Translate

Thứ Tư, 30 tháng 9, 2015

Which diet or weight-loss program makes the most sense for you?

People looking to shed the pounds seem to be bombarded with new and old diet strategies. Some promise quick and easy weight loss, while others require a more long-term commitment and lifestyle change. Can you really lose weight by solely eating fast food? Does grapefruit speed up your metabolism? Is going vegan or giving up carbs the answer? Read on as nutritional experts sound off on today's most popular diet plans. Learn the pros and cons of the following diets:
Người đăng: vào lúc Không có nhận xét nào:
Nhãn:

5 Surprising Foods That Have Little Impact on Blood Sugar

  • Keep These Foods on the Menu

    When you're diagnosed with diabetes, one of the first changes that your doctor will recommend is cleaning up your diet. Suddenly even seemingly-healthy foods are placed on a do-not-eat list. While you may start to feel like there are very few foods you can eat safely, you'll be happy to hear that a handful of foods commonly assumed to be off-limits are actually healthy choices for those living with the condition.
    These “off-limits” foods actually have a much lower impact on glucose levels than people think, and get the green light to include in a diabetes-friendly diet.


  •

    Carrots

    If you’ve been under the impression that carrots are a sugar-loaded danger food, you’re not alone. Although this is a common misconception, “it is simply not true,” states Rene Ficek, RD at Seattle Sutton's Healthy Eating. “Carrots are considered a non-starchy vegetable along with options such as broccoli and lettuce. These foods are safe for people with diabetes to eat at each meal without worry that glucose levels will spike.” If you want to take extra precautions against a rise in glucose levels, enjoy carrots raw instead of cooked. “Cooking vegetables makes their carbohydrates more bioavailable, so sticking with raw will have a more minimal impact on blood sugar,” adds Ficek.
  •

    Sweet Potatoes

    If you think living with diabetes means never enjoying a potato without a side of guilt, think again! "Research has found sweet potatoes may play a role in stabilizing or lowering blood sugar, due to their low glycemic index," says Lauren Harris-Pincus, MS, RDN. The glycemic index is a scale that shows the impact a food has on blood-sugar levels. Foods low on the scale break down more slowly in the body, which may produce fewer fluctuations in blood glucose and insulin levels. "For the least impact on blood-glucose levels, enjoy sweet potatoes with the skin on or in their raw form, which lowers their glycemic impact,” says Harris-Pincus. "And sprinkle on a dash of cinnamon to further assist with blood-sugar control."
  •

    Cottage Cheese

    Many people assume that all dairy products contain equal amounts of carbohydrate and impact blood sugar in similar ways; however, cottage cheese actually contains much less carbohydrate than yogurt or milk. “Low-fat cottage cheese is high in protein and low in carbohydrates, making it a terrific addition to a snack or a meal,” says Jill Weisenberger, MS, RDN, author of 21 Things You Need to Know About Diabetes and Your Heart. Be sure to select a variety with no carbohydrate-containing additives, which are added to certain brands and can lead to a spike in blood sugar levels. “You don’t need extra carbohydrates in such a wholesome food,” says Weisenberger. “Be a label sleuth and choose a variety with only pure, simple ingredients, and no added carbohydrates.”
  •

    Strawberries

    Strawberries are often thought to have more sugar than other fruits. But in reality, strawberries have the lowest amount of sugar per one-cup serving (7 grams) when compared to popular fruits such as apples and oranges. “Strawberries can be the perfect low-calorie solution for someone with a sweet tooth," says Mitzi Dulan, RD, author of The Pinterest Diet: How to Pin Your Way Thin. "Research suggests that eating strawberries may help our bodies better use insulin, which can lower the amount needed to manage blood sugar after eating.”
  •

