Love your menstrual cycle

Veronica Tift advocates for women to love their menstrual cycle and explains how reflexology can ease the moody blues.


The menstrual cycle temper tantrum of 2022 will go down in our house as the big one. It was a day, like any other, except this day my kids used my yoga matt in their fort and while they had cleaned up, they had neglected to put my mat away. My Rottweiler had the audacity to casually walk on the matt, her nail nicking a little hole into my beautiful matt.

Well, this set me off and it spiralled, it was no longer about the tiny tear in my matt, it was about the kids not packing away, my husband for not fixing that thing, the expired tin of baked beans. Nothing was off limits.

My husband stood by and watch this scene unfold; 18 years together has given him extra special PMS sensors and he slowly picked up his keys and headed out the door.

Later that day when I got home, a new yoga matt was waiting in our room, I immediately burst into tears. The next day I started my period and my melt down suddenly made sense, PMS had struck again.

What is premenstrual syndrome (PMS)?

PMS is a somatic (bodily or physical) and psychological (mental and emotional) collection of symptoms (hence my emotional meltdown) that occurs late in the post-ovulatory phase. This is usually a week or two before the start of menstruation, the luteal phase.

Signs and symptoms can include oedema, breast swelling or tenderness, abdominal distension, backache, joint pain, constipation, aggression, skin breakouts, food binges, fatigue, anxiety and irritability, mood swings, food cravings, headaches, sex drive changes and even clumsiness.

According to Christiane Northrup’s book Women’s Bodies, Women’s Wisdom, the high consumption of certain dairy products, excessive caffeine consumption, rapidly elevated insulin levels, changing hormone levels, hormonal imbalance and the associated cellular inflammation, excessive body weight, a deficiency in the diet, lack of exercise, emotional stressors and unresolved trauma are all contributing factors that she has seen in her practice.

The reason there isn’t a one-time magic solution for PMS is because the causes are so varied from person to person. We can dive into the science of PMS, looking at the biological changes that happen in the body. However, it doesn’t give us the whole picture. Looking back, the days before my PMS emotional explosion, I can see how I had been neglecting myself and what my body was trying to communicate with me. Plus, I hadn’t eaten breakfast yet.

Creating balance 

Medication that balances hormones can help some women with PMS. There are also solutions for managing the emotional roller coaster that for some women can become extreme. Never ignore these symptoms and find a doctor or healthcare provider you trust and can communicate openly with about how you are feeling.

A nutrient-rich whole food diet can add in the balancing of insulin and glucagon, why is that important? Dr Katharine Dalton’s work on PMS treatment showed that poor-eating habits can cause PMS symptoms and that when blood glucose levels were stabilised, it not only helped with PMS, but also with fertility. This is because when your blood glucose levels zoom up and down chaotically, it can have an effect on your hormones and spark off sugar cravings, creating a vicious circle of bingeing habits and weight gain.

Stress has an effect on your menstrual cycle and PMS symptoms. Deep relaxation like meditation and breathwork have been shown to help reduce PMS within three months of regular practice.

Learning your cycle and loving it

We all have cycles, ebbing and flowing in our bodies and in nature, night and day, breathing in and out, our heartbeats. Being conscious of these cycles can help you better adapt to the changes they bring, seasonal or hormonal.

If you can find a way to welcome and appreciate your menstrual cycle, then the transition into phases like menopause could be much easier. When you start to use encouraging language around your cycle, positivity can be injected into these changes and make this inner guidance system part of your life, you can then start to heal both emotionally and hormonally.

See each phase as a gift

If you break down your menstrual cycle, you can see each phase as a gift. The luteal phase happens in the second part of your menstrual cycle. It begins around day 15 of a 28-day cycle and ends when you get your period. The luteal phase prepares your uterus for pregnancy by thickening your uterine lining.

 This phase is when you can use the opportunity to be in tune with your inner knowing and use this time to witness what is working and isn’t working in your life.

Studies have shown that women even experience more frequent and vivid dreams during this phase. So, you have access to parts of your unconscious during this time of the month and this can then aid in your ability to recognise and transform the more painful and difficult areas.

While you might feel more emotional in this stage of your cycle, I think that what you feel more emotional about is usually something that has more meaning in your life and this increased sensitivity can be a gift of insight. Taking a look at what you might need for full personal development.

According to American author, Louise L. Hay, emotionally you can heal your life. PMS is a result of emotionally allowing confusion to reign and giving power to outside influences or the rejection of the feminine process. Part of her new thought pattern affirmation is I am a powerful, dynamic woman! Yes, you should be saying this all the time to yourself and loving how your body functions, falling in love with its wonderful cycle.

Respect your body

How you feel about your body matters and the level of respect you pay to your menstrual cycle; honour your body’s needs. Things like rest, nutrition and replenishing when feeling PMS taking hold.

In my case, slowing down, taking a deep breath and making a cup of tea would have been a much wiser choice in that moment, possibly a good breakfast.

PMS is not just medical and is related to other areas of a woman’s life. If you are able to learn how to tune into the languages of your body, you can make decisions that are informed, listening to the wisdom of your body.

Reflexology

According to author Frankie Avalon Wolfe, PMS is one of the most studied uses of reflexology and the results have been positive. How does reflexology help for such a host of symptoms?

One way is the promotion of endorphin production that can relieve pain and can help with relaxation. Reflexology can help the hormones, encouraging them back into balance, and the swelling and bloating symptoms can be helped when working on the lymph system reflex. The reflexes that a reflexologist would work to aid in PMS would be the ovaries, uterus and fallopian tubes working on relaxing the whole pelvic area. Not only the reproduction reflexes are worked and looking at the body as the beautiful connected being it is, the solar plexus reflexes, relaxation techniques and the brain reflex are worked to aid the whole nervous system. The process of addressing the emotional and psychological stresses can directly result in biochemical changes to the body.

A systematic review and meta-analysis on the effects of reflexology on premenstrual syndrome was conducted; in the results, 6 to 10 sessions of reflexology could decrease the severity of PMS. Reflexology had a significant impact on the severity of PMS.

Reflexology could also significantly affect somatic and psychological symptoms arising from PMS. The study also concluded that with each session the efficiency of the reflexology also increased.

No more temper tantrums

I can report that there has not been another PMS tantrum as fierce as the one of 2022. However, I can honestly say that I haven’t been free from all symptoms and this was clear when my husband hysterically laughed at my mentioning that I thought my PMS wasn’t that bad this month. It’s all about balance and some months are better than others in the busyness of life.

However, paying attention to these moments always brings me back to the importance of taking the time to ask; what are my emotional needs right now and do some inner work. I encourage you to do the same, you might be very surprised at the answer.


References

https://pubmed.ncbi.nlm.nih.gov/31673284/

Ruth Hull the complete guide to reflexology second edition Lotus publishing.

The complete idiots guide to Reflexology – Frankie Avalon Wolfe, Ph.D., Alpha books

Woman’s Bodies, Women’s Wisdom: Creating physical and emotional health and healing – Christine Northrup M.D 5th edition Hay House

Natural solutions to Infertility, how to increase your chances of conceiving and preventing miscarriages – Marilyn Glenville PhD published in the UK in 2000 by Judy Piakus (Publishers) limited

You can heal your life – Louise L. Hay – Hay House Inc

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

MEET THE EXPERT


Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.


