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Studies with sibutramine and orlistat in a clinical setting have been designed to show what happens in ‘real life’. Results from both are favourable, and indeed broadly comparable. On average, one can expect weight loss of around 9% maintained over 12 months, among those who respond to, and continue treatment. However, while every physician involved in weight management will be able to tell you of the marvelously successful patient who lost 40% body weight, they will equally be able to tell you of their abject failures.

Sibutramine

When used in conjunction with a low-calorie diet, data show that 77% of sibutramine-administered patients achieve a medically beneficial weight loss of at least 5%. Importantly, continuation of therapy can sustain these weight losses for at least 2 years. Further, a recent meta-analysis has shown that, in sibutramine-administered obese patients, subjects who achieved weight losses of over 4 kg in the first 3 months of treatment were more likely to achieve long-term weight loss maintenance if therapy was continued. This in turn, led to marked improvements in metabolic factors such as lipid profile, insulin sensitivity and hypertension.

Orlistat

A placebo-controlled study involving obese patients found that orlistat can promote and maintain weight loss (when administered in conjunction with a hypocaloric and a eucaloric diet, respectively). During the weight-loss phase (year 1), orlistat patients lost 10.2% body weight, compared with 6.1% in the placebo group. Results from the weight-maintenance phase of the trial (year 2) showed that patients who continued on orlistat regained half as much weight as patients switched to placebo. Weight-loss-associated improvements in cardiovascular risk factors, including lipid profile, blood pressure and fasting glucose, have also been demonstrated.

*49/312/5*

WEIGHT LOSS/BODY-BUILDING

Cause

Epiglottitis is caused by a germ (Haemophilus influenzae) which causes inflammation and swelling of the epiglottis. The epiglottis normally sits at the top of the windpipe and prevents food and liquid entering the windpipe during swallowing. When it is inflamed and swollen, the epiglottis blocks air flow, causing breathing difficulty and marked distress.

Clinical features

The onset of epiglottitis is very rapid. Unlike croup, where the child has symptoms of a cold before he develops a barking cough and stridor, epiglottitis develops rapidly in a child who has previously been perfectly well. Within a few hours the child is often desperately sick. He looks toxic and unwell, pale, with saliva drooling from his open mouth. He will often have a soft snoring noise when he breathes, and will sit well forward, refusing to lie down because it causes him further respiratory distress. He is irritable and restless, feels hot, and it is difficult to console him.

No investigations are indicated. The diagnosis of epiglottitis is made on the basis of a very rapid onset of symptoms in a previously well child, and characteristic clinical signs. In fact, no investigations or procedures (such as taking blood, measuring temperature) etc. should be performed if epiglottitis is suspected because they may distress the child and precipitate obstruction of the windpipe.

Treatment

If epiglottitis is suspected, the child must be transferred immediately to a hospital which has an intensive care unit. There a breathing tube is usually inserted to help the child breathe, and antibiotics given intravenously.

When to see your doctor

Epiglottitis is a medical emergency, and if it is suspected then medical assessment must be obtained immediately. Do not delay — it is literally a matter of life and death.

Prevention

Epiglottitis is preventable by having your child vaccinated against Haemophilus influenzae. This is commonly called the Hib vaccine, and is now available in Australia. Make sure your child is fully immunised. This will prevent him from contracting this and other potentially fatal diseases.

*223\90\8*

Miscarriage is common. One in five pregnancies ends in miscarriage, and 75% of these occur within the first 10 weeks. Most miscarriages that occur in the early stages of pregnancy are a result of an abnormality in the foetus. Sometimes the miscarriage is due to a blighted ovum, that is, an egg that was not fertilised but caused a ‘phantom pregnancy’. Some fertilised eggs simply do not develop properly, and are rejected by the mother’s body.

Miscarriages during the later stages of pregnancy can be due to numerous factors, cental insufficiency (a placenta which stops functioning properly).

Having a miscarriage is not an experience that you need to go through alone, and talking over your feelings with others who have had similar experiences may help to ease the burden of guilt (unfounded) that you may be carrying. It may also give you the opportunity to air the sadness that you are bound to feel. This will help to rebuild your confidence, and make you feel more positive about trying again. Talk to your partner, who will also be feeling down. Share your concerns, feelings of guilt, fantasies with each other. Couples who have gone through repeated miscarriages, or who have had difficulty conceiving, may experience a sense of grief with the onset of each period, as if they have lost another ‘potential child’. This is a perfectly normal reaction, and you both need to mourn for this too, in order to achieve acceptance of the loss and to heal the ‘wounds’. Not discussing these feelings openly with each other can lead to a sense of resentment and anger which may interfere with sexuality too. This can lead to a vicious cycle of anxiety about sex, which is exactly what you don’t need if you are trying to conceive again.

*56\90\8*

ANSWER: Even though the rectum has connotations in our culture that make it seem dirty and corrupt, it is actually a very sensitive area. You know that, because you know how much it hurts you when he tries to enter you there. There is nothing unnatural about anal penetration. It is purely a matter of two things, preference and knowledge. The issue of preference can be addressed only by open communication. The issue of knowledge may help in this situation, because the facts may help you both to come up with a solution to your differences. The tissue in that area of the body is not only sensitive but can be damaged easily. Lubrication is important, so if you ever decide to do it, use a well-lubricated condom. Infection can be a problem, too, so make sure there is no cross-stimulation from the rectum to other areas of the body. Finally, it takes practice and cooperation to accomplish penetration of the anus. Practicing with slight insertion of the little finger and moving on to more and more penetration can help, and learning to relax the muscles in that area facilitates entry. Super marital sex rules indicate that the small-step approach can help here, with approximations of penetration aided by verbal fantasy of penetration. Surrendering or forcing only causes you both to relate such activity to the cultural orientation of “a pain in the ass.” An important super marital sex rule is that there should never be intentional mental or physical pain or coercion during any sexual interaction.

*247\97\8*

The bigger the tumour, the more of these relatively resistant cells it will contain. However, some of them are present even in tumours that are only a few millimetres across. The chances of curing growths which contain some poorly oxygenated cells and some cells which are not dividing can be improved by giving the radiation treatment in small doses spread over some weeks rather than giving the whole dose in one treatment session. As the cancer shrinks, cells which were not dividing start to divide and cells which were poorly oxygenated get more oxygen. Thus, as the weeks go by, these cells become much more sensitive to radiation treatment than they were to start with. Although the results are better when the treatment is spread out like this, bigger cancers still need a much higher total dose. Even with a higher dose, there is still a much smaller chance of curing the bigger cancers. Very big cancers simply cannot be cured with doses that are safe.

*262/40/1*

Sometimes, hospitalisation may be necessary but this may give the hysteric an opportunity to observe those with organic illness, and so the symptoms may become more definite and closer to real illness and further delay proper evaluation.

The underlying inadequate personality of the hysteric makes complete recovery difficult. The aim of treatment should be to restore the person as a functioning unit of society, rather than seeking to fully unravel all the hidden conflicts which have precipitated the illness or remove all the symptoms which have developed.

Too many medical opinions and examinations are only likely to reinforce the symptoms and to create further invalidism. Those treating hysteria should remain non-judgmental and should not react to attempts to manipulate them.

Those of us with an uncompromising view of life may deplore malingering and even hysteria and show this in our attitudes to those exhibiting such symptoms.

*452/71/1*

The symptoms that may result from anaemia are tiredness and shortness of breath. With iron deficiency anaemia there are other symptoms such as a sore red tongue and there may be a reduced amount of acid secreted by the stomach leading to digestive problems.

The diagnosis of iron deficiency anaemia is made by simple tests of the blood to determine the amount of haemoglobin and also by looking at the red blood cells under the microscope.

They will be less in number and they are also smaller and paler than normal.

The amount of iron in the blood may be measured and this reflects the amount of iron stored in the tissues.

Treatment is simple — iron tablets are given by mouth, usually in the form of the salt, ferrous sulphate which is cheap and effective.

Sometimes iron tablets may upset the bowel, causing diarrohoea or constipation. The iron will also stain the patient’s motion black and the patient needs to be warned about this.

*196/71/1*

Recent probes into the theory of retrograde menstruation reveal that a great percentage of women show an increased amount of blood in the pelvic cavity around menstruation and after ovulation. Blood has even been present in the dialysate (liquid drawn from the abdominal cavity) of women undergoing kidney dialysis while they had their periods. What this proves, again and again, is that retrograde menstruation it common.

Earlier experiments, specifically those performed in the 1950s, were more aggressive. One team—doctors R. B. Scott, R. W. TeLinde, and L. R. Wharton, Jr., of Chicago’s Northwestern Medical Centers-created pelvic endometriosis in rhesus monkeys by inducing retrograde menstruation in an extreme manner. Basically, what they did was cot into the monkey’s uterus, opening it so that menstrual blood spilled directly into the pelvic cavity instead of being washed out through the vagina. Six of the ten experimental monkeys developed endometriosis—some within two and a half months, whereas others had no signs of it for nearly three years. In 1958 a number of women voluntarily submitted to an experiment wherein doctors injected endometrial cells into a laparotomy incision. This experiment also produced endometriosis in most women,

Sampson’s theory has found a few detractors, but most doctors agree that the backward spraying of menstrual blood places endometrial tissue on vulnerable organs. Even Sampson postulated that in all probability there is “more than one” avenue available for the development and spread of this disease. One conclusion was that, he wrote, “the invasion and dissemination of endometrial tissue employ the same channels as the invasion of cancer.” This meant that fragments of endometrial tissue reached other parts of the body through channels such as the blood and lymph systems. The actual process of tissue transference from one organ to another by blood or lymph glands is known as metastasis.

*21\43\4*

Ultraviolet light seems to have a similar exfoliating effect on the skin and is therefore most beneficial in the treatment of this condition. It appears to be further helped by salt water, due no doubt to its drying action.

Oral antibiotics, particularly tetracycline, have a most dramatic and beneficial effect. Their action appears to be threefold. They reduce comedone formation, resulting in less blockages of sebaceous gland ducts. Furthermore they reduce the acidity of the sebum, which then results in less tissue breakdown when the glands rupture. They also decrease the amount of propionibacterium acnes. This results in less chemical or enzyme being released into the skin when the glands rupture. The overall result of this is much less inflammation. It can be seen, therefore, that the antibiotics are used not so much for their anti-bacterial effect as for a side effect that they appear to have on the oil glands. Very small doses of these antibiotics may be used, in fact much smaller doses than those required for the treatment of normal mild infections of the skin. Consequently they may be used for prolonged periods, except of course with pregnant women or children under the age of 12 years, or if side-effects appear.

*47\44\4*

• A low-fat diet has an automatically high percentage of carbohydrate.

• Carbohydrate is most simply classified as either sugar, starch or fibre.

• More complex classifications are currently being developed.

• A high-carbohydrate intake has not been linked to obesity in populations.

• A reduction in sugar consumption may be wise for some individuals.

• Client education should involve:

— assessment of dietary carbohydrate intake and its specific components; sugar, starch and fibre

— recommended food selection for increasing dietary fibre

— information on how to read food labels and ingredient lists

— explanation of nutritional claims about carbohydrate in food

Until recently, carbohydrates have drawn far less scientific attention than dietary fat. Now there is ample evidence to show that specific components of carbohydrate are beneficial for both health and body fat management. In percentage terms, carbohydrate will replace fat in the diet if a lower-fat eating plan is adopted.

*101\186\4*

It is thought that women with endometriosis have higher concentrations of prostaglandins in their peritoneal fluid and that these higher concentrations may contribute to infertility by hindering or preventing conception and implantation in a number of ways.

It is possible that prostaglandins interfere with the functioning of the ovaries and prevent the release of the ovum thereby preventing fertilisation.

Prostaglandins may affect the sperm as they move towards the ovum by slowing down their movement and thus reducing the number of healthy sperm that can reach the ovum in time for fertilisation.

