We are used to searching online for ANSWERS TO MOST OF THE QUESTIONS OF EXCITING US . In this series of articles, we ask just such questions – burning, unexpected or common – to professionals in a variety of fields.

When information on any diseases and conditions is available on the Internet, many medicines are sold without a prescription, and paid examinations can be done at least every day, it is easy to go too far in health care. Does it make sense to donate blood for analysis yourself from time to time? What and when to check so as not to miss something serious? Does any abnormality on the printout mean you are sick? We asked these questions to an expert.

Galina Palkova

doctor-dermatologist, endocrinologist ‘ Clinic Julia Scherbatova “

For many, this will be a surprise, but in the absence of specific complaints and hereditary predispositions, it is not necessary to do tests at all. There is no standard set of “recommended annual tests”; you do not need to donate blood even for a common cold or before a routine vaccination. And it makes no sense to assign yourself any research at your own discretion: to take care of your health, an annual conversation with a competent doctor who has been leading you for a long time is more than enough.

At the same time, it is important to understand that the absence of complaints is a loose concept. Frequent headaches, bruising under the eyes, loss of energy, depression, weight gain, sudden love for sweets, irritability, hair or skin problems are what you need to go to the doctor with. It is dangerous to explain such symptoms for a long time by saying that you simply did not get enough sleep. True, trying to find the cause on your own, checking suspected diagnoses from the Internet with the results of tests from the laboratory near the house, is even more dangerous.

In what cases are tests still needed? In the life of most people, there are three stages at which it is recommended to undergo a detailed screening. The first one is at the age of eighteen or twenty, when it is important to make sure that the body has entered the reproductive period and is working correctly. At this stage, hereditary problems and early stages of disorders can be identified, which can develop into serious chronic diseases if they are not dealt with.

The second important stage is the moment when the level of sex hormones begins to decrease (35–40 years old). Menopause or andropause at this time does not yet occur, but the level of hormones begins to decrease markedly, and global changes occur in the body: the condition of the skin worsens, the lack of oxygen in the tissues increases, against the background of a decrease in the production of sex hormones, weight gain may begin. Being mindful of yourself at this point can make it easier to enter menopause in the future.

The third stage is not tied to a specific age – this is preparing for pregnancy and the pregnancy itself or planning for conception, if you are a man. Quitting smoking and drinking alcohol at this point is important, but not enough. In order to guarantee good health for yourself and your child, it is important to undergo a detailed examination and, if necessary, correction.

At all these stages, it is necessary to do general clinical and biochemical blood tests, blood tests for hormones and basic trace elements (vitamin D and B12, copper, zinc, magnesium, folic acid), parameters of oxidative stress (hemoglobin and iron), as well as ultrasound of small organs. pelvis, thyroid gland and mammary glands. A general clinical analysis shows the number and ratio between blood cells – erythrocytes, leukocytes, platelets, and biochemical analysis determines the concentration of different molecules, such as glucose or cholesterol. It is important to understand that you cannot go with this list to the nearest laboratory and calm down if the results are within the normal range – just like panic if they fall outside the normal intervals. Analyzes should be prescribed and, most importantly, only a doctor should interpret their results.

In addition, blood and urine tests are by no means the main diagnostic methods. In rare cases, it is possible to make a diagnosis only by the results of a blood test.

There are several reasons for this. For example, the reference values ​​are not absolute: in fact, the norm for a particular patient can vary greatly depending on your gender, age, height, weight, the presence of certain diseases, a list of what you have been ill with before, and even ethnic characteristics. In addition, the normal range may differ slightly between different laboratories: in the printout of the results, your hemoglobin level will be marked with an asterisk as too low, and in the other it will be normal, although close to the lower limit of the normal range. Such differences may be due, for example, to the equipment used. Only a doctor can decide whether the result is normal.

In addition, blood and urine tests are auxiliary, but by no means the main diagnostic methods. It is possible to make a diagnosis only by the results of a blood test in the rarest cases – with rare infections and a couple of endocrine diseases. In other cases, it is important to look at the ratio of different parameters with each other, at their combination with symptoms, history and characteristics of a particular patient. In a word, only a good doctor can do it again.

Like any other high-tech industry, laboratory diagnostics are constantly evolving, and the methods are becoming more complex and accurate. If a general clinical blood test or an analysis for thyroid hormones can be performed anywhere, then more complex things – a blood test for homocysteine, vitamin D, most trace elements, indicators of oxidative stress – are best done in laboratories where there is equipment for mass spectrometry, one of the most advanced techniques. On the other hand, donating blood for the simplest tests in a cool and expensive laboratory is often a waste of money, so it is better to listen to the advice of a doctor who will explain which parameters it is better to go to a more modern laboratory for analysis.

Much also depends on the state in which you are at the time of donating blood – and which can greatly affect the result. For example, on the eve of donating a blood sample for analysis for prolactin, you cannot have sex, and you cannot eat sweets, fatty foods or smoke in front of others. In absolutely all cases, it is better not to drink alcohol. The results may depend on the phase of the menstrual cycle, vitamins taken and a huge number of factors. It also happens the other way around: many of the usual restrictions are outdated from the point of view of modern medicine and a competent doctor will recommend, for example, donating blood not on an empty stomach, but after dinner.

In general, not all conditions are immediately reflected in the test results directly. Some hormonal disorders often first appear as a deficiency or excess of vitamins or trace elements, with the use of which these hormones are synthesized. Or the simplest example: in hypothyroidism – a reduced function of the thyroid gland – the level of its hormones may be normal, and not lowered, so their amount as a result of the analysis will not say anything. In this case, the pituitary hormone, which stimulates the thyroid gland (thyroid-stimulating hormone), will be produced in large quantities in order to spur its function. It is hardly possible to understand all these intricacies without a higher medical education, but it is easy to miss the onset of the disease by independently prescribing tests for yourself.

There has been a lot of talk lately about genetic tests – but they cost a lot of money, and not everyone benefits. For example, for some already identified tumors, analysis for genetic mutations is necessary – for the same breast cancer, it helps to choose an effective treatment and better understand the prognosis. But for prevention, not everyone needs to do genetic tests; even if such a test is needed, then we are talking about the profiles of specific genes, and not a complete decoding. It turns out that only a professional is capable of prescribing and interpreting the test results. And the patient’s task is to find an attentive doctor who can be trusted.

POOLS AND WATERS ARE A GREAT PLACE TO RELAX AND EXERCISE, no matter if you’re STEPPING back from the heat or strengthening your back muscles. But the more often you find yourself in the water, the more obsessive the thought that something might go wrong. It also happens the other way around: it’s so comfortable in the aquatic environment that you don’t want to notice the dangers. We have collected popular myths about bathing and debunk them together with experts: the chief physician of the Gemotest Laboratory Olga Dekhtyareva, an expert at the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor Timur Pesterev, therapist of the Medicina clinic, a doctor of the highest category Iraida Belyaeva, obstetrician-gynecologist Beauty Clinic by Boris Nemanov and open water swimming record holder, founder of the SwimRocket swimming school Nikita Kislov.

It’s easier to learn to swim in the sea

Despite the fact that salty seawater has a high density and it is easier to stay afloat in it, the sea is a natural body of water, and learning to swim in it is often complicated by waves, underwater currents, and marine life that can bite, sting or frighten. Therefore, the pool is the best place to meet this challenge. According to Nikita Kislov, record holder in open water swimming, there is no need to put an equal sign between swimming in a pool with seawater and in the sea: the concentration of salt in the sea is hundreds of times higher. But the difference between swimming in pools with sea and fresh water will be imperceptible.

You can’t drown in shallow water

Splashes into the respiratory tract, loss of consciousness or heart problems can lead to dire consequences even where the water is knee-deep. It is known of cases when children drowned at a depth of five centimeters – that is why, when bathing a child in a bathtub, one should not be distracted for a second, and it is better to ignore the ringing phone.

Nikita Kislov notes that it is important for those who are just learning to swim to overcome their fear of water first. To do this, you need to create the safest conditions around yourself that will not distract from learning. It is best to start in a pool in shallow water (if necessary, hold on to the side or ladder) under the guidance of a trainer. A professional will talk about safety rules in the water, explain how to keep your body afloat, and correct your movement technique.

