Regular exercise is integral to our health, but one must exercise properly to avoid inadvertently doing
harm. Often this means proper clothing, shoes, and warm ups. Equally important, however, are the risks of dehydration and depletion of the body’s carbohydrate stores.

We maintain our core body temperature by sweating. This will lead to a loss of water, electrolytes and minerals, which might prove costly to performance if not compensated for.

Witness the effect of fluid loss upon performance

Carbohydrates are stored as glycogen in the liver. When called upon, they are released in the form of glucose, which is a highly efficient source of energy. It’s efficiency stems from less oxygen needing to be expended during glucose utilization than with either protein or fat.

During rigorous exercise, carbohydrates can be depleted to such an extent that within two hours muscle performance can be impaired. Recovery of carbohydrate stores (glycogen) will normally require 24 to 48 hours. An athlete who consumes carbohydrates before, during, and after exercise will largely prevent blood glucose from plummeting, and also will preserve glycogen stores.

Obviously it’s not realistic to presume one can eat during exercise, so formulated beverages which provide carbohydrates are an excellent option. According to the American College of Sports Medicine, performance is improved by consuming carbohydrate-containing beverages at a rate which will provide 25 to 30 grams of carbohydrate each hour. This translates into consuming fluids with 6 to 8% carbohydrates at a rate of 4 to 8 ounces every 15 to 20 minutes of exercise. Five or six swallows will yield 4 to 8 ounces. A good start is to consume 10 to 12 ounces just before exercise.

Not all forms of carbohydrate are appropriate. Glucose and Sucrose are good sources, as they are, if in low concentration, absorbed as easily as water. The best concentration is in the 6 to 8% range. It’s felt that higher concentrations impede liquid absorption, however sustained exercise for longer than four hours may require such high concentration formulas. Up to 15 % concentrations have been found to improve such sustained performances versus 5 %, without significant slowing of absorption.

Fructose is not a good source of carbohydrate. Fruit juices are comprised of fructose, and accordingly they are regarded as inferior sources of hydration and energy during exercise. Fructose reduces the rate of water absorption, so that cells have a delay in rehydration. Furthermore, it cannot be metabolized rapidly enough to spare liver carbohydrate (glycogen) stores. Finally, fructose often causes gastrointestinal distress and even diarrhea if consumed during exercise.

For most exercise regimens, the quantity of electrolytes and minerals lost is not significant, so that a sports drink is most important as a hydration and carbohydrate source. With prolonged exertion, exceeding four hours, the electrolyte and mineral composition do become important. For less rigorous exertion, those elements have some value in that they speed up absorption.

The next time you exercise remember that if your exertion is for less than one hour, water alone will suffice. If you exercise for longer than an hour, a sports drink with 6 to 8% carbohydrate in the form of glucose or sucrose is best. This is typical of the most popular sports drinks we see at the grocery store. Consume liquids in the quantities discussed above. For those exerting for longer than four hours, one might consider a higher concentration, in the 10 to 15% carbohydrate range.

Unlike the carbohydrate concentration, the actual amounts of electrolytes and minerals (e.g. calcium, phosphorus, magnesium) in sports drinks available at grocery stores are not that important. By remaining aware of your hydration and energy needs, you can enjoy yourself amidst the beauty of our special state.

Below are some suggestions for improving overall health and for reducing risk of disease.

Eat more vegetarian sources of protein [beans, nuts,
low fat dairy] and less animal meats.

Daily intake for Americans often looks something like this: egg and
bacon on a hard roll for breakfast, sandwich made with cold cuts at
lunch, and a 6+ ounce piece of meat with a small amount of starch and
minimal vegetables for supper. It is not necessary to eat meat so frequently,
if at all. Most of us get plenty of protein in their diets, and too
much protein can draw calcium out of the bones—a concern particularly
for women. Instead try to eat smaller portions of animal products, and
increasingly incorporate products made with legumes such as rice and
beans, bean soups or chili, hummus, tofu, low fat yogurts, nuts and
seeds.

Eat more fruits and vegetables.

Dark yellow, red or green fruits and vegetables are associated with
decreased risk for cancer, heart disease, hypertension, and eye disorders.
These foods are low in calories and provide fiber, vitamins, minerals
and phytonutrients. Each day strive to eat a dark green vegetable, a
yellow or orange fruit or vegetable, a red fruit or vegetable, beans
or nuts, and a citrus fruit, such as oranges. Frozen or canned vegetables
are often as good for you as “fresh” from a supermarket, since
the produce may have been picked weeks—or months—earlier.

Get more unsaturated fat and less saturated
and trans fatty acids.

