10 Self-Help Tips to Stop Smoking

If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up.

Related: How-to Quit Smoking and Save Your Life

Think positive

You might have tried to quit smoking before and not managed it, but don’t let that put you off. Look back at the things your experience has taught you and think about how you’re really going to do it this time.

Make a plan to quit smoking

Make a promise, set a date and stick to it. Sticking to the not a drag rule can really help. Whenever you find yourself in difficulty say to yourself, I will not have even a single drag and stick with this until the cravings pass.

Think ahead to times where it might be difficult a party for instance and plan your actions and escape routes in advance.

Consider your diet

Is your after-dinner cigarette your favorite? A recent study revealed that some foods, including meat, make cigarettes more satisfying. Others, including cheese, fruit and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead.

You may also want to change your routine at or after mealtimes. Getting up and doing the dishes straight away, or settling down in a room where you don’t smoke may help.

Change your drink

The same study looked at drinks. Fizzy drinks, alcohol, cola, tea and coffee all make cigarettes taste better. So when you’re out, drink more water and juice. Some people find simply changing their drink (for example, switching from wine to a vodka and tomato juice) affects their need to reach for a cigarette.

Identify when you crave cigarettes

A craving can last five minutes. Before you give up, make a list of five-minute strategies. For example, you could leave the party for a minute, dance, or go to the bar. And think about this: the combination of smoking and drinking raises your risk of mouth cancer by 38 times.

Get some stop smoking support

If friends or family members want to give up too, suggest to them that you give up together.

There is also support available from your local stop smoking service. Did you know that you’re up to four times more likely to quit successfully with their expert help and advice?

You can also call the NHS Smokefree Helpline on 0300 123 1044 open Monday to Friday 9am to 8pm, and Saturday to Sunday 11am to 4pm.

Get moving

A review of scientific studies has proved exercise – even a five-minute walk or stretch – cuts cravings and may help your brain produce anti-craving chemicals.

Make non-smoking friends

When you’re at a party, stick with the non-smokers. When you look at the smokers, don’t envy them, says Louise, 52, an ex-smoker. Think of what they’re doing as a bit strange – lighting a small white tube and breathing in smoke.

Keep your hands and mouth busy

Nicotine replacement therapy (NRT) can double your chances of success.

As well as patches, there are tablets, lozenges, gum and a nasal spray. And if you like holding a cigarette, there are handheld products like the inhalator. There are also e-cigarettes.

When you’re out, try putting your drink in the hand that usually holds a cigarette, or drink from a straw to keep your mouth busy.

Make a list of reasons to quit

Keep reminding yourself why you made the decision to give up. Make a list of the reasons and read it when you need support. Ex-smoker Chris, 28, says: I used to take a picture of my baby daughter with me when I went out. If I was tempted, Id look at that.

10 Studies That Will Change What You Think You Know About Yourself

Why do we do the things we do? Despite our best attempts to “know thyself,” the truth is that we often know astonishingly little about our own minds, and even less about the way others think. As Charles Dickens once put it, “A wonderful fact to reflect upon, that every human creature is constituted to be that profound secret and mystery to every other.”

Psychologists have long sought insights into how we perceive the world and what motivates our behavior, and they’ve made enormous strides in lifting that veil of mystery. Aside from providing fodder for stimulating cocktail-party conversations, some of the most famous psychological experiments of the past century reveal universal and often surprising truths about human nature. Here are 10 classic psychological studies that may change the way you understand yourself.

We all have some capacity for evil.

Long time

Arguably the most famous experiment in the history of psychology, the 1971 Stanford prison study put a microscope on how social situations can affect human behavior. The researchers, led by psychologist Philip Zimbardo, set up a mock prison in the basement of the Stanford psych building and selected 24 undergraduates (who had no criminal record and were deemed psychologically healthy) to act as prisoners and guards. Researchers then observed the prisoners (who had to stay in the cells 24 hours a day) and guards (who shared eight-hour shifts) using hidden cameras.

The experiment, which was scheduled to last for two weeks, had to be cut short after just six days due to the guards’ abusive behavior — in some cases they even inflicted psychological torture — and the extreme emotional stress and anxiety exhibited by the prisoners.

“The guards escalated their aggression against the prisoners, stripping them naked, putting bags over their heads, and then finally had them engage in increasingly humiliating sexual activities,” Zimbardo told American Scientist. “After six days I had to end it because it was out of control — I couldn’t really go to sleep at night without worrying what the guards could do to the prisoners.”

We don’t notice what’s right in front of us.

Think you know what’s going on around you? You might not be nearly as aware as you think. In 1998, researchers from Harvard and Kent State University targeted pedestrians on a college campus to determine how much people notice about their immediate environments. In the experiment, an actor came up to a pedestrian and asked for directions. While the pedestrian was giving the directions, two men carrying a large wooden door walked between the actor and the pedestrian, completely blocking their view of each other for several seconds. During that time, the actor was replaced by another actor, one of a different height and build, and with a different outfit, haircut and voice. A full half of the participants didn’t notice the substitution.

The experiment was one of the first to illustrate the phenomenon of “change blindness,” which shows just how selective we are about what we take in from any given visual scene — and it seems that we rely on memory and pattern-recognition significantly more than we might think.

Delaying gratification is hard — but we’re more successful when we do.

