10 People Who Have Dealt With Eating Disorders Share What Recovery Looks Like for Them

It’s easy to assume that recovery from an eating disorder implies—poof!—those harmful behaviors or negative thoughts and emotions have ended, and the person never has to deal with them again. But, just like with any other mental health condition (be it depression or OCD) recovery from an eating disorder is not black and white. Everyone’s recovery story, and even their definition of “recovery,” is unique and personal.

As society slowly works to understand that eating disorders affect more than thin, white, cisgendered women, it’s also important to recognize that eating disorders can manifest very differently from person to person, which may also affect their recovery path. People may be at different stages of recovery and move between those stages in a nonlinear way.

Recovery for one person at a given time may look like a reduction in how often they practice restrictive behaviors related to their eating disorder; for another, it may mean they have stopped the behavioral habits but are still working on the emotional aspects of it. Recovery also doesn’t mean perfection, or a total absence of relapse. As the National Eating Disorders Association (NEDA) states, “Slips, backslides, and relapse tend to be the rule, rather than the exception … Overcoming food and eating concerns during recovery is a central goal, but it’s far from the only task of recovery.”

To spotlight just how many shades of recovery really exist and how subjective it is, SELF asked 10 people to share their experiences with disordered eating, and what recovery really means to them now.

1. “As I have gone through recovery, my eating disorder’s voice has become quieter, and my own voice louder.” — Alicia, 24

“Since childhood, my relationship with food has always been a tension,” Alicia tells SELF. Growing up in a larger body, they experienced significant bullying. They also dealt with a variety of medical issues, which required them to go on medication for many years. At one point, Alicia’s doctor suggested that they lose a significant amount of weight to help with their symptoms. “That is where my experience with eating disorders began,” they say. After reaching that initial goal, “I didn’t feel that I could stop. I had been promised by society that if I lost weight, I would be happier, however no matter how much weight I lost, the happiness never came,” they say. Their anorexia eventually transitioned into bulimia.

In 2015, Alicia started looking into treatment programs. “But being genderqueer, the programs were very cisnormative and not conducive to my recovery,” they explain. Instead, Alicia sought support through online peer support groups and an independent psychologist.

“I don’t believe I will ever view myself as ‘recovered,’” they say. “The way I explain my eating disorder is that there is a voice in my head, and when I was at my lowest it was screaming, drowning out every other thought. As I have gone through recovery, my eating disorder’s voice has become quieter, and my own voice louder.” Although Alicia believes the voice will always be there, they turn to their partner and best friend when they have a hard day. “I am living my best life currently, and that for me is where I always seek to be.”

2. “It took nearly three decades to get here, and it’s not perfect, but it’s so worth it.” — Raquel, 28

Raquel’s family called her “gordita” (meaning “chubby girl” in Spanish) or “Quelly Belly” as a child. But when they moved back to the U.S. from Puerto Rico when she was 5, “I learned quickly that to be fat meant to be ugly, dirty, and inferior. Those sweet monikers started to feel like attacks, and I wanted to disassociate myself from them,” she tells SELF.

Around the age of 8 or 9, she began dieting, but it never occurred to her that her eating was disordered. “I was a voluptuous, low-income Latina girl from the ‘hood, and according to every portrayal of eating disorders I had seen growing up, you had to be a white, middle-class, emaciated teen obsessed with models and haute couture to have the illness,” she explains.

At 20, she began therapy. And today, eight years later, she occasionally purges. “Intense pressure or hardship is definitely a trigger for me,” she says. But more often, she uses self-soothing practices such as dancing, singing, or spending time laughing with loved ones. “It took nearly three decades to get here, and it’s not perfect, but it’s so worth it. Recovery vale la pena,” she says (which means “it’s worth it”). “Just because I may never be ‘recovered,’ whatever that even means, doesn’t mean I can’t lead a healthy, joyous, and loving life. And I really believe I am living that life right now.”

3. “Full recovery doesn’t seem like an absolute that means I am free from every eating disorder thought every second of every day.” — Sarah, 36

Sarah attempted to recover for 17 years. Oftentimes they would restrict and have orthorexic behaviors for long periods of time, only to end up bingeing for a few days before returning to restrictive eating and repeating the pattern.

Still, they were never diagnosed. “I think this was mostly due to my size. No one thinks that a fat person restricting or being obsessed with clean eating is a negative behavior. No one thinks that a fat person losing a significant amount of weight is unhealthy,” Sarah tells SELF. “Our culture typically praises and congratulates this behavior.” It wasn’t until they were sitting in a graduate school class on eating disorders that they realized they had been dealing with an eating disorder of some type for nearly two decades.

Over those years, Sarah used Overeaters Anonymous, individual therapy, and a mind-body retreat for help. “The retreat [at age 34] is really what shifted my perspective on recovery,” they say. “Full recovery doesn’t seem like an absolute that means I am free from every eating disorder thought every second of every day. Sometimes I think that this is what it is supposed to mean. I don’t think that it is realistic for people who deal with discrimination and prejudice on a daily basis. I’m a large fat person. Every day I face looks, comments, and the world not being designed with consideration for my body.”

Sarah rarely thinks about restricting, purging, or bingeing anymore and continues to work with a therapist who is queer and trans-friendly. “Most of the time I am completely accepting of my body size. Other days when I have to deal with really obvious types of discrimination or deal with the barriers to access that others don’t, I am not very accepting and wish my body was smaller,” they say. “Does this mean I’m participating in eating disorder behaviors? Nope. It is very much dealing with the culture that we live in.”

