Неврозы – Neuroses

There are short term and long term risks associated with pollutants in the air. The short term risks of breathing polluted air include headache, eye irritations, inflamation of the respiratory tract and asthma related disorders. In the long term, air pollution can contribute to the development of cancer, emphysema, birth defects and behavioural problems in children.

Lead, once a major domestic pollutant as an ingredient in house paint, is now pumped into the air in vehicle exhaust or found in soil contaminated by industry. In children, high lead levels are thought to be responsible for a lowering of the intelligence quotient, loss of concentration and hyperactivity. Workers in certain industries run a high risk of lead poisoning. These include zinc miners, petroleum plant workers, car mechanics, sheet metal workers and those dealing with explosives. Lead poisoning results in nervous disorders and stomach and brain related illnesses. To avoid its effects, workers should wear appropriate protective clothing. Parents can have their children’s blood lead levels tested and may consider moving to an area of lower contamination if levels are high. Avoid walking, cycling or jogging in heavy traffic or wear a face mask.

Insecticides, fertilisers, bleaches and blooms of toxic algae affect many of our waterways and can seriously affect our health. Even within our reservoirs, the fluoride and chlorine added to the water to kill bacteria are themselves under a health cloud. Try to drink the purest water available to you and invest in a good water filter. Otherwise, always drink from the cold tap as hot water has sat still in a tank and in pipes and will contain more metals.

Chemicals are not the only pollutants of the atmosphere. Concern is mounting over the dangers of electromagnetic waves to human health, particularly to those living in the vicinity of high voltage power cables. The links between television and computer screen emissions and conditions such as cancer, nervous disorders and cataracts are being investigated. Sit at least 2.5 metres from a television screen and if possible, fit a shield to the screen of your computer.

*34\69\2*

Greater enjoyment of sex and improved sexual functioning are among the most commonly reported contrasts between the effects of St John’s Wort and those of the selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Lustral and Seroxat. Although the literature on the SSRIs reports very low levels of sexual side-effects (for example, less than 1 per cent for Prozac and 2.5 per cent for Lustral), any clinician who uses these medications will tell you that these figures are grossly underestimated. One survey of patients on SSRIs reported the frequency of such side-effects to be approximately 34 per cent, and it would not surprise me to find an even higher percentage depending on how carefully the patients are questioned. Considering the importance of sex in the lives of many (if not most) people, it is worth considering the difference in the sex lives of people who have switched from an SSRI to St John’s Wort.

In some people the sexual side-effects of the SSRIs can be extremely marked. For example, they may cause impotence in men or complete inability to achieve orgasm in women. Depressed people generally have a diminished interest in sex to start with, and any anti-depressant may improve the level of interest and overall drive to connect with others sexually as well as socially by reversing7 the symptoms of depression. Initially people are so grateful to be free of their depression that any sexual side-effects they might experience might seem like a small price to pay for feeling better. After a while, though, the side-effects become less and less acceptable as they begin to take a toll on a person’s relationships and impair one’s quality of life.

Sexual side-effects of the SSRIs can involve decreases in sexual interest or arousal or subtle changes in the experience of sex. A colleague of mine, for example, who was previously on Lustral and is now taking St John’s Wort, described how on Lustral he had been able to function sexually but the orgasms just did not feel as good. ‘On Lustral’ he recalls, ‘I was still interested in sex and my erections were fine, but it took me longer to reach orgasm and, when I did, the arc of the orgasm was slower and more protracted and did not reach its previously satisfying level of intensity. I am glad to say that on St John’s Wort my orgasms are back to normal again.’

It would not surprise me, however, if in the course of time evidence emerges for alterations in sexual functioning on St John’s Wort as well, though perhaps only in a very small percentage of those who use the herb. This might be more likely to occur if people push the dosage of the herb above 900 mg per day, as I predict many will in their attempts to explore the full range of the herb’s efficacy. I have already encountered two people who claim some alteration in libido and sexual pleasure on St John’s Wort, albeit to a lesser degree than on the SSRIs. Given our best understanding, that St John’s Wort probably works at least in part by increasing the availability of serotonin, the biological mechanism believed to be responsible for the sexual side-effects of the SSRIs, some sexual side-effects might be expected to be reported as the herbal anti-depressant is more widely used.

It is important to remember that a slight decrease in sexual enjoyment may be an acceptable trade-off in exchange for being free of the painful symptoms of depression. One man whose depression had been successfully treated with Prozac for the previous two years switched to St John’s Wort after seeing a television programme about it. Two weeks after the switch he wrote to me that ‘the ol’ sex drive has come back with a vengeance … my wife is thrilled.’ Several months later, however, I checked up on how he was doing and learned that his depression had returned and that he had developed panic attacks, which resulted in his returning to conventional anti-depressants. It must be acknowledged that no medication, herbal or otherwise, is right for everyone. Nevertheless, St John’s Wort may actually turn out also to be of some value in panic disorder, as the following accounts suggest.

*11\75\2*

This theory was confirmed in the case of Ted Parsons, whom I first saw in 1948. Parsons had been a successful executive, on the way up, associated with a large company in Chicago. After a rapid rise he had become, over a period of years, an alcoholic. He was suspended from his job and actually became a «skid row» type of drunkard.

With his family’s help, he had managed to pull out of this nosedive and had become a founding member of the Alcoholics Anonymous group in his area. But after ten years «on the wagon,» he had begun to backslide. Another interval of alcoholism ensued, followed by a period of abstinence. This time, however, he recovered his sobriety but not his health. When he was not drinking, he suffered from extreme fatigue and almost constant headaches.

In preparing to perform food-ingestion tests with corn and wheat (which from an allergy point of view is virtually identical to barley and malt), he avoided these foods for four days. His fatigue was greatly accentuated for two days as a withdrawal reaction, following which he felt much better. During the test with wheat porridge, he developed progressive nasal obstruction and fatigue, as well as tautness of the nape of his neck and delayed dizziness. Reactions persisted for several days.

Some nasal symptoms and fatigue were still present prior to Parsons’ corn test four days later. The trial ingestion of corn porridge and com sugar was also followed by a progressive increase in fatigue and some staggering upon leaving the office. Fearing that he might head for the nearest bar on the way home, I placed him in a taxi, paid the driver to take him home directly, and called his wife to tell her what I had done. His fatigue increased during the night.

Parsons called me the next morning and commented, «It is funny to have a hangover twenty-one months after having stopped drinking. There is no difference between the fatigue this morning and a bad alcoholic hangover.» He went on to describe how he had to crawl to the bathroom because he was too weak and dizzy to walk, but that his lassitude, dizziness, and uneasiness could be relieved just like that (as if by a snap of the fingers) with a drink.

