When pain lingers, another fear comes to us. Most of us fear death when faced directly with it, and lingering pain brings the fear of death even when the doctors assure us that there is nothing seriously wrong. Fear brings doubts: “Doctors make mistakes; and anyway they don’t tell you the worst.” If the pain is in the abdomen we are soon convinced that it is due to cancer; if it is in the chest we think of a coronary. Even when the pain is in some other part, if fear takes over, the same thoughts come to us. Strange as it may seem, in these circumstances the pain may spread so that we feel it in the heart, and fear leads us to think that the injury to our leg has brought on a heart attack.
The Destructive Effect of Pain-We can see, then, that instead of being a helpful warning against injury, pain that is too severe and too prolonged, when associated with distress and guilt and fear, soon becomes a destructive influence to both body and mind. It is only with the stoutest heart that morale does not weaken; and with failure of morale in any illness the healing process is correspondingly retarded. So anything that we can do in the way of learning the control of pain will not only boost our morale, but will also have an indirect effect on the physical healing of our body.
As an example of this process it is as well to recall that some years ago it was the custom to change the bandages on surgical wounds very frequently. This, particularly in the case of burns, would cause the patient great pain. The patient would wait in fear for the next change of dressings.
Children would scream at the approach of the nurses. Even before the advent of the antibiotic drugs, the change to less frequent dressings improved, both morale and healing.
*116\57\2*
Q. Let us spend a few moments in summing up the various forms of investigation and treatment currently available and see how it works out.
A. Why not. Symptoms lead to medical investigation. This may include a medical examination and history taking, then probably either a barium meal x-ray examination of the stomach and duodenum, an endoscopic examination of the same areas. A diagnosis of chronic peptic ulcer is made, being either in the stomach or duodenum. If in the stomach, a biopsy will indicate if it is only an ulcer or an ulcer plus cancer. Provided the diagnosis of an ulcer is confirmed there are four most likely courses available. The patient may be given antacids in large doses, or cimetidine, or colloidal bismuth or he or she may be admitted to hospital. Antacids may give symptomatic relief and hospital care may cause the ulcer to heal. With cimetidine and colloidal bismuth healing usually occurs rapidly. In 3 weeks, about 50% improvement; in 6 weeks, about 75%; in 9 weeks, about 90%.
Q. What if healing does not occur?
A. If healing is slow or absent (and the experts say that this occurs in about 10% of cases), then the diagnosis must be re-checked. Hopefully, the gastric ulcer will not turn out to be a cancer after all — but it is always a possibility which certainly warrants verification. Or it may be due to the patient surreptitiously taking some other form of medication, such as analgesics which are notorious for creating gastric bleeding and ulcers. If a peptic ulcer is still in evidence a variant to cimetidine may be tried, such as ranitidine, or the patient may be hospitalised for treatment there.
This is the current routine often recommended by gastroenterologists. Today, diagnosis and treatment of peptic ulcers have never been better. There is no reason why anyone with an ulcer should put up with the pain and discomfort that it entails. Adequate investigation and therapy are readily, and fairly cheaply, available to everybody in this country.
Q. Do some people complain of costs?
A. Some misguided individuals complain that medication is costly. These people are misguided in the extreme. At present the government in this country picks up the bulk of the tab for most of the forms of ulcer treatment. However, even if the patient had to pay the entire drug cost himself, this is minimal when the alternatives are considered.
In the bad old days a severe ulcer required up to three months’ absence from work plus, in many cases, the financial hardship that this entailed, plus the costs of hospitalisation, drugs, medical attention, etc. The economics were often mind-blowing and bank-busting.
But today, within a few days, with a relatively small drug bill, the patient may be back to work again, with symptoms gone and the ulcer well on the way to healing. The economics have taken a dramatic change for the better. I always tell my patients never to begrudge the small price they are paying for their medication. The very same persons who complain will think nothing of going out to dinner for the evening with friends and blowing twice the sum as it costs, for example, for the retail price for six weeks’ cimetidine treatment. If you are tempted to complain of costs, please remember the alternatives which in the past used to be dramatically expensive.
