Exercise is Medicine by ACSM

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21 Feb

Gout is a form of arthritis that typically affects the big toe area. Warning signs include pain, redness, swelling, and the area feels hot. A gout “attack” can strike swiftly, even waking someone up during the night. The joint becomes extremely tender to even the slightest touch. Although it is most commonly occurring in the big toe joint, gout can take its toll on any joint it decides. Then moving that joint becomes difficult. The first 12 hours are the worst feelings of pain reported by sufferers. The pain can last for a few days or for a few weeks.

This condition occurs when urate crystals start to accumulate in the joint. These crystals come from high levels of uric acid in the body. The body has to break down purines that are found both naturally in the body as well as in foods like steak and seafood and alcoholic beverages. A bi product of this breaking down process is uric acid. Typically, uric acid dissolves in the body, passes through the kidneys, and is excreted through urine. However, if the body is on uric acid overload and the kidneys aren’t passing the biproduct through, this uric acid builds up. Soon, sharp crystals start to form in a joint and pain sets in.

It is important to take note of what can cause uric acid to build up in the body. As mentioned, eating too much meat or seafood can cause accumulation. This is true for alcoholic beverage consumption as well in excess, especially beer. Obesity is also a cause due to this body type producing more uric acid for the kidneys to struggle to push through. High blood pressure and diabetes are also uric acid culprits. Gout is genetically related. Men tend to experience gout more than women. However, after menopause, women’s uric acid levels seem to rise.

There are medications to treat gout, especially if one experiences this condition repeatedly. It is important to treat gout at early onset in order to prevent kidney stones. Drinking plenty of water can help the kidneys do their work. A doctor might test the fluid of the affected joint for crystals. An ultrasound can also detect urate crystals. Luckily, there are medications to treat and prevent gout attacks. NSAIDs are nonsteroidal anti-inflammatory drugs such as ibuprofen or Aleve that a doctor might prescribe in a higher dose. Corticosteroids, such as prednisone, can come in pill or shot form to help alleviate pain. Colchicine is a pain reliever that specifically reduces gout pain. Xanthine oxidase inhibitors (XOIs) actually block uric acid production. Uricosurics help the kidneys remove uric acid.

Pain anywhere in the body should be addressed. This is certainly the case when any sign of gout arises. Pay attention to what triggers an attack. Your body and kidneys will thank you for taking care of your health. Uric crystals mean the near fortune is not good, so be sure to hydrate, watch your diet, and manage your weight.

15 Feb

Garlic comes from Central Asia and northeastern Iran. However, it is a seasoning that is used all over the world. This spice is a relative to onion, leek, chives, and shallots. It is readily used for cooking and sautéing. The perks of garlic are many, and the health benefits have made many people fans.

  1. The most popular benefit of garlic is its ability to boost the immune system with its powerful ability to fight infection. Garlic contains antibacterial, anti-fungal, and antiviral properties. Garlic in raw form, can be rubbed on skin conditions that are fungi, virus, or bacterial related. One of the components called, ajoene, can help fight yeast infections.
  2. Garlic can also boost immunity. This spice is absolutely loaded with vitamin C. It also contains a high amount of potassium which means it helps with the absorption of other nutrients. The smell clears up lunge and throat problems.
  3. It helps fight off fatigue.
  4. It helps with digestive problems.
  5. Garlic is a major fighter against cancer. Studies have linked garlic consumption to a decreased risk for breast, stomach, colon, esophagus, and pancreatic cancer.
  6. Garlic is an anti-inflammatory. This spice contains diallyl sulfide (DAS) and thiacremonone which have anti-arthritic properties.
  7. Garlic blocks the growing progress of fat cells which can help ward off obesity because of its sulfur containing compounds.
  8. Garlic can help cleanse the body of toxins. It activates the liver enzymes to get rid of waist.
  9. It helps with earaches when warmed up and dropped into the ear.
  10. It is a mosquito repellant.
  11. It can help get rid of warts.
  12. When boiled and drank as a tea, it can help get rid of a cough.
  13. Cooked garlic can lower cholesterol.
  14. Cooked garlic can lower blood pressure.

Garlic is quite the super food and incredibly great for our health. It might make your breathe stink, but the benefits far exceed a little aftertaste. The trick is to have a little parsley after, which actually negates the smell of garlic. Beyond using it in so many different recipes, not just traditional spaghetti, garlic is something we all can have a little more of. Garlic comes in fresh form, powdered, crushed, you name it. A little garlic a day can really help keep poor health away and is an incredible home remedy that is easy, convenient, and even tasty.

