Health related information and news from around the world.

I mentioned the importance of walking together as a couple every day. For this “sexual sig wisdom walk,” one person talks, the other listens on the entire walk. Next walk, change roles. The listener uses the L.O. V.E. technique while the talker discusses anything at all. There is a wisdom in all of us, and, as Buckminster Fuller once said, “All of us are geniuses. Some of us are just less damaged than most.”

One wife reported, “I had a hard time at first getting used to being the talker and then just a listener, but it was something. I looked forward to both roles, but hearing him talk while we walked, talk about trees, work, kids, neighbors, whatever, without reacting to me was a real trip.”

“I realized how much I interrupt and control the conversation. While we walked, it seemed easier to listen and not take over. We kind of got in a rhythm,” said her husband.

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The third-date phenomenon, sex on the third date, is universally known. Due to the AIDS issue and fear of other sexually transmissible diseases, the third-date phenomenon is becoming the tenth-date phenomenon, but the timing is irrelevant. Sex is nowhere near as important as everyone says it is, and probably very important to those people who tell you it does not matter at all.

Remember, the rules are that the whole game changes after the sex act takes place. It is the turning point. For men, the conquest may be complete, and they may disappear. For women, emotional involvement may intensify now, but they must be courageous and not let the man know they take this sex thing too seriously. No research supports this sexist view, but these rules have little to do with fact.

Some people cheat on this rule flagrantly. Men and women may become close, feelings may get involved, honesty, caring, and vulnerability may follow. When this involvement happens, start discussing philosophical issues of recreational sex, short life spans, limited life pleasures, and the value of extensive sexual training prior to any real commitment. Even though there is no data to show that amount or frequency of sex relates to fulfilling sex, this argument can protect you from any real involvement related to sex.

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The spine consists of many small bones; the vertebrae, which are separated from each other by a cushion of cartilage known as the inter-vertebral disc.

Projections from the back of the vertebra enclose a canal through which passes the spinal cord consisting of nerve cells and fibres.

These projections from the back of the vertebra connect with the ones above and below by means of small joints.

Viewed from the side the spine has two S curves, one above the other. The end result, functionally, results in a vertical position and viewed from the front or back the spine is straight.

In the condition known as scoliosis there is a sideways curve of the spine which is complicated by a rotational deformity. In the chest this rotation can affect the ribs and distort the chest cavity.

Once a kink develops in the spine a corresponding tilt must also develop the other way at some other level so as to enable the person to stand upright.

Sometimes scoliosis may be secondary to muscle weakness or paralysis, such as may occur with poliomyelitis.

Sometimes the condition is due to poor posture in the child, but under this condition it is always mild.

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Iatrogenic disease is caused by medical treatment and the more potent and effective remedies we have, the more complications and side effects we get.

Every doctor who prescribes for a patient has to weigh the good effects from his treatment against the likely bad effects.

In most cases, the side effects are rare, so he can prescribe with little risk to his patient.

Sometimes the doctor may be aware of the risks of side effects, yet his patient may be blissfully unaware.

I do not advocate telling every patient about every side effect or the secondary anxiety we cause may be worse than the complaint for which the patient originally consulted us or he might refuse to take the medication and suffer severely from the disease because of fear of rare side effects.

Potent cortisone creams and ointments are freely prescribed for many skin conditions and, if not emptied, the tubes lie around in the cupboard and are often self-prescribed for any subsequent rash.

These strong cortisones should not be used on the face. It has been known since 1972 that they can convert a minor facial rash into a separate condition known as peri-oral dermatitis.

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For the normal emotional development of a child, certain requisites in his formative years should be met by the parents or a readily identifiable mother or father substitute.

The developing child needs: love and affection, given freely and without qualification; security; acceptance of himself as an individual; self respect; a sense of achievement; recognition of himself and his achievements; independence, the absence of prolonged dependence on mother or mother-substitute; and authority, knowing the limits of his ego and the limits that will be imposed upon him by the authoritative figure; not only by the parent but also by the teacher.

