Health related information and news from around the world.

What is it?

Itchy, irritating, dry skin from any cause. The skin becomes prematurely wrinkled and often drives the person (especially a child) mad with itching.

What causes it?

• Extremes of temperature from freezing winds to direct sun.

• Ageing itself makes skin drier.

• Central heating without humidifiers.

• The use of detergents as bath foams (especially children’s ‘fun’ bath products). This removes the natural oils from the skin.

• The misuse of cosmetics which block the oil glands that normally lubricate the skin.

Prevention

• Drink more water.

• Stay out of harsh sunlight unless you wear an effective sunscreen.

• Never use detergents in the bath and use soaps sparingly.

• Wear gloves if you use detergents for washing up dishes.

• Try to get a humidifier installed in your place of work or any other air-conditioned building where you spend a lot of time.

• Use only small amounts of skin lotions-the skin can absorb only so much, after which you block the natural ducts that bring oils to the surface. The best moisturizer for the skin is water-not oils. Use oils and creams, therefore, on slightly moistened skin. Many good moisturizer creams are mostly water for this reason.

• One skin expert uses a mixture of five vitamin A capsules to a 4 ounce jar of hand or body lotion to alleviate dry skin, with some success.

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Choosing a doctor

Starting from scratch to find a specialist that will suit both your needs and expectations is not easy. Where do you start?

It is best to shop around by talking to friends and relatives – in particular those who have either been diagnosed as having endometriosis or those who suffer from menstrual problems. These women are more likely to have had previous contact with a specialist and can perhaps make recommendations for you. Think about whether you are likely to feel more comfortable with a female or a male specialist.

Once you have decided on a doctor you would like to consult, you need to visit your GP to obtain a referral. It is helpful if your GP is familiar with the specialist you plan to visit as the pair should be in constant communication about your treatment and progress over the coming months.

There are several points to consider when choosing the doctor who will manage your illness and its treatment and help you plan for the future. However, there is no such thing as the perfect doctor – or the perfect patient – so the material in this chapter is merely a guide.

What to look for

You and the specialist you select will be working together to improve your health and well-being, so it is important you feel comfortable and can talk openly. At your first visit, ask yourself the following questions:

•    Does the doctor appear interested in me as an individual and show concern with my general well-being?

•    Does she or he communicate and explain in a way I can understand?

•    Are all my problems taken seriously or do I feel patronized?

•    Has the doctor explained all the options of diagnosis, treatment, etc. thoroughly so that I understand?

•     Does the doctor encourage questions and then answer them completely and in easily understood language?

•     Has further reading been suggested, along with the names of self-help groups for further education and support?

•     Does the doctor show sympathy and understanding and provide some genuine comfort.

It is important to remember that your doctor should let you talk freely and should listen closely to your concerns. It is not unreasonable to expect your doctor to spend some time explaining and talking over concerns and problems with you. After all, you need to develop a relationship where you can feel confident in the doctor’s skills and where mutual respect exists.

There should be enough time during the appointment for you to ask questions. Do not feel intimidated. You may feel the doctor is rushing you and that your time is up but if you have questions you want answered and concerns that need to be cleared up, and then you have every right to continue the consultation.

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Growing old is a growing business with an ever increasing proportion of the population being over 65. People over 65 are at much greater risk than other age groups of having a fatal accident. The problem gets worse as the person becomes older, and women are more likely to be hurt than men.

Suffocating and choking

These accidents are chiefly associated with food. The problems may be exacerbated by arthritic hands which have difficulty cutting up food, ill-fitting dentures, or a total lack of teeth with which to chew the food. There is little that can be done positively to prevent such hazards.

Falls

Falls are the most common type of accident amongst elderly people. More than half of them occur when the elderly person is moving about on the same level but a substantial proportion also take place on the stairs.

Environmental hazards such as poor lighting and worn carpets play a part in this type of accident but physical factors are a more potent factor. These could include physical impairment, drugs or alcohol, inactivity and the reduced ability to retain one’s balance.

