July 26th, 2011
Where you were in life at the time of your injury (your age, relationship status, geographic location, education and job) has a crucial bearing on how you react, adapt, and reconcile to this new part of your life. People have different strengths and challenges. Bella’s past included international travel and athletics. Would they be part of her future or influence her direction? Ray painted houses for a living and was the sole breadwinner for his family of five when, in his late fifties, he climbed the ladder to clean the gutters on his house and fell, injuring his spinal cord. How would he reconstruct his future?
How individuals build their lives depends on many variables. For a young person, the task is to define the direction for a lifetime. This will be aided or hindered by support or lack of support, such as family attitudes, education, economic means, and whether adequate rehabilitation facilities are available. An older person, on the other hand, has to deal with the disruption of an established lifestyle at a time when one usually expects life to be in a fairly stable pattern. The situation can be even more complicated for a person in a rocky relationship and with few people who are able and willing to serve as a support network.
So, where you are at the time of injury helps you assess and understand yourself and the assets and deficits of your situation. It helps in explaining why your puzzle looks the way it does . . . and how you might change it.
July 16th, 2011
In Finland, researchers doing a study gave a large group of longtime smokers beta-carotene supplements. The idea was to see if these supplements could reduce the risk of lung cancer in these folks. The results showed that there was no reduction in the risk of lung cancer, and some indication that there was more lung cancer in the group. Panic set in. The study was terminated. Other studies dealing with beta-carotene supplements were suspended. Now that the dust has settled what do we know? We know that the smokers were in a very high risk group for developing lung cancer. We know that there are hundreds and hundreds of studies showing beta-carotene in food to be a powerful and healing antioxidant fighting all kinds of diseases including cancer very successfully. We know that Nature may have included some element we still haven’t figured out in food sources of beta-carotene that was left out of the synthetic version. We know that food is crucial when it comes to our longevity. We ki^ that this small ripple is no reason not to eat our carrots.
July 3rd, 2011
There are some very simple guidelines which can be applied to choosing quality supplements. It is important to be aware of these guidelines to ensure that you do actually experience what good quality medicinal herbs and therapeutic vitamins can do for your vitality and ongoing quality of life.
There are so many brands of vitamins and herbs in health food stores and pharmacies – all of different qualities and prices – and it is very difficult to know what exactly you should buy. In this book I have given general dosages for each condition, so you know what to look for. However, I always recommend, if you do want to get the most out of supplements and complementary therapies, a visit to a qualified, registered naturopath, herbalist, nutritionist or health consultant.
Tell them as much as you can about your medical history and lifestyle in relation to your health. Make notes before your visit. If possible have a complete blood test before visiting your health consultant, or take along your latest test results. Also take along any medication you are on, as well as any vitamins or complementary medicines you may have been taking. It is vital that your practitioner knows what medication you are on from your doctor so they can discuss any contraindications in relation to your vitamins and herbs. They can sort out if they are suitable in dosage and quality and also check on expiry dates.
June 23rd, 2011
Foams, Suppositories, Jellies, and Creams
Like condoms, jellies, creams, suppositories, and foam do not require a prescription. Chemically, they are referred to as spermicides – substances designed to kill sperm. Foams, suppositories, jellies, and creams usually contain nonoxynol-9, a detergent believed to be effective in also killing viruses, bacteria, and other organisms. Although they are not recommended as the primary form of contraception, spermicides are often recommended for use with other forms of contraception. Though they help prevent the spread of certain STIs, they are most effective when used in conjunction with a condom.
Jellies and creams are packaged in tubes, and foams are available in aerosol cans. All have tubes designed for insertion into the vagina. They must be inserted far enough to cover the cervix, providing both a chemical barrier that kills sperm and a physical barrier that stops sperm from continuing toward an egg.
Suppositories are waxy capsules that are placed deep in the vagina and melt once they are inside. They must be inserted 10 to 20 minutes before intercourse to have time to melt but no longer than one hour prior to intercourse or they lose their effectiveness.
