Blog About Health & Medicine

Mumps (epidemic parotitis) is an infection caused by a virus. This affects the salivary glands, especially the parotid gland which lies in front of and below the ear.

The incubation period is about three weeks. The illness usually appears as fever and enlargement, pain and tenderness of one or both parotid glands. There may be difficulty in opening the mouth and in eating and drinking.

The illness rarely lasts beyond one week, unless one of the complications sets in.

As in other viral infections the brain may become involved, causing an encephalitis.

In young men and boys beyond puberty, the testes may be involved. When orchitis (inflammation of the testes) is present, there is usually a high temperature and considerable pain.

As a rule, only one testis is involved but, occasionally, both may be.

Cortisone may be used in an attempt to reduce the inflammation, as atrophy (shrinking of the testis) may occur and it may lose its function.

Involvement of the testes before puberty is rare.

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Many of the changes discussed above that occur over the longer term with slimming make relapse a key issue in fat loss maintenance. Long term studies (i.e. over 10 years) show that the cure rate for obesity is usually no more than 5-10 per cent. Even 1-2 year follow-ups with females show a high attrition rate (i.e. 40-60 per cent) and the success rate for males is largely unknown. About 80 per cent of people who go on a fat loss program can lose 10-20 per cent of their weight in up to 20 weeks without too much pain. However, within 12 months, about one-third of those who have lost fat will have regained it. The problem is even worse for those following a very low energy diet. Regain occurs around 76 per cent of those who were successful at keeping weight off over the long term had built exercise into their lifestyle compared with only 36 per cent of those who had failed. More maintainers than regainers (73-40 per cent) had also developed a personal eating plan as a lifestyle habit, whereas more regainers had used structured ‘diet’ programs, followed prescription from doctors, or used advice from books or magazines. Regainers snacked more during the day, and used chocolate and candy more often as their usual snack.

The other major difference between these groups and a control group of women who had never had a weight problem was in psychological techniques of coping with stress. The controls and those who were able to maintain their weight usually dealt with difficult situations by problem solving or confronting the issue. Significantly more regainers on the other hand used escape/avoidance techniques such as sleeping, eating or not dealing with the problem, in response to stress. This is consistent with other research that suggests that unless adequate coping skills are developed, individuals who don’t make behaviour changes will return to their former negative pattern when a high-risk situation develops.

These three factors: lifestyle changes in eating patterns, regular exercise and successful coping techniques are now recognised as key factors for long term maintenance of fat loss. In addition, Stern and her colleagues have shown that weight cycling through ‘yo-yo’ dieting and ‘exercise cycling’ (i.e. exercising for a period and then stopping) may have long term effects on dietary fat preference and fat intake. These are, therefore, also long term dangers for maintenance and reinforce the fact that long term techniques of fat loss, to be successful, must incorporate long term changes in lifestyle rather than short term aberrations such as dieting or exercise ‘programs’.

Dr Tim Wadden, a psychologist from the University of Pennsylvania, has also analysed relapse and maintenance by studying the habits of those who are successful with fat loss over the long term. He suggests that:

• although diet may be important in helping to lose weight, those who develop a lifetime pattern of exercise manage to keep it off better

• greater maintenance occurs in women who do long, regular (although not necessarily vigorous) exercise like walking

• people who regularly eat just one fatty food have no increased risk of regaining. But those who eat two, might just as well eat six—all are a recipe for relapse.

• most successful weight loss maintainers:

- don’t count calories, but develop a personal eating plan

- exercise regularly

- closely monitor their weight

- monitor their food intake

• Best maintenance comes from setting realistic goals. In some severely obese people, there may be biological limits to big reductions. Satisfaction with more modest goals can improve the situation.

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In any operating manual or handbook, there is always a section on trouble-shooting—how to handle problems and what to do if things go wrong.