Prostaglandins help the ovum move along the fallopian tube.

If the fertilised ovum is propelled too rapidly along the tube the ovum will reach the uterus too quickly. Therefore, when the fertilised ovum reaches the uterus it may not be mature enough to implant itself in the endometrium or the endometrium may not be ready to accept the fertilised ovum. If the fertilised ovum is propelled too slowly down the fallopian tube it may not reach the uterus in time to embed itself in the endometrium.

Prostaglandins may also affect the relaxation and contraction of the uterus. If they produce excessive contractions of the uterus they may prevent implantation of the fertilised ovum or they may cause it to be expelled soon after implantation.

*91\83\2*

The diagnosis usually involves several stages which may include some or all of the following:

Reporting your symptoms to a doctor

Giving a history of your symptoms

Having a physical examination

Having an ultrasound

Having a laparoscopy

Taking a biopsy during a laparoscopy.

An early diagnosis is important as endometriosis is generally thought to be a progressive condition in which treatment is more effective in the early stages. If the progression of the condition can be stopped, or at least slowed down, then the likelihood of developing long-term complications such as infertility, adhesions and chronic pain is reduced.

For many women the road to a diagnosis is often long and it is not uncommon for women to see several doctors regarding their symptoms over a number of years before a diagnosis is made. In a survey conducted by the Endometriosis Association (Victoria), the average time between the onset of symptoms and diagnosis was over six years.

The long delay in diagnosis experienced by many women is partly due to the fact that endometriosis is often difficult to diagnose, especially in the early stages. The symptoms are easily confused with several other conditions and some doctors are not fully aware of the range of possible symptoms. In addition, a pelvic examination often appears normal.

Unfortunately, the diagnosis of endometriosis is also sometimes affected by doctors’ attitudes to the symptoms. Many doctors do not take women’s and teenager’s symptoms, such as period pain, seriously. Like many people in our community, they tend to assume that period pain is normal or psychological.

Doctors often do not consider a diagnosis in women and teenagers who do not conform to the traditional stereotype of women with endometriosis. Consequently teenagers and women under the age of 25, women who have had children and women from lower socio-economic backgrounds are often simply not considered for a diagnosis.

*31\83\2*

Intended weight loss for health or other reasons involves a number of factors. There are many theories regarding weight loss which encompass genetics, food intake and exercise. There is some evidence of a genetic predisposition to obesity and variations in metabolic function. There is also evidence, however, that while some people weigh considerably more than others but have the same food intake, those who weigh more do less exercise.

Most nutritionists agree that effective weight reduction involves a long-term change in eating patterns and behaviour and a gradual but significant increase in exercise. Fad or crash diets used for a short period actually reduce the amount of muscle and water in the body and weight is rapidly regained once the diet is discontinued.

Approaches to gradual weight loss include lowering fat and kilojoule intake while increasing the amount of fatburning exercise. Fat content is reduced by eliminating junk foods and refined sugar and reducing dairy products and fatty meats. Lowering the amount of fat in the diet should correspond with an increase in the intake of fruit, vegetables, legumes and grains. Drinking around 8 glasses of water a day is also recommended. Exercise involving at least three 20 minute periods per week will increase the metabolic rate and burn fat.

*80\69\2*

Depressed people lose their capacity to see meaning and significance in their lives. A religious person when depressed may feel cut off from God, a particularly distressing loss at a time when spiritual comfort may be most deeply needed. In such a spiritual void, the depressed person may naturally feel that there is very little purpose in living.

Related to our ability to find a sense of meaning and purpose in life is our capacity to enjoy ourselves and have fun. We can see this ability at play even in the midst of all sorts of difficulties. Poor people retain their ability to celebrate, as anyone can see who has walked through the impoverished neighbourhoods of some European town during the festival for a saint or at carnival time. Even very hard-working people take time out for recreation. When difficult times let up, even for a short interval, the ability to have fun pops up again like the crocuses that sprout their shoots and flowers after a long winter.

All of these normal abilities are the opposite of what we see in depression. Even in the midst of plenty – enough money, good physical health, supportive friends and family — the depressed person is unable to have a good time. This inability to enjoy life can come on insidiously and it may take a while to realize that you are not enjoying life as you used to. Sometimes this recognition is triggered by returning to a place you’ve been before or an activity you used to relish and realizing that you don’t have the same feelings or enthusiasm for it that you enjoyed before. Sometimes friends will ask you what the matter is. You just don’t seem to be enjoying yourself as you used to. Suddenly or gradually you realize that nothing feels like fun anymore. As one of my patients put it, depression is like an unwelcome guest that follows you around your house and just won’t go away. The formal clinical term for this state is anhedonia, which means the inability to experience pleasure. Life feels dreary. Sometimes this dreariness is experienced through the senses. Colours seem less bright than they did before. The world may look grey or dark where formerly it was full of vivid colours. Whatever it is that you may have loved -music, dancing, films – now feels like a drag. In this way, depression is like a thief that robs you of the joy of living. This is another reason not to delay in treating it and reclaiming the ability to experience joy once again.

If nothing seems like fun anymore and life seems dreary, and this has been going on for more than a few weeks, consider the possibility that you may be clinically depressed.

*53\75\2*

The use of the word “natural” in this context is misleading. Natural gas comes from the earth, but by and large it has lain there, trapped, for millennia. It is only in the past century that man has tapped this resource and brought himself into physical contact with it. Thus, natural gas is highly unnatural as far as the human body is concerned—a substance with which the body has no physiological method of coping. Synthetic chemicals are also added to this “natural” product, such as the one used to give it its characteristic “skunky” odor.

A leaking gas line is, of course, a life-threatening hazard: each year over a thousand people die of gas poisoning in the home. An equally serious threat, in my opinion, is posed by the day-in and day-out inhalation of minute quantities of this same poisonous substance by the chemically susceptible.

We have been convinced by skillful advertising and public relations that natural gas is not only natural, but “safe” and “clean.” Yet studies at the University of California and elsewhere have shown that the carbon monoxide and nitrogen dioxide levels in a vented kitchen become as high as in Los Angeles during a smog attack, when an oven has been heated to 350°F. for one hour. If the kitchen does not have an exhaust fan, these levels climb to three times the Los Angeles smog level in the same period. Few people would not be susceptible to such high levels of indoor air pollution.

There are individuals, however, who are kept in a perpetual state of illness by far lower levels of the same poisonous substances. The gas which emanates from normal pilot lights or escapes from a well-saturated stove is often the main source of a patient’s illness.

Given a choice, then, everyone should choose an electric range over a gas range. The first rule of prevention in this field is to minimize one’s exposure to utility gas.

Since changing the stove might very well entail some expense, it is advisable to test oneself for reactions to the gas range first. This can be done by temporarily removing the range from the house, if at all possible. (A shut-off stove is better than a connected one but still disseminates gas into the environment.) Electric appliances such as a hot plate can be substituted for the range while the test is under way.

After the gas stove has been removed for a week or so, it can then be returned. The reader should keep a symptom diary, in which changes (positive or negative) in his condition can be noted. Both the removal of the gas stove and its reintroduction may be accompanied by changes in health. In cases in which the stove is definitely incriminated as a cause of symptoms, it should be permanently removed.

Although there may be some expense involved in making this change, it is a worthwhile investment in health. Several thousand patients have been guided in removing their gas ranges on the basis of such positive tests and not one has complained about the cost or reported being dissatisfied with the change.

*104\110\2*

To avoid the problem, musicians should not play continuously for long periods. Parents and teachers of children learning to play an instrument should not insist upon unbroken hour-long sessions of practice. Sporting activity and exercises that extend the range of motion of the spine and strengthen the muscles are helpful. Any repertoire that brings on pain or discomfort should be abandoned.

Lastly, supporting devices that take the weight of an instrument off the musicians’ arms can make a considerable difference. If partial resting fails to alleviate the pain and tenderness, the musician should give up playing completely for many months, until all of the symptoms have disappeared altogether. Other activities (e.g: writing or turning taps) that also bring on the symptoms must be abandoned, too. Medical care is necessary.

Only after the symptoms have cleared completely can the musician safely resume playing, starting with one minute twice daily and extending the time very gradually. Since the overuse syndrome can be so disabling and difficult to overcome, music performers need to be alert to the danger of playing for too long.

*182\143\2*

Home care: No home care is required for an innocent murmur.

Precautions:

-    Believe your doctor’s assurance that innocent murmurs are normal.

-    Do not make the mistake of over-protecting a child who has an innocent murmur; it is not necessary.

-    Try not to be alarmed by the long medical names given to innocent murmurs.

-    Most innocent murmurs disappear by the time the child is a teenager.

A heart murmur is an extra sound made by the heart as it pumps. A heart murmur may indicate abnormalities in the heart, or it may simply be a normal sound caused by turbulence as the blood rushes through the heart. The sounds that do not indicate heart disease or abnormalities are called “innocent murmurs,” “insignificant murmurs”, or “functional murmurs.” They are perfectly normal. Some experts believe that almost every healthy child has at least one innocent murmur, and if the child will stay still long enough in a quiet room a doctor will eventually be able to hear it. Other experts put the figure lower, at half of all normal children. As the child grows, the extra sound or sounds usually become increasingly hard to hear. By the time the child is a teenager, the murmur usually disappears, or becomes so quiet it cannot be detected. Only 15 to 20 percent of innocent murmurs continues into adolescence or adulthood.

*99/84/5*

To optimize your health, you should eat plenty of unrefined complex carbohydrates. This means choosing brown whole meal bread, brown rice and brown pasta, instead of the refined white versions which have been stripped of essential vitamins, minerals, trace elements and valuable fibre content. (In order to digest these refined foods your body has to use its own vitamins and minerals, thus depleting your stores.)

Simple carbohydrates, in the form of fruit and dried fruit, certainly have a place in a healthy, balanced diet. But it’s important, for your health and fertility, to maintain a steady blood sugar level. For this reason, you should avoid sugar, honey and undiluted fruit juice, which can all produce a sudden rise in blood sugar, followed by a sudden fall.

Soya

Soya is being studied extensively around the world for its effectiveness in lowering cholesterol and preventing cardiovascular disease. It also appears to have an important role to play in balancing male and female sex hormones. Scientists believe that hormonal imbalance and over-exposure to chemicals that have oestrogen-like qualities may be one reason for the rapid increase in breast and prostate cancers over the last couple of decades. Crucially, this hormonal dysfunction and overload are also implicated in the menstrual and reproductive problems that affect fertility.

Soya is classed as a phyto-oestrogen, which means that it contains substances that act like hormones. These phyto-oestrogens fit into oestrogen receptors in the breast and block them, effectively shielding the body from exposure to oestrogen which is believed to be one of the major causes of breast cancer. Studies of Japanese women, who traditionally eat a great deal of soya, suggest that it may protect them from this disease.

Oestrogen is not only implicated in breast cancer but is also believed to play a part in causing other problems like endometriosis, fibroids, and heavy and/or long periods – all of which can affect female fertility.

Some women have problems conceiving because the second half of their menstrual cycle, just after ovulation, is shorter than it should be. This ‘luteal phase defect’, as it is known, means that there is not enough progesterone at the right time to maintain a pregnancy. Scientists have found that if they add soya to a woman’s diet it can lengthen the cycle by 2.5 days.

For all these reasons, it’s well worth adding soya to your diet – perhaps in the form of soya milk and tofu (soya bean curd, often used in Oriental stir-fried dishes). However, you need to ensure that the soya used to manufacture these products is not genetically modified, so buy organic.

