Great Health Guide: Sept/Oct 2018 by Great Health Guide

September/October 2018

Clarity

& Better

MEMORY

Dietary CHANGES

& conception

Pain Killers

& Heart Attack RISK

OUR Planet’s

health

BREAST CANCER & EXERCISE • BODY LOVE • PARENTING & YOUR PARTNER • HITTING THE WALL

ontents

GREAT HEALTH

THE DIABETES EPIDEMIC Program to manage a diabetes epidemic in Sydney, Australia Prof Glen Maberly

FITNESS: NO GUARANTEE OF HEART HEALTH Passing the stress test but not the heart imaging test Dr Warrick Bishop

OPIATE PAIN KILLERS & HEART ATTACK RISK Newly prescribed opioids can cause an early death after heart attacks

Dr Warrick Bishop

ASTHMA AT WORK! You don’t have to wheeze at work Dr David McIntosh

MANAGE PAIN WITHOUT CODEINE How to cope without pain medication Melissa Hui

OUR PLANET’S HEALTH How our health & the planet’s health are closely linked

24 JAW AND FACE PAIN Physiotherapy can assist with pain in the jaw & face Margarita Gurevich

Dr Tammra Warby

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MINDSET

BE ACTIVE & RETAIN BETTER CLARITY OF THOUGHT How activity can improve thinking, memory & remove brain fog Dr Jenny Brockis

RELATIONSHIPS

BODY LOVE Discover how to like your body before you love it Dr Matthew Anderson

LISTENING TO UNDERSTAND Six ways to deeply listen & increase your understanding Dr Suzanne Henwood

ARE YOU PUSHING YOUR PARTNER AWAY? A new baby can affect the relationship with your partner Leanne Allen

KIDS MATTERS

HELPING KIDS THROUGH THE DIGITAL AGE What is the long term impact of screen technology? Dr Ash Nayate

NUTRITION

DIETARY CHANGES BEFORE YOU CONCEIVE The best foods you should eat before conceiving Melanie McGrice

FITNESS

EXERCISING AFTER BREAST CANCER Exerise is a stategy for surviving & thriving beyond breast cancer

Jennifer Smallridge

TEETH GRINDING, SLEEP WALKING & SLEEP TALKING Discover the nasal link to teeth grinding, sleep talking & sleep walking Dr David McIntosh

FITNESS: WHEN HITTING THE WALL How to overcome hitting the wall in your fitness journey

Kusal Goonewardena

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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 ADMINISTRATION Weng Yee Leong CONTRIBUTING WRITERS Leanne Allen, Dr Mathew Anderson, Dr Warrick Bishop, Dr Jenny Brockis, Kusal Goonewardena, Margarita Gurevich, Dr Suzanne Henwood, Melissa Hui, Prof Glen Maberly, Melanie McGrice, Dr David McIntosh, Dr Ash Nayate, Jennifer Smallridge, Dr Tammra Warby CONNECT WITH US:

Hello Friends In this issue of Great Health GuideTM, there are several hard-hitting articles about health problems thought of as ‘old people diseases’. Because of that younger people tend to not worry about them until it’s too late. However, with our current fast paced, highly stressed style of living without due regards to our health, these diseases are now becoming more common in young people. With the increase in heart disease and stroke around the world, Great Health GuideTM is continuing to bring you two more powerful articles by Dr Warrick Bishop, a prominent cardiologist. He discusses why being fit and healthy is no guarantee that the arteries in your heart are in good shape. He also describes the increased risk associated with the use of codeine in patients after heart attack. A prominent endocrinologist, Professor Glen Maberly, highlights the sobering facts about the diabetes epidemic in Western Sydney, with disease rates higher than the New South Wales (NSW) average. People in Western Sydney are living in an environment where the population, community, local economy and built environment make it difficult for the residents to engage in a healthy lifestyle. There is an urgent need to change the environments in which people live, work and play, to address the social determinants of health not only in Western Sydney but around the world. Dr David McIntosh, Ear, Nose and Throat specialist, raises the issue of asthma in the work place caused by second hand smoke, fine dust and irritation from cleaning products. It is estimated that nearly 10% of people with asthma find that exposure to their work environment makes their asthma worse.

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

This is a hard-hitting issue of Great Health GuideTM. Please find time to consider and to apply some of these practical, lifechanging ideas to your life. To your great health.

Kathryn x

© Antalya Developments Pty Ltd 2018 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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Always consult your healthcare professional regarding treatment of your diabetes. 6 | GREAT HEALTH GUIDE

Diabetes

The

Epidemic

Professor Glen Maberly

iabetes is now one of the biggest challenges confronting Australia’s health system. Approximately 1.7 million Australians have diabetes, including all types of diagnosed diabetes with 1.2 million known, as well as silent, undiagnosed type 2 diabetes, estimated to be up to 500,000. The diabetes epidemic in Western Sydney typifies this massive problem. Western Sydney is a diabetes hotspot with disease rates higher than the New South Wales (NSW) average. People in Western Sydney are living in a ‘diabetogenic’ environment where the population, community, local economy and built environment make it difficult for the residents to engage in a healthy lifestyle. There is an urgent need to change the environments in which people

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live, work and play, to address the social determinants of health in Western Sydney.

WHAT IS THE WESTERN SYDNEY DIABETES INITIATIVE? At Western Sydney Diabetics (WSD), we want to increase the proportion of the healthy population, slow the community’s progression towards being at risk of diabetes and reduce the size of the atrisk population. It is estimated that over 200,000 people, which is a quarter of the Western Sydney population, are likely to be affected by diabetes or pre-diabetes. The WSD initiative, recognises that diabetes is everybody’s business. Partnerships between community health services, general practice, hospitals, specialist practices and allied health need to be improved so that people with GREAT HEALTH GUIDE | 7

Great Health diabetes or at risk of diabetes have access to more integrated and comprehensive diabetes services. Only then can we reduce the burden on the health system, reduce the number of people with diabetes and pre-diabetes symptoms and slow the diabetes epidemic.

COLLABORATIVE DIABETES CARE. One of our initiatives introduced in 2014, was aimed at encouraging a much more collaborative approach to diabetes care, involving the person with diabetes and all key members of their healthcare professional team for one joint appointment â&#x20AC;&#x201C; called the Joint Specialist Case Conference (JSCC). At each appointment, the person living with diabetes meets with their GP and specialists, which may include their endocrinologist, practice nurse, resident medical staff, diabetes nurse educator and pharmacist, in the GP setting. This meeting allows all aspects of diabetes care to be discussed in an open forum involving the person living with diabetes and their team and provides an opportunity to share learnings and experiences. It also allows for immediate decisions on care plans for patients, covering diagnosis, treatments and interventions in one consultation.

trained healthcare professional, can lead to significant improvements in the patientsâ&#x20AC;&#x2122; health and encourage people to follow the five golden rules of injection technique.

These discussions include everything from medication review, cholesterol and blood sugar testing (HbA1c), diet and lifestyle review and for those people injecting their diabetes medication, a review of their injection technique. We have found that review and education on correct injection technique by a

1. Always inject into the healthy fatty layer under your skin.

8 | GREAT HEALTH GUIDE

THE FIVE GOLDEN RULES OF INJECTION TECHNIQUE FROM MAYO CLINIC:

2. A 4mm length pen/needle, inserted at 90 degrees is recommended for all adults and children. 3. Inject diabetes medication into areas on the abdomen, thighs and buttocks. SUBSCRIBE

Great Health 4. Check injection sites for lumps and bumps. 5. Rotate injection sites properly.

WHAT IMPACT HAS OUR APPROACH HAD? Since WSD created the JSCC, we have been gathering feedback from GPs and patients and the overall impact on practice diabetes management.