A famous Stanford experiment from the late 1960s tested preschool children’s ability to resist the lure of instant gratification — and it yielded some powerful insights about willpower and self-discipline. In the experiment, four-year-olds were put in a room by themselves with a marshmallow on a plate in front of them, and told that they could either eat the treat now, or if they waited until the researcher returned 15 minutes later, they could have two marshmallows.

While most of the children said they’d wait, they often struggled to resist and then gave in, eating the treat before the researcher returned, TIME reports. The children who did manage to hold off for the full 15 minutes generally used avoidance tactics, like turning away or covering their eyes. The implications of the children’s behavior were significant: Those who were able to delay gratification were much less likely to be obese, or to have drug addiction or behavioral problems by the time they were teenagers, and were more successful later in life.

We can experience deeply conflicting moral impulses.

A famous 1961 study by Yale psychologist Stanley Milgram tested (rather alarmingly) how far people would go to obey authority figures when asked to harm others, and the intense internal conflict between personal morals and the obligation to obey authority figures.

Milgram wanted to conduct the experiment to provide insight into how Nazi war criminals could have perpetuated unspeakable acts during the Holocaust. To do so, he tested a pair of participants, one deemed the “teacher” and the other deemed the “learner.” The teacher was instructed to administer electric shocks to the learner (who was supposedly sitting in another room, but in reality was not being shocked) each time they got questions wrong. Milgram instead played recordings which made it sound like the learner was in pain, and if the “teacher” subject expressed a desire to stop, the experimenter prodded him to go on. During the first experiment, 65 percent of participants administered a painful, final 450-volt shock (labeled “XXX”), although many were visibly stressed and uncomfortable about doing so.

While the study has commonly been seen as a warning of blind obedience to authority, Scientific American recently revisited it, arguing that the results were more suggestive of deep moral conflict.

“Human moral nature includes a propensity to be empathetic, kind and good to our fellow kin and group members, plus an inclination to be xenophobic, cruel and evil to tribal others,” journalist Michael Shermer wrote. “The shock experiments reveal not blind obedience but conflicting moral tendencies that lie deep within.”

Recently, some commenters have called Milgram’s methodology into question, and one critic noted that records of the experiment performed at Yale suggested that 60 percent of participants actually disobeyed orders to administer the highest-dosage shock.

We’re easily corrupted by power.

There’s a psychological reason behind the fact that those in power sometimes act towards others with a sense of entitlement and disrespect. A 2003 study published in the journal Psychological Review put students into groups of three to write a short paper together. Two students were instructed to write the paper, while the other was told to evaluate the paper and determine how much each student would be paid. In the middle of their work, a researcher brought in a plate of five cookies. Although generally the last cookie was never eaten, the “boss” almost always ate the fourth cookie — and ate it sloppily, mouth open.

“When researchers give people power in scientific experiments, they are more likely to physically touch others in potentially inappropriate ways, to flirt in more direct fashion, to make risky choices and gambles, to make first offers in negotiations, to speak their mind, and to eat cookies like the Cookie Monster, with crumbs all over their chins and chests,” psychologist Dacher Keltner, one of the study’s leaders, wrote in an article for UC Berkeley’s Greater Good Science Center.

We seek out loyalty to social groups and are easily drawn to inter-group conflict.

This classic 1950s social psychology experiment shined a light on the possible psychological basis of why social groups and countries find themselves embroiled in conflict with one another — and how they can learn to cooperate again.

Study leader Muzafer Sherif took two groups of 11 boys (all age 11) to Robbers Cave State Park in Oklahoma for “summer camp.” The groups (named the “Eagles” and the “Rattlers”) spent a week apart, having fun together and bonding, with no knowledge of the existence of the other group. When the two groups finally integrated, the boys started calling each other names, and when they started competing in various games, more conflict ensued and eventually the groups refused to eat together. In the next phase of the research, Sherif designed experiments to try to reconcile the boys by having them enjoy leisure activities together (which was unsuccessful) and then having them solve a problem together, which finally began to ease the conflict.

We only need one thing to be happy.

The 75-year Harvard Grant study —one of the most comprehensive longitudinal studies ever conducted — followed 268 male Harvard undergraduates from the classes of 1938-1940 (now well into their 90s) for 75 years, regularly collecting data on various aspects of their lives. The universal conclusion? Love really is all that matters, at least when it comes to determining long-term happiness and life satisfaction.

The study’s longtime director, psychiatrist George Vaillant, told The Huffington Post that there are two pillars of happiness: “One is love. The other is finding a way of coping with life that does not push love away.” For example, one participant began the study with the lowest rating for future stability of all the subjects and he had previously attempted suicide. But at the end of his life, he was one of the happiest. Why? As Vaillant explains, “He spent his life searching for love.”

We thrive when we have strong self-esteem and social status.

Achieving fame and success isn’t just an ego boost — it could also be a key to longevity, according to the notorious Oscar winners study. Researchers from Toronto’s Sunnybrook and Women’s College Health Sciences Centre found that Academy Award-winning actors and directors tend to live longer than those who were nominated but lost, with winning actors and actresses outliving their losing peers by nearly four years.

“We are not saying that you will live longer if you win an Academy Award,” Donald Redelmeier, the lead author of the study, told ABC News. “Or that people should go out and take acting courses. Our main conclusion is simply that social factors are important It suggests that an internal sense of self-esteem is an important aspect to health and health care.”

We constantly try to justify our experiences so that they make sense to us.