This contraceptive device for internal use by women was approved by the FDA in 1993. The female condom is a single-use, soft, loose-fitting polyurethane sheath. It is designed as one unit with two diaphragm-like rings. One ring, which lies inside the sheath, serves as an insertion mechanism and internal anchor. The other ring, which remains outside the vagina once the device is inserted, protects the labia and the base of the penis from infection. Many women like the female condom because it gives them more control over reproduction than does the male condom. They believe that women must take full responsibility for birth control since they are the ones who become pregnant. When used correctly, the female condom provides protection against HIV and STIs comparable to that of a latex male condom.
June 18th, 2011
For many, being overweight in our society clearly becomes a paramount concern and a significant source of worry. Some find that this fear makes the task of losing weight too overwhelming even to begin, while for others it creates a willingness to take extreme measures. Stearns and others concerned with the issue wonder if whether a change in the way doctors, insurance companies, and the media approach weight loss might be helpful.
Says Stearns: “I think there are at least two obvious suggestions. One would be to encourage doctors and insurance experts to get their act together and push more realistic models of body types. Some doctors will come out saying that adherence to the most rigorous weight standards does not demonstrably improve health, that oscillation in weight is possibly more dangerous than a certain degree of overweight. I think most people hear diversity of opinion from medical and insurance sources, and the easiest voices to spot are the ones that say ‘Just get the weight off. If you’re ten pounds under your desired weight you’ll be healthier.’ I don’t deny the possibility that that’s scientifically true, but I think in terms of human impact it’s proving counterproductive. It makes the
“The second source would be the media. A larger array of body types in the media should be seen as effective and desirable. Unfortunately television and the movies compound the problem by the fact that these media add ten pounds to the frame, so that even to look normal actual stars have to be pretty damn skinny. Again, if we eased up here, if we simply applied the message that we like to apply in other respects—that is, a welcoming of diversity—we might see a certain relaxation of the pressure. Whether we would choose to do this, given our fascination with these types and our insistence that our role models be particularly thin … I really don’t know.”
June 8th, 2011
Large, brown marks on the face and on the back of the hands are caused by long-term sun exposure. They are not due to age nor have anything to do with the liver, as the term ‘liver spots’ suggests. These marks can be readily treated with either liquid nitrogen (dry ice) or with a peeling solution of Trichlorecetic acid, which is done as an outpatient procedure and can be safely performed at any age. Fading and bleaching creams, however, are ineffective.
Cellulite refers to the lumpy fat and skin dimpling that is commonly seen on the thighs. In many women these fatty deposits are genetically determined, and weight loss and exercise do little to help. Many of these women also have a band of fibrous tissue connecting the fat to the skin, which produces the dimpling.
Although there are many creams advertised for eliminating cellulite, none have any proven benefit. There is also a vogue for massage and exercise treatments, which are not effective. The fatty deposits can be successively removed by liposuction, which is generally done under local anesthetic in day procedure centers. Liposuction, however, is not suitable for people who are generally overweight.
May 27th, 2011
The phase of early adulthood, from approximately ages twenty to forty, is a time when people make important life choices (marriage, occupation, life-style) and move from the relatively untested ambitions of adolescence to a personal maturity shaped by the realities of the world in which they live. For most people, it is a time of increasing responsibility in terms of interpersonal relations and family life.
In recent years, both in the United States and abroad, there has been a definite trend toward marriage at a later age than in past decades. As a result, many young men and women face an extended period of being single after adolescence that unquestionably changes patterns of sexual behavior from Kinsey’s day. Today, most people in their twenties believe that becoming sexually experienced rather than preserving virginity is an important prelude for selecting a mate. Erikson remarked in 1968 that developing the capacity for intimacy is a central task for the young adult.
