FAD DIETS: IMPLICATIONS

Weight loss diets abound, all with the promise of eagerly sought results. If any formularised eating plan is to be used, those working in fat loss need to:

1. Look to scientific research for the basis of claims, and ensure the eating plan is not actually a danger to health.

2. Sort through the claims and promises for the actual strategies required.

3. Assess if it requires anything special to make it work, including pills, potions or machdnes.

4. Assess its consistency with recommended food selection guides and the use of locally available foods.

5. Assess the promised rate of weight loss.

6. Assess the energy level and macronutrient composition and compare this with national recommendations.

7. Ensure that it is nutritionally adequate in micronutrients, and not reliant on supplements.

8. Assess the cost of the plan, particularly for long-term implementation.

9. Ensure that it is sustainable, incorporating commonsense food selection and regular, appropriately chosen physical activity.

10. Refer to an appropriately qualified health professional if unsure.

11. Reject any diet promoting a specific food or drink as a fat ‘burner’.

12. Consider only those eating plans which are likely to be adhered to for extended periods without alterations to physical nutrient profiles.

13. Be aware that liquid meal replacement diets without an accompanying activity program should only ever be used for the very obese and with appropriate professional supervision.

14. Discourage dieting in favour of healthy eating plans.

15. Keep in mind that diets of less than 1200kcals per day should not be used except under strict professional supervision and only in cases of extreme and life-threatening obesity.

SOME TIPS TO PREVENT FLUID RETENTION

•     Wear elastic stockings if your legs swell.

•     Do the same in pregnancy and in both cases use every opportunity to take the weight off your feet. This greatly helps reduce the swelling.

•     Come off the Pill and use another method of contraception.

•     Prevent allergies by eliminating foods and other allergens from your diet and surroundings.

•     Take vitamin B6. This seems to affect the balance between oestrogen and sodium. Taking 200 mg a day pre-menstrually has been shown to prevent fluid retention. B6 is especially good in pregnancy. Never take more than 200 mg a day.

•     Take vitamin Ñ-it seems to enhance the action of vitamin B6. It also has a diuretic effect of its own.

•     Drink more water – additional 4-6 glasses a day on top of what you currently drink. This increases the excretion efficiency of the kidneys.

•     Take less salt. Some people are exceptionally sensitive to salt and as little as 1 g can produce swelling in them. One large pickled cucumber, for example, contains 2 g salt.

•     Eat only complex carbohydrates (as found in fruit, vegetables and whole grains)-no refined ones. Sugar is a major culprit when it comes to water retention, and we consume quantities of sugar without being aware of its presence. Look for anything with the suffix ‘ose’ on the label (fructose, lactose, dextrose, maltose etc) and avoid it.

•     Include in your diet natural diuretics, such as pineapple, cucumber, parsley, alfalfa, strawberries, apples, grapes, beetroot and chamomile tea.

•     Ensure that you eat plenty of calcium-containing foods, especially if your fluid retention is a part of your pregnancy symptoms, as there is a link between the amount of calcium in the diet and fluid retention during pregnancy.

•    Take more exercise. Any exercise that improves the tone of blood vessels will help.

•    Try to lie down flat at least once a day for twenty minutes or so, as urine production is increased in the horizontal position.

UNDERSTANDING BPH AND HOW IFS DIAGNOSED: WHAT SETS ALL THIS IN MOTION?

There probably isn’t one clear-cut explanation for BPH; it involves too many disparate factors. But we do know that the development of BPH has at least two prerequisites—the testes, and aging. And new research suggests that a third condition, family history, may also be important.

The testes, housed in the scrotum, are the main source of the male hormone, or androgen, called testosterone, which is responsible for secondary sex characteristics, like post-puberty body hair and deepening of the voice, and for fertility. Testosterone acts on the prostate, but it’s not the only thing that makes the prostate grow. In fact, as it turns out, testosterone is not even the primary troublemaker in BPH; it just initiates the process. The trouble starts when testosterone is converted by an enzyme called 5-alpha-reductase to DHT (dihydrotestosterone). DHT is the major androgen, or male hormone, inside the prostate cell. (The thermostat that regulates all this activity is the hypothalamus, located in the brain.)

What are the Benefits of Using Green Tea?

It seems as if a week doesn’t go by before another study showing the health benefits of green tea comes out. The tea, brewed from the leaves of the plant, Camellia sinensis, is proving to be a powerhouse when it comes to health.

