SEVERE TO CRIPPLING OSTEOARTHRITIS

April 28, 2009

In Group #4, fourteen subjects presenting with severe to crippling osteoarthritis were supplied with 50 capsules to be taken in two series, two capsules each morning and evening for seven days, with a seven day interval before repeating the same dosage for 5 1/2 2 more days. Three of these subjects were unable to walk and were accustomed to being transported by wheelchairs. The other eleven could move about with crutches, walkers, or canes. All presented with pain, inflammation, and marked deformation of nearly all interphalangeal and large joints. Four presented with limited lumbar flexion and pain in the vertebral column. Ten had difficulty grasping and manipulating common objects.

After four days of treatment ten in this group reported 30% to 50% improvement in articulation and inflammation and about 40% to 60% relief of arthritic pain. In these ten subjects improvement continued rapidly over the next three days, reaching 80% to 100% by the end of seven days. One reported no perceptible change.

On the fourteenth day, at the end of the one week interval without treatment, nine subjects reported continuing minor improvement, four reported maintaining their improved status, and one continued to show no improvement. Treatment was resumed on the fifteenth day for 5 1/2 more days.

By the end of the treatment period eleven subjects reported 80% to 100% relief of pain with a return of 80% to 100% mobility. Two subjects reported 70% to 80% return of articular mobility with a 70% to 90% reduction of arthritic pain. The one non-responsive subject proved to have previous liver damage as a result of sports-related steroid abuse. Further studies are necessary to determine the role of liver function in this protocol.

*63\142\2*

CHILDREN’S MENINGITIS: PRECAUTIONS AND TREATMENT

Precautions

• The unnecessary use of antibiotics for an upper respiratory tract infection may mask the onset of meningitis.

• A child who is suffering from exhaustion or extreme weakness, and who has fever and a stiff neck is in danger and should be taken to a medical facility immediately.

Medical treatment

Your doctor will take the child’s complete medical history and perform a thorough examination. The doctor will then order a spinal tap. Spinal fluid will be examined for cells, bacteria, and abnormal chemical components. This is the only way to differentiate between meningitis and encephalitis (inflammation of the brain), which is also a life-threatening disease. The doctor will also require cultures of the spinal fluid, blood, and nose and throat mucus. Immediately following the spinal tap and cultures your doctor will administer intravenous fluids and antibiotics. If the infecting organism is unknown, the doctor may put the child on two antibiotics at the same time. If the meningitis turns out to be caused by a virus, no antibiotics will be used, since viruses do not respond to antibiotics.

If your child has been in contact with a person with meningococcal or Haemophilus influenzae meningitis, your doctor may choose to administer penicillin, sulphonamide, or rifampin by mouth prevent your child from developing meningitis.

Vaccines against meningococci, pneumococci, and Haemophilius influenzae are available, but they are still in the experimental stage and not currently recommended for general use.

*149/84/5*

KEEP YOUR HOMOCYSTEINE LOW

April 23, 2009

Vitamins B6, Â12 and B9 (also called folic acid) are important to keep your blood homocysteine levels low. Elevated homocysteine levels are a major risk factor for heart disease because homocysteine has an abrasive effect on the inner lining of our arteries, initiating inflammation and atherosclerosis. It also makes the formation of blood clots more likely. Folic acid, vitamin Â12 and B6 all work together to keep homocysteine levels low by helping to convert homocysteine into the amino acid methionine.

Good sources of folic acid include oranges, avocados, spinach, asparagus and any green leafy vegetable. Vitamin B6 is found in high concentrations in bananas, salmon, chicken, potatoes and hazelnuts. Good sources of vitamin Â12 are salmon, mussels, crab, beef, chicken and eggs. Betaine is another nutrient found in eggs which is needed to keep homocysteine low.

