Visiting with people and taking phone calls can be exhausting.

And with every activity — “preparing meals, ironing a shirt, putzing around the house” — she has to pace herself.

“I have to break down tasks little by little,” Malott said. “What I can do today, I might not be able to do tomorrow.”

Chronic fatigue syndrome, also known as myalgic encephalopathy, is a devastating and little-understood disorder, characterized by an overwhelming lack of energy and a variety of other symptoms, including muscle pain, memory problems, swollen lymph nodes, sore throat, achy joints and unrestful sleep.

Malott, 49, has been living with the disorder for more than five years.

She has had to give up a 28-year nursing career, can no longer work out at the gym and now attends church from her red leather recliner at home, via the Internet.

But that hasn’t stopped her from being the best mother she can be to her children, Sara, 9 and Luke, 7.

And it doesn’t diminish her capacity to give and receive love.

“Before the illness, I was a very active mom. I would run through the door, start supper, round up the children for baths, run here, run there. Parenting was more of a task-based role,” Malott shared. “Now, it’s more emotional, supportive and educational.”

Malott said she “didn’t see this right away, but there are some gifts in this for my kids. their mom is home every morning and every evening when they come home, without fail. they will have a heart for people with illness and disability and they will benefit from the fact that I have greatly increased my efforts to educate them about life’s lessons and not taking anything for granted.”

Malott married her husband Jason when she was 38 and had her daughter Sara when she was 39, followed by a son, Luke.

“It was six months after Luke was born that I started to experience some health issues that now, in retrospect, were related to the illness,” she said.

“I was a very hands-on kind of mom and would get on the floor and play and run around in the yard with the children. I remember thinking how much I couldn’t wait to ride roller coaster with my kids. I was a front-seat, hands-up kind of girl.”

Little did she know, she reflected, how drastically her life would change.

The diagnosis

Malott said it was March of 2006 when she began to experience hand pain for about three weeks.

“I didn’t feel well,” she recalled. “So I went to my primary care doctor who sent me for carpal tunnel testing, which was negative. then, about three days later, I just felt really tired — flu-like, but also lightheaded.”

At the time, she said, she was taking a spinning class three to four times a week. When she got on the treadmill at the fitness center and started walking, “I felt like I was going to pass out. I told my husband I didn’t feel right and thought I needed to go to the emergency room. I went, and as it turns out, my heart was beating irregularly and my potassium was low.”

Malott said she had a cardiac catheterization and other cardiac tests that came back normal.

Six months later, she once again began suffering from extreme hand pain, as well as a fever and body aches that lasted 10 days.

“I could barely function,” she said. “All I could do was lay down and get up for meals and go to the bathroom. I felt like I had a severe case of the flu. It went away after 10 days, but came back again in two months and has been there ever since.”

Malott said the low-grade fevers were concerning to her doctors, as well as the hand pain, cardiac irregularities and low potassium.

“I noticed a decline in my short-term memory and my ability to concentrate at work,” she said. “I also developed severe insomnia, making it difficult to function day to day. I lost 60 pounds in about four months, which was another baffling piece.  this was a real telltale sign that something was wrong, as I have fought the battle of the bulge most of my adult life.”

Malott visited a rheumatologist at Johns Hopkins University Hospital in 2007, who was the first to tell her she might have CFS and/or fibromyalgia, a syndrome also associated with fatigue and muscle pain.

Depression is a true medical illness, just like having diabetes or high blood pressure. It’s not a weakness, having the blues or something one can just snap out of. Fortunately, like most illnesses, it is treatable through medication and psychotherapy.

Common symptoms of depression include feeling sad, unhappy, irritable or frustrated; a loss of interest in things that usually bring pleasure; feeling worthless; fatigue, excessive sleeping or insomnia; indecisiveness and decreased concentration; and in some cases, thoughts of death, dying or suicide.

Many of us may briefly experience any of the above symptoms, but the person with true depression lives with these symptoms day in and day out.

Some risk factors of depression are having biological relatives who have depression or who have committed suicide and experiencing stressful events, such as the death or loss of a loved one. Women are also at risk, especially after a pregnancy. Other risk factors are serious, chronic illness and abuse of alcohol, drugs or nicotine.