The key outcomes of the program, Effectiveness of joint specialist case conferences for building general practice capacity to enhance diabetes care: A pilot study in Western Sydney, Australia, include: 1. Engaging 1,200 patients, 165 GPs, across 57 different practices in Western Sydney. 2. Key improvement in key clinical measures in three years following JSCC include: • An average of 2.30 kilograms in weight loss

Everyone has a role to play in reducing the risk of developing diabetes and managing it effectively if diagnosed - we continue to find that diabetes is more prevalent than we thought. 2. Involve people in their role to manage diabetes. Encouraging people with diabetes to play a central role in their diabetes care management has been very successful for us in Western Sydney. Regular blood sugar testing, small weight loss and education on diabetes medication and injection technique can lead to better diabetes management. 3. Lose weight. Any weight loss is good for reducing the risk of developing diabetes, 30% of those with pre-diabetes who lose 2 kilograms, won’t go on to develop diabetes. 4. Get tested. If you have any doubts or have been diagnosed with pre-diabetes, get tested regularly for diabetes.

• A decrease of 0.93% in HbA1c (sugar levels) • A decrease of 4.61% in diastolic blood pressure • Almost half report increased GP confidence in managing diabetes • Ninety percentage of patients have reported that JSCC were useful.

CONCLUSIONS: 1. Diabetes is an epidemic in Australia and the Western world. DISCLAIMER

Professor Glen Maberly, Senior Endocrinologist and Program Lead, Western Sydney Diabetes. He is the driving force behind the Western Sydney Diabetes initiative. The Western Sydney Local Health District (WSLHD) is a diabetes hot-spot and has built a program with numerous partners in all sectors to beat diabetes. Throughout his career, Glen has focused on bringing public health evidence-based research findings to large scale implementation. GREAT HEALTH GUIDE | 9

Great Health

Fitness:

No Guarantee of

Dr Warrick Bishop

10 | GREAT HEALTH GUIDE

Great Health

This very fit-looking man, training for an endurance event, had a significant narrowing in the artery that supplies blood to the heart.

ou may surprise that fitness is no guarantee of heart health and that the arteries in your heart are in good shape. For instance, in recent years, I had an extremely fit patient come to see me for a stress test. At that time, he was training for an endurance event and by all accounts, he was in fantastic shape. Several years earlier we had scanned his heart and we found that he had a buildup of cholesterol in his arteries for which he was already receiving therapy. He had been training hard for the endurance event and he confided that he felt ready for the challenge.

was experiencing breathlessness when his heart rate approached 150 to 160 beats per minute. Nevertheless, when he undertook the stress test, he appeared as though he could keep running all day and that is exactly what he had been training to do. As the treadmill progressively got faster, his heart rate increased and when he eventually hit 160 beats per minute, he was noticeably gasping for air. However, he did not experience chest pain and compared with many other patients, he seemed be doing exceptionally well.

PASSING THE STRESS TEST.

HEART IMAGING TOLD A DIFFERENT STORY.

The reason for the timing of the stress test is that he routinely wore a heart rate monitor and he noticed that he

However, other data that we collected from him was telling a completely different story. His ECG indicated that

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GREAT HEALTH GUIDE | 11

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there was a reduced blood flow to his heart as soon as he went over 140 beats per minute and this got gradually worse. I then took him off the treadmill and put him on a bed so that we could ultrasound his heart to see what was happening. The images clearly indicated that the posterior part of his heart was not contracting properly. This test was telling us that this very fit-looking man who had been training for an endurance

12 | GREAT HEALTH GUIDE

event, had a significant narrowing in the artery that supplies blood to the posterior wall of his heart. Within days he had an angiogram to confirm the diagnosis and arrangements were made so that he could have angioplasty which opens blocked arteries and restores normal blood flow to the heart. As suspected, the results indicated a narrowing of the artery and he received a stent implant. Thus, his fitness was no guarantee of heart health. Now, he is in

Great Health good health and has resumed his full training regime.

ARE YOU FOOLED BY YOUR LEVEL OF FITNESS? It was very lucky that this man decided to get checked before he participated in the endurance event, because we can only surmise what would have happened otherwise. What if he had been fooled by his exercise capacity and his level of fitness? What if halfway through his endurance event his narrowed artery had become a blocked artery? Well, I don’t have the power of divination, but I do know that we can avert this type of risk through heart imaging, rather than simply relying on the health of the individual. Heart imaging is not for everyone, but it is certainly a test that everyone should discuss with their doctor to find out if it is appropriate for them. Fitness is no guarantee of heart health.

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

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

Good health! Dr Warrick Bishop is experienced cardiologist, with extensive training & expertise in CT coronary angiograms. The fundamental focus of this book is: • primary preventative cardiology by using much earlier intervention than traditionally undertaken

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

• 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

GREAT HEALTH GUIDE | 13

Opiate Pain Killers &

Heart A ack Dr Warrick Bishop

14 | GREAT HEALTH GUIDE

RISK

Great Health

pioid use has been found to exert numerous damaging effects on the heart. Below are the real facts that you need to know about opiate pain killers and heart attack risk.

1. OPIATES SLOW HEART RATE. Opiates are depressant drugs, which slow down most bodily functions. Therefore, the cardiac effects of opioid use include the slowing of the heart rate (called bradycardia).

2. OPIATES DISRUPT THE HEART’S NORMAL RHYTHM. It has been found that prolonged opioid use can cause prolonged QT syndrome, which is a defect that impacts the electric function of the heart and in turn, this can disrupt the heart’s normal rhythm.

3. OPIATES CAN CAUSE HEART DAMAGE. Long-term opioid abuse can cause a permanent delay in heart rhythm and this delay in the heart’s rhythm, can result in heart damage and inadequate oxygen delivery.

4. OPIATES CAN INFECT THE HEART LINING. There is an increased risk of infection of the heart lining with IV use. Additionally, it has been found that longterm opioid use, by intravenous injection, can increase risk of infection of the heart lining and valves. DISCLAIMER

5. OPIATES CAN CAUSE HEART PALPITATIONS AND ARRHYTHMIAS. Concerningly, it has been shown that even short-term opioid use, can disrupt this normal rhythm, causing heart palpitations and arrhythmias. In a recent study, data was collected between 1999 and 2012 from 23,000 patients who had recently been prescribed a long-acting opioid medication. This dataset was compared with an equal number of patients who had been prescribed alternative pain medication, including anticonvulsants and lowdose antidepressants. The results of this research suggest unforeseen heart risks with opiate drugs, during the early days of taking the medication. The important conclusions were as follows:

1. RISK IS GREATER FOR PATIENTS ON NEWLY PRESCRIBED OPIATES. Patients who have been newly prescribed an opioid painkiller, have a significantly greater risk of early death compared with patients who were prescribed alternative pain medications. Notwithstanding the risk of overdose with powerful opioid drugs, such as Oxycontin and Fentanyl, this new study has uncovered unforeseen heart risks with opiate drugs during the early days of taking the medication.

2. OPIOIDS CAUSE INCREASED RISK DURING SLEEP. The risk of premature death was found to be related to breathing difficulties during sleep. Specifically, patients who had been GREAT HEALTH GUIDE | 15

Great Health

newly prescribed opiate medication were reported to have a greater risk of premature death compared with patients who were prescribed different pain medications. Much of this increased risk was found to be related to breathing difficulties during sleep. Nevertheless, the substantial increase in cardiovascular death risk during sleep, is a new finding. Thus, caution must be advised when prescribing opioids for patients who are at higher cardiovascular risk.

