Month: November 2021

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What Is A Panic Attack?

what is a panic attack

What Is A Panic Attack?

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If you know, you know. Your heart pounding in your chest, your breaths are becoming shorter and shorter and the dizziness is setting in. You may have heard the terms ‘anxiety attacks’ and ‘panic attacks’ tossed around and used interchangeably as if they both mean the same thing. While they have some symptoms in common, they’re both very different conditions and are treated in different ways.

Panic attacks come on very suddenly and involve intense and overwhelming fear. Most often than not, they are accompanied by several mental and physical symptoms. Panic attack symptoms are often so extreme that they can cause severe disruption to your daily life.

An ‘anxiety attack’ is not a recognized term in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). However, anxiety is an emotional response hardwired into the body and usually builds gradually, in anticipation of a stressful situation, event or experience.

Panic attack symptoms

Mental

  • Feeling detached from oneself and the world
  • Fear of losing control or going crazy
  • Fear of dying

Physical:

  • Heart palpitations
  • Excessive sweating
  • Trembling or shaking
  • Difficulty breathing
  • Chest pain
  • Nausea
  • Dizziness
  • Numbness
  • Chills or hot flashes
  • Tightness in the throat
panic attack

During a panic attack, your body responds as if you are in real danger even if there is no threat around you. You could be going for a walk, watching TV or cooking in the kitchen.

What is the difference between a panic attack and having anxiety?

 

 

Panic attacks often occur out of the blue and involve severe, disruptive symptoms. On the other hand, anxiety can be mild or severe and gradually build up over time. Symptoms of anxiety can be persistent and last days, weeks or even months.

Additionally, during a panic attack, the body’s fight-or-flight response takes over. These physical symptoms are often more intense than the physical symptoms of anxiety.

panic attack vs anxiety attack

How long does a panic attack last?

Panic attack symptoms usually occur for around 10 minutes and then subside. However, some attacks may last longer or may occur simultaneously, making it difficult to know when one attack ends and another begins. Following an attack, you may feel worried, out-of-sorts, or on edge for the rest of the day.

What can trigger a panic attack?

It is not exactly clear what causes a panic attack but the triggers differ from person to person. Potential triggers could include social events, public speaking, situations that remind you of stress and even bright lights or loud noises can trigger a person’s panic attacks. Certain people, places or events can trigger the attack as well. It is a good idea to watch out for your triggers

How do you stop a panic attack in the moment?

Since panic attacks hit you so quickly, it can be extremely scary and fearful. Here are a few things you can try to stop or manage the attacks.

  • Deep breathing –  You may have difficulty breathing in the moment, but trying to take deep, long breaths can reduce panic and fear. Focus on taking deep breaths in and out through your mouth. Breathe in a count of four, hold for a second, and then breathe out for a count of four
  • Recognize that you’re having a panic attack – Recognize that you’re not having a heart attack, remind yourself that this feeling is just temporary and that it will pass soon and you will be OK.
  • Close your eyes – If you’re in an environment that overwhelms you, close your eyes to block out any extra stimuli and focus on your breathing
  • Focus on other senses and sensations around you – During a panic attack, focus all your attention onto one thing. It could be your watch, the pockets on your jeans, the book on the table next to you, the A.C in the room. You can hold onto something soft like a pillow or run your hands along something textured like a blanket. Focus all your energy on this one object and take note of its size, shape, pattern, colour, and more.
  • Keep lavender on hand – Research suggests that lavender has a calming effect and can reduce symptoms of the panic attack
deep breathing

Read more about coping methods at 5 Hacks To Try When You Feel Anxious

Can you prevent a panic attack from happening?

It’s not always possible to prevent a future panic attack but you figure out what triggers your panic attacks and try to avoid or eliminate them from your life. Other tips that can help prevent your panic attack include:

  • Breathing exercises every day
  • Regular exercise
  • Avoid smoking, drinking alcohol and caffeine excessively
  • Make sure you’re getting enough sleep

Another preventative measure is to speak to a licensed mental health professional who can help you identify your triggers, develop ways to manage them, work through past pain and gain a clearer perspective for the future.

How can you support a person going through a panic attack?

If you suffer from panic attacks or are facing severe anxiety, speak to the mental health doctors on oDoc. Download oDoc today.

