“A significant challenge for diagnosing women with heart disease is the lack of recognition of symptoms that might be related to heart disease, or that don’t fit into classic definitions. Women can develop symptoms that are subtler and harder to detect as a heart attack, especially if the physician is only looking for the “usual” heart attack symptoms.

“Women are much more likely to have atypical heart attack symptoms,” says Dr. Lili Barouch, director of the Johns Hopkins Columbia Heart Failure Clinic. “So while the classical symptoms, such as chest pains, apply to both men and women, women are much more likely to get less common symptoms such as indigestion, shortness of breath, and back pain, sometimes even in the absence of obvious chest discomfort.”

John Hopkins Medicine (https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-disease-differences-in-men-and-women)

Many many women and their doctors don’t know that heart disease is the number one killer of women. Furthermore, the heart disease that is seen in women is often not quite the same as heart disease in men.

Let’s remember that Heart disease is an umbrella term that includes heart failure, coronary artery disease (CAD), arrhythmias, angina, and other heart-related infections, irregularities, and birth defects

These facts lead to two common (and sometimes tragic) misapprehensions held by many women and their doctors: That women don’t really get much heart disease, and when they do, it behaves pretty much like the heart disease that men get.

The truth is that not only is heart disease very common in women, but also, when women get heart disease it often acts quite differently than it does in men. Failing to understand these two fundamental truths leads to a lot of preventable deaths and disability in women with heart disease.

If you are a woman, you need to know the basics about heart disease – especially heart disease as it behaves in women.

When women have angina, they are more likely than men to experience “atypical” symptoms. Instead of chest pain, they are more likely to experience a hot or burning sensation, or even tenderness to touch, which may be located in the back, shoulders, arms or jaw – and often women have no chest discomfort at all. An alert doctor will think of angina whenever a patient describes any sort of fleeting, exertion-related discomfort located anywhere above the waist, and they really shouldn’t be thrown off by such “atypical” descriptions of symptoms. However, unless doctors are thinking specifically of the possibility of CAD, they are all too likely to write such symptoms off to mere musculoskeletal pain or gastrointestinal disturbances.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• • • Neck, jaw, shoulder, upper back or abdominal discomfort.
    • Shortness of breath.
    • Right arm pain.
    • Nausea or vomiting.
    • Sweating.
    • Lightheadedness or dizziness.
    • Unusual fatigue.

Heart attacks (or myocardial infarctions)  also tend to behave differently in women.

Frequently, instead of the crushing chest pain that is considered typical for a heart attack, women may experience nausea, vomiting, indigestion, shortness of breath or extreme fatigue – but no chest pain. Unfortunately, these symptoms are also easy to attribute to something other than the heart. Furthermore, women (especially women with diabetes) are more likely than men to have “silent” heart attacks – that is, heart attacks without any acute symptoms at all, and which are diagnosed only at a later time, when subsequent cardiac symptoms occur.

The Diagnosis Of CAD in Women Can Be More Difficult.

Diagnostic tests that work quite well in men can be misleading in women. The most common problem is seen with stress testing – in women, the electrocardiogram (ECG) during exercise can often show changes suggesting CAD, whether CAD is present or not, making the study difficult to interpret. Many cardiologists routinely add an echocardiogram or a thallium study when doing a stress test in a woman, which greatly improves diagnostic accuracy.

In women with typical CAD, coronary angiography is every bit as useful as in men; it identifies the exact location of any plaques (i.e., blockages) within the coronary arteries, and guides therapeutic decisions. However, in women with atypical coronary artery disorders (to be discussed in the next section), coronary angiograms often appear misleadingly normal. Thus, in women angiography is often not the gold standard for diagnosis, as it is for most men.

CAD In Women Can Take Atypical Forms.

At least four atypical coronary artery disorders can occur in women, usually in younger (i.e., pre-menopausal) women. Each of these conditions can produce symptoms of angina with apparently “normal” coronary arteries (that is, coronary arteries that often appear normal on angiogram). The problem, obviously, is that if the physician trusts the results of the angiogram, he/she is likely to miss the real diagnosis.

