Mental Health265 

The daily dose of calm: tune in to the rhythm of nature

Psychologist Linda Blair offers a daily idea that will help you cope during the corona virus epidemic

Truly, these are unprecedented times. As our interconnected world goes into physical lockdown, it's easy to feel a rising sense of anxiety, even panic. Lives are changing beyond recognition and livelihoods are being threatened. We're in the corona virus tunnel and it's hard to see the glimmer of light at the end.

But it is there. Corona virus will pass; and in the meantime, others are here to help you manage the disruption of daily life. As part of the You Are Not Alone platform, which is designed to help readers through this testing time, Linda Blair's is offering tips to increase your sense of wellbeing. It might be a positive thought, or a useful technique to help deal with the stress we are all feeling.

Tune in to the rhythm of nature

Back when we hurried through our busy days, we rarely took time to notice how nature marks time. Now we have the chance to be aware of how things change at the beginning and end of each day, particularly as we’re lucky to be in the middle of a spell of settled weather.

The sun will set tonight at about 18.25, and it rises the next morning at around 5.50. Depending on whether you’re a lark or an owl, why not stop whatever you’re doing just before sunrise or sunset. If you can, step outside, otherwise, look out from your window. Simply watch and listen. Notice the changes in colour in the sky, the way birdsong quickens or diminishes, how a sense of energy slowly rises with the sun or how it settles into quiet as darkness falls.

Find new ways to stay connected

It can be really difficult to adjust to the fact that the people we relied on to share our workload, our concerns, and our hobbies are suddenly hard to contact. It’s even more challenging to arrange to be in touch with more than one person at a time.

But in the face of this, people are coming up with truly creative ways to get around their feelings of isolation and feel connected again to those who matter so much. 

Film lovers are arranging online film parties: everyone watches the same film at the same time, then exchanges comments.

One woman I know cooks lunch together with her elderly father each day on Skype.

But perhaps the best example comes from the Rotterdam Philharmonic. Take four minutes to watch them on YouTube, and celebrate the ingenuity of the human spirit.

Renew energy with a power nap

It’s not surprising many of us are feeling tired and distractible right now, even after a night of apparently good sleep. Huge amounts of energy are required to adjust to so many changes.

The quickest and most effective way to renew energy and restore wellbeing is to enjoy a power nap. It won’t take long, 10 minutes is enough; 20 minutes is ideal. Find a quiet space on a floor or bed with enough room to lie down. Set an alert on your phone or ask someone to tell you when 10 to 20 minutes have passed.

Lie on your back, head supported by a book or firm pillow. Bend your knees, hip width apart. Allow your arms to fall comfortably to your sides. Close your eyes and breathe slowly and evenly, in for a count of 3, out for 6. Don’t address any thoughts, just let them drift away.

When time’s up, roll gently to one side and sit up slowly. Now back to whatever you need to do, refreshed, calmer and much more focused.

Share a memory with your mother

Mother’s Day is a precious opportunity to honour Mum. But think how we’ve done that in recent years, we give perfume, flowers, and other gifts, all created by others. Even the cards we offer already come with a printed greeting. That’s lovely, and I’m sure all mothers appreciate the gesture. But what mothers really hope to know, especially mothers whose children are now adults, is that they’ve made a positive contribution to their child’s life.

This Mother’s Day it probably won’t be possible to spend time directly with your mother, and ready-made gifts and cards may be hard to source. Take that as the chance to make this Mother’s Day truly special. Ring and remind your mother of something she once said or did that has made your life so much richer and better. Share some of your happiest childhood memories with her. It will mean so much.

Feed the birds

Today is the first day of Spring. That means the birds in your area are nesting, breeding, and beginning to feed their young. 

Most of us assume garden birds may need us to scatter some food for them during the Winter months, but not once Spring arrives. Not so, according to the RSPB. Food shortages can occur at any time. However, what you choose to give them should be slightly different now. Avoid loose peanuts, dry hard food, large chunks of bread, or fats. Instead, select a spot that’s out of reach from predators, and offer them a bit of grated mild cheese or some soaked sultanas or raisins. Or cut up and soften a few chunks of an apple or a pear for them to enjoy.