In general, the most effective treatment for depression is a combination of medication and psychotherapy.

There are many types of antidepressant drugs available, and finding the right one may take some trial and error. Antidepressant drugs may take several weeks to take effect.

A patient who experiences undesired side effects should not stop taking the medication without consulting the prescribing doctor. In many cases, one must taper off the drug to avoid withdrawal.

Psychotherapy is provided by a trained and licensed professional, who can help one to understand one’s thoughts and behaviors and guide one in making effective changes. Ideally, this treatment can also provide a regained feeling of hope, happiness and control.

If someone you know is having suicidal thoughts, help is needed immediately. Here’s what needs to be done:

- Contact a family member, friend or clergy member for help.

- call a suicide hotline number. our local number is 877-663-5433.

- Seek professional consultation from a doctor or a mental health provider.

If someone you know is on the verge of, or has attempted, suicide, call 911 immediately for professional and rapid help.

Depression is not a weakness; it is a treatable illness. A doctor can help.

- Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or email him at . Information in this column is not intended to replace advice from your own health care professional. for any medical concern, consult your own doctor.

Ovarian cancer is a disease in which malignant cells develop in the ovaries — two small hormone-producing organs on both sides of the uterus. the American Cancer Society estimated that there will be about 22,280 new cases of ovarian cancer and 15,500 deaths from ovarian cancer in 2012.

It has been called the silent killer because of its nearly asymptomatic early stages, but given these statistics, it’s more important than ever to spread awareness and increase early detection. In fact, David Fishman, director of the National Ovarian Cancer Detection program, said, “if you diagnose ovarian cancer in the earliest stage, it’s over 90 percent curable.”

CausesThe exact cause of ovarian cancer currently evades scientists. Healthy cells multiply at a steady rate, with new cells replacing old, dying cells, and so on. Cancer cells, on the other hand, do not die. they continue multiplying until they amass into a tumor. These cancer cells then metastasize, which means they beyond the initial ovarian tumor to corrupt other areas in the body.

The Mayo Clinic reported that cancer that begins on the outside of the ovaries forms an epithelial tumor. when the cancer starts in the egg-producing cells is forms a germ cell tumor. when it beings in the hormone-producing cells, it forms stromal tumors. more Caucasian women develop ovarian cancer than African-American women.

SymptomsSince the ovaries are deep within the abdominal cavity, symptoms during the early stages are difficult to detect, according to the National Ovarian Cancer Coalition(NOCC). Stephen J. Iacoboni, medical director of hematology/oncology at Kennewick General Hospital, said that ovarian cancer often presents itself in the later stages (III-IV) “because this illness is asymptomatic in the early stages and because there is no effective screening method.”

Common symptoms include bloating, pelvic or abdominal pain, trouble eating, feeling full quickly and frequent need to urinate. the NOCC added that fatigue, upset stomach, back pain, pain during intercourse and constipation can also be warning signs, especially if they persist for longer than two weeks.

DiagnosisDoctors may monitor women who are at high risk or demonstrate warning signs with various early detection tests: blood tests, transvaginal ultrasounds and pelvic exams. the Ovarian Cancer National Alliance (OCNA) explained that a high concentration of protein CA-125 exists in cancerous cells. Blood tests can evaluate the prevalence of this protein in women. Transvaginal ultrasounds, which are administered by inserting a probe into a woman’s vagina, can provide computer images of her reproductive organs and bladder. a doctor can assess the size and shape of a woman’s ovaries and uterus by inserting a finger or two into her vagina and placing his other hand over her abdomen, during a pelvic exam.

If these tests reveal a possibility of ovarian cancer, the doctor can proceed to PT or CT scans. the only definitive diagnosis procedure, however, is surgery and biopsy, according to the OCNA.

Beth Karlan, a gynecologic oncologist at Cedars-Sinai Medical Center, recommended seeking treatment from a gynecologic oncologist because they are trained as surgeons and as oncologists. This specialty has the privilege of caring for patients from diagnosis through to follow-up after treatment. she also said there is also data suggesting that ovarian cancer patients have a better chance of survival when treated by gynecologic oncologists.