Some fats are good for you! There is a proven benefit of unsaturated
fats, which are oils that are liquid at room temperature. While all
fats are equivalent in calories, polyunsaturated and monounsaturated
fats should be substituted wherever possible. Dip bread in olive oil
rather than spreading with butter; sauté foods with olive, canola
or peanut oils rather than using shortening; use natural-style peanut
butter rather than most commercial brands [which are higher in trans-fatty
acids] and avoid foods whose label states “partially hydrogenated
oil”.

Eat more whole grains and less refined
grains and sugars.

Whole grains, fruits, and vegetables should be the bulk of your diet.
Milling removes most of the vitamins and minerals from grain, and almost
all of the phytochemicals. Consuming whole grains reduces the chance
of heart and bowel diseases, as well as many cancers. Make sure that
the word “whole” is listed with the first ingredient. Try
whole grain breads, cereals, pasta [or pasta made with 50% whole wheat],
brown rice, steel-cut oats, kasha, bulgur and barley are all good choices.
Try to vary the diet away from pasta, white rice and white potatoes:
the more variety the better!

Food Suggestions

Here are some particularly good food choices. All are readily available,
relatively inexpensive and easy to prepare as well as healthy choices.

1. Eggs. Surprised? Eating up to 1 egg each day does not increase
   the risk of heart disease. One large egg contains only 75 calories
   and provides the highest quality protein available. Eggs are also
   good sources of chromium, choline, vitamins B12, D and K [essential
   for healthy bones], folate, carotenoids and protein. So don’t hesitate
   to include a few eggs each week.
2. Skim or 1% milk. Whole milk is high in calories and saturated
   fats. However, non-fat milk has only 85 calories per cup and is
   rich in protein, vitamin D, riboflavin and, of course, calcium.
   Try nonfat or low fat yogurts mixed with fresh fruit and nuts or
   in fruit smoothies.
3. Oranges. Citrus fruits in general are great sources of vitamin
   C, folate and antioxidants such as flavonoids and carotenoids.
4. Tomatoes. Tomatoes and tomato products are so widely available
   that they deserve a spot on the list. In addition to being good
   sources of fiber, vitamins C and A, and potassium, they are rich
   sources of lycopene a cancer-fighting compound. Thankfully, cooking
   the tomatoes into a sauce enhances the cancer-fighting effects!
5. Fish, such as salmon, tuna, sardines or
   bluefish.

   These varieties
   of fish are rich sources of omega-3 fatty acids which have been
   shown to be protective against cardiovascular disease. They are
   low in calories and total fat, but are high in protein, and vitamins
   B6, B12, and B3.

6. Nuts. Walnuts and almonds are rich in alpha-linoleic acid, unsaturated
   fats, protein, omega-3 fatty acids and magnesium. Eight walnut
   halves, or 14 almonds supply about 100 calories, so don’t eat nuts
   by the bagful. Instead, eat a small handful in place of chips or
   crackers when looking for a filling healthy snack. You can also
   choose other nuts, or natural-style peanut butter.
7. Legumes, such as soybeans, lentils, peas or beans.

   Not only are these foods high in protein, fiber and anti-oxidants, they are
   also low in fats and inexpensive. Try substituting vegetarian baked beans,
   vegetarian chili, or dishes with tofu for foods usually made with meat.

8. Olive oil. Olive oil, canola, soy and peanut oil are low in saturated
   fats and high in monounsaturated fats. Use in cooking, and stay
   away from fast foods and commercial baked products such as muffins
   which are often made using fats that are high in artery-clogging
   trans-fatty acids. Vegetable oils are some of the few sources of
   vitamin E.
9. Whole grains breads. Make sure “whole grain” appears
   as the first ingredient. Whole wheat, corn, rye, spelt, and oats
   are good sources of phytochemicals, magnesium, fiber, manganese,
   pantothenic acid, as well as vitamins K, B6

   and B3.

10. Broccoli. Dark green vegetables tend to be rich in vitamins A,
    K, C, and folate, magnesium, fiber, and various classes of antioxidant
    compounds such as carotenoids.

Foods and eating should be fun. There is no single perfect food. Feel
free to mix up the diet, while sticking to a few simple guidelines.
You’ll end up feeling better, performing more consistently, and as an
additional bonus—be protected from chronic diseases for years
to come!

What causes it?

Diarrhea is frequently caused by a viral infection of the intestines. In this case it may be associated with vomiting and abdominal cramps, although the diarrhea may be present by itself. Other conditions may also cause diarrhea, including bacterial infections and parasites, eating contaminated food, food allergies, medication side effects, and some serious conditions.

What you should do about it?

Diarrhea may last several days or longer. If you are vomiting, you should control the vomiting first. The most important concern with diarrhea is to prevent dehydration by making sure you are taking enough fluids to make up for fluids lost in the stool.