Anyone who’s taken a freshman Psych 101 class is familiar with cognitive dissonance, a theory which dictates that human beings have a natural propensity to avoid psychological conflict based on disharmonious or mutually exclusive beliefs. In an often-cited 1959 experiment, psychologist Leon Festinger asked participants to perform a series of dull tasks, like turning pegs in a wooden knob, for an hour. They were then paid either $1 or $20 to tell a “waiting participant” (aka a researcher) that the task was very interesting. Those who were paid $1 to lie rated the tasks as more enjoyable than those who were paid $20. Their conclusion? Those who were paid more felt that they had sufficient justification for having performed the rote task for an hour, but those who were only paid $1 felt the need to justify the time spent (and reduce the level of dissonance between their beliefs and their behavior) by saying that the activity was fun. In other words, we commonly tell ourselves lies to make the world appear a more logical, harmonious place.

We buy into stereotypes in a big way.

Stereotyping various groups of people based on social group, ethnicity or class is something nearly all of us do, even if we make an effort not to — and it can lead us to draw unfair and potentially damaging conclusions about entire populations. NYU psychologist John Bargh’s experiments on “automaticity of social behavior” revealed that we often judge people based on unconscious stereotypes — and we can’t help but act on them. We also tend to buy into stereotypes for social groups that we see ourselves being a part of. In one study, Bargh found that a group of participants who were asked to unscramble words related to old age — “Florida,” “helpless” and “wrinkled” — walked significantly slower down the hallway after the experiment than the group who unscrambled words unrelated to age. Bargh repeated the findings in two other comparable studies that enforced stereotypes based on race and politeness.

“Stereotypes are categories that have gone too far,” Bargh told Psychology Today. “When we use stereotypes, we take in the gender, the age, the color of the skin of the person before us, and our minds respond with messages that say hostile, stupid, slow, weak. Those qualities aren’t out there in the environment. They don’t reflect reality.”

10 Things You May Not Know About Diabetic Neuropathy

There are an estimated 20 million who suffer from peripheral neuropathy. Yet not all diabetics have symptoms of neuropathy. Treatment requires a partnership between patient and doctor to find individualized solutions.

1. Diabetic neuropathy can affect the function of the sensory, motor (strength) or autonomic (i.e. lungs, heart, kidney, stomach) nervous systems.

2. Shoes and socks made for diabetics help alleviate symptoms of diabetic neuropathy by cushioning the feet and allowing for greater blood flow.

3. A neuromuscular neurologist is the best source of help with the symptoms of diabetic neuropathy.

4. Partnering with your doctor to discover what works best for you is a critical factor in reducing diabetic nerve pain.

5. Neuropathic pain comes from damaged sensory nerves, sending real but faulty signals to the brain. This type pain can be reduced for most patients using the anti-depressant or anti-seizure classes of drugs or a combination of such drugs.

6. Coping with the loss of feeling and strength in hands requires creative solutions. Examples are the use of thick pens that help in grasping or putting Velcro on items to increase sensation of grip. Patients are good sources for practical coping ideas!

7. Exercise type, intensity or duration is important for muscle retention, flexibility and strength. Forcing damaged nerves to work using the wrong exercise will increase the pain.

8. Good nutrition is very important for everyone, but it is especially important for neuropathy patients to help feed, protect and heal the nerves. Vitamin supplements help minimize symptoms.

9. Burning sensations in the feet are treated with Lidocaine patches or special compounded topical creams containing Lidocaine, Ketamine, Gabapentin, and Amitriptyline. Burning can be reduced by soaking the feet in cool (not freezing) water for 15 minutes before bedtime.

10. Natural chemicals called serotonins reduce pain and can be increased by positive mental thoughts visualization, calming music and Biofeedback.

10 Symptoms of Thyroid Problems Your Doctor May Miss

About 12% of Americans develop thyroid disease, and of those who get it 60% will never know they have it. [1]That’s a problem. The thyroid regulates hormone balance and contributes to weight, mood, and mental stability. If ignored, a thyroid imbalance can develop into serious medical conditions. Awareness is key, so to help, here are 10 symptoms of thyroid problems that are often missed.

1. Cholesterol That’s Too High or Too Low

Too much fat in your diet causes high cholesterol, right? Wrong. High cholesterol can have a number of originating factors; and diet is only a small contributor compared to others. If diet and exercise don’t help, it may be time to consider that there is an underlying problem. If you take medication for cholesterol and it’s not working, then definitely have your thyroid checked. You may have hypothyroidism, or low thyroid hormone levels. In some cases, low cholesterol may be a problem. It’s always a good idea to get tested for hyperthyroidism, which is too much circulating thyroid hormone.

2. Sore Joints and Nerve Pain

Research has find that thyroid diseases, both hypo- and hyperthyroidism, can cause nerve pain in some people who suffer from thyroid disease and getting their thyroid in check has lead to improvements in wrist pain and tingling sensations in some people. [2] In one case, a 60-year-old Italian woman suffering from a burning sensation showed symptoms of hypothyroidism. As she progressed with her thyroid treatment, the pain went away. [3]

3. Heart Disease

Checking your thyroid may be a good plan if you discover you have heart disease. Thyroid hormones play a direct role in heart health. A 2014 study out of John Hopkins University reported low thyroid hormone levels were common in young and middle-aged adults with early stage coronary artery disease and blood vessel calcification. [4] A Polish study similarly compared 25 patients with low levels of thyroid stimulating hormone to 25 patients with normal levels. Those with the lower levels had more cardiac events. [5]

4. Weak, Fragile Fingernails

Don’t ignore your nails when they crack or flake; it may reflect a bigger problem. Those with hypothyroidism often have soft, fragile nails, and those with hyperthyroidism may find the nail coming off its bed on the fingertip. [6] Dry skin and brittle hair often accompanies this symptom.

