Health news from around the world.

There is the evidence of my own experience and my work with patients which shows that we have within us the ability to control excessive pain. But our everyday experience of life makes it equally clear that under ordinary circumstances we are quite unable to use this ability. It would seem that we, civilized people, have somehow lost the knack of using it. On the other hand, some primitive peoples still retain this ability to some extent, and as a result cope with the pain of severe injury better than the more civilized and sophisticated Western peoples. This idea is quite important to our self-management of pain because it makes us realize that we are not attempting something new and difficult, but instead are merely relearning now to use an ability that we already have within us.

Our Lack of Experience of Pain-One reason for our relative inability to cope with excessive pain is simply our lack of experience in the matter. Life in Western communities is so organized now that we have very little firsthand experience of pain except an occasional visit to the dentist; and even he gives us an injection if he thinks it necessary or if we wish it This is all a very wonderful advance in the history of man but it has this unfortunate side-effect, that we are less able to cope with severe pain if it should befall us; and we turn more and more to the use of drugs for pain of less and less severity.

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Q. We often hear of the disastrous complications that may occur in patients with peptic ulcers. What are these and how serious?

A. Complications may certainly take place and can be serious, and in certain cases life-endangering. Fortunately, according to recently published reports, there seems to be a fairly large reduction in these complications over the past decade and hopefully this trend will continue. With today’s quick and accurate methods of early diagnosis and excellent methods for treatment it is highly likely complications may gradually become unusual.

Q. Are the complications usually serious?

A. In most cases they are and often represent a surgical emergency. It is generally obvious the person is acutely ill and needs urgent hospital care.

Q. Let’s consider the complications. Which one comes first?

A. Let’s start with haemorrhage or haematemesis as the doctors say. This may present as acute vomiting of bright red blood, or vomitus with the appearance of ‘coffee grounds’ (the more common). There is often the passage of loose, black, ‘tarry’ stools (‘melaena’), or even bright red blood via the back passage. There is a sudden onset of weakness, faintness and dizziness, chilliness, thirst, cold moist skin and a desire to have a bowel action. This may be in a person with a dyspeptic history or even in those with no such history. It indicates the ulcer has increased in size. It has eroded a large artery or vein in the wall of the duodenum.

Q. If this happens what does the patient or those who are with him do?

A. This is a surgical emergency and demands urgent medical assistance. Do not delay. Get the patient to a doctor or hospital as promptly as possible. Often a blood transfusion is required and full investigation necessary. Promptness is essential.

Q. What is next on the list of complications?

A. Perforation. This usually occurs in males between 25 and 40 years. It indicates the ulcer has ruptured through its wall and contents are spilling into the abdominal cavity. There is usually an acute onset of pain in the epigastric region (just below the breast-bone). It often radiates to the right shoulder or right lower abdomen. There may be nausea or vomiting. This may be followed by a temporary reduction in pain. This could last a few hours. This is followed by a sudden board-like rigidity of the abdominal wall; there is a fever, rebound tenderness (when the area is pressed), an increased heart rate and often signs of prostration.

Q. What treatment is carried out?

A. Acute cases require urgent medical assistance. Any symptoms that come in this category must be treated as a surgical emergency. Although these cases are often ‘acute’, milder ‘sub-acute’ or ‘chronic’ ones occur, in which the perforation in a milder form occurs over a period of time.

Q. What comes next?

A. Penetration. Sometimes the ulcer penetrates into adjoining structures rather than rupturing into the abdominal space. It may involve adjacent organs such as the pancreas, liver, bile ducts or the omentum. This may be indicated by radiation of the pain into the back, nocturnal distress, inadequate or no relief from food or medication. Symptoms such as this in a person who has suffered ‘ulcers’ or ‘dyspepsia’ indicate an immediate need for expert medical attention and investigation.

Q. Earlier on you talked about ulcers forming near the pylorus, the narrow canal leading from the stomach to the duodenum. How does this fit into the picture?

