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### Human:\nis there a drug interaction between synthroid and prevacid?\n\n### Assistant: currently there are no drug interactions found between synthroid and prevacid. however this does not mean that interactions cannot exist. it is important to work with your pharmacist to see if there is any new information regarding these two products. prevacid should be taken 30 minutes prior to a meal. synthroid should be taken 30 minutes to one hour prior to a meal. they can be taken together with water on an empty stomach.

### Human:\nare there certain foods that should be avoided after ones gall badder is removed?\n\n### Assistant: because the gallbladder is a storage space for bile that breaks down fat (originally produced in the liver) you'll need to watch your fat intake. while the body eventually adjusts to not having a gallbladder every person is different in how their body reacts. you'll want to keep the following points in mind for your diet moving forward: consume small frequent meals over large infrequent ones. avoid greasy foods high in fat such as fried food and creamy sauces. and when you do choose to eat these foods consume them in small amounts. gradually increase fiber in your diet (fruits vegetables and whole grains) to help move food through your intestines. keep a food dairy to note foods that may not be tolerated. some people who have had their gall bladder removed notice foods like dairy are more difficult to tolerate. if you are noticing many symptoms see a registered dietitian for help. i t have removed my gallbladder 8 months ago and i always feel pain when i consume meals high in fat. and its true that every person reacts in different way to food. so just monitor your food intake and your reaction to it. if you ever felt uncomfortable then you should lower its intake. saturated fats. everyone should avoid these! saturated fats are the fats that at room temperature solidify. such as bacon grease the fat in the pan of ground beef melted margarine that cools down and becomes solid again. these are some of the fats that get into the arteries and eventually clog them causing heart attacks and strokes cut out or at least down on the cholesterol too as well as the triglycerides. as many physicians and nurses recommend consult with a dietitian they will help.

### Human:\nhow should i take omeprazole and levothyroxine which are to be taken in the morning four hours apart?\n\n### Assistant: currently there are no drug interactions found between levothyroxine and omeprazole. however this does not mean that interactions cannot exist. it is important to work with your pharmacist to see if there is any new information regarding these two products. omeprazole should be taken 30 minutes prior to a meal. levothyroxine should be taken 30 minutes to one hour prior to a meal. they can be taken together with water on an empty stomach if needed. the previous answer is not only false but can lead to very serious health implications. co-administration of omeprazole/other ppis/acid reducers/etc. along with thyroid meds (whether for tsh t4 or others) can cause a drastic decrease in absorption of the thyroid medication. there are many peer reviewed studies that prove this all one needs to do is a proper google search or a subscription to any of the popular medical journals. your stomach needs an acidic environment to properly convert your thyroid medication into a usable medication to get into your bloodstream and if you take an acid reducer with your thyroid med this can cause problems. if you must take both (as i personally do because of my tsh levels reaching 24. 6 plus ulcers and cancerous polyps due to gerd) make sure you take your acid reducing medication at least 4 hours before your thyroid medication (no matter what kind it is) and make sure not to take another acid reducing medication at least 4 hours after your thyroid med. if you do not separate the acid reducers 4 hours before and 4 hours after your thyroid medication your thyroid levels will become unstable and you will need to adjust your dosage. but in order to prevent your levels from getting out of whack and potentially causing more harm just separate your meds as posted above and you should have no issue. the above answer telling you that it is okay to take at the same time is incredibly harmful. don't take my word for it (someone who has been dealing with both issues for a decade) trust the scientists that have figured this out through multiple peer reviewed studies. just a few sources proving the point of my previous answer after 2 minutes of google searches (wow was that previous post really posted by a doctor? i feel bad for their patients): <link> <link> <link> <link>

### Human:\nwhen does rs3gold 10% free bonus for rs3gold and their other product begin? . as the best runescape gold site there is no doubt that it is your best choice to buy cheapest rs gold along with 10-minute delivery here. during the activity time you will be offered 10% free bonus for rs 3 gold 07 gold osrs deadman gold & ds gold on rs3gold. . rs3gold spring promo will start at 03:00 a. m. gmt on feb. 4 and end at 03:00 a. m. gmt on feb. 15 2016. . never miss 10% off code bestday to cheap rs3gold from <link> (1. 15-2. 15. )\n\n### Assistant: please be respectful of this wonderful medical information site and not post advertising or non-medical postings. this takes up valuable space from people with real medical issues that are requesting a response.

### Human:\ncan my 9-year-old take over-the-counter prevacid?\n\n### Assistant: prevacid or lansoprazole has recently moved from prescription strength to over-the-counter. the over-the-counter dose is labeled for adults 18 and older. this medication is intended to treat stomach ulcers or heartburn that occurs 2 or more times per week. it is not a quick fix to elevate symptoms for heartburn. it slows the production of acid within the stomach over a period of time and is taken daily for 14 days. we recommend seeking medical advice if the product needs to be taken for more than 14 days. i would not give prevacid to your 9-year-old child. while this product is found over the counter it still must be used according to its labeled directions in order to be safe and effective. if your child is having constant heartburn or stomach issues seek medical advice from your pediatrician. consider looking at the cause of the symptoms to help educate your child. for instance eating slower avoiding certain foods that trigger symptoms or eating smaller portions may help his/her symptoms. while medications are readily available and sometimes seem to be the quick fix look at preventing the symptoms by changing behaviors.

### Human:\ni swallow excessively in social situations and at home. it interferes with conversation. what can i do?\n\n### Assistant: swallowing usually accompanies anxiety so i would think that handling the basic anxiety will cross over to the swallowing. you can use relaxation breathing to help yourself calm down during the day and especially when you're about to go into a social situation. it does help and you will need to also switch your thinking around to keeping your mind off your swallowing problem. use positive reinforcing self-talk for this. if you find you can't do it as well as you need then i'd think a few sessions with an experienced cognitive psychologist who deals with anxiety disorders might be a good idea.

### Human:\ni have no trouble falling asleep. but i wake up between 15-20 times a night. do i need to undergo a sleep study?\n\n### Assistant: having difficulty maintaining sleep is a very common problem; you are definitely not alone! insomnia in all its forms is the commonest sleep disorder. there are many causes of sleep maintenance insomnia. some common ones include sleep hygiene/habits that prevent sleep continuity (such as alcohol or caffeine use in the evening) poor sleep environment (pets in bed bad mattress snoring from bed partner etc. ) use of certain medications at night certain medical and psychiatric disorders and various sleep disorders (such as sleep apnea leg movements at night). the list of disorders that can cause this problem is large. you should definitely discuss this with your family physician. he/she may be able to recommend ways to improve your sleep; if not he/she may refer you to a sleep specialist. however i would not necessarily simply get a sleep study as that in of itself may not lead to a diagnosis.

### Human:\nhi i'm 15 years old take nature-made b complex omega369 100mg ubiquinol daily is this okay? . i'm using nature-made super b-complex omega 3-6-9 and qunol 100mg ubuiquinol as alternative adhd medicine. i'm just concerned that these pills maybe detrimental. i've read the label on the nature-made super b-comples and it contains 6 667% daily value of thiamin 1 176% riboflavin and 250% b12. also the qunol has 100mg of pure coq10 (i've heard the reccomended amount was around 50mg) is this too much for my body to handle? should i cut the pills into smaller portions? please help! . thanks!\n\n### Assistant: i'm not sure why you are taking all those supplements but let's go down the list. i don't know of any evidence that shows that taking large amounts of b vitamins is beneficial or particularly harmful. if you don't eat fish twice a week taking fish oil high in omega 3 fatty acids dha and epa can help but americans get more than enough omega 6 fatty acids so i'm not sure why this would be needed in a supplement. there seems to be some research that qunol (coenzyme10) can help people who take cholesterol lowering medications who have lower levels in the body but not sure how it helps the general population. i'm not familiar with ubuiquinol but like any supplement check to see if there is any research to show its safety and effectiveness. supplements are not regulated by the fda so safety has to be demonstrated by the company. according to a recent study in pediatrics teenagers fall short on various nutrients including magnesium phosphorus and vitamins a c and e. so if you feel your diet is lacking include a multivitamin that provides 100% daily value for the majority of vitamins and minerals. many people (of all ages) need to supplement with vitamin d because they get little sunshine and foods are generally low in this vitamin. recommendations for calcium at your age are 1300mg because this is a peak time for bone growth. one cup of milk 1. 5 ounce cheese and 6-8 ounce yogurt contains about 300mg calcium so if you are falling short you may want to consider supplementation. no supplement can make up for a diet poor in nutrition. i always recommend a food first strategy but sometimes supplementation is needed to fill nutrition gaps. and most importantly make sure supplements have the research behind them to show they are safe and effective. always check with your healthcare provider about supplements you take.

### Human:\nif i have alot of anger stress and emotional baggage what is the best sport i could exercise or learn to help me vent?\n\n### Assistant: exercise can help you manage stress by releasing endorphins which are neurotransmitters in your brain that help you to feel good. another benefit of exercise for stress management is that it can also be used as a break or as personal time away from your stressors to clear your head if necessary. exercise can also help with depression and anxiety and can help improve your sleep help you to feel better or boost your energy levels. there is no one type of exercise that will help you manage stress better than any other. the main thing that you need to find is a type of exercise that you enjoy doing. exercise should come naturally and should be something that you look forward to doing not something that you feel forced to do and don’t get enjoyment out of. remember this is about making yourself happy so you may have to experiment with different activities until you find something that really works well for you. set realistic goals that are achievable and dedicate an amount of time that you find manageable so that you’re not adding more stress or creating another burden. besides exercise there are many other stress-reduction techniques like journaling meditating using breathing exercises or mental/guided imagery. you could also meet with a psychologist psychiatrist or your doctor to discuss other treatment/management options. hi a big sorry that should read rugby otherwise we don't wont you running around looking for ruby to get rid of your anger she would not like it? then again? good luck hi first your stress google natural ways out of stress lots of ideas for you to look at even meditation may help you. \as for your emotional baggage possible therapy could be a lot of help if you go to the right person who can talk over your problems with they say a problem shared is a problem halved. but if you need to get rid of anger try some english ruby may be just what you want get with the right team its ruff and tough. hope this helps. good luck hi yes back again i was doing some searching this afternoon and found this its packed with info for ways out of stress the link <link> good luck i too have a great deal of almost constant seething anger. i used to do competitive sports but found that ultimately they made me even angrier. i discovered peace wonder a sense of personal power the release of anger and adventure in hiking and walking. suggestion: get an ipod or similar device if you can with some of your favorite music on it. find a nice park and look for good hiking trails. wear rugged clothes and good shoes. don't push too hard just hard enough to release tensions burn up the excess stress hormones such as adrenaline and cortisol and bring forth your body's natural endorphins and serotonin which will make you feel good and appreciate the beauty around you. after you hike stretch to cool down to prevent muscle cramps and be sure to rest well; allow more than enough time to sleep and clear your mind of worries as you rest. i live in a noisy place without as much privacy as i'd like and i use my ipod when i rest too with soft soothing music that helps me fall asleep. some people use a fan or other "white noise". when you are actively angry you cannot digest food but once you've calmed down eat food that will replenish the resources you've burned up because anger uses up a lot of the body's natural fuel. be sure to stay hydrated throughout. it may take some time but gradually this just might help. good luck.

### Human:\nhow can i prevent premature ejaculation?\n\n### Assistant: rapid ejaculation (coming more quickly than you'd like; also called premature ejaculation) is quite common particularly among young men or those just beginning to have sex. the good news is that many men find strategies that work for them to help them last longer and gain ejaculatory control with time and practice. both the stop-start and squeeze techniques are useful long term strategies that men can use to teach themselves to pay attention to the physical sensations they experience as they get closer to climax. . short-term solutions include desensitizing condoms. that are lubricated internally with a substance that includes benzocaine. . you want to be careful not to let that substance or any other numbing agents touch your partner's mouth or vagina as it can desensitize her parts too! . to prevent premature ejaculation you need to take these 3 factors into consideration: focus on feeling focusing too much on the feelings in your penis will activate the ejaculation program (which completes within one minute. ) if you are already overstimulated before you begin intercourse you may ejaculate within seconds. performance anxiety worrying about how long you are going to last is the fastest way to lose control. this is because your lack of focus means your conscious mind is no longer focused on controlling the sexual act - which makes you lose control and ejaculate early and/or lose your erection. sexual position one of the most common sexual positions makes it difficult to stay in control of when you ejaculate. a slight tweak to this position makes it the best sexual position - and the easiest for staying connected with your partner and in control. sexual fantasies must only be used at the right time! if you are already feeling over aroused thinking about sexual fantasies will make you lose control and ejaculate. other factors to take into consideration are: sexual frustration stress and lack of confidence. all of which cause you to lose focus and lose control. hi! i am 33 years old. i tried duramale after i suffered from premature ejaculation for many months. i saw the money refund policy so i decided to buy 3 bottles on <link> since there were no risks. i was very happy about the results even after 6 weeks but i followed the treatment very strict. this was my secret i guess. i recommend duramale to everyone who suffer from early orgasm. duramale pills can be purchased only online from website through credit card debit card or paypal. for complete details and best price of duramale visit <link>

### Human:\ncan you inherit depression from your parents?\n\n### Assistant: 1. depression may be inherited from family members. the more family you have that are depressed the more likely you will be. perhaps genetics is to blame for about 30% of depression where stress family upbringing trauma and personality style is the other 70%. 2. you may inherit genes for depression. you can also inherit the ability to respond to certain medicines that other family members respond too. so if your dad responded well to prozac your chances are good too as you likely have the same type of 'genetic' depression which was reversed by prozac in your dad. doctors should ask you if you have had a family history of depression and what meds your family took and their response to it.

