglect is taking breaks. What I mean is that when a game becomes overly stressful, most gamers bite their lip and continue playing despite better judgment. As a psych major, I cannot stress enough the importance of pushing pause, taking a break, and letting your heart rate come down before playing again.

Cognitive fatigue is concerning, because it is something quite prevalent in today’s society. 60% of Americans, for example, regularly experience stress, including feelings of frustration, anxiety, and fatigue, and this affects all areas of life, including gaming. Taking breaks to relax, take a nap, read a book, or go on a walk are all effective ways to calm the mind and heart, but studies have even shown that playing simple and casual games can equally relax players (Rupp et al., 2017).

That means that if you are playing something like versus mode in Splatoon 3 and become angry, frustrated, stressed, etc, closing that game and opening up something else that is easier to play, like the wonderful Animal Crossing: New Horizons, can help as well. There are a lot of means to take a break, so find which one serves you the most and apply it to your gaming life.

psych major

Journal Your Thoughts and Feelings

Journaling is one of the best practices for getting your thoughts and feelings out there so that they do not swell. There are many ways to journal, and technically there is no “right way” or “wrong way”. You can just write your days down, focus on emotions, pains, and victories, or sketch/draw as a means of visual journaling. Whichever you prefer, the practice is still incredible and something we should all do.

According to numerous studies focused on the incredibly high stress levels of medical students, journaling has been found to reduce stress levels tremendously and give people the power to put how they feel into words. According to a study by Flinchbaugh and others (2012), journaling allowed students who were experiencing high levels of stress to acknowledge said stress and face certain demons that they did not know were festering within them.

Many times in our busy days, we tend to bottle up our feelings and emotions, and people who have the lowest control of their emotions tend to bottle repeatedly until those emotions explode in such a way that they hurt those around them. Journaling is yet another means by which to help you document your feelings and communicate them to loved ones, including yourself, in a better way.

psych major

Practice CBT/CPT Methods

Cognitive Behavioral Therapy (CBT) and Cognitive Processing Therapy (CPT) are long-studied means by which to help intervene in stressful situations and serve to reduce stress and even burnout. There are other methods out there, but I am focusing on these two as the lessons are easier to swallow and practice over time. One major thing with CBT and CPT is the use of Socratic Questioning which comes from the ancient philosopher, Socrates.

One study focused on the application of CBT-training for groups at a university to help with high levels of stress and anxiety, and by training in stress management in this particular way, students found themselves functioning at a much higher level thanks to keeping their untrue thoughts and emotions at check thanks to the practices within CBT (Molla Jafar et al., 2015). If you have severe PTSD and are hoping to apply these methods to your own life, I would moreso recommend to go to a therapist for a few sessions to help coach you in CBT/CPT to process your stress-induced trauma and pain.

See Also


If you are interested in applying Socratic Questioning to your daily life, I recommend downloading this PDF and using the questions to help challenge certain thoughts that may be influencing your emotions and behaviors. Often times in our lives, we leave heavy and potential harmful thoughts and emotions unchecked, and that will ultimately create bigger problems down the road. Keeping a close check on this is healthy, and if you are interested in something else, there is an excellent smart phone application called CBT Thought Diary that takes you through the process on a daily basis.


References

Burg, Matthew M. Matthew M., Schwartz, Joseph E. Joseph E., Kronish, Ian M. Ian M., Diaz, Keith M. Keith M., Alcantara, C. C., Duer-Hefele, J. J., & Davidson, Karina W. Karina W. (2017). Does stress result in you exercising less? or does exercising result in you being less stressed? or is it both?: Testing the bidirectional stress-exercise association at the group and person (N of 1) level. Annals of Behavioral Medicine, 51(6), 799-809. doi.org/10.1007/s12160-017-9902-4

Flinchbaugh, C. L., Moore, E. W. G., Chang, Y. K., & May, D. R. (2012). Student well-being interventions: The effects of stress management techniques and gratitude journaling in the management education classroom. Journal of Management Education, 36(2), 191-219. doi.org/10.1177/1052562911430062

Gopichandran, L., Srivastsava, A. K., Vanamail, P., Kanniammal, C., Valli, G., Mahendra, J., & Dhandapani, M. (2021). Effectiveness of progressive muscle relaxation and deep breathing exercise on pain, disability, and sleep among patients with chronic tension-type headache: A randomized control trial. Holistic Nursing Practice, Publish Ahead of Printdoi.org/10.1097/HNP.0000000000000460

Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368. doi.org/10.1001/jamainternmed.2013.13018

Molla Jafar, H., Salabifard, S., Mousavi, S. M., & Sobhani, Z. (2015). The effectiveness of group training of CBT-based stress management on anxiety, psychological hardiness and general self-efficacy among university students. Global Journal of Health Science, 8(6), 47-54. doi.org/10.5539/gjhs.v8n6p47

Rupp, M. A., Sweetman, R., Sosa, A. E., Smither, J. A., & McConnell, D. S. (2017). Searching for affective and cognitive restoration: Examining the restorative effects of casual video game play. Human Factors, 59(7), 1096-1107. doi.org/10.1177/0018720817715360

Sakano, D., Uefune, F., Tokuma, H., Sonoda, Y., Matsuura, K., Takeda, N., Nakagata, N., Kume, K., Shiraki, N., & Kume, S. (2020). VMAT2 safeguards β-cells against dopamine cytotoxicity under high-fat diet-induced stress. Diabetes (New York, N.Y.), 69(11), 2377-2391. doi.org/10.2337/db20-0207


Thank you for stopping by Nintendo Link for all of your gaming features and helpful tips from a psych major! What do you think of these tips and tricks to help calm you down while playing games? Did you find them helpful? Let us know in the comments below! Happy gaming, everyone.

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If you experience sudden onset anxiety, you are not alone. The American Psychological Association (APA) found that U.S. adults who reported anxiety symptoms jumped more than 25% after 2020. If you suffer a sudden anxiety attack, the first to do is try to take a few deep breaths. The Counseling Center at the University of Toledo says that getting more oxygen to the brain can calm the fight or flight fear response, helping you feel safer and think more clearly. Medical News Today offers a handful of gentle and effective breathing exercises to help calm a pounding heart and loosen tense muscles. 

Lighting incense, a scented candle, or smelling calming essential oils can help you feel more relaxed and slow racing thoughts. Healthline recommends soothing scents like lavender, chamomile, or sandalwood to help further calm your body and mind. If you can, grab a pen and write your thoughts down on paper. Writing can help you get out of your mind and make the situation seem more manageable. 

These simple exercises can work in a pinch. However, you should talk to a therapist or counselor if you think you may have an anxiety disorder. And even if you only experience anxiety symptoms sporadically, talking to a therapist versed in cognitive behavioral therapy can help you cope when you need it most.

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HEALTH WATCH

 

 

A panic attack is a sudden, intense experience of fear coupled with an overwhelming feeling of danger, accompanied by physical symptoms of anxiety, such as a pounding heart, sweating, and rapid breathing. A person with panic disorder may have repeated panic attacks (at least several a month) and feel severe anxiety about having another attack. While many people experience moments of anxiety, panic attacks are sudden and unprovoked, having little to do with real danger.

Panic disorder is a chronic, debilitating condition that can have a devastating impact on a person’s family, work, and social life. Typically, the first attack strikes without warning. A person might be walking down the street, driving a car, or riding an escalator when suddenly panic strikes. Pounding heart, sweating palms, and an overwhelming feeling of impending doom are common features. While the attack may last only seconds or minutes, the experience can be profoundly disturbing. A person who has had one panic attack typically worries that another one may occur at any time.

As the fear of future panic attacks deepens, the person begins to avoid situations in which panic occurred in the past. In severe cases of panic disorder, the victim refuses to leave the house for fear of having a panic attack. This fear of being in exposed places is often called agoraphobia. People with untreated panic disorder may have problems getting to work or staying on the job. As the person’s world narrows, untreated panic disorder can lead to depression, substance abuse, and in rare instances, suicide.

Causes and symptoms

Scientists are not sure what causes panic disorder, but they suspect the tendency to develop the condition can be inherited. Some experts think that people with panic disorder may have a hypersensitive nervous system that unnecessarily responds to nonexistent threats. Research suggests that people with panic disorder may not be able to make proper use of their body’s normal stress-reducing chemicals.

People with panic disorder usually have their first panic attack in their 20s. Four or more of the following symptoms during panic attacks would indicate panic disorder if no medical, drug-related, neurologic, or other psychiatric disorder is found:

  • Pounding, skipping or palpitating heartbeat.
  • Shortness of breath or the sensation of smothering.
  • Chest pains or pressure.
  • Choking sensation or a ‘lump in the throat’.
  • Fear of dying.
  • Feelings of unreality or being detached.
  • Shaking and trembling.
  • Fear of losing control or going crazy.

A panic attack is often accompanied by the urge to escape, together with a feeling of certainty that death is imminent. Others are convinced they are about to have a heart attack, suffocate, lose control, or “go crazy.” Once people experience a panic attack, they tend to worry so much about having another attack that they avoid the place or situation associated with the original episode.

Diagnosis

Because its physical symptoms are easily confused with other conditions, panic disorder often goes undiagnosed. A thorough physical examination is needed to rule out a medical condition. Because the physical symptoms are so pronounced and frightening, panic attacks can be mistaken for a heart problem. Some people experiencing a panic attack go to an emergency room and endure batteries of tests until a diagnosis is made.

Once a medical condition is ruled out, a mental health professional is the best person to diagnose panic attack and panic disorder, taking into account not just the actual episodes, but how the patient feels about the attacks, and how they affect everyday life.

Treatment

Most patients with panic disorder respond best to a combination of cognitive-behavioral therapy and medication. Cognitive-behavioral therapy usually runs from 12–15 sessions. It teaches patients:

  • How to identify and alter thought patterns so as not to misconstrue bodily sensations, events, or situations as catastrophic.
  • How to prepare for the situations and physical symptoms that trigger a panic attack.
  • How to identify and change unrealistic self-talk (such as “I’m going to die!”) that can worsen a panic attack.
  • How to calm down and learn breathing exercises to counteract the physical symptoms of panic.
  • How to gradually confront the frightening situation step by step until it becomes less terrifying.
  • How to “desensitize” themselves to their own physical sensations, such as rapid heart rate.

 

At the same time, many people find that medications can help reduce or prevent panic attacks by changing the way certain chemicals interact in the brain. People with panic disorder usually notice whether or not the drug is effective within two months, but most people take medication for at least six months to a year. Several kinds of drugs can reduce or prevent panic attacks.

