Great Health Guide: January/February 2019 by Great Health Guide

January/February 2019

Sleep

Deprivation in

how to

Children

Fitness

IVF &

Sleep

Better Brain for

Health

Nutrition Why Should I

Forgive цMYSELF?

VIRTUAL AUTISM • EAR ACHE IN CHILDREN • HIP PAIN & PHYSIOTHERAPY • ASPIRIN IN HEART HEALTH

ontents

GREAT HEALTH

SLEEP FOR BETTER BRAIN HEALTH Sleep is essential for several reasons & we cannot survive without it.

WHY SHOULD I FORGIVE MYSELF? I have an obligation to accept & share forgiveness. Dr Mathew Anderson

Dr Jenny Brockis

ASPIRIN IN HEART HEALTH: PART 1 Aspirin in secondary prevention, AFTER a cardiovascular event.

Dr Warrick Bishop

ASPIRIN IN HEART HEALTH: PART 2 Aspirin in primary prevention, BEFORE a cardiovascular event.

Dr Warrick Bishop

NUTRITION

IVF & NUTRITION

When addressing fertility issues, IVF & nutrition are closely linked.

Melanie McGrice

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RELATIONSHIPS

HEALTHY TEXTING IN ROMANTIC RELATIONSHIPS The pros & cons of texting with your partner.

Dr Lori Whatley

KIDS MATTERS

VIRTUAL AUTISM How screen use is increasing autistic symptoms in children.

Sarah Godfey

SLEEP DEPRIVATION IN CHILDREN Behavioural changes can help break the sleep deprivation cycle in children.

Kim Corley

FITNESS

PHYSIOTHERAPY FOR HIP PAIN There are several common causes of hip pain, treatable with physiotherapy Justin Balbir

HOW TO MAINTAIN FITNESS Using three different intensities, low, medium & high, keeps exercise interesting & your fitness growing. Kusal Goonewardena

MINDSET

SELF-CARE & HAPPINESS Find the time to love who you are & create moments to self-care.

EAR ACHE IN CHILDREN Reasons for ear ache & why itâ&#x20AC;&#x2122;s important to be checked by your GP. Dr David McIntosh

Sarah Godfrey DISCLAIMER

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Team

GHG

FOUNDER + EDITOR-IN-CHIEF Kathryn Dodd

DEPUTY EDITORS Dr Helen J. Dodd Dr William A. Dodd DESIGNERS Olha Blagodir Belinda Nelson Oleksandra Zuieva CONTRIBUTING WRITERS Dr Mathew Anderson, Justin Balbir, Dr Warrick Bishop, Dr Jenny Brockis, Kim Corley, Sarah Godfrey, Kusal Goonewardena, Melanie McGrice, Dr David McIntosh, Lori Whatley CONNECT WITH US:

SUBSCRIBE: W: www.GreatHealthGuide.com.au P: +61 (0)7 3394 8263 E: CustomerCare@ GreatHealthGuide.com.au

Hello Friends Recently, several articles have come across my desk highlighting the unintended consequences of information technology. This technology has revolutionised personal communications. So, what are the unintended consequences that I am referring to? The article on Virtual Autism, describes how toddlers and young children are at risk of developing autistic symptoms induced by electronic screens. The problem was solved by taking away the screens or reducing screen time and replacing them with human interactions. Similarly, the solution in the article on Sleep Deprivation in Children, was to limit screen time for an hour before bed. The specific problem is that light emitted from screens suppresses melatonin, the sleep hormone and this can greatly contribute to sleep issues. Adults also suffer sleep depredation as a result of screen use because light from a blue screen excites the brain, increasing the rate of neuronal firing, as discussed in Sleep for Better Brain Health. So, switching off screen technology at least 40 minutes before going to bed helps calm the mind to prepare for sleep. In the article, Healthy Texting in Romantic Relationships, a question is posed, ‘Would you say this in a face-to-face discussion?’. Just because texting has become the accepted way of communicating, is it the best way to build a strong and healthy relationship? These four articles in this latest issue of Great Health GuideTM highlight some unintended consequences as a result of the information technology revolution. It is important to realize that we must take a deeper look into our communication style and the health problems that are associated with the use of screens as the technology revolution gains speed and strength. Here’s to your best health,

Kathryn x

© Antalya Developments Pty Ltd 2019 Any information made available in the Great Health Guide Magazine (electronic or hard copy formats), or from Antalya Developments Pty Limited or Kathryn Dodd, including by way of third party authored articles or discussions, is made available for readers’ interest only. The purpose of making the information available is to stimulate research, public discussion and debate. Readers are encouraged to undertake their own research and consult with professional advisors to form their own independent views about the topic/s discussed. The information made available in the Great Health Guide Magazine (electronic or hard copy formats) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Readers should seek the advice of a qualified health provider with any questions regarding a potential or actual medical condition or the proposed use or decision not to use any particular product. Readers should not disregard professional medical advice or delay in seeking it at any time, including because of the content of any information made available in the Great Health Guide Magazine (electronic or hard copy formats). Each of Antalya Developments Pty Ltd and Kathryn Dodd do not warrant, guarantee or make any representation regarding the accuracy, veracity, adequacy, reliability, completeness or timeliness of any information available on, or arising in relation to, the Great Health Guide Magazine (electronic or hard copy formats). Neither Antalya Developments Pty Limited nor Kathryn Dodd endorses the views of any contributing authors to the Great Health Guide Magazine (electronic or hard copy formats).

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rain B Health

Sleep for Better

Dr Jenny Brockis

leep. It’s such a paradox.

For the sleepless, the desire for a full night’s unencumbered sleep can be as elusive as the world’s largest Queen Alexandra’s birdwing butterfly, from Papua New Guinea, which has a wingspan of 30cm. For those with too much on their minds and an endless to-do list, sleep is seen as a nuisance, something taking up mental bandwidth, time that could be diverted to the more useful accomplishment of completing that big assignment or project. The truth is we all need sleep for better brain health, whether a giraffe relying on 2 hours of giraffe naps, a cat sleeping for 15 hours or a human, evolved to function at our best on 7-9 hours good quality, uninterrupted sleep. 6 | GREAT HEALTH GUIDE

Sleep is our unspoken power, restoring energy, cognitive prowess and emotional stability. Without sleep there would be no dreams, no remembering or forgetting, no freshening up with a deep clean to get rid of all that amyloid build up and other unwanted metabolic waste. During sleep we go through a number of sleep cycles each lasting about 90 minutes, starting with light sleep, then deep sleep followed by REM before lightening up again. Deep sleep is restorative and REM is important for consolidating longterm memories. That’s why fragmented sleep feels less refreshing than a short uninterrupted sleep. The advent of technology, Netflix and changing work habits has led to SUBSCRIBE

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Up to one third of the population is sleep deprived & weâ&#x20AC;&#x2122;, re paying a massive cognitive cost.