Pee
in the pool turns purple water

In American comedies, you can see a scene: the hero is swimming in a pool – and suddenly a bright spot appears around him. After that, it is supposed to laugh or make a face, because almost every American knows: water begins to color when a special reagent interacts with urine.

This method of water purification was at one time used in public pools in America and Europe, but was quickly canceled due to the high cost and infringement of human dignity. True, sometimes in our country, next to the pool, you can find a sign informing about the presence of a dye in the water. The purpose of such a warning is to intimidate swimmers so that they do not have thoughts to pee in the water while swimming. In most modern pools, water is purified with ozone, but always with the addition of chlorine, because the latter is the best disinfectant for water.

Chlorinated water is bad for the skin

If you are not allergic to chlorine-containing disinfectants (skin redness and itching), swimming in the pool will only be beneficial. In addition, if the pool uses ozone water purification, the chlorine concentration will be reduced. Chlorinated water can actually dry out skin – especially dry or sensitive skin. Other factors also cause this effect: washing with soap, dry air due to the operation of an air conditioner or heater. Therefore, special care for problem skin is necessary in any case. If your skin is normal, after swimming in the pool, it is enough to shower and apply a moisturizer or lotion.

Swimming can lead to pregnancy
or HIV infection

According to the doctor Olga Dekhtyareva, the concentration of sexually transmitted infections (HIV, syphilis, gonorrhea, chlamydia and others) in the pool and water bodies is so low that the risk of infection while swimming is close to zero: if it gets into the external environment, microorganisms quickly die , and chlorine kills them even faster. At the same time, the likelihood of catching the human papillomavirus (HPV), for example, using someone else’s towel, exists.

It is also impossible to get pregnant in the pool : sperm in the external environment quickly die if special conditions are not created (as in sperm banks); in addition, even with a theoretical hit from the pool into the vagina, they are not able to reach the fallopian tubes, where conception occurs.

You can’t get fungus in a good pool

Unlike viral and bacterial infections, fungal infections in the pool are not uncommon. Only this does not happen in the water itself, but in the space surrounding the pool, even if all sanitary standards are observed there. A warm and humid alkaline environment encourages the growth of fungi that often inhabit pool sides and handrails, showers, rubber slippers, towels and bathrobes. The risk of infection is especially high if there is microtrauma on the skin or immunity is reduced, as well as in people with diabetes mellitus or thrombophlebitis and in adulthood.

To protect against fungal infections (mycoses), Olga Dekhtyareva advises not to walk barefoot outside the swimming area and not to sit on the side, after visiting the pool, take a shower with soap or gel, use only your own towel and your slippers, treating them with a chlorhexidine solution, and wipe dry your feet and the space between your toes after a shower. It also does not hurt to apply an antifungal cream or varnish for prevention.

After bathing in salt water, you can skip the shower

Pure fresh water helps not only cleanse the skin of bacteria, fungi and eliminate the smell of bleach, but also rinse off the sea salt. This avoids skin irritation and sunburn; Ideally, after each swim in the sea, rinse off the salt in the shower, dry your body with a towel, and reapply the sunscreen.

If everyone swims, the reservoir is safe

Do not ignore the sign “Swimming is prohibited” next to the reservoir, even if there are many vacationers around. It means that the water from this reservoir, as well as such characteristics as the current, relief and bottom, have been checked – and it is unsafe to swim here. Olga Dekhtyareva draws attention to the fact that in summer ponds, quarries and lakes can be breeding grounds for pathogens of intestinal, eye and ear infections, as well as parasites and the hepatitis A virus. … Water pollution with mineral fertilizers and their decay products can provoke allergies, and poison that has entered the body can cause skin problems and diseases of internal organs.

“Blooming” water with an unpleasant odor is another reason to abandon the idea of ​​going into the water: such a reservoir is oversaturated with organic waste and nutrients. According to Timur Pesterev, an expert at the Central Research Institute of Epidemiology of Rospotrebnadzor, fresh water bodies in hot weather become an ideal breeding ground for many bacteria, and in stagnant water where ducks live, it is easy to pick up the so-called bather’s itch. In fact, this is a severe dermatitis caused by the larvae of parasites that live in the circulatory system of waterfowl: when they get on human skin, they provoke severe itching, rashes, and an increase in body temperature.

To protect yourself from possible health problems, you need to swim only in reservoirs checked by Rospotrebnadzor (if we are talking about Russia) and try not to swallow water. If you are planning a trip to hot countries, it is worth collecting information in advance about the infections that you may encounter there. The best prevention method for some of these is vaccination. In addition, in southern countries, infections are often found that are not familiar to the inhabitants of the middle lane, which means that one should not rely heavily on strong immunity.

Yesterday the world spread the news about a nine-year-old girl who defeated HIV infection “without treatment” – however, with a deeper study of the issue, it becomes clear that therapy was carried out, albeit quite a long time ago, and English speakers accurately call the child’s condition remission, not cure. We tried to figure out whether it is generally possible to talk about a complete recovery after infections with hepatitis or HIV viruses and whether the body is able to cope with them on its own.

The problem with viruses is that they are all very different and, unlike bacteria, do not have a cellular structure. To destroy bacteria, it is enough to destroy their membrane, that is, the outer wall of the cell itself – this is how the very first antibiotic, penicillin, works . There are antibiotics that disrupt protein synthesis inside bacteria and prevent them from multiplying; Be that as it may, bacteria are independent organisms. The virus, in fact, is a carrier of genetic information – DNA or RNA – in a protein coat with several auxiliary molecules like enzymes. The DNA of the virus can be incorporated into the cell of the human or animal organism in place of the “master” – therefore it is so difficult to develop drugs that destroy viruses and do not damage the cells of the body.

It must be understood that the viability of both bacteria and viruses in the body and outside it is not the same – the same hepatitis viruses can be easily destroyed by high temperatures, for example, when sterilizing dental or manicure instruments. And not all means of exposure are equally applicable inside and outside our body: you can treat the skin with an antiseptic, but you cannot enter it into the blood if bacteria multiply uncontrollably in it. Fragile, quickly dying in the air, HIV becomes powerful and dangerous when it enters the bloodstream – and worst of all, it destroys the immune cells that are called upon to fight infections. Still, scientists are not working in vain, and there are already quite effective drugs that have made HIV infection a chronic disease – and the life expectancy of patients receiving therapy is 70-80 years.

These drugs are called highly active antiretroviral therapy, and they work on different components of the infection and are used in combination with each other. For example, one drug can inhibit a viral enzyme that affects proteins in human cells, while another can block receptors on immune cells, preventing the virus from contacting them. While a person is taking medication, the amount of virus in the blood may decrease to a minimum, but after some time after stopping treatment, HIV infection usually reappears. This period can be several months or a couple of years – or it can be much longer. This happens even without treatment: in some people, HIV infection does not progress eight to ten years after infection, and scientists cannot yet name the exact reason for this.

It is important to understand that there is practically no concept of “zero” in virology: if the virus is not detected, perhaps the sensitivity of the equipment simply does not allow it to be found in such low quantities

What counts as a cure is also a controversial question. For example, in the practice of treating infections with hepatitis viruses, they are considered the so-called sustained virological response. If no relapse occurs within twelve weeks after completion of therapy, then the patient is considered cured. If the hepatitis C virus is detected after a significant period of time after that, it is most likely that reinfection has occurred (this is not uncommon when it comes, for example, about people who inject drugs). It is important to understand that there is practically no concept of “zero” in virology: if the virus is not detected, it is possible that the sensitivity of the equipment simply does not allow it to be found in such low quantities. Another thing is that the body is able to cope with single viral particles of even such dangerous infections on its own.

With HIV infection it is even more difficult: in some studies, the number of viral copies is considered low, less than five thousand per milliliter of blood, in others – less than fifty. If we do not see the virus, can we say that it is completely destroyed? After how many years of remission, can the patient be considered healed and follow up? If a person dies during the period of remission for reasons unrelated to HIV, can it be assumed that a relapse would never have happened? These are not only medical, but also philosophical questions – and so far the case of long-term remission in an African girl only suggests that it is necessary to continue to study the issue and try to understand whether this effect can be achieved in other patients.