4. “Recovery is a daily battle, and though I may not be ‘cured,’ I can be stronger than the voice inside my head.” — Lakesha, 27

When the stress and pain of being placed into foster care at 9 years old become too much, Lakesha began bingeing at night. She continued when she was placed with family members, and by 16 she cycled bingeing and purging with restriction. In 2010, she entered an outpatient program, mainly for her other mental illnesses including bipolar disorder, borderline personality disorder, and PTSD. She recognized that she had an eating disorder as well. However, she felt the treatment team didn’t take this seriously “because I didn’t fit the profile of someone with an eating disorder, because I am black and also queer,” she tells SELF. Eventually the therapist she began working with for her other conditions addressed Lakesha’s eating disorder and became the catalyst to start her recovery.

Today, at 27, she considers herself in recovery. “I see things on a continuum, not a straight-shot destination,” she says. “Recovery is a daily battle, and though I may not be ‘cured,’ I can be stronger than the voice inside my head.” She adds that the thoughts and “the mindset” are the hardest parts about recovery. “The thoughts about my body, about food, and about my worth tied to that, have quite the grip,” she says. In addition to writing and sharing her work on Instagram, she continues to see a psychologist and turns to friends, family, and Facebook groups for support. “If I am fighting, I am winning, and if I am winning, I am living,” she says.

5. “There are days when I feel nostalgic for my eating disorder, but looking back, that was the lowest point of my life.” — Olivia, 23

After a bad car accident in the summer of 2017, Olivia developed depression. “I tried to use food and exercise as a way to regain control of my life,” she tells SELF. What started as restricting shifted into bingeing and later purging. By November of 2017, she entered an inpatient treatment program and later moved to an intensive outpatient program.

“Compared to where I was last year, I’m a million times happier and have a much better relationship with food,” she says. “I consider myself as recovered as one really can be with this disease.” She no longer makes excuses about why she can’t go out to eat with friends or attend events where food will be served. When she’s tempted to control by restricting, she turns to exercise, which she’s now able to do in a healthy manner, and leans on her family and close friends. “There are days when I feel nostalgic for my eating disorder, but looking back, that was the lowest point of my life,” she says. “Today I’m in a much better place in basically all areas of my life.”

6. “Understanding certain patterns and truths about myself empowered me to want to accept and care for myself rather than punish myself and try to escape my body.” — Marissa, 32

A formal diagnosis at 19 confirmed what Marissa already knew: She struggled with anorexia and bulimia. However, it wasn’t until about four years later that she began making real strides in recovery. “I decided on my own that I wanted to get better. I began learning more about myself and what led me to the disorder to begin with,” she tells SELF.

Writing her book, Starving in Search of Me, helped Marissa see that her disorder had nothing to do with food. “Understanding certain patterns and truths about myself empowered me to want to accept and care for myself rather than punish myself and try to escape my body,” she says. “What I was actually struggling with was a lot of anxiety around my identity and sexuality, paired with social anxiety.”

Although she considers herself recovered from the eating disorder, she still experiences anxiety and body image issues and has a slew of self-care habits to help manage those things. “I definitely still struggle with a lot of irrational shame around my sexuality, wanting my body to appear more ‘male’ or androgynous. That’s what you get after so many years of being conditioned inside of a heteronormative society,” she says.

7. “There are still times when I see a diet commercial or a beautiful celebrity and her fitness regime that I think about dieting again.” — Rebecca, 36

Rebecca struggled with body image since about 10 years old. “I was aware that being fat was bad and being small and skinny was good,” she tells SELF. “I often tried to be anorexic, but anorexia wasn’t my eating disorder of choice. I liked to eat too much.” She began purging around age 15 and continued until her mid-30s when she was “ready to be done with bulimia,” she says. With the help of a psychiatrist, dietitian, and Prozac, she considers herself recovered today.

“I no longer feel urges to binge and purge. Permission is the hardest part—recovery is all about giving yourself permission to eat all types of foods. And once I got my anxiety under control with medication and therapy, I was able to allow myself more and more of those foods that were ‘forbidden,’” she says. “And when something isn’t ‘forbidden’ anymore, it’s just normal.”

She acknowledges that recovery isn’t a straight line: “There are still times when I see a diet commercial or a beautiful celebrity and her fitness regime that I think about dieting again,” she says. But when Rebecca still struggles with body image, she writes, meditates, and practices yoga and gratitude. “And I tell myself that I love myself every day at least once. I know, I know. It sounds cheesy. But that’s really what I do and it works for me,” she says. She also pays attention to who she spends time with. “I know now that I can’t hang around people who don’t love their bodies and openly express that. It’s not healthy for me,” she says.

8. “I don’t think that [my eating disorder] will ever magically disappear. I’m not cured of it; I simply manage it, day to day.” — Melissa, 33

In her early 20s, an emotionally abusive partner told Melissa that she was fat, had to go to the gym, and didn’t look good naked. “I went on a diet to prove him wrong—and it spun out of control into an eating disorder,” she tells SELF. After a good friend expressed concern, she sought help from her primary care doctor and then a dietitian, in addition to going on an SSRI.

Today, she works within the field of eating disorders and body image and considers herself in recovery. “I don’t think that [my eating disorder] will ever magically disappear. I’m not cured of it; I simply manage it, day to day. It isn’t a perfect process; it isn’t like recovering from the flu, where one day you’re sick, and then one day you’re better,” she says. “I see my eating disorder more as a disability now, a chronic condition, something that ebbs and flows, something that flares up. And I find that acknowledging that aspect of it—that recovery is less about perfection and more about management—allows me to have more compassion for myself as I move through this journey.”

