ALLERGY SHOTS: SIDE EFFECTS OF IMMUNOTHERAPYThere are five possible side effects to an allergy shot: 1. A small area of redness (smaller than the size of a quarter), swelling, and itching at the site of injection that begins within a few minutes of your receiving the injection and that goes away within 1 to 2 hours.2. A larger reaction (larger than a quarter but smaller than a silver dollar in size), swelling, and itching at the site of injection, beginning a few minutes after the injection and clearing in 1 to 2 hours.3. A very large area of swelling (inches of swelling), redness, and itching that begins some 4 to 6 hours after a shot, lasts a number of hours, then gradually resolves itself over 24 to 48 hours.4. A mild generalized reaction that begins within 30 minutes of receiving an injection and consists of generalized itching, hives, and some coughing and mild wheezing.5. A severe, life-threatening reaction; this typically begins within 20 to 30 minutes after an injection, and takes the form of severe shock.The very mild reactions are common, large local reactions are less common, very large local reactions even less common, generalized mild reactions are uncommon, and the life threatening reactions are very, very rare. A recent study of deaths from allergy skin testing or allergy immunotherapy shots revealed 46 deaths since 1945. Considering the millions of such injections given each year – some say as many as 10 million each year – such a catastrophe is rare indeed. In fact, the chances of your dying from an allergy injection are 30 times less than those of dying from being struck by lightening, 2,000 times less than dying from the effects of smoking or passively smoking cigarettes, and 16,000 times less than dying in an automobile accident. I mention this because sometimes one hears scare messages about immunotherapy, implying that it carries a high risk of life-threatening reaction. Such messages are in fact, unfounded, providing the physician knows and understands what he or she is doing. Again, you should be absolutely certain that the physician in charge of your immunotherapy is properly trained and experienced in the safe and effective administration of this therapy.*56/322/5*

LUPUS (SYSTEMIC LUPUS ERYTHEMATOSIS – SLE)Systemic lupus erythematosis is a chronic inflammatory disease, similar in some ways to rheumatoid arthritis, that may develop at any period of life but most often affects women between the ages of ten and forty years. It exists in many forms ranging from very mild to severe and even fatal. SLE may affect various parts of the body singly or in combination. Among the structures involved are the skin, joints, kidneys, nervous system, linings of body cavities, and other organs. There is a striking tendency toward remissions and exacerbations, and laboratory abnormalities are frequently found in the blood.There are two types of the illness: systemic and discoid. Discoid is a disorder that is usually limited to the skin and usually confined to a facial rash that may be similar to that which occurs in SLE. Less than 5 percent of the cases of discoid lupus erythematosis will include involvement of other organs and structures besides the skin.SLE occasionally includes a butterfly-shape facial reddening over the bridge of the nose and the cheeks. Other findings in SLE may be discoid lupus, Reynaud’s phenomenon (pallor caused by spasm of small arteries that reduce the blood flow), photosensitivity, non-deforming arthritis, kidney inflammation, pericarditis (inflammation of the sac that encloses the heart), pleurisy, and nervous system involvement (psychotic behavior or convulsions). The general symptoms that usually appear first are fever, weakness, easy fatigue, and loss of weight. The majority of cases develop anemia because the red blood cells are destroyed and there are decreased numbers of white blood cells and abnormal bleeding, as well as other changes in the blood (these can cause false positive blood tests for syphilis in as many as one out of five cases of SLE).The treatment of SLE is directed toward protection of vital organs by reducing or controlling inflammation. Aspirin is used to reduce fever and relieve pain, especially when the joints are affected. Milder forms are treated with certain anti-malaria drugs. Steroids are given in most cases to reduce the inflammation in acute crises.The course of the illness varies but very often becomes chronic and smolders on for months and years, with ups and downs. There may be very long symptom-free periods. The major factor with regard to survival is the severity of the kidney disorder and the response of the kidney to treatment. Cases involving mainly the joints do best.*7/295/5*

IBS AND THE NERVOUS SYSTEM: FEAR OF NOT MAKING THE LAVATORY IN TIMEYour diarrhoea may be so bad that you are afraid to go out of the house, or only if you plan a route where you have access to a lavatory several times on the way. You are on the treadmill of fear- diarrhoea, fear-diarrhoea. If you are constantly sending fearful messages to the bowel, the diarrhoea will continue. You could take a diarrhoea mixture to give you more confidence for special occasions but the essential treatment is to change the message to the bowel – this is the only permanent treatment. You are the only one who can heal your nervous system and don’t be surprised if there are ups and downs, nature does not heal in a straight line. Help with this is on page 120 but you could also try delaying the call to stool. When you have the urge to go to the lavatory practise hanging on: even if you can only manage two seconds, keep trying and you will gradually gain more control. Stand or sit on a chair outside the lavatory, breathe