This simple-sounding disorder also has the impressive name of infectious mononucleosis (a name with which you can confound your friends and bank manager, I feel sure; you might even get an increased bank overdraft). It is caused by a virus called the Epstein-Barr virus, and is often contacted during childhood. In many cases, no symptoms occur then, but do in later years. The most common time for symptoms is in girls in the 15-25 age group. But nobody is immune. It is not highly contagious, and occurs in between two and six persons per 10000 of the population. Incubation period— the time elapsing between the time of infection and the onset of symptoms—is between 7 and 49 days.
Three main symptoms occur: a sore throat, swollen glands in the neck (and later elsewhere), and a fever. Often this is preceded by the patient feeling generally off-colour. The tongue and often the tonsils become coated with a creamy discharge. Breath is unpleasant, nose congested, and tiny lymph glands under the jaw and in front of the neck swell and become tender.
As the illness develops, the liver and spleen (two large organs in the upper part of the abdomen) swell, and tenderness in this region is common.
Lack of appetite, feeling unwell in a vague sort of way, lack of energy, aches all over the body, nausea, sweating and general abdominal discomfort are typical symptoms. Occasionally there is a red rash, especially on those who have been given penicillin. Sometimes a mild jaundice may occur (the whites of the eyes and the skin turn yellow). Depression, headaches, fatigue and inability to concentrate are common symptoms that often persist for many weeks, and often months. A simple blood test usually gives the doctor the diagnosis.
Treatment
This illness is a self-limiting one and invariably cures itself. It simply takes time. Bed, fluids and adequate nutrition are necessary. Small, attractively prepared meals, emphasizing foods the patient normally likes, are the best idea. Gargling the throat with warm salty water gives relief from the sore throat. Analgesics and antipyretics aimed at reducing elevated temperatures and relieving aches and pains are given. There is no single drug that will magically bring about a cure. Vitamins aimed at increasing the body’s general health and vitality are often prescribed. Proper medical supervision is recommended with any of the symptoms that suggest this disorder.
Infectivity is low but appears to be spread via the saliva; therefore, kissing and sharing drinking utensils should be avoided until the patient is cured.
*43\87\2*
The name ringworm is misleading, because the ailment to which it refers is not caused by a worm. It is in fact a form of tinea, a fungal infection, and is also known as tinea circinata. The name refers to the fact that it causes a raised ring-shaped inflammation of the skin. Ringworms are most commonly found in warm, moist areas of the body such as the armpits, groin, and beneath the breasts. The skin becomes inflamed and tends to flake and peel. Ringworms can be intensely itchy and are highly contagious.
To avoid spreading the infection, care should be taken to avoid sharing clothing, towels and bedlinen. Keeping the skin dry will prevent further growth of the fungus.
Tea tree oil applied directly to the area is often beneficial. Antifungal ointments and powders are also available from chemists without prescription. Garlic, either eaten fresh or in the form of capsules, may also help the infection clear up.
Dietary habits which may help to reduce the incidence of ringworm and other fungal infections include the elimination of refined starches and sugars and alcohol from the diet, as fungi thrive on these foods. Diabetics are particularly prone to ringworm when their sugar levels are high.
*44\69\2*
Experience with St John’s Wort based on people entering research protocols and seeking help from psychiatrists tells us only about the way the herbal remedy is being used and is working for relatively severe clinical problems. But the large majority of people who have turned to the herb would probably not fit into research protocols nor see fit to consult a psychiatrist. How is St John’s Wort being used by the general public, and how is it working for the problems of everyday life? Those are questions that I wanted to answer and realized that in order to do so, I needed to survey the public directly. I did so by means of a questionnaire, distributed in health food shops and pharmacies both in the United States and in Germany, and posted on certain Internet newsgroups. The stories detailed in this chapter are derived largely from responses to this questionnaire, some of which I followed up with telephone interviews.
*19\75\2*
Sandra Casey was twenty-one years old when she entered the Ecology Unit. Her headaches centered around her eyes and forehead. They were steady in nature and accompanied by sensitivity to light. She had these headaches three
or four times a month, and each lasted for three or four days. While having a headache, she was unable to sleep or rest yet could take no medication, for medicine seemed to make her depressed.
Miss Casey had been diagnosed as having hypoglycemia (low blood sugar) several months before she came to the unit. She had been on a hypoglycemia diet which consisted of six small, high-protein meals a day. At first she felt much better on this diet, but eventually she became depressed and suicidal. (Doctors see many such cases of alleged hypoglycemia. The symptoms, including marked swings in blood-sugar levels after consumption of corn sugar, may frequently be the result of food allergies, not of true hypoglycemia, a point first noted by Dr. William A. Philpott of Oklahoma City.)
