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#DONT TAKE IF YOU DONT RESPOND WELL TO OTHER NSAIDS
milkweedman · 5 months
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The new meds I'm on have, as far as I can tell, caused my hands to be very weak, to the point that I can't tension this thin sock yarn :/ I'm in the gussets of sock 2 but the sock is definitely bigger and a thinner fabric.
Im... not positive what to do (whether to frog or not, or maybe just switch to a worsted weight project?) Other than tell the doctor this shit is not good.
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brian-cdates · 5 years
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Do You Have Hormone Imbalance? 7 Signs and How to Heal Naturally
Hormone imbalance is exactly what it sounds like—hormones that are out of whack. From PCOS, PMS, menopause hot flashes, amenorrhea (period loss), and birth control side effects, hormone imbalances have been said to affect at least 80% of all women. 
Approximately 3 in 4 women experience PMS throughout their lifetime (Casper, 2018), the same amount also experience hot flashes and mood swings during menopause (Johns Hopkins Medicine, 2017).
Upwards of 1 in 5 women have PCOS (polycystic ovary syndrome), characterized by high testosterone, enlarged ovaries with cysts, extra hair growth and acne and unwanted weight gain (NIH, 2017)
A total of 1 in 4 women are on the birth control pill, and more than 50% of birth control pill users use the pill for “non-contraceptive” (hormone imbalance) purposes (Guttmacher Institute, 2018)
Amennorhea 
With the widespread prevalence of hormone imbalance amongst women kind, it’s easy to believe hormone imbalances are a “normal” part of being a woman…they don’t have to be—at least to the degree of being an ongoing “norm.”
Do you have hormone imbalance?
Here’s all you need to know about hormones and hormone imbalance imbalances, including:
What Hormones Do for Your Body
13 Causes of Hormone Imbalance
8 Common (little known) Signs of Hormone Imbalance
4 Steps to Heal Hormone Imbalance Naturally
WHAT HORMONES DO FOR YOUR BODY
You have 50 total hormones and your hormones are your body’s chemical messengers that are responsible for stimulating the trillions of cells in your body and their metabolic processes into action. 
For instance, your sex hormones—such as estrogen, progesterone, testosterone—influence your behavior, mood and fertility. Your cortisol (stress hormone) influences your body’s fight or flight response. And ghrelin and leptin, your hunger and fullness hormones, tell you when it’s time to eat and when it’s time to put your fork down.
Cortisol – Stress Hormone
Helps respond to stress and in healthy, less-stressed people, cortisol helps you breakdown fat and fight inflammation. However, if elevated, cortisol: Inhibits glucose uptake in muscle (storing glucose as “fat” OR casting malabsorption). High cortisol can also increase fat tissue or cause muscle wasting. 
Estradiol – “Woman” Hormone
The primary form of estrogen. Regulates period, mood and healthy maintenance of female “parts.” Protects against bone loss. Super high estrogen reduces gut motility, increases constipation, contributes to skin breakouts, mood swings, water retention, and increases cortisol and growth hormone. Super low estradiol leads to amenorrhea, increased cortisol, mood imbalances and gut problems. 
Insulin – “Fat Storage” & “Muscle Building” Hormone
Intakes & converts sugar (glucose) and fats (lipids) into energy for your cells
Ghrelin – “Hunger Hormone”
Stimulates appetite. 
Wake up hungry? Need a 3 pm snack break? Midnight snack strike? Ghrelin is speaking. Are you listening?
Gonadotropin Releasing Hormones – “Fertility Hormone”
Stimulates reproductive function, puberty and sexual maturation. Impaired GRH is linked to infertility.
Leptin – “Fullness Hormone”
Decreases appetite
Orexin – Energy, Mood & Appetite Hormone
Promotes wakefulness, boosts mood, increases metabolism, and regulates your cravings and appetite. However, more (or less) is not necessarily better. More orexin makes you hungrier and may also make you more “addicted” to certain foods or substances (like alcohol). Less orexin makes you sleepier (narcolepsy, insomnia). Ideally you want it to be balanced. 