### Human:\ndo men and women handle stress differently?\n\n### Assistant: i think they generally do and unfortunately men handle it in a way that is counter productive. we have noticed that more men will begin to drink alcohol excessively and that is probably because they want to be seen as strong and if they go to a doctor for any kind of help with this it will mean that they are not men so better to drink and try to drink your troubles away than to try and get some help. women on the other hand will say look if i’m this stressed i’ve got to go get some help. we know that more women enter therapy than man. that has always been as long as i can remember and they’ve been keeping statistics that women are willing to talk to others and to try to come to terms with how do i cope with this how can i change this what am i missing they will talk about their problems. men will talk about the baseball scores. they won’t talk about their problems. that’s why the statistics are skewed probably that they say that women have more anxiety and depression than men. no it’s because more women show up at the office and get counted and men don’t get counted. if we went into bars and started doing some kind of research i would wonder before they took their first drink how would they register on stress measures on anxiety depression measures and i think we would find a rather dramatic shift. you know what is stopping them what is so unmanly about getting help when you need it. if you have hypertension and you are a man you go and get help. is that unmanly? no. if you have anxiety and stress that is causing you serious problems and can end up in a heart attack is that unmanly or should you go and get some help just the way you got with your hypertension. remember these kinds of illnesses are just as important and can have as catastrophic results as the medical illnesses that you’ve accepted all these years.

### Human:\n<link> neuro nzt brain pill apex mastermind : mental faculties product is built to enhance yourself and you should believe every day when utilizing it. apex mastermind : mental faculties product may be the supplement you'll want. leader human brain is a cognitive bettering supplement by onnit labs it's 9 fully normal and extremely well-researched substances specifically made as a possible successful along with balanced nootropic. <link>\n\n### Assistant: please be respectful of this wonderful webmd medical site. do not post advertising. this takes up valuable space for people who have real medical concerns. thank you.

### Human:\ni am five and a half months pregnant and take xanax. can this drug harm the fetus and how do i taper off my dosage?\n\n### Assistant: the u. s. food and drug administration (fda) assigns a category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. xanax and its generic (alprazolam) have been assigned pregnancy category d meaning this class of medication have shown clear evidence of risk to the fetus in studies. pregnancy category d is a stronger warning class than pregnancy categories c or b classifications. a pregnancy category d medicine may still be given to a pregnant woman if the health care provider believes that the benefits to the woman outweigh the possible risks to the unborn child. i would not just stop taking the medication if you are concerned that you may be causing harm to your baby. work with your health care provider to decide whether you should be taking the medication. if you reach a decision to not take the medication any longer work with your provider or pharmacist to taper (decrease gradually) the dose to take and to prevent withdrawal symptoms. common withdrawal symptoms consist of but are not limited to nausea vomiting diarrhea increased heart rate palpitations hallucinations memory loss confusion panic attacks seizures dizziness headaches depression and insomnia. it is important to work with your health care provider to make sure you are getting the best care possible. one side effect is clef lip to your unborn child

### Human:\nmale 25 yrs old. i have low t. cat scan shows no pitutary tumor. symptoms low sex drive fatigue mild depression. cause? . surprised by low testosterone in blood work. i have a lot of body hair. what is the cause? will this always be a problem?\n\n### Assistant: there are two areas of the body where problems can arise which cause low testosterone levels. the first area is in your testicles. testosterone is produced in the testicles. the second area is the hormone control centers in the brain the hypothalamus and the pituitary. when testosterone levels fall the hypothalamus sends a signal to the pituitary to produce the hormones lh and fsh. these hormones travel in the blood stream and cause the testicles to produce testosterone and sperm. the effect of low testosterone levels on a man depends on his age when the low levels develop. in adults fatigue lack of sex drive and depression occur within a few weeks of developing low testosterone levels. decreased muscle mass and body hair are less common and do not occur for a year or more after the onset of testosterone deficiency. the first step when low testosterone levels are found is to confirm the results with repeat testing and test for free or bioavailable testosterone. free and bioavailable testosterone are a clearer representation of the active hormone as opposed to the total testosterone which is the more commonly measured initial test. the next step is to measure lh and fsh. normal or low levels of lh and fsh in the face of a low testosterone level suggest that the control centers in the brain are not working properly. high levels of lh and fsh pinpoint to a problem in the testicles. a cat scan is done to see if there is a tumor in the pituitary. a common pituitary tumor that causes low testosterone levels is a prolactin tumor. this is another hormone secreted by the pituitary. prolactin causes the hypothalamic region of the brain to malfunction. besides tumors damage to the pituitary gland or hypothalamus in adults can occur from surgery injury infections radiation therapy and with high doses or long-term use of narcotics or steroids. causes of failure of the testicles to produce testosterone include; chemotherapy radiation therapy excessive alcohol consumption infections such as mumps tumors medications trauma toxins chronic diseases and torsion of the testicles (twisting). sometimes no specific cause is found. talk with your doctor about your hormone levels and what could be causing your symptoms. treatment for low testosterone levels is important in men not only for their wellbeing but to make sure that their muscles and bones stay strong.

### Human:\nwhy do new dads get depressed?\n\n### Assistant: you’d think any new parent would be elated to hold a precious newborn in their arms. although guys can’t blame it on their hormones sleep deprivation has a major impact on someone’s view of life. spend two (or more) months with three-hour stretches of sleep and see how you feel! some dads also get stressed about 50/50 shared parenting responsibilities. (although they are happy to help many of them don’t have their own dads as role models. ) dads’ depression symptoms often go unnoticed. that’s because men don’t cry. depressed men may act angry withdrawn or even abusive. it’s important for friends family and health care providers to identify dads with postpartum depression and encourage them to seek help.

### Human:\nhow can i convince the medical insurer to pay for newly on-the-market drugs (re cancer patient stage 4)? . my sister has metastasized breast cancer. afinitor appears to be the drug treatment option with the most hope. how can i convince the medical insurer to ok (and pay for) this drug treatment? what are the most likely to succeed methods to put the pressure on them for the purpose of extending my sister's life with these new medical treatments?\n\n### Assistant: insurance companies pay for medications when a drug has received fda approval for treatment or there are advanced clinical trials (phase iii and above) which show that the treatment is effective. what is hard for patients and families to sometimes understand is that insurance companies only pay for proven therapies not experimental therapies. this is especially hard when the disease is cancer. fortunately the national institute of health and drug manufacturers are very involved in clinical trials for new cancer drugs or new indications for cancer drugs. clinical trials are very important because cancer drugs are generally very toxic and expensive and we need scientific evidence to decide on the best treatment options not anecdotal successes. because each cancer patient’s situation is different we want to make sure that a drug works for a particular patient. not all breast cancer patients are the same. some have limited disease some have advanced disease some breast cancers occur before menopause some after and hormonal and genetic characteristics can vary from patient to patient. afinitor (everolimus) is fda approved for breast cancer in combination with aromasin (exemestane) for certain postmenopausal women. the breast cancer must be advanced hormone-receptor positive her2-negative and in patients who experienced a recurrence or progression of their cancer after treatment with hormone therapy using femara (letrozole) or arimidex (anastrozole). if your sister fits in this category then her cancer doctor can write a letter to the insurance company citing her qualifications. another important avenue to pursue for cancer patients is clinical trials. you can look up clinical trials on the web site <link> by cancer type and features in your zip code or state. there are several ongoing breast cancer trials using everolimus (afinitor) that may be applicable to your sister. talk with her cancer doctor about clinical trials and assistance in working with the insurance company to get the best treatment for your sister.

### Human:\ni gave birth last week and am excessively anxious about going back to work. it doesn't seem like baby blues. what is it? . i’m worried about giving my eldest child attention. i have bipolar disorder but this isn't it.\n\n### Assistant: as you said you have a pre-existing condition and you have recently given birth to a child. only one of these giving birth would be enough to cause this type of depression and anxiety. you however have an additional component of bipolar disorder and together this can be a very difficult time for you as i see it is. please be sure that your husband and your ob know the extent of your current anxiety and possible depression so that they can quickly help you. if you had been receiving some treatment from a psychiatrist prior to your pregnancy consider putting a call immediately in to that person. your body is experiencing a change in hormones because of the birth and we know that this will upset anyone's normal mood and anxiety levels. so it is biological and you do need some help now.

### Human:\nwhy am i always hungry and tired? . i am a 19 year old male 6'0" tall 150 pounds. i work out at least 4 times a week including cardio and weight training. i eat healthy and balanced with the occasional junk food. i don't drink caffeine or soda. i always eat breakfast lunch and dinner and snack throughout the whole day. some days i eat over 3500 calories. i don't gain or lose weight easily. i sleep between 8-10 hours every night including the weekends. however i am constantly hungry even after a meal and i am always tired.\n\n### Assistant: there could be a few things going on. even though you eat healthy you could be low in nutrients causing you to feel tired. the only way to know for sure is to go for a physical and get labs run including vitamin d glucose and iron. also less likely increased hunger accompanied with thirst and weight loss could be sign of diabetes. also look closely at the quality of your diet. are you eating filling foods with meals including healthy fats (nuts and seeds/avocado/veg oils) whole grains lean proteins dairy beans/legumes and fruits and veggies? the fiber found in plant foods such as fruits vegetables whole grains and beans help fill you up. fat provides adequate calories and is satisfying and protein is also filling. make sure your meals contain 4-5 food groups and snacks 2-3. you want to avoid grazing on less filling snacks high in refined grains and low in nutrients (crackers pretzels chips). if you need help see a registered dietitian. you can find one in your area at eatright. org. read more. filling foods do you feel hungry and tired on days when you eat more than 3500 calories? probably there is mismatch between calorie intake and expenditure. feeling hungry is ok with your workout schedule but feeling tired is worrisome. any family history of diabetes please check. there are a few reasons you are feeling tired without any reason. one of them is anemia which is a lack of red blood cells and conversely oxygen from the lungs is not properly brought to the tissues and cells. anemia may be caused by deficiency of vitamins or minerals internal bleeding or chronic diseases. women who are at “that time” of the month are susceptible to anemia as blood is lost during menstruation. still iron deficiency due to menstruation is less than in pregnant women or lactating mothers as their body needs extra iron to maintain healthy blood levels. things may also go wrong when your thyroid glands refuse to cooperate with you. thyroid hormones thyroxine (t4) and triiodothyronine (t3) are responsible for metabolic processes in the body. too much thyroid hormone causes hyperthyroidism which speeds up metabolism while too little thyroid hormone slows down metabolism. hyperthyroidism causes fatigue and muscle weakness and starts in the thighs. doing energy demanding activities become difficult and other symptoms include weight loss feeling warm shorter menstruations increased heart rate and thirst. hypothyroidism also causes fatigue and muscle weakness. the symptoms are reversed to hyperthyroidism such as weight gain feeling cold and longer menstruations. diabetes notorious for causing a range of problems in the body is also related to fatigue. as glucose is the staple fuel of the body it is not utilized properly in patients with type 2 diabetes as the absence of insulin causes the glucose to build up in the body. without its staple fuel the tissues of the body are not nourished properly and causes fatigue. sadly being sad can also be the reason you feel tired. depression induces negative feelings and also has negative effects on the body as it causes a reduction in energy levels changes in sleep and eating patterns decreased concentration and overall laziness and worthlessness which keeps you in bed all day. reference: <link>

### Human:\ni have a history of depression and am entering menopause. i was diagnosed with major depression. are hormones to blame?\n\n### Assistant: women are at greatest risk for depression around puberty post partum and around menopause statistically. . these are times when estrogen levels falter; i think serotonin and neurotrophic factors (brain growth and health chemicals) also falter. this likely conveys some risk for depression. let's face it these times are also stressful for women which raises depression risk. given the recurrence of your depression i would suggest that whatever med you take next that resolves your depression stick with it much much longer to hopefully prevent future depressions.

### Human:\ncan depression be inherited?\n\n### Assistant: 1. depression may be inherited from family members. the more family you have that are depressed the more likely you will be. perhaps genetics is to blame for about 30% of depression where stress family upbringing trauma and personality style is the other 70%. 2. you may inherit genes for depression. you can also inherit the ability to respond to certain medicines that other family members respond too. so if your dad responded well to prozac your chances are good too as you likely have the same type of "genetic" depression which was reversed by prozac in your dad. doctors should ask you if you have had a family history of depression and what meds your family took and their response to it.

### Human:\nshould i continue exercise if i have a cold or bronchitis? . i developed sinus pressure and chest congestion. i continued my running. when my symptoms didn't improve after 3 weeks i went to a doctor who gave me a steroid and an antibiotic but said it was okay to keep running. i recovered mostly though i still felt the symptoms a little. last night i developed a dry cough which feels again to be in my chest and i have a little sinus pressure again. my exercise helps me mentally but is it the cause of my prolonged problem?\n\n### Assistant: deciding to exercise while you’re sick can depend a lot on your illness and your symptoms. to be honest the answer to your question often depends on who you’re asking since there really doesn’t seem to be a clear consensus or agreement. i personally feel more often than not that it’s best to take time to rest and recover from your illness before continuing with exercise. my rationale comes from a physiological standpoint. basically exercise can put a lot of stress on your body and your immune system is the only way that your body fights infections and pathogens that make you sick. when you exercise you’re devoting some of your body’s resources towards recovery from exercise instead of recovery from illness. in some instances exercise may even make you sicker or even prolong your illness. you also have to consider how comfortable you would feel while exercising with some of your various symptoms. medication may help alleviate some symptoms but otherwise how would you feel trying to go for a run if you’re congested or have a persistent cough? if you choose to exercise while sick you should consider decreasing your exercise intensity frequency or duration until you fully recover. please be considerate by following proper gym etiquette if you choose to work out in a gym. check out this webmd article for more input and guidance: <link>. i have the same symptoms. i feel its closer to the bronchitis side of things because of the clear mucus i cough when i am not riding. i am able to comfortably take my heart rate over 160 but i still have a cough which lasts for weeks after an upper respiratory tract infection (generally also involving the sinuses. i also get the odd drainage from my sinuses after/during a hot shower for example which seems to clear them. my explanation is as follows: when i am riding outdoors in the summer i breath a lot of pollens (i am not in the city) a little exhaust and this will tend to exacerbate an existing irritation. corticosteroids have limited effect to reduce the irritation but can reduce an acute irritation to the point where it is no longer chronic and my body's defenses can make a difference. thus its a combination of factors which typically plays out in the following order 1. bad cold/urt infection (5 days) 2. chronic cough (1 week to 8 weeks) but lungs good enough to exercise. 3. clear 2-8 months managing the level 2 is what this is all about. on occasions where i have been at the coast swimming in the sea often clears things up much faster. (which supports the sinus/allergen/irritant theory).