3. AN INCREASED RISK OF DEATH, DUE TO NEW HEART COMPLICATIONS. An important caveat of this studyâ&#x20AC;&#x2122;s results, is that the study focused exclusively on the risks of opiate medication for first-time opioid users. During the average tracking period of approximately five months, there were 185 deaths in the opioid treatment group versus 87 deaths in the alternate pain medication group. The study found that with firsttime opiate treatments, these patients had a 65% increased risk of death due to new heart complications. The studyâ&#x20AC;&#x2122;s authors concluded that alternate pain medications

Patients have a greater risk of early death during treatment with a newly prescribed opioid. 16 | GREAT HEALTH GUIDE

Great Health should be favoured over long-acting opioids whenever possible, particularly for those patients who have a history of heart disease, heart attack or diabetes. According to the investigators who stated, ‘Our opinion, which is consistent with the recent guidelines from the Centres for Disease Control and Prevention, is that opioids should be used as a last resort’.

Editor ,s Choice HAVE YOU PLANNED YOUR HEART ATTACK? By Dr Warrick Bishop

4. CEASING LONG-TERM USE, SUDDENLY INCREASED THE RISK OF AN ADVERSE EVENT. The above study focused exclusively on the risks of opiate medication for firsttime opioid users. However, there is a need for more research to assess the risks experienced by patients who are attempting to cease long-term opioid use. Transition can be very difficult among long-term opiate users and suddenly stopping opiate medication after longterm usage can actually increase the risk of some adverse events for some patients. Therefore, before you make any changes to your pain medications, it’s important that you speak with your physician to establish the best course of action for you with opiate pain killers and heart attack risk.

By Dr Warrick Bishop, is an experienced cardiologist, with extensive training & expertise in CT coronary angiograms. This book is for you, if you: • want to determine your individual risk level of a heart attack • want to reduce your risk of heart attack • believe prevention is better than waiting for an attack to occur • have high cholesterol and not sure about taking statins • suffer side effects from statins • find out if plaques are blocking your coronary arteries Paperback

Published February 2017

RRP $34.99 Now $26.95 Booktopia may vary prices from those published. Postage $6.95 per order AUST/NZ

Great Health

Asthma Work! AT

Dr David McIntosh

18 | GREAT HEALTH GUIDE

Great Health

spend more time at work than we do at home. Apart from the many obvious problems of this when it comes to work-life balance, there are some certain health implications related to the working environment. One area that affects too many people is exposure to certain irritants at work that potentially trigger allergies. These can affect your skin, throat, eyes and your lungs. And when it comes to your lungs, this can lead to asthma or asthma-like symptoms including wheezing. Do you have asthma at work?

If you notice you tend to cough and struggle to breathe at or after work but on the weekend or holidays you are fine, then there may be something in your workplace that is affecting your health. It is estimated that nearly 10% of people with asthma find that exposure to their work environment makes their asthma worse.

1. IT IS NOT ALWAYS EASY TO DEFINE THE PROBLEM IN THE WORKPLACE. You may not be able to manage your exposure to the irritants. It can be as simple as the air conditioner filters not having been cleaned recently and being full of mould, pollens or dust. Also, there may be specific chemicals in the environment that cause irritation such as cleaning chemicals.

2. EXPOSURE TO SECOND HAND CIGARETTE SMOKE. One thing that most workplaces should have already addressed, is exposure to second hand cigarette smoke. Smoking is bad for an individual’s health, but DISCLAIMER

if you are asthmatic, it can be a major trigger for an attack of asthma. With the current age of science and knowledge, society really needs to advance and remove cigarettes from the workplace entirely. There is much legislation in places like restaurants, bars and clubs and there are laws about smoking within a certain distance to buildings such as hospitals. However, there are still gaps in the workplace environment that need to be addressed. Whilst those who choose to smoke have the right to do so, people who choose not to smoke are equally entitled to not be exposed to toxic passive smoke at work.

3. A LIST OF MORE SPECIFIC IRRITANTS AND ALLERGENS IN WORK PLACE: • general dust in the building and offices • some worksites have a lot of dust, such as concrete factories, wood working and cutting factories

GREAT HEALTH GUIDE | 19

Great Health • some work environments can emit gases and fumes, including fumes from cleaning chemicals • lotions and fragrances including strong perfumes used by some people, can be equally toxic to those who are sensitive to certain fragrances • sensitivity to perfumes is a very real condition and some people are quite allergic, developing watery eyes and runny noses when exposed to even small amounts. So, if you love wearing perfumes, then it would be wise to ask your colleagues at work, if they are struggling with the odour from your perfume or deodorant.

4. WHAT YOU CAN DO TO MINIMISE ASTHMA AT WORK? With such a list of problems, how does one go about reducing the exposure to potential allergens? The first thing to

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do is to work out what is triggering the attacks. This can be easier said than done. If you think you have worked out what may be causing you to be unwell, then you need to talk to your employer or health safety officer. There may be protective equipment that can solve the issue. If it is something like the cleaning products being used by the office cleaners, maybe they can try something different. A friendly chat to the perfume addict maybe helpful too! Remember it is your health and it is your right to be safe and minimize asthma at work.

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 website.

Manage Pain Without Codeine ––– Melissa

Hui –––

Great Health

he economic cost of pain in Australia is estimated at $34.3 billion per year. It is the nation’s third most costly health problem, after cardiovascular disease and musculoskeletal conditions. The cost to the health system is approximately $7 billion per annum. As of February 1st, 2018, any pain tablets containing a mixture of codeine became prescription only. Since this requires a visit to a general practitioner, many patients are seeking alternative ways to manage pain without codeine.

As a Professional Services Pharmacist, here are some suggestions on how you can manage pain without codeine.

pharmacist or general practitioner before making radical changes. 2. Pursue alternative remedies.

1. Seek expert advice from your doctor or pharmacist. While the codeine change requiring a prescription may be overwhelming, your doctor or pharmacist can assist you with the transition to manage pain without codeine. Some codeine and opioid medication help reduce strong pain sensations, but they may not assist in the recovery or improvement of physical functions. Studies have also shown long-term use of codeine and opioid medication can increase a person’s sensitivity to pain, not provide relief. It is important to be honest about your symptoms so correct medication is prescribed to manage your discomfort. Also, keep in mind everyone tolerates and experiences pain differently. Be sure to have this conversation with your

Taking medication by mouth is one option for dealing with pain but there are other options: • Anti-inflammatory gets and rubs. Depending on the degree and type of pain, anti-inflammatory gels, muscular rubs, massage oils and liniments can be alternatives for pain management. • Heat to relax muscles and increase circulation. Heat treatments are another simple, effective way of relieving muscular and joint pain. Patients can use a hot water bottle, heat pack or electric blanket to increase joint mobility and relax muscles. • Alternative treatments. Acupuncture and dietary supplements could also help with certain types of pain. However, talk with your general

Your doctor or pharmacist can assist you to manage pain without codeine. 22 | GREAT HEALTH GUIDE

Great Health practitioner before taking any new supplements or receiving alternative treatments. 3. Find the right exercise routine for you. • If patients take steps to improve their daily and physical functions, it can positively impact their overall recovery from persistent pain. • A daily routine should include gentle exercise, stress management or physiotherapy. Less strenuous exercise such as yoga and relaxation therapy are good options to begin with. • An achievable exercise routine combined with a personalised pain management plan can also help to reduce symptoms. Patients can access more information about pain management from their pharmacist with private one-on-one consultations, to assist patients to understand and manage their pain. While these tips may not work for everyone, those experiencing persistent pain need to adjust to the changes in codeine availability, now only through prescription. Seek expert advice from your doctor or pharmacist, look at alternative remedies and implementing a daily exercise routine is a start to a more comfortable way to manage pain without codeine.