Another problem which Mrs. Casey had was what she called “attacks.” The first attack came after she took some hashish at the age of fifteen. She became very cold, and her limbs felt as if they were frozen all day. She thought she were going to die or go insane, yet a physician who examined her declared that there were no permanent effects from the drug.
Since that time, however, she had had frequent sensations of numbness, which would start in her back and radiate over her head. This feeling was quite difficult for her to explain; she said it was similar to having a bucket of cold water poured over one’s head. After the attack she became disoriented, depressed, and suicidal.
As stated, this patient’s symptoms ranged from localized physical reactions (minus-one) to more profound systemic changes. She complained of sore throat, phlegm in the back of her throat, chest pain, lightheadedness, and dizziness. Her abdominal bloating became so troublesome that she looked as if she were pregnant.
Because of her depression and suicidal tendencies, Sandra had been under the care of a psychiatrist and had been institutionalized for nineteen days. Antidepressive drugs made her even more suicidal. In fact, her suicidal thoughts were becoming obsessive, especially since her husband was a gun collector who kept arms within easy reach around the house.
She reported a craving for sugar and sweet foods in general and said she loved to go through a box of cookies at a single sitting. Not surprisingly, her strongest reactions in testing were to wheat, corn, peas, blueberries, beets and beet sugar, and other commonly eaten foods, taken singly according to the methods of the Ecology Unit. Commercial foods gave her a headache, cumulatively, after five meals.
She left the hospital headache-free and in a normal frame of mind. Her problem was diagnosed as multiple food and chemical susceptibility, and her chances of recovery were excellent, provided she followed the recommended procedures. Suffice it to say, in summary, that headaches demonstrated to be on an allergic basis may be of any descriptive type—that is, any location, any degree of severity, with or without usual symptoms, nausea, vomiting, or other features. Although allergic headaches are far more commonly demonstrated to be on the basis of reactions to given foods and/or environmental chemical exposures, they may also be related to such allergens as house dust, pollens, and sometimes drugs. Indeed, I have seen patients whose treatment with such pain-relieving drugs as codeine accentuates their headaches.
As mentioned earlier, allergic headaches were described over a half century ago. Under these circumstances, there is no excuse for patients to be told to “live” with their headaches. When headache patients are investigated by means of proper techniques to demonstrate their environmental causes, to which susceptibility exists, most cases may be readily diagnosed and treated in the absence of drug therapy.
Finally, although headaches are sometimes said to be on a psychogenic basis, I have not been able to demonstrate such a relationship. If this exists, it must be exceedingly rare.
*71\110\2*
Sister Francesca came to me with a peculiar complaint. She suffered from aches and pains in her rib cage, on both sides, about six inches below her armpits. While aches and pains are commonly the result of allergylike problems, there were no organs in that particular part of the body which would be likely to give rise to them. I was confused, more so when I noticed that her associate, who had accompanied her to the doctor, was fighting back a smile as the sister related her problem.
I later found out the reason for the strange soreness: the sister had a habit of falling asleep every morning at Mass. As she began to snore, her fellow nuns on either side would crack her in the ribs with their elbows to wake her up again. This went on repeatedly during Mass, giving rise to her medical complaint.
Upon inquiry, I found that the chapel of her convent was directly over the garage which held the community’s five automobiles. I therefore arranged with the priests who drove these cars to leave all of them outside for a week and leave the doors of the garage wide open. They were sworn to secrecy, however, and Sister Francesca was never told anything about this arrangement.
That week, Sister Francesca attended Mass as usual, but was alert and awake all week, with no snoring and no sore ribs. Then, again without telling her, the priests were instructed to resume parking the cars in the garage with the door closed. On the next morning, Sister Francesca entered the chapel, took her seat, and promptly fell asleep. The other nuns awakened her as she began to snore.
It was a very convincing experiment, and from that point on the automobiles were kept outside the incriminated garage.
*41\110\2*
Tears form in the tear glands that lie above the eyeballs within the bony eye sockets. These tear glands continuously produce fluid that flows across the eyeballs and down the slender tear ducts that connect each eye with the nose (nasolacrimal ducts). The two openings into each tear duct are pinpoint in size and can be seen at the edge of the upper and lower eyelids, near the corner of the eye next to the nose.
In newborns, the openings into the tear ducts are often too small. These openings may be further blocked by the silver nitrate or other drops placed in the eyes at birth to prevent eye infections. Blockage of these openings may cause tears to flow out of the outer corner of the baby’s eye, even when the infant is not crying. Occasionally, instead of normal eye fluid, green or yellow pus will collect in the eye. This discharge will further block the tiny tear ducts.