Drink plenty of clear liquids like Gatorade, sweetened tea, soup broth or bouillon. Soft drinks are OK, but you also need some fluids which contain salts, like broth or bouillon. When the number of bowel movements decreases, you may start eating solid foods. Toast, cookies, crackers, chicken noodle soup, rice, baked potato, bananas, and lean meats such as chicken or turkey are best. Save milk and milk products, other fruit and fruit juice, and fatty foods until last.

Remember…

• Diarrhea caused by viruses and bacteria may be contagious. Avoid spreading it to others by washing your hands frequently, especially after using the toilet.
• Extra fluids and proper diet work best to control diarrhea.
• Imodium-AD, which can be obtained without a prescription, may be useful in some cases. Call us first.
• With some forms of diarrhea by bacteria or parasites, specific medications may help. However, you need to see us first to get a diagnosis.

Symptoms of Clinical Depression:

• Persistent sad, anxious or “empty” mood
• Sleeping too much or too little, middle of the night or early morning waking
• Reduced appetite and weight loss, or increased appetite and weight gain
• Loss of pleasure and interest in activities once enjoyed, including sex
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
• Difficulty concentrating, remembering or making decisions
• Fatigue or loss of energy
• Feeling guilty, hopeless or worthless
• Thoughts of suicide or death

Basic Facts About Clinical Depression:

• Clinical depression is one of the most common mental illnesses, affecting more than 19 million Americans each year.
• Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide.
• Depression can occur to anyone, at any age, and to people of any race or ethnic group.
• Unfortunately, though treatment for depression is almost always successful, fewer than half of those suffering from this illness seek treatment. Too many people resist treatment because they believe depression isn’t serious, that they can treat it themselves, or that it is a personal weakness rather than a serious medical illness.
  Treatments for Clinical Depression:
• Clinical depression is very treatable, with more than 80% of those who seek treatment showing improvement. The most commonly used treatments are antidepressant medication, psychotherapy or a combination of the two. The choice of treatment depends on the pattern, severity, persistence of depressive symptoms and the history of the illness. As with many illnesses, early treatment is more effective and helps prevent the likelihood of serious recurrences. Depression must be treated by a physician or qualified mental health professional.

What are date rape drugs?

These are drugs that are sometimes used to assist a sexual assault.
Sexual assault is any type of sexual activity that a person does not
agree to. It can include inappropriate touching, vaginal penetration,
sexual intercourse, rape, and attempted rape. Because of the effects
of these drugs, victims may be physically helpless, unable to refuse
sex, and can’t remember what happened. The drugs often have no
color, smell, or taste and are easily added to flavored drinks without
the victim’s knowledge. There are at least three date rape drugs:
GHB (gamma hydroxybutyric acid), Rohypnol (flunitrazepam), and Ketamine
(ketamine hydrochloride).

Although we use the term “date rape,” most experts prefer
the term “drug-facilitated sexual assault.” These drugs
have been used to help people commit other crimes, like robbery and
physical assault, and have been used on both men and women.

Is alcohol a date rape drug?

While GHB, rohypnol, and ketamine are considered “date rape drugs,” there are other drugs that affect judgment and behavior, and can put a person at risk for unwanted or risky sexual activity. In terms of sexual assault, alcohol is the NUMBER ONE “date rape drug.” When a person is drinking alcohol:

• It’s harder to think clearly and evaluate a potentially dangerous situation.
• It’s harder to resist sexual or physical assault.
• Drinking too much alcohol can also cause black-outs and memory loss.

But remember: even if a survivor of sexual assault drank alcohol, he or she is NOT at fault for being assaulted. The responsibility for the assault lies solely on the shoulders of the perpetrator.

What do the drugs look like?

• GHB has a few forms: a liquid with no odor or color, white powder,
  and pill.
• Rohypnol is a pill and dissolves in liquids. New pills turn blue
  when added to liquids. However, the old pills, with no color, are
  still available.
• Ketamine is a white powder.

What effects do these drugs have on the body?

The drugs can affect you quickly. The length of time that the effects
last varies. It depends on how much of the drug is taken and if the
drug is mixed with other substances, like alcohol. Alcohol can worsen
the drug’s effects and can cause more health problems. Also, one
drug — GHB — can be made by people in their homes, so you
don’t know what’s in it.

GHB
GHB can cause these problems:
Relaxation, drowsiness, dizziness, nausea,
problems seeing, unconsciousness (black out), seizures, can’t
remember what happened while drugged, problems breathing, tremors,
sweating, vomiting, slow heart rate, dream-like feeling, coma, and death

Rohypnol
Rohypnol can cause these problems:
Can’t remember what happened
while drugged, lower blood pressure, sleepiness, muscle relaxation
or loss of muscle control, drunk feeling, nausea, problems talking, difficulty
with motor movements, loss of consciousness, confusion, problems
seeing, dizziness, confusion, and stomach problems

Ketamine
Ketamine can cause these problems:
Hallucinations, lost sense of time
and identity, distorted perceptions of sight and sound, feeling out
of control, impaired motor function, problems breathing, convulsions,
vomiting, out of body experiences, memory problems, dream-like feeling,
numbness, loss of coordination, aggressive or violent behavior, slurred
speech

Are these drugs legal in the United States?