*19\61\2*
Although still considered by many as more of an ‘alternative’ therapy than physiotherapy, osteopathy has nevertheless gained great acceptance from the medical profession. Developed in the late 19th century by Andrew Taylor Still, osteopathy is based on the underlying principle that ‘structure governs function’, and the therapy therefore relies primarily on manipulative techniques, these being mainly applied to the back and neck.
Central to the osteopathic concept is that much of the pain and disability affecting people stems from abnormalities in the function of the musculoskeletal system rather than in any identifiable or discernible pathology. According to osteopaths, impaired function in one part of the musculoskeletal system can exist without symptoms but may throw considerable strain on another part of the body.
Like physiotherapists, osteopaths build up a full picture of the patient’s particular dysfunction, which may have developed over a long period of time. Says the Osteopathic Information Service: “Osteopaths do not look on patients simply as back sufferers but as individuals with their own unique requirements. Treatment is designed to correct each individual’s mechanical and spinal problems in order to stimulate their own natural healing processes.”
A recent survey of osteopathic practices throughout the county revealed that more than half of the patients had sought help because of low back trouble.
*18\124\2*
Overweight people with big abdomens are in much worse health than are equally obese people whose fat is distributed around the hips and limbs, Medical World News (26#3:74) reports.
In people who are equally overweight, abdominal obesity carries about five times as much risk of heart attack and stroke as does fat deposited elsewhere. Fat in the abdomen, apparently, is much more “active”, so far as the body’s chemistry is concerned, than fat elsewhere. It is associated with elevation of the blood cholesterol levels, sluggishness of fat disposal by the liver, and impairment of insulin secretion in response to sugary meals.
The easiest way to determine a fat person’s degree of risk from this type of obesity, according to the News, is to measure the circumferences both the waist and hips. When the waist-to-hips ratio is above 1.0 in men, or above 0.8 in women, the risk of heart attack and stroke is five to 10 times greater than normal.
Men, it has been found, are more prone than women to abdominal obesity, even though in general, they are less likely to be overweight. Beer drinkers had better beware.
*225\143\2*
Emergency symptoms: Choking; inability to breathe or cry
Emergency treatment: Call police or paramedic squad.
Symptoms: Gagging; pain in throat or chest; difficulty swallowing; abdominal pain; vomiting
Home care:
A small, smooth object that the child has swallowed should pass out of the body in the stool without treatment; examine the stools until the object is passed.
In the case of a larger object, examine each stool to see if the object has been passed. If it does not appear within one week, notify the doctor.
- Do not give the child a laxative in an effort to speed passage of a swallowed object.
- No medication or other agent is available to speed up or make safer the passage of a swallowed object through the system.
- An object lodged in the oesophagus must be removed promptly, preferably by a doctor.
- Any object that has not left the body within one week should be reported to the doctor.
Over 95 percent of the cent-size foreign objects that are swallowed by children cause no trouble and pass from the body in the child’s stool. However, objects that are larger may become lodged in the oesophagus (the tube through which food passes on its way to the stomach). Sharp objects (pins, needles, bones, matchsticks, nails, glass splinters) may lodge in the tonsils, throat, or oesophagus. Objects longer than a toothpick may not be able to pass out of the stomach and may have to be removed surgically.
*212/84/5*
Children tempted
“We. You and me, and people like us. We know what is right and what is wrong. We have strength. Inward strength of some degree. So we are not easily tempted. We have seen something of the world. We know where danger lies. We know something of how to avoid it. But children! You see them moving into areas of temptation. They are young. They may not have the strength to avoid it. They have not been about long enough to recognize the danger signs as we do. I fear for them.
