mental health

How To Manage Blood Test Anxiety

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I’ve never been a massive fan of blood tests, and my opinion of them hasn’t exactly improved with much closer acquaintance. And trust me, diagnosing a TSH-secreting pituitary adenoma involves a very close acquaintance with the phlebotomists (a.k.a. vampires, a.k.a. people who draw blood for testing) of your local hospital. People are weird, so there’s probably at least a couple of oddballs out there who positively enjoy having their blood drawn, but I am not one of them. In fact, needle phobia is really common – affecting perhaps one in ten people. So how do you manage blood test anxiety if you have a condition that requires lots of blood tests?

How To Manage Blood Test Anxiety

Try to understand your anxiety and symptoms

It may be helpful to consider if there is any particular source of your blood test anxiety or needle phobia – for instance, an upsetting experience as a child, or a fear of fainting, feeling sick, or the pain of the needle. Or it could be associated with the sight of blood, which many people can find to be a trigger for anxiety, a more general fear of medical procedures or hospitals – or even having a parent or caregiver as a child who exhibited anxiety about any of these things. Understanding the triggers for your anxiety doesn’t necessarily solve anything, but it can help you work out what parts of the blood test situation are a problem for you.

In terms of symptoms, anxiety tends to be linked to one of two things:

  • Often needle phobia or anxiety around blood tests is linked to feeling faint, or a fear of feeling faint. Fainting can occur as a result of a drop in blood pressure.
  • Otherwise, it may be linked to physical symptoms of stress or panic, such as a racing heart, sweating and/or feeling nauseous.

Understand what to expect

It’s helpful to understand what to expect in your blood test appointment, and prepare yourself for it. The unknown is always scary. Probably the most important thing to keep reminding yourself is that blood tests usually don’t take more than a couple of minutes! So hopefully you shouldn’t have to manage your blood test anxiety for too long.

Usually, at the start of your appointment you will be asked to confirm some details about yourself. Then the phlebotomist will disinfect the skin where the needle will go (you usually get to pick which arm they’ll target!) and wrap a tourniquet around your upper arm, to make the veins stand out more. They may ask you to make a fist or pump your hand – again, to make the veins stand out. Then they’ll put the needle in – usually they’ll warn you just before it happens, and ideally you want to keep your arm relaxed. They may need to keep the needle in while swapping over blood collection tubes, if they need to do a number of tests.

When your phlebotomist removes the needle, they may ask you to press on the vein, to reduce bleeding, and they’ll probably offer a plaster or cotton wool and tape to cover the cut.

Follow some key steps before your appointment

Eat and drink beforehand (if allowed)

Some blood tests require fasting, so if that’s the case, make sure you follow the rules – but fast for the minimum time allowed. It’s really important to stay hydrated, because dehydration lowers your blood pressure, which makes drawing blood more difficult and makes it more likely that you may feel faint after your blood test.

If, like me, you’re also a bit inclined to end up with low blood sugar, then making sure you’ve had enough to eat or a sugary drink beforehand (if allowed) may also help, as low blood sugar can also make you feel faint.

Wrap up warm

It’s helpful to make sure you stay warm. When your body is cold, it causes the veins near the surface of your skin to shrink down, making it harder to draw your blood.

Plan something nice for afterwards

Try to give yourself something to look forward to after your appointment; something that you can focus on as a pleasant experience. It can be something small, like a nice coffee from the hospital canteen, or something bigger like a trip out or exciting dinner plans. Try to focus on this as something positive to look forward to, rather than focusing on the blood test appointment.

Key steps to manage blood test anxiety during your appointment

Talk to your phlebotomist about your blood test anxiety

Make sure you tell whoever’s taking your blood that you’re anxious about blood tests. There’s no need to be embarrassed; they will have seen hundreds of people with needle phobia before. They can help ensure that you feel as comfortable as possible, and distract you from what’s going on. They may also be able to make other accommodations, such as allowing you to lie down if you’re concerned about fainting, or allowing you to bring a friend or family member with you for moral support.

Similarly, if you have veins that are difficult to find, make sure you warn your phlebotomist.

Remember to breathe

So far, so obvious. If you’re anxious, you may find yourself unintentionally holding your breath while you wait for the needle to pinch you. But that won’t help – in fact, holding your breath interrupts the oxygenation of your blood and may make you more likely to faint.

Instead, try using relaxation breathing techniques to help you get through your blood test appointment. Slow, controlled breathing has been proven to affect the nervous system and brain activity, and to increase sensations of comfort and relaxation. So it’s definitely worth a try!

The NHS provides basic online guidance on breathing techniques for stress that are simple and easy to do. You can also easily find guidance and videos online via a quick search. Breathing exercises usually involve counting patterns of breath, which also works to distract your brain from what’s going on.

Don’t look!

Try not to look at the needle. These days, I’ve had so many blood tests that they don’t really bother me any more, but when I did find them more stressful, I always found that it was best not to look at my arm or what the phlebotomist was doing. In fact, the sight of the needle or of blood may actually set off the anxiety reaction (vasovagal syncope) that can cause you to faint – so it’s best avoided.

Instead, I would pick something else to look at – there are often posters or notices on hospital walls, so pick one and focus on that instead.

Distract yourself

Anxiety can increase when you focus on the source of your anxiety, so distracting yourself is a helpful way to manage blood test anxiety. You can try counting in your head, trying to remember or run through song lyrics, or chatting with the person who’s drawing your blood. You could even watch a video or listen to music on your phone during the blood test, to keep your mind off what’s going on.

Use the Applied Tension technique

If you tend to faint during blood tests, you can use something called the ‘Applied Tension Technique’ to help. This aims to help maintain blood pressure and prevent the sudden drop in blood pressure that can lead to fainting (or just feeling faint), through undertaking some physical exercises. It’s a straightforward technique, which simply involves tensing the muscles in your body to increase your blood pressure. You can read more about this technique and how to use it here.

Consider professional help

If your blood test anxiety or needle phobia is very severe, it can interfere with your medical treatment if it results in you avoiding blood tests. If the steps outlined above don’t help you manage your blood test anxiety, consider whether it could be helpful to seek professional help. You should be able to find a therapist who can help you address your anxiety over time.

