Mens Health Blog. Medical Blog

A common story is for parents to be woken by the stertorous breathing or grunting of a child in the next bedroom. They go to him, thinking usually that he is having a bad dream, and find him staring, unresponsive, convulsing, and perhaps blue. Few if any parents can cope calmly with such a scene. It is usual for the family doctor to be telephoned at once, and, if there is any delay in his arrival, for an ambulance to be summoned as well. Many parents subsequently confess that they thought their child was dying, so they are acting in an entirely rational way. Almost invariably, however, by the time the family doctor or ambulance has arrived, the seizure is over, the child is sleeping peacefully, and the adults are making tea. But they will not sleep again that night. Many—though not all—are immediately aware of the nature of what they have just seen.

Although the first seizure can occur anywhere and at any time, another common scenario is for the first seizure to occur in a young woman in the company of her friends or at work. In this case, the lack of ready access to the family doctor, whose name and telephone number is unlikely to be known to the bystanders, results in an ambulance being almost invariably called, and the unfortunate young woman being rushed off to hospital. She will recover consciousness either in the ambulance or in the Accident and Emergency Department of the hospital. To the confusion invariably consequent to the generalized seizure must be added the feeling of ‘What on earth has happened to me, and how have I finished up here on a stretcher with strangers peering at me?’ Obviously, therefore, although ambulance services are rather prickly on this point, a friend should accompany her to hospital—not only to provide moral support when recovery of consciousness occurs but also to give an accurate account of events to the hospital staff. In this case, the diagnosis of a tonic-clonic seizure is clear, but in others matters are not so straightforward. It is important to distinguish between an epileptic seizure and some other event which may initially seem to be one. Patients may speak in terms of a ‘black-out’, ‘funny turn’, or ‘blank spell’, and we have to do our best to analyse the cause.

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Comments (0) Apr 28 2009

Ms HM, Cambridgeshire, England. “I started taking the [CMO] at the beginning of October. By the end of the course I had improved quite a lot but still needed as many painkillers. Since Christmas it has taken another spurt. I was able to play snowballing and was able to build a snowman in the beautiful Christmas snowfall. Now after seven years of only being able to take showers, I can get in and out of the bath quite easily. I have not needed to take antiinflammatories for two months and am now able to cut down on the pain killers…..So many thanks.”

Mrs M K, Staffordshire, England. “I have suffered with arthritis for the last two years in my feet and legs – nothing too drastic but enough to curb a lot of my activities, particularly my love of gardening.”

“I had a course of Acupuncture last year for about six months, it did halt the pain only left me for a few days after each session. I was told it would need a lot of treatment. I was then told about your treatment and have taken a full course of tablets following a strict diet for recommended. Within a few days I could feel improvement and after the fall course felt more like my old self again. I am now back on my gardening. I am able to do a lot of things I was unable to do last year. I shall always be very grateful to the [CMO] treatment and to all of you that have helped me.”

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Comments (0) Apr 28 2009

Symptom

Yellowing of skin and whites of eyes.

Home care

Home treatment cannot be undertaken until an accurate diagnosis has been made.

Precaution

Jaundice caused by a drug will disappear when the child is taken off the particular medication. All other types of jaundice in children are potentially serious and require prompt medical attention.

Jaundice is a yellowing of the skin and the whites of the eyes due to the accumulation in the body of a substance called bilirubin, which is released when old red blood cells are replaced by new ones. Bilirubin is excreted by the liver into the intestine as bile. Jaundice develops when the red blood cells are rapidly destroyed (as in sickle cell and other forms of anaemia); when the liver cannot transform bilirubin into bile; or when bile cannot flow through the bile ducts into the intestine, for example, if the bile duct is blocked by stones, cysts, or a malformation.

Jaundice rarely occurs as a complication of a generalized infection, but it may be caused by some drugs and poisons. The usual cause of jaundice in children over one month of age is hepatitis, which damages the liver cells and interferes with the formation of bile.

Signs and symptoms

The yellow-gold-orange color of the skin and whites of the eyes suggests jaundice. When a child has jaundice, all of the body fluids are stained; the tears are yellow, and the urine is dark orange. However, the diagnosis can be exceedingly complex and depends upon laboratory tests.

Home care

Only after a clear diagnosis has been made can anything be done in the home.

Precaution

Jaundice caused by a certain medication will disappear when the child is taken off the medication. Other causes of jaundice in children are potentially serious and hard to diagnose. They all require a doctor’s attention.