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Great Health voluntary sleep restriction or bedtime procrastination – we go to bed late and get up early, chasing time. Shift work, flexi-time and time poverty compound the problem. It’s estimated that up to one third of the population is sleep deprived and we’re paying a massive cognitive cost. With over 100 recognised sleep disorders to choose from, it’s a marvel any of us sleep well. Typically sleep problems fall into three categories: • an inability to fall asleep • difficulty maintaining sleep • waking too early, this sometimes is a warning sign of too much worry or depression. There’s nothing more frustrating than falling exhausted into bed and your brain then deciding it is party time, determined to keep you awake thinking. Which hints at the clue as to why this happens. Our brain, just like our young children needs to prepare itself for sleep and our modern way of living, can get in the way. Working too hard and focusing for too long leaves us mentally and physically exhausted. We’re not designed to operate this way. Far better to instill two or three brain breaks of 10-15 minutes into our day where we uncouple from that heavy lifting thinking of focus, decision making and problem solving to allow the mind a quick dip down the nearest rabbit hole for a little mind wander, to enjoy unfocused or reflective thought. However, this is not the time for updating your social media! Technology excites the brain, increasing 8 | GREAT HEALTH GUIDE

the rate of neuronal firing even with a yellow rather than blue backlight. Switching off from all technology at least 40 minutes before bed and keeping the bedroom for sleep and sex only, helps calm the mind to prepare for sleep. Increasing daytime physical activity, regular aerobic exercise and relaxation techniques including breathing exercises, listening to music and meditation have SUBSCRIBE

Great Health all been shown to enhance sleep and provide better brain health. Avoid the sleep poisons of alcohol, caffeine and smoking. Two glasses of wine in the evening is enough to halve the amount of time spent in REM sleep required for consolidating memory. Caffeine competes with a naturally occurring compound called adenosine produced in increasing amounts across the day that prepares us for sleep by slowing down the rate of neuronal firing. With a half-life of 6 hours, that late cup of afternoon coffee is enough to interfere with normal sleep patterns unless you are one of the fortunate few who can metabolise caffeine at a faster rate. Naps disparagingly previously called nanna naps have been rebranded as Power Naps. The 15-20-minute snooze has been revealed as the best way for everyone young and old to revive an overtired brain, boosting creativity, attention and alertness for several hours. Best of all you don’t even need to fall fully asleep, resting with your eyes closed works just as well. But do time your nap before 3 pm, to avoid disturbing your nocturnal slumber. Poor sleep patterns can quickly become entrenched. So, if you’re not sleeping like a baby and daytime fatigue is getting you down, it’s time to chat to your medical practitioner. Many types of sleep problems can readily be resolved by adopting good sleep hygiene habits and implementing some lifestyle modifications and your brain will thank you for that. So, sleep for better brain health is vital. DISCLAIMER

Dr Jenny Brockis is a Medical Practitioner and specialises in the science of high performance thinking. Jenny’s approach to overcoming life’s challenges is based on practical neuroscience which enables people to understand their thoughts and actions leading to effective behavioural change. Jenny is the author of ‘Future Brain - the 12 Keys to Create Your High-Performance Brain’ and may be contacted via her website.

Editor ,s Choice FUTURE BRAIN

by Dr Jenny Brockis

The 12 Keys to Create Your HighPerformance Brain. •

Reduce stress & avoid stressrelated illnesses

•

Foster healthy thinking habits to boost efficiency

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Build your expertise with renewed focus &stamina

•

Drive innovation through productive collaboration

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Help you to get more done with less effort & time

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Aspirin Part1

Heart Health Dr Warrick Bishop

10 | GREAT HEALTH GUIDE

Great Health

spirin is a household word. The chemical name of the compound is acetylsalicylic acid, which is referred to simply as ‘Aspirin’. Aspirin, registered in 1899, is the name of acetylsalicylic acid that was developed by the German pharmaceutical company Bayer in the late 1800s.

The fascinating background to that is for over 2000 years prior to Bayer’s discovery, there was a realisation that something in the leaves of a willow tree could give therapeutic benefit for pain relief. In fact, a group of agents or salicylates in the primary compound were derived from the naturally occurring compounds within the leaves of the willow tree. Since the refining of acetylsalicylic acid and the marketing of aspirin, its use has become widespread and currently is the most widely used medical preparation in the world with somewhere around 100 billion tablets of the formulation produced each year. Aspirin works by blocking a special enzyme called cyclooxygenase. This enzyme then alters production of other compounds or chemicals which act as chemical messengers, called prostaglandins. These prostaglandins occur throughout the body in different situations and altering their production has an impact in a range of different scenarios.

PROSTAGLANDINS IN THE BRAIN: Prostaglandins within the brain, influence the way fevers develop. Therefore, if you are in bed with the flu and have a fever, by taking a couple of aspirin and blocking your cyclooxygenase, you will lower DISCLAIMER

your prostaglandin production that is responsible for the fever, hence reducing your temperature.

PROSTAGLANDINS IN FEELING PAIN: Prostaglandins have a role in appreciation of pain and the way pain receptors respond, so that if you have a headache (perhaps with your fever) then blocking your cyclooxygenase and lowering your prostaglandin production, will ease the pain.

PROSTAGLANDINS IN INFLAMMATION AND SWELLING: Prostaglandins also have an effect on the way blood vessels respond to inflammation, so if you had a sore arthritic knee from too much work in the garden, the associated swelling could be reduced by again blocking the cyclooxygenase, which will reduce the prostaglandins involved in the inflammatory response. So, for pain, fever and inflammation, it is pretty handy to keep a box of aspirin in the cupboard to use on an as needed basis.