Melissa Hui, B.Pharm, is a qualified Pharmacist with over 10 years’ experience in community pharmacy and is a Professional Services Pharmacist for the National Discount Drug Stores Franchise Support Office. DISCLAIMER

GREAT HEALTH GUIDE | 23

Jaw & Face Pain Margarita Gurevich

24 | GREAT HEALTH GUIDE

Great Health

aw and face pain can be very debilitating. The medical term for jaw and face pain is ‘temporomandibular joint pain’ - sounds like a mouthful, doesn’t it? In fact, temporomandibular joint pain which is also known as TMJ pain, is the pain which is felt in the jaw and/or the muscles which control the movements of the jaw. The focus of this article will be on the available treatment options for jaw and face pain and how physiotherapy can help. However, before looking at this, a brief review of the causes and symptoms is needed.

While the exact cause of TMJ pain is not clear, there is evidence to suggest that the following conditions need to be considered.

POSSIBLE CAUSES ARE: • • • •

genetics arthritis prior jaw injury grinding or clenching your teeth has also been linked to TMJ pain, although this has not been proven.

TYPICAL SYMPTOMS INCLUDE THE FOLLOWING: • jaw pain/tenderness • pain in one or both temporomandibular joints (the hinge-like joints which connect the jawbone to the skull) • pain in/around the ears • facial pain • pain when chewing • difficulty with opening/closing the mouth due to locking of the joints. DISCLAIMER

Sometimes the symptoms of jaw and face pain may resolve with time without any treatment. However, if they persist it is important to see your GP to make sure that you have the right diagnosis as certain conditions can occasionally masquerade as TMJ pain. If necessary, your doctor will refer you for a dental X-Ray/CT scan or for a TMJ arthroscopy. Once the diagnosis is confirmed there are a number of treatment options available. It is important to seek treatment early to prevent the condition from becoming chronic. Certain medications, such as analgesic and anti-inflammatories, may help, as well as oral splints.

PHYSIOTHERAPY TREATMENT INCLUDES: 1. Therapeutic ultrasound: Most likely your physiotherapist will recommend therapeutic ultrasound to reduce the pain and inflammation that arise from jaw and face pain.

2. Drug phoresis: Occasionally drug phoresis may be used, which allows medications (pain relieving and anti-inflammatory) to be delivered directly to the jaw joint. This means that the medication will not go through the stomach and gut, which in turn leads to lower concentration of the drug and fewer side effects. Results should generally be felt within a few treatment sessions.

3. Specific exercises: Once the symptoms of jaw and face pain are under control, your physiotherapist will provide you with specific exercises which can be done at home. These GREAT HEALTH GUIDE | 25

Great Health

exercises help to improve the TMJ range of motion and strengthen the jaw muscles, which subsequently results in less pain, clicking and locking. In fact, a 2010 study concluded that TMJ exercises speeds up jaw recovery compared to splints. Your physiotherapist will be able to review and modify the exercises accordingly as you go through the recovery process in order to reduce the likelihood of TMJ pain recurrence.

26 | GREAT HEALTH GUIDE

Margarita Gurevich is Senior Physiotherapist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialises in sports injuries, women’s health (including incontinence) and gastrointestinal issues. Margarita may be contacted via her website.

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, H Planet s ealth Our

––– Dr

28 | GREAT HEALTH GUIDE

Tammra Warby –––

Great Health

lanetary health is a rapidly expanding area of study that recognises that human health depends on flourishing natural systems. It also suggests that we need to wisely look after the natural systems and the planet’s finite resources on which we depend as it loops back and keeps us healthy. Think about the basics of what keeps us alive and thriving; water, food and air, all of which are affected by the ecosystem’s health and climate. Our protection and care of these systems is therefore crucial, especially for future generations and our planet’s health.

WATER IS RUNNING SHORT. Let’s look at water as an example. Currently, only 0.3% of the world’s freshwater is available for human use and up to 70% of it goes towards use in agriculture. As the world’s population and therefore the need for food and water grows, there will be an increasing burden placed on water and land, especially to raise livestock. According to the CSIRO Mega Trends report, serious health impacts will be felt by the next generation in the form of water scarcity and reduced food security.

CARBON DIOXIDE EMISSIONS. The fact is that our planet’s health and therefore our health, starts at home. To improve the situation, we need to consider our impact on Earth’s resources, such as via carbon dioxide emissions as well as the sustainability of our choices. With that in mind, consider two small changes we can make that can increase our personal health immediately, as well as protecting the planet’s health and sustainability, a happy co-benefit. DISCLAIMER

THESE TWO SMALL CHANGES ARE: 1. The consumption of red meat. This is convincingly associated with an increased risk of bowel cancer and places massive pressure on the ecosystem. Personally, I have vastly reduced my red meat consumption and chosen to increase my fish intake and plant-based protein diet. This has less environmental impact and forms the basis of the Mediterranean Diet, which is also considered to be heartprotective. Choosing sustainably sourced seafood is vital, as the populations of commercially important species of fish has been reduced by 90% in the last 50 years. 2. Increasing physical activity via active transport such as walking and biking. ‘Lifestyle exercise’ increases physical and mental health and in turn decreases the negative impact on air pollution and ecosystems. In the most

GREAT HEALTH GUIDE | 29

Our planets health & therefore our health starts at home.

bike-friendly cities in the world, such as Copenhagen (where 62% of the population rides to work), the public health savings are staggering. The infrastructure, time and motivation are needed to make these changes, but even small changes are possible. I rode or walked everywhere for 13 years before I had to reluctantly buy a car. And yes, I still ride my bike! Why not start with one less trip to the shops in the car per week, instead riding your bike there? Or a Sunday ride with friends or family? Biking is much more fun. If you would like to further understand how you can impact on our planet’s 30 | GREAT HEALTH GUIDE

health, you can use a carbon footprint calculator and start to reduce your personal burden on the Earth’s resources and keep the future generations healthy. We can all work towards our planet’s health with the knowledge that ‘what is good for the world…will be good for us’.

Dr Tammra Warby is a General Practitioner with a PhD, who works at Foxwell Medical. She is on the FRACGP Future Leaders program 2018 and manages chronic disease such as asthma and diabetes, with further qualification in skin cancer surgery. She can be followed on Twitter. SUBSCRIBE

Nutrition

DISCLAIMER

GREAT HEALTH GUIDE | 31

Dietary Changes

Before you Conceive –––

32 | GREAT HEALTH GUIDE

Melanie McGrice –––

NUTRITION

ne after another your girlfriends are announcing that they are expecting a baby. The coffee catch-up conversation has switched from how to cope with your hangover to how to tell when you’re ovulating. Now you’ve started fantasising about holding your own little one in your arms too.

As a fertility and prenatal dietitian, one of the first things you should do when you’re thinking about conceiving, is to review your dietary intake before you conceive. The reason this is so important is that what you eat in the lead up to conception and during pregnancy can influence your baby’s epigenetics, which will then impact his or her health, wellbeing and intelligence for the rest of his or her life. It is worthwhile to skip the chocolate and opt for the almonds instead, so that you commence your dietary changes before you conceive.