Sharing makes us feel happier. And your reward, more birdsong, will not only lift your mood, but give all around you the added pleasure of more birdsong. 

How to go back to sleep if you keep waking at night

Are you suffering disturbed sleep. You're not alone. Either we can’t fall asleep because our mind is racing with worries, or we wake up in the middle of the night agitated and uncomfortable.

Take heart. There is a way to settle back and enjoy a refreshing sleep, but you need to do a bit of preparation first.

Start by creating your own special comfort spot. Choose the place you like best at home. Place your favourite chair in that space, and put a small table or tray beside it. Add a notebook and pen, a book you’ve been meaning to read, and anything that to you spells comfort, hot water bottle, blanket, warm socks, kettle and mug plus herb tea and honey.

Go to bed as usual tonight. If after about 25 minutes you’re still awake, or if you wake later in the night, get up (hard I know, but worth it) and go to your special spot. 

Pick up the notebook and write down everything that’s on your mind, in any order (it’s important to write by hand because the effect is stronger). Keep going until you’ve emptied out absolutely every thought.

Next, put the notebook down and get comfortable. Fix some tea, heat the hot water bottle, whatever. Read until you feel tired.

Now back to bed, and sweet dreams!

Have a six-point plan for your kids

Just when you may have found your new footing regarding work and self-care, you learn your children will be at home 24/7 with you.

A sense of calm can only come if you operate with one rule: prioritise structure.

Structure allows us to feel confident about what to do when. Working hours, train schedules, school runs, they’ve all created a meaningful framework for your efforts. Now you must recreate that framework.

Start by choosing six daily focus points. For the first two, I suggest a set waking and bed time for everyone in the family. This will frame your day. 

Now select four times within that frame, and choose an activity for each child at each time. For example, if they have work from school, they’ll do that between 10am and Noon. You could bake a cake together at 2pm and share it at tea time. Or everyone could do something to help prepare supper at 6.30pm.

Play around with the tasks, but stick to the same time points each day to encourage a feeling of security and purpose.

Breathe away your anxiety

Most of us, when told to pay attention to the breath, focus on inhalation. But inhalation is concerned with action. Inhalation stimulates the sympathetic nervous system which in turn raises heart rate and blood pressure and increases muscle tension.

Focus instead on exhalation, which stimulates your parasympathetic nervous system. This will settle your heart rate, lower blood pressure, encourage muscle relaxation, and create a sense of calm. 

Here’s how.

Breathing in and out through your nose, take a big in-breath. Now exhale, as slowly as you can, not to the point where you’re forcing breath out, just until your lungs feel emptied. Then simply allow air to flow back into your lungs effortlessly. Repeat ten times.

Aim for an exhalation that’s twice as long as your inhalation. You can achieve this by counting slowly, or follow the suggestion of neuroscientist and keen tennis player Richard Bergland: exhale for as long as it takes to bounce a tennis ball four times before serving.

Try this whenever you notice your stress barometer rising.  



My ear hurts – from swimming too much?

Such an earache can cause a lot of pain : its severity is generally not in proportion to the small organ which the ear actually is. Earache refers to a pain or severe discomfort which is felt in the ear, and sometimes even may be felt in the jaw, the skull, or the neck, the problem might be located in any part of the ear, in the earlobe, in the ear canal, or in the middle ear.

Occasionally however, this pain can also be a referred pain, and may for instance originate in the neck, or in the jaw and trigger a pain in the ear.

Even a mild infection, accompanied by a certain degree of inflammation in the ear can produce disproportionately severe pain and tenderness!!!!

I will go over the main conditions which I frequently encounter here in the Costa del Sol, and especially in the summer.

And let me start by saying that simply buying drops over the counter, without a qualified and experienced medical professional having looked into the ear, and thus no correct diagnosis having been made, is silly. I will explain this later in this article.

  1. Pain caused by a problem in the ear.

The pain which has its origins in the ear can be caused by several diseases or pathological processes in the respective anatomical parts of the ear:

  1. The Earlobe.

The most common causes are trauma, like a blow to the ear, and infections of either the cartilage or the skin of the earlobe, for instance due to an insect bite, or from scratching.