Cuts

This type of accident is rarely fatal, with only about twenty-five deaths a year across all age groups. Although the younger groups suffer most there is still a substantial number of accidents in the older range too. There can be medical consequences too as wounds may heal more slowly in the elderly.

Among the younger retired group lawn-mowers and garden tools are major offenders. Handling difficulties among the older group may lead to hitherto unlikely accidents with kitchen knives and can openers.

Fire

Fire and flames are the second major hazard for the older age groups. Nearly 10 per cent of cases are fatal in the 65-74 age group, and 13 per cent in the over 75 age group. Nonfatal accidents are likely to be serious. Many accidents occur because of physical problems in elderly people. Dizziness, blackouts, strokes and heart conditions are often involved in a fall on to a radiant or open fire.

Blows

Once again there are few fatal cases of a person being struck by another person or an object but there are a significant number of such incidents causing injury to elderly people. The younger age group of elderly people is typically hurt trying to retrieve an object from the top of a wardrobe or cupboard while the older age group bumps into furniture while moving about.

The general lowering of shelves and improvement of low-level storage is a task for pre-retirement days with a view to making life easier later.

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Why meditation?

As I have been discussing throughout the book, our recovery depends upon learning to manage our anxiety and attacks ourselves. Understanding and accepting our disorder are the first two steps to taking the power back. Learning to manage the attacks and anxiety are the third and fourth step.

This chapter will look at meditation; what it is and why it works. In the next chapter two different meditation techniques will be described.

Managing them means we need to follow a disciplined approach to a formal relaxation program. At first glance some people hesitate. Although they want to recover they don’t like the idea of having to become disciplined in their approach to relaxation.

Meditation can become a superior relaxation technique if it is practised daily. In one way, ‘having to relax’ is a contradiction to the practice itself, but many of us find we reach the stage where we do it because we want to, not because we have to.

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Cynthia

Cynthia had panic disorder but didn’t avoid anything. She went to work and did everything she had to do, but it was very difficult. She went to see a specialist, although she had to wait five months for an appointment. When she got there he was three hours late. He finally arrived, but didn’t apologise for keeping her waiting. Although Cynthia had an hour appointment, it only lasted for twenty minutes. She told the specialist about the panic attacks and he kept asking her what she was scared of. Cynthia kept telling him she was always scared and anxious that she might die from the attacks. The specialist kept saying she had to be scared of something and Cynthia wasn’t sure what he was getting at. In the end she said she had always been scared of elevators, but that was long before the panic attacks started. The specialist told her to go into the foyer and get into an elevator and go up and down in it until her anxiety disappeared. With that he finished the appointment and told her to book another with his secretary. She was so confused and angry she never went back.

Alice, Toni, Carlie

Alice asked the local discussion group what she should do about her therapist, who always went to sleep during her appointments. Toni and Carlie looked at her and told her their therapists always went to sleep too. It didn’t take long for them to realise they were talking about the same therapist. When the group asked them why they didn’t speak to him about it or try and find another therapist, the three of them said he was obviously very tired and they didn’t want to hurt his feelings.

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Medication

Drugs are another control people use. The risk of dependence on drugs is well researched. Medication is one of the main treatments for the disorder, yet the anxiety and panic attacks can blast through our ‘chemical calm’. In many cases the dosage is increased, either by ourselves or by our doctor. When attempts are made to withdraw from the medication, anxiety and panic attacks can return in full force, along with withdrawal symptoms. In an effort to stop the increased anxiety, panic attacks and symptoms of withdrawal, some people will continue with the medication and become trapped in the cycle of dependence.

Depression

With little or no effective treatment many people may develop a major depression in reaction to their disorder. Until recently this depression was also seen as a primary condition. Although steps were taken to treat the depression, the primary cause—the anxiety disorder—was rarely considered, let alone treated.

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It is the lack of diagnosis and the lack of adequate treatment services which is the driving force behind the development of the secondary conditions of these disorders. Although the symptoms of panic disorder were first noted in the 1800s (Boyd et al. 1991), panic disorder was only classified as a separate anxiety disorder by the American Psychiatric Association in February 1980 (APA 1980). As a consequence there was little understanding of it, not only by the people who suffer from it, but by the health professions generally. Many people have developed secondary conditions such as agoraphobia, major reactive depression, and drug and/or alcohol abuse.