Oxytocin – The “Love” Hormone
Not only does oxytocin release feelings of empathy, generosity, and butterflies (like when you snuggle with your significant other or your crush smiled at you in the 7th grade), but it also produces the feeling of orgasms and stimulates uterus contraction to induce labor during pregnancy.
Parathyroid Hormone (PTH) – Bone-Building Hormone 
Activates Vitamin D, stimulate bone building osteoclasts & help uptake Calcium.
Progesterone – “Balancing” Sex Hormone
Helps keep estrogen and testosterone in a yin-yang balance. Supports fertility and pregnancy. Fights inflammation. Assists in thyroid function (metabolism). Supports healthy skin and nerve firing. 
Secretin – Digestive Process Hormone
Stops production of gastric juices. If it’s increased, gut motility and low stomach acid are more likely. 
Somastostatin – “Body Balancing” Hormone (Particularly Digestive & Blood Sugar Balance)
Responsible for just-right digestion and blood sugar regulations. High levels of this hormone can cause digestive problems like IBS or constipation, to impaired insulin sensitivity, triggering diabetes. Low levels are linked to low mood and psychological distress.
Serotonin – “Feel Good” Hormone
Upwards of 95% is produced in your gut. Helps balance your mood, keep you free from anxiety, depression and OCD. 
Testosterone – Growth & Sex-Drive Hormone
Stimulates libido, growth of muscle mass and strength, and increased bone density. Super high testosterone and lower estrogen in women is connected to PCOS. 
TSH (Thyroid Stimulating Hormone) – Stimulates Metabolism
Primary Thyroid Hormone that creates T4 and T3. High TSH above 2.5 suggests both sub-clinical and/or clinical hypo-thyroidism.
“Your hormones are the gateway to helping your cells do their job and keep your body balanced.” 
In short: Your hormones are the gateway to helping your cells do their job and keep your body balanced.
However, if your hormones are thrown off or out of balance due to STRESS, then “hormone imbalance” is inevitable.
Enter: Malfunctioning of your body’s cellular processes.
WHAT CAUSES HORMONE IMBALANCE?
Stress is the #1 driver of all hormone imbalance.
Stress cannot be stressed enough. A surefire way to experiencing hormonal imbalance is to stress your body out.
Sort of like what happened when you pulled all-nighters studying in college, eating Taco Bell and running off Red Bull (eventually you hit a wall), the same thing happens with your hormones. If and when stress persists, hormones “hit a wall” are unable to signal to your cells how to do their job naturally. 
Even though stress is a NORMAL part of life, when stress mounts and persists, it wreaks havoc on your hormone balance. 
And contrary to popular belief, stress doesn’t just mean mental stress either. Physical stress is often times the “bigger” elephant in the room that most people are unaware of—simply because many physical stressors side under the radar as “normal” stressors in life. 
Here are 13 common (stress) causes of hormone imbalance. 
13 COMMON (LITTLE KNOWN) CAUSES OF HORMONE IMBALANCE
1. Overtraining or Lack of “Mixed” Training
Pushing your body day in and day out, or failing to incorporate variety into the mix (i.e. running all the time, chronic cardio).
2. Sedentary or Screen-Based Lifestyles
The average American sits upwards of 10-12 hours per day. We were made to move. Lack of movement disrupts balance. 
3. Circadian Rhythm Dysfunction
Speaking of screen-based lifestyles, screen and artificial light exposure —particularly at night disrupts your internal biological and hormonal clock—disrupting hormone production and balance. For the vast majority of our evolutionary history, we lived in peace with the natural circadian rhythms of day and night (without exposure to artificial light). We were physically active throughout the day and rested at night, we didn’t have access to stimulants like coffee and sugar, and we didn’t have iPhones, laptops, video games, and Netflix.
While artificial light certainly has many benefits (such as extending the length of the productive day), this does not come without consequences. Other stressors of our natural circadian clock include: shift work, jet lag, early rising without enough sleep and eating at irregular times—all of which suppress melatonin production and inhibit or stimulate cortisol production.