9. “I have faith that I will be able to say I am fully recovered one day.” — Lexie, 23

As Lexie tried to recover from bulimia as a teen, her behaviors changed from purging and restricting, to binge-eating, to emotional eating. “Binge-eating felt like a comfort, and purging felt like a release,” she tells SELF.

Today she sees a therapist weekly and can notice when stress, anxiety, or feeling overwhelmed elicits an urge to binge and purge. “Recovery has taught me to be more self-aware, so I remind myself that using those behaviors in the moment could feel like a relief, but they’re also a Band-aid. The short-term relief will cause long-term consequences,” she explains.

She cannot currently afford a dietitian or support group on top of her therapy and instead relies on friends or uplifting music and funny shows for support when she has hard times. “I am in recovery still, but I have faith that I will be able to say I am fully recovered one day,” she says.

10. “I have a really incredible relationship with my body and food on the whole. It blows my mind that I’m at this juncture. I can’t believe it’s the same person sometimes.” — Caroline, 35

From the ages of 11 to 21, “I had a cocktail of eating disorders,” Caroline tells SELF. She saw everyone from therapists and eating disorder specialists to acupuncturists and nutritionists. “I had physical access to recovery, but I didn’t have the emotional and spiritual access,” she explains. “It was the choice to get recovered and stay recovered that kept me in recovery.”

She now considers herself fully recovered for 14 years, which for her means that she no longer has urges to engage with eating disorder behaviors. “I have a really incredible relationship with my body and food on the whole. It blows my mind that I’m at this juncture. I can’t believe it’s the same person sometimes,” she says.

But she doesn’t deny that body image issues can still creep in: “I am in this body for the rest of my life. I will have emotions and feelings and thoughts the rest of my life,” she says. “The only way for me to manage a body image flare-up is thinking about what my feelings are, how can I be more present in my body—do I need more self care, do I need more ice cream? It isn’t in my wheelhouse to hurt myself as a way to cope with being alive.” Instead, she gives her body whatever it’s telling her that it needs.

However, she emphasizes that her view of recovery isn’t the only way to recover. “We have to make space for the expansiveness of recovery. It is possible to recover and not struggle every day,” she says. “And it’s equally important for someone to face challenges every day in order to survive. There’s no one answer and no one way for recovery to look. We have to be able to support each other in that.”

If you or someone you love struggle with disordered eating, contact the National Eating Disorders Association (U.S.) helpline at (800) 931-2237 or National Eating Disorder Information Centre (Canada) at (866) 633-4220.

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Newborn babies’ brain responses to being touched on the face measured for the first time

A newborn baby’s brain responds to being touched on the face, according to new research co-led by UCL.

Babies use this sense of touch — facial somatosensation — to find and latch onto their mother’s nipple, and should have this ability from birth.

Premature babies often have difficulty feeding, and underdevelopment of their facial sensitivity may be one of the main causes.

Researchers from UCL, Imperial College London, UCLH and Universitá Campus Bio-Medico di Roma developed a new method to study this sense of touch in babies and how their brains reacted using electroencephalography (EEG).

Current methods of evoking brain activity in response to touch aren’t suitable for a newborn’s face, so academics have developed a device — based on a transducer — worn on the fingertip, covered by a clinical glove.

The baby can be lightly tapped on the cheek, and then brain responses are measured as well as the force of the tapping.

The report, ‘A novel sensor design for accurate measurement of facial somatosensation in pre-term infants’, is published in the journal PLOS ONE.

Dr Lorenzo Fabrizi (UCL Biosciences) said: “This research provides a way of understanding how pre-term babies process touch information, and could help medical professionals to make informed decisions relating to their development.

“We’ve proved that we can record the sense of touch from the face. This means that for premature babies, it is possible to study how they process the tactile information that they receive from the face, how this changes as they mature and whether disruption of this process might lead to longer-term feeding problems.”

Babies’ brains develop quicker than at any other point in life. Facial somatosensation is necessary for breastfeeding; for example if a newborn baby’s right cheek is lying on their mother’s breast, the baby uses this information to turn its head to the right in order to feed (rooting). Therefore finding a way to measure brain responses to facial touch is important for understanding brain development in newborns.

Professor Etienne Burdet (Imperial College London) said: “We had to develop a stimulating system that was safe to use on the delicate face of the babies and acceptable to their parents. We used an iterative design approach to develop a seamless wearable device that can measure a natural finger tap to the skin.

“After we found that conventional sensors were not practical, we developed a dedicated sensor and packaging using 3D printing.”

The study looked at seven babies who were on average seven days old at UCLH’s postnatal and neonatal wards, each one having been born prematurely (before 37 weeks).

The research was supported by the UK Medical Research Council, European Commission grants, and a UK EPSRC MOTION grant. The force transducer was developed at Imperial College London and the trial was carried out at UCL and the UCLH Elizabeth Garrett Anderson wing. Ethical approval was obtained from the NHS Research Ethics Committee along with informed parental consent for each baby.

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Materials provided by University College London. Note: Content may be edited for style and length.

The Dangerous Health Risks That Could Follow the California Wildfires

The California wildfires that have already caused so much death and destruction continue to blaze, with death tolls and damage reports constantly being updated. The New York Times reports that the largest one—the Camp Fire in Paradise, Calif., located in Butte County in Northern California—has become the deadliest and most destructive wildfire in the state’s history.