Some of these drugs are legal, but that doesn’t mean they’re
not going to hurt you. Even if they’re legal, you should not use
them unless your health care provider prescribes them.

• Rohypnol is NOT legal in the U.S. It is legal in Europe and Mexico
  and prescribed for sleep problems and as an anesthetic (medicine
  given during surgery so you don’t feel pain). It is brought
  into the U.S. illegally.
• Ketamine is legal in the U.S. for use as an anesthetic for humans
  and animals. It is mostly used on animals. Veterinary clinics
  are robbed for their Ketamine supply.
• GHB was recently made legal in the U.S to treat problems from narcolepsy
  (a sleep problem).

Things to remember

• Don’t accept drinks from other people, except trusted friends.
• Open containers yourself.
• Keep your drink with you at all times, even when you go to the bathroom.
• Don’t share drinks.
• Don’t drink from punch bowls or other large, common, open
  containers. They may already have drugs in them.
• Don’t drink anything that tastes or smells strange. Sometimes,
  GHB tastes salty.
• Have a non-drinking friend with you to make sure nothing happens.

If you think that you have been drugged and raped

• Go to the police station or hospital right away.
• Get a urine (pee) test as soon as possible. The drugs leave your
  system quickly. Rohypnol leaves your body 72 hours after you take
  it. GHB leaves the body in 12 hours.
• Don’t urinate before getting help.
• Don’t douche, bathe, or change clothes before getting
  help. These things may give evidence of the
  rape.
• You also can call a crisis center or a hotline to talk with a counselor.
  One national hotline is the National Domestic Violence Hotline
  at 800-799-SAFE or 800-787-3224 (TDD). Feelings of shame, guilt, fear
  and shock are normal. It is important to get counseling from a trusted
  professional.
• Call the Sexual Assault Survivor Advocate (SASA) Network for free and confidential advice about next steps. On call 24/7 during the Fall, Winter, and Spring quarters 303.871.3456.

Source: www.4women.gov

General Information

Crutches have been prescribed for you by your doctor to rest your injured leg / foot so that it may heal. The top of your crutch should be about two or three finger widths below your armpit when standing straight. It is very important not to lean your armpit on the top of the crutch because this can cause nerve damage.

Instrutions

1. You should wear a sturdy, low-heeled shoe on your healthy leg/foot. Do not wear a slipper, high heel, sandal, or clog.
2. For total non-weight bearing (keep injured leg/foot entirely off the floor, never placing any weight on it):
   • Keep the injured leg/foot in front of you to provide better balance.
   • Place both crutches forward at the same time, about 12 inches in front of and 6 to 8 inches on the side of your healthy foot.
   • Place all of your weight on your hands and swing the healthy foot forward to the crutches or slightly beyond the crutches.
3. For touch down, non-weight bearing (injured limb is allowed to touch very lightly on the floor):
   • Place the crutches forward about 12 inches and about six to eight inches on the side of your healthy leg/foot.
   • Place the injured foot or leg between the crutches, resting the foot lightly on the floor.
   • Place all your weight on your hands and swing the healthy foot/leg forward to the crutches or slightly beyond the crutches.
   • For partial weight-bearing (injured limb is allowed to have some weight):
   • Do as prescribed in 3, however, place partial weight on the injured foot or leg as directed by your doctor.
4. To sit:
   • First, remove the crutches from under your arms.
   • Place the crutches together on the injured side, using the hand grips to support your weight.
   • Slide the injured leg/foot forward and reach for the chair seat with your free hand as you sit down.
5. To walk on stairs:
   • When going up, put your healthy leg/foot up first. Then, bring up the injured leg and then the crutches.
   • If you are using a handrail on one side, place both crutches on the opposite side. If there is no handrail, use the crutches on both sides.
   • When going down, put the crutches down first, then the injured leg and then the healthy leg.

How to Make a Referral

It is difficult to watch someone you know and care
about be in distress. Whether this individual is a friend, colleague,
or student, sometimes it is confusing to know how to help a person
who is struggling with life problems, be they physical or emotional. The
following is a list of suggestions to help refer someone to the Health and Counseling Center.

