Pregnant during the COVID-19 crisis

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The COVID-19 pandemic has changed the healthcare landscape for many patient populations — including pregnant women.

To mark Mental Health Awareness Month this May, we’re bringing you research-backed information to help support the mental well-being of you and your loved ones during this difficult time.

Altered hospital policies, concerns about contracting the SARS-CoV-2 virus, and changes to doctors’ office hours have all affected pregnancy.

Information regarding pregnancy and COVID-19 is continually evolving. This article will cover the currently available information relating to pregnancy during the pandemic.

Pregnancy can be an exciting time, but also one of uncertainty. The COVID-19 pandemic understandably adds further stress and may cause anxiety in some people.

During pregnancy, signs and symptoms of high stress include:

  • changes in appetite
  • frequent feelings of fear and worry about the pregnancy and delivery
  • poor quality sleep
  • problems concentrating

Pregnant women may wish to try the following stress-relieving practices and tips:

  • Refrain from looking at physical media or watching the news around the clock. Instead, limit the news to key times of the day, such as the morning or before dinner, leaving the evenings free for unwinding and promoting sleep.
  • Ask a doctor or midwife about online antenatal classes, which are excellent places to meet and talk to other pregnant women.
  • Try meditating, deep breathing, or gentle stretching.
  • Take care of key relationships by connecting with friends and family over the phone or through video conferences.
  • Get enough sleep by going to bed at a consistent time and limiting screen time beforehand.
  • Maintain a healthful diet and engage in regular exercise. Eating well and staying active can help the body stay healthy in times of mental ill health.
  • Take up a new hobby or rediscover an old one, such as playing an instrument, learning a language, or reading. People may also enjoy making blankets, clothes, or handmade toys for the coming baby, or decorating a nursery.
  • Make use of online support groups and forums for pregnant women and new parents.
  • Consider online counseling. Therapy can be helpful for anyone experiencing anxiety, depression, or stress.
  • Ask for extra help — this may mean that a partner takes a greater share of caring for the children, if applicable, or that a neighbor does the grocery shopping and drops the bags outside the door.

If a woman is experiencing significant mental distress, it is vital to speak to a doctor, midwife, or counselor.

Depression during pregnancy is common but treatable. Even if they are physical distancing, pregnant women do not have to face depression or other mental health concerns alone.

Physical distancing while pregnant

Avoiding contact with others, especially large groups of people, can reduce the transmission of the coronavirus.

Many areas have enacted shelter-at-home or safer-at-home policies that discourage people from going outside except for essential travel, such as going to the grocery store or pharmacy or making other necessary visits.

It is essential to keep attending prenatal appointments, but be aware that some of these appointments may occur over the phone.

Modern technology enables doctors’ offices to change the way in which they help people, including pregnant women.

The American College of Obstetricians and Gynecologists recommend that pregnant women talk with a doctor to determine how often they should go for in-person visits.

Our doctors offer online video call visits called telemedicine. They may recommend spacing out ultrasound appointments or other in-person visits to reduce a woman’s risk for transmission.

If possible, having a partner or delivery service secure key items can help reduce a pregnant woman’s exposure to the public.

People should always wash their hands when returning from the grocery store or a walk outside.

COVID-19 effects during pregnancy

As COVID-19 is a new and developing health crisis, experts have not yet identified its effects on pregnancy. They remain unsure whether pregnant women are more at risk of getting COVID-19 or experiencing more severe symptoms and whether they might pass the virus to the baby.

According to the World Health Organization (WHO), no evidence currently exists to suggest that pregnant women are at higher risk of experiencing severe COVID-19 symptoms than the general population.

A small study of nine pregnant women in their third trimester with COVID-19 and pneumonia symptoms in Wuhan, China, found that one baby tested positive for the virus 36 hours after birth.

However, tests of the woman’s placenta and umbilical cord were negative, which could mean that the newborn contracted the virus after birth, rather than in the womb. This sample size was very small, which makes drawing conclusions difficult.

Another study of 38 pregnant women testing positive for COVID-19 in China did not find that their symptoms were more severe than those affecting the general population.

The study did not report any maternal deaths or the transmission of COVID-19 to any babies.

When to self-isolate

If a pregnant woman has symptoms that resemble those of COVID-19, such as coughing, fever, or shortness of breath, she should call a doctor.

The doctor can make recommendations about whether or not COVID-19 testing is necessary.

If the woman’s symptoms are mild, a doctor will likely recommend that she self-isolate at home.

Home treatment includes taking acetaminophen for fever relief, resting, and drinking plenty of water.

A high fever or difficulty breathing are signs that urgent care is necessary. Try to call the hospital before arriving at the emergency room so that they can take any necessary precautions.

Do you have to give birth alone in the hospital?

Some hospitals in the United States have prohibited visitors for the foreseeable future — including during childbirth — to protect healthcare staff and other patients from the virus. The number of support people who may enter the delivery room can vary from hospital to hospital, however.

Questions to ask a doctor

The pandemic has resulted in many pregnant women experiencing changes to their birth plan, which can cause stress and uncertainty.

Having all the necessary information may help them feel in control and reduce anxiety.

Questions to ask a doctor include:

  • How may your office hours or accessibility change?
  • Are there online alternatives to antenatal classes where I can meet and talk to other pregnant women?
  • How can I ensure that I am safe when visiting my doctor’s office or going to the hospital?
  • How can I expect COVID-19 concerns at the hospital to affect my delivery?
  • Will there be changes in terms of the medications that I may receive or the number of people present in the delivery room?