08 Feb

General health can be greatly affected by hormones, and an imbalance can alter our mood and emotions. Hormone fluctuation can cause embarrassing acne outbreaks, and can make a person feel sad, mad, or just irritable. Sexual desire can be impacted and for women, the ability to become pregnant can be jeopardized. The bottom line is that hormones control most of our bodily functions. From hunger, to sleep, to puberty, even the smallest changes in hormones can cause life changing side effects.

The body’s hormones must work as a team to make the body thrive. The endocrine glands produce these chemicals that travel through the blood in the body. They tell the tissues and organs what to do. Together, the recipe for good health is created. However, just like when baking a cake, too much or too little of any one item can affect the final product. Lack of exercise, poor eating, and irregular sleep patterns are bad habits that some can get away for a while. However, for some, these choices can quickly derail a person’s overall health, especially when hormones are not in sync.

Symptoms that an imbalance is occurring might include:

1. Fatigue

2. Weight gain

3. Weight loss

4. Depression

5. Thinning hair

6. Anxiety or irritability

7. Muscle weakness

8. Frequent urination

9. Decreased sex drive

10. Infertility

There are 3 ways to measure a hormone imbalance.

1. Blood

2. Urine

3. Saliva

It is important to determine what the normal hormone level for your body is. Hormone levels vary based on gender and age and the exact hormone being tested. Blood tests can be performed to measure estrogen, testosterone, cortisol, DHEA, thyroid, and progesterone. Urine tests are mainly used for ovulation and pregnancy. Saliva testing helps determine the concentration of the specific hormone being tested.

Imbalances are not uncommon. Some of the most common imbalances result in the following:

1. Irregular periods

2. Chronic fatigue

3. Acne

4. Weight gain

5. Tender breasts

6. Increased facial hair

7. Cysts in the ovaries or breasts

8. Migraines/headaches

9. Hot flashes/ night sweats

10. Constipation

11. Memory loss

12. Insomnia

13. Difficulty concentrating

The study of endocrinology involves the endocrine system and the associated hormones. An endocrinologist can diagnose and treat hormone related problems and diseases. Growth and development, metabolism, and tissue function are all part of this branch of biology and medicine. Finding the root of the problem and addressing the imbalance can help a person start to feel more like themselves again. Hormones are a complex medical phenomenon that are part of nearly all that our body does for us. Keeping them in check and in line is necessary for optimal health.

01 Feb

Varicose veins are the bluish cords just below the surface of the skin, usually on the legs and feet. These all twisted up veins are usually harmless. Although ever present, they are not a threat but can be painful and become swollen from time to time.  They might be tender, ache, or become itchy when they want attention. They’re much more common in women and generally a genetic gift from one’s parents.

Our blood is pushed back to the heart through the veins. The veins operate with the muscles and valves of the arteries. These muscles use their force to push the blood through and the valves open to let blood pass. The valves then close after. In a varicose vein, the valve is not performing its duty and the muscles aren’t able to push the blood through. Blood starts to pool as the blood team members aren’t cooperating. Pressure starts to build, and the veins start to protrude and twist amongst this chaos. Circulation has become inhibited. The veins become more visible due to becoming so enlarged. One may feel not change to the body, but can see the bluish, purple veins coiled near the surface of their skin. Spider veins are a milder form of this poor blood flow outcome.

Varicosity can be amplified by obesity, standing for prolonged periods, chronic constipation, and pregnancy. When a female is pregnant, the uterus is causing extra pressure to the legs. Blood circulation changes to help the growing fetus. Coupled with hormonal changes, this is why women are more at risk for these veins. Female hormones relax the walls of the veins. Living a mostly sedentary lifestyle leads to a blood pumping team that is not conditioned to perform its job. Exercise increases blood flow, which in turn can help prevent and alleviate varicose veins. Our blood pumping veins do weaken with age, so our veins become more vulnerable to this condition the older we get.

For most people with varicose veins, medical attention is not needed. Treatment can start with compression socks. These are sold over the counter, but a doctor can prescribe high pressure compression socks. These socks apply strong pressure beginning at the ankles and tapering off towards the knee. They help the leg muscles do their job to push blood up to the heart and can be worn throughout the day. Swelling can be alleviated by ibuprofen or aspirin.

