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Is there a way to deal with depression that doesn’t involve taking drugs?

While many people think depression can only be treated with medication, this is a big misconception. One of the best ways to deal with depression is actually with what we call cognitive behavioral therapy (CBT). CBT is a form of psychotherapy that helps to treat the underlying cause of the depression. CBT can be done with a counselor, therapist or social worker where they help the patients/clients modify their dysfunctional emotions, behaviors and thoughts. As humans, often times our thoughts and perceptions influence our behaviors. For example, if someone is not granted a promotion at work, they may perceive that as their boss/manager doesn’t like them, that their work is worthless or even that they are a failure. In this state of distress, these thoughts distort one’s perception of reality. Thus, CBT works to identify these harmful and distorted thoughts, determine if they are an accurate depiction of reality, and if they are not, the therapist will then help the patient develop strategies to overcome these thoughts. CBT works for people of all ages even including young children. CBT isn’t just used for depression but it can also be used for anxiety disorders, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders and many more.

A friend went in for surgery and his stomach turned black and blue. What caused that?

Without more information and seeing the stomach I can’t say with one hundred percent certainty what caused it, but I have a good speculation. I’m going to make a few assumptions here in that one, the surgery involved the abdomen and two, when you say stomach, you actually mean the skin on the abdomen and not the actual organ of the stomach. With these two assumptions, it is likely that the black and blue you were seeing was actually blood that had leaked out of the blood vessel during surgery and was collected superficially under the skin. The medical term for this is ecchymosis or in lay-man terms, a bruise. When you bump your arm or leg on something and get a bruise, this is the same thing. The superficial blood vessels, under the area of the skin that you just bumped, got damaged and are now leaking small amounts of blood out of the vessel an into the area surrounding the vessels. Thus, this then initially forms a purple/blue/black color. With time, these dark colors fade to a greenish/yellow color and eventually disappear. This is because our bodies, at the microscopic level, break down this collection of blood and reabsorb its components. When we undergo surgery, this same things happens but to a greater degree and it generally takes a bit longer for our bodies to break down and reabsorb all that blood.

Why am I sleeping in short doses at night? After a couple of hours, I’ll get up and then have to try to get back to sleep again. How can I avoid this?

A big part of our sleeping cycle is based on what we call a circadian rhythm. Our body’s master clock or suprachiasmatic nucleus (SCN) is an area of our brain that controls the production of the sleep hormone, melatonin. The SCN receives information, about light, from our eyes via the optic nerve. When it gets darker at night and there is less light, the eyes sense this and tell the SCN. In turn, the SCN tells the brain to make more melatonin and thus, we get drowsy. When this pattern gets disturbed, it can cause problems in our sleeping pattern. So, when people are having sleeping issues, there are a few habits we want to look at first to determine if they could be the cause.

Is the person drinking caffeine or exercising before they go to bed? Are they watching TV in bed or sleeping with the TV/side lamp on? Are you using a tablet or on your cell phone while in bed? These are all things that can affect our circadian rhythm, thus we do not recommend them.

If a patient is still having sleeping issues after correcting the above bad habits, we then recommend taking some over-the-ounter melatonin as perhaps the body just isn’t making enough melatonin. If no change is noticed with the extra melatonin, the next thing we assess is if the patient could have sleep apnea. Sleep apnea is where you stop breathing for short periods of time while sleeping. This in turn can cause issues with our sleep pattern to which you tend to wake up more frequently during the night.

To assess if a person has sleep apnea, a polysomnography, or sleep study is generally done. During this sleep study, which usually takes place at a hospital or medical facility, a person is hooked up to monitors that primarily assess how many times a person stops breathing as they sleep, how long those apnea periods are and also the blood oxygen level as the person sleeps. If sleep apnea is diagnosed, it is then recommended that the patient start utilizing a CPAP machine while they sleep. CPAP stands for continuous positive airway pressure and what the machine does is connect to a mask that the patient wears over their nose and mouth or just over their nose. It provides a continuous positive pressure to the patient’s lungs as they sleep and thus keeps their airways open. Once patients’ apnea is corrected, they tend to notice that they have less sleeping issues such as those frequent awakenings.

If, by chance, none of the above have helped improve a person’s sleep, then it is likely that there could be a different underlying issue. Sometimes things such as high stress levels, anxiety and depression can affect our sleep cycles. If this is the case, once the underlying issue is controlled, the sleep cycle tends to go back to normal with good consistent sleep throughout the night.

Does it matter where they take blood? I’ve had some nurses get it out of the middle of my arm and others have got it from the top of my hand. Is it just a matter of veins? What information do you get from that?

For the most part, it does not matter where a nurse/phlebotomist/doctor takes your blood from. The only time it really matters is if arterial blood gases have been ordered and in that case, they generally get the blood from your radial artery in your wrist area.

Other than that, most other labs can be drawn from the veins and where they access the vein is based on a personal preference for the person drawing the blood.

Many prefer to use the middle of the arm where your arm bends. This is called the antecubital fossa and the vessels here are bigger in size compared to the vessels on the back of the hand. From the blood that is collected on blood draws, a significant amount of information can be obtained.

Things such as if you have an infection or inflammation in your body, if you have anemia, how your kidneys/liver/pancreas/heart/glands/muscles are functioning, if there are drugs/alcohol in your body, if you’re pregnant, if you have diabetes, and the list just keeps going on.

Does severe cold weather slow down our systems? When I go out in the cold, then come back inside, it seems like it takes forever to warm up. Is that good?

The cold weather doesn’t necessarily slow down our body systems but it does affect the different systems in various ways. Our core body temperature is 98.6 degrees Fahrenheit.

When we go out into the cold, in order to help keep our bodies warm, the vessels in our body constrict or shrink in diameter. Our body does this first in our hands and feet and then our arms and legs. By constricting our peripheral vessels first, this helps make sure our vital organs such as our brain, heart, kidneys and lungs get the warmer blood. With the increase in blood volume in our core body, this can increase our blood pressure and cause extra strain on the heart. Since there is less blood in our extremities, this makes them more prone to frostbite.

Due to the increase in blood to the core body, this means that the blood supply to our immune system is decreased which in turn causes a weakened immune system. Research has shown that people who have more adipose tissue tend to get less cold outside because that adipose tissue serves as an insulator so to say.

When our bodies don’t have as much insulation a reaction mechanism our body does to help us stay warm is what we call shivering. This is essentially where our muscles begin to shake in small movement and when they do this, they are using body energy. Thus a product of the energy breakdown is heat.

When a person goes from a cold environment to a warm environment, our body does the reverse of what it did in the cold. So, the vessels in our arms and legs begin to dilate or get bigger in diameter and then the vessels in our hands and feet do the same thing. Depending on how low our core body temperature dropped and how much adipose tissue we have, will depend on how long it takes for use to get back to our core temperature once back inside.

Any time you go out in the cold, it is recommended to dress in layers. The first layer should be a close fitting base layer. Next, an insulating middle layer. Last, a looser fitted layer that is going to repel wind and water. It is also important to wear good insulated gloves and boots along with something on your head as this is where a large amount of body heat is lost.

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