5. Anxiety and Mood Imbalances

Your hormones play a huge role in affecting how you feel. Low hormone levels, such as in the case of hypothyroidism, can leave you feeling down in the dumps. Excess of hormones leads to frequent anxiety or panic attacks. If you have regular feelings like this, it might be a good idea to get your thyroid tested before considering any psychiatric drugs that may make your problems worse.

6. Inexplicably Gaining or Losing Weight

If you can’t can’t explain your weight gain or loss, it could be your thyroid. How fast or slow your metabolism is directly depends on hormone activity. A sudden change in weight, up or down, can be an indication of a thyroid problem.

7. Constant Fatigue

This symptom is common, yet often ignored. Many young adults write fatigue and poor energy off as a sign of their lifestyle; but, if you’ve got an established routine and get regular sleep, you shouldn’t ignore chronic fatigue. Do you get 7-8 hours of sleep and feel like it’s not enough? It could be an early symptom of a thyroid issue. Those suffering from hyperthyroidism may find it hard to fall asleep, which can leave you dragging during waking hours.

8. Low Libido

Since the thyroid is all about hormones, it comes as no surprise men and women experience problems with their reproductive organs. Women can have a more frequent, longer menstruation with low hormones and short, light menstruation–or have a cycle stop altogether–with too many circulating hormones. Fertility may also be a problem. Men experience infertility, low libido, and may even develop enlarged breasts when sex hormones and the thyroid become imbalanced.

9. Gut Problems

IBS isn’t always caused by what you eat. In fact, it may be that your metabolism isn’t working right. This prevents necessary enzymes from getting to the gut to help with digestion. If constipation, diarrhea, or IBS are ongoing problems and therapies aren’t helping, it may be time to consider checking your thyroid.

10. Weakness

As hormone levels get out of whack, other imbalances follow, and terrible dips in energy levels is a classic. Your thyroid, your metabolism, your energy levels — all connected. If you’re feeling week but your nutrition is good and you get enough sleep, it’s time to consider underlying possibilities, and your thyroid is one.

Promoting Thyroid Balance

Thyroid health has a number of contributing factors and there are a few things you can do to encourage them to be optimal.

  1. Make sure you’re getting enough iodine. It’s not a cure or treatment but it is the exact nutrition your thyroid needs to function normally. Iodine-rich foods are one way to get your iodine requirements, an iodine supplement is another.
  2. Exercise regularly. The goal isn’t to become a bodybuilder, it’s to use and work your muscles — all of them. Get up and move around.
  3. Eat a balanced diet that meets all your nutritional requirements. Your body is like a Swiss watch, all its parts need to be functioning individually for it to function properly as a whole. If you have nutritional deficiencies, of any kind, you’re not going to feel balance.

10 Easy Ways to Beat Anxiety Now

I’m halfway out the door in the morning with a heavy bag in one hand and a mug of coffee in the other. Then I wonder: Where did I put my keys? And so begins the 20-minute panicked reconnaissance mission for the keys I swore were on the coffee table. I start to feel flustered and irritable as I frantically search. My memory gets foggy as my heart starts to pound and my palms sweat. It’s another anxious morning.

Related: 10 Self-Help Tips to Stop Smoking

Anxiety Alert—the Need-to-Know

Technically, anxiety is apprehension over an upcoming event. We anticipate the future with sometimes scary predictions that don’t necessarily have any basis in truth. In everyday life, anxiety’s physical and emotional symptoms can mean an increased heart rate (and even heart attack), poor concentration at work and school, sleeping problems, and just being a total Crankasaurus Rex to family, friends, and co-workers.

Anxiety and stress are physical and emotional responses to perceived dangers (that aren’t always real). And since most of us aren’t running from tigers or hunting and gathering in the woods, it’s often the little things that put us over the edge: an over-loaded email inbox, morning rush hour, or losing those keys before running out the door. Luckily, it’s easy to beat this kind of stress with just a few easy changes added throughout the day.

Note: If you feel like you might be dealing with a serious anxiety disorder, please talk to a medical professional about treatment. There are lots of options available to manage your symptoms. But if you’re looking to reduce daily anxiety, these 15 tips will get you on your way to being calm and collected in no time.

Cool as a Cucumber: Your Action Plan

1. Get enough sleep. Inconsistent sleep can have some serious consequences. Not only does it affect our physical health, but lack of sleep can also contribute to overall anxiety and stress. And sometimes it turns into a vicious cycle, since anxiety often leads to disruptions in sleep. Especially when feeling anxious, try to schedule a full seven to nine hours of snooze time and see what a few nights of sweet slumber do for those anxiety levels throughout the day.

2. Smile. When work has got us down, it’s a good idea to take a quick break to get some giggles on. Research suggests that laughter can reduce symptoms of depression and anxiety, so consider checking out a funny YouTube clip to calm those jittery nerves.

3. De-clutter the brain. Physical clutter = mental clutter. A messy workspace can make it more difficult to relax and make it seem like our work is never-ending. So take 15 minutes or so to tidy up the living space or work area, and then make a habit of keeping things clean and anxiety-free. It’ll help us think rationally, and there won’t be as much room for anxiety.