DALLAS, February 19, 2013 — A new study show women’s heart disease awareness is increasing.  A study with the number of women aware that heart disease is the leading cause of death nearly is doubling in the last 15 years, but that this knowledge still lags in minorities and younger women, according to the American Heart Association (AHA).

Among the study’s major findings, researchers comparing women’s views about heart disease in 1997 and today found:

• In 2012, 56 percent of women identified heart disease as the leading cause of death compared with 30 percent in 1997.
• In 1997, women were more likely to cite cancer than heart disease as the leading killer (35 percent versus 30 percent); but in 2012, only 24 percent cited cancer.
• In 2012, 36 percent of black women and 34 percent of Hispanic women identified heart disease as the　top killer — awareness levels that white women had in 1997 (33 percent).
• Women 25-34 years old had the lowest awareness rate of any age group at 44 percent.

Among the women surveyed in 2012, researchers found:

• Racial and ethnic minorities reported higher levels of trust in their healthcare providers compared with whites, and were also more likely to act on the information provided—dispelling the myth that mistrust of providers contributes to disparities.
• Compared with older women, younger women were more likely to report not discussing heart disease risk with their doctors (6 percent among those 25-34 versus 33 percent for those 65 and older).

Risk Factors for Heart Disease in Women – Those we can’t change = Nonmodifiable Factors:

Age and Family History, Gender, Ethnicity.

The risk of having heart disease increases with age and this is due to stiffening of heart muscles which makes the heart less efficient in pumping blood around the body. You can determine your heart age by using this tool, developed by the British Heart Foundation: https://www.bhf.org.uk/heart-health/risk-factors/check-your-heart-age.

Another risk factor you cannot change is if you have a history of heart disease among family members. This can double your risk, so if your mother, father, sister or brother has suffered from heart disease before the age of 60 you are at a greater risk of developing heart disease.

Modifiable Risk Factors – Those we can change are:

1-Smoking is the single largest preventable cause of death in Australia, and approximately 40% of women who smoke die due to heart disease, stroke or blood vessel disease. Smokers are 2-4 times more at risk of developing heart disease compared to non-smokers. In 2011/2012, over 1.3 million women in Australia smoked, and 89% of them did this on a daily basis. While these numbers are for women aged 15 and over, the largest group were in the 25-34 age group.

Passive smoking (exposure to the cigarette smoke of others) also causes an increase in the risk of developing heart disease, which increases further in people having high blood pressure or high cholesterol. Women who smoke and also take the contraceptive pill have a 10 times higher risk of having a heart attack.

2-Alcohol. Do you know that drinking too much alcohol increases the risk of heart disease? Excessive drinking causes more weight gain (due to increased calories!), increase in blood pressure and blood lipids. Over a long period of time it can weaken the heart muscle and cause abnormal heart rhythms. Try and not drink alcohol every day, limit it to two standard drinks at a time and aim for at least two alcohol free days a week and make sure you don’t increase the amount you drink on the other days. Periodically take a break from any alcohol for a week or more and you will notice many benefits including a better nights sleep.

3.High Blood Pressure or Hypertension. Your blood pressure is a measurement of how ‘hard’ your heart is working to push blood around your body, through the blood vessels. It can be a ‘silent’ killer and if you do not know your blood pressure then it is worth having it checked by your GP. Changing your lifestyle will reduce your blood pressure. A recent study suggests that keeping your blood pressure under 140/90 can increase your life expectancy by 5 years at the age of 50 years. You can assess your high blood pressure through your MD monthly or less expensive buy a b/p machine and check your b/p everyday especially if your on antihypertensive meds to make sure your b/p isn’t under 100/60 to prevent hypotension.

4.Diabetes. Do you have diabetes and if so, is it under control?

Diabetes doubles your risk of having heart disease. People who have uncontrolled diabetes are at risk of having heart disease at an earlier age. For pre-menopausal women, having diabetes cancels the protective effects of hormone present in women and significantly increases the risk of heart disease. Taking steps to find out what your blood sugar is and keeping it well-controlled is essential.