A woman can also ask her doctor about any area-specific or condition-specific changes.

Summary

Pregnant women may feel additional stress, anxiety, or depression during the COVID-19 pandemic. But even if they are self-isolating, they do not have to face these problems alone.

It is best for pregnant women to focus on the elements that they can control, including self-care and physical distancing.

Keeping in regular contact with a doctor or midwife can also help alleviate worries about health and the birth.

Covid-19 patients recovering quickly after getting experimental drug remdesivir

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COVID-19 patients on the antiviral remdesivir recovered about 30 percent faster than those on a placebo, the results of a major clinical trial showed Wednesday, as a top US scientist hailed the drug’s “clear-cut” benefit.

The patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever, but were able to leave the hospital after less than a week of treatment, STAT quoted the doctor leading the trial as saying.

“The best news is that most of our patients have already been discharged, which is great.

“Partial data from an ongoing clinical trial is by definition incomplete and should never be used to draw conclusions about the safety or efficacy of a potential treatment that is under investigation.

There is no approved therapy for the Covid-19, which can cause severe pneumonia and acute respiratory distress syndrome in some patients. But the National Institutes of Health is organizing trials of several drugs and other treatments, among them remdesivir.

The drug, made by Gilead Sciences, was tested against Ebola with little success, but multiple studies in animals showed the drug could both prevent and treat coronaviruses related to Covid-19, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

Back in February, the World Health Organization said remdesivir showed potential against Covid-19.

Most of our patients are severe and most of them are leaving at six days, so that tells us duration of therapy doesn’t have to be 10 days.

However, the trial does not include what’s known as a control group, so it will be difficult to say whether the drug is truly helping patients recover better. With a control arm, some patients do not receive the drug being tested so that doctors can determine whether it’s the drug that is really affecting their condition.

Trials of the drug are ongoing at dozens of other clinical centers, as well. Gilead is sponsoring tests of the drug in 2,400 patients with severe Covid-19 symptoms in 152 trial sites around the world. It’s also testing the drug in 1,600 patients with moderate symptoms at 169 hospitals and clinics around the world.

Gilead said it expected results from the trial by the end of the month.

“We understand the urgent need for a COVID-19 treatment and the resulting interest in data on our investigational antiviral drug remdesivir,” the company said in a statement. But it said a few stories about patients are just that.

“The totality of the data need to be analyzed in order to draw any conclusions from the trial. Anecdotal reports, while encouraging, do not provide the statistical power necessary to determine the safety and efficacy profile of remdesivir as a treatment for Covid-19.

Who is at higher risk of CoronaVirus?

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WEarly information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

Get ready for COVID-19 now

Take actions to reduce your risk of getting sick

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

  • Stock up on supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • Avoid cruise travel and non-essential air travel.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

Have supplies on hand

  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
  • If you cannot get extra medications, consider using mail-order for medications.
  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

Are children actually ‘as likely’ to get COVID-19 as adults?

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So far, reports have maintained that children appear to be less susceptible to infection with the new coronavirus, SARS-CoV-2, than adults. But some researchers now claim that this is not the case.

Researchers are still uncertain how susceptible children are to SARS-CoV-2.

As the new coronavirus continues to spread, the public still wonders who is most at risk of infection.

Children are a primary concern: How susceptible are they to SARS-CoV-2 infection, really?

Until now, reports in peer-reviewed journals — such as this one featured in JAMA Network last month — have suggested that children appear to be less likely to develop COVID-19 than adults.

Now, an international team of researchers — many from the Shenzhen Center for Disease Control and Prevention and Peng Cheng Laboratory, both in China — has conducted a study and reached a different conclusion.

This study is preliminary and has not yet been published in a peer-reviewed journal. This means that it has not yet undergone a thorough quality and accuracy assessment from specialists in the field.

Nevertheless, the authors have made their findings available online in preprint form.

Kids’ infection rate similar to adults’

The researchers analyzed data from people in Shenzhen, China with confirmed SARS-CoV-2 infections and data from their close contacts.

In total, they looked at 391 people with confirmed COVID-19 and 1,286 individuals who were in close contact.

The researchers’ aim was to find out whether close contacts of people with COVID-19 would test positive for SARS-CoV-2, even when they presented no obvious symptoms of the infection.

The investigators found that children under 10 who were in close contact with people who had COVID-19 demonstrated a 7.4% infection rate — very similar to the 7.9% infection rate in adults.

However, the researchers also determined that children were less likely to develop symptoms, even though they seemed just as likely as adults to contract the virus.

“Kids are just as likely to get infected [as grownups] and they’re not getting sick,” notes co-author Justin Lessler, Ph.D., from the Johns Hopkins Bloomberg School of Public Health, in Baltimore, MD.

In the study paper, the researchers also report that people who lived with individuals who had diagnosed COVID-19 were more likely to develop the infection than other close contacts.

Still, they write that “Even in this group, less than 1 in 6 contacts were infected; and, overall, we observed far less than one (0.4) onward transmission per primary case.”

The researchers caution that their study “has numerous limitations,” since the data were collected by different teams following different protocols, and while definitions of what qualified as SARS-CoV-2 infection changed as understanding of the outbreak evolved.

Meditation vs Medication

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Even a brief introduction to meditation can ease pain

New research has found that a 30-minute introduction to mindfulness can significantly reduce negative emotions and ease physical pain — even for those who have never practiced the technique before.

Research has shown that mindfulness and mindful acceptance have multiple benefits for physical and emotional health.