When he asked, «What is wrong with me?» I explained that he was having a true hangover—not from bourbon, but from corn, its principal ingredient. He had apparently been allergic to wheat (barley malt) and corn, as well as certain other foods, for years without realizing it. His addiction to bourbon had been an attempt to get a high level of cereal grains into his system as rapidly as possible and to maintain that level of stimulation. His more recent headache and fatigue could be explained by the perpetuation of his corn and wheat (barley malt) addictions, but at a much lower, unsatisfactory level, by the use of more slowly absorbed wheat- and corn-containing foods.

By the avoidance of wheat, com, and a few other incriminated foods, Parsons’ headache and fatigue not only subsided, but what is more, his craving for alcohol disappeared.

This craving is, of course, the bane of many ex-alcoholics’ existence. One can, with extraordinary willpower, stop drinking, but it is far harder to conquer the desire to drink. Parsons’ case suggested a possible reason for this. The consumption of other grain-containing foods would perpetuate the underlying problem—food addiction/allergy. Thus, in a sense, the alcoholic is never completely free of his «alcoholism» as long as he is consuming the foods which constitute his addictant.

Parsons, for instance, carried around with him a pocket full of candies containing corn sugar, which he sucked whenever he had the urge to drink. This was, in fact, the standard operating procedure of his Alcoholics Anonymous unit. Through practice, these individuals had found that they could relieve their craving for grain-containing alcoholic beverages by sucking on another rapidly absorbed form of grain. They had, in effect, transferred food addiction in its highest form—alcoholism—to food addiction in a less severe (and from the addict’s point of view, less satisfactory) form, corn sugar addiction. When Parsons realized that he was actually perpetuating his problem by eating this candy, he stopped immediately and avoided all contact with wheat, corn, and related foods which had been implicated.

It was through Parsons that I became acquainted with the members of Alcoholics Anonymous in the Chicago area. In the late 1940s, I carried out a study of forty-four members of this organization. I attended meetings, but instead of participating in discussions (which was forbidden to outsiders, under the organization’s rules), I stayed in the kitchen and interviewed members. Their histories, at least, suggested a strong correlation between alcoholism and susceptibility to the various food components of alcoholic beverages.

What are these food components? It soon became apparent that the study of alcoholism from the point of view of clinical ecology was hampered by the lack of information on the manufacture of liquor. Through much detective work, it was possible to track down the components of various drinks, though some of this information was guarded as trade secrets. Government regulation in this respect was lax, and alcohol was not regulated by the Food and Drug Administration but by the less food-conscious Treasury Department.

Gradually it was possible to put together a comprehensive theory of alcoholism as the apex of food allergy (the term «food addiction» did not come into use until 1952). According to this view, alcoholism is the acme of the food-allergy problem because alcohol is rapidly absorbed all along the gastrointestinal tract, from the mouth to the stomach to the intestines. Food, on the other hand, is mainly absorbed in the intestines, and more slowly at that.

There were four facts about alcohol which did not seem to fit into the theory. Their existence threw doubt on the entire concept. Wanting to obtain pure samples of corn mash whiskey, and other pure items for testing, I called a meeting with the research and technical directors of a major Illinois distillery. 1 presented my theory to them and pointed out the four existing discrepancies:

Why did corn-sensitive patients react to Scotch whiskey? Scotch comes from the British Isles but no corn (maize) grows there.

Why did grape-sensitive patients react to Puerto Rican and Cuban rum but not to Jamaican rum?

Why did corn-sensitive patients also react to apple brandy? The public relations officer of the producer of the brand in question had assured me that no corn went into the manufacture of their product.

Why did corn-sensitive patients react adversely to a popular American brandy but not to French brandy?

The research and technical directors of this distillery had been polite but somewhat skeptical, when I first presented this possible interpretation of alcoholism. But as I explained apparent exceptions to the theory, they became increasingly interested. They not only knew some of the answers but began to fill in some of the holes in the theory themselves.

First, all-malt Scotch whiskey is made of dried, roasted barley or malt, which, from the allergy standpoint, is closely related to wheat, if not virtually identical with it. But blended Scotch whiskey manufactured for export to the United States is blended with cereal-grain whiskey made from corn which is shipped from the United States or Argentina. Thus, persons sensitive to corn could be expected to react to it.

Second, Jamaican rum, like other rums, is made from cane. However, the laws of Jamaica demand that rum manufactured there be bottled on the island, whereas Cuban and Puerto Rican rums are shipped from their home ports to the United States in big hogshead barrels. Most of these were then blended with up to two-and-one-half percent grape brandy before bottling. Hence, grape-sensitive patients could be expected to react to the Cuban and Puerto Rican rums.

The distillery experts were not sure why the patients sensitive to corn reacted to apple brandy, however, and the whole theory was put in doubt when the manufacturer told me that the product did not contain corn. But after testing a few more patients highly sensitive to corn and confirming my earlier impression, I wrote the president of the company manufacturing this brand of apple brandy and suggested that the person answering my earlier inquiry had misled me. In the meantime, I had learned about trade practices in the liquor industry and asked specifically what the source of the caramel was which was used to maintain uniformity of color in the brandy. No one knew, off-hand. But upon corresponding with the manufacturer of this product, they learned that it was made from half corn sugar (dextrose) and half cane sugar.

Fourth, the possible corn content of the popular brand of grape brandy which precipitated reactions in corn-sensitive patients could not be confirmed through correspondence with the manufacturer of the product. But upon visiting their California plant in the early 1950s, I learned that corn sugar was used in its production.

This interpretation of alcoholism has not been widely accepted, either by those responsible for the policies of Alcoholics Anonymous or by those who teach courses on alcoholism. One apparent reason is that many alcoholics were quick to grasp an implication of this theory: namely, that some reformed alcoholics could drink compatible alcoholic beverages as long as they avoided both drinks and foods prepared from those substances to which they were allergic. In other words, a corn-sensitive patient who was a confirmed bourbon alcoholic could drink some wines and rums, provided these alcoholic beverages were free of cereal grains and he was not susceptible to grape, cane, or yeast. The effects of alcohol per se on the body did not seem to be an appreciable cause of alcoholism.

It should be emphasized, however, that the prospect of social drinking of compatible alcoholic beverages is not for all alcoholics. Although such a program may be possible for an alcoholic having a very limited food allergy problem, it cannot be considered if one is yeast-sensitive, because yeast is present in all alcoholic beverages. Also, the person who already has a wide base of food allergy usually also has a tendency to develop new food allergies readily, even though he indulges in a compatible alcoholic beverage in moderate amounts and only once, or at the most, twice, weekly. Not only the foods used in manufacturing an alcoholic beverage but also the foods eaten while drinking must be taken into account, due to the extremely rapid absorption of food-alcohol mixtures. In order to minimize the chance of sensitivity spreading to other items of the diet, all compatible foods—including those entering food-alcohol mixtures—should be used according to the principles of the Rotary Diversified Diet.