TreatmentAccording to the department of pathology at John Hopkins, there are three basic forms of ovarian cancer treatment: surgery, chemotherapy and radiation. Robin Cohen, an oncology nurse and co-founder of the Sandy Rollman Ovarian Cancer Foundation, said, “The treatment depends on the staging. For advanced cancer (which is most common), a total hysterectomy and debulking (removal of as much cancer as possible) are performed.”

The goal of surgery is to remove the cancer from the ovaries and surrounding infected areas. This could necessitate removal of the ovaries, fallopian tubes, uterus, omentum and lymph nodes, depending on how far the cancer has spread.

Chemotherapy drugs kill cancer cells and can be given intravenously or directly into the abdominal cavity. These can be administered alone or in combination with other approaches. Smith added, “Chemotherapy is used to shrink ovarian cancer and slow cancer growth. But of course, it comes with potential side effects – the most common are nausea and vomiting.”

In certain circumstances, patients benefit from radiation treatment, which destroys cancer cells with high energy X-rays.

Tuberculosis (TB) is a potentially fatal contagious disease that spreads between people via coughs and sneezes. Jorge Parada, medical director of infectious disease at Loyola University Health System, noted that TB is the most common infection in the world and the second leading cause of death due to infectious disease, after HIV/AIDS.

CausesWhen a person with untreated TB coughs, sneezes or laughs, he or she can spread bacteria through droplets in the air. Contracting TB typically requires close contact with someone who has TB for an extensive period of time, often in confined quarters. so one is more likely to get TB from a colleague or family member than a stranger.

Someone can be infected with TB (i.e. has the TB germs) but not have TB disease, if the body’s immune system protects him or her–a condition known as latent TB. but the immune system can be weakened by AIDS, diabetes, previous TB exposure, drug abuse, chemotherapy, malnutrition, old age or another factor.

TB has spread concomitantly with HIV because each propels the development of the other. The number of TB cases has risen since the 1980s, reports the Mayo Clinic.

Since TB is an infectious disease, your risk of getting it increase if you live or travel in places with high TB rates. Sections of sub-saharan Africa, India, China, Mexico, the former Soviet Union, southeast Asia and Micronesia have high rates of TB, according to the Mayo Clinic.

SymptomsLatent TB is not contagious and has no symptoms. once active, TB becomes contagious and can cause weight loss, fevers, chills, fatigue and night sweats. Since TB primarily affects the lungs, the most telling signs involve coughing. Coughing up blood, chest pain, breathing difficulties and persistent coughing are common.

DiagnosisDuring a common TB diagnostic skin test, the doctor injects tuberculin into one’s forearm. between two days to three days later, a doctor will see if your arm has a large, hard red bump, which indicates TB infection but not that the disease has transpired. Blood and sputum tests along with a chest X-ray may be necessary to corroborate one’s health or illness.

Since blood and skin tests are not perfect, infectious disease specialist Walt Tomford, noted, “A complete history and physical exam is a bedside diagnostician’s best clinical tool.”

TreatmentThe American Lung Association reports that people with latent TB will receive preventative therapy. The most common therapy of this kind is a six to nine month daily dose of isoniazid (INH). Tomford emphasized the importance of proceeding past denial and taking the prescribed medicine for latent TB so it doesn’t evolve into active TB.

Those with active TB will be prescribed a combination of various medicines for between six and 12 months. Keeping up with proper drug intake is of the utmost importance because if one lapses, and TB comes back it may be drug resistant. this will make it much more difficult to cure. Multi-drug resistant TB is particularly lethal.

Many people treated for cancer are worn out for a time, but new findings suggest that long-lasting fatigue may be less common than thought — at least for women with early-stage breast cancer.

The study, of 218 women treated for early breast cancer, found that almost one-third had “cancer-related fatigue” at the end of treatment. But far fewer — six percent — still had the problem a year later.

That suggests for most women with the disease post-treatment fatigue will fade with some time, the researchers report in the Journal of Clinical Oncology.

