Blog About Health & Medicine

Allergic Asthma

The acute attack of allergic (or extrinsic) asthma is an episodic shortness of breath which lasts hours or days and varies from a tightness in the chest to a severe difficulty in breathing, accompanied by wheezing sounds in the lungs. It may develop suddenly; it may be accompanied by a cough which produces thick mucus; and it may cause breathing which is easy in inspiration but difficult in expiration. Prolonged coughing spells may cause vomiting of food and mucus. Between attacks, the child may be free of symptoms, or he may suffer from spells of coughing and difficulty in breathing.

The attack becomes chronic if the above symptoms continue for a few days in which mild activity and minor events (such as laughing) may be enough to start a new strong attack.

The acute attack becomes statics asthmaticus if it is not relieved by the conventional asthma drugs. The child becomes apprehensive and agitated; he leans forward in his bed, sweats, and strains to expand his chest; he has a quick heartbeat and a wheezing sound in the lungs that one can hear at a distance; his chest becomes inflated; and his breath sounds are diminished.

Allergic asthma may be caused by foods such as nuts, shellfish, eggs, chocolate, fresh fruit, and mustard; by inhalants such as pollen, house dust, epidermoids, and molds; by drugs; and by bacteria and viruses.

A special kind of asthma caused by molds has certain characteristics which distinguish it from other types of asthma. It has a dramatic onset at night. The child wakes up short of breath, livid, and panicky, but with very little wheezing in his chest. Or it may happen during any day of the year, provided that day has been sunny and warm. The child is free of symptoms when snow is on the ground because snow covers the soil and prevents the mold spores from rising into the air. It is also connected to the eating of mold-containing foods such as Chinese sauces or blue, Roquefort, or Camembert cheeses or to the drinking of any kind of beer fermented with yeast. It is frequent among children of farmers because manure, compost, dead leaves, and musty hay harbor molds.

The advent of air travel (causing extreme changes in the climatic environment), the increase of intermarriage, the use of molds as drugs (penicillin), and the frenzied pace of modern life all contribute to an increase in this kind of asthma.

Non-allergic Asthma

Non-allergic (intrinsic) asthma comes about when a spasm in the muscles of the bronchi occurs after irritants such as cold, damp air, or air containing fumes, tobacco smoke, insecticides, perfumes, and sprays succeed in breaking a child’s asthma threshold. An asthma threshold is a theoretical line of defense against spasm situated in the sensory nerve endings lying under the mucosa of the lungs.

Mixed asthma is both allergic and non-allergic at the same time; aspirin asthma is neither allergic nor non-allergic.

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•    Breastfeed your children totally for at least the first six months. Wean them on to sugar-free, unrefined whole-foods right from the start of solids.

•     Discourage a taste for sweet foods. Read labels carefully and avoid foods and drinks with added sugar. If you can’t ban sweets altogether, give them in batches after meals rather than letting children eat them between meals; or have a ’sweet day’ once a week when the children can eat sweets to their heart’s content and then prohibit them during the rest of the week.

•     Give them fruit or savory foods for school snacks and discourage them from buying sweets at the tuck-shop.

•     As a family eat healthy, unrefined foods rich in dietary fibre.

•     Ensure that you have a toothbrush for every member of the family. A good brush should have a small head, with soft nylon bristles and a flat brushing surface, so that you can reach all parts of the mouth. As soon as the bristles begin to splay out, replace the brush.

•     Teach your children to clean their teeth from a very early age. A toddler can play with a toothbrush to get used to it but until they are about 8 or 9 children need to have their teeth cleaned for them by an adult if it is to be done well. Get the child to do them first; then follow up with a proper clean.

•     Teaching children to clean their teeth properly is greatly helped by using disclosing tablets or solutions. These are harmless food dyes that stain the plaque and show how ineffective the brushing has been at getting rid of it. Once the plaque has been disclosed (stained) get the child to try to brush it away-both of you will be surprised at just how sticky plaque is. Disclosing tablets can be obtained from chemists and dentists.

•     Always use fluoride toothpaste, but discourage little children from swallowing it. Never scrub the teeth across, always brush from gum to tooth, and remember to clean the inside surfaces of the teeth and the crinkly biting surfaces of the big back teeth.