PROSTAGLANDINS PROTECT THE LINING OF THE STOMACH FROM ACID: Another effect of prostaglandins is help protect the lining of the stomach from acid. This is important to understand GREAT HEALTH GUIDE | 11

Great Health

because if you use aspirin for any length of time, it is quite possible to decrease the prostaglandins within the stomach which may lead to less resistance in stomach lining and the formation of an ulcer. This is where side effects from aspirin lead to possible bleeding within the gastrointestinal tract. It is the same process of cyclooxygenase being blocked, thus, reducing protective prostaglandins in this situation, which leads to increased risk of erosions or ulcers within the upper GI tract and therefore possible bleeding. This is one of the side effects that we really need to be aware of when we are considering the risks and benefits in terms of taking aspirin, particularly for the longer term. Taking a couple of tablets on the rare occasion when we have a headache, a sore throat or even a flu with fever like symptoms, will not have detrimental effects on the gastric or upper gastrointestinal lining, however, aspirin will have an effect on reducing the impact of the prostaglandins. 12 | GREAT HEALTH GUIDE

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PLATELETS AND THE EFFECT ON BLOOD CLOTTING: However, there are reasons to take aspirin for the longer term. The role that aspirin has in reducing the stickiness of platelets is very important. Platelets are the small particles in the blood stream involved in the formation of clots. These small particles become activated when there is any irregularity within the blood vessel. If there is a cut and foreign material or factors from the tissue come into contact with the platelets, the platelet activation leads to platelets clumping. If platelets clump and they happen to be in an artery, then the clot that is subsequently formed can block that artery. A ruptured plaque within an artery is the mechanism by which a heart attack occurs when that ruptured plaque exposes tissue factors to the platelets that lead to them clumping and forming a clot. The benefit of reduction of platelet stickiness with aspirin, in reducing the risk of a heart attack, has been demonstrated multiple times since 1988.

So, 30 odd years ago, a trial called the ISIS-2 trial showed that giving aspirin to patients very early on after a heart attack would reduce the likelihood of that patient having a heart attack in the future compared to not giving aspirin at all. This first trial demonstrating benefit of aspirin was followed up by many others, all of them in the setting of preventing a second event and all showing benefit in terms of reducing the risk of subsequent heart attack. Importantly this collection of trials very specifically revealed very highrisk patients, i.e. individuals who have demonstrated themselves at being very high risk by having a heart attack, and treating that group only. The ISIS-2 trial and subsequent trials that followed supported the use of aspirin in secondary prevention, thus, stopping or reducing the risk of a second event. The following article, (Part 2), will discuss if taking aspirin before a person has a heart attack, i.e. primary prevention, has the same beneficial effect as in secondary prevention.

Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book â&#x20AC;&#x2DC;Have You Planned Your Heart Attack?â&#x20AC;&#x2122;, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website. DISCLAIMER

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Aspirin Part 2

Heart Health Dr Warrick Bishop

the previous article entitled Aspirin in Heart Health Part 1, the importance of using aspirin in secondary prevention was discussed. Secondary prevention is stopping or reducing the risk of a second event such as a further heart attack or stroke. However, giving aspirin to people before they have an event, i.e. in primary prevention, has caused controversy over subsequent years. Does giving aspirin in primary prevention offer any benefits in hear health? In the last three to six months, a number of trials have tried to answer this question. In August 2018, a study called ASCEND was published in the New England Journal of Medicine. This trial studied patients who were diabetic, but had not had any history of heart problems, i.e. they were a primary prevention population. 14 | GREAT HEALTH GUIDE

These patients, 15,000 of them were in fact followed for over seven years and although at the end of that time, there was some suggestion that the risk of having a heart attack was reduced in the group receiving aspirin, this benefit was offset by an increased risk of bleeding caused by taking aspirin for a long term. There was an increased risk of bleeding from the upper part of the gut or of bleeding into the brain. Unfortunately, the ASCEND trial did not show a benefit in giving aspirin for a group of diabetic patients, who had not had previous heart problems. Released at the same time as the ASCEND trial results, a study called ARRIVE published in The Lancet, showed that aspirin had no significant benefit in outcome when given to 13,000 subjects randomised to take aspirin or not. These SUBSCRIBE

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were people with ‘moderate cardiovascular risk’ but had not had a previous heart attack or stroke. Moderate cardiovascular risk means that the risk of an event in the next ten years is between 10 and 20% risk. This group of patients was followed for approximately six years and during that time any benefits in reduction of stroke or heart attack were matched by complications of bleeding. The most recent trial for aspirin, studied for its role in ‘primary prevention’, was the ASPREE trial. Primary prevention deals with delaying or preventing the onset of a cardiovascular event. Nearly 20,000 people across the world were enrolled to try and evaluate whether aspirin given to otherwise healthy older adults, over 70 years of age, would improve function and reduce death. These participants in the trial were followed

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Great Health for approximately six years and there was no suggestion that giving aspirin to this healthy group of older citizens made any difference. In fact, there was even a small suggestion that it could worsen the outcome. It is worth noting that these healthy older adults had lived to be healthy older adults, because they did not have coronary artery or cardiovascular disease up to that point and so to some degree, the group already had a relatively low risk to benefit from aspirin, in the context of reducing cardiovascular risk.

SO WHERE DOES ALL THIS INFORMATION LEAVE US NOW? It would certainly seem that aspirin should not just be tried to reduce risk of heart attack and stroke for everyone. It certainly does not have a clear-cut use in normal primary preventative situations of low or moderate/intermediate risk patients. There is some data to suggest that patients with elevated blood pressure may well benefit from being on aspirin and that is because elevated blood pressure can push people into a higher risk category. I tend to try and be more precise about how to evaluate the risk that an individual may have in the primary preventative setting by undertaking imaging of their coronary arteries. None of the primary prevention studies as above, have incorporated imaging as a selector for aspirin therapy or not, so the use of imaging in primary prevention by aspirin remains somewhat unanswered and speculative. However, if we find people 16 | GREAT HEALTH GUIDE

with high or very high-risk features on imaging, then understanding the pros and cons of aspirin based on the individualâ&#x20AC;&#x2122;s situation, the use of aspirin may well be a reasonable consideration. This is something that needs to be considered on a patient to patient basis with all the information available and with a clear conversation between doctor and patient striving for the best management strategy for that individual. I have written a book on this very subject. SUBSCRIBE

Great Health When it comes to secondary prevention i.e. people who have had a heart attack or stroke, there remains no question that aspirin is beneficial, and these current trials do not impact or alter the way we view aspirin in that situation. This means that if you have had a problem with your heart arteries, neck arteries or arteries in the legs and you have been put on aspirin by your doctor, then that aspirin is going to be doing a good job for you.

Editor ,s Choice KNOW YOUR REAL RISK OF HEART ATTACK Dr Warrick Bishop

What if we could PLAN NOT to have a heart attack?

Please do not stop your therapy based on the way some media outlets have presented the data from ASCEND, ARRIVE and ASPREE, check if it relates to your condition. Every treatment needs to be considered for the individual patient based on the merits of benefit of that therapy, weighed up clearly against the risks that could be inherent. This is something that your doctor needs to work through with you and something you need to be aware of and informed of. Please work with your doctor for your own best outcomes.