5.Obesity- Do you know your body fat content? 　If you think that you are overweight then you put yourself at risk of having heart disease. Being overweight will increase your blood pressure and contribute to developing diabetes. In addition to that, women who carry weight around their middle (belly fat) as opposed to their hips are twice as likely to develop heart disease.

By taking the steps to reduce your weight, you can reduce your risk of heart disease. A great tool developed by National Heart Foundation of Australia calculates if you might be at risk: http://www.heartfoundation.org.au/healthy-eating/Pages/bmi-calculator.aspx

6- INACTIVE-Are you physically active every day? Recent research indicates that “sitting is the new smoking” and being physically inactive can double your risk of having heart disease. It is important to get some exercise every day, such as a 30 minute walk where you raise your heart rate. It also raises your serotonin levels (feel-good hormone) and can reduce depression

7- STRESS-We could almost ask – do you know anyone who is not stressed?! However, while everyday life is stressful, those people who are almost constantly stressed are at risk of adopting unhealthy behaviours in order to reduce their stress levels. Examples include increasing their alcohol intake or smoking in order to relax; or tending to eat more junk food because they are often short of time. All of these factors increase their risk of heart disease.

Women, stress and the risk of heart disease

Along with poor diet, lack of exercise and smoking, unmanaged stress may increase the risk for heart disease. Now medical experts are discovering that mental stress affects women in different, and in some cases, more devastating ways, especially if they already have coronary conditions. One study that…

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease. The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions. Communities, health professionals, and families can work together to create opportunities for people to make healthier choices. Make a difference in your community: Spread the word about strategies for preventing heart disease and encourage people to live heart healthy lives

“The Foundation for Women’s Cancer (FWC) understands the importance of bringing awareness to all gynecologic cancers — cervical, ovarian, uterine/ endometrial, vaginal and vulvar cancer. The month of September has been established as Gynecologic Cancer Awareness Month (GCAM), with a goal of reaching more and more people each year.

These resources give you the tools to share knowledge about gynecologic cancer symptoms, risk factors, prevention and early detection — because every five minutes, someone will be diagnosed with one of these cancers.”

Foundation for Women’s Cancer (https://foundationforwomenscancer.org/gcam/)

“Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.”

American Cancer Society (https://www.cancer.org/cancer/types/leukemia-in-children.html)

Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors.

Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.

There are a few known RISK FACTORS for childhood leukemia.

Inherited syndromes

-Some inherited disorders increase a child’s risk of developing leukemia:

• Down syndrome (trisomy 21): Children with Down syndrome have an extra (third) copy of chromosome 21. They are many times more likely to develop either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) than are other children, with an overall risk of about 2% to 3%. Down syndrome has also been linked with transient leukemia (also known as transient myeloproliferative disorder) – a leukemia-like condition within the first month of life, which often resolves on its own without treatment.
• Li-Fraumeni syndrome: This is a rare condition caused by a change in the TP53 tumor suppressor gene. People with this change have a higher risk of developing several kinds of cancer, including leukemia, bone or soft tissue sarcomas, breast cancer, adrenal gland cancer, and brain tumors.Other genetic disorders (such as neurofibromatosis and Fanconi anemia) also carry an increased risk of leukemia, as well as some other types of cancers.Having a parent who develops leukemia as an adult does not seem to raise a child’s risk of leukemia.The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.1-Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the chance of a cure is greatly reduced.
• The word “acute” in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. The “lymphocytic” in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia.
• What is Leukemia?  First their are types of leukemia, which are cancers of the bone marrow and blood and this is the most common childhood cancers unfortunately.  They account for about 30% of all cancers in children.  The most common types that are found in children they are 1.) acute lymphocytic leukemia (ALL) 2.) acute myelogenous leukemia (AML).
• Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML, usually within 6 to 8 years after exposure. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.
• Siblings (brothers or sisters) with leukemia have a slightly increased chance (2 to 4 times normal) of developing leukemia, but the overall risk is still low. The risk is much higher among identical twins. If one twin develops childhood leukemia, the other twin has about a 1 in 5 chance of getting leukemia as well. This risk is much higher if the leukemia develops in the first year of life.