Medical treatment

A child suspected of having jaundice will require laboratory tests to define the reason for the jaundice. Hospitalization is sometimes required.

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Comments (0) Apr 28 2009

•     After the age of 30 or so regular brushing of the teeth becomes more valuable in terms of what it can do to promote healthy gums than in the battle against tooth decay. Brush your teeth at least once a day with fluoride toothpaste, ensuring that you have a good-quality nylon brush. Always brush from gum to tooth and never scrub across the teeth. Work systematically around your mouth so that no area is missed. Don’t forget the inside surfaces of the teeth.

Now return to where you started and, using small circular motions with the brush at the junction of tooth and gum, work around your mouth from tooth to tooth ‘massaging’ the gums gently. If you notice that your teeth trap food between them (this is especially likely with meats) see your dentist to have this area looked at. A piece of food caught between two teeth even for a day or two can make your gum very sore and start up an infection.

•      If you do get a sore gum, don’t panic. Simply start the above routine and within days it should be better. In other words, thorough brushing can actually cure early gum disease, provided your technique is good.

•     Take more vitamin Ñ on a regular basis-1 g a day and double this when you have a sore area of gum. Animal research has proved that vitamin Ñ helps reduce the risk of gum disease, and experiments in Yugoslavia have found that the vitamin can reverse the kind of gum breakdown seen in gum disease. When the volunteers were given as little as 75 mg vitamin Ñ daily for six weeks the cells in the gums became observably healthier.

But vitamin Ñ alone may not be enough-calcium too may be vital. Certainly it is true that calcium deficiency can weaken the jawbone into which the teeth are set, but in addition this is now thought to make the bone more liable to infection. After the menopause women especially lose calcium in large amounts and many a woman first notices loose teeth at this time of life. Repeated pregnancies also cause a substantial loss of calcium into the fetuses. These plus slimming diets that involve eating no milk or dairy products can leave a lot of women calcium-deficient.

One US study used folate (the  vitamin) too with great success. After sixty days of gargling with folate-rich water the subjects’ gums were examined. They had soaked up folate ‘like a sponge’ and were much less inflamed than those of a control group who had been gargling with plain water for the same sixty days.

•     There is some evidence that gum problems are linked to emotions. Trench mouth, for example, is a very rampant type of gum disease. Sufferers have higher levels of the natural steroid Cortisol in their urine than normal. One study found that these patients had experienced more negative, unsettling life events in the previous year than had other people. They also demonstrably had higher levels of anxiety, depression and emotional disturbances. Clearly, preventing these life events is one way to combat at least this cause of gum disease.

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Comments (0) Apr 23 2009

Brenda is 51, married, with two children aged 14 and 19, and works as a nursing sister in an operating theatre at a large hospital.

A year ago she attended her first routine breast screening, and a week later received a letter asking her to return for a repeat mammogram. Brenda had had no breast problems, and was unable to feel a lump, but although the letter stated that the request did not mean that she had cancer, this was, of course, her overriding fear. She went immediately to talk to a surgeon at the hospital where she works, and he examined her breasts, finding no abnormality. Despite his reassurance, she found the next few days traumatic, and was unable to eat or sleep properly.

Brenda rang the breast screening clinic to cancel her appointment as she was sure there was nothing wrong, but was persuaded, rather unsympathetically in her opinion, not to do so.

At her second appointment, several mammograms were taken of both her breasts. She found the process uncomfortable, and felt that little was done to reassure or cheer her. After waiting a short time at the clinic while the X-rays were developed, she saw a doctor who explained that what had been detected on the original mammograms were tiny areas of calcification in her breasts which, on further examination, did not appear to be a cause for concern. The doctor thought they had probably been there for some time, and were likely to be quite a ‘normal’ aberration.

Brenda was very upset to discover that she had spent a week worrying about something that, as an experienced nurse herself, she would have been able to understand if it had been explained in the letter. She felt that the doctor was unsympathetic, and that the entire experience had been an unnecessarily distressing one.

Brenda was asked to return a year later for further mammograms and the doctor she saw immediately after these had been developed was very helpful and understanding. She explained to Brenda that the areas of calcification had not altered at all in the previous 12 months, and that she had nothing to worry about, but should return for further mammograms every 2 years.

Brenda’s relief at finding there was nothing wrong was tempered by her frustration about the difficult and anxious time she had had to spend. Although she appreciates that breast screening can play an important part in the early detection of breast disease, she does feel that there must be a better way of recalling women for further investigation.