### Human:\nwhat is a nervous breakdown?\n\n### Assistant: nervous breakdown is not a clinical term so it doesn’t mean anything specific to doctors. people may use nervous breakdown to describe an episode of severe emotional distress. the word “breakdown” may suggest the person showed unusual behavior or stopped performing his or her expected duties at home or work. people described as having a nervous breakdown may or may not meet the criteria for a formal psychiatric diagnosis.

### Human:\ni have type ii diabetes. what is the best form of exercise for my condition? . i take metformin twice a day and insulin in the evening. i would like a recommendation on a good exercise program especially since i have a busy and sometimes inconsistant schedule.\n\n### Assistant: most helpful answer the easy answer would be any exercise. find an activity that you like. it can be as simple as walking (aerobic) or even taking up a sport like tennis. the best exercise program is really one that you will do on a regular consistent basis at least three or more times per week. find a partner - it is easier to exercise with a friend. having type 2 diabetes means you need to make the time. having a busy schedule is the norm for everyone. the insulin you take daily makes up for the little insulin that you produce. metformin helps sensitizes your body and muscles to insulin. in people with diabetes the only way to break and improve insulin resistance and reduce your risk of heart disease and other complications is by using muscles. most any type of regularly performed physical activity will do. find something you like it helps increase the chance that you will stick to it. a buddy system for exercise also helps make you more accountable and less likely to miss out on the social mental and physical benefits of exercise. a combination of aerobic type exercise and weights targeting core muscles is something to aim for. find an endocrinologist that is passionate about working with people that have type 2 diabetes. the surgeon general recommends 30 minutes of moderate intensity physical activity most days per week. for individuals with diabetes it’s recommended that there should not be more than two consecutive days without aerobic physical activity because the benefit of increased insulin sensitivity gained from exercise generally doesn’t last longer than 48-72 hours. moreover high-intensity physical activity will tend to enhance insulin sensitivity more than low-intensity physical activity. also a greater duration spent on exercise appears to more effective than a lesser duration. with both intensity and duration however the benefits appear to be a result of more energy being expended. exercise can significantly lower a1c levels and can even help glycemic control during times when not exercising. both resistance training and aerobic exercise have helpful effects on insulin and can help with diabetes management. do not exercise if your blood sugar is too low and stop exercise if you feel faint have chest tightness or are extremely short of breath. i generally recommend a combination of both aerobic exercise and some resistance exercise in most of my patients. and the good news is that most people can do low-impact exercise (like walking) and still see a benefit. you should talk to your doctor about your own specific exercise prescription. and while you're asking see if your doctor is exercising too! walking is the best exercise for everything! if you don't seem to have time to go and walk park as far from the door at work grocery store drug store anywhere you go as possible. then walk briskly while going in and out and if possible while you are shopping. this will help some and hopefully make you want to walk more and get into a routine! you can always find 30 min 3 times a week to walk!

### Human:\ni take zonisamide lyrica entocort ec maxalt and atenolol and now celexa. are there any known drug interactions?\n\n### Assistant: zonisamide lyrica and celexa have a similar side effect of increased dizziness and drowsiness. combining all three of these medications can increase the intensity of their side effects. driving and doing activities that require cognitive function may be more difficult than usual. the side effects may subside with time. maxalt is a triptan medication for symptomatic relief of the migraine. celexa works on serotonin receptors just as maxalt can. the increased combination of both these products may potentiate the risk of serotonin syndrome which is a rare but serious and potentially fatal condition. symptoms of the serotonin syndrome may include mental status changes such as irritability altered consciousness confusion hallucinations and coma; autonomic dysfunction such as tachycardia hyperthermia diaphoresis shivering blood pressure lability and mydriasis; neuromuscular abnormalities such as hyperreflexia myoclonus tremor rigidity and ataxia; and gastrointestinal symptoms such as abdominal cramping nausea vomiting and diarrhea. because of these side effects i would monitor how frequently the migraines occur and how often you are taking the maxalt. if you are taking the maxalt more than twice a week then you may need to start taking a preventative medication. monitor all your side effects if you have any and make sure to partner with your pharmacist or health care professional regarding any concerns or discomfort.

### Human:\nwe are having some weight gain and growth issues with our 17 month old. my daughter stella is 17 months old. she is only 18 lbs and not growing well. she is in the "less than 2nd %" on both height and weight. we have been to several doctors and have had several tests done and luckily everything has come back fine. stella loves to eat! she can eat a kids meal and 10 minutes later be asking for a snack. with all the food she eats she should be an obese baby. she is doing great developmentally. anyone with some advice on other tests please let me know.\n\n### Assistant: the key for growth at this age is looking at her growth over time. has her growth been steady since birth but at lower percentiles or has it dropped recently? red flags for growth are when they cross 2 percentile lines either up or down. also doctors should be using the world health organization growth charts for children under 2. if you pediatrician is using the cdc ones it could give you daughter a lower reading. lastly i highly recommend seeing a pediatric dietitian. he/she can assess what/when/how your child is eating and provide recommendations. typical reasons for groth issues include difficulty transitioning to solid food excessive juice/milk stressful feeding and a low fat/low calorie diet. children under 2 need more fat so that is an important consideration when deciding what foods to offer. also timing and feeding interactions can make a big difference in how well a child eats. you can get a referral through your doctor to a outpatient program at a children's hospital or find a dietitian that specializes in pediatrics by visiting eatright. org. once you get some answers you can rest easy knowing you are doing all you can do.

### Human:\nwhat can i do to increase my potassium? . i already take a potassium supplement. so i am taking two a day now. i also was already eating several bananas a week. i am eating at least one a day now. i already eat pretty much all of the foods that contain potassium so i don't know what to do. i am doing this by doctors orders but am now more tired than ever and having soft stools and frequent urination too. i go back for more tests in a few days but don't feel better at all (worse actually). what else can i do? !\n\n### Assistant: having low potassium is not always due to diet but fluid balance. that's because potassium along with sodium helps regulate body fluids (they are called electrolytes) so when fluid changes occur with certain disease states or medications like diuretics it can go too low or high. diet cannot always correct changes in potassium so working with your doctor on the appropriate medical management will be key. if you are getting worse call your doctor to see if you need to go in earlier. it is important to know which foods have potassium and how to balance your intake which this webmd article discusses in detail. also eating well moderate exercise and good sleep will only help you feel better. hope you feel better soon! finding the cause for your low potassium needs to be the first objective. here is a list of some possible reasons for low potassium: 1. ) sometimes low potassium is a symptom of some other problem. for example having low magnesium l evels can be a contributing cause for low potassium. it may be difficult in these cases to stabilize potassium levels until magnesium levels are increased. routine serum blood studies do not always uncover low magnesium. 2. ) consuming foods that are insufficient or lacking in nutrients necessary to maintain potassium at an optimal level can be a real challenge. yes consuming foods that are rich in required nutrients is a worthy objective. but due to hectic life styles and the frequent fast eating of fast foods your diet may come-up lacking in potassium. 3. ) some medications can cause low potassium levels. be especially careful in taking laxatives and diuretics which can deplete potassium levels. 4. ) electrolyte imbalances as seen with vomiting and diarrhea can also cause potassium levels to plummet. 5. ) some digestive irregularities as seen in conditions like crohns disease gluten sensitivity issues and irritable bowel syndrome can cause fluid loss and ultimately to cause low potassium levels. 6. ) drinking alcoholic beverages to excess drinking large amounts of tea coffee and soda can cause excessive urination and result in potassium depletion. here are my recommendations as a lay person who has had family members suffering the negative effects of having low potassium levels : - start a food diary listing as best you can (with only a few days until your follow-up appointment) all foods and beverages that are being ingested. also annotate any physical or emotional symptoms like excessive sweating feeling anxious muscle cramps lightheadedness thirst and overall body weakness. - for the immediate time follow your doctor's plan of action. keep that appointment with your doctor to follow -up with the results achieved. - show your diary to the doctor along with an updated list of all prescription medications and over the counterdrugs. that person has been highly trained in nutrition pharmacology and medical conditions. digestive problems absorption defects low magnesium levels and many other problems may be uncovered by your physician who is also a diagnostic detective. - once the cause of your low potassium level is determined then an effective treatment plan may be started. hi this first bit is from the uk paper the daily mail. this is an interesting question because although potassium is rarely in the limelight we actually need it in higher amounts than any other mineral - around 3 500mg a day by adult men and women. potassium plays a fundamental role in maintaining the fluid and acid/alkaline balance of the body. it is vital for the transmission of nerve impulses and helps the heart to beat regularly. it also counterbalances sodium in the body and is known to help lower blood pressure. to get enough you need to eat plenty of fruit and vegetables which are especially good sources because they also provide a low level of sodium. (health-wise it's a high potassium to sodium ratio that really counts). however several other foods also provide potassium including whole bread and pasta brown rice milk fish and meat. the dietary and nutritional survey of british adults (hmso 1990) showed that the average intake of potassium is 3 187mg in males and 2 434mg in females. compared with the daily recommendation of 3500mg intakes they are therefore low. to make up the difference eat an extra banana or two daily - each banana contains around 400mg. people most at risk of marginal potassium include the elderly athletes and manual workers who sweat out a lot of potassium and people taking certain diuretic drugs. heavy coffee and alcohol drinkers may lack the mineral and should try to increase their dietary intake i think from this and other stuff around with your supplements you should be getting there but keep of any fast foods junk foods and sodas just keep eating healthy. do hope this helps good luck ps the extra urination is from all the fruit your eating same as the soft stools.

### Human:\nas school begins how can i help my child succeed?\n\n### Assistant: self-discipline: have a conversation about personal responsibility. as a parent it’s our inclination to rescue our kids… which sometimes means making a special trip up to school to drop off the homework that got left on the kitchen table. but school gives children an opportunity to practice their life skills in a safe environment. let your child forget his homework and let him see the consequence of being disorganized. these are teaching moments. confidence: talk about making good decisions and sticking to them. a child with good self-esteem will to cave to peer pressure. she will lead and not follow. remember those words every exasperated parent has shouted: “if everyone else was jumping off of a bridge would you? ! ” make your child feel good about her reasoning and judgment. then you won’t have to worry that she will blindly follow others. exercise: if your child plays a sport exercise time is automatically part of his schedule. but many tweens and teens don’t exercise on a regular basis if they aren’t involved in a team sport. make physical activity part of your child’s daily routine. kids spend several hours a day sitting at a desk and then a few hours (or more) sitting down to do their homework. make exercise a priority and a mental health break. set media limits: twitter facebook cell phones text messaging video games tv shows and surfing the web… need i go on? as if school homework and after-school activities aren’t enough electronic communications and screen time can take up the rest of a child’s waking hours. make a family plan to spend time together without disruption from a tv or a friend who is calling or texting your child during dinner. turn off the electronics completely or set a curfew for them. sleep: sleep is powerful and underrated. with so many things on your child’s plate she may sacrifice sleep to cram for a math test or have a text conversation with her best friend. remind your child how much better she will feel (and how much better she will perform on that math test) if she gets the sleep her body needs. set a reasonable bedtime and try to enforce it as much as possible.

### Human:\ni am restricting food and i've been feeling exhausted as well as having a low pulse. does this mean i'm anorexic? . i still have my period and i haven't been working out that much though.\n\n### Assistant: most helpful answer it is difficult to say whether or not you have anorexia based on the limited information you provide but what you are doing is problematic and could lead to an eating disorder. the signs and symptoms of anorexia include but are not limited to restricting food fear of gaining weight body weight of 85% ideal or less and exercising too much. here are more of the signs including physical symptoms. i suggest you get a physical and take care of yourself. if you are asking the question it is likely you could use some support either form a dietitian or psychologist who specializes in eating disorders. while you may not have an eating disorder disordered eating (eating too much or too little/obsessing about food) is very common and can have negative effects. don't delay getting help! your health and well being depend on it.

### Human:\nwhat if my therapy is not helping my depression?\n\n### Assistant: 1- start with any therapist you like. ask if they use time-limited short-term therapy or open-ended long-term. if the latter ask how long is long term. 2- work with your therapist weekly for 8-12 sessions. often patients feel they don't click have some conflict and quit therapy too soon. just like patients quit medicines too soon. a key to therapy is to discuss that you feel you are not getting along or there are conflicts in the therapy itself. sometimes it is not the content of what happened to you during the week that is important to discuss it is the process of dealing with your therapist that is actually the therapy! 3- if you are not at least partially better after about 6 months seriously ask your therapist what chance you have of responding to their therapy techniques. consider adding a med add a group therapy that uses a different style or skill consider changing therapists. 4- if you are not better at all after a year really consider a new therapist who uses a different therapy style. it doesn't mean your therapist is poor at doing therapy it means the therapy style isn't helping you. if you are gradually improving even at a slow pace stick with the therapist forever -- as long as you are improving. some therapies can take several years but expect to see gradual improvement. 5. like using antidepressants some meds don't work for some people. so we switch and add meds around. some psychotherapies do not work for some people either. know when to stay in and know when to get out. have this discussion with your therapist if you feel stuck.

### Human:\nmy daughter takes citalopram hydrobromide tab 20 mg and seroquel tab 100 mg. which is for indicated for sleeplessness?\n\n### Assistant: both medications are depression medications and have side effects for drowsiness. seroquel tends to cause more drowsiness but both have the side effect. when used adjunctively the side effect tendency increases. neither of these medications will be prescribed for sleep aid alone. you should consult your daughter’s doctor for a better understanding as to why these medications were prescribed and use your pharmacist for a better understanding of how these medications work in the body.

### Human:\ni feel sad and just like i don't want to do anything. i want to do nothing and talk to nobody and just lay down and cry. i am supposed to go out with my boyfriend today and i feel obligated to because he's my boyfriend and it's valentine's day and i really don't want to. i don't know how to tell him because he's so sensitive and i actually do wanna go out but i also want to do nothing and i really think i'm asexual but i want love and happiness and kids but then i don't want it at the same time. i don't know what's wrong with me.\n\n### Assistant: most helpful answer based on your posting depression would be high on my list. depression can certainly be managed by a variety of ways but you will need to take the first and most important step. see your medical provider so you can be properly evaluated and treated. it would not be possible to do these things blindly over the internet so it is really up to you to do this. if your boyfriend is sensitive he will understand until you have time and help to sort out your feelings.

