Is a sense of purpose good for our health?

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Perhaps it’s just about getting older, but as each year goes by, I feel less inclined to make New Year resolutions – too conscious of the many that have come in with a bang like a firework display only to fade into a whisper of smoke before the first week of January is gone. However, some interesting recent research suggests that living a more resolved and purposeful life can make a measurable difference to our health. Tom Jacobs, of Pacific Standard Magazine, reports that genetic researchers Barbara Fredrickson and Steven Cole studied the relationship between the activity of genes regulating the immune system, and forms of happiness. Though the focus of happiness is as variable as people are, the researchers identified two main forms, which they called “hedonic” and “eudaemonic”. Hedonic comes from a form of moral philosophy which holds that pleasure is the only intrinsic good in life. Eudaemonic, as readers of Plato or Philip Pullman might guess, refers to the guardian spirit or angel that guides us wisely and well; or, according to Socrates, the invisible plane in which mortals encounter the divine. Fredrickson and Cole, being geneticists, are more interested in molecular physiology than moral philosophy. However, it turns out that both are equally complicated. Participants in the research filled out a questionnaire about their feelings and self image in the past week: happy, satisfied, having a sense of direction in life, having something to contribute to society, or “challenged to grow and become a better person”. Questions about health and about depression were also included. Not surprisingly there was a strong overlap between the two types of happiness: both can flow from the same source, such as a rewarding job, a happy relationship, or being creative. Also not surprisingly, people who reported high levels of either form of happiness were less likely to have depressive symptoms. At that point the obvious turned into the unexpected, as researchers compared the genetic results. People who reported more hedonic happiness also showed higher levels of a genetic activity associated with extended stress in the immune system. This activity promotes inflammation and reduces other responses to immune challenge (such as a virus). The people reporting more eudaemonic happiness showed a ‘markedly divergent’ genetic response in comparison to their pleasure seeking comrades. Levels of unwanted genetic activity were lower; therefore their immune systems would function better and they would have less inflammation – seen as a culprit in a variety of chronic health conditions. What could be provoking this genetic stress response in pleasure seekers who lack a sense of direction or purpose? They’re enjoying life and not depressed, so why are they physiologically at odds with themselves? Jacobs speculates that...

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Lymph Node Scan

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Lucien Kaarse of the Nuclear Medicine Department (Drs Visser, Erasmus, Vawda and Partners, Radiologists) provided the following helpful FAQ  for patients undergoing a “sentinel node” scan prior to surgery which will test the lymph nodes following a cancer diagnosis, and/or remove them. What is a sentinel node scan? A sentinel node scan is used to identify ‘sentinel’ lymph nodes. These are the first lymph nodes in a group that receive the lymph from a particular area of the body. The scan is carried out in preparation for your sentinel lymph node biopsy later on the same day, or the following day. How does the scan work? A tiny amount of radioactivity called a tracer will be injected into the skin around the primary site of the cancer. You are then positioned under a scanner called a gamma camera. The tracer moves from the injection site through the lymph vessels to the lymph nodes. The positions of the sentinel nodes will be marked on the skin surface. This identifies those nodes which your surgeon may want to remove. Is there any preparation for the scan? • No • You must tell us in advance if you know you are (or think that you may be) pregnant, or are breast feeding. What happens during the scan? • Our staff will explain the procedure to you fully when you arrive for your appointment. • We will then ask you to lie on the scan bed. We will make sure you are as comfortable as possible for the scan, as is it extremely important that you remain as still as you can. • While you are lying on the bed we will inject a very small amount of the tracer into the skin around the site of the cancer. • You will then be positioned under the scanner and we will take the first pictures for up to 30 minutes. Following that we will take several more pictures, from the front and the side. • When we have seen the sentinel node/s, we will mark the position on your skin with a permanent pen. • Most scans take about one hour, but if we have not seen the node/s, you may be asked to return later in the day for further pictures to be taken. Will I feel anything during the scan? Having the injection will sting momentarily but there are no side effects from the injection and it will not make you feel sleepy or affect your ability to drive. Having the pictures taken will not hurt. What happens after the scan? When we have checked the technical quality of your scan and are happy we have all the information we need, you will...

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What does it mean when I have nipple discharge?

