Tag Archives: medication

Doug Strain

June 23, 2016 by
Photography by Bill Sitzmann

Nestled in the leafy upper levels of the Old Market Passageway, tucked in the conjoining rooms of a former yoga studio, you’ll find the cozy abode of Aether & Epsom, a massage therapy studio and spa just a flight of stairs up from the bustle of Howard Street.

You may also encounter the studio’s founder, Doug Strain, either brewing a cup of tea at the end of the hall or engaged in a session with a client. Strain practices a variety of techniques, from deep-tissue massage to aromatherapy, with self-concocted distillates.

“I work with a large population in migraines,” Strain explains. “They’ve popped every pill and seen 500 neurologists, tried every CT scan, and I’ve been able to get a lot of them off of medication. They’re so frustrated and desperate to find something, anything, that will help them, and being able to be that resource for them—that’s pretty cool.”

DougStrain2

Strain found himself disillusioned with nursing practice after four years of CNA work, and decided to pursue massage therapy where he could still pay homage to his science roots and “work proactively with people’s pain, not just in damage control.” Strain’s practices subscribe chiefly to neuromuscular massage, a deep-tissue technique that focuses on relieving the body’s pressure points to ease physical pain and tension. After adhering to Nebraska’s hefty requirement of 1,000 hours of massage therapy school, Strain’s decision to start his own business seemed like the natural conclusion.

“I have full control of my working environment, practice the way I want to in a way I know is best, and honestly, I can offer a private, quiet setting for someone to receive body work in,” Strain says. “You’re already getting treatment, that puts you in a vulnerable place; the quiet environment is just more comfortable for people.”

Beyond various massage techniques, Strain also self-studies aromatherapy, creating his own scents and detailing them in a therapeutic index. His secondary passion is making craft cocktails, where he uses the hydrosols, or herbal distillates, as additives for the drinks.

Doesn’t it get stressful, managing all those tasks?

“Because it’s just me here, I wear all the hats, which can be stressful,” Strain agrees. “When it comes to customers, it’s really cool because I interact with them on every level. I’m their receptionist when they come in; I’m their therapist; I’m their manager. It actually gives me the opportunity to develop a better customer relationship than the average business might.”

Another service Strain offers is the chance to relax while viewing original art. Right next door to Strain’s studio is the art studio of abstract painter Mary Ann Chaney. Chaney exhibits a collection of barn paintings in the hallway for clients to peruse while waiting for their massage appointments.

The synthesis between massage therapy and artwork is a natural one, it would seem. “You’re almost in a zone when you paint; I like that aspect of it, it’s like therapy,” Chaney says about her work. “I like painting abstract, not tight realism. They have to look kind of relaxed, but also controlled.”

She pauses, smiles, and adds, “Just like massage.” Encounter

Visit aetherandepsom.com for more information

DougStrain1

The Road Home

October 25, 2013 by
Photography by Bill Sitzmann

A loaf of bread. A tank of gas. Pick up the dry cleaning. There are myriad detours one may take in the drive home on any 
given evening.

But the road home for David Hayes almost never varies. On most nights, he drives his car in a trance-like state, methodically wending his way through the streets of Omaha. The vehicle comes to rest after ascending what starts out as an almost imperceptible hill. The scenery never changes. The vehicle once again deposits its driver at his final destination—Evergreen Cemetery.

That’s where he goes to visit his son, Dillon.

A toxicology report listed the cause of Dillon’s 2010 death as due to a mix of cold medication and oxycodone. The medicine was an innocuous, over-the-counter purchase, a $6.99 solution to a case of the sniffles. The oxycodone was a much less innocent acquisition, a $40 score the then 15-year-old sophomore made in the halls of Millard North High School.

Hayes is now a member of the saddest of fraternities—fathers who have lost their sons to prescription drug abuse. “It’s a crappy club I belong to,” says Hayes, who has since dedicated his life to serving Dillon’s memory by talking about the dangers of a problem that will claim nearly 15,000 lives in America this year. And he’ll talk to anyone who will listen.

