10000 steps=5 miles

April is National Foot Health Awareness Month and research shows that approximately 20 percent of Americans experience at least one foot problem each year. These issues can be the result of an underlying health problem such as obesity, diabetes, or peripheral neuropathy.

Today Dr. Amanda Bartell and Dr. Andrew Bartell of North Florida Foot & Ankle Center in Jacksonville, FL, Southside, and Duval County are sharing their tips for happy, healthy feet!

• Examine your feet each day, using a mirror – if needed – to inspect the bottom of your feet for cracks, peeling, injuries or dry skin. This is particularly important if you have diabetes to avoid a non-healing wound.
• Wear shoes in public areas where your feet can be scratched or cut, leading to infection, athlete’s foot or plantar warts.
• Replace the shoes you wear to exercise every six months or 500 miles to avoid heal and foot pain when the inside of the shoe begins to lose support.
• Stretch your ankles, lower legs and feet daily and before any activity to avoid injury.
• Thoroughly dry your feet and between your toes after bathing to reduce the risk of fungal infections. Follow up by applying a good moisturizer.
• Don’t leave polish on nails all the time as it can lead to fungal toenails.
• Apply sunscreen on ankles and between toes to avoid sunburn and guard against skin cancer.
• There is a good chance you will not wear the same size in shoes your entire life, so have them measured on a regular basis.
• Maintain a healthy weight because extra weight puts pressure on the feet, often causing heel or foot pain, circulatory problems, arthritis, and stress fractures.
• Try to wear shoes with good support and a low heel and use custom orthotics to provide proper arch support.

“A good laugh has great short-term effects. When you start to laugh, it doesn’t just lighten your load mentally, it actually induces physical changes in your body.

Laughter or humor in short term changes it does this to the body:

• Stimulate many organs. Laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs and muscles, and increases the endorphins that are released by your brain.
• Activate and relieve your stress response. A rollicking laugh fires up and then cools down your stress response, and it can increase and then decrease your heart rate and blood pressure. The result? A good, relaxed feeling.
• Soothe tension.Laughter can also stimulate circulation and aid muscle relaxation, both of which can help reduce some of the physical symptoms of stress.

Laughter or humor in Long Term Effects it does this to the body:

• Improve your immune system. Negative thoughts manifest into chemical reactions that can affect your body by bringing more stress into your system and decreasing your immunity. By contrast, positive thoughts can actually release neuropeptides that help fight stress and potentially more-serious illnesses.
• Relieve pain. Laughter may ease pain by causing the body to produce its own natural painkillers.
• Increase personal satisfaction. Laughter can also make it easier to cope with difficult situations. It also helps you connect with other people.
• Improve your mood. Many people experience depression, sometimes due to chronic illnesses. Laughter can help lessen your stress, depression and anxiety and may make you feel happier. It can also improve your self-esteem.”

MAYO CLINIC (https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456)

EVER FEELING RUN DOWN?

Try laughing more. Some researchers think laughter just might be the best medicine, helping you feel better and putting that spring back in your step. “I believe that if people can get more laughter in their lives, they are a lot better off,” says Steve Wilson, MA, CSP, a psychologist and laugh therapist. “They might be healthier too.”

Recommended Related to Mind, Body, Spirit How to Get the Life You Want By Kristyn Kusek Lewis’s point of view she says:   You’ve been putting it off forever — that secret dream to start a business, write a book, run a marathon…. Whatever your desire, ignoring it means denying who you really are. And don’t you deserve better? Here, your no-excuses, no-regrets guide to answering the voice in your head that says, “I want more.” Ask yourself: Are you ready to finally tackle the burden or bad habit that’s been dragging you down? You’re many things—maybe a wife and mom, prized employee,… Read the How to Get the Life You Want article > > Yet researchers aren’t sure if it’s actually the act of laughing that makes people feel better. A good sense of humor, a positive attitude, and the support of friends and family might play a role, too.