So, for optimum health, you should eat plenty of:

• Essential fats (nuts, seeds and oily fish)

• High-fibre foods (fruit, vegetables, whole grains, beans, nuts and seeds)

• Complex carbohydrates (whole grains, beans, pulses and vegetables)

• Non-GM organic soya

*27/73/5*

As you might expect, those at greatest risk for dying on the job are men who work in the great outdoors, where the whims of Mother Nature often become a factor, says Guy A. Toscano, economist in the Office of Safety, Health, and Working Conditions at the Bureau of Labor Statistics in Washington, D.C. Fishermen and loggers have it the worst by far. While the national average for deaths on the job is 5 out of every 100,000 workers, these out-doormen die at rates 20 to 30 times higher- losing more than 100 workers and, in some years, even rates as high as 150, out of every 100,000 on the job. “Truck drivers, farmers, and construction laborers have occupations that have high fatality rates as well as high numbers of job-related fatal injuries as well,” says Toscano.

But as bad as those figures sound, things are actually better than they used to be. Back in 1912, when we knew (and some would say cared) less about job safety, between 18,000 and 21,000 workers a year lost their lives while earning their daily bread. By 1995, with a work force more than triple in size producing 13 times as many goods and services, occupational deaths had decreased by more than two-thirds. “We have become more aware of safety issues in society at large,” explains Michael Buchet, manager of the construction division and the labor division at the National Safety Council in Itasca, Illinois. “In industry, we’ve been encouraging safer workplace practices and are pushing for training, training, and more training.”

That said, after decades of progress, it seems harder to make gains in workplace safety these days, Toscano says. “We’ve clearly hit a plateau in that the number of fatal occupational injuries has held steady at the 6,000 to 6,500 mark for the past five years,” he says. “That doesn’t mean that we can’t make any more progress. But it does mean that safety professionals have to be willing to work harder to recognize risk and promote safety measures.”

*108/36/5*

Osteoarthritis is, as the name suggests, connected with the bone structure. In general terms it might be described as a degenerative joint disease where the degenerative factor is with the articular cartilage and structure of the bone. The changes in bone structure can in fact include new bone formation. Unfortunately, this new growth may occur in the form of spurs, or appear in areas which should be occupied by cartilage. In simple terms a ‘spur’ might be described as an abnormal projection of bone.

Osteoarthritis would tend to be associated more with elderly people but it is not restricted to this group. It can also set in as a consequence of bone injuries resulting from sporting activities or accidents. It has several possible causes. One is natural wear and tear during the ageing process of the body. This may start at quite an early age but not give trouble until later in life. Another cause is a breakdown of the lubrication of the joint causing excessive wear. In the case of sporting activities it can be the result of repeated impact shock on the joint. With increasing age the bones become suffer and less elastic. They tend, therefore, to give a sharper impact on the joint cartilage. It may be seen from the above that an overweight person might stand a greater risk of developing osteoarthritis simply because of the extra weight on the load-bearing surfaces of the joints.

Gouty-arthritis

Gout or gouty arthritis is a condition in which painful inflammatory attacks, mainly in the feet, knees, or wrists, occur, as a result of the precipitation of crystals of sodium urate. This occurrence, probably resulting from hyperuricaemia (the presence of an excessive amount of uric acid in the blood), is pre-eminently a disorder associated with the male. When present in females it is mainly in the post menopausal groups.

It is believed that heredity can play a part in gouty arthritis. However, it is not necessary to panic if we happen to have a picture of an ancient relative in a wheelchair with a heavily bandaged foot! There is evidence to suggest that gout is associated with over indulgence in food and alcohol. In earlier times over-indulgence was usually associated with affluence too, but like most diseases the causes are not limited to one well-defined feature and people who live in moderation can also suffer attacks. An interesting feature which relates to our topic of the sea and to gout is that involving Polynesian people and diet. A significant increase in the incidence of gout amongst the New Zealand Maoris and other Polynesian people has occurred with the change in their basic diet of seafood and vegetables to our diet of meat, processed breads, sugar, etc.

*2/48/5*

One of the best-studied gastrointestinal peptides is cholecystokinin, or CCK. After you eat, the small intestine releases this hormone, which stimulates pancreatic secretion and gallbladder contraction. It also sends satiety signals up to the hypothalamus. Women who have bulimia may have a malfunction in their CCK system. In one study, bulimic women tested before a meal had the same amount of CCK as normal women. Yet after eating they had a significantly smaller increase in CCK than did normal women. They also reported fewer feelings of fullness than the normal women did. Treatment with tricyclic antidepressants not only reduced their bingeing, but also helped their CCK levels return to normal.

This important new research doesn’t necessarily mean that a faulty CCK system causes bulimia. But decreased CCK, and thus the decrease in satiety signals, may reinforce a woman’s urge to keep eating.

Such findings have led to a revolution in the way we think about the digestive system. As one expert put it, rather than being a passive system, the gut now appears to be a “great sensory sheet extending from the mouth to the small intestine.” This sheet is exquisitely sensitive not only to the presence of food, but to its exact chemical composition as well.

THE BIOLOGICAL THERMOSTAT

Think of the thermostat in your home. You set the dial to maintain a constant temperature of, say, seventy-two degrees. When the furnace has put out enough heat, the thermostat switches it off for a while. If someone leaves the front door open and cold air rushes in, the thermostat kicks on again, staying on until the temperature returns to the desired level.

Your body works in a similar way. Earlier, I used the term homeostatic to describe how your body tries to maintain its equilibrium. The biological “homeostat” responds to changes in the environment to keep your metabolism working on an even keel.

Currently, one of the most exciting fields in medicine involves research into the fascinating and complex ways the body responds to such signals. We are beginning to learn that a number of subsystems work together to control eating as well as other types of behavior.

These subsystems operate on the feedback principle: Signal A activates process B, which in turn sends signal Ñ to shut off signal A. These signals are carried by hormones or other chemical messengers that activate nerves or stimulate other responses. Many of these processes are triggered, not just internally, but by physical and social cues from the outside world. Just about anything, from contact with other people to the amount of daylight you receive in a twenty-four-hour period, can affect your body’s function—your homeostasis.

The concept of feedback is important to eating disorders for several reasons. For example, your body tries to keep weight at a constant. If you start weighing too much, your metabolism speeds up to burn off the excess pounds. Conversely, should your weight drop, so will your metabolism, to conserve dwindling energy supplies.

Another series of feedback loops involves your body’s cravings for certain nutrients and its response to the nutritional content of the food you eat. Studies on animals (and simple observation of humans) show that at times we prefer to eat carbohydrates, for example, and at other times we choose protein-rich foods. The menus we choose can have a tremendous impact on our moods and our behavior.

*39/35/5*

Orienteering is a cross-country sport where people find their way through unfamiliar terrain using only a compass and a map. Sharon got involved in it as a way to improve her skills in another sport—backpacking. “I’m what you might call geographically diallenged,” she explains. “I wanted to learn how to use a compass when I blaze trails.”

So when Sharon joined the Bay Area Orienteering Club, weight loss wasn’t even on her mind. But it sure turned out to be a fabulous perk. Instead of spending time munching on junk food in front of the TV, she was out in the fresh air learning navigational skills that called on her mental and physical faculties. Better fitness would contribute to better competition times, so Sharon finally had a reason to stick with a jogging program. Her club’s social network gave her support not only as her orienteering skills grew but as her waistline shrank. “They were all so excited to share their experiences; it was very contagious and inspiring,” she says.

Today, Sharon is a seasoned orienteering veteran. Moreover, she has maintained her fit form and taken on other outdoor challenges. “Through the skills I’ve learned in orienteering, plus the better fitness level I’m at, I feel more confident to do things like backpacking, repelling, climbing, even working on a horse farm,” she says. She’s even training to be a volunteer firefighter.

For Sharon, navigating her way to successful weight loss has been a life-enhancing experience.

WINNING ACTION

Find an activity that suits your personality. Weight loss can happen with no effort at all if you can make fitness a hobby as Sharon did. You don’t have to take up orienteering or rock climbing. Any activity that involves a social network can make getting fit a lot of fun.

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1. Begin by admitting to yourself that you have feelings, that you’re not without emotions.

2. At the start of each day, face yourself in the mirror. Acknowledge your problems and your feelings. Tell yourself what positive steps you’re going to take to handle a problem and how good you feel now that you’ve made the decision to change.

3. Look at yourself in the mirror and tell yourself how enthusiastic you feel—that you walk, talk and behave enthusiastically. Keep that spirited feeling with you all day. It will help you generate endorphins and other good biochemicals, and overcome obstacles.

4. Believe and act as if you are someone with worthwhile opinions and attitudes. You are. You are someone who deserves to be heard. Seek and you’ll find the method that will enable you to be heard.

5. Learn to speak up when you feel put upon. Gently but firmly pursue your goal. Your friends will have more respect for you when you assert yourself. Gather up the facts necessary to present your side of a discussion and state them in plain language. You’ll feel better when you express yourself; it’s a healing feeling.

6. Look for the opportunities that are present in your life to make beneficial changes. You aren’t fated to have poor health or to live in poverty. You are destined for optimal health and prosperity, and you must tell yourself so, believe it’s so and act upon that belief.

7. Learn to ferret out the causes of dissatisfaction in your life. Face them. Take the steps necessary to correct them, or learn to accept what you cannot change. In any case, get going with your life.

8. Learn to like yourself. The steps that follow will help you develop a sense of self-respect and worth.

9. If you’re not sure of your purpose in life, don’t worry. It will come to you eventually. In the meantime, get on with your life; life is to be lived.

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Whether you’re 30 or 70, you want your muscles to be well exercised and toned. Without good muscle tone we feel tired and weak and have difficulty at work, home and play. I use a dynamometer to measure the muscle strength in the hands of my patients. I find that people who can squeeze only 30 or 40 pounds of pressure can double or triple that figure after a simple exercise program. I’m not suggesting that you need to develop a bodybuilder’s physique. Muscles do not need to be bulky, but they should be toned. Depending on the exercise, you can tone and stengthen various muscles in your body to give yourself a feeling of health and put a spring in your step.

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If you carefully read the labels, you’ll find that many packaged, canned and frozen items have very little real food left in them, and even less real food value. Many of their nutrients have been heated, frozen, processed or leached out. What you get is the food “shell,” along with large dollops of added fat, salt, sugar and chemicals. Occasionally, you also receive just enough spray-on vitamins to satisfy government regulations.

Nature fills her foods with nutrients. Man fills his foods with fat, sugar, salt, fillers, modifiers, texturizers, flavorers, preservatives and coloring agents. I am awed by the creativity of food chemists, but I am appalled by their lack of concern for our health.

Compare a real potato, for example, to a typical brand of artificially flavored mashed potatoes. A potato contains potato. Artificially flavored mashed potatoes contain potato flakes, monoglycerides, natural and artificial flavors, sodium bisulfite, calcium stearoyllactylate, BHA and BHT, sodium acid pyrophosphate and citric acid. Now, I’m not saying that everything in artificial potatoes is harmful. But why take a chance when the alternative is a tasty, 100 percent safe and nutritious potato? It comes back to the general rule: Did Nature make the food or did man? Nature makes potatoes. Man makes artificial potatoes.

Fast foods are also a health problem, for the same reason that processed foods are. The people who make fast foods and processed foods load their products with fat, sugar, refined carbohydrates, salt and chemical additives.

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Your “doctor within” is an interlocking system, so some problems may affect more than one part of your “doctor within.” Depression, which is linked to a biochemical imbalance in the brain, can also trigger the release of high-voltage chemicals that can weaken the immune system. Anger and hatred spur the production of supercharged chemicals, which may hasten a heart attack.

Think of your “doctor within” as your shield. If you drop that shield, even a little, you’re exposing yourself to disease. What kind of disease? Anything from a heart attack to herpes. But remember, the heart attacks, herpes and other disorders are really symptoms. The real problem is a breakdown of your “doctor within.” The weak link may be in the immune system, it may be in the mind, it may be improper regulation of blood pressure or blood sugar. But the immune system, the mind and the mechanisms that oversee blood pressure and blood sugar are all part of your “doctor within.”