### Human:\ni am going through some major issues and don’t have insurance to see a psychologist. should i try pastoral counseling?\n\n### Assistant: i think many priests pastors rabbis have good counseling skills. let's face it they help us through many tough times. so if you cannot afford anyone else not a bad place to start. they will tell you if your symptoms are way out of their league.

### Human:\nhow does saphris work?\n\n### Assistant: saphris (asenapine) is fda approved to treat acute mania from bipolar disorder or the symptoms of schizophrenia. it is a drug that is placed under the tongue and not swallowed directly. you ask how it works. by blocking one type of dopamine receptor it stops the above disorders. it blocks a serotonin receptor which is counter intuitive but this blocking may help increase other chemicals that help depression (dopamine norepinephrine). in other parts of the brain. it is also my understanding that it shares chemical properties with a well-known antidepressant called remeron/mirtazapine. many of these meds for schizophrenia have been used for treating depression and some have been fda approved recently (abilify and seroquel xr).

### Human:\nmy 5 1/2-year-old son displays adhd symptoms for 20 days then for 10 days he has none. is it adhd or another condition?\n\n### Assistant: adhd and bipolar mood disorder (bmd) can coexist or be mistaken for one another. bmd usually is not diagnosed until young adulthood. however studies have shown that the earlier a person is diagnosed with bmd the more likely he is to have been diagnosed with adhd previously. in this case i would just like to reiterate that there is not enough information to discuss either possibility for your son. you mentioned that he becomes hyperactive for 3 weeks but not what his behaviors are like during those 10 days. you also do not mention irritability or mood swings just adhd symptoms. keep documenting the symptoms you are concerned about including what goes on in the home and at school when you see changes in behavior (do you work those weeks does he visit a relative or have a different aide in the classroom). you also mentioned that this began 7 months ago. i would also urge you to think about what also might have changed in your son's life about that time. consulting your pediatrician or a child psychiatrist should help you unravel the mystery of your son's behavior.

### Human:\nive been trying to loose wgt for mths with no results. i exer. have made my eat habit healthier. why cant i loose weight. i had my thyroid checked i changed my eating habits ive started exercising and i have not lost a pound. why? i am getting very depressed and somedays i feel that i'd rather be dead then fat. im 51 and extremely sad over my weight. i have never been this weight other then when i was preg. my normal weight is around 120 im 5'2" i have gotten to 160 and i hate it. help please.\n\n### Assistant: first off if you are thinking the thoughts you mentioned in your question seek help from a mental health professional. without knowing how much and what you are eating it's tough to say why you aren't losing weight. while eating healthy is good total calories are key to bringing weight down. i highly recommend you see a registered dietitian. he or she will work with you on your current diet changing habits that caused the weight gain and individualizing it all to your lifestyle and preferences. you can find a dietitian in your area at eatright. org. research also shows that body dissatisfaction and being hard on yourself is linked to weight gain over time. as tough as it be try to think more kindly towards your struggles and your body. practicing self care and self compassion are important (but overlooked) factors in successfully managing health and weight. hang in there! there might be some problems with your diet. try the zeltiq in nyc or visit www. bodytreatmentcenter. com for an effective way to reduce fats.

### Human:\nwhat happens when you try and fast for a long period of time?\n\n### Assistant: not good things. your body needs a baseline of electrolytes minerals and vitamins to survive. you can get by about 48 hours without them and then you start running into trouble. dehydration dizziness fatigue constipation and cold intolerance are typical as well as mental grogginess. it’s difficult to achieve restful sleep when you’re hungry and prolonged fasting can take a toll on moods as well. this is why most religious fasts take place over 24 hours not 24 days. you die. no webmd it's a fact!

### Human:\ndoes hair normally turn gray starting at the scalp or can it change midway down the strand?\n\n### Assistant: hair follicles are responsible for producing pigment in the hair shaft. therefore the loss of pigment should occur from the root. however certain environmental processes -- such as weathering from the sun and styling -- may cause the hair to appear to have lost pigment after it has grown out.

### Human:\nwhat is vitamin b12?\n\n### Assistant: vitamin b12 one of the eight water-soluble b vitamins contains the mineral cobalt which is why it is often referred to as "cobalamin. " all b vitamins are involved in cell metabolism but b12 plays a key role in keeping nerve and blood cells healthy. adequate vitamin b12 also prevents megaloblastic anemia a type of anemia that occurs with larger-than-normal red blood cells. vitamin b12 can only be found in foods of animal origin so vegans (vegetarians who omit all animal products) need to eat foods fortified with b12 or take supplemental b12.

### Human:\nwhat is delirium?\n\n### Assistant: delirium is a form of altered consciousness that occurs in people with medical illnesses or who have dementia. in delirium the person’s level of consciousness and understanding of her surroundings rises and falls. she may be lucid and appropriate for part of the day but be confused and disoriented at other times. people who are delirious may be lethargic and “out of it ” agitated and aggressive or somewhere in between. delirium most often affects older adults and children. infections and medications are probably the most common causes of delirium. people with dementia are more likely to become delirious. treating the underlying cause (such as an infection) is the most important treatment for delirium. antipsychotic medications can be used to treat delirium. re-orienting and comforting a delirious person is also often helpful and may reduce the need for antipsychotic medication.

### Human:\nour child in college is being treated for depression. we feel more support is needed but live far away. what can we do?\n\n### Assistant: i think it is tough in that you want to balance your child's autonomy and also make sure they get the care they need. i would ask your child to sign a release of information where their counselor at college is free to contact you and disclose information. then have a discussion with therapist that you would like to be notified of future appointments (so you can push your kid to attend) and also of missed appointments. some campuses may have a support group -- the student counseling service at college might be able to direct [you to] -- they may even run the groups.

### Human:\nmy primary doctor diagnosed me with anxiety disorder and prescribed xanax and zoloft. why do i still have panic attacks?\n\n### Assistant: i'm a firm believer in a conservative approach to everything and i don't feel that a diagnosis of an anxiety disorder necessarily requires medication. it may require medication but first i believe other things should be attempted. first i think you should look at any stress you may have in your life because there may be something that is causing you stress and which can be bringing this on. have you considered what might be happening in your life lately? remember stress builds up over time so it may be something that has been something about which you were unaware as to how much it was affecting you. the medication you were given although originally formulated to treat depression is now used for panic attacks. since anxiety and panic attacks usually also have a component of depression these medications have been found effective. there are of course other older medications which can be just as effective. it looks like your doctor was providing "bridge therapy" which means he was providing the xanax to help you until the other medication was fully effective. research indicates that panic disorder may happen as we reach later midlife even though we've never had them before. this may be a function of our changing biology and nothing more. it may also however reflect the change in stressors in our life as we age. for that reason i suggest you look at your lifestyle and see if there might be something that is distressing for you i've been dealing with panic disorder; officially since 1976. i'm not sure there is just one singular cause of it period. it could be in your diet the air or even the water we drink. something triggers the flight / fight syndrome when there doesn't seem to be a reason for it. something is activating the adrenal glands. i do think stress; while it's hard to tell if you're under stress sometimes will cause the episodes or make them more intense. dealing with this issue; when you're new to it can cause much stress. i've been on benzodiazepines on and off since 1976. i’ve been more on meds over the last 25 years than off. your medication doses may need adjusted but anti depressants tend to give you a boost or make you feel weird; which can kick in an attack. try looking for more holistic approaches to feeling better like change your diet see it if helps. exercise try meditation reading or listening to your favorite music and breathing exercises help a lot. the medication; should you stay on it long will eventually need changes to another type or a higher dose. my panic was so bad; i had to open my own company to stay at home whenever i had to. it usually comes and goes; as they say waxes and wanes. usually it has other phobias which develop as well. you want to steer clear of people and places which you think cause the attacks. i don't know that they will ever disappear; however they should diminish in frequency and intensity. best of luck and work on your end helps a lot!

### Human:\ni am 17 male height 5'2''. want to increase height.\n\n### Assistant: boys stop growing at 20 years of age whereas girls stop growing around age 18 so there still is time. first make sure you are getting enough calories. this chart will give you an idea of how much you need based on your gender age and activity level. you also want to eat regular meals and in between snacks. aim for 4-5 food groups at main meals (lean protein fruit vegetable grain dairy and healthy fat) and 2-3 food groups in between meals. make sure you get adequate calcium and vitamin d for bone growth. you are at beak bone mass and need 1300mg calcium each day! most servings of dairy contain about 300mg (1 cup milk/yogurt and 1/5 ounce of cheese) so 3-4 daily servings helps you meet your needs. the american academy of pediatrics recommend children and adolescents take supplemental vitamin d if they can't get it through diet. remember vitamin d enhances calcium absorbtion. the recommended amount is 600iu but if you are low you may need more. you can also get blood work done to be sure. lastly adequate sleep is needed during times of growth so make sure you get to bed at a decent time at night. you may not be able to do anything about genetics but maximizing nutrition and taking care of yourself can only help you grow to your potential.

### Human:\ndoes prozac cause weight gain? what about zoloft?\n\n### Assistant: selective serotonin reuptake inhibitors (ssris) are a class of antidepressant medications that include citalopram (celexa) fluoxetine (prozac) sertraline (zoloft) and several others. in clinical trials these medicines did not consistently cause weight gain. some people taking an ssri for two to three months lost a pound or two while others gained 5 pounds or more -- but rarely were the weight changes much different than those in people taking a placebo (sugar pill). it can be hard to separate out any side effects of the ssri itself from the positive response to treatment. for example some people with depression and/or anxiety may regain their appetite as they start to feel better eat more and gain weight. others may find the energy to exercise when they couldn’t easily do so before maintaining or losing weight. each person responds to ssri treatment slightly differently. by devoting energy to eating right and exercising while taking an ssri you may be able to avoid unhealthy weight gain.

### Human:\nwhy has my 5 month old gone from sleeping through the night to waking up crying? we have to feed her to help her sleep.\n\n### Assistant: your situation is very common and there are many possibilities for why your baby is waking up now: 1) she could be teething. even though teeth don't break through the surface of the gums until 6 to 8 months on average they can still be moving upward and causing pain. 2) she could be having a growth spurt. this might explain why the feeding helps. 3) she is more alert and aware during the periods of light sleep at night. also as she reaches the stage of separation anxiety (usually around 8 or 9 months but could be sooner) so may be looking for you. 4) she is waking up out of habit. if you feed her to sleep at the beginning of the night she may need to feed again to fall back asleep in the middle of the night. 5) she could be hot cold in pain etc. if this behavior keeps going i encourage you to see your pediatrician to make sure your baby doesn't have an ear infection reflux or other illness. these are just some of the common causes of night-waking that i see in my practice. .

### Human:\nhow do i stay motivated with my diet when i see no change at all in my waistline? . i've been trying to lose weight for about two years now. i thought i'd see a noticable difference when i went from drinking 4-5 cans of soda a day to one (and sometimes none) but no difference at all. i started doing pilates. no difference. two days of strength trainging. no change. added a cardio day. no difference. cut portion sizes in half (except for my fruits and veggies) no difference. i don't look better i certainly don't feel better and now i'm hungry all the time.\n\n### Assistant: you don't say whether or not you are overweight which can be a factor but i understand how hard it can be to make changes and not see the results you want. i think the biggest myth about eating healthy and exericse is that weight is a long-term motivator. when we focus solely on weight we make more extreme changes for results and feel deprived and frustrated when we don't see results. i recommend you go see a registered dietitian for strategies on how to eat a balanced diet that is also satisfying (go to eatright. org to find one in your area). she/he can also help you troubleshoot your weight and help with appetite control (you shouldn't be hungry! ). when you eat a healthy diet that matches your lifestyle and preferences you'll continue to eat that way even when weight loss slows. a recent study showed that women who exercised because it made them feel good (quality of life) exercised more often than those who did it for weight and health. you are more likely to exercise and keep at it if you truly enjoy it and see the daily benefits including improved mood better sleep and productivity. for more on this study and my interview with the researcher see this webmd post <link> weight is one part of a healthy lifestyle. don't let it stop you from being healthy and enjoying your life! i would suggest that you meet with your doctor or a dietitian for more guidance. they may be able to help you determine if there’s something that you could still improve upon or perhaps to do differently to promote better results. your doctor may also be able to do tests to see if you have any other diseases or conditions that could be interfering with your progress. also i’d recommend that you don’t just judge your progress by weight loss alone. look for changes in body composition such as a loss of inches a more “toned” appearance or even whether clothes fit differently. schedule a wellness visit with your doctor that includes blood work and try to understand what’s happening with other areas of your health such as cholesterol blood sugar or blood pressure. these can also be used as indicators of progress or improvement with the changes that you’ve made. it can definitely be very discouraging to put so much hard work and effort into something and to not see the results. it might be best to get professional assistance and to look for other indicators of progress besides weight loss. stay positive and keep up the great work! keep it up! you may start noticing the weight loss in other places before you see it in your "trouble spots". unfortunately we can't control where the weight drops first but you will eventually see the changes. make sure to monitor your food intake too - to make sure your calorie intake is not higher than the amount of calories burned. at the end of the day as long as you are burning more calories than the amount of calories consumed you will see the weight drop. most importantly don't lose your momentum. stay active and you'll reap the benefits in time - just give yourself time to see it pay off! even a 10% loss in body weight makes a huge difference in your health. hopefully while you wait to see the pounds drop you will at least feel more energy and feel good about yourself! you're at least on the right track in searching for answers. from what you've shared it sounds as though you're basing your results on generalities more than measurable specifics. i recommend having very specific parameters for measuring progress from hereon. i mean: weight body fat percentage (a good trainer will know how to measure best with calipers and there are less invasive methods like bio-impendance scales) then girth measures on specific locations across your chest torso abdomen and hips. at the very least having these will show you where you have improved given your efforts. as a formerly obese kid i can tell you that my subjective view of looking better or feeling better did not correlate to my actual progress. keep that in mind. lastly since you're keeping measurements in check you might as well keep track of the exact changes you're making in your food/drink intake and exercise. there's a website and app that's most frequently used right now called myfitnesspal. i use it to see what my clients have been up to. you'll be surprised how a food/weight/exercise log makes a big difference. good luck. delf www. delfenriquez. com sometimes there are emotional issues/reasons why we don't lose weight. at our office we use mind-body techniques such as eft (emotional freedom technique meditation etc. ) to help resolve core beliefs that keep us stuck. if you are interested and think it might help feel free to contact me at excelweightloss@gmail. com. best to you!

