Blog About Health & Medicine

When I first began my medical practice, one of the first patients I saw was an elderly gentleman who came into my office off the street because he couldn’t stop belching; he was also mildly short of breath. He thought all he had was a severe case of indigestion. However, I admitted him to the emergency room because he was actually having a heart attack, though he didn’t believe me. At times a person may have heart attack symptoms—such as belching—without any significant chest pain.

In fact, if you have been diagnosed with heart disease and show some of the risk factors for a heart attack, if you start belching and can’t stop, go to the hospital immediately!

*338\167\8*

Because there are so many reasons why your throat may be sore, the treatment will depend on the cause. If you think pollution is causing your sore throat, your only remedy is to stay inside more and to venture outside only in the early morning and on days when the air pollution index is low.

If you have a sinus infection, antihistamines can help alleviate a sore throat by stopping the postnasal drip. If your mouth is dry because of the sinus infection, sipping water frequently during the day will help keep your throat moist and more comfortable.

If I think a patient has strep throat, I’ll take a throat culture. It’s important to seek treatment for strep throat right away, since it can lead to scarlet fever or rheumatic fever if left untreated. If the culture comes back positive, I’ll treat it with penicillin or erythromycin for a 10-day period. Although strep throat occurs more frequently in children than adults, you should know that if you have strep throat, you can easily pass it to your children.

*283\167\8*

An article in Emergency Medicine (16# 14:69) contained some rather practical ideas about preventing headaches that migraine sufferers may wish to try.

It is especially important, the article emphasized, for these people to limit their intake of caffeine because, when taken in excess, caffeine can bring on attacks. An excess of caffeine is defined as taking more than 500 mg per day, an amount that is contained in five cups of strong coffee. The need for restricting one’s caffeine intake applies not only to one’s coffee drinking but also to one’s total caffeine intake from all sources.

Migraine sufferers must also eat very regularly, to the point that they get up for breakfast at the same time every day, even on weekends, in order to avoid hypoglycemia (low blood sugar), which can trigger migraine. For the same reason, they should always eat at regular intervals and avoid excess carbohydrates. Furthermore, they should not eat foods that are rich in tyramine (e.g., aged cheeses, chicken livers), sodium nitrate (found in cured meats), or sodium glutamate (which is widely used in prepared foods). It is also important to note that some migraine headaches are triggered by food allergies, which is the subject of the next article.

Migraine sufferers are much less tolerant of high altitudes than are normal persons and should take the drug Diamox (acetazolamine) before ascending. In addition, since they react to feminizing hormones, they should not take oral contraceptives or, after the menopause, estrogens for the prevention of osteoporosis.

*136\143\2*

Exercising regularly and intensely enough to increase the pulse rate and make oneself short of breath, many physicians believe, will help a person overcome mental depression. Although there is no scientific proof for this, the Physician and Sportsmedicine (13#9:192) reports, many psychologists and psychiatrists are sufficiently convinced of a beneficial relationship between hard exercise and a positive frame of mind that they now recommend it routinely for all of their depressed patients if there is no health contraindication.

Mental depression of the type that responds to exercise (reactive depression) is defined as a feeling of sadness greater and more prolonged than is warranted by its cause. It is characterized by sadness, dullness, immobility, a sense of helplessness, and loss of self esteem. Depression that occurs without a triggering event and as a part of a severe mental illness (psychosis) will never respond to exercise alone, but requires psychotherapy and special medication.

One need not be a jogger or runner to overcome reactive depression, it has been found, and people who regularly engage in such activities as tennis, walking long distances, swimming, or rowing can benefit. To be of value, however, the exercise should be a kind that is somewhat demanding and also improves physical fitness.

*103\143\2*

There is now good evidence to show that smokers’ lung cancer is due to radioactivity carried down into the lungs with smoke. Radioactive lead contained in tobacco is volatilized by the heat of burning and condenses onto the membranous lining of the airways, especially where the passages divide (bifurcations). Over the years, more and more radioactive lead (which “decays” into radioactive polonium) accumulates. Whether or not it stays at these sites largely depends upon how normal a person’s lungs remain.

If damaged beyond repair by tar and infection, the membrane’s lining cells lose their cilia (tail-like processes that, by constantly beating, waft inhaled particles up and out of the chest) and become unable to rid themselves of the radioactive contamination.

Eight groups of scientists recently wrote about this to New England Journal of Medicine, which published their letters together in the same issue (307:309). Most significantly, they reported, discovery of radioactive lead in smoke has been the most powerful anti-smoking influence they had ever encountered. News of it, apparently, has convinced many heavy smokers, for the first time, to stop smoking immediately.

