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When you decide you want to stop taking HRT, ask your doctor about reducing the dosage gradually, as this will prevent a return of short-term symptoms, like hot flushes. A possible routine might be: If you are taking HRT as tablets, change to a lower dose tablet for a few weeks, then take one every alternate day for a few weeks, then just once or twice a week for two weeks, then stop altogether. If you are using a patch, change to a lower dose patch for a few weeks, then leave 1-2 days between changing patches without using one at all, then leave 3-4 days between patches, then, after you have been wearing a patch for only half the time, you should be able to stop.
Implants are more difficult to cut down on, so talk to your doctor about this. He may suggest that when your current implant comes to an end you try tablets or patches that are easier to cut down.
During this ‘weaning off’ process, some symptoms may return, but they will probably not be frequent or severe. If they are, you will have to decide whether to live with the symptoms or go back to full-time HRT. Plushes and night sweats are usually worse in hot weather or when you are under stress, so it is easier to stop taking HRT when the weather is cooler and when you are feeling calm and in control of your life.
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Although a safer procedure than, for example, removal of the appendix, hysterectomy is not without risk. For every 2000 abdominal hysterectomies performed, between one and four women die within a month of surgery (the variation in figures depends on which study is consulted). Death rates may be less for vaginal and laparoscopically assisted hysterectomies.
In addition, reports suggest that between 25 and 50% of all women who have a hysterectomy encounter one or more complications. In the case of abdominal hysterectomy, 1-3% of women experience a major complication such as significant post-operative bleeding, the formation of a blood clot in the lungs, or damage to the ureter, the bowel or the bladder, all of which may require further surgery. Vaginal prolapse and sexual problems may also occur with any type of hysterectomy because there is reduced support for the upper part of the vagina from other pelvic structures. To minimise this risk, the ligaments supporting the bladder, bowel and vagina are stitched together after the uterus is removed.
Other complications include infections of the surgical wound and urinary tract, weight gain, abdominal or back pain, constipation, fatigue and frequent urination. Some of these, for example urinary tract infections, usually clear quickly provided antibiotic therapy is administered promptly. In some women, however, they become a persistent source of unsettling symptoms requiring treatment. For Rita, the biggest surprise following her hysterectomy was the kilos she suddenly gained. An enthusiast for keeping in shape, she couldn’t understand why she had put on weight, given that she was just as careful about what she ate after her hysterectomy as before. ‘My doctor thought it might have something to do with changes in my sex hormones, but when I asked about hormone replacement therapy he said this might cause even more weight gain/ Rita embarked on a vigorous schedule of physical activity which, at last report, had helped her weight to plateau. She is not alone in experiencing this complication of hysterectomy. Some studies report that weight problems occur in nearly a quarter of women after the operation. It seems that women who want to maintain their weight at pre-hysterectomy levels need to be prepared to reduce their calorie intake somewhat in the two to six weeks after surgery in line with their reduced activity levels.
Psychological disturbances have been widely reported in women who have had hysterectomies, with depression, mood change, anxiety and irritability often cited. Other studies have, however, raised the possibility that it is not hysterectomy itself that triggers these disturbances. Rather, they may reflect psychological states which developed during the period of stress and ill-health preceding the operation.
For pre-menopausal women, hysterectomy may lead to an early menopause and distressing menopausal symptoms such as hot flushes and vaginal dryness if the ovaries are removed along with the uterus. This may also occur in women whose ovaries are saved, but less frequently, particularly if the surgeon who does the operation is skilful and experienced. An uncertain factor in all this is the state of the ovaries before surgery. It may be that women who resort to hysterectomy have a higher incidence of problems with their ovaries than women who do not, and that even if they were able to avoid surgery, their ovaries might not function particularly well. What can now be said with some certainty is that women who have had a hysterectomy are much more likely than average to embark on hormone therapy. The Melbourne Women’s Midlife Health Project, which questioned 2000 randomly selected women aged forty-five to fifty-five years, found that half the women who had both ovaries removed at the time of hysterectomy were on hormone therapy, as were a third who had a hysterectomy but retained their ovaries. In contrast about one in six women who had not had a hysterectomy was on hormone therapy. In a comparable group of US women, the rate was about the same in the surgical menopause group and significantly lower in the natural menopause group. Rates seem to vary widely across Western Europe, but there is not enough information to enable a valid comparison.