 

Alternative treatment

One approach used in several medical centers focuses on teaching patients how to accept their fear instead of dreading it. In this method, the therapist repeatedly stimulates a person’s body sensations (such as a pounding heartbeat) that can trigger fear. Eventually, the patient gets used to these sensations and learns not to be afraid of them. Patients who respond report almost complete absence of panic attacks. A variety of other alternative therapies may be helpful in treating panic attacks. Neurolinguistic programming and hypnotherapy can be beneficial, since these techniques can help bring an awareness of the root cause of the attacks to the conscious mind.

 

Prognosis

While there may be occasional periods of improvement, the episodes of panic rarely disappear on their own. Fortunately, panic disorder responds very well to treatment; panic attacks decrease in up to 90% of people after 6-8 weeks of a combination of cognitive-behavioral therapy and medication. Unfortunately, many people with panic disorder never get the help they need. If untreated, panic disorder can last for years and may become so severe that a normal life is impossible. Many people who struggle with untreated panic disorder and try to hide their symptoms end up losing their friends, family, and jobs.

 

(Author is a medical practitioner and can be reached on: [email protected])

 

 

 

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  • A new study found that a type of breathwork (or breath training) performed for 30 minutes per day can lower blood pressure.
  • A special device and a technique called high-resistance inspiratory muscle strength training (IMST) can lower systolic blood pressure by almost 10 mmHg and DBP by nearly 5 mmHg.
  • Daniel Harrison Craigheahd, Ph.D., breaks down his research and how the breathing technique actually works to lower blood pressure.

Taking a deep breath can do so much more than calm anxiety and lower your heart rate. A recent study found that a type of breath training, paired with an over-the-counter breathing device, can help lower blood pressure (BP) by almost 10 points.

The study, published in the Journal of Applied Physiology earlier this month, practiced breathwork, or breathing exercises, with a total of 128 healthy adults, aged 18 to 82, for six weeks.

Daniel Harrison Craighead, Ph.D., assistant research professor of integrative physiology of aging laboratory at the University of Colorado Boulder, and co-author of the study, says breathwork is a broad term that refers to any sort of conscious control of breathing. Many types have been shown to have effects on BP when performed regularly for 30 minutes per day, according to Craighead. The specific type of breathwork used in the study for lowering BP is high-resistance inspiratory muscle strength training, (IMST), which involves taking 30 resisted breaths a day for five to 10 minutes through a handheld device that provides resistance. The trick is that each of those 30 inhales is really challenging and requires a lot of effort, he says.

According to Craighead, initial reductions in BP are observed within two weeks, which is faster than the BP benefits usually seen with more conventional forms of exercise. And your BP will continue to decline over at least the first six weeks of training and may decline more with prolonged training, he says.

High blood pressure can lead to a slew of health issues, such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. Recent research has even found Americans’ blood pressure has been on the rise and was significantly higher during the COVID-19 pandemic than pre-pandemic. So now, more than ever, it’s important to take preventative measures and stay on top of your health.

Ahead, Craighead breaks down everything you need to know about breath training for lowering blood pressure.

How does breath training lower blood pressure?

IMST likely lowers BP in a few different ways, he explains. One is by turning down the activity of the sympathetic nervous system—your fight-or-flight response. People with high BP tend to have this system overactivated and the deep breathing techniques with IMST likely lower the activity. Another main mechanism is by improving the health of endothelial cells—the cells lining the inside of blood vessels and are critical for cardiovascular health. IMST might lower BP by making these cells function better.

How does it work?

During a single session, users will perform 30 resisted inspirations through a handheld device (he used the POWERbreathe) featuring an end-piece that loosely resembles a snorkel; there is no resistance to exhaling. You breathe in through the mouthpiece as quickly and powerfully as possible, trying to make as full of a breath as you can. While doing this, the device is providing resistance, making the inhale very challenging. The study had people do five sets of six successive resisted inhales, with a one-minute break of unresisted breathing between each set. Craighead notes that the last set of six breaths is usually very challenging and users will struggle to overcome the resistance of the device.

Who should try it?

Everyone should consult with their physician before performing IMST to make sure it is safe for them. In general, though, IMST will be safe for most people. Most of the research on IMST has been done in healthy adults or in adults with high BP. Thus far Craighead says they’ve seen that the BP benefits of IMST aren’t really impacted by age, sex, or body weight, suggesting IMST will be generally effective at lowering BP in most people. He says researchers are still studying various patient populations though, as such, we don’t currently know how effective IMST is for people with serious chronic illnesses.

If you’re interested in trying breathwork for lowering blood pressure, consult your doctor before purchasing any devices and practicing at home.

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While World Lung Day on 25 September has come and gone, lung health is still something which needs to be considered.

Taking care of your lungs is now more important than ever. If the past few years have shown us anything, it’s how we take breathing for granted.

Breathing is a function we need to survive but because it is involuntary, it is easily overlooked. To know if you have healthy lungs, the best thing to do is to consult your doctor or pulmonary specialist.

However, most people who have lung problems will already know that they get short of breath very quickly, have tight chests or battle with breathing in general.

Poor lungs or bad breathing habits lead to low energy, slower metabolism and poor sleep. Steven Sadie, managing director at Airofit SA, gave some pointers on better lung health and breathing.

“The best way to increase lung health is to stop bad habits and immediately start breathing exercises and RMT [respiratory muscle training],” he said.

The World Health Organisation (WHO) said the following about RMT: “Increasing exercise and fitness can be aided by RMT. RMT can improve breathing through reducing the effort required by the body as it breathes.

Inspiratory muscle training (IMT) is facilitated through the loading of inspiration, normally by using a breathing device.”

Sadie added: “We have had post-Covid patients down and out for months not able to recover who, once they start training their lungs, are able get back to normal in no time.”

Lung capacity can be measured as the full amount of gas in the lungs after a full inspiration – but normally measured on your expiratory amount.

Over time, our lung capacity and lung function typically decrease slowly as we age after our mid-20s. “There are many exercises such as diaphragmatic breathing – or “belly breathing” – to engage the diaphragm, and pursed lips breathing, said Sadie.

There are other options for breath training such as making use of the PEP flute, he added. You can live three weeks without food, four to five days without water but most people can’t live for more than a few minutes without breathing.

“So putting some time and effort into lung health makes sense,” said Sadie.

“By just spending five to 10 minutes a day exercising, you will have all you need to make a huge difference in your life. The biggest bonus is that you do not do this while running, at the gym or under duress, you do this calmly in your own home sitting on the couch.”

ALSO READ: Cleaning products can affect lung health in women but not men

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(WBNG) - September is National Self-Care Awareness Month, and although September ends at the end of this work week, self-care is something that should be a focus 365 days a year.

Over at Binghamton University, Jennifer Wegmann is a lecturer in Health and Wellness Studies. In her classes over at BU, she stresses the connection between self-care and navigating stress in a healthy way.

“When we’re in states of chronic stress, like most of us are, what happens is we stay kind of tuned up,” said Wegmann. “When we’re tuned up, we deplete our resources our personal resources. Over a period of time, that wears us out. So one of the things that we have to figure out how to do is come to a place where it’s called close the stress cycle.”

According to Wegmann, being able to close our stress cycle on a regular basis is what gives us respite and allows us to recharge when we are in states of stress. Wegmann said that’s where self-care comes in. “Self-care helps us close our stress cycle,” she said. “What may close your stress cycle might not close mine, it might be different for me. Across the board, one of the things that we know is super effective in bringing our bodies back down and out of this tuned-up stress state is breath. So breathing and breathing exercises.”

Wegmann said we live in such a fast-paced culture and are taught to keep busy. However, her advice is to give yourself permission to slow down and take care of yourself. The slowdown should not be perceived as not being productive, but an investment in yourself that will pay off with long-term benefits.

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FRESNO, Calif. (KFSN) -- Your overall health can improve by doing daily breath work.

Maria Mayes is a well-being coach in Fresno, who specializes in breath work -- which is a stress-reduction technique that also brings physical benefits, including to the digestive system.

"Slowing down and taking a few slower than normal, deeper than normal breath cycles, prior to tasting your food, is going to take you from a mobilized sympathetic nervous system into a parasympathetic state -- where you're more calm and ready, and then your digestive system is able to work," explained Mayes.

Certain breathing exercises can change your mood and state of mind.

"We can use the breath to energize and increase our heart rate, or calm and decrease our heart rate," said Mayes.

Mayes led Action News reporter Amanda Aguilar through a coherent breath exercise, where she inhaled through the nose for five seconds, then exhaled through the nose for another five seconds.

"You can do breathing exercises, anytime, anywhere," Mayes said. "I do them at my desk. I do them when I'm driving in the car."

She also encourages adults to practice breath work with children, as many are now dealing with stress and anxiety following these past two years.

Mayes added that doing daily breathing exercises is an all-natural way to enhance your well-being.

A recent study also shows it could be more effective than making lifestyle changes, such as when working on weight loss.

Mayes is the founder of Take 5 Health, where she offers breath work videos.

Copyright © 2022 KFSN-TV. All Rights Reserved.



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Strength training isn't just for your biceps.

They can also support the muscles that help us breathe to lower our blood pressure.

Daily exercise for six weeks of high resistance inspiratory muscle training (IMST) lowers systolic blood pressure by an average of nine millimeters of mercury, according to a new study published in the Journal of Applied Physiology.

Because muscles weaken over time, strength training is often used to keep the body's muscles healthy.

Researchers decided to apply the same concept to the muscles that help us breathe, such as the diaphragm.

As part of the study, they recruited healthy volunteers ages 18-82 to use a device called the PowerBreathe, which provides resistance training for the muscles that help us breathe in. 

Study participants were asked to use the device for five minutes a day for six weeks.

This device is also often referred to as a "diaphragm dumbbell."

The new study found that doing 30 breathing exercises a day for six weeks reduced systolic blood pressure by about 9 millimeters of mercury, which is similar to the reduction achieved by normal aerobic exercise, such as walking, running or bicycling.

Reducing systolic blood pressure by 10 mm Hg reduces the risk of stroke by about 35% and the risk of cardiovascular disease by about 25% at age 65, according to a British Medical Journal report. 

The American Heart Association defines normal blood pressure as less than 120/80 mm Hg.

The upper number is the systolic pressure, which is the pressure inside the artery when the heart is contracting and sending blood throughout the body.

The lower number is the diastolic pressure, or pressure in the artery when the heart is at rest and filling with blood, according to Johns Hopkins Medicine.