The only way to know whether one is actually sensitive to corn, wheat (rye, barley, malt), or other grains, yeast, grape, potato, or other ingredients of alcoholic beverages is to undergo extensive food testing. And only in the presence of a food allergy problem of limited extent (a distinct minority of cases) should social drinking of compatible alcoholic beverages by reformed alcoholics be considered.

In the great bulk of addicted drinkers of alcoholic beverages, abstinence from drinking, according to the Alcoholics Anonymous approach, is still the most highly successful rehabilitation program. However, there are obstacles in the application of this program, because this concept of alcoholism is not widely known.

My interpretation of alcoholism was first published in various medical journals starting in 1950.1,2 This view has also been confirmed by several clinical ecologists, including Richard Mackarness of England and Marshall Mandell of this country.3,4 My list of the food sources entering the manufacturing of alcoholic beverages has been published recently.

*63\110\2*

Denise Miller was the manager of a large retail store. She worked in the business office of that store, in the rear of the building, adjacent to the parking lot. When she sat near an open window and worked, she inevitably became depressed. The source of her problem was located in the cars and busses which spewed their exhausts in the direction of her office all day long. Since she could not change her place of employment, she was able to get a good deal of relief simply by keeping the windows shut and sitting some distance away from them.

One winter she took her vacation in Florida. Staying with relatives, she was given a big room, with the bed away from the walls of the room. She had no problem. But during the last two days of her stay, other relatives came to visit, and so she was moved into a smaller room with the bed wedged in one corner. The walls of this room, as well as the rest of the house, had been painted not long before, and Miss Miller began to react.

She hallucinated, seeing purple frogs hopping around her room. A lion sat on the foot of her bed and scared her out of her wits. In desperation, she decided to go home. On the Twentieth Century Limited to New York, she later said, she shared her bed with a gorilla. She was very upset, since every time she tried to get to sleep, the gorilla’s arms enfolded her!

Tests revealed that these strange symptoms were brought on by exposure to fresh paint, which was part of her overall susceptibility to many chemicals. By avoiding such exposure, she was able to maintain relatively good health.

*33\110\2*

Signs and symptoms

Dyslexia varies in severity. Some of the problems dyslexics may have include: confusion about whether they are right-handed or left-handed; difficulty learning to tell time or remembering the order of days, months, or seasons; hyperactivity; problems with language; difficulty telling left from right and up from down; coordination and balance problems; problems with memory; and seeing letters and numbers reversed.

Dyslexia is diagnosed by a series of tests of visual perception, memory, and space and time perception, and by medical and psychological evaluations. A child who has the symptoms of dyslexia may have a disorder or disease of the central nervous system, problems with hearing or vision, or emotional problems, rather than a learning disability. The possibility of a physical or psychological cause for the problem must be ruled out before a diagnosis can be made.

Home care

A child with dyslexia needs special support and help from the family. However, the child does not need to be over-protected. The child should be challenged as well as encouraged. Finding a balance is not an easy job. The child’s teachers and doctor may be able to help parents work with a dyslexic child. The situation can be hard on the whole family, so a parent needs to be sensitive to how the problem may affect the dyslexic child’s brothers or sisters. They may need extra attention or professional help.

Precautions

• If your child seems to be intelligent but has unexpected problems with reading, the child may have dyslexia. The sooner the problem is identified, the easier it will be for the child, so get professional help as soon as possible.

• Rather than consider the child a failure, encourage him or her to develop new skills.

Medical treatment

There is no cure for dyslexia. If the child has physical or emotional problems as well as dyslexia, these will probably be treated first. Then a treatment plan will be made to work on the reading problem. The plan may be developed by a team of educational professionals, in consultation with the child and the child’s parents, doctor, and teachers. The plan will include special education and training for the child based on his or her particular problems and strengths.

*58/84/5*

That’s not to say that everything about your sex life is going to stay the same as you get older. It never stayed the same your first 50 years, so why should your last 50 be change-free? The problem is that younger men, looking ahead, see change leading only to some kind of feeble approximation of the real thing.

Not so. «Your physical responsiveness is altered to a degree, but not radically,» says Dr. Brauer.

So if you want to have sex for the rest of your life, don’t focus on your physical changes. Focus on the things you can do to make sure that you keep having sex for the rest of your life.

Do it or eschew it. The secret to healthy sex in your sixties or seventies and beyond is to have healthy sex in your fifties and forties and before. «It’s very difficult for a man who pretty much stopped having sex in his fifties to start it up again when he’s 75,» Dr. Brauer says.

That’s because sex is plumbing. The more the blood flows to the penis, the more it wants to. «If you stop having sexual relationships, the disuse leads to atrophy of the blood vessels in the penis and impairment of blood flow to the penis,» Dr. Vinik says. Translation: Your equipment shuts down, taking your sex life along with it.

Go solo. Those times in your life when you might be partnerless are no reason to let the plumbing back up. «I recommend that men maintain a certain frequency of erection and orgasm,» Dr. Brauer says. «At least two orgasms a week have been found to be associated with improved physical health and longevity. And that can be achieved with solo sex if that’s what it takes.»

You won’t be the only guy using masturbation to keep his equipment in working order.

«Two-thirds of married men are doing some kind of regular self-stimulation,» Dr. Brauer says. «That can and probably should continue throughout life.»

Ask for a helping hand. At 20, your erection may happen from just thinking about her disrobing. At 35, it may happen by watching her disrobe. At 60, it happens if she fondles your genitals, robed or not. «Direct stimulation is very important for a man in his middle or later years,» Dr. Brauer says. «And not only direct stimulation but continuous stimulation.»

That shouldn’t be a problem since you don’t often hear men grumbling, «What a drag. I have to put up with a lot of stroking and licking from her before the real action.» But Dr. Brauer suggests that you find tactful ways to instruct her on this since she may misinterpret the new requirement as an insult to her sex appeal.

Stay high and dry. Fact: You’ll deliver less ejaculate as you get older. And sometimes you won’t ejaculate at all, a change that’s considerately accompanied by less urge to do so. «Enjoy the process without feeling that you necessarily have to ejaculate to finish it off,» Dr. Brauer says. Having orgasms without ejaculating may allow you to have this sort of climax more frequently than if you did ejaculate, he adds.

Check your hormones. Your hormone levels don’t generally drop enough with age to cramp your sexual style. But sometimes they do, and you may feel the need to talk to your doctor about getting testosterone supplements, often in the form of a skin patch you apply to your body.

«If your testosterone levels are lower than average for your age, you may benefit from supplementation,» Dr. Brauer says. «In fact, some doctors believe that if your testosterone levels are lower than average and you are in your mid-thirties, supplements may be desirable. It may also be worthwhile to make sure that other hormones are also at a reasonable level. Other hormones to check are thyroid and adrenal since these, too, can have an influence on sexual interest and response.»