Emerging studies suggest green tea has multiple health benefits, including fighting heart disease, lowering cholesterol and blood pressure, increasing metabolism and fat loss, fighting breast cancer, and more. Studies also suggest green tea may be beneficial in preventing diseases of the eye, such as glaucoma.

Green tea is also proving to be quite a potent antibiotic, helping fight bacteria and tooth decay. This isn’t surprising, given that the substance that makes green tea green, chlorophyll, is known to be antimicrobial.

If you’re looking for something to get you going in the morning besides coffee, you might give green tea a try. Coffee does provide energy, but it does so at a price. Many people get the “jitters” after a few cups, and find themselves crashing later.

Green tea contains a little caffeine and L-theanine – a substance that reduces stress while raising alertness and mood. A good term for the feeling green tea gives is “calm energy”.

DO THESE TREATMENTS WORK?

Many articles in dermatology journals state that patients with BDD frequently have a poor response to dermatologic treatment. Of great concern is a study done in two dermatology practices in England, which found that the most frequent causes of patient suicide were acne and BDD. I’ve talked with dermatologists who told me about BDD patients of theirs who committed suicide. One dermatologist said that six of his patients with probable BDD had committed is and how important it is for people with this disorder to get effective psychiatric treatment.

There’s a great need for more studies of this important issue. What’s especially needed are prospective studies, in which patients are followed over time and carefully assessed before and after surgery or dermatologic treatment to see whether their BDD improves, is unchanged, or worsens. Patients should be clearly identified as having BDD, and their outcome after these treatments should be assessed over a long period of time.

Even though BDD appears unlikely to get better with these treatments, some people who initially consult surgeons, dermatologists, or dentists may be reluctant to see a psychiatrist. If this is true for you, keep in mind that as best we know, these treatments usually don’t work. Seeing a psychiatrist or therapist doesn’t mean you’re “crazy.” It simply means that you have a potentially treatable illness that in many ways is no different from heart disease or any other medical illness. Psychiatric treatment is very likely to help you feel a lot better. There’s a good chance it will give you more control over your obsessions, help you get your life back on track, and relieve your mind of worry, anxiety, and depression.

It may be hard for you to accept this advice if you think your defect is real and truly looks bad, as almost all people with BDD do. Most people with BDD have the hope that a physical change in their appearance will solve their problem. But look back at what my patients have told me about how they wish they’d never had surgery. Remember that as best we know, these treatments almost never help. And keep in mind that regardless of what you actually look like, if you’re obsessing about an appearance flaw, and if you’re distressed over it or it’s causing problems in your life, psychiatric treatment is likely to quell your obsessions, alleviate your suffering and distress, and help you function better and start enjoying your life again.

TYPE 1 DIABETES: PATHOGENESIS

As noted in the section on classification of diabetes, type 1 diabetes may be immune-mediated (type 1A) or idiopathic (type 1B). In either case, complete (or almost complete) loss of pancreatic beta cell function results in an absolute need for insulin therapy.

 The pathogenesis of immune-mediated destruction of the pancreatic beta cells has received the most attention, and is better understood than idiopathic loss of beta cell function. Pathologically, it is characterized by degranulated beta cells, an inflammatory infiltrate, and preservation of the other pancreatic islet cells, such as the glucagon-secreting alpha cells or the somatostatin-producing delta cells. The inflammatory infiltrate is composed of lymphocytes (CD4 and CD8 cells), natural killer cells, and macrophages.

 Islet involvement may be variable, and the clinical course of islet destruction may be slow or rapid.
Autoantibodies in the plasma are predictive and diagnostic for type 1A diabetes. Autoantibodies to the pancreatic islets were the first to be described. Subsequently, other autoantibodies have been found, including antibodies to glutamic acid decarboxylase (GAD), insulin, and other islet cell antigens. Type 1 diabetes-associated autoantibodies have been recognized before the onset of clinical disease, and their presence indicates a high risk of developing type 1 diabetes.

 First-phase insulin release is often reduced, and hyperglycemia eventually occurs. Islet cell autoantibodies are present in at least 70-80% of people with newly diagnosed type 1 diabetes, and insulin autoantibodies are present in about 50%. As the disease progresses, titers of autoantibodies fall and may be undetectable with long-standing autoimmune type 1 diabetes. A relatively high incidence of other autoimmune diseases (thyroiditis, celiac disease, pernicious anemia,or Addison’s disease) in people with type 1 diabetes supports the role of autoimmunity in the pathogenesis of the disease.