That’s why I say that most of the diseases we get are really failures of our “doctor within.” You can call them heart disease or infections or herpes or depression or stroke or high blood pressure or cancer, but the truth is that they are all due to a breakdown of your natural defenses. If your “doctor within” is strong, you can shrug off most diseases. That’s what this book is all about: keeping your “doctor within” in tip-top shape.

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The history of medicine is littered with bogus ‘miracle cures’ that apparently worked wonders in their day. Hydropathy, popular in the nineteenth century, was said to be a cure for all sorts of nervous complaints and long-term illnesses. The treatments consisted of alternate hot and cold baths, wrapping the patient in wet blankets, and requiring him to drink huge quantities of water. These measures were supposed to ‘strengthen the fibres’ of the body and rid it of poisons. ‘Direct Faradism’ (named after Faraday, who helped to discover electricity) involved giving mild electric shocks to the arms and legs.

It was recommended to anyone who was tired, run down, or had other nervous afflictions. The electric shocks supposedly ‘stimulated the constitution’. Both these therapies were highly regarded in their day, and thousands felt they had benefited from them. Mass enthusiasm is a strange thing – simply feeling caught up in some wonderful new discovery may be a powerful form of treatment.

There are various other preconceived ideas that work against food intolerance – the belief that food is essentially passive and innocuous for example, the notion that what we have eaten for thousands of years must be good for us and the simplistic model of digestion which assumes that no complex molecules reach the bloodstream. These mistaken ideas all contribute to the understandable scepticism of the medical world.

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Besides the starch, the grain contains bran. This, in turn, is made up of layers of gluten, various minerals and trace elements. Research has shown that only the most minute amounts of these trace elements are required, yet if they are missing altogether, the various functions of the system begin to suffer. These known and unknown trace elements are found in the outer layers of the grain, the bran.

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Molkosan can be applied externally with the same success as when it is used internally. It has proved to be more valuable in the treatment of pimples, eczema and cradle cap than many more expensive preparations. For the most part, eczema can be treated by dabbing on undiluted whey concentrate. In cases of skin impurities and blemishes fine results are achieved if Molkosan is

both taken internally and applied externally. Where athlete’s foot and nail mould have not yet yielded to any other remedy, Molkosan will give quick and reliable relief. Just soak some absorbent cotton in it, bind this on the affected part and leave it on overnight. Dr Devrient of Berlin has confirmed that no other remedy for mycotic diseases is quicker and more reliable than Molkosan whey concentrate. When used to clean minor wounds, scratches and cuts, it is a first-class antiseptic.

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Regular sitz baths are beneficial to your health, will preserve your youthfulness and, of course, have a great influence on your mental and emotional disposition and attitude.

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Like all foods that have a penetrating smell and a strong taste, garlic should be taken in small amounts only, otherwise it could be harmful, especially to the kidneys. Garlic as well as onions contain a sulphurous essential oil that is probably responsible for its effectiveness as a vermifuge, an agent that causes the expulsion of intestinal worms. Garlic milk is excellent for this purpose, as described below. Crushed garlic can also be added to a wormwood infusion instead of milk, to be drunk or used as an enema in the same way as garlic milk.

Half a clove of garlic, placed between the gums and cheek, will often soothe a headache. Earache and headaches often respond to a garlic or onion poultice applied to the back of the neck.

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If you suffer from constant infections and bleeding of the gums and mucous membranes, you would do well to take sea buckthorn products as a dietary supplement. Sea buckthorn berries being rich in many vitamins and trace elements, it is obvious that the products based on them are recommended for children and adults alike as food supplements and a tonic.

In Switzerland, sea buckthorn grows abundantly in the upper Inn valley and in Ticino, especially in the Maggia valley. When ripe, the orange-coloured berries nestling between olive-green leaves are quite conspicuous, and in the wintertime birds can be seen enjoying them to the full. We use sea buckthorn extract as one of the ingredients in our vitamin preparation called Bio-C-Lozenges.

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In the present chapter this study has been used, as well as the glimpses of men’s attitudes to contraception seen during many years in general practice. Because of the strength of the stereotypes some of these common assumptions about male behaviour have been used as headings under which to consider the varied feelings of different individuals.

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It is always useful to start by seeing people as they wish to be seen, as individuals, couples or even in more bizarre combinations.

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The sexual relationship may be for mutual pleasure and joy, but it can be used to control, dominate or compensate for feelings of inadequacy. By not using contraception there may be an unconscious wish to control or limit the partner’s sexual activity. Resentment or envy of the other’s sexual enjoyment can also lead to a more overt expression of non-use of contraception exemplified by the phrase, ‘Well, why should I take the Pill (with all its dangers) when he is the one who gets the pleasure?’

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Heat therapy is still highly controversial and should not be undertaken without the guidance or direction of a qualified medical practitioner or therapist.

It involves the application of heat to cancerous tissues and cells, by a variety of different methods. The most common method of heat therapy, brought about by the body’s natural defense mechanisms, is a fever. This heats up the body’s internal environment, making it difficult for cancerous cells to survive. Fever is a spontaneous form of healing, enhancing the body’s natural defense proteins.

Most of us try to suppress fevers. By doing this we are suppressing our body’s natural healing response. This may cause the bacteria or virus to be suppressed, allowing it to manifest itself later in a more serious condition. The body in all its magnificence has some amazing healing mechanisms designed to restore harmony and balance.

Cancer cells become damaged at 42 degrees Celsius to 43 degrees Celsius. This intense heat may lead to the self-destruction of tumours and may also slow down the growth of malignant cells and their oxygen respiration. Heat goes selectively to cancerous tissue. The major problem with heat therapy is how to gain access to cancerous cells in the body without severely harming other parts of the body. Skin cancers are the easiest to treat, as they are easily accessible on the outside of the body. It becomes difficult to obtain access to internal organs.

Today, practitioners use a modified food-warming oven consisting of a chamber that produces radiant heat up to 40 degrees Celsius. Using heat therapy in conjunction with chemotherapy and radiation therapy may enhance the effectiveness of these orthodox cancer treatments.

Other new heat therapy techniques includes laser light via needles, radio waves, believed to induce tumour regression, scan focused ultrasound systems and interstitial ferromagnetic seed implants.

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Breathe very slowly in and out through your nose and imagine yourself becoming more and more relaxed with each breath. On the out breath, imagine your body and muscles and skin and internal organs relaxing more and more. With each breath, imagine your body falling deeper towards the ground as you become more and more relaxed. You can feel your breath becoming slower as you relax.

With every breath out, your mind and body becomes more relaxed and heavy, falling into the earth in total ease. Release all of your thoughts, empty your mind. On every out breath imagine your thoughts flowing out of you with complete ease and on every in breath imagine a beautiful golden or white light entering your body through your nose. Continue to do this until your mind feels empty and clear.

It may take some time to reach this comfortable and relaxed state. When you do, you can begin imagining the following positive imagery to eliminate harmful cancer cells from your body:

You see yourself exactly as you are, yet miniature, wearing a long red magician’s coat. Imagine yourself entering through your mouth and sliding down your throat. Everything is soft and smooth, and you are laughing. You have a bright magician’s wand in your hand and it is glowing with a white ball of light on the end. You are sliding and laughing as you are drawn gently along to the area of your body where the cancer is located.

Everything around you is shiny, healthy, pink and smooth. As you reach the cancerous area of your body, you see a black ball. Laughing, you run up to the black ball and swipe at it with your magician’s wand with the glowing white ball. With every swipe of your wand, the black ball evaporates in the air with a puff of smoke. You do it again and again, laughing and smiling as more and more puffs of smoke evaporate in front of your eyes. Continue to aim with your magician’s wand until the black ball has completely disappeared leaving you with a beautiful, glowing pink colour. You feel very happy, all of the darkness is gone and everything has a beautiful pink, shiny, clean surface.

Your job is done and you are drawn back up the whirling slide, up and up, laughing and laughing, back into your mouth as you realize that you have conquered the black ball. As you reach your mouth, you gently tap yourself over the top of your head with the magician’s wand and disappear with a puff of smoke. When you are ready you can slowly open your eyes, feeling completely relaxed and clean and clear within your body.

The magician’s wand creative visualization is an excellent guided imagery for children to use. I know of one wonderful man who made his little sister, who was only five years old, a magician’s wand painted with crystals and beautiful colours. We told her that she is a magician and to tap her head every day with the wand, and to imagine the cancer disappearing in the air with a puff of smoke. This gorgeous girl had a brain tumour and the doctor’s gave her only a short time to live. She is still going strong and healing every day – proving that magic can occur every day, even in the smallest ways!

You can also create your own imagery exercises. The best exercise to help eliminate cancer is to imagine yourself destroying the cancer in any way you desire and always feeling content and happy with the outcome. Keep the exercises positive. To enhance immune system function, imagine your white blood cells full of energy and glowing with light. See them fighting the diseased cells and destroying them one by one. Any images you imprint on your subconscious mind create the ultimate result in your physical body.

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Aloe vera is a great skin healer and moisturizer that softens and soothes wounds, burns, cuts, bruises and welts. The juice is regularly used for cleansing of the colon and intestinal problems. Throughout history, human experience has proven in-depth, the miraculous healing powers contained within the aloe vera plant.

Aloe contains high amounts of the compound emodin, which has strong anti-tumour capabilities. It has an ability to stimulate the scavenging activity of white blood cells in the immune system, giving it remarkable anti-cancer activity. Aloe juice is believed to reduce tumour mass and decrease the frequency of metastases (cancer spread). Another cancer-fighting ingredient found in Aloe is acemannan. Acemannan is believed to inhibit cancerous tumours by boosting helper Ò cells, white blood cells that act as the immune system’s alert watchdogs.

Aloe vera is also able to protect individuals with weakened immunity against infection, as it is immune-enhancing. It is extremely protective on the skin against x-rays and can be used both topically and internally. It soothes burned areas and fibrous skin after radiation treatment.

Why is aloe vera such a miraculous plant for healing wounds? Firstly, it contains large amounts of water, which keeps wounds sterile by starving bacteria of the air they need to grow. Additionally, it contains large amounts of magnesium compounds, which act as effective ‘pain-killers’. Finally, it contains several essential vitamins and a substance called allatonin, which has been proven to soothe tissues and speed tissue repair.

Aloe vera has strong liver-protecting qualities, particularly against alcohol. In addition, it helps to alleviate the side effects of constipation and diarrhoea caused from radiation damage and chemotherapy.

What is the best way to use Aloe Vera?

• Internal use – take 0.1 to 0.3 grams of the fresh juice. If you have constipation or a stomach upset, take 1 teaspoon of aloe vera juice after meals. For healing purposes, take 1 tablespoon 3 times daily.

• External use – If you have a fresh plant – pull off one of the leaves, open and apply the fresh gel from the leaves to the affected area. If you have a burn, bandage the open leaf onto the affected area and leave on for 24 hours. The fresh gel can be used for any burn, wound, fungal infection or dry skin area.

Caution!

As aloe stimulates uterine contractions, it should be avoided during pregnancy and breastfeeding.

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Vitamin Ê exists in three forms, including naturally occurring Vitamin Kl, K2 and the synthetic form of Vitamin ÊÇ. It is well known for its ability to produce prothrombin, needed for healthy blood clot formation. It is also essential for healthy liver function. Vitamin Ê is considered an effective anti-cancer agent. It is believed a combination of Vitamin Ê and the drug warfarin prevents a number of different types of cancers, including ovarian, breast, colon, stomach, kidneys, lungs, bladder and their metastases. It is also considered to be effective against liver cancer cells.

Vitamin Ê has an ability to increase the effect and decrease the toxicity of a number of toxic anti-cancer pharmaceuticals. It is thought to enhance the effects of chemotherapy drugs. It may help to prevent the risk of infection in the kidneys and prevent cancers that target the inner linings of the organs. It is believed to be a major vitamin in aiding longevity.