### Human:\nwhat effect can wellbutrin have while my wife and i are trying to conceive and on the baby while it is breastfeeding?\n\n### Assistant: you probably can relax so you can plan your child. we do not know of any real fetal anomalies that occur because the male takes the medication. remember the medication will only be on the sperm (if any) and it will not affect breast feeding or any other issue with the baby. wellbutrin we use for mothers during and after pregnancy. the biggest issue you need to understand if you have depression we believe it may be passed to your child. it may be passed in a dominant fashion so 50% of your children may be affected by depression. knowing this may help you identify the problem early so they can be seen and treated. .

### Human:\nis the shortage of family doctors going to be an issue because of the affordable care act? . some people worry about longer waits to see their primary care physician.\n\n### Assistant: well i think it’s absolutely an issue whether or not we had a new health care law pass or not which is why the president made sure that it’s part of the initial recovery act bill. we looked out for the work force of the future the health care work force and there was additional money put in so we can double the number of doctors whose medical loans will be paid off if they actually come into family medicine and serve in an under-served area which is why there will be more scholarship money for nurses and nurse practitioners for mental health technicians. the affordable care act the health care reform law that was passed increases that number. so we are really looking for ways to make sure that there are accessible docs. …if we are going to shift from a sickness system to a real health and wellness system primary care docs will be more in demand not waiting until you need a specialist in a hospital but hopefully getting to the illness in the first place keeping people healthy. so we’re also changing the payment rate for primary care docs. right now specialists can make a lot more money and medicare is updating the amount of money that will be paid to family practice docs to gerontologists and to others who deal with people to keep them healthy in the first place.

### Human:\nour water is from a well and has no added fluoride. is using fluoride toothpaste enough?\n\n### Assistant: if there is no fluoride in your well water you will probably need fluoride treatments from your dentist at your cleaning visits and a supplemental fluoride mouth rinse to use at home. ask your dentist what is best.

### Human:\nat 29 i still bite and pick at my fingernails. what can i do to quit this habit?\n\n### Assistant: your first goal is to determine if there underlying reasons for your habit. potential issues can range from an obsessive compulsive disorder to stress. severe nail biting can lead to serious health risks. bacteria can be transferred from your hands to your mouth. i would suggest that you consider an evaluation with a qualified psychotherapist and if there are secondary medical problems from the biting (such as an infection) your dermatologist can treat them. often a team approach can be effective for complex issues. i had the same problem until my late 20's. a friend invited me to a nail salon & i had the acrylic nails put on for fun. i actually tried to bite & pick at those too! every month or so i would go back & have my nails touched up. as time went by i noticed that i had stopped biting my nails. i still get manicures but i stopped getting the acrylic nails. it has been at least 5 years now since i have stopped bitting my nails.

### Human:\nhow do i choose a calcium supplement?\n\n### Assistant: if you don't get enough calcium from foods you may need to take a calcium supplement. many people ask which calcium supplement they should take. the best supplement is the one that meets your individual needs. calcium supplements are available without a prescription in a variety of types such as tablets capsules chewables and liquids. they are also available in different amounts and doses. the body easily absorbs most brand name calcium products. calcium supplements need to dissolve in the stomach for calcium to absorb. chewable and liquid supplements dissolve well because they break down before entering the stomach. calcium whether from diet or supplements is best absorbed when taken in amounts of 500 — 600 mg or less. taking your calcium all at once however is better than not taking it at all. try to get your calcium-rich foods and/or supplements in smaller amounts throughout the day preferably with a meal. most calcium supplements should be taken with food. eating food produces stomach acid that helps your body absorb calcium. calcium citrate supplements on the other hand absorb well when taken with or without food. side effects such as gas or constipation may occur from calcium supplements. if increasing fluids and fiber in your diet does not solve the problem try another type or brand of calcium. it is important to drink plenty of water (six 8 oz glasses) throughout the day when you are taking calcium supplements. it may require trial and error but fortunately there are many choices. when you take a new calcium supplement start with smaller amounts. for example start with 200-300 mg of calcium a day for a week and drink an extra 6-8 ounces of water with it. then gradually add more calcium each week. look carefully at calcium supplement labels for the serving size. often the amount of calcium shown on the label is the amount you receive in more than 1 tablet or unit. for example the label may show "calcium 630 mg " but if you look at serving size it may show "2 tablets". choose a calcium supplement with vitamin d added to help you reach the daily intake of vitamin d recommended by your healthcare professional. and finally unless otherwise advised by your health care professional avoid consuming more than 2 500 mg of calcium (food plus supplements) per day. if you are an active woman over 50 reconsider your decision to take a calcium supplement. recent research has shown that supplemental calcium does nothing to prevent fractures in active post-menopausal women and it is associated with increased risk of kidney stones and heart attacks. google to read the studies.

### Human:\ni'm due for my next round of chemotherapy but just learned i have neutropenia. what is this and what does it mean?\n\n### Assistant: neutropenia pronounced noo-troh-pee-nee-uh is a decrease in the number of white blood cells. chemotherapy drugs work by killing fast-growing cells in the body. this means these drugs kill cancer cells as well as healthy white blood cells. since white blood cells are the body’s main defense against infection this means you are at an increased risk for getting an infection while you have neutropenia. i also suggest that you visit www. preventcancerinfections. org to learn more about your risk for developing neutropenia during your chemotherapy. many times neutropenia produces little symptomology and is only diagnosed through other unrelated serum blood testing. neutropenia is an abnormal low number of neutrophils. neutrophils are a form of white blood cells that help the immune system to fight-off infections. the bone marrow produces these cells which release chemicals when the body is being attacked by bacteria such as caused by wounds. your bone marrow creates these cells. they then travel in your bloodstream and move to areas of infection. they release chemicals to kill invading microorganisms. during chemotherapy interference with the bone marrow’s ability to produce neutrophils may occur resulting in even more intense neutropenia. treatment of neutropenia is directed at its cause such as eliminating certain medications (antibiotics psychiatric drugs & antiepileptic meds etc. ) and other causes. it is advisable to control the neutropenia before starting chemotherapy. i wish you well on your journey to renewed health.

### Human:\nits been 14 years since i had weight loss surgery. i am 190lbs 5' tall can i have surgery again?\n\n### Assistant: your best bet is to get follow up either from your doctor who did the surgery or another surgeon. they will check in with your labs diet and offer suggestions. the bariatric team (consisting of rd psychologist rn and surgeon) can weigh in on whether or not another surgery is necessary. an important part of the follow up will be for the surgeon can check to see if there are any problems with your original surgery etc. regular follow up is really important for anyone who has had weight loss surgery so that is the best place to start. good luck!

### Human:\nhow can i get control back in my life after a cancer diagnosis?\n\n### Assistant: once you have dealt with the shock of a cancer diagnosis you will need to be as organized as possible in order to make your cancer journey as livable as possible. your treatment: choose caregivers whom you like and trust. choose one oncologist to be your most trusted adviser and ally to help you make the best decisions at every juncture of your cancer journey. your loved ones: although there is only one person going under the surgical knife or receiving chemotherapy cancer still affects an entire family and more. seek the help of professional counselors who will help you cope with cancer as well as provide guidance on how to communicate effectively with your loved ones about your situation. your support system: family and friends will want to help you cope with cancer but they will need guidance on how best to do so. let them help you with chores children and transportation to and from treatment. your mind: the diagnosis and treatment of cancer no matter how successful the result frequently causes depression and anxiety and nearly always uncertainty. learning how best to cope with these is vitally important to getting through the treatment phase and especially during long-term survivorship. your work: you and your employer will want to know how much time you will need to deal with cancer. do not try to maintain a full work schedule during arduous treatments. consider short or long-term disability depending on the rigors and after-effects of treatment. your finances: even if you are highly likely to survive your cancer the diagnosis is a good reason to get your financial situation in order for the sake of you and your loved ones. your time: the ultimate goal is for you to have your life so organized that you can deal with cancer treatment almost on autopilot. this will also enable you to have time for yourself which is an essential component of the recovery process.

### Human:\nunder health-care reform when will there be fewer restrictions on mental-health sessions? . why is an insurance company allowed to limit how many therapy sessions a patient can have a year?\n\n### Assistant: last year the obama administration issued new rules that prohibit group health-insurance plans — typically offered by employers — from restricting access to care by limiting mental-health benefits and requiring higher patient costs than those that apply to general medical or surgical benefits. the rules implement the paul wellstone and pete domenici mental health parity and addiction equity act of 2008 (mhpaea). in other words the mhpaea states that a group health plan may not impose annual or lifetime dollar limits on mental-health benefits that are less favorable than any such limits imposed on medical surgical benefits. the affordable care act also takes steps to help people access the mental health services they need: right now if you haven’t been able to find health insurance due to a pre-existing mental-health condition you may be able to access the new pre-existing condition insurance plan. starting in 2014 substance abuse or mental illness can no longer be used by insurers to deny coverage as a “pre-existing condition” – and insurers also won’t be able to use those conditions to raise your premiums. also in 2014 mental-health and substance-use disorder services will be part of the essential benefits package a set of health-care service categories that must be covered by certain plans including all insurance policies that will be offered through the exchanges and most coverage in medicaid. these reforms all work to make the health-insurance marketplace a more accessible affordable place for people with mental-health and substance-abuse disorders.

### Human:\nmy appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight. i am a 64 year old male. my appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight as a result.\n\n### Assistant: a good appetite is a sign of good health but if your appetite has suddenly increased in might be a sign of disease. an important distinguishing point is if you are gaining weight. an increase in your weight suggests that your increased appetite might be a response to boredom stress or depression. certain drugs might also explain an increased appetite and weight gain. steroids such as prednisone and dexamethasone which are given for asthma joint and skin problems can cause an increased appetite. certain antidepressants cause an increased appetite and weight gain. increased appetite is a side effect of tricyclic antidepressants; amitriptyline (elavil) imipramine (tofranil) and doxepin (sinequan). increased appetite also occurs with medications used for schizophrenia or bipolar disorder; olanzapine (zyprexa) and clozapine (clozaril). some women experience appetite changes right before a period. this is especially true for women with pre-menstrual syndrome who can experience craving for carbohydrates and increased appetite around the time of menstruation. even changes in your diet can affect your appetite. eating a lot of carbohydrates and junk food increases insulin secretion from your pancreas to stabilize your body’s blood sugar and that can make you hungry. if on the other hand your appetite is increased but you are losing weight then diseases that affect your metabolism may be responsible. elevated thyroid levels (grave’s disease or hyperthyroidism) cause an increased appetite because thyroid hormone speeds up your metabolism. diabetes can present with an increased appetite and weight loss. increased exercise can cause your appetite to improve and depending on the calories burned from exercise and your intake your weight may vary. don’t ignore an increased appetite. keep a diary of the foods you are eating and note whether your behavior is affecting your appetite. check your weight and see if you are gaining or losing. see your doctor about a change in appetite to make sure that you do not have a medical condition that needs to be treated. there are many things that can increase appetite -- some beneficial and some not. for example an increase in physical activity may give you a more robust appetite which is fine if you feed your body well. but a lack of sleep or change in eating patterns can also increase appetite which is not so good. think about what has changed in your life both physically and emotionally that could be increasing your appetite. here are some other tips that can help: look not just what you are eating but how. try to sit for meals be mindful of the food enjoy eating an stop when you are comfortably full and satisfied. avoid eaitng on the go or grazng all day which may not satisfy your hunger. too many processed foods can also increase hunger because they aren't very filling or sustaining. eat filling foods including those high in fiber (whole grains fruits vegetables and beans) and protein (lean meats) along with healthy fats (nuts seeds healthy oils). get adequate sleep and physical activity.

### Human:\nhow is depression diagnosed?\n\n### Assistant: we often use a simple mnemonic in practice: there are 9 typical symptoms s leep disruption or oversleeping m ood lowering i nterest loss or loss of enjoyment g uilty or worthless feelings e nergy loss/fatigue c oncentration loss a ppetite changes p sychomotor change (being either agitated or slowed down) s uicidal thinking if you have 5 or more of these consistently the depression may be occurring. there are several types of depression and depression often travels with other psychiatric problems (anxiety alcoholism etc. ) so the above is the tip of the diagnostic iceberg. if you or someone you know has these symptoms they may want to bring it up with their family doc!

### Human:\ncan you take pills for yeast infection while on antidepressants? . i am taking 10mg escitalopram and 150mg bupropion daily for treatment of depression and have just taken a one-time dose of 150 mg fluconazole (5 hours after the other two medications) for treatment of yeast infection. should i be concerned about drug interactions between these? what would be the signs and symptoms if there was a problem? and will they go away on their own since the fluconazole is just one dose or do i need to see a doctor?\n\n### Assistant: most helpful answer whenever you take several medications it is important to check with your doctor and pharmacist about drug interactions. you are wise to question the combination of bupropion (wellbutrin) escitalopram (lexapro) and fluconazole (diflucan). bupropion increases your risk of seizures and the addition of escitalopram (lexapro) raises that risk further. this is especially worrisome for the elderly and for those who are at risk for seizures for example from a head injury. presumably the doctor who prescribed both of these medications felt that the benefit of this combination outweighed the risk. sometimes your doctor will need to check your blood levels of escitalopram when bupropion and escitalopram are used together. adding a single dose of fluconazole a fungal medication taken by mouth probably won’t have a significant effect on how you feel. however when fluconazole is used for several days it can raise the blood levels of escitalopram increasing your risk of complications. there are several web sites that allow you to check drug interactions online but the safest path is to check with your doctor. when you are seeing several doctors who are prescribing medications there is a risk that drug interactions between medications will be overlooked. to safeguard against this happening it is always best to have one doctor a family practitioner or internist overseeing all your care. checking with your pharmacist before filling medications is also important.