 The components of the immune system that are primarily responsible for cell destruction are under study. Elaboration of the cytokine interleukin-1 (IL-1) is thought to be of pathogenetic importance. IL-inhibits insulin secretion and may be cytotoxic to the islets. Another cytokine, IL-6, is produced by beta cells and can stimulate the immune response, enhance insulitis, and result in beta cell destruction. In one m it is hypothesized that viral infection of a beta cell increases release cytokines and adhesion of leukocytes. The infected beta cell is susceptible to attack by antiviral cytotoxic CD8 lymphocytes. Macrophages in the islets are stimulated to produce cytokines and free radicals, increasing the cytoxicity to the beta cells.

 Macrophages offer viral antigens to CD4 lymphocytes, which activate B lymphocytes to produce antiviral and anti-beta-cell antibodies. The process is obviously a complicated one with evolving concepts. The end product of virtually complete beta cell destruction leads to an absolute need for insulin therapy.

HOW MUCH SLEEP?

How much sleep is enough? This question is not easy to answer, and is very subjective. Some mink they need at least seven hours, some say ten. In fact this varies from person to person and also with age. It has been shown that babies sleep nearly all day. As they get older, they need less and less sleep. It is well known that the older we are, the less sleep we need. One of the common complaints of the elderly is that they cannot sleep. They hate to be awake and alone at night. They take sleeping pills, as they feel distressed when they cannot sleep.

Sleep is something we have no control over. We cannot close our eyes and give the magic word sleep, as sleep may not follow. In studies of how people fall asleep, it is observed that we are not folly awake one second and asleep the next. We all go through a very brief hypnotic state, which is called the Transitional Hypnotic State or THS.

How much sleep is required to restore, to repair, to recuperate, so that the next day we feel refreshed and satisfied? We will explore this question in two parts:

* Sleep deprivation and how much sleep is enough

* Psychological influence of how much sleep is enough

GENERAL ANSWERS TO QUESTIONS ABOUT BREAST DISEASES

After a recent needle biopsy of a cyst in my breast, I have extensive bruising and tenderness in the area. Is this a sign of something wrong?

Bruising is caused by blood leaking from tiny blood vessels under the surface of the skin and is likely to occur to some degree following a biopsy whatever the precautions taken to prevent it. There is unlikely to be any cause for concern, and the bruising should gradually disappear over the next few days or weeks. If it does persist, is painful or spreads, ask your doctor’s advice.

I have been referred to a general surgeon at my local hospital to investigate a lump in my breast. My GP said there is no specialist breast surgeon in our immediate area, but, having thought about it again, I would rather see such a specialist even if it means travelling to do so. However, I am nervous about asking my GP to change the arrangement. What should I do?

You are entitled to see a specialist breast surgeon and, in fact, it is a good idea to do so. A consultant who specializes in breast diseases will inevitably have more experience in this field than a general surgeon who does not have a specific interest in breast diseases. If there is no breast specialist in your area, you can ask to see one elsewhere, although you may have to insist. You may prefer to write to your GP requesting a referral to a breast specialist if you are anxious about talking to him or her again. Alternatively, you could contact your local hospital and ask if there is a breast care nurse you could talk to; she may be able to advise you and to support your request for another referral.

Following the recent discovery of a small lump in my breast, an appointment has been made for me to see a specialist. I am 48 years old. What are the chances that the lump is cancer?

Although most types of breast cancer are more common in women around the time of their menopause, approximately only 1 in 10 of those who are referred to a specialist with breast problems are found to have cancer. There are, of course, different types of breast cancer with different prognoses, and treatment of a small lump detected at an early stage of development may have a better outcome than that of one which is detected later.

I frequently have pain in my breasts which does not seem to be related to my periods. I cannot feel a lump. What should I do, and what might be the cause of this pain?

Non-cyclical breast pain can have several causes, most of which are benign. It is not common for breast cancer to be associated with pain in the breast, although it can be. You should make an appointment to see your doctor, having first made sure that you are wearing a well-fitting bra. If you have not been measured for a bra for some time, and particularly if you have lost or gained a significant amount of weight recently, it may be that the bras you wear are too big or too small and are not supporting your breasts properly.