The ‘friendly bacteria’ in the intestines synthesizes the majority of the body’s vitamin K. Good sources of vitamin Ê include asparagus, broccoli, blackstrap molasses, Brussels sprouts, cabbage, cauliflower, green leafy vegetables, egg yolks, oatmeal, oats, rye, soybeans and safflower oil. Herbal sources of vitamin Ê include alfalfa, green tea, kelp, nettles and oat-straw.

Vitamin L

Vitamin L is also known as the ‘Love Vitamin’, as coined by humanologist Bethany Arglsle. One of our most important nutrients for optimum health is a daily dose of love and nurturing. It is necessary for the optimal functioning of people and all their cells, tissues and organs.

A long term deficiency of vitamin L can cause fatigue, muscle tension, increased likelihood of stress conditions, addictions, sexual problems, digestive upsets and weakened immunity. Vitamin L is essential in any psychological disturbance such as depression, sadness, anger, fear, worry, pain and everyday stresses. Emotions such as these would benefit greatly from a daily dose of ‘love therapy’.

Vitamin L is referred to as the ‘catalytic vitamin for healing’. As cancer can manifest from repressed emotions, vitamin L would prove essential in healing and preventing cancer. ‘Love’ is found in a great variety of sources but must be developed and nurtured to be available. It is found readily in mums and dads and grandparents. Sisters and brothers, caring lovers and good friends may also be a good source of ‘love’. Vitamin L is also found in animals, in flowers and in trees and plants. In food, ‘love’ is especially found in home cooked meals. It is digested and absorbed easily, and used by the body in its pure state.

The International Hug Association suggests that a minimum of four hugs a day is needed to prevent vitamin L deficiency, six hugs a day for maintenance and 10 hugs a day for growth and happiness.

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Reishi, also known as ling-zhi or soul mushrooms, have been popular for at least 2000 years in the Far East. The Chinese believe this unique wood-decomposing fungus promotes eternal youth and longevity.

Reishi mushrooms are a traditional medicinal substance that aids the body in resistance against a wide range of physical, biological and environmental stresses. They protect against some forms of cancer and stimulate the function of the immune system by acting as antioxidants. The mushrooms are believed to have anti-tumour properties, inhibiting tumour growth and aids in building resistance to disease. They are also useful in the treatment of fatigue, viral infections, allergies, bronchial asthma, high cholesterol, high blood pressure and dizziness.

Reishi have strong antioxidant properties with the ability to scavenge free radicals in blood plasma. Studies carried out in Japan have confirmed reishi may be capable of arresting metastatic cancer. The Japanese cancer society has found reishi effective against sarcomas. The active ingredient responsible for this are polysaccharides, mainly ganoderic acid.

Reishi mushrooms are considered the most valuable medicine in the orient, far outweighing even ginseng. The mystical qualities are attributed to their rarity – only two to three mushrooms are found for every 10,000 dead plum or hemlock logs. They are documented way back in 56 ÂÑ as having the most extensive and effective healing powers.

Shitake

Shitake is a Japanese mushroom with amazing health-promoting properties. Shitake contains a polysaccharide called lentinan (lentinula) that strengthens the immune system by increasing T cell function. Lentinan is a polysaccharide with strong immune-stimulatory functions and anti-tumour actions. Lentinan is believed to suppress the growth and spread of some forms of breast, colon and stomach cancer. It is therefore able to increase the lifespan of people with colon, prostate, stomach and breast cancer by preventing its spread.

Shitake mushrooms also contain 18 amino acids, seven of which are essential amino acids. They are very rich in  vitamins, especially Bl, B2 and B3. When sun-dried they contain high amounts of vitamin D. Their effectiveness in treating cancer has been reported in various studies in Japan, suggesting that shitake can retard even very advanced cancers.

Laboratory research suggests that one of the active ingredients in shitake, lentinan, enhances the effectiveness of the immune system by increasing the activity of macrophages, T-helper cells and other white blood cells. Positive results have also been seen in human studies involving people with stomach cancer, gastrointestinal tumours, cervical cancer and breast cancer. KS-2, a peptidomannan found in shitake is another ingredient that is thought to be highly effective in one’s fight against cancer.

White Jelly Fungus and Xloud

The white jelly fungus mushroom is thought to protect against cancer. The xloud mushroom effectively fights cancer due to its high kureha content. Scientific research indicates kureha, a polysaccharide, is beneficial in the treatment of cancer.

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Be careful not to binge or overload if you use substitutes that are closely related to things to which you are sensitive, in case you become sensitive to those as well. If you have to leave cow’s milk out of your diet, you can try goat’s milk or sheep’s milk as a substitute, but take care not to overload since they are related to cow’s milk. Goat’s milk, in particular, is very closely related to cow’s milk and it is common for people to become sensitive to it. Put it in your diet, but rotate it – once every four days at first – and use it sparingly. Increase its use later if you tolerate it well.

Sheep’s milk is generally much less troublesome than goat’s milk or cow’s milk, although this may be because it is more rare in the diet.

Rotate once every four days at first and keep it two days apart from goat’s milk if you are on a four-day rotation. Mail order sources of sheep’s and goat’s milk powder and cheese are given on page 167. You can also buy yogurt and cheese culture so you can make your own.

Fresh bought goat’s and sheep’s milk and yogurts are often unpas-teurised. Cook them before serving to babies and young children, pregnant women, the infirm or the elderly.

You can also use soya milk and nut milks as a substitute for cow, goat or sheep milks. These are rich sources of calcium and particularly useful in casseroles and baked dishes. Be careful not to overuse these since both soya and nuts can cause reactions. Some people are sensitive to processed soya milk in cartons, but not if they make their own. The reason for this may possibly be minute contaminants, either from the water used or from the packaging.

You can make nut milks by liquidising 100 g (4 oz) nuts with 340 ml ? pint) water. Hazelnut, almond, cashew and peanut are particularly delicious. You can use these as bases for puddings, to thicken soups or stews, or, sweetened, to drink.

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Tobacco smoke

Vehicle exhausts

Cavity wall insulation

Paper coatings and finishes

Printing inks Newsprint

Textile and fabric finishes

Chipboard, blockboard and other building boards

Glass fibre insulation

Resin adhesive Melamine

Foam rubber fillings and fascia Photographic chemicals

Tanned leather

Insecticides and moth-proofing Fungicides

Propellant in spray aerosols Preservative in cosmetics, toiletries, personal hygiene products, pharmaceuticals and cleaning products of all kinds:

disinfectants

cleaning liquids

antiseptics

toothpastes

shampoo

soaps

cosmetics

hair treatments

WHERE IS CHLORINE FOUND?

Liquid bleaches Powder bleaches Household cleaners Disinfectants

Sterilisers and hand rinses Tapwater

Swimming pool water Bleached fabrics Bleached paper Fungicides Mould inhibitors

WHERE IS AMMONIA FOUND?

Household cleaners Disinfectants Deodorants Toothpastes

Preservative in some latex products Permanent wave solution Hair bleaches

WHERE IS ROSIN FOUND?

Adhesives Chewing-gum Grease removers Cosmetics

Paper coatings and finishes Soaps

Grip aids and resins Varnishes and lacquers Waxes and polishes Fabric finishes

Pharmaceutical ointments and plasters

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A wide range of chemical ingredients in grooming and beauty products cause sensitivity and allergy, the most common being perfumes and preservatives. Natural plant extracts or oils are no less allergenic than synthetic chemicals and are not automatically safer.

Hypoallergenic (low-allergen) products exclude the most allergenic substances. This does not mean that they are totally safe, but the major sensitisers are absent and most people tolerate them well.

Sensitivity to skincare products is highly idiosyncratic. You may not be able to tolerate one brand of products, but could tolerate another brand, or selected products within a range, quite well. If you react to a hypoallergenic product, do not therefore assume that you will react to any low-allergen product or brand. Try another with care and see how you go.

If you want to know how medical treatments can help you cope. If you know that you are sensitive to cosmetic and skincare products, your best advice for avoidance is to:

• Use unperfumed products where possible

• Try low-allergen products (details below) until you find some that suit you

• Use as few products on your skin, hair and body as you feel able to. Reducing the load will help your system cope

• Use perfume, cologne or aftershave as seldom as possible

If you suspect that you are sensitive to cosmetic and skincare products and want to find out,

Either

• Switch to low-allergen products and see if you see any improvement

or

• Reduce the amount that you use or cut out certain products or

• Stop using products altogether for one week. Use low-allergen soap and shampoo only, then reintroduce products one by one, at intervals of at least a day and preferably one a week. Use either your previous products, or low-allergen brands. Monitor any symptoms carefully.

Caution

You may feel worse before you get better when you stop using things you have used regularly. This is a form of withdrawal and new symptoms can result.

You can also use the Sniff Test and the Patch Test (see pages 88) to test a small amount of product to see if it upsets you. If you want more detailed advice about sensitivity to cosmetics, toiletries and skincare products.

Avoid using fragrance-free products if you are very sensitive to perfume. These are legally allowed to contain one perfume, usually for the purpose of masking the smells of other ingredients. Use unperfumed products in preference – these cannot contain any perfume at all.

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If you work in the building trade and are sensitive to the materials you use, then your life will be very hard. You may have no say at all in the choice of materials you use. The Health and Safety Executive is increasingly active in the field of hazards from building materials and can provide specific guidelines on basic precautions to take when using them. These will not always prevent low-level exposure sufficient to cause sensitivity, but may be important information for you to bring to the attention of an employer or contractor, if you are concerned that adequate care is not being taken. Consult the telephone directory to find your local branch of the Executive.

Alternatively, the building union UCATT produces health and safety information and recommendations for handling and working with hazardous materials.

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If you know that you react severely to stings, you can carry an emergency kit containing a syringe of adrenalin, which can be used in case of sudden reaction. It may also be wise to wear a disc or locket giving details of your allergy for fuller details.

In other cases of milder reactions – say to mosquito or tick bites -the reaction manifests itself usually as an exaggerated local reaction at the site of the sting or bite – a red, raised bump and flare. You can use topical anti-histamine cream to relieve these. Alternatively, if you are highly chemically sensitive and react to topical creams, wiping the site with Cream of Magnesia (unflavoured from Boots the Chemist) works very well.

Desensitisation – a course of injections of dilute amounts of the allergen, which prevents the body reacting allergically – can be effective against insect bites and stings and may be your most useful protection if you are highly allergic.

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Before an IUD is fitted the woman should have sufficient information about other methods in order to make an informed choice. She also needs to know the advantages and disadvantages of an IUD.

The advantages include the fact that nothing contraceptive needs to be done at the time of intercourse. Secondly, except at the time of insertion, it requires no motivation. Thirdly, if she is symptom-free and does not object to its presence, as some women do, it is an acceptable method; and finally, it does not disturb the hormones in the body as does the Pill.

The disadvantages are that the device is expelled in 2-10 per cent of women perhaps unknown to the woman herself. Although recent designs minimise this risk, the IUD has a failure rate which is about the same as the progestogen-only Pill. An IUD can produce menstrual disorders with resultant anaemia and also inflammation of the fallopian tubes, with the risk of subsequent infertility, if an infection with organisms such as chlamydia is present. This eventuality, and pregnancy, occur most commonly in the early months after the device is fitted but manufacturers recommend removal and the fitting of a new one every z or 3 years. If the woman is allergic to copper then devices containing copper should not be used and neither should the IUD be used in women with valvular heart disease or those on corticosteroid drugs. Furthermore, at the time of insertion or later, the device may pass into or through the wall of the uterus.

IUDs do not increase the chances of cancer of the cervix or uterus but deaths do occur from it at the rate of 3 to 5 per million users per year. Overall it is as safe from this point of view as other methods and safer than using no contraception.

With all this in mind the method is best used by older women who have completed their families and in whom sexual life style is fairly settled.