Medical News Today have covered studies showcasing the many benefits of mindfulness, from lowering blood pressure to coping with phobias.

There are two other areas that mindfulness can be helpful with: pain and emotion regulation.

Neuroscientific experiments have found that participants felt less physical pain as a result of practicing mindfulness, and researchers have suggested that this may have implications for managing chronic pain.

Further studies using brain scans have showed that mindfulness helps control emotions, which may help people overcome addiction or lower their stress levels.

However, is it possible that someone who has never meditated before can reap these benefits? This is what a group of researchers — led by Hedy Kober, an associate professor of psychiatry and psychology at Yale University in New Haven, CT — has set out to examine.

Specifically, Kober and colleagues wanted to see whether or not people with no previous mindfulness experience could benefit from a 30-minute introduction to the technique.

The results — which now appear in the journal Social, Cognitive, and Affective Neuroscience — do seem to suggest that a brief introduction to mindfulness can help ease pain and reduce negative emotions.

Mindfulness, pain, and negative emotions

Kober and team tested 17 “meditation-naïve” participants, aged 18–45, under two experimental conditions.

In one condition, the participants had to look at 30 negative images vs. 30 neutral images. In the other, they experienced painful vs. warm temperature stimuli 30 times each.

Before the experiments, the researchers trained the participants in mindfulness and how to complete the tasks for a period of 30 minutes.

During this time, the researchers instructed the participants to “react naturally, whatever [their] response might be” in the control condition, so that the scientists could establish a baseline measure of emotional response.

The researchers achieved this by performing brain imaging scans of the participants as they were completing the tasks.

Then, they asked the participants “to attend to and accept their experience as it is.” This was the mindful acceptance mindset, which consisted of two components: “attention to present moment sensation” and “non-judgmental acceptance of the sensation as it is, allowing it to exist without trying to avoid it or react to it.”

For example, in the experiments that involved the physical application of heat to the participants’ forearms, the researchers instructed them to accept the sensation in a non-judgmental way.

“[P]participants were told ‘if you feel a sensation of warmth on your forearm, you should simply attend to what is felt, without making any judgment of the ‘goodness’ or ‘badness’ of that sensation,” explain the study authors in their paper.

The effect of 30 minutes of mindfulness

The experiments revealed that the participants reported less physical pain and negative emotions in the mindfulness condition.

This coincided with changes in their brains. According to the study authors, “Emotion regulation using mindful acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images, and reduced heat-evoked responses in medial and lateral pain systems.”

Referring to the physical pain experiments, Kober explains, “It’s as if the brain was responding to warm temperature, not very high heat.”

Kober goes on to comment on the clinical significance of the findings:

“The ability to stay in the moment when experiencing pain or negative emotions suggests there may be clinical benefits to mindfulness practice in chronic conditions as well — even without long meditation practice.”

– Hedy Kober

Eating red meat and processed meat hikes heart disease, death risk: study

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Drop the steak knife. After a controversial study last fall recommending that it was not necessary for people to change their diet in terms of red meat and processed meat, a large, carefully analyzed new study links red and processed meat consumption with slightly higher risk of heart disease and death, according to a new study from Northwestern Medicine and Cornell University.

Eating two servings of red meat, processed meat or poultry—but not fish—per week was linked to a 3 to 7% higher risk of cardiovascular disease, the study found. Eating two servings of red meat or processed meat—but not poultry or fish—per week was associated with a 3% higher risk of all causes of death.

“It’s a small difference, but it’s worth trying to reduce red meat and processed meat like pepperoni, bologna and deli meats,” said senior study author Norrina Allen, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine. “Red meat consumption also is consistently linked to other health problems like cancer.”

“Modifying intake of these animal protein foods may be an important strategy to help reduce the risk of cardiovascular disease and premature death at a population level,” said lead study author Victor Zhong, assistant professor of nutritional sciences at Cornell, who did the research when he was a postdoctoral fellow in Allen’s lab.

The paper will be published Feb. 3 in JAMA Internal Medicine.

The new findings come on the heels of a controversial meta-analysis published last November that recommended people not reduce the amount of red meat and processed meat they eat. “Everyone interpreted that it was OK to eat red meat, but I don’t think that is what the science supports,” Allen said.

“Our study shows the link to cardiovascular disease and mortality was robust,” Zhong said.

What should we eat?

“Fish, seafood and plant-based sources of protein such as nuts and legumes, including beans and peas, are excellent alternatives to meat and are under-consumed in the U.S.,” said study coauthor Linda Van Horn, professor of preventive medicine at Feinberg who also is a member of the 2020 U.S. Dietary Guidelines Advisory committee.

The study found a positive association between poultry intake and cardiovascular disease, but the evidence so far isn’t sufficient to make a clear recommendation about poultry intake, Zhong said. Still, fried chicken is not recommended.

The new study pooled together a large diverse sample from six cohorts, included long follow-up data up to three decades, harmonized diet data to reduce heterogeneity, adjusted a comprehensive set of confounders and conducted multiple sensitivity analyses. The study included 29,682 participants (mean age of 53.7 years at baseline, 44.4% men and 30.7% non-white). Diet data were self-reported by participants, who were asked a long list of what they ate for the previous year or month.

Key findings:

  • A 3 to 7% higher risk of cardiovascular disease and premature death for people who ate red meat and processed meat two servings a week.
  • A 4% higher risk of cardiovascular disease for people who ate two servings per week of poultry, but the evidence so far is not sufficient to make a clear recommendation about poultry intake. And the relationship may be related to the method of cooking the chicken and consumption of the skin rather than the chicken meat itself.
  • No association between eating fish and cardiovascular disease or mortality.

