Health news blog

The perfectionist unconsciously tries to ward off his inner tension by having everything just right. If everything is in order there is nothing to worry about. His efforts to be perfectly neat, scrupulously conscientious, and meticulously clean soon bring worries of their own, and at the same time fail to ward off his inner anxieties. The result is that the perfectionist comes to live a rigid and rather constricted way of life with a constantly high level of mental tension.

These difficulties are so much the more accentuated if the perfectionist is married to, or works with, a person who is freer and less restricted than himself. Then he is constantly ill at ease, wanting to clean up after his less orderly companion so that he can once again establish the pattern of having everything just right.

A patient who sought relief from inner tension fits this picture of the perfectionist. He was a jeweller, a modest and rather humble man, and extremely conscientious and fussy about his job, so that the work he produced was of exceptionally high quality. He had three apprentices working under him. In actual fact they did good work, and no one had ever found fault with it. But he was always worrying, fearing that it might not be quite perfect and wanting to check over the work of the apprentices just as he did his own.

With the relaxing mental exercises he was able to reduce his tension, so that he could carry on in relative ease, although he still remained very conscientious and a perfectionistic workman.

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It is not uncommon for an anti-depressant that works initially to stop working after a period, which may range from weeks to years. St John’s Wort is no exception in this regard and depressive symptoms may recur after an initial response. A relapse of this kind may be due to a worsening of the depression, which is sometimes the result of a definable cause such as a personal loss, a new stress or the onset of winter. Wherever possible, the first-line response to such a setback is to deal with the underlying cause, for example to obtain extra support from friends and family, adopt strategies to help deal with the stress or increase the amount of environmental light.

If the trigger for relapse cannot be identified or if the steps to correct it by making environmental changes are unsuccessful, medication adjustments can be made, including increasing the dosage of St John’s Wort or adding another anti-depressant. Sometimes a person develops what is known as tolerance to an antidepressant, which means that certain chemical changes in the brain override the beneficial effects of the medication. In this case it can pay to switch to another medication or to add a medication specifically designed to potentiate the effects of the anti-depressant. Drugs such as lithium carbonate and synthetic thyroid hormone have been reported to be effective potentiators of conventional anti-depressants and may be of value when added to St John’s Wort as well. If the medication situation is complicated enough to warrant potentiation of an anti-depressant, it is certainly necessary for a highly skilled doctor to be involved in treatment decisions. The purpose of providing you with this information is so that you can understand some of the steps your doctor is likely to consider in dealing with the delayed development of unresponsiveness to an anti-depressant.

One possible reason why St John’s Wort may stop working is that the composition of active ingredients may vary from one batch of St John’s Wort to another. You might suspect this to be the case if you purchased a new batch of St John’s Wort just before noticing the change in anti-depressant effect. Reliability of quality control is one reason why I recommend the brand of St John’s Wort with the best documented and most reliable track record, namely Kira™, so as to minimize the likelihood of relapses due to inconsistencies between batches.

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Most referrals occur not because family doctors are uncertain as to whether a patient has had a seizure or not, nor because they are seriously concerned in every case about the possibility of serious underlying disease, but for the following reasons:

• People do not like being told they have had an epileptic seizure. One survey showed that this difficult task is left to the hospital doctor in about half the cases.

• People with epilepsy themselves very often feel that some sort of special test is necessary to ‘prove’ the diagnosis. It must be very difficult to accept the diagnosis, with all its social implications, when it is made on the basis of a 30-second description given to a doctor by a relative or bystander. Somehow it does not seem ‘scientific’ enough, and yet paediatricians and neurologists place enormous weight on the recounted stories.

• People with epilepsy are very concerned to discover the ’cause’ of their epilepsy. A cause is often not found, but most people think in terms of a single cause, which they believe, if eradicated, will result in the problem being solved once and for all. Occasionally, of course, an important treatable cause is found, and usually special tests are indeed necessary to show this. The difficulty lies in deciding which patients should be so investigated.

• Traditional medical textbooks accentuate the unusual and ‘interesting’ causes of epilepsy, at the expense of the more usual patients. Family doctors, educated partly by these books, tend to play safe and refer if referral centres are available.

• The necessary decisions are quite complex. There are three possible preliminary

diagnoses—seizure, not seizure, and may be seizure; two policies about investigation—to be arranged or not; and four possible outcomes—treatment, no treatment, adoption of a

wait-and-see policy, and referral to another specialist. We do have some sympathy with our colleagues in primary care, when all these combinations are considered, and can readily understand why so many patients are referred.

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Mr DL, Doncaster, England. “I am so delighted with curative effect of the CMO I purchased from you recently, that I am prompted to write to you, and tell you of my experience.”