A patient is at risk for high blood pressure, also known as hypertension, if the systolic blood pressure reading is consistently 120-129, which is called high blood pressure.

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Obesity constitutes an important threat to national and global public health in terms of its prevalence and rising incidence, quality of life, life expectancy, and economic burden [1,2]. In severe obesity, bariatric surgery is the most effective therapeutic option to achieve long-term weight loss and improve the associated comorbidities [3]. This has made Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding the most popular and commonly performed bariatric surgeries [4]. However, a small proportion of patients have also been reported to not reach their optimum goal for weight loss two years after the procedure and very few can fail or regain the weight. While anatomical factors can play a part, behavioural and psychosocial optimizations are regarded as equally important. This includes eating patterns, depression, nutritional factors, and exercise [5,6].

Virtual reality (VR) development and applications have gained wide recognition in medical services by providing solutions to improve patients’ outcomes. This is through patients’ education, improving mental health, and post-operative care, including pain management, physical therapy, and rehabilitation [7,8]. VR is a computer-generated simulation of a real or imagined environment. It can be immersive or non-immersive according to its ability to involve the users [9]. The former has been the focus of many medical applications due to its ability to give the user control of the reproduced environment. Immersive virtual reality (IVR) is usually delivered in a variety of ways and the most popular being head-mounted displays or simply a headset [8].

We aim to provide insight on some of these immersive applications and how they can be included to enhance the patient pathway to optimize outcomes both in the pre- and post-operative period for patients undergoing bariatric surgery.

Methods

A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) research criteria was conducted from January 2015 to December 2021. PubMed was searched using the following keywords: virtual reality, patient education, anxiety and pain, physical rehabilitation, behavioural support, obesity, eating disorders, body image, and substance cessation.

Thirty-four studies were identified and included in the final manuscript (Figure 1) supporting VR technology across applications that can be applied to bariatric patients’ surgical pathways. The applications were subcategorized into eight different areas of interest, which can help to shape the concept of the virtual ecosystem of bariatric patients (Figure 2).

Results

VR applications have been described in the eight domains mentioned below, which can be applied in relation to patients undergoing bariatric surgery.

Virtual Reality Patient Education (VR PE)

VR education has been introduced to make the information more meaningful and patient-centred by enabling its users to be fully immersed in an interactive simulated and self-controllable visual and auditory experience [10]. In a study by Pandrangi et al. [11], VR was found to be a useful informative tool in educating patients about their aneurysmal disease through interactive reconstructed three-dimensional (3D) images of their aortic anatomy. The majority of the patients in this study agreed that VR 3D anatomy helped to improve their understanding and therefore felt more engaged in their healthcare decisions [11].

VR PE has also played a role in improving the stress levels of patients undergoing radiotherapy (RT) by improving clarity and levels of education about their treatment. A randomized study on 60 patients with chest malignancy showed that patients who received VR PE showed significant improvement in comprehension and reduction in stress and anxiety levels when compared to standard education [12]. Another study on 43 patients utilized VR PE by creating 3D images of patients in RT sessions and what to expect during the treatment. After the VR PE, 95% of patients agreed that they had a clear understanding of how they would feel when lying on the treatment table. Also, patients’ understanding of the location and the size of their cancer had significantly improved from around 50% to 95% with an increase in the orientation of side effects of the treatment by 30% post-VR PE [13].

In bariatric surgery, there is no currently reported data on the applications of VR education. However, the potential impact of VR PE can be numerous across the weight management pathway. Preoperatively, bariatric patients could potentially utilize VR to be virtually educated about different surgical options versus conservative treatment through enhanced 3D interactive images. This could be seen to help in better understanding of their options including surgery and thereby enhancing informed consent and overall education.

Post-operatively, VR-enhanced education could provide an option for daily or weekly updates on lifestyle changes, which could help in improving compliance. Importantly, this can be done from the comfort of the patient’s home with the added advantage of reducing costs and time for travelling to attend appointments.

Anxiety Related to Surgery

A significant amount of anxiety related to surgery is due to the fear and uncertainty of the outcomes. Its psychological and physical effects are associated with longer recovery, an increase in the need for analgesia, anaesthetic requirement, and unfavourable behavioural and emotional outcomes [14]. Conventional methods of mitigation of preoperative anxiety are pharmacological and non-pharmacological strategies [15].

Recently, with promising results in the management of anxiety and other psychiatric disorders, VR has been successfully applied to reduce anxiety related to surgery in different surgical settings [16]. Chan et al. [17] tested the effect of VR relaxing meditation and breathing exercises on 108 women undergoing hysteroscopy. This showed that anxiety scores were significantly reduced after the 10 minutes of VR content, which helped in reducing pain and stress related to surgery. Also, around 85% of patients reported the VR experience as good or excellent [17].

In minimally invasive abdominal surgery, Haisley et al. [18] used VR meditation as a perioperative tool with favourable results in reducing pain, anxiety, and nausea and around 75% of patients stated that they would use the VR again [18]. Similarly, VR meditation showed favourable results in reducing pain and anxiety in burns and complex pain [19,20].

The rationale for using VR to improve anxiety preoperatively is by immersing patients in a fully simulated relaxing environment with the objective of placing them in a more empowered state to deal with the triggers of their anxiety [21]. This could be applied to the bariatric population before surgery. It is to be seen from future studies whether these expected results can be validated in bariatric patients. There is therefore the potential for obtaining better evidence for patient satisfaction and reducing stress related to bariatric surgery.

Pain Management

Successful pain management is a key element of the post-operative course as it shortens recovery and reduces risks of cardiovascular and pulmonary complications. In bariatric surgery, pain management is essential to enhance recovery and prompt early mobilization, which helps to decrease venous thromboembolism, prevent other events, and reduce hospitalization [22]. Therefore, a multimodal approach through regional and systematic analgesia is considered the most effective method as it minimizes opiate use, which can induce obstructive sleep apnoea, which is more liable due to the co-morbidities of obesity [23].

Applications of VR in pain management in other surgical patients have been reported to have numerous benefits. This includes a reduction in pain scores after cardiac, knee, abdominal, and spinal surgery with overall patients reporting the use of VR as a pleasant experience and stating that they would use it again on further occasions [18,24,25]. VR pain management follows a similar concept to VR and anxiety meditation by immersing patients in a simulated relaxing environment, which can help to divert the patient's feelings from their pain. This could be playing a major role in bariatric patients' management of pain and anxiety related to surgery with proper application integration in their peri-operative pathway.

Optimizing Pulmonary Function for Surgery

Respiratory function in morbidly obese patients follows a restrictive pattern with up to 77% suffering from obstructive sleep apnoea [26]. This increases the risk of impaired post-operative oxygenation and other respiratory complications in the form of atelectasis. Optimization of pulmonary function for surgery includes smoking cessation, breathing exercises, including inspiratory muscle training, incentive spirometry, and optimization of chronic disease, for example, asthma and chronic obstructive pulmonary disease (CPOD) [27].

With the increase of applications of VR in different rehabilitation programmes, VR has been aiding in pulmonary exercises in both healthy individuals and COPD patients [28,29]. VR pulmonary rehabilitation is designed to enable home-based exercises in the form of a 3D avatar instructor in an immersive relaxing environment to guide patients through breathing exercises based on traditional rehabilitation programmes [30]. In COPD patients, VR-based respiratory rehabilitation has shown to have similar outcomes when compared to a conventional programme with the additional benefit of performing the exercises from home. Moreover, VR showed enrichment of experience by also decreasing the levels of anxiety during exercise and therefore optimizing cardiorespiratory function [31].

Physical Fitness Applications

Pre- and post-operative physical activity (PA) is regarded as an important element in enhancing recovery after surgery as it improves physical state, responses to stress from surgery, and improvement of cardiovascular function, thereby reducing complications [32].

In the bariatric population, a structured exercise regime is considered a feasible and effective adjunct therapy that benefits cardiometabolic parameters when compared to those with bariatric surgery alone [33]. Exercise before surgery has shown to be beneficial in reducing body weight, improving blood pressure, general fitness, quality of life satisfaction, and decreasing fasting plasma insulin and blood lipid. Exercise after bariatric surgery has been shown to preserve dynamic muscle strength and contribute to maintaining weight loss after calorie restriction [34].

Although PA promotion is recognized as an important component of weight loss programmes, there are no current evidence-based or standardized bariatric surgery-specific PA guidelines [35]. Reported exercise regimes ranged from walking, aquatic, resistance, and supervised exercises. Also, adherence to exercise before and after surgery plays a big role in physical rehabilitation. As in the bariatric population, many can face barriers in the form of low confidence levels in their abilities and not feeling comfortable going to the gym due to real and perceived discrimination. Therefore, many come up with the belief of not having time to participate in sports [36].

VR rehabilitation has gained much recognition from dedicated platforms like treadmills, diving, cycling simulators, and medically oriented VR rehabilitation. These studies have demonstrated increased participation of users utilizing VR exercise programmes [37]. VR rehabilitation and exercise have shown to be effective in healthy individuals and different medical rehabilitations. It was reported to be equivalent and sometimes more superior to standard physiotherapy in cerebral palsy, spinal injury, and stroke [38]. In healthy individuals, VR exercise was demonstrated to increase adherence and enjoyment with positive physiological effects during exercise [39]. It was also reported that obese children performed better on treadmills while using VR than traditional walking, as VR allowed more distraction and less discomfort [40].

VR exercises during rehabilitation can therefore potentially play a major role in pre- and post-operative PA improvement in bariatric patients. Given the feasibility and the safety of these home-based devices, it can decrease the load on healthcare services, as most of the standard pre-operative programmes are resource intensive.

Virtual Reality and Enhanced Cognitive Behavioural Therapy

Eating and depressive disorders significantly affect the bariatric population with a prevalence of 24% and 17%, respectively. Both can lead to less post-operative weight loss, weight regains, impaired general psychology, and quality of life [41]. Cognitive behavioural therapy (CBT) is recommended for patients undergoing weight loss surgery (WLS). It has been shown to improve self-monitoring and control eating behaviours with significant improvement in depression and anxiety and therefore better results [42].

Over the last decades, VR-enhanced cognitive therapy (VRCBT) has been embraced for being a novel way to deliver CBT. The technique creates an interactive 3D environment to simulate successful goal achievement. This helps patients to overcome memories of previous real-life experiences through emotionally guided virtual exposure [43]. VRCBT has shown favourable results in anxiety, phobias, social anxiety disorders, and depression [21]. Moreover, randomized trials have shown VRCBT to be superior to conventional CBT in managing eating disorders and binge eating [44,45]. This helped in weight reduction therapy and adding adherence to programmes [46].