FIVE SIMPLE RECOMMENDATIONS FOR YOU TO START WITH INCLUDE: 1. Review your nutritional supplements. As a dietitian, I usually prefer that people get most of their nutrients from food rather than supplements BUT when it comes to fertility and pregnancy, it’s very hard to meet the high levels of nutrients required without them. I suggest that you speak to your local dietitian to get individually-tailored recommendations, but as a minimum you need some folic acid. Most women require iodine and vitamin D as well. DISCLAIMER

2. Ensure you are eating enough fish. The omega 3 fats in fish are great for your egg health. Aim to eat low mercury, omega 3 rich fish such as salmon two to three times per week when you’re trying to conceive. Click here to learn about which fish are best to eat for fertility. Try to get into a weekly routine by having ‘Friday fish night’ so that you know that you’re meeting your requirements. 3. Optimise your weight. Being overweight or underweight can significantly impact your production of the hormone oestrogen which goes on to impact your ovulation frequency and consequently, your chances of conception. In fact, about 30% of infertility is thought to be due to oestrogen imbalance. Losing or gaining weight can take a while so if you’re planning to conceive in the next year, it’s something that you may need to start working on now. Avoid fad dieting or bingeing, instead aim to optimise your weight in a healthy way. 4. Space your meals. Many women I see in my practice, skip meals. I know it can be difficult, but try to eat small, regular meals throughout the day. This helps to optimise your insulin levels, which then impacts other fertility GREAT HEALTH GUIDE | 33

NUTRITION hormones to have a big impact on your likelihood of a stress-free conception. 5. Eat a nutrient-rich diet. Research shows that following a nutrientrich fertility diet can boost your fertility by up to 69%. Your diet should be packed full of nourishing foods such as wholegrains, lean proteins, fruit and vegetables. Minimise your intake of high kilojoule snacks such as chips, biscuits and chocolate and focus on eating foods which will nourish your body – as it will

34 | GREAT HEALTH GUIDE

soon be the home to your growing baby. If you’re planning to conceive, download your free fertility meal plan to help plan your dietary changes before you conceive.

Melanie McGrice is a fertility and prenatal dietitian who runs the YouTube channel Nourish With Melanie and Nutrition Plus women’s clinics. She has created a free fertility meal plan to help all women have access to a nutritious fertility diet.

DISCLAIMER

Fitness

GREAT HEALTH GUIDE | 35

Exercising with

Breast Cancer Jennifer Smallridge

36 | GREAT HEALTH GUIDE

Fitness

side from non-melanoma skin cancer, breast cancer is the most common cancer among Australian women â&#x20AC;&#x201C; it is highly likely that you will either know a breast cancer survivor, or perhaps you are one yourself. Fortunately, 89 out of 100 women diagnosed with invasive breast cancer survive five or more years beyond diagnosis, but the impact of treatment can persist even after remission has occurred.

The good news is that appropriate exercise can assist with the changes to the body associated with treatment and significantly improve quality of life. Exercise is not only safe after breast cancer, it is now considered an essential part of management before, during and after treatment. Read on to discover the top four reasons why exercising with breast cancer should be included at all stages.

1. EXERCISE BOOSTS MENTAL PROCESSING SPEED. With or without chemotherapy, many breast cancer survivors report a decline in brain function which affects memory, thinking and concentration. A study from the San Diego School of Medicine in 2017, found that incorporating 12 weeks of regular exercise showed more than double the improvements in cognitive processing speed than those who did no physical activity.

2. EXERCISE ALTERS TUMOUR GENE EXPRESSION. Emerging research presented at the San Antonio Breast Cancer Symposium DISCLAIMER

in 2016 have confirmed what has been found in animal studies for years â&#x20AC;&#x201C; exercise in humans changes the genetic makeup of tumour cells. Study participants in the exercise intervention showed upregulation of the processes responsible for tumour cell death and downregulation of the processes responsible for tumour growth.

3. EXERCISE PREVENTS THE RISK OF CARDIOVASCULAR DISEASE IN BREAST CANCER SURVIVORS. For women with non-metastatic breast cancer, cardiovascular disease is the leading cause of death. In 2016, research detailed in the Journal of Clinical Oncology reported that regular exercise results in a substantial reduction in the incidence of cardiovascular events, coronary artery disease and heart failure.

4. EXERCISE IS VITAL DURING CHEMOTHERAPY. Studies show that being physically active during chemotherapy for early-stage breast cancer improves fitness, quality GREAT HEALTH GUIDE | 37

Fitness of life, chemotherapy completion rate and disease-free survival. The recommendations from the research were to complete 3 x 60 minute sessions per week during this time, incorporating a mixture of strength and aerobic exercise.

THE TAKE HOME MESSAGE. Although breast cancer treatment is associated with changes in the body, mind and energy levels, exercising with breast cancer must be considered to preserve wellbeing and assist at a cellular level during treatment, recovery and beyond. The Breast Cancer Network of Australia has compiled a fantastic resource outlining available exercise options which are all overseen by qualified health professionals. At a local level, the simplicity of going for a walk with a friend or jumping in the water for a swim are also highly effective ways to keep exercising with breast cancer.

Jennifer Smallridge is an Accredited Exercise Physiologist at Upwell Health Collective in Camberwell, Victoria; as well as an Academic Lecturer in the fields of Exercise Science and Functional Human Anatomy.

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Fitness

Fitness:

Hitting the Wall ––– Kusal

DISCLAIMER

Goonewardena –––

GREAT HEALTH GUIDE | 39

Fitness

you exercise regularly then eventually you might ‘hit the wall’. The big question is: do you try to crash through the wall or do you take it as a cue to relax? Hitting the wall is more than experiencing a slowdown. In fact, truly hitting the wall is peak exhaustion. You are physically and mentally spent. You literally cannot keep going. Hitting the wall can be emotional and demoralising. You can feel like all the fitness gains you have made to date have vanished.

But it’s normal and you haven’t lost your fitness. Elite athletes give us some cues. They will plan when they might hit the wall during their training cycle, so it doesn’t happen during an event. If you’ve taken any interest in sports you will have seen what happens when elite athletes hit the wall.

BUT WHAT DO ATHLETES DO WHEN IT HAPPENS? Steven Kotler, one of the world’s leading experts on high performance, sums it up best, explaining different stages of an exercise program.

THESE FOUR STAGES ARE: 1. The struggle stage Starting a new activity loads the brain with new information: planning the run, doing the run, learning what our body can and cannot do. This stage consists of training, during which the body releases cortisol, adrenaline, norepinephrine – stress hormones which prepare the body for increased intensity. But these hormones also cloud judgement and use energy. They tense your muscles, increase your heart rate, prepare the body for the ‘fight or flight response’ and increase frustration and tension. 40 | GREAT HEALTH GUIDE

2. The relaxation stage Athletes know they must move out of Stage One, take their mind off training and their sport, or they will hit the wall. This may surprise, but it’s important to stop training and do something completely different like go to a movie. The relaxation stage allows the body to flush the stress hormones while the brain introduces nitric oxide, which improves blood flow. The body then releases the feel-good hormones dopamine and endorphins and you feel good again. 3. The competition stage An athlete’s body and mind are now ready to be tested in competition. Timing Stage One and Stage Two well, is critical. If athletes skip Stage Two, then stress will prevent them from performing at their best and they might hit the wall during the event. But if they have successfully managed Stage One and Two, athletes can reach the ‘flow stage’, where they can perform at their peak. 4. The recovery stage Athletes use a huge amount of energy across stages 1-3. A planned recovery is crucial. This is where an athlete is ready to go to the next level. SUBSCRIBE

Fitness

By listening to your body, hitting the wall will only be temporary. Sleep, rest, good diet, healthy habits all combine to make a good recovery. It allows the athlete to complete the cycle. It means they have mastered their current level and can plan for the next level.

WHAT DOES THIS MEAN FOR THE REST OF US? Many people exercise hard without the structures and discipline of elite athletes. Yet scientists have found just a 4% increase in intensity, duration or frequency can push us from our comfort zone. Our mind and body respond positively to this, but we can become overloaded. If you are overloaded, stressed and just can’t take it anymore, you may have hit the wall. In time, as you learn to listen to your body and your mind when exercising, you will learn to recognise the signs.

KEY POINTS: • Hitting the wall is a normal part of exercise. • Athletes hit the wall more than most and plan for it. • By listening to your body, hitting the wall will only be temporary.

Kusal Goonewardena is an experienced physiotherapist, lecturer, consultant and mentor to thousands of physiotherapy students around the world. Kusal 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.