4.  Poor Quality Foods & Hidden Food Intolerances
Some of the top allergenic foods include gluten and grains, dairy, peanuts, eggs, and nuts. Even “healthy” foods like protein bars, shakes, grilled chicken and broccoli cooked in canola oil, Diet Soda and artificial sweeteners can wreak havoc on gut health and digestion.
5. Glycemic Dysregulation
Blood sugar balance and hormone balance (and imbalance) go hand in hand. When we train our body to “function” off of blood sugar “imbalance”—(like eating lots of sugar, high grain/carb diets, caffeine, artificial sweeteners, low fat diets, low protein diets, or low calorie diets)— in turn, our hormones get imbalanced. (One of the primary features of cortisol—our stress hormone— itself is to make more energy and run off “sugar” for a life-saving fight-or-flight response). Equally, NOT eating carbs can ALSO throw glycemic REGULATION and hormone balance off. Read more on this here.
6. More Than 1 Cup Quality Coffee Per Day.
A little bit does a body good, a lot-a-bit stimulates cortisol (stress hormones)—even “decaf.”
7. Less Than 7 Hours of Sleep
7-9 hours is the gold standard for MOST people.
8. Saying YES to Everything
People pleasing and failing to take care of yourself first will catch up with you.
9. Toxic Beauty & Hygiene Products
Our skin is an organ that absorbs what we put into it, and all products on our skin must pass through our detoxification and liver pathways. Talc, parabens, sulfates and beyond are endocrine “disruptors” that disrupt healthy hormone balance and production.
10. Medication & Substance Use (Antibiotics, SSRI’s, Birth Control, NSAIDS)
One word: Impaired gut health. Given that 31 hormones are produced in your gut alone, long term use of substances can affect gut health, which in turn affects hormone health.
11. Tap Water & Poor Quality Water
More than 70% of Americans drink water contaminated with toxic chemicals that affect total body balance—hormones included. (And if you don’t drink water, water is STILL the base of sodas, juices and other beverages as well)
12. Inflammation
Any source of inflammation is a chronic stressor that affects hormones. Gut issues (like SIBO, IBS or parasites), cardiovascular disease, diabetes, acne, chronic injuries, and even  side effects from surgery or trauma that cause inflammation in the body can throw hormones off. As more energy from the body (and cortisol) is called upon to “address” the stressor, balance of other hormones in the body may be thwarted.
13. Social Isolation
Loneliness by default raises stress hormones (Hawkley et al, 2012).
Chronically elevated or suppressed cortisol (stress hormones) impairs the production of other hormones. 
The Bottom Line:
No, we cannot live in bubbles to hide from stress. Ideally, you want a Goldilocks approach to balancing stress—definitely some exercise…but not too much. Definitely some work time (often on screens)…but not too much. Get the picture?
DO YOU HAVE HORMONE IMBALANCE?
So do you have hormone imbalance?!…And how do you know if you have hormone imbalance—(beyond a diagnosis of PMS, PCOS, amenorrhea or menopause?!)
Here are 8 (Little Known) Signs of Hormone Imbalance
8 LITTLE KNOWN SIGNS OF HORMONE IMBALANCE
1. Difficulty Losing Weight & Body Fat or Low Muscle Mass & Difficulty Gaining Weight
Hormones are the master regulators of body fat, cell growth and metabolism. Hormones, like insulin, are also responsible for utilizing your body’s energy (food you eat) and fat stores efficiently.
And cortisol (your stress hormone) is responsible for keeping your body fit and healthy (as imbalanced cortisol is associated with increased body fat—especially belly fat— and/or muscle loss or wasting).
Enter: Unwanted body fat or weight gain OR difficulty putting on weight and building lean muscle. Both ends of the spectrum may mean there’s something going on “underneath the hood” (beyond the amount of calories you eat or how much you workout or not).
2. Adult Acne
“Hormone imbalance” has long been to blame for adult acne—something approximately 50% of all adults will experience at some time. Androgen hormones (like testosterone) are particular culprits in the acne conundrum, and are most often affected by cortisol balance (your stress hormone). If stress goes up or is unable to recover from multiple stressors (both physical and/or mental), then testosterone production and balance is effected. Hello zits you thought you said good-bye to in college!
