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.
The usual symptoms of candidal vaginitis are itching in the anogenital area, a vaginal discharge which may be white and cheesy or mucopurulent, and odour. Signs include a vaginal discharge, excoriation of the skin and violaceous oedema of the vulva. The presence of yeasts may be noted in cervical smears.
The history and clinical examination will frequently indicate the diagnosis. The organism can be detected by microscopic examination of vaginal smears or by culture on Sabouraud’s medium. If the patient’s history suggests exposure to STD, examination for concurrent infections should be considered.
The possibility of a predisposing condition should be considered and patients should be tested for glycosuria.
The physical examination should include oral, genital and anal examination. In female patients, a vaginal speculum should always be used to visualise the cervix and bimanual pelvic examination should be done. In patients with anorectal symptoms and in homosexual men, proctoscopy should be done to exclude anal canal pathology.
Patients must be treated with the same consideration as other patients. The examination should be carried out in privacy without interruption. Appropriate instruments should be used with gentleness and skill.
Laboratory investigations are directed at:
identification of the causative organism or organisms.
Patients should be told what investigations are being done and why they are considered necessary.
The investigations to be undertaken will be determined by the presentation and clinical findings, test results and the differential diagnosis
Basic Yoga Breathing Exercises
1) Lie on your back and relax. Inhale slowly, to the count of four, pushing out your diaphragm, bulging your stomach and distending your ribs. Then, exhale to the count of four. Your stomach will flatten and your ribs retract. This breathing exercise can also be performed while you are walking or sitting.
2) Sit with your hips touching the back of a chair and your feet flat on the floor. Make sure your knees are comfortably apart, and then take a deep breath through your nose as you raise both arms over your head. Lean forward slightly and exhale slowly. Keep breathing through your nose as you bend over until your chest rests lightly against your knees. Allow your head to hang between your knees and your arms to dangle by your sides as you press out all air. Hold this position for a count of 8 after exhaling. Begin breathing in as you lift your arms and return to a sitting position. Maintain the sitting position, with your arms overhead for a count of 8, then relax. Repeat the entire exercise a total of 3 times.
Basic Yoga Relaxation Exercise
Lie on your back, with your arms by your sides, palms up. Your legs should be slightly apart. Close your eyes and imagine that you are floating. Unflex your neck muscles— very slowly roll your head from left to right 10 times. Relax the other parts of your body, beginning with your feet, your ankles, your lower legs, and continue upward toward your head. Concentrate on each part of your body until it feels free of tension and you are completely relaxed.
Finding a sex therapist who is qualified, experienced and trained to handle problems like yours is important. We believe that a personal recommendation from a qualified professional is one of the best ways to find someone to help you. Ask the urologist who examined you for physical problems for a recommendation.
Another good source of referral is a university which has a sex therapy clinic, or a program to train sex therapists. Even if the clinic itself is too far away or otherwise inconvenient for you to use, many will provide referrals to graduates or other qualified sex therapists who practice near you.
Paying for Sex Therapy
How much you pay for sex therapy depends on where you live, which therapist you see, the length of treatment and the type of program. Hourly rates may be the same or close to those charged for other types of therapy. Intensive programs may cost $1,500 to $2,000, or substantially more. Some therapists do offer sliding scales based on the client’ s ability to pay, and some university training programs may occasionally offer therapy at reduced prices.
What’ s important is that you understand, up front, how much the therapy will cost. Get an estimate as to the number of sessions. And ask if at any point in the program you decide not to continue—or if the therapist decides you should stop—do you get a partial refund of any money you’ve paid in advance?
Many health insurance policies will not pay for sex therapy, so be sure to check out your coverage in advance.