Limitations of the study are participants’ dietary intake was assessed once, and dietary behaviors may have changed over time. In addition, cooking methods were not considered. Fried chicken, especially deep fat-fried sources that contribute trans-fatty acids, and fried fish intake have been positively linked to chronic diseases, Zhong said.

What is the coronavirus illness blamed for multiple deaths in China?

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Officials in China are racing to contain a deadly new strain of virus that has infected more than 2,700 people and left at least 81 dead. Chinese officials have blocked all transportation in and out of the city of Wuhan and surrounding areas, where the outbreak of the “2019 novel coronavirus” or “2019-nCoV” originated. 

Five cases of the illness have been confirmed in the United States — all in people who had recently traveled from Wuhan, China. U.S. health officials confirmed the first case on Tuesday, involving a man in his 30s in Seattle. The second case was confirmed Friday in a woman in her 60s in Chicago. Health officials said she was “doing well.” Over the weekend, two additional cases were confirmed in California and one in Arizona.

The U.S. Centers for Disease Control and Prevention said Friday that more than 60 people in 22 states were being monitored for possible infection.

  • China locks down cities in unprecedented effort to contain coronavirus

Health officials believe the virus was initially transmitted from animals to humans, but that human-to-human transmission of the flu-like illness is now occurring.

What is a coronavirus?

Coronaviruses are a large group of viruses that can cause illnesses as minor as a cold, or as serious as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), according to the World Health Organization. They often present with pneumonia-like symptoms.

The viruses can be transmitted from animals to humans; the virus that causes SARS, for example, was originally transmitted to humans from a cat-like animal called a civet. But in some instances, as appears to be the case with this new strain of coronavirus, they can also be transmitted between humans. 

The World Health Organization said there are multiple known coronaviruses circulating in animals that have not yet been transmitted to humans.

How did the new strain start?

The outbreak began in Wuhan, a city of 11 million people. Many of the early patients were reportedly linked to Hua Nan Seafood Wholesale Market, a large seafood and animal market in the city, according to CBS News’ Ramy Inocencio. But since then, a rising number of people have apparently contracted the virus without exposure to the market.

The market was closed on January 1, 2020 for “environmental sanitation and disinfection,” according to the World Health Organization. 

How many people have died?

At least 81 people have died from the illness, according to Chinese officials. Most of those deaths occurred in Wuhan, which is in the central Hubei province. The first death was reported January 9. 

Where is it?

While the virus originated around Wuhan, cases have also been reported in Thailand, Taiwan, Japan, South Korea, Vietnam, Malaysia, Nepal, Singapore, the U.S., Australia and France. 

How is it transmitted?

It’s well-established that coronaviruses can spread from animals to humans, according to the World Health Organization. But health officials confirmed there have been cases in which this virus has spread from human to human. 

Chinese state-run media quoted Zhong Nanshan, a scientist at the China’s National Health Commission, as saying such transmission was “affirmative.” The scientist did not say how many cases were the result of human-to-human transmission — but in one case, a hospital patient is said to have infected 14 medical workers, reports Inocencio.

What’s being done to stop the spread? 

The World Health Organization convened an emergency committee on the virus in Geneva, Switzerland. It said Thursday that the outbreak does not rise to the level of being designated an international public health emergency, but WHO will continue working with nations to contain it.

Meanwhile in the U.S., the CDC deployed public health workers to screen passengers arriving from Wuhan at five major ports of airline entry: New York-JFK, Los Angeles, San Francisco, Atlanta and Chicago-O’Hare.

The CDC said it has developed a test to diagnose the virus. Currently, that test must be administered at the CDC, but the organization is working to share the test with domestic and international partners.

In Hong Kong, which was ravaged by SARS in 2002 and 2003, hospitals upped their alert level to “serious” and implemented temperature checkpoints for inbound travelers.

While China has closed transportation in and out of Wuhan and 12 other cities, there are concerns that as hundreds of millions of people travel around the country to celebrate the Chinese New Year, the virus could spread even faster.

Breast implant illness

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“I feel like I’m being poisoned.” I will never forget the night I told my parents that I thought my breast implants were the cause of a decade’s worth of unexplained medical phenomena.

What started as a sudden onset of panic attacks 7 years ago transformed into a laundry list of debilitating mental and physical ailments that I was forced to cope with daily.

The day before my explant surgery, I tallied 49 symptoms that I was actively experiencing. I had received misdiagnoses of mental health conditions, such as panic disorder, anxiety disorder, depression, PTSD, and most recently, bipolar disorder.

I struggled with bouts of extreme insomnia, where I wouldn’t sleep at all for 2 to 3 days on end.

Doctors had prescribed pretty much every combination of SSRIs, benzos, stimulants, and sleep medications on the market. The slew of debilitating side effects from these drugs landed me in the ER too many times to count.

Physically, I experienced an onset of sudden food intolerances and allergies that caused digestive issues, such as acid reflux, GERD, and gastritis.

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I lived with symptoms of autoimmune diseases, such as joint pain, swollen lymph nodes, and liver and kidney dysfunction, all with no conclusive diagnosis.

My feet and hands turned purple and were ice cold to the touch. My hair fell out in clumps in the shower, and the strands that remained were dry and brittle. My blood tests showed abnormal liver and kidney function, and my kidney grew a mass twice the size of itself. I experienced other unexplained symptoms, such as skin rashes, migraines, brain fog, and numbness and tingling in extremities.