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How accurate are blood glucose meters?

Diabetes nurse educator, Christine Manga, answers the burning question: how accurate are blood glucose meters?


Blood glucose meters are an essential and convenient tool for people living with diabetes to manage their condition. These small devices allow you to measure your blood glucose levels quickly and accurately whilst on the go.

However, some people are concerned about the accuracy of these glucose meters. This is a valid concern as inaccurate readings can lead to incorrect treatment decisions, which can have serious consequences.

Trialled and tested

The accuracy of blood glucose meters has improved significantly in recent years. The accuracy of these devices is tested by regulatory bodies such as the Food and Drug Administration (FDA) in the United States before they are approved for use by the public.

Over and above this, manufacturers are also required to meet certain accuracy standards. The International Organisation for Standardisation (ISO) has established a standard for blood glucose meter accuracy which requires readings fall within 15% of a laboratory reference value. This explains why glucose readings can differ even when taken at the same time but on different fingers. Using two different meters will also yield different results due to the 15% allowance.

Blood glucose meters are generally considered to be accurate. Some meters come with a control solution that have a known glucose concentration, which you can use to test your meter’s accuracy. Newer meters don’t come with this.

Maintenance and use of the blood glucose meter

The accuracy of a blood glucose meter depends on several factors, most of which the user has control over. Included here are maintenance and use of the meter.

  • Check expiry date of strips, expired strips can give inaccurate results.
  • Use the meter according to the manufacturer’s instructions.
  • Close the strip container securely each time as moisture/humidity can damage the strips.
  • Avoid exposing strips and meters to extreme temperatures such as leaving them in a hot car or keeping them in a fridge.
  • Wash and dry hands properly before testing. Contamination from food and hand creams among other things can alter glucose readings.
  • Hands should be warm when testing, if they are cold, more pressure is applied to obtain the blood drop, getting some interstitial fluid (ISF) that can lead to unreliable readings.
  • Dehydration can affect readings, try to drink enough fluid every day.
  • Use a sufficient size blood drop, too little blood may give inaccurate results.
  • Do not share your meter.

Glucose sensor vs finger-prick readings

For people who wear glucose sensors, they may notice a substantial difference between their finger prick and sensor readings. This is not due to inaccuracy of either device.

Sensor glucose and capillary blood glucose are different because they measure glucose levels using different body fluids. Sensor glucose readings come from interstitial fluid (ISF), which is the fluid that surrounds the cells under the skin.

Finger-prick blood glucose readings come from the blood that flows in the small blood vessels near the surface of the skin. There is a delay between the glucose levels in the blood and the ISF because glucose first enters the bloodstream from the digestion of food, and then diffuses into the ISF. This delay can be up to five minutes.

Therefore, sensor glucose and finger-prick blood glucose readings may not always match, especially when glucose levels are changing rapidly, such as after eating, exercising, or taking insulin. This is normal and expected.

The difference in sensor and blood glucose doesn’t matter if you understand why they may not always match and how to use them correctly. Sensor glucose readings can give you a more complete picture of your glucose trends and patterns over time as they test your glucose every 60 seconds, while capillary blood glucose readings can give you a more precise measurement of your glucose level at a specific moment.

Ask for advice

If you are concerned about the accuracy of your readings, you should talk to your doctor or diabetes educator for advice. They can help you choose a meter and test strips and teach you how to use them correctly.

As another option, you can do a finger-prick test on your meter at the same time as you have blood drawn in a lab and compare the results. They should be within 15% of each other.

Blood glucose meters are fantastic devices that assist in day-to-day management of diabetes. They have without a doubt evolved over time.

Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

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Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.


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Managing diabetes when you have flu

Diabetes nurse educator, Kate Bristow, shares effective tips to manage diabetes when you have flu.


Winter season is here and with it an increase in the incidence of colds and flu. For someone with diabetes, flu can be more than just an irritation as it makes managing blood glucose levels more challenging.

What is the difference between a cold and flu?

A cold is an upper respiratory tract infection. Common symptoms include: starting with a sore throat, followed by a runny nose and some congestion and then a cough. Fever is uncommon in adults.

Colds and flu do share many symptoms, but an infection with influenza also manifests with higher temperatures, body aches, and cold sweats or shivers. This may be a good way to tell the two apart.

Flu symptoms are normally more severe and come on quickly. Both are caused by viruses and generally need to run their course. If they progress to a bacterial infection, then an antibiotic may be necessary. Stay in touch with your healthcare team when you are unwell.

SYMPTOMS COLD FLU
Fever Sometimes – mild Usual – lasts 3 – 4 days
Headache Occasionally Common
General aches and pains Slight Usual – often severe
Fatigue/weakness Sometimes Usual – can last 2-3weeks
Exhaustion Never Usual – especially at the beginning
Stuffy nose Common Sometimes
Sneezing Usual Sometimes
Sore throat Common Sometimes
Cough/chest discomfort Mild to moderate cough Common – can become severe
Complications Sinus congestion/middle ear infection Sinusitis, bronchitis, ear infection, pneumonia
Prevention Wash hands often and avoid contact with sufferers. Wash hands and avoid contact with sufferers,

annual flu vaccine,

possibly pneumococcal vaccine too.

Treatment Decongestants, pain relief medication. Decongestants,

pain relief medication.

Call your doctor – antiviral medication sometimes used.

How best can you manage your diabetes when you have a cold or flu?

When you are sick your body will make more glucose to give itself the energy to fight the infection, and to add to this you may make more of the stress hormone cortisol. Cortisol makes you more insulin resistant. This means that when you are sick you need more insulin and not less.

So, in effect what happens when you are sick is that your liver will produce more glucose and you will be more insulin resistant. It’s a double whammy for your body and your glucose levels. You will probably be thirstier and pass more urine in this case and the cells in the body will start looking for other ways to get energy.

The lack of fuel into the cells means that they will start looking for other energy sources and sometimes the body starts to break down fat to provide this. Fat is converted into ketones by the liver. Ketones are toxic to the body and can be very dangerous.

Look out for signs such as stomach aches, nausea and vomiting along with high blood glucose levels. This is called ketoacidosis and it’s important that you have an individualised sick day management plan that you have discussed with your healthcare team.

If you are not taking insulin

It’s still important to track your glucose levels even if you are not using insulin. Follow the guidance below:

  • Test your blood glucose more regularly; this includes during the night and 2 to 4 hourly during the day depending on your numbers.
  • Drink more water. You may be thirstier than normal. If you are feeling nauseous then sip steadily rather than gulping it down. It’s not necessary to eat if you are feeling nauseous. But do ensure you stay hydrated.
  • Take your medication as prescribed. Your doctor may ask you to stop certain oral diabetes medications when you are sick.

If you are taking insulin

  • Do not stop taking your insulin. You may need more rather than less due to the higher glucose levels.
  • If you are taking insulin to manage your diabetes and your glucose levels are high, check for ketones – see the symptoms of ketoacidosis below.

SIGNS AND SYMPTOMS OF KETOACIDOSIS (DKA)

High blood sugar levels – you will be thirsty and may urinate more often.  This leads to dehydration and further stress on your body.

Possible signs of ketone build-up:

  • Nausea and stomach-ache and eventually vomiting.
  • Be aware of vomiting without diarrhoea.
  • Rapid breathing with no cough or fever
  • Abdominal pain – can be severe.