Varicose veins can be removed but there are also natural remedies to try. Eating foods that support vein health are part of this. These include foods high in fiber (e.g., whole grains, beans, broccoli) that help with digestion. When you are constipated this actually puts pressure on veins to push the food through. Foods with potassium ((e.g., yogurt, almonds, salmon) also help with water retention. When the body is potassium-deficient this increases blood volume in the veins which then extra pressure. Foods with flavonoids (e.g., onion, garlic, bell peppers) help with cardiovascular health which is necessary for blood circulation. There are also herbal options that can be taken orally or used topically. Grape seed extract has been found to help with swelling, cramping, and restless leg syndrome which are all caused by chronic venous insufficiency.

For the most part, varicose veins just add color and character to your lower body. However, if they are painful, itchy, and a persistent hinderance, medical attention may be in order. Our blood is our body’s fuel, so we have to make sure each team member for flow is able to do their part. Be sure to exercise, manage your weight, avoid high heels and tight clothing that restricts blood flow, and elevate your legs from time to time if the majority of your day is standing. Pressure can be stressful, and your blood shares this sentiment. The Lifestyle of the FIT and healthy knows that your heart health is influenced by your blood health, so we must make sure the veins live in a healthy environment where their job is not disrupted.

24 Jan

Sleep apnea affects nearly 30 million people in the US. That’s approximately 9% of the population. The condition causes interruptions that pause breathing because the throat or airway has collapsed, creating blockage. This is called obstructive sleep apnea (OSA) and is the most common type. Central sleep apnea (CSA) occurs due to neurological issues when the brain doesn’t communicate to continuously breathe during sleep. There is also a complex type which is the combination of OSA and CSA. The CPAP machine, which stands for continuous positive airway pressure, has become a widely used tool to help address these sleep issues. Almost 8 million people use a CPAP machine, and studies point towards it being 99% effective. The machine can send pressurized airflow into the nose and mouth which keeps the airways open for normal breathing.

The CPAP machine has a motor that produces pressurized air that generates a steady stream of air through a tube. The person wears an air mask that fits around the nose or mouth and the flexible tube is connected to the mask. The air that comes through pushes through the blockages so that the airways remain open. Now nothing will obstruct the oxygen getting to the lungs and breathing won’t be paused. There are several benefits to using a CPAP. These include of course better sleep quality, feeling less sleepy during daytime, lower blood pressure, reduction in blood glucose, lower cholesterol levels, and lower risk of heart attack and/or stroke.

The machines are all very similar in style based on brands and designers, but there are variations between the CPAP, BiPAP, and APAP. The BiPAP stands for bi-level positive airflow pressure. There are two pressure levels. One is for inhaling and the other is for exhaling. This machine is used by people who don’t like the CPAP and who have high levels of carbon dioxide in their blood. The APAP machine stands for automatic positive airflow pressure. It checks your breathing through the night and automatically adjusts the pressure accordingly. This works for people who change positions a lot or take medications that can affect breathing. There are different options for masks. Selection of which mask type is based on comfort, type of sleep apnea you have, and your breathing habits. There are nasal masks with pillow type cushions and there are full masks that cover the nose and mask.

A person who has Medicare Part B and who is officially diagnosed with sleep apnea, will qualify for Medicare paying 80% of the machine cost. Whether renting it or buying it, the person will need to pay their deductible and the other 20%. Otherwise, CPAP machines can vary between $500 and $3,000 dollars.

Some people complain of dry mouth, nosebleeds, feeling claustrophobic, feeling bloated, nasal congestion, feeling uncomfortable, and skin irritation. However, left untreated, sleep apnea can cause headaches, depression, high blood pressure, higher risk for heart attack and stroke, diabetes, and feeling constantly tired and fatigued. There can be pros and cons to using the CPAP, but the health issue should not be ignored. Sleep is essential and interrupted sleep over a period will catch up with the body. Some people can be in denial, but if you’re snoring loudly, having mood swings, feel tired too much of the time, have headaches, and insomnia, then it’s best to get checked for sleep apnea. Being proactive versus reactive when it comes to our health is always the recommended protocol.