“If I can stop one kid from going down the wrong road, if I can help one parent, it will be worth all the pain. It would be…priceless.” —David Hayes

Hayes has spoken before over 7,500 school kids in the second half of 2013 alone, along with hundreds of adults at service clubs, churches, and other settings. “It’s hard for me to speak. Really hard,” Hayes says. “But seeing the results is worth it. If I can stop one kid from going down the wrong road, if I can help one parent, it will be worth all the pain. It would be…priceless.”

Oxycodone, most often available under the trade name of OxyContin, is a semi-synthetic opioid made from poppy-derived thebaine. It is a narcotic analgesic generally prescribed for relief of severe pain. Its connection to the poppy has earned it the street handle of “hillbilly heroin,” just one entry in a lexicon that includes such slang as 80s (as in 80 mg), kickers, killers, blues, and most commonly, oxy.

Alcohol, along with many cold medications, shares the opiate affect of suppressing breathing, which is why mixing it with OxyContin is so dangerous. A person who takes a swig of cough syrup or a single drink before ingesting oxy will likely notice no adverse affects. Later during sleep, however, the combined effect of the continuous-release oxy (thus the “Contin” half of OxyContin name) may cause the lungs to simply shut down and cease functioning.

That’s what happened to Dillon.

Hayes, perhaps most widely known as owner of the acclaimed V. Mertz and other popular restaurants, turned to counseling and clergy after Dillon’s death, but an abyss of sorrow still haunted him. To borrow from the lingo of 12 Step programs, he got better when he got busy.

20131011_bs_6193

So Hayes and longtime family friend Carey Pomykata launched Dillon’s House, a nonprofit that operates under the auspices of Youth for Christ. A basement playhouse that was the scene of many of Dillon’s greatest childhood adventures inspired the name. In his playhouse, the young boy could take the guise of astronaut, spy, or action hero, lost in all manner of valiant reveries. They were roles that Dillon would never have a chance to play in real, adult life. A reimagined though much grander version of the playhouse, a gift from Hayes to the children of Sonshine Christian Preschool, now stands on the grounds of Harvey Oaks Baptist Church, where he is a member.

“The kids here are, of course, too young to understand,” says Mollie Logan, director of the preschool, “but one day they will come to learn the full meaning of 
Dillon’s House.”

Hayes’ speaking gigs are aimed at the older siblings of the tykes who romp in Dillon’s House, as was the case during his presentation at Millard Public Schools’ Andersen Middle School.

Some motions—like riding a bike or the graceful swing of a professional golfer—are unthinking ones. They are acts of all but unconscious muscle memory. Hayes has his own. Not one minute into his school chat, he was reaching for a tissue. It is a gesture that defines the gentle, soft-spoken man. He first demonstrated it over coffee in an initial interview. He repeated it at the school and then again in a photo session. Even at an otherwise festive social function, talk of Dillon soon had Hayes fumbling through his pockets.

“Remember that old, old American Express travelers checks commercial with Karl Malden?” Hayes asks as an index finger darts to a cheek to intercept a salty intruder. “That’s me, but with Kleenex. I never leave home without them.”

“My dad didn’t want to wake after that, after Dillon died,” adds Hayes’ other son, Noah, now a 17-year-old junior at Elkhorn South High School. “Every morning was the same. He’d wake up, and it would take a moment or two for things to sink in, even months later. Was that real? Did that really happen? Then the pain would come again.”

“Kids my age think they’re invincible. Nothing can stop them. It’s an ego thing…But what kids don’t understand is not only that drugs can take control; they can take your life. That’s what happened to my brother.” —Noah Hayes

His struggle is different. While Hayes is bewitched by the specter of one lone oxy, Noah must witness firsthand the ongoing ravages of prescription drug abuse among his teens.