A. It may cause obstruction. About 30 per cent of patients with a duodenal ulcer suffer obstruction of the pylorus, the canal joining the stomach to the duodenum. There may be no symptoms. Alternatively, it may produce fullness in the epigastric region, and vomiting may occur soon after a meal. This will contain much undigested, recently eaten food. This also needs proper medical investigation.

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This is a well-known discipline that broadly speaking consists of two separate yet closely-linked components: first, there’s a series of static or stretching exercises as well as breathing exercises; secondly, there are meditation techniques that aim to help the subject attain a state of peace and harmony within the inner self.

At the physical level, yoga has proven itself to be an extremely effective way of loosening and mobilising joints whose movement has become restricted. Additionally, the meditation techniques can help reduce mental and emotional stress which can at times exacerbate back problems.

Although nearly all yoga exercises are considered to be safe for a moderately fit person, they can create a great deal of pressure on parts of the back and neck, and it’s therefore essential that even the simplest of yoga exercises should only be undertaken under the supervision of a fully qualified teacher. Naturally, should you join a yoga class, make sure that the instructor is fully aware of any existing difficulties you may have.

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To be lastingly effective, weight-losing diets should be gradual and realistic and must never involve the omission of any meals. If one skips breakfast or any other meal, the body merely stores more of the calories from the next meals in the form of fat to make up for the period of fasting and, at the same time, decreases energy expenditure by one means or another (making one feel tired and sleep more).

Fasting is therefore not usually helpful for those who wish to lose weight. Rather, they should eat three meals a day at specified times, take predetermined amounts of food, eat slowly, and keep food out sight between meals.

One interesting study about dieting and weight loss did not emphasize quantity of food at all, but rather zeroed in on when the food was eaten. Even though the participants did not eat any less than usual, merely by doing most of their eating earlier in the day, these overweight people easily managed to lose five to 10 pounds every month, Postgraduate Medicine (79#4:352) reports.

The dietary research from which this finding emerged involved 595 overweight people treated in the Department of Nutrition at Tulane University’s School of Public Health in New Orleans.

These people were instructed to change their eating patterns from heavy meals in the evening to a heavy morning meal, a modest lunch and a light afternoon snack, with no change in the daily total intake. They were also told not to go to sleep for at least eight and a half hours after the last meal of the day.

The report stressed that this was a “preliminary” finding that needs to be confirmed by studies involving a “control” comparison group treated some other way. Meanwhile, many who are feeling desperate about obesity will no doubt want to give this method a personal trial.

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Symptoms: itching or clogging of ear can; discharge from ear canal; pain; fever; swollen and tender lymph nodes

Home care:

To relieve pain, give aspirin or paracetamol and apply warm compresses to the outside of the ear.

Try to prevent swimmer’s ear in a susceptible child by drying the ear canals after each swimming session; to do this, place a few drops of rubbing alcohol or glycerin in each ear.

After administering any ear drops, keep the child’s head tilted for a little while so that the drops can penetrate deeply into the ear canal.

Precautions

-    Severe pain, fever, or swollen glands, or failure to respond to home treatment within a few days indicate that the child should see a doctor.

-    Earplugs of iamb’s wool coated with petroleum jelly keep water out better than rubber plugs and can be made at home.

-    Never clean inside a child’s ear canal.

Irritation or infection of the ear canal is known as swimmer’s ear. Swimmer’s ear may arise from a middle ear infection that has caused the eardrum to rupture and allowed infected material (pus) to drain into the outer canal. The condition can also occur if an injury to the ear canal becomes infected. Usually, however, swimmer’s ear is caused by swimming in fresh water or pools. Frequent and sustained moisture in the ear softens, swells, and cracks the ear canal, allowing germs to penetrate the canal and cause infection.

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The shakes

«I get the shakes. It seems silly. I’m not shaking. You can’t see it. But I am shaking. Shaking inwardly. Horrible. Demands my attention. So I can’t listen to what people say. It’s all inward. They don’t know I am shaking.