3. Sugar & Caffeine Cravings
Your hormones are not only responsible for regulating your appetite and cravings, but ALSO responsible for balancing your blood sugar. So when hormones are off, blood sugar typically takes a hit. Hypo or hyperglycemia (low or high blood sugar) is common in hormone imbalances. As hormones drive blood sugar levels down or up in the stress response, sugar and caffeine cravings are inevitable for many people.
Why? As stimulants sugar and caffeine “naturally” combat dips in blood sugar to get your blood sugar up to speed. Once up to speed, your body also can become addicted to feeling more energy in the hyperglycemia (high blood sugar) state and in turn, as energy wanes, it naturally signals “Feed me sugar or coffee…NOW!”
4. Hangry or Never Hunger
Hormone imbalances typically present in one of two extremes. In the case of hunger, difficulty with feeling satisfied (constantly hungry) or rarely having an appetite can be a sign of hormone imbalance—particularly Ghrelin (your “hunger” hormone) and Leptin (your “fullness” hormone).
Orexin is also responsible for satiety, and studies have shown leaner rats are typically more sensitive to the signals of Orexin (Rodgers et al, 2002 S). 
5. Feeling Wired & Tired at Night (and Slow-to-Start in the Morning)
Wound up once 9 or 10 pm strikes (despite needing sleep)? Or constantly hitting “snooze” on your alarm when 6 am rolls around? It may be your hormones—particularly melatonin, your sleep inducing hormone, and/or cortisol, both an energy arousal and energy suppression hormone if out of sync. 
6. Easily Anxious, Depressed or “Flat”
Your hormones are the key ingredients for balancing mood. Serotonin—your hormone responsible for producing “feel good” brain chemicals—governs your mood and emotions. Even more: 90-95% of your serotonin levels are produced in your gut alone. So, if your gut health is “off,” then by default serotonin levels are often impacted as well. 
7. Easily Hot or Cold
Your hypothalamus is the key processing center in your brain responsible for regulating body temperature. Your hypothalamus is ALSO responsible for producing many hormones—particularly hormones that control your pituitary gland (the “master gland” of ALL other hormones in your body, including the thyroid and adrenals). If either of these glands are suppressed, overworked, or unable to produce the “just right” amount of hormones, then body temperature is affected by default. Hello hot flashes or feeling cold (all the time).
8. Frequent Bloating and/or Constipation
Last but not least, digestive distress and hormone imbalances are bi-directional. Of your 50 some hormones produced in the body, 31 of those hormones are produced in your gut alone. So…if your gut health is off, chances are your hormones are “off” and vice versa. Hormones in particular that regulate digestion include your thyroid hormones, somatostatin and secretin. 
So what to do about it?!
Glad you asked! 
Here are 4 Steps to Reverse Hormone Imbalance Naturally. 
4 STEPS TO REVERSE HORMONE IMBALANCE NATURALLY 
1. ADDRESS STRESS
Easier said than done…But necessary. Take inventory of the current stressors present in your life—mental and physical. Some of these areas to consider may be:Staying on your screens (at all hours of the night)
Lack of Social Connectedness.
Getting by on 5-6 hours of sleep most nights.
Pushing it too hard in your marathon training.
Imbalanced Healthy Fat, Protein & Carb Intake.
Drinking more than 1 cup of quality coffee most days.
Toxic beauty and hygiene products (check out www.ewg.org and www.thinkdirtyapp.com).
Unaddressed inflammation (not getting to the root of your Diabetes, Acne, IBS, etc.).
Long-term birth control, NSAID, SSRI or other medication use.
Burning a candle at both ends.
Trying to be all things to all people.
2. CUT OUT THE CULPRITS
Once you’ve determined some potential top stressors in your life, start small by making little changes—focusing on ONE stressor at a time. No, you don’t have to give up working on your computer, using eyeliner or staying out late with friends, BUT this could look like:
Downloading the f.lux orange-tinted blue-light blocker app on your computer and even using “blue blocking” glasses at night.