Adults often forget that children have anxieties, fears, hopes and desires. Children may suffer depression or frustration. These emotional problems may show themselves differently from that in adults due to the child’s limited experience and limited powers of expression.

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The symptoms of cancer depend on its location. I will be describing a number of possible symptoms here, none are inevitable. In Chapter 6 we will find out how to treat them. Remember that, whether or not you are having treatment to control the cancer itself, it is usually possible to do something towards relieving the symptoms it produces.

Now, what about the symptoms of extensive or metastatic cancer? First of all, there are the local symptoms which depend on which parts of the body are affected. Whichever organs are involved may eventually stop working altogether.

If cancer affects the bones it weakens them. The weak bones break more easily than normal bones. If the spine is affected there may be pressure on the spinal cord or nerves. Such pressure can lead to pins and needles, or loss of strength in the limbs, usually the legs or feet. Cancer in the bones is not always painful. Sometimes one or two spots are painful while others which look very similar on an X-ray are not.

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Hormone replacement therapy isn’t right for every woman. Some can’t take it because of medical conditions they either have or are at risk of having; some are completely turned off by the various side-effects; others don’t want to take it because they believe it is unnatural, interfering with nature. Women who spent most of their reproductive years on the Pill may now want to have a break from all hormones; and many don’t want to ‘pop a pill every day’ to prevent conditions they haven’t got and may never have.

If you are in the lucky 20 per cent who sail through the menopause with hardly a symptom to complain about, you will probably not give HRT a second thought. Osteoporosis and heart attacks seem far away on life’s distant horizon. However, if you feel you are at risk of developing either of these conditions, then HRT is a form of prevention you should think about – it is not just for treating hot flushes.

Of the remaining 80 per cent who get menopausal symptoms, only a very small proportion at present take HRT, although their number is now growing steadily as women understand more about it, and doctors feel more confident about prescribing it. Even so, many women are still unable or unwilling to receive hormone treatment, so what else is available for diem at this time?

There are many and varied ways of coping with the different symptoms that afflict menopausal women. Some involve taking medication of different types, others involve making lifestyle changes. None of them is a true replacement for oestrogen, and it really is worth keeping this thought at the back of your mind, especially if you want to protect yourself from osteoporosis and coronary heart disease.

As we get older, we must work at being healthy. We can no longer abuse our bodies and expect to get away with it. The teenager or young woman who smokes, drinks and takes no exercise probably won’t notice the effect for many years; for the older woman it is different – suddenly these habits affect her life now.

Smoking, coffee and alcohol all make vasomotor symptoms (hot flushes and night sweats) worse; alcohol and tobacco lower the oestrogen supply; alcohol also interferes with the body’s effective use of calcium; taking no exercise increases the risk of getting osteoporosis and a heart attack. Isn’t it unfair!

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Women who have had hysterectomies or who are on certain drugs to control endometriosis are more likely than average to be prescribed hormone therapy (sometimes referred to as hormone replacement therapy or HRT). The following points should be taken into account when making a decision about whether hormone therapy is suitable for you.

• Oestrogen is effective in relieving hot flushes and night sweats, vaginal dryness and some urinary symptoms.

• Hormone therapy is particularly helpful to women who have had a premature menopause, whether it has been natural, or medically or surgically induced. They are likely to benefit most from it because they tend to suffer more extreme symptoms of menopause and are at an increased risk of osteoporosis and diseases of the heart and blood vessels, and because in many cases they no longer have a uterus and so the hormone therapy tends to be simpler (oestrogen only is usually prescribed, but sometimes progestogen or testosterone are added).

There is some evidence that oestrogen used on its own may offer protection against heart and blood vessel disease. This benefit is heightened for women who have had an early menopause. The decision about which hormone preparation is suitable for women who have not had a hysterectomy depends on the balance between several potential benefits and hazards. There are gaps in information on both sides that research will start to fill during the rest of this decade.