Breast pain that is not related to the menstrual periods can be referred pain from a back or shoulder problem, and your doctor will probably want to investigate this possibility. Sometimes, the cause of breast pain is never discovered, but it does often resolve itself in time.

I am 48, and have recently been able to feel hardness around the edges of both my breasts. What is this likely to be?

The breast tissue changes in women around the time of their menopause, and what you are feeling is likely to be a benign condition called dysplasia or fibrocystic disease. However, it is worth checking with your doctor to rule out any other possible cause.

I am about to have a mastectomy. WM I need to wear special bras after my operation, and will I be able to wear swimsuits and sundresses?

There is no reason why you should need special bras; the bras you usually wear will probably be able to be adapted to hold and conceal a prosthesis. This is also likely to be true for most of your clothes. If there is a breast care nurse at your local hospital, she will be able to arrange this for you. Do discuss it with her or with your consultant. Swimsuits, bras and sundresses can usually have a pocket sewn into them to hold the prosthesis, and this will allow you to take part in all sports and your usual activities without worrying about your prosthesis becoming dislodged. Mastectomy swimsuits are available, but they are expensive, and should be unnecessary if your own can be adapted.

Although the underwiring of strapless bras can damage a prosthesis, it is probably all right to wear one for short periods of time if you want to wear a strapless dress. Low-cut dresses may not conceal your prosthesis, but apart from this, you should have no restriction on the clothes you will be able to wear.

PREVENTING ASTHMA: SOME NECESSARY PRECAUTIONS – EXERCISE

Many children get attacks after some form of exercise. This tends to lead to a lifestyle without regular physical activity. However, such children should be encouraged to participate in regular sports starting off at a comfortable level and progressively working towards more difficult sports which require higher levels of strength and endurance.

There is no reason why such children should avoid sports or physical activity so long as they understand their limitations and take proper medication. Several Olympic athletes have had asthma and yet gone on to win world class competitions.
An excellent physical exercise for children with asthma is swimming. As emphasised earlier, children should learn to recognise their own physical limitations through experience. There may be episodes of wheezing or tightness during such activity but these should be taken as a part of the learning experience. Parents and teachers should help these children manage these episodes. This will help these children become more confident about their activities.

Exercise: Some Important Tips

• Physical exercise is a must.
• Consult the physician about:
a. What exercise is best and convenient for the child.
b. Whether a defibrillator pre-medication is required.
• The child should be motivated to take regular exercise.
• The child should know his or her limitations.
• If one kind of exercise induces asthma the child should be encouraged to try another one under the guidance of a physical instructor.
• The child should warm up with a light exercise.
• After exercise the child should cool down with a light exercise.

CREATE A SUPPORTIVE HOME ENVIRONMENT

During Times of Stress, You May Need to Modify Your Expectations

BDD symptoms can increase at times of stress. Virtually any type of change can be stressful—positive events as well as negative ones. Don’t be discouraged if the BDD sufferer has a temporary setback during stressful times. At these times, you may need to lower your expectations a little bit. Keep implementing the suggestions in this chapter (e.g., encouraging progress, praising small gains) while also keeping in mind that progress may be slower, or may even stop, during stressful times. At times like these, your encouragement, support, and understanding may be especially helpful.
Create a Supportive Home Environment

Because BDD can be so hard to cope with, it’s easy to criticize and express anger toward someone who has it. It’s best to avoid this. Instead, do your best to create a supportive home environment. Help them talk about their feelings of anxiety, depression, shame, and isolation. Show your support, and help them fight BDD. Without being judgmental, critical, or hostile, explain that if you participate in their rituals or help them avoid things like social situations, this will only strengthen the BDD. Let them know that you care and that you’ll try to understand and support them through the recovery process.

HETEROSEXUAL OFFENDERS VS. CHILDREN: MASTURBATION

The importance of masturbation to these offenders when the easy availability of coitus afforded by marriage was absent suggests difficulty in heterosexual adjustment, a difficulty also reflected in other aspects of their lives. The extremely large masturbatory proportions of total outlet shown by those whose marriages broke up in their teens or early twenties leads one to think that the marital failure aggravated preexisting difficulties in working out sexual adjustments with women.