“I have suffered from the most excruciating pain in my right hip, because of osteoarthritis, so bad was the incessant pain, I could not walk 10 yards without pain. As this condition was something I had endured for several years and my doctors could offer only antioxidents and cortisone, and nothing else, I was told the condition was degenerative and that the only hope was a hip replacement operation, to which I agreed and awaited at my local hospital.”

“I took the [CMO] capsules more in hope than in confidence in their effectiveness, but after ten days, I felt and indeed deep down inside I knew something very wonderful was happening. After thirty days I had taken my last capsule, and I went to Filey on the East coast in a party of four, and much to my surprise I walked a mile on the sands and on the uneven slippery seaweed covered rocks. After resting on a large rock for 20 minutes I walked back, frequently on a most uneven undulating path.”

“I was truly amazed. Although tired when I got back to my car, and I was glad to sit down again. I knew one thing CMO had worked for me!!. I felt cured of the dreaded arthritic condition. I felt like a new man.”

“The only thing I can say to Dr Sands and his team of assistants is THANK YOU. I only wish every sufferer could have access to these wonderful CMO, and the sooner the better. For the first time in seven years, I am now pain free.”

“When I kept an appointment with a consultant at my local hospital, I told him I was pain free, and he was amazed, and asked me all about CMO. I was pleased to share what I knew with him. And he told me, because I was now pain free, I did not now qualify for a hip operation. How wonderful.”

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Signs and symptoms

Tenderness without swelling at the edges of the kneecap usually indicates that the cartilage on the underside of the kneecap has been bruised and softened (chondromalacia). Swelling of the knee joint-fullness on both sides of the kneecap- indicates inflammation in the joint or an internal injury. Diagnosing the cause of knee pain depends upon the patient’s history, the presence or absence of symptoms, and upon the location of pain.

Home care

Treatment depends upon the problem, but usually – as in Osgood-Schlatter’s disease – it involves limiting your child’s activities. For two to four weeks, or until the swelling and tenderness are gone, the knee must not be bent; if the knee is not bent, it follows that it cannot be forcefully extended. From the child’s point of view, this rules out two-legged stair climbing, bicycling, running, and jumping. An elastic knee support can be a helpful reminder that the knee needs rest during this period of healing. Treatment of chondromalacia involves the temporary limitation of strenuous activities like track, trampoline, football, and soccer.

Precautions

• Swelling of the knee joint may be serious; it requires a doctor’s attention.

• If one knee cannot be straightened to match the opposite knee, fluid (blood or the serum that remains after blood has formed a clot), or pus has probably accumulated at the joint; the knee should be seen by a doctor.

• The child should not put weight on a swollen knee until it has been seen by a doctor.

• Remember that knee pain may be a sign of a hip problem.

Medical treatment

The doctor will make a thorough, detailed examination of each part of the knee and leg and check the range of normal and abnormal movement. The doctor may order X rays of knees and hips. Sometimes, an arthrogram, which is an X ray taken after a special opaque fluid has been injected into the area, will be necessary. The opaque fluid, which can be seen on the X ray, outlines the interior of the joint. Swelling, accumulation of fluid, and distortion or injury of parts of the joint can then be seen. The doctor may also require tests of fluid drawn from the joint. Depending upon the diagnosis, treatment of knee pain may include bed rest, antibiotics, a cast, crutches, or surgery.

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All people need good health to enjoy life and do the things they want. When you first found out you had diabetes it may have seemed to you that you might lose some of this good health. But you will not.

Diabetes may have made you ill when it first developed. Perhaps you got very thirsty and found yourself passing a lot of urine. Perhaps you actually felt sick and lost weight.

Once treatment has started, however, you will no longer be sick, and will return to normal health. This treatment will allow you to keep healthy and to be no different from your friends in how you are and in what you can do.

You will have to continue looking after yourself, of course, because nobody can actually cure diabetes yet.

Once you get used to it, the treatment is easy. It soon becomes part of your life, and the daily injection of insulin and the regulation of meals will be rather like brushing your hair or cleaning your teeth: you will not need to think about it much.

Even so, with the many new developments that are happening because of research, the care of your diabetes will be even easier in the future. Perhaps even a cure may be possible one day.

Try to learn as much about diabetes as possible. It will be interesting and help you to understand how to look after yourself. This way you will be healthy because diabetes is not a disease in the way measles or influenza are.

Diabetes should not interfere with school or a career or your job. You will almost certainly be able to lead the same life and play the same sport and have the same friends you would if you did not have diabetes.

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Obtain Omega 3 Fats in Your Diet

An enormous amount of research has been done on the benefits of omega 3 fats for cardiovascular health. Omega 3 fatty acids are a type of polyunsaturated fatty acid with strong anti-inflammatory properties. As well as benefiting the heart, omega 3 fats are particularly good for helping arthritis, cognitive function and depression.