Your suggestions to manage blood test anxiety

Have you suffered from needle phobia or blood test anxiety? How did you learn to manage your fears and get through blood tests? Please share your experiences and suggestions in the comments!

mental health · tea

Tea For Mental Health And Wellbeing

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It’s no secret that I love tea. I have a regular tea review feature on my instagram page, and occasionally tea reviews make their way onto this blog as well. I probably drink too many cups of tea a day, and that only escalated while I was on maternity leave – probably partly due to a need for caffeine thanks to being up all night with Little Man, and partly as a reaction to being forced onto the decaff stuff while I was pregnant. I’ve always found tea drinking to be soothing, and I have a range of different teas at home. But can drinking tea actually be good for your mental health?

Tea For Mental Health

In the UK, at least, we tend to brew up a cuppa as an automatic response to any stressful situation. It’s a stereotype that’s also kind of true – we drink 50 billion cups of tea a year, and one in ten of us drinks six or more cups per day. That’s a lot of tea. So is all that tea working to help us deal with stress – or are we just drinking for the flavour?

What does the science say?

Before we look at the science around tea and mental health, we need to first consider: what is tea? Technically, “tea” is a beverage prepared using the leaves of the camellia sinensis plant – this includes teas such as black tea, green tea, and matcha. If your tea isn’t made from camellia sinensis leaves, then it’s really a herbal tea a.k.a. a tisane or infusion. Different types of tea will have different chemical properties, making that their effect on mental health will not be directly comparable. So in looking at research on tea and mental health, we first have to understand what “tea” the researchers were actually using for their work…

Studies on the effects of drinking tea on mental health

Researchers have found that drinking camellia sinensis tea lowers the stress hormone cortisol. And that’s not all: drinking half a cup of green tea a day also seems to lower the risk of depression and dementia – one study in Korea found that people who habitually drank green tea were 21% less likely to develop depression over their lifetime, compared to non-drinkers. That is a protective effect equivalent to undertaking 2.5 hours of exercise a week – not bad for a cuppa you can enjoy while sat on your sofa.

Similarly, studies in Japan and China also found green tea drinking to be associated with a lower risk of depression. And it’s not just green tea – other studies have shown that camomile tea (a herbal tea or tisane) may also have an antidepressent effect.

The small print

However, it should be noted that, while there is evidence that regularly drinking some teas can help improve mood in healthy populations, there’s not yet any evidence that it can help people who are already suffering from mental illness. And, of course, the studies discussed above only look at two types of tea – green tea and camomile – out of the huge variety of different teas and tisanes that you can buy. So it’s a little premature to reach a conclusion about the benefits of tea drinking…

Additionally, the studies that have been done don’t necessarily tell us where this protective effect is coming from. Is there a chemical (or chemicals) in tea which reduces our risk of depression – or could it actually be more complicated than that?

Tea Drinking and Mindfulness

Some researchers have suggested that some of the physical and mental health benefits from tea could actually be related to the act of preparing tea, rather than the ingredients within the drink itself.

Tea preparation as a form of mindfulness

The rituals of making and drinking tea can act as a form of mindfulness. Mindfulness is about paying attention to the present moment, to your body, your sensations and what’s happening around you. It is recommended by the NHS and the National Institute for Health and Care Excellence as a recognised way to treat depression. You can read more about mindfulness here. Preparing and drinking tea can act as a form of mindfulness, because it involves taking time out of your day, stopping whatever you’re doing to focus on preparing your tea, engaging your body in making the tea and enjoying the smells and flavours that go with it.

Tea preparation rituals around the world

In fact, all around the globe, many cultures have developed formal practices around the making and drinking of tea, which reflect this meditative and ritualistic aspect to tea preparation.

In parts of East Asia, the ritual of making tea has been elevated into the tea ceremony, a ceremonial way of preparing and presenting tea – perhaps the most famous form of tea preparation ritual. In Morocco, mint tea is traditionally prepared for visitors to the home and three glasses are served, each representing a different aspect of life (check out my recipe for fresh mint tea here). Russia has its zavarka tradition; Argentina its mate culture; and of course here in the UK we have the traditional afternoon tea, where the cakes and sandwiches are arguably as important (or even more important?) than the tea itself. It’s interesting that so many different cultures across the world have all developed these distinct rituals around preparing and serving tea.

How to create your own tea ritual for mindfulness

The simple process of taking time out of your day to prepare and enjoy a cup of tea is really a ritual in itself. But if you’re specifically looking to practice mindfulness for your mental health, you can consider creating your own tea ritual for mindfulness and wellbeing. It can be easier to bring elements of mindfulness to an every day activity like making tea, compared to finding the time to meditate or undertake other more formal mindfulness rituals.

The key element of any mindfulness practice is to really pay attention to what you’re doing and the physical experience you’re undergoing. So as you’re preparing your tea, consider:

  • What sounds are you hearing? For instance – a boiling kettle, the clink of a teaspoon, the gurgling as you pour hot water into a cup.
  • What do you see? How does the liquid change colour as the hot water and/or milk is added to the cup?
  • What else can you sense? The warmth of the cup in your hands, the smell of the tea as it’s brewing, the taste of the tea when you start to drink.
  • How do you feel? As you sip your tea, can you take a few moments to consciously relax your body, take some deep breaths, and enjoy this time?

Top tips on creating your own tea drinking mindfulness ritual

If you’re looking for some more detailed guidance on how to create a mindfulness practice based around tea drinking, there are lots of great resources out there. I like this guide about how to be mindful with a cup of tea, and this guide to creating a slightly longer tea ritual, for when you have more time to spare.

Tea for Mental Health: A Summary

So, in summary – yes, tea drinking can indeed be good for your mental health. And frankly, that’s enough of an excuse to justify my next cuppa! But it’s not a magic cure that will leave you feeling better overnight… Things are rarely that simple. By incorporating mindfulness practice into the simple enjoyment of making a cup of tea, you may be able to take best advantage of the mental health benefits of drinking tea.