Where are cancer cells most likely to escape being killed by chemotherapy drugs? Firstly, they may escape wherever there are big deposits. One of the biggest deposits is often, but not always, the primary cancer. There may be a choice between surgery and radiation to tackle these large deposits. Secondly, there are parts of the body where there seems to be some sort of barrier to the penetration of chemotherapy drugs. Radiotherapy can be used to treat these areas. They are the central nervous system (brain and spinal cord), the testis and the ovary. For example, in acute lymphoblastic leukaemia of children, the chance of leukaemia cells getting into the central nervous system, testis or ovary is so high that preventive treatment of these areas by radiation is recommended. This addition to the usual chemotherapy treatment has been shown to improve the cure rate.
Bone marrow transplantation is a special instance where radiation is combined with other treatments to produce some cures. The preparation includes radiation of the whole body. Although bone marrow transplantation has been tried for many types of cancer, the only ones it can cure are certain types of leukaemia. The entire treatment package is very arduous, dangerous and lengthy and the chance of cure is usually not high. Try very hard to get all the facts before agreeing to this type of treatment.
Obviously, the more different types of treatment you have, the more your treatment is likely to ‘cost’. The situation with combination treatments is so complex that you could be very tempted just to tell your doctor to go ahead with whatever is most likely to cure you. The problem is that doctors have a tendency to overtreat, as we have seen. They are likely to want to add to your treatment anything that could be active against your cancer. They will probably make little or no attempt to weigh the likely additional cost against the likely additional benefit. In any case, you can do that much better than they can. It is therefore very important that you ask exactly what difference each part of your treatment is likely to make. What could happen if you only had one type of treatment? Does the addition of radiation improve the cure rate or only the local recurrence rate? How difficult is it to treat a recurrence? Would you still have a chance of cure if the disease recurred or is the ‘first bite at the cherry’ really your only chance? You will have to try to weigh up the possible costs against the possible benefits to come up with the decision that is best for you.
Insulin, while performing lifesaving functions like leveling out blood sugar levels, does so by increasing the risk of heart and other diseases and by contributing to obesity. The normal concentration of blood sugar is from 80 to 120 milligrams of glucose for each 100 milliliters of blood.6
We understand that insulin is somehow associated with diabetes and that insulin’s job is to bring down excessively high levels of blood sugar. Type II diabetics have either lost the ability to secrete enough insulin to keep blood sugar levels in check or have developed a condition called insulin resistance, which essentially "locks" insulin out of target cells and keeps it circulating at high levels, a major risk factor in the development of cardiovascular and artery diseases. Insulin regulatory mechanisms break down from weak genetics, obesity, or from the overuse of blood sugar homeostatic mechanisms (eating too much sugar!). Stress also plays a role in increased insulin resistance.
‘When I get annoyed about something I go after the largest carbonated drink I can find!"
The role insulin plays in the body, however, is much more diverse and powerful than bringing blood sugar levels under control. As one textbook terms it, "The major function of insulin is to promote storage of ingested nutrients." As a storage hormone, it has an impact on virtually every tissue in the body. Insulin’s primary targets are the liver, muscles, and adipose (fat) tissue. Insulin first pulls sugars out of the bloodstream and deposits them in the liver as glycogen, then in the muscle as glycogen, and finally converts it into triglycerides for storage in fat tissue. Insulin hormone "builds" fat.
Insulin increases the synthesis of several types of fat/protein and fat/sugar complexes, such as triglycerides, cholesterol, and very low density lipoproteins (VLDL), which aid in the building of muscle tissue and deliver glucose to those muscle cells for energy. LPL (lipoprotein lipase) is an enzyme that actually pulls triglycerides into fat cells for storage; insulin increases both the production and the action of LPL and inhibits those same fat cells from converting back into blood glucose.
Just keep two facts in mind as we continue this discussion: Insulin promotes fat storage, and excess carbohydrates stimulate insulin.
At times it is impossible to walk away from the child in the midst of a tantrum: for example, at other people’s houses or when shopping. It is still important that the behaviour not be reinforced. Suggested strategies for dealing with tantrums are outlined in a separate section on management of behaviour problems.