At least 63 people have been killed by the Camp Fire, with 200 still missing and death tolls expected to rise, according to the Times. The fire has already burned through 130,000 acres and 8,800 structures (most of them homes), and is only 35 percent contained. Meanwhile, the Woolsey Fire west of Los Angeles has burned over 97,000 acres and is only 40 percent contained.

In addition to the unimaginable death and destruction, these wildfires are impacting the health of the people fighting and fleeing these fires now and for years to come. Here’s how—and what you can do to help.

Large wildfires have serious health effects for civilians near (and not so near) the flames.

The health effects are generally more pronounced the closer you are to the fire, where the smoke is most concentrated, which is why those on the front lines are most at risk. But “that smoke’s going to go where physics dictate,” Thomas Welle, a retired fire captain and manager of the Denver Field Office in the Wildfire Division of the National Fire Prevention Association (NFPA), tells SELF. Large fires can affect the air quality of the surrounding areas up to hundreds of miles away, Gene Gantt, executive director of the California State Firefighters’ Association, who has 35 years of firefighting experience, tells SELF. “So this is affecting the general public all over the state.”

Wildfire smoke generated by burning trees and plant life, a mix of gases and tiny particles, can cause respiratory system irritation, according to the Centers for Disease Control and Prevention (CDC). (Think about how uncomfortable you feel after a couple minutes of smoke from a tiny campfire blowing in your face, Gantt points out, but incalculably worse.) Common symptoms include coughing, nasal discharge, difficulty breathing, tightness in your chest, wheezing, and watery, itchy, eyes or eye pain, Gantt says. Headaches and tiredness are also not unusual. “You might feel like [you] have a horrible cold,” Gantt says.

This smoke can also exacerbate pre-existing health issues, which is why people with heart disease, lung disease, asthma, and chest pain are at a greater risk for issues, per the CDC. Children, who have developing airways and breathe more air per pound of body weight, are also at increased risk. Elderly people and pregnant women should also take extra caution, Gantt says.

If you’re in the area, you can take common-sense precautions to minimize your exposure to smoke.

The Environmental Protection Agency (EPA) advises temporarily relocating if possible, staying indoors, using HEPA-filtered air cleaners, buying particulate respirator masks, and reducing physical activity. (You can check your local air quality here.)

If you’re worried about an existing health issue or think the fires are making you unwell, get checked out. “Our recommendation for everyone is to go see your local doctor just to get a baseline on where you are,” Gantt says.

But the best way to stay safe is to be prepared for the fire, Welle says. “When the call comes, you need to go. Follow the directions of the local authorities, and get yourselves and your families and your pets safe,” he says. “That can go a long way towards reducing the stress around everything.”

The health risks firefighters face are heightened, both in the short and long term.

Firefighters can experience all of the above symptoms caused by smoke inhalation to a very severe degree because of the intensity and length of their exposure. They typically work 12 hour shifts at a time, and are on the scene for two to three weeks, Wille says.

While they’re fighting the fire, the incredibly high temperature of the air and smoke they’re breathing in can cause irritation, pain, and damage to the lungs and airways of firefighters, Gantt says. (They also might be dodging dangers like falling trees and battling weather conditions, Welle adds.) And while you might picture firefighters having special protection, the reality is that the self-contained breathing apparatuses that firefighters use in structural fires are too heavy and inefficient for any kind of prolonged use in a wildfire situation, Gantt explains.

So most firefighters rely on bandanas and respirator masks, he says, which filter out big particles but fail to block out smaller ones. Plus, they tend to clog up and impede breathing fairly quickly.

The risks or bad air quality persist around the clock, though, Welle explains, because squads will usually set up base camp nearby—far enough from the fire to be safe, but close enough to bus or truck firefighters in and out. “They’re sleeping, eating, showering near the smoke, so they’re constantly exposed,” Welle says. Many firefighters also find they don’t have time to shower and wash their gear between shifts (during which they also have to find time to eat and sleep), so the smoke can stay on their skin and clothes for prolonged periods.

Then, there is exposure to carcinogenic gases. When houses and structures begin to burn, as is happening in California right now, the materials inside—cleaning supplies, plastic furniture and appliances, diesel tanks—can produce toxic gases and carcinogens. There is also the potential for asbestos to be released from the bedrock of older homes, Gantt says. “Firefighters are the ones right in the middle of all of that, breathing all that in.”

The other health impacts may not show up until years down the line.

“My big concern is the long term effects that you will see…in firefighters in the next five or 10 years,” Gantt says. While many of the reported links between firefighting and a number of health issues are not well established, Gantt notes, he worries about illnesses like chronic obstructive pulmonary disease (COPD), lung cancer, and adult-onset asthma among the men and women fighting the fires today. This long-term data is especially difficult to gather because forest firefighting is a seasonal job for many, Welle explains, and cross-sectional studies require studying the same population over a period of many years. One thing experts do know (and are studying more) is that firefighters experience various types of cancer at higher rates, according to the CDC.

Like other first responders—police officers, paramedics—firefighters also face an increased risk of mental health issues, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). This makes sense given the high stress and trauma they experience both daily and during crises like this. “Firefighters are susceptible to PTSD,” Welle says. “It may not affect you right then, but there are certain things that do come back to you.” Gantt adds, “If you’re doing a body search, and it’s the community you happen to live or work in—which for a lot of these guys it is—that’s really rough.”

These traumatic events can impact the mental health of disaster survivors too, of course, “People are losing neighbors, homes, pets. They’re concerned about people that may be missing,” Welle says. “All that stress alone can be really difficult.”