Call for assistance if you have symptoms that worry you or that are not responding to your efforts to treat them. If you have abdominal pain or difficulty breathing, go straight to the hospital.

  • Have a sick day plan in place as discussed with your healthcare team.

 Take medication as suggested by your pharmacist, nurse, or doctor to relieve the symptoms of your cold or flu.  Be aware that some preparations may contain some sugar – discuss this with the pharmacist. If you are not getting better or start to feel worse call your doctor.

 What you should have on hand

  • Blood glucose meter.
  • Glucose test strips.
  • Other medication.
  • Quick-acting carbs, such as fruit juice, sugary drinks or sweets.
  • Water.
  • Insulin and ketone test strips.
  • Glucagon.
  • Contact details of your healthcare team in case of emergency.
Sister Kate Bristow is a qualified nursing sister and certified diabetes educator.

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Kate Bristow is a qualified nursing sister and certified diabetes educator.


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Foot disease and diabetes

Dr Paula Diab stresses that every complication of foot disease relating to diabetes is preventable and gives guidelines to spot these complications in early stages.


Foot disease is probably one of the most feared aspects of diabetes. Almost everyone has a horror story about a friend or neighbour or sometimes tragically, a relative, who developed foot disease, gangrene or needed an amputation.

The statistics relating to foot disease are horrifying but what is worse, is that almost every single complication related to foot disease is entirely preventable. It’s not normal for people with diabetes to get foot ulcers and then need an amputation; it’s only through poor diabetes management that you lose sensation and circulation in the feet.

Educating yourself and knowing the signs and symptoms to look out for can radically improve your chances at retaining healthy feet despite having diabetes.

What causes diabetic foot disease?

You may have heard about macro- and microvascular complications related to diabetes. This refers to whether the large (macro) or small (micro) vessels in the body are affected. Foot disease can be caused by both macrovascular or microvascular disease which it is probably why is such a common complication.

Macrovascular disease occurs when blood circulation from the heart is diminished either through excessive glucose or cholesterol deposits in the vessels or narrowing due to high blood pressure. This reduces the blood flow into the distal peripheries and the feet are usually the first to show signs of this lack of circulation. Smoking and other cardiovascular risk factors will also enhance this risk and further slowdown blood flow.

Microvascular disease caused by persistently high glucose levels affects the nerves in the feet. When these become damaged, you may feel pain, tingling or even numbness in the feet.

These two mechanisms can also occur simultaneously when a loss of sensation in the feet can make it difficult to discern when you have a blister, minor cut or injury on the foot. As these minor injuries are left untreated, infection can set in causing bigger wounds or even ulceration. Due to blood flow being restricted, healing is further delayed, and the wound progresses even more.

Sometimes infections become so deeply invasive that intravenous antibiotics, surgical debridement or hospitalisation are required. High blood glucose levels can cause the arteries to become stiff and prevent blood flow to the feet.

What are the signs and symptoms of foot disease?

The most common symptoms of damage to the feet is increased swelling of the legs and feet or a change in skin colour on the feet. This usually manifests as a purple discolouration of the skin around the ankles or mottling of the skin. You may also notice a decrease in the hair growth on the top of your feet or lower leg.

All these symptoms are due to the decreased blood flow and poor circulation of blood from the heart. Nerve damage initially causes burning or tingling in the feet and then develops into a lack of sensation and numbness. This may happen intermittently at first but then begins to become more obvious and more difficult to treat.

Delayed healing of wounds, cracks and blisters on the feet are more advanced signs of foot damage.

Please also pay careful attention to ingrown toenails, warts, corns, calluses, bunions and hammertoes. These minor deformities often result in abnormal gait (the manner in which you walk) and as a result puts pressure on areas of the feet where you would not normally. This results in damage to the nerves and further enhances the risk of microvascular damage.

There are also nerves in the body over which you have no control. These are called autonomic nerves and control functions such as digestion, sweating and temperature regulation in the body. They too can be damaged by diabetes and may cause dryness, cracks, fissures, blisters and callus formation in the feet, all of which may lead to secondary infections and damage.

How should you take care of your feet?

As with all complications of diabetes, the basic control of glucose levels is of huge importance. Check your levels regularly and seek expert advice when they are not in target. Regular exercise can also prevent foot disease and promote good blood flow in the feet.

All that we require with regard to exercise is that you are simply more active today than you were yesterday. Aim to do 20-30 minutes of moderate intensity cardiovascular activity a day on most days of the week. Walking, jogging, swimming, cycling or even sustained household chores, such as mowing the lawn or vacuuming, may count towards this activity.

Other important footcare advice

  • Wash your feet every day with lukewarm (not hot) water and mild soap.
  • Dry your feet well, especially between the toes. Use a soft towel and pat gently but don’t rub the feet too vigorously.
  • Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
  • Keep your feet dry by dusting them with non-medicated powder before putting on shoes, socks or stockings.
  • Check your feet every day. You may need a mirror to look at the underside of your feet. Call your doctor if you have redness, swelling or pain that doesn’t go away, numbness or tingling in any part of your foot.
  • Don’t treat calluses, corns or bunions without talking to your doctor first.
  • Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them. File the edges of your toenails carefully.
  • Don’t let your feet get too hot or too cold.
  • Don’t walk barefoot. This is to prevent injuries to your feet.
  • Avoid putting your feet in front of a fire in winter to warm then, if they have lost sensation you could end up with burns or blisters which you do not feel.
  • Avoid using hot water bottles to warm your feet in winter as the bottle may be too hot and also cause blisters if your nerves are damaged.

Choosing footwear

You certainly don’t need high fashion or expensive footwear in diabetes. But you also don’t have to wear big bulky boots that look ugly. Here are important tips to consider when choosing your footwear:

  • Try not to wear shoes without socks as they protect the feet and prevent excessive sweating and pressure from the shoes.
  • Ensure that your socks are good quality and not worn or frayed that will cause damage to the feet.
  • Avoid open sandals or shoes where feet are not adequately protected from external injury.
  • Avoid high-heeled shoes and shoes with pointed toes that will change the architecture of the feet.
  • Wear well-padded socks or stockings in winter. Don’t wear stretch socks, nylon socks, socks with an elastic band or garter at the top, or socks with inside seams as these place undue stress on the skin and constrict blood flow.
  • Don’t wear uncomfortable or tight shoes that rub or cut into your feet. If you’ve had problems before because of shoes that didn’t fit, you may want to be fitted for a custom-moulded shoe.
  • Talk to your doctor or podiatrist before you buy special shoes or inserts.
  • Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they’ll probably be comfortable all day.
  • Break in new shoes slowly by wearing them for no more than an hour a day for several days.
  • Change socks and shoes every day. Have at least two pairs of regular shoes so you can switch pairs every other day.
  • Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores.

Seek help

If you do develop some type of wound on your feet, please get it seen to as soon as possible. Don’t wait until it’s too late before you seek help.

Your doctor, diabetic nurse educator or podiatrist can all examine the feet on a regular basis to test a variety of different functions and help prevent further injury and infection.