Sometimes the child can become quite frightened during a tantrum, probably because he feels out of control, and appears genuinely distressed. On these occasions you should simply hold the child for a few minutes, until he is back in control. Even during this period it is important not to reinforce the behaviour by being too warm and affectionate to the child. Furthermore, there should never be a reward for the child at the end of the temper tantrum. For example, a child may have a tantrum after his parents have insisted that he tidy up the toys, or perform another task. Once the tantrum is over and the child has regained composure, you should gently guide him back to the original task. If this is not done, then the child will very quickly learn that the way to avoid doing things is to have a temper tantrum.
If parents can manage a child’s temper tantrums correctly, then they will be able to manage successfully most of the other difficult behaviours that are an integral part of childhood. If they unwittingly allow the child to use repeated temper tantrums to get his own way, there is a good chance that the child will continue to use temper tantrums, or variations of them, as a way of relating to parents, other adults and peers. It will be likely to interfere with social learning, relationships and learning to deal with frustration.
You may want to speak to your doctor or another health professional to ‘coach’ you about behaviour management techniques. It is very often helpful to have somebody to support and encourage you during what is often a taxing time. Occasionally the family doctor will refer you and the child to a paediatrician or psychologist for more specialised advice.
It is unlikely that temper tantrums can be totally prevented — they are a normal part of growing up. However, parents can certainly do much to make sure that they are not prolonged or made worse and that there are no associated behaviour problems, by handling the tantrums appropriately in the way suggested above. A commonsense, low key approach will usually work.
THREATENING SAME-SEX CHILDHOOD FOE
Do you remember a bully, a “meany,” some child who just seemed to have it in for you? There seemed to be something about you that resulted in a monstrous reaction on the part of this one particular child. You might have sprinted with terror past his house, snuck down the alley on the way home from school, done anything to avoid direct confrontation with this one child.
One husband reported, “His name was Carl. This kid hated my looks, my name, my clothes, my walk, my parents, even my dog. I have never been so afraid in my life, not even in the war, as I was afraid of Carl.”
“She was the meanest girl. She gave the word ‘bitch’ a bad name. She put me down to everybody. I hated her. I wished she would die. I’ll bet she became a gossip columnist.” This wife frowned, reliving her anger as she described this love-map imprint.
The same-gender conflict and fear gets on our love map, a danger zone that is reflected in our choice of a partner and in our day-today working and loving. Think about conflicts with people at work, about conflicts with certain family members, and try to relate these relationships to your love map. You will see that these maps influence all living.
At this stage of the process some people may go into psychotherapy. As was discussed in chapter four, psychotherapy can be extremely beneficial. Many of us who have an anxiety disorder have suppressed our primary emotions of anger, grief and so on. Psychotherapy helps us contact these feelings. Experiencing them is part of the healing process.
People have asked the question of what to do with their thoughts while working through issues in psychotherapy. There will be issues in therapy which need to be thought through and worked with, and they may cause anxiety and attacks. Again, it means walking a fine line. Be aware of why they have occurred and let them happen.
As our management skills increase we will begin to realise a subtle pattern emerging with our anxiety and attacks. When we are avoiding confronting particular personal issues, or in other words, not being honest with ourselves, we may find ourselves reacting with anxiety or an attack. We can use these subtle guides to get to know and understand ourselves on a deeper level.
For many types of cancer, complete surgical removal of the primary tumour is the only treatment that is ever capable of producing a complete and permanent cure. Surgery cures more cancers than does any other form of treatment. Surgery is also recommended to cancer patients for other reasons: to make a diagnosis, to relieve or prevent symptoms and to reconstruct parts of the body. We will look at each of these in turn later in this chapter.
There is one basic problem with surgical treatment which does not apply with other types of treatment. Surgery is done while you are unconscious and therefore incapable of making any decisions.
If something unexpected is found during an operation on you, decisions about the best immediate course of action will be taken out of your hands. They will be made on your behalf by the surgeon. Most surgeons take it for granted that they should be making all the decisions, so they have no strong reasons for trying to prevent this situation from arising. There is only one way to make sure that you make the decisions about what operation will be done. You must make sure that you know, as completely and accurately as possible, before your operation what will be found when you are opened up, and what can be done to deal with this situation. The more careful and thorough your pre-operative assessment is, the greater the possibility of the exact opertion lat you agree to being performed.