‘What can I do? Think of them all day. And the night as well. Tell them of all the dangers, and I shall make them timid, or drive them from me. Let them face it. Let them suffer. Let them learn by experience. Oh God. I can’t. The experience may be crippling. Criminal. Criminal to do that.
‘I cannot cope. Is it that I should never have had children?”
She is worried. Disturbing impulses stream into her brain. The children sense her anxiety which makes them anxious too. We catch the mood of those around us. If we are calm, the children will take in some of our calmness. Children identify with their parents. Such is the law of nature.
“I know that it is not, but I feel that it is. That it is my fault that my son is the way he is. My fault. The feeling of it lives with me. Something that I must have done while carrying him. I have asked myself a hundred times. I did no evil thing. No neglect that I know of. So why? Why must this be? Somehow, somehow it must be that the fault is mine.”
Many a mother and not a few fathers have thought like this. It is the recurring thought. Somebody must be responsible. Somebody’s fault. It must be mine. I created him. Any imperfection that he shows is surely my doing.
The thought of it occupies her mind, and the messages so induced clog her brain.
Reassurance from an authoritative person may do something to help. But similar reassurance in friendly conversation leaves little impact. More important is that other process of the mind. The understanding, just the understanding, that we cannot know it all.
*10/98/5*
The prevention of bee stings can be achieved by teaching the child to:
a. Avoid food that is discarded in outside garbage cans.
b. Avoid gardens (because flowers attract bees and vines conceal their nests).
c. Avoid clothes with bright, flowery prints, for they, too, attract bees.
d. Wear shoes when outdoors.
e. Take vitamin Bl during the summer (it gives an odor to the body which bees avoid).
Children who are known to be allergic to bees should be desensitized with a mixture of bee, wasp, hornet, and yellow jacket antigens
Other insects such as the ant, mosquito, bedbug, flea, spider, tick, mite, and scorpion may cause allergic reactions. They can be avoided with house screens, or discouraged with repellents. The U.S. Department of Agriculture, Bureau of Entomology, Washington, D.C., is ready to give advice on the eradication of any one of these insects.
The eradication of bee hives from an area has to be done by a professional exterminator who should inspect the premises at weekly intervals during the spring and summer to detect budding hives. Wasps build hives in almost any protected place, and their nests can be destroyed by hosing them or knocking them down with a stick or broom handle. Spraying tie area with an insecticide discourages them from rebuilding in the same place. Yellow jackets build hives in the ground and emerge through a small hole which should be marked, it dust (after all the insects have returned for tie night), gasoline, which need not be lighted, should be poured down the hole. Hornets build nests in the branches of tall shrubs or trees.
Allergic children going to camp should carry an emergency kit containing 10 mg. Isuprel tablets, an adrenalin aerosol (for inhalation), a tourniquet, a pair of tweezers (for the removal of the stinger and venom sac), and an antiseptic towel.
The child should be taught to immediately remove the bee stinger and its sac with the tweezers (particularly in a sting by a honey bee, instant removal of the stinger and sac may help prevent the poison from being absorbed into the blood); to suck one tablet of Isuprel under the tongue; to use the adrenalin inhaler if there is difficulty in breathing; to apply a tourniquet on the arm above the sting site; to clean the sting site with an antiseptic towel; to apply a cold pack to the sting area; to take an antihistamine by mouth; and to contact the nearest doctor or hospital as soon as possible.
*40/99/5*
Infections
As you may know, Chlamydia can damage your fertility. And, once you are pregnant, it can cause other problems.
An infected pregnant woman can pass on Chlamydia trachomatis to her baby during delivery, resulting in conjunctivitis, failure to thrive, gastro-enteritis and respiratory problems. It may also be a causal agent for otitis media (‘glue ear’), so it needs to be treated as soon as possible when diagnosed.