In principle, it has long been known about mutations that make the body resistant to HIV infection. It is possible that, in addition to forty weeks of antiretroviral therapy, carried out shortly after birth, the child was helped by some unique feature of the body – it is not yet known which one. At the moment, complete remission, without the possibility of detecting viral particles in the blood, was achieved in three children – and one of them still had a relapse. Today we can only trust doctors and scientists and hope for the success of new developments – and for children in complete remission, expect that it will last a lifetime. Statements like “The child’s immune system coped with HIV infection on its own” should be treated with great caution: so far no one has managed to cope with HIV without treatment, and, unfortunately, such high-profile headlines can lead to refusal of therapy when it is needed.

MEDICAL SCIENCE IN THE PAST DECADES HAS MADE incredible progress: many tumors have ceased to be a sentence, cyber prostheses almost indistinguishable from real legs have appeared, it is possible to give birth almost painlessly or to correct myopia with a laser in a matter of minutes . It is all the more surprising that the army of supporters of anti-scientific methods does not give up their positions – these are homeopaths , HIV dissidents , and lactivists who equate the harm of formula milk almost to the harm of heroin. In an effort to “heal with natural remedies,” people spend time and money on superfoods, engage in mindless detox programs , and even eat the placenta after childbirth. We figure out why they do it and whether there is a healthy grain in it.

The placenta is the only temporary organ in the human body; during pregnancy, it serves as a kind of filter, protecting the fetus from the penetration of harmful components. That is why, when discussing medication during pregnancy, it is important whether a particular substance passes through this barrier. The functions of the placenta are protecting the fetus, feeding it, maintaining a stable temperature, delivering oxygen (after all, the baby is not breathing yet) and eliminating decay products. Also, the tissue of the placenta produces hormones that support the normal course of pregnancy.

The baby is connected to the placenta by the umbilical cord – that is, a few minutes after birth, when the umbilical cord was cut, the connection is lost, and the placenta is considered to have fulfilled its function. In a maternity hospital or hospital, it is disposed of – ideally in compliance with all sanitary standards, because any biological materials can be dangerous. But now a movement is gaining momentum, which can only be called the worship of the placenta – it is carefully collected, they talk to it, buried in a certain place, make prints and pendants, or take it inside in one form or another.

It is believed that for centuries some peoples of New Zealand, China or Hawaii have done this – however, science refutes it ; nevertheless, placenta worship is coming to the Western world, with all its advanced medicine and modern technology. The hype has not spared celebrities: in 2013, pregnant Kim Kardashian publicly asked the chef if she could cook the placenta. The Big Bang Theory star Mayim Bialik has repeatedly emphasized that all mammals eat the placenta and that its benefits are undeniable. Other well-known fans of the placenta include Alicia Silverstone and, for example, Russian singer Sasha Zvereva. Decent money is earned on the idea of ​​returning to “everything natural”: Instagram is replete with advertisements for placenta capsules – a bottle can cost , for example, 250 British pounds. Amazon sells the Twenty-Five Placenta Dishes cookbook – especially ironic (hopefully) comments like “my guests don’t talk to me anymore “, “why isn’t there a vegan option?” or “only a real baby tastes better.”

The positive effects of eating the placenta include faster recovery after childbirth, increased energy levels, stimulation of milk production and improved hormonal balance. Needless to say, milk synthesis and normalization of hormonal balance occur on their own after childbirth, and it is impossible to conduct a full study of how much the “energy level” has increased after eating the placenta? What is “faster recovery” and how to compare its speed after the same birth, only with and without placental capsules? As usual, if a scientific basis is assumed behind the loud formulations, then it is far-fetched. “The placenta is an endocrine organ, which means it will quickly restore hormonal balance” – somewhere we have already heard about “the treatment of like like like “. The argument that all mammals eat the placenta after giving birth is also not strong enough – according to scientists , this is done in the first place so as not to leave traces for predators.

This is not to say that science is not at all aware of this trend – placentophagy is being actively studied; a detailed review of articles and research on the topic was published last year . According to the authors, although the placenta does contain iron, hormones and nutrients, one cannot speak of their stability either in a raw placenta that has left the human body, and even more so during the cooking process. One of the articles studied reported that most of 189 women had a positive experience of eating the placenta and improved their mood – however, depression after the previous birth, with which the current condition was compared, was not officially diagnosed in many of them, and the author of the study was the founder placenta capsule companies.

There is no current research into how the placenta affects milk synthesis – and the only one cited by advocates of placenta consumption was conducted in 1954 and does not meet current scientific standards. Several animal studies have shown that eating the placenta immediately after childbirth relieves pain by promoting the production of natural opioids. True, this is hardly applicable to the situation of the birth of a child for practical reasons – and is such anesthesia necessary for those who have access to high-quality and safe anesthesia? In terms of women’s reported mood and energy gains, it is very likely that the placebo effect is responsible.

There is no evidence or benefit of placental components in creams and serums. Although cosmetics with placenta have been sold with varying success for about fifty years, there is no scientific basis for any special effects, and advertising traditionally affects the consumer’s emotions: “What’s good for a baby is good for you.” Some doctors even express doubts about the safety of such creams: it is not known what effects the residual amounts of hormones can have if they remain active. The authors of the official toxicological report emphasize that there is no evidence of the safety of placenta derivatives in cosmetics – and if they are used, they should be as purified as possible and devoid of any activity.

Even worse, the placenta as a dietary supplement is not only useless, but also unsafe – it is non-sterile and can contain a wide variety of bacteria and viruses. In addition, as a protective function of the fetus, it can accumulate harmful elements such as cadmium, mercury or lead. Capsules are often made in home laboratories without adhering to any dietary supplement standards – and the companies providing these services are not regulated by official health authorities.

Less than a month ago, the American Centers for Disease Control and Prevention published a report on a severe streptococcal infection in a newborn – the source of infection was placenta capsules taken by the mother. Fortunately, the child survived after several courses of antibiotics. According to experts, the temperature to which the placenta is heated during the manufacture of capsules is simply not enough to destroy dangerous microorganisms. Unfortunately, placentophagy is not another harmless hobby of celebrities and instagram bloggers – it can cause serious harm, including to a small child.

“Recommend a good gynecologist” is perhaps the most common request in “women’s” groups on social networks, but the recommendations of friends often do not become a solution to the problem. The most polite doctor may not have a modern approach to the treatment of infections or the management of pregnancy – and vice versa, the doctor may practice evidence-based medicine, but spoil the whole experience by turning to the patient “you”. Nevertheless, there are excellent specialists who are a pleasure to visit – and we have collected ten signs that it is time to look for such a doctor and get away from the usual.

1

They speak to you condescendingly

Paternalism in doctor-patient communication – the attitude of an “adult” to a “child” – has been a normal practice for centuries, but modern medical ethics presupposes partnership. This means that the patient should be told what is happening to him, be interested in his opinion and even allow him to participate in making medical decisions. But if the doctor adheres to the classical attitudes – paternalism implies sympathy, care and responsibility, and not condescension and rudeness, which he often turns into.

Appealing to “you”, a condescending tone, accusations of licentiousness are manifestations of rudeness and unprofessionalism and should not be tolerated. Personal data protection is also the most important point of medical ethics; in Russia, you can count on strict confidentiality with a gynecologist from the age of fifteen (which, frankly, is quite late). If they call from the clinic to report the test results, they should be reported only to you personally, and not to your mother, sister or husband; this also applies to e-mail – any medical data can be sent only to the address you have left yourself.

2

You are ashamed for your love life

The task of the gynecologist is to collect the information necessary to determine your general state of health, diagnose diseases, select treatment, or, for example, contraceptives. It is perfectly normal if the doctor asks if you are sexually active and if you have one partner, if you want to become pregnant in the foreseeable future, if there was a change of sexual partner after the previous visit. All these questions are needed not to condemn you or hint that it is “time to give birth,” but to understand which examinations and contraceptives to recommend.