slowly, tighten your buttocks and start to count on your fingers squeezing each one hard. You could do something similar when you are out too; count how many steps you can go past the lavatory before you double back.Since there is a good clean out in the mornings or several stools per day the amount of faeces on these panic visits is small. Although people with this problem are rarely incontinent outdoors it might make you feel safer if you protected yourself against the possibility. You could line your underpants or knickers with plastic and then cover that with tissue, kitchen roll, cotton wool or sanitary towels. Boots sell baby pants that are just a piece of plastic without elastic, or you could cut a plastic carrier bag to the shape you want. You may throw up your hands in horror and say you would rather stay indoors, but think about it; who but you would know? After all it is a temporary state, but when your nerves are better your diarrhoea will be a thing of the past. Get your mind out of your bowel and stop giving it all those negative commands: ‘I’ll never make the loo,’ ‘I can’t go out because of the diarrhoea,’ and so on.Vicky had been housebound with fear of incontinence outside for two years, then one day the person who normally collected her children from school rang to say she was delayed and could not make it in time. Vicky was panic-stricken but knew she would have to go. The school was only two streets away and she delayed leaving the house until the last minute. As she rushed out of the gate she turned her ankle on  the  step.  It was not until she was back home that she realized that she had not given her diarrhoea a thought; her bowel had had a rest from worrying messages because her thoughts were concentrated on the pain of her ankle.While the nerves of the internal organs are not normally under the control of the will you can train yourself to have some degree of control, and change the functioning of any organ of your body.*62\326\8*

CONTROLLING YOUR OWN EPILEPTIC SEIZURES: FINDING A COUNTER MEASUREThe aim of the ABC chart is to help you see the behaviour that is most likely to precipitate a seizure and enable you or your doctor to work out appropriate counter measures to help you control your seizures.A counter measure is a piece of behaviour which you use either to inhibit the seizure completely, or at least to stop its spread. The counter measure is carried out either when you are in a situation in which you know a seizure is likely to occur, or at the beginning of a seizure.Counter measures are often strategies which lead either to an increase or decrease in arousal or alertness. The A of your ABC chart may, for example, show that you are more likely to have seizures when you are aroused – excited or tense. In this case a relaxation technique would be a good counter measure. You would use an alerting strategy if you found that you were most likely to get a seizure when you were day-dreaming or in a very boring situation. One patient with complex partial seizures found he could often abort a seizure just by saying ‘No’ to himself, or attending to something different at the onset of the aura. Another found hitting his arm would sometimes abort a seizure. Arousing yourself by walking about, pinching yourself, or distracting yourself either in seizure-prone situations or at seizure onset, is often effective. Some of the alternative methods of seizure control discussed in the last chapter, for example aromatherapy and relaxation techniques, probably work at least partly because they help you to change your level of arousal quickly when you feel a seizure beginning.Many patients, particularly if they have complex partial seizures, have a seizure onset related to negative emotions such as anxiety or unhappiness. Here the counter measure would be designed either to help you avoid such thoughts, or to distract attention from them. Some people find that sniffing at a bottle of old-fashioned smelling salts, or indeed any substance with a powerful smell, can distract attention from feelings of anxiety and inhibit a seizure. An elastic band around the wrist, twanged at seizure onset, has the same effect. (This can be a way of arousing or alerting yourself, too).Learning to avoid feelings such as unhappiness or guilt that trigger a seizure is obviously more difficult than simply distracting your attention from them. But once you recognize the part these feelings play, you can at least make an attempt to adjust your life so that you experience them less often.Sometimes counter measures can be very specific. For example, if a seizure usually starts with the same movement, such as flexing an arm, it can often be stopped if you deliberately make an opposing movement – in this case, straightening the arm.Whatever counter measure you use, enter all your seizures on your annual plan chart so that you can see how successful the counter measure is at reducing your seizure frequency.*49\193\2*

DIETS AND DIABETES: FIBRE AND SODIUMFibreThe WHO recommendations for fibre intake for persons with coronary artery disease and diabetes are the same as recommendations for the general public: approximately 35 – 40 g/day of dietary fibre from a variety of food sources. Dietary fibre may be beneficial in maintaining gastrointestinal function and in treating or preventing several benign gastrointestinal disorders and colon cancer, and large amounts of soluble fibre may have a beneficial effect on serum lipids. Although selected soluble fibre are capable of delaying glucose absorption and their effect on glycaemia is probably insignificant. This is in contrast to what many dietetics professionals have been recommending based on earlier research.