    Yogurt

    Yogurt has gotten a bad rap as a source of hidden sugar. While some flavored varieties have sky-high sugar counts, plain yogurt can be a smart choice for those monitoring their blood-glucose levels. “Yogurt naturally contains both high-quality carbohydrates and protein, making it an excellent food for slowing or preventing an unhealthy rise in blood sugar,” says Ficek. “In fact, research has shown diets high in calcium-rich foods may even help to reduce the risk of developing type 2 diabetes.” When selecting yogurt, make sure to be on the lookout for added sugars. The best choice is a low-fat, plain Greek yogurt (for an extra protein boost) with no added sugars — add your own whole fruit for additional flavor if desired.
Người đăng: vào lúc Không có nhận xét nào:
Nhãn:

PARADIGM Drug Dose Reduction Doesn't Cut Benefit

Similar benefit with LCZ696 vs ACE inhibitor across lower achieved doses in trial substudy

  • author name

  • by Crystal Phend
    Senior Staff Writer, MedPage Today

  • This article is a collaboration between MedPage Today® and:
    Medpage Today

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
NATIONAL HARBOR, Md. -- Heart failure drug LCZ696 (Entresto) maintains its effect on hospitalizations and mortality even when the dose must be reduced, a PARADIGM-HF trial substudy showed.
The hazard ratios for the primary composite endpoint of death from cardiovascular causes or heart failure hospitalization remained similar across achieved LCZ696 dose categories:
  • 0.79 (95% confidence interval 0.71-0.88) for the full 200 mg target dose versus 10 mg enalapril
  • 0.80 (95% CI 0.67-0.94) for a reduced 100-200 mg dose versus 5-10 mg enalapril
  • 0.76 (95% CI 0.58-0.99) for doses under 100 mg versus under 5 mg enalapril
The comparative efficacy likewise was similar for the primary outcome censored at dose reduction (HR 0.79) and when looking only at events after dose reduction (HR 0.80), Orly Vardeny, PharmD, of the University of Wisconsin in Madison, and colleagues reported here at the Heart Failure Society of America meeting.
"As one looks at the data and as, say, a physician in Minnesota you look at a patient and see the patient tolerates a lower dose and the dose beats enalapril -- Is this the beginning of rethinking the dose range of this drug?" posited John Burnett, Jr., MD, of the Mayo Clinic in Rochester, Minn., as a moderator at the rapid-fire abstract session.
"In general as clinicians, we really need to target doses that were used in the clinical trials," Vardeny responded. "Even though we're saying the relative benefit remains at a lower dose, it's important to still try to target. That's something we always strive for with all our neurohormonal blockers, whether it be beta-blockers, ACE inhibitors, or MRAs. We should still try to target 200 mg BID for the most part [with LCZ696]."
While the findings are reassuring, "I wouldn't routinely reduce the dose, I would only reduce the dose if one had an adverse side effect or outcome," Matthew Wolf, MD, PhD, of the University of Virginia Health System in Charlottesville, agreed in an interview with MedPage Today.
The most common reasons for dose reduction in the trial were:
  • Hyperkalemia (6.2% LCZ696, 7.2% enalapril)
  • Hypotension (19.7% LCZ696, 14.6% enalapril)
  • Patient request (13.3% LCZ696, 13.2% enalapril)
The single strongest predictor of dose reduction was elevated serum creatinine (OR 2.27, 95% CI 2.27-3.26).
The reduced-dose versus reduced-dose comparison was a reasonable way to look at the outcomes, commented Jean Nappi, PharmD, of the Medical University of South Carolina in Charleston.
"I think it's a fair comparison, because they both cause hyperkalemia, they both cause hypotension," she told MedPage Today, so a patient requiring a reduced dose of the one drug likely wouldn't have tolerated a full dose of the other.
From the American Heart Association:
Người đăng: vào lúc Không có nhận xét nào:
Nhãn:

Powerful Food Combos to Control Diabetes

  • The Need-to-Know Nutrient Combo

    It's important for all of us to eat a diet that supports and controls blood sugar, whether we have diabetes or not. All you need to remember is one simple formula to ensure that every meal fills you up and keeps levels stable: Protein + carbs + healthy fats.
    While whole-grain carbs are satisfying, eating them alone can lead to changes in blood-sugar levels that take your mood and energy on a roller coaster ride. Adding a dose of protein and healthy fats provides sustained energy and stabilizes blood-glucose levels. Ready to give it a try? These simple food pairings take all three nutrients into account for a tasty, satisfying dish.