It’s well known that cancer patients often suffer fatigue. and some studies have concluded it’s common for that weariness to last for years after treatment ends. Among breast cancer survivors, researchers have found that more than one-third have fatigue two to three years after treatment.

The reasons, though, have not been clear. and the new findings support the idea that some cases of chronic fatigue in earlier studies may have had causes other than the cancer itself.

Past studies have often been “cross-sectional,” meaning they studied people at one time-point.

So it’s possible to catch some bouts of fatigue that are related to various causes, explained Dr. David Goldstein, who led the new study.

That could mean lingering fatigue from a viral illness, for example, or fatigue related to depression, according to Goldstein, of Prince of Wales Hospital in Randwick, Australia.

“There are cancer survivors with true post-cancer fatigue,” Goldstein said in an email. It’s just that the number may be “less than previously thought.”

That may be true at least with early-stage breast cancer — and possibly some other early cancers, Goldstein said — but not necessarily more-advanced cancer.

“The fatigue associated with advanced cancer is a much more complex issue — tied up with the biology of an active tumor and its many physical effects, as well as the drugs used (for treatment),” Goldstein explained.

The findings are based on 218 women who were treated for early-stage breast cancer with surgery and some type of “adjuvant” therapy, usually radiation, chemotherapy or both.

The women answered questions about their physical and psychological health every few months for a year after treatment. Overall, Goldstein’s team found, 11 percent persistently had fatigue at the six-month mark, while six percent still had symptoms a year after treatment ended.

Goldstein said the study used a questionnaire that distinguished between physical and psychological symptoms, which some past studies have not done. and women who had persistent fatigue at six months were evaluated to rule out “alternative” causes — like low thyroid hormone levels or depression.

It’s not clear why some women treated for early breast cancer remain fatigued for months or longer, according to Goldstein.

Some recent research, he noted, has hinted that some patients could have a genetic predisposition to an “exaggerated bodily response” to chemotherapy, for example.

Other work has suggested that chronic, body-wide inflammation could play a role.

As for fatigue treatment, there’s evidence that good sleep habits and regular exercise can help, if people can keep those habits up.

Based on research into chronic fatigue, a combination of exercise plus cognitive behavioral therapy might help some patients, according to Goldstein. he said he and his colleagues are currently studying that approach.

Cognitive behavioral therapy is a form of talk therapy focused on changing the thought patterns and behaviors that seem to be feeding physical or mental symptoms.

One recent study also found that breast cancer survivors who got more omega-3 fats in their diets were less likely to have long-lasting fatigue than survivors who ate less. (See Reuters Health story of March 29, 2012)

Omega-3 fats, which are thought to fight inflammation, are largely found in oily fish like salmon, mackerel and tuna.

Those findings, though, do not prove that omega-3 directly affects the long-term risk of fatigue. and the researchers said it was too soon for cancer survivors to be taking fish oil to battle fatigue.

They noted, though, that eating fish a couple times a week — something that’s already recommended for general health — could be a good idea.

There are many readily identifiable and measurable causes of long-term fatigue, including anaemia, low thyroid, adrenal burnout, chronic infection (such as brucellosis and Q Fever), sleep apnoea, narcolepsy and pineal hypofunction from microwave radiation emanating from electrical items. There is another cause, chronic fatigue syndrome (CFS), whose symptoms are severe but, paradoxically and diagnostically, without positive findings on physical examination, scanning or laboratory testing. the fact that CFS is not measurable does not rule out its presence as a disease. Albert Einstein’s maxim “not everything that counts can be counted” could well apply here.

… medical doctors and government regard CSF?as psychological, unaware of recent scientific advances…- Charles Edward Corney, Sliema

A remarkably similar condition, neurasthenia, was first described by G.M. Beard (1869) and was believed to be psychological in origin – Florence Nightingale was a sufferer. J.H. Musser (1912) was the first researcher to suggest a physical origin. since then, there have been several name changes reflecting the continuing uncertainty of the origin of the symptoms – atypical poliomyelitis in 1934, the royal free hospital outbreak in 1955, myalgic encephalitis in 1969, yuppie flu in 1980 and, finally, chronic fatigue syndrome in 1988. These outbreaks suggested an infective origin. Epstein-Barr virus was isolated from some, but not all, patients. Conversely, this virus was isolated from patients who were not suffering CFS, thus boosting the psychological origin belief. Others believed it was a physical condition causing secondary psychological depression.