SodiumThere is an association between hypertension and both type I and type II diabetes, especially for people with type II diabetes who are obese. There is also evidence that people with type II diabetes are more salt-sensitive than the general population.Sodium intake recommendations for people with diabetes are the same for the general population: less than 5 g/day. For persons with hypertension and diabetes, the intake should be reduced to less than 3 g/day. In hypertensive or oedematous patients with nephropathy, sodium restriction is required and sodium intake should not exceed 2 g/day.*6/356/5*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: IMPROVING YOUR ACTIVITY LEVEL – HOW TO JUDGE THE INTENSITY OF YOUR EXERCISE – THE BORG PERCEIVED EXERTION SCALEAnother way to gauge the intensity of your exercise is to use the Borg Perceived Exertion Scale. It rates the intensity of exercise on a scale from 6 to 20; 6 indicates a minimal level of exertion such as sitting comfortably in a chair, and 20 corresponds to a maximal effort such as jogging up a very steep hill. Doctors usually recommend ratings between 11 and 15 on the scale. A rating of 13 usually corresponds to 70 percent of maximal exercise capacity and is considered a good intensity for most people. When you use the scale, do not become preoccupied with any one factor such as leg discomfort or labored breathing. Instead, try to concentrate on your overall feeling of exertion.There is no real advantage to exercising at a high intensity, unless you are an athlete. You do not get major fitness benefits beyond moderate exercise, and you increase the risk of muscle or joint soreness or injury.A moderate exercise program should not cause discomfort. You should stop exercising and call your doctor if any of the following symptoms develops:Chest discomfort or pressure (or arm, jaw, neck, or back discomfort)Severe shortness of breathBurst of very rapid or slow heart rateIrregular heart rateExcessive fatigueMarked joint or muscle painDizziness or fainting*314\252\8*

SMOKING AND CANCER: GOVERNMENT AND ECONOMICSWhat cannot be done by individuals and educators may in some measure be done by governments. We cannot advocate that tobacco should be made illegal. Experience from the prohibition of alcohol in the United States in the 1920s suggests that prohibition of smoking would be costly and futile. Restrictions on advertising and increased taxation to gradually price cigarettes out of the market would be more logical. The trend towards the prohibition of smoking in public vehicles and public buildings should certainly be encouraged. Smokers may grumble as the territory for their habit is reduced and may perhaps understandably, react in a defiant way if prohibitions are introduced to the accompaniment of hectoring comments on their filthy, dangerous and self-destructive habit, but they usually adapt fairly quickly to me fact that a particular setting can no longer be associated with smoking.There are many factors which work against the effective reduction in cigarette smoking. A good example of one such factor was given in a study recently published by Dr Warner and colleagues from the United States in the New England Journal of Medicine. They analysed ‘cigarette advertising and magazine coverage of the hazards of smoking’. They found strong evidence that magazines that carried cigarette advertising tended to have fewer articles on the hazards of smoking. This was particularly true for magazines directed at women. This shows very starkly how uncontrolled cigarette advertising can not only have the direct effect of reducing the likelihood of people stopping smoking but can also indirectly inhibit the spread of knowledge about the hazards of smoking.Although in northern European countries there is an identified downward trend in smoking, particularly among professionals, this is much test marked in the southern European countries. In I985, 64 per cent of Spanish physicians smoked and one third of these said they did not consider it of any importance to set a good example to their patients. In the United Kingdom doctors and teachers are not doing badly but nurses have not done well at all and were in fact increasing their rate of smoking until very recently.In 1992, the Department of Health in the United Kingdom produced a document called ‘The Health of the Nation. It included as an objective the reduction of death and ill health from cancers and acknowledged that tobacco use accounted for around 30 per cent of all cancer deaths. Those who produced this policy on health acknowledged that a reduction in smoking would depend on a number of measures, including health education, health promotion, new policies in the workplace and controls on advertising.Currently, some 33 per cent of men and 30 per cent of women in the United Kingdom smoke cigarettes. The number is falling and is predicted to be of the order of 25 per cent by the year 2000. The new health policies include a commitment to try to reduce the proportion of people who smoke cigarettes to 22 per cent of men and 21 per cent of women by the year 2000. If even this modest goal can be achieved there should be a major impact on lung cancer deaths and the many other tobacco-related cancers.More powerful and pervasive economic forces are also at work. The case against smoking is overwhelmingly strong and a large reduction in mortality from many important cancers would be brought about if we could eradicate the habit of smoking within the European Community. The health departments of the member countries are active on the anti-smoking front and the Europe against Cancer campaign has been particularly energetic in organizing campaigns against smoking. There are many reasons why such campaigns are not having a dramatic impact, and we have already touched on some of these.*120\194\4*