This is rarely the cause of earache, since it is such an obvious and visible area it will in most patients show immediately.

Treatment must be prompt to avoid a permanent deformity of the earlobe: an example of this are the cauliflower ears of rugby players. 

  1. The Ear canal.

Several processes can be causing pain or discomfort here.

Firstly there are the obstructions of the ear canal, they may be caused by, for instance, wax, (there can be itching, pain, loss of hearing and a feeling of pressure, often aggravated by water, which causes the wax plug to swell), or an acute infection of the ear canal, since it can also cause a feeling of obstruction due to a build-up of pus, or a foreign object (small children especially are prone to this: they often put beads, beans etc. in their nostrils and ears). Occasionally an insect can crawl into the ear canal, or fly into it, and this surely needs medical evaluation and treatment.

Wax is the most commonly occurring cause of obstruction and earache. The treatment consists obviously of the removal of this obstruction, usually by syringing, or microscopic cleaning, but this should be performed only after proper inspection and preparation, a crucial error is to buy wax-dissolving eardrops at the Pharmacy, over the counter, without prior inspection and evaluation by a doctor, and then to put these drops into an ear canal, they may well aggravate or even provoke an ear infection.

Secondly, infections of the ear canal (like swimmers ear) are a frequent cause of earache, especially here in the hot summer. As the name indicates, such an infection is very common during the summer swimming season, the combination of earwax, or any type of dirt in the ear canal, water/humidity, and elevated temperatures form an ideal culture-medium in which bacteria will thrive!

These infections in the ear canal can be either localised (like an abscess), or more diffuse, spread out, when the whole ear canal is involved. And, poking in the ear with an ear bud will aggravate the infection even more.

Here are some of the types of Otitis Externa (OE) which we commonly encounter:

Acute diffuse OE - Most common form of OE, typically seen in swimmers.

Acute localized OE (furunculosis) - where an abcess has formed.

Chronic OE - Same as acute diffuse OE but is of longer duration (>6 weeks).

Eczematous (eczematoid) OE - Encompasses various dermatologic conditions (eg, atopic dermatitis, psoriasis, systemic lupus erythematosus, and eczema) that may cause OE.

Necrotizing (malignant) OE - Infection that extends into the deeper tissues, occurs rimarily in immunocompromised adults (eg, diabetics, patients with AIDS)

Otomycosis - Infection of the ear canal by a fungus.

The symptoms will vary according to the condition, but usually are itching, pain, sometimes a discharge from the ear, and even loss of hearing, due to swelling or the build-up of infectious material in the ear canal. The pain can even be so severe that it prevents the patient from sleeping on the affected side, and may drive the sufferer on the wall from the pain!!!

The indicated treatment here consists of:

Pain management.

Removal of debris from the ear canal.

Administration of topical medications to control edema and infection.

Avoidance of contributing factors.

Very rarely, in my experience, are oral antibiotics effective, and thus used or needed less than five times each year.

These are the main problems related to the ear canal which I tend to encounter here in the summer; and it is important to properly distinguish between them and treat them accordingly.

  1. The Middle Ear.

The main condition responsible for ear ache here is an infection of the middle ear, better known as otitis media. This usually is accompanied by fever, sore throat, itchiness in the ear ,cough and pain on swallowing. Flying can often aggravate this condition; children in particular are prone to it.

Otitis media is a chapter on itself; the treatment may consist of antibiotics, and drugs to reduce the inflammation; achieving this will relieve the pressure on the middle ear and thus alleviate the pain.

  1. Pain caused by problems outside the ear, the so-called referred pain.

In the vast majority of people suffering with such a pain, the symptoms are due to a malfunctioning of the temporo - mandibular joint (this means the joint between the skull and your jaw-bone). The actual problem may be found in this joint itself, or in the surrounding muscles. It affects especially women in their thirties, and possible causes are incorrect chewing, or excessive grinding of the teeth.

In a second group of these referred pains, the pain is due to dental problems, mainly in the lower jaw, and specifically the wisdom teeth.

Lastly there can be a tonsillitis or pharyngitis, or even a problem in the cervical column which triggers the pain to refer into the ear.

