Fiona Hardie explains how reflexology can help with easing the symptoms of menopause.

Menopause is a momentous time in a woman’s life marked by major transitions. From cessation of her periods, physical changes in her body, emotional highs and lows, and her general identity shifting, menopause is the ideal time when a woman needs more than ever to care for herself psychologically, emotionally, spiritually and physically.

The threat of ill-health is also ever greater as blood glucose levels fluctuate due to hormone imbalances that are more prevalent, making it harder to keep diabetes well-controlled.

Generally occurring between the ages of 45 and 55, menopause is when fertility ceases, and oestrogen and progesterone are no longer produced by the ovaries. This really need not be a time of discomfort, hot flushes or depression, particularly if a therapy such as therapeutic reflexology is made use of regularly.

What is therapeutic reflexology?

Therapeutic reflexology is an ancient treatment which involves stimulation of the tops and soles of the feet (hands, face and ears can also be treated) using the thumbs to apply pressure.

Reflexology is not a foot massage but a targeted treatment using a specific technique which aims to bring the body’s systems into a state of homeostasis or balance. The reflexes that are worked on correspond to different parts of the body. For example, in working on the ball of the foot which is the lung reflex, the actual lungs will be stimulated together with their partner meridian the lung meridian.

Benefits related to menopause

This makes for a powerful treatment to aid in alleviating many of the symptoms of menopause, such as bloating, constipation, insomnia, brain fog and not to mention the ever-dreaded hot flushes.

Several clients enduring hot flushes and who after receiving reflexology, noticed a considerable drop in the occurrence and severity of these sweaty episodes. It’s suggested that at onset of any symptoms, in fact even before, a regimen of reflexology sessions be started and continued regularly throughout these years.

What will reflexology will alleviate?

Reflexology will in alleviating other symptoms such as:

Hot flushes

The hypothalamus is a gland in the brain that regulates body temperature by sending signals to the organs, muscles, and endocrine and nervous systems. During menopause the body becomes more sensitive to fluctuations in core body temperature, so enlargement of blood vessels and sweating is increased. By working the big toe which is where the reflex for the hypothalamus is located, this function can be regulated.

Hormone regulation

The reflexes of the endocrine glands, such as the thyroid, and the reproductive system, such as the ovaries and uterus, are stimulated to ensure energy flow and harmony in these areas. And of course, the release of “love” hormones, such as oxytocin, enhance the feeling of well-being and self-care. Feeling good about oneself is of great importance during this massive transitory period.

Insomnia

Recipients of a session report better quality sleep. Reflexology is extremely relaxing and this in itself can help the body to regulate itself for it’s when the body is relaxed, it’s able to heal and function efficiently.

Anxiety

Due to the adrenal glands producing more of the stress hormones, adrenalin and cortisol, anxiety levels can increase exponentially especially as an array of other hormones are also out of balance. Reflexology brings about a wonderful feeling of ease and hence a reduction in anxiety. Coupled with anxiety is very often a dose of constipation. By working on the sole of the foot where the digestive reflexes are situated, regular bowel movements are encouraged.

Peripheral neuropathy

The loss of sensation in the extremities particularly the feet which can be problematic in people with diabetes. Reflexology is very effective in ensuring blood flow to the feet, stimulating the nerves and keeping the heels well-moisturised as a treatment is usually wrapped up with a nurturing oil or cream massage. The reflexologist can also pick up if there are any cuts or sores that perhaps have not been felt by the patient.

Research

Research into reflexology sessions on menopausal women found that two sessions a week for six weeks significantly reduced fatigue, total cholesterol levels and cortisol levels.¹

Therapeutic reflexology is a well-respected therapy and modality which can hold its own as an extremely effective ongoing treatment not only for menopause or to ease symptoms thereof, but to maintain a healthy, well-functioning body. When we feel loved and nurture our bodies, our minds respond with health and calm. A therapeutic reflexology session can give that and so much more.

Reference:

1. (Ref: Evidence based reflexology research for Health Professionals and Researchers by Barbara and Kevin Kunz pg. 89).

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Diabetologist, Dr Paula Diab, explains the four scenarios in which changing medication is needed when treating diabetes.