Toxins
Mercury
Mercury is a toxic metal found in dental fillings and there are concerns about its effects during pregnancy. One study demonstrated how quickly mercury passes from the mother to the baby. Pregnant sheep were fitted with 12 molars filled with amalgam (a mixture of mercury and other metals used in dentistry). These contained radioactive mercury so that the researchers could track the path of the mercury. As early as three days after putting in the fillings, mercury accumulation was seen in both the mother’s and baby’s blood and in the amniotic fluid. The mercury was also present in the baby’s kidneys and liver, which showed higher mercury accumulation than the mother. After the birth of the lambs, the mercury continued to be transferred to the lambs via the milk, with the level in the milk testing eight times higher than in the mother’s blood.
The Department of Health has suggested that pregnant women do not have mercury (amalgam) fillings during pregnancy. I would take that further and recommend that you avoid all dental work, if at all possible, during pregnancy.
Occupational Hazards
Many occupations pose a risk once the woman is pregnant. It has been found that pregnant women exposed to organic solvents have a 13-fold risk of having a baby with a serious congenital malformation. These solvents can be present in the printing, graphic design, clothing, textile and healthcare professions. The suspected solvents include hydrocarbons, phenols, trichloroethylene, xylene, vinyl chloride and acetone.
Normal office equipment, such as photocopiers, fax machines, computers and laser printers, can produce high levels of ozone. It is worth keeping the office stocked with plants to keep the air as fresh as possible. Houseplants will stop the air becoming too dry, as well as absorbing a certain amount of radiation and acting as air purifiers.
You may be in a job that regularly exposes you to hazards and you will need to think about whether the risk can be minimized or whether you may have to change your occupation. Women exposed to pesticides can have miscarriages, stillbirths and babies with malformations. This is why it is so important to think about your occupation and consider whether you have to make changes in order to protect yourself and your child.
*116/73/5*
What is it?
A reddening, blistering and eventual burning of the skin when exposed to sunshine. Sunshine can also predispose to the formation of certain skin cancers.
What causes it?
Most westerners perceive that they look better if their skin is brown rather than pale. This leads many millions purposefully to expose themselves to sunshine, usually when on holiday in warm, sunny climates.
The sun continually bombards the earth with all kinds of radiation. Direct exposure to the whole spectrum would be fatal but the earth has a protective layer called the ozone layer which encircles the globe at high altitude. This layer lets through only the relatively harmless long-wave radiation (UVA) and a little of the short-wave type (UVB) which is more dangerous. It is UVB that is the main culprit in sunburn, skin ageing and skin cancers caused by sunlight. Clouds further cut out a lot of the less harmful UVA waves but let through as much as 80 per cent of the UVBs that have got this far. This makes hazy and overcast days just as dangerous as sunny days.
Certain drugs can sensitize people to the sun. All the following make people burn more easily: antibiotics such as tetracycline; diuretics; oral contraceptives; some anti-histamines and tranquillizers; and certain heart medications. Even some perfumes and aftershaves can do this.
Exposure to the sun triggers a chemical reaction to produce a pigment called melanin in the skin.
Melanin absorbs UVBs, and the more the skin is exposed to sunshine the more melanin is produced and the better the protection from the harmful effects of UVBs. Dark-skinned ‘white’ people and, of course, brown-skinned people, have more melanin in their skin anyway and so tan with less sunburn. No tan offers total protection from the sun though. Recent research has found that sun can weaken the body’s immune systems. A group of fair-skinned people were exposed to artificial sunlight for half an hour daily over a two-week period. Tests showed a weakening of the immune system, including a slight reduction in white-blood-cell numbers. In some people these changes remained for up to two weeks after the exposure to the sunlight.
Prevention
The secret of sunburn is to prevent it. Here’s how:
• It takes several days to get used to the sun, so start slowly. Expose yourself for only two half-hour periods a day over the first few days. Increase this exposure as the days go by. Take it especially gently if you are a blonde or a redhead.
• Drink plenty of fluids (not alcoholic).
• Remember that sea-water makes you burn faster.