The surgery changed everything

My entire life suffered from the toxic blow of this unexplained condition. Before I got sick, I was a college senior at USC, on the Dean’s list, with an abundance of friends. I was in a healthy relationship and involved in every extracurricular activity I could fit into my overpacked schedule.

I was headed to Nashville upon graduation to pursue my dream job of working in the entertainment industry. I was free of mental and physical ailments. It was the last time I can remember being effortlessly happy. I continually asked myself, “What happened to my old life? Will I ever get it back?”

From the outside looking in, it’s hard to understand. From the inside looking out, it’s hard to explain.

It’s difficult to put into words the dichotomy my life had become because, on the outside, I looked fine, but inside, my body was waging war on itself. The truth is that this illness took everything from me that I once recognized, admired, and valued about myself. My life bore no resemblance to the version I left behind almost a decade ago.

I spent entire days stuck in bed, ruminating on to-do lists I didn’t have the energy or motivation to begin, let alone complete. I got so anxious at times that I wanted to crawl out of my skin. Each day I woke up with the hope that today would be the beginning of a new start. I put in what felt like 150% effort, while I watched others coast along.

I went to bed every night with the notion that I hadn’t achieved nearly enough. I chalked it up to another day inside a body that wouldn’t work and a mind that couldn’t stop ruminating on the pain.

I fight for my health every day in a way most people don’t understand. I’m not lazy; I am a warrior.

At the height of my illness, I was taking five prescription medications to manage the mental symptoms alone. I was taking meds to wake up, meds to concentrate, meds to relax, and meds to fall asleep.

My entire life was chemically induced, and none of my emotions felt like my own. I was also a regular in the emergency room, thanks to the physical symptoms that accompanied this illness.

Most recently, I was brought in for stroke symptoms and unexplained bleeding from my mouth. After hours of bloodwork and imaging, I was sent home with a generic, temporary Band-Aid in the form of steroids, Benadryl, and a prescription for Xanax, but no answers.

From rock bottom came the answers

I am learning to be thankful for my rock bottom, as it was the catalyst that brought me the answers I was seeking.

I went home that night, and at an all-time low, I put out a desperate Facebook post explaining my situation. I was met with a reply from a college friend, directing me to Breast Implant Illness and Healing by Nicole.

After hours of scrolling through tens of thousands of women’s stories that sounded all too familiar to me, I reached a verdict. I was sure that my breast implants were the culprit.

“Save yourself a surgery,” the plastic surgeon who fitted my implants told me when I enquired about having my 7-year-old Mentor-brand, textured, silicone breast implants removed.

“I have been in practice for over 30 years, and you are the first person who has ever wanted them taken out. You aren’t going to like the way you look without them, and you will want them put back in.”

“I strongly believe that the proper removal of my breast implants was key to my recovery.”

I still have regrets about that day. After weeks of self-conducted research, I regret not bringing him the facts I had uncovered about certain implants. Some silicone breast implants contain carcinogens, neurotoxins, and cleaning agents, among other things.

Now, I don’t claim to have an MD, but it’s hard to believe that the almost identical symptoms that myself and thousands of other women with breast implants experienced were merely a coincidence.

There is a growing body of research suggesting that breast implants can cause autoimmune disorders in some women. The Food and Drug Administration (FDA) released a worldwide recall of Allergan textured breast implants last month in a bid “to protect women from breast implant-associated anaplastic large cell lymphoma.”

If you have breast implants, don’t panic. First, focus on identification of your symptoms and then move to explant.

I strongly believe that the proper removal of my breast implants was key to my recovery. An international list of recommended explant surgeons can be found here.

The detoxification process can take up to 2 years, so even though I have removed the source of my suffering, the symptoms still come and go like a clingy house guest who doesn’t pick up on social cues.

Recovery and rediscovering myself

I am now 2 months post-op and am already seeing improvements. Before my surgery, I had bloodwork done, and my liver enzymes were indicative of someone with lifelong alcohol dependency. Recently, my bloodwork has miraculously normalized.

The symptoms seem to be falling away one by one. The physical symptoms I mentioned, such as skin rashes, stroke symptoms, flu symptoms, and liver and kidney issues, have all gone. I have lost 30 pounds already, all of which was inflammation weight. I have even started weening myself off of antidepressants, as I feel so much stronger mentally.

For the first time in a decade, when I look in the mirror, I recognize the person staring back at me. We all have the same hours in a day, and this illness has taught me how to live them with purpose, to treasure every alert moment, and relish every second of pain free bliss. My perspective is shifting from hopeless to limitless.

The best part about recovery is when we get to rediscover ourselves, to find our passion, and to find our purpose.

I am still learning how to be thankful for my struggle because, without it, I wouldn’t have stumbled across my strength. I am learning that I’m not a victim for sharing my story, but a survivor setting the world on fire with my truth.

I am no longer ashamed of my journey, as I have emerged with an appreciation, a sensitivity, and an understanding of life that fills me with compassion, gentleness, and a deep loving concern for others.

In a society that profits from your self-doubt, liking yourself is a rebellious act.

I have learned the hard way never to let external factors dictate my sense of self-worth. If you needed to hear this today, you are beautiful just the way you are.

Your sheer existence is a miracle, and the sooner you accept that and start creating your life accordingly, the better.

Five ways to quit smoking

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Deciding that you are now ready to quit smoking is only half the battle. Knowing where to start on your path to becoming smoke-free can help you to take the leap. We have put together some effective ways for you to stop smoking today.