If the nasolacrimal duct becomes blocked at the end inside the nose, tearing and possible infection will occur. Blockage at the nose end of the duct can be present at birth, or it may be caused by congestion from a cold or an allergy. When the nose end of the duct is blocked, the nasolacrimal sac between the eye and the side of the nose may swell with fluid and be visible as a distinct lump the size of a green pea.
Signs and symptoms
In infants, simple tearing of one or both eyes is so common as to be considered normal; it is harmless. However, if there is pus in the eye, redness and rawness at the outer coiners of the eyelids, or swelling of the tear sac (with or without redness), treatment may be needed.
Home care
Simple tearing needs no treatment. The tears can be wiped away and the eyelids cleaned by wiping with a cotton ball dipped in sterile water. Call the doctor if the eye is red, pus is present, or the tear duct is swollen. Redness of the skin at the outer corner of the eye, redness of the eye itself, or the presence of pus may be treated with antibiotic eye drops prescribed by the doctor, often over the telephone. If the tear sac at the side of the nose is swollen, your doctor may teach you how to gently massage the tear sac. (Do not attempt to massage the tear sac without a doctor’s instructions.)
Precautions
• With home treatment, the eyes should improve within 24 hours. If there is no improvement, notify your doctor.
• If improvement is prompt, continue treatment until the eye is clear for at least two days.
• Repeated problems of eye tearing are common in infants; save the eye drops for possible future use, but check the expiration date on the label before reusing.
Medical treatment
Your doctor’s treatment is the same as home treatment. Your doctor can demonstrate the proper method of massaging the tear sac, if needed. If the condition continues past the age of eight months to one year, your doctor may refer your child to an ophthalmologist (an eye specialist) who may surgically enlarge the nasolacrimal duct under general anesthesia.
*66/84/5*
The main way our body gets rid of excess cholesterol is through our bowel movements. The liver pumps excess cholesterol that is not needed into the bile, which is stored in the gallbladder. Bile then enters our intestines through an opening called Vater’s ampulla and leaves our body in bowel movements. If there is not much fibre in our diet, we don’t drink enough water and are constipated, cholesterol in bile can get reabsorbed back into our bloodstream and we end up with high cholesterol levels. Therefore, one of the best ways to lower your cholesterol is to ensure that you have regular bowel movements.
The best kind of fibre for lowering cholesterol is soluble fibre. This kind of fibre becomes a gel-like consistency in the intestines, and it is able to bind with cholesterol and other toxins in our intestines and carry them out of our body. Good sources of soluble fibre include oats, legumes such as kidney beans or chickpeas, rice, barley, apples, strawberries and citrus fruits.
Another benefit of fibre is that it slows the absorption of sugar into our bloodstream when we eat some in our meal. This means that fibre lowers the glycaemic index of a meal. This is good for reducing your risk of Syndrome X or diabetes, both major risk factors for heart disease.
*9/53/5*
Research has shown that drinking alcohol causes a decrease in sperm count, an increase in abnormal sperm and a lower proportion of motile sperm.
Alcohol also affects a man’s fertility by changing his hormone levels because it can alter the way testosterone is produced and then released. Because alcohol affects the liver (the organ which normally clears out any excess hormones), a man who drinks alcohol may accumulate small amounts of female hormones (men produce ‘female’ hormones, just as women produce testosterone). These female hormones can lower sperm production and potency.
In addition, alcohol stops absorption of nutrients like zinc which is one of the most important minerals for male fertility. Zinc is found in high concentrations in the sperm. Adequate levels of zinc are needed to make the outer layer and tail and are therefore essential for healthy sperm. If you reduce the amount of zinc in a man’s diet, his sperm count goes down.
Finally, alcohol reduces fertility in mammals, and studies show that women who drink heavily may stop ovulating and menstruating, and take longer to conceive.
A study of 430 women demonstrated that drinking more than 5 units of alcohol (equal to five glasses of wine) a week could stop women conceiving. Researchers discovered that the women in the survey who drank less than 5 units a week were twice as likely to get pregnant within six months compared with those who drank more. A study published in the British Medical Journal concluded that women should be ‘warned to avoid alcohol when trying to conceive’.
The fact is that drinking any alcohol can reduce your fertility by half- and the more you drink, the worse the impact on your chances of conception.
Studies have also shown a strong relationship between alcohol and miscarriages. Women who have a drink every day have a much higher risk of miscarriage (2.5 times more) than non-drinkers. The same study found that if the woman was a drinker and a smoker her chance of a miscarriage was four times higher.