Your thoughts on tea and mental health

Do you practice mindfulness when drinking your morning cuppa? Do you feel that tea drinking has had mental health benefits for you? Or have you enjoyed experiencing tea culture around the globe? Please share your experiences in the comments, below!

fatigue · lifestyle · sport

How To Get Exercising With Chronic Illness

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Getting regular exercise is important for everyone, but when you have a chronic illness, or if you’re recovering from an illness or surgery, it can feel like a potential minefield – there’s the risk of hurting yourself, impacting your recovery… and to be perfectly honest, it might just feel like too much hard work. But appropriate exercise can help with a lot of health conditions, by managing symptoms, improving sleep, and increasing strength. So how can you get into exercising with chronic illness? I’ve pulled together my thoughts and top tips based on my own experience (which has included recovering from brain surgery twice, post-viral fatigue syndrome, exercise-induced asthma, hypermobility spectrum disorder, and more!).

Exercising With Chronic Illness

Recognise what you’re already doing

First things first. It’s important to acknowledge the exercise you’re already doing. Whether that’s walking to town to buy shopping, or cleaning the bathroom, or just getting up and having a shower, chances are you’re already doing some exercise. Understand what you’re already doing on a regular basis, how difficult you find it and the impact on your body. That should give you an idea of your current ‘baseline’ level of fitness and exercise, and how variable it is. Then you can use that as a starting point to build up from.

Do your research

Next, you need to ensure you understand your health condition(s) and the kinds of limitations they may place on your ability to exercise or the type of exercise you can do. For instance, because of my hypermobility spectrum disorder I should try to avoid high-impact exercise and instead focus on low-impact exercises such as swimming. I also need to be extra careful about ensuring I have good form and don’t over-extend my joints when I’m doing yoga.

Try talking to your doctor, and make sure they approve of the exercise you’re planning on doing. You could also be asked to be referred to a physiotherapist, who may be able to recommend specific exercises that will help your condition.

But also – have a research online for advice on exercising with your specific health condition or chronic illness. Often you can find very detailed information online (for instance, this article on exercising with hypermobility) which your doctor may not be familiar with. Of course, it’s important to be careful to use reputable sites and look for advice which is backed up by peer-reviewed scientific research (quick rule of thumb: if the site you’re looking at is trying to get you to buy something, be a bit more sceptical of its health advice…). And, of course, check any proposed new exercise regimen with your doctor.

Set realistic targets for exercising with chronic illness

If you’re currently struggling to get into the shower in the mornings, it’s probably not realistic to set yourself the target of running a marathon – and it probably won’t do your body much good to try. Set yourself realistic targets, which are in line with the advice for your condition and which permit time off for rest. For instance, rather than saying you want to do a certain type of exercise once a day, you could set yourself a target to do a certain number of minutes of exercise (or steps, miles etc.) in a week. That way, you can do more on days when you feel good, and take a break on bad days. Start small, and aim to build up over time, so that it’s not too much of a shock to your body.

If your health condition tends to be quite variable, you could also think about giving yourself workout options which you can select from depending on how you’re feeling each day. For example, aiming for ten minutes of gentle stretching on a bad day, twenty minutes of yoga on an okay day, and a short run on a good day (or whatever works for you!), will mean that you’re flexing your workouts around your chronic illness.

Work with your body, not against it

Following on from the above, the most important thing when you’re exercising with chronic illness (or when recovering from surgery or illness) is to listen to your body and work with it, not against it.

There’s a culture in some fitness circles to “push yourself to your limits”, that “pain is temporary” or something to push through. That kind of attitude is not going to help you develop a good relationship with exercise in the long run (no pun intended…), if you’re suffering from chronic illness. If your body tells you to stop – stop! You can always do more exercise when you’re feeling better.

Over time you’ll probably get the feel for when your body is saying no as a result of your health condition, and when it’s just saying no because you’re giving it a good workout. But it can take a while to get to know what you can handle, how to recognise when your body’s had enough, and how a workout will impact you the next day. You may also start to notice other patterns that you hadn’t picked up on previously, in terms of how activity affects your condition.

Measure progress against yourself – not other people

As the old saying goes: comparison is the thief of joy. If your friends are comparing notes on the 5k they ran at the weekend, don’t let that make you feel bad about the fact that you can only run 1k, or that you were proud of managing a five minute walk the other day. Even comparing yourself to others with the same health condition is not helpful. Remember that your body is unique, and everyone responds differently to illness (and to exercising with chronic illness!). Focus on your progress by comparing yourself to your previous achievements and your baseline ability to exercise. That way, it’s a fair comparison and you can celebrate your progress, instead of feeling like you’re not doing enough.

Cut yourself some slack

This is probably the most important point on the list. You need to cut yourself some slack. Things won’t just go smoothly. There will be times when your health condition probably means that your progress goes backwards for a while. You may feel frustrated that you’re ‘back where you started’ (or even further back), as a result of a flare up in your illness.

That’s okay. It’s okay to go backwards, and it’s okay to be frustrated by it. But try to be kind to yourself. If you need a break, have a break. If you need the day off, take the day off. If you need the week off – likewise. Remember that it’s okay to find things difficult, or need to rest. The whole point of exercise is to look after your health and wellbeing.

Don’t be afraid to give up and do something different

With exercise, there can be a culture that it’s bad to be a “quitter”. Well, that’s true – if you stop exercising completely. But if you’re just not getting on with a specific type of exercise, then there’s nothing wrong with quitting it in order to try something else. For instance, if you’re finding running too difficult, you could try swimming or yoga instead. The point is to find something that you actually enjoy doing, and build it into your routine, so that it’s sustainable for the long term.

Build a habit again… And again… And again.

One of the most important things when you’re trying to improve your fitness is to get into a routine with your exercise. Then, it just becomes part of your day to day life. And the tricky thing when you’re trying to exercise with chronic illness, is that the routine tends to get broken. For instance, I remember a couple of years ago when I’d got into a really good routine with dance classes and rock climbing, and had gained a lot of strength and fitness… And then randomly had a really bad asthma flare up that meant I struggled just walking around for weeks and weeks. I lost the habit of going to class, I lost a lot of muscle mass. It was totally disheartening.

It can be hard to force yourself to get back into a routine one it’s been broken, but the only advice I can give is to persevere and be patient. Chances are, you’ll have to keep re-starting your routine as time goes by. But I think it helps to focus on the positives. For instance, even though I had lost a lot of strength and fitness, when I restarted dance and climbing, I hadn’t forgotten the theory and skills I’d learned. Although I felt like I was back to square one, in fact I was still a couple of squares further along the board, compared to when I originally started. And the second time around, it didn’t take quite so long to get back up to speed.

How to get into exercising with chronic illness… Your tips!