But questions about how many sexual partners you have had in your entire life are superfluous and certainly should not be repeated at every visit. The doctor should not comment on the specifics of your personal life, whatever they may be. Phrases like “what is it with you, so young and beautiful, no one is there” is a reason to at least ask not to discuss non-medical issues, but as a maximum – to start looking for another doctor. And, of course, the gynecologist should not scold you for epilation, tattoos, piercings or insufficiently white socks – they have nothing to do with a medical reception.

3

Are you afraid to ask questions

Actually, there is no place for any accusations at a doctor’s appointment – including accusations of ignorance. Of course, a general idea of ​​the structure of the human body or the work of hormones will not hurt anyone – but everyone knows that the situation with sex education is generally not very good. The relationship with the doctor should be such that you do not hesitate to ask even seemingly stupid questions – and the doctor calmly answered them.

Even a specialist cannot remember everything – and it is normal for a doctor to check the compatibility of different drugs in a reference book. It happens that the diagnosis cannot be determined the first time and you need to undergo several examinations. There is nothing wrong with the fact that the gynecologist clarifies the data in various sources, and vice versa, excessive self-confidence is bad, especially in combination with the requirements of the same from the patient.

4

You are being persuaded to give birth as soon as possible

Of course, if you are planning a pregnancy in the coming years, and the reproductive age is already approaching the senior, it is logical to hear the doctor’s advice not to delay this moment if you are interested in children. But persuading to give birth simply “for health”, without taking into account your personal situation – the presence of a couple, financial conditions, views – is unethical, and not very competent.

Indeed, there are situations when general health and well-being after the hormonal shock associated with pregnancy and childbirth become better – but it also happens vice versa. There are no diseases that can be guaranteed to be cured by pregnancy. A child is a new life, an individual person for whom his parents are responsible, and not an opportunity to improve their own health.

5

You are being diagnosed with non-existent diagnoses

Erosion of the cervix is ​​perhaps the most common example of a non-existent diagnosis in gynecology. In fact, erosion, of course, exists, but in the post-Soviet space, in a huge number of cases, ectopia is given for it – one of the variants of the norm, when the “junction” between the epithelium of the outer part of the cervix and its canal is visible during examination. Ectopia does not need to be treated – moreover, its “cauterization” can lead to the fact that when truly important changes appear, they will be difficult to notice.

It is also impossible to assert that a “precancer” was found on the cervix, according to only one examination, especially with the naked eye. Of course, with colposcopy (examination of the cervix with a strong magnification), neglected changes can be detected, but any oncological diagnosis can be confirmed only after examining the tissue under a microscope in a special laboratory.

6

Many things are forbidden to you during pregnancy.

A normal pregnancy is not a disease, and expecting a child does not mean at all that you need to give up sports, stop going to the beach or sauna and go on a strict diet. Indeed, there are a number of foods and medications that are not recommended for pregnant women – and there is a specific rationale for each of them. Ask why exactly something is forbidden to you – the answer must be unambiguous and accurate.

If the doctor intimidates with complications, reinsures himself, prescribes bed rest without a clear diagnosis, insists on a caesarean section “just in case” – it may be worth looking for another specialist. Recall that the “uterine tone”, which in Russia is actively treated with pills and suppositories, are often completely normal Braxton-Hicks contractions for any stage of pregnancy. Banning any medication by default is also unreasonable – for example, conventional remedies for treating cold symptoms can be safely taken (of course, only if indicated and for a short course).

7

You are being treated with unscientific methods

We will not tire of repeating that in medicine there is no place to refuse vaccination without clear indications or to treat with homeopathy . The emphasis on treatment only with natural remedies and grandma’s methods can make things worse for two reasons: First, the herbal remedies themselves can cause completely unexpected reactions, that is, they are unsafe. Secondly, valuable time can be missed when it should be treated with normal methods with proven effectiveness, and the condition will become more serious.

A doctor or midwife should not insist on natural childbirth without anesthesia, calling anesthesia evil and scaring the consequences for the child – this is simply not true. You should be aware of your options and have the right to decide for yourself whether you want to use pain relief – and no one should judge you for your choice.

eight

You are forced to treat “sexually transmitted diseases” when they are not there

The human body is inhabited by bacteria and fungi – and this also applies to the genitals. A shift in microflora can occur for various reasons; sometimes a certain type of microbes begins to multiply too quickly, and then thrush (fungal infection) or, for example, gardnerellosis appears. Often this happens when changing a sexual partner – and a woman who does not have deep medical knowledge has the impression that she has become infected with something.

It is even more difficult if the partner has not changed: suspicions of cheating may arise, and this will not benefit the relationship. A gynecologist should not support such a position – on the contrary, he should be explained that the microflora of the vagina can change for a variety of reasons that are not related to the loyalty of a partner. Taking antibiotics, strong summer heat, and changing the brand of condoms can also affect. If a doctor calls thrush a sexually transmitted disease, seek another doctor.

nine

Your doctor does not know current treatment protocols

Russian official recommendations for the provision of gynecological care are not inferior to international ones, but not all comply with them – therefore, instead of medical abortions, surgical abortions continue to be performed, and adult women are not even offered vaccination against the papillomavirus. It is clear that patients cannot be aware of the correct medical tactics for any issue, but some things should be kept in mind.

For example, HPV vaccination – a powerful prevention of cervical cancer – can be done not only during adolescence and not just for those who are not yet sexually active. It is known that the vaccine helps to reduce the level of the virus when it has already been identified – and, according to updated indications, it can be done for up to forty-five years . If you are told that you need to take breaks in taking COCs, and intrauterine contraceptive systems are suitable only for those who have given birth, the doctor is not familiar with modern approaches (or simply violates them).

ten

Your doctor is hiding information
and extorting money

Referral to “proven” specialists strictly in a specific clinic, prescribing a lot of unnecessary tests, demonstrative shifting of packages with gifts from other patients are obvious reasons to part with the doctor. If you are in a paid clinic, then the calculations should be made through the cashier, and not personally with the doctor – otherwise, problems may arise, for example, when you need a medical statement, and it does not contain half of the procedures performed.

It happens that you really need a complex analysis, which is best done in a specific laboratory, but the doctor must answer your questions why this is so. For example, other laboratories may not have suitable analytical equipment – and you can check this information if you want. In general, insist on the transparency of any data.

HORMONES REGULATE ALMOST ALL PROCESSES in the human body. Each of them can have several functions, and they interact with each other through the most complex algorithms. Violation of the synthesis of just one hormone can lead to a whole cascade of health problems – and hormonal disorders are also reflected in the skin. They can manifest themselves in different ways: as acne, dryness, flaking or too early loss of elasticity.

In order for the skin to feel good, it is worth not monitoring the level of a particular hormone, but of the overall hormonal balance, under the supervision of a competent and credible doctor. Irina Vyatkina, Candidate of Medical Sciences, a gynecologist-endocrinologist at the Marina Ryabus Clinic , told us about which hormones and how they affect the condition of the skin .

Androgens

Testosterone and its derivatives are usually called male hormones – but in fact, everyone has both androgens and “female” estrogens, but only their quantity differs. Androgens stimulate the cells of the connective tissue that produce collagen – as a result, the deep layers of the skin are renewed and its elasticity is maintained.

Lack of androgens, including age-related, reduces the protective function of the skin and the rate of its renewal – it gradually loses its elasticity and density, becomes drier and thinner. An excess of androgens – for example, in the last phase of the menstrual cycle, a few days before menstruation – causes an increase in the work of the sebaceous glands, which makes the skin oily and prone to rashes.

Estrogens

The average female phenotype depends on estrogens – for example, the tendency to accumulate fat on the hips and other features of the figure. Estrogens are involved in the renewal of skin and hair cells. At a normal rate of this process, the skin remains elastic and hydrated – and shrinks well after dramatic changes in weight.

With an excess of estrogen, problems with blood vessels may appear (for example, varicose veins or vascular mesh on the legs), and body weight may also increase dramatically. Lack of estrogen in women can be manifested by a breakdown, excessive and uncharacteristic hair growth, and a decrease in libido.