It has also been found that the cancer-producing effect of smoking may not all be due to damage done directly to the lungs. According to the Medical Journal of Australia (2:425), the lymphocytes (one of the many types of white blood cell that defend the body against invading microorganisms) in smokers become much more sluggish than usual.

In particular, the ability of the lymphocytes to become “killer cells,” which attack any other cells of the body that begin to behave abnormally (e.g: become cancerous), is greatly reduced by smoking. This could explain why smokers have so many more infections than non-smokers, and why their tumors, such as melanomas, grow and spread more quickly to other parts of the body. Because the lymphocytes quickly regain their normal killer cell activities when smoking is stopped, it is never too late to give up the habit.

*72\143\2*

According to a report in Arthritis and Rheumatism (25:1013), memory loss, inability to concentrate, and changes in personality are being encountered in elderly people who take one of the nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis. All of these drugs relieve pain, whether or not it is due to arthritis, and must therefore have some effect on nerve tissue.

Accordingly, it is not too surprising that they can affect the brain as well. Some of the most widely used drugs of this type include Clinoral, Motrin, Nalfon, Naprosyn, Rufen, and Tol-ectin. These effects have appeared after about two months of treatment and have disappeared completely within two weeks after the causative drug has been discontinued.

Because mental changes are so often ascribed to “senility,” be on the lookout for this side effect. Aspirin, as well, can do this, Clinical Pharmacology and Therapeutics (32:362) reports, but only with very high doses that are far greater than most people use.

*41\143\2*

To make sure that our bones remain strong and are not too easily fractured in old age, it is essential that we get not only sufficient calcium (1.5-2 grams every day) but also enough vitamin D. Since vitamin D is responsible for efficient absorption of calcium from the diet and for calcium’ s retention by the bones, lack of this vitamin is now regarded as an often overlooked factor in the loss of calcium and the fractures that occur in so many older adults.

A poor dietary intake is not the only cause of vitamin D deficiency, Geriatrics (40#8:45) reports. Other causes include chronic diarrhea, gall bladder disease, kidney failure, absence of the stomach (after its removal because of an ulcer or cancer), alcoholism, liver disease, and certain medications (anticonvulsants and some cholesterol-lowering drugs).

Another factor, Geriatrics (42#7:30) reports, is that old skin is less efficient than young skin at producing vitamin D when exposed to the ultraviolet light in sunshine. Adults, in addition, are becoming increasingly concerned (and rightfully so) about skin cancer, which is likely to occur if the skin is exposed excessively to the sun. However, while minimizing exposure of our skin to the sun, we must take care as we grow older to avoid letting ourselves become deficient of vitamin D.

Normally, we need to get at least 400 units of vitamin D every day and may need twice that much if there is any doubt about our ability to absorb it. However, adults are less likely than children to take vitamin supplements (many older people try to save money by not buying them).

To avoid a vitamin D deficiency, Geriatrics recommends, elderly persons should be exposed outdoors to sunshine at least 15 minutes twice a week. When this is not possible, it is essential that they be given a supplement of the vitamin by mouth.

*10\143\2*

You should first take in everything we have said about self-masturbation for women.

If your partner is used to masturbating herself, she will guide you and show you the kind of caressing she wants. Her hand will guide yours towards the exact spots that excite her. She will tell you if she wants you to go faster or slower, press harder or stroke very lightly.

With practice in the course of living together the man will be able to perfect his masturbation technique to give his lover maximum pleasure. She will reach orgasm faster than if she masturbated herself because of the additional excitement of her partner’s kissing and caressing.

The man can also insert a finger or two into the vagina while stimulating the clitoris and slide them in and out, especially against the front wall of the vagina. This massage is very important, since the famous “G spot”, which can itself provide a whole succession of violent orgasms, lies about a finger’s length along the vagina wall.

For the man to properly stimulate the G spot, however, it is almost indispensable for the woman to teach him where to find it; until it has already been stimulated long enough to make it stand out from the vagina wall, there is no way of finding it simply by feel. Here even more than with the clitoris, it is the woman who has to guide her partner.

As a final note on female masturbation, let us add that the hands are not the only means of masturbating. Women sometimes rub against the edge of a bath or the back of a chair, or use a brush handle, a candle or a vibrator (see the chapter on sex aids).

And lastly there is the thigh-crossing method. The woman crosses her legs very high up the thigh so that the whole genital area is squeezed. At the same time she contracts her vagina repeatedly, as if to stop the flow during urination. This way she can reach orgasm without hands or aids.

