Q. I’m in my 50s, and I’ve recently started noticing a fluttering feeling in my chest. Is this something I should be worried about, and is there anything I can do?
A. Fluttering in the chest, or palpitations, is a commonly encountered problem and usually signifies “extra” beats from the top or bottom chambers of the heart. In general, this should be evaluated by a clinician and is a great time for a cardiovascular checkup to make sure your blood pressure, blood glucose, and cholesterol levels are optimal. An EKG is usually performed as well as a physical exam. At that point, a care plan will be determined to see if you need imaging of your heart or a heart monitor. Lifestyle changes like limiting caffeine, getting adequate sleep, and minimizing your stress response can help limit recurrences.
Q. My husband recently quit drinking. He wants to be involved in all the upcoming holiday parties, but I’m worried that there may be alcohol at many of them. Do you have any advice for how I can support him in his sobriety?
A. Holidays are a time of celebration and joy for most of us, but they can also bring stress. For those recovering from addiction, maintaining sobriety can be challenging when attending holiday events. These tips may help those you care about to enjoy the holidays and maintain sobriety.
First, plan and prepare. Before an event, find out as much as you can about the environment, the activities planned, and the availability of alcohol. This will reduce your anxiety and you will be able to plan how to participate in the event. Next, lean on your support system. Ask for assistance in developing strategies to cope with any concerns that come up at the event. Most importantly, relax and focus on the joy of the holidays. Develop a mantra that you can repeat to yourself to help focus on the happiness of the event. ‘I am enjoying the season in new ways this year’ is a good example.
Q. Every time my family goes on vacation, my son ends up dealing with pretty bad constipation. Is there anything I can do for him?
A. Constipation while traveling is a common condition that can occur for many reasons including high stress levels, dehydration, decreased mobility, change in schedule, different eating habits, and more. Thankfully there are several steps that you can take to prevent constipation while traveling. First, make sure to drink plenty of water and eat foods that are rich in fiber. Try to include at least one to two servings of fruits, vegetables, and/or whole grains at every meal. Second, stay active. Movement can stimulate the muscles of the intestines, while sitting for long periods of time can slow down digestion. Third, allow plenty of breaks to give your son the opportunity to use the bathroom. Finally, if this is a recurring issue, talk to your son’s healthcare provider about a short course of a gentle laxative or stool softener to prevent constipation.
Q. My family and I will be moving later this year, and I am worried about how this transition will affect my 5-year-old who has autism. Is there anything I can do to make it easier for him?
A. Change is so hard for autistic children. Because they live in a world that doesn’t always make sense to their autistic brain, it is logical that they will want to have a sense of control over things like routines and changes to their environment. It is important to normalize that transitioning will be difficult and to start preparing them for those challenges. Start talking about the move now. Create visual schedules to help them understand the upcoming order of events. If it’s possible to visit the new location in advance, that could give them the ability to develop a mental picture. If not, show them pictures online of what their new house and new school will look like. Help them feel as in control as possible and know that while it may be challenging, they are capable of adapting at their own pace.
Q. I have hyperthyroidism and am currently pregnant with my first baby. Are there any extra steps I should be taking to make sure my baby is healthy?
A. Proper management of hyperthyroidism during pregnancy, ideally under an endocrinologist’s supervision, is crucial. Uncontrolled hyperthyroidism during pregnancy may lead to low birth weight, maternal hypertension, premature labor, and even fetal loss. Regular monitoring of thyroid levels is essential, with interpretation using pregnancy-adjusted normal ranges, and safe medications prescribed when levels are too high. For women who have ever had Graves’ disease, measurement of the thyrotropin receptor antibody is necessary around week 18-22 and, if elevated, again at week 28-32. A significantly positive result requires additional monitoring of the baby before and after birth, as the antibody can cross the placenta. Importantly, pregnant women should avoid radioactive iodine and uptake scans; a thyroid ultrasound is the appropriate imaging if needed during pregnancy.