Tobacco use and exposure to second-hand smoke are responsible for more than 480,000 deaths each year in the United States, according to the American Lung Association.

Most people are aware of the numerous health risks that arise from cigarette smoking and yet, “tobacco use continues to be the leading cause of preventable death and disease” in the U.S.

Quitting smoking is not a single event that happens on one day; it is a journey. By quitting, you will improve your health and the quality and duration of your life, as well as the lives of those around you.

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To quit smoking, you not only need to alter your behavior and cope with the withdrawal symptoms experienced from cutting out nicotine, but you also need to find other ways to manage your moods.

With the right game plan, you can break free from nicotine addiction and kick the habit for good. Here are five ways to tackle smoking cessation.

1. Prepare for quit day

Once you have decided to stop smoking, you are ready to set a quit date. Pick a day that is not too far in the future (so that you do not change your mind), but which gives you enough time to prepare.

There are several ways to stop smoking, but ultimately, you need to decide whether you are going to:

  • quit abruptly, or continue smoking right up until your quit date and then stop
  • quit gradually, or reduce your cigarette intake slowly until your quit date and then stop

Research that compared abrupt quitting with reducing smoking found that neither produced superior quit rates over the other, so choose the method that best suits you.

Here are some tips recommended by the American Cancer Society to help you to prepare for your quit date:

  • Tell friends, family, and co-workers about your quit date.
  • Throw away all cigarettes and ashtrays.
  • Decide whether you are going to go “cold turkey” or use nicotine replacement therapy (NRT) or other medicines.
  • If you plan to attend a stop-smoking group, sign up now.
  • Stock up on oral substitutes, such as hard candy, sugarless gum, carrot sticks, coffee stirrers, straws, and toothpicks.
  • Set up a support system, such as a family member that has successfully quit and is happy to help you.
  • Ask friends and family who smoke to not smoke around you.
  • If you have tried to quit before, think about what worked and what did not.

Daily activities – such as getting up in the morning, finishing a meal, and taking a coffee break – can often trigger your urge to smoke a cigarette. But breaking the association between the trigger and smoking is a good way to help you to fight the urge to smoke.

On your quit day:

  • Do not smoke at all.
  • Stay busy.
  • Begin use of your NRT if you have chosen to use one.
  • Attend a stop-smoking group or follow a self-help plan.
  • Drink more water and juice.
  • Drink less or no alcohol.
  • Avoid individuals who are smoking.
  • Avoid situations wherein you have a strong urge to smoke.

You will almost certainly feel the urge to smoke many times during your quit day, but it will pass. The following actions may help you to battle the urge to smoke:

  • Delay until the craving passes. The urge to smoke often comes and goes within 3 to 5 minutes.
  • Deep breathe. Breathe in slowly through your nose for a count of three and exhale through your mouth for a count of three. Visualize your lungs filling with fresh air.
  • Drink water sip by sip to beat the craving.
  • Do something else to distract yourself. Perhaps go for a walk.

Remembering the four Ds can often help you to move beyond your urge to light up.

2. Use NRTs

Going cold turkey, or quitting smoking without the help of NRT, medication, or therapy, is a popular way to give up smoking. However, only around 6 percent of these quit attempts are successful. It is easy to underestimate how powerful nicotine dependence really is.

NRT can reduce the cravings and withdrawal symptoms you experience that may hinder your attempt to give up smoking. NRTs are designed to wean your body off cigarettes and supply you with a controlled dose of nicotine while sparing you from exposure to other chemicals found in tobacco.

The U.S Food and Drug Administration (FDA) have approved five types of NRT:

  • skin patches
  • chewing gum
  • lozenges
  • nasal spray (prescription only)
  • inhaler (prescription only)

If you have decided to go down the NRT route, discuss your dose with a healthcare professional before you quit smoking. Remember that while you will be more likely to quit smoking using NRT, the goal is to end your addiction to nicotine altogether, and not just to quit tobacco.

Contact your healthcare professional if you experience dizziness, weakness, nausea, vomiting, fast or irregular heartbeat, mouth problems, or skin swelling while using these products.

3. Consider non-nicotine medications

The FDA have approved two non-nicotine-containing drugs to help smokers quit. These are bupropion (Zyban) and varenicline (Chantix).

cravings and withdrawal symptoms.

Talk to your healthcare provider if you feel that you would like to try one of these to help you to stop smoking, as you will need a prescription.

Bupropion acts on chemicals in the brain that play a role in nicotine craving and reduces cravings and symptoms of nicotine withdrawal. Bupropion is taken in tablet form for 12 weeks, but if you have successfully quit smoking in that time, you can use it for a further 3 to 6 months to reduce the risk of smoking relapse.

Varenicline interferes with the nicotine receptors in the brain, which results in reducing the pleasure that you get from tobacco use, and decreases nicotine withdrawal symptoms. Varenicline is used for 12 weeks, but again, if you have successfully kicked the habit, then you can use the drug for another 12 weeks to reduce smoking relapse risk.

Risks involved with using these drugs include behavioral changes, depressed mood, aggression, hostility, and suicidal thoughts or actions.

4. Seek behavioral support

The emotional and physical dependence you have on smoking makes it challenging to stay away from nicotine after your quit day. To quit, you need to tackle this dependence. Trying counseling services, self-help materials, and support services can help you to get through this time. As your physical symptoms get better over time, so will your emotional ones.