“Kids my age think they’re invincible,” Noah explains. “Nothing can stop them. It’s an ego thing. Drugs can’t possibly have negative consequences, they think. They could see this story and not even blink. They just don’t think that way. But what kids don’t understand is not only that drugs can take control, they can take your life. That’s what happened to my brother. He went to bed one night and never woke up.” Close your eyes, Noah says, and Monday morning locker chatter can be indistinguishable from that of the scholarly banter found in a lecture hall for third-year pharmacy students. “It’s really prevalent in our school and must be in others. It’s like a dirty little secret.”

Omaha Magazine invited three different area school districts to participate in a variety of ways in compiling this story. Some of those media requests were decidedly weighty and challenging. None accepted the invitation.

Pomykata, who acts as the director of Dillon’s House, has also had the soul-crushing experience of facing the persistence of dirty little secrets. She once happened to bump into thirteen of Dillon’s friends on a pilgrimage to Evergreen Cemetery. “It was the sweetest scene,” she says, “crying and laughing and then crying some more as we remembered Dillon.” But the conversation took a grim, darker turn as time wore on and the teens opened up about life after Dillon. “Twelve of the 13 admitted to using prescription drugs again since Dillon’s death.”

When it comes to the volatile power of a narcotic like oxy, there is no such thing as innocent, youthful experimentation, and repeated use can easily lead to addiction.

“I stole money from my mom,” says Jason (not his real name) on how he funded an insidious oxy addiction. “I stole a TV from my grandma, even though it was a lame piece of junk that I sold for only $30.” Jason dropped out of school at 16 before hitting bottom and landing in rehab under court-ordered supervision. Now 19, Jason is in recovery and back in school, studying computer programming while working a steady job, both ideas that were once entirely foreign to him. “Recovery has been a long road to travel. My family expected to get the old Jason back, but the new Jason is still pretty okay with them. The first thing I did when I had any money was to buy grandma a new TV, nicer than the one I took. She had already replaced the TV and laughed about it, but it was something I had to do for myself as much as for her.”

“Recovery has been a long road to travel. My family expected to get the old Jason back, but the new Jason is still pretty okay with them.” —”Jason,” a recovering addict

All addictions are family diseases. Often beginning as the elephant in the room, addiction acts like a malicious virus, infecting those closest to the user.

“I went to Al-Anon because I thought those people could tell me how to get my daughter to stop [prescription drugs],” says Sarah, who also requested anonymity for this story. “I was wrong about that but in a good way. What I found there really surprised me. Al-Anon helps me answer questions about me. I learned how to live again. It’s about sharing experience, strength, and hope. My daughter ended up getting better even before I did,” Sarah adds with a chuckle. “She still goes to NA [Narcotics Anonymous], I go to Al-Anon, and sometimes we go to each others’ meetings together.”

Reed Campbell, Clinical Director of NOVA Treatment Community in Omaha, has worked with scores of “Jasons” and “Sarahs” on what can be shared roads to recovery between parent and child. “In the stage between late childhood and early adulthood, curiosity runs rampant,” he says. “Anything that can get youth out of a place that is uncomfortable by providing some sense of security is a thing that kids might easily cling to. The grip of drugs like oxycodone and other heavy-duty pharmaceuticals is powerful but teens don’t think of the consequences.”

Pomykata agrees. “Kids see this stuff in their parents’ medicine cabinet and think ‘A doctor says this is good for my mom’s back. This must be safe or a doctor wouldn’t have given it to her.’”

Hayes reached for a tissue when Pomykata painted the picture of Dillon’s friends at the cemetery but prefers to point to happier, more encouraging brushes with those touched by prescription drug abuse. “A young man stopped me in the grocery store recently. He started crying as he introduced himself, saying that he had heard me talk at Millard South High School and had struggled with a drug problem, including prescription drug abuse. Then, he said something that reminds me of why I get out of bed in the morning. ‘That could be me,’ he said, ‘I could have been Dillon.’”