There used to be a variety of IUDs but choice is now more limited because of manufacturers withdrawing products from the market as a result of litigation, especially in the US. The Multiload Cu 375 gained a favourable report from the World Health Organisation. High hopes also exist for the Novagard/Nova-T which releases progesterone and can be left in position for 5 years. A failure rate of 1 per hundred woman years is claimed and it is associated with less menstrual pain and less blood loss.

For a variety of reasons the success of an IUD is associated with the fitting of the device by a doctor who has some enthusiasm, but not too much, for the method and who has a lot of experience in fitting them and caring for the patient afterwards. This factor appears to influence success more than the actual device fitted.

Chemical methods-Various substances kill sperms and, if put into the vagina before intercourse, reduce the chances of conception. Vaginal foams and pessaries are probably the most effective but any of the chemical methods can cause irritation. A possible advantage of these methods is that as well as killing sperms they may kill gonococci and cither organisms.

The effectiveness of such chemical methods is increased by using them along with a barrier method, such as a condom (sheath, rubber, protective) or a cervical cap (diaphragm) all of which are intended to prevent the sperms reaching the cervix.

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A degree of apprehension and nervousness is understandable at first when sharing fantasies and one way round this is to read sexy books in bed together, especially those with readers’ letters. Use the topics raised to see if they excite any response. Checking the genitals of your partner to see if they have become aroused also helps.

An interesting fact is that when partners in an established relationship eventually do reveal all they often discover that their fantasies match with, for example, the woman fantasising about a man doing to her just what her partner fantasises doing to a woman.

In clinical practice it is usually found that individuals in a good, satisfying relationship very commonly use fantasies involving members of the opposite sex other than their partner. These may be well-known figures such as film stars, friends, acquaintances or even strangers encountered in everyday life. Of course men and women also commonly have fantasies involving faceless, non-specific members of the opposite sex. This, along with occasional flirting, can be protective to the marital relationship because it is less threatening than actually having intercourse with others.

Other difficulties can arise from sharing fantasies. Some individuals, both men and women, have been brought up to be so inhibited about sex that they consciously restrict their fantasies or even abolish them from the consciousness altogether. In this way a woman may feel that prostitution, for example, is so revolting that even if a prostitution-type fantasy came into her mind she would banish it at once.

Some men’s fantasies are perpetually passive – the woman always takes charge of them. Women often fantasise that they are in a passive role because they have been brought up to believe that sex is something men do to them. Obviously if both partners fantasise passively they cannot really satisfy each other. The best solution in this situation is for them to agree to take it in turns to have their fantasy indulged.

A similar type of difficulty can arise when one partner, usually the man, always has fantasies of activities that do not culminate in intercourse. Some individuals are inhibited about intercourse and so encourage activities close to it, such as oral sex, which avoid the act of intercourse itself. Sometimes, although intercourse is what they would like, their most arousing fantasies are about, for example, dressing in women’s clothing, or the woman being tied up and/or beaten.

With these difficulties in mind, the sharing of fantasies allows the circumstances and types of intercourse to be so adjusted as to give maximal pleasure to both partners. It means that intercourse becomes unique to that couple and adds to their sense of private adventure. It also, perhaps, makes it less likely that either partner will seek adventure elsewhere, because they are both totally pleased and catered for within their sharing relationship.

Women frequently say that if they have to tell their man what to do it reduces their pleasure. This problem is solved if the man reserves some of her fantasies for occasional and unexpected use, especially if he adds a few variations of his own.

Good sex is neither exclusively of the mind nor of the body — it is a blend of both. As a result intercourse proceeds at least as much at the psychological level as at the physical level. The sharing of fantasies teaches partners about each other and this can be very important for men, who are frequently brought up to believe, usually unconsciously, that women are really sexless and have intercourse only to please a man or because they love him.

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Biologists differentiate between males and females in seven main ways: i the chromosomes; 2 the sex organs; 3 the sex hormones; 4 the internal reproductive organs; 5 the secondary characteristics; 6 the gender role; and 7 sexual identification.

Chromosomes-All living organisms are made up of cells, each of which has a nucleus which contains chromosomes. These carry the genes which contain the blueprint which defines every detail of each organism’s structures and function. These genes are inherited, thus explaining how it is that physical and psychological characteristics can be passed from generation to generation. Genes control the myriad of complex enzyme systems in the body, some of which are responsible for brain and hormone metabolism — both of which probably affect behaviour to some extent. Every cell in the human body contains twenty-three pairs of chromosomes, each of which in turn carries thousands of genes. The exception to this rule are the sex cells (sperms and eggs) each of which contains twenty-three single chromosomes. When an egg is fertilised by a sperm the two sets of twenty-three link to form a complex double set which is essential for the development of a new human being.

One pair of the twenty-three pairs of chromosomes is responsible for determining the sex of the individual. Generally each chromosome matches its partner in the pair, except for the sex chromosomes in males which are different. One is called the X chromosome and the other is very small and is called the Y chromosome. A woman has two X (normal-sized chromosomes) and a man an X and a Y. So women are XX and men are XY in sex-chromosome structure. Sperms carry either an X or a Y chromosome. The sex of the baby is decided by which reaches the egg first. If this is a Y-carrying sperm, the baby will be male. An absence of a Y chromosomes produces a female even if one of the chromosomes is missing (as sometimes occurs) with an XO pattern.

Because the Y chromosome is so small it is obvious that females have more genetic material than males right from the start. There is now evidence that one of these Xs is repressed and that only one is really operative. This would make sense in that both sexes would thus tend to have roughly equal amounts of chromosomal material.

But Nature plays some odd tricks from time to time and as a result teaches us some interesting things about males and females. Many of these lessons go to prove how difficult it is to be dogmatic even about something as seemingly straightforward as whether a person is male or female.

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*58\164\2*

self-loving, mid-adolescent phase straight to an ‘other-centred’ type of love without some sort of intermediate learning phase. Romantic love is this phase in adolescence. Romantic love is a way in which we learn to bring together our sexual and loving feelings and to ‘aim’ them at the same person for the first time.

This phase of romantic love, which many young people experience more in fantasy than in fact and which others never grow out of, is still very much concerned with the self — it is almost entirely a preoccupation with one’s own feelings. This might seem strange at first sight because romantic love is, on the surface, very much concerned with the other person.

Both in literature and in fact, this phase of romantic love can also be associated with bouts of anxiety and depression. The loving feelings may even be experienced as a form of agony and yearning. Romantic writers very often talk of ‘the agony of being in love’ and in a sense suffering and tragedy are often an integral part of romance. Some women unfortunately never grow out of this phase and remain tragedy queens, as it were, all their lives. They have perfectly acceptable and enjoyable relationships yet spoil them by creating traumas and tragedies which they feel are necessary to their concept of romantic love.

So, it can be seen that the phase of romantic love is a learning one. Learning to love is much like learning any other skill; just as adolescents have to learn social skills, they have to learn the skill of love. Because it is immature love, it is often described as ‘calflove’ or ‘puppy love’ but this misses its importance. Unless one uses this stage as a foundation, one cannot build the love structure an adult needs. Parents should never make fun of or put down their teenagers in this stage of puppy love — the teenager needs to go through it.

Most people, however, progress to other relationships and, it is to be hoped, begin to get some idea as to what sort of partner would really suit them. Such a relationship once again releases romantic feelings, but now they are simply one component of the more complex emotional and sexual reactions of the chosen partner. Ideally the romantic portion of the relationship should be encouraged to emerge slowly so as to allow realistic assessments to be made. Romantic love then becomes increasingly added to the relationship rather than being its starting-point. In this way the objection that love is blind can be overcome.

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Stiff joints also seem to be a fact of life for many people, beginning at about age 40. The health of joints depends on the strength of the muscles supporting them. Regular exercise—walking or running, weightlifting—is essential if you are to hold your own in the battle with aging muscles and joints.

Lower-back pain is also more common among people in their 40s and 50s. Researchers say that a slow, natural degeneration of the disks that cushion the vertebrae and stress can both contribute to back problems in middle-age people. But most people can overcome the pain and prevent further problems by strengthening the lower body and abdominal muscles through exercise.

2) Bone deterioration— strong bones are essential in order to prevent osteoporosis, a health problem which often afflicts older women. Osteoporosis causes bones*to become thin and porous enough to fracture or break easily. The condition accelerates at menopause and affects about 25 percent of women older than 65.

Studies have shown that the stronger a women’s bones are before menopause, the better her chances of avoiding osteoporosis. Adequate calcium intake and regular weight-bearing exercise—walking or running—are recommended to all women to ensure dense bones.

3) Sex— for most women, the hormonal shifts of menopause have little or no effect on desire or responsiveness. Many women at menopause, however, find sexual intercourse painful because of a drying and thinning of vaginal tissues. Many experts agree that the best treatment is to remain sexually active. Studies reveal that postmenopausal women who keep sexually active— with sexual intercourse at least once or twice a week—have considerably less vaginal atrophy than sexually inactive women.

As for men, evidence indicates that older men who keep in good physical condition can apparently maintain their output of sex hormones at the levels of young men. In fact, studies show that both men and women can enjoy sex into their eighties and beyond.

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Homes with unvented kerosene or gas heaters, leaking chimneys and furnaces, and gas stoves are all at risk of carbon monoxide exposure. Low concentration of carbon monoxide can cause fatigue in healthy people and chest pain in those with heart disease. Higher exposures can cause impaired vision and coordination, dizziness, nausea, and death.

Here are several ways you can reduce the risk of carbon monoxide exposure in your home:

1) If possible, install a vented gas furnace and space heaters.

2) Have a trained professional inspect and clean your central heating system once a year.

3) If you have a gas stove, install an exhaust fan vented to the outdoors.

4) Don’t use charcoal indoors because it produces deadly amounts of CO (carbon monoxide).

A new device recently approved by Underwriters Laboratories is designed to prevent death from carbon monoxide poisoning. The new device resembles a smoke detector and is supposed to sound an alarm if the carbon monoxide in the air nears a dangerous level.

Records indicate that most of the 230 cases of fatal carbon monoxide poisoning reported each year are due to faulty appliances or damaged chimneys and vents. Others result from automobile exhaust in houses that have attached garages.

The new carbon monoxide detectors can operate on batteries or they can be plugged into a household electric outlet. Their sensors, unlike those in smoke detectors, must be replaced every 3 to 5 years, and cost from $15 to $20. The detectors themselves sell for $50 to $70.

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1) Breathe slowly and deeply. Let your head drop forward, then cup the back of your neck with your hands. Press gently, so you will stretch your neck muscles without straining them.

2) Using thumbs and fingers, massage the back of your neck from the base of your skull down to your upper back.

3) As your muscles begin to relax, massage up from your shoulders to the back of your head, then around both sides of your head to your temples and back down again. Continue until your muscles are completely relaxed.

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2) Running— this exercise offers excellent long-term fat-burning potential. The injury risk with running is considered moderate for less than 35 miles per week and very high for more than 35 miles a week. The only equipment needed to start running is a pair of good running shoes.

3) Cycling— the long-term fat-burning potential from cycling is moderate. The injury risk from the exercise itself is low, but can be high if you cycle in areas of high traffic. Since it uses fewer muscles than running, and because it is not weight-bearing, you have to cycle about 40 minutes to equal 20 minutes of running or jogging.

4) Walking— if the total walking time is 30 minutes or less, or if the walking speed is less than 15 minutes a mile, the long-term fat-burning potential is moderate to low. II the walking time is more than 30 minutes, or the walking speed is more than 15 minutes a mile, the long-term fat-burning potential is moderate. The risk of injury with walking is

low.

In order to get maximum fat-burning benefits from walking you should try to set a brisk pace of at least 100 steps a minute and less than 20 minutes a mile. About 4< minutes of brisk walking is equal to 20 minutes of jogging.

5) Swimming— both the long-term fat-burning potential and injury risk are low Swimming is actually the most injury-free sport and it provides excellent benefits for th< cardiovascular system. It also tones practically all muscles. However, if you are overweight, swimming should not be your only exercise. Of all the people tested fo body fat, swimmers usually carry more fat than either runners or cyclists.