Combining medication – such as NRT, bupropion, and varenicline – with behavioral support has been demonstrated to increase the chances of long-term smoking cessation by up to 25 percent.

Behavioral support can range from written information and advice to group therapy or individual counseling in person, by phone, or online. Self-help materials likely increase quit rates compared with no support at all, but overall, individual counseling is the most effective behavioral support method.

The National Cancer Institute (NCI) provide help to anyone who wants to stop smoking through their support services:

  • smoking helpline: 1-877-44U-QUIT (1-877-448-7848)
  • local and state quitlines: 1- 800-QUIT-NOW (1-800-784-8669)
  • LiveHelp online chat
  • Smokefree website
  • SmokefreeTXT text messaging service
  • Twitter
  • Facebook
  • Instagram

Support groups, such as Nicotine Anonymous (NicA), can prove useful too. NicA applies the 12-step process of Alcoholics Anonymous to tobacco addiction. You can find your nearest NicA group using their website or by calling 1-877-TRY-NICA (1-877-879-6422).

5. Try alternative therapies

Some people find alternative therapies useful to help them to quit smoking, but there is currently no strong evidence that any of these will improve your chances of becoming smoke-free, and, in some cases, these methods may actually cause the person to smoke more.

Some alternative methods to help you to stop smoking might include:

cessation.

  • filters
  • smoking deterrents
  • electronic cigarettes (e-cigarettes)
  • tobacco strips and sticks
  • nicotine drinks, lollipops, straws, and lip balms
  • hypnosis
  • acupuncture
  • magnet therapy
  • cold laser therapy
  • herbs and supplements
  • yoga, mindfulness, and meditation

E-cigarettes

E-cigarettes are not supposed to be sold as a quit smoking aid, but many people who smoke view them as a method to give up the habit.

E-cigarettes are a hot research topic at the moment. Studies have found that e-cigarettes are less addictive than cigarettes, that the rise in e-cigarette use has been linked with a significant increase in smoking cessation, and that established smokers who use e-cigarettes daily are more likely to quit smoking than people who have not tried e-cigarettes.

The gains from using e-cigarettes may not be risk-free. Studies have suggested that e-cigarettes are potentially as harmful as tobacco cigarettes in causing DNA damage and are linked to an increase in arterial stiffness, blood pressure, and heart rate.

Quitting smoking requires planning and commitment – not luck. Decide on a personal plan to stop tobacco use and make a commitment to stick to it.

Weigh up all your options and decide whether you are going to join a quit-smoking class, call a quitline, go to a support meeting, seek online support or self-help guidance, or use NRTs or medications. A combination of two or more of these methods will improve your chances of becoming smoke-free.

In addition to trying out these steps, you could check out our selection of the best apps for quitting smoking.

High blood pressure research

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In this special feature, we collate some of the most intriguing hypertension studies from 2019. We particularly focus on nutrition, risk factors, and hypertension’s relationship with dementia.

Today, in the United States, around 1 in 3 adults has high blood pressure, which doctors also call hypertension.

Hypertension increases the risk of cardiovascular events, such as stroke and coronary disease, and, if doctors don’t treat it, it can reduce lifespan.

Because it is worryingly prevalent, and because the physical ramifications can be significant, scientists are plowing a great deal of effort into understanding hypertension.

Although people first identified hypertension as a medical condition thousands of years ago, scientists are still picking away at the details.

Research that scientists completed in 2019 has thrown out some exciting and, in some cases, unexpected findings. For instance, a paper appearing in February concluded that, for women over 80 years of age, having “normal” blood pressure had an increased risk of mortality when compared with individuals with high blood pressure.

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Elsewhere, Greek scientists concluded that napping might help reduce blood pressure. “Midday sleep appears to lower blood pressure levels at the same magnitude as other lifestyle changes,” explains one of the researchers, Dr. Manolis Kallistratos.

Another surprising study, which scientists presented at the 83rd Annual Scientific Meeting of the Japanese Circulation Society, concluded that needing to urinate multiple times at night might be a sign of hypertension.

The role of nutrition

The food that we eat has a huge impact on our overall health; that goes without saying. The America Heart Association, for instance, suggest that eating a diet rich in fruits and vegetables and avoiding products with high levels of salt and fat can help keep blood pressure in check.

Over the past few years, interest in nutrition, in general, has skyrocketed. More and more, scientists are focusing on individual foods or food compounds that can directly benefit health. So, although poor diet is a well-known risk factor for hypertension, researchers in 2019 drilled down deeper.

Specific foods and supplements

One study appearing in 2019 investigated the impact of consuming walnuts on blood pressure. It concluded that the individuals who ate an experimental walnut-heavy diet experienced a significant reduction in blood pressure.

In these types of studies, it is worth digging a little deeper; often, industry or organizations who might stand to benefit from positive results are funding them. The walnut study above, for instance, was partly funded by the California Walnut Commission.

This observation does not mean that we should dismiss the results out of hand, but it provides pause for thought.

Another recent study concentrated on spirulina, which is the dried biomass of a bacterium called Spirulina platensis. Manufacturers can add it to foods, and some people take it as a supplement.

Earlier experiments hinted at spirulina’s potential to reduce hypertension, and in the most recent study, they attempted to find out why this might be.

The scientists concluded that a protein that the digestion of spirulina produces causes blood vessels to relax. The authors hope that this protein, known as SP6, might one day be useful in the treatment of hypertension.

Preservatives, additives, and water

Rather than focus on specific foods, a further study looked at the impact of buying food from local retailers rather than supermarkets.