Have you managed to develop a good exercise routine with chronic illness – or while recovering from surgery or illness? What are your top tips? Let me know in the comments below!

Just for fun

Why You Should Always Find Out Your Surgeon’s Birthday

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Today is my birthday! How old am I? Fortunately that’s not relevant to this blog post. Because today, we’re going to be talking about the most important birthday you need to add to your calendar. And, hard though it is to believe – it’s not my birthday… It’s your surgeon’s. Because a study in the British Medical Journal (BMJ) has found that patients who underwent surgery on the surgeon’s birthday exhibited higher mortality than patients who underwent surgery on other days.

Wait, what?

Yes, that’s correct. Your surgeon is more likely to kill you if they’re operating on you on their birthday. How’s that for a crazy fact – and a completely inappropriate topic for a light-hearted celebratory birthday blog post? In my defense, the study was published as part of the British Medical Journal’s fun and festive Christmas edition, so I’m not the only one completely misjudging the suitability of the topic for light entertainment.

It’s my surgeon’s birthday. How worried should I be?

The study looked at almost a million surgical procedures performed by 47,489 surgeons, and found that mortality rates were 6.9% on surgeon’s birthdays, compared to 5.6% on other days. That’s a pretty noticeable difference – but there are, of course, a few “buts”…

The study looked at 17 common emergency surgical procedures, performed on patients aged 65 – 99, at US hospitals from 2011 – 2014. The fact that these were emergency procedures performed on older people means the expected mortality rate for the first 30 days after surgery was already quite high. Unless you’re a 65+ year old undergoing a common medical emergency, even if it is your surgeon’s birthday, you’ve probably not got a 6.9% chance of dying. Good news for anyone getting an ingrowing toenail removed (or having pituitary surgery).

Additionally, apparently it’s actually comparable to the kind of increase in death rates that is seen at other times – including Christmas, New Year and weekends. So that’s… not at all reassuring, actually, now I think of it.

Why does it happen?

Well, the study was observational, meaning that the authors couldn’t establish the reasons behind the ‘birthday effect’ they observed, or exclude the impact of other, unmeasured factors. But they suggested a number of factors that could be at play:

  • Surgeons rushing to complete procedures on their birthday if they have plans to celebrate later on.
  • More distractions from birthday phone messages or conversations with team members, which could lead to more errors.
  • Surgeons being less likely to check up on patients following surgery, if they are busy with birthday plans.

They all sound totally plausible, although I’ve also thought of a few of my own that the researchers somehow missed:

  • Surgical staff suffering from a sugar rush and subsequent drop in blood sugars after eating birthday cake, impairing surgical performance.
  • One or two evil surgeons intentionally killing patients as part of some kind of sick annual birthday ritual. It’s probably a whole conspiracy, guys. I wouldn’t be surprised if it turned out Bill Gates was involved.

How reliable is the study?

I’m not a statistician, so I’ll leave that question to more experienced maths jockeys. I will say, however, that the letters section of the British Medical Journal website contains a number of letters on the topic from some very disgruntled surgeons, and is well worth a read. To quote one letter from neurosurgeon Steven A. Reid: “One wonders about the intrusion of errors on the part of statisticians on their birthdays — I’m certain the outcome isn’t as dramatic. More speeding tickets perhaps?”

And in conclusion…

Well, I’m not a surgeon, but you’ll be glad to hear I’ve booked my birthday off work anyway. You can’t be too careful, right? And if you’re reading this while in the office, well… play it safe and go read about my experience of transsphenoidal pituitary surgery rather than doing any more of that dangerous work stuff…

Uncategorised

Top Tips For Having Transsphenoidal Pituitary Surgery

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Now, I fully recognise that this is a bit of a niche blog post, one which is principally going to be of interest to anyone about to have pituitary surgery. But hey! Pituitary tumors are actually surprisingly common, so there’s a lot of people out there who might be awaiting surgery. Maybe one of them is your, dear reader.

And before going into hospital for your transsphenoidal pituitary surgery, you will be anxious. You will have questions. However, I should note that many of your questions will already have been answered on legitimate medical sites elsewhere on the internet. So instead of regurgitating the same old advice (“Don’t sneeze after surgery or your brain will shoot out of your nose”, “Warning: after they’ve drilled through your head, it may be a little sore”), I have decided I will go down a different route, and write down the more obscure things that I wish I’d known before heading into hospital for transsphenoidal pituitary surgery…

Top Tips For Having Pituitary Surgery

Let me present my top tips for people about to have pituitary surgery:

1. Shave your inside elbows.

“She’s gone mad,” I hear you cry. “She’s raving. It was probably the brain surgery that did it.” In fact, this is an entirely logical step, because of all the blood tests you’ll undergo after your pituitary surgery; you’re basically going to be a human pincushion for a couple of days as the doctors seek to keep a very close watch on various hormone levels. And I mean VERY ClOSE. Both times I’ve had pituitary surgery, I’ve had blood tests every two hours for the first twelve hours after waking up, and then they gradually reduce in frequency… But not fast enough. You will literally be woken up through the night for blood tests in hospital.

This means that the post-blood-test strip of tape and cotton wool that the phlebotomist sticks over your inside elbow is going to get ripped off repeatedly, and then stuck back on. And then ripped off again, along with much of your arm hair. After the sixth time this happens in one day, you’ll be wishing you had taken my advice and shaved your inside elbows. I did this for my second surgery (having learned this lesson the hard way after my first pituitary surgery) and it made all those bloody blood tests just a little bit easier.

2. Drink enough.

If this seems obvious to you, then presumably you’re a normal person who gets thirsty when you haven’t drunk sufficient amounts of water to keep yourself hydrated. However, I am an odd sort of person and I only really notice I’m thirsty when it’s hot or I’ve done exercise (or, for some reason, when I’m pregnant!). Otherwise, I can go for hours and hours without drinking and not even notice; even back when I was a teeny child, my mum would tell me off for not drinking enough.

This was slightly problematic in hospital. Because of the risk of surgery damaging your pituitary gland and causing a condition called diabetes insipidus, your fluid balance is monitored carefully. If they believe you’re becoming dehydrated, they will put you on a drip. This is rubbish. Therefore, drink lots of water. And if you don’t like water, keep a supply of tastier drinks at hand. And by “tastier drinks”, I mean Ribena.