In most cases a thorough and proper clinical examination will be sufficient to establish the diagnosis; and the problem causing this pain can then adequately be dealt with.





Is it bad to sleep near your Smartphone?

IF YOU’RE ANYTHING like the average mobile phone owner, you probably sleep with your smartphone within arm’s reach. A recent report has found that 71% of people sleep with or near their phones ,  and that includes the 13% who said they slept with their phones in their beds.

Maybe you’ve wondered whether keeping your phone nearby is a bad idea ,  perhaps it’s zapping your brain with radio waves or otherwise harming your health. It would be comforting if researchers firmly and finally quashed any notions that our devices can cause negative health effects. No such luck.

In November 2018, the U.S. government’s National Toxicology Program wrapped up a 10-year, $30 million study on the health effects of cellphone radiation exposure. In essence, the government scientists blasted rats with different levels of radio frequency radiation (RFR) for varying lengths of time and then watched to see what would happen.

“Our studies showed that radio frequency radiation at the frequencies and modulations used in cellular telecommunications and under the exposure conditions we used can produce adverse biological effects,” says John Bucher, one of the study’s authors and a senior scientist with the National Institute of Environmental Health Sciences. Specifically, Bucher’s study found “clear evidence” of tumours in the hearts of male rats exposed to RFR, as well as “some evidence” of tumours in the brains and adrenal glands of male rats. They found “equivocal” evidence of adverse effects in female rats, meaning it wasn’t clear if the tumours that turned up were caused by RFR exposure.

What to make of these findings? Depends on who you ask.

Bucher says his study was never intended to be the final word on the issue of cellphone radiation and human health. “We’re using this to put together follow-up research programs,” he says.

Even so, Bucher says there may be some “low” risk when a phone is held against the head or body ,  like if you’re on a call or keeping the phone in your pocket while using some kind of hands-free setup. He says these risks could go up with “prolonged and persistent use,” though at this point, defining each of these terms is guesswork.

“If there is a risk, I think it’s minimal,” says Larry Junck, MD, a neuro-oncologist and professor of neurology at the University of Michigan. “We haven’t seen an increase in brain tumours since mobile phone use has become widespread.” Moreover, Junck says the research showing any mechanistic link between cellphone radiation and brain tumours is inconsistent and “methodologically flawed.”

Others look at the existing research with great concern. “I think there’s compelling evidence that electromagnetic radiation exposure is indeed harmful,” says Joel Moskowitz, director of the Center for Family and Community Health at the University of California, Berkeley. He reels off the findings of a dozen recent studies, including a 2017 review from China that found heavy mobile phone users were at significantly increased risk of glioma ,  a type of malignant tumour in the brain and spinal cord.

A 2018 U.K. study found rates of glioblastoma , another cancerous brain tumor ,  more than doubled in England between 1995 and 2015. Specifically, frontal and temporal lobe tumors ,  locations that correspond with where we rest our phones during calls , showed some of the steepest increases. In a follow-up letter to the journal’s editor, the authors of that U.K. study say they looked closely at the U.S. data on glioblastoma rates. After adjusting for post-2000 population changes , changes they say are not factored into the U.S. Central Brain Tumour Registry and other databases that track tumours ,  they turned up glioblastoma increases similar to the ones they tracked in England.

Brain tumours aren’t the only worry for cellphone users. “If you look at modern smartphones, the antennas are in the corners ,  both upper and lower,” Moskowitz says. But the bulk of the cellular signal is now directed down through the lower antennas, “which would make the most significant exposures in the neck area,” he says. He mentions tumours of the neck and thyroid as particularly concerning. And there again, some data suggest rates are rising. Rates of thyroid cancer have tripled in the past three decades and are increasing more rapidly than any other type of cancer, according to the American Cancer Society (ACS).

But none of these findings constitute proof that cellphones are to blame. For example, the ACS says the increased use of tumour-detecting thyroid ultrasounds could explain the uptick in rates of those cancers.

“If there is a risk, I think it’s minimal.”

Why is it so hard to pin down the potential health effects of our devices? One gigantic hurdle is that the technologies these devices employ are constantly evolving, and the research on their health effects is often running a decade or two behind. “Most of the epidemiological studies looking at brain tumour risk collected data in the early to mid-2000s from users who used the old candy bar or flip phones, which were primarily using 1G or 2G cellular technology,” Moskowitz says.

