Chronic stress. There is good anecdotal evidence of a link between stress and body fat levels, although the association is a complex one. Under cases of acute, life threatening stress, animals (including humans) stop eating and go into a protection mode. They also tend to burn more energy, both through increased physical activity and increased ‘nervous energy’. However, most modern day stress is usually less life threatening and more chronic, or long term in nature. Under these circumstances many humans—particularly fat ones—tend to eat more, drink more alcohol, and generally become less active, all factors predisposing to increases in body fatness. Long term, ‘chronic’ stress can increase obesity by:
• encouraging over-eating (especially of high-fat snack foods)
• immobilising efforts to improve lifestyle
• decreasing feelings of ‘self control’
• consuming available energy and efforts while in survival mode
• increasing alcohol consumption.
‘Restrained eaters’ (those who restrict their food intake because of consciousness of being too fat) tend to be most likely to gain fat under periods of chronic stress.” Caution about eating, and all other concerns about food intake usually go by the wayside with long term increases in stress levels and food may serve a ‘comfort’ role to the stressed individual. In one research study, women were shown to be more prone to over-eating during stressful periods, whereas only men regarded as ‘emotional eaters’ respond in this way. In any case, anyone prone to fat gain during stressful situations should perhaps deal with the stress as a means of body fat regulation. Stress alleviation initiatives, therefore, may be an integral part of a body fat management program for some individuals.
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Will I need help when I come home? What about driving?
Many women find they need help with cooking and showering during the first week home. If there is no one to whom you can turn for such assistance, home help can usually be arranged through local councils with the aid of a doctor’s certificate. Driving is best avoided until you are fit enough to walk up stairs and move your body freely, which usually takes two to four weeks from the time of surgery.
I had a hysterectomy three weeks ago and still find I need to
take painkillers. Is this usual?
No, this sounds like there may be a problem whose diagnosis requires a medical check-up. Most healing takes place during the first two weeks after surgery so pain should have disappeared by this stage. Prolonged pain suggests there may be something amiss with the wound such as an infection, or an internal problem such as bleeding, blood clot formation, infection or adhesion formation.
When I come home after a myomectomy or hysterectomy what will I be able to do?
Most women find that they need to rest during the first week at home, gradually increasing their activities after this. Most doctors can provide examples of abdominal exercises which can help strengthen the abdomen and improve the flexibility of the scar once the wound heals (seven to ten days). Walking or light gardening is usually possible three to six weeks after surgery. Lifting will do no harm at this stage and a gradual increase in the weight and the amount of stretching involved is beneficial. Make sure that you bend your knees and keep your back upright when lifting objects. The common worry that activities such as lifting or stretching (for example to hang washing on a clothes-line) may weaken wounds or undo stitches is groundless.
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For the purpose of learning how to sleep, the relationship between the higher control (cerebral cortex) and the lower control (sleep centre) must be made clear. Many studies, including animal experiments, have attempted to demonstrate the existence of a sleep centre. The exact location of this is still controversial, although it is believed to be located somewhere in the brain stem.
This is a few animal experiments that may be helpful in establishing the model of how sleep is controlled. The following animal experiments were conducted to demonstrate that the higher control (the cerebral cortex) has an arousal effect on the lower control (the sleep centre):
(1) If the sleep centre is stimulated electrically, the animal goes into sleep.
(2) If electrical stimulation is applied to the cerebral cortex of a sleeping animal, the animal wakes up. The cerebral cortex has relayed this stimulation to the sleep centre and this has an arousal effect.
(3) If a surgical cut is made in the mid-brain separating the connection between the cerebral cortex and the sleep centre, the animal goes into chronic sleep. Even if the cerebral cortex is now stimulated electrically, the sleep centre is no longer influenced and the sleeping animal cannot be aroused.
Hence the reason why we are sometimes awake for many hours in bed is that the thinking part of the brain—the cerebral cortex— is sending arousal messages to the sleep centre. The higher control has taken over and is preventing the sleep centre from switching into sleep; this is the commonest cause of insomnia.
To facilitate sleep we have to stop the cerebral cortex from sending arousal messages to the sleep centre, so that the latter can take over and trigger sleep. Arousal messages are uncontrolled thoughts. If we can learn how to control thoughts, we can shift from the waking mode to the transitional hypnotic state (THS) and consequently into sleep.
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