A diagnostic symptom of CFS is a self-reported fatigue lasting over six months, often necessitating weeks of bed rest, producing a life-changing effect. Characteristically, exercise aggravates the fatigue and sleep is not refreshing. Sometimes, there are headaches, muscle pains and a sore throat due to preceding glandular fever. Similar symptoms may occur with Gulf War syndrome but the history of multiple vaccinations excludes CFS.

Commonly, the patient admits to fewer symptoms, such as exhaustion with poor sleeping patterns and an inability to keep working at a stressful job. However, these symptoms could reflect bipolar depression rather than CFS.

Another similar condition, fibromyalgia (FM), should be considered when the patient complains more about muscle pain and tenderness, rather than fatigue. An undue sensitivity to drugs and alcohol is often present requiring lower than expected dosing to avoid overdose effects.

Low levels of thyroid and progesterone hormones have often been observed in both CFS and FM. low progesterone may occur with certain drugs or when ovulation ceases menopausally or premenstrually – perhaps explaining the commoner incidence in women compared with men. Correction of these hormone levels sometimes ameliorates the CFS/FM, suggesting a treatable hormonal cause.

The presence of stress, by lowering the progesterone level, depresses the thyroid receptors in all the cells of the body, effectively causing hypothyroidism. both low progesterone and low thyroid function can directly cause the similar symptoms of fatigue, depression and muscle aches.

This overlap reveals the impossibility of defining the exact cause and the exact diagnosis of these symptoms. often, the diagnosis of CFS is made indirectly by the specific treatment of the other causes of long-term fatigue. Any remaining symptoms may then be regarded as those of CFS. Maybe long-term fatigue is a single, overarching disease consisting of a spectrum of conditions based on symptom predominance.

There is no specific treatment for CFS but supportive and symptomatic treatments are important.

The main aim is rest, balanced by exercising the body and the brain to within the limits dictated by the onset of exhaustion.

Gradually, this exercise is increased. Good nutritious meals are essential. Psychotherapy may help to overcome depression. Any hormone deficiencies should be corrected.

The presence of CFS has such a profound, adverse effect on home life, relationships and ability to work that the patient often fears that the condition could be terminal but this is untrue. some patients recover within 10 years while others suffer exacerbations and remissions for more than a decade.

Many medical doctors and governments regard CFS as psychological. they are unaware of recent scientific advances increasingly indicating a physical disease, whose origin will at last be revealed after 150 years of uncertainty. Better management and a cure will surely follow.

A new study suggests that taking ibuprofen before a trip to the mountains may help some people avoid the headaches and nausea that come with altitude sickness.

Still, both a study author and one altitude expert not involved in the research said the approach won’t help all travelers and climbers — and isn’t necessarily any better than taking prescription altitude-sickness drugs.

Even with ibuprofen, “there are still a lot of people who do have symptoms,” said Robert Roach, head of the Altitude Research Center at the University of Colorado Denver School of Medicine.

Because the body’s response to high altitudes varies person-by-person, there may be some people who do better with ibuprofen than with prescription drugs, including acetazolamide — which increases the amount of oxygen in the blood — and the steroid dexamethasone, he said.

But the opposite is also true.

“There are for sure going to be some people where ibuprofen doesn’t do much,” Roach told Reuters Health.

Research has suggested ibuprofen, marketed as Advil, among other brand names, helps relieve symptoms in people who already have altitude sickness — which typically feels like a hangover, according to Roach, who wasn’t part of the study team.

Researchers wanted to see if the over-the-counter drug could prevent those symptoms before they started.

For the study, volunteers were driven and hiked a few miles from an altitude of about 4,000 feet to over 12,000 feet in the White Mountains of California during the summer of 2010. half of them were given 600 milligrams of ibuprofen three times during the day, starting six hours before the ascent. The other half took a drug-free placebo pill.