References:

  • How To Help Someone Having a Panic Attack, 2020, Healthline
  • Panic Attack vs. Anxiety Attack, 2020, VeryWell Mind
  • Grip on crippling anxiety attacks, 2017, Daily News
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Birth Plans – what you need to know

Birth Plans – what you need to know

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Yes, Birth Plans are a thing and it is also very useful to have one. 

If you are approaching your third trimester the chances are you have already given a lot of thought to childbirth and all the options available to you. It is vital you write your preferences down and share what your preference for labour and delivery is with a loved one. This should be done well in advance because whilst you are going through labour it will be quite a task to make decisions in the middle of, you know, all the pain and hormones and stuff. Having a birth plan in advance will help you focus on the most important thing on the day – bringing your new baby into the world. We have broken down everything you need to know while creating your birth plan. 

Before we proceed, let’s go through the basics quickly. 

What is a Birth Plan?

A Birth plan is a written, typed or even drawn document which states your preferences during labour, delivery and after childbirth. It’s similar to a wish list, for example, where you can list out who you want with you in the room while you are in labour, or if you want pain meds, dimmed lights in the room, background music and other preferences. You can add anything you wish to make your delivery day as comfortable as possible. 

However, it is important to keep in mind that unexpected things can happen during labour so it might be quite difficult to follow your birth plan to the T. 

So how do you create a birth plan?

First, start with the basics. Include your

  • Name 
  • Age 
  • Brief medical history like chronic medical conditions, medicine allergies etc.

Here are a few other things you should consider when adding to your birth plan: 

Location

Where do you want to give birth? At home or at the hospital?

State your location so everyone is aware of where they need to take you when the labour pain starts.

Atmosphere

Who do you want around you when you are giving birth? Do you want a spacious room so you can walk around? Do you want a TV to help you calm down? Would you like music to be playing in the background – if so what playlist?

Listing these preferences out will help your loved ones set the atmosphere to your liking. 

Birthing positions 

Would you like to give birth on a birthing bed or stool or ball? 

There are many positions you could try if you opt for a birthing bed. Some are listed below. 

  • Lying down: On your back, with your head flat or elevated, and your legs elevated
  • Side-lying: With one leg elevated (this is good if you’re tired or if your blood pressure levels are fluctuating)
  • Kneeling: On the lower part of the bed with your arms or upper body resting on the upper section (this posture helps ease the backache)
  • All fours: With your stomach facing down, supported by your hands and knees (helps ease backache)
  • Squatting: On your feet, with support from bed or partner (this position takes advantage of gravity and shortens the depth of the birth canal)

It is good to know the different options so you can experiment with these during childbirth easily. Please note that in Sri Lanka these positions are not practiced regularly but do talk to a VOG if you’d like to explore these positions.

Pain management 

An important component of childbirth is pain management. It is common to be confused about whether or not you should take an epidural. Please note that whatever you choose in the birth plan, you can always change your mind on the day. It is advised you discuss the pain management options available to you with your VOG doctor well before your due date. A few examples of questions you can ask are listed below: 

  • What are my choices?
  • What is the risks of taking an epidural?

 

Delivery

Expecting mums, it’s never too early to discuss this with your VOG doctors. Have a think about if you’d like a normal vaginal birth or a C-Section. Other important things to consider are: 

  • Would you like your partner to cut the umbilical cord? 
  • Would you like to opt for an episiotomy (an incision through the area between your vaginal opening and your anus to make your vaginal opening larger for childbirth) or only do it if medically required? 

Feeding after the baby is born

How do you want to feed your newborn – breastfeed or bottle-feed? It is important to let your doctors and caregivers know this beforehand. 

The above list might seem obvious, but under the pressure of labour, the raging hormones and pain, it will be difficult to communicate your choices. So we encourage you to build your birth plan well in advance and share it with your partner and most importantly your VOG doctor so they know what your preferences are when it comes to labour and delivery.   

If you would like to discuss your birth plan or would like some guidance on how to build it, you can speak to a VOG doctor via oDoc from the comfort and safety of your home.

Source

  • Dailey, K. (2012, June 8). How to Create a Birth Plan. WebMD. Retrieved November 19, 2021, from https://www.webmd.com/baby/guide/how-to-create-a-birth-plan#1

  • NHS website. (2021, November 18). How to make a birth plan. NHS UK. Retrieved November 19, 2021, from https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/

  • Dorfner, M. (2018, November 7). The Importance of a Birth Plan. Mayo Clinic. Retrieved November 19, 2021, from https://newsnetwork.mayoclinic.org/discussion/the-importance-of-a-birth-plan/

  • Slide show: Labor positions. (2021, February 23). Mayo Clinic. Retrieved November 19, 2021, from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/labor/sls-20077009?s=9

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What’s The Deal With COVID19 Boosters?