The development of major depression can lead to suicide. According to one American study, 26.5 per cent of people who experience panic disorder will attempt suicide. People who have not been diagnosed as suffering from panic disorder, but who nevertheless experience panic attacks, are seven times more likely than the general population to attempt suicide (Malison et al. 1990). Other studies confirm that 10-40 per cent of people with an alcohol dependence had an anxiety-related disorder before their dependence developed (Cox et al. 1990).

The recognition of the sometimes severe disabilities associated with anxiety disorders has seen the inclusion of the more severe forms of panic disorder, obsessive compulsive disorder and social phobia into the category of serious mental disorder

(Andrews 1994). This is not to say people with severe disorders have a serious mental illness. Rather it is the recognition of the extreme disablement caused through the disorders.

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The other side of the placebo coin is that people can be made ill by something they believe will make them ill. Some patients are more suggestible than others in this respect, but a fair proportion of food-sensitive people will react with symptoms if they think they have eaten one of their culprit foods. This reaction in no way invalidates their food sensitivity – it is real, even if the symptoms of the moment are mentally generated or psychogenic.

Such reactions are not really surprising, if you remember Pavlov’s famous experiment with the dog and the dinner bell. The dog was ‘conditioned’ by a bell being sounded every time it was fed. Even before it was given the food, the dog began to produce saliva in response to the appetizing smell. After a time, the dog would salivate whenever it heard the bell, whether food was present or not.

An experiment with guinea pigs has shown that immune reactions can be conditioned in exactly the same way. The guinea pigs were sensitized to an antigen by having it injected into them, and they were simultaneously exposed to a strong odour. Later, the odour alone was enough to make them release large amounts of histamine. If guinea pigs can do this, then why not humans?

Certainly anyone who has ever had a severe, immediate reaction to a food is likely to react in the same way if they are told that they have consumed some of the same food. And people whose intolerance of a food has long since cleared up may continue to react to that food for purely psychological reasons.

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If you think you have testicular torsion, you should see your doctor or urologist immediately. He will first try to manually untwist the spermatic cord. It’s likely, however, that even when he succeeds, he will also want to perform minor surgery by placing a few judiciously placed stitches that will prevent the cord from twisting again, which is a likely possibility. The surgical procedure to repair the torsion and prevent future episodes will require several days in the hospital and about a week of recuperation.

If the pain is caused by an infection in your testicle caused by bacteria in your urinary tract, the doctor will need to find out what particular bacterium is causing the infection. He will do a prostate exam through the rectum or massage the penis to extract a sample of discharge (if it exists) to send to the lab for a culture. An antibiotic will then be prescribed depending on the organism isolated. If the infection is caused by a sexually transmitted disease, your doctor will prescribe the antibiotic Floxin 300, which you will take twice a day for 10 days; your sexual partner or partners will also need to be treated.

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Sometimes diarrhea can be the body’s way of ridding itself of a harmful substance, such as the bacteria that cause food poisoning or contaminate water. However, when you have diarrhea that lasts for more than a few days, it’s usually due to another reason.

Whenever a patient complains to me about chronic diarrhea, the first thing I look for is a change in his diet. Juice diets or diets that are high in fruit can cause chronic diarrhea when you first start the new regimen. A new medication, especially blood pressure medication, can also cause chronic diarrhea. Obviously, the continuing use of laxatives, stool softeners, and antacids can cause chronic diarrhea, as can new vitamin regimens, especially when they contain yeast.

If “you have lost weight during your bout with diarrhea, it’s probably because your intestines are not absorbing most of the food you eat; the most common cause of this malabsorption is lactose intolerance. Lactose is found in dairy products such as milk, ice cream, yogurt, and cheese.

A more serious kind of malabsorption is caused by an intolerance to gluten, which is found in all bread products and cereals made with wheat. If you have a gluten intolerance, you probably have a long history of diarrhea and weight loss, in addition to hair loss, mild anemia, and abnormalities in any liver function tests you take.

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