Anyone experiencing distress can call SAMHSA’s Disaster Distress Helpline.

It’s normal to feel helpless in the face of a natural disaster, but there are a number of meaningful ways to help.

  • Give to the American Red Cross, which provides food and shelter to people displaced by the fires.

  • Find a cause through GoFundMe, which has set up collection pages of verified campaigns for local groups—including aid for first responders. They also have a Direct Impact Fund to ensure your donation goes straight to the individuals or charities in the communities affected.

  • If you live in Ventura, Los Angeles, Santa Barbara, San Diego, or Butte Counties, you can sign up with Airbnb to open your home to people in need of a temporary place to stay.

  • Give money to the California Fire Foundation, which will put your donation towards $100 gift cards that firefighters give directly to victims on the ground through their Supplying Aid to Victims of Emergency (SAVE) program.

  • Donate to the California Community Foundation’s Wildfire Relief Fund to support intermediate and long-term relief and recovery efforts statewide.

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Different types of physical activity offer varying protection against heart disease

While it is well known that physical activity is important for heart health, neither research nor recommendations consistently differentiate between the benefits of different types of physical activity. New research, presented at the ACC Latin America Conference 2018 in Lima, Peru, found that while all physical activity is beneficial, static activities — such as strength training — were more strongly associated with reducing heart disease risks than dynamic activities like walking and cycling.

“Both strength training and aerobic activity appeared to be heart healthy, even in small amounts, at the population level,” said Maia P. Smith, PhD, MS, statistical epidemiologist and assistant professor in the Department of Public Health and Preventive Medicine at St. George’s University in St. George’s, Grenada. “Clinicians should counsel patients to exercise regardless — both activity types were beneficial. However, static activity appeared more beneficial than dynamic, and patients who did both types of physical activity fared better than patients who simply increased the level of one type of activity.”

Researchers analyzed cardiovascular risk factors, such as high blood pressure, overweight, diabetes and high cholesterol, as a function of self-reported static and/or dynamic activity (strength training or walking/biking) in 4,086 American adults using data from the 2005-2006 National Health and Nutrition Examination Survey. The researchers then adjusted for age, ethnicity, gender and smoking and stratified by age: 21 to 44 years old or over 45 years old.

In total, 36 percent of younger and 25 percent of older adults engaged in static activity, and 28 percent of younger and 21 percent of older adults engaged in dynamic activity. Researchers found engaging in either type of activity was associated with 30 to 70 percent lower rates of cardiovascular disease risk factors, but associations were strongest for static activity and in youth.

“One interesting takeaway was that both static and dynamic activity were almost as popular in older people as younger,” Smith said. “I believe this gives clinicians the opportunity to counsel their older patients that they will fit into the gym or the road race just fine. The important thing is to make sure they are engaging in physical activity.”

Smith said future research and data collection should use definitions of physical activity that separate static from dynamic activity to further investigate independent effects.

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Materials provided by American College of Cardiology. Note: Content may be edited for style and length.

Why Khloé Kardashian Had to Wear an Oxygen Mask During Labor

Fans are finally getting to see some details of Khloé Kardashian‘s pregnancy and the birth of her daughter True. In a preview for an upcoming episode of Keeping Up with the Kardashians, Kardashian can be seen wearing an oxygen mask while in the delivery room, surrounded by family and friends.

At one point in the clip, Kardashian is seen talking through the mask when her sister Kylie Jenner FaceTimes with her. “What’s wrong with you?” Jenner asks. “I needed to get the baby’s oxygen back up,” Kardashian responds.

While some viewers—especially those who haven’t given birth or been present for someone else’s birth—may have been similarly concerned, no one in the room seemed overly alarmed by Kardashian’s oxygen mask, including the mom-to-be.

Although it might look a little alarming, it’s surprisingly common (and normal) for people to receive supplemental oxygen when they’re in labor.

“Many people do at some point during the labor process,” Jessica Shepherd, M.D., a minimally invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF.

It’s standard practice for doctors to put a fetal heart monitor on your baby when you’re delivering at a hospital. It can be monitored externally via a pair of belts wrapped around your abdomen, the American College of Obstetricians and Gynecologists (ACOG) explains, or internally using an electrode placed on the part of the fetus that’s closest to the cervix, most often the scalp. Either way, fetal heart rate monitoring is a pretty regular part of the process, especially is your pregnancy is considered high risk for any reason.

“That way we can know how well the baby is responding to labor,” Dr. Shepherd says. The baby’s heart rate might change as it responds to things happening during labor, such as contractions. But if your or your baby’s heart rate is abnormal, that could mean the baby isn’t getting enough oxygen. If, after further testing, your doctors determine that’s the case, supplemental oxygen is usually the next step.

In utero, your baby receives oxygen via the oxygen in your blood. So if supplemental oxygen is required, whether the issue is your heart rate or your baby’s, you’re the one that gets it, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF.

There are many reasons why your or your baby’s heart rate might be a bit off at the hospital, so you don’t need to panic if you end up needing an oxygen mask.

“It’s not a bad thing and doesn’t mean anything bad is happening to the baby,” Dr. Shepherd says. “But sometimes we want to do anything we can do to increase oxygenation at certain times during labor.”

Again, a baby’s heart rate can drop as a response to stress from the labor or contractions. If labor is induced, you might see a low heart rate because the medications used in labor induction can cause even more contractions, the Mayo Clinic explains. If you’re having a vaginal delivery, you may also be handed an oxygen mask when you’re pushing because it can stress the baby, Dr. Shepherd says.