Trying to ‘crash through’ this wall often creates more stress and risks injury, which may prevent you doing the exercise you enjoy. Perhaps take a cue from elite athletes and relax for a while – do something else, go to a movie, catch up with some friends, take a little time out. Chances are you’ll come back stronger. DISCLAIMER

GREAT HEALTH GUIDE | 41

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DISCLAIMER

Mindset

GREAT HEALTH GUIDE | 43

Mindset

Find ways to be more active & retain greatera clarity of thought. 44 | GREAT HEALTH GUIDE

Be Active & Retain Greater Clarity of Thought Dr Jenny Brockis

taying ‘on your toes’ is the expression meaning that we’re directing our energy to focus on what we’re doing. Which is not a bad thing to do, given we’re living in this crazy, busy, super-fast world where it is critical to ensure that we get all our tasks done and with fewer mistakes.

It turns out that staying on our toes is also exactly what provides the best activity to retain greater clarity of thought.

WE THINK BETTER ON OUR FEET. Several studies have looked at the neurocognitive benefits of standing when learning. One such study in 2016 showed how the use of standing desks improved executive function and working memory in high school students, indicating how changing our environment is a simple way to enhance DISCLAIMER

cognitive learning.

function

and

effective

SITTING IS THE NEW SMOKING. We sit way too much. While sitting is not harmful, sitting for prolonged periods of time reduces blood flow to our head and thus reduces our ability to think well. It’s about moving more and sitting less. Increasing physical activity by one hour has been shown to improve cognitive function, even in the presence of Alzheimer’s disease. GREAT HEALTH GUIDE | 45

Mindset

REDUCE BRAIN SHRINKAGE BY SITTING LESS. A new study has revealed the more we sit, we greater the amount of shrinkage that occurs in the area of the brain that is important to the formation of new memory and learning. In this small study the researchers noted that increased sedentary behaviour was a significant predictor of thinning of the brain that could be offset by increasing physical activity. Brain atrophy is associated with ageing, but why choose to add to this by remaining too sedentary? It’s time to move more.

An increasing number of companies now provide the option of working by using a variable height desk. If your boss remains to be convinced, it’s time to take matters into your own hands and choose to stand: • when on the phone • when having a face to face conversation • when attending a meeting • when meeting a colleague for lunch of coffee • when reading.

CHANGE YOUR WORKING ENVIRONMENT.

CHANGE WHAT YOU DO AT HOME.

Whatever your role, look for ways to stand up more during the day and help retain greater clarity of thought.

It’s been estimated that many of us spend around 4-5 hours per day being sedentary at home watching TV or Netflix and

46 | GREAT HEALTH GUIDE

Mindset interacting with our digital technology. This adds up to sitting for two months of the year! Try totting up how much time you spend sitting per day on leisure activities and then look for how you could reduce this time. Keep asking yourself – where could I be standing more? How can I sit less and move more?

TO BE MORE ACTIVE, YOU COULD: 1. Choose to stand while watching a screen. 2. Put the treadmill or exercise bike in front of the TV. 3. Choose to switch off from your technology for an hour each evening and undertake some physical activity instead. 4. Park and walk, whenever you can. 5. Try an activity tracker - it’s a powerful motivator to help you reach your activity target. 6. Be grateful for being kept waiting in line – it’s an opportunity to be on your feet. When it comes to improving brain health and function, it’s often the little things we do that help us to ‘stay on our toes’. Be active and retain greater clarity of thought.

Dr Jenny Brockis is a Medical Practitioner and specialises in the science of high performance thinking. Jenny’s approach DISCLAIMER

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.

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Listening Understand to

Dr Suzanne Henwood

48 | GREAT HEALTH GUIDE

Mindset

ave you ever been in mid conversation with someone and then realised they are waiting for you to reply and you have no idea what they have just asked you? Your mind had wondered? While you are not fully listening, you will think about times that you can relate to, shared experiences, searching for how that feels, so you can empathise with the other person and in doing so jump in with what you want to say. We all do it. But this means that we have stopped listening to understand.

HERE ARE SIX WAYS TO LISTEN MORE DEEPLY: 1. Being aware. Become aware of your communication style – reflect on your preferences in how you communicate, so that you can adapt your way of speaking and listening to honour others. Examples include: • Do you prefer big picture or detail? At work, if your boss is giving you the big picture, but you want the detail, then you will not be fully listening but considering what else to ask, so that you can make even better sense of what you are being told. • Do you speak literally or inferentially? When I say to my husband ‘the bin needs emptying’, I speak inferentially. My husband however is literal in his approach and requires me to say specifically what and when something is to be done. • Which sense do you process information with (sight, sound, DISCLAIMER

kinaesthetic feeling, smell, taste)? If I describe my holiday and in doing so talk about the sound of the sea, the different bird calls and you prefer visual processing, then you will not be listening to me, but creating your own images and story in your head. By understanding your own preferences, you can be alert to any differences and adjust your listening to understand.

2. Active listening. Be intentional in your listening. Have your full focus on the other person and what they are saying (both verbally and non-verbally). Mindful listening is about being genuinely interested in the topic of conversation, without the intention to judge, correct or offer your views. Your intention is to hear and understand.

Most people do not listen with the intent to understand; they listen with the intent to reply.

Steven Covey GREAT HEALTH GUIDE | 49

Mindset You might demonstrate this by having appropriate eye contact, being face to face, putting down anything you were working on or holding, so that you can concentrate fully on the other person.

3. Encourage talking. Encourage talking without interrupting using non-verbal prompts like smiling, nodding, retaining eye contact and with body language. Lean in towards the person to show interest. Avoid the temptation to interrupt or interject. Any interruption to flow can derail the persons thought and prevent

50 | GREAT HEALTH GUIDE

them from finishing what they wished to share. Avoid completing sentences for them or jumping in with a story of your own. Show respect for the other person by letting them explain, explore, share until natural completion. Let them fully express themselves and then show that you have heard and understood. This is one of the greatest gifts you can give another person â&#x20AC;&#x201C; and they will notice and be grateful for it.

4. Embrace difference in opinion. It very likely at some point that you will be involved in conversation where you

Mindset disagree with some or all of what is expressed. Instead of seeing that as right and wrong, embrace the difference and value different perspectives. Get curious about how other people see the world. In practice this requires seeing a situation from anther persons perspective: walking in their shoes. A great question to ask is, ‘In what circumstances could this be true?’ Listen with an intention of understanding; caring for the other person and respecting their right to have their own views. There is a caveat to this – it is not about you putting yourself down or letting someone walk all over you. This is about mutual respect. If you are not being respected, or you feel unsafe in any way, you can politely stop the conversation and walk away.

5. Communication is more than words. We talk about ‘Actions speak louder than words’. This is especially true of emotions. If there is a mismatch between words spoken and body language, people believe the body language. This is also true when listening. Be aware of your body language to ensure it is not showing any lack of interest.

any point when there is a lull or pause, but never in mid-sentence or flow. • This is not about having the last word – it is to respect the other person and show that you are actively listening to understand. It is impossible to enter a conversation without your own history, values and experiences. It’s natural to refer to what you already know, to understand what you have heard. By being aware of your own views and recognising when they are different from others, you can control your reaction and ensure you retain a respectful active listening stance. This means that you respect others enough to allow them to express themselves freely and that you care enough about them to listen. Dianne Shilling said in a Forbes Magazine article, ‘Genuine Listening has become a rare gift – the gift of time.’ One of the greatest gifts we can give another person is the time to listen. To let them know they are seen and heard and we are listening to understand.