4. Express gratitude. Studies have found expressing gratitude helps reduce anxiety, especially when we’re well-rested.Start a gratitude journal to get in the mindset of appreciation, and out of the mindset of being overwhelmed.

5. Eat right. Anxiety can throw our bodies totally out of whack: Our appetite might change, or we might crave certain foods. But to give the body the support it needs, try eating more of foods that contain nutrients such as vitamin B and omega-3s, plus some healthy whole-grain carbohydrates. Studies have linked vitamin B with good mental health, and omega-3s may help reduce symptoms of depression and anxiety. Whole-grain carbs help regulate levels of serotonin, the “feel-good” neurotransmitter that helps us remain calm. And even though our cravings might be telling us otherwise, research suggests that eating sugary and processed foods can increase symptoms of anxiety.

6. Learn to breathe. A useful tool to prevent panic attacks, the breath is also a great marker of where your anxiety level is at throughout the day. Short, shallow breaths signify stress and anxiety in the brain and body. On the flip side, consciously breathing, plus lengthening and strengthening the breath helps send signals to the brain that it’s okay to relax.

7. Meditate. By now most of us have heard that meditation is relaxing, but what scientists are also discovering is that meditation actually increases the amount of grey matter in the brain, essentially rewiring the body to stress less. A number of recent studies highlight the positive effects of meditation on anxiety, mood, and stress symptoms. Meditation is also a way to observe the brain, letting us figure out how our mind generates anxiety-provoking thoughts. And understanding the brain’s thought patterns can help create distance from those thoughts.

8. Create a vision board. If the future seems big and scary, try changing the thoughts about what lies ahead. Sometimes the mere act of setting concrete goals can take the edge off anxiety about future unknowns. Take an hour to produce a vision board that creates excitement about projects and possibilities to come. And for those who aren’t the crafty type, try making an e-vision board using Pinterest for some Pinspiration. While making the board, try using the T.H.I.N.K. tool: Is my thought true, helpful, inspirational, necessary and kind? If not, dump the thought.

9. Play around. Kids and animals seem to have an innate ability to play, without stressing about their overflowing inboxes. Until business offices give us recess breaks, we’ll have to take responsibility for our own playtime. Offer to take a friend’s dog out for a walk, or babysit for an afternoon to get out of your head and let the careless creatures lead by example.

10. Be silent. Plan for a time when you can completely disconnect. Start with increments of time that seem sustainable and doable for you, even if it’s just five minutes. That means phone off, no emails, no TV, no news, nothing. Let other people know they won’t be able to reach you so you can veg worry free. There’s some evidence that too much noise can boost our stress levels, so schedule some sacred silent time among all the ruckus of daily life.

Answering the Same Questions Over and Over: How-to Talk to People with Dementia

Watching the deterioration of a loved one with dementia or Alzheimer’s disease is painful. As it progresses, minor forgetfulness transforms to a severe impairment.

Understanding how to both communicate and connect with our loved ones is crucial. However, few of us instinctively have the skills to communicate with a person with dementia. It’s something we must learn. By improving your communication skills your caregiving for a loved one will be less stressful and you’ll improve the quality of your relationship, too.

Good communication skills will also enhance your ability to handle the difficult behavior you may encounter as you care for a person with a memory loss illness.

Here are 10 tips from around the web on how to effectively communicate with someone who has dementia.

1. A Place for Mom suggestsRecognize what you’re up against. Dementia inevitably gets worse with time. People with dementia will gradually have a more difficult time understanding others, as well as communicating in general.”

2. “Get the person’s attention Limit distractions and noise — turn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have her attention; address her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. If she is seated, get down to her level and maintain eye contact.‬”, says Next Avenue.

3. Next Avenue also recommends that you “State your message clearly Use simple words and sentences. Speak slowly, distinctly and in a reassuring tone. Refrain from raising your voice higher or louder; instead, pitch your voice lower. If she doesn’t understand the first time, use the same wording to repeat your message or question. If she still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns‬ or abbreviations.”

4. Another tip by A Place for Mom is to “Refer to people by their names. Avoid pronouns like he, she, and they during conversation. Names are also important when greeting a loved one with dementia. For example: “Hi, Grandma.  It’s me, Jeff,” is to be preferred over, “Hi. It’s me.”

5. Unforgettable stresses that it’s important to “Get your body language right. Stand or sit so you are both at eye level and they can see your body and facial expressions. Smile and make eye contact. This will help the person with dementia feel at ease, and therefore more likely to open up and chat, even if they don’t quite remember who you are.”

6. Be patient. Here, Unforgettable offers this suggestion, “The conversation may take longer than it used to but that doesn’t mean you should ‘hurry them on’ if they’re stumbling or grasping for words, or try to speak on their behalf. Don’t let frustration get the better of you. Just smile, relax and wait for them to finish what they’re saying. Make a conscious effort to speak more slowly yourself too, and if you realize that you’ve said something quite complicated, try re-phrasing it.”

7. Don’t infantilize the person. This is the advice of Esther Heerema, MSW, who explains, “Don’t talk down to the person or treat him or her like an infant. This is sometimes called “elderspeak” and it’s got to go. Have you ever observed how people talk to babies? They might use a high pitched tone and get close to the baby’s face. While this is appropriate for infants, it’s not fitting for communicating with adults. Regardless of how much the person with dementia can or cannot understand, treat him or her with honor and use a respectful tone of voice.”