‘Sometimes, just sometimes, I do shake outwardly. Feel such a fool. Pass someone a cup of tea. The cup rattles on the saucer. The spoon jigs about as if to fall on the floor. Feel a fool. And feeling a fool makes it worse. »

The over-alertness of our brain cells plays tricks on the muscles they control. The feeling of insecurity and loss of control adds to our anxiety, and makes things worse.

Spots before the eyes

«I get spots before the eyes. They are not really spots. Funny little transparent shapes. Sometimes curled like a comma or a question mark. I don’t get them all the time. If I am looking down, and then look up, they shoot up, in front of whatever I am looking at. Then if I keep looking there, the spots slowly sink down. If I keep looking where I was, there are no spots. But if I look down, and look up again, I see them just as before. It’s strange. It makes me worry. I have heard of a person with cancer of his eye. »

These specks seen floating before the eyes are technically known as ‘muscae volitantes’, or ‘flitting flies’. More commonly they are called ‘floaters’. They are due to little bits of sediment in the aqueous compartment of the eyeball. When the eye is still, they rest at the bottom, but if we look up quickly they are thrown into the fluid of the compartment in front of our line of vision. If we hold our eye looking upwards, they gradually sink down.

‘Floaters’ are quite harmless, and are of no ill import at all. Usually we become aware of them only when stress increases our perception of things that normally would not reach our consciousness. As the stress is relieved, we are no longer troubled in this way.

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The best of both worlds?

“She smothers me with love. My mother all over again. I don’t want it. I’m a man now. I can’t stand it. Bring work home at night. Want to get on in the world. To get on is to have the work done. There is no answer to that. She wants me to come to bed. I don’t want that. I ought to do the work. Grizzles about my golf. A man must have some time with his friends. Says I’m not with the children enough. I might as well tell you, there is a girl. Younger. Beautiful. Makes no demands. It’s I that makes the demands! And it’s good.

‘Say I’ve got the best of both worlds. The children at home and the girl. Both worlds and I should be happy. But I’m not. I’m fussed about it all. And my work. My work is not as good as it was. Deteriorating.”

More messages coming to his brain that can be integrated. Stress is upon him.

Life is for living. Life is for pleasure. Have what fun you can. But the seeking of it brings problems. Problem after problem. Let the mind run quiet. Just quiet. Messages arriving at the brain become integrated. It dawns. It does not have to be spelled out on the screen of the mind for us to see it all in better perspective.

The lonely woman

“How can you be lonely if you are married with two young children? Sounds crazy! To me it is the reality of life. The kiddies. They come to me, I love them. I mother them. But that does not fulfill the loneliness within me.

‘My husband. He does not have other women. I am sure of that. He provides well. No long overseas business trips like other men. But there is still a loneliness. An emptiness in my life. We seem to get along all right. That is the terrible paradox. Getting along all right, and the essence of man and woman together, are just poles apart.”

She is poised on the brink. Some other pressure and she will be forced over the edge.

Problems, such as the chronic illness of one of the children, would add to this background. Stress develops, and is likely to show itself in restlessness and irritability.

We have biological needs. Food and sex are obvious enough. If these needs are not satisfied, our brain soon becomes clogged with messages reporting our condition. But other biological needs also play upon our mind, and such a one is the need of man and woman together, in its naturalness and simplicity.

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Hayfever is a seasonal inflammation of the nose and eyes caused by allergy to pollen or molds. In the United States, about ten percent of hayfever patients suffer from allergy to tree pollen; thirty percent suffer from allergy to grass pollen; and sixty percent suffer from allergy to weed pollen. The most characteristic feature of hayfever is its periodicity: it recurs each year in the season of pollination of the plant or the sporulation of the mold that causes the allergy. The seasons of plant pollination are different in different areas of the country.