If the blockage occurs in a large artery, so much heart muscle may be deprived of blood that the heart cannot cope with its normal function and death may occur. This may be immediate or happen within a few hours, a day, or longer.
Sudden death is always a possibility following a heart attack and the risk is greatest in the first few hours, decreasing over the following 48.
The cause of death is usually due to the development of an abnormal heart rhythm.
There are a number of abnormalities of rhythm but the one causing death is ventricular fibrillation.
The best way to prevent or treat this is for the person to be under the care of trained medical or paramedical personnel.
Coronary care units have been established in all public and most large private hospitals. The person with the suspected heart attack is admitted to this special ward and is monitored by having a continuous electrocardiograph displayed on screens.
It must be stressed that the evidence is not all bad. Some of the studies involve such small numbers that no valid conclusions can be drawn.
An epileptic woman who stops taking drugs because she becomes pregnant is at risk of having convulsions. The convulsion with the associated lack of oxygen during the fit may, in itself, be dangerous to the foetus.
The developing foetus has already been exposed to the drug and stopping it when pregnancy is confirmed may be too late, if in fact, the drug does have harmful effects.
All life is a risk and, at the moment, it appears there is a greater risk to the baby if the epileptic woman stops her medication during pregnancy than if she continues it.
Firstly, it performs an essential protective role. Because of its resilience or ability to resume its previous shape after deformation, it can withstand considerable trauma without permanent damage. This mechanical barrier is mainly due to the arrangement and nature of the collagen and elastic fibres in the dermis. It also constitutes an effective barrier to the passage of substances into or out of the skin. This chemical barrier is provided by the layered cells of the epidermis, which impede the loss of water and body salts and prevent the penetration of external substances.
Secondly, the skin is a most effective and essential sensory organ. This is a result of it being richly supplied with nerve endings, which provide an effective sensory defence against potentially harmful stimuli. It also acts as a ‘relay station’ between external influences and internal organs, via a network of nerve fibres. Of equal importance, is its role as an organ of expression: for instance we may express anxiety by sweating, fear by pallor, anger by redness, pain as a grimace, or happiness with a smile.
Thirdly, the skin acts as a remarkable thermostat. This is mainly achieved by its blood vessels and sweat glands. The metabolic processes of the body continually produce heat, which must be dissipated to maintain a constant body temperature. Under normal environmental conditions this may be achieved by varying the diameter of the blood vessels in the skin, resulting in changes in the volume of the blood flow. This blood flow can be varied 100-fold from maximum constriction to maximum dilation of the vessels. Increased blood flow is accompanied by increased heat loss, whereas a reduced blood flow retains heat.
If, however, blood flow alterations are insufficient to regulate the body temperature, then the sweat glands are activated. This will occur with extreme external temperature increases, excessive exertion, or the fever accompanying an illness. The sweat bathes the skin and cooling results from its evaporation.
Fourthly, the skin plays an active part in the body’s defence against such micro-organisms as bacteria, fungi, and viruses. The surface of the skin is never sterile. It is host to a permanent resident colony of various bacteria which are relatively innocuous. Their presence, however, inhibits the growth of more dangerous organisms on the skin. Further protection is provided by the dryness of the skin’s surface. Most organisms are relatively intolerant to dry conditions, much preferring humid or moist environments. The continual shedding of the superficial epidermis also discourages bacterial invaders. Sebum, the oily secretion produced by the active sebaceous glands, contains fatty adds which have a strong anti-bacterial and anti-fungal action. A thin coating of this on the skin provides a further protection.
