কভিড বিচ্ছিন্নতা: বাড়িতে থাকাকালীন মানসিক সুস্থতা

The UK NHS has released a list of helpful resources to assist in safeguarding your mental health during this current COVID isolation period. We have reproduced some of it here for the purpose of allowing indexing of the many sections, hopefully making access a bit quicker and easier.

Taking care of your mind as well as your body is really important while staying at home because of coronavirus (COVID-19).

You may feel bored, frustrated or lonely. You may also be low, worried or anxious, or concerned about your finances, your health or those close to you.

It’s important to remember that it is OK to feel this way and that everyone reacts differently. Remember, this situation is temporary and, for most of us, these feelings will pass. Staying at home may be difficult, but you are helping to protect yourself and others by doing it.

The tips and advice here are things you can do now to help you keep on top of your mental wellbeing and cope with how you may feel while staying at home. Make sure you get further support if you feel you need it.

The government also has wider guidance on staying at home as a result of coronavirus.

To read the complete NHS page ‘Worried about coronavirus’ click here

 

 

For a more complete resource on mental health see the NHS page ‘Every Mind Matters’.

EMM - Coronavirus - Stay at home - Find out about your rights

1. Find out about your employment and benefits rights

You may be worried about work and money while you have to stay home – these issues can have a big effect on your mental health.

If you have not already, talk with your employer about working from home, and learn about your sick pay and benefits rights. Knowing the details about what the coronavirus outbreak means for you (England and Wales only) can reduce worry and help you feel more in control.

GOV.UK: Coronavirus support

2. Plan practical things

Work out how you can get any household supplies you need. You could try asking neighbours or family friends, or find a delivery service.

Continue accessing treatment and support for any existing physical or mental health problems where possible. Let services know you are staying at home, and discuss how to continue receiving support.

If you need regular medicine, you might be able to order repeat prescriptions by phone, or online via a website or app. Contact your GP and ask if they offer this. You can also ask your pharmacy about getting your medicine delivered, or ask someone else to collect it for you.

If you support or care for others, either in your home or by visiting them regularly, think about who can help out while you are staying at home. Let your local authority (England, Scotland and Wales only) know if you provide care or support someone you do not live with. Carers UK has further advice on creating a contingency plan.

Carers UK: Coronavirus

3. Stay connected with others

Maintaining healthy relationships with people you trust is important for your mental wellbeing. Think about how you can stay in touch with friends and family while you are all staying at home – by phone, messaging, video calls or social media – whether it’s people you usually see often, or connecting with old friends.

Lots of people are finding the current situation difficult, so staying in touch could help them too.

4. Talk about your worries

It’s normal to feel a bit worried, scared or helpless about the current situation. Remember: it is OK to share your concerns with others you trust – and doing so may help them too.

If you cannot speak to someone you know or if doing so has not helped, there are plenty of helplines you can try instead.

NHS – recommended helplines

5. Look after your body

Our physical health has a big impact on how we feel. At times like these, it can be easy to fall into unhealthy patterns of behaviour that end up making you feel worse.

Try to eat healthy, well-balanced meals, drink enough water and exercise regularly. Avoid smoking or drugs, and try not to drink too much alcohol.

You can leave your house, alone or with members of your household, for 1 form of exercise a day – like a walk, run or bike ride. But make you keep a safe 2-metre distance from others. Or you could try one of our easy 10-minute home workouts.

Try a 10-minute home workout

6. Stay on top of difficult feelings

Concern about the coronavirus outbreak is perfectly normal. However, some people may experience intense anxiety that can affect their day-to-day life.

Try to focus on the things you can control, such as how you act, who you speak to and where you get information from.

It’s fine to acknowledge that some things are outside of your control, but if constant thoughts about the situation are making you feel anxious or overwhelmed, try some ideas to help manage your anxiety.

7. Do not stay glued to the news

Try to limit the time you spend watching, reading or listening to coverage of the outbreak, including on social media, and think about turning off breaking-news alerts on your phone.

You could set yourself a specific time to read updates or limit yourself to checking a couple of times a day.

Use trustworthy sources – such as GOV.UK or the NHS website – and fact-check information from the news, social media or other people.

GOV.UK: Coronavirus response

8. Carry on doing things you enjoy

If we are feeling worried, anxious, lonely or low, we may stop doing things we usually enjoy.

Make an effort to focus on your favourite hobby if it is something you can still do at home. If not, picking something new to learn at home might help.

There are lots of free tutorials and courses online, and people are coming up with inventive ways to do things, like hosting online pub quizzes and music concerts.

9. Take time to relax

This can help with difficult emotions and worries, and improve our wellbeing. Relaxation techniques can also help deal with feelings of anxiety.