Progesterone

Every month, progesterone prepares the female body for pregnancy, and if it comes, it helps to maintain and bear the baby until the placenta takes over this function. The work of this hormone also affects the appearance: an increase in progesterone levels leads to fluid retention and edema. In addition, the permeability of the vascular wall increases, and as a result, the skin becomes more extensible and prone to rashes, and the likelihood of pigmentation increases. An extra couple of kilograms just before menstruation is the merit of progesterone. Thanks to this hormone and for all the favorite PMS symptoms: irritability, irascibility, resentment, tearfulness and lethargy.

An increase in progesterone levels in the last phase of the menstrual cycle is normal. It is possible to suspect that there is too much of it on other days if there is a clear stretch of the skin, swelling, increased cellulite (this is due to fluid retention), mood swings, hyperpigmentation. Too long periods, brittle nails and hair may indicate a lack of progesterone.

Prolactin

First of all, this hormone is responsible for the formation of breast milk and is actively synthesized during lactation – but its level can also increase in stressful situations and during emotional stress. Its excess provokes edema, chest pain, skin tendency to oily and rashes. A deficiency can lead to dry skin, headaches, and loss of strength. The only indirect plus of prolactin for the skin is that it increases the production of oxytocin.

Oxytocin

This hormone is responsible for feelings of tenderness and affection, and in the greatest quantities it is produced under the influence of prolactin after childbirth – this explains the instant wave of love that occurs in some women for a newborn. Oxytocin increases local (on the skin surface) immunity and reduces the risk of breakouts. This hormone utilizes glucose, namely sugar – the main food of pathogenic bacteria, and the less it is, the lower the risk of inflammation.

Melatonin

Well-being and a fresh look are hardly possible without normal sleep, and melatonin is responsible for its quality. Its synthesis occurs at night, from about midnight to four in the morning, in a dream and only in complete darkness. “Owls” who are awake at this time should be especially careful to monitor their melatonin levels.

Melatonin neutralizes the destructive effects of oxidative processes – it binds free radicals that are formed during oxidation, for example, of fats. Oxidative stress is one of the main causes of visual aging of the skin (loss of shine and elasticity), so the skin condition depends directly on the level of melatonin. The level of melatonin is closely related to the level of another important hormone – cortisol, and it is the smooth change in their concentrations that takes us from sleep to wakefulness when daylight comes. If you sleep in the light, there is more cortisol in the body and less melatonin.

Cortisol

Cortisol is usually called the stress hormone, but it participates in all metabolic processes – in case of stress, it is responsible for the instant mobilization of the body. If cortisol is in excess, then it affects us in a truly destructive way. Its level affects, for example, carbohydrate metabolism and insulin production, and its excess can lead to a typical redistribution of body fat. At the same time, the face, neck, upper shoulder girdle become very fat, and the legs and pelvis lose weight disproportionately.

With an increase in cortisol levels, acne and peeling appear, the skin becomes oily and thinned, and the risk of hyperpigmentation increases. The lesions take longer to heal, leaving behind scars and age spots. In addition, cortisol causes swelling, brittle hair, and can lead to seborrhea and even hair loss.

Dopamine

This hormone goes hand in hand with cortisol – it is called the “hormone of joy.” During natural aging, dopamine levels decline – and the problem is, of course, not aging itself , but the associated risks of disease and general malaise. Dopamine deficiency can be seen in impoverished facial expressions, lethargy, stoop, stiffness of movement, loss of dexterity and plasticity.

Insulin

Insulin is known to be responsible for the level of glucose in the blood, and the development of resistance to it is associated with one of the most formidable diseases – diabetes mellitus. In the already developed diabetes mellitus, complications are terrible first of all – from both the heart and large vessels, and capillaries, which nourish the skin, among other things. In severe cases, a violation of this process leads to necrosis of the tissues of the feet and can result in amputation.

Emerging problems with insulin levels can externally manifest themselves in the form of hyperpigmentation, a decrease in the protective function of the skin, a tendency to inflammation, and darkening of certain areas – for example, in the armpits and on the neck.

Thyroid hormones

Thyroid hormones are involved in many processes – they regulate metabolism, vitamin A synthesis, and the rate of oxygen absorption. If the function of the thyroid gland is reduced, dryness, yellowness, and marbling of the skin appear. Hair falls out, nails break and exfoliate, and hairs of the outer third of the eyebrows can also fall out. When thyroid hormones are in excess, hair becomes thin, soft, and oily, and skin becomes oily, hot, and sweating excessively. Often this condition is accompanied by hyperpigmentation.

WE KNOW FOR A LONG TIME THAT BACTERIA LIVE INSIDE AND OUTSIDE OUR BODY, but right now everyone is paying close attention to them. American nutritionist, founder of NutritionFacts.org and bestselling author of “How Not to Die: Discover Nutrition that Prevents and Cures Disease” Michael Gregor focuses on how bacteria are affected by the food we eat; in the publishing house ” Eksmo ” this year there was published a book by the German student Julia Enders “Charming intestines. As the most powerful organ governs us ”- now the author is writing a doctoral dissertation on intestinal microorganisms; cosmetic brands like Dior began to produce cosmetics that work to maintain the correct microflora of the skin, and DuPont uses bacteria to invent new materials. Let’s figure out what caused the excitement around bacteria and what we should know about their effect on our lives.

Why are you interested in bacteria right now?

In 2003, the international project “Human Genome” was completed – scientists from all over the world deciphered human DNA. It is the largest collaboration between scientists from different countries in the history of biology, and it marked the beginning of many new opportunities. “In each of such world projects as launching a man into space, creating nuclear weapons or decoding DNA, there are many third-party technologies that then reach energy, telecommunications and medicine,” says Dmitry Alekseev, director of the development and research department of the biomedical holding Atlas “. – And now a lot of new technologies for DNA research have come to medicine. It turned out that the methods of decoding the genome are universal and suitable even for microbes – and we have a lot of them, for example, not only bifidobacteria and Escherichia coli live in the intestines ”.

Of course, decoding the bacterial genome is used not only in medicine. Serious investments are being made in this area, and therefore its popularity is growing. “Each unexplored bacterium is fraught with a lot of money for a businessman. Now all kinds of development and money are directed precisely at studying these bacteria, – explains Alekseev. – For example, projects are already underway to create non-woven clothing using bacteria. Of course, microbes still do not weave fabric on the mannequin, as they would like, but they are already creating materials for such clothes. “

Where do bacteria come from in us?

Intrauterine presence under the protection of the placenta creates sterile conditions for us, but already at birth, passing through the birth canal, we get acquainted with the first microbes. Scientists are sure that the best bacteria for the formation of defense mechanisms in a child are the bacteria of his mother, therefore, for example, doctors around the world do not recommend specifically washing the breast before feeding (of course, normal hygiene must be maintained). There are even ideas that after a cesarean section it is useful to apply the mother’s vaginal microbes to the baby’s skin – however, there is no single opinion on this yet .

“In addition, the habit of dragging everything into our mouth at a young age exists not only in humans, but also in most mammals – this is how we collect bacteria from the environment and train our immunity,” says Alekseev. “What gets into the baby’s mouth also penetrates into the mother’s body, including through the skin of the nipples, and by the next feeding, the mother provides the child with the correct immune response in milk and teaches him how to react to different bacteria.”

What are bacteria doing inside us?

The intestines are a paradise for bacteria: it’s wet, dark and there is food all the time. The main goal of bacteria is to take a sweet spot and not let anyone else in. “A lot of microbes enter us through our mouths. Of course, they are slightly digested in the hydrochloric acid of the stomach, but they still reach the intestines, says Alekseev. – If certain bacteria had not already lived in the intestines, then any “enemy” could settle there, that is, beneficial bacteria protect us from harmful ones. The second thing they do is to digest those food leftovers that we did not have time or could not digest ourselves. “

In the breakdown of food in the intestines, not only enzymes are involved – bacteria are also working on this. In the process, they release various nutrients (for example, vitamins), which are then absorbed. At the same time, we cannot say that we do not need harmful bacteria at all – they keep local immunity and beneficial bacteria in good shape, so that they are constantly ready to fight for territory in the event of an invasion of parasitic microbes from the outside. “Good bacteria are hard workers who do everything very slowly, but professionally. And the bad ones do everything only for themselves, not caring about the environment in which they live, and, accordingly, about our health, ”says Dmitry.