Very often we get stuck in a place where we’re comfortable. We tend to stick with the same toothpaste or washing powder and go to the same restaurant for dinner. It’s good to feel comfortable but sometimes change is also good. This doesn’t mean a new set of wheels every year or trying out every restaurant in town, but it’s good to re-evaluate things from time to time.

So, why should you change your medication?

1. Firstly, diabetes changes

It’s a little-known fact that the underlying pathogenic metabolism of Type 2 diabetes is present prior to the actual diagnosis of diabetes. What this means is that the cells in your body that produce insulin are significantly damaged even at the very start of your journey with diabetes. It’s important to remain ahead of these changes and ensure that the medication that you’re taking is constantly providing maximum benefit both in terms of managing your day-to-day health and preventing further damage and complications.

Over time, further pathological changes occur in the body which often necessitates a change in medication. Kidneys or vessels may become damaged and may require additional support or protection. These changes may occur not only because of lifestyle or dietary choices but purely due to the development of diabetes through the years. In addition, it also doesn’t make sense to continue targeting your therapy at a damaged organ. For example, as the cells in your pancreas become damaged, stimulating those cells to produce more insulin is like flogging a dead horse. Rather target a different pathway or mechanism of action.

2. Your lifestyle may change

The most obvious example here is to compare a busy thirty-year-old working mother to a retired old lady living in an old age home where meals are provided at set times and activity is limited, not only by choice but also by physical ability. The same medication isn’t going to work for both of these people.

Some people eat erratic meals; they may eat out often, have business lunches whilst others have little to no control over their choice of food. Activities change on a daily basis and over time. The day you run a half marathon will require a different strategy from the rainy weekend you spend watching movies at home.

Sometimes our financial position and priorities in life also change. Rather than struggling with the same status quo, we may need to consider a different perspective. As we get older, our metabolism changes, our lifestyles change, and our goals change. Medication may also need to change.

3. New medications are developed all the time

In just over two decades of managing people with diabetes, the scope of medication has almost completely changed. Some of the original medications used, no longer exist and others have been completely replaced. In fact, there is probably not one single tablet or insulin that was popular then, that is still used frequently today.

In the last two years that we have all been staying home and avoiding public events, there have been about eight new drugs developed and launched on the South African market specifically targeted for diabetes. This includes one completely new combination of medication as well as new delivery devices. Continuous glucose monitoring systems and pump therapy has changed, and closed-loop pumps are now also on the market.

These new drugs often provide an easier dosing regime, upgraded technology or an improved side effect profile. Recently, pharmaceutical companies have also been working at combining different classes of drugs so that multiple pathways can be targeted at the same time. Drugs that work synergistically not only benefit your body in that they often have a complementary side effect profile and enhance the action of the other but are also much easier to administer and reduce the burden of a box full of medication every day.

Researchers are also working on looking at additional mechanisms of treating diabetes and managing high glucose levels. Is it possible to prevent complications or even enhance the functioning of certain organs at the same time as managing your daily glucose fluctuations? There are very few other chronic diseases where the medication aims to treat daily symptoms and prevent further damage. This is exactly what we are striving for in diabetes.

4. Protocols also change

The new South African guidelines are due to be released towards the end of this year. These will cover a range of topics that are associated with diabetes and provide expert guidance in terms of best available evidence. Although these guidelines are updated every five years, financial implications often mean that they don’t make their way into routine care. However, evidence-based, cost-effective medicine is still the ultimate goal of every healthcare provider no matter where they work or who the patient is.

Your responsibility

It’s your responsibility as a person living with diabetes, to identify key lifestyle factors that may influence your diabetes management and discuss these with your doctor.

Your doctor’s responsibility is to keep up to date with latest guidelines, evidence and protocols and to understand how the medications work.

The art of medicine is then beautifully demonstrated in the conversation that follows where doctor and patient work together to negotiate and decide on the best possible plan for that individual. A plan that is cost-effective, simple, evidence-based and will ultimately reduce the burden of diabetes.

Regular follow-up and changes to your medication shouldn’t be seen as a failure or medical authorities trying to benefit financially from the situation, but rather an opportunity to achieve a healthier and more manageable outcome. Ask your healthcare provider to assess your individual risk and situation and discuss the various alternatives with you: how the medications work, why they’re preferable and what benefit they have, and then you can make an informed decision about your health and disease management.