The parent’s heart rate can also drop as a response to stress from labor. It’s also not uncommon for the parent’s heart rate to go down in response to the epidural or anesthesia, Dr. Shepherd says. Depending on the type of pain management you receive, you may get medication that “decreases your blood oxygenation and decreases blood flow toward the baby,” she explains. Usually, you’ll be monitored after an epidural to keep an eye on your heart rate and your baby’s in case you need supplemental oxygen.

If the fetal heart rate doesn’t improve or there are other complications brewing, you may need to have an emergency C-section, (something Beyoncé experienced while giving birth to her daughter after her heart rate dropped dramatically during labor, as SELF wrote previously).

Again, needing supplemental oxygen is not automatically a sign that anything is seriously wrong. “Don’t be concerned,” Dr. Shepherd says. “This is just part of our way of trying to make sure that the baby stays safe.”

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21 Cooking Gifts for Your Favorite Home Cook in 2018

If you don’t cook a lot, it can be hard to know what cooking gifts to get your friends that do. You might think a set of measuring cups would be nice, but the home cook in your life probably already has at least one set of those (and maybe even more). Finding out what they want isn’t as easy as walking into a Sur La Table. Sure, everything there looks fun, cute, and potentially useful, but there’s so much that it can feel impossible to tell what they’d appreciate and what they’d probably re-gift.

That’s where I come in. As a home cook who often writes about home cooking, I always have my finger on the pulse of what’s hot and what’s not in the kitchen gadget industry. I know just which products will actually be helpful in the kitchen, and which are simply one trick ponies that’ll take up your cabinet space.

So if you’re wondering what to get your favorite home cook, look no further than these 21 cooking gifts. They’ll solve a lot of their problems—whether that’s non-stop grease splatter or never having a lid that’s the right size—and they’ll seriously impress them. Just don’t tell them I told you to buy them—that can be our secret.

Updated: Now 246 People Have Gotten Sick After Beef Recalled Over Salmonella Fears

Update: More people have fallen ill after eating ground beef contaminated with salmonella, despite last month’s recall on JBS Tolleson, Inc. raw beef products, which were identified as the probable source of the outbreak.

The bacterial outbreak has now expanded to include 246 people across 25 states, according to a new CDC report. The initial investigation report on October 4 included 57 people and 16 states. Now, 63 new patients and six states were added in an October 23 update, and 126 more cases and three new states were added to the tally this week.

As the investigation widens, the CDC has learned more about who has been affected by the illness and how. The youngest person infected is under a year old and the oldest is 88, with a median age of 38. Slightly more than half (56 percent) are male. Based on the data available from 168 patients, about one in three (35 percent) has been hospitalized. And interviews with 137 of the patients reveal that 90 percent (123) ate the ground beef at home.

Fortunately, no deaths have been reported, and the CDC lab testing performed on 180 bacteria isolates has not found any antibiotic resistance.

But, as the CDC notes, given that there is on average a two- to four-week lag between the date someone becomes sick and the date that case is reported, we may learn of even more cases as the investigation continues.

Original Report (October 4, 2018):

Just last week Cargill Meat Solutions recalled more than 25,000 pounds of raw ground beef due to E. coli fears. But check your freezer again—because now, Arizona-based company JBS Tolleson, Inc. is recalling 3,250 tons (6,500,966 pounds) of raw beef products that may have been contaminated with salmonella.

According to an investigation by the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), there have been 57 cases of salmonella infection in 16 states associated with the JBS beef.

The investigation, which began on September 5, linked receipts and shopper card numbers of eight people who later became sick back to the purchase of these particular products, the FSIS said in a press release.

“FSIS, the Centers for Disease Control and Prevention (CDC), and state public health and agriculture partners have now determined that raw ground beef was the probable source of the reported illnesses,” according to the press release, which also noted that the illnesses occurred between August 5 and September 6. “Traceback has identified JBS as the common supplier of the ground beef products.”

The products, which were packaged between July 26 and September 7, 2018 and shipped to stores around the country, include several kinds of ground beef. Per the FSIS, look for “EST. 267” inside the USDA mark of inspection to determine whether your product is subject to recall. You can see the full list here.

Salmonella is an extremely common bacterial infection that can cause nasty symptoms, but it’s typically brief and non-life-threatening, as SELF previously reported.

Symptoms usually begin between 12 and 72 hours after you eat something contaminated. Those symptoms may include:

  • Diarrhea
  • Stomach cramps
  • Headache
  • Nausea
  • Vomiting
  • Fever

Luckily, most healthy adults will recover after four to seven days of feeling crappy without doing more than staying hydrated and getting rest at home.

Some people, however, including young children, pregnant women, elderly adults, and those with weakened immune systems, are at a greater risk for developing complications that require medical attention. Treatment usually includes antibiotics, anti-diarrheal medication, or IV fluids for dehydration.

If your symptoms persist or get worse—that may mean you’re having difficulty staying hydrated, see blood in your stool, or aren’t feeling better after a few days—then you should check in with your doctor.

The FSIS advises anyone who has purchased these products to either throw them out or return them to the store where they bought them.

The concern is that these products may be stored away in people’s freezers—so make sure to check. And, as a reminder, the FSIS advises everyone to cook their ground beef products to an internal temperature of 160 degrees Fahrenheit in order to kill any potentially harmful bacteria like salmonella. (All other cuts must reached an internal temperature of 145 degrees Fahrenheit and be allowed to rest for three minutes after cooking.)

