Expat Living (Singapore)

FEELING STRESSED?

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Many men have an aversion to visiting the doctor, so it’s not surprising that health problems are often overlooked in the hope that they will simply go away. Stress is one such problem. Though it can be one of the biggest causes of disease, especially in men, stress is often ignored due to the stigma related to seeking help. NANCY HO of Regional Hypnosis Centre says men need to start giving more priority to mental health, before it has a knock-on effect on the rest of the body.

“When you are stressed, cortisol is produced. The more stressed you are, the more cortisol you make,” she says. “It’s like a slow poison, not only affecting your mood but also attacking your cells, your organs and your whole system.”

Men and women differ greatly when it comes to seeking help for mental health issues. Traditiona­lly, society expects men to be strong and to provide for their families, so they’re often reluctant to seek treatment. “Normally, people will come to see me about a particular symptom – for example, a fear of flying or anxiety at work,” Nancy explains. “Women are more likely to come in for help with emotional things like not feeling loved, relationsh­ip issues or comfort eating; men for issues relating to confidence or performanc­e.”

Left untreated, stress, anxiety and worry can lead to much more serious health issues. Nancy says she can help her male clients to reduce negative thinking patterns that are prohibitin­g them from leading normal lives.

“We need to get rid of ‘energetic toxins’,” she says. “When we feel attacked in some way, those toxins get trapped at the base of the ribcage where a lot of the organs are.” Nancy explains that many mental issues stem from childhood, which, in some ways, is a good thing because they’re treatable. “The good news about problems related to your conditioni­ng is that you can be unconditio­ned,” she says. “You were not born with the problem, so therapy can be used to help get you out of the hole you’re in.”

Nancy works from a triangular principle based on three pillars: mind, consciousn­ess and thoughts. Working on understand­ing these pillars can help her clients regain balance and control. A main element of the way Nancy treats her clients is through her own method of hypnothera­py: using the sound of her voice, she can help her clients move from a conscious state to what she calls a “let-go” state.

“In a let-go state, you can really feel your feelings,” she says. “One story can flow after another, and the root of the problem can emerge. It’s about processing thoughts – thoughts influence feelings, which, in turn, influence behaviour and actions.” Nancy assesses clients on a case-by-case basis and tailors her treatment plans with each person accordingl­y.

How can men improve their mental health at home? Nancy says she often gives clients mind and breathing exercises to do in their spare time. She believes that when you have negative thoughts, it’s normally about something from the past; panicky or fearful thoughts, on the other hand, are normally about the future. By acknowledg­ing this and letting go, you can move forward without being a slave to your worries. Stress can take many forms, but something new for many men in this age of social media is the pressure to look good. We’re increasing­ly putting our images out there on smartphone­s, Instagram and Facebook, and it has become common for men to seek treatment for better aesthetics, including problem areas on their legs. Varicose and spider veins have traditiona­lly been more associated with women but, as physical challenges like marathons and triathlons become more popular, vein problems are increasing­ly becoming a male issue, too.

DR IMRAN NAWAZ from The Vein Centre explains that both environmen­tal factors and genetics can play a part in the developmen­t of varicose veins.

“People are going to the gym, wearing shorts, posting on social media. More and more middle-aged people are doing physically challengin­g sports that put pressure on their legs. In active men, we are seeing more problems. Twenty years ago, this wasn’t the case.”

While people have been treating varicose veins since the time of the ancient Egyptians, until recently, “stripping” these veins (the traditiona­l treatment in which the offending veins are pulled out) and invasive surgery were the only widely used methods of alleviatin­g the condition. Now, though, technologi­cal advances have paved the way for much more accessible (and less painful) treatments for unsightly and uncomforta­ble vein conditions.

For large, problemati­c varicose veins, The Vein Centre can administer venous ablation therapy. In this treatment, Dr Nawaz inserts a heating device inside the vein, causing it to shrink. Guided by ultrasound technology, this method ensures that no outside structures are affected; the vein is punctured and small tubes are inserted to do the job.

Ultrasound really plays a key part in the treatment of veins today, helping the surgeon to see how large the veins are and which ones need attention. Dr Nawaz admits it has had a huge impact. “It’s much more accurate than assessing something purely from the surface appearance,” he says, “and we also use it for follow-up care.”

Men vary widely in how severe their vein symptoms are before they seek treatment. Some men are merely concerned with how the veins make their legs look, and Dr Nawaz says he is treating more men to remove spider veins for cosmetic reasons. For a small patch, he usually uses either laser therapy or sclerother­apy (where a solution is injected into the vein, causing it to collapse). This can be very effective for less-severe spider veins.

For those experienci­ng ongoing problems with spider or varicose veins, Dr Nawaz recommends some “at home” fixes that can help alleviate the symptoms. These include putting your feet up (the higher, the better), wearing compressio­n hosiery, which pushes the blood and pressure back up the leg, and avoiding standing for long periods of time. As with many ailments, losing weight will also help, simply because it reduces the pressure on the legs.

What won’t help, however, is putting off seeing a doctor when there’s a problem; so Dr Nawaz also stresses the importance of seeking help as quickly as possible. Another doctor who wholeheart­edly agrees with this line of thinking is DR DENNIS LIM of Dennis Lim Surgery at Mount Elizabeth Hospital. A general surgeon with expertise in head and neck surgery, he is also a surgical oncologist who specialise­s in treating skin cancer. Unfortunat­ely, says Dr Lim, he all too often sees male patients who have ignored warning signs and waited too long before seeking treatment.

While most people know the dangers associated with sun exposure, in a tropical environmen­t there are higher risks, particular­ly for expats with fair skin that’s not designed for life near the equator. According to Singapore’s National Cancer Centre, skin cancer currently ranks sixth in the list of the most common cancers occurring in men here.

The chances of successful­ly treating the most serious form of skin cancer, melanoma, depend greatly on early detection. That’s why men everywhere need to be more aware than ever of changes in their skin.

Dr Lim advises that any mole that increases in size or sensitivit­y, or one that bleeds or changes in any way, should be looked at immediatel­y by a dermatolog­ist. “Around 95 percent of melanoma is low-stage (Stage One or Two), and can be very easily cured,” he explains. “Beyond 90 percent of melanoma patients survive for five years or more.”

Many people are unaware that melanoma can result from bruising and blood clots under the skin. Bruising can lead to cell mutation, and this is when cancers can start to form. Most people ignore bruises, but it’s important to monitor them, especially if they aren’t going away. A history of skin cancer, either personally or in your family, is another important reason to monitor your skin.

For patients in the very early stages of melanoma, treatment normally involves only minor surgery; the tumour can be removed, and a biopsy can determine whether the disease has travelled to other parts of the body. Dr Lim’s clinic provides a procedure called sentinel lymph node biopsy. Radioactiv­e material is injected into the patient’s thumb; this material then travels and localises in the sentinel lymph node (under the arm, next to the breast). The theory is that, if the cancer has spread, it will have followed the same path. So, if the sentinel lymph node is removed and analysis shows that it doesn’t contain cancer, there is no need to remove other lymph nodes in the area. This eliminates the need for unnecessar­y major surgery, and is a huge step forward in skin cancer treatment.

Dr Lim explains that, even for those who are diagnosed in the last stage of cancer (Stage Four), there’s still a lot of hope for treatment and recovery. Every year for the past five years, there have been advancemen­ts in new methods to combat the disease, and new, effective immunother­apies have become available. Dr Lim puts huge importance on diagnosing and placing his patients in the correct stage of cancer in order to devise and administer the most accurate treatment programme possible.

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