Meanwhile, the telecom industry is now moving forward with 5G technologies, even though health experts still hardly have any data on 4G, he says.

Since this might keep you up at night, let’s get back to the question of sleeping next to your phone. Moskowitz says tumour risks don’t top his list of concerns, because a sleeper’s phone isn’t steadily transmitting the way it does during a call. But he says it’s likely that low-level night time radiation exposures could disrupt sleep and cause other neurological effects.

He points to a small 2016 study from Germany that found exposing men to cellphone radiation seemed to change the structure of their sleep ,  increasing or decreasing REM and other sleep parameters ,  though the health ramifications of these shifts aren’t clear.

Whatever risks may exist could be heightened in kids. “I personally believe that children should be dissuaded from sleeping with a phone under their pillow, as RFR is thought to penetrate farther into their tissues than in adults,” Bucher says.

The obvious advice is to keep your phone out of the bedroom. Or, if you use it as an alarm clock, you could switch it into airplane mode, which stops it from sending or receiving signals, Moskowitz says. He also repeats the longstanding advice to use a wired hands-free device when making calls and to keep your phone away from your body.

Start with all that and hope that the cellphone-radiation Pollyannas turn out to be right.




Pneumonia refers to an infection of the lung tissue. Which often follows a common cold or influenza (hence the importance of vaccination!) and is can be a cause of death,especially in elderly people, or in patients with a depressed immunity or concomitant ilnesses.

Several types of pneumonia exist, and the so-called ‘Legionnaires’ disease’ is just one of them, and perhaps the best known one.

How are they classified?

Several ways of classifying the different types of pneumonia exist.

Depending either on the site, localisation of the pneumonia inside the lung, or depending on the causative organism, bacteria, virus, fungus, or any other kind of micro-organism. Chemical products also can cause a pneumonia, as well as radiation, foreign bodies in the bronchi, or a lung embolism.

Usually pneumonias are classified according to the organism, causing it, bacterial, viral...

How do they present?

A typical bacterial pneumonia will - usually - present with the following symptoms:

Sudden onset of a high fever, or cold chills, and a general feeling of weakness, malaise.

Coughing, accompanied with shortness of breath. Typical especially in children is the ‘flaring nostrils’, where the patient struggles to get air into the lungs.

Often this appears together with a cold sore, or follows a middle ear infection, common cold or a bout of influenza.

Pain is often felt over the ribcage on deep inhalation over the site of the pneumonia, however, especially in children, this pain can sometimes radiate to the abdomen.

Cough is usually producing dark sputum, quite often mixed with blood.

It is important to realise that, besides the typical pneumonias, also atypical pneumonias exist, which present differently, i.e. atypical from the normal pneumonias.

Here the presenting features will be:

Usually a gradual onset,with slow worsening of the symptoms.

Headaches, general body pains and a slight fever are often the first symptoms

Cough is not productive in the majority of cases, with little or no sputum.

Who is at risk?

In fact, anyone can contract a pneumonia, from neonates upwards.

But in normal, healthy people the own immunity is strong enough to fend off the invading bacteria or viruses.

Thus, the people most at risk to get a pneumonia are...

Patients with damaged lungs, for instance: smokers, asthmatics, patients who had TB or radiotherapy of the lungs.

Immunnodepressed patients, patients with cancer or under cancer treatment, AIDS-patients, Diabetics, Alcoholics, patients taking severe anti-rheumatic drugs.

The elderly, in general, fall under this category, since they don’t have such a strong defense against invading diseases anymore.

Are pneumonias curable?

With the wide range of available drugs, and specially antibiotics, most forms of pneumonia can effectively be treated nowadays. It is very important to recognise the symptoms as early as possible, and not to let the disease do too much damage.

Better still is to avoid it, if possible of course, by getting your influenza- immunisation if you are over 60-65 years of age, or fall under one of the risk-categories. Also, by protecting you from the cold and exposure to damp, chilly weather. And, very important, by treating other infections - even as trivial as an ear infection - adequately and promptly.