Finally, the skin is an important barrier against damaging ionizing radiation, such as ultra-violet light. For skin unprotected by hair or clothing, the only significant defence against the destructive effects of U.V.L. is melanin. Without melanin the epidermis would be a thin transparent membrane, allowing
U.V.L to damage the sensitive structure of the dermis. Melanin is a complicated large protein produced by special cells, melanocytes in the basal layer. From there it is distributed throughout the epidermis. The amount of melanin in the epidermis governs the colour of a person’s skin: the more melanin, the darker the skin colour. There is no difference though in the number of melanocytes in white and in black skin. The difference is simply one of activity, reflected in the amount of melanin or pigment these cells produce. Various factors may influence this, including sun exposure, pregnancy, various hormonal disorders, and drugs.
Hypoglycaemia is a condition in which the sugar level in the blood fails below normal levels. From the Greek words hypo meaning under and glycaemia meaning blood sugar—hence blood sugar level below normal.
These days, hypoglycaemia is a popular diagnosis for all sorts of problems which cannot be attributed to a more specific diagnosis. There has been considerable publicity about hypoglycaemia which is often blamed for many non-specific health problems ranging from tiredness to depression. Unfortunately, it is often wrongly blamed which can delay a proper diagnosis and correct treatment.
Nevertheless, genuine hypoglycaemia does occur in a few people, and the G.I. factor has a role to play in treating some forms of this condition. The most common form of hypoglycaemia occurs after a meal is eaten. This is called reactive hypoglycaemia.
Normally, when a meal containing carbohydrate is eaten, the blood sugar level rises. This causes the pancreas to make insulin which ‘pushes’ the sugar out of the blood and into the muscles where it provides energy for you to carry out your regular tasks and activities. The movement of sugar out of the blood and into the muscles is finely controlled by just the right amount of insulin to drop the sugar back to normal. In some people, the blood sugar level rises too quickly after eating and causes an excessive amount of insulin to be released. This draws too much sugar out of the blood and causes the blood sugar level to fall below normal. The result is hypoglycaemia.
Hypoglycaemia causes a variety of unpleasant symptoms. Many of these are stress-like symptoms such as sweating, tremor, anxiety, palpitations and weakness. Others affect mental function and lead to restlessness, irritability, poor concentration, lethargy and drowsiness.
The diagnosis of true reactive hypoglycaemia cannot be made on the basis of vague symptoms. It depends on detecting a low blood sugar level when the symptoms are actually being experienced. This means a blood test.
Because it may be difficult (or almost impossible) for someone to be in the right place at the right time to have a blood sample taken while experiencing the symptoms, a glucose tolerance test is sometimes used to try to make the diagnosis. This involves drinking pure glucose which causes the blood sugar levels to rise. If too much insulin is produced in response, a person with reactive hypoglycaemia will experience an excessive fall in their blood sugar level. Sounds simple enough, but there are pitfalls.
Testing must be done under strictly controlled conditions and capillary (not venous) blood samples collected correctly. Home blood glucose meters are not sufficient for the diagnosis of hypoglycaemia in people without diabetes.
Body Mass Index (BMI). BMI (sometimes also called ‘Quetelet’s index’) was developed to account for the influence of height on body mass. The measure is weight (in kg) divided by height (in m) squared, i.e. BMI = wt(kg)/ht(m)2. Recommended ideal range for BMI is 20-25 kg/m2. Overweight is regarded as over these upper levels and the different levels of obesity are defined.
BMI has as its main advantage the ability to be used in large scale population studies. It requires only two measures; height and weight, which can both be measured accurately by a person with minimal training. It suffers similar deficiencies to weight in that it is less valid in those with a mesomorphic build, and particularly athletic men. The validity of BMI, although higher than weight, is lower than is necessary for a good measure of body fatness. Validity has also been found to be higher in women than men and to be significantly influenced by body build.
Comparisons with other anthropometric measures, at least in large populations, show the usefulness of BMI measures. Its reliability is relatively high, but as with weight, this can be influenced by fluid content. Sensitivity could be expected to be similar to that for weight as height is not expected to change significantly, except with age. The BMI therefore is useful for large scale population studies and, in combination with other measures, is useful for individuals. Some researchers have called for the total abandonment of BMI. However, according to Lohman. ‘. . . BMI needs to be included with skinfolds or bioelectric impedence and other laboratory body composition measures of muscle, bone, and fat’.