8. “Consider using gentle touch to ask for their attention” is another tip suggested by Heerema. She says, “While some people might get defensive if you break their bubble of personal space around them, many appreciate a gentle touch. You could give a little pat on the shoulders or hold her hand as you talk with her. Personal touch is important and can communicate that you care.”

9. “Being Reasonable, Rational, and Logical Will Just Get You into Trouble”, cautions caregiver.org. They explain, “When someone is acting in ways that don’t make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the person with dementia doesn’t have a “boss” in his brain any longer, so he does not respond to our arguments, no matter how logical. Straightforward, simple sentences about what is going to happen are usually the best.”

10. The folks over at caregiver.org also suggest that we “Tell, Don’t Ask. Asking “What would you like for dinner?” may have been a perfectly normal question at another time. But now we are asking our loved one to come up with an answer when he or she might not have the words for what they want, might not be hungry, and even if they answer, might not want the food when it is served after all. Saying “We are going to eat now” encourages the person to eat and doesn’t put them in the dilemma of having failed to respond.”

Have you discovered tips that have helped you communicate with your loved one better? Please tell us about it.


3 Simple Steps to Eliminate Heartburn and Acid Reflux

Are millions of us born with a genetic defect that makes us produce too much stomach acid? Do we just have a major evolutionary design flaw that requires us to take powerful acid-blocking drugs to prevent heartburn and reflux?

I believe that the answer to all of these questions is a resounding no.

In this weeks blog, Ill explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes.

The Truth about Acid-Blocking Medications

At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or GERD (gastroesophageal reflux disease, also known as heartburn) affects a whopping 25 to 35 percent of the US population! (i) As a result, acid-blocking medications are the third top-selling type of drug in America today. Two other drugs to treat reflux, Nexium and Prevacid, are among the worlds best-selling drugs(ii) and account for $5.1 and $3.4 billion in sales annually (in 2006)!

Things have certainly changed since I was in medical school. In those days, GERD wasnt even considered a serious disease. Instead, people had heartburn or ulcers, but that was pretty much it. When acid-blocking drugs first came on the market, even the pharmaceutical representatives warned us how powerful these drugs were. They told us not to prescribe them any longer than six weeks and only for patients with documented ulcers.

Now, these drugs are given like candy to anyone who ate too many hot dogs at a ball game and one drug, Prilosec, is available without a prescription. Their manufacturers have created the illusion that we can eat whatever we want with no consequences, just by popping a pill. They even have commercials showing a family rushing to stop their father from eating a big sausage with fried onions and peppers and he tells them not to worry because he took his acid-blocking pill!

I know someone who used to work for the makers of Pepcid, another acid blocker. He told me that when it first became available over the counter, teams of drug company representatives would stand at the gates of county fairs and southern barbecues and hand out free samples.

In reality, acid-blocking drugs are a double-edged sword. Lets look at some of the recent research on the dangers of these drugs.

What the Research Tells Us About Acid-Blocking Medications

Acid blocking drugs obviously block acid that can cause symptoms of heartburn and reflux. But your body actually needs stomach acid to stay healthy. Stomach acid is necessary to digest protein and food, activate digestive enzymes in your small intestine, keep the bacteria from growing in your small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12.

There’s evidence that taking these medications can prevent you from properly digesting food, cause vitamin and mineral deficiencies, and lead to problems like irritable bowel syndrome, depression, hip fractures, and more.

For example, studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12,(iii) which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly.

The research also tells us that taking these drugs can cause dangerous overgrowth of bacteria in the intestine called Clostridia, leading to life-threatening infections.(iv) For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain, and diarrhea (many of the common side effects noted in the warnings for these drugs). This can cause irritable bowel syndrome.

In addition, a recent study in the Journal of the American Medical Association found that chronic use of acid-blocking drugs leads to an increase in the development of osteoporosis and increase in hip fracture because blocking acid prevents the absorption of calcium and other minerals necessary for bone health.(v)

All this is only part of the problem. There have even been some reports that these drugs may increase the risk of certain cancers.

These are serious health concerns, and its pretty clear that in this case, the cure of acid-blocking drugs is worse than the disease of GERD. But that’s of little comfort when you’re suffering from heartburn.

So if drugs are not the answer, what is? We need to find the real causes of reflux and heartburn, get rid of them, and use the right foods, nutrients, and lifestyle therapies to heal the problem.

What Causes GERD?

Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux. Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux. These are the most obvious causes, and the ones you have probably heard about. However, there are a few more that bear mentioning.

Stress contributes to reflux. Clearly, food is supposed to go down, not up, when you eat. Thats why there are two main valves, or sphincters, that control food going in and out of your stomach the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve). When youre stressed, the valve on the top relaxes and the valve on the bottom tightens up. This may result in food traveling back up your esophagus. Practice active relaxation and you mitigate this problem.

Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.

While controversial, I believe that a common infection can cause not just ulcers but reflux as well. This bug is called Helicobacter pylori and can be identified by a simple test blood or breath test. In my experience with patients, this treating the bacteria can eliminate reflux even if you don’t have an ulcer.

Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux.

These are all treatable conditions that you dont need powerful acid blocking drugs to fix.

To properly diagnose the causes of your reflux, you may need to do the following.

  1. Ask your doctor for an H. pylori blood antibody test or breath test.
  2. Consider a test for IgG food allergies and celiac disease.
  3. Get a breath or urine organic acid test to check for small bowel bacterial overgrowth.
  4. If you dont get better with the suggestions below, consider getting an upper endoscopy or upper GI series x-ray to see if there is anything else wrong.

