Tears and anger may come from adrenalin

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

Linda Cal­abresi is a GP and ed­i­tor of Med­i­calOb­server. Send your queries to linda.cal­abresi@medobs.com.au I ama 58-year-old wo­man. About three weeks ago I de­vel­oped a painful left shoul­der. There was no fall or in­jury that I re­mem­ber. The pain has been get­ting worse, es­pe­cially at night, and the shoul­der is get­ting stiffer. I’ve tried rest­ing it, a heat pack, and pain-killers. Any sug­ges­tions? CHECK with your doc­tor to be sure, but it sounds as though you might have what is known as a frozen shoul­der. A frozen shoul­der tends to de­velop in three stages. The first is the painful in­flam­ma­tory stage where the cap­sule hous­ing the shoul­der joint be­comes acutely in­flamed. This is usu­ally fol­lowed by the less painful ‘‘ freez­ing’’ stage, in which scar tis­sue de­vel­ops and move­ment be­comes sig­nif­i­cantly re­duced. Fi­nally there is the ‘‘ thaw­ing’’ stage, where move­ment grad­u­ally re­turns. No mat­ter what you do, chances are the shoul­der will get bet­ter by it­self. This can take up to two years — longer in rare cases. Anal­gesics and an­ti­in­flam­ma­to­ries should help in the painful phase. Your doc­tor might also of­fer a cor­ti­cos­teroid in­jec­tion, which is of­ten very ef­fec­tive. Once the pain has sub­sided, treat­ments such as mas­sage, acupuncture, and phys­io­ther­apy can be use­ful to get the joint mov­ing again. Oc­ca­sion­ally, surgery is needed to di­vide the scar tis­sue. When my body is over­taxed, such as when re­cov­er­ing from an op­er­a­tion, sleep­de­prived, or work­ing a lot of over­time, I be­come very emo­tional. This usu­ally man­i­fests as burst­ing into tears and oc­ca­sional an­gry out­bursts. Why? This threat­ens to se­ri­ously af­fect my per­sonal and pro­fes­sional re­la­tion­ships . I am usu­ally a happy, easy-go­ing per­son. IT is not un­com­mon that at times of stress, with higher than nor­mal lev­els of cir­cu­lat­ing adrenalin in the body, one re­ac­tion is emo­tional la­bil­ity (the tech­ni­cal term for be­ing par­tic­u­larly sen­si­tive). If this is a rel­a­tively new phe­nom­e­non for you, it might be worth­while check­ing with your doc­tor to see if there is any un­der­ly­ing con­di­tion that could be con­tribut­ing to this, such as thy­roid dis­ease, anaemia, hor­monal im­bal­ance (such as in menopause), de­pres­sion or even some re­cently com­menced med­i­ca­tion. You might also want to look at how you can re­duce un­der­ly­ing stress lev­els, thereby mak­ing you more re­silient when th­ese added bur­dens come along. Ef­fec­tive stress man­age­ment will mean dif­fer­ent things to dif­fer­ent peo­ple. For some, yoga and med­i­ta­tion is the key, while for oth­ers phys­i­cal ex­er­cise works bet­ter. You are for­tu­nate in that you recog­nise that the prob­lem lies in your re­sponse to stress — many peo­ple blame the stres­sors, and that is far more de­struc­tive to re­la­tion­ships. Psy­chother­apy is of­ten very ef­fec­tive in chang­ing be­hav­iour pat­terns. For over 20 years we have al­ways boiled tap wa­ter. Is boil­ing wa­ter re­ally ben­e­fi­cial in re­mov­ing harm­ful mat­ter? YOU must be re­ceiv­ing your wa­ter from an un­treated source, be­cause in the vast ma­jor­ity of ar­eas in Aus­tralia tap wa­ter has al­ready been treated, ren­der­ing it safe for con­sump­tion and mak­ing boil­ing un­nec­es­sary. Wa­ter sup­plies are tested reg­u­larly to en­sure treat­ment is ef­fec­tive and that con­tam­i­nants level re­mains low and safe for con­sump­tion. For un­treated wa­ter, or in ar­eas re­ly­ing on wa­ter from rain­wa­ter tanks or bores, cor­rectly done boil­ing ef­fec­tively elim­i­nates prac­ti­cally all pos­si­ble con­tam­i­nants — in par­tic­u­lar bac­te­ria and viruses. Some fun­gal spores and pri­ons can sur­vive, but th­ese are very un­com­mon. Ef­fec­tive ster­il­i­sa­tion is achieved through bring­ing the wa­ter to boil vig­or­ously and con­tin­u­ously for one minute.

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