Using natural skin care products (like Skin Foodie or Fat Co) and slowly replacing makeup products with more natural options (I love Josie Maran)
If you stay up later, giving yourself permission to sleep in (over working out first thing the next morning if you have to); or at the very least, keeping things “balanced” by aiming for more than 6 hours of sleep other nights
3. LOVE YOUR GUT!
Considering 31 hormones are produced in your gut, “gut love” is an understatement. Addressing the “roots” of imbalance is critical to balance—gut health included. Check out this post for all you need to know.
4. TEST (DON’T GUESS) & SUPPLEMENT SMART
Last, but not least: Hormone testing and appropriate supplemental support is the shortest path to hormonal “success” when it comes to assessing the balance of many of your key hormones—including cortisol, estrogen, progesterone, testosterone, and melatonin. Common mistakes many people (including practitioners) make in addressing hormone imbalances include:
a.) Over-supplementing or prescribing “hormone balancing” medications or supplements that do the REVERSE (imbalance your hormones MORE).
Such as prescribing a patient take a licorice supplement for “adrenal fatigue” when their cortisol is actually already HIGH (this makes the problem worse
b.) Using serum blood testing as the primary testing measures for hormones (blood testing is a one-shot in time test.
The majority of hormones—particularly cortisol—are excreted in urine, and best assessed via urine testing)
c.) Prescribing hormones to address hormone “imbalances”—however if you are low in any one hormone (be it estrogen, testosterone, thyroid, etc.).
If you JUST medicate the problem with hormone alone, it throws the natural production and processes of other hormones as well as cortisol levels OFF. In turn, you over-compensate with hormone without addressing the true underlying reasons (namely stress and gut issues) that were driving hormone “problems” in the first place. There can be a time and season for certain hormone therapies—namely in the case of chronic hypo/hyperthyroidism, but for other cases, a more natural approach is gentler on the body by addressing the true causes of hormone imbalance first, and gently supplementing if necessary to bring it up.
What supplements to take or what tests to do?!
Consult with a practitioner to customize an appropriate supplement, nutrition and lifestyle plan for you, as well as get the #1 test I recommend for assessing hormone imbalance. 
The post Do You Have Hormone Imbalance? 7 Signs and How to Heal Naturally appeared first on Meet Dr. Lauryn.
Source/Repost=> https://drlauryn.com/uncategorized/hormone-imbalance-7-signs/ ** Dr. Lauryn Lax __Nutrition. Therapy. Functional Medicine ** https://drlauryn.com/ Do You Have Hormone Imbalance? 7 Signs and How to Heal Naturally via http://drlaurynlax.tumblr.com/
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nursynurse · 6 years
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Pain in the butt!
Surgical Pain
Many patients will come to you in pain, or you will start a shift and they will be in pain. Pain can be a frustrating stimuli not only for the patient but for the you when you're interventions are unsuccessful. Lets have the lowdown on Pain
Acute vs Chronic
Acute pain is protective pain. It usually comes on suddenly and my result from injury, surgery, a medical disorder, or diagnostic procedure. It is caused by damage to the tissues. Chronic pain is any pain that lasts longer than 6 months but it is not a warning pain. It can be related to ongoing inflammatory disorders, muscle strains, etc. In chronic pain the body gets used to the stimuli and doesn't respond the same physiologically as acute pain (therefore there are usually no changes in vital signs (vs) or facial expressions). 
PQRST Assessment
Precipitating Factors: What makes this pain better/worse?
Quality: What does it feel like? Describe the pain.
Radiation:  Is the pain in one place? Or does it move around? 
Site and Severity: Where is it and on a scale of 1-10 how bad is it?
Timing & Treatment: When did it start, how often does it occur? What are the patterns? Is it constant or waves? Have you taken anything for it and did that help?
Note* Although you likely know that the pain is related to surgery, there are always potentials for complications. I had one guy who had and ALIF surgery and then ended up getting appendicitis! Talk about trying to differentiate pain!
Pain Scales
Personally I find this a tough one. I can't even begin to count how many patients I've had NOT understand the 1-10 scale, and if they do, they often dont know when to ask for pain relief. It can be pretty frustrating to say the least. 
