Mens Health Blog. Medical Blog

Pain is often associated with melancholia and depressive illness. There are two main types of psychological depression. In one type the depression results from a reaction to the loss of some loved one or to worry about some misfortune or wrongdoing. The other type of depression is not caused by any loss, misfortune, or wrongdoing, but comes on from some internal force acting upon us. But with severe depression there is a tendency to blame one’s self. In this state of mind it is easy for psychological pain to develop. The patient feels depressed, he keeps thinking that he has done something wrong, and that he should be punished. He feels that pain is his just desert.

It is important to remember that if your pain is associated with mental depression that shows itself in a tendency to be tearful or just a difficulty in getting started at everyday tasks, then you should see your doctor. If the pain is in fact due to depression it is often effectively relieved by taking one of the new anti-depressant drugs.

We must be clear in our mind about the relationship of pain to depression. Sometimes depressive illness becomes the cause of chronic pain, at other times pain from some other cause brings about nervous depression.

*114\57\2*

Q. At long last, let’s get on to the standby therapy of the past fifty years or more — antacids. What is their current status in ulcer treatment?

A. I’m glad you mentioned them, for the current reaction to them is a mixed one. For many years they have been the sheet anchor of therapy, but mainly by default rather than because of their intrinsic worth.

There is little doubt that they will reduce ulcer pain. However, as far as healing is concerned, evidence indicates that very large doses are required. According to a leading Sydney gastro-enterologist who has treated ulcers for many years, “when given in high dosage (equivalent to 30 ml double strength aluminium hydroxide gel one hour before and after each meal and also before retiring), antacids have also been shown to be effective in treating peptic ulcers. Liquid antacids are generally more effective than tablet formulations, but are less convenient for the working person.”

Q. Could taking all that medication each day in itself produce unpleasant side effects?

A. It seems this is possible and many patients on high doses may develop diarrhoea or constipation. Also, long term, a condition called ‘hypophosphataemia’ with anorexia (loss of appetite), muscular weakness, and a bone condition called osteomalacia may take place, if used in high doses over prolonged periods of time. Other side effects are also possible, depending on the type of antacid used. One case was recently reported in the medical journals of a patient with very large bladder stones which had developed after many years of taking a calcium antacid.

However, there is little doubt that used with discretion, and under proper supervision, antacids can bring a good deal of symptom relief. They are cheap, readily available and, in smaller doses, may do little harm, even if they are not as dramatically beneficial as some of the newer forms of medication. The antacids are available in many forms, as mixtures, tablets, powders. Many patients will continue using them, especially if there is occasional abdominal discomfort. What’s more, they often help in simple cases of dyspepsia, a feeling of fullness, bloat, and the unpleasant sensation which commonly follows from ‘dietetic indiscretions’, as the doctors succinctly put it.

*17\61\2*

While you should always first seek advice from your doctor if you’re troubled by back symptoms, there are also many instances in which other therapies can be very helpful. In fact, your doctor may well refer you to a physiotherapist or, at times, suggest that you consult a practitioner of an alternative therapy as many of these have a proven track record in dealing very successfully with back problems.

The so-called ‘other’ treatments are normally divided into two main groups:

The ‘complementary’ therapies that work alongside of and often as virtually part of conventional medicine; and

The ‘alternative’ therapies which, as the label implies, offer an alternative to conventional medicine.

Although the distinction between the two types of therapies is usually quite clear, it can become somewhat blurred when looking solely at how effective some of these ‘other’ therapies can be in dealing with back problems. For example, the relatively little known Alexander Technique is usually considered to be an alternative therapy. However, because it concentrates upon posture, something that is so directly and obviously relevant to back troubles, this method is perhaps more ‘complementary’ than ‘alternative’ when it comes to difficulties involving the spine.

Rather than try to classify therapies as either complementary or alternative, it seemed more logical in this book to separate them into two groups depending upon how commonly they are employed in treating back problems.

*16\124\2*

Salt substitutes contain potassium chloride in place of sodium chloride (our common table salt). Although by no means a “poison,” potassium chloride must be used sparingly, otherwise too much potassium will get into the blood and tissues.

