For many years, Liz, thought that her son’s congenital problems were a fluke. Just one of those terrible things that happen to some people. But all that changed, when she found she was pregnant again.She made an appointment with her obstetrician. After some tests, the nurse walked into the examining room with a paper and pen in one hand and a needle in the other. She brusquely asked Liz to sign a paper so she could proceed with the “progesterone” shot. Liz began to read the waiver. It was for the same synthetic progesterone she had been prescribed for Charlie’s pregnancy. The waiver contained the FDA’sstrongest warning, called a “Black Box Warning”, describing all the possible side-effects. Included in that list were birth defects, such as “genital abnormalities” and “risk of hypospadias” (urethra opening at the bottom of the penis).”Then it hit me like a ton of bricks. Oh my God, that’s what caused my little boy to have this horrible birth defect!”.Even though the warning was dated years before Liz’s first pregnancy, her doctor had never presented her with the waiver nor warned her of any possible side-effects. In fact, her doctor insisted that synthetic progestins were totally safe. Liz finds it incomprehensible that many in the medical profession, in spite of the FDA’s Black Box Warning, continued to prescribe the synthetic progestins instead of the totally safe bio-identical progesterone, known as natural progesterone.*39/165/1*

The benefits of intentional weight loss can be very significant. In addition to the directly physiological changes, improvements in disease risk markers, there is also an improvement in comorbid disease control and, not to be forgotten, the very profound psychological benefits that can follow.In 1997, Jung published estimates of the benefits of intentional weight loss. He estimated the effects of 10% body weight loss that being an average of 10-kg weight loss in subjects averaging 100-kg in weight. Jung’s study also recognized that a 10% loss of bodyweight produced a >50% decrease in the risk of developing type 2 diabetes, a fall in fasting glucose levels of between 30 and 50%, and a 15% decrease in HbA1c. Clinical experience shows that even a 5% bodyweight loss can produce quite profound benefits and many patients will express subjective improvements of decreased breathlessness’, less weight-bearing joint pain, more energy and a more positive outlook.To achieve these long-term health benefits, initial weight loss has to be maintained. In developing any weight-loss programme the emphasis must be on long-term weight management, and this has proven to be the greater challenge over early weight-loss success. The long-term prospects for those who are able to maintain their weight loss can be very significant. Hypertensive patients might be able to manage their hypertension and find they no longer require a prescription of antihypertensive agents. Type 1 diabetics might be able to reduce their insulin dosage levels, type 2 diabetics might decrease and even remove their need for hypoglycaemic agents. Additionally, they are highly likely to delay the onset of cardiovascular disease and to improve their life expectancy.However, many experts would emphasize that the improvements are best seen as a means of delaying disease and long-term monitoring of those at risk is essential. Recent research would suggest that those who are obese at the age of 40, despite long-term weight loss, do carry a decrease in life expectancy of approximately 3 years.*63/312/5*

Aspirin This is the commonest pain reliever and nearly every one has taken this drug, but only in recent years has the way it works been found out: it acts by preventing the formation of prostaglandin, a naturally occurring fat with a wide variety of actions. Other drugs besides aspirin work in this way and include a variety of anti-rheumatic drugs such as indomethacin, phenylbutazone, ibuprofen, and Anturan. Many migraine sufferers show a good response to these drugs, the headaches being lessened in intensity and frequency when these compounds are used prophylactically.Trials have started to assess the value of sulphinpyrazone (Anturan) in the treatment of migraine. This type of drug can be used when food allergy causes migraine.
AntihistaminesAnti-inflammatory substances used by migraine sufferers include indomethacin, an anti-rheumatic agent, and disodium cromoglygate, a substance that prevents the release of histamine and other substances concerned with inflammation and proven to be effective in asthma and hay-fever. Platelets release histamine as well as 5HT. Many people with hay-fever take antihistamines, which act by preventing the effect of histamine on tissues, e.g. inflammation and irritation of the lining of the nose, eyes, and throat. There are a number of other compounds used in migraine which have anti-5HT effects and antihistamine effects.The part histamine plays in the production of migraine attacks is uncertain and results with antihistamine preparations have been disappointing except in cluster headaches and in some patients whose migraine may be allergic in origin.
*63/152/5*