If you have diagnosed elevated homocysteine levels in your blood, then as well as eating these foods and drinking raw vegetable juices, you will need to take a supplement of these vitamins. An ideal daily dose of each would be 1 000 mcg folic acid, 50mg vitamin B6 and 400mcg vitamin B12.

Researchers at the Oregon Health and Science University in the US claim I that diets low in foods containing folate and carotenoids may be a “major contributing factor” to the high rate of heart disease in men and women in Central and Eastern Europe, compared with Western Europe, the US and Asian countries. The researchers found substantially higher death rates

10 heart saving tips you must follow from cardiac disease among men and women, especially men between the ages of 30 and 50 years in Estonia, Hungary, Russia and Lithuania, which correlated with low intakes of folate and carotenoids in their diet. Carotenoids include beta carotene, lycopene, lutein and related compounds found mainly in brightly coloured vegetables.

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NUTRITIONAL SUPPLEMENTS FOR FERTILITY: ZINC

Zinc is the most widely studied nutrient in terms of fertility for both men and women. It is an essential component of genetic material, and a zinc deficiency can cause chromosome changes in either the man or the woman, leading to reduced fertility and an increased risk of miscarriages.

Zinc is necessary for the body to attract and hold the reproductive hormones, oestrogen and progesterone.

Zinc also plays a vital role in cell division so it is especially important that adequate levels are available at the time of conception. When couples go for IVF treatment, and the egg has been fertilised, the doctors have to wait until it divides sufficiently before it is put back in the woman. If the cell division is inadequate then that fertilised egg will not be used. This same cell division takes place during natural conception and it also requires good levels of zinc. If levels are not optimum, then it not only makes it difficult to conceive but there are also risks of having a baby with low birth weight, malformations or poor development of the brain and nervous system.

Zinc deficiency can block the absorption of folic acid so having a deficiency of one nutrient can lead to deficiencies in other nutrients. This is why getting a good intake of a number of nutrients is so important.

Zinc is also vital for your partner because it is crucial for the proper development of sperm. We know this because when young animals are fed a zinc-deficient diet they can produce abnormal sperm. For example, 60 day-old mice were found to be sterile after only three weeks of being fed a zinc-deficient diet.

Studies carried out in the 1980s showed that zinc deficiency in men causes a temporary but reversible reduction in sperm count and a reduced testosterone level. And this reduction in testosterone level has since been confirmed by other studies.

Giving zinc to men with low testosterone levels raises the hormone to a more normal level and increases the sperm count. In one study some men had an increase of 150 per cent in their sperm count, and in nine cases out of 22 their partners conceived while they were taking the zinc.

Simply comparing men with low sperm counts to men with normal sperm counts has shown that serum (blood) zinc levels and seminal zinc levels are significantly lower in infertile men.

With each ejaculation, men lose up to 9 per cent of their daily zinc intake. So it is crucial that your partner keeps up a good daily intake of zinc.

Clearly, zinc should be taken as a supplement if there is any problem with sperm count or quality. You and your partner should also include sources of zinc, such as oats, rye, whole-wheat, almonds, pumpkin seeds and peas, in your diet.

Symptoms of zinc deficiency include:

• white spots on nails

• low sperm count

• poor sense of taste

• poor sense of smell

You should take 30mg zinc a day.

Your partner should take 30mg zinc a day.

*46/73/5*

SELF-HELP PREVENTION: HEAT RASH (PRICKLY HEAT) AND HEATSTROKE

Heat rash (prickly heat)

It is an itching skin condition caused by heavy sweating (usually in hot climates). Little red pimples occur in sweaty areas.

What causes it?

Inflammation of the sweat ducts.

Prevention

• In hot and sweaty climates reduce your physical activity and hence the amount you sweat.

• Don’t drink hot drinks.

• Wear as few clothes as possible, preferably made of light, natural fibres.

• Shower in tepid water and use no soap. Dry carefully and use a dusting powder.

• Soothe the bad areas with calamine lotion.