It’s also good practice to examine your own feet on a regular basis. Look for changes in skin colouration, hair growth and new sores or blisters that may have developed. Look at your feet at the end of the day when you remove your shoes and make sure that the shoes are not damaging your feet in any way. You should also make sure that a healthcare practitioner examines your feet at least once a year. If there are any concerns or changes, you should see a podiatrist immediately and treat the problem in its early stages.

The old adage prevention is better than cure is certainly true of foot disease. Regular exercise, monitoring your blood glucose levels and keeping them well-controlled and stopping smoking will go a long way to ensuring that you don’t land up under the surgeon’s knife or with complex infections.

Dr Paula Diab

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Dr Paula Diab is a diabetologist at Atrium Lifestyle Centre and is an extra-ordinary lecturer, Dept of Family Medicine, University of Pretoria.


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Eating for steady glucose

Dietitian, Felicity Black, offers guidance on how to get off the glucose rollercoaster by clothing your carbs for steady glucose.


Do you sometimes feel as if you are riding the rollercoaster of blood glucose spikes and crashes and not getting steading glucose readings? Unfortunately, this leaves you moody, exhausted and reaching for that next cup of coffee to get you through the day. Maybe you are struggling with cravings for sweet things or are finding you are constantly hungry. You have been riding the glucose rollercoaster.

How does the food you eat affect the ride?

Some foods lead to a steep ascent; they speed up the release of glucose into your bloodstream. Other foods put on the brakes; slowing down and stabilising the blood glucose levels. 

What goes up, must come down

Foods that cause glucose to climb then cause it to plummet leading to low moods, fatigue and cravings. Refined starches and sugar are the driving force behind these steep spikes. Think of a fluffy piece of white bread, minimal chewing and digestion is required while glucose is rapidly flowing into the bloodstream.

Breads, pasta, crackers, pastries, crisps, pizza bases, rolls, biscuits, rusks and cereals. How to tell if starches are refined? Well if it is made from mostly flour, has gone through many processes, has many ingredients listed, has no naturally occurring fibre or nutrients and won’t be found in nature; then yes it is most likely refined.

Synthetic vitamins and some bran fibre is often added in during manufacturing to make these products look more desirable by health-conscious shoppers.

Sugar speeds things up, especially in a liquid form. Smoothies, fruit juices, fizzy drinks, chocolate milk, flavoured drinking yoghurt, hot chocolate-type drinks can all cause glucose levels to rise quickly.

Which foods slow things down?

Protein, fat and fibre-rich foods all slow down your digestion which slows down the release of glucose into your bloodstream.

Protein-rich foods are mostly from animal sources. Think meat, chicken, fish, seafood and eggs.

Cheese and other dairy products don’t actually have all that much protein and are not a suitable substitute for the above foods. Whole unsweetened dairy has been shown to provide glucose stabilising effects even in small amounts.

Fats are wonderful at keeping glucose steady and help you stay fuller for longer.

Healthy fats to include are avocados, olive oil, olives, nuts and seeds.

Berries, green vegetables (such as broccoli) and legumes (beans and lentils) are great fibre-rich foods to include daily.

If you make sure to include either or all of these foods in your meals then you are sure to avoid post-meal glucose spikes.

Fibre – where should we get it from?

Many people assume high fibre means high starch. Fibre should be mainly be sourced from vegetables, not from breads and cereals. Fruit can also provide fibre but we need to manage how and when we eat it. If fruit was to be your main dietary fibre source then you would end up consuming far too much natural sugar.

As humans we are not made to eat starch without fibre. In nature we would find tubers, roots, nuts, fruits, whole grains – all of which have fibre alongside starch.

This fibre acts to slow down the release of sugars into your bloodstream, giving you a steady supply resulting in stable blood glucose levels.

In our modern world, we have breads, cereals, pastries, crisps, pasta – all without adequate fibre and consumed in large quantities.

There is a common misconception that brown refined starches are far superior than their white counterparts. Believe me, six slices of brown bread a day will not do you any favours. Clients need to be educated on lowering total refined starches regardless of the colour of said starch.

Most low-GI breads, cereals and pasta do not contain enough fibre to slow down the resultant spike. Therefore, reduce your overall carbohydrate and cut back on refined starches, they are not nutritious regardless of the colour.

Breakfast – setting a good foundation

Starting the day off right is very important for steady blood glucose levels. We are most sensitive to high sugar intake in the mornings than any other time of day. Therefore, if your blood glucose is not stabilised early on in the day, then you will struggle to manage it as the day goes on. Think of it as setting a solid foundation for the day.

A breakfast made up of only starch especially simple refined starches, such as bread and cereal, is sure to set you up for a rollercoaster of hunger, fatigue and cravings.

A good concept is the idea of clothing your carbs and this is also mentioned in the book The Glucose Revolution by Jessie Inchauspé. When you eat carbohydrates by themselves (without protein, fat or fibre) then your blood glucose spikes rather high and quite quickly.

Dessert vs sugary snack

If you are going to eat something with sugar, then have it as dessert after your meal and not between meals. Sugar that lands in a full stomach will lead to less severe glucose spikes. Rethink that afternoon coffee and cake. Bring out some fresh fruit to end off your meal.

Clothing for your carbs for steady glucose

Carbohydrate should be combined with either protein or fat or both. That includes fruit, do not eat fruit alone as a snack. The French have it right – cheese with fruit. The fat and protein in cheese (it’s mostly fat) helps reduce the spike from the fruit.

Other combinations are: biltong, nuts, full fat yoghurt, avocado, sugar-free nut butters and seeds. So, do yourself a favour and clothe your carbs.

Felicity Black is a registered dietitian at the Centre for Diabetes and Endocrinology and is based at the Port Elizabeth practice in Mill Park. Having completed the in-depth CDE Foundation Course in Diabetes Care, she has been able to treat her clients holistically and with a greater understanding of their individual needs.

MEET THE EXPERT


Felicity Black is a registered dietitian at the Centre for Diabetes and Endocrinology and is based at the Port Elizabeth practice in Mill Park. Having completed the in-depth CDE Foundation Course in Diabetes Care, she has been able to treat her clients holistically and with a greater understanding of their individual needs.


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Lana Breedt – No day will ever be the same

Lana Breedt gives us a rundown of a typical day in her life of having a child living with diabetes, though she states no day will ever be the same,


Lana Breedt lives with her husband, Maurits van der Horst, and their five-year-old son, Rudi in Port Elizabeth. Rudi has Type 1 diabetes.

Rudi’s diagnosis

It was March 2019 when Rudi was diagnosed with diabetes Type 1 at the mere age of 19 months. My husband, Maurits, and I were both unpleasantly surprised since neither of our families has a history of diabetes. We are one chaotic household at any given time, so the diagnosis added a whole bunch of curves to our rollercoaster.

Rudi just started nursery school and was still in nappies at the time. It started with what we initially thought was a tummy bug of some sort; I had to pick him up early from school a couple of times. It was strange since he was a very healthy kid from birth and going to the doctor was not the norm.

The nursery school has been incredibly supportive since his diagnosis and his class even celebrated World Diabetes Day with us last year. We are very fortunate that both our employers are very understanding as well and they know when we need to leave work right now.

The first year

The first year was a nightmare. We relied on blood measurements only and could not see the trend of his glucose levels. We used to test Rudi every two hours day and night, at home and at school.