6. Checking it out To show that you have listened, it is a good idea to: • Summarise back what you have heard, giving the person an opportunity to say, ‘that is not what I said’ or ‘that’s not what I meant’. • Ask a question to check that you heard correctly. This can be done at DISCLAIMER

Dr Suzanne Henwood is the Director and Lead Coach and Trainer of mBraining4Success. She is also the CEO of The Healthy Workplace and a Master Trainer and Master Coach of mBIT (Multiple Brain Integration Techniques) and can be contacted via her website. SUBSCRIBE

| 51

Rela ionships

52 | GREAT HEALTH GUIDE

BodyLove Relationships

Dr Matthew Anderson

ow do you feel about your body right now? Do you have body love, or do you look in the mirror and see something that you dislike or even despise? You have a thousand observations that are really judgments about every single aspect of your body. You can’t imagine changing your perceptions even the slightest. Feeling that way is common and is easy to understand how people fall into this way of feeling about themselves. But there is a new way to deal with this that may be helpful to you.

If we are going to take better care of our bodies, we need to change our attitudes about them. We have to learn to love them as it is almost impossible to change or care for something we hate. Here are a few important truths that relate to body love:

1. LIKING YOUR BODY. Body love does not mean that you have to LIKE your body. Many weight-challenged individuals resist body love because they think they have to like it before they lose all that ‘nasty’ weight. However, loving your body is different from liking it and anyone can develop the ability to have body love. Body like will come later. DISCLAIMER

2. HAVE COMPASSION FOR YOUR BODY. Body love means that you have to learn to have some compassion for your body. For example, relate to it as if it was an abused child that asked for your help. If you begin to see your body as an object worthy of your love (not like), then the entire process of caring for it will change.

3. LEARN TO LISTEN TO YOUR BODY. Another part of loving your body is learning to listen to it. Most people who are overweight stopped listening to their GREAT HEALTH GUIDE | 53

Relationships

54 | GREAT HEALTH GUIDE

Relationships and eating becomes almost always about feeling better. Then we get fatter. The truth is, your body is actually your friend and can tell you exactly what you need and want to eat and when you are full and satisfied. You don’t have to like your body to listen to it. But if you do listen, you will discover that it will be the best weight loss friend you ever had.

4. END YOUR SELF-CRITICISM OF YOUR BODY. This is another way that will really help you learn to love your body. STOP your bodycriticism monologues. STOP the constant mental attacks on your body every time you happen to look in a mirror. You would not tolerate that kind of abuse from anyone, so decide to stop doing it to your own body. It never eases the sadness, loneliness and pain and it usually makes you feel so bad that you want to eat to make yourself feel better. bodies long ago. We (weight-challenged persons) have learned that food would help us manage our unpleasant feelings. Once we discovered this, we stopped listening to our bodies and paid sole attention to our emotions.

Stopping your body-criticism will create a space in which you can listen to and care for your body whether you like that body or not. Soon you may even notice that your body thoughts are becoming a bit more compassionate and then you will be on the way to real body love.

For instance, our anxiety said, ‘Please help me feel better. I need pasta and bread to calm down!’ Then anger spoke up and said, ‘Listen, I would kill for a French fry. Get it and get it now!’ After that, sadness, loneliness and hurt all combine to force us to eat tons of anything that will fill that terrible empty space that those feelings cause. Pretty soon we have lost awareness of our body’s messages of being full or satisfied

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.

DISCLAIMER

GREAT HEALTH GUIDE | 55

Relationships

56 | GREAT HEALTH GUIDE

Pushing Partner Are You

Your

Away?

––– Leanne

a psychologist I often see couples for relationship counselling. One of the issues that arise on a regular basis is that of parenting. Why do Mums sometimes exclude Dads in caring for the young child? This extends into the question, ‘Are you pushing your partner away’ by excluding him?

THERE ARE A FEW COMMON THEMES THAT ARISE, THESE ARE: • mum ‘not allowing’ dad to do anything • time spent with the child by each parent • different parenting styles (one is ‘easy’ on the child, the other is not) • behaviour challenges of the child and how to deal with them effectively • ‘spoiling’ the child with gifts (one DISCLAIMER

Allen –––

parent wants to buy, the other doesn’t). All these issues are important and need to be worked on, because parents that parent together are far more effective than parents that parent against each other (and believe me, your toddler knows who to go to for the biscuit!). This article will discuss the first point, ‘mum not allowing dad to do anything’ - because it is something that is very common. GREAT HEALTH GUIDE | 57

Relationships

Apart from breast feeding, a father is just as capable as a mother at looking after children. It usually sounds like this:

Her: ‘My partner just will not do anything with the kids, it drives me crazy’. Him: ‘Every time I do something it is not good enough; I try and she just does not like the way I do things, so what’s the point?’.

all. And hence the problem has started. If dad is left feeling worried, devalued, left out or not good enough, he will not bond effectively with the child. As well, many dads go back to work and cannot spend the time with the child. That is OK, but that also means that it is MORE important for dad to spend time with the child when he comes home.

Does this sound familiar? This issue often starts with the birth of the child. Many women feel that their partners can’t do as good a job as they can, or they feel so nervous about being a parent (particularly first-time mums), that they want to do it all themselves. Apart from breast feeding, a father is just as capable as a mother at looking after children, if given the opportunity.

BELIEVE THAT EVERYTHING IS FIXABLE SO JUST START WITH THESE SIMPLE STEPS:

Or perhaps dad feels nervous about the tiny new bundle and just lets mum do it

Is it really that bad to allow your partner to do things his way now and then? After all

58 | GREAT HEALTH GUIDE

If you are Mum, what are some things you can do to help your partner? 1. Don’t give up. 2. Assess the situation slowly.

Relationships there are many ways to do the same job. 3. Have a long-term perspective. What will it mean to you, your partner, your relationship and your child, if dad is given more space to participate? 4. Ask for help. Ask for help and accept it when it is given, even if you don’t like the way the task was done. 5. Be patient. The way you speak to your partner will influence his reaction and response to what it is you are asking of him. 6. Take practical action. Go out, leave your child with their dad, even if it is for 30 minutes and you will probably all begin to feel more confident. Remember that as a woman, you are more likely to have discussed parenting with your mother, with your female friends and colleagues and read magazines that are aimed at women. Men do not read, sit down and talk parenting tips with each other! So, it is up to you to talk about it with your partner.

IF YOU ARE DAD, WHAT ARE SOME THINGS YOU CAN DO FOR YOUR PARTNER? 1. Don’t give up. 2. Give reassurance. Reassure your partner calmly that you can do it and you want to do it. The best way to gain confidence is through practice. 3. Offer assistance. DISCLAIMER

Talk to her about the burden of doing it all alone and that you are there to help her with your child. Make sure you talk to her in a calm voice. 4. Ask advice. Ask her for advice if you are unsure; don’t just say ‘I can’t do it’, because parenting does not come naturally, even for women! We all must learn what to do. 5. Offer her time-out. Offer her some time out with the girls or on her own, when you will look after the child. 6. Have fun. Have fun with your child, if you are not sure how, speak to other fathers, read, remember what you did as a child, or ask your child if they are old enough, they will tell you! Are you pushing your partner away? Remember there are many psychologists and parenting experts in all areas of the country, so if you need some help you can use Google to find someone near you or use the Find a Psychologist site, to help if you are pushing your partner away.

Leanne Allen (BA Psych(Hons)), is the Principle Psychologist at Reconnect Wellness Centre. She has trained in Sandplay Therapy, NLP and CBT and has had extensive training in relationship therapy. Leanne has also completed training as a life coach. Her approach is to look forward whilst releasing the trauma of the past. Connect with Leanne via email or website or at her office on 1300 132 252. GREAT HEALTH GUIDE | 59

Kids Ma ers

60 | GREAT HEALTH GUIDE

Help Kids Through the

Digital Age Dr Ash Nayate

DISCLAIMER

GREAT HEALTH GUIDE | 61

kids matters

is very important to understand the influence that screen use now has on our society and to find ways to help kids through the digital age. In a recent American study by Common Sense Media, CNN reported that children aged 8-12 are spending an average of 4 hours & 39 minutes on screen media. For children under eight, the average time spent is 2 hours & 19 minutes.