“What I found there really surprised me. Al-Anon helps me answer questions about me. I learned how to live again. It’s about sharing experience, strength and hope.” —”Sarah,” Al-Anon member

The tireless advocate has recently broadened the reach of Dillon’s House, taking its message on tour to five school districts in New York, where he says officials use the word “epidemic” to describe their prescription drug problem. Never one to rest, he loaded the evenings of his itinerary fulfilling invitations from universities and church groups.

Back in Omaha, Hayes dashes off to another school and then another and then another. He consults maps in planning his next national road trip. On many days, he is in danger of forgetting what’s next on his dizzying calendar.

But there will always be Evergreen Cemetery. And there will always be the shadow cast by a little blue pill. Hayes’ road home is always the same.

ADHD

September 24, 2013 by

One of the most common neurobehavioral disorders found among children is Attention-Deficit/Hyperactivity Disorder (ADHD), according to the Centers for Disease Control and Prevention (CDC). And rates are on the rise.

Dr. Ashley Harlow, psychologist at Children’s Hospital & Medical Center, believes that this spike in diagnoses is due to a combination of factors. “Parents, teachers, and [health care] providers are more aware of the signs and symptoms and, therefore, are investigating this diagnosis as a possibility,” he says.

Because ADHD is so prevalent, there is concern that children are being misdiagnosed.

Misdiagnosis can go many ways, explains Dr. Harlow. “I think misdiagnosis is a problem, although I think it is important to consider misdiagnosis as both diagnosing another condition as ADHD and diagnosing ADHD as another condition.

“I see kids who have been diagnosed with ADHD because they do not like their teacher, they do not listen to their parents, or they do not follow through on what their parents tell them to do,” says Dr. Harlow. “These behaviors do not necessarily indicate ADHD.”

Also complicating the issue are instances where children have ADHD and are instead diagnosed with another disorder, like Autism Spectrum Disorder, or when high-school and college students use ADHD medication to support studying. “In these cases of students seeking study aids, misdiagnosis might occur because of misrepresentation of the symptoms by the patient,” adds Dr. Harlow.

Dr. Harlow says that visible signs of ADHD can include behaviors like “difficulty sitting still in the classroom, disorganization in completing homework or turning it in, making careless mistakes, staring off into space, interacting with peers in immature ways, or starting chores but not finishing them.”

Many children may demonstrate these behaviors, so Dr. Harlow advises careful consideration before jumping to conclusions. “[Health care] providers, in consultation with families, work to determine if enough symptoms are present and impairment is at a level to warrant a clinical diagnosis.”

The CDC states that “children with ADHD do not grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends.” Therefore, it is important to treat children who are afflicted with ADHD.

Treatment of ADHD focuses on reducing the impact of the symptoms, not eliminating them. “It is important to remember that ADHD is a neurologically based disorder, and so improving behavior likely means learning to manage symptoms rather than removing the symptoms entirely,” explains Dr. Harlow.

He recommends a combination of medical and behavioral health interventions, including setting up the environment (classroom or home) to be predictable and organized for the child and to make consequences immediate and consistent.

Children’s Hospital & Medical Center offers free parent education sessions related to topics surrounding ADHD. For more information, visit ChildrensOmaha.org/BehavioralHealth.

Shingles

June 20, 2013 by

Most of us weathered childhood chickenpox years ago with no worse than some intense itching and a few missed days of school. But for approximately one out of three people who’ve had chickenpox—99 percent of us, according to the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention—that’s not the end of it. A painful viral infection called shingles can show up years later.

“It’s pretty common. About 30 percent of Americans will get shingles at some time in their lifetime; it turns out to be one million cases a year,” says Dr. Michael Walts, a family medicine physician with Alegent Creighton Health. “Usually shingles only occurs once. In most cases, it’s self-limiting; it goes away, and you don’t have any further problems.”