So, you don’t have to go totally without your burgers, but you do need to practice basic meat safety rules before chowing down.

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Uh, Is It a Problem If You Can ‘Pop’ Your Jaw?

The human body can come with plenty of random quirks. Shoutout to anyone who’s captivated friends by rolling the tip of their tongue into a tiny W. Being able to “pop” your jaw when you open your mouth wide is another interesting physical oddity, but if you’ve ever done this, you know it can just feel…wrong. Shouldn’t we leave jaw-unhinging to snakes? Here’s how to know if your ability to pop your jaw is just an interesting party trick, or if it’s a sign of something more serious.

You can thank the temporomandibular joints (TMJ) on the side of your head for that not-so-lovely jaw pop.

You have a temporomandibular joint in front of each ear to bridge the gap between your jawbone and your skull, according to the Mayo Clinic. These joints act as hinges that allow you to belt out Ariana Grande’s latest at karaoke, devour your “lunch” at 11 A.M. because your stomach commanded it, and do anything else that requires opening your mouth.

These joints are pretty unique in that they’re not only able to open and close—they can slide back and forth and side to side, according to Merck Manuals, making them some of the most complex joints in your body. But sometimes your temporomandibular joints can get a little wonky, leading to a popping or clicking noise and sensation when you open your mouth wide. Luckily, this isn’t always a problem.

Being able to pop or click your jaw is really only an issue if it causes you pain or uncomfortable symptoms like jaw stiffness.

If it does, you may be dealing with a jaw condition that falls under a broader category known as TMJ disorders (or temporomandibular joint and muscle disorders). Painful clicking or popping when you open and close your mouth is one of the biggest symptoms, according to the National Institute of Dental and Craniofacial Research (NIDCR), but you can also have jaw stiffness, trouble opening your mouth, feeling like your jaw is “locking,” a change in the way your upper and lower teeth fit together, and general jaw pain.

Although the cause of TMJ disorders isn’t always apparent, sometimes it comes down to an issue with a cartilage disc inside each of the joints, Erich Voigt, M.D., an otolaryngologist (ear, nose, and throat doctor) at NYU Langone Health, tells SELF. These are called articular discs, and as slippery pieces of tissue, they are supposed to prevent your skull and jawbone from grinding against each other, according to Merck Manuals.

For instance, pain when you pop your jaw can be a sign that one or both of your articular discs have been pushed forward from their usual location so they can’t fully do their job, Helen Giannakopoulos, D.D.S., M.D., director of the Oral & Maxillofacial Surgery Residency Program at the Perelman School of Medicine at the University of Pennsylvania, tells SELF. This is a form of what’s known as internal temporomandibular joint derangement, and it can happen due to habits like clenching and grinding your teeth severely or chewing gum to the point where you regularly exhaust your jaw, she explains.

If you can pop your jaw and it doesn’t bother you or cause pain, you don’t necessarily need to seek help. “Jaw popping in and of itself without associated pain does not require any intervention,” Dr. Giannakopoulos says. If this is what you’re dealing with, it could mean a few different things. One or both of your articular discs could be worn or irregularly shaped, but not severely enough to cause discomfort, Dr. Voigt says—just that delightful sound. Or you could be dealing with internal temporomandibular joint derangement that only presents with clicking or popping without pain, according to Merck Manuals. Another potential factor is that structural components in your jaw, like ligaments, just happen to be extra-elastic and allow the lower half of your jaw to shift down more than normal, which might cause a popping sound, Dr. Voigt says.

If it hurts when your jaw pops, you have other symptoms of a TMJ disorder, or you’re just thoroughly freaked out, you should go see a dentist or doctor.

The professional in question will want to physically examine you, which will likely involve them listening to and feeling your jaw when you open and close your mouth, otherwise investigating the range of motion in your jaw, and pressing on areas around your jaw to see where you feel pain or discomfort, the Mayo Clinic says.

They will also probably order a CT scan, which can show detailed images of your jaw’s structure, or an MRI, which can show problems with your jaw’s discs. In some cases, your doctor or dentist will do a TMJ arthroscopy, which involves inserting a small thin tube into the joint space, followed by a small camera to check out the area, the Mayo Clinic says.

If you’re diagnosed with a TMJ disorder, your doctor or dentist may recommend you use pain relievers like nonsteroidal anti-inflammatory drugs, along with muscle relaxants for a few days or weeks until you feel better, according to the Mayo Clinic. They may also recommend wearing a device like an oral splint or special mouth guard, doing physical therapy, and learning more about the cause of your TMJ disorder so you can adjust your behavior as much as possible (like by using stress-relieving techniques to avoid grinding your teeth), the Mayo Clinic says.

In the most severe cases, people with TMJ disorders may require surgery to repair the joint (or joints) or corticosteroid injections to tame inflammation and help with the pain. But that’s the worst-case scenario, so don’t let it keep you from telling a medical professional about your jaw’s special, uh, talent, if it’s concerning you at all.

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16 of the Best Beauty Gift Sets This Holiday Season

Receiving a gift set during the holidays is like ordering a sampling appetizer at your favorite restaurant. Not only do you get to try a little of everything, but you may be introduced to new items you’ll grow to love. Plus, the smaller-sized products usually found in gift sets allow you to try brands in a way that’s easier on the wallet. For these reasons, beauty gift sets are among my personal favorite to give (and receive).

Read on for some of the best beauty gift sets we’ve already added to our shopping lists (and wish lists) for the holidays this year.