Young adults are generally less subject to “sexual peer pressure” than adolescents but more driven by an internal need to become sexually knowledgeable. Freedom from parental limits is accompanied by easier access to private surroundings (an apartment, a motel room, a vacation spot), which also creates more sexual opportunity. In this state of singlehood, several common patterns of sexual behavior can be seen. The experimenter seems to judge sexual experiences in terms of frequency, variety, and performance proficiency. She or he seems to view the world as a sexual smorgasbord and generally has the attitude that “now’s the time to play, because later I’ll settle down.” The seeker strives to find the ideal relationship (and perfect marriage partner) by developing sexual relationships and hoping for the best. Living together can be a proving ground for a relationship begun on this basis. The traditionalist participates willingly and joyously in sex, but reserves intercourse for “serious relationships.” The traditionalist may have several sexual partners before ultimately marrying, but does so one at a time. There are undoubtedly other patterns that can be identified, but these three seem to be most common.
The early years of adulthood are a time of sexual uncertainty for some and sexual satisfaction for others. Conflict can arise because of attitudes of sexual guilt or immorality carried over from earlier ages. The adolescent’s concern with sexual normality has not fully disappeared, and the young adult continues to worry about his or her physique, sexual endowment, and personal skill in making love. Sexual identity conflicts may not yet have been resolved, and even for those who have, come to accept themselves as homosexual or bisexual, social pressures and prejudice? may cause some difficulty.
Despite the existence of such problems, young adults are more sexually active today than in the past. A major factor contributing to this change has been the relative disappearance of the old double standard that regarded premarital sexual experience as permissible for men but not for women. Thus, it is not surprising to see that the gender gap in premarital sexual experience has narrowed considerably from what it used to be.
Today’s young adults are faced with some additional sexual conflicts that may represent a sort of backlash against the “anything goes” banner of the sexual revolution of the 1960s and 1970s. For example, while attitudes toward premarital sex have changed dramatically in the last three decades, having sex with a large number of partners is still somewhat frowned on. Furthermore, although most singles don’t believe that love is necessary for good sex, there seems to be increasing disillusionment with casual sex or one-night stands.
This trend seems to be at least partly the result of increased awareness of the possibility of exposure to a sexually transmitted disease, such as the much-publicized genital herpes. Among young adult homosexual men, who have — as a group — typically participated in casual sex much more than their heterosexual age-mates, fear of contracting AIDS has also led recently to a reduction in the number of sexual partners and more interest in establishing “monogamous” relationships. Fear is not, however, the only element operating here. Many of the young adults we have interviewed are concerned with another aspect of casual sex: its relatively impersonal nature. The following remarks are typical of what we have been told:
A twenty-six-year-old man: Having one-night stands was fun at first because there were no demands attached, no one’s expectations to fulfill. But after a year or so I began to realize that something was missing from these encounters — a sense of caring about the person I was making it with, or a feeling that she cared about me.
A thirty-year-old woman: You just can’t compare the quality of sex with someone you hardly know and feel nothing for with the quality of sex in a caring relationship. Casual sex is just mechanical, one-dimensional release. Sex with someone I care about is warmer and psychologically far more satisfying.
Why are a number of young adults becoming disillusioned with having only casual sexual encounters? Peter Marin, in an article titled “A Revolution’s Broken Promises,” offers one interesting analysis of what may be occurring: he suggests that while loosening restraints on sexual behavior creates a climate of sexual freedom and choice, this freedom is not unequivocably positive. Sexual freedom can lead to disappointment, pressure, and conflict as well as satisfaction, so that “To the extent that it diversifies and expands experience, it also diversifies and multiplies the pain that accompanies experience, the kinds of errors that we can make, the kinds of harm we can do to one another.”
Similarly, Susan Washburn claims that the commercialization of sex in our society leads to completely unrealistic expectations of what sex should be:
When sex is treated as a commodity, the consumerist credo, “more is better” is extended to sexual interactions. If one partner is good, two are better, and an orgy the ultimate sexual experience; if one orgasm is good, a Chinese firecracker string of multiple orgasms is better. . . . We collect sexual experiences with the same compulsiveness that marks our accumulation of material goods. We’re afraid that we won’t get ours before the supply runs out.
To be sure, sexual experiences in early adulthood are often warm, exciting, gratifying, and untroubled. Even casual sex can serve a number of useful purposes, psychologically as well as physically, and there is certainly no reason why having fun is to be frowned on. But the prevailing trend is clearly toward sex in the context of caring relationships, and one place this is particularly evident is in the relatively recent growth of cohabitation — unmarried heterosexual couples living together.