2-Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

“Leukemia is a broad term for cancers of the blood cells. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.  There is Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia , Chronic Myelogenous Leukemia, Hairy Cell Leukemia, Childhood Acute Lymphoblastic Leukemia, and Childhood Acute Myeloid Leukemia.”

National Cancer Institute (https://www.cancer.gov/types/leukemia#: ~:text=Leukemia%20is%20a%20broad%20term,in%20children%20younger%20than%2015.)

Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors.

Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.

There are a few known RISK FACTORS for childhood leukemia.

Inherited syndromes

-Some inherited disorders increase a child’s risk of developing leukemia:

• Down syndrome (trisomy 21): Children with Down syndrome have an extra (third) copy of chromosome 21. They are many times more likely to develop either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) than are other children, with an overall risk of about 2% to 3%. Down syndrome has also been linked with transient leukemia (also known as transient myeloproliferative disorder) – a leukemia-like condition within the first month of life, which often resolves on its own without treatment.
• Li-Fraumeni syndrome: This is a rare condition caused by a change in the TP53 tumor suppressor gene. People with this change have a higher risk of developing several kinds of cancer, including leukemia, bone or soft tissue sarcomas, breast cancer, adrenal gland cancer, and brain tumors.

Other genetic disorders (such as neurofibromatosis and Fanconi anemia) also carry an increased risk of leukemia, as well as some other types of cancers.

Siblings (brothers or sisters) with leukemia have a slightly increased chance (2 to 4 times normal) of developing leukemia, but the overall risk is still low. The risk is much higher among identical twins. If one twin develops childhood leukemia, the other twin has about a 1 in 5 chance of getting leukemia as well. This risk is much higher if the leukemia develops in the first year of life.

Having a parent who develops leukemia as an adult does not seem to raise a child’s risk of leukemia.

Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML, usually within 6 to 8 years after exposure. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.

The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.

What is Leukemia?  First their are types of leukemia, which are cancers of the bone marrow and blood and this is the most common childhood cancers unfortunately.  They account for about 30% of all cancers in children.  The most common types that are found in children they are 1.) acute lymphocytic leukemia (ALL) 2.) acute myelogenous leukemia (AML).

1.)-Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. The “lymphocytic” in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia.

Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the chance of a cure is greatly reduced.

2.)-Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

2.) Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

“Chronic pain is pain that lasts for over three months. You may feel the pain all the time or it may come and go. It can happen anywhere in your body and has countless causes.

Chronic pain is a very common condition and one of the most common reasons why people seek medical care. In 2021, about 20.9% of U.S. adults (51.6 million people) experienced chronic pain, according to a study from the U.S. Centers for Disease Control and Prevention (CDC).

Pain is your body’s way of telling you that something’s wrong, like an alarm. But when that alarm continues to go off for months or years, it can drown out many aspects of life that bring you joy. And it can take quite a toll on your physical, mental and emotional health. Because of this, it’s essential to seek help for chronic pain. Together, you and your healthcare provider can develop a plan to help dampen chronic pain.”.

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/4798-chronic-pain)

In most instances, painful sensations arise from tissue injury in the body. Sensitive nerve endings pick up pain signals and carry these messages along nerves to the spinal cord and then onto the brain. All along these complex pathways, there are biological “gates” that can be either opened or closed. When these gates are closed, pain is reduced or eliminated. When open, pain messages continue through the circuit. It is when these gates are jammed open that chronic pain cycles begin.

As you recall, acute pain is short lived and serves as a warning signal. When you fix whatever is wrong, the pain usually goes away. In the case of chronic pain, pain does not necessarily signal that the body is undergoing more damage. Most chronic pain is caused by a malfunction of the nervous system, either in nerves or the brain. The malfunction or opening of the pain gates causes and endless barrage of pain signals to cycle. Chronic pain then becomes a disease itself, taking on a life of its own.