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Although it can be upsetting when a woman who isn’t breastfeeding has fluid coming out of one or both nipples, it’s true to say that this is actually very common and seldom leads to serious concern. The human female breast is a complex and beautiful structure. It is unique in the animal kingdom for combining multiple ducts into one shapely form, with a well designed “bulls-eye” in the middle so that even a newborn baby knows where to find food. We can thank our lucky stars for this, because every foetus starts out with two converging rows of nipples similar to the ones you can see on your pet dog! All but two of these disappear long before birth, though occasionally a child is born with a third nipple – Napoleon was rumoured to have this unusual feature. Most women can press fluid from their nipples if they try – though this is no longer recommended as part of routine self-examination as it’s not likely to do any good. The nipple is a sensitive and erotic zone in which the boundary between pleasurable stimulation (which may also cause discharge) and harmful irritation can be somewhat subjective! The nipple has microscopic openings or pores for milk release which occurs under the influence of hormones.  Discharge from both nipples and from several pores suggests hormonal upset; this is fairly common during peri-menopause whilst some thyroid conditions also affect breasts.  Fluid that looks similar to milk and comes out freely (in the absence of a baby to feed) could indicate a very rare non-cancerous pituitary tumour, for which you may need a blood test followed by MRI scan and specialist advice, as this tiny master-gland lies too deep within the brain for a simple operation.  Although there isn’t always an obvious reason for nipple discharge, medications including certain antidepressants, anti-anxiety treatments, mood stabilizers, blood pressure medicine, ulcer medicine, and long-term psychiatric drugs can cause it. Birth control pills and hormone replacement therapy, by altering hormone levels, are also common culprits, as are some herbal treatments and street drugs especially cannabis. Men can also experience breast problems such as enlargement, pain and discharge. Though often a source of amusement to others it is no laughing matter for the man concerned, who should make no delay to consult his doctor and find out the cause.  It’s fascinating to note that in circumstances of high emotional stress, the nipples can leak bloody fluid – for example, after a public disaster that affects us personally, when children leave home, or when new grandchildren are painfully missed. It seems that women really are mothers of the nation: our breasts can express our love for those “children” and...

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What do I do when I have an abnormal mammogram?

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Mammograms, along with a healthy lifestyle, regular breast examination, and ultrasound, can help you and your doctors to become aware of what’s going on deep in the tissue of your breast.  Many women dislike mammograms and it’s hardly surprising. Since puberty, most of us have been protecting, covering and supporting our breasts, and the self-consciousness of youth often re-emerges when we submit to unceremonious uncovering and squashing from different angles! However, radiographers in today’s hospitals and clinics have specialised post-graduate mammography training, and they know how to help you relax as they expertly scan your breasts including the “tail” of breast tissue that lies under the armpit. If the radiographer sees something untoward, she will take care not to stress you but will explain that there is something on the mammogram that’s not clear, and which requires more attention. It’s likely that a further examination will follow, using ultrasound which can show up tissue abnormalities that might not be easily seen on the the mammogram. She will then call in a radiologist, who is a medical specialist in the field of hi-tech imagery, for an opinion. There is nothing much to be done in this situation but keep breathing deeply and calmly… Remember that mammography, if undertaken as a routine part of your normal health care, is a method of surveillance – keeping watch. Although obviously everyone hopes for an “all clear” every time, breast tissue is complex, often dense; and there are many aspects that change over time. Most changes are harmless, but there would be little point in going to the trouble of a mammogram if we don’t take advantage of the specialist opinion that’s available along with the procedure. At one end of the spectrum of concern the radiologist might note a change which is obviously harmless (such as small areas of calcium deposit that are common as we get older), or perhaps a larger benign growth which has been noted on an earlier mammogram and shows no sign of unhealthy change. At the other end of the spectrum, a mammogram will occasionally reveal a very obvious cancer spot – and this is precisely why we went there, to take charge of that possibility. In between these extremes, there is a range of “doubtful” lumps and bumps which may be uncertain because of their shape or position, or perhaps because there is no track record from previous mammograms to confirm that they’re harmless. Your age and previous mammography relevant: if you are 50+ and an abnormality is seen for the first time, you will be advised to take further action, but the same finding in a younger patient might merely be noted for future reference. The...

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