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Comments (0) Apr 22 2009

A hysterectomy for endometriosis is surgery which involves the removal of the uterus and as many remaining endometrial implants and adhesions as possible. It may also involve the removal of one or both ovaries and fallopian tubes.

A hysterectomy is often said to be the only cure for endometriosis apart from the natural menopause. However, it does not always cure endometriosis, especially if the ovaries are not removed.

A hysterectomy in which the uterus and cervix are removed is known as a total abdominal hysterectomy (often abbreviated to a TAH). Sometimes all or part of an ovary and/or fallopian tube will be removed at the same time if they are diseased but at least part of one ovary is always left.

Following a total abdominal hysterectomy a woman will no longer menstruate but she will continue to ovulate until the time of her natural menopause.

A hysterectomy which involves the removal of the uterus and cervix as well as both fallopian tubes and ovaries is known as a total abdominal hysterectomy and bilateral salpingectomy and oophorectomy (often abbreviated to a TAH and BSO). It is also sometimes known as a radical hysterectomy.

Following a radical hysterectomy a woman will no longer menstruate or ovulate and she will undergo the menopause almost immediately.

To simplify matters and avoid confusion we will refer to a total abdominal hysterectomy as a total hysterectomy; and a total abdominal hysterectomy and bilateral salpingectomy and oophorectomy as a radical hysterectomy. We will use the term hysterectomy if we are referring collectively to both types.

Hysterectomy is usually only used as a last resort to treat women whose endometriosis is so chronic and their symptoms so severe that their quality of life is intolerable. The most common reasons that women with endometriosis have a hysterectomy are the persistence of intractable and incapacitating pain or severe and persistent heavy bleeding. It should not be used, except in a few rare life threatening situations, until a range of other hormonal and surgical treatments have been tried without success.

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Comments (0) Apr 22 2009

Anxiety, loneliness, and anger are common emotions, feelings that are part of being human.

What is a feeling? It’s a response that occurs on a non-intellectual level. Feelings are subjective experiences that can’t be verified by someone else.

Feelings can spur us into action, usually some form of self-preservation. If we touch something hot, we draw back our hand. Similarly, if something makes us unhappy, we may act by changing the situation or pulling away from it -whatever it takes to save our psychic skins.

Unpleasant feelings can actually serve a healthy purpose: They may prompt action that attacks a problem directly. Yes, an oral final in history can be terrifying, but one way of handling that feeling is to study. Someone who knows everything about the War of 1812 can walk into the exam with confidence. That person conquers anxiety by confronting it. The same with loneliness, or anger, or fear, or any of the dozens of other emotions we experience every day. Emotions can also help guide future actions. A student whose heavy course load causes anxiety may be more careful in planning her schedule the following semester.

Easy to say. But for some people with eating disorders, not so easy to do. Emotions spur them into action, sure, but sometimes in twisted and unhealthy ways.

For years now it seems as if everyone has been running around trying to “get in touch with their feelings.” The phrase has been the psychobabble cliche of the last two decades.

Cliche or not, for the person with an eating disorder, getting in touch with her feelings is exactly what she needs to do.

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Comments (0) Apr 22 2009

Being elected to the U.S. House of Representatives was great for congressman Matt Salmon’s political career. But it was lousy for his health, not to mention his waistline.

The 41-year-old congressman from Arizona had been active for most of his life. Tennis, racquetball, and basketball were his favorite sports. But once he took office in 1994, his exercise program ground to a halt. Instead, he spent most of his time sitting—on airplanes, on the floor of the House, and in legislative hearings.

His eating habits went downhill, too. All of those political fundraisers and charity events provided ample opportunity for consuming all the wrong kinds of food. Between legislative meetings, he’d nosh on whatever was within reach—usually cookies or a piece of cake. “And I ate more than my share of Big Macs while waiting for flights between Washington, D.C., and Arizona,” he says.

Within 2 years of his election, Congressman Salmon added 70 pounds to his post-high school weight of 165 pounds. But it wasn’t only his waisdine that suffered. He developed back pain, and he had frequent nighttime bouts of heartburn. A visit to the doctor revealed that his cholesterol was too high.

Congressman Salmon hated the way that he felt. And he hated the way that he looked. As much as he loved being a public official, he wasn’t about to let it ruin his health. He committed to changing his lifestyle for the better.

His first step was to make time for exercise in his daily routine. Because his schedule was so hectic, he decided to get up earlier to work out first thing in the morning. He began his days at 6:00 A.M., with a 20-minute walk. Within a month, the walk became a run. Within 2 months, he dropped 40 pounds, and his physical symptoms all but disappeared.