Dr Warrick Bishop is experienced cardiologist, with extensive training & expertise in CT coronary angiograms. The fundamental focus of this book is:

Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website. DISCLAIMER

• primary preventative cardiology by using much earlier intervention than traditionally undertaken • re-evaluation of our approach to primary prevention • managing the individual rather than the population What if we could be forewarned about, or prepared for, a potential problem with our coronary arteries?

GET YOUR FREE eBook NOW

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Nutrition SUBSCRIBE

and

Melanie McGrice

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NUTRITION

hen preparing to undergo IVF (in vitro fertilisation) treatment, itâ&#x20AC;&#x2122;s important to consider your current diet and how it may be influencing the health of your eggs. When your eggs are healthy, your chances of conceiving are higher. Eggs take approximately three months to mature before ovulation, so ideally, dietary changes made in preparation for IVF are more likely to make an impact when made at least 90 days before your first cycle. Eating a healthy, balanced diet contributes to overall health on multiple levels, however when addressing fertility for IVF, nutrition is most important. There are certain foods that are recommended to be increased and other foods that should be decreased or avoided altogether while attempting to conceive.

THE IMPORTANT FOODS IN PREPARATION FOR IVF AND NUTRITION. There are a few nutrients that stand out when looking to improve egg quality. These include:

Zinc Ever wondered why oysters are known as one of the best fertility foods available? Oysters and other crustaceans are a rich source of zinc which promotes cell division and cell growth.

Antioxidants Antioxidants protect the body from free radical damage. They also protect our eggs from damage which is especially helpful if you are trying to conceive. Coloured 20 | GREAT HEALTH GUIDE

When addressing fertility issues, IVF and nutrition are closely linked. fruits and vegetables are the best sources of antioxidants. Different colours often represent different types of antioxidants, so ensure that your plate always looks like a rainbow. Herbs, such as thyme and oregano, are also rich in antioxidants and can provide a lot of flavour.

Coenzyme Q10 Coenzyme Q10 (also known as ubiquinone or CoQ10) is required for cell maintenance and is known for keeping our eggs healthy. Premium lean, red meat is a great source of Coenzyme Q10, so include small, premium serves of meat once or twice each week.

Omega-3 Omega-3â&#x20AC;&#x2122;s has been found to reduce levels of inflammation in the body, which greatly benefits egg health. Long-chain omega-3 fatty acids are EPA (eicosapentaenoic acid) and DHA SUBSCRIBE

NUTRITION (docosahexaenoic acid). They are found predominately in fish and particularly in salmon. The best way to ensure egg quality is to eat oily fish 2-3 times a week in the lead up to conception or egg collection. For vegans and those who don’t like fish, chia seeds, flaxseed and walnuts are rich sources of the shorter chain omega-3, alpha-linolenic acid (ALA), which can be converted into the longer chain omega-3 DHA and EPA in small amounts.

FOODS TO AVOID WHILE PLANNING FOR IVF. There are some foods that are best left off your plate when planning for IVF. These include sugar-laden foods and

drinks, alcohol, foods high in saturated fat such as bacon, artificial sweeteners (commonly found in diet soft drinks and ‘low fat’ processed foods). Flake (shark meat) often has high mercury levels as they are predators of other fish, building up mercury in their bodies and have long life spans. Foods that are in plastic containers or bottles or wrapped in plastic that contains bisphenol A (BPA) should also be avoided as it is thought to be a hormone disruptor. Polycarbonate contains bisphenol-A and is #7 in the recycling triangle on the container.

YOU’RE ONLY HALF OF THE EQUATION. If you’re preparing to undergo IVF with a your partner, there are a few things he can do to maximise his fertility. These include taking 14mg of zinc per day (oysters for two!), boosting vitamin D levels by spending time outdoors, reducing alcohol intake, boosting antioxidant intake by eating plenty of coloured fruits and folic acid from green leafy vegetables. For more tips about IVF and nutrition, check out my YouTube site Nourish With Melanie or download my free fertility meal plan.

Melanie McGrice is an Advanced Accredited Practicing Dietitian and is the director of Nutrition Plus, a dietetic practice based in Melbourne, Australia. Melanie is a highly respected nutrition blogger, journalist and media personality, and is regularly invited to consult to the media on a range of nutrition & dietary topics. Melanie is the author of ‘The Pregnancy Weight Plan’ and may be contacted via her website. DISCLAIMER

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Fitness

Physiotherapy for

Hip Pain Justin Balbir

DISCLAIMER

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Fitness

ip pain is a common complaint that physiotherapists are requested to treat. The cause isn’t always clear and discomfort in this region can hinder a person’s ability to participate in physical activity, as well as performing simple daily tasks. A thorough examination can help determine what is the likely cause, as well as developing an appropriate and effective treatment plan. There are several common causes of hip pain that are described below.

HIP ARTHRITIS (OSTEOARTHRITIS): This is one of the most common causes of hip pain, especially in the older population. Osteoarthritis means there are changes to the structure of the joint, which can cause pain and discomfort when the joint is loaded (i.e. when weight bearing). It is important to note that arthritic changes are common to see on x-rays. To an extent this is a normal part of ageing and does not always cause pain or dysfunction, but sometimes will lead to issues and when severe can be debilitating.

FEMOROACETABULAR IMPINGEMENT (FAI): The hip is composed of a ball and socket joint. The ball (femoral head) sits inside the socket (acetabulum). Normally these two fit perfectly within one another, allowing for smooth movement of the ball inside the socket. When there is a mismatch, impingement can occur. This can lead to pain and reduced function of the hip joint. 24 | GREAT HEALTH GUIDE

The three main types of FAI’s are: • Cam: where the ball has an abnormal ‘bump’ on its surface, which rubs against the socket of the hip joint. • Pincer: where the socket is larger than normal, impeding the freedom of the ball movement. • Mixed: typically, a combination of the two aforementioned abnormalities.

GLUTEAL TENDINOPATHY: Tendons are the strong tissues connecting your muscle to bone. A tendinopathy typically develops over an extended period of time, where micro-tears build up and lead to weakening of the tendon. Inflammation can also be present and will also add to pain in the affected region.

TROCHANTERIC BURSITIS: Many joints in our bodies have little sacs filled with fluid. This sac is known as a bursa. Its purpose is to allow smooth gliding of tendons along its surface. If this bursa becomes inflamed, the smooth gliding mechanism can become compromised, causing pain with movement. Repetitive trauma or overuse are common causes of this issue. This can also be present in conjunction with a tendinopathy.