How can we close the gates of pain?

The gates are affected by several factors, most importantly by the pattern of nerve impulses which reach the spinal cord from the rest of the body, and nerve impulses coming from the brain. Sometimes the nerve impulses traveling through the spinal gates can be affected by other forms of physical stimulation. Giving your nervous system a competing source of input can fool the nervous system and alter your perception of pain.

There are many ways to accomplish this. You may have noticed that rubbing or massaging a painful area may have relieved your pain in the past. Applying electrical stimulation (e.g. TENS), applying heat or cold, acupuncture, or nerve blocks may also provide a competing source of input. It is also important to realize that certain mental activities or thoughts taking place in the brain can help to close the spinal gates.

Another way we can work to close the gates of pain is to affect the release of several chemicals that help pain signals travel to the brain. Neurotransmitters are biochemical messengers that carry pain signals from one nerve cell to the next. The three main neurotransmitters that send pain signals to the brain are substance P, NMDA (n-methyl-d-aspartate), and glutamate. Excess amounts of these chemicals, especially substance P, make it easier for pain signals to reach the brain.

Therefore, another way of stopping pain involves manipulating pain provoking neurotransmitters. This can be accomplished by prescription or over the counter medications, acupuncture, injections, hypnosis, or biofeedback.:

The role of the Endorphins:

The endorphins are another class of chemicals which are produced in the brain and serve an important role in the pain experience. These chemical are naturally occurring pain relieving substances, similar to morphine or other opiates, produced in the body. Endorphins work on special receptor sites in the brain. They act as keys which unlock receptors thus generating nerve impulses to shut down pain. Morphine and other opiates have similar chemical structures which turn off pain.
Several situations or conditions raise endorphin levels in the brain thus reducing pain. They include thinking with a positive attitude, happiness, and regular exercise.

The Role of Stress:

It is natural to connect a physical stress to the body, such a broken arm, to the perception of pain. The role of psychological stress may not seem as obvious. The brain structures involved in stress can affect the production of key hormones in the body, suppress the body’s immune system, and activate the autonomic nervous. These are the same biological changes that may occur from physical stresses on the body-the body may not differentiate between physical and psychological stress. The net effects of these changes on the body are to lower our internal resistance to pain, thus further encouraging the chronic pain cycle.

Many sources of stress feed into the chronic pain cycle. First off, as you would expect, pain itself is stressful. Pain sensations are perceived as undesirable and are at very least annoying. Pain creates tension, both physical and emotional. Physical tension may show itself as muscle tension or affect the cardiovascular, gastrointestinal, or immune systems. Emotional tension may reveal itself as anger, frustration, worry, depression, or frustration. Both physical and emotional tension, initially set in motion by pain, worsen pain. Thus the vicious cycle of pain is begins-pain leads to tension and tension leads to more pain.

A second source of stress comes from all the negative consequences that occur as a result of a chronic pain condition. Chronic pain may create difficulties with family relationships, social or recreation activities, self-esteem, and employment.

Yet another source of stress arises from the hardships that can be encountered from the stresses of everyday living. Everything from difficulties putting on your shoes in the morning to difficulties standing long enough to go grocery shopping are added on top of pain-related stressors. In the end, an individual not only suffers from chronic pain, but from chronic stress.

The consequences of chronic stress:

Whatever the type of stress, either physical or psychological, the outcome on pain is to worsen it. Chronic stress also may result in other physical ailments such as tension headaches, muscle spasms, gastrointestinal problems, and elevated blood pressure. It can also lead to fatigue, depression, and a sense of hopelessness.

The key is how to prevent chronic pain:

Chronic pain can’t always be prevented But rememeber if you have pain go to a MD to help you get to your optimal level of function and hopes you get to PAIN FREE.

1-  ONE is staying in good physical and mental health may be the best way to prevent it or help you cope with it.
2-  Treat your health problems early.
3- Get enough sleep every night. Learn to alternate activity with rest throughout each day.
4- Exercise.
5- Eat a balanced diet.

Try to reduce stress in your life.