Researchers asked the participants about their altitude-related symptoms, including headaches, dizziness and nausea after they finished their trip and again in the morning after a night spent at altitude.

Out of the 86 participants in the study, 43 percent of those given ibuprofen reported symptoms of altitude sickness, compared to 69 percent of those on the placebo pills instead.

Eight of the volunteers had symptoms serious enough to warrant treatment — six who had taken ibuprofen and two in the comparison group, the research team reported in the Annals of Emergency Medicine.

Dr. Jeffrey Gertsch from the University of California, San Diego School of Medicine and his colleagues calculated that four people would need to take ibuprofen before and during their high-altitude trip to prevent one from getting sick.

False sense of security?

Gertsch said one big question his team’s study can’t answer is whether ibuprofen is just easing altitude symptoms by providing pain relief or if it’s really getting at the underlying causes of those symptoms, including inflammation and changes in blood vessels.

If it’s only easing pain, he said, that could actually be worrisome for climbers.

“You could have a false sense of security… and get yourself into real trouble” at higher altitudes with low oxygen, Gertsch told Reuters Health.

Researchers will need to find objective ways to measure altitude sickness, besides patients’ perceived pain and nausea, to try to answer that question, he added.

The researchers agreed that ibuprofen is an option for people who’d rather not take prescription drugs, which may cause side effects. Acetazolamide comes with a risk of nausea and fatigue — symptoms of altitude sickness itself — and dexamethasone may raise blood sugar levels and disturb sleep. And ibuprofen costs pennies per pill.

“People would be welcome to try it… and see how it works for them,” Roach said — assuming they realize ibuprofen can also come with side effects, including stomach problems.

“If people want to use this to prevent altitude sickness, I’m not going to say that’s bad, they just need to be very careful,” Gertsch added.

When it comes to high-altitude climbing, he said, “there is no substitute for careful planning, which is staged ascent, just going slow.”

Johnny Wilson spent 24 years as a Navy photographer. when he retired in 2009, he started aiming his lens at people with interesting stories to tell: combat veterans, breast cancer survivors, heart transplant patients.

But the one of the young woman with the haunting eyes and bandaged, scarred belly, clutching a mass of prescription bottles, may be his crowning achievement to date.

“I thought, ‘I’ve probably just taken the most powerful photo of my life. To see her body destroyed by lupus … ,” Wilson said, his voice trailing off. “hopefully, we get the word out.”Raising awareness about lupus is the goal of a monthlong exhibit that Wilson and the nonprofit Life Without Lupus Project will unveil Monday at Penrose Cancer Center.

The exhibit consists of 14 portraits, accompanied by hand-written statements from each subject on how the  energy-zapping, organ-attacking, often-debilitating and sometimes fatal autoimmune disease has affected their lives.(Excerpts of their statements are included withthe accompanying photos.)

Amazingly, most are able to find hope and faith amid a life filled with complex medication regimens, crushing fatigue, and any number of unpleasant and painful symptoms.

“There were times in my life when I just wanted to die,” wrote 21-year-old Alyssa Robb, the woman holding more than a half dozen bottles of pills in Wilson’s photo. “But, thanks to new faith and a new outlook on life, I now know that my trials and storms are preparing me for my eternal life.”

Wilson’s idea for the exhibit grew out of his post-military mission to photograph people with gripping stories to tell.

He gives them an 11-by-14 inch sheet of archival paper and archival ink, then creates a portrait from the stories they write. so far, he has about 40 stories on a variety of subjects.

A few years ago, he met ReNai Frisco, the founder and head of Life Without Lupus, and invited her to an exhibit he had at the Air Force Academy.

“I was telling her: ‘Here’s a way to get the lupus story out to the public,’” he said.Frisco jumped at the opportunity. her sister died of lupus at age 48, leaving behind a son whose portrait will be in the Penrose exhibit.

“I don’t think people really get the impact of Lupus,” Frisco said. “Survivors call it the ‘invisible disease,’ because you can have a decent day, but that next day can be a whole different story. these folks end up on a cycle of treating the symptoms, because there’s no known cause or cure. There are endless medications, staggering co-pays and really, no resolution.”