3 Steps to Permanently Overcoming Heartburn and Acid Reflux

Step 1: Treat the Bugs If You Have Them

• If you have H. pylori, treat it with triple antibiotic therapy from your doctor.
• Treat yeast overgrowth with antifungal drugs such as nystatin or Diflucan or herbs such as oregano or caprylic acid.
• Treat bacterial overgrowth in the small bowel with Xifaxin (see my blog on irritable bowel syndrome).

Step 2: Change Your Diet

• Try to eliminate dairy and gluten (see www.celiac.com for sources of gluten in the diet).
• Eliminate alcohol, caffeine, citrus, tomato-based, and spicy foods.
• Don’t eat within 3 hours before bed.
• Don’t eat junk food.
• Avoid processed foods.
• Eat cooked foods, like fish, chicken, cooked veggies, and rice; avoid raw food for now.
• Eat smaller, more frequent meals, at least four to five times a day.

Step 3: Try Some Natural Remedies to Help Soothe the Gut

• Take two to three capsules of digestive enzymes with each meal.
• Re-inoculate the gut with healthy bacteria by using probiotics.
• Try 75 to 150 mg of zinc carnosine twice a day between meals this has been extensively studied and is used frequently in Japan.
• Take 3 to 5 grams of glutamine powder in water twice a day to help heal the gut lining.
• Chew two to three chewable tablets of DGL (a form of licorice) 15 minutes before meals.
• Try 200 to 400 mg of magnesium citrate or glycinate twice a day.

As you can see, theres no need to suffer from heartburn and reflux or to take expensive and dangerous acid-blocking drugs. I hope the changes Ive suggested here will soothe your stomach and have you feeling healthy in no time!

Now Id like to hear from you

Do you have heartburn, reflux or GERD? What seems to trigger it?

Have you taken acid-blocking drugs? What was your experience?

What changes have worked for you in preventing and treating these problems?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.


(i) Shaheen, N. and D.F. Ransohoff. 2002. Gastroesophageal reflux, Barrett Esophagus, and esophageal cancer. JAMA. 287(15): 1972-1981.

(ii) http://en.wikipedia.org/wiki/List_of_top_selling_drugs

(iii) Ruscin, J.M., Page, R.L., and R.J. Valuck. 2002. Vitamin B(12) deficiency associated with histamine(2)-receptor antagonists and a proton-pump inhibitor. The Annals of Psychopharmacology. 36(5) 812-816.

(iv) Dial, S., Delaney, J.A.C., Barkun, A.N., and S. Suissa. 2005. Use of gastric acid-suppressive agents and the risk of community acquired clostridium difficile-associated disease. JAMA. 294(23): 2989-2995.

(v) Yang, Y., Lewis, J.D., Epstein, S., and David Metz. 2006. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 296(24): 2947-2953.

10 Things you NEED to Know About Melanoma

Three years ago today I began a journey that would change my life, and the lives of my family–forever. It was three years ago that I learned that the mole on my back was melanoma. Three days later I was meeting a surgeon, and two days after that I was in surgery. He removed the primary lesion on my back (which required a skin graft from my thigh), and then tested (and removed) 30 lymph nodes from under my left arm. Stage 3B. Sigh. If only I had been smarter about the sun…and about tanning beds.

There’s no point in beating myself up about it now, but I can sure do all I can to make sure that YOU don’t end up where I am today. I put up with a year of Interferon, and then did Yervoy when the Interferon didn’t stop the melanoma, and have had FIVE major surgeries, all because of melanoma.

So…here are 10 Things you NEED to know about melanoma to make sure this doesn’t happen to you. If you do anything today, PLEASE read this. It could save your life. And then…please share it, because YOU could save lives too.

Now, if you’ll excuse me, I’m going out with my husband to celebrate the fact that I’m still here. Come on, click on the link above and READ! One day you might be really happy that you did.

10 Things You (Probably) Do Not Know About Peripheral Neuropathy

1. Approximately 50% of diabetics (as well as untold numbers of non-diabetics) will be diagnosed with peripheral neuropathy. You’re not alone in dealing with some form of peripheral neuropathy! Millions of people just like you deal with the discomfort and frustration of numbness, pain, tingling and loss of mobility and feeling in the lower extremities.

Related: 10 Things You May Not Know About Diabetic Neuropathy

2. Neuropathy is treatable – through natural supplements, neuropathy vitamins, pharmaceutical neuropathy medication, and neuropathic pain treatment, neuropathy symptoms can be reduced or eliminated, and mobility and quality of life improved.

3. Neuropathy can be preventable – achieving and maintaining control of your blood sugar, a healthy diet, regular exercise, and intake of appropriate natural vitamins for neuropathy helps maintain or restore nerve function. Some diabetics will develop neuropathy even when their blood sugar is controlled. So take ALL of these steps to lessen the chance of developing neuropathy.

4. Prescription medications won’t cure your neuropathy they’re prescribed only to control the symptoms of neuropathy. Pharmaceuticals focus on pain management and don’t address the underlying causes of neuropathy. They do not support regeneration of nerve cells, tissues or function.

5. Metformin (one of the most commonly prescribed medications for diabetes), may actually increase your risk for developing neuropathy. Recent studies suggest it can lead directly to B12 deficiency, which can result in neuropathy.