10. Think about your new daily routine

Life is changing for a while and you are likely to see some disruption to your normal routine. Think about how you can adapt and create positive new routines and set yourself goals.

You might find it helpful to write a plan for your day or your week. If you are working from home, try to get up and get ready in the same way as normal, keep to the same hours you would normally work and stick to the same sleeping schedule.

You could set a new time for a daily home workout, and pick a regular time to clean, read, watch a TV programme or film, or cook.

11. Look after your sleep

Good-quality sleep makes a big difference to how we feel, so it’s important to get enough.

Try to maintain your regular sleeping pattern and stick to good sleep practices.

12. Keep your mind active

Read, write, play games, do crosswords, complete sudoku puzzles, finish jigsaws, or try drawing and painting.

Whatever it is, find something that works for you.

How can I protect myself from air pollution?

Air pollution is increasingly reported as being something we need to improve if we are to prevent damaging the health of millions of people. Anyone who experienced the ‘pea-souper’ fogs of the 1960s and earlier needs little introduction to the subject, but the Clean Air Acts in the UK in 1956, 1963 and 1993 sorted that out didn’t they? After all, we don’t see those dreadful weather conditions any more do we and now that we no longer burn coal very much those chimneys belching black smoke are a thing of the past?

In truth, conditions are very much better now compared with the 50s but we are a long way from eliminating the air pollution problem, The rise of the motor car and diesel goods transport is a major factor and the harmful, irritant gasses released are much less obvious so tend to be hidden. In the UK these pollutants are now closely monitored by the Environmental Agency and include nitrogen dioxide, sulfur dioxide, carbon monoxide, pm2.5 particulates.

Exposure to airway irritants is still very common outside the home – the popularity of wood-burning stoves in urban and suburban areas is a good example of a new trend that can make matters worse. Bonfires and fireworks are a problem at some times of the year and Global Warming may also lead to increased risk of uncontrolled burning such as happened on the moors surrounding Manchester in 2018 and happens in the US and are currently ongoing in large parts of Australia. Burning causes vast quantities of very fine dust particles and gasses to be released that someone with asthma can find very disabling and after the ongoing bushfires National Asthma Council Australia have published useful help about how to cope with asthma if you find yourself in a smoky area.

An excellent review of the harm air pollution can do to our health and a call to government to take action was released in 2018 by the Royal College of Physicians (Every breath we take: the lifelong impact of air pollution ) and it has been followed up two years later in 2020 when, rather discouragingly they note that some chances to change things have already been missed and progress has been minimal: https://www.rcplondon.ac.uk/news/reducing-air-pollution-uk-progress-report-2018

Is there anything we can do to reduce prevent us from inhaling these irritants?

The British Lung Foundation has an extensive article on this subject for outdoor air. They aren’t particularly supportive about the use of facemasks but some aspergillosis patients report that there is some benefit, especially when travelling or gardening.

Indoors as long as we keep doors and windows closed we can keep out a lot of the pollution in the outside air, but of course, it is not always possible to do so as we also need to vent out excess moisture from our homes at regular intervals eg when we shower, bathe, cook or do the laundry. Air filters for use in the home have long been available varying from the token small device to large floor standing devices but are they any good? The answer is that they can reliably clean some things out of the air provided that they are big enough to suit your room size. Good Housekeeping has written a useful guide.

There is a freely available world map of air pollution at https://waqi.info/

map of air pollution

 

How people with aspergillosis can help look after their liver

What does our liver do?

Our livers are really important for us to live a healthy life. Tucked right underneath our ribcage it is a large soft organ that has a rich blood supply. It can recognise and break down or filter any toxic substances that it may find – consequently our blood is quickly cleaned of anything that is not meant to be in our bloodstream.

Toxic substances can get into our body when we eat them, drink them, inhale then or when our doctors inject substances directly into our bloodstream. They can even be part of the daily process that continually renews the tissues that make up our bodies, breaking down proteins and ridding us of any toxic by-products of this process. This is a hugely complex process that we are as yet unable to reproduce artificially – the only way we can replace a badly damaged liver is to replace it with a transplanted donated liver.

What happens if our liver stops working?

Not surprisingly if our livers become dysfunctional our bodies soon start to suffer and there is a long list of illnesses caused by a sick liver. One of the most well-known ways we can damage our livers is to take alcoholic drinks to excess regularly, but we should also be aware that obesity is also a risk to our livers.

Why is this important to aspergillosis patients?

In addition aspergillosis patients should be aware that the medications that they have to take can risk damaging their livers. Doctors closely monitor their patients especially when they first prescribe a mediation that may cause toxicity. They need to watch closely for signs of the liver starting to be distressed by monitoring the signs using blood tests referred to as liver function tests. The purpose of these tests is to detect the very early signs of liver distress so that the doctor can take action to prevent any long term damage.
We know that antifungal medication can cause liver damage in some people, sometimes because the dose of an antifungal is too high and a quick adjustment can prevent further problems, or sometimes the patient is switched to a different drug if dose reduction doesn’t have the desired impact on the liver.