There is a paucity of evidence of the use of VR in the overweight and morbidly obese population. Phelan et al. [47] tested the use of a VR environment on 15 overweight adults for four weeks with the main hypothesis to evaluate the effect of the simulated scenes on behavioural skills related to eating habits. Although they showed no difference in weight loss among participants, VR intervention was more preferred by patients over traditional weight loss programmes [47]. Manzoni et al. [45] tested the efficacy of an enhanced VRCBT module aimed to unlock the negative memory of the body and modify its behavioural and emotional behaviour. A total of 163 female morbidly obese inpatients were randomly assigned to three CBT-based treatments: a standard behavioural inpatient programme (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. The study showed that patients in the VR group had a greater probability of maintaining or improving weight loss at one-year follow-up than SBP patients and, to a lesser extent, CBT patients. On the contrary, participants who received only a behavioural programme regained on average most of the weight they had lost [45].

VRCBT can therefore be a valuable tool in managing behavioural disorders related to obesity in patients undergoing WLS. This can help in maintaining weight loss and improving well-being and quality of life.

Virtual Reality and Body Image (VRBI)

Body image disorders (BIDs) are linked to various psychological and physical sequelae of impaired functions, for instance, depression, anxiety, eating disorders, and poor quality of life [48]. Among the bariatric population, body image dissatisfaction is associated with binge eating, depression, and lower self-esteem, with one in five bariatric patients identifying appearance as their main motive for surgery [49]. Improvement in body image perception after successful surgery has been linked to a decrease in compulsive eating syndromes, reduction in body mass index (BMI), and improvement in self-esteem and intimate relationships [50].

A contrary aspect of body image after surgery includes the issue of excess skin with massive weight reduction. This has been linked to poor body satisfaction, dermatitis and skin fold irritations, and impairment in daily activities and exercise. In turn, this leads 85% of bariatric patients to seek body-contouring surgery (BCS) to elevate this problem [51].

The application of VR has been used to improve BID. This is by creating a 3D simulation of their bodies in the form of avatars through an immersive environment that reproduces situations related to their body image concerns. Through multisensory simulations, it produces an empowered feeling of ownership of one’s body, which consequently promotes a healthier body image and behaviour [52]. A recent systematic review of six studies utilizing avatars and VR in weight loss programmes showed that avatar-based interventions were effective in both short- and mid-term weight loss. Also, the technology helped to improve exercise adherence in the long term [53]. VR was also used to assess the BID of 78 women with different BMIs by exposing the participants to different versions of avatars: slimmer, same weight, and overweight. The study showed that women with higher BMI reported more BID on their replicated avatar and showed satisfaction with their slimmer version. This finding indicated that VR may serve as a novel tool for measuring BID [54].

Potentially, VR avatars can also play a role in body image perception in bariatric patients. It can be integrated to improve BIDs by recreating slimmer avatars, which could promote adherence to weight loss and exercise programmes.

Smoking and Alcohol

While the increase in BMI is a risk factor for adverse outcomes related to surgical procedures, smoking's hazardous effects range from increased risks of pulmonary complications, wound infection, venous thromboembolism, and slower recovery. Similarly, alcohol consumption before surgery can lead to increased unfavourable outcomes [55]. Smoking and other substance abuse are recommended to be stopped four to six weeks pre-operatively [56]. VR has been tested as a potential solution to stop smoking and alcohol usage by inducing an advanced cue exposure therapy (CET), which was superior to static images or videos used in conventical settings [57]. Also, VR exposure therapy (VRET) has been reported to be more effective if combined with conventional cognitive behaviour therapy in relation to stopping smoking [58].

Although its applications are still under development and validation, VRET in smoking and alcohol cessation could play an important role in optimizing patients undergoing bariatric surgery as a part of a virtual reality surgical care package (VRSCP).

Discussion

Patients who are candidates for WLS usually undergo variable preparatory phase and post-operative optimization to improve both short- and long-term results. Standard care models usually involve education and follow-up through multidisciplinary teams with reflection on the patient's progress through educational sessions and follow-up plans.

While VR applications are being investigated in many surgical and medical specialities, their application to patients undergoing WLS is limited and not yet explored. The favourable applications of VR in patient education, anxiety and pain management, preoperative optimization, and behavioural and physiological treatment can be packaged as a surgical care bundle making bariatric patients' journey more satisfactory with the potential for improved outcomes.

Despite its promising applications, VR is still an emerging technology and has its own initial drawbacks to gaining traction in the healthcare system. There are several reasons for this. Firstly, the obvious cost of the systems and the absence of adequate clinical validation could play a major role in limiting widespread adoption. Further delays in adoption would likely be seen within the education of both healthcare providers and their patients, particularly on the application and utilization of the systems. The technology is still seen to be clumsy to wear and will need educational support to use [59].

With the increased investments and advancement in VR technology, education of healthcare professionals and further studies demonstrating evidence of improved outcomes, VR will play a major role in surgical patients and more specifically bariatric patients. This could be even refined as a personalized surgical care package. This will contribute to a fully virtual ecosystem in health care.



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Fear is an unpleasant and uncomfortable feeling triggered by the perception or assumption of real or imagined danger. Fear takes over our lives, gets the best of us, and influences many of our decisions. It could be the fear of making the same mistakes from your past, the fear of failure or success, of what people will say, the fear of the unknown, or even the fear of fear itself. 

We were born with only two innate fears, the fear of falling and the fear of loud sounds, however, we have also learned and developed the fear of many things at different times in our lives. Fear can be a major stumbling block that holds us back from being all we can be and truly successful. So here are my top 9 tips for overcoming fear. 

Separate assumptions from reality 

Be at the moment and ask yourself the following questions:

  • What is going on right now?
  • Am I currently focused on the past, present, or future?
  • What do I have control over?
  • Can I change the past?
  • What can I learn from this past fact that will help me grow?
  • Can I influence the future without making the right decision at this moment?
  • What decision(s) must I make now to influence my future? 

Then act based on these facts garnered. Remember: don’t assume. 

Identify your triggers 

Ask yourself:

  • Why am I really afraid?
  • What exactly happened?
  • What triggered the fear?
  • What am I really afraid of?
  • Am I really afraid of what I think I’m afraid of?
  • So, what am I really afraid of?

Be aware of what triggers your fear. Identify this trigger and learn how best to overcome it.

Know where the fear is in your body

Fear affects us in different ways – emotionally, psychologically, and physically. To overcome fear, you must become aware of how fear affects you physiologically. This level of awareness in your physical body helps you provide the care that your body needs. 

Although fear is emotional and psychological, it often represents itself physiologically. Some grind their teeth, clench their fist, hold stress in their neck or back, and feel very tense when they’re afraid.

To overcome the physiological representation of fear, reverse your physiology. That is, stop grinding your teeth, free your jaw, free and flex your fingers, relax your neck and back muscles by adjusting your poise, do some stretches and focus on your breathing to stay calm and focus on a time you were on top of your game. Understand that your mind and body are the same systems, you can access and change your mind, by altering your body.

Practice gratitude daily 

During difficult times, and even at all times, gratitude is important. Gratitude can help us cope with traumatic and fearful events, regulate negative emotions, improve our well-being and transform our lives. 

To benefit from the power of gratitude, just like everything else, you have to build your gratitude muscles through daily practice. So develop the habit of writing a gratitude list of at least 12 things you are thankful for in your life each day. It doesn’t have to be the big things, be grateful even for tiny things, and everything about your life. Fear dwells on the negative, and gratitude helps shift your mind from negativity into positivity.

Listen to the message fear is delivering 

Sometimes it’s a very helpful thing to know that fear is a messenger trying to call your attention to something, or working with your subconscious mind to keep you safe and free from harm. At other times, fear can become a barrier that keeps you stuck. Oftentimes, fear triggers the response reactions of freeze, flight, fight, and so on, all geared towards your protection.

So, if you suddenly feel fear when called to do a public presentation, pause and ask yourself what that feeling may be trying to tell you.

For example:

  • Are you unprepared for the presentation?
  • Is this presentation in your area of weakness?
  • Is the time too short for you to deliver a great presentation?

Identify the message in the fear and focus on addressing it. 

Change your focus

Understand that bad experiences are temporary, not permanent. Remind yourself that the feeling and the moment will pass. Focus on having a positive outlook on the situation.

Perception is powerful, and how you see your situation dictates how you feel and respond to it. 

Calm your Nerves Using Breathing Exercise

Breathing helps center your body and reduces anxiety. When you are afraid, you become anxious, stop breathing and your heart beats faster. You can do breathing and grounding exercises by taking inhaling and exhaling slowly. Start your day with this and practice it all day long.

 So, do this when anxious and in fear: 

  • Lie down, sit comfortably, close your eyes and allow yourself to remain calm.
  • Gently close your mouth and breathe in through your nose while counting to 6. 
  • Breathe from your diaphragm, don’t fill your lungs too full of air.
  • Inhale for 6 seconds, hold it for 7 seconds and exhale for 6 seconds, allowing your breath to enter and leave your body slowly and gently. 
  • Continue for up to 4 times.

Also, incorporate the practice of yogi breathing, including nostril breathing and the lion’s breath in your breathing routine from time to time.

Try to create a safe environment for yourself

When you feel safe and secure, there is no room for fear. Find somewhere safe you can retreat to when you start having negative feelings. It could be a physical place like your bedroom, or somewhere within you like a happy thought. This sense of comfort will soothe you momentarily.

Meditate

Meditation helps to overcome fear and anxiety by interrupting thinking patterns that trigger stress. Wherever you are, and at any time, you can practice meditation by sitting or lying down, all that matters is that you can relax your mind. 

You can choose to listen to calming recordings or music while relaxing your body and steadying your breathing. While meditating, breathe calmly, visualise yourself relaxed and stress-free. Meditation helps you gain control over negative, limiting, disempowering, and intrusive thoughts that trigger anxiety. It can also help you establish new thinking patterns and habits.

Please keep in mind that not every hack will work for everyone at all times, but this is a good way to start. Start implementing these techniques and don’t let fear hold you back from reaching your goals and your highest potential.



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According to Belgian tech startup, moonbird, using breathwork as a way to relax is growing rapidly in popularity. To answer this demand, the company has recently developed a pocket-sized intuitive breathwork coach tool to guide people through breathing exercises and improve their sense of wellbeing.