•     When your children are older (about 12 or 13) they can be shown how to use dental floss. Pull out about 10 in from the container and wrap it around the middle fingers of both hands and make a ‘bridge’ of floss across your two thumbs. Gently ease the floss between the two teeth (in front of a mirror is easiest) being very careful not to snap it down and cut the gum. Gently scrape it up and down the sides of the neighboring teeth to remove plaque and food residues. Once you have done one gap go on to the next and work systematically from gap to gap. The whole thing takes about two minutes when you get good at it.

•     Take your children to the dentist regularly every six months from the age of 3. This will enable him or her to pick up disease early, to prevent the unnecessary loss of valuable first teeth, and to use surface applications of fluoride which are valuable preventives against decay. Discuss with your dentist whether fluoride tablets would be beneficial to your child.

•     If in doubt about anything ask your dentist, and encourage him or her to be interested in prevention. Show him that you think it is important for you and your children.

•     Adults should follow the advice given above but don’t need to go for regular check-ups nearly so often as children. Fluoride toothpaste is still advisable and valuable.

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•     Feed your baby at the breast alone for at least 4-6 months, especially if there is any family history of asthma, eczema or hay fever. This protects the susceptible baby from cows’ milk proteins and makes asthma less likely to occur in later life.

•     If there is a history of allergy in the family it makes sense to take this one stage further and restrict the intake of eggs, milk, wheat and nuts during pregnancy. Recent research suggests that intra-uterine sensitization can occur in highly susceptible families so an excess of any food, drug or chemical is best avoided during pregnancy.

•     Avoid cold air whenever possible. Keep away from smokers and don’t smoke yourself.

•     Get a good air filter. The best models are high-particulate smoker’s air filters and can relieve asthmatic symptoms in 10-30 minutes. A summer camp in West Virginia installed air filters in the sleeping accommodation and found that the number of asthmatic episodes among the children was significantly reduced.

•     Drink plenty of fluids to keep chest mucus thin and coughable. Drink 1/2-l cup of fluid every waking hour. Drink only warm (i.e. not cold) fluids or you could actually trigger an attack. Warm drinks dilate the airways and can be used as a way of preventing an attack as you feel one coming on.

•    Clear your house of the dust mite if this is what troubles you. Scrupulous cleaning of a child’s room helps. Vacuum the mattress thoroughly and enclose it in an impervious plastic box-type cover. Blankets made from synthetic fibres, foam pillows and vinyl floor coverings are best. Frequent, damp dusting and vacuuming will keep the mite population to a minimum. Certain children obtain relief from a series of desensitizing injections to the house-dust mite.

•    You may have to get rid of your pet if it is causing really troublesome asthmatic attacks but this is often not necessary with scrupulous domestic hygiene. Keep all animals out of the bedrooms.

•    Avoid foods you know bring on your asthma. Similarly, avoid all drugs containing aspirin if they affect you adversely.

•    If you feel an attack coming on-don’t panic. Practice the following deep breathing exercise to abort the attack.

1. Think of your stomach and chest as two containers of air. Breathe slowly through your nose and fill first the bottom container. Continue until your abdomen bulges out.

2. Exhale through your mouth. The abdomen should now feel empty and your tummy should feel flat.

3. Repeat this inhaling and exhaling gently and slowly twelve times. The average asthmatic breathes at only 60 or 70 per cent of his or her total capacity, and during an attack this can fall to 20 per cent. By learning to breathe deeply an asthmatic can increase the amount of oxygen he or she takes in and can reduce the severity of an attack or abort it altogether.

•    Reduce weight. Even being only a little overweight can be a problem for an asthmatic because carrying too much fat, especially around the diaphragm, is like wearing a tight garment-it restricts breathing.

•    Take vitamin C. In one study volunteers who usually suffered from exercise-induced asthma were given 500 mg vitamin Ñ before an exercise test. Their tolerance to exercise was doubled. In another study 1 g vitamin Ñ a day seemed to protect against having asthmatic attacks. Those who took it had 75 per cent fewer attacks than those receiving a placebo. When they stopped the vitamin Ñ they once more suffered from their attacks.

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The fourth anthropometric test to help ascertain nutritional status is measurement of mid-arm muscle circumference (MAMC), which estimates skeletal muscle mass. This is also a quick and easy test, in which a measuring tape is used to determine the circumference of the arm, midway between the elbow and the shoulder (where the triceps skin-fold measure was taken). Having measured the mid-arm circumference, the next step is to subtract the fat, which is represented by the triceps skin-fat thickness measurment. What remains represents muscle and lean body tissue. Plug your mid-arm circumference into this formula to derive your mid-arm muscle circumference:

•Summary of the finding of Frisancho, A.R. Am. J. Clin. Nut, 34:2540, 1981.