*5/73/5*
Yoga claims to be a science – a spiritual science at that.
Interestingly, science has proved many of the medical claims made by yoga to be valid.
Surprised? Most American men are. But then, the only yogis most of us ever knew were Yogi Bear and Yogi Berra. And since the end of the 1960s, it’s been easy to dismiss the concept of yoga as some navel-gazing, hippie-dippie waste of time. Not anymore.
Yoga has been shown to be effective in helping treat heart disease, diabetes, back pain, chronic pain, asthma, colitis, arthritis, depressed immune systems, all manner of stress-related illnesses, and more, says Dr. Arthur Brownstein of the University of Hawaii John A. Burns School of Medicine.
Yoga itself is a complex, several-thousand-year-old, multifaceted system of living drawn and adapted from Hindu teachings. Hatha yoga is the style taught most commonly in the West at health clubs and colleges. This consists primarily of focusing attention on the breath and gentle stretches, says Barbara Lang of the Duke University Center for Living.
The greatest and most quickly realized medical benefits seem to derive from the profound calming effect that yoga produces in the mind and body, Dr. Brownstein says. This breaks the debilitating stress cycle, he says. It does this in four ways.
• Through properly and positively aligning body posture through specific positions (known as poses) and placing mental focus on the efforts
• Through slowing, relaxing, and deepening breathing
• Through directing attention inward, peacefully, meditatively
• Through stretching and limbering muscles gently and increasing circulation
A typical hatha yoga class is programmed to take each participant’s body through a full range of motion, stretching and strengthening each joint according to its capacity. Regular practice has been shown to ease pain for arthritis sufferers, says Dr. Brownstein. It does this by increasing flexibility – a benefit every practitioner enjoys, and one that makes us feel better.
*74/36/5*
To some extent, it helps to think of anorexia and bulimia in the same way as any other illness, such as diabetes or asthma. One advantage of this approach, called the medical model, is that it helps reinforce the “no-fault” concept I described earlier. A person with asthma is not responsible for the condition, but is expected to participate actively in managing the problem.
The medical model follows certain logical steps: evaluating the patient and the problem, arriving at a proper diagnosis, designing a treatment plan, then carrying out that treatment. This approach takes each person’s individuality into account and looks at all the forces that may be contributing to the disorder. It also lets the physician choose from many therapeutic strategies to find the ones that have the best chance of working.
Such an approach is vastly superior to one in which a doctor assumes from the beginning that all eating disorders result from one cause-for example, a defective sense of self-esteem. Such restrictive, simple-minded thinking can lead to one-dimensional therapy that fails to address the multifaceted-perhaps I should just say human-nature of the disorder. As the saying goes, if all you have is a hammer, then every problem is a nail. It is better if the physician takes into account the nuts and bolts of the problem as well.
The medical model has limits. For one thing, anorexia and bulimia are not really like pneumonia. Most people would agree that there is nothing good whatsoever about pneumonia, unless you happen to be the bacterium that goes around causing it. Similarly, there is very little “good” about psychiatric disorders such as schizophrenia or depression.
However, I believe there is something positive that exists in the strangely inverted world of eating disorders. That positive element concerns the patient’s attempt to exert her willpower to solve what she perceives as a problem. Rather than lying back passively and falling victim to the raging psychological and social forces that swirl around and inside her, she has adopted an active, even aggressive stance. She is taking a decisive course of action to achieve a goal-a goal she is willing to risk her life to achieve. While her goal is unreachable and her method is harmful, I feel her basic impulse is good and worthy of respect: She is trying to deal with a difficult situation by taking control and finding something in her life that makes her feel successful, special, and proud. In a strange way, eating disorders express a very American kind of thinking: Pull yourself up by your bootstraps, get a hold of yourself, improve your life, set a goal and work hard to achieve it, distinguish yourself. However, the approach taken by the bulimic or the anorexic is too rigid, too extreme, and is completely out of harmony with the needs of the body and the mind. The strategy is doomed to fail. When it does, the patient will suffer guilt, despair, and a sense of worthlessness-the very feelings that precipitated the disorder in the first place.
My approach as a physician is to recognize the complexity of the problem and try to take into account the many psychological and social factors that affect a patient. I accept that she is trying to solve her crisis, and I will try to help her channel that energy in a healthier way. When this approach works, the patient changes her faulty patterns of thinking, alters her destructive eating behavior, and improves her relationships with other people. Ideally, she leaves treatment with the resources she needs to cope in healthy ways with the pressure to be thin, pressure that will undoubtedly continue over the years.
*6/35/5*