Lifting Heavy Weights Is My Favorite Way to Help Manage My Anxiety

“Calm” probably isn’t the first word that comes to mind when stepping foot in a weight room, more often than not teeming with swole, sweaty gym bros. But as I set up the barbell for squats, usually the first lift of my workout sessions, I already start to feel relief rippling over me.

The physical weight of the iron on my upper back anchors me mentally, directing my entire attention to moving through each repetition. Inhale, squat, hold, release, exhale. One. Inhale, squat, hold, release, exhale. Two. And so on—until the end of the set. My monkey mind stills and enters an almost meditative state.

Besides helping me gain strength and muscle, lifting has also helped me manage my generalized anxiety disorder (GAD).

Lifting silences my internal chatter and teaches me to savor the process of working out. Feeling physically strong also helps me feel mentally and emotionally strong enough to face any challenges I encounter. I lift weights at least three times a week, usually in the evenings after work.

My sister introduced me to lifting about seven months ago. I signed up for a gym membership and started following a 12-week strength training plan for beginners. I didn’t anticipate the mental health benefits; up until then, I was an avid distance runner mainly seeking to challenge my body in a different way.

At around the same time, my anxiety had hit a peak, pushing me to the brink of a panic attack nearly every week. After the insecurities it triggered culminated in an angry meltdown with my partner, I finally took my therapist’s longtime suggestion to explore medication. I saw my primary care doctor, who diagnosed me with GAD and started me on an anti-anxiety drug.

Lifting hasn’t completely erased all of my anxiety symptoms, but like therapy and medication, it’s a tool that helps me manage it in several ways.

The repetitive nature of lifting also satisfies my need for predictability, as uncertainty fuels my anxiety. When I lift, I know exactly what to expect. I know I’ll move through each rep, over and over, until I finish the set. Repetition gives my restless mind something sturdy to grasp onto. “Anything that’s routinized can be very reassuring,” Antonia Baum, M.D., a psychiatrist in Chevy Chase, Md., and former president of the International Society for Sports Psychiatry, tells SELF. “It’s something you don’t even need to think about. It can take you to a Zen-like, meditative state that quiets the cacophony of anxious thoughts.”

You could compare it to the soothing effects of praying a rosary bead by bead, or fingering kombolói, Greek worry beads, Dr. Baum explains. “These tactile things can be a distraction from, or help discharge, anxiety.” She adds that, as physical symptoms of anxiety worsen, it can cause cognitive symptoms to worsen, and vice-versa, so repetition could also quell anxious thoughts by easing the physical symptoms of anxiety. (The repetitive movement may help slow down your breathing, for instance, and in turn make you feel calmer).

Besides quieting my mind, lifting has taught me to appreciate the process of working out, rather than just anxiously anticipate the physical results. At first, I felt frustrated and embarrassed when I noticed how light I was lifting compared to the fitness influencers I followed on Instagram—then I realized how much longer they had been lifting than I have. Instead of expecting years’ worth of progress in mere months, I focus on what I love about lifting, regardless of my stats: how deeply it connects me to my body, the pleasure of feeling my muscles hard at work, the rush of pride after I push through a hard set. I de-load if I need to, always keeping in mind that this workout is just one snapshot of my overall progress.

“It’s very much about the process and thinking about it as a means—not just as a means to an end,” Dr. Baum says. Focusing on how one specific session feels may help me be more in the moment, while focusing on long-term, unrealistic aesthetic goals could actually cause anxiety—so I don’t think that way.

Lifting has also helped me manage my anxiety by boosting my confidence. Insecurity is a form of the uncertainty that feeds my anxiety; for me, that uncertainty tends to center on my abilities. It makes me second-guess myself and shy away from pursuing what I want. Through lifting, I’ve proven to myself that I’m capable of more than I give myself credit for. Looking at the Google sheet on my phone, where I record my lifts—typically loading on five more pounds every week or two—I feel proud of my steady progress.

Seven months ago, I couldn’t imagine deadlifting nearly my body weight. Occasionally, I experience the thrill of pushing through a mental block and lifting at a weight I initially worried would be too heavy for me. I revel in my newfound strength outside the gym too, celebrating everyday victories like being able to now unscrew tight lids and carry armloads of groceries up my partner’s long, vertiginous driveway. Soft-spoken and standing only a little over 5 feet, I’ve never thought of myself as strong, yet here I am.

Of course, not everyone who deals with anxiety issues will find lifting helpful, but emerging research suggests it could have benefits. A 2017 analysis of 16 studies that looked at the effects of resistance training on anxiety, published in Sports Medicine, found that strength training improves anxiety symptoms. Scientists are still teasing apart how, but the focus I’ve experienced during my workouts may play a role. “[Lifting] can be a focus unto itself that can help reduce the anxious cognition that would otherwise enter one’s head,” says Dr. Baum.

Running has also helped me quiet my internal monologue, and research suggests that it, too, could help reduce anxiety for some people. Again, everyone’s experience is different, but I’ve personally found lifting to be more effective for me. While I enjoy the exhilarating release running provides, lifting demands more of my focus. My mind has a much harder time spiraling into rumination during a lift than during a run.

Exceeding my expectations of what my body can accomplish makes me feel more capable of overcoming challenges in general, even if they seem scary, even if I doubt myself at first.

Dr. Baum has seen similar changes in her patients who routinely engage in strength training, as well as other forms of exercise. “You feel like you could at least metaphorically conquer the world,” she says. “Those worries seem less overwhelming.”

GAD often makes my life seem more threatening than it really is. Lifting makes me feel strong enough to tackle it.

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