Call a mechanic. If technical difficulties beyond your control do keep you from getting erections in your later years, take advantage of some tools available for men with erection problems. The ideas of using a vacuum pump to draw blood into the penis, or injecting an erection-producing substance directly into the penis before sex, might have seemed weird a few decades ago but are now increasingly common among diabetics and others. A new device known as Muse inserts a rice grain-size soft pellet of the erection-enhancing substance called alprostadil one inch up the urethra. «It is helpful for some men with unstable natural erections,» says Dr. Brauer.

«For a certain number of men with erection insecurity, a mechanical device is wonderful,» Dr. Brauer says.

And in case you’re wondering, the shots are relatively simple. «During genital examinations, we give the patient a little pinch,» says Dr. Vinik. «When he asks what that was all about, we tell him that’s all he’ll feel when he gives himself the shot. It’s a piece of cake.»

*66/36/5*

You may have pins and needles and some pain or discomfort in your chest for a few days. Any numbness or tingling’ sensation under your arm may last several weeks or months. If you have had a mastectomy or auxiliary lymph glands removed, your shoulder will probably also be stiff. The exercises explained above will help you to regain the movement in your arm, and apart from doing these regularly, you should try to use your arm normally as much as possible. However, heavy housework and lifting should be avoided for about 6 weeks, and you should use your other arm to carry shopping etc.

Depression

You are likely to feel tired for at least a few days, and may find you become easily depressed. Many women experience a sense of elation immediately after their operation which then gives way to lethargy and exhaustion as the anxiety they have been feeling starts to be relieved. Mood swings are common, ranging from elation to depression and anger. This is a normal reaction which should settle down in time.

If you have problems sleeping, waking in the night and worrying so that you are exhausted during the day, your GP should be able to prescribe a light sedative which you can take for a few nights. Even three good nights’ sleep can help you to cope again, and stop the cycle of tiredness and anxiety.

If your appetite is poor, it will improve in time, and you should eat what you want when you want until it does so.

Although you should take things easy and rest when you need to for the first few days you are at home, it is important to try to get out and about as much as possible and to return to your normal life as soon as you feel able to do so.

Some women worry that they will be less attractive to their partners, or will be unable to find a partner, after a breast operation, but in the majority of cases these fears are unfounded.

Telling children about cancer

Young children can only understand very simple*’explanations about why their mothers have to go into hospital. By the age of 10, most children can grasp quite complicated details, and it is better to be honest rather than let their imaginations dream up something much worse than the reality. However, it is probably better to give them a little information at a time and gradually build up the whole picture, taking your cue from your children about how much they want to know. All children need reassurance, and a chance to express their own fears and to talk about things if they want to. Older children may find their anxieties difficult to cope with and to express or understand. They should be encouraged to talk about their fears, but not pushed into doing so before they are ready.

*44/39/5*

A definite diagnosis of endometriosis is one made when a gynecologist has actually observed endometrial implants or cysts in your pelvic cavity during a laparoscopy (a minor surgical operation using a laparoscope) or, occasionally, a laparotomy (major abdominal surgery).

In general, a laparoscopy is the preferred method of diagnosing endometriosis because it is a simpler and shorter operation and the use of the laparoscope enables better detection of small implants as it magnifies them to several times their actual size.

Classical endometrial implants and cysts can usually be easily recognized and diagnosed by a gynecologist during a laparoscopy. However, atypical implants and microscopic endometriosis can be missed if the gynecologist relies only on a visual impression. An increasing number of gynecologists are using biopsies to diagnose endometriosis in doubtful cases. This involves removing a sample of tissue, known as a biopsy, from any area that the gynecologist thinks may be the site of an endometrial implant for examination and diagnosis under a microscope.

A definite diagnosis is extremely important as it enables an accurate assessment of the severity and extent of the disease to be made and provides a guide as to the likely effect of the condition on your fertility. This is essential information if you are to think about and make informed decisions regarding the management of your endometriosis.

The Commonwealth Department of Community Services and Health, which administers the Pharmaceutical Benefits Scheme, will not subsidize the cost of some of the drugs used in the treatment of endometriosis unless a definite diagnosis has been made.

*22/41/5*

Studies in East Africa in the 1930s found that diabetes was rare. Nowadays there are diabetic clinics in all town hospitals.

Diabetes is undoubtedly an ancient disease and Galen, who lived in the second century and was the greatest medical authority in the Roman Empire, certainly described it. What most people do not realize is that he only saw two cases! The condition was further described in the seventeenth century in Europe, but it was rare until the eighteenth century, when it became a common disease among the English aristocracy. Obesity and diabetes emerged together as societies became affluent and ate more fat, oil, sugar, meat, wine and beer, together with refined cereals. In 1971 one researcher reviewing diabetes in the tropics wrote that, ‘The incidence of diabetes is likely to increase with urbanization or as the complexity of civilization takes hold of any racial group.’

Diabetes is not one simple condition, but a family of conditions. There are, however, two common types. The first (now called Type I diabetes) most commonly first occurs in children but can affect people of any age. Such people need insulin by injection – usually for life. This is a very rare condition among the children of many tropical communities and is also rare in Japanese children. Type II diabetes is the adult-onset type that usually, but not always, occurs in the obese (usually women). In both types genetic and environmental factors are important.

The cause of diabetes is as yet unknown but it has recently been suggested that a high intake of foods rich in high-fibre starch is protective and might even be a good treatment for diabetes. Trials have now shown that slimming on a high-fibre diet can ‘cure’ many cases of adult-onset diabetes completely. Other studies have shown that eating a high-fibre diet can reduce the need for insulin in Type 1 diabetes, and in certain trials patients have been able to stop taking insulin completely when eating the correct diet rich in unrefined starches. Obviously this all has to be done under the watchful eye of a doctor who is expert in diabetes-it is not a do-it-yourself treatment for diabetics.

*59/72/5*

Shereen Tate discovered that eating a salad before she hit the party circuit put the brakes on her holiday overeating—and her inevitable 5- to 10-pound weight gain at holiday time.

Normally, the 32-year-old Niskayuna, New York, resident maintained good eating and exercise habits. She limited junk food, made sure she ate lots of fruits and vegetables, and worked out regularly. Even when’ her last pregnancy left her with 20 pounds of «baby fat,» she was able to take off the weight within a year, thanks to her healthy lifestyle.

Still, Shereen couldn’t seem to get through the holidays without picking up a few unwanted pounds. Every year was the same: At holiday soirees, in the presence of savory appetizers, tempting high-fat desserts, and sparkling champagne, Shereen would feel her willpower wane. By the time the New Year arrived, Shereen found herself toting around some of weight she had once worked so hard to lose.