“The definitive research into the potential health benefits of laughter just hasn’t been done yet,” says Robert R. Provine, professor of psychology and neuroscience at the University of Maryland, Baltimore County and author of Laughter: A Scientific Investigation. But while we don’t know for sure that laughter helps people feel better, it certainly isn’t hurting. Continue reading below…

Laughter Therapy: What Happens When We Laugh? We change physiologically when we laugh. We stretch muscles throughout our face and body, our pulse and blood pressure go up, and we breathe faster, sending more oxygen to our tissues. People who believe in the benefits of laughter say it can be like a mild workout — and may offer some of the same advantages as a workout. “The effects of laughter and exercise are very similar,” says Wilson. “Combining laughter and movement, like waving your arms, is a great way to boost your heart rate.”

One pioneer in laughter research, William Fry, claimed it took ten minutes on a rowing machine for his heart rate to reach the level it would after just one minute of hearty laughter. And laughter appears to burn calories, too.

Maciej Buchowski, a researcher from Vanderbilt University, conducted a small study in which he measured the amount of calories expended in laughing. It turned out that 10-15 minutes of laughter burned 50 calories. While the results are intriguing, don’t be too hasty in ditching that treadmill. One piece of chocolate has about 50 calories; at the rate of 50 calories per hour, losing one pound would require about 12 hours of concentrated laughter!

Laughter’s Effects on the Body In the last few decades, researchers have studied laughter’s effects on the body and turned up some potentially interesting information on how it affects us:

• Blood flow – Researchers at the University of Maryland studied the effects on blood vessels when people were shown either comedies or dramas. After the screening, the blood vessels of the group who watched the comedy behaved normally — expanding and contracting easily. But the blood vessels in people who watched the drama tended to tense up, restricting blood flow.
• Immune response – Increased stress is associated with decreased immune system response, says Provine. Some studies have shown that the ability to use humor may raise the level of infection-fighting antibodies in the body and boost the levels of immune cells, as well.
• Blood sugar levels – One study of 19 people with diabetes looked at the effects of laughter on blood sugar levels. After eating, the group attended a tedious lecture. On the next day, the group ate the same meal and then watched a comedy. After the comedy, the group had lower blood sugar levels than they did after the lecture.
• Relaxation and sleep – The focus on the benefits of laughter really began with Norman Cousin’s memoir, Anatomy of an Illness. Cousins, who was diagnosed with ankylosing spondylitis, a painful spine condition, found that a diet of comedies, like Marx Brothers films and episodes of Candid Camera, helped him feel better. He said that ten minutes of laughter allowed him two hours of pain-free sleep.
• Humor is infectious – The sound of roaring laughter is far more contagious than any cough, sniffle, or sneeze. When laughter is shared, it binds people together and increases happiness and intimacy. Laughter also triggers healthy physical changes in the body. Humor and laughter strengthen your immune system, boost your energy, diminish pain, and protect you from the damaging effects of stress. Best of all, this priceless medicine is fun, free, and easy to use.  Laughter is strong medicine for mind and body.
• Laughter – is a powerful antidote to stress, pain, and conflict. Nothing works faster or more dependably to bring your mind and body back into balance than a good laugh. Humor lightens your burdens, inspires hopes, connects you to others, and keeps you grounded, focused, and alert.  With so much power to heal and renew, the ability to laugh easily and frequently is a tremendous resource for surmounting problems, enhancing your relationships, and supporting both physical and emotional health.
• Laughter – is good for your health.
• Laughter – relaxes the whole body. A good, hearty laugh relieves physical tension and stress, leaving your muscles relaxed for up to 45 minutes after.
• Laughter boosts the immune system – Laughter decreases stress hormones and increases immune cells and infection-fighting antibodies, thus improving your resistance to disease.
• Laughter triggers the release of endorphins, the body’s natural feel-good chemicals.  Endorphins promote an overall sense of well-being and can even temporarily relieve pain.
• Laughter protects the heart – Laughter improves the function of blood vessels and increases blood flow, which can help protect you against a heart attack and other cardiovascular problems.