Interestingly, beneficial bacteria feed mainly on plant foods, and when we refuse vegetables and fruits, we deprive ourselves of useful substances not only ourselves, but also our bacteria. As a result, if there are no plant fibers in the lower intestines, the entire environment is disturbed – an inflammatory process occurs. Even if it is light and does not manifest itself in any way, an imbalance arises in the defense mechanisms of our body – instead of more important things, the immune system is distracted by a sluggish inflammation in the intestines, and we can often catch colds or get other infections.

How bacteria affect mental health

Surprisingly, normal intestinal microflora also affects the synthesis of serotonin and dopamine – the main neurotransmitters of joy and pleasure. This means that the state of joy depends, among other things, on the health of the intestines, and this, in turn, on our nutrition. Treatment for depression should include not only medication and psychotherapy, but also the normalization of eating habits. “Recently, a link has been found between bacteria and anorexia. It turns out that one of the hormones that regulate satiety is very similar to a protein made by gut bacteria. And, apparently, a misinterpretation of the behavior of this bacterium by the immune system can lead to a violation of hormonal regulation of the feeling of satiety, says Alekseev. “In the case of depression, we also understand that the“ depot ”of neurotransmitters responsible for feelings of joy and pleasure is located in the intestines rather than the brain, and we can try to find nutrition to improve our mood.”

“Meeting friends or dating for food is not just a cultural tradition. Because of the food, our bacteria begin to increase the production of hormones of joy and pleasure, and the person is, in a good way, high, says Dmitry. For all the dangers of fast food, scientists do not insist on switching to a full healthy lifestyle. Alcohol, for example, does not negatively affect the good bacteria. In healthy people, it is absorbed earlier than it reaches the intestines, and at the same time provides disinfection from pathogenic microorganisms. “If you are going to, say, India, you can take alcohol with you and drink it in reasonable quantities throughout the trip,” advises Dmitry.

Antibiotics and weight

Everyone has heard that antibiotics harm the intestinal microflora – but when they are taken, according to indications, nothing terrible will happen. A slight malfunction of the microflora can manifest itself in the form of diarrhea, but usually everything normalizes on its own within a couple of weeks. It is much more dangerous not to finish the prescribed course of antibiotic or interrupt therapy – resistance can develop , and the next time with such an infection, the drug will no longer work. But the chronic intake of antibiotics in low doses, for example, if they are found in meat, can seriously harm.

“If in factories micro-doses of antibiotics are added to animal feed, they gain weight faster and produce more meat. This antibiotic remains in the meat, gets to the person, and the person gains weight in the same way, ”says Alexander Tyakht, head of the Atlas microbiota department . “Of course, this will not happen immediately, but after many years of regular eating with cheap meat products.” The bacterial composition of the intestine is influenced not only by antibiotics, but also by highly salty food – such food is inedible for bacteria. This is clearly shown by the famous Happy Meal project , in which a group of enthusiasts watched a cheeseburger and fries from McDonald’s for a year . After 365 days, nothing happened to the fast food meal – it only slightly decreased in size, but the bacteria did not eat it either inside or outside. McDonald’s commented on this fact very simply, saying that they add a lot of salt to their food.

Allergies and excessive hygiene

There is a so-called hygiene hypothesis of allergies and autoimmune diseases – it is that as the level of sanitation increases, people become more susceptible to allergic diseases. This phenomenon is noticeable in developed countries, where in the past few decades children grow up in an almost sterile environment – as a result, any contact is perceived by the body as a hostile attack, and the immune system is overly activated. Autoimmune diseases develop – allergic reactions, bronchial asthma, rheumatoid arthritis. Even for multiple sclerosis, there is a correlation with life in the developed countries of the northern hemisphere.

The centuries-old cult of Moidodyr taught more than one generation to wash their hands – but everything needs a measure. Not only is it better not to use antibacterial soap – progressive dermatologists are now advising to populate the surface of the skin with beneficial bacteria. The American company AOBiome produces Mother Dirt body products with germs that live on the skin, expelling harmful bacteria and replacing deodorant – sweat stops smelling. Of course, you can do without such funds, but you should understand that even hygiene can be too much.

THERE IS NOTHING BAD IN AGE CHANGES IN THE SKIN AND BODY – while in a healthy person they occur gradually, reflecting, among other things, changes in metabolism and the work of internal organs. The processes that are typically associated with aging, such as loss of firmness and pigmentation, can also occur for some external reasons. Our body works every day to fulfill its functions – how to make this work even more harmonious, we figure it out together with the experts: the head of the cosmetology department of the Austrian health center Verba Mayr , the cosmetologist Natalia Novitskaya, the chief doctor of the Icon Lab aesthetic cosmetology center Sona Kocharova    and an orthopedic dentist of the Smile SPA Clinic of Aesthetic and Functional Dentistry Sergey Kovalchuk.

How wrinkles are formed

Wrinkles appear for a variety of reasons. For example, mimic – due to active facial expressions when we frown, squint or laugh. As a result of the work of muscles on the skin, a hall is formed, which eventually turns into a wrinkle. Neck wrinkles can appear from improper sleeping position. With a sharp decrease in weight, especially if you have recovered before that, the skin may simply not have time to contract – then sagging and wrinkles also appear . The condition of the skin is influenced by various diseases, hormonal disorders, smoking, insufficient moisture, exposure to ultraviolet radiation; the main age-related factor in the appearance of wrinkles is a decrease in the production of collagen and elastin, which are responsible for the smoothness of the skin and complexion.

The benefits of many of the ingredients in anti-aging cosmetics are not scientifically proven, and they tend to have minimal or no effect. Only a few ingredients have been proven effective, meaning they actually make the skin smoother. For example, peptides (short protein molecules) in creams or injections are one of the safest ways to reduce the number and depth of wrinkles. Cosmetologist Natalya Novitskaya notes that peptides stimulate the production of intercellular protein, resulting in a renewal of the dermis – the layer of skin in which collagen and elastin are produced. These procedures have no side effects, but for a noticeable result they need to be carried out regularly.

Another option is retinoid products . These are biologically active forms of vitamin A that accelerate the process of cell renewal in the connective tissue. Retinoids are part of anti-aging creams and serums that are used in courses; when using them, side effects are not excluded – irritation, peeling, increased skin sensitivity. Polyphenols – powerful plant antioxidants – can also help reduce fine lines and wrinkles by protecting the skin from free radicals that damage skin cells. At the same time, according to Natalia Novitskaya, it is important to understand that antioxidants coming from outside disrupt the body’s internal defense system against free radicals, and before using a cream with polyphenols, it is important to assess whether there is a real need for external antioxidants. Therefore, a consultation with a doctor in this case will not be superfluous.

Tightening and reducing the number of wrinkles with a laser is a radical method that is not suitable for everyone. The essence of the procedure is to warm up the dermis, the deep layer of the skin. Thermal stimulation of fibroblasts – the cells of this layer – produces collagen and elastin (by the way, fibroblasts can also be stimulated with peeling or massage). This is a serious procedure, after which the recovery period usually takes from five days to a week. Laser procedures are contraindicated during pregnancy and lactation or in the presence of cancer and blood clotting disorders.

Why do age spots appear

Pigmentation is the result of increased production of melanin, the pigment responsible for skin color. A number of factors contribute to this “staining”: from heredity and exposure to the sun to problems with internal organs, skin injuries and taking hormonal drugs. Before trying to remove a dark spot, it is important to understand the reason for its appearance, otherwise the effect of the procedure may be very short or even absent. Natalia Novitskaya explains that each phototype has its own resource of being in the sun without a reaction from melanocytes , cells that produce melanin. For example, for a person with the first phototype , that is, white skin and red hair, this resource will last for five minutes, and with the second phototype (dark hair and a little darker skin) – for ten. After that, skin cells begin to produce melanin (and if it does not cope with protection, then a sunburn occurs).