Sleepless nights with itchy skin are common during the last trimester of pregnancy. The cause of this condition is unknown but it spontaneously resolves after delivery. There are several remedies for this annoying condition:- Soft, cotton clothes should be worn directly against the skin to minimize itching, while rough fabrics and wool will make the skin itchier.- Keeping cool, particularly at night, is also important. Use fans and air-conditioners and do not have too many bed covers.- Bathing in cool, soothing bath oil, such as Alpha Keri, Hamilton’s Bath Oil or QV Bath Oil is helpful, and excessive use of soap should be avoided.- Cooling creams such as menthol cream and cold compresses are beneficial. It is best to avoid topical anesthetics and antihistamines as they often cause allergic reactions which make the skin itchier.- Topical cortisone creams can be very helpful and are safe during pregnancy, but should be used only under a doctor’s supervision.- Oral antihistamines are often needed when the itch causes sleeplessness, and many are safe during pregnancy.
*30/150/5*

If pain persists and treatment fails, it is not surprising that depression sets in. Some patients plod sadly on, convinced that somewhere in the world there is a therapist with the answer. For some, it is a variation of the same answer but administered by a therapist with the right stuff. It is well known in affluent countries for people to have more than ten repeated operations on the same painful back. Surgeons are nothing if not high in confidence, and are not above hinting to the patient that they had been unlucky to encounter incompetent butchers before they reached the right one.Early in his career, the Canadian neurosurgeon Wilder Penfleld learned that his sister had a brain tumour and said: ‘She must be operated on by the best neurosurgeon in the world. Me!’. Sometimes these charismatic fireworks are associated with success and sometimes not. The higher the patient scales the ladder of more and more distinguished therapists, the harder the fall. Frustration and anger are added to depression. Depression is a progressive certainty in a miserable future. Attention scans every detail of the pain to confirm that no change for the better has occurred and that it is in fact even worse than suspected. Every small change becomes a catastrophe for some.This grim picture of anxiety and depression, phobia and fatalism is so commonly seen in chronic pain patients that there are those who claim that these conditions become the primary cause of pain, rather than being secondary to the pain that caused the anxiety and depression. Needless to say, this view is popular amongst doctors committed to some therapy that has failed a particular patient. Such doctors believe they have given the appropriate therapy to the patient and if the patient fails to respond, it must be the fault of the patient. There are, of course, psychologists of the ‘mind over matter’ psychosomatic school who are happy to support doctors who claim that the apparent body fault must be produced by faulty thinking if patients have failed to respond to therapy. One important school of behaviour therapy believes that one can condition the patient out of his pain by ignoring any sign or word associated with pain, and by rewarding and encouraging any sign or word associated with non-painful activity. Of course, smart patients soon learn what the therapists want and shut up about their pains. They are considered successes.I have not seen a scrap of convincing evidence that the mood and attitude create the pain. A recent new successful therapy by the surgeon Bultitude at St Thomas’ Hospital in London provides clear evidence that the pain drives the attitude. A rare urological disease, ‘flank pain with haematuria’, is characterized by intense pain, no known pathology and no known therapy. The patients are anxious, depressed, heavy users of narcotics and are at their wits’ end. The treatment consists of flushing the affected kidney under anaesthesia with a specific nerve poison. The patients become pain free and at the same time their anxious depressed personalities return into the normal range. These are not anxious, depressed personalities liable to create or exaggerate kidney pain.However, there is no doubt that the pain-produced anxiety, fear, depression and obsession feeds back onto attention and posture and makes pain and living with pain harder to bear. Therefore, every effort made to treat these helps the patient. Rehabilitation programmes focusing on education, movement and relief of fear, depression and anxiety do not cure pains but give the patients a freer lifestyle.*78\219\2*