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What’s The Deal With COVID19 Boosters?

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As Sri Lanka rolls out its COVID19 booster program, we break down the answers to your most pressing questions.

Firstly, what is a booster?

A booster is an additional shot of the vaccine given to supplement the protection from the original doses. It is timed to be administered as the protection from original doses wane so you can maintain a good level of immunity for a longer period of time.

But aren’t I good with the two doses I got previously? Why do I need another dose?

A recent Public Health England(4) report detailed how vaccine effectiveness changes with time for those that received two doses of AstraZeneca and two doses of Pfizer.

Twenty weeks after the second dose:

covid19 booster
vaccine effectiveness pfizer

The same study showed there was a greater waning of vaccine effectiveness for the 60+ age group that received AZ.

By administering a booster, especially that of a more efficacious vaccine, we kick into gear the immune response against COVID19 and its variants.

What do variants mean for boosters?

We saw the carnage that was wrecked by the delta variant in Sri Lanka & around the world over the last few months. Vaccination and preventing spread is important in curtailing variants from forming in the first place. However, once they appear, vaccines play a large role in preventing symptomatic sickness, hospitalisations and deaths.

Pfizer and Moderna, the mRNA vaccines, have shown better vaccine effectiveness against the more potent delta variant vs. alpha.

alpha delta variant

When is the booster administered?

Across the world, including in Sri Lanka, the booster is given three months after the second dose of the original regime.

Who can get a COVID booster in Sri Lanka?

At the time of writing, the Ministry of Health is rolling out the booster program for:

  • Healthcare and front line workers
  • Over 60 population
  • Those who are 20 years and above with comorbidities or are immunocompromised (at least after one month after the second dose)

The booster is currently given to those above 60 in the Southern & Western provinces, Anuradhapura and Ampara. They will receive an SMS with the date, time and location of the booster.

Which vaccine is used as a booster in Sri Lanka?

Pfizer/BioNTech mRNA vaccine (30mg dosage) is used as a booster in Sri Lanka. This method of mixing different vaccines (heterologous booster) has been previously used for other vaccines such as Ebola.

Wait, but I got AstraZeneca as my first two doses. Is it safe to mix & match?

Short answer: Yes.

Long answer: In May 2021, a UK trial(3) of 830 participants reported safety data for mix & match vaccines when compared to same type (homologous) vaccines. Though those that received Pfizer after AstraZeneca reported greater intensity of fatigue, headaches and muscle aches – these side effects only lasted 48 hours. There were no hospitalisations or any severe adverse events reported.

What about Sinopharm?

There have been no published studies on mixing mRNA vaccines with Sinopharm. However, Bahrain started boosting those that received two doses of Sinopharm with Pfizer in June.

Are we the only country mixing and matching vaccines?

Nope! Pfizer and Moderna have been approved as booster doses for those that have taken other vaccines in major countries such as the U.K, U.S, Canada and Israel.

Okay, say I get this booster. What does it mean for my immunity against COVID-19?

The Spanish CombiVac trial(2) with 663 people reported in May 2021 that the participants who received a Pfizer booster eight weeks after receiving their first AstraZeneca dose showed a markedly higher level of antibodies than the response generated after two doses of AstraZeneca.

This is expected. When additional doses of a viral vaccine like AZ is administered, the body generates an immune response quickly to destroy the foreign particles. Basically, it becomes good at recognising the virus that it doesn’t allow the vaccine to do its thing – last long enough in the body to actually boost the immune response.

However, by introducing an mRNA vaccine after a viral vaccine, the body is made to work a little harder and longer to recognise the virus. This results in a boosted immune response.

Okay but how many boosters will we need? Will this pandemic ever end?

This too shall pass so the pandemic will end. However, we have a large role to play in this. Our behaviour will dictate whether the pandemic rages on with newer and more potent variants or it gets squashed sooner than later. Variants occur when the virus is allowed to spread so stopping the spread by sticking to COVID19 guidelines is of paramount importance. The less variants, the less need for boosters.