Heatstroke

Heat stroke is a condition in which the body is unable to lose heat, for example in extremely hot climates in which the air is hotter than the body so that the body does not lose heat into the air. It can also occur in very humid conditions in which the body is unable to sweat and so lose heat. The skin is hot, dry and red, and the sufferer has a rapid pulse and a high temperature and may also vomit and be irritable. If severe, it can lead to a coma.

What causes it?

An inability of the body to cool off by normal heat loss or via sweating (which also reduces body temperature).

Prevention

•     Avoid extremely hot situations.

•     Drink ice-cold liquids to lower the body temperature.

NB This is not a treatment. No one with this condition should be cooled quickly.

•     When in hot climates wear thin, natural-fibre clothes and keep out of the direct sun.

*167/72/5*

WEIGHT LOSS: STRUCTURE OF THERAPY GROUPS

How many patients should there be in a therapy group? Between four and eight patients seems ideal-small enough so each can relate to the others, large enough to bring together people with a range of experiences. Many groups are made up entirely of women because there are relatively few males with eating disorders.

Most outpatient groups meet once a week, with sessions lasting from one and a quarter to two hours. Some shorter-term programs meet twice a week. Meeting more frequently provides additional support to very symptomatic patients.

Inpatient groups are more varied. I have found it helpful to combine daily group psychotherapy with other groups, such as psychodrama, art, movement, nutrition, relaxation, women’s issues, and body image groups.

Outpatient groups can meet for a limited number of weeks or they may be open-ended. Short-term groups are generally more structured. They may have a preset agenda with different specific topics each week. In addition, members continue to monitor their symptomatic behavior and work to change it.

Group leaders should make sure all members know when and where meetings will be and how to get there. An eating-disordered patient has enough trouble dealing with her insecurities. She doesn’t need to wander the halls of some huge building, anxious and alone, looking for the meeting room. Lack of clear instructions can cause a patient to quit the group before she has even started.

Groups are usually more effective if they are made up of patients with similar problems. Like oil and water, bulimics in the same group may not easily mix. An anorexic may feel “bullied” by a bulimic, while the bulimic may feel frustrated that the anorexic won’t open up and share what’s going on inside. Higher-weight patients may feel angry or envious in the presence of emaciated ones.

*90/35/5*

STIMULATE YOUR DETERMINATION: NEVER TOO OLD TO LOSE

Connie Bissonnette had all but given up on slimming down. At age 50 and 172 pounds, the full-time university instructor from Stillwater, Minnesota, believed that weight gain was a normal part of the aging process.

Lucky for her, her son Jeff knew better. And as a result of his persistence, Connie is 41 pounds thinner.

In 1992, Jeff was a student at the University of Wisconsin, majoring in human performance. When he came home for Christmas break that year, he had a mission: to persuade his mom to start exercising. “I was his first project,” Connie jokes.

She responded with her usual litany of excuses—she didn’t have time, she didn’t have the energy, her knees bothered her. But Jeff persisted. “He said, ‘Just give me 10 minutes, three times a week,’” Connie recalls. “He devised a workout that I could do at home, with what I had on hand. I started out by sitting in a chair and doing leg lifts. Then I added other exercises, like doing pushups against the wall.”

Despite her initial protests, Connie found herself enjoying her workout. Within a few months, she noticed that her knees felt better. So she asked Jeff to add some more exercises to her routine. Her 10-minute exercise sessions stretched to as long as 30 minutes.Plus, she started walking for 30 minutes, 2 or 3 days a week. One year later, she was 20 pounds lighter.

But Jeff wasn’t done. His next challenge was to transform his mother’s longtime meat-and-potatoes diet. Again, he advised Connie to start small. She substituted jam for butter on her morning toast, fresh fruit for her snack time potato chips and candy bars. Eventually, she traded frying for baking as her cooking method of choice.

It took some time, but all those little changes added up. Four years after she began exercising, Connie had lost a total of 41 pounds. Now, at age 58, she has maintained her weight at about 131 pounds since 1996.