As is usual, the masturbation was ordinarily accompanied by sexual fantasies. The fantasies of the heterosexual offenders vs. children seem to have been, with two exceptions, similar in general content to those of other sex offenders. The two exceptions to this are fantasies of sexual contact with animals and fantasies of a bizarre or highly specialized nature. Some 8 per cent of the offenders vs. children fantasied, on occasion, contact with animals; this is a small percentage in absolute terms, but it is the second largest exhibited by any group, and more than double that of the control group. Perhaps those who will disregard age taboo are more inclined than other offenders to disregard species taboo, at least in fantasy. However, not an unduly large percentage of the offenders vs. children had had actual sexual contact with animals. About one fifth had bizarre fantasies, the third highest figure within that classification and far in excess of the prison (2 per cent) and control groups (1 per cent).

The offenders vs. children closely match the control-group individuals in the amount they worry about the possible bad effects of masturbation. During 40 per cent of the years in which masturbation occurred there was concomitant worry ranging from mild concern to real anxiety. In terms of rank-order this percentage is neither high nor low.

Turning to the question of how they first learned of self-masturbation, the offenders vs. children reveal no distinctive trends. As in all other groups, the majority obtained this knowledge through a mixture of talking, reading, and observation.

IBS AND FOOD INTOLERANCE – MARGARET’S STORY

The condition responds well to treatment, but because of the lack of information it can be difficult to find someone who understands the problem. Some clinical nutritionists believe many chronic conditions, such as certain chest and kidney troubles and arthritis, are caused by food intolerance. The dramatic improvement in some degenerative and nervous illnesses in people who have been treated for food intolerance – even if they have only used self-help methods – would seem to confirm this.


 Here is Margaret’s story:It all started when I was pregnant. I had lost a lot of weight and my bowel movement was never normal; I either had diarrhoea or constipation. After my son was born I had a rash on my legs which formed blisters.The doctor said it was post-natal depression and gave me tranquillizers. This went on for years, I was convinced it was something to do with food but I was given more and more tranquillizers, then anti-depressants.

 When I developed migraine -although it seemed like the last straw – it put me on the right road. I found a book in the health shop on headaches. It was the first time I had heard of food intolerance or elimination diets. I cut out all dairy produce, chocolate, tea and coffee and did improve a little but it was not until I had an asthma attack after drinking a glass of orange squash (containing E102, Tartrazine) that the doctor began to think about allergies.

 He referred me to a private doctor who just said I had severe allergies and sent me to a dietician. This was not very helpful and it was not until I found a doctor with an interest in clinical nutrition that I started to make progress. Tests revealed I had trouble with wheat, yeast and several other foods. The treatment suggested was an elimination /anti-Candida diet, vitamins and minerals.I really feel I am getting somewhere; for the first time in years my head is clear, I am not depressed, and my silly bowel is starting to behave.

ANOREXIA NERVOSA: BEHAVIORAL TREATMENT

Having a contract reduces the “arbitrariness” of treatment and makes it easier to accept. The rules are codified, written down, and stored away someplace-somewhat like the Constitution. The patient might argue about how to interpret those rules, or how they should be enforced, but she can’t dispute that they exist.

Of course, it’s important to work with patients to help them overcome their fears and anxieties. I tell them, “Look, I know this whole situation is pretty scary. But we want to help you. Of course we want you to gain weight, but that’s really your responsibility. We’re not going to be spies and monitor every mouthful you eat. But if you find you’re having trouble, we’ll have someone sit with you and help you get through the fear. Yes, we need to give you enough calories so that you begin to gain weight, but we don’t want to go too fast. We’re not here to just fatten you up and send you on your way. We want to help you gain weight in a healthy and calm manner, so that we can begin to find out what’s really troubling you deep down inside.”

The food journal provides clues about strategies that might work. Anorexics might not be ready to fill out such sheets, especially at first. They dwell on food constantly anyway; writing it all down might just make them more anxious (that can be true for bulimics, too). If they feel that way, I don’t push it. Sometimes keeping a journal focusing just on feelings and events (not food) can be useful.

A journal can provide a vivid record of the patient’s thoughts and feelings about her situation. By examining these thoughts, we can often reveal distortions in the way the patient perceives and interprets events in her life. Cognitive therapy, which I will discuss in just a moment, is a good method for correcting such distortions.

In the final phase, we concentrate on helping the patient maintain her weight within the target range. We reinforce normal eating habits and look ahead to her continued recovery as an outpatient.

Before sending her home, we work out a plan to monitor her weight. We agree on who should do the weighing-a doctor, a nurse, her parents. She understands that if her weight drops below a certain limit, she will have to come back to the hospital.