17 Jan

Eventually, all of us will get gray hair. More friendly terms are silver, salt and pepper, or charcoal. We associate gray with aging or a phenomenon that occurs only in the elderly. That is not the case for all people, in fact some can gray as early as in their 20s. The reason that hair goes gray is because the color-producing cells stop making pigment. The color becomes naturally bleached and hydrogen peroxide actually builds up in the hair. The pigment in our hair is called melanin which is released by melanocytes.  As we age, our hair follicles and hair shaft wear down. The melanocytes don’t work as efficiently. Almost half of all people have some amount of gray hair by age 50. However, Caucasians start to go gray in their mid-30s, African Americans in their late 40s, and Asians in their late 30s. If a Caucasian person goes gray before age 20 and an Asian or African American before age 30, then they are considered to have premature gray hair.

This is not classified as a medical problem, but rather more of a vanity concern. There is no scientific proof that stress causes gray hair. Although we have watched each of our president’s hair turn grey while in office, this wasn’t the result of their chronic stress. Genes play a major role. Problems with the thyroid or low vitamin B-12 levels can cause graying. Inadequate levels of vitamin C, D, and E can also cause graying. Sun damage and smoking have been linked to graying.

There are of course ways to cover the gray or rather, to just embrace it. Stars such as Steve Martin and Anderson Cooper wear their gray with pride. Unfortunately, you can’t really escape gray. Antioxidant rich foods can slow the process of aging. Great foods to consider are vitamin B-12 (eggs, fish, poultry, milk), vitamin A (eggs, carrots, dark leafy greens), vitamin C (citrus, berries, sweet potatoes), vitamin E (nuts, seeds, green vegetables), iron (leafy green and red meat), and antioxidants (berries, onion, garlic, and legumes). Hormonal problems should be treated. Stopping smoking will reduce the rate at which gray hair produces. You may just have the DNA for graying. You might just have the same gene that causes lighter hair in Europeans (IRF4).

Gray can be sophisticated so don’t always say you are getting old. Graying means you have experienced life. Just like your age, your number of grays is only part of your timeline. You are as young as feel. Most importantly, take care of your health and your body will take care of you. Just be glad if you still have hair gray or not.

11 Jan

The stigmatism around gluten has been growing especially as more and more people have discovered food allergies and digestive problems with their diets. In fact, 1 in 100 people have celiac disease (Celiac Disease Foundation, 2022). Complaints of diarrhea, fatigue, nausea, bloating, and anemia warrant a trip to the doctor who is likely to ask you about the foods you are consuming. Nearly 80% of people with celiac disease go undiagnosed for a prolonged period living in pain and discomfort before seeking help or finding the culprit (Celiac Disease Foundation, 2022). Eventually the two-step process for a blood test and endoscopy would find celiac disease. The large intestine is speaking to you, but the cause of discomfort isn’t always clear at first. Sometimes by elimination, one can discover it’s gluten that is causing havoc. Gluten is found in wheat, barley, and rye, which are ingredients in many processed foods and bread type items. Most of us have lived a life with plenty of bread, buns, cereals, pastries, noodles, crackers, and bagels. Take those away and real, whole foods are put in place by default that are gluten free.

What’s interesting is that many people don’t develop celiac disease until later in life. It’s important to address it right away because the gluten allergy is causing the lining of the small intestine to not absorb nutrients as it should. Malabsorption can lead to nutritional deficiencies, hence some of the side effects of fatigue and discomfort occur because the body isn’t getting what it needs for functioning. Most people with celiac disease are deficient in iron, fiber, calcium, folate, zinc, B12, and vitamin D (Celiac Disease Foundation, 2022). To date, there is no cure-all for celiac disease other than just adjusting one’s diet accordingly or taking medications that address side effects.

Not all celiac disease side effects are necessarily digestive related. Other side effects due to the allergy include skin rashes, blisters, joint pain, headaches, dysfunction to the spleen, and numbness in hands and feet. Dermatitis herpetiformis can develop on the elbows, knees, scalp and buttock which causes a very itchy and blistering rash. Getting rid of gluten is needed and there is medication for this.

It actually all boils down to having a leaky gut. When eating gluten and a person is sensitive to it, zonulin is released. It is a protein that when not activated correctly, causes tight junctions in the lining of the gut, which then leads to the leaky gut. When a person has a leaky gut, toxins and even gluten gets released into the bloodstream. A leaky gut can be a big deal because 70 to 80% of our immune system is located in our gut and our gut is our second brain. When our gut is not in proper operating ability, health risks are rampant (Johnson, 2015).