Shereen was able to take off the extra pounds, but she hated having to do it year after year. As yet another holiday season approached, she knew she had to find a way to stop herself from overindulging. Then it hit her: Since she was most likely to eat too much when her stomach was empty, she’d make sure that her stomach was full before she started celebrating.

Shereen got into the habit of eating a pre-party plate of ro-maine lettuce or green leaf lettuce topped with carrots, cucumbers, and a splash of balsamic vinegar. She would leave her home with her tummy politely full. Once at the party, instead of lingering by the buffet table, she’d mingle with other guests. She’d sample a treat or two, but she didn’t feel the urge to overindulge, as she had before.

Shereen’s strategy worked like a charm. She survived that holiday season and seasons afterward without gaining a pound. Now that’s a cause for celebration!

WINNING ACTION

Start social celebrations with a private mini-meal. Before heading to a party, help yourself to a snack to take the edge off your hunger. I like to grab a V8 before party time. It’s easy, it’s quick, and I pick it up at a convenience store on the way. Other good choices include a piece of fruit, yogurt, or even a small plate of pasta.

*52\89\8*

The best form of treatment available for post-herpetic neuralgia is the early administration of antidepressant medication such as Prothiaden or Tolvon (particularly useful in the elderly) and Rivotril. Other anticonvulsant medications have also been successfully used.

In recent years the early administration of the anti-viral drug Zovirax also appears to reduce the severity of the rash and subsequent pain in this condition, and the related conditions of Herpes Simplex Type I causing cold sores, and Type II which causes genital herpes.

Another new medication is a cream which contains capsaicin — a derivative of chili peppers — which appears to selectively exhaust substance P, a pain-causing natural chemical in the nerve endings. This cream, known as Capsig in Australia, must be applied at least 3-4 times per day for periods of up to 3 months to be of any long term effect.

Physical therapy may be of use in the early stages of the disease. Accordingly, acupuncture and perhaps TENS may have a role in the early treatment of post-herpetic neuralgia.

*76\37\8*

Psychiatrists sometimes also like to play a variation of the game: ‘After you’ve cleared up the physical problem, send him to me for his emotional one!’

Such splitting of the mind and body is impossible, as any successful healer knows.

The ‘nobody will touch me’ game sounds as if it’s a patient-directed one. But this has been found to be rare. Despite much talk about doctors wanting their patients back from specialists, neurosurgeons and pain specialists, they do not go about it in a way that will achieve this. Some doctors treat patients who have major neurological problems like lepers. This can often happen with those suffering intractable pain and those who are failures of traditional medical and surgical therapy, and patients with implanted stimulators. (Implanted stimulators include dorsal column stimulation,in which wires are placed inside the vertebral column to directly stimulate the spinal cord to produce pain relief.) This is an extremely expensive, and sometimes painful, procedure which often fails to produce pain relief for more than six months.

*53\37\8*

Fight or flight? Stand your ground or cut and run to fight another day.? Fear, stress, pain and suffering have been the companions of homo sapiens since the days of the cave-men. But the terrors of winged dinosaurs, giant cave-bears and lurking sabre-tooth tigers have been replaced by the even more menacing stresses and tensions of the roar of the morning rush hour to start another working day in the twentieth century jungle.

A stress may be congenital, muscular, immunological, infectious, neoplastic, chemical, degenerate, emotional, psychological, or even environmental, such as accident or shock.

Why the pressure’s on

Unlike our ancestors, who picked up a rock and hurled it at a menacing animal, it’s a lot harder for a New Technology tribe member to pick up a computer terminal and hurl it at the menacing deadline pressures, at a tyrannical boss pacing up and down for a late report, to hit back blindly at creative burnout when a sales strategy/adver-tising campaign for a truly awful product is demanded.

*32\37\8*

The currently accepted definition of pain from the Taxonomy Subcommittee of the International Association for the Study of Pain — I ASP — in its 1979 report reads: ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ In addition it is noted that pain is always a subjective experience — that is to say that pain is only experienced by the person suffering it.’

Each individual learns the application of the word through experiences related to injury in early life. In an earlier definition of pain Dr Harold Merskey, the Canadian psychiatrist working in the pain area, drew attention to the fact that pain was almost always associated with some form of visible or audible behaviour. Califor-nian psychologist Richard Sternbach had already proposed that pain had three components: a component pointing to the pain source as a harmful stimulus signalling possible tissue damage: a pattern of responses permitting recognition of the pain by an observer; and, finally, the subjective or private feeling of hurt.

*9\37\8*

There are two forms of urticaria which differ mainly in their timing. The type which troubled Kustner (see p22) is acute urticaria, which comes on very rapidly and usually clears within 24 hours. It is usually accompanied by other symptoms, such as feverishness, faintness or nausea. Chronic urticaria, the other form, is a persistent rash, or one which comes and goes over a much longer period of time.

The blame for acute urticaria can usually be pinned on a food that was eaten just before the attack began, although there are other causes of acute urticaria, including insect stings, drugs (notably penicillin), and, more rarely, something that was applied to the skin. Whatever the cause, the reaction is usually so prompt and unequivocal that the patient easily makes the correct diagnosis.

With chronic urticaria, things are not so simple. Only about 20 or 30 per cent of people with this distressing problem are likely to discover the underlying cause. Two-thirds of those afflicted do not have high IgE levels, nor any other allergic illness, and it is not at all certain what causes their symptoms. However, those that can identify the source of their problem very often find that there are several triggers, including food or food additives. Whether they are acting as allergens, or have a drug-like effect, is an open question.

The subject of urticaria will come up again in Chapter Five, because even when the rash is truly allergic it can be caused in more than one way.

*54\180\8*

In cases of varicose veins, the regular taking of Ginkgo drops will counteract the formation of blood clots (thrombosis). Everyone who is reasonably sensible and natural in his approach to nutrition and life-style will be able to achieve a veritable regeneration and rejuvenation when taking a course of these drops.

I have received many encouraging letters from patients who have found Ginkgo biloba to be an excellent remedy for a variety of complaints. In February 1986, one lady wrote:

‘I have been taking this remedy since October 1985. For years I kept getting a pain behind my left eye and when out walking I would involuntarily swerve to the left, often bumping into people. I even feared I had a brain tumour, but neither the eye specialist nor X-rays discovered anything like that. Tests of the throat, nose, ears and sinus were all negative. One doctor said that vascular and circulatory problems were to blame and prescribed Ginkgo biloba, «the best remedy there is,» he added. And that reminded me of your article in Gesundheits-Nachrichten (Health News), where you recommended Ginkgo biloba for the same complaints.’

*714/28/1*

The importance and effectiveness of combining different substances is illustrated in the case of vitamins. For example, an easily assimilated calcium preparation is not necessarily absorbed into the system if there is a deficiency of vitamin D, or if the two are not taken together. The body cannot absorb the calcium if there is a lack of vitamin D and, conversely, the vitamin D will not benefit the body if there is a lack of calcium. One complements the other.