Hayfever is a disease that affects a total of five to ten percent of the population of the United States. It begins in early childhood (usually after the age of three), and whether a child gets it or not is determined by heredity and by the amount of pollen or molds he inhales. However, fatigue, exertion, infection, and emotional stress contribute to its early development. Boys and girls develop it equally, but the black and yellow races seem to develop it less than the white race, and the full-blooded American Indian does not seem to develop it at all. The disease is found all over the world, but it is most frequent in the temperate zone.

Hayfever symptoms appear in the early hours of the morning as sneezing, nasal obstruction, a profuse watery discharge from the nose, a sensation of heat and fullness in the eyes, a discharge of a copious fluid from the eyes, a huskiness of the voice, fatigue, loss of appetite, restlessness, profuse perspiration, a quickening of the pulse, a dry and irritating cough, headaches, slight temperature elevation, and general discomfort and nervousness.

The following conditions are necessary for any kind of pollen or mold to be accepted as a cause of hayfever:

a.     The pollen or mold should cause the disorder when brought in contact with the nose.

b.     The disorder should show itself only when the specific pollen or mold is abundant in the air.

The treatment of hayfever is:

Preventive: By avoidance of the specific pollen through the use of a mechanical filtering device or an electrostatic precipitator in the bedroom; by sending the child to a pollen-free area; and by keeping the child indoors as much as possible during the pollen season.

Symptomatic: With antihistamines.

Specific: Through desensitization which is to be started three months before the season of the pollen and given throughout the entire year, if that is possible.

The prevention of hayf ever is made more complete by:

a.     Removing all flowers, trees, grasses, or weeds from the backyard.

b.     Having the child avoid flowers which are members of the; ragweed family, such as asters, bachelor’s buttons, calendulas, chrysanthemums, cosmos, dahlias, daisies, dandelions, marigolds, sunflowers, zinnias, golden-rod, or any other type of flower in full bloom.

ñ     Being aware that dust (originating in longtime closed trunks, attics, oil books, old pillows, old mattresses, woolens, and cottons), cosmetics (highly scented toilet articles, nail lacquer, lacquer removers, hair tonics), chemical fumes (floor wax, gasoline, insecticides, dry-cleaning fluids, fumigating gases, moth preventives, and tobacco smoke), strong light rays (near the sea or in motion picture houses), and chlorine (in swimming pools) may cause symptoms similar to those of hayfever.

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What is it?

A sense of fatigue, either mental or physical-a feeling that you never really have much energy. Chronic fatigue takes millions of people to their doctors yet in more than four out of five no physical cause is found.

What causes it?

•     Overwork either at home or in your job.

•     An undiagnosed underlying physical disease such as anaemia.

•     An underlying emotional or psychological problem such as depression, unhappiness, a sense of failure, sexual or marital tensions, and so on.

•     A shortage of magnesium.

•     A shortage of potassium.

•     Iron-deficiency anaemia.

•     A lack of folic acid in the diet.

•     Vitamin Ñ shortage.

•     A shortage of good-quality sleep.

•     Too little exercise.

•     Being bored with your life and yourself.

Prevention

•    Many people are overworked, especially those in stressful jobs and women who do a job as well as looking after a family. Many such people don’t realize how tired they are getting because it all builds up slowly. The answer to this problem is to work less if at all possible, and to make a real effort to relax more. If you have a stressful job you should take up a hobby something totally different from your job and preferably something that is not goal-centered or competitive. If you have demanding responsibilities looking after a family, make sure that there are at least a couple of periods during the week that you spend doing something just for you and not for the family-go to an exercise class, or an evening class, or join a group of people who share an interest with you. Find labour-saving ways of running the house; get other members of the household to do more and to think more about you. Spread the load of heavier jobs among the family.

•     Go to your doctor and ask for a blood test and a general check-up. You may be suffering from a treatable medical condition and it is a waste to walk around feeling under the weather with something that could be treated. This is what often happens with anaemia in women.