Shingles is so common because it’s caused by the varicella-zoster virus, the same virus that causes chickenpox, he explains.

“Although the [chickenpox] rash goes away, the virus doesn’t. It crawls into your spinal column, where it goes to sleep, maybe forever,” Walts says. “But maybe, for most reasons we don’t know, the virus wakes up and will crawl down one nerve of the spinal cord and into the skin. Wherever that nerve is going to, that’s where the shingles rash will show up.”

And unlike chickenpox, this rash is more than just annoying.

“The most significant risk factor for the development of shingles is age. The reason we think that’s the case is that the immune system, like everything else as we get older, just doesn’t work as well.” – Michael Walts, M.D., family medicine physician with Alegent Creighton Health

“You’ll have pain first, and then all of a sudden the rash appears…It can be excruciatingly painful,” Walts says. And for some, the pain is long-lasting, even permanent.

“One of the most significant complications of shingles, a small percentage of time, is that even after the rash goes away, the pain doesn’t,” Walts explains. “The condition is called postherpetic neuralgia, or PHN.”

Shingles is more common after age 60, Walts says. “The most significant risk factor for the development of shingles is age. The reason we think that’s the case is that the immune system, like everything else as we get older, just doesn’t work as well. And the older you are when you get shingles—if you do—the more likely you are to get postherpetic neuralgia.”

It’s even possible that people who’ve been immunized against chickenpox can still get shingles later, he says, and it also strikes people who believe they’ve never had the chickenpox.

“People will say ‘I got shingles, but I never had chickenpox as a kid,’ and my response to that is, ‘Yeah, you did. You just didn’t know it,’” Walts says. “Maybe you had a bump or two that nobody ever even noticed, or maybe you had a rash that somebody said was contact dermatitis, because there’s no way you can get shingles unless that virus is living in your spinal cord.”

It’s not all bad news. A single-dose vaccine called Zostavax may prevent shingles altogether or prevent a recurrence. And if a person suspects shingles, especially when a rash appears on only one side of the body, he or she can still see their physician for treatment.

“(Anti-viral) medication does help. It does speed up the resolution of the pain and the rash, so go to your doctor and make sure it’s shingles,” Walts says. “We’re not sure about this, but one of the theories is that maybe treatment will not only decrease the amount of time you’re symptomatic, but it might decrease your risk for that postherpetic neuralgia. That’s all the more reason to get treatment, because, boy, anything you can do to prevent that side effect—even though it’s not common—you ought to try.”

There’s No Place Like Home

April 25, 2013 by

If you’ve spent time in the Midwest, you are no stranger to tornados. Many of us could share a story of “the Big One” or a storm we’ll never forget. Hopefully, with stories come memories of survival and preparedness. The following tips can help you prepare for when the next tornado strikes.

Who’s at Risk?

Tornadoes strike most often between March and June in the central U.S., but they’ve been reported in all 48 continental states, at all times of the year. Older adults need to take additional actions, like having their medications accessible and giving themselves plenty of time to get to shelter.

What to Do if a Tornado is Coming

Seek shelter immediately! If you’re away from home, your best bets are basements or interior corridors of office buildings, tunnels, or underground parking lots. Avoid auditoriums, upper stories of office buildings, trailers, and parked vehicles. And stay away from windows. If you’re out in the open, lie flat in a ditch or other low-lying area and protect your head. Stay away from poles and overhead lines.

If you’re driving, drive at right angles to the tornado’s path. If you can’t escape the path of the tornado, get out of the vehicle to avoid being overturned and crushed. If you’re at home, head for the basement and take cover under a heavy table or workbench. If you don’t have a basement, go into a windowless room in the center of the house. If that’s not possible, stay away from windows and cover yourself with a rug for protection against flying glass and debris.