A word about outpatients: It is possible to set up a contract with anorexics treated outside the hospital, even though they are not being monitored twenty-four hours a day. Usually such contracts set lower goals for weight gain-say, between one and two pounds a week. In family therapy sessions we work out the system of rewards and penalties. The parents may agree, for example, that if the patient fails to meet her target, they will suspend her allowance or ground her.

THE HUSBANDS’ ORGASMIC INVENTORY

SCORING: 3—ALWAYS 2—USUALLY 1-SELDOM 0—NEVER

1. I feel responsible for the sexual experience. Whether the interaction is good or bad depends on me.  
2. Once I ejaculate, I have to rest. I feel less energetic and have to recuperate.

3. When I begin to feel very good sexually, I know I am getting very close to “coming” or’ ‘climaxing.” The better it feels, the sooner I know I will come.  

4. It is better if my wife is relatively still during the act of intercourse. If she moves too vigorously, it tends to make me come sooner.  

5. When I ejaculate, I feel a few strong throbs in my penis at the time of ejaculation.  

6. I seem to come much sooner when I have not had sex for a long time.

7. I feel a numbness or insensitivity in most of my body just after I come. This is particularly true in my genitals.  

8. I need to take a PON (post-orgasmic nap) or even a POS (post-orgasmic sleep) after I come.  

9. I notice that my wife really seems to get much more intensely involved in her orgasms than I do in mine. She seems to almost be “gone”.

10. I feel that ejaculation is essentially the same thing as orgasm. If I don’t ejaculate, then I know I haven’t come.  

11. My orgasms are essentially the same no matter. what type of sex I am having (coitus, oral sex, masturbation). Whatever the source of stimulation, I essentially come the same way.  

12. I have noticed as I get older that my orgasms are less intense than they used to be. The throbbing is less intense and there are fewer of them.

13. I have sex mostly at night. It sort of allows me to release the tension so I can sleep.  

14. My sexual patterns with my wife are essentially “turn-taking.” I try to help her have an orgasm before I try to have mine.  

Before I come, I feel as if I would have loved to have sex all night. After

15 I come, I seem to lose interest.  

I usually get to the point that no matter what happens, there is nothing I

can do to stop my ejaculation. Even if all stimulation is stopped, I ejaculate

anyway.  

17 I try so hard to time my ejaculation that I cannot ejaculate at all during intercourse.  

18 I am a quiet person during sex. I might moan or groan, but I do not intentionally say much.  

19 If I have masturbated, I tend not to want to have intercourse several hours after I have masturbated.  
20. When I am having sex, everything seems to be focused in my genitals. I notice very little about any stimulation to any other part of my body.

TOTAL POINTS    

If you score thirty-five or more points on this test, it is very likely that you are experiencing the physiological reflex of orgasm emphasized by the first three perspectives of sexuality but are not experiencing psychasm, the ability to enjoy a full emotional and cognitive dimension to the sexual experience. The idea is not to replace the quest for orgasm with a quest for psychasm. The idea instead is to open up new options for sexual interaction free of the artificially imposed limits of a mechanical, gender-assigned model of sexual intimacy.

IBS AND FOOD INTOLERANCE – MARGARET’S STORY

The condition responds well to treatment, but because of the lack of information it can be difficult to find someone who understands the problem. Some clinical nutritionists believe many chronic conditions, such as certain chest and kidney troubles and arthritis, are caused by food intolerance. The dramatic improvement in some degenerative and nervous illnesses in people who have been treated for food intolerance – even if they have only used self-help methods – would seem to confirm this. Here is Margaret’s story:It all started when I was pregnant. I had lost a lot of weight and my bowel movement was never normal; I either had diarrhoea or constipation. After my son was born I had a rash on my legs which formed blisters.The doctor said it was post-natal depression and gave me tranquillizers. This went on for years, I was convinced it was something to do with food but I was given more and more tranquillizers, then anti-depressants. When I developed migraine -although it seemed like the last straw – it put me on the right road. I found a book in the health shop on headaches. It was the first time I had heard of food intolerance or elimination diets. I cut out all dairy produce, chocolate, tea and coffee and did improve a little but it was not until I had an asthma attack after drinking a glass of orange squash (containing E102, Tartrazine) that the doctor began to think about allergies. He referred me to a private doctor who just said I had severe allergies and sent me to a dietician. This was not very helpful and it was not until I found a doctor with an interest in clinical nutrition that I started to make progress. Tests revealed I had trouble with wheat, yeast and several other foods. The treatment suggested was an elimination /anti-Candida diet, vitamins and minerals.I really feel I am getting somewhere; for the first time in years my head is clear, I am not depressed, and my silly bowel is starting to behave.