Other long-term complications, which stem in part from the early menopause that sometimes occurs after hysterectomy, are an increased risk of heart disease and of the bone thinning disorder, osteoporosis. In order to reduce these risks, as well as to resolve menopausal symptoms, hormone therapy containing oestrogen is often prescribed after a hysterectomy.
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Understanding the biological clock is important for people who have sleep problems. If we wake up every morning at the same time and sleep at about the same time every night, we are helping to keep the biological clock accurate. If we sometimes read, watch television, or have wild parties late into the night, this irregular life style disturbs the accuracy of the biological clock, so that when we want to sleep we may not feel sleepy. By keeping irregular hours of sleeping and waking, we cause ourselves to experience a mini jet lag all the time. To help the biological clock work in our favour, we should wake up at the same time each day. We know that under free running experimental conditions, without any outside time cue, our natural biological clock is about 25 hours. Were we to let nature take its course, we would sleep about one hour late each day. After a few days, we would be sleeping a few hours later than our normal sleep time. To reset the biological clock to 24 hours, we must ensure that we wake at the same hour each day. Although we think we have little control over sleeping, we do have full control over waking up. Waking up at the same time each morning is now one of the most important disciplines recommended by most sleep experts for treating insomnia.
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We naturally think of being quite still while we are relaxing. This is so for the early stages. However, we have now mastered the technique. We are familiar with the relaxed feeling of the mind, and we have learned to induce it quite easily and quickly while sitting down. We have now reached the stage when we can practise the exercises while we are actually doing things.
The first step in this direction is a very simple one. As we relax, we allow our eyes to open a little, and to close again very slowly. We do this in time with our breathing. As we breathe in our eyes open, then they close again as we breathe out. All the time we maintain the deep relaxation of our mind. At first we are content to have our eyes open just a little. As we become more experienced, they can open wider and wider.
The next stage is to do our exercises as we walk slowly down the street. We feel the relaxation of our mind. We are conscious of the ease and rhythm of our body as we move; and all the time we are aware of the relaxation of the muscles of our face and the calm of our mind.
In a similar way the housewife can practise while doing rhythmical domestic tasks such as polishing or using the vacuum cleaner on the floor. By this means the calm and ease of mind induced by the exercises is kept with us in all the tasks of our everyday life.
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The program of vital nutrition outlined above has the greatest potential for optimum health and prevention of disease. It is important to realize, however, that a diet which is perfect for the building of health and prevention of disease is not necessarily the best possible diet for a sick person. Particularly in the case of arthritis, certain specific changes in this general nutritional plan must be made. During the first stages of a therapeutic biological program, for example, all bread and milk should be excluded, with the exception of soured milk and yogurt, sprouted grains, and raw wheat germ. The only form of cheese permitted is homemade cottage cheese. When the patient is well on his way to recovery, whole grain bread and milk and milk products can be gradually added to the diet again. However, a person recovering or recovered from arthritis should always be careful with acid-forming foods: bread, cereals, animal proteins, cheese, etc. It is imperative to continue with the program of vital nutrition long after recovery if lasting results are to be expected. The biological program of treatments establishes favorable conditions in your body for the rebuilding and healing processes to take place. These favorable conditions must be maintained indefinitely in order to assure the continuance of good health and prevent the recurrence of disease.
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The treatment of infantile spasms is unlike that of other epilepsies. Treatment usually consists of giving a steroid, either by intramuscular injection, or by mouth. The drug which is given by injection is called ACTH (adrenocorticotrophic hormone), and by mouth, prednisolone. The injections are usually given once (rarely twice) a day for two weeks until the spasms have stopped, and then every other day, and eventually just once a week. Only about one half to
two-thirds of children will respond to ACTH or prednisolone, and a number of these children will relapse (have further spasms) once the medication is discontinued. Unfortunately, these medications may be associated with serious side-effects, and therefore the children must be monitored very closely. Other drugs which may be useful in treating spasms include: sodium valproate (Epilim) and nitrazepam (Mogadon). More recently, one of the newer anti-epileptic drugs, vigabatrin (Sabril) is appearing to be successful in treating spasms, particularly if the cause is tuberous sclerosis or as a result of earlier meningitis/encephalitis. This drug seems to be safer, with less serious side-effects, than the steroid drugs. It may soon become the ‘first choice’ drug in the treatment of infantile spasms. One of us already uses vigabatrin to treat every child who has infantile spasms, irrespective of the cause because it appears to have so few side-effects.