In the body we find a similar interdependence of functions. Hydrochloric acid and the digestive enzyme pepsin work in close association with each other in the stomach. Pepsin can break down the food proteins only if the gastric environment is kept acid through the presence of hydrochloric acid in the right concentration; otherwise pepsin is completely ineffective. There are many associations like these, and if we are to produce medicines that fulfil their intended purpose, we must find out more about them.

*670/28/1*

Beauty culture is almost as old as the human race. The desire to look attractive and to improve one’s looks is somehow inborn and it is especially women who take full advantage of the possibilities. However, although cosmetics can be beneficial to the skin and its functions they can also be detrimental, as, for example, are all creams and other preparations that block the pores and impair or stop the exudation of sweat, thus making the skin flaccid and tired looking. Frequent powdering also has the same effect. This explains why some women with tired skin certainly do not look their best without their make-up and can give you quite a shock if you see them first thing in the morning. Without make-up a forty-year-old woman who has been accustomed to applying non-biological cosmetics for many years may look like a seventy-year-old grandmother.

*626/28/1*

Perhaps this is an odd, not quite scientific, way to illustrate the problem we have with a virus, but it helped me to understand the researcher’s point of view.

We have only one option in order to fight pathogenic agents, in this case viruses, for which there is no known antidote or remedy, and that is to support the body in defending itself, by helping to mobilise its defence forces, or mechanisms. Thus, if we want to take up the fight against viruses and win it, we must do all we can to back up the body’s own regenerative power. The virologist in the Swiss hospital agreed with me. This is the only correct way to treat viral diseases.

*582/28/1*

I am fully convinced that many causes work together and put such great stress on the healthy cells that they have to give in; the harmony of their natural life and function becomes so disrupted that they degenerate and become malignant.

Predisposition is often responsible for cell degeneration, that is, it may be due to the inherited genetic make-up. However, such a predisposition need not lead to cancer if one’s life-style is sensible.

An inadequate diet, a constant companion of our modern way of living and eating, upsets the body’s biological balance and so damages the entire cellular system.

Too much protein intake, and of a poor quality, plays a considerable part.

Fats have a bearing on the development of cancer. Animal fats and fats lacking in unsaturated fatty acids are especially detrimental.

Disturbances in the mineral metabolism caused by the consumption of refined foods have proved to be a contributory cause of cell degeneration.

*538/28/1*

This oil has been included as a supplement because it’s the only food source on earth that contains almost all the essential fatty acids needed by the body. Some of these essential fatty acids can be made by the body (which is why they are not widely found in food) if it’s well nourished, not under stress or assailed by drugs and alcohol. The conditions required for optimum essential fatty acid formation are rare today which is why evening primrose oil is an essential food component of the programs in this book.

The fatty acids in evening primrose oil are needed to maintain the structural integrity of the membranes of all the cells in the body. Cell membranes are subject to damage from the wear and tear of substances passing through them—bacterial, viral and fungal infections and histamine released during allergic reactions. If the cell is unable to repair its membranes, holes appear that allow the passage of foreign substances into the cell. Heavy metals, toxins from infections and the assorted flotsam and jetsam that accumulates in the body (from breathing polluted air, drinking tap water, eating processed food and the waste products of body metabolism) can float in and out of the cell. These unwanted foreign substances get themselves involved in normally occurring chemical reactions, altering their outcome, thus disrupting the cell’s metabolism. Not only that, enzymes essential to the cell’s function can float out further disrupting the cell’s metabolism.

The body prefers to make its cell membrane from the unsaturated oils. If there is a deficiency in them it’s forced to use the hard, saturated animal fats. These are not as good and the membrane becomes hard and less permeable to the admission of nutrients and the emission of waste products. The fatty acids in evening primrose oil and MaxEPA—the marine oil (lipid) concentrate—are necessary for the cell to make special chemicals called prostaglandins. These chemicals are imperative for keeping the metabolism balanced. Particularly the metabolism of the kidneys. Fluid retention (over-weight) is a major symptom of metabolic imbalance born of prostaglandin synthesis inhibition. The fatty acids are needed to make the stress and sex hormones, the latter being particularly important for maintaining metabolic balance.

*223\18\9*

While white flour and sugar are responsible for the theft of vitamin B6 from the T-lymphocytes they also cause a deficiency in the thyroid hormone. Thyroxine, the hormone produced by the thyroid gland, regulates the speed at which the cells burn glucose for energy. A thyroxine deficiency means that the cells burn glucose less efficiently and therefore lack energy. Because most of the body cells rely on thyroxine, a lack of thyroxine causes a slowing of the metabolic rate and a slow metabolic rate means that less of the food we eat is burned for energy and more of it is stored as fat.

The T-lymphocytes also rely on thyroxine to burn glucose for energy, therefore a thyroxine deficiency causes the T-lymphocytes to lack vitality and diminishes their capacity to kill cancer cells and resist allergies. To produce thyroxine the thyroid gland needs adequate supplies of vitamin A, B6, C, B12 and E as well as the minerals iodine, zinc, manganese and copper. The complex interaction between all of these nutrients enables the thyroid gland to manufacture thyroxine and if one of these nutrients is absent no thyroxine is produced. A vitamin B6 deficiency, caused by eating too much white bread and products containing white sugar, can in time, single-handedly cause an under-active thyroid gland.

*205\18\9*

Don’t tell anyone in a health store you arc on the Anti-Candida Program. Some health store attendants fancy themselves as physicians and offer conflicting advice on treatment or try to sell products they believe to be superior to those recommended in this book. Inevitably you will react adversely to what they sell you. This will leave you confused and disheartened. If a health store doesn’t have the brand you are looking for, decline all substitutes and go to another store. It’s not worth faking supplements you are going to react allergically to. To get results from the programs, you must have the recommended brands. This is the only way you can be sure of not reacting allergically to a given food.

As with the Metabolism-Balancing Program you may need to take a bottle of water to work and sip from it steadily through the day as you work. This is to reach your optimum fluid intake levels.

Now that you are well you must keep taking Formula Six for the rest of your life. The vitality of your white blood cells will fall otherwise and candida plants will slowly grow back on the gut wall. There arc not enough vitamins and minerals in our foods (even fresh fruits and vegetables) to maintain optimum candida-killing power of our white blood cells.

I have tried to get people well without supplementary vitamins and minerals only to find that fresh food alone is not enough to achieve a cure.

Note: As there is so much important data in this chapter to be remembered, I suggest you read it three or four times before getting started and several times more through the course.