What can I do?

What can you, the patient do to help yourselves when taking an antifungal medication? Firstly, of course, it is very important to have a good working relationship with your medication team and report any new symptoms quickly to your doctor can assess if any action is needed.

You can also help by keeping your liver in the best condition it can be so that it can detoxify your blood quickly and keep you in the best health possible. You may be surprised by some of the things you should and shouldn’t do!

  • Smoking is bad. There are hundreds of toxins in cigarette smoke that your liver has to work on to keep you well while it should be working on other toxins
  • Coffee is good! Take a few cups a day but ensure you are still taking plenty of water as well
  • Alcoholic drinks – stick to medical advice. If you are taking antifungal drugs I am afraid the advice is no alcohol consumption (your liver will love you for it)
  • Eat the rainbow – select fruit and veg of every colour to be part of your diet.
  • Take care when using acetaminophen – often found in colds & flu remedies. No more than 4000 milligrams per day.
  • Weight – keep your Body Mass Index between 18 and 25
  • Infection control – wash your hands well after using the toilet and before preparing food
  • Exercise as much as you can – see your specialist physio for advice
  • Get vaccinated against hepatitis
  • Practice safe sex – diseases transmitted by sex can hurt your liver
  • Avoid ‘liver detox’ products eg milk thistle, turmeric. Tell your doctor what you are taking.

NOTE: Herbs and supplements cause 25% of the liver damage treated by doctors – especially borage, comfrey, groomwell, coltsfoot but also Atractylis gummifera, celandine, chaparral, germander and pennyroyal oil.

Good foods for your liver (all in moderation)

  • Coffee
  • Oatmeal
  • Green tea
  • Water
  • Almonds
  • Spinach
  • Blueberries
  • Herbs & spices

Foods you should limit

  • Sugar
  • Fatty foods
  • Salt
  • snack foods (usually rich in the above)
  • Alcohol

Stoptober

Stoptober is an initiative which aims to help people quit smoking. The dangers of smoking are well understood, but for those with chronic lung conditions the risks can be even greater – for example smokers are 5 times more likely to catch the flu, a major complication for aspergillosis patients.

We have had 2 talks at the National Aspergillosis Centre patient and carer support meeting that mentioned smoking and aspergillosis. At one meeting, Dr Khaled Al-shair (National Aspergillosis Centre Researcher) spoke of several guidelines to help patients suffering from Chronic Pulmonary Aspergillosis (CPA) feel their best while being treated at the NAC. Exercise and good diet played their part but one of the major improvements many patients can make to their lifestyle was to stop smoking cigarettes.

We have also had a talk from our local ‘Stop Smoking’ nurse – this talk focused what can be done locally using UHSM (University Hospital of South Manchester) services; so if you are a NAC patient or live withing striking distance of UHSM (Manchester, UK) you can take advantage of this help directly. There was also extensive information for anyone about the advantages of giving up cigarettes and different strategies to employ when trying to find a way to stop smoking.

The NHS also provides a wealth of information and advice on quitting smoking which can be found here.

Advice for people with respiratory conditions in winter

https://www.youtube.com/watch?v=uvweHEQ6nYs

Many patients with respiratory conditions like aspergillosis report increased frequency of chest infections during the winter months, and this is mentioned repeatedly in our Facebook support groups (Public, Private). The cold weather brings problems of many kinds, but respiratory infection is one of the most serious. Infections by bacteria or virus have a major impact on their quality of life as their breathing becomes restricted and often they quickly become too exhausted to carry on with tasks of daily living.

Why does the winter cause increased vulnerability to respiratory infections? Is it because of the cold weather making us weaker and unable to fight off infection? In part – yes it is! Cold air cannot hold moisture as well as warmer air and thus cold air, is drier air. Inhaling dry air tends to dry out our airways and this can make us vulnerable to infection. This has two impacts – it irritates the lining of our airways and makes us cough, which itself increases our risk of infection, but it also dries out the mucous lining our airways and makes it more difficult to move – so we end up coughing much more than normal as we try to cough up this thickened substance.

People with chronic respiratory disease such as COPD, asthma, aspergillosis are particularly vulnerable to dry air as their airways are very sensitive to irritation.

Winter holds all kinds of pressures for the NHS and one of the biggest is a huge increase in people with respiratory conditions whose condition has become worse as a result of the cold weather. This video includes some advice on how to make sure the cold doesn’t affect your condition to prevent you from needing hospital treatment.

Reproduced with thanks, produced by NHS Blackpool CCG 2019

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