The compact moonbird tool guides the user’s breathing slowly while also providing feedback on heart rate and how the body relaxes via a connected app.

The founders of moonbird – brother and sister duo, Stefanie Broes (PhD in Pharmaceutical Sciences) and Michael Broes (Economist) – launched the company because they saw a gap in the market to make the benefits of breathing more widely accessible.

Stefanie said: "We founded moonbird after seeing many friends and family members struggling with insomnia, stress and anxiety attacks. Sadly, the truth is that these emotions are increasingly part of our daily lives, even more so amid the pressure we're facing as a result of the pandemic and its impacts felt widely all over the world.

“While medication can sometimes be the answer, it’s not always necessary and there are
other proven techniques people can turn to, which is where the importance of breathwork
comes in.

“moonbird is designed to be an effective, manageable and discreet tool that goes with you anywhere and everywhere to nip anxiety and stress in the bud as and when it happens.

“Our technology is making a big difference already, as can be seen through the many customers already benefiting from it in their daily lives.”

In a recent investment round, moonbird raised €1.5m (£1.3m US$1.5m) of growth capital that will be used for international expansion. Among others, Akiles, ScaleFund, imec.istart, the Flemish investment company PMV, Buysse & Partners and other private investors are contributing.

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It's a technique self-help gurus and influencers swear by for controlling stress levels. 

Now experts have shown that mindfulness breathing exercises can physically lower blood pressure.

Just 30 deep breaths a day with an inhaler-like device was found to be as effective as medication.

The device creates resistance, forcing the patient to use their breathing muscles to push and pull air through it. 

Scientists believe having strong respiratory muscles allows for deeper breathing without the device.  

It is thought that taking in deep breaths helps dilate blood vessels, allowing more blood to flow through them and lowering blood pressure.

But researchers say it should not be a replacement for other healthy habits like exercise, which have benefits beyond just blood pressure. 

Previous research has indicated that breathing exercises - often used during meditation of mindfulness practices - can help ward off hypertension.

Meditation is a popular mindfulness practice in which the subject focuses on their breath.

Meditation is a popular mindfulness practice in which the subject focuses on their breath. 

The POWERbreathe device strengthens the user's respiratory muscles with each use.

The POWERbreathe device strengthens the user's respiratory muscles with each use.

Researchers from the University of Colorado Boulder and the University of Arizona looked at 128 healthy adults ranging in age from 18 to 82 for a span of six weeks.

Participants used a $32 PowerBreathe device for about five to 10 minutes each day, taking 30 deep breaths.

Within two weeks participants started to see improvements with very few side effects.

What is mindfulness? 

Mindfulness is a popular form of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment.

The practice involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress.

It is often touted as a universal tool for boosting mental wellbeing by reducing stress, anxiety and depression.

Mindfulness has become popular in recent years as a way to improve mental and physical well-being. 

Celebrities endorsing it include Emma Watson, Davina McCall, Angelina Jolie and Oprah Winfrey.

How can it lower blood pressure?

It is thought that taking in deep breaths helps dilate blood vessels, allowing more blood to flow through them and lowering blood pressure.

Scientists believe having strong respiratory muscles allows for deeper breathing, increasing the effectiveness of the practice.

But researchers say it should not be a replacement for other healthy habits like exercise, which have benefits beyond just blood pressure. 

By the trial's end, researchers saw an average drop of 9 mmHg in systolic blood pressure among the participants. 

That is on par with many commonly prescribed medications, previous studies suggest.

Older volunteers who had higher blood pressure to begin with saw the most notable decreases in blood pressure but even young subjects benefitted.

'We would expect that if you went longer, blood pressure would go down even more,' lead study author Professor Daniel Craighead told Insider

He added: 'People with blood pressure at an unhealthy level could stand to benefit from adding this to their routine now.'

The study was published in the Journal of Applied Physiology.

High blood pressure, or hypertension, is defined as 130 or higher for the first number, or 80 or higher for the second number. 

Normal BP is 120/80 or lower. If left untreated, hypertension can lead to serious health problems including heart attacks and strokes. 

People who smoke, do not exercise or maintain a health diet, or are chronically stressed out are at far higher risk of experiencing high blood pressure. 

Roughly 116 million Americans and 12 million Brits have hypertension. 

Doctors have an arsenal of treatments designed to manage the condition. 

The most common medicines used to treat high BP include diuretics, which cause the kidneys to excrete more sodium and water, thus reducing fluid volume throughout the body and widening blood vessels. 

Doctors may also reach for ACE inhibitors, which block production of the hormone angiotensin II, a compound in the blood that causes narrowing of blood vessels and increases blood pressure. 

Young Female Medical Worker Measuring Arterial Blood Pressure Of Senior Black Man Using Cuff

Young Female Medical Worker Measuring Arterial Blood Pressure Of Senior Black Man Using Cuff

Oprah Winfrey, Sept. 21, 2022.

Sir Paul McCartney, Sept. 7, 2022.

Celebrities have gotten in on mindfulness meditation practices to cope with stress.  

Deep breathing is a key tenet of mindfulness, or the practice of being present with one's emotions without needing to react to them.

It often incorporates simple yoga as well as mindfulness meditation and body scanning, a technique where a person pays attention to their body and sensations in a gradual sequence from head to toe. 

The term 'mindfulness' has become a catch-all in certain circles for any activity that promotes self-improvement. 

A swath of celebrities have become proponents of mindful breathing and meditation, such as Oprah Winfrey, singer Katy Perry, and musician Paul McCartney.  

Mindfulness practice is on the rise, particularly in the US, with some studies estimating 5.7million Americans have tried it at least once. 

The true number could be much higher. Forty per cent of Americans meditate at least weekly, according to Pew Research.  

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Parenting is no easy task and even the calmest among us feel stressed out at home on occasion. You know, when dinner is ready and no one listens and clothes are all over the floor AGAIN.

But how do we regain our composure after a not-so-calm-parent moment or keep it together when we feel the tension rising?

MORE: How to help your teenager stay safe on TikTok

Clinical Psychologist Dr. Catherine Wikholm and Serenata Flowers have shared some brilliant advice with HELLO! on techniques to keep our cool, from breathing exercises to unwinding tips and how to deal with ongoing parental stress. Read her suggestions below…

 

Try breathing exercises

Dr. Catherine Wikholm explains: "Breathing exercises are a great tool to have in your stress management 'toolkit' as they are a simple, effective way of eliciting the relaxation response.

If you’re feeling stressed or anxious, using a deep breathing technique with a slow, steady inhalation to exhalation ratio is of the simplest, most effective ways to calm your nervous system.

During a deep breathing exercise, you want to aim to breathe from your diaphragm.

Place one hand on your chest and another on your abdomen, and you should notice your abdomen (not your chest) expanding as you inhale and retracting as you exhale.

Breathe in through your nose, and out through your mouth, aiming for a slow, controlled out breath. It can help to imagine that you are softly blowing on a candle - not hard enough to blow it out, but enough to make the flame dance.

Try initially breathing in for a count of two, hold for one, then exhale gently to a count of four… then extend the breaths, breathing in to a count of four, hold for one, and out for six.

If it feels comfortable, you can try extending it further, to a count of in for six, hold for one and out for eight.

It’s not so important how long the breaths are, so long as the exhale is longer than the inhale. Just do what feels comfortable for you. After a couple of minutes, you will likely notice that you feel physically and mentally more relaxed.

Children and teenagers can really benefit from breathing exercises too. If you have young kids, a fun way to introduce this is by using bubble mixture and encouraging them to blow as many bubbles as they can - as doing this naturally requires the long, slow, controlled out-breath."

 

How to unwind in the evening

"As a parent, it can often feel that there aren’t enough hours in the day to get everything done and meeting your own needs can often end up bottom of your priority list.

However, in order to cope well with the stress of parenting, it is important that you give yourself some time to intentionally unwind on a daily basis and that this becomes a regular part of your routine.

Try to think of relaxation and self-care as a necessity, not a luxury.

Doing things that help to reduce your stress levels will not only benefit you personally but help you to be a more calm, emotionally-regulated parent for your kids.

If you’re feeling physically tense, you may benefit from trying relaxation techniques like progressive muscle relaxation, gentle movement such as yoga or pilates, or just having a long bath.

Or to calm a busy, worried mind choose a soothing yet immersive activity like reading, listening to music or a podcast, doing something creative (like drawing), or a guided visualisation audio."

MORE: Kids' Halloween pyjamas you'll love as much as they do

 

What to do when you get frustrated or angry 

"When you get frustrated or angry with the kids, first of all, know that these are normal human emotions that we can all experience during times of stress. You are not a bad parent for feeling this way, and your kids are not bad kids.

Take it as an opportunity to model emotional regulation and relationship repair to your children.

Name your emotion and say what it is you need to do to help yourself to calm down e.g. 'I am very frustrated right now, so I am going to take five minutes to myself and go drink a glass of water.'

Once you are feeling more regulated, reconnect with your child.

This might look like offering a hug and an apology - and perhaps also suggesting a 'do over’'. This is a great tool for repairing with your child if your emotions have got the better of you and you haven’t handled a situation how you might have wanted to (e.g. you end up shouting at your kids for taking too long getting dressed).

In the 'do over', you and your child start the activity or task again, and this time, you both play it out differently, in a calmer, more connected way, as you would have wanted it to go.

Kids tend to love this creative approach and after a few times, you may find your child starts suggesting the do-over themselves in situations where emotions have run high and things haven’t gone to plan.

Learning about the stages of children’s brain development and capacity for emotional regulation can also be helpful in terms of being able to better manage our own emotions as parents.

For example, dealing with tantrums can be very triggering especially if you believe the behaviour is intentional and that your child could just ‘snap out of it’.

Understanding that this kind of emotional dysregulation is not intentional allows you to make a reframe like 'my child is having a hard time', rather than 'they are giving me a hard time,' which can help to take the edge off your own frustration."

 

How to avoid feeling stressed all the time as a parent

 

Aim for 'good enough' parenting, not perfect parenting

"Perfect parents don’t exist; striving for this will only backfire and lead to inevitable feelings of failure, stress and anxiety.

Lower your stress levels by letting go of unrealistic perfection as a goal and embracing ‘good enough’ parenting, wherein you aim to parent as best as you can while accepting that you’re only human.

Of course, it’s positive to aim to be a calm, responsive and engaged parent - but don’t beat yourself up about it if you aren’t able to fully meet all of your children’s needs 100% of the time. In fact, learning to cope with minor disappointments and frustrations can actually be helpful for children’s cognitive and emotional development."