    •

      Pasta and Protein

      If you think pasta is off the menu, we've got some good news! It’s a misconception that you need to avoid this satisfying staple when you have diabetes. You just need to pay attention to the type of pasta you’re eating, how it’s prepared, the portion size, and what you're eating it with. “Pasta cooked al dente (not overcooked), should be eaten in combination with vegetables, tofu, seafood, or chicken,” says Johanna Burani, RD, author of Good Carbs, Bad Carbs. Why al dente? “Overcooked pasta becomes soft, loses its form, and gives up glucose more readily, likely giving you a bigger rise in blood glucose,” says David J. A. Jenkins, PhD. “A pasta recipe can provide a completely balanced meal when you include protein, heart-healthy fat, vegetables, fiber, and low-glycemic carbohydrates,” adds Burani. Stick to whole-wheat or whole-grain pasta and keep in mind that one serving size is a half cup cooked of cooked pasta.
    •

      Crackers, Cheese, and Avocado

      Fats are slowly shedding their bad reputation, and for good reason: Choosing healthy fats over unhealthy saturated and trans fats can help lower cholesterol levels while keeping blood-sugar levels stable. For a perfect snack, Melissa Joy Dobbins, MS, suggests two whole-grain crackers topped with one slice (1 ounce) low-fat cheese, and a few slices of avocado or 2 tablespoons of a simple guacamole spread made of avocado, lime juice, and cilantro. "The protein and fat helps slow down the release of glucose (from the carbohydrates) into the blood stream,” Dobbins says. “If you eat carbs alone, they will be absorbed more quickly into the blood stream and ‘spike’ blood sugars.”
    •

      Salad and Shrimp

      The word “salad” has a health halo around it, but looks and labels can be deceiving. Popular toppings like croutons, crispy noodles, and creamy dressings are laden with unhealthy fat and empty calories. On the flip side, some people try to keep their salad light by just tossing together a few vegetables. While this may seem like a healthy option at first, it can be less than satisfying, triggering unnecessary snacking later on. Skimping on some meals and overeating at others can lead to unstable peaks and valleys in your blood-sugar levels. To ensure your salad is a complete meal, add lean protein like grilled chicken, shrimp, shredded cheese, or beans and some crunch with veggies like fresh beets, jicama, and sliced nuts.
    •

      Sorghum and Zucchini

      If you haven’t tried sorghum, you may want to add it to your shopping list. A 1/4 cup serving of whole-grain sorghum has 5 grams of filling protein and 3 grams of fiber per serving, and has been linked to reduced risk of cancer and heart disease. When paired with non-starchy veggies like zucchini, which adds vitamins, minerals, and additional fiber, the grain dish works to stabilize blood sugar. Bonus points for adding a lean protein like skinless chicken or tofu — toss all three ingredients for a tasty salad or stir-fry!
    •

      Apple, Peanut Butter, and Dark Chocolate

      For a sweet treat with health benefits, Andrea Conner, RD, recommends munching on apple slices with all-natural nut butter (peanut, almond, cashew, or pistachio) and dark chocolate shavings. “The cholesterol-lowering soluble fiber in the apple slows down stomach emptying and may result in a more moderate rise in blood glucose, while the peanut butter provides a great balance of protein and monounsaturated fat that helps with satiety and better blood-sugar control,” says Conner. A sprinkling of dark chocolate chips adds some decadence, which will satisfy sweet cravings without spiking blood sugar.
    •

      Greek Yogurt and Oats

      Yogurt itself contains protein, carbs, and fat, all in one convenient container. “Plain, low-fat Greek yogurt, or fat-free Greek yogurt, high in protein and calcium and relatively low in carbs and saturated fat, is the perfect breakfast when combined with whole-grain oats,” says Marlene Koch, RDN, author of Eat What You Love. She suggests topping yogurt with low-sugar jam or berries and crunchy toasted oats, or making a smoothie with vegetables, oats, yogurt, milk, and fruit, for a high-protein, high-fiber meal that will keep blood sugar and hunger in check.
    •