My husband created an Excel spreadsheet for us and I manually updated the document weekly to see where we stood more or less. I would send the graph to Rudi’s paediatrician at the end of each week for feedback and he would then adjust Rudi’s insulin intake accordingly. Our first HbA1c test result was just above 10.

Diabetes devices a game changer

When Rudi got a little bigger in size, we started using the Freestyle Libre which did wonders for his little fingers. It made both our and the teachers’ lives a whole lot easier.

Even though we still had to get up every two hours at night, it felt like we could live a fairly normal life without feeling so exhausted every morning.

It was only when we got the Miao Miao Bluetooth extension that our entire ballgame changed. We don’t need to worry about manually measuring him anymore, since the app has an alarm that goes off when his glucose is going too high or too low. We receive the data on our mobiles, so we can monitor him from anywhere, anytime.

No two days will be the same

One sentence from the book, Type 1 Diabetes in Children, Adolescents and Young Adults, sums diabetes up very well: No two days will be the same.

We have a very strict routine we stick to even during school holidays. Our days don’t always go according to plan, but at least we have a framework to work from. The rest of the time we just make stuff up as we go along. Maurits understands and relies on science and I understand nutrition and rely on motherly instincts, so we make a great team.

A typical day

We get up between 4am – 5am Rudi sometimes sleeps slightly later, but that is rarely the case. Maurits will give Rudi his Optisulin between 5am – 6am.

At 6:15 Rudi gets his breakfast injection and then we wait for a good glucose reading before he eats. This is anything from 6:30 until 7am. We’ve had instances where it takes a really long time for his glucose to drop after a high night, and then he will only eat an hour after his injection.

Under normal circumstances, his main meals last around two hours. So, by the time I drop him off at school, his glucose levels are nearly at a stage where he needs to snack again. We have a WhatsApp group including three staff members from the school, Maurits and myself. I usually type the ready for snack message when I leave home and constantly keep an eye on his glucose while driving to work. When it is time, I just press the send button and Rudi will have his snack. It sometimes feels like all this kid does is eat.

School snack time

School snack time is between 9:30 and 10am. I don’t have the energy to pack his lunchbox at night, so I normally do this between 5:30 – 6am. It’s difficult to decide what to pack and what to leave out since his glucose varies so often. In the beginning, I was obsessed with carb counting, but after a chat with a dietician at one of the PE diabetes wellness meetings, my perspective changed completely. She told me to feed my child the rainbow. So, I do just that.

I pack small portions of fruit and vegetables in as many colours as possible along with something carby like popcorn. When he had a high night, I will replace this with something non-carb like droëwors and biltong.

Somewhere close to 11am, his glucose starts to drop again, and the teachers will either give him an apple or a protein bar, depending on how close to home time it is. We also rely on Super Cs for lows and keep rolls of it everywhere.

Lunch

For lunch, he has a sandwich with his flavour of the week (at the moment it’s honey) and a generous portion of protein along with a glass of milk.

During the afternoons we just play it by ear. I’m at home in the afternoons so it makes it easy for me to manage his glucose levels by finding something in the fridge or cupboard when necessary.

When he does go to aftercare, I pack him an entire bag of carb and non-carb snacks, along with his emergency kit consisting of protein bars and Super Cs.

Aftercare is at his school and I have contact with the teacher in charge. She sees that he eats the right things at the right time and is available on WhatsApp all afternoon as well.

Dinner

Just after Rudi was diagnosed, we followed a specific meal plan for supper and I had his menu planned at least a week in advance. After the aha-moment with the dietitian, all of that changed and he now eats what we eat. Even sushi and pizza. It’s a win-some, learn-some experience when it comes to his diet and we figure things out as we progress.

After the pyjama drill, we will either read stories or watch a movie. By about 8pm his blood glucose will be at a stable low and he then has a glass of milk as a nightcap. Ideally, the milk should last him until morning, but when it doesn’t, we give him milk with glucose powder to keep his blood glucose going. Occasionally we need to inject him because of high blood glucose, but he doesn’t even wake up for that anymore.

Rudi’s fourth diabetes anniversary

We recently celebrated Rudi’s fourth diabetes anniversary. It’s hard to imagine things without the sensor and Bluetooth device, but imagining a life without the support we get from friends, family, employers, paediatrician and his school is even harder.

Living with a six-year-old diabetic child is a 24-hour duty and you can’t afford to lose focus for one minute. Our latest HbA1c result was an incredible 6.6 for the second time in a row. It takes a lot of effort and hard work, but the reward is priceless. Looking back, I don’t think we’d ever thought we’d get this far.

Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

MEET OUR EDITOR


Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za


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Hair loss and diabetes

Dr Louise Johnson explains the connection of hair loss in people living with diabetes.


The average human normally sheds 50 to 100 hairs per day according to The American Academy of Dermatology. Losing hair is part of the hair lifecycle. As one hair is shed, another replaces it. The hair follicle is a complex mini organ that produces hair from terminal differentiated cells called keratinocytes. On average, a human has between 2 and 5 million hair follicles of which 100 000 are on the scalp. But there is a difference between shedding hair and hair loss.

The hair follicle

The growth of the hair follicle can be divided into three phases:

  1. Anagen (growth)

Anagen growth is the active phase in which the hair follicle takes on its onion shape and works to produce the hair fibre. This phase lasts between two and six years. During this phase, rapid cell division occurs in the hair bulb. In addition, new hairs begin to protrude from the scalp.

  1. Catagen (transition)

Catagen is a transitional phase that last two to four weeks.

  1. Telogen (rest)

This phase last three to five months and is the resting phase.

Hair loss

Excessive hair shedding can occur during times of stress or after pregnancy. This is not the same as hair loss which is referred to as alopecia, occurs when something stops the hair from growing. This falls into three categories:

  1. Androgenetic alopecia
  2. Alopecia areata
  3. Telogen effluvium

Androgenetic alopecia

This is characterised by male pattern baldness and can happen to both males and females due to hormonal changes. The incidence varies across races, but its prevalence increases with age, visibly affecting 57% of women and 73.5% of men who are at least 80 years old.2

Alopecia areata

This develops when the immune system attacks the hair follicle and can be associated to Type 1 diabetes since it’s an autoimmune disease.

Telogen effluvium

This is due to a response to stress.

Is hair loss a symptom of diabetes?

Hair loss can occur in both Type 1 and Type 2 diabetes. In Type 1 diabetes there are often other autoimmune diseases associated. Alopecia areata is one where antibodies attack the hair follicle which leads to hair loss. Hashimoto thyroiditis is another autoimmune disease which causes dry skin and hair loss due to an underactive thyroid gland.

In Type 2 diabetes, cortisol levels (stress hormone) can be high due to insulin resistance. Excess cortisol can disrupt the hair follicle leading to hair loss.

In a 2019 study1, it was shown that in Type 2 diabetes of African origin were associated with increased risk of central scalp hair loss. There may be a genetic factor to central hair loss.

Clinicians should also screen women with central scalp hair loss for Type 2 diabetes if they are not yet diagnosed. Whether successful treatment of Type 2 diabetes might protect African women from central scalp hair loss remains to be determined.

In long-standing diabetes, both Type 1 and Type 2, there is often microvascular (small vessel) damage which leads to impaired blood flow to the affected area as well as less nutrients and oxygen. This can be seen in eye, kidney, feet and hair. Typically seen in patients with peripheral neuropathy (lower leg loss of sensation due to nerve damage), the hair growth on the lower leg is reduced or absent.