6. Years of studies of high dose vitamin therapy for peripheral neuropathy have demonstrated success in the treatment of both the symptoms and causeof peripheral neuropathy. Natural remedies for neuropathy have been shown to be safe, effective and don’t produce significant side effects. You also don’t have to worry about drug interactions with most natural supplements (but always check with your doctor).

7. Peripheral neuropathy, including numbness, is the most reliable predictor of serious complications of diabetes, including limb loss. That’s why it’s so important to understand and manage your diabetes, take great care of your feet and to recognize the signs and symptoms of peripheral neuropathy.

8. Numbness may be the absence of pain, but it can be dangerous! Far from being a relief, it signifies your neuropathy has moved farther into the danger zone. Without adequate sensation, you may injure your foot without realizing it, which may lead to serious complications. Something as simple as a callus or an ingrown toenail, without the protective sensation of pain, may quickly progress without your knowing it.

9. Diabetics aren’t the only people who benefit from treatment of peripheral neuropathy. Although neuropathy is most common in diabetics, it may be present in many other conditions. Peripheral neuropathy from causes such as chemotherapy can be effectively lessened with the use of high dose neuropathy vitamin therapy to restore nerve function after treatment. (Always check with your doctor).

10. Your neuropathy won’t go away by itself. Your neuropathy symptoms and condition may worsen unless YOU take action and do something about it.

10 Things to Know About Hypertension

1. Hypertension or high blood pressure is a silent disease that occurs when your blood pressure is more than 140/90. The top number or systolic is just as important as the bottom number or diastolic. The range for a normal blood pressure is from 90/60 to 140/90.

Low blood pressure occurs when the blood pressure is less than 90/60, and in some cases higher than that, if accompanied by signs of low blood pressure such as light-headedness.

2. Bulks up the heart muscle: Hypertension places the heart under strain, leading to increased thickening of the heart muscle, and over time, if not controlled, can lead to enlargement of the heart and a weak heart.

The majority of patients in our local heart clinics develop heart failure as a consequence of hypertension damage to the heart.

3. High blood pressure damage to the heart is reversible: High blood pressure damage to the heart may be reversible if picked up early and the hypertension is treated and controlled with medication and lifestyle changes.

Within the medical community, it used to be taught that once your heart has been damaged by high blood pressure, the changes are not reversible. In the past 10 years or so, research has shown that with good blood pressure control for six months or more, the heart muscle thickness can be reversed.

If the heart has started to enlarge or weaken, these changes are less likely to be reversible

4. Medications can be used to control hypertension and reverse some of the early changes of hypertensive heart disease and slow progression of advanced hypertensive heart disease. Any medication that controls the blood pressure will help.

Medications for hypertension are lifetime. There is a common misconception that if you treat the hypertension and the blood pressure becomes normal, you can stop the treatment. Once you have been diagnosed with hypertension, you will likely need medication for the rest of your life. You should not stop the medication without doctors orders. In some cases, with drastic lifestyle changes the number of medication and dosage may be cut, sometimes to nothing, but you will still require monitoring.

5. Medications and sexual activity/erectile dysfunction: This is a common concern for male patients being treated for hypertension. Whereas there are a few medications that may affect the ability to generate an erection, the majority of patients under treatment experience erectile dysfunction as a result of the high blood pressure damage to the blood vessels in the penis that help to initiate and sustain an erection.

6. Salt/sodium: Though its role in causing hypertension is controversial, we do know that salt restriction helps in lowering the blood pressure by 5-8 mmHG. The daily recommended maximum salt intake for a hypertensive is 1500 mg.

It is important to take stock of what you eat daily to track your salt consumption. It is not just salt that you add to meal before eating, or meals that taste salty that are problematic. There are hidden sources of salt in all processed foods. We recommend that you read the nutrition label on each item to see the sodium content.

7. Brisk walking drops blood pressure by 4-9mmHG. Aerobic exercise is known to lower the blood pressure naturally. During exercise, the blood pressure and heart rate will increase, to meet the increased demands of the body. Over time, with sustained activity, the blood pressure will lower. Thirty minutes per day for five days a week of moderate intensity aerobic exercise or 50 minutes per day for three days a week of high intensity aerobic exercise, total 150 minutes per week.

Patients may say: But I walk to work, or I sweep the house. That is not sustained long enough to have the benefits to the heart, but is good for general health to keep active.

8. Weight loss helps to reduce blood pressure. Loss of as little as 10 lbs or 4.5kg helps to reduce your blood pressure. This is especially so, if the weight lost helps to reduce your belly. In addition to the other health benefits of weight loss, such as less risk of diabetes as joint issues. This is so for persons who are overweight or obese, so that BMI is more than 25kg/m2.

9. Natural remedies: While there are several natural remedies that are touted for reducing blood pressure, the only one I know which has scientific support is lemon grass (fever grass).

This has been studied extensively in Cuba and has been shown to reduce blood pressure by as much as 8mmHG from baseline. It can help as a tea or fresh lemonade.

The benefit of garlic, etc has not been proven.

10. Hypertension may be a sign of other problems. In majority of cases, hypertension is not caused by another underlying medical problem, that is essential hypertension. In five to 10 per cent of cases, hypertension is caused by an underlying medical problem such as: Obstructive sleep apnoea, overactive thyroid gland, and kidney failure.

It is important to have a full evaluation by your family doctor to exclude some of these potentially treatable causes. This is especially so for young people (younger than 40 years old), without a strong family history of hypertension.

Related: 10 Symptoms of Thyroid Problems Your Doctor May Miss