Q: Ever since my mastectomy I've been a wreck -- I can't sleep and I'm distant from my kids and my husband. They say the cancer is gone, but I can't shake the fear. What can I do? - Lauren J., Montpellier, Vt.
A: You've been through a very stressful experience. It's natural to feel some turmoil. But the emotions you're describing may be more than the expected ups and downs of breast cancer diagnosis and treatment (and they're plenty distressing).
Turns out that 25 percent of breast cancer survivors, 20 percent of those who've had spinal fusion and many others who've been in intensive-care units exhibit symptoms of post-traumatic stress disorder, such as nightmares, anxiety, an exaggerated startle response, emotional detachment and flashbacks to unsettling moments (getting the diagnosis, going into surgery, etc.).
Illness-related PTSD develops from a combination of psychological upset (particularly among people who have a severe illness, additional health problems or are without economic resources) and purely physical trauma. Treatments and medications can disrupt the body's biochemical balance, throwing off hormone function, and interfering with neurotransmitter production, which can trigger bodywide distress.
Fortunately, cutting-edge research is revealing ways to prevent and ease PTSD; you may find them to be helpful.
» Try to express your worry as you feel it. If you're uncomfortable telling your family about your fears, enlist the help of a psychiatrist, psychologist or counselor.
» If possible, continue to be physically active before and after your medical procedure or treatment. Exercise aids physical recovery and relieves mental stress.
» Take up meditation. Just 10 minutes a day of mindfulness can give you the sense of peace you seek. (Soldiers with PTSD have found meditation to be a great help.)
» And most important, talk with other people who have gone through what you're going through; there are support groups affiliated with hospitals and various breast cancer organizations.
Q: I think I'm putting on pounds because my metabolism is slowing down. Dieting doesn't seem to work for me. How can I rev up my metabolism? - Amy D., Chillicothe, Ohio
A: That's a burning question, for sure. Your body's metabolism is a two-part process designed to convert calories into energy and then use that energy to make muscle and other vital components of your body (your brain cells use energy, too). It's fueled by food, the hormones your body secretes and the chemical reactions that go on within (and between) all of your cells.
Metabolism slows down for a couple of reasons: As you age, you tend to lose brain and muscle mass (you can minimize both), so you burn fewer calories per minute. If you don't decrease your calorie intake, you'll gain weight. Also, if you're on a super-low-calorie diet (less than 1,200 calories a day), your metabolism slows down in an attempt to keep you from starving.
So the key to increasing your metabolism and losing weight is to take in fewer calories than you burn, but not so much that your body goes into "protect from starvation" mode. At the same time you want to build muscle (and brain) mass. That'll increase the number of calories per minute that you burn, even while sleeping.
» 1. To lose one pound a week (don't try for more), you want to eat 250 fewer calories a day and do an additional 45 minutes of walking (at 3 mph) every day.
» 2. Do strength (translate that as muscle) building exercises two to three times a week for 30 minutes, using exercise bands or hand weights/weight machines. Focus on exhausting a muscle within two minutes, and repeating each exercise twice. Consider working with a trainer who can teach you to avoid injury and build muscle.
» The bonus: As you adopt these healthier habits and rev up your metabolism, you'll lose weight and protect yourself from cancer, dementia, osteoarthritis, heart disease and a lousy sex life. Now that's something everyone can get revved up about.
Mehmet Oz, M.D., is host of "The Dr. Oz Show," and Mike Roizen, M.D., is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at firstname.lastname@example.org.