Only 1 per cent of people can’t – try it. You might have to try on a few occasions before you can be sure, but the more you practise, the more sensitive your hands will become. The movement used to build up the field between the hands is like that of playing a concertina slowly:J   Sit in an upright chair with your back straight but not tense, drop your shoulders and breathe slowly from the abdomen. If you can continue to do this while you are following the rest of the exercise it would be better, but if you cannot fit it in with the rest just do a few slow breaths before you start.2 Stretch your fingers out wide and become aware of the palms of your hands.3 Rub your hands together briskly for about fifteen seconds.4 Hold your hands about eight inches apart then gradually bring them towards each other until they are about one inch apart; do not let them touch.5 Separate the hands again, this time to about six inches apart and then bring them towards each other, again without touching.6 Separate them once more, and this time bring them together again and bounce them together, remembering to keep the hands relaxed. You will feel a resistance or a feeling of pressure between your hands. Some people say they feel as if there is foam rubber between their hands, others describe feelings of heat, tingling, throbbing or pulling.*132\326\8*

Surgeons throughout the world have devised a number of approaches to diseases of the coronary arteries. Fortunately, surgery is not necessary for most people who have these diseases.Persons who have recently sustained a heart attack or who have developed angina pectoris should be carefully evaluated for the presence of any factors that could have predisposed them to the event. One or more causative factors are frequently found that can be altered to reduce the patient’s chances of developing additional trouble. The surgical attack to this problem is usually aimed at removing obstructions or bypassing obstructions in the coronary arteries. The goal is to improve the blood supply to the heart. The angina patient has a narrowing in his coronary arteries at one or more places, with inadequate blood flow beyond the obstruction. The heart attack patient has a blood vessel blockage that produced heart damage, and he hopes to avoid additional blood vessel occlusion and a subsequent heart attack.When considering medical versus surgical therapy for coronary artery disease, two important points must be kept in mind. First, a localized artery narrowing of 95 percent may still allow an almost normal quantity of blood to pass by through the compensatory mechanism of increased flow. This phenomenon occurs in nature when a wide, lazy river narrows down to a gorge and the water rushes through the narrows. Second, during the process of removing or bypassing obstructions in the coronary arteries by surgery, only parts of the total arterial system are repaired. It is impossible to widen all the narrowed areas.I have frequently seen men or women recently afflicted with angina pectoris who have obtained complete relief from pain during certain activities by giving up cigarette smoking. These activities were previously incapacitating, since they predictably caused severe chest pressure. The exact reason for this is not known, but nicotine probably causes blood vessels throughout the body to constrict, or narrow down. The heart then must work harder to pump blood through these tinier channels at a higher pressure. Removing the nicotine results in a relaxation and widening of the blood vessels and decreased heart work.A large number of patients are also found to have high blood pressure associated with their angina or heart attack. Hypertension probably preceded the onset of heart disease and may have accelerated the development of coronary artery narrowing. Effective drugs are available that will lower most blood pressures, and it is very common to find that a person has less angina after his pressure returns to near normal. Similarly, a person who has hypertension and develops a myocardial infarct is less likely to have a subsequent infarct if elevated blood pressure is brought under control.Obesity is a common finding among heart attack victims. The heart’s work is increased with every pound of extra weight that a person carries above his bare minimum weight. A person who is 30 pounds overweight may decrease the amount of work that his heart performs by 20 percent if he reduces his weight to ideal levels. This reduction of heart work may very well compensate for the amount of heart muscle that has been lost by a heart attack. An obese heart attack patient may therefore end up no worse off after a heart attack if he can shrink his size. The angina patient has chest pain because, at a certain level of body activity, his coronary arteries cannot supply enough blood to the heart muscle. The heart muscle will need less blood to function if he looses weight because the heart will not have to pump as much blood to his thinner body during the same amount of exercise.*16/309/5*