The limitations of BMI, as with weight, need to be understood in working with individuals, i.e. there is a need to apply other assessments (including a practised ‘calibrated eyeball technique’) to raw BMI data.
This means the kidney structure is affected by disease. It also goes by the name acute glomerulonephritis. It may be preceded by a seemingly simple infection of the throat, or skin, by a germ called the haemolytic streptococcus. By the time kidney symptoms occur, the original infection has usually cleared up.
Symptoms are often vague to start with. The first may be blood in the urine, and the patient might not seem very ill. Sometimes the amount of urine passed is less than normal, and the patient may seem to gain weight quickly as fluid is retained. There may be slight headaches, feeling off colour, tummy upsets and a mild fever.
Sometimes as the disease progresses, more serious symptoms may occur, as the blood pressure rises and adversely affects the brain. The child may become restless and vomit, and mental vagueness, convulsions, visual disturbances and coma are possible. These complicated forms are uncommon, but if any of these symptoms take place, urgent medical attention is essential. Sometimes as the disease worsens, the heart may be affected and the kidneys become more severely involved.
Prompt medical attention is essential with any abnormal urinary symptoms. Blood in the urine needs immediate investigation by the doctor. Although a large number of children appear to recover completely, a certain number develop a longer illness, chronic nephritis. Often hospitalization is necessary.
The important fact is for the parents to be aware of the seriousness of kidney disorders and make certain the child receives prompt attention if showing any of the sinister symptoms that may indicate kidney disease.
The outside world is a hostile place, as a baby soon discovers. Germs abound and are ever ready to pounce upon anybody who is susceptible. Babies are extremely prone, and so are infants and children of school age.
Fortunately babies receive a fairly high level of immunity (in built protection) from their mothers, and for their first several months are fairly resistant to these onslaughts. Breast-fed babies continually receive protective factors from the mother, which add to this normal protection and keep it going.
But sooner or later this comes to an end, and the baby then has to face these hostile enemies, who are ready and waiting for a new victim.
In recent years, researchers have developed an astounding array of protective methods for keeping baby free from many of the more serious potential invaders. These are readily available to all babies in this country in the form of immunization. This gives each baby a flying start in life; it ensures a high level of immunity, right throughout life, from some of the terrible life-threatening germs that are still around.
Many infectious diseases are spread simply from person to person. Often this happens by droplet infection. A person with the disease may cough or sneeze, in so doing imparting an enormous number of germs into the surrounding air. Anyone who comes into this radius may pick these germs up and, if personal resistance is low, subsequently contract that illness. In those of a young age group, when their normal body resistance is not high (after mum’s immunity is no longer available), then there is a high level of susceptibility to these germs.
Many are caused by viruses—extremely minute germs. Others are caused by germs called bacteria—these are ones that are larger. We often have suitable treatment in the form of antibiotics that will effectively counter bacteria. But the viruses still have doctors baffled, and at present very few antibiotics are available that will destroy them.
As a general rule, children are more susceptible to the infectious diseases than adults. In older persons, there has been built up a fairly high level of immunity, often from a previous attack of the disease or from constant contacting of small doses of the germs over a long period of time.
In most cases, a reasonable-sized infection yields a fairly high level of resistance to subsequent bouts. It does not give total protection for every infection; but if subsequent attacks do occur, they are usually far less severe.
Many of the childhood infectious diseases are fairly mild. Many may be treated at home with fairly simple measures available to most parents. Others need the doctor’s attention.
As a general rule, never fail to call the doctor if your child appears to be ill, is not obviously responding to your home medications, or if the condition is worsening.
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.
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.
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.
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.
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.
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.
• 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.
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.
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.”
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.
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.
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.
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.
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.
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!
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.
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.
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!’
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.
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.
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.
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.
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.
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 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.’
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.
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.
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.