This does not mean that gluten is bad for everyone, and there is no long-term association between poor health or increased poor health risks for persons who consume gluten their whole life. Although not scientifically backed, there have been claims that all people should partake in a gluten-free diet suggesting that the modern digestive system is not equipped to break down the proteins from gluten. For those who do eliminate gluten, there can be benefits and claims of feeling better mainly because getting rid of gluten naturally leads to getting rid of many processed foods. That takes away many fast-food options, snacks and cereals out of boxes, and most sugary treats. Yes, these foods have gluten, but they also have tons of unnecessary carbohydrates, sugars, and fats that make the desire to have them so tasty. High sugar and carbohydrate diets do typically cause weight gain and fatigue and we can all attest to not feeling our best went we aren’t exactly eating healthy.

From a fitness standpoint, clean eating practically eliminates gluten in and of itself. Besides some protein bars or snacks and possible powders, clean foods aren’t processed, and that takes care of plenty of gluten choices. Furthermore, we do want to have our gut working optimally for us for performance purposes. Having malabsorption or digestive problems can hinder training and performance. Imagine trying to powerlift or compete on stage at a bodybuilding show when your stomach is inflamed and even worse if you both feel and look bloated? Skip the gluten if that’s the case.

There are so many gluten-free products available, and many restaurants now include options. It’s always important to ask if gluten is included despite what the menu might say. Reading labels and nutrition panels becomes a regular task. For a label to meet gluten free requirements, the food cannot contain more than 20 parts per million gluten. Otherwise, below this amount is considered the safe threshold of gluten someone can have (Celiac Disease Foundation, 2022). Making your own food is probably the safest and eating fruits, vegetables, and lean meats is the right way to go. Furthermore, gluten free doesn’t mean calorie or fat free, so it doesn’t mean portions don’t matter anymore. Our intake and expenditure remain, but less processed foods are probably the best when it outcome to having celiac disease and learning to eat nutritionally packed choices.

04 Jan

The flu season is here. According to the Centers for Disease Control (CDC), annually there have been close to 11.7 million cases of the flu, up to 5.6 medical visits related, and nearly 141,000 hospitalizations. We know that the flu is highly contagious and is caused by the influenza viruses. It can be mild, severe, or even lead to death. Unlike a cold, the flu strikes quickly. It is a respiratory illness that happens suddenly. Symptoms include fever, headaches, fatigue, coughing, runny nose, or vomiting. The duration of the flu can be just a few miserable days, or it can last up to two weeks. Anyone can fall victim to the flu, and it typically spreads during the colder months.  

The flu itself is not easy to endure. Complications can arise especially for those over the age of 65, pregnant women, and children under age 5. Sometimes a person can develop an additional sinus infection or even pneumonia in addition to the flu. When these complications arise there are typically warning sides that should not be ignored. Medical help should be sought right away if a person has trouble breathing, severe vomiting, confusion, dizziness, and any pain in the abdomen or chest. In children, warning signs include fever with a rash, bluish skin color, trouble breathing, not being able to keep fluids down, and constant irritability. For infants, warning signs include having no tears when crying, being unable to eat, trouble breathing, and having few wet diapers.

The CDC does recommend the flu shot for anyone ages 6 months or older and to receive an annual vaccination. The risk is reduced by as much as 60% when vaccinated. There are different strains of the virus, and the shot seems to be most effective in the fight against influenza B and influenza A (H1N1). A doctor can test you for the flu within 10 to 15 minutes using one of the rapid influenza diagnostic tests (RIDTs). Upon diagnosis, antiviral drugs can be used to at least lessen the duration of the illness. In most cases just staying home and resting away from people is best. Medication can be used to help suppress fever.

When the flu hits, it’s time to isolate and wash your hands. You should stay home at least 24 hours after your final fever is gone to avoid spreading germs. The flu likes to make friends with all those you are in contact with so don’t let it become anymore popular than it is. Anyone who has had the flu doesn’t have anything nice to say about it at all. The fear or catching it makes vaccination a yearly task. Do what you can to reduce your risk and stay flu free again this year.

28 Dec

Headaches are actually quite complicated and not always a simple answer when it comes to causality. That is why some people continue to suffer from chronic headaches. There are different types of headaches, different reasons why they happen, and different types of treatments. The complexity of headaches lies in the fact that there are over 150 types.