Connie was so grateful to her son for helping her slim down that she decided to return the favor. In May 1997, she became a certified personal trainer. Now, she works in her son’s gym. “It’s great to be able to encourage the clients I train by telling them about my own weight-loss experience,” she reports. “I don’t let anyone say, ‘I can’t.’”

WINNING ACTION

Stop believing the myth of middle-age spread. Yes, most of us do gain weight as the birthdays roll by. But this accumulation of extra pounds isn’t written in our genes, our hormones, or the laws of nature. We gain weight, quite simply, because we become less active. According to William Evans, Ph.D., director of the Noll Physiological Research Center at Pennsylvania State University in University Park, about 80 percent of overweight is caused by a sedentary lifestyle. So keep moving, no matter what your age. You’ll look slimmer and you’ll feel younger.

*144\89\8*

WHAT DO YOU KNOW ABOUT HRT?

April 21, 2009

- I understand that endometriosis becomes less of a problem after menopause without any treatment. Does HRT make a difference? Endometriosis present at the time of menopause usually disappears after it. In exceptional cases, adhesions caused by endometriosis may continue to cause problems. If oestrogen is given from the time of menopause, there is a theoretical risk of stimulating the endometriosis, but in practice this rarely occurs. Taking oestrogen and progestogen together every day is likely to be less stimulatory than taking cyclical progestogen (for ten to fourteen days of each cycle).

- I have developed patches of discoloured skin since using oestrogen. Is this normal? Will it go away when I come off hormone therapy?

Many women on oestrogen (in contraceptive pill or HRT form) are dismayed to find that patches of coloured pigment appear on their skin after they have spent time in the sun. This is called chloasma, and is caused by deposits of melanin in the skin. In a small proportion of women, oestrogen seems to stimulate chloasma development. The effect will usually fade when you stop taking oestrogen, but this depends on how much exposure you have to the sun. Always use a sunblock: your doctor or pharmacist may suggest an anti-chloasma type.

- Are lumpy breasts a reason not to take oestrogen?

No . . . but whether you use oestrogen or not, it is important to examine your breasts regularly, have your doctor check them over too (at least annually), have regular mammograms and avoid smoking.

- I have had breast cancer. Is there any form of therapy, including HRT, that might help to control the severe flushes I am having? HRT is sometimes considered for women who’ve had breast cancer, particularly if quality of life is the priority and nothing else works to reduce flushes. In these cases, Provera or low doses of natural oestrogens (and daily progestogen if you have a uterus) are likely to be chosen. If your breast surgeon and oncologist feel you should not use HRT, you might like to try regular exercise, evening primrose oil or pressed linseed oil, vitamin E, relaxation and meditation to control your flushes. The prescription medication clonidine may also be helpful.

- Since starting on Estigyn eleven years ago I have developed benign cysts in one breast. Is it possible that HRT caused this problem? Should I change my therapy or come off HRT altogether?

There is no evidence that oestrogen, even the synthetic form of oestrogen you are on, causes breast cysts. However, oestrogen may stimulate the growth of existing breast abnormalities like cysts or fibroadenomas, causing them to become larger and more obvious. You should certainly consider changing the type of oestrogen you use. Estigyn is a powerful synthetic oestrogen and, as we explained in chapter 2, it is more likely to produce side effects than a natural oestrogen formulation. There is no justification for you to come off HRT in the circumstances you describe.

- The reason I am taking oestrogen is to make sure that my bone strength is maintained. How can I be certain that the dosage of oestrogen is high enough?

The only reliable way is to have two bone density scans twelve to eighteen months apart. This will indicate whether your bone density has been maintained or has deteriorated while you have been on HRT. If the density has fallen, your dose of oestrogen should be increased if there are no medical reasons against this.