SCIATICA: Sciatica refers to pain that is felt anywhere along the path of the sciatic nerve. This nerve runs from your lower back, all the way down to your lower leg (passing your buttock and hamstrings along the way). Hence, irritation of this nerve can present as ‘hip’ pain as the nerve passes along the buttock. Pressure on the sciatic nerve caused by disc bulge is a common SUBSCRIBE

Fitness

occurrence, as well as facet joint irritation or compression of the nerve from various surrounding structures.

HOW CAN PHYSIOTHERAPY HELP? Initially, physiotherapists can help distinguish between the potential diagnoses. This will ultimately determine the best course of treatment. Sometimes additional input will be required, such as referral back to your GP to organise an X-ray or ultrasound if it is deemed necessary. This is typically sought, if initial treatment is not very effective. A number of treatments can be utilised to initially reduce pain symptoms. This includes electrotherapy, ultrasound, passive mobilisations or soft tissue massage, as well as simpler modalities such as heat and ice. Additionally, lifestyle advice and education will play a key role in recovery, as sometimes it is certain DISCLAIMER

habits or activities in our daily routine that are part of the problem. Once pain is improved, a gradual increase in physical activity is likely to be incorporated. This will generally be in the form of a specific exercise program, either supervised, to be done at home or both. A variety of the above treatment options can be done in combination. Each person is treated individually and therefore treatment is determined on a case by case basis.

Justin Balbir has a Bachelor of Health Sciences & Masters of Physiotherapy Practice. He has worked for five years as a sports trainer for the Ajax Football Club, with experience in soft-tissue massage & injuryÂ management. Justin specializes in manual therapy & sportsÂ injuries and may be contacted via website. GREAT HEALTH GUIDE | 25

Fitness

How to Maintain

––– Kusal

26 | GREAT HEALTH GUIDE

Goonewardena –––

Fitness

xercise fads come and go but three little words have always underpinned the best possible blend for maintaining your health. They are, simply: low, medium and high. You’ve heard about the benefits available from high intensity interval training (HIIT) and benefits from low intensity training.

But what we don’t hear often enough is that the best and most sustainable fitness and training regimes incorporate all intensity levels – low, medium and high intensity. Even elite athletes have a blend of low, medium and high intensity exercise across their week. They appreciate that you cannot have high intensity workouts all the time. Nor should you stay in your comfort zone for too long. You can apply any exercise you like to the mixture of low, medium and high training, because the focus is on the intensity rather than the activity – you can be running, swimming, riding an exercise bike, lifting weights, boxercise or anything else you can imagine, provided you are doing that activity at the desired intensity.

WHY IS LOW, MEDIUM AND HIGH A POWERFUL BLEND? We need low, medium and high intensity exercise to push ourselves outside our comfort zone. We grow physically and mentally when we do this. Our bodies are meant to move and be pushed in different ways. Doing three different intensities is far more beneficial than one intensity – for example, it’s widely considered that walking 10,000 steps per day is great exercise, but there’s no doubt many people do this exercise at the same intensity every time and become bored. DISCLAIMER

Using three different intensities, incorporating different activities, keeps things interesting. The importance of this cannot be stressed enough, because when an activity is interesting, people are more likely to stick with it. Research increasingly shows even small increases in exercise have an impact. A recent report from the Australian Institute of Health and Welfare found: ‘If all Australians did an extra 15 minutes of brisk walking for at least five days each week, this would reduce disease burden due to physical inactivity in the population by approximately 13%. By increasing this to 30 minutes, the burden of disease attributed to physical inactivity could be reduced by 26%.’

HOW CAN THIS WORK IN PRACTICE? Key is to find physical activities that you enjoy. Low intensity exercise includes walking, gentle swimming, gardening and so on – ideally everybody will be doing a good amount of low intensity exercise on at least five days per week. Medium intensity exercise should be two to three times a week, for about 25-45 minutes each time. Medium is pushing

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Fitness yourself to somewhere between 5.5 and 7 out of 10 in terms of exertion. Moderate exercise may include running, cycling, fast walking or swimming. High intensity exercise can give you an edge and research show tangible health

benefits, even at short durations. Aim for a high intensity burst three times a week. Push yourself to 8.5 out of 10 intensity – it’s just a step back from going at full capacity, because any higher than this can invite injury. How long should a high intensity workout be? There are many options. I have seen great results with a three minute workout that I initially developed for my athletes, which is adaptable for anyone at any level of fitness, while others will do slightly longer or slightly shorter. Finally, it’s good to mix things up a bit. Change the activities you are doing, mix up the days when you do the activities and mix up the intensity of the exercise as well. For example, if you feel up to it, try doing high intensity for five days in a week instead of three, or try high intensity with a different exercise.

KEY POINTS: • The body responds best to a mix of low, medium and high intensity exercise. • You can do any exercise you wish, provided you are reaching these levels of intensity.

Kusal Goonewardena is an experienced physiotherapist, lecturer, consultant and mentor to thousands of physiotherapy students around the world. Kusal recently developed the App KINRGIZE, available at Google Play and the App store. He has has authored books including: Low Back Pain – 30 Days to Pain Free; 3 Minute Workouts; and co-authored Natural Healing: Quiet and Calm. Kusal consults via his clinic, Elite Akademy. 28 | GREAT HEALTH GUIDE

Mindset DISCLAIMER

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Self-Care & Happiness Sarah Godfrey

a psychologist and coach, the most common question asked is, ‘How can I be happy?’ Happiness is a state of mind. It is an emotional experience created from what we do, how we invest out time, thoughts, dreams and love. Sometimes it is an elusive ideal; other times it abundantly falls at our feet. Happiness ebbs and flows, disappears and reappears throughout our lives. The skill of being happy is knowing what increases the frequency and longevity of our joyful moments. We need to invest in these skills, learn how we look for and master them, leading to self-care and happiness. Like anything built to last, happiness requires strong and sustainable foundations. Those foundations are a

simple puzzle made from achieving five pieces of self-development. Self-care and happiness are pieces of that puzzle to create our happiness stability. Self-care is intrinsically attached to worthiness. It’s made up of health, emotions, intellect and spirituality. How we care for ourselves, nurture our minds and maintain our environment, is vital to leading a healthy and happy life. Where we choose to ignore our physical self, we are harming the vessel that keeps us moving and participating in our lives. If we neglect our emotional self, we undermine our resilience and mental ability, struggling to build self-worth, esteem and confidence. When we stop looking after our intellect by not expanding our interests and understanding of the world, we limit our knowledge and wisdom.