*187\18\9*

The dietary supplements are an integral part of the programs in this book. Without them, the programs don’t work properly and mediocre results are the best you can hope for. I have tried to balance body metabolisms with diet alone and have never succeeded. The supplements are not therapeutic agents in the manner that drug medications are, they are included to add to the overall nutrient content of the program. After twenty-two years of trial and error experimentation, I’ve learned which supplements give the best results and for this reason have included them in the book. In the case of Formula Six, the multi-vitamin and mineral tablets, I had to formulate them myself as there was nothing on the market that gave the results I was looking for.

In the first edition of this book I omitted to mention which brand of supplements to take and where to get them. This upset a few people because they didn’t know what to buy or where to buy it and some were not getting the results from the programs the book had led them to expect.

Many people became stressed-out trying to hunt down what they hoped were the appropriate supplements. Many complained by phone and letter that they had wasted a lot of time searching for suitable supplements and still didn’t have them. As a result of this a mail order service was born, as I felt obliged to procure the appropriate supplements and post them to those people.

The supplements described in this book should be available at your health store. However, experience has taught my readers, my patients and myself that some health store proprietors are not reliable at keeping stocks up and reordering when out of stock.

Do not start the programs without the supplements—their effects will be minimised and I don’t want you to be disheartened, especially if you have been let down by other treatment regimes in the past. The programs are not complete without the supplements as even fresh foods are vitamin and mineral deficient these days.

After you have completed the ninety-plus days on the Anti-Candida/Anti-Allergy Program, and are feeling well again, you must return to the Metabolism-Balancing Program and stay on it for the rest of your life.

If you want to be assured of optimum results I personally recommend you stay on all the supplements listed in this program, for all time. However, I realise that tablet taking annoys some people and the cost of long term supplementation is prohibitive to others. Both of these factors can be stresses, which undermine the good effects of the program. If you fall into either of these categories reduce the oils, vitamin C powder and Lugol’s iodine by 50 per cent, but be prepared to raise them again if you feel your form dropping. Don’t reduce the Formula Six. I wish there was an easier way than dietary supplementation to get and stay well, but unfortunately there is not. The age of dietary supplements is upon us, whether we like it or not.

Remember: The two most important nutrients are water and oxygen. If you are deficient in either, results from the program and supplements will be mediocre. Fluid levels can drop quickly (within an hour or so) and cause a corresponding drop in physical energy and mental alertness. Don’t miss a drink. Consume the appropriate number of glasses every day. Consult the water consumption tables earlier in this chapter to make sure you are getting the right amount. These water tables are based on accurate scientific measurements of the fluid needs of body tissues (non-fat) and weight-to-water ratio. The amounts recommended are those needed to facilitate optimum metabolic function.

Try and do the deep-breathing exercises every day.

Because there is so much important data in this chapter that has to be remembered, I suggest you read it three or four times before getting started on the program.

*169\18\9*

Like any change of habit, overcoming the tendency lo think self-sabotaging thoughts requires time and effort. To achieve this task you need to:

1. Keep your energy levels up by eating well, getting adequate rest and taking in adequate fluid, oxygen, vitamins and minerals. It’s easier to think positively when your energy is up.

2. Promptly dispute all self-sabotaging thoughts whenever they arise, attacking them instantly before they grow in size and intensity.

3. Each day, write down on a card one of the self-enhancing attitudes and take time to read and memorise it several times through the day. Carry them in your wallet. Cellotape them to your mirror.

4. Practise daily the mental relaxation exercises. It. is far easier for new attitudes to filter down from the conscious mind to the subconscious when we’re relaxed. Changing ones attitudes is less of a chore when we’re relaxed. We tend to interpret people’s words and actions more positively when we’re relaxed and our reactions to them are more appropriate. Repetition is the key.

Keep repeating the self-enhancing attitude every day even if such an attitude feels unattainable. If you hear it often enough for long enough, you’ll start to believe it. That’s the way the subconscious works. Repetition is the powerful reprogrammer of the subconscious mind.

Remember: A willingness to accept change lowers stress levels. Those who enjoy high levels of well-being all have one thing in common—a willingness to risk change.

*151\18\9*

Start by lying on the floor with knees bent.

1. Keep feet and knees together and let legs drop down from side to side. Progress to doing

the same movement with the feet off the floor.

This mobilises the spine and strengthens the abdominal muscles.

2. Bend one knee on to chest and hold it with both hands; push the straight leg as flat as

possible on to the floor. Repeat with the other leg.

This mobilises hips and stretches the psoas muscles.

3. From the same position, lift buttocks as high as possible and then lower them. Repeat while

raising both arms above head at the same time; next lower yourself on to one hip only, then

raise yourself and rotate down on to the other hip.

4.Straighten one leg; make the straight leg longer and shorter by tilting the pelvis sideways

away from your waist and towards it. Keep the knee straight. Repeat with other leg.

Remember being comfortable during your floor exercises is important. If any of these exercises produce pain discuss alternative exercises with your therapist.

The next two exercises start while you are standing and involve a chair.

5 Stand with your toes about 30 to 45 centimetres in front of a firm chair. Put one foot up on

to the chair and lean forwards. You will feel the stretch in the front of the straight leg. Repeat

with the other leg. This stretches the psoas muscles.

6. This time, put your heel on to the chair and, keeping the knee straight, lean forwards,

letting the standing leg bend. Repeat with the other leg.

This stetches the hamstring.

*108\111\2*

Back trouble – chiefly in the form of lower back pain – has taken on some of the aspects of an epidemic in the western world; that is to say, though it is not an infectious complaint, its incidence is seen to be constantly increasing. In Australia, it creates a demand for treatment which represents an ever-increasing burden on the health services. The already huge number of working days lost each year would also be likely to increase in proportion. The sum of all the individual misery that back trouble causes may, shortly, represent a luxury that this country cannot afford.

It would seem, therefore, that back pain sufferers of the future are more likely to be offered short shrift by doctors and employers alike. Harsh though this may seem, it has some backing from some advanced medical opinion.

Attitudes to pain-At the root of this search for medical help is said to be the psychological problem of the fear of pain. Attitudes to pain are highly subjective, and conditioned by each person’s individual psychology, which is the product of many different factors. Thus tolerance of pain varies enormously, and the identical kind of pain provokes widely different reactions.

A vigorous approach to back pain is seen in a new exercise method being developed in Denmark. It is designed to strengthen the back and shoulder muscles, which are said to grow weak because modern living causes them to be underused. Contrary to accepted notions, patients are advised to start the exercises while still suffering an acute attack of pain; but the exercises are claimed to be equally beneficial in cases of chronic pain. They are also said to have preventive value.

This new method received a lot of publicity a couple of years ago, and there was controversy over how safe it was as it had not undergone controlled trials. In general, if you are suffering from back pain you should not attempt vigorous exercise unless you have been carefully reassessed and investigated by your medical specialist and seen by a physiotherapist or other health professional, who can advise you as to the suitability for you of particular exercises, and can monitor their effect.