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That name’s such a mouthful that many people with temporal mandibular jaw disorder can’t even say it without their jaws locking up. No it’s not the tetanus infection called lockjaw. TMJ is a problem usually caused by jaw malformation, fracture, dislocation, or arthritis. It can even come just from biting down too hard on something.
It can vary from an occasionally bothersome jolt of pain when chewing or talking to a constant terrible pain that even inhibits normal speech. Minor cases can disappear in a few hours or a few days. Chronic TMJ can cause constant and dreadful pain that can last a lifetime.
To resolve the problem, doctors like to prescribe pain medications. Surgeons like to recommend surgery. Neurosurgeons will suggest neurosurgery. Chiropractors propose manipulative therapy. Dentists want to x-ray it. Acupuncturists want to jab you with needles. Any or all of these procedures may prove helpful. We have nothing against them.
But can you guess what usually works best for chronic TMJ? CMO, of course.
One female patient suffered from recurring TMJ pains as a result of her misaligned jaw. She had already run the gamut before finding CMO. Her chiropractor had manipulated her jaw and made it worse. A neurosurgeon had offered her pain medications. She saw a slew of dentists claiming to be TMJ specialists. One x-rayed her jaw, injected it with something, and constructed a splint for her to wear 24 hours a day. She tried acupuncture but that didn’t help either.
The misalignment remained and the pains kept coming back. Then a bit of dental work on one tooth worsened the situation. She began taking a lot of Advil and a number of prescription codeine tablets daily just to maintain.
Two days after starting CMO she reported that her pains were subsiding. She now enjoys an improvement of better than 80% overall, more than enough to feel quite comfortable again.
Hers was a quick response to a very severe case. Most TMJ cases respond just as quickly. Dozens have reported 100% recoveries from the problem.
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Symptoms: general bodily discomfort; fever; sore throat; nausea; sore, stiff muscles; stiff neck or spine.
Home care
The best home care is prevention; be sure your child is adequately protected against polio by immunization.
Precautions
- The child needs the full series of immunizations to receive long-lasting immunity.
- If the child originally received the Salk polio vaccine, he or she must have boosters or receive two full series of the Sabin vaccine in order to be fully protected.
- Polio is caused by one of three different viruses, and attack by any one of the three confers immunity against that virus only. It is, therefore, technically possible to have three separate attacks of polio.
Polio – poliomyelitis or infantile paralysis – is an infection of the spinal cord. It is due to one of three related but different viruses. Attack by one of these three viruses confers lifelong immunity against that type only. Therefore, it is possible to have three separate attacks of the disease.
The polio virus is found in the saliva and the stool of the infected person. It is transmitted by direct contact or through contact with something that has been contaminated by the virus carried in an infected stool – for example, foods, toys, or the water in a swimming pool. The incubation period – the time it takes for the symptoms to appear once the person is exposed to the virus – for polio is three to 14 days.
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You be instructed as to what type of insulin your child needs and the correct dose for him. He may be on a single type of insulin – for example, Isophane insulin – or he may be on a mixture of insulins – for example, Isophane and Actrapid insulin. It is of course important to measure the dosage accurately, as a small variation may affect the blood glucose significantly. The method of drawing up the insulin is set out below.
Clean hands
Wash hands thoroughly in soap and water. Dry them well.
Clean the insulin bottle
Wipe over the upper cap of the insulin bottle with a cotton wool swab which has been moistened with spirits.