      Whole-Grain Bread and Lean Meat

      Many people shy away from sandwiches because they can be high in calories and fat. While turning to a lettuce leaf or mushroom cap in place of bread can be a smart way to cut calories, “a lean meat sandwich would leave you more satisfied and would provide the protein to reduce the postprandial rise in blood sugar,” says Roberta Anding, MS, certified diabetes educator, and clinical dietitian at Baylor College of Medicine. Whole-grain bread has a lower glycemic load than white bread made with refined flour, thereby producing less of a rise in blood sugar after meals. Be sure to make your sandwich with a lean protein like low-sodium turkey or chicken breast, and load on the veggies!
  • Last Updated: 08/28/15


  • Pasta and Protein

    If you think pasta is off the menu, we've got some good news! It’s a misconception that you need to avoid this satisfying staple when you have diabetes. You just need to pay attention to the type of pasta you’re eating, how it’s prepared, the portion size, and what you're eating it with. “Pasta cooked al dente (not overcooked), should be eaten in combination with vegetables, tofu, seafood, or chicken,” says Johanna Burani, RD, author of Good Carbs, Bad Carbs. Why al dente? “Overcooked pasta becomes soft, loses its form, and gives up glucose more readily, likely giving you a bigger rise in blood glucose,” says David J. A. Jenkins, PhD. “A pasta recipe can provide a completely balanced meal when you include protein, heart-healthy fat, vegetables, fiber, and low-glycemic carbohydrates,” adds Burani. Stick to whole-wheat or whole-grain pasta and keep in mind that one serving size is a half cup cooked of cooked pasta.
  •

    Crackers, Cheese, and Avocado

    Fats are slowly shedding their bad reputation, and for good reason: Choosing healthy fats over unhealthy saturated and trans fats can help lower cholesterol levels while keeping blood-sugar levels stable. For a perfect snack, Melissa Joy Dobbins, MS, suggests two whole-grain crackers topped with one slice (1 ounce) low-fat cheese, and a few slices of avocado or 2 tablespoons of a simple guacamole spread made of avocado, lime juice, and cilantro. "The protein and fat helps slow down the release of glucose (from the carbohydrates) into the blood stream,” Dobbins says. “If you eat carbs alone, they will be absorbed more quickly into the blood stream and ‘spike’ blood sugars.”
  •

    Salad and Shrimp

    The word “salad” has a health halo around it, but looks and labels can be deceiving. Popular toppings like croutons, crispy noodles, and creamy dressings are laden with unhealthy fat and empty calories. On the flip side, some people try to keep their salad light by just tossing together a few vegetables. While this may seem like a healthy option at first, it can be less than satisfying, triggering unnecessary snacking later on. Skimping on some meals and overeating at others can lead to unstable peaks and valleys in your blood-sugar levels. To ensure your salad is a complete meal, add lean protein like grilled chicken, shrimp, shredded cheese, or beans and some crunch with veggies like fresh beets, jicama, and sliced nuts.
  •

    Sorghum and Zucchini

    If you haven’t tried sorghum, you may want to add it to your shopping list. A 1/4 cup serving of whole-grain sorghum has 5 grams of filling protein and 3 grams of fiber per serving, and has been linked to reduced risk of cancer and heart disease. When paired with non-starchy veggies like zucchini, which adds vitamins, minerals, and additional fiber, the grain dish works to stabilize blood sugar. Bonus points for adding a lean protein like skinless chicken or tofu — toss all three ingredients for a tasty salad or stir-fry!
  •