Know the Difference Between a Watch and a Warning

A tornado watch means conditions are right for the formation of a tornado. Stay alert, and be prepared to take shelter. A tornado warning means a tornado has been spotted in your area. Take shelter immediately!

What to Prepare

Here are suggested items for your emergency kit: One gallon water per person per day for at least three days; a three-day supply of non-perishable food; battery-powered or hand-crank radio and a NOAA weather radio with tone alert, and extra batteries; flashlight and extra batteries; first aid kit including a whistle to signal help; prescription medications and glasses, including medical equipment like test strips or syringes, if needed; pet food and extra water for your pet; a sleeping bag or warm blanket; change of clothing, including a long-sleeved shirt, long pants, and sturdy shoes; fire extinguisher; matches in a waterproof container; personal hygiene items; moist towelettes, garbage bags, and plastic ties for personal sanitation; disinfectant wipes and hand sanitizer; and paper cups and plates, plastic utensils, paper towels, and a can opener.

FEMA (Federal Emergency Management Agency) recommends preparing a survival kit of basic needs (food, water, etc.) for 72 hours for the home and car. Visit ready.gov for a complete list of emergency preparedness items. When a tornado strikes, there is often little time to gather items or get to a store. Make your own kit and store in a plastic tote, or purchase a kit from National Safety Council, Nebraska for $45 or $69 at safenebraska.org or call 402-896-0454.

Adapted from National Safety Council. NSC makes no guarantee as to and assumes no responsibility for the correctness, sufficiency, or completeness of such information or recommendations. Other or additional safety measures may be required under particular circumstances. For more information, visit safenebraska.org.

Smoking Cessation Aids

March 25, 2013 by
Photography by Bill Sitzmann

The old saying “third time’s the charm” didn’t work so well for Laura Adams when it came to quitting smoking.

“Every time I quit, I’d be good for about six months,” she says. “Then I’d get stressed about something and decide to have just one. Well, once you start up again, it’s all over. It’s an all-or-nothing thing.”

Adams is not in the minority. Most smokers will try quitting multiple times before they are successful. There’s a lot more to smoking than meets the eye, say local smoking cessation experts. “There’s an addiction to nicotine, the actual habit, and the emotional dependence that all need to be addressed,” says Laura Krajicek, a smoking cessation coordinator for Nebraska Methodist Health System.

A smoker for more than 20 years, smoking had become a crutch for Adams. “It helped me deal with daily stresses,” she explains. “When I had a cigarette, that was my relaxation time, my ‘me time.’ Coffee, cigarettes, and break time all went together. It was hard to have one without the other.”

Adams knew that it wasn’t a “pretty habit,” nor one she was proud of. With a campus-wide no smoking policy at her place of employment, Alegent Creighton Health Immanuel Medical Center, Adams would have to “sneak” to an off-site parking lot to smoke. To mask the nasty smoke odor, she would slip on a different coat, pull her hair back in a ponytail, wash her hands, and coat herself with body spray before returning to the office. “It was an embarrassing addiction,” she recalls.

“When I had a cigarette, that was my relaxation time, my ‘me time.’” – Laura Adams, former smoker

When Adams learned about Alegent Creighton Health’s smoking cessation program, Tobacco Free U, she decided this might be the extra push she needed to help her quit for good. The program focuses on the use of group or individual counseling in combination with a smoking cessation aid such as nicotine patches, nicotine gum, or medications.

According to the Cochrane Review, an internationally recognized reviewer of health care and research, combining counseling and medication improves quit rates by as much as 70 to 100 percent compared to minimal intervention or no treatment.

“Success rates rise drastically when you combine the two,” says Lisa Fuchs, a certified tobacco treatment specialist at Alegent Creighton Health. The counseling portion helps people tackle the behavioral addiction, and the smoking cessation aids help with the nicotine addiction.