WHAT DO THE PEOPLE SAY FOR ARTHRITIS: STORY 9

Mrs. T.M., age 81, of California sent us a great photo of her smiling beautifully after taking CMO. She had suffered since 1982 with extremely severe pain in her back, shoulder, and knee. She also suffered from sciatica because of a herniated spinal disk [which results in pressure on the sciatic nerve from the inflammation].

 She tried various arthritis medications and devices, and though some of them helped, as she put it, “nothing lasted.” Her chiropractor couldn’t help. She tried Prednisone, Orudis pills, Cortisone creams, BenGay, EMU rub ($56.00 ajar), Capzasin rub, vibrators, heat massage, papain shots, laser treatments, and chelation therapy. None were of any lasting help. Some slowly helped take the pain away by bedtime, “but it was back full blast when I’d wake up.” A battery operated device called Alpha Stim ($2600 for three) helped a little.

“However, I was in terrible pain all the time – couldn’t sleep. Pain was present always. The pain was severe … worst in the mornings. Full joint movement was difficult … affected with knobby lumps. Knee and hands affected with swelling.” She took CMO in March 1997 and later in August she reported, “I improved suddenly. The first day there was no pain with CMO. The pain never came back – it’s been five months now. I took DHEA and aloe vera plus all the things listed that would help. I got complete freedom from pain … the very next day after starting the capsules the pain left for good. It’s a wonderful blessed relief…”

She can now walk up and down stairs and inclines, work in her garden, and exercise on her peddler again without pain. “Even after CMO I walk slowly, sometimes unsteadily, and sometimes shuffle a little. But there’s no more pain. Dr. Sands was such a big help. Three times when in doubt my husband called and he told us what we should do. 

INTRA-ABDOMINAL INFECTIONS: SUBPHRENIC ABSCESS

Subphrenic abscesses most commonly develop after surgery involving the duodenum, stomach, biliary tract, or appendix, or after rupture of a hollow viscus, such as a perforated peptic ulcer or acute appendicitis. Patients may present with fever and abdominal pain in the right or left upper quadrants. Other symptoms may include hiccups, jaundice, shoulder pain, chest pain, cough, dyspnea, or a pleural effusion.

 The syndrome may be an acute, febrile illness, or a more chronic, insidious process with intermittent fevers, weight loss, and other constitutional symptoms. The chronic form develops most often in patients who have previously received antibiotics. The diagnosis of subphrenic abscess should always be considered in patients presenting with fever of unknown origin, especially if they have a history of abdominal surgery within the preceding few months.Computed tomographic scan and ultrasonography are the best methods for diagnosing a subphrenic abscess. An initial plain radiograph may give clues to the diagnosis, often showing a pleural effusion, an elevated hemidiaphragm, and concomitant lower lobe atelectasis or pneumonia.The primary treatment is drainage, via either a percutaneous procedure or an open laparotomy. Empiric antibiotic therapy is aimed at the organisms likely to be involved, depending on the mechanism of infection, and is the same as that recommended for secondary 

CIRCULATION: BLOOD VESSELS

The fine subdivisions of blood vessels result in every minute portion of the body getting supplied, as you may readily realize when you consider how even a pin prick produces bleeding. A little way back the resemblance of the blood system to the branching tree was suggested. It has often been so depicted. But if a branch is broken, the leaves at its tip wither.

 Such a calamitous result is uncommon in the body, for the blood system really is like the network of highways in the country. If the main route is blocked, it is bothersome, but traffic can be rerouted. The side routes for the blood are referred to as collateral circulation.

 John Hunter, the famous eighteenth-century English surgeon, did a great deal to study and described these side circulations.His most famous experiment consisted in tying the vessels which carry blood to a deer’s antler. One would naturally suppose that this constriction would interfere with the growth of the antler, but Hunter found that other large vessels appeared, or at least enlarged so that they became noticeable, and the antler continued to grow.

We used to think that there were a number of places in the body that were supplied by what we called end arteries; that there was only one route for the blood to traverse, and if this was blocked then no blood reached the part. The more the matter has been investigated, the more we find that this is not so. The coronary arteries in the heart were among the last to be proved to have this side circulation. Recent investigations have shown that coronary arteries can be blocked off and in many instances the blood does get to the tissues by side routes.