While swimming will help keep you lean and fit, you will not lose fat as fast as you would with land sports. Even with that drawback, swimming is a good starting program for overweight people who aren’t used to exercise.

6) Rowing— the long-term fat burning potential of rowing is high, and the injury risk is low. Either indoors or outdoors, rowing is an excellent fat- consuming exercise. It exercises most of the large muscle groups without placing stress on joints and it also helps develop the muscles of the upper body. It should also be noted that rowing causes back problems in some people.

7) Stair-climbing— while the long-term fat-burning potential with this exercise is high, the risk of injury is moderately low. While you are not really simulating stair-climbing, this exercise does require as much energy as running. But it places only about the same amount of stress on the joints as walking.

Treadmill— depending on the incline and speed, the long-term fat-burning potential is moderate to high. The injury risk is low. Treadmills require a good deal of balance and involvement, which enhances the exerciser’s motivation. The best pace on a treadmill is a fast walk or a slow jog.

9) Stationary Bicycling— like its counterpart outdoor cycling, the long-term fat-burning potential is moderate, and the injury risk is low with stationary bicycling. Stationary bikes are both stable and easy to use. This type of exercising has become popular because you can do two things at one time— exercise, and read a book or watch television.

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To avoid consuming an excessive number of calories in the things you drink, try giving up cola. Most colas are overloaded with calories and have very little nutritional value. Instead of cola, try substituting more healthful drinks such as club soda, decaffeinated tea and coffee, fruit juices, and of course, water

This Tastes Just Like Chocolate… Plus It’s Healthy

You might not want to hear it, but chocolate is not especially good for you. Besides being fattening, it also contains a chemical—tyramine—which can trigger headaches. And since it is nearly all fat and contains caffeine, it should be avoided at all costs if you’re suffering from heartburn.

There is some good news, however. For those people who love the taste of chocolate, many people have found that “chocolate” frozen yogurt actually tastes like real chocolate, and it’s a healthier choice for dessert, or anytime. Try it!

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Elderly homosexual people have particular difficulties in this area. Retirement villages and nursing homes are just not geared for people who prefer same-sex partners, and so aging will make the prospect of social isolation even more likely. The problem is probably greater for men than for women because society has less trouble accepting close and loving relationships between women than between men. In either case it is clear that this group of people have special needs as they age that are not being met by the current system. Part of the reason for this is that this group in the community has been virtually invisible until this generation. So what are the solutions?

The first is to somehow integrate the needs of elderly homosexual people into the existing structures. Now this may sound simple enough on the surface, but when you consider the potential barriers it is not as easy as it sounds. To overcome those barriers there would need to be special training or selective employment of nursing and domestic staff. The heads of various government departments and administrators of the nursing homes or retirement villages would need to be supportive of the idea and willing to spend the money to put the changes in place, and the relevant politicians would need to see some political gain for themselves.

The other option is to develop special purpose retirement and nursing home facilities to cater specifically for the needs of the aging gay population. This concept is already in practice for some ethnic and religious groups. Some might say that this approach is separatist, far removed from the cosier notion of everyone accepting the individuality of others. But we are trying to deal with realities here. No single solution is going to be the right one, so what we are talking about is choice, freedom and right to privacy.

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Some men think they are ‘impotent’ because they lose their erections before or soon after penetration. However if the erection disappears because he has already ejaculated, that’s an entirely different matter. We call that premature ejaculation. It’s a bit hard to come up with a definition for premature ejaculation because, like many sexual problems, it’s largely a matter of perception. Many women who orgasm quite quickly (often during foreplay) are not rapt in the concept of being pumped for ages.

Over the years they’ve tried to define premature ejaculation by a variety of methods — not being able to last two minutes after penetration, or a certain number of thrusts and so on. The definition I like is that a man or his partner wishes he could last longer.

One of the myths about the best way to deal with premature ejaculation involved the man distracting himself by reciting some list, like the American presidents. ‘George Washington, John Adams … oops! What is it about Thomas Jefferson?’ or ‘That was great darling … at least a Woodrow Wilson!’ Sports fans could try lists like the batting averages of the cricket Tests since 1912 … ‘What do you mean “You’re out”? Don’t you think there is a certain irony about trying to enhance a mutually erotic experience by pretending you aren’t doing it?

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Even the most adaptable relationships can take some adjusting and many people just don’t expect the degree of change, including the differences in their sexual needs. One mother told me, ‘We were very sexual before the baby arrived and it came as a great shock to me that I wasn’t the slightest bit interested for ages afterwards. My breasts were always a really important part of stimulation for me and it just wasn’t the same going to bed wearing a nursing bra. My libido didn’t come back until I’d stopped breastfeeding. Actually, I found feeding was almost a sexual experience in itself. It’s not like an orgasm you’d get with your partner, but it’s certainly incredibly sensual.’

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When there are children involved it can get very complicated. One of the main problems for a new relationship is that there never seems enough time to be alone and that will be intensely frustrating. The system of jealousies can be incredibly complex. The reactions of children will depend a lot on their age but seeing your parent relating physically or sleeping with a person who is not your other parent can create confusion, resentment and even anger at any age. If your parents’ relationship was strained for some time you may never have seen the adults around you engaged in any sort of intimate behavior before and that can be particularly confronting. Children can be very protective of their parents and new partners may find themselves competing for attention, physical affection and personal space with their partner’s child. Stepparents may feel inhibited about showing affection in front of each other’s children for fear of setting off a reaction. So establishing a blended family raises a multiplicity of sexual issues that will take time, patience, understanding and a big dose of common sense to unravel.

The main answer to dealing with relationship problems and breakdowns is early preparation. Obviously the example set by your own parents is a vital element, but in any relationship the backgrounds of the two people will be different in some respects. Just because one of you knows how to communicate emotions, it takes two to tango. It would be like sending a message over the radio when your intended audience is tuned to another station. The missing link is relationship education by specially trained teachers in schools. In fact, understanding relationships is so integral to our emotional survival that it needs to be a cornerstone in the education system. To survive in the modern world we need the ‘four Rs’ … Reading, wRiting, aRithmetic and Relationships.

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But it’s not enough to silently hope that your partner, no matter how committed they may be to the relationship, will never have a sexual encounter with another person. If you look at the statistics, the truth of the matter is that the majority of married men and women will have an extramarital liaison at some time. Denying this reality or just refusing to acknowledge it or talk about it leaves far too much to chance. Some therapists argue that it is not necessarily the affair itself, but the exposure of the affair or the fear of what it might do to the relationship that actually does the damage. The feeling of betrayal and loss of trust that follow can tear a relationship apart. Catching an STD and then having to tell your primary partner is a sure way of exposing an extracurricular relationship, and it can be devastating.

However, the discovery of an STD may have nothing to do with infidelity, so it’s essential to have your facts right before you pick up the phone to call your lawyer. (For that matter call a counsellor before you call a lawyer.) Find out all you can about the infection. Take chlamydia for example. By the 1980s it had become the most common sexually transmitted bacterial infection in North America, Europe and Australia, so its impact has been widespread. Chlamydia is one infection that can lay dormant for years before it is detected, so even though it may be found on a test today it may have been the result of a sexual contact some years before. It can go on causing damage for all that time with no symptoms at all, until it ultimately leads to infertility in both men and women.

*65\17\9*

There are a few extra things to keep in mind if you’re over 60 years of age.

Diet

Good nutrition is always important. It’s hard to know just how important particular types of diet are in maintaining health. Around the world, people who have widely varying diets are now living to a ripe old age. Japan and Sweden have the highest life expectancy, with diets that could hardly be more different. Australia is close behind. The French, renowned for the richness of their cuisine and their wine consumption, also have excellent life expectancy.

If you’ve reached the age of 70 and you’re in good health, what you’ve been eating so far hasn’t done you any harm. Most people of this age will have grown up being taught that meat and dairy produce were good for you and bread and potatoes were the ‘baddies’. The new dietary guidelines are different, but they are based on a modern understanding of nutrition so it makes sense to follow them.

One big advantage of the new guidelines is that they advise you to increase the amount of fibre in your diet. This reduces the risk of constipation, which for some people increases as they grow older.

If you have problems with chewing, see your dentist promptly. Inability to chew properly used to be one of the main causes of malnutrition in older people.

The most important thing about food is to enjoy it. Eat enough of a mixture of foods that you like to maintain a healthy weight. Your doctor will advise you about healthy weight range for your height.

Try to choose foods from the Diet Pyramid to ensure that you obtain all the nutrients you need for good health. This will help increase your resistance to infection and keep you feeling healthy and vital.

As already discussed, many women are unhappy about certain features of their breasts. Because of their powerful sexual significance in our society, breasts seem to be a greater source of dissatisfaction than most other body features.

It’s easy to say that we should accept our bodies as they are and that people love us for our whole selves whatever the size of our breasts, the colour of our hair, the shape of our noses and so on. This type of statement doesn’t make much of an impression on the woman who’s been embarrassed since her early teens because of her big bosom, or the young woman with one breast twice the size of the other, or the woman whose breasts droop so much after her first pregnancy that she won’t undress in front of her husband.

I agree with the ideology that people should accept and love us for ourselves, warts and all. But unfortunately many people can’t love themselves if they feel that they have a physical feature that is freakish or ugly: they become depressed and withdrawn. I believe that there are many instances where the benefits of cosmetic surgery, in terms of improved self-esteem and confidence, outweigh any amount of ideological argument.

A skilled, caring surgeon and thorough counselling are the most important factors in ensuring satisfactory results.

Should we wear bras?

This question would never have arisen between about 1910 and the mid-1960s when all women wore bras, either to flatten and conceal breasts in the ‘flapper’ era, or to mould them into the fashionable shape of the 1940s-60s.

Today, the main advantage of a bra is that it supports the weight of the breasts, thus preventing premature stretching of the fibrous ligaments that anchor the breasts to the chest wall. Support is more important for heavy breasts, especially in the following circumstances:

Lack of oestrogen is the most important factor in the development of osteoporosis in women. Oestrogen decreases bone breakdown, prevents loss of calcium via the kidneys and improves absorption of calcium from the bowel. Even with enough exercise and calcium, women who lack oestrogen before or after the menopause will lose more bone more rapidly that those who don’t.

Health authorities now recognize the importance of oestrogen replacement in maintaining older women’s health, especially in the prevention of osteoporosis. However, some women don’t want to use HRT, and it would be overkill to recommend that all women take oestrogen to prevent fractures when two out of three postmenopausal women won’t suffer the symptoms of osteoporosis. It’s generally possible to predict whether a woman is at increased risk.

Techniques have been devised to measure bone density and the degree of bone loss from osteoporosis. These tests may be used to identify early those at higher risk of fractures in later life so that vigorous steps can be taken to prevent further bone loss. Your doctor might suggest such tests if you seem to be at high risk, though many doctors skip the tests and encourage all middle-aged women to begin and maintain a routine that will prevent them from ever suffering disability from osteoporosis. This means having enough exercise and calcium, and hormone replacement if needed.

For women who can’t take oestrogen, other medications may be helpful. Calcitonin (a hormone produced in the thyroid gland) and calcitriol (a type of vitamin D) have been used with some success in the prevention and treatment of osteoporosis, but they are not suitable for everyone and should be used only under supervision of a specialist in osteoporosis. Anabolic steroids seem to relieve the symptoms of established osteoporosis and slow down or halt the process, but also may have unwanted side-effects in some cases.

Other risk factors

Other factors can influence the risk of fractures from osteoporosis.

Body build

Thin women are at greater risk than plump women. Body fat can convert hormones from the adrenal gland into oestrogen: not as much as the ovaries produce before menopause, but enough to slow down bone loss. Also, the bones of heavier women are more stimulated by the greater weight they support. Short women are at greater risk than tall women, because they have less bone mass and so lose relatively more bone as they age.