Medication can also contribute to it. In patients taking metformin it’s important to monitor the vitamin B12 and folate levels. This can be diminished which would cause impaired hair growth.

Management of hair loss in diabetes

  1. Good glucose control is important. Make sure that your average blood glucose (HbA1c) is below 7% or the target that your healthcare practitioner suggests.
  2. Healthy eating, exercise and stay hydrated.
  3. Make sure your thyroid levels, vitamin B12 and folic acid levels are normal. Also remember to check iron levels since iron carry red cells and oxygen. If not replace as needed.
  4. Get enough sleep.
  5. Be gentle when washing and brushing your hair.
  6. Seek medical help early.
  7. In cases where it interferes with quality of life, a wig or hair prosthesis should be considered until the hair grows back.

References

  1. Coogan P.F. Traci n et. al. “Association of type 2 diabetes with central scalp hair loss in a large cohort of African American women” Int. Jour of women’s dermatology, 5(2019) p 261 – 266
  2. Gan DCC, Sinclair RD “Prevalence of male and female pattern hair loss in Maryborough.” J Investig Dermatol Symp Proc. 2005;10(3)184-9
Dr Louise Johnson

MEET THE EXPERT


Dr Louise Johnson is a specialist physician passionate about diabetes and endocrinology. She enjoys helping people with diabetes live a full life with optimal quality. She is based in Pretoria in private practice.


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The miracle treatment: insulin

Insulin has been available for a century and has gone from poorly defined animal insulin to pure and precisely controlled formulations. Dr Louise Johnson tells us more about this miracle treatment.


History of insulin

The discovery of insulin, the miracle treatment, is attributed to a group at the university of Toronto, Canada. In 1922, a 22-year-old physician, Frederick G Banting, worked in a laboratory to test his idea that pancreas extracts will reduce blood glucose levels in diabetic dogs. Banting was assisted by a student, Charles Best. This led to the first successful test of insulin in a 14-year-old boy, Leonard Thompson.

In January 1922, this boy with diabetes received the first dose of purified animal insulin and his life was saved. Leonard Thompson lived another 13 years to be 27 years and he passed away due to bronchopneumonia.

What is insulin?

Insulin is a hormone produced by the beta cells of the pancreas called the islet cells of Langerhans, in a response to reduce blood glucose. It works on cellular level to allow sugar to enter each cell by opening a channel in the cell. Glucose enters the cells and is used inside the cell to produce energy. The organs that are highly insulin dependent are the muscle, liver and fat.

Who needs insulin?

All living creatures needs insulin for uptake of glucose to be used as a source of energy.

Insulin is the primary treatment for people living with Type 1 diabetes since they have no endogenous or own insulin. They were previously called insulin-dependent diabetes mellitus (IDDM).

People with Type 2 diabetes, previously called non-insulin-dependent diabetes mellitus (NIDDM), also requires insulin at some time during their disease. As time progresses, the amount of the beta cells of the pancreas diminish and a supplementation with once-daily insulin, called basal insulin, is needed.

In Type 2 diabetes with insulin resistance where more insulin is needed, supplementation would also be required. The treatment of Type 2 diabetes always included diet, exercise, metformin, other antidiabetic agents such as incretins, SGLT2 inhibitors and sulphonylureas. When the HbA1c is above 7.5% on these regimens’ insulin supplementation is needed.

How do miracle treatment injections work?

Insulin is injected in the subcutaneous fat layer (just beneath the skin) on the abdomen, upper thigh, arm and buttocks. Once injected in the subcutaneous layer, it’s not immediately absorbed in the bloodstream. The insulin molecule first dissociates into dimers and monomers before being absorbed.

Insulin initiation

Patients with Type 1 diabetes require insulin immediately and usually multiple daily dosages to cover both mealtime and sleeping glucose levels. This regime is called basal-bolus insulins.

The preferred method on insulin initiation in Type 2 diabetes will be to add a once-daily long-acting insulin when needed. If glucose targets are not met, then a mealtime insulin or bolus insulin will be added according to the need.

Types of insulin

  1. Basal insulin therapy
  2. Bolus insulin therapy
  3. Premixed insulin
  4. Concentrated insulin
  5. Inhaled insulin
  1. Basal insulin therapy

Manipulating various side chains of the insulin molecule has permitted availability of long-acting insulin, such as glargine, determir and degludec (Lantus, Basaglar, Optisulin, Toujeo, Tresiba).

These long-acting insulins are peak less with a long duration of action. Basal insulin slows the production of glucose from the liver. In a fasting state this will maintain glucose homeostasis.

In general, basal insulin is administered once-daily in 24-hour cycle at the same time every day. It’s important that basal insulin should always be administered regardless of food intake as this serves as the background insulin normally secreted by the pancreas.

NPH insulin (Protophane) is one of the oldest basal insulin and because of its shorter lifespan needed to be injected twice a day. It has been available since 1964. The primary advantage of NPH is financial as it is typically less costly than the newer long-acting insulins. The downside of NPH is that it does make a small peak which can lead to hypoglycaemic events.

  1. Bolus insulin therapy

Bolus insulin is rapid-acting insulin that can be given before meals to reduce mealtime peaks of sugar. The combination of basal and bolus insulin is a flexible regime.

The newer short-acting insulins are called analogues (Novorapid, Apidra, Humalog, FiAspart). Analogues differ from human preparation (regular insulin) by small substitutions in amino acid chains which in turn prevent formation of polymers or hexamers.

The onset and peak action of rapid-acting insulin analogues more closely resemble endogenous (own) human insulin secreted in response to a meal.

Due to the fact that it is rapid-acting insulin, it can be given before, during or directly after a meal. The mealtime dosage of insulin can be calculated according to the amount of carbohydrates in the meal. Patients with a varying appetite can increase, decrease or omit the mealtime insulin according to the carbohydrates in the meal.

  1. Premix insulin

Premix insulin preparations is a combination of short-acting and intermediate/long-acting insulin in a fixed ratio. Although this provides convenience for some and may be appealing to those who refuse to inject more than twice a day, it does not allow for flexibility in mealtime or changes in the ratio of short to long-acting insulin doses.

An example is Novomix which is a fix combination of 70% NPH (protophane) and 30 % Novorapid. Another example is Ryzodeg which is a combination of 70 % degludec (Tresiba) and 30% insulin aspart (Novorapid). The numbers expressed in the ratio after the insulin refer to the percentage of insulin in the premix solution. An example is Humalog 25 which has 75 % long-acting and 25% short-acting insulin.

  1. Concentrated insulin

Insulin that is two to three times more concentrated than the normal U 100 insulin is now available. The available concentrated insulin in South Africa is glargine U300 (Toujeo).

The positive effect of more concentrated insulin is that the volume that is needed to inject is smaller in patients that are severe insulin resistant and need high volume insulin.

Humalog U500 is a short-acting concentrated insulin that is available on special request in severe insulin resistant patients that need more that 200 units per day.

  1. Inhaled insulin

The least often used preparation is human insulin inhalation powder (Alfrezza), however this is not available in South Africa. It’s administered at the beginning of a meal. Lung function must be assessed before initiation and after six months and thereafter yearly. It’s contraindicated in patients with lung disease and asthma.