1. Know your
limits

From the outset, think about what role you feel comfortable
playing in the current situation. While expressing your concern
or confronting someone about his or her problem may entail challenging
yourself to do something you do not do every day, it is important to respect
your feelings about what boundaries will be necessary for you to
feel comfortable. For example, you may feel comfortable giving
someone information about the Health and Counseling Center and
walking them over to the center, but not sitting in with them during
their first counseling session to give them support or providing them with
your home phone number and an invitation to call at any time.

Additionally, ask yourself
whether you are approaching the person of concern as a friend, supervisor,
or professional colleague, and how you may act differently given
the definition of your relationship. Be aware of any ethical or legal issues
that may impact your assistance. For instance, if you are a supervisor,
make sure you have a good understanding about what issues you discuss with
your supervisee will be confidential. Remember, it is not your responsibility
to become this person’s therapist or
doctor. If you want to assist this individual, the best thing to
do for them is to make sure they receive the professional help that they
need.

If you begin to feel that your limits are being exceeded while you
are helping someone, or you are unclear as to what your limits should

be, call the Health and Counseling Center (303.871.2205)
to consult with a professional.

2.
Practice

Practice what it is you would like to say to the person.
This may also include obtaining some resources that you can give
the person if you feel it is appropriate. For example, you may want
to have the number and location of the HCC, a brochure on their services,
and perhaps a pamphlet on the issue with which you feel the person
is struggling. These can be obtained by contacting the HCC.
Do not underestimate the importance of giving the person good information.
Frequently such pamphlets and brochures are kept for a long time
and offer a reminder to the person that you are concerned, help exists,
and others experience similar difficulties.

3. Express your concern

Find a place where you and the individual you are
concerned about can speak privately and without distraction. Begin
by expressing that you are concerned about them. A small, but important,
conversational technique that can be used is beginning your statements
with “I”.
This places the focus on what your are noticing, feeling, and experiencing,
as opposed to what the individual of concern is doing, making for
a less threatening situation. For example, saying “I’ve been
worried about your health for several months now because you don’t
seem to be eating at mealtimes and it appears that you’ve lost a
lot of weight” is
better than saying “You’re not eating! I’ve seen you.
I have a cousin who is anorexic and you look just like her.”

4. Offer
your assistance

Express that you are willing to help in “whatever
way I can”.
This statement allows you to keep the limits you have set for yourself.
For example, if a person states that he or she would like to meet
with you one on one for counseling, you can explain to them: “I explained
that I would help in whatever way I can. I’m not able to help in
that way because I am not professionally trained but I can help in
other ways”[explain how you can help].

Make sure you ask them if they
would like your assistance. “I’m
concerned about you, would you like some help from me?” is often
an easy way to ask such a question. A person may not want your assistance
with the matter at hand because he or she wishes to keep the issue
private, is already seeking help, or is simply shy. Determine from
the beginning what it is you would like to hear, or if you are a
supervisor, what you may need to hear, in order to feel that the
person is safe and getting the assistance he or she needs.

5. Provide your
assistance

While this may sound like an obvious step, it is important
to realize that once you have offered your assistance it is vital
that you follow-up on your offers. This may entail putting some of your
other priorities and obligations on hold. For example, if you have offered
to walk the person over to the HCC, make sure that you do not have
to be at the airport in an hour to catch a flight. Similarly, if
you offer to help the person find community resources on substance
abuse treatment centers, make sure that you have the time and can
expend the effort to do so quickly. Do not offer something that you
cannot do, because if the individual of concern feels let down by
you, he or she may expect disappointment from other helpers and be
that much more reluctant seek assistance in the future. This having
been said, remember that you have certain limits as well, and you
should feel comfortable establishing reasonable boundaries with the
individual of concern. If the person says he wants you to help him
find resources this moment, and you have an important meeting that cannot
be cancelled, offer a reasonable alternative and follow through on the
offer (e.g. “I
can’t help you find resources at this moment, but I’d be happy
to have some resources for you by the end of the day, tomorrow, etc.”).

Please be aware that an individual’s treatment
at the HCC is strictly confidential and you will not be provided
any information about that person’s treatment or even if they received
services or not without the individual’s signed consent.

What causes it?

Cough is usually caused by an irritation or inflammation of the air passages from the windpipe to the lungs. These passages are called the trachea and bronchi. Persistent cough may be due to an infection, either viral or bacterial, of these passages – a variety of viruses and bacterias can cause these infections. Persistent cough may also be caused by an allergic reaction which induces spasm and inflammation of the bronchi (such as asthma).

Persistent cough is sometimes caused by an infection of the lungs themselves – this is called pneumonitis or pneumonia.

Inhaling tobacco smoke can cause cough in itself and my eventually lead to lung cancer, chronic bronchitis, or emphysema which can cause cough.

A cough may be dry or productive or mucus, blood-tinged mucus, or blood depending upon the cause.