Family history

Our genes determine our body shape and height, and family habits of diet and exercise may also be important factors in the development of osteoporosis.

Drugs and smoking

Certain drugs promote bone loss, mi through their effects on body calcium. These are alcohol, some diuretic anticonvulsants, thyroid hormone, cortisone and tetracycline antibiotics. Women who are prescribed these drugs for a long time will have been warned by their doctors that they may need more calcium.

Cigarette smoking encourages bone to by increasing the rate of oestrogen breakdown in the body and perhaps the rate of calcium loss in urine.

Amenorrhoea

Women who’ve had long episodes amenorrhoea between puberty and menopause are more likely to begin postmenopausal years with reduced bone strength.

Until recently one in three women coil expect to suffer a fracture from osteoporosis if they lived beyond 65 years. Now we can help prevent osteoporosis from casing disability by maintaining healthy bones before menopause, and by continuing adequate exercise, taking enough calcium and using HRT if needed, after menopause. If you’re around the age of 50, discuss these measures with your doctor.

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It’s generally better to set off for the hospital early rather than too late. Check with the delivery suite if in doubt (there is someone on duty 24 hours a day). Your partner or the taxi driver could probably rise to the occasion if necessary, but I’m sure that both you and they would prefer
experienced hands for your delivery! Until about 70 years ago, most babies were born at home, usually with the help of the local midwife or GP. During the 1920s the trend to having a baby in hospital began, and by 1950 a home birth in Australia was a rarity. Childbirth in hospital became (and still is) favoured for its greater safety, leading to the rapid growth of obstetrics as a speciality, and medical technology was applied to childbirth. We’ve now gone the full circle. Since the late 1970s there’s been an increasing demand for the services of midwives for home births and for hospital services that would allow a natural delivery if appropriate, rather than every confinement being subjected to high-technology
interference.

Twenty years ago women rarely questioned what happened to them during hospital confinement. Today the reason and need for many common obstetric procedures has been challenged, and women expect to have a much greater say about how they would like their childbirth to be managed. The aim of all obstetric interventions should be the birth of as healthy a baby as is possible with minimum risk to the mother. Here are some of the controversies.

Recent changes in approach to childbirth

Many women these days have well-formed ideas about how they would like their labour and delivery to proceed. Judith was delighted when I confirmed her first pregnancy. She said: ‘I want to have this baby naturally. Jim and I have decided that we want our baby to be born without anaesthetics or any interference.’ Marie’s reaction was quite different. She said: ‘Refer me to a hospital where they believe in pain relief in labour. I don’t mind how the baby is born, as long as everything is done to ensure a safe delivery.’

Which approach is best? It’s impossible to say. It’s good to gather information about modern childbirth services so that you can decide what you would prefer, and then find a birth attendant – GP, midwife or obstetrician – who will respect your wishes, answer your questions clearly and carefully explain anything that necessitates a change in plans.

Judith may be sadly disappointed if, for safety’s sake, she needs assistance during delivery. On the other hand, Marie may be pleasantly surprised if she doesn’t need pain relief during labour. Because what’s going to happen is so unpredictable, I think it’s better to keep an open mind.

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It wasn’t until the invention of the microscope in the late eighteenth century that sperm were seen in semen and identified as the male contribution to pregnancy. At this time sperm were thought to be miniature men, and one scientist of the time even claimed to have seen microscopic horses cantering through semen! The first human vasectomy was performed in England in 1893, but for treatment of a prostate disorder rather than sterilisation. Over the next few decades die operation became disreputable because it was used involuntarily to treat sex offenders, to prevent masturbation and for eugenic purposes. Voluntary vasectomy as a method of birth control didn’t become established until after the Second World War, and even then there were doubts about its legality in some countries. The first nationally promoted vasectomy programme began in India in 1956, but acceptance of male sterilisation worldwide was slow until the 1970s and it is still forbidden by some nations and religions.

How vasectomy is done

This simple operation is usually done with local anaesthetic in a doctor’s rooms or outpatient clinic. Counselling, preferably of the couple, is best done at a separate visit beforehand.

A small incision is made in the centre font of the scrotum after injecting a small amount of anaesthetic (some surgeons use an incision on each side). The vas from each side is brought through the opening, cut, folded back on itself and tied. Many surgeons also cauterise the cut end. Each bid is then buried in the tissue beneath the skin. The incision rarely needs a stitch; a small dressing is usually enough. The procedure takes 30 minutes or less and most men say it causes little or no discomfort. Afterwards there may be discomfort, swelling and bruising of the scrotum that usually settle in a week or so. A scrotal support or firm-fitting underpants should be worn until the scrotum returns to normal. Usual activities can be resumed the next day (including sex if the man feels like it), though heavy exertion should be avoided for about a week.

Vasectomy doesn’t immediately result in sterility.
The long spermatic ducts between the site of vasectomy and the prostate are full of sperm-containing semen at the time of the procedure. It takes about 15-20 ejaculations to clear out all these sperm. Couples are advised to continue their usual method of contraception until semen examination has shown that all sperm have disappeared. The first test is usually done two months after vasectomy (or after 15 ejaculations, whichever is sooner), when more than 95 per cent will have zero sperm counts. If any sperm are seen, the check is repeated four weeks later. Checking picks up failure in the operation before there’s any risk of pregnancy.

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The main reasons for the continuing controversy are moral and political. It is feared that injections may be given to women against their will or without telling them that they are for contraception and/or without telling them of the possible side-effects or problems. This is an abuse of human rights that should be condemned in every circumstance.

The opponents of DPMA certainly have a strong case against its abuse, but their arguments against its proper use to treat disorders or for contraception tend to ignore the evidence that it is safe and exaggerate the risk of side-effects.

To eliminate the possibility of abuse, any woman who is offered DPMA must be given full details about all its possible effects plus an unbiased account of the controversy, so that she can make a fully informed decision about using it.

DPMA has been used for many years in high dosage to treat breast and endometrial cancer, and has been used in low dosage for contraception by more than 10 million women. As a contraceptive, it has less health risks than the Pill, and no deaths have resulted from using a contraceptive injection. DPMA is used for contraception in more than 80 countries, and has been endorsed by such prestigious groups as WHO, the International Planned Parenthood Federation and the American and British Colleges of Obstetrics and Gynaecology.

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How long do periods last?

They usually continue for three to six days. The most common pattern is for the discharge to be slow and darkish for the first few hours; then a steady, brighter red flow; for the next day or so; becoming slower: and darker over the next couple of days.

How much blood is lost at menstruation?

First of all, the menstrual flow is not all blood, though there is blood in the endometrium when it is shed, plus some more that leaks from the raw surface it leaves behind. The flow also contains the liquefied endometrium and some secretions from the cervix and vagina.

The average blood loss per period is around 40 ml, though it seems like more when it’s spread out on pads and tampons (but pour just 10 ml – 2 tsp – of coloured liquid onto a pad and see what a wide area it covers). A loss of more than 80 ml is abnormally heavy bleeding.

How can menstrual flow he measured?

The usual way has been to get women to save all the tampons and pads used during a period, and to extract the blood pigment (haemoglobin) they contain. By measuring the amount of haemoglobin per ml in each woman’s blood, her blood loss during the period can be calculated. Measuring the total amount of fluid in the Sow is more difficult. One way would be to weigh all pads and tampons before and after use and attempt to calculate the weight of the fluid, but this doesn’t give an accurate measurement.

Why doesn’t menstrual blood clot?

This is because the liquefied endometrium contains substances that dissolve blood clots. If there are clots in the menstrual flow it means that blood is flowing so quickly that it dilutes these substances I too much for them to be effective.

How long is the menstrual cycle?

It’s conventional to describe a menstrual cycle as covering 28 days, and in the majority of women menstruation does occur around every four weeks. However, anything from 22 to 35 days is within the normal range, and for most of us the cycle can vary by a few days from one month to the next.

Other questions about the menstrual cycle

Do other animals menstruate?

Only mammals (animals that breast-feed their young) have reproductive functions similar to those of humans. In cycles where there is no conception most other mammals absorb the dead lining of the uterus back into their bodies. Apes and some species of monkeys menstruate.

Can you tell when you’re ovulating?

Some women can. They notice brief lower abdominal pain at mid-cycle (also called mittelschmerz - German for ‘middle pain’) when the ovarian follicle ruptures. The pain may be followed by 12 hours or so of a tight feeling and tenderness in the lower abdomen due to irritation of the pelvic lining by the fluid released with the ovum. A few women regularly have a spot or two of bleeding from the vagina with ovulation.

If you’re watching your cervical mucus and basal body temperature, ovulation is near the time of peak fertile mucus, and you’ll know that ovulation happened 12-24 hours before the mucus becomes thick and sticky and the temperature rises.

Do women ovulate every month?

Regular periods don’t necessarily mean that you ovulate every month. The ebb and flow of hormones can lead to bleeding even if the ovarian follicles don’t ripen completely and release an ovum. This is called an anovulatory cycle. Without ovulation, bleeding may be somewhat heavier and longer and is usually painless.

Anovulatory cycles are very common for a year or so after the menarche and in older women approaching the menopause.

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The process of growing up includes! some experimenting and risk-taking to I find out what life has to offer and what is safe, good and right for you. If you didn’t take some chances you’d never grow up. Many of your new experiences will be wonderful and enrich your adult life. Unfortunately a few new adolescent activities bring risks to health and life.

Accidents

It’s a great day when you get your driving licence. What an exhilarating feeling of freedom and power to be in charge of a; car or motorbike. But whoa! It’s also a great responsibility. Are you ready for it? It takes time and practice to develop prudence and caution needed for safe driving.

I think the P-plate system helps young people learn to drive carefully. Most so keen to retain their licence that the] take all precautions during the provisions period. Still, road accidents seriously injure and kill more young people than any other cause. In more than half of the accidents, the driver is under the influence of alcohol or drugs. Even a blood alcohol level of 0.05 doubles the accident risk; at 0.15 a crash is 25 times more likely.

Never, never take a chance with drugs or alcohol on the road. Don’t drive yourself, and don’t be a passenger if the driver’s alertness and co-ordination could be affected by drinking (or anything else) This may sometimes mean that you must take public transport or a taxi home and collect the car next day. A nuisance? Yes, but it’s never worth risking serious injury or death.

Teenagers and alcohol

A survey of New South Wales school students that’s been going on since 1971 shows that they now drink twice as much as they did 15 years ago. Many are drinking regularly at the age of 14, with the heaviest drinking occurring among the 16-17-year-olds. Girls now drink as much as boys, so it seems that the old attitude that it was manly but unladylike to drink has disappeared in Australia. Boys tend to stick with beer, while girls prefer more sophisticated mixed drinks like rum and Coke (which don’t taste like booze but make you drank very quickly). Meanwhile health authorities continue to hammer away about the dangers of alcohol: its association with road accidents, domestic violence and increased risk of heart disease, liver disease, brain damage and all the social evils of alcoholism. You wonder why anyone drinks! Why do teenagers start drinking? And why so young? Teenagers see drinking as a thing adults do and seem to enjoy, so they want to try it. Often they see no harm come from it. They may doubt the message of the health authorities when they see no ill effects from Mum and Dad having a drink after work and a glass or two of wine with dinner, though the teenager whose home life is wrecked by a drunken parent may have a different opinion.

The fact is that alcoholic drinks are part of our way of life. Drinking is part of most of our social rituals. Australians swallow more alcohol per head than any other country in the Western world. It would be hypocritical to advise young people not to drink at all when they see their parents and other adults drinking all around them; alcohol is advertised everywhere and many big sporting contests are sponsored by breweries.

The credible message for young people is moderation, know your limits, don’t get drunk and, of course, never drink any alcohol if you’re going to drive. Still, a lot will get drunk once, just to see what it’s like. Let’s hope that most of them will decide in the misery of the next morning that they’ll never do it again.

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