3. Always eat the custard first.

Hospital food gets a bad rep. The food at my hospital was pretty tasty really, and there was a good selection. But for some obscure reason, the dessert was often served before the main. If you waited for your main meal to rock up before eating dessert (like any normal person would), your custard would congeal disconcertingly by the time you got to it.
So remember: you’ve just had brain surgery. Screw societal norms regarding the “correct” order in which to eat sweet or savory comestibles. Don’t let that custard go to waste!

4. Make your visitors play musical chairs.

Again, this may initially seem nonsensical. But I was fortunate enough to have a fair few visitors in hospital after each pituitary surgery (thank you guys!), which was lovely. However, for the most part they sat in the same chair on the left-hand side of my bed. Consequently, by the end of my stay in hospital I had done my neck in, from continually turning my head to the left. It was pretty painful and entirely my own fault. Make them alternate sides. I did for my second surgery and it was much easier on the neck.

5. Get wheeled out in a wheelchair.

Because a) you’ll be feeling rubbish and won’t want to walk, and b) it’s fun!

6. Steroids + morphine = surprisingly fun.

After waking up from my first surgery, initially I felt rubbish. It was very, very painful. Fortunately, the nurse at hand quickly gave me some morphine. By the time I was properly awake, I was pain-free, wired, and weirdly delighted that the nurse had the same first name as my mum. They took me out of the post-surgical care room and up to the main neurosurgical ward, and about half an hour after I woke up I was already texting various members of my friends and family and talking nineteen to the dozen about how unusually chirpy I felt.

7. Play your “brain surgery” card.

I regret not doing this more, in retrospect. When you’ve had brain surgery, you should be able to really milk that fact for all it’s worth. I have no doubt that there are hours of fun to be had in pretending not to recognise household objects, friends, family, political systems and/or branches of philosophy.

I remember speaking to one friend a few weeks after my first brain surgery, and I mentioned that I was always forgetting where I’d left my books. She gave me a sorrowful look and whispered, “Is that because of the surgery?”It was disappointing to have to confess to her that no, I have in fact always been that stupid.

8. Get a free pill slicer. They are awesome.

After pituitary surgery, you’ll be put on steroid replacement medication in case the neurosurgeon accidentally removed your body’s ability to make its own steroid hormone when required. Said pills can be broken into different-sized chunks so you can take, for example, a whole dose in the morning, half a pill at lunch, and the other half in the early afternoon. When I left hospital, I obviously looked too pathetic even to break a tiny pill in two, because they provided me with a pill slicer. You put the pill in, shut the lid, and SHAZAM! A razorblade hidden inside will slice that bad boy in twain.

I managed to lose my pill slicer after a couple of months, and I was pretty cut up about it. …Geddit? Cut up?

Your top tips for having pituitary surgery

Have you had transsphenoidal pituitary surgery? Do you have any top tips you think I’ve missed? Let me know in the comments!

Uncategorised

Best Ways To Relax And Enjoy Life When You’re In Pain

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I’ve written previously about alternative ways to cope with pain when you can’t (or don’t want) to use painkillers. I thought it was time to follow that up with a post about ways to relax, and even try to enjoy your time, when you’re in pain.

I’m writing mainly from my perspective as someone who’s had chronic pain from my hypermobility spectrum disorder throughout my life. My joint pain tends to come and go – sometimes it’s really bad, sometimes it’s just an annoying backnote. This post is focused around things you can do to relax and distract yourself from pain – perhaps when you’re waiting for pain relief to kick in, or if your normal treatment hasn’t got rid of the pain entirely. There is a strong connection between mental health and pain; stress exacerbates pain, so by using these ideas to help relax, it may also help to reduce your perception of the pain. You might find it useful if you suffer from chronic pain, or you have a current injury that’s bothering you…

Best Ways To Relax And Enjoy Life When You’re In Pain

1. Take a bath

Heat can be a great way to treat pain, so a warm bath is a great way to treat pain but also to distract yourself from it and have an enjoyable time. I always love having a bath with nicely scented bath products – there are plenty of bath soaks on the market which are specifically targeted at soothing sore muscles or relaxing you. You can take a cup of herbal tea and a book, or play some relaxing music, and just chill in relative comfort. There’s also the benefit that the water takes some of the weight off your muscles and joints.

2. Yummy smells

I guess technically the word I’m looking for is ‘aromatherapy’, but that sounds very formal for the kind of thing I’m talking about. When you’re in physical pain, it can be difficult to focus on anything other than the pain, but strong comforting scents can be a really good, pleasant distraction – especially if they come with comforting memories or associations attached. You can try using an oil burner, reed diffuser or wax melts that scent your whole house; scented massage oils or moisturisers; or you can use essential oils on a handkerchief or on your pillow at night.

3. Gentle Exercise

It depends on the cause of your pain as to whether this one is likely to help – obviously if you have a sports injury that needs resting up, or a condition that means your pain worsens with exertion, then this is not the suggestion for you! But gentle exercise can really help with some joint and muscle pain, which can actually be exacerbated if you stay still for too long.

I love taking a walk when my joints are painful, because not only does the exercise help to reduce stiffness and ease the pain, but also just being outside is a lovely distraction for my mind, and it gives me something else to focus on. Since having Little Man, I’ve actually discovered that walking with a pram is especially nice if my hips and leg joints are playing up, for some reason.

Alternatively, light stretching, yoga or tai chi can be really good for pain as well. Yoga With Adriene has free online videos including this yoga routine for chronic pain, and other yoga flows aimed at targeting different types of pain including migraine, sciatica, back pain and more.

4. Mindfulness and Meditation

Mmm it’s time to get hippy dippy! Meditation has also been shown to be effective in reducing pain, and it’s believed this is because it reduces the stress response in the body. I find it’s especially helpful at bedtime if you’re trying to go to sleep while you’re in pain. Personally, I enjoy guided meditations where you visualise peaceful locations like a beach or a forest, but there are lots of different styles of meditation around, so keep looking until you find one that works for you. There’s loads of free guided meditations online – try experimenting to find a meditation style you enjoy.

5. Get Closer to Nature

Spending time in nature is inherently relaxing. Walking, gardening, or going foraging are all great ways to relax and gently distract yourself; but even if you’re not up to doing anything too physical, just taking some time in the great outdoors is a great way to feel better. On a sunny day, a spot of sunbathing can boost your mood (obviously use sunscreen and limit your time in the sun!) but as long as you wrap up, even on colder days the sight and sounds of nature are really soothing.