Now what can go wrong with the control of our in-built sleep mechanism? The main failure with the psychological switch is our lack of perseverence in maintaining the THS. We lose confidence and let our thoughts go wild without coming back repeatedly to the THS. We must control that spotlight so that it will only focus on our relaxing thoughts. Self-hypnosis is an active exercise, and we must activate that spotlight to focus on the relaxing parts of our bodies. Do not reject any intruding thoughts, as rejection means focusing on them.

Not being able to follow good sleep hygiene is another failure. Too much caffiene, not putting the alarm clock away, or waking up at different times every morning are all detrimental to good sleep.

If you suffer chronic insomnia because of chronic stress, you must learn how to manage your stress properly. Normal ordinary stress should not cause insomnia, as we experience this everyday. Look at the 80 per cent of what you have achieved and ignore the 20 per cent of bad luck, as one can never be always lucky. Revise chapter 16 on Sleep and Stress if you still have a problem coping.

Sleeping pills are useful in only a limited number of circumstances, and they should not be used for more than two weeks. When you stop them, they must be stopped very gradually to minimize rebound insomnia. You must distinguish between true insomnia and rebound insomnia.

You cannot fall asleep if you already have had too much sleep. Also you cannot fall asleep easily at the wrong time of day, according to the biological clock.

Finally, if all else fails, call in the professionals.

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We have seen that if we really understand the basic cause of our pain, we do something to reduce our anxiety and so lessen the pain. Further, if the cause of our anxiety lies in some conflict that we are aware of, then we can reduce our anxiety and pain by facing up to the problem realistically. However, as we now know there is another way to reduce our anxiety, and that is by learning how to be more relaxed. We do this by means of our relaxing mental exercises. While we are practising them we are more relaxed. Some of this relaxation stays with us afterward. Then with continued practice we find it pervading our everyday life. There is less anxiety in us to motivate functional pain, and we find that it gradually disappears.

Increasing Our Threshold of Pain-If we gently pinch our skin, we feel it but it does not hurt us. If we pinch it harder we come to the stage when it does hurt. This is our threshold of pain in these particular circumstances. We can see that our threshold of pain is quite a variable affair. If we get someone else to pinch us, and at the same time if we ourselves consciously relax, he is able to pinch much harder before we feel pain. In a similar way if he distracts our attention as he pinches us, we do not feel the pain of it so readily. But if our friend makes rather a show of what he is going to do, pain comes more readily because he has mobilized our anxiety, and this lowers our pain threshold.

Our relaxing mental exercises are used to increase our pain threshold in two ways. In the first place the reduction of our general level of anxiety makes us less sensitive to pain, and in the second place we can use our relaxing mental exercises in a positive way to condition ourselves against being disturbed by painful stimuli. It is important to remember that this approach is effective with pain which is due to either functional or organic causes.

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Q. I imagine bowel obstruction means what it says — there is a blockage along the intestinal system.

A. True, and this may be serious. It often presents as a surgical emergency and often prompt surgery is life saving. It may occur anywhere along the bowel but probably the most common site is the large bowel.

In older people, a sinister and serious cause is an obstruction caused by a cancer. Sometimes a loop of bowel may be blocked by bands and adhesions from previous surgery or inflammation. A loop of bowel being caught in a hernia in the groin is a common cause. Generally this will show up as an obvious tender swelling making diagnosis easier.

In children and infants, obstruction may occur if the bowel telescopes in itself, a condition called intussusception, or it may twist, causing a volvulus. Ulcers near the pylorus of the stomach may contract as they heal, causing scarring and narrowing of the canal, also blocking the free flow of food. An obstruction may occur suddenly, causing abdominal pain, followed by vomiting. After a time, this may become faecal. Babies are sometimes born with a very narrow pyloric canal called pyloric stenosis.

Q. What is the treatment?

A. Treatment is invariably surgical and often as an emergency measure. The source of the blockage must be found and relieved. In older people, if a cancer is found, the surgery may be extensive for the effects of the obstruction plus the cancer must be dealt with at the same time. The risks are high.