The consequences of sun exposure or ultraviolet radiation – this pigmentation, which may be non-uniform, and overdrying the skin; burns are the most dangerous – they dramatically increase the risk of melanoma , the most dangerous malignant skin tumor. Therefore , everyone needs sunscreen all year round, just like sunglasses on sunny days. If after the vacation the skin is dehydrated, then intensive nutrition and deep hydration will not interfere with it.

If you do not like age spots, then biorevitalization is suitable from salon procedures : injections of hyaluronic acid stimulate skin renewal, providing nutrition and hydration. Another option is bioreparation . The procedure includes injections based on hyaluronic acid, but in combination with vitamins, peptides and amino acids. As a result, collagen and elastin are produced more actively, the protective properties of the skin are increased and cell regeneration is accelerated. According to Sona Kocharova , home care is also necessary. In the cosmetic arsenal, not only a moisturizer, but also a nourishing cream will come in handy.

Doctor Sona Kocharova draws attention to the fact that in the case of a predisposition to increased pigmentation it will not be possible to get rid of the spots once and for all, but good results can be achieved with the help of a laser. The effect is achieved due to the non-contact point effect of the laser beam on the skin. The laser coagulates the pigment, that is, “brews” it – the process resembles how the protein in an egg folds during boiling. After that, the pigment rises to the surface of the skin and exfoliates after a while . This effect is painless, but you should not expect a high result after the first procedure. It will appear only after five to six sessions (the exact number of procedures will be determined by the cosmetologist). However, with diabetes mellitus, cancer, the presence of a pacemaker, as well as pregnant women and those who are not yet eighteen years old, laser procedures will have to be abandoned.

Another way is to use hydroquinone: when applied, it blocks the production of melanin. However, there are a couple of nuances: hydroquinone is a strong chemical and should not be used for too long, and after the procedure, one should not be in the sun (as is the case with a laser), otherwise pigmentation may increase. If you opt for exfoliating your skin, a medium or deep peel will help lighten the dark areas . Natalya Novitskaya notes that these procedures should also be done in the autumn-winter period in order to reduce the effect of ultraviolet radiation, and in any case, apply a sunscreen to the skin.

What causes the skin to become flabby

Disruption of metabolic processes, decreased production of hyaluronic acid, which is involved in skin hydration , and constant stress are common reasons why skin looks flabby. The growth of elastin and collagen fibers slows down, and the tissues do not have time to recover. By warming up the dermis, laser and photo procedures stimulate fibroblasts (connective tissue cells), and the production of collagen and elastin is enhanced. Injections of hyaluronic acid fillers or fillers can also reduce the laxity or appearance of a fold (eg, nasolabial), but they wo n’t change the core of the process . There are exercises that train the muscles of the face – they give a good effect, but they will have to be performed regularly.

Orthopedic dentist Sergey Kovalchuk draws attention to the fact that sagging skin on the face is often associated with pathological abrasion of teeth, when hard tooth tissues – enamel and dentin – decrease. Moreover, if the first is erased rather slowly (enamel is the hardest tissue in the human body), then the second leaves many times faster. As a result, the bite decreases, the height of the lower third of the face decreases – and the soft tissues (muscles and skin) begin to sag. On both sides of the chin, areas of sagging skin form, the nasolabial folds become more noticeable, and saliva collects in the lowered corners of the lips, provoking dry skin and cracks in these places.

Incorrect bite, incorrect placement of a filling or crown, the habit of biting nails and even some diseases can lead to pathological abrasion of teeth. In this case, it is worth going to the dentist’s office; sometimes you need the participation of other specialists – for example, a neurologist. Manifestations of abrasion can be obvious as early as twenty-five to thirty years and contribute not only to sagging skin, but also to the development of problems with the temporomandibular joint. Bruxism (overexertion of the chewing muscles in a dream) is also called night grinding of teeth; while sounds have not always, but abrasion of enamel occurs. In this case, a good prevention is wearing a special plastic mouth guard at night, which is individually made in the clinic.

Why does the skin get rough

Exposure to ultraviolet radiation and free radicals damage the nucleus and structure of skin cells. The latter lose their ability to regenerate and exfoliate – and horny masses begin to accumulate on the surface. Peels with alpha hydroxy acids (glycolic, apple, citric, tartaric) contained in fruits and berries provide a slight exfoliating effect and remove dead skin cells. Novitskaya recommends having exfoliating products with fruit acids at home, as well as occasionally doing professional peeling in salons. Sona Kocharova adds that hormonal disruptions, viral diseases and allergies can also provoke increased keratinization of the skin, so if the above appeared too abruptly, it is better to undergo a medical examination first.

WHEN WE ARE IN A COOL ROOM or outside in frost, the body turns on the mechanisms of thermoregulation. If the body freezes, it becomes covered with goose bumps, begins to tremble. This is how the body’s defensive reaction manifests itself: the vessels narrow, reducing heat transfer, and small muscle movements help to keep warm. In the event of a draft, the situation changes. How exactly this happens and what threatens, we found out from the experts: the chief physician of the “Gemotest” Laboratory ”Olga Dekhtyareva and the doctor of medical sciences, neurologist, chief physician of the clinic of oriental and traditional medicine“ Doctor Choi ”Choi Yong Joon.

Why is a draft dangerous?

A draft is a flow of air that occurs in an almost enclosed space through openings that are opposite each other. When the body finds itself in this stream, the air stream acts locally, that is, it is directed to a specific area of ​​the body, for example, the neck or lower back. Doctor Olga Dekhtyareva gives an example: if a vessel with a liquid is placed under a stream of cold water, after a while the entire contents of the vessel will cool down, in about the same way as the temperature of the surface of a human body will imperceptibly decrease while being in a draft. The latter can provoke an exacerbation of myositis (muscle inflammation), intercostal neuralgia, inflammation of the facial nerve, or exacerbation of chronic infections. For example, imperceptible cooling activates the herpes virus living in the body, which attacks the nervous tissue – and blistering eruptions appear along the affected nerve.

At the same time, neurologist Choi Yong Joon draws attention to the fact that a draft in a room or a cold wind outside does not cause illness by itself. These are only factors that activate the problems already existing in the body. True, if health is in order, but I had to spend half a day at the computer in a sitting position with a tense neck, then even a small draft can increase muscle spasm – this will cause muscle inflammation. Let’s repeat: the neck begins to ache not because it was “blown”, but from excessive muscle contraction – including as a reaction to cold.

How to be treated if “blew”

Myositis is an inflammation of one or more muscles, when muscle fibers swell, spasm occurs and nerve endings are pinched. This very problem is often hidden behind the phrase “blew my neck”. Sharp pain when moving or pressing is a common symptom that cannot be relieved with massage, compress or rubbing with a warming agent (a mistake of many patients). An anti-inflammatory analgesic ointment will help get rid of discomfort, but if the condition has not improved after a couple of days or has become worse, do not postpone a visit to a neurologist. After the examination, it is necessary to undergo the prescribed treatment, for example, a course of physiotherapy.

If the doctor determines that the nerve endings entering the intervertebral foramen are inflamed, and the pain intensifies and “lumbago” appears in the arm or head, the diagnosis will be different – neuritis, that is, inflammation of the nerve (it is also called radiculitis or radiculopathy). The treatment of the disease is usually helped by injections of non-steroidal anti-inflammatory drugs (the usual ibuprofen and similar drugs), as well as drugs to relieve pain and swelling. With intercostal neuralgia, the nerve endings cause pain along the entire length of the spine, in particular, in the thoracic region. According to Olga Dekhtyareva, patients are often frightened and confuse this problem with heart disease: chest pain appears, which either disappears or intensifies during coughing, deep breaths or changes in body position, and breathing may become difficult. We talked about how to distinguish angina pectoris (pain associated with heart problems) from intercostal neuralgia. Treatment is reduced to pain relief and inflammation relief with an anti-inflammatory agent.