Find the time to love who you are. 30 | GREAT HEALTH GUIDE

Mindset

Caring for ourselves causes us to care for others. In dismissing self-development and reflection, we avoid understanding our spirituality and our meaning in this world. Self-care is not selfishness or a selfabsorbed obsession. It is about the pride and value you grow and extend outwards to others and the environment. Caring for ourselves forces us to care for others. They reflect each other. Self-care is the acceptance that we are all worthy and of value. Investing in this means that we need to include moments of self-care in our daily lives. DISCLAIMER

A SELF-CARE CHECKLIST: • Do you skip healthy and nutritious meals, taking vitamins instead, because you tell yourself you are too busy to cook? • Do you look in the mirror focusing on a perception of what’s wrong instead of seeing yourself with kindness and self-compassion? • Do you live in a space filled with clutter and mess, avoiding cleaning and organising your environment? GREAT HEALTH GUIDE | 31

Mindset • Do you get lazy with hygiene, physical fitness or appearance telling yourself it doesn’t matter?

HERE ARE FIVE WAYS TO ACTIVATE YOUR SELF-CARE AND HAPPINESS TODAY.

• Do you avoid cultural, social or educational activities, preferring social media or reality TV?

1. Slow down and eat well. Learn to cook a nutritious meal that rewards the body and will give you healthy energy.

If you answered yes to any of these, you’re in need of self-care. People lacking in self-care talk a lot about time being the problem. Lack of time to eat properly, exercise, have hobbies or clean their spaces. As if time was stopping them finding happiness, not the absence of self-care. They walk in this world with the weight of feeling unworthy and unhappy. Lack of self-care spreads from their own loss of value to the devaluing of those around them and the environment.

2. Find five minutes a day to meditate. Be mindful or reflect, to allow that active brain check on how you are really travelling.

To sustain a happy and successful life, we can implement acts of self-care emotionally, intellectually, spiritually and physically on a daily basis. Enjoying the benefits almost immediately. All you have to do is start.

3. Start a grooming and hygiene routine. This allows you to physically care and pamper your body, so you see it as an extension of your mind and not the enemy. 4. Look at your room. See it as your emotional state. If it is chaotic, clean it up and show yourself and others that you care about your spaces, as they are an extension of your worth. 5. Join groups or take up a hobby. This gives you a passion that will challenge your intellect and creative mind. And don’t forget to get my book Life Works When - A story of piecing happiness together for a successful life, to follow and explore the other pieces of the jigsaw of happiness.

Sarah Godfrey has been a practising psychologist for two decades focusing on personal development. She works with her clients to build successful futures, speaks at conferences and writes books and blogs on discovering how to improve your life, find happiness and master human skills. Sarah may be contacted via website or email.

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Rela ionships DISCLAIMER

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H ealthy Texting in Romantic Relationships

Dr Lori Whatley

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Relationships

echnology is changing the way we interact in our romantic relationships. Approximately 83 percent of the population in most major cities use texting as a key mode of communication and over 90 percent of couples report texting to a partner at least once per day. There are pros and cons to texting a lover. Research supports that we text far more than having verbal conversations by phoning which can make texting a valuable tool, but there are also times when texting in a relationship can be harmful.

Learning to text in a way that is advantageous to the partnership can maximize our communications and strengthen the relationship. For many, texting has become a necessary means of communication in romantic dialogue. We know it is here to stay so learning how to use it properly is important. Thus healthy texting in a romantic relationship is vital in today’s face paced world.

TEXTING CAN BENEFIT A RELATIONSHIP WHEN DONE CORRECTLY. One helpful way to text is when we communicate logistics to our partner such as when and where to meet us for dinner. This is quick and easy and we have a record of the facts to refer back to for convenience. In this way, healthy texting has the ability to connect us quickly to our partners and communicate needed information. However some types of messages are more acceptable than others when it comes to texting and the type of information we communicate can affect the partnership. Using healthy texting in a relationship can be beneficial but constant texting can lead to intimacy issues in our relationship as we begin to rely more on nonverbal than in-person conversations. Personal conversations are imperative to

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building strong relationships and viable connections with our partners.

SHOULD YOU APOLOGIZE BY TEXT OR IN PERSON? When we spend a great amount of time interacting with our partners through text, it negatively effects our in-person time with them. The more an individual uses texting to discuss important topics like apologies, the more disagreeable the face-to-face interactions become. This is one way it becomes problematic in relationships and has grown to be problematic for couples. There is a greater possibility of misinterpretation through texting, as we can’t notice the body language or emotions attached to the message. The result is that we sometimes interpret the message that might not be an accurate description of our partner’s intentions. We know that the more often we text our partners, the lower the quality of the relationship.

WOULD YOU SAY THIS IN A FACE TO FACE DISCUSSION? Many of us become keyboard warriors when texting and say things to our partners we would not convey in person. The relationship might suffer as we choose to communicate negatively with our partner

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Relationships

Texting exacerbates emotional detachment in romantic partnerships. through text. Often we text quickly when in fact the relationship and important relational conversations should be made a priority. If our schedules are more significant than the wellbeing of the marriage, then there is a negative predicament to begin with. For all of us, investing in-person time with our partners should be a priority and if we already have negative communication patterns, then texting can be utilized in a way that further harms the relationship, as opposed to enhancing it. Therapy sessions for couples are more frequently discussing texting as being problematic in the relationship. As we grow to understand the effects of texting, we can eliminate possible issues going forward. We know that texting exacerbates emotional detachment in romantic partnerships and that it brings a false sense of security. For example, sometimes we think that words texted will not trigger negative emotion and thoughtlessly shoot off a text that might unconsciously link to a negative thought with our partner. 36 | GREAT HEALTH GUIDE

KEEP STRONG PERSONAL CONNECTIONS. Communication for couples should build intimacy and closeness and interacting through text can create isolation that is negative for building a strong connection with our partner. Strong connections are the cornerstone of healthy relationships and only when we can learn to use our texting in a positive way, will it be a tool to better those connections.

Dr. Lori Whatley is a licensed marriage and family therapist specialising in relational connecting based in Atlanta, USA. Dr Loriâ&#x20AC;&#x2122;s research focuses on the act of bringing people together and as a professional she takes a researchbased approach to help others forge impactful, functional relationships. Dr Lori graduated from Mercer Medical School and earned her undergraduate degree from the University of Georgia. She can be contacted via website. SUBSCRIBE

Relationships

DISCLAIMER

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Forgive myself? Why Should I

Dr Matthew Anderson

ho am I to forgive myself for things I have done that truly hurt, harmed and damaged others or

myself?