Insulin sliding scale

Although commonly utilised in hospitals when patients are acutely ill, it’s not recommended as a routine method of insulin management. The reason for this is that it causes extreme fluctuations of glucose values which are far worse than continuous slightly elevated blood glucose. The best method to use short-acting insulin is via carbohydrate counting before meals.

Side effects of the miracle treatment

Hypoglycaemia

The most severe side effect is hypoglycaemia. It’s important that all diabetic patients on medication know how to treat the symptoms of low blood sugar. Usually if glucose is below 4.0 mmol, 15 gram of carbs is indicated. This can be in the form of a small fruit juice.

It’s important that all diabetic patients on insulin have a glucagon hypo kit at home for their spouse or parent to administer should the patient not respond. Always recheck the glucose after an episode of hypoglycaemia and try to establish the cause. If hypoglycaemia occurs frequently speak to your doctor for a thorough evaluation.

Weight gain

It was clearly shown in the UKPDS study that patients on insulin gain 5 to 8kg over a 10-year period. To prevent weight gain, try to limit carbohydrates and prevent hypoglycaemia. Should you pick up weight speak to your doctor. Remember that underactive thyroid disease can be associated with diabetes.

Lipodystrophy

Lipodystrophy is hardened fat tissue. This happens when you are injecting on the same place every time and it causes poor insulin absorption. To prevent this from happening, it’s important to rotate the injection sited daily

Insulin has now been available for 100 years and this miracle treatment for diabetes has saved many lives and prevents many complications if used correctly. Remember that insulin is not the enemy but in persons with diabetes, it’s your best friend.

Dr Louise Johnson

MEET THE EXPERT


Dr Louise Johnson is a specialist physician passionate about diabetes and endocrinology. She enjoys helping people with diabetes live a full life with optimal quality. She is based in Pretoria in private practice.


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Your 24-hour plan to get more energy

Monique Marias shares a constructive 24-hour plan to get more energy every day.


The modern era requires you to move at the speed of light, to get things done and meet your targets. This is exciting but can also be exhausting. To do your best, you need to be the best versions of yourself to prevent burnout, fatigue and despair.

Your energy levels need to be sustained throughout the day. Energy drinks might give you an immediate lift, but it will soon wear off, leaving you feeling sluggish and drained. How do you then maintain your energy levels? By implementing a 24-hour plan that will boost your energy levels and keep you motivated throughout the day.

Increase your energy levels on a daily basis

  1. Sleep well

Good quality sleep is critical for good health and overall quality of life. It’s important to get enough sleep as well as quality sleep. By getting enough sleep and prioritising good sleep habits, you can support your immune system and reduce your risk of infections and illnesses, such as cardiovascular problems and diabetes.

Monitor your sleeping habits; get to bed at roughly the same time each night, as well as waking up around the same time each morning. You need to train your body and mind to slow down; do specific things before getting to bed that will let your mind and body know its time to settle in. This can include listening to relaxing music, turning the lights off, reading, or drinking a warm drink to help you relax.

  1. Stay hydrated

One of the symptoms of dehydration is fatigue. Make a point of staying hydrated during the day (this excludes the cups of coffee you’re drinking). The amount of water you need varies based on factors like your body weight, activity level, and climate. However, a general guideline is to aim for at least 8-10 glasses of water per day, and more if you are physically active or in a hot climate.

Find a rhythm that works for you, whether that is having one large bottle that you need to finish by the end of the day or having multiple glasses of water throughout the day. You can also add different fruits to change the flavour, if this helps you drink more water. Healthy options include lemon, ginger, cucumber, mint and different forms of berries.

By staying hydrated and drinking plenty of water and other fluids, you can support your immune system and reduce your risk of infections and illnesses.

  1. Eat balanced meals

Eating a balanced diet that is rich in nutrients is essential for maintaining a healthy immune system. A balanced diet provides the body with the vitamins, minerals, and other nutrients that it needs to function properly which improves your immune system and aids in maintaining healthy blood glucose levels.

This means including foods from multiple food groups: whole grains, lean protein, fibre-rich fruits and vegetables, and fat-free or low-fat dairy. Choose foods with a low glycaemic index (where sugar content is broken down by your body at a slow rate), such as whole grains, nuts, bananas, grapes, apples, peaches, beans, peas, and leafy greens.

  1. Get moving

Regular exercise can help to reduce stress levels and support immune function. In addition to these immune-boosting benefits, regular exercise has many other health benefits, including improving cardiovascular health, reducing the risk of chronic diseases like obesity and diabetes, and improving mental health and mood.

Not everyone has time in their schedule for daily exercise sessions, but it’s important to keep moving. This is especially important if you have a job that is mostly desk-bound. Make a conscious effort to stand up regularly, walk around and do stretches. If you have access to a smart watch or an app on your phone to track your steps, set your daily target for 8000 steps per day. Having a visible reminder will help with motivation and keep you focused to meet your daily goal.

If you have a water dispenser at work, combine your walking with drinking water, get up every hour and walk to the dispenser and refill your glass. If your daily routine allows for exercise, all the better.

  1. Control your stress

Stress can weaken the immune system and increase the risk of infections and illnesses. Chronic stress can also have long-term effects on the immune system, increasing the risk of chronic diseases like heart disease, diabetes, and autoimmune disorders.

The first step is to identify aspects in your daily life that cause you stress and the second step is to find ways to reduce it or control the situation. Break it down to stress at work and stress in your private life, then look at what you can control and what is out of your control; focus on the aspects that are within your control.

Learn to delegate tasks at work and to say no and prioritise tasks that need to be completed urgently and what can wait until the next day. Find ways that reduce your stress, such as exercise, hobbies, meditating or spending quality time with friends and family.

We all experience times that are more stressful than others, but if you know how to identify your triggers, and you have implemented ways to deal with it in your daily routine, it becomes easier to fall back on those techniques that will help you relax.

  1. Do something fun

Do something you enjoy, every day! Know what makes you happy and make a conscious effort to do small things each day that leaves you feeling happy and energized at the end of the day. This can include cooking a hearty meal, exercising, checking in with a friend or family member, buying yourself flowers, learning something new or listening to a podcast. This doesn’t have to be a long activity, 10-15min is enough to give you that mental boost.

  1. Use caffeine sensibly

Many people rely on their morning cup of coffee to get them started, whereas others rely more heavily on their caffeine boost to get them through the day. It’s wise to remember; the more you drink coffee, the more you need to give you the same level of stimulation. Studies have also shown a negative impact on anxiety levels when used in excess. It can also adversely affect your mood and increase insomnia, and these all impact on your ability to maintain healthy lifestyle choices that will increase your energy levels.

Caffeine in itself isn’t harmful and can definitely give you that much needed boost but use it in moderation. Try to not exceed three cups a day, don’t drink coffee late in the afternoon and try to alternate the time of day that you drink coffee so that your body doesn’t become dependent on that “kick” the same time every day.

  1. Light up your life

Daylight queues the brain that it’s time to get up, time to be active and get things done. The more natural light you are exposed to, the easier your brain adjusts to the routine. Where possible, ensure that natural light enters your workspace as much as possible.