There is a theory that in the early stages of life all these vessels are equally important, but then some one vessel takes over most of the load and the others do not develop. When your pulse is counted, the throb comes through the radial artery in the wrist for that is carrying lots of blood to your very important hand. Most of you could find no evidence of blood getting through by any other channel. Yet the’ radial artery can be cut and tied off, and other vessels will take over the work with very little difficulty.The veins which bring the blood back have even more side routes to help out.

 The circulation of blood in the brain has to be carefully adjusted. Too little or too much makes a great difference here. The jugular veins, one on each side of the neck, are tremendous big pipes; but when we dissect the side of the neck, as we frequently do for cancer, we think little of removing the jugular. That big flow of blood goes off by other channels and the brain minds it not at all. The patient may be up and around the next day. Nature is a good traffic engineer. She can adjust to peak loads and times of light traffic more successfully than is done on our streets.

SKIN TROUBLES: CONDITIONING THE STOMACH AND THE BOWELS

It may almost be taken for granted that in all skin complaints there will be some disturbance of the digestive system, and a preparatory course will be necessary to bring it into a condition to be able to deal in a satisfactory manner with the food that is taken.

 The stomach should be given a rest for a few days, and during that time no solid food of any kind should be taken. Those who are possessed of sufficient will-power should keep watering only for twenty-four to forty-eight hours; others should take fruit juices only. This liquid diet may be kept up for three or four days, and will be a good start in clearing the stomach of the offending mucus.If there has been a tendency to constipation – and this is practically certain to be the case in skin complaints – then the warm-water enema should be used once a day to clear the lower bowel and activate the intestines. Just plain water should be used, and nothing should be added to it.

 Its use is simple and a matter of personal experiment, and is far easier to do than to describe. It is much better and safer than taking laxatives.This cleansing process should be followed by the all-fruit diet, if the weather is not too cold; in the middle of a cold spell it may be better to take two meals of fruit and one of nicely cooked vegetables. This restricted diet may be carried on for another four to seven days, depending on the reaction and the condition of the sufferer. Many people find it quite easy to carry on in this way for ten days or two weeks, and if the condition of the skin is responding to it the extra time will be well worth while.

 The bulkiness of the diet will keep the bowels acting as a rule, but there is no danger if they are rather sluggish. The flora of the colon will gradually change through the large amount of cellulose that is in the fruit and vegetables and bring the bowels back to normal activity.The idea of this restricted diet is thoroughly to cleanse the whole alimentary tract, so that when the ordinary diet is adopted the system will be able to make full use of the nutritional elements.

 A short cleansing diet will do more to tone up the stomach and the bowels than any amount of medicine, and apart from its good effect upon the skin it will improve the general health. Conditioning the digestive tract in this way should be done at least twice a year. It will be beneficial to those who do not suffer from any specific trouble, and will help to prevent the development of disease, especially the complaints that have their roots in digestive disorders.With fruit and vegetables as the basic diet it is very easy to build up a sensible daily menu. One should add the protein and the starchy foods gradually.

 The protein foods consist of meat, fish, eggs, cheese, nuts and such preparations, and the starchy foods are potatoes and those containing the cereal flours, bread, oatmeal and all the various things that are made from flour. As a rule it is safer to add these foods to the fruits and the vegetables rather than to approach it from the other angle, because the fruits and the vegetables should take precedence.

BOWEL CANCER – BLEEDING AS A SIGN

There are many normal bacteria present in the bowel, and many of these perform a useful function for the host.

They may produce certain vitamins which the host absorbs and uses.

The type of diet influences the type of bacteria present.

Some of these may act on the breakdown products of meat and fat in the diet and form cancer-causing substances.

Perhaps a high fibre diet, because of the bulk it produces, tends to dilute these cancer-causing chemicals — carcinogens — or else limits the contact between them and the bowel wall by hastening their progress through the gut.

A study in the U.S. shows a link between beer consumption and death from bowel cancer.

How beer drinking can lead to large bowel cancer is not clear.

Bowel cancer can occur in the young although it becomes more common after the age of 40.

Bleeding is the earliest and commonest sign.

Although bleeding may often be due to piles, all cases of bleeding need investigation, to exclude the possibility of cancer, as the two conditions may co-exist.