Are these numbers surprising? Screen time has long been a contentious issue for parents and educators. Our cultural reliance on technology seems to be ever increasing. Children even as young as five or six are encouraged to own electronic devices for class work and homework and presumably for some entertainment as well. Even infants are learning to interact with screens, well before they’ve started putting words together.

HOW CAN WE HELP KIDS THROUGH THE DIGITAL AGE? National organizations often propose guidelines for the use of screen time, prescribing a maximum number of hours per day. These guidelines are frequently revised and updated, which can be confusing for parents.

WHAT IS THE LONGTERM IMPACT OF SCREEN TECHNOLOGY? The long-term impact of screen use, especially on developing brains, is yet unknown. It seems reasonable to assume that there will be individual differences in the way children react to screens, just as there are individual differences in the way children react to food additives. Some children might show signs of excessive screen use after a short time, while others might not. 62 | GREAT HEALTH GUIDE

For many children, screens can be mesmerising and highly stimulating. Apps, videos, cartoons and TV shows, are often fast-paced, with music, sound effects, rapid camera switches and bright colours. Immersed in a fast-paced virtual world, children quickly become over-stimulated. So, when the screen is eventually switched off, the real world seems slow paced and boring.

HOW DO CHILDREN’S MINDS ADJUST FROM THE VIRTUAL TO THE REAL WORLD? When children transition from the virtual world to the real world, their brains seek to maintain the same level of stimulation. They engage in restless and over-active behaviour, e.g. ‘jumping off the walls’, rapidly switching from one activity to the next and are unable to focus on an activity – all to recreate the same level of intense stimulation offered by a screen. As their minds struggle with this adjustment, irritability and emotional outbursts are common.

HOW MUCH SCREEN TIME IS TOO MUCH? Usually, our child’s behaviour and wellbeing are good indicators. Our child may show signs of addiction and withdrawal, such as using electronic devices as stress relief or mood enhancer, SUBSCRIBE

kids matters preoccupation with using devices or habituation to devices, so that longer and longer periods of use are requested. For some children, the concentration and restless behaviour can affect them in other areas of life, such as school functioning, friendships, family relationships, physical activity and sleep. They may lose the inclination to have face-to-face interactions with their friends or lose interest in hobbies and sports that they once enjoyed. The decision about whether children are spending too much time with screens is a personal one. It’s all down to our own judgement. If we think our children are having too much screen time – the chances are, they probably are. If we wish to curb our children’s screen time, what can we do? A zero-tolerance policy may not be realistic or even practical in our increasingly technological

The long-term impact of screen use, especially on developing brains, is yet unknown.

schools. The ideal situation may be where technology enhances a child’s quality of life, rather than detracting from it. How can we help kids through the digital age?

HERE ARE SOME IDEAS FOR REDUCING SCREEN TIME: 1. Reducing screen time is often a family challenge, rather than an individual one. It’s hardly fair to expect a child to reduce their use of screens, if the rest of the family are allowed to use their devices indiscriminately. Consider it a team effort and a challenge for each person in the family to cultivate better habits. 2. As a team, brainstorm ways to curb screen time. Some ideas include keeping all devices in communal areas rather than in bedrooms; prohibiting screens from family meal times; participating in one screen-free

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family activity each week. Let each person in the family hold one another accountable and the kids will love taking the adults to task! 3. Ensure that kids have appealing screen-free alternatives. Initially, our children may struggle to come up with their own ideas about how to use their ‘free time’. The best activities are those that most closely align with their interests – perhaps it’s helping them build and race paper aeroplanes. Perhaps it’s borrowing a cookbook from the library and finding a delicious and healthy recipe to prepare together. Perhaps it’s going to the museum or planetarium or a trip to the beach to explore rock pools. Rest assured, we will not have to maintain this level of direction forever. As our children become accustomed to less screen time and their minds adjust to the slower pace of the ‘real’ world, their own creative thinking skills will flourish. You can do much to help kids through the digital age.

Dr Ash Nayate is a clinical neuropsychologist specializing in brain function and resulting behaviour. Ash has almost 15 years’ experience working with children and families, supporting them to feel happier, more confident and resilient. To contact Ash please visit her website. 64 | GREAT HEALTH GUIDE

Sleep Walking

Teeth Grinding,

& Sleep Talking

Dr David McIntosh

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hen we sleep, it is a time of rest not only for your body but your brain. Sleep itself is not just something that happens - it is programmed and runs in an orderly sequence. Each night our brain goes through a couple of cycles of specific events that we call stages. To move through these stages, the environment within which the brain functions, needs to be just right. You may know what it is like - a busy place. Sometimes, teeth grinding, sleep walking and sleep talking happen during sleep and you really struggle to get into a good deep sleep. Wake up in the morning after an interrupted sleep and you just cannot quite function as well as you would like to.

A ‘stressed’ brain at night is not due to anxiety but low oxygen level. Apart from the obvious clue that you have had a bad night sleep since you wake up tired, there are other things that can occur through the night, such as teeth grinding, sleep walking and sleep talking, that are signs that the sleep cycle program is not going to plan. Now these are things that you won’t be aware of yourself directly, but once you have read this, it will seem a lot clearer.

1. TEETH GRINDING: So, let’s start with teeth grinding at night. When we are asleep there are a couple of stages where our muscles are all relaxed and one stage where the muscle tone increases. During this stage of increased tonicity, if there is something wrong with 66 | GREAT HEALTH GUIDE

the sleep quality, the brain may react in such a way that it is in a state of anxiety. One thing some people do when they are awake if they are stressed, is to clench their teeth or grind them. The same thing can happen in people who have ‘stressed’ brains at night. The research is showing that one of the most common causes of a ‘stressed’ brain at night is not anxiety but low oxygen levels. The reasons for low oxygen levels during sleep is discussed below.

2. SLEEP WALKING AND TALKING IN SLEEP: Most of the time with sleep talking this is just an audible mumbling of nonsense that occurs when the brain is treading the line between awake and asleep with active dreaming going on. Sometimes the brain gets so active that people get up and start walking. They have no idea they are doing it and bemusing to some is the tendency to want to pee, all be it in places that are not the toilet!

WHAT HAS ALL OF THIS TO DO WITH THE NOSE? There is a greater tendency for children to have teeth grinding, sleep walking and sleep talking and in extreme cases to have SUBSCRIBE

kids matters

Children with these night time behaviours will stop once they can breathe clearly again. night terrors, when their nose is blocked and they cannot breathe properly. It seems that a slight drop in their oxygen levels is enough to set off a panic alarm with brain springing into action.

WHAT SHOULD YOU DO IF YOU SUSPECT TEETH GRINDING, SLEEP WALKING AND SLEEP TALKING? 1. If you or someone in the house grinds their teeth, sleep walks or sleep talks, realise this is not normal. 2. If associated with snoring, sleep apnoea or mouth breathing at night, definitely get it investigated by a specialist. 3. In dentistry, teeth grinding has changed from being attributed to anxiety to being considered a prime symptom of potential airway obstruction. 4. Sometimes special sleep tests are DISCLAIMER

required for complex cases. 5. The treatments vary, from surgery, to mouth guards, to breathing devices. Approximately 80% of children that exhibit these night time behaviours will stop doing them once they can breathe clearly again. The first step to helping these children is to have an ENT check the reasons for airway obstruction. So, finding the underlying cause for teeth grinding, sleep walking and sleep talking, needs to be a priority.