MAMC (cm) = mid-arm circumference—(TSF [mm] x 0.314) MAMC = mid arm muscle circumference TSF = triceps skin fold cm = centimeter mm = millimeters

Then take your MAMC and rate yourself on the chart below:

Mid-arm muscle circumference (in centimeters)*

A MAMC of 20 percent or more below the numbers on the table above would help support a diagnosis of loss of lean body mass.

These four tests—height, weight, triceps skin fold and mid-arm circumference-are not the only anthropometric measurements that can be taken. But these four are quick and easy to do and provide a good starting point for further investigation.

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A low blood/body level of iron is the most common mineral deficiency in the world. Iron is part of the hemoglobulin molecule that binds oxygen to red blood cells. A lack of iron can result in poor oxygen delivery to the various parts of the body. This can cause all sorts of problems, including immune-system deficits.

In the absence of adequate iron, the thymus and other lymphoid glands may shrink, the number of T- and B-cells in the blood can fall, and the ability of cell “eaters” to ingest and destroy bacteria may be impaired. The ability of the body to respond to antigen challenge is thus diminished.

Years ago, doctors gave iron tonics to patients who suffered from multiple infections. The tonics helped, but today we know that iron shouldn’t automatically be given to patients with low blood levels of iron.

Bacteria need iron to flourish. So, during infections, the body sequesters iron in the bone marrow and other organs to keep it away from the bacteria. That’s pretty smart of the body, hiding the bacteria’s food. For this reason, I advise my patients not to take iron when they’re suffering from an infection.

If you have symptoms of anemia (such as fatigue), don’t self-medicate by taking iron—or anything else, for that matter. The anemia may be caused by a serious medical problem that requires attention. In men, the problem may be cancer of the colon, gastritis, esophagitis or peptic-ulcer disease. Taking iron may make you feel better, but it won’t do anything for the underlying problem. And because you feel better, you may not seek the treatment you need. Women should also be checked out when suffering from symptoms of anemia. This may sound like a very conservative approach, but through the years I’ve seen too many people who treated their anemia by taking iron, not knowing until it was too late that the anemia was caused by a serious medical condition that could have been corrected had it been attended to earlier.

Too much iron can also be a problem, and it may suppress the immune system.

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SARCOIDOSIS: we don’t know what causes it; possibly a virus.

Signs and Symptoms: may be fever; pains in joints; generalized body aches; cough; weight loss. Can have shortness of breath, lumps on the skin; enlarged liver; inflammation of a portion of the eye, which can lead to glaucoma and loss of vision. May get into heart and cause chest pain. Usually gets into lungs, causing shortness of breath. Many times I have made the diagnosis of sarcoidosis from the characteristic appearance of the X-ray, which shows enlarged lymph glands in the chest.

SCLERODERMA (progressive systemic sclerosis): chronic disease with generalized fibrosis (thickening) of the skin, joints and many internal organs.

Signs and Symptoms: joint pains; stomach upsets; heartburn; weight loss; malaise; difficulty in swallowing; shortness of breath. Skin of fingers and face becomes thick. Normal creases on the fingers and face disappear. Fingers become purple and hurt when exposed to cold. Face become thick, like a mask, and blood vessels on face, lips and tongue become prominent. Other symptoms may be esophogitis; (inflamations of the esophagus); pleurisy; pericarditis (inflammation of the sac surrounding the heart); heart irregularities; muscle weakness. Death from pneumonia often occurs.

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ANKYLOSING SPONDYLITIS: a progressive, inflammatory arthritis characterized by fusion of various joints, especially of the spine, that leads to years of suffering. Norman Cousins described his experience with ankylosing spondylitis in his bestselling book, Anatomy of an Illness.

Signs and Symptoms: fatigue; malaise; weight loss; low back pains; sacroiliac pains; sometimes pain down the back of the legs; stiffness of the back, especially in the morning; stiffness and pain spreading up to involve the rest of the back; hips and shoulders ache and feel stiff; in advanced stages there is forward flexion of the spine, forcing the person to walk with his head facing the ground (almost like an exaggerated Groucho Marx walk).