### Human:\nif you see a patient for meds only (with someone else as psychotherapist) how many minutes do you spend with a patient?\n\n### Assistant: i afford patients 30 minutes. if folks are doing super well the session may take 10 minutes but i allow 30 minutes. if not going well or we are making lots of med changes we use all 30. some sessions are 60 minutes which depends on staffing levels at my office the patient what day of the week it is. but 30 is average. also some docs at big practices or public practices aren't their own boss and are forced to see a patient every 15 minutes which i personally think is pushing it. in areas low on psychiatrists this is common too as the idea is that 15 minutes of psych care is better than zero. it does depend on many factors.

### Human:\ni can't shake complete unhappiness with living and myself. should i talk to my doctor? i don't want to take medicine.\n\n### Assistant: outside of medications psychotherapy can be very helpful and sometimes equal to or better than the effects of meds. actually some studies show that the brain changes the same way whether depression is alleviated by meds or therapy. . talk to your doctor about your options as it sounds like you have symptoms that are causing you distress.

### Human:\nis it safe to take buspar and drink alcohol?\n\n### Assistant: caution should be the watchword here. any med taken with alcohol can be a problem because almost all meds have to go through the liver to be broken down and that's exactly where the alcohol goes too. so there's a fight in the liver for passage and because of this the med builds up in your system since it can't be broken down. the result is something like a massive dose of the med and this has consequences. it's never a good idea to drink alcohol when you're taking any type of psychotropic med. some of them can have extremely bad effects but not everyone is aware enough of this. the best advice is to avoid alcohol.

### Human:\nif a mother says to her 12 year old girl "i love u more if u were skinny" will it mentally scar the child? . will the child also develop abnormal behavior and think abnormally. i have a friend who is always depressed and she asked me why i would hang out with her. i said becuz u are nice and clean and a good person and u love god. she didn't believe me saying that she was too fat for that and explained to me that her mom didn't love her becuz she said "i love u more if u were skinny". she said she thinks her mom doesn't care if she was rude or disrespectful as long as she is skinny. .\n\n### Assistant: if a parents send their kids the message that they value appearance more than who they are as a person it will not have beneficial effects. that being said every person is different in how they react to such circumstances so it's hard to generalize. this article discusses the connection between weight and mothers and daughters. maybe your friend can get help with this issue so she can see how it is affecting her life today.

### Human:\ncan a symptom of going thru menopause be crying for no reason at all and feeling sad. i am normally a happy person. can a symptom of going thru menopause be crying for no reason at all and feeling sad. i am normally a happy person.\n\n### Assistant: some women ride an emotional roller coaster as they pass through the years surrounding menopause. they may feel moody and anxious at times or sad and teary at others. but menopause is not the only thing that can cause a woman to feel like this. other conditions including depression can cause feelings of hopelessness sadness and a loss of pleasure in things that were once enjoyable. depression can also cause trouble sleeping changes in appetite difficulty concentrating and fatigue—things that can also be associated with menopause. if you are having any of these symptoms you should talk with your doctor or gynecologist. they can help you sort out what may be causing you to feel this way. then you can get back to enjoying life again.

### Human:\nhow bad do the symptoms of depression have to be to get ect (electro-convulsive therapy) treatments?\n\n### Assistant: ect is generally performed by a psychiatrist at a hospital. you can have your general doc or your psychiatrist refer you to an ect expert psychiatrist. they meet you go over info about ect and set it up if you are a good candidate. it is a bona fide and good treatment for certain individuals. it is no longer barbaric with patients thrashing around having full body seizures. basically you are under anesthesia and your brain has a seizure and your body does not. info about side effects are noted on the link noted. other links: www. acnp. org/g4/gn40100010<negative_smiley>default. htm for those who like medical jargon www. nami. org/content/navigationmenu/advocate_magazine/e-newsletter/20065/gma_transcript. htm for those who like stories

### Human:\nwhat are some easy excersises to do at work? . i work in a call center. i am in desperate need for some light activity through out the day. i try to get out and walk on my breaks but is there anything i can do at my desk to not only keep me active but to keep me awake as well?\n\n### Assistant: sitting all day at a sedentary desk job can increase your risk for heart attack or stroke and can increase your risk of developing many other different health conditions. therefore it’s important to incorporate as much physical activity as possible throughout the day. first discuss your concerns with your employer to see how they may be able to help address your concerns. if your employer allows try setting up your desk so that you can occasionally stand while performing your normal work functions as some studies have demonstrated standing to be more favorable compared to sitting. although expensive some employers have been willing to equip their office with a treadmill desk that their employees can sign-up for and take turns using throughout the day. also set regular intervals to get up and walk around the office for five to ten minutes. frequent small breaks can help break up the prolonged sitting that is so detrimental to your health. try using a restroom or break room on an opposite side of the building or on a different floor altogether. try doing desk exercises as well. check out this article from webmd for ideas on how to incorporate stretching and exercise at your desk. stay active on a lunch break by taking advantage of any on-site or nearby fitness centers or even dedicating some time to go for a walk. remember every little bit counts. walking on your breaks is an excellent choice. however you might also want to work in some strengthening and stretching exercises as well. strengthening exercises (begin with one set of 10-15 repetitions and increase up to 3 sets of 15 repetitions for each exercise) 1. sit to stand: just like it says stand up then sit down. 2. body weight squat: with your feet shoulder width apart squat down as far as comfortable and then stand back up. 3. push-ups: yes just like you did in pe class back in the day. if you can't do them on the floor do standing push-ups standing an arms length from a wall bring your arms to chest level and lean into the wall so your hands are touching the wall then perform push-ups just like you would if you were lying on the floor. 4. floor crunches: lie on the floor with your feet flat knees bent and your hands clasped behind your head slowly lift your upper back off the floor pause and then lower down to the starting position. for some additional suggestions click on the links below the bonus is they are videos so you can see how to perform the exercise with perfect form decreasing the chance of injury. <link> <link> don't forget to stretch sitting hunched over in front of a computer day after day is a sure fire recipe for low back shoulder and neck pain. repeat each stretch 3 times 1. half moon stretch: seated at your desk sit up straight with both feet flat on the floor raise your arms over your head with your fingers pointing to the ceiling lift your torso up and then gently bend at the waist to one side (hold for a count of 10-15) return to the middle then repeat on the other side 2. chest stretch: sitting up straight in a chair with both feet flat on the floor and your back unsupported move your arms behind you then if you can clasp your hands. next gently raise your arms or hands to the ceiling while keeping your back straight. (hold for a count of 10-15 seconds) 3. neck rotation: sitting straight in your chair slowly turn your head to look over your shoulder hold for a count of 5 then turn your head back to the center and turn to the other side. for some more stretching ideas click on the link below: <link> try these and see how they work. however if its been a long time since you've exercised or if you have a history of illness or injury be sure to check with you doctor before starting.

### Human:\ni am unemployed and can’t get insurance. i have social anxiety gad and depression. how can i get help i can't afford?\n\n### Assistant: a lack of insurance and an inability to pay more than a minimal amount should never prevent you from getting the help you need and deserve. licensed professionals including psychologists have an ethical responsibility to take a number of "pro-bono" cases. this means for little or no fee. of course there is a limit to the number of these cases that anyone can take but it's worth asking. you can call your local psychologists association explain your situation and ask for the names of psychologists in your area who would be willing to help you. you can also check social service agencies as well as any major hospital center because these entities generally have access to mental-health providers who require minimal fees. hello -- in the depression community <link> (first and tenth posts) we have a list of resources for finding free/low-cost medical care including counseling. take a look there for some other ideas. i'm so sorry you are suffering such heartache. -- susie margaret

### Human:\nwhat are some tips for getting started exercising if i am depressed?\n\n### Assistant: when you first start your exercise program you should plan a routine that is easy to follow and maintain. when you start feeling comfortable with your routine then you can start varying your exercise times and activities. here are some tips to help you get started: choose an activity you enjoy. exercising should be fun. put your exercise routine into your schedule. if you need reminding put it on your calendar. variety is the spice of life. make sure you vary your exercises so that you don't get bored. check your local gymnasium or community center for an assortment of exercise programs. don't let exercise programs break the bank. unless you are going to be using them regularly avoid buying health club memberships or expensive equipment. stick with it. if you exercise regularly it will soon become part of your lifestyle and will help reduce your depression. exercise can be a very effective way to help treat or manage depression. to begin find something that you enjoy and start out slow. it’s important to set realistic goals and expectations too so that you’re not setting yourself up for disappointment or failure. developing a good consistent exercise routine takes time so don’t overwhelm yourself by trying to do too much too soon. above all else don’t be hard on yourself. it’s very common for people to have lapses and setbacks as they begin to establish an exercise routine. learn from your mistakes and try your best to move forward. exercise is meant to be a very relaxing and pleasurable experience that can help ease your symptoms of depression. have fun and enjoy!

### Human:\nwhy do i get so tired after exercising? . i haven't gone out and done physical activity for about a month so i just went out for a nice and easy power walk for about 50 minutes. i come home and suddenly i just feel sluggish and exhausted. i don't starve myself. i eat when i'm hungry and when i need to eat. i get super tired and when i come home i just knock out. because i get so tired i don't like to exercise when i have school. it's been affecting my health and my body. i really want to exercise daily. help please <negative_smiley>\n\n### Assistant: maybe you could start with smaller bouts of exercise instead of 50 minutes. start walking for 5 minutes per day and as you feel stronger increase to 10 and so on. make sure you eat something about 30 minutes before exercising like a banana yogurt or granola bar. if you are low on glycogen (stores of carbohydrates in muscle) it could increase your tiredness after exercise. if you continue to feel tired without a good reason visit your healthcare provider for a full blood work-up. certain nutrient deficiencies like anemia can also make you tired. hey there can be a lot of reasons for all this happening to you 1. first of you should must adjust carbohydrate quantity and qualityin your diet 2. your muscles are also not strong enough as you dont do workout regularly 3. may be you are not well hydrated. take fluids with essential electrolytes before during and after exercise. 4. start working out regularly or alternatively one day rest and the next workout. 5. always do a little warm up before exercise and stretching after the exercise. 6. eat proteins a bit more than you normally eat so that your muscles can develop. 7. take at least 8 hours sleep a day which should must have a ciesta of 1 to 2 hours. 8. take a cup of coffee an hour before doing exercise this will boost your metabolism and keep you vigilant for a couple of hour at least. 9. and at last your tiredness can also be a result of some medical condition like hypothyroidism or some metabolic disease i am a 5 year med student i was skinny a 2 year before and same things used to happen to me then i started using the techniques that i mentioned above and it really improved my stamina my muscle size and my mood especially i gained 10 kg of weight without any increase in my waist. that was a just a brief overview of the solution to your problem if you want details of all this i am here to help you muhammad noman imtiaz cuba nomanimtiaz@ucmex. vcl. sld. cu i have chronic fatigue syndrome and exercising makes me worse. it's called "exercise malaise". i don't know if that's what you have but i would ask your doctor. i like yoga. i always feel rejuvenated after yoga.

### Human:\nhow long does xanax stay in your system?\n\n### Assistant: alprazolam (xanax) is an anxiety-relieving medicine that starts to work within about an hour after taking the pill. the level of drug reaches a peak in the bloodstream after one to two hours and its felt effects last on average about 5 hours. however xanax remains in the bloodstream long after its anti-anxiety effects have worn off. xanax’s average half-life is 11 hours. this means that it takes an average of 11 hours for the body to eliminate half the xanax dose. in older or obese people or those with liver disease xanax’s half-life is longer as long as 40 hours. it takes several half-lives to eliminate a drug completely. so for most people there may still be a small fraction of xanax in your blood two days or more after taking a single pill. people who take xanax on a regular basis maintain a higher drug level in the bloodstream and it could take several weeks to eliminate all the xanax from the body. xanax is excreted from the blood into the urine and is detectable in drug tests. different drug tests have different sensitivities and may or may not detect a low level of xanax in the urine. how long does xanax stay in your system? i know everyone is different but this is my story. i don't take xanax but i took 1 mg a day for 7 days straight and than stopped completely my system was totally clean before i started taking them. my job does test so i had purchased some drug screen urine test cards for benzos just to see how long it would take before it got out of my system. i figured probably 72 hours well it actually took 8 days for my tests to start reading a negative result. thank god i wasn't tested at work. now my system is totally clean. i am 30 male 6'0" and weigh 190 lbs. so if you take them you better give yourself a good bit of time for it to clear your system it is depend on many things like body weight/height/fat level: genetic problem: liver functionality metabolic rate age here is best guide on how long does xanax stay in your system urine and blood you can read all about that. thanks i took 2 mgs 3times a day for years and it was out of my system at the end of the 4th day

### Human:\nmy cancer is in remission. how do i deal with the fear of reoccurrence?\n\n### Assistant: one of the most difficult challenges in coping with cancer is dealing with the fears of recurrence. in the jargon of cancer we talk of “remission ” which can be partial (cancer goes partly away) or complete (no evidence of cancer can be found). examples of partial remission include stage iv cancers (metastatic to different regions of the body) that reduce in size as detected by tests such as cat pet or bone scans; complete remission may be obtained at surgery (for early stages of breast colon prostate lung etc. ) which is often followed by some type of chemotherapy or hormonal therapy to prevent a cancer relapse or recurrence. so whether a person is living with an active cancer or has been told they are “cancer- free ” the possibility of the cancer returning or reactivating is very real. it takes work to deal with the fears of recurrence. the first step in doing so is to acknowledge the reality of the situation — not to bury it mentally and ignore it. but it is not helpful to focus on it again and again; it is important to “live for today ” as i have recently blogged about. there are many other helpful coping strategies and helpful individuals experienced in this field. finally i would encourage all cancer patients and their loved ones to attend a support group led by an experienced professional such as an oncology social worker or family therapist. rather than inciting more fear bonding with other survivors can be a great comfort. individual counseling should also be sought out especially for those who have private concerns that they would not like to share with others. most cancer centers have counselors available free of charge; there are also other organizations that have support groups and counseling such as cancercare or gilda’s club. i have had cancer twice in 5 years and i now in remission with my second cancer. how i deal with it is to take one day at a time and hope for the best. try to do exercising everyday and try to eat healthy and hopefully that will help. it's really hard. you will have your good days and bad days. try to keep busy. another thing is to look on the bright side such as your family friends. they're there for you and if that don't help try to seek some help through the cancercare. gov. they have been good for me. there is a lot of information etc that is very helpfull. you might even want to join a group session.