Harvinder was to participate in a debate to be held in School after a week.She had fully prepared her lesson, remembered it thoroughly and had rehearsed it successfully at home. But she was apprehensive. After all it was to be her first appearance before a large audience. What if she became tongue-tied before uttering a word and what if her memory failed at the time. But she was unnecessarily worried, because 3 doses daily of the combination-Mimulus (for fear of a large audience) and Scleranthus (to ensure remembering at the proper time) given 3 days before the date ensured her success in the school debate.Miss Supreet Kaur—6 years—had a very weak memory. She took quite sometime in expressing herself. She used to grind teeth at night during sleep, had no appetite and had aversion for milk and could not control her bed-wetting habit. She was afraid to go to school for fear of punishment from school teacher and was always depressed and sad. A dose of Cina 200 T.D.S removed her “worm symptoms’ i.e. teeth grinding, loss of appetite etc. Mimulus Remedy given T.D.S. for 3 weeks removed the fear complex from her mind and she started going to school by herself and her memory improved. With the same treatment continued for 3 months’ she became a normal child.*141\308\8*

Your health is influenced by many aspects of your life: diet, stress levels, exercise, environment, and emotion all play a part in your well-being.No matter how effective the substances we’ve discussed might be, they do not operate apart from the rest of your life. It is better to view them as part of a more complete, or holistic, approach to managing your disease process. Elements of this holistic approach certainly include eating a prudent diet, maintaining a proportionate weight for your height, and getting regular exercise. Steps based on ergonomics – the study of using your body efficiently – are also important. For example, you should try to adjust your seat height to keep your knee at approximately a 90-degree angle.Other non-medicinal therapies that may be helpful include physical therapy, acupuncture, and the application of magnets. Acupuncture is an ancient Chinese healing art in which very fine needles are placed in specific points to provide pain relief. The use of magnets is an offshoot of acupuncture that comes from Japan.Education and support is also very important. Learning about your disease and what you can do to improve the situation, as well as addressing the emotional impact that such physical problems can have on you, can make a real difference in how well you will respond to treatment.*84/306/5*

A single blood glucose measurement tells you what your glucose level is at that moment. It does not tell you what your glucose level was ten minutes ago or what it was earlier the same day. If you test several times a day and record all your results you can build up a picture of what is happening to your blood glucose level over weeks or months. If you wish, you can calculate your average blood glucose level at a given time of day or throughout a given period, as in the computer system I have just mentioned. Alternatively, hospital clinics are now using a single blood test which can give an indication of your average blood glucose level over a period of several weeks before the blood was taken. This is the glycosylated hemoglobin or hemoglobin A1c test.Hemoglobin carries oxygen in the blood stream, inside the red blood cells, and is responsible for their red colour. Each person has several types of hemoglobin including one called hemoglobin A1c. During the 120 days in the life of a red blood cell the hemoglobin A1c (like many other body proteins) is exposed to the prevailing blood glucose levels. Glucose is ‘attached’ to the hemoglobin A1c to form glycosylated hemoglobin. The percentage of glycosylated hemoglobin depends on how high the blood glucose level has been during the life of the red cells. Different hospital laboratories have different ways of measuring glycosylated hemoglobin, and thus different normal ranges, but as a rough guide, your glycosylated hemoglobin should be below about 8 per cent. The test is useful as a check on whether finger prick blood tests are giving a representative picture of what is happening to the blood glucose level. It is especially useful for diabetics who rarely or never test their blood glucose level. For example, Mark, who is thirty-nine, works in a horse racing stable and finds that his hands are too dirty to allow finger prick tests. When he went to his clinic, his blood glucose level (from a vein) was 7 mmol/1 (126 mg/dl) which looked very good. Then we saw that his glycosylated hemoglobin level was 18 per cent, indicating that he had had very high blood glucose levels over the preceding few weeks. His glucose level was 7 mmol/1 that day because he had missed his lunch rushing to get to the clinic. One of the difficulties in interpreting the glycosylated hemoglobin result is that a normal level may represent relatively high blood glucose concentrations alternating with hypoglycemia. Also, if you are anaemic or have any condition in which the life of the red blood cells is shortened, the result of the test is difficult to interpret. Nevertheless, it is a helpful test and some clinics now use it instead of blood glucose estimations.
*8/102/5*

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