*85\111\2*

Exercise techniques are often important in the treatment of spinal conditions. They may be used as an adjunct to mobilising procedures, to enable the patient to maintain the restored range of movement and to strengthen muscles which have become weak through disuse or inhibition by pain.

Assisted or resisted exercises-Joints can become stiff if the muscles which move them are weak; by strengthening these, mobility can be increased. Since each joint movement involves the tensing of a set of muscles and the relaxation of the opposing set, assisted and resisted movement strengthens the muscle by working it in both directions of movement. Assisted movement is when you work your muscles but the therapist helps with the range and direction; resisted movement is when the therapist pushes against you doing the movement.

Proprioceptive neuromuscular facilitation (PNF)-PNF is a system of exercise which aims to obtain maximum muscle activity by using sensory and auditory stimuli to increase the response of the neuromuscular system. Resistance and stretch are also applied to groups of muscles. All muscles function most efficiently in groups – both ‘working together’ and ‘working against’ groups. In essence, the patient performs or tries to perform movements against the manual resistance offered by the therapist in certain spiral and diagonal patterns of movement. The movements contain elements of flexion (or extension) together with a rotatory component, and are closely related to normal functional movement. Maximum contraction of strong muscles is used to reinforce the effort of weaker muscles in the pattern. The specific placing of hands to apply pressure, the use of the voice to stimulate ‘push’ or ‘pull’, the stretching of muscles to initiate movement, are stimuli used to encourage movement. PNF procedures are normally done with the patient lying supine. It is hard work for therapist and patient.

*64\111\2*

Tut a board under your mattress’ is the piece of advice that the back pain victim hears from practically everybody. But this should be necessary only if your bed has a very soft base or an old, sagging mattress. There is no need to support a reasonably firm mattress. However, if you do need a bed board but have not got one, ask someone to drag your mattress on to the floor. Or simply do what many back sufferers do, sleep on a quilt or sleeping bag spread on the floor itself, using pillows, as already described, to relieve pressure and to keep your spine straight. When in acute pain, it is difficult to get down on to the floor and even harder to get up again; going via the kneeling position helps.

If you lie mostly on your back, you may find it most comfortable to support your legs, from the knees down, on a pile of cushions; or on a chair or a stool or footstool if you are sleeping on the floor. In this position, the back is kept from arching by being pressed firmly against the mattress (or floor).

If you have managed to find a comfortable position, the tendency is to stay put, but you should try to vary it from time to time, for the good of your circulation. Also, if you remain immobile because of back pain you may find yourself feeling stiff all over after a time. Changing position may call for some courage: do it slowly and gradually. Changing from a horizontal to a vertical position is what hurts most, so do not try to sit up. As for turning over in bed, you may find this easier to do if you bend your knees, bringing your heels up towards your buttocks, and, keeping your shoulder in line with your hips, let the knees fall to one side and use the weight of your legs to roll you over.

For getting out of bed, try this method: turn on your side, then edge over to the side of the bed, keeping your knees bent; then let your legs slide over the edge, acting as a counterweight as you push yourself upright with your arms. Have a chair at hand to lean on as you get to your feet.

In the end, you will probably work out for yourself, by painful trial and error, the method of getting out of bed that causes the least discomfort. Even so, try to limit the number of occasions of doing it, especially during the first day or so. Moderation in eating and drinking will limit the number of times you have to go to the toilet; and you may not have much appetite in any case. Avoid alcohol, which may interact with the pain-killing drugs you are taking; some people find that it makes the pain worse.

You may find yourself temporarily constipated, which may be the effect of taking some types of pain-killer, or of immobility, or fear of the pain that getting out of bed causes. This is a temporary problem, and there is no need to worry or do anything about it.

Keeping moving-At this stage you cannot do much in the way of exercise, but try to move your legs at regular intervals. The longer you remain immobile, the longer it will take you to recover your strength and mobility.

Even when you are suffering severe pain, and are frightened to move, there are bound to be some movements you can make without pain.

Start with these. Try wriggling your toes, bending and circling your ankles, working the feet up and down, bending and extending the knees. Do this for a few minutes, every hour or so. If any movement causes you pain, avoid it, and try to find another that does not. In between spells of leg movements, do some slow deep breathing.

A weight off your mind-It may not be easy for you to induce your tensed muscles to relax if at the same time you are brooding about the work and other obligations for which you are now temporarily disabled. A serene frame of mind may seem rather too much to expect from someone who is being racked by acute back pain, but relaxation involves both body and mind, so if you can find a way of relaxing your mental tension, the pain may affect you less.

The best thing to do is to accept the situation, and abandon, as much as possible, feelings of guilt about neglected work, missed appointments and so on. You are a victim of force majeure: the matter is out of your hands for the time being. You will have to ask someone to do some telephoning for you, cancelling engagements, and arranging for other people to stand in for you, at home and at work. Accept the need to rest and look after yourself for a few days. Do not be tempted to get up too soon. The more you can allow yourself to be philosophical about the situation, the more rapid is recovery likely to be. For a while the world will have to roll on its course without you. This advice is more easily given than followed.

But don’t become an invalid-Other people can affect your back pain. Some families enjoy making a fuss of an invalid and that may actually inhibit the natural desire to resume normal life. One danger with giving in to back pain for too long is the stiffness and weakness which ensue.

Supporters of the ‘pain confrontation’ school of thought argue that there is no evidence that activity is harmful and that, contrary to common belief, it does not necessarily even aggravate the pain as long as specific activities which increase the load on the spine are avoided. Increased activity may promote bone and muscle strength and may increase endorphin (a pain-reducing hormone) levels and reduce sensitivity to pain. They also claim that there is no evidence that early return to work increases the likelihood of future recurrences. These views are not universally accepted. Remember, seek professional advice. Know what is the cause of your backpain.

*43\111\2*

The vertebrae, like any other bones, can be fractured by a blow, accidental or deliberate – a car crash, a fall from a height, a bullet may chip one of the vertebrae, or even detach a fragment. Too vigorous exercise may do the same: if a tendon attached to one of the transverse processes is overstretched, it may come away, taking a piece of the bone with it. Violent, unskilled physical effort may also cause microscopic fractures in the cartilage covering the flat sides of the vertebral bodies.

Compression forces which are too powerful for the discs to absorb – for instance, the violent jolt of a leap from a height, as in a poor parachute landing – may cause a crush fracture of a vertebra: shattering the vertebral body or forcing it out of shape, or breaking off the transverse processes.

Spinal fractures are often, but not invariably, painful; they usually mend with rest. A crush fracture may displace part of a vertebra so as to produce a slight hump that can be seen and felt. Sometimes an X-ray discloses bone damage of which the owner of the spine was unaware, and which gave no trouble. However, the most serious fractures, those that damage the spinal cord, can cause paralysis below the site of the injury.

*19\111\2*