### Human:\ni am a 6'3'' 20- year-old male at 175 pounds and want to lose fat and weight. but how do i overcome my fear of food?\n\n### Assistant: i have worked with many men and women who demonstrate a fear of food. the root cause is psychological and often resonates around control issues complicated by anxiety and depression. you're already quite thin yet you want to drop fat and weight. why? think back to when you made that decision. it sounds as though you've had the fear for a while and that you may already be a chronic food restrictor. i'm quite concerned about your desire to shed weight. you absolutely should be working with a therapist who is expert in eating disorders. these experts will help you tease apart your unique situation and develop a strategy to create a healthier relationship with food. go to the web site for the international associaton of eating disorder professionals and find a therapist in your location. you really need to speak with someone as soon as possible. if you can't find anyone see your doctor and let your medical team find someone for you.

### Human:\nshould toddlers take vitamins with omega 3 and vitamin d3\n\n### Assistant: that depends on their diet. most kids need supplemental vitamin d because it not found naturally in many foods and the sun is not reliable. the american academy of pediatrics recommends supplementing with d for children not receiving enough through diet. it would take 6 cups of milk to get the 600iu recommended -- and that would be too much milk for kids anyway. as for omega-3 fatty acids i assume your referring to dha which is important for health and brain development in babies and young toddlers. if a toddler eats fish about twice a week (small portions) than it's not needed. if he doesn't eat any fish you may want to consider supplementing. fortified foods have some but not as much as in fish.

### Human:\nwhat foods have the highest levels of pesticides?\n\n### Assistant: here is a list of the "dirty dozen " according to the environmental working group: peaches strawberries apples nectarines pears cherries red raspberries imported grapes spinach celery potatoes sweet bell peppers

### Human:\ndoes saliva kill sperm?\n\n### Assistant: remember that sperm were designed to live in a moist warm environment with a certain ph. thus even though a bath tub/hot tub is a warm moist place water by itself (as opposed to a bath tub of normal saline) can hurt sperm by causing them to absorb unwanted water (osmotic shock). additionally hot tubs usually have chemicals which can change ph and add toxic to sperm chemicals. even the use of soap can strip sperm’s protective cell membranes off. sperm on hard surfaces remain mobile until they have dried out. the time for this to occur depends upon the environmental temperature and humidity. sperm are destined to swim in vaginal secretions and cervical mucus. a towel or men’s boxer shorts provide a barrier which is not occlusive as latex but it slows down sperm movement as some of them end up in the fabric where they dry out. laundry soap and hand washing will kill sperm on clothes and on fingers. sperm in the mouth have to contend with the enzymes in the saliva. suffice it to say that sperm outside the vagina or male reproductive organs will have a more difficult survival--at best 30 to 120 minutes under the most ideal conditions. that coupled with the need for an ovulating female makes pregnancy from this cause unlikely. hi this is not an answer but a queston i hope can be answered by a professional. i woke up and for some reason ejaculated in my sleep. i was with my girlfriend and she performed oral sex for a few min until i remembered what had happened. i went to the bathroom and used some soap and water quick to wash my penis and rinsed it after with a alittle water. then she performed oral sex briefly again and we had sex. is it a legitamite possiblilty that she could be pregnant? i did not come close to finishing we were intrrupted thanks

### Human:\nshould you take your depression medications at the same time every day?\n\n### Assistant: it makes sense to take them at same time each day but it is not 100% necessary. antidepressants are made to work with each tablet. for example if you take it one day you are not depressed and if you miss a day you get depressed. they are not 'on/off' switches. the idea is to take antidepressants every day so they build up in your system and then they start to work 4-6 weeks later as a cumulative effect over time. .

### Human:\ncan zoloft cause intrusive thoughts?\n\n### Assistant: interestingly zoloft is designed to take away suicidal thinking and obsessions and is fda-approved to remove symptoms like these when associated with depression or ocd. now every now and then it does work in reverse especially in those under age 25. so if it is making you worse call your doc and get advice on how to lower off it.

### Human:\ni was diagnosed with uc in 2011. i'm obese and considering gastric bypass. can i have the surgery with my condition? . i have tried every diet out there but nothing has worked for me. i would like some facts on if this is safe.\n\n### Assistant: the best thing to do if you are serious about weight loss surgery is to visit a bariatric surgeon's office. these clinics have a team of people including the surgeon dietitian psychologist and nurse. the doctor can inform you if he things you are a candidate from a safety perspective and sometimes insurance requires a 6-month program first. these professionals are experienced in helping people like you make the right decision. also see i s weight loss surgery for you? good luck!

### Human:\nhow to gain weight back from unexpected weight loss also having fatigue and nausea? . i have had an ongoing anxiety disorder for 3 years. i've finall found a med combination that works for me. venlafaxline and bupropion. i had been on the bupropion for about a year before so one drug was new. before i started this drug i started having unexplained naused food eversions and lots of fatigue i have dropped my weight from 105 to 91 pounds. am a personal trainer just trying to put on muscle but nothing is helping! i feel like im constantly forcing myself to eat. hcg= neg tsh= normal\n\n### Assistant: the key is to get the cause of the weight loss under control which it sounds like have started to do. as for weight gain you need to make food and eating a priority. frequent meals (5-<positive_smiley> may work better especially if you still having nausea. take advantage of the times your appetite is high which for most people with nausea is in the first half of the day. provide yourself with as many food groups as possible when you do eat-- grains protein dairy (or alternative) healthy fats and fruits and vegetables. so instead of just cereal in the morning top it with nuts and fruit and also have a boiled egg. at snack time have full fat yogurt with nuts and graham crackers. make sure you up the fat where you can such as adding a fat source to sandwiches like sliced avocado mayonnaise nut butters or hummus. add full fat dairy products to smoothies and soups and butter or nut butters to toast. protein sources are beneficial such as meats tuna (packed in oil) and beans. with time and vigilance you can get your weight back up. for more tips on healthy ways to gain weight see this webmd article. good luck!

### Human:\ncan a male alcoholic pass on the disease to fetus\n\n### Assistant: some people feel that genes related to addiction can be transmitted to the offspring since alcoholism can run in families. it can be very difficult to say what human characteristics are genetic versus environmental factors. growing up in a family that has more than their share of alcoholism i can certainly say that it never surfaced in me. i actually detest alcohol. alcoholism is classified as a disease and certain characteristics in our personality can be genetically transmitted but to worry that a male alcoholic would create an alcoholic child would be a stretch at this point. an alcoholic. one who continues to drink. would not make a good father/husband for lots of reasons.

### Human:\nfruit is big part of my diet but i'm having issues with urge intontinence. what fruits won't irritate my bladder? . i recently saw a urologist for having severe issues with urge incontinence feeling like i had to go as frequently as every 10 minutes. he determined stress in my life was causing my muscle around my bladder to flex. i've recently been put on anxiety and stress medication which seem to be helping with that but the urge incontinence is still pretty bad a lot of the time. i've read a ton of fruits which are a huge part of my diet can cause bladder irritation. what fruits are best/safest to eat?\n\n### Assistant: the most problematic fruits that irritate the bladder are citrus fruits like oranges grapefruit lemons and limes. fruits that aren't acidic like pears apples grapes and melon are better choices. for more on trigger food and drinks see this webmd article.

### Human:\nis a vegan diet healthy for my 3 year old son?\n\n### Assistant: with careful planning a vegan diet can meet the needs of your child. but you do have to be more vigilant about key nutrients such as iron zinc calcium vitamin d vitamin b12 and dha. because iron and zinc are not absorbed as well in plant foods include higher-than-recommended amounts. adding vitamin-c rich sources (strawberries tomatoes/tomato based products oranges kiwi and broccoli) to help absorb iron from fortified foods and plant sources. vegan children need a supplemental source of b12 (either fortified foods or supplements) because it only occurs naturally in animal foods. here are vegan foods sources for key nutrients that are important to stay on top of: vitamin b12: fortified nutritional yeast fortified cereals fortified soymilk meat analogues and supplements. iron: iron-fortified cereal beans tofu spinach raisins and enriched bread. zinc: cashews chickpeas oatmeal almonds beans and peas (be careful with nuts which are choking hazards) vitamin d: fortified foods (like soy milk) and supplements. the american academy of pediatrics recommends supplementation for children who don't get enough from diet. the recommended amount is 600iu. omega-3 dha: not naturally found in plant foods but can be found in some fortified foods and supplements. calcium: tofu made with calcium sulfate fortified soy milk/yogurt turnip greens kale fortified cereals a vegan diet is perfectly healthy for your son. you can get a complete diet based on the food pyramid if you are a vegan. here is how: grains - all natural forms of these products are vegan. if you buy processed foods you will need to check all the labels as some often contain animal products. be careful as some products use terminology that does not make it explicit that they are animal products. i recommend that you check an official vegan website for some of this terminology like sheffafoods veganfoods and many more you can do some online searches to find the relevant information. dairy: if you are a lacto vegan you can eat most dairy products. milk is not an animal so you might be okay with this. you will need b12 supplement if you are pure vegan; it is supplied in soy milk. drink it daily if you are pure vegan. if you ask me animal protein can't be replaced by anything else! so i would say that a vegan diet would not be a good idea especially for a 3-year child!

### Human:\ndoes 2 or 2 1/2 glasses of wine a day caues high blood preasure?\n\n### Assistant: although consuming a moderate amount of alcohol can have some potential health benefits drinking too much alcohol can raise your blood pressure. a moderate amount of alcohol consumption per day is considered 2 servings for men (under 65 years old) and 1 serving for women and men over 65 years old. a serving is considered: 12 ounces of beer 5 ounces of wine or 1. 5 ounces of 80-proof distilled spirits so the answer to your question depends on if you’re male or female how old you are and whether you’re having an appropriate serving size. if you’re already an alcohol drinker small amounts of alcohol may actually lower your blood pressure but this isn’t to suggest that you start drinking if you don’t already. the potential benefits of alcohol need to be weighed against the possible detrimental health effects since consuming alcohol can lead to other health problems too. this would be an area to discuss further with your doctor. drinking too much alcohol in one sitting can temporarily raise your blood pressure and drinking too much on a regular basis can cause long term blood pressure problems. keep in mind that consuming excess alcohol can also increase calorie consumption which could possibly lead to weight gain another risk factor for hypertension. it’s typically not recommended to start drinking alcohol if you don’t already and it’s important to limit alcohol consumption to moderate amounts if you already consume alcohol. no yes yes if its a women.

### Human:\nwhat types of problems can x-rays detect?\n\n### Assistant: in adults dental x-rays can be used to: show areas of decay that may not be visible with an oral exam especially small areas of decay between teeth identify decay occurring beneath an existing filling reveal bone loss that accompanies gum disease reveal changes in the bone or in the root canal resulting from infection assist in the preparation of tooth implants braces dentures or other dental procedures reveal abscesses (an infection at the root of a tooth or between the gum and a tooth) reveal other developmental abnormalities such as cysts and some types of tumors in children dental x-rays are used to: watch for decay determine if there is enough space in the mouth to fit all incoming teeth determine if primary teeth are being lost quickly enough to allow permanent teeth to erupt properly check for the development of wisdom teeth and identify if the teeth are impacted (unable to emerge through the gums)

### Human:\nhow can i age with vigor?\n\n### Assistant: in 2008 i was asked to lead a half marathon team for more magazine’s annual spring run in central park. my team of peeke performers was comprised of women who were cancer survivors and included women who had triumphed over cancers of the breast thyroid lung and bladder. one woman ran with just one lung and did great. all of these women were extraordinary but one was a real character. that’s elaine doll dunn. like me she’s got a wicked wit and plenty of sass. tall and regal she looked ageless and in reality was 71 years young. she carried herself with grace and elegance but her impish grins gave away her real personality— a powerful survivor who brushed off her bladder cancer as a speed bump along a winding hilly and joyful life journey. that’s elaine. we did lots of pr for the half marathon including a segment on "good morning america. " her one-liners kept me laughing and her endless energy was astonishing. after completing the half marathon elaine insisted i come to south dakota and keynote her marathon in the spearfish canyon about 45 miles outside of rapid city. to sweeten the deal she informed me that the marathon weekend coincided with biker week where over 250 000 harley enthusiasts descend upon the town of sturgis (not far from spearfish) and basically rally tour the countryside and yes indeed have a party or two. i had a funny feeling she would become quite a fount of enlightenment for me. and i was right. as you know by now this coming sunday august 22nd i’ll be competing in the iron girl triathlon with a group of my patients the peeke performers. i was thinking about this upcoming race as i addressed elaine’s marathoners who were experiencing the usual pre-race day blend of anxiety and excitement. as i looked around the room i noticed that at least half the crowd of runners was women well into their 60’s and beyond. and i knew why. presently 73 years old elaine has been a living inspiration for women who dared to push their envelope at any age. and she’s been doing this for many years. her motto is: “i postpone death by living by suffering by error by risking by giving by loving. ” anais nin here’s a quick sampling of her achievements. at each age she: 52 — climbed 900 foot devil’s tower in wyoming 53 — had a major role in last of the red hot lovers. 54 — placed second in a body building contest that was not age grouped! 55 — ran the centennial trail 113 miles across south dakota from wind cave national park to the top of the sacred bear butte 56 — was challenged by bladder cancer and won. 57 — married jerry dunn during the disney world marathon and finished the race. they were interviewed on the today show just after the ceremony at the magic kingdom. 58 — climbed mt. kilimanjaro and won the marathon there the day after we got off the mountain. 59 — won the swimsuit competition in the golden times newspaper and was featured on the front page and as the centerfold. 60 — ran from the atlantic to the pacific ocean across panama 60 miles to celebrate her 60th birthday. 61 — became mrs. south dakota and participated at the national level for mrs. america. she was 30 years older than the other contestants. 62 — ran a marathon of marathons 26. 2 marathons in the year 2000. one of these was completed with three of her children who were running their first marathon. 65 — completed a doctor of philosophy in psychology researching the self-efficacy of women who begin marathoning after the age of 40. 71 — was the recipient of the spirit of dakota award annually honoring one woman whose leadership qualities courage strength and community commitment illustrate the best of south dakota womanhood. alright elaine’s quite an exceptional woman and i’m not asking anyone to start rock climbing at the age of 60 or pick up marathoning. however i just wanted to drive home the point with my velvet sledgehammer that it’s never ever too late in life to wake up get up and challenge yourself for mental spiritual and physical growth and fitness. become fearless and don’t be afraid to put it out there no matter your age. here’s the lesson. never say “i’m too old to do that. ” old is an attitude that gets in the way of living your life to the fullest. approach new challenges you may want to participate in with this phrase on your lips “that sounds interesting. i’ll give it a whirl and see what happens. ” don’t look at numbers. focus on the quality of every breath you take. age is after all just a number.