Alpha-linolenic acid (ALA) is an essential fatty acid found in flaxseeds, walnuts and other seeds and vegetables. Our cells convert ALA into two omega 3 fatty acids called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); they are especially abundant in brain cells, the retina of the eyes, adrenal gland and sex glands (ovaries and testes). In addition to making them in our cells, we can obtain EPA and DHA by eating oily fish such as salmon, sardines, herrings, mackerel, tuna and halibut.

Omega 3 fatty acids have the following benefits for our heart:

•     They make our platelets less sticky, therefore reducing the risk of blood clots forming which can lead to a heart attack or stroke.

•     They lower blood triglyceride levels.

•     They decrease the risk of cardiac arrhythmias (disturbances in the heart’s rhythm that can lead to a heart attack).

•     They lower blood pressure.

•     They decrease the rate of plaque accumulation in the arteries.

•     They help to stabilize arterial plaques, making them less likely to rupture and lead to a heart attack.

•     They increase levels of HDL “good” cholesterol.

•     They can help to break up blood clots already present.

A study published in the Journal of the American Medical Association evaluated more than 84 000 women and found those who ate fish five or more times per week had a 34 percent lower chance of coronary heart disease than women who ate fish less than once a month. In another study, patients with high cholesterol were given either EPA and DHA or a placebo for seven weeks. The patients who took EPA and DHA were found to have a significant improvement in the elasticity of their arteries. This means their blood pressure was likely to be lower, and they had a lower chance of blockages in their arteries.

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What is it?

An allergic condition affecting one person in ten in which the sufferer overreacts to pollens, moulds or spores in the air.

Hay fever-a seasonal form of allergic rhinitis-is really an inflammation of the nasal passages. The sufferer complains of sneezing, an itchy, blocked or runny nose, itchy eyes (which may also be red, watery and sensitive to light) and an itchy throat.

The condition can easily be confused with perennial allergic rhinitis which occurs year-round and is caused by an allergy to house-dust mites which live in carpets and bedding. Some people who appear to have allergic rhinitis are in fact sensitive to the weather, a deodorant spray or indeed one or more of many other things. This is not a true allergy but simply oversensitivity.

Most people who have hay fever start having trouble before the age of 15 and some grow out of it. Hay fever, like all allergies, tends to run in families. You don’t need to live in the country to be troubled with hay fever but if you live at the seaside you will be protected to some extent by winds that are pollen-free coming off the sea.

What causes it?

• An oversensitivity to pollens, moulds or spores. Tree pollens are most plentiful in April and May; grass pollens in June and July; and moulds and spores in August and September.

• Allergies run in families. We can’t choose our parents but a couple one or both of whom has a family history of allergy can take certain steps to reduce the chances of their children suffering from allergies.

Prevention

• Do all you can to avoid producing allergic children.

• Take preventive medications prescribed by your doctor or have a series of desensitizing injections. Discuss these with your doctor.

• Try an ‘alternative’ therapy. Homoeopathy, acupuncture and hypnotherapy all claim to prevent hay fever.

• Buy a car that has a ventilation system that can filter out pollens.

Only one European car does this (Saab). Sneezing when driving can be very dangerous because if your eyes are shut for half a second, say at 60 mph, you will travel ‘blind’ for 44 ft.

• If you have to drive start early in the day or late at night when pollens are not so plentiful in the cool air. Keep your car windows shut and the ventilators closed.

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“Can I go home now?” Stephanie, a nineteen-year-old college sophomore, spat out the words.

She had been in my office just ten minutes. She had spent the whole time listing reasons why she didn’t need help-even though she weighed less than ninety pounds: “I don’t need a shrink. I know what I’m doing. I am too fat and I have to lose weight. My diet is no one else’s business. It doesn’t interfere with my life. I feel fine, I exercise, and I get good grades. What I choose to do with my body concerns no one but me.”

When she paused for breath, I asked, “What do you think would happen if you tried to stop starving yourself to death?”

Here eyes flashed. “I would lose the one thing that makes me special. That’s what you’re trying to do-take away the only thing that makes me feel good about myself!”

Stephanie seemed very afraid. “I know you feel that way now,” I said. “But working together, we can look at why you don’t feel good about yourself, and why you don’t think you are special in other ways. I think part of you recognizes the danger you’re in. But another part of you is scared to give up your starving identity.”

It took many more sessions to complete the process, but in that moment we began work on the most important task of individual therapy: to help the patient find a new identity, free of the suffocating symptoms of an eating disorder.

As Dr. Arnold Andersen puts it, therapy can be a kind of “mourning period.” Part of the patient-her starving persona- must pass away. The patient has to let go of her fantasy that being thin will solve all of her problems. That’s very hard to do. As her therapist, I try to show that I understand her struggle and realize how difficult and painful it will be for her.