•     If no physical cause is found, see a counselor or other trained professional to try to sort out any emotional or psychological problems in your life. Many people find such conditions every bit as draining as true physical illness, yet often no notice is taken until they become a form of psychological illness that cannot be ignored. Mental and emotional wear and tear creeps up insidiously on us and makes the strongest person tired. Often, the help of a professional can make all the difference to knowing how to cope with what seems to the sufferer to be an impossible situation. Many things can’t be changed but the way you deal with them can be.

•     Magnesium is vital for many of the body’s vital functions and gross deficiency signs are unlikely to go unnoticed. However, as with iron deficiency, most doctors are not trained to recognize mild magnesium deficiency. It has only one noticeable symptom-chronic fatigue. In one study of magnesium and fatigue 200 men and women who were tired during the day were given magnesium. In all but two the tiredness disappeared.

•    Similarly, potassium can be in short supply. This deficiency is well recognized in long-distance runners and in those taking diuretic drugs (water tablets). In one study researchers took people at random and measured their potassium intakes. Those with a deficient intake (60 per cent of the men and 40 per cent of the women) had weaker grip strengths than those with a normal intake. As potassium intake fell, so did muscular strength. A study of 100 chronically fatigued people (84 women and 16 men) found that on a magnesium and potassium supplement 87 improved in 4-5 weeks.

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Anal fissure

It is an anal fissure is a painful crack in, or ulceration of, the skin at the opening of the back passage. It starts off as a small tear, which is then reopened every time the person opens his or her bowels.

What causes it?

Constipation. As hard, difficult-to-pass stools are forced through the delicate lining of the anus, the skin tears.

Prevention

• As for constipation.

• While the high-fibre diet is starting to act use a little lubricant on the bowel opening. Saliva will do, or you can buy some KY jelly from a chemist’s. This enables the hard stools to pass more easily and reduces pain and bleeding a little.

Anaemia

Anaemia is a condition with many causes in which the oxygen-carrying power of the blood is reduced. By far the commonest cause is iron deficiency, which is still a very common condition indeed, even in westernized countries where one would imagine almost everyone had access to healthy foods. In the Third World much of the iron consumed is in relatively unusable forms and is bound to phytic acid in cereal fibre. The best sources of usable iron are red meat and poor people eat little red meat. In the Third World millions of people have intestinal worms that cause a continuous loss of blood from the digestive system.

Although iron has been known to be an essential nutrient since ancient times there is much that is not known about it and doctors still debate what iron deficiency is and how it should best be treated.

Iron is essential in the body mainly because without it red blood cells could not carry vital oxygen to the rest of the body. About two-thirds of the body’s 4 g of iron are tied up in hemoglobin, the red blood-cell pigment. Some is stored in the liver and yet more in the muscles as myoglobin. Red cells live for about 120 days and are then broken down and some of the iron is re-used. Some, however, is totally lost and so needs to be replaced if the person is not to become anaemic.

Only about 10 per cent of the iron we eat is available to the body and some foods yield less than 5 per cent of their iron.

It is easy to see how people can end up eating too little iron when we see the foods that are rich in it. Meat and fish contain the most readily absorbed form of iron. Iron absorption, even from iron-containing foods that do not readily yield up their iron, is somewhat enhanced by including meat in the diet. But even in people eating iron-rich foods (see below) blood losses may outstrip what is eaten or absorbed. Women in their childbearing years are most at risk of developing iron-deficiency anaemia because of losses during pregnancy (into the baby) and in the monthly menstruation. Breast-feeding too makes heavy demands on a woman’s iron stores. As if to combat these problems women are better able to absorb dietary iron than are men. (It is also interesting to note that the body of someone who is short of iron absorbs more of the element than does that of other people. A normal child or someone who is iron-deficient can absorb twice as much iron as a normal adult.)

But it is not only women who are susceptible to blood loss. Millions of people have bleeding piles, some have gastric and duodenal ulcers that bleed a little every day, and others take aspirin or anti-arthritis drugs which cause an increased loss of blood from the intestine.

Vitamin Ñ is now known to be essential in the absorption of iron. Copper too is an important co-factor -and most food refining removes copper fairly thoroughly.

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