Which smoking cessation aid is recommended depends on how heavy a smoker, health conditions, as well as what seems to be the best fit for that person’s lifestyle, notes Fuchs. These aids are most successful in individuals who have been counseled on how to use them appropriately. The most common aids include:

Nicotine patch – The patch is a long-acting therapy that delivers a steady dose of nicotine over a 24-hour period and is designed to curb a person’s cravings for nicotine. This may be appropriate for very heavy smokers. The dosage is gradually lowered to wean a person off the nicotine habit.

Nicotine gum or lozenges – Gum and lozenges are short-acting therapies that deliver smaller doses of nicotine and can be taken as needed to curb the nicotine urge. Tom Klingemann, certified tobacco treatment specialist at The Nebraska Medical Center, recommends that smokers schedule the doses so that they maintain a steady state of nicotine in the body to avoid the nicotine cravings and temptation to smoke. In general, he is opposed to short-acting nicotine replacement therapies because “they keep people looking for a chemical fix even though they may not be smoking anymore.” They are also very expensive, and most people trying to quit can’t afford the $40 a week price tag they would cost if used appropriately.

e-cigarettes – These work by heating up a liquid nicotine substance that is inhaled as vapor. The product is not regulated by the Food and Drug Administration (FDA) and many still have a lot of chemicals that may not be any healthier than actual smoking, notes Klingemann. “These are not intended to help people quit but keep them addicted to nicotine,” he says.

Medications – The two primary prescription medications used for smoking cessation include Zyban and Chantix, with Chantix being the preferred of the two, says Fuchs. “Zyban is an anti-depressant and may be recommended for a person with mild depression to help with moodiness as well as decreasing cravings and withdrawals,” notes Fuchs. It is believed to work by enhancing your mood and decreasing agitation related to trying to quit.

Chantix is a newer drug and works by binding to nicotine receptors in the brain and blocking them so that nicotine can no longer activate those receptors, causing a person to get less satisfaction from smoking. At the same time, it also triggers a small release of dopamine, the reward neurotransmitter in the brain. It appears to be safe and quite effective, notes Klingemann. Krijicek says that her clients have seen the most success with this aid.

“Success rates rise drastically when you combine [counseling and medication].” – Lisa Fuchs, certified tobacco treatment specialist at Alegent Creighton Health

Adams used Chantix, which she said helped curb her nicotine urges. But what helped the most, she says, was to change the habits that she associated with smoking. For instance, instead of coffee and cigarettes in the morning, she reached for coffee and orange juice. Because she normally smoked while driving, she changed the route she drove to work. She also replaced the time she would have spent smoking with more positive habits like walking her dogs, running, bicycling, and swimming.

“Once I quit, I started making healthier decisions in other parts of my life as well,” she says. “I started eating better, drinking less caffeine, and exercising more. I feel better now.”

“For 90 percent of smokers, the addiction is behavioral,” notes Klingemann. “It’s all of the other stuff that drives the smoking addiction. Until you start changing your behaviors and routines, it’s really hard to quit.”

Bipolar Disease

November 25, 2012 by

“My husband didn’t know if he was going to come home to Cruella Deville or Dolly Levi from Hello Dolly.” That’s how Jane Pauley, broadcast journalist and former co-host of the TV morning show Today, described her battle with bi-polar disease in a interview on Healthy Minds, produced by New York Public Radio. “Who knows what provokes it, but it was like a swarm of bees that wants a target,” she says.

Being diagnosed with bipolar disease was a shock, recalls Pauley, but getting a diagnosis and subsequent treatment, however, allowed her to regain some normalcy in her life again.

Bipolar disease is a serious mental illness that is associated with extreme mood swings from mania to depression. “It is one of the most serious illnesses we deal with because of the disruptive nature of the disease,” says Sharon Hammer, M.D., psychiatrist at the University of Nebraska Medical Center (UNMC). “It is more serous than depression or schizophrenia because it can lead to risky behaviors, such as drug and alcohol abuse, damaged relationships, and suicide. And because of the impulsive nature of the disease, there is often no time to intervene.”