Okay. The 1-10 scale. Pretty simple, “Whats your pain based on 1-10, 10 being the worse pain imaginable and 0 being none at all?” If they are post op, some amount of pain is to be expected. I tell my patients that likely zero is an unreal expectation and we’re happy with anything under 4. However, if you've had surgery, toughing out the pain and trying to be a hero will only get you into trouble. Surgical pain does NOT go away! Here’s my superpower trick too keeping pain well controlled. I tell my patients that they should expect some level of pain, IF their pain starts to head up to 4 or 5 to give me a call for some analgesia. First this gives me time to get it (and on a surgical ward that can sometimes be up to 20 minutes on a crazy day) and by the time they gets it on board it'll take another 20-30 mins to kick in. Secondly, if you're asking for pain relief at 4-5 we can bring that pain back down to 2-3, if we’re waiting until we’re 8/10 pain, were only really going to be bringing that pain back down to a 6-7, and then we’re chasing the pain rather than staying on top of it. This explanation usually works like a charm. Dont forget to come back and and reassess the pain after 40-60 minutes to see if your intervention was effective. 
Now.... if I get a patient that rates his pain at 8/10 on a constant basis and is sitting there smiling or better yet sleeping through his pain, then I have to question wether or not he understand the scale, or wether there is something else going on. If the 1-10 isn't working i’ll go with the mild, moderate, severe question. Same idea as the 1-10. Sometimes this works better in the geriatric population. 
Then theres the little ones. If you're not familiar with kids then google the Wong Baker scale. Its the one where the happy face goes into the really sad crying face. Depending on your age group, this is a useful tool. Sometimes you just have to make a judgment call. Often we have wee little kiddies that can't talk yet. Crying is a good indication or not eating can signal pain too. Sometimes they just get a little fussy too. Other times they will tell you straight up that its an owie and won't let you touch the site. 
Pharmacological Intervention
After surgery, we love to give Tylenol (Panadol) out like candy. This works well for mild pain, personally it doesn't ever touch my headaches. But it works for a lot of people so I roll with it. Depending on the surgery NSAIDS are usually avoided due to their causing an increase risk of bleeding. We use them with gyne patients and it seems to work well. Ketorolac  is another NSAID that I am a huge fan of, however, depending on what country you work in might not be readily available.  These are basically your non opioids. For any pain thats not being managed with the above, you move to your narcotic selection. There are probably too many too mention but they are things like morphine, fentanyl, pethidine, oxycodone, hydromorphone, tramadol etc. All I can say is start low and go slow! You will never be faulted for under dosing your patient if you dont know what they can handle!! If these aren't really cutting it either, get the doctor to review or consider stacking a long acting medication like oxycontin, palexia SR, or Targin. Again these will all vary depending what country you're in. I did my training in Canada, and now work in Australia, so name brands will vary as will what you use. 
The only exception to this rule is the dreaded WIND pain! Wind pain will knock a grown ass man OVER! Im not even exaggerating, that shit is worse than surgical patients AND patients will rarely believe you. Unfortunately wind is common after surgery especially laparoscopic surgery because they pump the cavity full of it to get better views. The only thing to get rid of it is to MOBILIZE! You can use heat packs and simethecone (Degas), they can be slightly effective but the only fool proof hack is to walk, walk, walk. Thats it. Wind pain can also cause shoulder tip pain. This is when the gas rises and gets trapped in your shoulders (I've never had it but I've seen it numerous times and it doesn't look pleasant!). Opioids will NOT touch this pain and thats a good sign that its probably gas. 
Lastly, you want to keep your patients pain at bay so that they can mobilize. Mobilizing prevents muscle wastage, blood clots (pulmonary embolisms and deep vein thrombosis), pneumonia, bed sores, and wind. Keep reassessing their pain through out your shift, especially those that like to be heroes (usually though they're only silly enough to do it once and then never again). Sometimes you got to get a little tough too, get them out moving, suggests that pain relief might be a good idea, explain that they will not become addicted after one dose, whatever it takes to get your patient feeling well and confident. 
I hope that was helpful! If you have any questions let me know :) If you want anymore topics, leave a request. Im a surgical nurse with a lot of experience with post op patients and I love to teach :)
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