Neuritis of the facial nerve is another disease that can be caused by reduced immunity due to local cooling (especially in cold weather): spasm of blood vessels and muscles temporarily disrupts the nutrition of the facial nerve, and it becomes inflamed. The facial nerve passes through very narrow channels in the bones of the face, so even minor inflammation and swelling lead to compression, which causes the symptoms of the disease. Usually, unpleasant sensations appear behind the ear and gradually shift to the area of ​​the face and neck. As a result, literally in a few days it becomes difficult to control facial expressions, the symmetry of the face is noticeably disturbed, speech becomes slurred, nervous tics are not excluded. Experts note that the disease can be protracted, and its severity and recovery time depend on which part of the nerve is damaged and how quickly treatment was started. At the onset of the disease, vasodilators and decongestants, B vitamins and pain relievers are effective. From the second week, you can apply physiotherapy and facial massage. In difficult cases, when there is no improvement within 8-12 months, an operation is prescribed.

Is it possible to catch a cold from a draft?

A positive answer to this question seems obvious – but it is wrong. We have already written that, for example, viruses are the cause of ARVI , and not a walk in windy weather, a draft in the office or an ice cocktail drunk in one gulp. Of course, if you are constantly freezing, it is easier to get sick: the body simply spends more resources on trying to warm up, “forgetting” about the protective functions, and viruses have more chances for uncontrolled reproduction. True, usually a single draft or even wet feet is not enough for this. If you do get sick, we remind you that you do not need to treat a cold, you just have to wait for the body to defeat it and relieve the symptoms: high fever, sore throat, runny nose. Antiviral agents for the treatment of ARVI do not exist, and the effectiveness of immunomodulators and immunostimulants has not been proven to date.

The same applies to the risk of “chilling” the bladder or kidneys – theoretically it is possible, but only if you stay in the cold for several hours, preferably without moving and without clothes. True, in this case, big problems will begin not only with the kidneys. In other situations , it is almost impossible to reduce the temperature of internal organs , and inflammation of the bladder (cystitis) or kidneys (pyelonephritis) is usually associated with a bacterial infection, kidney stones, taking certain medications or congenital abnormalities, but definitely not with exposure to cold.

While the cold season is gaining strength, the temperature regime is quite gentle, and for many of us this is a reason to postpone the need to wear a hat, which is often prickly, electrifies hair and negates any styling. It is difficult not to be afraid of reckoning later for your frivolity, because from childhood we are told: “Put on a hat, otherwise you will get sick.” And worst of all, when, to persuade, they are frightened of the dire consequences of meningitis. Is it really so easy to protect yourself from this disease, or is it just an annoying myth? Why does meningitis develop at all, who can face it, and why shouldn’t treatment be delayed? We asked these questions to an expert.

Valentin Kovalev

infectious disease specialist, pediatrician

Many people are pretty well aware of how dangerous meningitis is and what it can lead to. But understanding how the disease works and what its nature is, is less common, which feeds some of the misconceptions about meningitis. In fact, most often it is an infectious disease in which foreign microorganisms enter the membranes of the brain and spinal cord. There they multiply, which causes tissue inflammation and characteristic symptoms of the disease. First, the pathogen enters the nasopharynx, from there it enters the bloodstream, spreads throughout the body and eventually reaches the meninges. So you can breathe out: whether you wear a hat in cold weather or not, this has nothing to do with the risk of illness.

Meningitis can be very different, but viral and bacterial forms are common in Russia. In more rare cases, fungi and parasites can become pathogens , or meningitis will not provoke an infection at all . The culprits of viral meningitis are most often enteroviruses, but others, including the influenza virus, can lead to this complication. Outbreaks of viral meningitis are more often recorded in summer and early autumn. You can catch the corresponding virus by swimming in reservoirs or pools where sanitary standards have been neglected, as well as through touch and airborne droplets.

In bacterial meningitis seasonality does not exist, and the disease is caused by meningococcus , pneumococcus and Haemophilus influenzae type Bed and . Such meningitis spreads through carriers: it is transmitted in the same ways as viral, either from older children (and children under two years of age are most susceptible to meningitis), or from adult adult carriers in whom the infection does not manifest itself. If the viral forms proceed relatively easily and usually end favorably, then bacterial meningitis manifests itself much more aggressively, the patient needs resuscitation assistance. Such meningitis can be fatal (which happens, according to some sources , in 10% of cases, and for pneumococcal – and in 30%). Moreover, a person can literally “burn out” in a few hours, so at the first suspicion it is necessary to act quickly and not hesitate to call a doctor.

It is, in general, easy to suspect meningitis by pronounced, specific symptoms. The patient suffers from severe headache, which does not go away from taking painkillers. It is accompanied by photophobia, high fever, which is not knocked down by antipyretics, it becomes difficult to tilt the neck. Sometimes drowsiness and disturbances of consciousness are also noted. In some cases, these symptoms are also accompanied by seizures, vomiting, and skin rashes.

Children under 3 months of age are
70 times more likely to catch a bacterial infection that causes meningitis than adults

With such a picture, it is quite difficult to miss meningitis, but the problem is that children often get meningitis. And the younger the child, the more vulnerable he is to the disease and the more dangerous it is. For example, children under three months old are 70 times more likely to catch a bacterial infection that causes meningitis than adults. But diagnosing a disease in a newborn is much more difficult, and a high temperature does not always indicate a problem. It is worth paying attention to drowsiness, refusal to eat, difficulty breathing, and skin rashes. By the way, to check if the spots on the body speak of meningitis, they lightly press on them with an ordinary glass – if they do not turn pale from the pressure, you should immediately consult a doctor.

Adults are also susceptible to disease. The risk group includes people over 65 (at this age, some types of meningitis are more common), as well as first-year students living in dormitories, military recruits and those who have been in closed groups for a long time. Outbreaks of bacterial meningitis in this case often occur due to crowding, close contact of people and under the influence of stress, which weakens the body as a whole. It should not be forgotten that meningitis can still be secondary, that is, develop against the background of other diseases, severe bacterial infections. For example, in the form of complications of otitis media or sinusitis, if treatment is started out of time. Or as a complication of tuberculosis in adults or children who are not vaccinated with BCG . In any case, a patient with meningitis is admitted to a hospital. He will undergo a lumbar puncture to collect cerebrospinal fluid for analysis. This will allow an accurate diagnosis to be made; puncture is the most reliable method for diagnosing meningitis, other methods are rather auxiliary.

Recovery from viral meningitis takes about two weeks on average. But how long it will take to improve health after the bacterial form depends on the characteristics of the organism and on the severity of the disease. In addition, unlike viral meningitis, bacterial meningitis often leads to serious consequences. Some children may develop hearing loss after the disease . This is quite common after pneumococcal and hemophilic meningitis. Epileptic manifestations (convulsions), various degrees of damage to the nervous system are not excluded – from rather mild ones like fatigue, headache and absent-mindedness to serious changes in behavior and learning ability. Viral meningitis rarely leaves serious consequences, although seizures can occur after it. In this matter, everything depends on the age of the patient, on the aggressiveness of the pathogen, on how soon the disease was discovered. Even with timely and complete treatment (including resuscitation) for some types of meningitis, complete recovery occurs in less than 50% of cases – that is, more than half of the children have some kind of residual defects.

It is impossible to predict the development of meningitis, but it is worth trying to protect yourself from it. The most effective prevention is vaccination. Although not all types of disease are vaccines, purulent meningitis in children, for example, can be prevented today. Within the framework of the National Vaccination Calendar in Russia, from the age of nine months, they are vaccinated against meningococcal infection (although it is believed that such vaccines can be administered earlier), against hemophilus influenza B infection – from three months, and since 2015 , children from two months of age are vaccinated against pneumococcal infections. Theoretically, it is still possible to inoculate the bacteria that cause purulent meningitis. But this method of “prevention” is much more difficult, if only because not everyone will find the strength to conscientiously monitor the regularity of analyzes, and the monetary aspect should not be written off. Vaccination in this sense is much simpler and cheaper, and, as the world practice shows (for example, in the USA ), the frequency of the same hemophilic meningitis is met by specialists abroad in a much smaller quantity.