The most common types of headaches include the following:

  1. Migraines: This pounding and throbbing pain can last for 3 to 4 hours or longer. They can also happen up to 4 times or more per month. A person becomes sensitive to light, might feel nauseous, lose their appetite, or become very sensitive to smells.
  2. Tension headaches: This is most common type of headache. They can cause mild to moderate pain and will go away over time.
  3. Cluster headache: This is the most severe type of headache. They tend to happen in groups, hence the name. They can happen multiple times per day and last anywhere from 15 minutes to 3 hours. The person might feel a piercing pain behind their eye with constant throbbing and pounding.
  4. Sinus headaches: The person feels a throbbing in their cheeks, bridge of the nose, and forehead. The person typically also has a runny nose, clogged ears, and a fever. They sinus cavities have become inflamed.
  5. Chronic daily headaches: This type of headache can last 15 days or more. Sometimes they are short and sometimes they can last 4 or more hours.

There are other types of headaches that are less common, but that doesn’t downplay their disruption to someone’s day. Exercise can cause headaches because the muscles in the head and neck and surrounding area need more blood. This can cause a pulsing pain. Post-traumatic headaches can also occur even up to 2 to 3 days after a head injury. Hemicrania continua is an ongoing headache that usually affects the same side of the face and head. Hormone headaches can occur as the hormones are shifting during menstruation or menopause.

The brain becomes overwhelmed by different signals coming from the brain, blood vessels, and nerves. Combine this will illness, stress, genetics, and environment, and one becomes at high risk for a headache. To this day doctors still do not know what exactly causes a migraine, making treatment difficult. Doctors might suggest a CT or MRI. Treatment depends on headache type, cause, and how often. There are of course pain management solutions such as a warm or cold compress, drinking herbal tea, lowering the lights, avoiding looking at screens, exercise, drinking plenty of water, avoiding certain foods, sleeping, massaging pressure points, for some people drinking coffee or soda can help, limiting alcohol, and avoiding certain smells and chemicals. Pressure is always difficult, especially to the head. Be patient and over time you will find an answer and a way to keep the headaches at bay.

21 Dec

Attention deficit hyperactive disorder, also called ADHD, is a condition that commonly involves hyperactivity, impulsive behavior, and the inability to pay attention. This condition used to just be called ADD or attention deficit disorder. This condition always begins in childhood and can be carried into adulthood. About 4 to 5% of adults have ADHD and not everyone seeks treatment. Some people even go undiagnosed but start to take notice later in life. As an adult it can be difficult to manage a job, be timely, or even try to set goals.

This behavioral condition is more common in boys than it is in girls. Typically, during the school age years, a child begins to have trouble paying attention or sitting still at school. The symptoms can be categorized into three forms: hyperactivity, inattentiveness, and impulsivity. A child with hyperactivity has trouble staying seated and tends to bounce or fidget. They’re restless and climbing on things. They also talk excessively. Inattention is characterized by being distracted, having a hard time following directions, trouble getting organized, daydreaming, and losing things. Impulsivity is marked by interrupting others, blurting out, and impatience. These characteristics spill over into adulthood and can cause problems at work, result in anger problems anxiety, mood swings, feeling bored a lot, relationship problems, and depression.

ADHD might be caused by several reasons, and the exact or direct cause is unknown. Most of the time, this condition occurs in families, it can also be caused by chemical imbalances in the brain, toxins that could affect the brain, a brain injury, or any substance abuse during pregnancy. Contrary to what most assume, sugar does not cause ADHD. It is also not caused by watching too much T.V. or going to a bad school.

Although there is no cure for ADHD, medication and therapy is available. Medications called stimulants can help. There are also non-stimulant medications which can be prescribed after age 6. Omega 3s have also been found to be effective. Therapy might involve behavior modification, transitioning into a special education classroom to learn structure and have a more conducive environment to addressing the issue, counseling that can help with emotional control, and there are support groups.

Many people with ADHD live happy lives and are successful despite diagnosis. Catching the signs and symptoms early can really help modify behaviors and learn coping skills. Sometimes the body adapts to medications and may need to be adjusted. Some people even grow out of these behaviors. Every individual is different and certain management therapies are effective for some and not others. When daily life gets hard to manage, seeking help is always important.