*22\77\2*

Cerebral palsy is due to damage in one or more of the three main areas of the brain. Previously, it was assumed that the brain was injured during birth, probably by forceps. Now we realize that the injury occurs more frequently before the baby is born, and sometimes it occurs after birth.

We have also found that in only a small percentage of cases does the injury cause a mental deficiency. Instead, it generally interferes with the nerves controlling the muscles. As a result, the victim of cerebral palsy may appear to be an imbecile, for example, by drooling, grunting instead of speaking, and making strange gestures and grimaces, even though his intelligence is normal. The injury to the brain may cause:

1 Spastic paralysis, with stiffness and impaired movement of the muscles. Such a person will walk with a scissorslike gait.

2 Tremors, and strange movements of the limbs and the head, which may be accompanied by bizarre grimaces.

3 Poor co-ordination.

Usually the parent or physician can observe indications of cerebral palsy when a baby is only a few months old. Such an infant should be examined at a hospital that specializes in this disease. It is extremely important for parents to understand that it is not kindness to do everything for such a child, and they must encourage him in the difficult task of doing things himself.

*286\68\2*

Infections of the ovaries, Fallopian tubes, and uterus were extremely common in the past. Today, these diseases no longer cause untold misery to women. However, the fact that any woman still suffers from them is a needless tragedy. Other types of infectious diseases that may attack these organs are also yielding to modern medicines.

Injuries resulting from pregnancy and childbirth have also been tremendously reduced by modern obstetrical methods.

Relaxed tissues or muscular injuries can cause hernias such as a cystocele—a bulging of the bladder due to the weakness of the vaginal wall; or a prolapse of the uterus, in which the cervix is pushed far down into the vagina; or a displacement of the uterus. If any of these conditions is severe, surgery may be necessary. Often, however, they can be treated by other means.

Leukorrhoea

Non-bloody vaginal discharges, usually called leukorrhoea or the whites, are almost as troublesome as menstrual disorders. They, too, are symptoms rather than diseases, and may be due to something relatively minor or potentially serious.

An excessive discharge can be due to any disease of the genital tract, including gonorrhoea and syphilis and other infections, cancer, polyps, lacerations of the cervix that sometimes occur during childbirth, or the irritation caused by an ill-fitting pessary. Occasionally, it is due to some condition outside the genital tract—for example, malnutrition or even pelvic congestion associated with heart disease.

Always consult a doctor for persistent leukorrhoea, or any discharge that is not colourless or that is accompanied by itching or irritation.

Leukorrhoea is frequently caused by a one-celled micro-organism known as Trichomonas vaginalis. This organism causes a yellowish discharge with an unpleasant odour, often accompanied by itching of the external genitals, and sometimes chronic inflammation of the cervix.

Infections of the cervix

The cervix of the uterus may become inflamed by the same condition that causes leukorrhoea, and also by injuries during childbirth and by irritations of various kinds. Chronic cervicitis is usually cured by cauterization, which removes or destroys the inflamed area. It is not a painful procedure. An inflamed cervix should be treated promptly, because it is a fertile area for cancer.

Cervical polyps, a type of small tumour, should always be removed and examined under the microscope to see if they are malignant.

Atrophis vaginalis

Elderly women are very prone to have vaginal infections, due to the ageing of the tissues. After the doctor has eliminated the possibility of cancer and other diseases that might cause the vaginal discharge, he can usually relieve the condition by treatment with vaginal suppositories containing the ovarian oestrogen hormone.

Itching of the genitals

Itching of the genitals (pruritus vulvae) is frequently caused by leukorrhoea and vanishes when it is corrected. However, itching may be due to irritation from urine, especially in diabetics, to skin diseases, and to mechanical irritations such as chafing or nervous scratching of a very minor inflammation. The possibility of an allergic reaction should not be overlooked. Pruritus vulvae is most frequently found in women who are in their later years. It is important to discover and eliminate the cause of the symptoms. Phenobarbitol or another sedative will relieve nervous tension caused by the itching.

Hysterectomy

Hysterectomy means removal of the uterus, or womb. Once the uterus has been removed, a woman is not able to bear a child. The unnecessary removal of the uterus is particularly tragic to women who want to have children, or who may want to have them in the future. A hysterectomy does not always include removal of the ovaries, so normal hormone production may continue after the operation, and a woman does not undergo symptoms of the menopause.

I recommend, however, that a hysterectomy never be performed unless two physicians agree on the need for it. One should be your family doctor, the other a specialist in gynaecology.

*230\68\2*