Why do I possess this sacred right, this privilege of bestowing Grace? I cannot mend or heal the wounds I have caused to others or even to myself. If I cannot heal or have these very real and painful hurts disappear, then why do I deserve to let go, be freed of my guilt, my regret, my shame and my well-deserved punishments for these harmful deeds and attitudes? Why do I have this sacred right? Because each guilt, each shame, each regret and 38 | GREAT HEALTH GUIDE

each punishment are a definite result of my egoâ&#x20AC;&#x2122;s arrogant need to be perfect. My willingness to receive forgiveness is an admission and acceptance of my imperfection and a letting go of my false sense of spiritual superiority. To accept forgiveness is to be released from my insane desire to be perfect (as a human). It frees me to become whole and thus to access my highest and best self. Refusing forgiveness is the essence of arrogance that creates and solidifies a rigid wall that isolates and darkens the heart. Every time I hate myself for any and all my failures and faults, I validate this arrogance and immediately block my ability to receive the true and magnificent blessings that want to come to me. SUBSCRIBE

Relationships

My ego resists forgiveness because it intuitively knows that humility is the first requirement. To receive, to fully experience forgiveness, my heart must open to a humility that is always difficult for my ego to accept. Every ego has a fear that humility will threaten its existence and yet it is only in facing this fear that the ego can be broken open and finally receive the transforming gift of forgiveness. In this sense, my ego is like the caterpillar that finds itself terrified that the cocoon will be its end, only to realize finally that this form of surrender is the only path to winged flight. As I humbly accept forgiveness, this sacred act, which my ego has so feared paradoxically, tears down my walls to Love and Joy and Freedom and floods my heart with the seeds of new being. Now, I am no longer a creature struggling DISCLAIMER

alone and isolated in the dark. Now I have become a being of Grace, who is all blessed and who blesses all. We might say given these truths, now, that I do not have a right to accept forgiveness. I have an obligation, a mandate, to accept and then share forgiveness. For without it, I cannot live into the shining being that I have been created to be.

Dr Matthew Anderson has a Doctor of Ministry specialising in counselling. He has extensive training and experience in Gestalt and Jungian Psychology and has helped many people successfully navigate relationship issues. Dr Anderson has a best-selling book, ‘The Resurrection of Romance’ and he may be contacted via his website. GREAT HEALTH GUIDE | 39

Kids Ma ers 40 | GREAT HEALTH GUIDE

Autism Virtual

Sarah Godfrey

old on to your iPad. This article is a must and might make you re-think how you and your children use technology. Research completed around the globe on our obsession with screens and social media is providing results that show a worrying increase in Autistic Spectrum Disorder (ASD). This is a new problem and it has a name - Virtual Autism. In brief, it means the development of autistic symptoms in children, induced by electronic screens. Significant research was presented by two French doctors, Drs Ducandwa and Terrasse, who demonstrated that there

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was a dramatic elevation of Autistic Spectrum Disorder in children who had high exposure to TV and digital screens. After removing screens from these children for a period of one-month, Ducanda and Terrasse found the autistic symptoms of these children disappeared completely. Now given that the rate of ASD is on a concerning upward trajectory, this research has huge implications. Technology is not totally to blame because there are some other factors at play. Better documentation of ASD behaviours and changes in diagnostic criteria of ASD have been adopted, so this may account for the increase in data,

Screen use is mimicking autism in children.

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kids matters but it does not account for the alarming rise in the overall statistics. Johns Hopkins Bloomberg School of Public Health report found the prevalence of ASD as one in 59 among children aged 8 years in 2014. This is a 15 percent increase from two years ago and the highest since tracking ASD in 2000. Boys were four times more likely to be identified with ASD than girls. Data from richer socio-economic areas, that can afford screen technology, also include the highest rates of ASD. Evidence over time shows rates of ASD have been increasing since the popularity of

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Virtual autism is a serious issue with far reaching consequences.

kids matters television after 1975, perhaps the initial introduction of screen transference away from each other to technology. It seems the more our children use screens rather than having human interaction, the greater their development is negatively impacted. Toddlers are being denied the development of normal social skills. Screens are training toddlers to read emotional facial expression and modelling, instead of engaging in personal conversation that develops the essential understanding of face and body language. These are critical human skills needed to live in this world. And what about parental investment in learning new skills? How are new parents developing better negotiation strategies, compassion and selflessness if these human abilities are being replaced by engaging toddlers with a screen rather than real life? How disengaged have we become as we stare at our own screens rather than interacting with our children and those around us? While technology had advanced our capabilities exponentially in some areas, excessive screen use is diminishing the next generations ability to connect.

THE GOOD NEWS THE SOLUTION IS SIMPLE: 1. Take the screens away and replace them with human interactions, such as playing peek-a-boo, reading a story book and just talking to toddlers and babies. 2. This teaches toddlers and babies how to read emotions through seeing DISCLAIMER

faces, interpret facial expressions, learn about speech patterns and tone, comprehend emotions and recognise body language. 3. This develops higher skill levels in parents to manage those often irrational and unpredictable emotional brains of children. Once screens are introduced as a natural part of our social and interpersonal evolution, it becomes the standard pattern for all interactions. And yes, in taking away screens there may be a tantrum or such. Parents may need support and guidance on how to do things differently, but change will always be a challenge. Virtual autism is a serious issue with far reaching consequence in our social world. We have an opportunity to change the socio-emotional direction of a generation of children emerging into a more technologically dependent world than ever before. It is up to all of us to turn the technology off and interact with each other, teach and learn how to grow as human beings and focus on connectivity in the real world. The choice is ours to make.

Sarah Godfrey has been a practisingÂ psychologist for two decades focusing on personal development. She works with her clients to build successful futures, speaks at conferences and writes books and blogs on discovering how to improve your life, find happiness and master human skills. Sarah may be contacted via website or email. GREAT HEALTH GUIDE | 43

kids matters

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Sleep Depriva ion in Children Kim Corley

leep deprivation in children is something that more and more children are experiencing. Itâ&#x20AC;&#x2122;s a vicious cycle that can lead to emotional and behavioural issues. However, an understanding of the issue and introducing some basic behavioural changes, can be key to breaking the cycle.

Sleep is still a relatively new field compared to other health initiatives, but research suggests it could be the single most important factor in determining how long we live. Lack of sleep is no longer a badge of honour. Associated with parenting, is an expectation of sleep deprivation. When you bring your new baby home, you do have to wake frequently throughout the night for feeds and those night feeds can play havoc with our adult body clocks.