What should you do about it?

• Drink plenty of fluids – this keeps you hydrated and enables mucus to stay thin and easily coughed up.
• Get a lot of rest and eat as well as possible.
• Don’t do a lot of running around, especially outside in the cold or dry air.
• Use a humidifier or breathe in vapor for the shower as frequently as possible.
• Use an over-the-counter expectorant cough syrup.
• If you have been previously diagnosed with asthma, start taking your regular asthma medication.

Remember…

• A cough frequently accompanies other infections of the respiratory tract, such as the common cold, influenza, or sinusitis.
• A cough is a symptom of many conditions, not a disease in itself.
• Antibiotics do not improve coughs due to viruses or allergic conditions.

Typical responses

• Shock and disbelief: immediately after learning
  about such tragedies, many people may feel numb, or feel like such
  events can’t quite be real.
• Speculation about what happened, and
  seeking more information, such as listening to or watching the
  news, checking the web for updates, talking to others about what you
  each know or have heard.
• Physical reactions including fatigue, nightmares, exhaustion,
  and health problems.
• Cognitive reactions including difficulty concentrating,
  making decisions, or memory problems.
• Emotional reactions including
  fear, guilt, anxiety, depression, feelings of helplessness, and
  anger.
• Wanting to check in with loved ones, even if they are not close to
  the disaster, or in any immediate danger. It is normal to want
  to touch base with someone you care about.
• In the hours and days following
  such tragedies, the shock begins to wear off, and more feelings
  may emerge. It
  is important to share these feelings with people that you trust.

Coping suggestions

• Do activities to de-stress and help yourself to feel
  safe.
• Structure your time – keep busy.
• Give yourself permission to have
  feelings and to share those feelings w/others.
• Help your fellow students
  by checking out how they’re doing.
• Talk to others – this is
  the most healing medicine.
• Listen to others – reassure them that
  they are safe, don’t
  take their feelings personally.
• Don’t scapegoat.
• Don’t turn to alcohol or drugs.
• Keep your life as normal as possible.
• Keep a journal.
• Reassure yourself that a wide range of reactions and feelings
  are normal.
• Remind yourself that DU takes your safety seriously and
  is doing everything possible to keep you safe.

Circumstances or signs that may lead you to seek additional counseling
support

• Having friends or family members in the areas of the tragedies
• Memories
  of previous loss, trauma, or crisis that you have faced
• Experiencing
  heightened feelings of anxiety, fear for your safety, or rage
• Crying
  more than usual in response to sadness

Abstinence

Continuous Abstinence is not having sex play with a partner. Abstinence
is 100% effective in preventing pregnancy. It also prevents sexually
transmitted infection.

Advantages:

• Has no medical or hormonal side effects.
• Any woman or man can abstain from sex play.

Disadvantages:

• People may find it difficult to abstain for long periods of time.
• Women and men often end their abstinence without being prepared
  to protect themselves against pregnancy or sexually transmitted
  infection.

Birth Control Pills

Oral Contraceptive Pills (Birth Control Pills) work by preventing the
egg from being released by the ovary (ovulation). Pills also make the fluid
in the cervix and fallopian tubes thick and sticky. Sperm need thin fluid
to be able to fertilize an egg and cause pregnancy. Most oral contraceptive
pills contain the two hormones that regulate the menstrual cycle, estrogen
and progestin. The differences between brands of pills are usually in the
amount of each hormone, and the type of progestin. Generally, the differences
are small. Most women can use any oral contraceptive pill safely and with
few problems. The Contraceptive Patch and Ring are really the same as Oral
Contraceptives, but the medication is absorbed through the skin instead
of the stomach.

Advantages:

• "The Pill" is easy to use, popular and safe for the
  majority of women.
• "The Pill" can make menstrual periods predictable and
  regular, and reduce the amount of bleeding and cramping. Birth
  control pills may help improve acne and reduce premenstrual syndrome
  (PMS).
• Women usually do not gain weight from using birth control pills.
• Birth control pills do not cause cancer or birth defects.
• Birth control pills are very effective if used correctly.

Disadvantages:

• You must remember to take a pill every day at the same time every
  day.
• If you smoke or have problems with high blood pressure or some
  types of migraine headaches, your provider will discuss health
  risks with you. Some of these women should not use birth control
  pills.
• A few women have mild nausea or headaches while using birth control
  pills. This usually resolves after several months, if not a different
  type of pill can be tried.
• Spotting between periods is common in the first 1-3 months of
  use. This is not harmful.

How effective is this method?