REFERENCES: 1.) Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: April 2014.  HELPGUIDE.ORG 2)  By R. Morgan Griffin   WebMD Feature  Reviewed by Michael W. Smith, MD

“You don’t have to face infertility alone. Find someone to talk to who understands through our support groups, online community, and HelpLine.  We can help you find reproductive endocrinologists, urologists, mental health therapists, and other family building professionals.We help you understand and advocate for insurance coverage and for legislation that improves access to all family building options.”

Resolve – The National Fertility Association (https://resolve.org/)

If you and your partner are struggling to have a baby, you’re not alone. In the United States, 10% to 15% of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.

Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Most couples will eventually conceive, with or without treatment.

Risk Factors to being prone to this diagnose:

Age. Women’s fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37.

Tobacco use. Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy.

Alcohol use. For women, there’s no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. With men it can decrease sperm count.

Being overweight. Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. Sperm count for men can be affected by low sperm count.

Being underweight. Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia.

Exercise issues. A lack of exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

When to take a trip to the doctor:

You probably don’t need to see your health care provider about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a care provider, the earlier the better, but if you haven’t yet go if you are:

• age 35 or older and have been trying to conceive for six months or longer
• over age 40
• having irregular or absent periods or very painful periods
• with known fertility problems
• diagnosed with endometriosis or pelvic inflammatory disease
• have had multiple miscarriages
• have undergone treatment for cancer
• have a history of endometriosis
• have a history of fallopian tube damage or blockage
• have a history of cancer and its treatment
• history of pelvic adhesions

Men should talk to a health care provider if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems

Know for many infertility can be treated with medicine, surgery, intrauterine insemination, or assisted reproductive technology.  So go to the doctor if you are having problems and they can give you direction.

“Thrombocytopenia-absent radius (TAR) syndrome is a rare disorder that is present at birth (congenital). It is characterized by low levels of platelets in the blood (thrombocytopenia) and absence (aplasia) of the long, thin bones of the forearms (radii) but with presence of thumbs. Other abnormalities are often present including additional skeletal defects such as absence or underdevelopment of the other bone of the forearm (ulna), structural malformations of the heart (congenital heart defects) and kidney (renal) defects.”

NORD National Organization For Rare Diseases (https://rarediseases.org/rare-diseases/thrombocytopenia-absent-radius-syndrome/)

Thrombocytopenia-absent radius (TAR) syndrome is a rare disorder that is present at birth (congenital). It is characterized by low levels of platelets in the blood (thrombocytopenia) and absence (aplasia) of the long, thin bones of the forearms (radii) but with presence of thumbs.

Other abnormalities are often present including additional skeletal defects such as absence or underdevelopment of the other bone of the forearm (ulna), structural malformations of the heart (congenital heart defects) and kidney (renal) defects. Affected individuals may be short for their age (short stature) and have cow’s milk intolerance.

Thrombocytopenia is congenital or develop within the first few weeks to months of life. Usually, platelet counts remain low during the first two years of life; then, they increase but do not normalize. Additional recurrent manifestations include: cardiac anomalies (atrial and/or ventricular septal defect, patent foramen ovale), gastro-intestinal involvement (cow’s milk allergy, increased susceptibility to gastro-enteritis), genitourinary anomalies (kidney agenesis or malrotation, horseshoe kidney, hydronephrosis, pyelectasis). Other rare manifestations include Mayer-Rokitansky-Kuster-Hauser syndrome, rib and vertebral anomalies, Langerhans cell histiocytosis, transient leukemoid reaction, acute myeloid or lymphoblastic leukemia. Cognitive development is usually normal.

The prevalence of thrombocytopenia-absent radius (TAR) syndrome is estimated at around 1/100,000-200,000 people.

Cause of TAR-Thrombocytopenia Absent Radius Syndrome:

TAR syndrome is inherited as an autosomal recessive genetic disorder and caused by deletion and/or variants in the RBM8A gene.

TAR syndrome is caused by compound heterozygosity for a null (most often a 1q21.1 deletion including RBM8A) and a hypomorphic RBM8A allele.  It was demonstrated that Rbm8a is an essential neurogenesis regulator in embryonic cortical development.  Most people with TAR syndrome have a mutation in one copy of the RBM8A gene and a deletion of genetic material from chromosome 1 that includes the other copy of the RBM8A gene in each cell.