Vaccines save lives and vaccinated people don’t spread the virus as easily as unvaccinated people. So the more people that get vaccinated, the less spread and the sooner we can end this merry go round.

Got more questions? Want to understand whether you should sign yourself or your loved one up for a booster dose? Speak to one of our doctors on oDoc! Download the app today!

Sources

  • Booster Shots and Third Doses for COVID19 Vaccines: Everything You Need to Know. (2021)., Johns Hopkins Medicine
  • Callaway, E (2021), Mix-and-match COVID vaccines trigger potent immune response., Nature.
  • Shaw, R et al (2021)., Heterologous prime-boost COVID19 vaccination: initial reactogenicity data., The Lancet., 397:2043-2046
  • Duration of protection of COVID-19 vaccines against clinical disease. (2021) Public Health England
  • Bernal et al (2021)., Effectiveness of COVID-19 vaccines against the Delta variant., NEJM., 385:585-594
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Sexually Transmitted Infections And Diseases: What You Need To Know

Sexually Transmitted Infections and Diseases

Sexually Transmitted Infections And Diseases: What You Need To Know

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What are STIs and STDs?

Sexually Transmitted Infections (STI) and Sexually Transmitted Diseases (STD) are usually acquired by sexual contact. The bacteria, viruses or parasites that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. However, these infections can be transmitted nonsexually as well. For instance, from mothers to their babies during pregnancy, childbirth, breastfeeding, blood transfusions or shared needles.

What is the difference between STIs and STDs?

It is the fundamental difference between an infection and disease. Most diseases start with infections. Infection occurs when the bacteria or virus first enters the body and multiplies, progressing it into a disease. Likewise, sexually transmitted diseases initially begin as sexually transmitted infections. 

There are more than 20 known types of STDs/STIs. In Sri Lanka, annual estimates of detected STI cases vary from approximately 60,000 to 200,000, of which government clinics report only 10-15%. About half of these are detected in people aged 15-24. Luckily, most STDs can be treated and cured.

What are the most common STIs/STDs in Sri Lanka?

  • Genital herpes
  • Gonorrhoea
  • Non-gonococcal urethritis (NGU)
  • Syphilis
  • Genital warts
  • Chlamydia infection

What are the most common symptoms of STIs/STDs?

Why is it important to prevent STIs/STDs?

Most STDs can be cured or treated with medication. However, the consequences of ignoring it can include infertility, cervical cancer,  pregnancy complications, congenital disabilities, pelvic inflammatory disease and an increased risk of HIV transmission.

How can the transmission of STIs/STDs be prevented?

The only effective way to completely prevent the transmission of STIs/STDs is abstinence. However, for sexually active persons, consistent and correct use of condoms is highly effective in preventing such infections or diseases.

Questions to ask your doctor?

There has almost always been a stigma around any STD, and it usually trickles down to anyone diagnosed with it. People also feel ashamed that they are somehow damaged. It is important to remember that only a few STDs could be life-threatening. However, with proper treatment, most of it has minimal health impacts. You can have a good life despite having an STD. The majority of it is treatable, and some are even curable. Those STDs for which there is not yet a cure, such as HIV, can still be manageable if adequately taken care of.

Here are a few questions you could ask your doctor:

  1. Should I be checked for STIs?

  2. Can I get an STI by open-mouth kissing?

  3. What if I am pregnant?

  4. Can STIs/STDs cause other health problems in women/men?

  5. How can I prevent having STIs/STDs?

Suppose you are experiencing any of the symptoms mentioned above or need any information on STIs and how to protect yourself or get tested. In that case, you can consult a Sexual Health specialist or an on-demand GP via the oDoc app.

Reference:

  1. What you need to know about sexually transmitted infections, MedicalNewsToday (2021)

  2. Sexually transmitted infections (STIs), World Health Organisation (2019)

  3. What is a sexually transmitted infection?, FPA Sri Lanka (2017)

  4. Types of Sexually Transmitted Infections, Healthy children.org (2015)

  5. How to Reduce Shame and Stigma When You Have an STD, Everydayhealth.com (2019)

  6. How Can You Tell If You Have HIV? HIV.gov (2020)

  7. STD vs STI: Common Types, Symptoms, and Treatment, State Urgent Care (2019)

  8. Sexually transmitted infections (STIs), NHS (2021)

  9. HIV/AIDS in Sri Lanka, The World Bank (2012)

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