Your tips for relaxing and enjoying life when you’re in pain:

Do you have experience of managing a chronic pain condition, or pain from an injury or illness? What are the ways you try to relax and chill out even when you’re in pain? Let me know your tips in the comments!

Just for fun · medication

How To Cope When Dealing With Hospital Administration Systems

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Something that no-one realises about chronic illness, until they become ill themselves, is the sheer amount of extra life admin it generates. It’s simply incredible how much time can be taken up by what should be simple tasks – booking appointments, getting hold of medication, finding out test results, getting in touch with the right person if your symptoms change… It can actually become extremely stressful and difficult to cope with hospital administration systems and the issues they can create through sheer inefficiency.

I think the worst instance of hospital administration failure that I encountered was when I was telephoned by the hospital and told off for missing an MRI appointment after my first pituitary surgery. I had indeed missed the appointment, because the letter had got lost in the post. As I had been expecting a scan appointment, though, I had actually called the hospital two weeks earlier to chase up, and been put through to the MRI department, who had told me that I was not booked in for any scans. I later discovered the hospital for some mad reason has two MRI departments, so presumably my scan was with the other department, and at no point did anyone think to tell me to check with both departments. Well done, hospital. Good use of public money.

I was first diagnosed with my pituitary tumor aged 21, which means that I’ve been dealing with the hell that is hospital admin for 11 years, the vast majority of my adult life. And that means that I have a few tips to share!

I used to think that the difficulties I encountered in getting anything done was because I was dealing with the National Health Service. I’m so grateful for the NHS funding my treatment that I would just remind myself to be grateful for it, and put up with the terrible admin, endless phonecalls and feeling of being lost in the system. Then one of my friends developed a serious medical issue which they had treated privately… And they encountered the exact same problems! It seems that terrible admin may well be a universal healthcare experience. So here are my top tips for how to cope with hospital administration, without falling into a pit of total despair…

Top Tips For How To Cope With Hospital Administration Systems

1. Be Organised

You have to be organised. Just because your doctor tells you something will happen doesn’t mean it will, without your intervention. Keep a note of what appointments you’re due to have, and if you haven’t heard from the hospital or doctor’s surgery well in advance, get in touch to check what’s happening.

2. Get Ahead Of The Game

Try to get in touch with your hospital nice and early if you haven’t heard anything. It gives you the most time to get something sorted. There’s nothing more stressful than realising that, for instance, you’re going to have a gap in treatment because the hospital has forgotten to send you a prescription or order the right tests. So make sure you chase up on things sooner rather than later.

3. Remember it’s not anyone’s individual fault

When you’ve made six phone calls and still made no progress with getting an appointment sorted, it’s incredibly frustrating. Try to remember it’s not the fault of the people you’re talking to, who are mostly just human beings trying to do their jobs in an imperfect system. You’ll get better progress by trying to be friendly and build a rapport with the staff you talk to, rather than getting annoyed.

4. Think outside the box

Most hospital departments and doctors surgeries have a public number you can call, but of course when you do, you end up speaking to someone who knows nothing about you or your issue. As a result, you can find yourself explaining yourself over and over again to different people, and feeling like you’re getting nowhere.

It’s time to think outside the box! Firstly, get Googling. In hospitals, often the consultant or head of the department you’re under will have their own secretary and you may be able to find their contact details online, or even on the letters you’re sent from the department. You may have better luck contacting the secretary if you have specific issues with your treatment or new symptoms.

Over time, you may also be able to build up other contacts. Some hospital departments have specialist nurses attached to the department who run certain tests or follow-ups. If you can find the public phone number for the specialist nurses, they may be especially helpful in chasing up on things for you. I love the specialist endocrine nurses at my hospital, they’re so lovely and super helpful.

5. Take up cathartic screaming

Ultimately, despite all your best efforts, your encounters with hospital admin systems will likely still be frustrating and inefficient. At some point, it’s best to accept this and try not to let it get to you. All you can do is try your best to smooth the process, give timely reminders, and chase up on things that should have been organised for you.

Make sure you can have a good rant to a friend or family member about how frustrating it all is. If you find yourself getting too stressed out, try to take a step back and give yourself a break. You can always start making phone calls again tomorrow.

What are your worst experiences with hospital admin? Do you have any tips for how to cope with hospital administration systems? Let me me know in the comments!

baking · mental health

Baking For Mental Health

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You may have heard of art therapy – but have you ever heard of culinary art therapy (or CAT)? Increasingly there’s a move to recognise that cooking and baking can be good for our wellbeing – and there is actual scientific evidence that baking is good for mental health. As you probably know if you read this blog regularly, I’m a big fan of baking (especially gluten-free baking!), so I wanted to explore this further in a blog post looking at why baking is good for our mental health, and sharing some top tips to help you get started with baking therapy…

Baking for Mental Health

Why is baking good for your mental health?

Firstly, let’s look at some of the reasons why baking is good for mental health…

Shifting your focus

Baking requires focus and concentration. You need to find the right ingredients, weigh them out, and run through the process of turning them into delicious baked goods. Baking is also often quite a physical process – activities such as kneading bread, or mixing together ingredients, get our bodies involved as well as our minds. It’s a great distraction that forces your mind away from focusing in on sources of stress and anxiety. It also gives you a sense of control and purpose, paying attention to the present and what’s going on around you. As such, it works as a form of mindfulness, which is a great way to manage anxiety and stress.

Taking Time For Yourself

Baking takes time – whether it’s fifteen minutes to whip up a quick batch of cookie dough, or four hours on a celebration cake. That’s time that you’re carving out of your day for yourself. Taking time for ourselves is an act of self-care that’s really important for wellbeing.

Get Creative

Baking is a form of creative self-expression. As such, it’s a way to release stress and an outlet for emotion. Baking can help us to express our feelings, and getting creative is a recognised way to manage mental wellbeing. Repetitive creative motions – like baking, knitting, or even DIY – actually help your brain release dopamine, the ‘feel-good’ chemical.

Engage your Senses

Baking engages all the senses – sight, sound, touch, taste and smell. Engaging those senses is pleasant and uplifting, and can also reawaken fond old memories and associations – such as baking as a child. And of course, we all enjoy biting into a lovely slice of cake at the end of the baking process (and maybe licking the spoon beforehand as well!).