Studies have also shown that blue-enriched white light improves alertness, positive mood, work performance, concentration, and irritability. If you have a desk lamp at the office, switch the globe to blue-enriched white light bulbs. If your office space doesn’t allow for you to alter the light-type, go outside at least three times per day for short periods. Not only will you be exposed to some helpful vitamin D, but you will also get moving.

  1. Be mindful

This aspect should form part of all the above steps you take on a daily basis. Mindfulness involves focusing on the present moment and accepting your thoughts and feelings without judgment. This can help to reduce stress and promote feelings of calm and relaxation. The more you are aware of your surroundings, your stressors, what brings you joy and what your dreams are, the easier it’s to manage the days that are more stressful and appreciate the good days even more.

Although there are many ways that you can boost energy levels, you need to find a rhythm that works for you; pick sustainable tasks and make it a habit. Some days might be easier to sustain your energy levels, other times might be more challenging, and that is when you need to fall back on healthy habits to sustain you. Once these habits form part of your healthy lifestyle, it will be more sustainable, and you will see better results.


References

An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities | American Journal of Respiratory and Critical Care Medicine (atsjournals.org)

NATURALLY BOOST YOUR IMMUNE SYSTEM: A DETAILED GUIDE – Outdoor Adventure (ribosomellc.com)

https://www.wikihow.com/Get-More-Energy

https://www.health.harvard.edu/energy-and-fatigue/9-tips-to-boost-your-energy-naturally

https://medicalnewstoday.com/articles/321938#2.Do-some-light-exercises

The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents – PMC (nih.gov)

The Effect of Coffee and Caffeine on Mood, Sleep, and Health-Related Quality of Life | Journal of Caffeine Research (liebertpub.com)

Blue-enriched white light in the workplace improves self-reported alertness, performance and sleep quality on JSTOR

Monique Marias is a registered social worker at the ClaytonCare Group which provides in-patient care to medically complex patients on a sub-acute level. She has specialised in physical rehabilitation for in-patients for 13 years, and has a passion to assist people to understand and manage their diagnoses and the impact on their biopsychosocial well-being.

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Monique Marais is a registered social worker at Care@Midstream sub-acute, specialising in physical rehabilitation for the past 11 years. She has a passion for the medical field and assisting people to understand and manage their diagnoses and the impact on their bio-psychosocial well-being.


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Body Stress Release

Kathy Heapy educates us on the benefits of Body Stress Release.


What is Body Stress Release?

Body Stress Release (BSR) is a unique, gentle and non-invasive health profession that originated in SA over 30 years ago. According to many client testimonials received over the years, BSR has served to make a difference in the lives of people around the world.

This complementary technique that works in co-operation with other forms of healthcare has a supportive role to play and may provide relief from pain and discomfort for those struggling with health challenges, ranging from mild discomfort and vague symptoms to diagnosed conditions.

BSR is a health practice that limits itself to its own area of expertise, locating and releasing of body stress. It’s not involved in diagnosis or treatment of any medical conditions, thus does not duplicate medical services. BSR has thus always enjoyed a co-operative relationship with medicine and enjoy receiving referrals from the medical fraternity who entrust their patients to us in a complementary role.

The benefits

BSR may enhance quality of life and is suitable for all ages, from the very young to the elderly. Facing daily onslaughts of mental, emotional, mechanical and chemical stress may have a negative impact on your body as it was designed to handle some stress, but as stress accumulates over time, the stress overload becomes locked in.

This may contribute to symptoms such as neck and back pain, pins and needles, postural distortion, muscle weakness, headaches/migraines, indigestion/heartburn, restless sleep, fatigue, numbness, stiffness, to name but a few.

Body stress overload is a powerful factor that may undermine health and well-being in a myriad of ways and may underlie and aggravate many health problems.

How does it work?

You lie down fully-clothed. The practitioner performs a series of pressure tests using the feet as a bio-feedback monitor. Using a light but definite pressure in the indicated direction releases the sites of body stress which may assist to improve and stimulate nerve communication.

We often find that after a BSR session, some clients report back that they had the best sleep ever, felt an emotional lightness, became aware of a greater mental clarity, or felt a surge of enthusiasm for life.

Diabetes case studies

In Gail Meggersee, BSR co-founder’s book, Self-healing with Body Stress Release Unlocking Stored Tension, she includes a case study submitted by a BSR Practitioner about two gents, Maarten and Graham titled: Diabetes: Revival in the 60s.

“After one BSR session, Maarten’s indigestion had improved so much he could hardly believe it. After six weeks of BSR the feeling in his feet had returned completely, no more pins and needles or numbness. Graham’s lower back pain improved considerably.

After about two years after their first BSR appointments, they came into the practice room laughing like two little excited boys. They told their story: at their annual check up with their physicians, she tested their urine samples with the ‘sugar sticks’, declared them to be faulty, and took out a new box of sticks. These were evidently not working either, so she took blood samples and sent them off to the pathology lab for testing.

The results

The results of these tests astonished everyone. Maarten and Graham, no longer had Type 2 diabetes. Their doctor was confused, but they were delighted. They said they knew BSR had assisted their bodies to heal themselves of their chronic condition.

Their cases illustrate some basic principles of BSR; tension stored in the lower back may adversely affect the functioning of the legs and feet.  Such tension may remain locked into the body for decades. By releasing the body stress, the body is assisted to heal itself in more ways than one would have imagined, in both cases the capacity of the pancreas to produce adequate insulin had been revived.

The evidence in these cases would not have been quite as conclusive if:

  • Only one of them had had diabetes.
  • They had not lived together and eaten the same diet.
  • They had not both come regularly for BSR maintenance.

“Their faith in BSR was sealed and they continued with the sessions. Ten years later, they appeared at least 10 years younger than when I first met them. They enjoyed regular exercise and had even improved their eating habits to a degree.”

How many sessions are needed?

Initially three sessions are recommended; for example – day 1, day 4 and day 11. This allows the body to go through necessary adaptations as the body adjusts to lines of tension being released.

At your initial session your practitioner will take your full medical history and during the consultation will also share with you on how to sit, sleep and bend correctly thus working with the natural bio-mechanical design of the body.

He/she will then guide you with regards to suggested intervals between sessions going forward, depending on individual case requirements. Maintenance sessions are usually looked forward to by our committed clients who recognise the value of self-care, and we often find a close friendship develops between the emphatic practitioner and client over time. Should a client be too weak to visit their practitioner, they may enquire about house visits in the comfort of their own home.


To find a dedicated BSR practitioner close to you, visit bodystressrelease.com

Kathy Heapy left the travel industry in 2010 as she always had a yearning to work with people in a healing capacity. After only her second BSR session, she decided to apply for the annual practitioner course held at the BSR Academy. She currently runs a successful Body Stress Release practice at a wellness centre in Midrand, Gauteng and looks forward to a continuation of a fulfilling and enriching future, assisting folk with a compassion and a sincere belief that BSR can offer hope in their world.

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Kathy Heapy left the travel industry in 2010 as she always had a yearning to work with people in a healing capacity. After only her second BSR session, she decided to apply for the annual practitioner course held at the BSR Academy. She currently runs a successful Body Stress Release practice at a wellness centre in Midrand, Gauteng and looks forward to a continuation of a fulfilling and enriching future, assisting folk with a compassion and a sincere belief that BSR can offer hope in their world.


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