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When a flood happens in a community it can be very upsetting for people, but there is a lot family, friends, volunteers and the community can do to help those that are impacted.Helpful thinking: Your thinking may have shifted to be more negative, for example, “Bad things always happen to people around me”.Our thoughts have a direct impact on how we feel.

If you notice that your thinking has shifted to see the world as more unpredictable and dangerous, you are more likely to be feeling sad, helpless or scared.It helps to change our way of thinking to more helpful thought patterns.Firstly, we need to be aware of our thinking and catch our negative thoughts.The second step is to come up with a more helpful and positive thought, that puts us more in control.For example, “This is hard and it takes a lot of work, but I’ll just keep doing little things each day that make it better.”Maintain social connections: We know that people need people.After a disaster, being with people can give us a sense of belonging, of feeling loved and cared for and that we’re not alone.Reconnecting with others is important for our wellbeing – but also for theirs.Helping out a community member who has suffered in the flood – or just lending an ear – can give us a sense of purpose and increase our own motivation and energy.Making time for pleasurable activities: Doing what you enjoy is good for you.After a disaster, many people feel like they have lost control of their life.Finding a new balance between work, getting life back on track and looking forward to doing something pleasurable gives us hope.So, plan something you like to do – watch a DVD, go for a bushwalk, go out for a night with friends, watch a game of football, or go to bed early with a good book.Be kind to yourself: Give yourself time to adjust – it can take time to bounce back.Keep reminding yourself that things will get better and you have the skills to manage.Ask for help if you need it.Try to avoid self-medicating (using alcohol or other drugs to cope) and instead express your feelings through journaling, art, or talking to friends.Things should slowly go back to normal and you should feel better over time.If that doesn’t happen and you are still struggling after 2-3 months, talk to your GP. For more information and specific help for children: www.psychology.org.au/for-the-public/Psychology-topics/Disasters

By Dr Sheila Lorenzo – Glenorie District Medical Centre

A meta-analysis published in the Lancet entitled Menopausal hormone therapy and 20-year breast cancer mortality showed that the risk of breast cancer was found to have increased the longer women used HRT, and doubling for women who used it for 10 years vs five years. However, there was no increased risk for women who used HRT for less than a year, and those who used it on and off were found to have a lower risk than those who used it daily.1

However, there are other factors that contribute to the risk of breast cancer.

Studies have shown that intake of 3 standard alcoholic drinks per week increases the risk of developing breast cancer by 15%! The risk further increases by another 10% for each additional standard alcoholic drink women have each day. It’s interesting to note that this increase is higher than that associated with HRT alone.  The results of studies linking breast cancer and HRT are based on older formulations of HRT which has dramatically changed².

There is also convincing evidence that being overweight and obese increases the risk not only of breast cancer but also bowel, oesophageal, pancreatic, kidney, and liver cancer. Observational studies, on the other hand, have shown that smoking increases the risk of breast cancer development by as high as 14%. Those who began smoking before the age of 17 have an increased risk as high as 24%³.

Medications can be viewed as double-edged swords in that they have benefits and risks.

Hormone replacement therapy is not an exception with its attendant advantages and disadvantages.  It was intended to alleviate menopausal symptoms such as hot flushes and vaginal dryness.  The risk associated with breast cancer and HRT has been a longstanding debate that up to now has not been conclusively resolved.

It is imperative that a shared decision making between you and your GP be placed so risks and benefits can be weighed and the appropriate treatment tailored to you.

References:

1. Lauren Vogel (CMAJ. 2019 Sep 30; 191(39): E1088–E1089.
2. Alcohol intake: https://www.breastcancer.org/risk/factors/alcohol( accessed 18/10/20)
3. Overweight and Obesity:https://www.canceraustralia.gov.au/publications-and-resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer/lifestyle-risk-factors/overweight-and-obesity(accessed 18/10/2020)
4. Smoking:https://breastcancernow.org/about-us/media/press-releases/smoking-–-particularly-if-started-during-adolescence-–-associated-increased-risk-breast-cancer-major-new-study-finds(accessed 18/10/2020)