Share the Love

One of the aspects of baking that can be so satisfying is the opportunity to share what you make with other people, friends and family. Making other people happy is itself tremendously rewarding – and who doesn’t feel happy when they’re presented with a slice of homemade cake, or a cookie? Gift-giving is an important part of human cultures across the globe, and interestingly studies have shown that it is actually often the person giving the gift – rather than the one receiving it – who reaps the greatest psychological benefit from gifting. It helps us to feel valuable and experience a positive self-concept, increasing self-esteem – so it’s not surprising that sharing our bakes is good for our mental health.

Baking for Mental Health: How To

So, you’re convinced about the benefits of baking for mental health. You’ve decided to give baking therapy a go, and you want to get on with it. But how do you actually make it work? Here are some key pointers to get you started.

Low Pressure Baking

Baking is not going to help reduce stress and anxiety if it becomes a high-pressure situation. For instance – baking a birthday cake, or agreeing to create dessert for a large dinner party, or host afternoon tea, places a lot of pressure on yourself. That creates more stress and anxiety. Instead, keep your baking low pressure by baking for yourself, in situations where it doesn’t really matter if the outcome is wonderful or if you burn the brownies.

Keep It Simple

Linked to the above, following incredibly long and complicated recipes is only going to work as good therapy if you’re already a very advanced baker. Try to start with simple recipes, and learn new techniques one at a time rather than trying to take them on all in one go. When I’m feeling in need of a bit of baking therapy, I generally try to go for straightforward recipes that yield yummy, satisfying results, like these gluten-free oatmeal raisin cookies, these mochaccino brownies, or this delicious rocky road recipe. Let’s be honest – if baking therapy is a thing, then chocolate therapy is most definitely real as well.

Maintain A Sense Of Humour

Bakes go wrong. This can be really frustrating. The other day, I was planning on making raspberry macarons at home. I’ve made macarons a bunch of times, but this time it went horribly wrong (I still don’t really know why!) and I had to throw out the entire batch and start again. And, if I’m honest, it put me in a godawful mood. All the fun went out of it – especially when the subsequent batch I made were still not really up to scratch, even though they tasted pretty good. It was the ultimate baking therapy failure: I ended up in a worse mood than I started in.

What did I do wrong? Not maintaining a sense of humour! Bakes go wrong. It shouldn’t be a big deal. Try not to let it stress you out, and try not to go into each bake with super-high expectations. Take a picture of the horrible mess you’ve created, text a friend or post on social media, and have a good laugh at yourself. You’ll live to bake again another day, and if you find yourself getting stressed out by your bake rather than enjoying it – just stop!

Bake Vicariously

Okay, so baking may be great for your mental health – but let’s be honest, it’s not always practical to crack out the mixing bowl. Whether you don’t have the energy, the time, or simply the drive to actually get baking, there is a Next Best Thing. You can bake vicariously with the aid of The Great British Bake Off (known in the US for some reason as The Great British Baking Show).

Don’t get me wrong, other baking shows are available. But I haven’t found any that have the charm of Bake Off. There’s something very lovely about the camaraderie of the show, and it’s a great form of escapism that will get you weirdly involved in the process of creating types of cake that you’ve never even heard of.

Baking Therapy: Your Experiences

Are you a keen baker? Have you found baking to be a great form of expression and therapy? Let me know your thoughts in the comments!

fatigue

How To: Looking After A Baby When You’re Sick/Fatigued

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Looking after a baby is hard work at the best of times, but when you’re sick it can be overwhelming. Whether you’re parenting with chronic illness, a bad cold or tummy bug, or fatigue (either from illness or too many sleepless nights!), it helps to have a plan for how you’re going to manage. So, based on my experience as a mama with chronic illness, I’ve pulled together my top tips on looking after a baby when you’re sick or fatigued. Read on to find out more…

Looking After A Baby When You’re Sick

Ask For Help

Whether you’re suffering from a temporary issue – a cold, a tummy bug, a flare up of your condition – or ongoing consistent symptoms from a chronic illness, ask for help. It’s okay! Even the healthiest, heartiest parents need help sometimes. It won’t do you any good to try to do everything yourself. And people love babies, so chances are you’ll have more people willing to help you out than you may imagine… But you do have to ask.

When you do ask for help, try to be specific about what you need – for instance, help around the house, fetching groceries or popping to the pharmacy, or just holding the baby. Most people will want to help if you let them know how. If people have popped over to see the baby, get them to help you out – for instance, they could hold baby for an hour so you can nap!

Do The Absolute Minimum

Again, might sound obvious. But if you’re feeling really unwell, do the absolute minimum you need to do. Things like the washing up, hoovering, tidying, even having a shower… You don’t absolutely have to do them. You need to feed yourself and baby, change baby, and sleep. Everything else is optional! So don’t force yourself to do anything unnecessary, if you don’t have the energy for it.

This may include cancelling on some guests, especially in the early days with a new baby. If people are planning to visit and you don’t think they’ll be helpful – or perhaps you know they won’t – and you’ll end up running around after them trying to be a good host and look after baby and yourself… Cancel the visit. You need to prioritise the well-being of yourself and your baby, and that’s okay.

…Except When You’re Okay

On the days or times where you are feeling better, that’s the time to prepare for the bad days! This may seem more obvious if you have a chronic health condition where the symptoms come and go – but even if you don’t, there will be good days and bad days. You never know when you might catch a cold or flu, or have an upset stomach, and even babies who are normally good sleepers will go through bad patches. So make sure that you’re prepped for bad days.

What does being prepared look like? Here are some suggestions:

  • A stash of easy emergency meals in the freezer – things you can just pop in the oven/microwave and leave.
  • An upstairs and downstairs nappy change station with everything you need for changing, so you don’t have to carry baby too far for changes.
  • A small stockpile of key items for baby (nappies, wipes, formula etc.) that will last for at least a week, so you’re not going to run out and need to go to the shops urgently when you’re feeling sick and/or exhausted.
  • Similarly, try to ensure you have a good stock of spare clothes for your little one, so you’re not going to end up in a pickle if you can’t do laundry for a few days.
  • Talking to your partner, friends and family about how you will manage childcare on sick days, in advance. Have a back-up plan if you are just too poorly to look after the little one – and ideally have a back-up back-up plan just in case!