MORE: The highest-earning baby names revealed - and two are royal

 

Practice self-compassion

"During times of stress, it’s easy to fall into patterns of negative self-talk, self-blame and self-criticism - which does nothing to change the situation and only makes you feel worse.

To cope better with stress (and feel better about yourself as a parent), try to practice self-compassion.

One way of doing this is to try to talk to yourself as you would a close friend. What would you say to someone you care about, if they were in the same stressful situation as you? Try to speak to yourself in the same way and notice how much better it feels."

 

Don’t make social media comparisons

"When you’re having a stressful day with the kids, scrolling through images of seemingly blissfully happy families can contribute to increased feelings of stress and guilt.

To counteract this, remind yourself that on social media you are mostly only seeing other people’s highlight reel, not the reality of their daily lives."

 

Pay attention to the small positives of each day

"When you are feeling stressed, your mind is likely to over-focus on problems and the things you are worried about, making you feel worse.

To help to rebalance your thinking, try to remind yourself on a daily basis of what has gone well that day, anything you enjoyed, felt grateful for, that you appreciated - or that made you feel appreciated.

Whether that’s hearing an 'I love you' from the kids, receiving a bunch of flowers from your partner or just allowing yourself the time for a relaxing bath, attending to the small positives can help to give us a boost on a stressful day."

 

Serenata Flowers is offering a discount code Blooms4Blues for 10% off until the end of September



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There are specific regions and pathways in the human brain that help us process fear. Alexey Kuzma/Stocksy
  • Fear-based mental health conditions are common, impacting millions of people worldwide.
  • Previous research has shown that specific regions and pathways in the brain may be responsible for processing fear.
  • A new study from Linköping University in Sweden has revealed a biological mechanism that impacts fear pathways and how fear memories are stored in the brain.
  • Their findings also shed light on the link between anxiety and alcohol use disorder.

According to statistics, approximately 284 million people worldwide experienced an anxiety disorder in 2017. Data also suggests that around 12 million adults experience post-traumatic stress disorder (PTSD) in the United States in any given year.

One of the primary causative factors among these mental health conditions is excessive fear.

Fear is a natural emotion that helps ensure a human or animal responds appropriately to danger. Still, it can become excessive in some individuals and may lead to mental health conditions, including anxiety and PTSD.

In addition, a 2019 study suggests that anxiety disorders can co-occur with alcohol use disorder (AUD).

Despite the known facts about fear-based conditions, the mechanisms behind how the brain regulates fear are not well understood.

Dr. Mirela Loftus, medical director for Newport Healthcare, told Medical News Today:

“It has been known for some time that the fear pathway in the brain entails connections between the hippocampus, the place that helps us build memories; the amygdala, the place that helps process fear and traumatic memories; and the medial prefrontal cortex that acts like the command center and controls these areas.”

Recent research uncovered evidence on how these brain regions communicate fear — specifically, the pathways in the brain that transmit threat cues to the amygdala. The scientists who conducted the study also suggest these pathways are involved in creating unpleasant fearful memories.

Now, a new study from researchers at Linköping University, Sweden, may offer more clues as to how these fearful memories are processed and stored in the brain.

The scientists found that reduced levels of an epigenetic enzyme called PRDM2 affect specific genes in the brain, resulting in increased nerve cell activity between the frontal lobes and the amygdala.

The researchers suggest this biological mechanism impacts how the brain strengthens and holds onto fear-related memories. Their discovery might also offer insight into the links between anxiety disorders and AUD.

Their research appears in the journal Molecular Psychiatry.

Previous research carried out in rodents by Linköping University scientists found that downregulation of PRDM2 caused by alcohol dependence leads to increased stress responses and alcohol-seeking behavior.

Because of their earlier findings and the links between anxiety and alcohol use disorder, the research team hypothesized that reduced PRDM2 levels in the brain could be a mechanism that plays a role in both conditions.

Using rats to test their theory, the scientists conducted several fear conditioning experiments to investigate the role PRDM2 plays in fear memory processes.

After analyzing the data, the scientists found that PRDM2 plays a role in modifying the strength of fear-memory storage in the brain. It does this by regulating the pathway between the dorsomedial prefrontal cortex and basolateral amygdala (dmPFC-BLA). This pathway is believed to be involved in processing emotions, including fear and anxiety.

Specifically, the study authors discovered that the downregulation of PRDM2 in the dorsomedial prefrontal cortex heightens fear expression by altering how effectively the brain holds onto fear memories.

In addition, the researchers also identified that reduced PRDM2 levels impact specific genes that assist in the formation of contact points between neurons.

The findings suggest that this gene expression may increase nerve cell activity between the frontal lobes and amygdala in the brain, resulting in a heightened response to fear-associated cues.

Lead study author Estelle Barbier, an assistant professor in the Center for Social and Affective Neuroscience (CSAN) and the Department of Biomedical and Clinical Sciences (BKV) at Linköping University, told MNT:

“In our study, we identify a biological mechanism that increases the consolidation of fear-related memory, making them stronger and long lasting. We show that increased activity in the network between the frontal lobe and the amygdala increases learned reactions. We found that this is in part driven by a downregulation of the epigenetic enzyme PRDM2.”

Some people may be more prone to experiencing anxiety disorders or AUD, yet the reasons behind this aren’t fully understood. Still, several factors may contribute to the development of these conditions.

Dr. Edward Ratush, a board certified psychiatrist who specializes in addiction treatment and co-founder of SOHOMD, told MNT:

“A general answer is that both environmental and genetic factors play a role — 40% of first-degree relatives with a fear-based disorder may develop a fear-based disorder themselves. Having a relative with [a] fear-based disorder means you could have inherited a predisposition to such a symptom complex.”

“It is possible that some individuals naturally have low levels of PRDM2 in the [prefrontal cortex] (PFC). However, more work is needed to demonstrate it. To date, we do not have data concerning adverse life experiences, but we have found lower PRDM2 expression in the PFC of alcoholic brains. It is difficult to determine here whether this was a pre-existing condition or whether this was resulting from long-term alcohol exposure,” pointed out Prof. Barbier.

As scientists uncover more evidence on specific brain pathways and mechanisms that may contribute to AUD and fear-based mental health conditions, it may lead to new treatment options.

Dr. Ratush explained that currently, “there are many directions that are taken to treat fear-based disorders. Some focus on the fear circuits’ intensity with breathing exercises, meditation, and mindfulness.”

He said that “many psychotherapy modalities attempt to amplify the connectivity between emotional regions and cognitive analytical regions,” while more modern therapies had more specific targets.

“Newer technological strategies employ electrical stimulation — directly and indirectly — to enhance or interrupt a relevant circuit. And of course, medications focus on the [neuro] transmitters most associated with these circuits,” Dr. Ratush said.

Dr. Loftus explained that with EMDR and neurofeedback therapy, patients can be “guided through treatment to retrain the brain and neurological pathways that are involved with PTSD and fear-based anxiety symptoms.”

Still, Prof. Barbier noted:

“We currently do not have the technology to increase PRDM2. However, genes that are regulated by PRDM2 can also be good candidate[s] for pharmacotherapies to treat AUD and anxiety disorders.”

“Our findings suggest that PRDM2 may be a shared mechanism between AUD and anxiety disorders. Therefore, this may also lead to the discovery of candidate targets for treating the comorbid condition.”
— Estelle Barbier, lead author

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Some health care providers in Arkansas are starting to offer services tailored to patients struggling to recover weeks or months after being diagnosed with covid-19.

An estimated one in five covid-19 survivors between 18 and 64 years old and one in four survivors 65 and older have a health condition related to their illness, according to a study released this year by the federal Centers for Disease Control and Prevention, which included 63.4 million individuals.

Another 2022 study published in the Journal of Infectious Diseases estimated millions of Americans -- about 1.7% to 3.8% of the U.S. population -- experienced new, long-term symptoms that limited daily activities one month or longer after covid-19 infection.

"Because the coronavirus can attack the lungs, heart, brain and other organs, there can be lasting internal damage," said Sheena CarlLee, director of the University of Arkansas for Medical Sciences' Long Covid Clinic, which opened Aug. 25 in Fayetteville.

Damage to vital organs can exacerbate long-term health problems such as heart disease, diabetes, kidney disease, blood disorders, neurological conditions and mental health disorders.

The new UAMS clinic brings together specialists in order to treat patients across the breadth of symptoms.

"We are seeing patients with a wide variety of symptoms that require a unique treatment regimen," CarlLee said. "Our long covid clinic offers extensive evaluation from a team of students and trained health care providers from the disciplines of medicine, pharmacy, nursing, physical therapy, occupational therapy and radiation sciences."

Some of the most successful long covid clinics in the country are team-based clinics, which can dive into a variety of symptoms and devise a detailed plan, according to CarlLee.

The clinic team also works closely with researchers at the UAMS campus in Little Rock, and patients may opt in to participate in that research, she said.

UAMS bills through insurance, and the cost for patients at the long covid clinic will be the same as a primary care clinic visit, according to CarlLee.

LONG COVID

CarlLee, a UAMS internal medicine doctor, and other doctors at various UAMS campuses have seen former covid-19 patients with prolonged symptoms related to the infection, she said.

Sometimes long covid symptoms develop for people who had little or no symptoms upon their initial positive test, but long covid tends to affect those who had a more complicated initial infection, she said.

Based on recent research, people who stayed in the ICU, were put on a ventilator, are unvaccinated or have underlying medical conditions all seem more likely to develop long covid, according to CarlLee. Women also may be disproportionately affected, she said.

Long covid is still being defined by the scientific community, according to health officials, but it generally signifies new or lingering symptoms of the virus occurring at least three or four weeks after a positive covid-19 test.

Because the term has yet to be precisely defined, data varies on the condition's prevalence, said Jennifer Dillaha, director of the Arkansas Department of Health.

The symptoms and conditions associated with long covid, which will likely affect many people in the coming years, are consistent throughout the scientific literature, Rachel Levine, U.S. assistant secretary for health, wrote last month in the Journal of the American Medical Association.

Symptoms such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell and problems with memory and concentration are among the more common symptoms. Heart palpitations, dizziness, diarrhea, stomach pain, rashes and joint or muscle pain have also been experienced post-covid, according to the federal Centers for Disease Control and Prevention.

Long covid isn't a singular case of long-term symptoms developing from viral infections, according to Dr. Marti Sharkey, Fayetteville's city health officer. Epstein-Barr virus is the cause of infectious mononucleosis, more commonly known as mono, she noted.