Pregnancy may influence a couple’s sexual activity, although it has no uniform effect on sexual feelings or function. For some women, pregnancy is a time of heightened sexual awareness and sensual pleasure, while for others no changes are noticed or sexual feelings decline. Some couples find that late in pregnancy the awkwardness of a bulging belly and concern about the baby lead to voluntary abstention from sex. For others, adjustments in sexual positions or the use of non-coital sex play solves these problems fairly easily.
There is marked variation in patterns of sexual behavior in the first trimester of pregnancy. Not surprisingly, women with morning sickness and high levels of fatigue report losing interest in sex and a lower frequency of sexual activity, but other women experience just the opposite effects. In the second trimester, however, 80 percent of pregnant women note heightened sexuality both in terms of desire and physical response. In the last trimester, there is typically a pronounced drop in the frequency of intercourse. While many women think this happens because they are less physically attractive, husbands generally deny this explanation and instead voice concern about injuring the fetus or their wife.
A few practical guidelines about sex during pregnancy are in order. Women who have a history of previous miscarriages or whose pregnancy is in danger of miscarriage should abstain from any type of sexual activity that might result in their having orgasms, since contractions of the, uterus during orgasm could be risky. If vaginal or uterine bleeding occurs during pregnancy, it is also wise to avoid all forms of sexual activity until receiving a medical okay. Air blown forcefully into the vagina during oral-genital contact can be dangerous for the pregnant woman, if it causes air embolism (air bubbles in the bloodstream). Cunnilingus without air blown into the vagina is not risky. If the membranes have ruptured, intercourse or cunnilingus should be prohibited because of the danger of fetal infection. Aside from these few cautionary notes, sex during pregnancy is quite safe for the fetus and the mother.
Despite the fact that divorce doesn’t always provide as neat a solution to problems as many people think it will, there are certainly many instances in which divorce is the soundest option available. Knowing when to put an end to an unpleasant or painful relationship is often a key step toward creating the chance for a new start.
May 13th, 2011
Treatment with radiation has been used in gynecological cancers for more than 100 years. Radiation works by destroying the chromosomes inside cells thereby preventing the cell from dividing and growing. Unfortunately, the radiation beam often passes through normal tissue so that side effects can occur. However the side effects depend on what other organs are in the immediate area being radiated. Side-effects can include cystitis when the bladder is affected resulting in burning when passing water and often having to urinate frequently. Likewise, the rectum can become inflamed, diarrhea can occur and occasionally bleeding from the back passage.
If the woman is pre-menopausal then the ovaries may be in the way of the radiation beam and will stop producing hormones. The radiation specialist will discuss possible side effects with each patient and ways that they can be reduced. It should be noted that many of these side-effects can be long lasting and may require counseling to help you to adjust to your sense of loss and the changes in your lifestyle. It also requires sensitive support and understanding by your carer or partner, especially if you are a young woman yet to form a permanent partnership and family. Radiation to the vulva will cause skin changes, but it is rare for other sites to change.
It is important to ask how long the side effects usually last so that at least when you are at the mid-point of treatment you have a sense of when it will finish.
I did go into instant menopause after radiotherapy, but as I had no intention of having a child I was not concerned about the loss of fertility. I was really relieved never to have a period again. I haven’t had any mood swings-just the hot flushes. I’m on HRT because of osteoporosis later. It keeps me sexually active. The six and a half weeks of radiotherapy left surface burns and scars almost like bicycle shorts, just waist down to my thighs. It’s all healed up now. It started off like sunburn, which got worse and worse.
When I was given that six weeks time span I thought ‘Oh good, then there’s a light at the end of this tunnel.’ So I didn’t feel that bad if they would have said it would be three months before they heal. I might have been depressed.
So it was important knowing that each thing was a finite span.