    Apple, Peanut Butter, and Dark Chocolate

    For a sweet treat with health benefits, Andrea Conner, RD, recommends munching on apple slices with all-natural nut butter (peanut, almond, cashew, or pistachio) and dark chocolate shavings. “The cholesterol-lowering soluble fiber in the apple slows down stomach emptying and may result in a more moderate rise in blood glucose, while the peanut butter provides a great balance of protein and monounsaturated fat that helps with satiety and better blood-sugar control,” says Conner. A sprinkling of dark chocolate chips adds some decadence, which will satisfy sweet cravings without spiking blood sugar.
  •

    Greek Yogurt and Oats

    Yogurt itself contains protein, carbs, and fat, all in one convenient container. “Plain, low-fat Greek yogurt, or fat-free Greek yogurt, high in protein and calcium and relatively low in carbs and saturated fat, is the perfect breakfast when combined with whole-grain oats,” says Marlene Koch, RDN, author of Eat What You Love. She suggests topping yogurt with low-sugar jam or berries and crunchy toasted oats, or making a smoothie with vegetables, oats, yogurt, milk, and fruit, for a high-protein, high-fiber meal that will keep blood sugar and hunger in check.
  •

    Whole-Grain Bread and Lean Meat

    Many people shy away from sandwiches because they can be high in calories and fat. While turning to a lettuce leaf or mushroom cap in place of bread can be a smart way to cut calories, “a lean meat sandwich would leave you more satisfied and would provide the protein to reduce the postprandial rise in blood sugar,” says Roberta Anding, MS, certified diabetes educator, and clinical dietitian at Baylor College of Medicine. Whole-grain bread has a lower glycemic load than white bread made with refined flour, thereby producing less of a rise in blood sugar after meals. Be sure to make your sandwich with a lean protein like low-sodium turkey or chicken breast, and load on the veggies!

  •

    Pasta and Protein

    If you think pasta is off the menu, we've got some good news! It’s a misconception that you need to avoid this satisfying staple when you have diabetes. You just need to pay attention to the type of pasta you’re eating, how it’s prepared, the portion size, and what you're eating it with. “Pasta cooked al dente (not overcooked), should be eaten in combination with vegetables, tofu, seafood, or chicken,” says Johanna Burani, RD, author of Good Carbs, Bad Carbs. Why al dente? “Overcooked pasta becomes soft, loses its form, and gives up glucose more readily, likely giving you a bigger rise in blood glucose,” says David J. A. Jenkins, PhD. “A pasta recipe can provide a completely balanced meal when you include protein, heart-healthy fat, vegetables, fiber, and low-glycemic carbohydrates,” adds Burani. Stick to whole-wheat or whole-grain pasta and keep in mind that one serving size is a half cup cooked of cooked pasta.
  •

    Crackers, Cheese, and Avocado

    Fats are slowly shedding their bad reputation, and for good reason: Choosing healthy fats over unhealthy saturated and trans fats can help lower cholesterol levels while keeping blood-sugar levels stable. For a perfect snack, Melissa Joy Dobbins, MS, suggests two whole-grain crackers topped with one slice (1 ounce) low-fat cheese, and a few slices of avocado or 2 tablespoons of a simple guacamole spread made of avocado, lime juice, and cilantro. "The protein and fat helps slow down the release of glucose (from the carbohydrates) into the blood stream,” Dobbins says. “If you eat carbs alone, they will be absorbed more quickly into the blood stream and ‘spike’ blood sugars.”
  •

    Salad and Shrimp

    The word “salad” has a health halo around it, but looks and labels can be deceiving. Popular toppings like croutons, crispy noodles, and creamy dressings are laden with unhealthy fat and empty calories. On the flip side, some people try to keep their salad light by just tossing together a few vegetables. While this may seem like a healthy option at first, it can be less than satisfying, triggering unnecessary snacking later on. Skimping on some meals and overeating at others can lead to unstable peaks and valleys in your blood-sugar levels. To ensure your salad is a complete meal, add lean protein like grilled chicken, shrimp, shredded cheese, or beans and some crunch with veggies like fresh beets, jicama, and sliced nuts.
  •