"It's not unusual to see prolonged systems. It's not surprising with a virus that has infected so many people," she said.

PATIENTS YOUNG AND OLD

In Central Arkansas, the Strong Hearts Rehabilitation Center by Arkansas Heart Hospital offers a rehab program for long covid patients at facilities in Little Rock, Russellville, Conway and Bryant.

The center enrolled its first post-covid patients in January shortly after the U.S. Centers for Medicare and Medicaid Services issued guidance allowing programs to treat lingering symptoms of the disease, said Amanda Xaysuda, director of the center.

"We had all of that planned before then but once Medicare was paying for that and more research was coming out that it was beneficial in this patient population, that's when we decided to go for it," she said.

Strong Hearts Rehabilitation Center's program focuses on pulmonary rehabilitation. Health care providers with the center help patients build their exercise tolerance and work on breathing exercises.

"Everything else we do is focused around the patient and what symptoms they are coming in with," said Xaysuda.

The program has helped post-covid patients dealing with postural orthostatic tachycardia syndrome, an abnormal spike in heart rate that occurs after sitting up or standing.

While the program's oldest patients have been in their 90s, the youngest was 16. Many patients are in their 30s and 40s, a demographic the Strong Hearts Rehabilitation Center isn't used to seeing.

"What we've always done is traditional cardiac rehab. Typically, our patients are Medicare age. They're 65 and older," said Xaysuda. "This is a whole new population of people."

Although Medicare and some private insurance companies cover pulmonary rehab for post-covid diagnoses, Xaysuda said Arkansas Blue Cross Blue Shield does not.

Other large Arkansas health care providers do not offer specialized clinics like the ones provided by UAMS and Arkansas Heart Hospital.

In a statement Thursday, spokesman Joshua Cook said CHI St. Vincent does not have a clinic dedicated to long covid treatment.

At Baptist Health, the prevalence of long covid is not high enough to warrant a specialty clinic, said Dr. Amanda Novack, medical director of infectious diseases in a statement Friday. Primary care physicians with Baptist Health nevertheless work with long covid patients to create personal care plans.

"These treatments might include specialized treatments such as physical therapy, nutritional support, cardiac or pulmonary rehabilitation," said Novack in the statement.

COMMUNITY RESPONSE

Sharkey, the Fayetteville city health officer, said preventing transmission should still be a goal of the community.

"Every time we get infected with this virus, there's another risk for long covid. Just because you haven't had long covid doesn't mean you won't," she said. "We have people who got covid on the first wave in winter of 2020 that are still suffering.

"We're definitely a lot better than where we were a year ago, but we're not at the end yet," she said.

Sharkey recommends people experiencing long-term covid symptoms visit a clinic with a team-based multidisciplinary approach, like the UAMS clinic.

"You need a team approach to assess multiple organ systems and have a very tailored approach to the symptoms of the person," she said.

Getting vaccinated will help fight transmission of the virus, Dillaha said.

"I'd encourage people to get primary vaccination doses, followed by at least one booster dose. Take reasonable steps to avoid getting infected. Especially if you're at high risk for severe illness," Dillaha said.

Dillaha worries people, especially parents, are not informed about long covid and do not consider the risks of infection when deciding whether to get themselves or their children vaccinated.

Even with mild symptoms, people should still get tested for covid-19, because they may be eligible for treatment with Pfizer's anti-viral drug Paxlovid and be able to minimize the risks of infection, according to Dillaha.

Arkansas' death toll from covid-19 topped 12,000 Tuesday. Nationally, more than 1 million people have died as a result of covid-19 infection, according to the centers.

Appointments

Residents can schedule an appointment at the UAMS clinic at 1125 N. College Avenue in Fayetteville by calling (479) 713-8701.

Source: University of Arkansas for Medical Sciences

 

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Some health care providers in Arkansas are starting to offer services tailored to patients struggling to recover weeks or months after being diagnosed with covid-19.

An estimated one in five covid-19 survivors between 18 and 64 years old and one in four survivors 65 and older have a health condition related to their illness, according to a study released this year by the federal Centers for Disease Control and Prevention, which included 63.4 million individuals.

Another 2022 study published in the Journal of Infectious Diseases estimated millions of Americans -- about 1.7% to 3.8% of the U.S. population -- experienced new, long-term symptoms that limited daily activities one month or longer after covid-19 infection.

"Because the coronavirus can attack the lungs, heart, brain and other organs, there can be lasting internal damage," said Sheena CarlLee, director of the University of Arkansas for Medical Sciences' Long Covid Clinic, which opened Aug. 25 in Fayetteville.

Damage to vital organs can exacerbate long-term health problems such as heart disease, diabetes, kidney disease, blood disorders, neurological conditions and mental health disorders.

The new UAMS clinic brings together specialists in order to treat patients across the breadth of symptoms.

"We are seeing patients with a wide variety of symptoms that require a unique treatment regimen," CarlLee said. "Our long covid clinic offers extensive evaluation from a team of students and trained health care providers from the disciplines of medicine, pharmacy, nursing, physical therapy, occupational therapy and radiation sciences."

Some of the most successful long covid clinics in the country are team-based clinics, which can dive into a variety of symptoms and devise a detailed plan, according to CarlLee.

The clinic team also works closely with researchers at the UAMS campus in Little Rock, and patients may opt in to participate in that research, she said.

UAMS bills through insurance, and the cost for patients at the long covid clinic will be the same as a primary care clinic visit, according to CarlLee.

LONG COVID

CarlLee, a UAMS internal medicine doctor, and other doctors at various UAMS campuses have seen former covid-19 patients with prolonged symptoms related to the infection, she said.

Sometimes long covid symptoms develop for people who had little or no symptoms upon their initial positive test, but long covid tends to affect those who had a more complicated initial infection, she said.

Based on recent research, people who stayed in the ICU, were put on a ventilator, are unvaccinated or have underlying medical conditions all seem more likely to develop long covid, according to CarlLee. Women also may be disproportionately affected, she said.

Long covid is still being defined by the scientific community, according to health officials, but it generally signifies new or lingering symptoms of the virus occurring at least three or four weeks after a positive covid-19 test.

Because the term has yet to be precisely defined, data varies on the condition's prevalence, said Jennifer Dillaha, director of the Arkansas Department of Health.

The symptoms and conditions associated with long covid, which will likely affect many people in the coming years, are consistent throughout the scientific literature, Rachel Levine, U.S. assistant secretary for health, wrote last month in the Journal of the American Medical Association.

Symptoms such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell and problems with memory and concentration are among the more common symptoms. Heart palpitations, dizziness, diarrhea, stomach pain, rashes and joint or muscle pain have also been experienced post-covid, according to the federal Centers for Disease Control and Prevention.

Long covid isn't a singular case of long-term symptoms developing from viral infections, according to Dr. Marti Sharkey, Fayetteville's city health officer. Epstein-Barr virus is the cause of infectious mononucleosis, more commonly known as mono, she noted.

"It's not unusual to see prolonged systems. It's not surprising with a virus that has infected so many people," she said.

PATIENTS YOUNG AND OLD

In Central Arkansas, the Strong Hearts Rehabilitation Center by Arkansas Heart Hospital offers a rehab program for long covid patients at facilities in Little Rock, Russellville, Conway and Bryant.

The center enrolled its first post-covid patients in January shortly after the U.S. Centers for Medicare and Medicaid Services issued guidance allowing programs to treat lingering symptoms of the disease, said Amanda Xaysuda, director of the center.

"We had all of that planned before then but once Medicare was paying for that and more research was coming out that it was beneficial in this patient population, that's when we decided to go for it," she said.

Strong Hearts Rehabilitation Center's program focuses on pulmonary rehabilitation. Health care providers with the center help patients build their exercise tolerance and work on breathing exercises.

"Everything else we do is focused around the patient and what symptoms they are coming in with," said Xaysuda.

The program has helped post-covid patients dealing with postural orthostatic tachycardia syndrome, an abnormal spike in heart rate that occurs after sitting up or standing.

While the program's oldest patients have been in their 90s, the youngest was 16. Many patients are in their 30s and 40s, a demographic the Strong Hearts Rehabilitation Center isn't used to seeing.

"What we've always done is traditional cardiac rehab. Typically, our patients are Medicare age. They're 65 and older," said Xaysuda. "This is a whole new population of people."

Although Medicare and some private insurance companies cover pulmonary rehab for post-covid diagnoses, Xaysuda said Arkansas Blue Cross Blue Shield does not.

Other large Arkansas health care providers do not offer specialized clinics like the ones provided by UAMS and Arkansas Heart Hospital.

In a statement Thursday, spokesman Joshua Cook said CHI St. Vincent does not have a clinic dedicated to long covid treatment.

At Baptist Health, the prevalence of long covid is not high enough to warrant a specialty clinic, said Dr. Amanda Novack, medical director of infectious diseases in a statement Friday. Primary care physicians with Baptist Health nevertheless work with long covid patients to create personal care plans.

"These treatments might include specialized treatments such as physical therapy, nutritional support, cardiac or pulmonary rehabilitation," said Novack in the statement.

COMMUNITY RESPONSE

Sharkey, the Fayetteville city health officer, said preventing transmission should still be a goal of the community.

"Every time we get infected with this virus, there's another risk for long covid. Just because you haven't had long covid doesn't mean you won't," she said. "We have people who got covid on the first wave in winter of 2020 that are still suffering.

"We're definitely a lot better than where we were a year ago, but we're not at the end yet," she said.

Sharkey recommends people experiencing long-term covid symptoms visit a clinic with a team-based multidisciplinary approach, like the UAMS clinic.

"You need a team approach to assess multiple organ systems and have a very tailored approach to the symptoms of the person," she said.

Getting vaccinated will help fight transmission of the virus, Dillaha said.

"I'd encourage people to get primary vaccination doses, followed by at least one booster dose. Take reasonable steps to avoid getting infected. Especially if you're at high risk for severe illness," Dillaha said.

Dillaha worries people, especially parents, are not informed about long covid and do not consider the risks of infection when deciding whether to get themselves or their children vaccinated.

Even with mild symptoms, people should still get tested for covid-19, because they may be eligible for treatment with Pfizer's anti-viral drug Paxlovid and be able to minimize the risks of infection, according to Dillaha.

Arkansas' death toll from covid-19 topped 12,000 Tuesday. Nationally, more than 1 million people have died as a result of covid-19 infection, according to the centers.