References available on request  

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Kate Bristow, a diabetes nurse educator, explains how to use a GlucaGen hypo kit and what to be aware of.

Hypoglycaemia or low blood glucose can be a diabetes emergency. Let’s talk more about how to manage this and when to use the GlucaGen kit.

Recognise a hypoglycaemic episode

The first thing that is important is to recognise a hypoglycaemic episode.

Early signs include:

• Sweating
• A feeling of tiredness
• Dizziness
• Hunger
• Tingling around the lips
• Shaking
• A rapid heartbeat – palpitations
• Irritability, anxious feelings
• Pallor

Symptoms of an untreated low can result in:

• Weakness
• Blurred vision
• Confusion and difficulty in concentration
• Slurred speech, unusual behaviour, and clumsiness (like being drunk)
• Sleepiness
• Seizures
• Collapsing or passing out

How to respond to a low

What is GlucaGen?

Your GlucaGen hypo kit contains an injection of GlucaGen, a generic drug called glucagon. Glucagon works by triggering the liver to release some of the sugar that it has stored to help increase blood glucose levels.

It’s injected into the outer thigh but it does have to be mixed before injecting it so teach your friends and family how to use it as you may not be able to do it yourself.

The kit comes in an orange box and there are instructions inside the lid to show you how to use it.

1. Pull out the syringe, slip off the grey needle protector on the syringe.
2. Clip off the orange cap on the powder-filled vial and push the liquid contents through the rubber stopper into the powder in the second vial. Do not use anything except the pre-filled syringe to reconstitute the powder in the vial.
3. Keeping the needle inside the vial, turn it the other way over and draw back all the contents of the second vial into the syringe. Make sure you have mixed the contents well before you do this by gently shaking it. You should end up with a clear solution. Be careful not to pull back air into the syringe.
4. Take the syringe and needle out of the vial and inject into the outer upper thigh. Gently pinch the skin at the injection site and with the other hand insert the needle into the skin and push the plunger downwards until the syringe is empty.
5. Your doctor should have told you exactly how much to inject. A child may not need as much as an adult so have clear instructions with your kit. The dose is calculated on weight of a child. Generally, a child under 6 years/below 25kg would be given 0,5mg. Over 6 years to adult would be given 1mg/1ml.
6. After administering the injection, turn the person on their side as a precaution against vomiting and choking.
7. ALWAYS CALL EMERGENCY SERVICES IMMEDIATELY AFTER ADMINISTRATION.
8. Be aware that even after using a GlucaGen injection a second hypoglycaemic is possible.

General rules

• It’s good idea to have two GlucaGen kits prescribed; one for home and another for the office or school.
• Teach family and close friends how to use the kit in case of emergency.
• It doesn’t have to be stored in the fridge by do try to keep it in a cool place, easily accesible.
• In the case of a severe hypoglycaemic event, GlucaGen should be used quickly and medical help should be summoned as soon as possible.
• Once concious and able to swallow have something sweet by mouth too.
• Advise your healthcare team every time you have to use the kit. Your diabetes medication may need to be adjusted to prevent hypos.

When not to use GlucaGen

• In rare cases where there may be other health conditions or rare tumours, GlucaGen is contraindicated. Please check this with your doctor.
• Severe allergic reactions include rash, difficulty in breathing or low blood pressure. If this happens do not use GlucaGen.

Common side effects

• Reactions at the injection site, generally localised and will resolve
• Nausea and/or vomiting
• Headache and dizziness
• A feeling of drowsiness
• Pallor
• Diarrhoea
• Low energy levels
• Low blood pressure

Side effects generally resolve when blood glucose normalises and the effect of the injection wears off.

Final thought

Prevention is better than cure and although it’s essential to have GlucaGen as part of your diabetes emergency kit, we would prefer that if it gets to expiry date that it shouldn’t be used.

If you are having regular hypoglycaemic events, please talk to your healthcare team about adjusting your insulin doses.

When your blood sugar has normalised, resume your normal diabetes regimen with guidance from your diabetes team.

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