• Use an effective sunscreen lotion. Most suntan lotions don’t protect you from the burning rays of the sun at all-they are simply fluids that help you ‘cook’. A protective sunscreen will contain a B-complex vitamin called para-amino-benzoic acid (PABA). Tests have found this to be by far the most effective protection against ultraviolet light. PABA still lets some of the UVBs through so you still get a tan, but you don’t burn. It is vital to keep topping up the sunscreen preparation throughout the day because it washes off in water. Experiments with rats found that feeding them vitamins E and Ñ built up a substantial resistance to the burning effects of ultraviolet light but this has not yet been confirmed in humans.
• Remember that water, concrete and sand reflect sun that can burn you badly and quickly.
• The sun is at its most dangerous between the hours of 11a.m. and 3 p.m. so avoid these times, at least at first.
• Wear a hat when you go sightseeing. The hours pass quickly and you can get a lot of sun without realizing it.
• Wear good-quality sunglasses. US ophthalmologists are concerned because they are seeing increasing numbers of people with a condition called macular degeneration. Some believe that this is directly related to sun exposure. It used to be seen only in the elderly but now is occurring in people in their thirties and forties. Experts think that, to be safe, you should wear sunglasses if you are in the sun for more than thirty minutes, and that sun-bathers should not expose their eyes to strong sun for more than fifteen minutes. Polaroid lenses keep out the glare but do not necessarily contain UV filters, and some experts maintain that wearing dark glasses that do not filter out U V light can actually be more dangerous than wearing none at all.
*233/72/5*
Anyone who drinks alcohol is affected by it – at least to some extent. In general, the more you drink and the more regularly you drink, the higher the risks.
The problem with controlling drinking has always been that it is so difficult to set safe limits. One aspect of this is the inability of most of us to compare one type of alcoholic drink with another. If you think of it in this way though you won’t go far wrong:
1 standard drink = 1 single measure of spirits or 1 pint of ordinary beer or lager or 1 glass of wine or 1 small sherry.
There are some surprises. For example, a half a pint of beer has the same amount of alcohol as a double whisky. Extra-strength lagers are very powerful and can contain as much as three times the alcohol of a normal beer. A glass of wine is as strong as a single whisky.
The first stage in prevention is to work out what you really drink. Don’t guess. Don’t cheat-it’s your life and your family’s future we are talking about. Start off by recalling, day by day, all the drinks you had last week. If this is too difficult start a diary today and enter at the end of each day what you drank, where and with whom. In another column put down how many standard drinks this added up to each day. Do this for a whole week. Bear in mind that if you pour yourself a ‘short’ at home it will probably amount to at least two or three standard drinks. Then total up the number of standard drinks.
If you are a man drinking up to 20 standard drinks a week (or a woman up to 13) you are probably safe. Try to keep your drinking at or below this level.
Men taking between 21 and 36 (14 and 24 for women) are probably unlikely to come to any great harm if the alcohol intake is spread throughout the week. But if you have binges and get drunk you risk having an accident. On average it takes the body an hour to get rid of the alcohol from one standard drink and you are much more likely to have an accident at work, at home or on the road if you have been drinking. One in five men admitted to hospital are there with an alcohol-related problem. One in three drivers killed in traffic accidents in the UK is over the legal limit (2 1/2 pints of beer or the equivalent).
If you score between 37 and 50 (25 and 35 for women) you are getting close to the danger level and you could start to be a danger on the road and a misery to live with at home. It makes sense to cut down on your heavier drinking days and to reduce a little right the way through the week.
Between 51 and 95 (36 and 63 for women) you are already harming yourself. Your liver and stomach are being damaged, perhaps permanently, and the drink will now be affecting your life seriously. You will be dull at work and play and may be drifting into sexual, marital, legal and social problems. You will probably be getting into debt and may have been involved in drinking-and-driving offences. You must take serious steps, probably with professional help, to get your drinking down.
*93/72/5*