While every patient is different, often there are discernible phases in therapy. In the first phase, the patient and the therapist spend time getting to know one another. However, they also focus on the symptoms themselves. The immediate goal is to break the bulimic cycle of bingeing and purging or to reduce the anorexic’s fear of eating and gaining weight.

In the next phase, work to change behavior and thinking patterns continues, but the focus shifts somewhat. Now we begin to explore the patient’s characteristic emotional difficulties. During this time the “purpose” of her symptoms-why they developed, what they mean to her-may become clearer. Starving won’t solve her problem with self-esteem, for example, but it does give her the illusion that she is “in control.” I tell her that it’s human nature to want to do something we’re good at. It helps us forget, or ignore, our other problems, but if our “talent” is self-destructive, then it can get in the way of solving the real problems.

We keep working to identify and change the stresses that trigger her behavior. We explore how eating (or not eating) came to play the central role in her life and why she turns to food (or abstains from it) for emotional support rather than to her parents or a friend. We look at the purpose that starving serves in her life and why weight is so important. If she wants to stop bingeing and purging but can’t, we examine the mental roadblocks that thwart her efforts at self-control.

Often we spend time looking at her relationships with her family. I want to know how she sees the interactions between family members. We then talk about what she can do to change the family’s style of dealing with each other and to pull back from parental conflicts.

In therapy we try to reduce the symptoms, and ideally eliminate them altogether. For months or even years, though, the patient has defined her personality through the disorder. Without self-starvation, an anorexic may feel she is nothing. For this reason therapy must not only take away, it must offer something in return.

And it does: It offers the chance to develop a mature and rational self. Maturity has many facets. It means the ability to recognize feelings and respond to them in healthy, life-affirming ways. It means breaking free of constricted thought-patterns and solving problems creatively. And it means self-esteem: a belief in one’s worth as a human being.

As a therapist I must listen, and listen hard, to what the patient has to say. If she has trouble recognizing feelings or articulating thoughts, I’ll do the best I can to help her along. I also encourage her to discover her true values and goals. I take her remarks seriously and accept her feelings as real-a courtesy that perhaps too few people in her life pay her. This doesn’t mean I have to agree with everything she says, but I at least acknowledge it as valid for her.

In the final phase of therapy, the patient gets ready to strike out on her own. We talk about strategies she can use to cope with problems as they arise. I make sure she knows that temporary relapses may occur in times of great stress. At such times it is important both to reach out to others and to utilize some of the tools that have been helpful in the past.

When it comes time to terminate therapy, the patient usually experiences emotions similar to those she felt during past times of separation or loss. Being aware of these emotions allows us to work through them during therapy sessions and helps the patient grow. Sometimes these feelings are so strong that they trigger a temporary return to poor eating. Helping the patient see the connection between these events works to minimize the damage.

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After failing at a dozen different weight-loss plans, Lisa Douglass decided to create her own.

“I just couldn’t have someone telling me what I could or couldn’t eat. I wanted to be responsible for my choices,” she says. “I wanted absolute control.”

Lisa, a computer analyst in Randallstown, Maryland, bought a dozen exercise-and-nutrition videos. She studied books on food. She planned her workouts, meals, and shopping trips. She kept a journal in which she noted how certain foods affected her weight and even her moods.

The plan she eventually created was healthy, sensible, and geared to her eating habits and exercise interests. She decreased the amount of fat and sodium in her diet by preparing meals featuring lots of vegetables but very little red meat as well as by avoiding salty snacks and fast food. “Because I was choosing foods that were healthier and lower in calories, I didn’t really have to limit my portion sizes,” she notes. She also started working out on a treadmill, gradually working her way up to 1 -hour runs, 5 or 6 days a week.

Her plan worked. Over a 2-year period, Lisa dropped from 280 to 160 pounds.

“I’m 5 foot 7, so I carry my weight well. People tell me I look good,” she says. “Still, I’d like to drop another 10 to 15 pounds.”

Lisa, now age 29, believes she needs a new plan to take off those last few stubborn pounds. She’s experimenting with changes in her diet and exercise routines, but concedes that it has been a battle to stay focused.

“Sometimes I make good choices, sometimes I make bad choice,” she says. “But I like the fact that I’m the one making the choices. That’s important to me.”

WINNING ACTION

Design the perfect plan for you. No one weight-loss plan fits all. The best is a hand-picked hodgepodge of personal secrets and strategies. To make your own, expose yourself to a variety of sources: books, classes, groups like Weight Watchers or TOPS (Take Off Pounds Sensibly), even nutritionists and personal trainers. Take the best from each and stick with what works for you

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