She started the nonprofit in 2008 to help lupus patients with their rent, food, transportation and other needs. on Saturday, she’s launching a lupus support group.

Meanwhile, Wilson hopes his photo-and-story concept will lead to coffee table books on various subjects that nonprofits can use to convey their missions and raise money. He used the example of a book that might be dedicated to photos and stories of people with breast cancer. “You’ll be able to go to a website or a bookstore, read inspiration stories on survivors of breast cancer, and learn more about it,” he said. “It’s a reference to help people.”

DID YOU KNOW?• There are several types of lupus, including one that affects the skin. But the most common is systemic lupus erythematosus, which affects the joints and organs, including the heart, lungs, kidneys and brain. It accounts for about 70 percent of all cases.• 90 percent of lupus patients are women. Women of color are two to three times more likely to develop lupus.• Lupus tends to develop in people ages 18 to 45.• Lupus organizations estimate that at least 1.5 million Americans have the disease. more than 16,000 new cases are reported annually.• 20 percent of people with lupus will have a parent or sibling who already has lupus or may develop lupus.• About 5 percent of the children born to individuals with lupus will develop the illness.• an estimated 10 percent to 15 percent of people with lupus die prematurely from complications related to the disease.• two of three lupus patients lose some or all of their income because they are no longer able to work full time.• one in three lupus patients has been temporarily disabled by the disease; one in four receive disability payments.• Symptoms vary from person to person, and can ebb and flow in intensity and frequency. Common symptoms include joint pain and swelling, chest pain when taking a deep breath, fatigue, fever with no other cause, hair loss, mouth sores, a “butterfly” rash over the cheeks and bridge of the nose, headaches, swollen lymph nodes, numbness, tingling, seizures, vision problems, abdominal pain.Sources: Lupus Foundation of America; U.S. National Library of Medicine: U.S. Centers for Disease Control

Hay fever is a leading cause of missed work days and poor productivity.  

An estimated 55 percent of employees reported experiencing hay fever symptoms for an average of 52.5 days, according to a study published in Current Medical Research and Opinion. they were absent an average of 3.6 days per year due to allergies, and were unproductive 2.3 hours per workday when they experienced symptoms. 

That results in an estimated cost of more than $601 million in total lost productivity annually, according to a study in the American Journal of Managed Care.

Why the poor performance? Allergies don’t just cause sniffling and sneezing, which most people can ignore. they can cause sore throats, headaches, sinus infections, itchy eyes, fatigue and general malaise—symptoms that make it difficult to tough it out.    

But experts believe that people with allergies don’t have to suffer quite as much as they do. many people don’t treat their allergies as aggressively as they could be. Here’s what you need to do to reduce your symptoms and increase your productivity at work:

1. start taking meds–now. Some people wait until the symptoms build up to the point of distraction before they start taking their allergy medications.  but as symptoms worsen, they become more difficult to treat, and can lead to complications like sinusitis. in addition, nasal steroid sprays take 5 to 7 days to quell your inflammatory response. It can prevent sneezing and congestion if started early, says allergist Dr. Dean Mitchell, author of The Allergy and Asthma Solution.

Start taking allergy medications a few weeks before allergy season hits (this year, spring has come early so you’ll need to start right away).

2. Don’t quit your meds.  Nasal sprays can take several days to reach their full effect, so don’t assume they’re not working if you don’t get relief right away. Make sure you stick with it for at least a week. And don’t stop using nasal sprays once your symptoms are under control, because your allergies will just return. if symptoms do get worse or your over-the-counter nasal sprays are not working, ask your doctor to write a prescription for a nasal cortisone spray.

3. take an antihistamine at night. The older OTC antihistamines (like Benadryl) are stronger than newer drugs, but they make you drowsy. That makes them perfect for nighttime use.

4. Don’t forget your eyes.  use a prescription antihistamine eye drop as soon as you feel mild itching. Avoid OTC decongestant eye drops because they can cause rebound redness when you stop using them.