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Not all hospitals have these special clinics that usually include teams of doctors, psychologists, nurses, physiotherapists, occupational therapists and others who together run ‘pain management programmes’ that aim to teach patients about pain, how best to cope with it and how to live a more active life. Acupuncture and other complementary therapies may be available through some of these clinics. Explaining the role of pain clinics, The Pain Society stated: “Pain management helps sufferers come to terms with what has happened to their lives and to accept that they may not find a magic answer to cure their pain. Unfortunately, there are times when no treatment for chronic pain works as well as we would like. The pain sufferer is then left with a difficult problem of continuing pain, and all the negative effects the pain can have on every part of life, including work, marriage, social life, mobility, mood and sleep. The ‘ripples’ of pain are not the same as the pain itself, but often go with it and make the whole experience much more difficult to cope with, both for the pain sufferer and for those close to them.”

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Jogging and Overweight

Overweight people trying to shed pounds would be wiser not to do so by jogging. Bones and joints in the legs and feet can be severely stressed by this type of exercise when one is overweight. The combination of running and excess weight can even crack the bones of the pelvis in otherwise fit young people, according to Medical World News (23#25:57). The cracked bone causes aching in the buttock with hip move ments, and requires that, for six weeks, all activities that produce the pain be stopped.

Exercise can certainly help dieters. However, it should be of a kind that does not overly stress weight-bearing structures in the lower limbs. Walking three or four miles a day or working up a sweat on an exercycle or rowing machine is helpful and safe. It is better to lose weight by other means first before taking up running or jogging.

Is Jogging Safe?

Every year, just enough slim young people collapse and die while jogging that many physicians hesitate to recommend this form of exercise. At autopsy, the heart muscle in these cases usually looks as if it has not been getting enough blood supply. Until recently, however, the cause of this has been a mystery, since the young victims’ coronary arteries are rarely found to be narrowed by fat and cholesterol deposits (atherosclerosis).

Now, it seems, the mystery has been solved by the discovery of “bridges” of heart muscle across the coronary arteries. When the muscle contracts, the bridges squeeze the coronary arteries and thus reduce the amount of blood they can deliver to the heart muscle. Since the bridges are part of the heart’s muscular wall, coronary blood flow is reduced most severely during exercise when the heart is beating faster and more forcibly than usual. There could be no worse time for this to happen.

Since few of us know whether or not we have this abnormality (only 1 percent of us do), it is recommended that we avoid exercising our hearts past the point where bridges, if present, would tighten excessively around our vessels.

According to a report in Medical World News, this means not letting your pulse rate exceed 150 per minute. If your pulse beats faster than this during exercise, rest until it slows down and thereafter exercise more slowly. By training, you will more easily be able to keep your pulse below 150.

Leg and lower body exercise, as in jogging, has become a national compulsion which, as the body ages, may do more harm than good, the editorial writer in Modern Medicine suspects. The trauma of repeatedly pounding one’s feet on pavement while jogging, he points out, damages the ankles, knees, hips, and spine because the human body (unlike the bodies of four-legged animals) is just not well designed for endurance running.

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Signs and symptoms

The condition exists if one or both testes do not rest in the scrotum at birth. However, an undescended testis must be distinguished from a migratory or retractile testis. A migrating or retractile testis has completed its descent into the scrotum, but has risen temporarily into the groin. A migratory or retractile testis returns to its normal position as a boy matures, and it needs no correction. If the size of the scrotum is normal, the testis is migrating; if it is small, the testis is undescended. An undescended testis sometimes can be felt in the groin, but it may be mistaken for a hernia or a swollen lymph gland.

Home care

If a testis appears to be missing from the scrotum after birth, check periodically to see if it has descended of its own accord. To check for an undescended testis, place the child in a tub of warm water and pull his knees up toward his chest. If the testis is migratory it will often descend into the scrotum. If the testis is undescended, it will not.

Precautions

• Don’t worry the child by discussing the condition. An undescended testis can usually be corrected.

• Do not postpone correction of an undescended testis. It should be corrected when the boy is between four and seven years old.