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At a certain point, babies should start consolidating their night sleep into longer stretches and drop night feeds. Sleep is important for growth and development, and good consolidated night sleep is vital. If a poor sleep habit in a child becomes the normal, then everyone suffers. Children need good quality sleep, much more than the 7- 9 hrs recommended for adults. If you are frequently getting up to your child at night, or they are having difficulty falling asleep at bedtime, chances are youâ&#x20AC;&#x2122;re starting to feel GREAT HEALTH GUIDE | 45

kids matters exhausted. If you are experiencing sleep deprivation, there is a very strong likelihood that your child is also feeling its effects. However, it’s not always as easy to spot. When children are overtired, they present very differently to an adult. Adults struggling with lack of sleep are slow and sluggish during the day. But an overtired child will become hyperactive and ‘wired’. Indeed, sleep deprivation in children mimics the symptoms of Attention Deficient Hyperactivity Disorder (ADHD). You can see more silliness, excessive energy and emotional outbursts, especially in toddlers and older children. In young babies, overtiredness can present as fussiness, irritability or excessive crying, making it almost impossible to help them settle. Young children have an optimal wake time. After this point they will get tired and that is when sleep helps rejuvenate them. However, if a child surpasses this point, their bodies can over compensate and start revving up with stimulating hormones to keep them awake. This second wind that children display, often leads parents to believe that their child isn’t tired and doesn’t need much sleep. It’s an easy pit to fall into if you don’t know the difference, but this can lead to a vicious cycle of more sleep deprivation in children. While medical issues can impact on sleep quality, a large majority of childhood sleep issues are behavioural. Basic sleep hygiene can be key to breaking the sleep deprivation cycle in these circumstances:

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kids matters

Sleep deprivation in children mimics the symptoms ofAttention Deficient Hyperactivity Disorder. 1. ENSURE YOUR CHILD RECEIVES ENOUGH SLEEP DAILY Typically, the younger the child, the more sleep they require over a 24-hour period. Younger children also require day naps to manage fatigue. In saying this, most children still require at least 11-13 hours of sleep overnight until the age of 10 years.

2. SET A CONSISTENT EARLY BEDTIME A bedtime between 6pm and 8pm helps ensure your child receives enough night sleep. Thus, going to bed at the same time each night will keep your child’s body clock in line.

3. HARNESS THE POWER OF A BEDTIME ROUTINE A good routine does more that physically prepare you for bed. It cues the body and brain that sleep is coming. The routine needs to be long enough for the body to wind down, but short enough for your child’s brain to anticipate what’s coming next. Around 30 - 45 minutes is ideal. DISCLAIMER

4. LIMIT SCREEN TIME FOR AN HOUR BEFORE BED The light emitted from screens suppresses melatonin, (the sleep hormone) and this can greatly contribute to sleep issues.

5. ALLOW OPPORTUNITIES TO CATCH UP Life happens and there will be late nights and missed sleep at times. The key to recovering quickly is to allow your child the opportunity to catch up. That may mean an extra nap or an earlier bedtime for a few days. While you can’t make a child sleep, you can encourage and give them clear social cues that sleep is expected. Please seek help if sleep isn’t going well. Because everyone needs a good night’s sleep!

Kim Corley is a certified baby and child sleep consultant with a Bachelor of Science in psychology and pharmacology. She is also a mother who believes in the healing power of sleep and has helped numerous families solve their sleep issues over the years. You can contact Kim via her website. SUBSCRIBE

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kids matters

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Ear Ache in Children Dr David McIntosh

arents often ask me, â&#x20AC;&#x2DC;My child always gets ear aches. Is this a problem?â&#x20AC;&#x2122; When children complain of ear ache, parents often wonder if the situation requires medical advice. Ear ache in children is often overlooked by parents, thinking that it is not very important. However, it is very important that a GP check out any signs of ear ache in children. There are many reasons why children get ear ache but fortunately there are only a couple that are common. 1. The most common cause is teething, which is not so serious. 2. The next most common cause is a middle ear infection and this is potentially serious.

DISCLAIMER

Now telling the difference between these two should be simple, but this is not always the case and so, these two main causes will be the focus of this article. However, be aware that other causes of ear ache can include conditions such as sore jaw joints, a tooth infection, a sinus infection, tonsillitis and air pressure on the ear drums (such as with flying in a plane).

WHY DOES TEETHING CAUSE EAR ACHE? When the tooth starts to erupt and emerge through the gum line, this causes irritation to the mucous membrane lining the gums. The sensory nerve then tells your brain that you have a toothache. There are also other nerve branches that tell the brain GREAT HEALTH GUIDE | 49

kids matters

, Don â&#x20AC;&#x2122; ignore ear ache in children have the cause checked out.

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kids matters when you have an earache. Sometimes those messages get a bit mixed up and the brain thinks the pain is coming from the ear, when in fact it is from the mouth. This confusion about where pain is coming from is called ‘referred pain’. It basically means that the pain is originating in one spot and felt in another. This gum pain can be relieved and the ear ache will disappear once the tooth has finally emerged. If ear ache persists after this time, then seek advice from a GP.

MIDDLE EAR INFECTIONS AND EAR ACHE. Middle ear infections cause varying degrees of pain, depending on the severity of the infection. When the infection is present, it causes pain by two main methods. • The first is the local irritation and inflammation of the middle ear. • The second is a build up of fluid that leads to a pressure build up on the eardrum. Sometimes this pressure becomes so high that it tears a hole through the eardrum. This is called a ‘perforation of the eardrum’. When this happens the child experiences an intense moment of pain and then actually feels better due to the release of all the pressure. Remarkably though, sometimes children get a perforation with minimal discomfort. This wide spectrum of pain experiences with ear infections, makes it much harder to work out the causes of ear ache in children DISCLAIMER

SO, WHAT ARE THE CLUES TO TELL ONE FROM THE OTHER, APART FROM SEVERE PAIN? One thing to check for, is the presence or absence of a fever. With an infection, an elevation in the body temperature is to be expected. Unfortunately, when it comes to teething, there can be a mild fever as this is the normal body response when there is inflammation, as happens when the teeth come through the gum. The only real difference is that a significantly high temperature is in keeping with a middle ear infection as the cause of the ear pain. This is the time to worry about the ear ache in children as being due to something serious and visit the GP to have the cause of the ear ache checked. The main concern with an ear infection is that it usually has other obvious symptoms, such as a runny nose, sweating, notable irritability and the child looks generally unwell. A GP assessment can usually clarify if there is any fluid building up behind the ear drum. With ear ache in children it is better to be safe than sorry as symptoms may appear uncertain. You know your child better than anyone, so if things are not quite right, don’t ignore the ear ache in children and have the cause checked out.

Dr David McIntosh is a Paediatric ENT Specialist with a particular interest in airway obstruction, facial and dental development and its relationship to ENT airway problems and middle ear disease. He also specialises in sinus disease and provides opinions on the benefit of revision of previous sinus operations. Dr McIntosh can be contacted via this website GREAT HEALTH GUIDE | 51