In deciding whether to undertake hormone therapy for prolonged periods in the absence of worrisome symptoms, women should take account of both the anticipated benefits and the possible risks. One of the benefits of oestrogen use is that it postpones bone thinning and reduces the likelihood of heart disease. When combined with a progestogen, there are still significant benefits for bones, but progestogen appears to negate some of the protective effect that oestrogen has on the heart and blood vessel system. In regard to the risks, the biggest concerns lie with cancers of the breast and endometrium. Breast cancer is the most common cancer of the reproductive organs and the one most feared by women, so consideration of the link between oestrogen and breast cancer is sometimes tremendously important in helping women decide about hormone therapy. If, for a particular woman, the avoidance of an increased cancer risk is more important than the benefit in terms of osteoporosis or cardiovascular disease, this is clearly the basis on which her treatment should be decided. In making a decision, it is important that women take account of their family history of breast cancer, strokes, heart disease and osteoporosis and that they try to identify the cause of death of all close female relatives.

For many women, drawbacks to combined oestrogen and progestogen include withdrawal bleeding, breakthrough bleeding and PMS-like side-effects, and the possibility that hormone therapy may increase the risk of breast cancer, especially in women with a family history of this cancer. For women who use oestrogen on its own and who still have a uterus, an important consideration is the need for regular and extended monitoring to detect any early changes suggestive of cancer of the uterus.

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Unresolved grief reaction. Is there anything we can do to ease the grief reaction? Not really. In fact grieving is to be encouraged, so that the locked up energy generated from the stress reaction can be expressed and shared. A person can be affected in the future if this locked up energy is allowed to remain inside. This is called unresolved grief reaction and can be damaging. One patient who was referred to me, a young lady, had agoraphobia after the death of her father. She was using up all her time to help her grieving mother and did not grieve for herself. Her mother was depressed and suicidal. The patient was young and just married, she moved in with her mother to comfort her, and was afraid to show her own emotion, as she was afraid this could harm her mother. Her mother got better, but the daughter fell ill and this lasted for many years afterwards.

Acceptance. The next phase of healing is acceptance of what has happened. A homeostatic peaceful rearrangement or a new balance of the psyche is reached. The person may be badly scarred, but may find life has a different meaning or that his feelings and experiences may now be in a different level of existence. Extraordinary stress sometimes changes a person for the better. Things that he used to take for granted are now treasured. Happiness is now more like a spice in life, a gift rather than a necessity.

Insomnia. Sleep may be a problem in the initial phase. But most patients do not want any sleeping medication. They want to feel the pain and want the wound to heal in its natural way. There will always be a scar. But they treasure the experience and look back on it occasionally. Once an equilibrium state is reached, most people are able to continue their normal life. They will never forget this kind of extraordinary stress and the loss they can never replace. Somehow life goes on and the sun is always up the next day.

We normally cope adequately with most stresses, but there are occasions when the coping mechanisms fail. We call this a nervous breakdown, and in such cases professional help is called for, as medications and other forms of treatment are sometimes indicated.

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We generally think of the sensation of pain as something we could well do without. When we are more thoughtful we can see the need for pain, but it still seems that pain as a warning sensation is much too severe and too prolonged. However, when we come to examine the situation more closely, we see that there is a reason for this. For instance, let us suppose that we burn our hand. The pain from the burn is sudden, intense, and severe. It overwhelms us and we immediately withdraw our hand. The pain is so intense that this reaction occurs automatically, quite beyond our control, and in the time of a split second. In this way the intensity of the pain causes the immediate withdrawal of our hand and so preserves it from further injury. We are not even given the chance to think about it. Thus, the severity of the pain is essential for its protective purpose. But the pain persists after we have withdrawn it from the flame, and is still so intense that we cannot even bear to touch the burnt area. This is again protective. By not touching it, we avoid bringing infection to the raw burn.

We sprain our ankle. The initial pain is so intense that we involuntarily fall to the ground, and our ankle is thus saved from further injury by immediately putting a stop to the stress which was tearing the ligaments. If we turn our foot in the direction of the twist there is an immediate recurrence of pain. So this movement is avoided and there is no further injury. This state of affairs persists for some days. The painful movement is avoided, and the torn ligaments are left undisturbed so that the process of repair can proceed in a way that would not be possible if the injured ankle was allowed pain-free movement.

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