Laurie Tarkan is an award-winning health journalist whose work appears in the new York Times, among other national magazines and websites. She has authored several health books, including “Perfect Hormone Balance for Fertility.” Follow her on Twitter and Facebook. 

Despite the rain, close to 200 area women arrived at the Fallbrook Library community room for the Healthy Woman Ladies Night out on Feb. 27. The topic for the evening was heart health and the program featured a presentation on “Heart Disease in Women” by local cardiologist Dr. Ernst Schwarz; a talk on “Healthy Cooking Made Easy” by Healthy Woman advisory council member Rose Brown-Salek; and food from Chick fil-A, in Temecula.

After checking in, the ladies were greeted with a healthy, bagged meal from Chick fil-A. The food was prepared fresh, on-site, as they arrived. The meal consisted of half of a grilled chicken cool wrap which included lots of fresh veggies and a multigrain flatbread, a small fruit salad, fudge nut brownie wedge, and a bottle of water donated by Major Market.

A delay caused by technical difficulties gave everyone a chance to chat and enjoy their food. with his computer hooked up, Dr. Schwarz quickly reviewed the general symptoms of a heart attack (pain in the middle of the chest radiating into the left arm and shoulder, and the abdomen, and sometimes into the right arm and shoulder) before going into more detail about the causes of chest pain, including several kinds of heart conditions.

Dr. Schwarz also explained how different problems in other areas of the body can cause chest pains including muscular skeletal disorders like chronic pain syndrome; digestive complaints such as heart burn and peptic ulcers; respiratory ailments like pneumonia and asthma; and other conditions including panic attacks, shingles and hyperventilation. Trauma suffered in car accidents and falls can also cause chest pain.

He said risk factors for heart trouble can be found in one?s family history, smoking, hypertension, diabetes and weight. sixty percent of heart attack patients are over 65 years of age; 46 percent are women. Coronary attacks are the single largest cause of death in Western society. Dr. Schwarz added, “Since 1984, the number of deaths for women has exceeded those for males if caused by heart disease.” He also said, “More women die from heart disease than breast cancer. One in two women will die from heart disease and one in 10 from cancer.”

Contributing to the problem is the fact that women have smaller arteries than men and “women can tolerate more pain than men, by the way,” said Dr. Schwarz. He also said that high cholesterol is more common in older women than in men and that diabetes increases the risk of suffering a heart attack up to seven times in women and only three times in men.

He then gave more details on the more atypical symptoms that women can have before a heart attack: abdominal pain, fatigue, and shortness of breath. He said women show up later in emergency rooms and are less likely to complain of symptoms. According to Dr. Schwarz, more gender specific research and guidelines are needed and women need to demand more gender specific care.

While hormone replacement therapy (HRT) can cause heart problems, he said that if HRT is started early in the menopausal years, it does not increase the likelihood of a heart attack. He recommended self care, recognition of symptoms, exercise and regularly weighing oneself as changes in weight can indicate water accumulation which is not good. As he did not have time to finish his presentation, the crowd agreed with Healthy Woman coordinator Monique Murphy-Mijares that Dr. Schwarz should come back to finish his program at another time.

Also short on time, Pampered Chef consultant Rose Brown-Salek shared some tips for cooking healthier meals including grilling chicken rather than frying it, using Himalayan sea salt rather than regular salt and rinsing canned vegetable to remove some of the sodium used in canning.

An interesting tip was to cook chicken in stoneware as it keeps moisture in, whereas glass and metal containers pull moisture out of the meat. One should also let chicken rest for five to 10 minutes before cutting to keep the juices in. For portion control, she recommended using small individual pans for making desserts. among the products she sells are cookbooks that help with making food fresh and healthy, and show how to read food labels.

The next Healthy Woman Ladies Night out will be on Thursday, March 29 at the Fallbrook Library community room and the guest speaker will be Dr. Annie Dai. Ahrend Studios will be taking “after” photos of the Healthier Me participants that evening. The program?s anniversary dinner will be on Tuesday, May 22 at Pala Mesa Resort and guest speaker Dale Smith Thomas will give a motivational speech, “Winners by choice.” More information on this event will be forthcoming.