May 8th, 2011
The major adverse event in the DCCT was a threefold increase in the incidence of severe hypoglycemia in the intensively treated group. Severe hypoglycemia was defined as an episode with symptoms consistent with hypoglycemia, in which the patient required the assistance of another person and which was associated with a blood glucose level <50 mg/dl or prompt recovery after oral carbohydrate, glucagon, or IV glucose. A total of 65% of patients in the intensive group had at least one episode of severe hypoglycemia vs. 35% of patients in the conventional therapy group. Overall rates were 61.2 per 100 years in the intensive group and 18.7 per 100 years in the conventional group. A history of severe hypoglycemia in the past was the best predictor.
Subgroup analyses showed that males, adolescents, and patients with no residual c-peptide secretion had a particularly high rate of severe hypoglycemia in both treatment groups. Intensive treatment was also associated with an increased risk of multiple episodes of severe hypoglycemia within the same patient. Approximately 25-30% of intensively treated patients vs. 5-11 % of the conventional group had severe hypoglycemia year, and about 10-12% vs. 3-5% resulted in a coma or seizure respectively in the two treatment groups. No changes in neuropsychological function were noted.
April 28th, 2011
Osteoporosis has been thought of as a woman’s disease. National statistics show that 5 million men in this country have osteoporosis— and 20 million women. Less conservative ways of looking at it still indicate that men are only half as likely to get osteoporosis as women. Of the whopping annual bill for all the health care costs racked up by low bone density patients, about 20 percent is for men.
The medical community is twenty years behind in evaluating men for bone density, just as it is only in the last twenty years that women have begun to be screened, diagnosed, and counseled on prevention (though many people can remember similar symptoms for generations back in their own families). As more men are screened, more will be diagnosed, and the total number of people with osteoporosis will be higher, as will the proportion of male patients.
Even before men will be in the unenviable position of having “caught up” to women, don’t make the mistake of taking the “more women than men” outlook to mean that small numbers of men are affected. Best estimates are that between 4 and 9 million American men have low bone density. Bone loss severe enough to have health consequences plagues half of men over 75. Under 65, more women than men are affected—though surely not by as wide a margin as official numbers dictate, since we don’t really screen men for low bone density. After age 65, the rates equalize.
Men take longer to show the symptoms of extremely low bone density, but once they do, they fare even worse than women in similar circumstances. For example, one study showed that half of men who break a hip leave the hospital only to go to a nursing home—and the vast majority of them are still there a year later. Far fewer than half ever regain the full level of ability they had before the fracture.
Men have heavier body frames than women, generally weigh more and have more muscle mass, and tend to be more physically active, so they build up more bone density to begin with (about 30 percent more, according to best estimates). Their diets are higher in calories on average, so they are more likely to get enough calcium. Hormones play an important role in all bone growth, and for men it is their dominant sex hormone—testosterone—that promotes healthy bones. Testosterone levels in men do drop as they age, but not as early or as steeply as estrogen does in women. For men, bone loss doesn’t accelerate until ten years or more after it does for women, and then proceeds at a slower rate, around 1 percent a year. Men also don’t live as long as women, so they just plain don’t have as much time to add up bone losses—on average. In all, men lose just two-thirds the amount of bone women do. But that is still more than enough to lead to serious trouble.
Men share all the same risks as women, and I don’t want to see any more men have the first sign of any trouble with their bone density be a life-threatening hip fracture. Any men with significant risk factors as outlined in the upcoming chapters—and all men over 65—need to be every bit as concerned as women already are. The bone density diet will be good for any skeleton, male or female, and men should follow all the same guidelines as women. The one exception: for much of their lives, men’s calcium requirement is slightly different (lower) than women’s. They should get 1,000 mg a day after 25 and before 65. After that, men and women are even in calcium needs as well as low bone density risk, and should increase their intake to 1,500 mg a day. During the time everyone is building up bone mass to peak levels (before age 25), the recommendations for males and females are also the same.
Culturally, we just haven’t considered bone density to be something that concerns men. Doctors don’t ask men about it or talk to them about prevention; women talk among themselves about taking calcium and lifting weights, but don’t discuss osteoporosis with the men in their lives; health-savvy adult children broach the topic with their aging mothers but not their fathers; men don’t have the awareness they need to avoid this completely preventable condition. It is past time we all did.