*123\38\8*

SEXUALITY AND EMOTIONAL GROWTH IN MENOPAUSE: STUDIES

Professor Marjorie Fiske, who initiated a long-term study of life changes among Californian adults, believes that developmental models based on men may be misleading where women are concerned. ‘The assumption that men and women undergo similar processes in terms of developing, coping, and “declining” has turned out to be fallacious. In nearly all ways of living, thinking and feeling, a young woman is far more likely to resemble an older woman than a young man her own age. Similarly, differences between groups of men in various periods of life are less significant than their differences from women in their own life stage.’

While women within male-female relationships have been largely overlooked by theorists, homosexual women and heterosexual women without partners have fared even worse, having had almost no attention paid to them in traditional analyses of sexuality after menopause. Simone de Beau voir made the point in her book The Coming of Age that enjoyment of sexual activities takes many forms, has many motivations, and is not necessarily extinguished with age. ‘It is understandable that a man or woman should be bitterly unwilling to give it up, whether the chief aim is pleasure, or the transfiguration of the world by desire, or the realisation of a certain image of oneself, or all this at the same time . . . The old person often desires to desire because she retains her longing for experiences that can never be replaced and because she is still attached to the erotic world she built up in her youth or maturity — desire will enable her to renew its fading colours.’

*89\38\8*

HRT AND MENOPAUSAL SYMPTOMCONTROL: SEX LIFE

Like psychological problems, sexual difficulties around the menopausal years are complex because they are affected by a wide range of social, environmental and interpersonal influences that may have little or nothing to do with menopause. The Melbourne Women’s Midlife Health Study found that sexual interest and activity did not change significantly in about 62 per cent of women who had had a natural menopause, while 31 per cent reported that they felt less sexually interested, had sex less often, and found it more

painful than previously. Approximately 7 per cent said they were more sexually interested and active, and some attributed this to a new partner in their lives.

Since sexual activities involve two partners, it is important not to assume that difficulties originate on the female side. As men age they tend to experience increasing problems with libido, erections, orgasmic capacity and penile sensitivity. This may compromise their sexual interest or capabilities. When Leah was fifty-seven, her husband Brian, aged sixty-four, suffered a heart attack. Although he was soon back at work, his sex drive all but disappeared and he had difficulty getting an erection. During counselling sessions he revealed that he feared dying during sexual activity, and that this weighed heavily on his mind.

In other couples, sex literally becomes a bruising experience. Some, but not all, women experience vaginal dryness and thinning of the vaginal lining after menopause, and this may make intercourse painful. This symptom is more frequent among postmenopausal women than their younger sisters, but is not confined to the postmenopause. A study of women in the south-east of England found that 40 per cent had this problem after menopause, but 26 per cent of premenopausal women also did. If the problem of painful intercourse becomes established, it can lead to lack of confidence in both partners and things may go from bad to worse.

This chapter looks specifically at the role of HRT, but hormone therapy is certainly not the whole answer to sexual difficulties around the time of menopause. There is some evidence that sexual problems will respond to HRT by its direct effect on vaginal lubrication, the vaginal lining (causing it to resume its former thickness), blood vessels and blood flow in the vagina, vulva and uterus, and perhaps also transmission of messages along nerve pathways to the genital organs. Oestrogen and testosterone seem to be the only hormone therapies that improve libido in women, although they are not universally effective.

Before embarking on HRT in the hope that it will improve your sex life, it is important that you explain the problem to your doctor in detail. Specialised sex therapy may be required, no matter how good your response to hormones, since the problem may have set in train patterns of sexual behaviour that are difficult to undo.

*54\38\8*

Related Posts:

• THE MENOPAUSE: HOT FLUSHES AND NIGHT SWEATS (PART 2)
• WHAT DO YOU KNOW ABOUT HRT?
• SEXUALITY AND EMOTIONAL GROWTH IN MENOPAUSE: STUDIES
• MENOPAUSE: CHALLENGES OF HRT

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