The average onset of bipolar disease tends to occur in older teenagers and young adults ages 20 to 25 years old. “Many women may start to experience symptoms of depression in their teenage years followed by their first manic episode in college,” says Hammer. “This is a very risky time because the college years are often mixed with stress, sleep deprivation, and alcohol use, which are all triggers for episodes.”

“It is one of the most serious illnesses we deal with because of the disruptive nature of the disease.” – Sharon Hammer, M.D., psychiatrist at UNMC

Women with bipolar disease typically spend about 80 percent of the time in depression and 20 percent in mania. Episodes of mania are characterized by abnormal elevated moods that include irritability, being easily agitated, impulsivity, racing thoughts, and insomnia.

Many women tend to be in denial and don’t start taking it seriously until they have children, notes Hammer. Even then, it is often misdiagnosed as depression or anxiety due to the extended depressive states associated with the condition, and the fact that women are twice as likely to have depression than men. In fact, bipolar disease is the most under-diagnosed mental illness and the most challenging to diagnose, notes Hammer.

Misdiagnosis can create more problems because medications used for depression and anxiety are different than those used to treat bipolar disease and can make the condition worse.

In addition, untreated bipolar disease tends to gain momentum and become more malignant with time, says P.J. Malin, M.D., a psychiatrist with Alegent Creighton Clinic and an associate professor of psychiatry at Creighton University School of Medicine. “It can be very disruptive to other parts of your life. Approximately 60 percent of people with bipolar disease will develop substance abuse problems, and it carries a 15 to 20 percent suicide rate.

“Early treatment of the disease can help prevent the disease from getting more aggressive. Untreated bipolar disease, on the other hand, lowers one’s life expectancy by 10 years.”

If you are being treated for depression and are not responding to depression medications or you are experiencing negative or an unusual response, it is important to communicate this with your provider, adds Malin.

“Early treatment of the disease can help prevent the disease from getting more aggressive.” – P.J. Malin, M.D., psychiatrist with Alegent Creighton Clinic

You can also do your own test by taking the Mood Disorders Questionnaire (MDQ) online, which provides fairly accurate results and can help you and your clinician determine whether you are bipolar, notes Hammer.

Environmental factors and heredity appear to be the major risk factors for bipolar disease, says Malin. “There are different theories as to how the environment plays a role, but they include: obstetric complications, intra-utero viral infections, use of hallucinogenic drugs, and traumatic life events, such as the death of family or friends or abuse.”

Treatment typically involves a combination of medications and counseling that may be necessary over a person’s lifetime. “Counseling is huge for long-term success and stabilization,” says Robin Houser, a counselor for Nebraska Methodist Hospital’s employee assistance program, Bestcare EAP. “Bipolar disease is a lifetime problem, and counseling can help people learn coping techniques and avoid unhealthy thinking and unhealthy patterns of behavior. A lot of people think that once they have become stabilized that they don’t need medications or counseling anymore, but that’s when we’ll start seeing imbalances and manic episodes occur again.”

Women with bipolar disease are very sensitive to stress, lack of sleep, and environmental and seasonal changes, all of which can trigger an episode, notes Hammer. Practicing healthy lifestyle habits like getting regular exercise, adequate sleep, managing stress, and light therapy during the winter months can help keep the disease stabilized.

 “Counseling is huge for long-term success and stabilization.” – Robin Houser, counselor for Nebraska Methodist Hospital

Postpartum is also a common time to experience recurrences, probably because of sleep deprivation, says Hammer. There are medications that are safe to use during pregnancy, which are important to take to prevent a relapse. If a woman stops her medications during pregnancy, it can take up to six months to get the symptoms under control again, says Hammer.

“Newer medications as a whole have fewer side effects,” she says, “but it’s important that you are matched with the medication that works best for you and has the fewest side effects.

“Patients who are being followed and treated by a trained health care professional can function vey well and live a normal life.”