 

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While advanced technological and infrastructural developments have made life easier for all of us, they have also had a disastrous impact on the environment, particularly on air quality. Air pollution has become one of the biggest problems of our time. Fine particulate matter polluting the air can easily penetrate your bloodstream and adversely impact your overall health, especially your lungs. According to the data collected by the World Health Organization (WHO), ambient air pollution was the cause of 4.2 million deaths in 2016 and is estimated to lead to about 16 percent of all lung cancer deaths.

So, how can you keep your lungs healthy while living in a polluted city? Here we’re revealing how a few lifestyle tips can keep lungs healthy.

Follow these 9 tips to keep lungs healthy and strengthen them to fight pollution:

1. Keep an eye on pollution forecast

There are many applications and websites that provide nearly accurate predictive outdoor air quality reports every day. With their colour-coded system, these apps help you comprehend just how much pollution you will expose yourself to when you step outside that day.

2. Stay indoors on bad AQI days

Spend as much time indoors as you can, particularly on days when the pollution forecast or the AQI (air quality index) shows an alarming number. In case you need to step out, wear a high-quality face mask at all times to avoid inhaling harmful particles in the air.

3. Don’t exercise outdoors

Whenever the pollution levels are high, avoid exercising outdoors. Walking, jogging or any other strenuous activities that might increase your breathing rate can lead to the inhalation of harmful particles present in the air.

4. Drink enough water

Drinking enough water can help in flushing toxins out of your body. It is advisable to drink at least 8 to 10 glasses of water every day to stay hydrated.

tips to keep lungs healthy
Don’t reduce your water intake. Image Courtesy: Shutterstock

5. Maintain a healthy diet

One of the best ways to resist harmful effects of air pollution is by building up your immunity against infections. For this, maintaining a healthy diet rich in vital nutrients like vitamins C and E is essential. Make sure that your diet is packed with the nutrients to keep up the health of your respiratory tract.

6. Quit smoking

You need to quit smoking now, especially if you live in a polluted city. Nothing is more damaging to your lungs than smoking cigarettes. The harmful chemicals in cigarettes compounded with the harmful particles in the air can be immensely damaging to your lungs.

7. Get an air purifier

The air inside your home can also be polluted, sometimes even more than the air outside. For this reason, it is a smart choice to invest in an air purifier. Make sure to keep your air purifier clean and replace its filter frequently.

8. Practice breathing exercises

Practicing breathing exercises every day can prove to be helpful in improving lung functions. Some of these exercises include belly breathing and pursed lip breathing.

tips to keep lungs healthy
Breathing properly in the morning can improve lung health. Image courtesy: Shutterstock

9. Go green!

Make sure you do everything you can towards reducing air pollution and improving air quality. To do your bit, you can consume less energy in your homes, use hand-powered equipment, and take a bike, walk, or carpool whenever possible.

Takeaway

With air pollution posing such a huge risk to your lung health as well as overall well-being, it is best to follow the above-mentioned measures, especially if you are living in a polluted city. If you experience any respiratory problems or symptoms of lung issues, consult with a doctor right away.

Air pollution, if not more, is as dangerous and harmful to the human body as has been smoking over the years. It’s time we realize it is harmful and take preventive measures to safeguard ourselves from this growing menace.

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The specialists agreed that stress influences all spheres of life, including sexual (Getty)
The specialists agreed that stress influences all spheres of life, including sexual (Getty)

To the fast pace of life, work obligations and tight daily routines, the COVID-19 pandemic has added anxiety, fear, uncertainty and a global traumatic situation that will undoubtedly raised stress levels in societyin some cases, to its maximum point.

And it is well known that when stress ceases to be a punctual reaction and becomes a chronic situation, it has multiple consequences in the physical and mental health.

According to the American Psychological Association, chronic stress, if left untreated, can lead to anxiety, insomnia, muscle pain, and a weakened immune system, and can even contribute to the development of certain pathologies, such as heart disease, depression, and obesity.

And although most people may not know it, stress can even affect the pelvic floor, that is, the group of muscles and other tissues that form a kind of sling or hammock across the pelvis. In women, this “floor” holds the uterus, bladder, intestines, and other pelvic organs in place so they can function properly.

Although most people may not know it, stress can even affect the pelvic floor (Getty)
Although most people may not know it, stress can even affect the pelvic floor (Getty)

Now, various investigations show that the pelvic floor muscles actively contract in response to physical or mental stress, generating consequences in people’s daily lives and even in their sexuality.

Rachel Gelman is a physiotherapist specialized in pelvic floor and assured that “it is common that when people feel tense or nervous they tend to tighten the gluteal muscles, and although it is a normal response, when it is caused by chronic stress, it can cause all kinds of pelvic floor disorders. In this way, according to the specialist, “diverse consequences can appear that range from pain during sexual intercourse, pelvic organ prolapse or lumbar pain to bladder dysfunction and constipation.”

And while stress may never have been linked to those consequences, according to Caroline Correiadirector of Fisiofit Mujer, a Spanish physiotherapy clinic dedicated to women’s health, “stress alters the postural and respiratory patternwhich leads to an alteration in the musculature of the diaphragm”.

Specifically, this usually remains more tense, favoring the increase in intra-abdominal pressure and the downward thrust of the abdominal viscera. In this way, the pelvic floor muscles are forced to contract to counteract the increased pressure and ensure urinary continence. All this process of pelvic floor contraction over time will lead to the formation of trigger points, which are basically pain points.

The group of muscles that holds the uterus, bladder, intestines, and other pelvic organs in place can contract just like any other (Getty)
The group of muscles that holds the uterus, bladder, intestines, and other pelvic organs in place can contract just like any other (Getty)

“Most of the time they are the cause of pain during sexual intercourse, back problems, pain that radiates to the leg or discomfort during the period,” Gelman pointed out. In addition to these problems, a constant contraction of the pelvic muscles can lead to muscle fatigue, favoring the appearance of the dreaded urinary incontinence”.

consulted by Infobaethe gynecologist Marisa Labovsky (MN 84376) explained that “the pelvic floor is made up of muscles and the muscles contract like any other in the bodyTherefore, when one is stressed, everything contracts”.

“On the other hand, when you are stressed you have less desire to have sex and sometimes you have sex just the same, so when the muscles are contracted, the area is not well lubricated and that causes discomfort and burning, and a vicious circle is generated in the one that when the person knows that they are going to have sex, they think that it will hurt and therefore they contract and when they contract it obviously hurts and so on”, the gynecologist deepened.

Along the same lines, according to a study by the University of Örebro, in Sweden, only among women under 30 years of age, around 20% report recurrent sexual pain. This pain, in addition, causes fear of sexual relations and, therefore, the avoidance of them. In this way, according to this work, “women with pain reported higher levels of fear avoidance and pain catastrophizing, as well as depression and anxiety.” A situation that does nothing but maintain the stress and the underlying cause of the pain itself.

Chronic stress, if left untreated, can lead to anxiety, insomnia, muscle pain, and a weakened immune system (Getty)
Chronic stress, if left untreated, can lead to anxiety, insomnia, muscle pain, and a weakened immune system (Getty)

In her turn, the gynecologist Gabriela Kosoy (MN 70409), said before the consultation of this medium that “obviously stress influences all spheres of life, including sexuality.” “It alters the microbiota, so it can cause constipation,” explained the specialist. The pelvic floor has a very precise innervationso everything that alters the nervous system can alter its structure”.

Regarding the variety of symptoms involved, Labovsky argued that “the pelvic floor is full of muscles, and if they contract, it makes intercourse difficult, going from body to body, etc. because the entire pelvic floor involves the anal, vaginal and urethral orifice.”

“Doing relaxation exercises, yoga, breathing and pelvic floor exercises will surely help" (Getty)
“Doing relaxation exercises, yoga, breathing and pelvic floor exercises will surely help” (Getty)

The first step, according to specialists, is to identify that the symptoms may be due to a situation of stress and not to any other problem.

“The key is precisely to rule out other possible causes,” said Correira, for whom “a very similar case is that of chronic constipation. There are many women who have a correct diet, adequate water intake and exercise regularly, but still suffer from constipation. The answer would be the level of stress.”

In the case of the pelvic floor, “we should rule out that the pain is due to a physical cause. For example, having gone through childbirth or having suffered some type of injury or infection in the area, added Gelman. If we do not find another apparent cause and we know that we are going through a long stage of stress, perhaps we should first try to work on it”.

In that sense, the physical therapist recommended “obvious things like spending time outdoors, doing gentle exercises like yoga and dancing, writing, spending time with friends, masturbating or, of course, going to therapy can be of great help.”

Functional improvements in breathing patterns and pelvic stability could indirectly influence changes in the pelvic floor (Getty)
Functional improvements in breathing patterns and pelvic stability could indirectly influence changes in the pelvic floor (Getty)

Do relaxation exercises, yoga, breathing and pelvic floor exercises will surely help, as well as being able to see what is the cause of stress and be able to solve it,” added Labovsky, while Kosoy added: “Anything that is breathing exercises, mindfulness, yoga of course that by improving stress will improve the symptom.”

On the other hand, there are also specific exercises to relieve stress on a more physical level. Correia recommended breathing mindfully for at least a minute. “Something so simple helps stimulate the parasympathetic nervous system, which is responsible for lowering stress levels,” she pointed out.

It should be remembered that there is a relationship between respiratory and postural function with the pelvic floor. According to some studies, functional improvements in breathing patterns and pelvic stability could indirectly affect the changes produced in the pelvic floor, even in the case of symptoms such as urinary incontinence. In addition, some stretching could also be useful to favor the relationship of the diaphragmatic muscles. “Such as stretching that favors hip opening, psoas stretching and quadratus lumborum”, Correira adds.

"Everything that is breathing exercises, mindfulness, yoga of course that by improving stress will improve the symptom" (Getty)
“Anything that is breathing exercises, mindfulness, yoga of course that by improving stress will improve the symptom” (Getty)

At this point, in dialogue with Infobaethe national teacher of Physical Education Mariela Catania contributed a exercise to strengthen the pelvic floor muscles.

“Lying on your back, with your legs bent, and feet supported, we place our hands on our belly and contract the pelvic floor. We have to feel how the sphincters close, how we raise the pelvic organs and how the lower abdomen tightens, ”she described.

And he continued: “Now we are going to contract the deep abdominal plane -transversus abdominis- without losing the pelvic floor. The contraction should be smooth. We breathe inhaling in two beats inflating the belly with air and exhale slowly in four beats. We repeat six to ten times and relax. We contract the pelvic floor, contract the inner abdomen, hold and relax.”

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