ARTHRITIS AND DRINKING WATER—A CURSE OR A BLESSING ?Arthritis and drinking water are definitely related. They have been down through the ages. To understand the role which water plays in your arthritic condition, we must go back through history.If we study the effects of water on animals, we can learn a great deal and draw comparisons with our own bodies. Which animal should we use as a “guinea pig” for our tests on arthritis? A chicken, a monkey, or a rat? No, let’s use a dinosaur.Arthritis appeared in animals thousands of years ago, even before man was on the earth. In fact, the earliest cases of arthritis probably developed about 200,000,000 years ago! The victim’s name was not Jones or Smith. It was Tyrannosaurus Rex, or some such dinosaur-like title.Yes, paleontologists have found symptoms of arthritis in the vertebrae of prehistoric land monsters. Examination of fossils show that the backbone of these creatures closely resembles the spinal arthritic changes of modern mankind. In the museum of the University of Kansas, one can examine the remains of an arthritic sea reptile, dead more than 100,000,000 years. This prehistoric swimming beast was known as a mosasaurus. Its fossils plainly exhibit chronic arthritis in the backbone and other joints.Some Really Old Cases of ArthritisIn other museums there are numerous fossils proving the susceptibility to arthritis in ancient men and animals. Chronic osteo-arthritis predominated then. Arthritis has been found in the small triassic and the diplodocus dinosaurs, as well as in the oreodon, a mammal. The primitive ungulates of 50,000,000 years ago also had it.The crocodile of 15,000,000 years ago, the camel of 1,800,000 years ago, the cave bear and the sabre-toothed tiger of 500,000 years ago—all show the markings of arthritis.Arthritis strikes the Earliest ManOf the early two-footed animals known as “man,” skeletons show that the Ape Man had a deformed spine. The “Java Man” was afflicted with bony spicules of the long bones, typical of osteoarthritis. The “Lansing Man,” round about the year 500,000 B.C., had multiple arthritic involvement of the lumbar vertebrae, first metatarsal bone, and the hip and knee joints. The Neolithics, the Ptolemaic Egyptians (who inhabited Alexandria during the Greek and Roman periods), the Copts of early Christian times, and the pre-Columbian Indians of America—all have borne the curse of arthritis in their bones and joints.The symptoms in these mammalian, reptilian, and amphibian fossils do not vary much. All these cases definitely belong in the category of osteoarthritis. They all could be diagnosed as “wear and tear” on the joints. Yet not every dinosaur and not every man had the disease. Some managed to stay well. Which means there must have been other causes—in addition to “wear and tear”—that had led to their arthritis.Was “Old Age” Responsible?What, then, did prehistoric animals and men have in common with the osteo-arthritics of today? The process of ageing has been suggested as the probable cause of their ailments. But the fossils of some “young” dinosaurs show arthritis, too. Just as the disease often strikes humans today in their thirties or forties. Age must be ruled out as the answer.The chronic arthritic of today is invariably troubled with constipation. It is a little late to check for this symptom in prehistoric mammals. All that is left of them are some bones and teeth. By the same token, it is too late to study the changes in skin, scalp, nails, etc., of ancient Egyptians, Greeks, and Romans. We will never know whether they lacked lustre, sheen, natural oils, or showed other signs of dryness.No records were ever kept to show whether early-day arthritics had kidney or thyroid difficulties. Perhaps their muscle or liver tissue showed degeneration. Muscle and liver tissue specimens are now being examined in some arthritic clinics. These tests are comparatively new, and are not widely used as yet. We hope they will be soon.As in the case of modern human beings, climate was not the basic cause of the arthritis in prehistoric animals. The beasts were found living all over the world, in all climes, and they still had arthritis.Certainly, we cannot accuse prehistoric animals of drinking carbonated soda pop, seltzer, tea, or other acid beverages. But they did have one liquid in common with us. Whether it was 200,000,000 years ago, or last Friday night, arthritics drank water.Water, Water EverywhereMosasauruses swam in water, as did the Egyptian crocodile. They drank a lot of it, too, during their meals, while munching on live fish. The Ape, Java, and Lansing men all were known to quench their thirst with water. They had no diet controls and no knowledge on how to shift their liquids to the proper part of their meal. Can this be the key to the cause of arthritis down through the ages?Do not get the impression that water alone can cause arthritis. Not in the sense that one glass of water can create pain just because you drink it with your meal. But it does slow down digestion, leads to faulty assimilation of food byproducts and cuts off the supply of oil to your joints.How Much Water in the Human System ?Let’s remember that we all have a great deal of water in our bodies already. The average man has approximately 100 pounds of water in his chemical make-up. This liquid forms about 70 per cent, of the body. Blood is 90 per cent, water, and our human bones are 22 per cent, water. This liquid—H20 (two parts of hydrogen and one part of oxygen)—is an essential part of every cell in our body.Men can survive longer without food than without water. If you lose just 20 per cent, of the body’s water supply, it can mean dehydration and death.We should take note of the fact that there are several different kinds of water. Distilled water, spring water and the regular reservoir type, for example. Water can be hard or soft. Hardness depends on the presence of mineral salts like sulphur, iron, and magnesium. When an arthritic thinks that mineral water is helping him keep regular, it is probably due only to the vast quantities he is drinking at regular intervals, rather than to the mineral content.How Water Serves UsThere is no doubt that water is vital to our health, if we drink it at the proper time. It aids in digestion, assimilation, circulation, and excretion. Through water, body heat is distributed quickly and in the right proportions. When too much heat is produced, the body cools itself by an air-conditioning method of its own, using the lungs and skin.Water also helps transport waste products from tissues to the blood, and then through the kidneys. It serves as a watery cushion for our central nervous system. All embryos develop in a water environment. It is said that even our backbones shift continuously in a watery medium.Sometimes an arthritic in a hospital depends on water for physical treatments. If he’s in a wheel-chair, he may need water therapy. It could be whirlpool baths, or exercises in a warm pool. Buoyed up, he is able to flex and work his muscles.*33\146\2*

BREAST IN NIPS: EARLY DETECTION MAY SAVE YOUR LIFEAbout 50% of all women will develop a breast lump before they reach menopause. The vast majority of these lumps are harmless. In fact, 80% of all lumps that are biopsied (tested) are benign (not cancerous). But some lumps are malignant (cancerous). With early detection, there may be more options for treatment and a better chance to catch any cancer that may spread to other parts of the body.Men can develop breast cancer, but it’s extremely rare.Although some risk factors for breast cancer have been identified, 70% of all women who develop the disease have no known risk factors. Having one or more of the following risk factors does not mean that breast cancer is inevitable:Over 50 years oldHaving a mother or sister who has had breast cancer, especially if the cancer was in both breasts or developed at an early ageEarly menstruation and/or late menopauseHaving a first child after the age of 30, or having no childrenA previous diagnosis of breast cancer
Note your symptoms A mass in the breast tissue may be hard or soft and can have a smooth orirregular contour. The size can range from microscopic to quite large.While some lumps are tender or painful, most are painless.
Some women have naturally lumpy breasts (called benign fibrocystic breasts). Fibrocystic breasts will feel lumpy and tender, and several lumps will be detected. The lumps usually increase in size just before menstruation and then disappear for a while when your period {menses) begins.
Fibroadenomas are another common type of breast lesion, characterized by a rubbery, firm, smooth mass. They are most often found in women under 30 and are almost always benign. Surgical removal of the lump cures the problem.What you can doTHREE-PART SCREENING PROGRAMMonthly breast self-examination: By taking a few minutes to check your own breasts each month, you will become familiar with how they normally feel and will be able to identify changes. If you still menstruate, the best time to examine yourself is two to three days after your menstrual period has ended. If you no longer menstruate, choose the same day each month to do the exam (the first day of the month, for example).  Call your doctor if you discover any lumps, discharge from nipples or have any concerns.Professional breast examination: Recommended for all women during routine checkup, beginning annually at age 40, or at age 35 if there is a family history of premenopausal breast cancer in mother or sister.Regular mammography: A mammogram — an x-ray of the breast — is generally recommended for all women beginning at age 40. It is not recommended that women under 40 have routine screening by mammogram unless there is a history of premenopausal breast cancer in mother or sister.
FIBROCYSTIC BREAST LUMPSFibrocystic breast lumps do not require treatment. Most associated pain or discomfort can be relieved by:Using mild analgesics such as aspirin, ibuprofen and acetaminophen (Tylenol). NEVER give aspirin to children/teenagers. It can cause Reye’s syndrome, a rare but often fatal condition.Wearing a larger or more supportive bra during the premenstrual phaseEliminating caffeineExamining your breasts on a monthly basis. This is very important because the presence of cysts may make it more difficult to find a potentially dangerous lump. However, women who have benign breast lumps are not at a higher risk for breast cancer.
Final notes Call your doctor as soon as possible if you think you have a breast lump, have unusual nipple discharge or have unusual pain or tenderness in your breast. The call could save your life.*104\303\2*