### Human:\ni've had almost no appetite for several months and am losing an unhealthy amount of weight. how to reverse both losses? . i've had no appetite for maybe three or four months. i have a history of anorexia but this is unintentional. i buy cook and order food i want to eat but the second it's in front of me i can't eat it. i recently moved took a less stressful job and am at a lower level of anxiety than i've ever been before but my jaw clenching is coming back and i can't make myself eat. i've lost a lot of weight and my starting point was already pretty thin. i'm five foot two inches and weigh around 90 lbs\n\n### Assistant: because of your history of anorexia its best to see someone who specializes in eating disorders to rule out relapse. even if you feel this is not the case doing so is in your best interest. if that leaves you with no answers you can get a physical to check the potential medical reasons for decreased appetite. for now when you do have an appetite take advantage of it. if breakfast is when you are the most hungry eat a full big breakfast. notice times your appetite changes and follow along. consider adding frequent meals throughout the day. meditation and mindfulness also can help. take care of yourself. anorexia with unintentional weight loss should not be ignored. this can be due to some severe ailment/condition. better visit your physician and get yourself checked up.

### Human:\ncan certain medications cause diabetes?\n\n### Assistant: yes. there are several classes of drugs that may increase blood sugar levels and thus increase the risk for diabetes. some of these are: • statins: these are very effective medicines that reduce cholesterol. they reduce risk of heart attack and stroke. these include atorvastatin (lipitor) simvastatin (zocor) rosuvastatin (crestor) fluvastatin (lescol) lovastatin (mevacor) and pravastatin (pravachol) • thiazide diuretics: these are a type of water pills that are sometimes used to treat high blood pressure or swelling. hydrochlorothiazide or hctz is a common example. • steroids: these are anti-inflammatory medicines such as prednisone and cortisone. they also include anabolic steroids used in muscle building. • beta-blockers: they are used to treat high blood pressure and certain heart problems including heart failure. they are also used after heart attacks to increase survival rate. examples include carvedilol (coreg) propranolol (ideral) metoprolol (toprol and lopressor) nadolol (corgard) and atenolol (tenormin). • atypical antipsychotics: these are used to treat a variety of psychiatric illnesses. these medications may cause weight gain and increase the risk for diabetes. they include: olanzapine (zyprexa) risperidone (risperdal) aripiprazole (abilify) and ziprasidone (geodon) in many cases the benefits of using these medicines outweigh any risks. only your own doctor can help you decide what medicine is right for you. never stop any medicine without first talking to your doctor. statins may be very effective at stopping our body from producing natural endogenous cholesterol but they are not very effective in stopping heart attacks according to the medical research i have read. this may be due to the fact that cholesterol is not the cause of arteriosclerosis; cholesterol buildup in the artery walls is caused by inflammation. forcibly lowering cholesterol causes other problems too numerous to list here. other than this important point the answers to the question seem to be accurate but the standard knee-jerk response that statin drugs are useful as a blanket approach to high cholesterol is outdated and misguided. it should be corrected. a study from brigham and women's hospital in boston published in july 2012 found a link between phthalates commonly called "plasticizers "and diabetes in women. researchers analyzed urinary concentrations of phthalates in 2 350 women aged 20 to 80 participating in the government-sponsored national health and nutrition examination survey and found that those with higher levels of phthalates in their urine were more likely to have diabetes than those with low levels. phthalates are found in medical products including tubing iv bags and some medications diabetic link does exist. can certain medications cause diabetes? maybe

### Human:\ncan antidepressants cause weight gain?\n\n### Assistant: most of the antidepressants and probably all of the mood stabilizer[s] can and do cause weight gain. bupropion -- commonly known as aplenzin wellbutrin or zyban -- usually does suppress appetite and can result in less weight gain than other antidepressants. within each family or class of meds there are some that are more weight-gain prone and others that are a bit more friendly. ask your doctor specifically about the more weight-friendly ones. also be careful in that weight gain may lead to diabetes and cholesterol problems. if you have gained ask your doctor to check on these and blood pressure too.

### Human:\ni have tried four different medications for depression. am i not giving these medications time to work? . each had side effects that caused me to stop taking them. should i continue to search for a new medication?\n\n### Assistant: there are 20 different meds you can try and sometimes it make sense to go until you find one that fits a bit better. you likely did not try them long enough and yes sometimes you get [the] worst first. but you have others you can try. psychotherapy has no side effects; ask to be referred to a psychologist for counseling perhaps.

### Human:\ni'm 40 and divorced afraid to date and have no friends. this happened when i was 17. i quit therapy. what should i do?\n\n### Assistant: it would seem as you say that you do have a pattern of being unable to make social contacts easily. since this is a long-standing problem it would appear that therapy would be most beneficial. sometimes people don't realize that it is actually easier to meet people than they ever thought. for example if you were to join some type of volunteer organization you would quickly meet many people and you could make a decision as to whether or not you wanted to have more of a social relationship with them. if not you could just go for the volunteer opportunity which would enable you to handle your possible social anxiety better. in any case you are lonely and you would like to have some friends and some social connections. i'm not sure why you left therapy but perhaps the person that you were seeing wasn't able to provide what you needed. not everyone who provides therapy is going to be a good fit for every purpose. i would suggest that you reconsider re-entering therapy either with the person you saw before or seeking out someone new. i do believe this should be part of your future-oriented solution for yourself.

### Human:\ni've had panic attacks since 2005. no medicine has helped and it's ruining my marriage and my life. what can i do?\n\n### Assistant: since it's now been five years since you had your first panic attack and you said you've tried many medications without success i'm wondering who was doing the prescribing. sometimes it takes a combination of more than one medication for you to get relief from persistent panic attacks. several other things which can help in controlling anxiety include regular mild exercise. proper diet access to social activities outside of the home positive self talk and relaxation breathing. getting yourself out of the home and having some time for yourself is always a good idea. that's where a yoga class or even one for tai chi would be good because it accomplishes two things; it gets you out and it provides exercise that is physically and emotionally relaxing. try some of these things and see how helpful they can be. it may take a few weeks but it's worth the effort.

### Human:\ni feel completely alone even when around others. i am seeing a psychiatrist psychologist and take meds. what can i do?\n\n### Assistant: sorry you feel this way. i am not sure what type of meds you are on what type of therapy you are getting so cannot tell if you have been getting treated long enough or are on appropriate doses. i would suggest you be up front ith your providers that you really are no better and ask them to be more aggressive with your treatment. sometimes when you drift off like this and get these feelings do something to get grounded. stop what you are doing and count to 10. something simple like this might bring you back; get the ipod out turn it to 11 and crank out a favorite song; write down something on a 3x5 card (for example "i am not alone i have the following folks who care about me. "). real simple stuff like this might act as a circuit breaker to pull you out of these funks.

### Human:\ndo dna skin repair products really work?\n\n### Assistant: up until fairly recently the only way to reverse sun damage was to have laser treatments chemical peels or use retinols and prescription tretinoin creams. a revolutionary innovation in the cosmeceutical industry is changing that. now all you may need to do is go to your drugstore or department store and look for products that contain dna repair ingredients. these ingredients now come in every product imaginable — creams lotions serums sunscreens. and here’s the wonderful thing: they really do work. dna skin repair ingredients are usually based on enzymes derived from a variety of sources including plankton and plants. most of the major skin care companies are already selling dna repair products and are closely following the new research. all these products seem to improve the skin so it is not necessary to buy the most expensive one. these enzymes work by restoring dna that has been damaged by free radicals most often caused by sun exposure pollution and other environmental factors. dna damage is what causes sagging wrinkles and rough-textured skin. in other words it’s what makes you look old. dna repair products don’t seem to fade brown spots though and though they soften fine lines they won’t have the dramatic effect of botox or hyaluronic acid fillers that plump deep creases. still people really notice a difference after a few weeks of using these products and they are usually happy with the results. one of the advantages of most dna repair products is that unlike tretinoin and retinols (which should only be used at night) they do not interact with sunlight and can be used during the day. in fact a few sunscreens already include dna repair ingredients. although the research is still coming in this may be the wave of the future in sun protection.

### Human:\ncan antidepressants help get the serotonin in your brain back in sync?\n\n### Assistant: serotonin is one of a few chemicals that may be low in depression but depression may be due to genetics stress and your personality or coping style. some of us think that psychotherapy actually exercises the front of the brain which helps to increase many of the chemicals that are low. so psychotherapy changes chemical levels too perhaps. if counseling has routinely helped you keep doing it. if it fails to help then a med may be called for. unfortunately i see that the more depression spells someone has then often they do end up on a med more often.

### Human:\nmy son brought home cell-tech hardcore pro series dietary supplement. are there any risks or dangers from this product?\n\n### Assistant: to determine if this product is right for your son’s age and developmental stage it is important to obtain an ingredient list of all the vitamins and minerals that the product contains. depending on his age it may not be wise to give him a supplement for muscle building that is high in protein. check with his pediatrician or physician to see if it is the right supplement for him.

### Human:\nhow to increase brain power? . drinking water is essential if you wish to stop being fat. being properly hydrated maintains feeling of well-being that allow for you to definitely stay inspired. drinking water consistently will mean would not brain booster pills become thirsty. this is dangerous as thirst can be mistaken as a rule as craving. replacing soft drinks with water will reduce the quantity you consume dramatically. mental health professionals :>>> <link>\n\n### Assistant: please be respectful of this important webmd medical information sites and not post advertising that takes up valuable space from individual seeking responses to their medical questions.

### Human:\nwhy am i always hungry?\n\n### Assistant: most people are not always hungry. just after eating the body releases chemicals into the bloodstream and directly onto nerves that create the sensation of satiety or feeling full. there are many causes for an increased appetite: increased activity (exercising) boredom feeling sad or blue high life stress mood disturbance (depression or bipolar disorder) oral corticosteroids an eating disorder (anorexia or bulimia) an overactive thyroid gland (hyperthyroidism). eating low-calorie foods sugary junk foods or low-fat foods can make you feel hunger that’s more intense and comes on sooner after eating. foods with whole grains healthy fats and proteins are more satisfying take longer to digest and stave off hunger pangs longer.

### Human:\nmy father constantly criticized my mother. as a child i tried hard not to be like her. how can i learn to love myself?\n\n### Assistant: it sounds like you have some insight into the issue at hand. it is often more complex and i wonder if you would do well seeing a psychotherapist? generally they could work with you in more depth with this and help you get some closure and move on. i'd suggest using your insurance call them or go their web site. look up mental health services and you want a phd psychologist. start calling them and tell them you are looking for a therapist that uses analytical or dynamic techniques as i think this approach may match your insight and your issues. if they say they do this type of therapy approach go see them weekly for 3-12 months and see how it goes.

### Human:\ni'm going to the dentist for a root canal and i've had a few glasses of wine. will this be a problem with the novocaine?\n\n### Assistant: it is never a good idea to drink alcohol right before a dental appointment. alcohol affects your blood clotting system and depresses the central nervous system. not to mention how it can affect your in-office behavior. if you have anxiety it is much better to tell the dentist beforehand and so you can discuss your options.

### Human:\nhow do i become a better runner as someone with moderate experience running?\n\n### Assistant: don’t get stuck constantly doing the same thing. challenge your current routine by experimenting with different types of runs. for example incorporate long runs to build endurance intervals to increase speed or hills to increase strength. you might find that experimenting with these different types of runs can add to the enjoyment you experience while running and can help to promote better running performance. next consider occasionally doing cross-training which in this case means doing exercise other than running. for example try adding swimming biking or strength training to your current exercise routine. cross-training helps to prevent burnout whether physical or mental and can help prevent overuse injuries. sometimes repeatedly doing the same exercise can be monotonous and redundant and you might get bored and want to discontinue with your exercise. adding variety to your routine can help keep exercise enjoyable for you. finally allow yourself time to rest and recover. over-training can hurt your progress and lead to injury such as stress fractures. resting is as important as the time you dedicate towards running.

### Human:\ni served in the navy and now have panic disorder. my family does not believe in mental illness. are they right?\n\n### Assistant: since you were in the navy i'm wondering if you are eligible for psychiatric services as an outpatient. you probably do need a complete evaluation including medical and then a consideration of what the next steps should be. i would think you need both outpatient therapy on a regular weekly basis some help finding appropriate financial assistance a place to live and perhaps medication. one thing that you definitely do not need is to be told you are either "insane or crazy. " you are not. you do need a mental health professional to advocate for you and who can help establish that you do not present a danger to anyone since you indicate that is the case. people often believe that anyone with a mental problem is dangerous and that's not so either. remember as a former service person who is now in need of help you deserve to get that help and to feel better. please see what person in the social service area can help you. if you cannot get help from anyone talk to local service person's organizations and see how they can help. very many times they do have individuals whose sole duty at the organization is to help people such as yourself get the services they need and deserve. you have served your country well and now your country owes you help.