Diagnosing TAR-Thrombocytopenia Absent Radius Syndrome:

It has been reported that TAR syndrome can be accompanied by craniofacial, cardiac, digestive, urogenital, and psychiatric abnormalities, as well as by lactose intolerance⁽⁴⁾. The diagnosis of TAR syndrome is based on ultrasound findings and fetal blood sampling by cordocentesis to determine the number of platelets.

Suggestive Findings. Thrombocytopenia absent radius (TAR) syndrome should be suspected in individuals with: Bilateral absence of the radii with the presence of both thumbs. Thrombocytopenia, usually <50 platelets/nL (normal range: 150-400 platelets/nL)

Management and Treatment of TAR-Thrombocytopenia Absent Radius Syndrome:

There is no curative treatment for TAR syndrome. Symptomatic treatment of manifestations and prevention of complications include: early detection of thrombocytopenia, prevention of bleeding and hemorrhage, platelet transfusions in case of severe thrombocytopenia, surgical interventions if required to manage cardiac, urinary or skeletal malformations, avoidance of cow’s milk.

Prognosis of TAR-Thrombocytopenia Absent Radius Syndrome:

Prognosis is variable and mainly conditioned by the severity of thrombocytopenia and its complications (intracranial, digestive hemorrhage). Cardiac defects, renal malformations, acute complications of cow’s milk intolerance, acute leukemia can also affect the prognosis.

If a patient survives the initial 2 years of life, life expectancy is normal, MedLinePlus.com states.

Affected children who survive this period and do not have damaging hemorrhages in the brain usually have a normal life expectancy and normal intellectual development. The severity of skeletal problems in TAR syndrome varies among affected individuals.

“Cotard’s syndrome is a relatively rare condition that was first described by Dr. Jules Cotard in 1882. Cotard’s syndrome comprises any one of a series of delusions that range from a belief that one has lost organs, blood, or body parts to insisting that one has lost one’s soul or is dead.”

NIH National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695744/)

Cotard delusion, also known as or nihilistic delusion or walking corpse syndrome or Cotard’s syndrome , is a rare mental disorder in which the affected person holds the delusional belief that they are already dead, do not exist, are putrefying, or have lost their blood or internal organs.

Signs and Symptoms: 

One of the main symptoms of Cotard delusion is nihilism. Nihilism is the belief that nothing has any value or meaning. It can also include the belief that nothing really exists. People with Cotard delusion feel as if they’re dead or rotting away. In some cases, they might feel like they’ve never existed.

While some people feel this way about their entire body, others only feel it in regard to specific organs, limbs, or even their soul.

Depression is also closely related to Cotard delusion. A 2011 review of existing research about Cotard delusion notes that 89% of documented cases include depression as a symptom.

Other symptoms include:

• anxiety
• hallucinations
• hypochondria
• guilt
• preoccupation with hurting yourself or death

Researchers aren’t sure what causes Cotard delusion, but there are a few possible risk factors. Several studies indicate that the average age of people with Cotard delusion is about 50. It can also occur in children and teenagers. People under the age of 25 with Cotard delusion tend to also have bipolar depression. Women also seem to be more likely to develop Cotard delusion.

In addition, Cotard delusion seems to occur more often in people who think their personal characteristics, rather than their environment, cause their behavior. People who believe that their environment causes their behavior are more likely to have a related condition called Capgras syndrome. This syndrome causes people to think their family and friends have been replaced by imposters. Cotard delusion and Capgras syndrome can also appear together.

Other mental health conditions that might increase someone’s risk of developing Cotard delusion include:

• bipolar disorder
• postpartum depression
• catatonia
• depersonalization disorder
• dissociative disorder
• psychotic depression
• schizophrenia

Cotard delusion also seems to be associated with certain neurological conditions, including:

• brain infections
• brain tumors
• dementia
• epilepsy
• migraines
• multiple sclerosis
• Parkinson’s disease
• stroke
• traumatic brain injuries