• A boy with an undescended testis has an increased chance of an inguinal hernia.

Medical treatment

Your doctor will examine the child’s scrotum and groin carefully and check for the presence of a hernia, which often accompanies an undescended testis. Some doctors give hormone injections to encourage the testis to descend, but most prefer to perform surgery when the child is between the ages of four and seven, and not to use hormones at all.

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“Asthma, Had it for years. Comes and goes. The threat of it is always there. Have been tested and tested. Allergic to dozens of things. Some may bring on an attack, some don’t seem to make any difference. A touch of ‘flu or even a cold may bring it on. Or something upsets me. Mother was affected the same way. I don’t know what to do about it.

Tm tied to this spray. Don’t move without it. Forgot it the other day. Everything going well. Then discovered I had not got it, and the fright was enough to bring on an attack.”

Asthma is one of the conditions which demonstrates clearly the multicausal nature of disease. There is the genetic factor, the allergy, the respiratory infection and the stress factor. In different patients the different factors are of varying importance. The ultimate physiological cause, of course, is the contraction of the small air passages in the lungs. This may be complicated by the exudation of mucus which further obstructs the air passages.

The genetic factor means that some individuals are inherently more susceptible. The allergy produces disordered function of the cells. The infection further irritates them. The muscles in the air tubes are supplied by nerves from the autonomic nervous system, and so are vulnerable to stress. If the influence of one factor can be reduced, it may mean that the total influence of all the other factors is insufficient to produce the contraction of the air passages, and so bring on an attack.

Approximately one third of asthma patients, whom I have seen, and who have learned to reduce their stress through intensive meditation, have ceased to suffer attacks. About one third have been improved, and about one third have not been helped. An interesting point is that many of those who have been helped had very well-marked allergies.

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Old age

“Winter is coming. The sun is setting. The cold wind blows. The last of autumn’s leaves flee across the grass. All natural enough. But why the thoughts? This leaf is me. And the next, and the next. They go to enrich the earth, and the new season’s growth. But me? Thoughts, thoughts, thoughts. It never ends. But of course it will.”

There is such a difference between simple repetitious thoughts and philosophical thinking. The one clogs our brain to no purpose, priming it for inevitable stress. But philosophical thinking allows some new understanding. Our coping mechanisms are enhanced, and the stream of disruptive thought subsides to a trickle.

Widowed

“Widowed, it is three or four years now. And I am coping no better. When part of you has gone you are maimed; life is not the same. Changes are made, and a new way of life starts. That’s not the coping I mean. That’s the chair where she used to sit. It’s empty now. How she would have liked this? What would she have said about that? Strange, because I know that she would have liked this. And I know what she would have said about that. But the thoughts of it are still there. The emptiness of home-coming. Why should I feel like this? I can cope, I can cope. But I can’t. The restless pillow. Restless, because it is made for two. My brain is in turmoil. Peace has gone from me. Team up with another? What would she think of that? If one does not know, how can it matter? But it is not as simple as that.”

We can test ourselves. Toes in the water before stepping in. Explore. Life is a sequence of explorations. One reality after the next. Why call a halt when one phase ends, and we must move to the next?

Dying

“I am older. This trouble I have could break out again at any moment. Keep thinking of death. We all must die. I know that. But knowing it is not much help. Say goodbye to a friend. Is this the last time? Will I ever see him again? It’s my own weakness. Tried going to church, but it did not seem to help.”

With some, the approach of death, and their thinking about it, sends enough messages to the brain to be a real cause of stress. I have seen others with whom the approach of death has brought no stress at all. Not just those who are seeking relief from the burden of life. But people who have developed some inner tranquility in which they seem to understand that life and death are really just different aspects of some greater process.

Many patients dying of cancer, whom I have shown how to meditate, have developed this tranquility of mind, without my saying anything about it.

The experience of letting the mind run quietly has enabled the brain to sort things out. The disturbing messages are integrated, and the individual is free from stress.

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