Encouraged, Congressman Salmon looked for ways to improve his eating habits. He found out that he could request low-fat meals at most political dinners and fund-raisers, so he did. He carried an apple or a banana in his briefcase so he wouldn’t binge on junk food between meetings or during long congressional sessions. And if one of his frequent flights included meal service, he ordered a vegetarian or low-fat entree in advance.

Congressman Salmon’s renewed commitment to a healthy lifestyle paid off. Within 12 months, he lost 70 pounds. He decided to celebrate with a victory run in the grueling Marine Corps Marathon. After 7 months of training, he succeeded.

WINNING ACTION

Think in terms of permanent changes, not temporary fixes. Congressman Salmon believes that the key to weight-loss success is to acknowledge that you’re making permanent lifestyle changes. I couldn’t agree more. You can’t go back to your old, unhealthful ways once you achieve your goal weight. Eating healthfully and exercising regularly are for life. That may seem like

a tall order. But keep in mind that over time, the lifestyle changes that you make now will become second nature to you—so much so that you won’t think of them as new anymore.

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Comments (0) Apr 22 2009

- Instead of taking progestogen each month, is it safe to take it, say, every three to six months so that I don’t have so many withdrawal bleeds?

Researchers are now looking into this possibility. The available evidence suggests that, in some women taking oral oestrogen each day and progestogen for ten to fourteen days every second month, the endometrium is protected sufficiently for this to be a safe and convenient option. Further research is needed to determine which women are best suited for this approach, however. Women who have a very light monthly bleed or no bleed at all could turn out to be suitable. Until the research under way has been completed, it seems likely that most doctors will continue to prescribe some progestogen each month.

- I am taking oestrogen and progestogen, with five days at the end of each cycle when I don’t have any hormones. Is this approach widely used?

There doesn’t seem to be any justification for this once-popular approach as menopausal symptoms can return during the hormone ‘break’.

- I’ve had a hysterectomy. Is there any reason why I should take progestogen as part of HRT?

It was suggested at one stage that progestogen might protect the breast from cancer development, and this remains controversial. At the 8th Congress of the International Menopause Society in Stockholm in 1993 there was considerable discussion of whether oestrogen or progestogen, or both, stimulate breast cell growth. It may be that less stimulation occurs in women on low-dose oestrogen and progestogen throughout each cycle. It was suggested that even women without ovaries should be on this combination. Research is assessing this. Meanwhile women without a uterus usually receive oestrogen alone. This does not seem to increase breast cancer risk in the short term (less than five years).

- I am fed up with hot flushes and night sweats and am considering HRT, but I have fibroids. Should this affect my decision? HRT can be prescribed to women with fibroids. However, if fibroids are bulging into the cavity of the uterus heavy bleeding may occur, and this will need to be investigated and may need to be treated before HRT is prescribed.

- My vagina is dry and itchy and sex is often painful. I have started using a vaginal cream that contains oestrogen and wonder if I also need a lubricant?

You will find that your oestrogen-containing cream improves lubrication and reduces itchiness within a week or two. Until then, you may want to use a lubricant when having sex.

- Are hysterectomy rates going up?

After peaking in the late 1970s, rates of hysterectomy appear to have stabilised in Australia, with about 25 per cent of women having the procedure by the age of sixty-five. A NSW study found women aged from thirty-five to forty-nine years were most likely to have it, particularly in their late forties. Most of the operations were for benign disease such as endometriosis or fibroids.

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Comments (0) Apr 21 2009

About a quarter of women starting on HRT experience a small weight gain (up to 3 kg) during the first cycle and for a few months after. A smaller proportion put on considerable weight, part of which seems to be due to fluid retention. Some other women gain weight because of increased muscle mass — because they have discovered exercise in midlife. In older women who already have trouble moving freely, further weight can present problems because it makes regular activity more difficult.

Heather was sixty-eight when her doctor suggested she go onto HRT because of a personal and family history of heart disease. (She had already had coronary bypass surgery and her mother had died of a heart attack.) Heather’s weight shot up after starting on a twice-weekly oestrogen patch and daily progestogen tablets. The doctor reduced the dose of the patch but her weight increase continued, amounting to 13 kg over a ten-month period. In consultation with her doctor she embarked on a program of exercise and dieting aimed at getting her weight down and benefiting her heart. At the time of writing she was trying to decide whether HRT was worth the trouble. ‘I’m looking at the information and making up my mind whether to continue with HRT,’ Heather said.

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Comments (0) Apr 20 2009