    Sorghum and Zucchini

    If you haven’t tried sorghum, you may want to add it to your shopping list. A 1/4 cup serving of whole-grain sorghum has 5 grams of filling protein and 3 grams of fiber per serving, and has been linked to reduced risk of cancer and heart disease. When paired with non-starchy veggies like zucchini, which adds vitamins, minerals, and additional fiber, the grain dish works to stabilize blood sugar. Bonus points for adding a lean protein like skinless chicken or tofu — toss all three ingredients for a tasty salad or stir-fry!
  •

    Apple, Peanut Butter, and Dark Chocolate

    For a sweet treat with health benefits, Andrea Conner, RD, recommends munching on apple slices with all-natural nut butter (peanut, almond, cashew, or pistachio) and dark chocolate shavings. “The cholesterol-lowering soluble fiber in the apple slows down stomach emptying and may result in a more moderate rise in blood glucose, while the peanut butter provides a great balance of protein and monounsaturated fat that helps with satiety and better blood-sugar control,” says Conner. A sprinkling of dark chocolate chips adds some decadence, which will satisfy sweet cravings without spiking blood sugar.
  •

    Greek Yogurt and Oats

    Yogurt itself contains protein, carbs, and fat, all in one convenient container. “Plain, low-fat Greek yogurt, or fat-free Greek yogurt, high in protein and calcium and relatively low in carbs and saturated fat, is the perfect breakfast when combined with whole-grain oats,” says Marlene Koch, RDN, author of Eat What You Love. She suggests topping yogurt with low-sugar jam or berries and crunchy toasted oats, or making a smoothie with vegetables, oats, yogurt, milk, and fruit, for a high-protein, high-fiber meal that will keep blood sugar and hunger in check.
  •

    Whole-Grain Bread and Lean Meat

    Many people shy away from sandwiches because they can be high in calories and fat. While turning to a lettuce leaf or mushroom cap in place of bread can be a smart way to cut calories, “a lean meat sandwich would leave you more satisfied and would provide the protein to reduce the postprandial rise in blood sugar,” says Roberta Anding, MS, certified diabetes educator, and clinical dietitian at Baylor College of Medicine. Whole-grain bread has a lower glycemic load than white bread made with refined flour, thereby producing less of a rise in blood sugar after meals. Be sure to make your sandwich with a lean protein like low-sodium turkey or chicken breast, and load on the veggies!
  • Last Updated: 08/28/15

  • Crackers, Cheese, and Avocado

    Fats are slowly shedding their bad reputation, and for good reason: Choosing healthy fats over unhealthy saturated and trans fats can help lower cholesterol levels while keeping blood-sugar levels stable. For a perfect snack, Melissa Joy Dobbins, MS, suggests two whole-grain crackers topped with one slice (1 ounce) low-fat cheese, and a few slices of avocado or 2 tablespoons of a simple guacamole spread made of avocado, lime juice, and cilantro. "The protein and fat helps slow down the release of glucose (from the carbohydrates) into the blood stream,” Dobbins says. “If you eat carbs alone, they will be absorbed more quickly into the blood stream and ‘spike’ blood sugars.”








Người đăng: vào lúc Không có nhận xét nào:
Nhãn:

Thứ Ba, 29 tháng 9, 2015

How to Break Free From the Narcissist in Your Life

By Everyday Health Guest Columnist
Published Sep 22, 2015
relationship with a narcissist
By Joseph Burgo, PhD, Special to Everyday Health
If you’re dating someone who seems completely self-absorbed, shows little interest in you or your feelings, and can’t tolerate criticism, then you may have entered into a relationship with a narcissist.
You may ask yourself: How do I manage this person’s ego and make my new relationship work?
But why would you remain in a relationship, exercising your empathy and relationship skills, with a person who will never be able to reciprocate? What’s in it for you?
In my experience, people who find themselves locked in a relationship with a narcissist often have their own unconscious, and usually unhealthy, reasons for staying. If you find yourself in that position, one of these five explanations could clue you in to why you’re staying when you know you ought to call it quits.