• 99% effective

Contraceptive Patch

The contraceptive patch contains the same hormones as the birth control
pill and it works the same way, but in a patch form. The hormones are absorbed
through the skin instead of from the stomach

Advantages:

• Hormone levels are steady for 7 days at a time.
• The patch is applied to the skin, and left in place for one week.
  It stays even with swimming or sweating for nearly all women.
• A new patch is applied every 7 days for 3 weeks.
• No patch is worn on week 4 and bleeding or a period occurs.
• The following week, a new patch is applied again.

Disadvantages:

• Women who should not use birth control pills should also not
  use the patch.

How effective is this method?

• 99% effective may actually be slightly higher than the pill due
  to compliance.

Contraceptive Ring

The contraceptive ring contains the same hormones as the birth control
pill, and patch. It works the same way. A flexible ring is worn inside
the vagina and the hormones are absorbed through the vaginal skin.

Advantages:

• The ring is worn continuously for weeks 1-3.
• The ring cannot be felt by the woman or her partner when it is
  in place.
• The ring is removed during week 4, and the "menstrual period" occurs.
• Hormone levels are steady for 3 weeks at a time.

Disadvantages

• Women who should not use birth control pills should also not
  use the ring.
• Some women do not feel comfortable inserting the ring.

How effective is this method?

99% effective may actually be slightly higher than the pill due to compliance.

Depo-Provera
Injectable ("3-month shot")

Depo-Provera works by making the fluid in the cervix and fallopian tubes
very thick and sticky. Sperm cannot swim through the fluid when it is not
thin. Depo also makes ovulation (release of an egg from the ovary) less
likely, and changes the lining of the uterus. All of these changes prevent
fertilization of an egg which leads to pregnancy.

Advantages:

• Depo-Provera is convenient and safe for most women—only 4 shots
  per year.
• Very reliable and effective in preventing pregnancy.
• "Depo" is safe to use while breastfeeding.
• Depo-Provera can reduce menstrual bleeding and cramping for some
  women. Many women stop having periods. This is not harmful - the
  uterus is "resting" and does not make a monthly period.
• You don’t have to remember to use it daily.

Disadvantages:

• Depo-Provera usually causes menstrual periods to be irregular
  - this might be no period at all, bleeding sometimes, or spotting
  nearly every day. After several injections (about 1 year) many
  women stop having periods. This is not harmful in any way. Some
  women feel this is an advantage.
• Many women notice an increased appetite. Weight gain can occur
  if you eat more calories that you burn during the day. Depo-Provera
  ITSELF causes little or no weigh gain.
• Some women notice mood swings or mild depression.
• Women at risk of having decreased bone density (low body weight
  due to anorexia or intense athletic training) should not use depo.

How effective is this method?

• 99% effective, may actually be slightly higher than the pill
  due to compliance

Intra-uterine device or system (IUD or IUS)

How the IUD works is not completely known. It is believed that
the Copper IUD in the uterus changes the fluid in the uterus, which
makes the sperm unable to fertilize an egg. If a pregnancy has already
attached to the uterus, the IUD does not cause an abortion. The Mirena
IUS contains a progestin hormone which also makes the fluid of the
cervix and fallopian tubes thick and sticky. Mirena may also reduce
ovulation (release of the egg from the ovary).

• The IUD or IUS is very convenient and safe for most women.
• IUD and IUS do not have hormone effects on the rest of the body.
  Women do not gain weight or notice mood changes when using the
  IUD or IUS.
• The Copper-T IUD is effective up to 10 years. You can become
  pregnant as soon as it is removed.
• The Mirena IUS is effective up to 5 years. You can become pregnant
  soon after it is removed.
• The Mirena IUS contains a progestin hormone that reduces the
  amount of bleeding and cramping with menstrual periods. Some women
  stop having periods after several months. This is not harmful.
  The uterus is "resting" and does not make a period.

Disadvantages:

• The IUD and IUS do not cause infection by itself but does increase
  the risk of serious infection if a woman is exposed to an STD. This
  infection could lead to infertility.
• Women should feel inside their vagina after each menstrual period
  to feel the IUD string.
• Some women notice somewhat heavier periods and slightly more
  cramping for a few months after the Copper-T IUD is placed.
• Even though IUDs and IUS are very effective in preventing pregnancy,
  some rare failures do occur. If pregnancy occurs while the device
  is in the uterus, it must be removed. Removing the IUD or IUS could
  cause a miscarriage.

How effective is this method?

• 99% effective

Spermicides (sperm-killing)

Spermicides are available in several forms. The most common is in contraceptive
jelly and in the lubricant on condoms. There are also spermicidal foams
and suppositories.

Advantages:

• Some couples find the lubrication of spermicidal creams to be
  helpful.