Practice self-care

Just scraping by will do for a few days here and there when you’re feeling especially dreadful, but it’s not sustainable for the long term. You need to take care of yourself and your mental and physical health.

So, once you’ve worked out what the absolute minimum is, have a think about the next step up – the minimum things you need in order to feel reasonably content. For instance, in my case, I absolutely hate not having a nice hot shower in the morning. Even if I feel rubbish, I know a shower always helps me feel better. So I really prioritised ensuring I got my morning shower every day, as far as reasonably possible. Little Man would be on the bathroom floor in his Moses basket when he was really small, or crawling around with a few toys and a baby sensory video once he was a bit bigger.

Work out your key self-care priorities – perhaps it’s having a shower, listening to music or watching a show, reading a book or getting outside for some fresh air once a day. And make sure you find time to do the things that help you feel okay, even if it’s at the expense of other day to day life admin.

Rest as much as possible

Before you have a baby, everyone tells you to “sleep when the baby sleeps” which in my experience is much easier said than done. If you can get some sleep when baby is napping or someone else comes to help out, then obviously that’s the best thing you can do. But even if you can’t sleep, you can try to rest up. Set up a comfortable spot in the house to have as your base for the day – an armchair, sofa, bed, whatever suits you – and collect as much stuff as possible that you’ll need for looking after baby to keep nearby. Not just obvious things like nappy change supplies, but also toys, books, whatever you’ve got to keep the little one entertained. Try to sit and chill as much as you can.

And when baby goes to bed for the night – go to bed too! It’s tempting to stay up and take some time for yourself, but you’re better off going to bed and getting as much sleep as you can before your next wake up call.

Let go of the mum/dad guilt

When you’re ill, you will not be winning any parenting awards, and that is fine. You need to keep baby safe, clean and fed. If they miss out on a few sensory play sessions, or they spend a bit more time watching YouTube videos to give you a break – it really will not matter in the long run. You’re still a good mother (or father!). They need a parent who takes care of him/herself, and if you don’t do that then sooner or later you will crash and end up much worse than before.

No parent is perfect, whether they suffer from chronic illness or not, so just do your best to let go of the guilt about what you can’t do because of your illness, and focus instead on all the positive things you can do, however small, to help your baby feel loved and cared for.

Your tips for looking after baby when you’re sick

Do you have any experience of looking after a baby while ill? What are your tips for others? Let me know in the comments!

Uncategorised

How To Brush Baby’s Teeth (Without Losing A Finger)

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It seemed like Little Man was teething for forever before his first tooth appeared! He started teething around three months, and he didn’t get his first tooth until he was gone six months old. It wasn’t until a little while after his first tooth arrived, though, that I realised… Hang on, we need to brush it! But how exactly do you brush a baby’s teeth without losing a finger? Wee Man’s first teeth are like tiny razors, and he once notoriously bit his dad so hard on the toe that he drew blood. We were not looking forward to trying to brush his teeth…

How To Brush Baby’s Teeth (Without Losing A Finger)

When should you start brushing?

As soon as that first baby tooth appears, it’s time to start brushing (oops! Took us a few weeks to realise). The NHS recommends brushing twice a day, including before bed in the evening, with a smear of baby toothpaste.

What makes baby toothpaste different and do I need it?

Baby toothpaste has less fluoride in than adult toothpaste. Swallowing a lot of fluoride may upset baby’s stomach in the short term, which is why it’s recommended to use only a smear of toothpaste on the brush.

Over the longer term, swallowing large amounts of fluoride toothpaste in early childhood could cause something called dental fluorosis, which can affect the appearance and strength of teeth. However, it is rare in the UK for dental fluorosis to be anything other than very mild, appearing as some white patches on the teeth which may or may not be visible to the naked eye. It is still recommended that children and babies do brush their teeth with a fluoride toothpaste, because it’s the best way to prevent tooth decay. Just don’t let them eat toothpaste straight out of the tube!

Baby toothpaste also often has a milder flavour which children may find easier to get used to, compared to the strong mint flavours of adult toothpaste.

How do you brush baby’s teeth?

And so, to the practicalities… How do you actually brush baby’s teeth?

Firstly, sit baby on your knee, with their head back against your chest (I got this tip from the NHS website!). We use a bamboo baby toothbrush, to try to reduce our plastic waste.

Brush baby’s teeth using circular motions, just like you would an adult’s teeth. Don’t restrict yourself to brushing the teeth they actually have, but brush their whole mouth and gums gently, to get them used to the idea.

Making tooth brushing fun for baby

Obviously tooth brushing is a bit strange for baby when you introduce it, so I think the best approach is to really try to make tooth brushing fun. We sing a little song to our baby while we brush his teeth and that seems to be a really good way to distract him! In fact, he enjoys it so much that he now looks forward to having his teeth brush and co-operates with opening his mouth, handing over his dummy etc.

Ideally if both me and my husband are free, one of us brushes his teeth, and the other one dances Little Man’s hands around to the song, as otherwise he tries to grab the brush. We sing the following song, to the tune of ‘Row Your Boat’:

Brush, brush, brush your teeth
Brush them nice and clean
Scrubbly-bubbly, bubbly-scrubbly
Brush them nice and clean

We actually got the idea from the Peppa Pig handwashing advert from the World Health Organisation, if you’ve seen it! We sing through the song three times and the last time we slow it right down so he knows we’re nearly done. After a couple of months of this routine, brushing Little Man’s teeth is not just easy, it’s actually quite a fun thing we do as a family.

I let Little Man take over the toothbrush after I’m done brushing, and he enjoys chewing on it. Then when it’s time to finish, I distract him with a dummy while I take the brush away, and we both watch as I clean the brush under the taps.

So for us, this approach seems to work pretty well. Little Man likes to feel involved and he seems to enjoy the flavour of the toothpaste and chewing on the brush is nice when he’s teething. He does often bite down on the toothbrush while I’m trying to move it, and he also often tries to grab the brush from me, which can be tricky! But in general, starting to brush his teeth has not been as horrendously difficult as I expected!

Your Top Tips For Brushing Baby’s Teeth

Do you have any great tips for persuading a reluctant baby to let you brush their teeth? Let me know in the comments!