1. You Want to Recapture the Magic

The seductive narcissist tries to win your love and admiration by making you feel good about yourself so that you’ll admire him or her in return. At least at the beginning of the relationship, he’ll shower you with gifts and compliments, and she’ll give you her undivided, adoring attention, making you feel that you’re the most beautiful and deserving person in the world.
Once you dare to criticize the narcissist, however, he may abruptly turn around and savage your self-esteem, blaming you for his own faults, and treating you with contempt. Once the narcissist calms down, if he wants to hold onto you, he may eventually apologize and revert to adoration mode. At that point, you may breathe a sigh of relief to have your “true” lover back — and you’ll gladly forgive him.
Don’t deceive yourself because you crave that feeling of adoration. The narcissist uses idealization only to manipulate you, and doesn’t truly care how you feel.

2. You’re Buying In to Your Partner’s Inflated Self-Image

Charismatic narcissists can make you feel it’s a privilege to be in their presence. Because they’re driven to demonstrate their winner status to the whole world, they’re often quite ambitious and successful people. We live in a culture that reveres the winners of the world, and if you find yourself involved with someone who strikes you as a rock star, you may get caught up in her grandiose self-image and want to stay close.
Be realistic. Nobody has it all, and anyone who tries hard to convince you she’s a superior being only wants to elicit your admiration.

3. You Fear You Don’t Deserve Any Better

The bullying narcissist builds himself up at the expense of other people, often demonstrating his “winner” status by triumphing over some “loser” he despises. In a romantic relationship, he may be emotionally abusive. Because he never admits his mistakes and needs someone to blame for them, he may treat you like an idiot, accuse you of being overly emotional, or insist you have mental problems. If you already doubt yourself and struggle with low self-esteem, you may be unable to defend yourself against this mistreatment, and find yourself believing his lies.
Protect yourself. Nobody deserves to suffer abuse at the hands of a narcissistic bully.

4. You’re Repeating a Relationship with a Narcissistic Parent

People reared by a narcissistic parent often find in adult life that being in a romantic relationship with a narcissist feels familiar. If you grew up feeling that you had to service the narcissistic needs of your mother or father, you might easily fall prey to a self-centered, self-absorbed person who expects you to do the same for her. If, during your childhood, you felt that you had to “earn” love by doing for others, the narcissist will exploit you and make you feel that nothing is ever enough.
Break free of the past. Take care not to repeat an unhealthy pattern simply because it feels familiar to you.

5. You’re Avoiding True Intimacy

The Narcissist You KnowBecause narcissists lack the ability to empathize with other people, it’s both unsafe and unwise to become emotionally dependent upon them. Especially with the addicted narcissist, you can easily become drawn into a co-dependent relationship where you exist merely to service the narcissist’s needs. This type of relationship often appeals to people in flight from their own neediness, who fear true intimacy and inter-dependency with another person.
Face your own needs. Don’t run from dependency by tending to a self-absorbed individual who makes you feel needed and important.
In my new book, The Narcissist You Know: Defending Yourself Against Extreme Narcissists in an All-About-Me Age, the advice I most consistently offer is to get as much distance as possible from the narcissist whenever you can. If you find yourself wanting to stick with him or her, despite all the danger signs, look inward for these unhealthy reasons that you might stay when you ought to go.
Joseph Burgo, PhD, is also the author Why Did I Do That? and The Hero as Narcissist.
Photo: Alberto Ruggieri/Getty Images
Người đăng: vào lúc Không có nhận xét nào:
Nhãn:

5 Ways to Protect Yourself From Overtreatment

By Everyday Health Guest Columnist
Published Sep 1, 2015
By Leslie Michelson, Special to Everyday Health
Leslie MichelsonThe United States spent $3.1 trillion on healthcare in 2014. And according to experts, about 30 percent of healthcare spending — almost $1 trillion — is regularly wasted on unnecessary tests, treatments, and procedures each year.
In my 30 years of helping people better navigate our medical system, I’ve seen overtreatment that’s as simple as a doctor’s prescribing antibiotics for the common cold or flu (which are caused by viruses, not bacteria that antibiotics fight), and as disastrous as a patient rushing into chemotherapy, only to learn she was diagnosed with the wrong cancer and must begin anew with a different therapy.
Staying keenly attuned to your physician’s recommendations, and to your emotional responses to them, can help you protect yourself from overtreatment. And to determine if you may be at risk of overtreatment, be aware of these five signs:

1. Your Physician Wants You to Start Treatment Immediately

Even if you’re facing a serious medical problem, there’s still usually at least a small window of time to do more research and consult with other experts. So take a step back and ask your doctor:
  • What are the side effects of this treatment, and are they reversible?
  • What will happen if we don’t do it?
  • Are there less invasive options we can try first?
Then listen to your gut: Are you being sold something you may not need?

2. You’re Sent for Surgery or Imaging Tests Before the Doctor Has Even Seen You

A physician needs to examine you, listen to your medical history, and thoroughly review your records in order to come to an educated hypothesis about your problem. Only then should he or she prescribe an MRI, CT scan, or exploratory surgery to potentially confirm or deny a diagnosis.
If you’re being asked to undergo these procedures first, or if you’ve recently undergone them at another physician’s behest, be wary. Ask:
  • How will the results of this procedure affect my treatment plan?
  • Will they help rule out or confirm a diagnosis?
  • I’ve already had this procedure and don’t want to repeat it if I don’t need to. Have you reviewed my previous results?
It’s possible that your doctor has a good reason, but hasn’t explained it to you properly. Give your doctor the chance. And if you’re not confident in the response you get, let the doctor know that you’d like to do some research first. The Choosing Wisely lists, created by the American Board of Internal Medicine, provide excellent talking points about certain types of commonly overused procedures.

3. You’re Upset That Your Physician Isn’t Prescribing Treatment

Sometimes we are in such a rush to get a medical problem behind us that we encourage our doctors to prescribe interventions we may not need.
Pay close attention to your emotional state. Are you seeking a quick fix? Do you feel disappointed when your doctor wants to wait, watch, and think it through?
Some health problems warrant progressive care relative to the symptoms you’re experiencing, and what’s been found on physical exams and diagnostic tests. For instance, with back pain you’d want to move slowly, first trying rest, then physical therapy, then maybe steroidal injections to see if the pain subsides. You’d resort to surgery last, and only when absolutely necessary.
On the other hand, if there’s a lump in your breast, it requires intervention sooner. But even then, you still have time to look up the treatment guidelines at the National Comprehensive Cancer Network and become more informed.

4. Your Doctor Is Dismissive of Your Viewpoint

Your physician needs to respect that you are the decision maker when it comes to your care. That means he or she takes the time to share the reasons for any recommendations, what the side effects might be, and what the less-invasive options are.
Ask your doctor to speak honestly with you about the risks and benefits of each intervention or treatment so that you’re making intelligent decisions. If you get curt answers — you have to do this; there’s no alternative option; there’s a range of side effects — you should consider getting additional opinions from specialists who are experts on your specific condition.

5. You’re Not Convinced That Living With Your Disease Is Worse Than the Side Effects of Treatment

The Patient's Playbook
Sometimes physicians are so focused on a single condition that they fail to consider the whole human being in front of them, who may have a multitude of other health problems or personal issues that complicate a treatment decision. This is especially true when the patient is elderly or frail.
A July 2015 study in the Journal of the American Medical Association, for example, found that end-stage cancer patients who were given chemotherapy to make their last few months more bearable actually did not benefit, and some patients suffered much worse than if they’d received no treatment at all.
The decision about how, when, or if to treat is yours alone. As a patient, remember that as long as you are making informed and thoughtful choices about what you want, there is no wrong approach.
Leslie Michelson is the founder and CEO of Private Health Management, and the author of The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love.
Photos courtesy of Penguin Random House
Người đăng: vào lúc Không có nhận xét nào:
Nhãn:
Đăng ký: Bài đăng (Atom)