The authors theorized that by eating local produce, individuals would avoid consuming the various preservatives and additives that keep food “fresh” over long distances.

Although the study was relatively small, the authors found that after 6 months, those who consumed local produce had lower levels of visceral fat, improved depression scores, and reduced systolic blood pressure.

Approaching from a different angle, a team of scientists recently asked whether drinking water that is high in minerals might reduce blood pressure.

To investigate, they focused on people living in a coastal region of Bangladesh. Drinking water there varies in salinity. In areas of high salinity, the water contains greater quantities of sodium, which we know increases blood pressure. However, the same water also includes more magnesium and calcium, both of which reduce blood pressure.

The authors concluded that higher salinity levels decreased blood pressure overall; they write that “the [blood pressure]-lowering effects of [calcium] and [magnesium] counteracted the harmful effects of [sodium].

Causes and risk factors

Some risk factors for hypertension are fairly well established; they include drinking excessive amounts of alcohol, smoking tobacco, stress, and obesity. However, because high blood pressure is so common, there are likely to be many more factors at play.

Similarly, although scientists know which lifestyle and dietary factors influence blood pressure, they are not entirely sure how they cause the changes.

Understanding why and how blood pressure arises in some people and not others is essential and could, potentially, lead to innovative ways of treating or preventing hypertension.

Some scientists are exploring possible risk factors which, at face value, seem unlikely. For instance, one paper, appearing in the Journal of Public Health in June, examined the role of where people live.

Earlier studies found an association between exposure to air pollution and hypertension risk, and this latest work confirms those earlier suspicions and takes it a step further.

As expected, the researchers found a relationship between air pollution and hypertension; however, the increase in risk was only significant for those who were living in multi-family homes, such as blocks of flats.

The authors believe that this might be due to several factors, for instance, living in close quarters with other people may be more stressful or more noisy. This study provides a glimpse of the complex realm of potential elements that might influence blood pressure.

Oral hygiene

Bizarrely, one group of scientists recently investigated how mouthwash might influence hypertension risk.

Publishing their findings in the journal Frontiers in Cellular and Infection Microbiology, the authors conclude that mouthwash kills “good bacteria” in the mouth. These good bacteria produce nitric oxide (NO), which is important for blood vessel health.

NO acts as a vasodilator, which means it causes the muscles that line blood vessels to relax, thereby widening the vessels and reducing blood pressure.

In particular, the scientists concentrated on the chemical chlorhexidine, which they found in some mouthwashes.

According to the authors, they demonstrated that “twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use, and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue.”

Still focusing on the oral region, a 2019 review looked for links between gum disease and hypertension. They showed that individuals with severe periodontitis — a form of gum disease — had a 49% increased risk of hypertension.

Senior author Prof. Francesco D’Aiuto explains their results in a nutshell: “We observed a linear association — the more severe periodontitis is, the higher the probability of hypertension.”

The role of zinc

Another project investigated the role of zinc in maintaining blood pressure at healthy levels. Over the years, researchers have noted links between low zinc levels and an increased risk of high blood pressure, but the precise mechanism has been tough to pin down.

The latest research identified the key player in this interaction between zinc and blood pressure; according to the authors, the sodium chloride cotransporter (NCC) in the kidney is the lynchpin. The NCC is responsible for pumping sodium back into the body, thereby preventing it from being excreted in the urine.

Zinc interacts with the NCC: when zinc is present, the NCC is less active, meaning that the body retains less sodium. This is important because high sodium levels — from consuming too much salt, for instance — are factors in increasing the risk of hypertension.

The authors hope that this new knowledge will help improve treatment and write:

“Understanding the specific mechanisms by which [zinc deficiency] contributes to [blood pressure] dysregulation may have an important effect on the treatment of hypertension in chronic disease settings.”

Hypertension and dementia

Scientists have identified a relationship between hypertension and vascular dementia. The association makes sense because vascular dementia can occur following stroke, and hypertension is a risk factor for stroke.

However, it also appears that hypertension might increase the risk of other types of dementia, including Alzheimer’s disease.

A study appearing in June this year found that a common blood pressure drug — nilvadipine — slowed the progress of Alzheimer’s disease by improving blood flow in the brain.

Specifically, the research team showed that people who took the medication had a 20% increase in blood flow in the hippocampus, a brain region vital for memory and learning, in comparison to those who did not take nilvadipine.

Patterns throughout life

Other scientists have looked at fluctuations in blood pressure and their possible role in dementia. For instance, one investigation that recruited participants who were living with Alzheimer’s disease found that the condition progressed quicker in those whose blood pressure fluctuated most.

“More fluctuations [in blood pressure] might affect whether cognitive function declines more slowly or rapidly.”

Senior author Dr. Jurgen Claassen

With a similar theme, another group of scientists observed the pattern of blood pressure across decades. The authors summarize their findings:

“[A] pattern of sustained hypertension from middle to late life and a pattern of midlife hypertension followed by late-life hypotension were associated with an increased risk for subsequent dementia, compared with participants who maintained normal blood pressure.”

Another project that charted hypertension over a lifespan found that individuals with high or rising blood pressure between 36 and 53 years of age were more likely to have white matter lesions and a smaller brain volume in later life.

The authors hope that these findings will inspire both doctors and the public to check and take charge of their blood pressure sooner rather than later.

As 2020 rolls into view, hypertension is sure to stay high on the medical research agenda. As science gradually untangles hypertension’s causes and mechanisms, managing and minimizing this highly prevalent condition must draw ever closer.