Disadvantages:

• Some women and men are sensitive to spermicidal creams. They
  may notice a rash, itching or burning. It is possible this irritation
  could increase the risk of the woman getting a sexually transmitted
  infection, if she is exposed. If a woman could possibly be exposed
  to sexually transmitted infection, it is now recommended that she
  use condoms without a spermicide.
• Spermicides ALONE are not very effective in preventing pregnancy.
  It is recommended that a spermicidal foam, gel or suppository be
  used along with condoms or a diaphragm.

How effective is this method?

• 94% effective, effectiveness increases with barrier method added.

Condoms

Condoms work by preventing the sperm in the man’s semen from entering
the vagina, cervix, uterus and tubes.

Advantages:

• Condoms are easy to use, and available to buy without a prescription.
• There are no hormonal effects, such as weight gain or mood changes.
• Condoms are the only method of birth control that also
  reduces (but does not eliminate) the risk of sexually transmitted
  infection, including HIV or AIDS. Condoms are recommended always
  if there is any chance of exposure to infection.
• Condoms can be used along with another type of birth control,
  such as pills or diaphragm to reduce the possibility of pregnancy
  as well as infection.

Disadvantages:

• Using condoms requires the cooperation of the man. They must
  be used correctly EVERY time you have sex, or you may become pregnant.
• Condoms alone are less effective in preventing pregnancy than
  the IUD or hormonal methods like the shots or birth control pills.
  In "real life", people often make mistakes and do not
  use the condom correctly. Women are more likely to become pregnant
  by accident when condoms are used as the only method of birth control.
  Using a spermicide (sperm-killing jelly) with condoms improves
  effectiveness in preventing pregnancy, but spermicide is not recommended
  if exposure to sexually transmitted infection is possible.
• Some women are sensitive to the latex or spermicide in condoms.
  It is possible this irritation could increase the risk of the woman
  getting a sexually transmitted infection, if she is exposed. If
  a woman could possibly be exposed to sexually transmitted infection,
  it is now recommended that she use condoms without spermicide.
• The failure rate for condoms alone is about 10-20%
• The condom must be cared for correctly, or it could leak or break.
  Condoms should not be exposed to heat or cold for long periods
  (not carried in the back pocket!).
• Only water-based products should be used with condoms. Contact
  with petroleum based products (Vaseline, lotion, etc.) can make
  the condom weak and cause it to break.

How effective is this method?

• 97% effective, when used correctly and condom doesn’t
  break.

Diaphragm

The Diaphragm works by holding spermicide (sperm-killing jelly) next to
the cervix for several hours so that sperm are killed before they can enter
the cervix and uterus to fertilize an egg.

Advantages:

• The diaphragm has no hormonal effects such as weight gain or
  mood changes. It does not change the normal menstrual cycle.
• It is easy to use. For women who are not frequently sexually
  active, it is only used when needed and not at other times.
• The diaphragm cannot be felt when it is in place. The man usually
  does not feel it either.

Disadvantages:

• The diaphragm must be fitted at an office visit.
• The diaphragm must be inserted BEFORE sex, up to one hour ahead
  of time.
• It must be used for EVERY act of intercourse. For intercourse
  more than once, you must insert additional spermicide without removing
  the diaphragm.
• The diaphragm must be left in the vagina for 6 hours after sex
  to be sure there are no live sperm left.
• It should be removed before 24 hours.
• A few women have problems with bladder infections when using
  the diaphragm because of pressure near the bladder.
• Rarely, a diaphragm cannot fit some women because of the shape
  of their pelvis or cervix.
• The diaphragm failure rate is about the same as for condoms -
  10-20%.

How effective is this method?

• 94% effective

Emergency Contraception

Emergency contraception pills are hormones commonly used in birth control
pills. It is believed they help prevent pregnancy by interfering with ovulation
(release of the egg from the ovary) or by the changing the ability of the
sperm to fertilize the egg. The hormones might also work by changing the
lining of the uterus so implantation does not occur.

Emergency contraception is NOT as effective as a regular method
of birth control, but it can help reduce to chance of pregnancy in an
emergency.

• Do not rely on this for ongoing birth control.
• Women might use emergency contraception after forced sex (such
  as an assault), or if a method fails (such as a broken condom),
  or if a method is not used correctly (forgotten pills, late Depo
  Provera shot).
• Emergency contraception is sometimes called the "morning
  after pill", but emergency contraception can be used up to
  72 hours (3 days) after unprotected sex, not just the next morning.
• Using emergency contraception can reduce the possibility of pregnancy,
  but it will not disrupt a pregnancy that is already implanted in
  the uterus (will not cause an abortion).
• Emergency contraception is usually a pill, or several pills taken
  as soon as possible after unprotected sex, and a second dose taken
  12 hours later.
• A prescription is needed for emergency contraception.

How effective is this method?

Effectiveness varies from 76-99% depending on how soon after intercourse
it is taken. It is more effective when taken as soon
as possible after intercourse.