Mix the cloudy insulin well
Any insulin which is cloudy such as Isophane insulin must be agitated so that it is thoroughly mixed just before drawing up. You can do this by gently inverting the bottle a number of times or by rolling the bottle gently between your hands. This must be done immediately before drawing up as insulin suspension settles very quickly.
First put air in the syringe
Take the syringe and draw the plunger down to the mark giving the correct dose that you are to give. This allows air to enter the needle and syringe and the volume of air will be the same as the dose that you are giving. Next, checking that the insulin has been mixed properly, plunge the needle through the cap of the bottle so that the needle is just through the cap.
Put the air into the bottle
Invert the bottle so that the point of needle is below the surface of the insulin, and push the plunger up so that all the air is expelled into the insulin bottle. This will make it easier to withdraw the insulin, as the pressure will remain the same inside the bottle, the withdrawn insulin being replaced by an equal volume of air.
Draw down insulin
When you draw down the plunger to the correct mark some air will enter the barrel. Hold the syringe with the needle and bottle still in place in a vertical position with the needle pointing upwards and tap the barrel gently so that the air bubble is at the top of the insulin in the syringe.
Now push the plunger back a little way to force the air back into the bottle. Draw down again to the correct mark. If air is still in the syringe, repeat this until it is completely gone. Now finally check that the plunger is down to the correct mark giving the right dose.
Remove the syringe and needle from the bottle. You are now ready to give the injection.
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You or your partner 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.
For example, working with lead (used to make storage batteries), radiation, pesticides and solvents can be a problem. If you work in a dry cleaners or hairdressers you are likely to come into contact with many different chemicals.
Visual Display Units
Research on the risks of radiation from VDUs is still in its early stages. However, you can reduce the risk if you:
• Keep the time spent on the VDU to a minimum, with the most being four hours per day.
• Ask your employer if it’s possible to give you other, non-computer work for at least the first three months of pregnancy.
• Use houseplants to stop the air becoming too dry. (Some plants are able to absorb a certain amount of radiation and to act as air purifiers, according to a NASA space project, which showed that the plants could remove toxic substances like carbon monoxide from the air. The most beneficial plants are the tropical ones such as lady palm (Rhapis), bamboo, parlour palm (Chaemaedorea), ficus, peace lily (Spathiphyllum) and spider plants.)
Occupational Hazards for Your Partner
The male organs are on the outside of the body for a good reason. The testes need to be several degrees cooler than body temperature because sperm production can only take place at 32°C (89°F). And our normal body temperature is 37°C (98.4°F). Anything that brings the testes closer to the body, and so raises their temperature, may affect the sperm count. An increased temperature of only 1°C has been shown to decrease the sperm count by about 14 per cent.
A number of studies on drivers have found that men who spend more than three hours a day in a car or lorry are less fertile. When men drive they are not only sitting for a long time but are getting the vibrations from the vehicle. So they are literally ‘in the hot seat’.
The same research showed that men who are exposed to heat during their work are four times less likely to make their partner pregnant within three months. This might apply to a range of occupations – including anyone working with boilers or welding. One man I saw, who is a baker, was getting great blasts of heat directly on his genital area every time he opened an oven door.
What He Can Do
• Avoid crossing his legs when sitting down.
• Take regular breaks to move around.
• Avoid wearing tight trousers or underpants which constrict the testes.
• Avoid hot baths – he should shower instead.
• Shower his genitals with cold water to lower their temperature and improve circulation.
• Avoid using electric blankets – particularly once he is in bed.
Exercise
It is important to have a good level of physical activity because it improves heart function, controls cholesterol, reduces blood pressure, reduces excess weight and generally optimizes health. But it is also important to keep a balance and some sports may compromise male fertility.
If a man exercises excessively it can lower his sperm count. Long hours of training for a marathon, for instance, could therefore be a problem.
Very vigorous sports, like squash or running, may not be advisable because of the knocking effect of the testes against the thighs as the man runs.
Likewise tight-fitting nylon shorts, either worn on their own for running or under shorts in the gym, may contribute to male fertility problems.
Finally, men who regularly go for long bike trips, especially on a racing bike, may spend a lot of time bent over, bringing the testes quite close to the body and crushing them against the seat of the bike, causing overheating and constriction.
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