BACTEREMIA: a condition in which bacteria invade the circulating blood. The bacteria can come from a small abcess on the skin, dental drilling or manipulations, infections in the urinary tract or female organs, lung infections, intravenous drug use, indwelling intravenous catheters, urinary catheters, surgical procedures, and almost any other way bacteria can get into your blood.

Signs and Symptoms: fever; fatigue; rapid heart rate; rapid breathing; cool, pale extremities; can lead to confusion or disorientation; shortness of breath.

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This assumes that the affected person makes IgE antibodies to the synthetic chemical concerned (see p25), or responds with some other inappropriate and damaging immune reaction. Since the chemicals concerned are too small to act as antigens in their own right, they would have to combine with body proteins and act as haptens.

It has been suggested that this can happen with some food additives, particularly preservatives and synthetic colours. These cause chronic urticaria (nettle-rash) in some people, and urticaria is sometimes due to an allergic reaction. There are also isolated cases of tartrazine (a synthetic colouring) causing acute asthma attacks, or a severe reaction that resembles anaphylactic shock in some very susceptible people. Other food colourings, particularly the synthetic ones, have been known to cause allergic dermatitis, mainly in food workers exposed to large amounts. The preservative, sorbic acid, has occasionally caused allergic dermatitis when used in medicinal creams.

In most of these cases, the tests to show that the reaction really is an allergic one have not been carried out. And when a group of patients who were apparently allergic to tartrazine were tested for IgE antibodies, none were found. So it looks as if these are not allergic reactions at all, even though they produce allergy-like symptoms. Doctors suspect that tartrazine produces symptoms in these people by directly affecting the immune response in some way – perhaps by stopping the synthesis of immune regulators called prostaglandins, or by triggering mast cells directly. In the case of synthetic chemicals apparently causing asthma, the effect may be due to irritation rather than an allergic reaction. This is well known for metabisulphites and sulphur dioxide.

These are cases where the symptoms provoked by chemicals at least looked like allergic symptoms. In the majority of chemical-sensitive people, the symptoms are not those commonly associated with allergy. So it seems unlikely that chemical sensitivity is allergic in origin. It is possible, however, that synthetic chemicals might affect the immune response in some way. This has indeed been shown for some chemicals, but the usual effect is to lower resistance to disease, rather than to make allergies more likely.

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Once a diagnosis is made regarding the knee’s status, treatment can take one of many forms. Since the knee is an easily damaged joint, you should see your doctor, who will probably take an X ray of the knee and manually examine the knee as well as the way you’re walking. She will tell you to test the knee and take aspirin or Advil to ease the pain and inflammation.

If, however, your doctor determines that your X rays reveal a torn meniscus that requires surgery to remove, you will undergo arthroscopic surgery, which involves inserting a stainless steel surgical tube through a tiny incision at the side of the kneecap and suctioning the torn cartilage out. This popular operation has enabled people to indulge in their chosen sport within a week after surgery, if not the next day.

Tips and Precautions

Preventing knee injury consists of two components: warm-up and conditioning. Walking rapidly for five minutes will serve as a warm-up before your regular exercise session, and being in shape will give you sufficient strength to get through your workout. Injury occurs most often when you’re tired or when you push past your energy reserves.

Stretching the hamstrings and other joints that surround the knee will also lessen the chance of injury to the knee. And if you strengthen the inside of the quadriceps, or thigh muscle, with a combination of stretching and walking, it’ll pave the way for smoothing the movement of the femur within the groove of the kneecap.

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For some reason, Mother Nature had it in for women when she designed their external genitalia. I once heard someone compare the urethra, vagina, and rectum to a highway where the exit tamps are all too close together.

A fourth physical flaw can be added: the woman’s urethra, or the tube that leads from the bladder to the outside of the body, is very short compared to a man’s. This shortness is what helps create urinary tract infections, since the bacteria don’t have very far to travel before they start to cause an infection in the urethra. The major symptoms of a urinary tract infection are a burning pain during urination and foul-smelling urine. A urinary tract infection can occur in different parts of the urinary tract. An infection of the urethra is called urethritis; if it spreads to the bladder, a bladder infection can occur. An infection of either the bladder or the urethra can be quite painful. Because urethrtis is often caused by intercourse, when bacteria are pushed up into the urethra, it is often called honeymoon cystitis.

Rarely, the infection will proceed to the kidney; this condition is called pyelonephritis. This can cause permanent kidney damage, so it’s important to treat urethritis in the early stages before it has a chance to spread.

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