If it accumulates in the body to excess, a letter to Journal of the American Medical Association (256:1726) points out, muscle weakness and heart beat disturbances with, eventually, complete stoppage of the heart, can occur. The chances of potassium toxicity developing increase when someone using a salt substitute is also taking medicine for arthritis, heart failure or high blood pressure.

The Journal, for example, tells of a lady who had been taking medicines for angina pectoris (chest pains due to narrowing of the heart’s coronary blood vessels) and had been consuming large quantities of homemade soup seasoned with salt substitute in place of regular salt. She became weak, could not stand, and complained of breathlessness and strange sensations in her limbs. In the hospital, she was found to have potassium intoxication, from which she was rescued with difficulty.

Although the labeling of salt substitutes (Morton’s Lite Salt, Morton’s Salt Substitute, Adolf’s Salt Substitute, No-Salt, Nu-Salt) warns the consumer that they should never be used without the advice of a physician, they can De purchased from supermarkets without a doctor’s prescription. Few people, therefore, are likely to take the warning seriously.

Furthermore, since salt is known to be dangerous for those with high blood pressure or heart failure, salt substitute products are generally thought of positively rather than negatively so far as their effects on health are concerned. Obviously, the public must be made more aware of the potential harm that can be done by salt substitutes.

*223\143\2*

Symptom

Red, blistering, painful skin

Home care

-    Prevent sunburn by regulating the child’s exposure to the sun and using an appropriate -sunscreen.

-    If the child does get burned, apply cold water compresses, then burn ointment, or a paste of baking soda and water to the burned area.

-    Give aspirin or paracetamol for pain, and antihistamines for itching.

-    Avoid breaking the blisters of sunburn.

Precautions

-    The sunscreen used on a child should contain para-aminobenzoic acid (PABA), titanium dioxide, methyl anthranilate, or sulisobenzone.

-    Sunscreens come off in water. Follow the instructions for reapplying the product after the child has been swimming.

-    Remember that children and babies can be burned by sun coming through a window.

-    Use sunburn medication sparingly; it can be absorbed through the skin and cause side effects.

-    Skin damage from overuse of sunlamps is often seen in teenagers.

-    Some medications increase sensitivity to the sun, and a child who is taking^ such a medication should use a sunscreen and limit exposure to the sun.

-    A child who has sunburn accompanied by fever or extreme fatigue or weakness needs a doctor’s care.

-    Fair-skinned babies and children can burn even on cloudy days or in shade.

*210/84/5*

The background problems at work are straightforward enough. For the most part we recognize them quite easily, and readily admit to them. But those at home are more subtle. There is a greater emotional overlay to the problem, and we often fail to admit to a problem that those around us can see quite clearly. As a result we may not be aware of the extent to which the minor problems at home contribute to our general state of stress.

“I have heard of women giving all their love to their children, so that none remains for the husband. Can a man give all his love to his work so that there is none left over for his wife? Sounds as if I’m joking, but I’m not. It’s deadly serious to me. All his physical energy, all his thoughts are directed that way. And his interest. Call it interest. I would call it love. And there seems little for me.

‘We are married only a couple of years. I work too. I like my work. But I can think of something else. What am I to do? Look around for another? I don’t want that. I tried to face him up with it. But all he said was that he did it for me. Did it for me because he loved me!

‘I want to cry. But I won’t let myself. Just a minute. No. Now, I am all right. He made my complaint seem heartless. I am young. Want to be loved, want to be cuddled. To feel his love, body to body. I feel deprived. Feel hostile. Keep worrying about it. Worry about it at work. Wonder what tonight will be like.”

In my experience this state of affairs occurs most commonly in men who have experienced poverty in early childhood. They strive for security. They are driven on, consciously or unconsciously, to make sure this will not happen to them again or to their children. In other cases the man’s father has been successful, and he is driven on to emulate his father. In either case the wife is made miserable, and at the same time has inflicted upon her a background of circumstances ready to produce stress.

The workaholic is usually a person who is basically conscientious with a tendency to be neat and tidy. He checks over things so as to be sure everything is just right.

The young man is not fully aware of what he is doing. This is a practical problem. It is really quite simple and does not warrant the intervention of a psychiatrist. Better a talk with an understanding general practitioner. It is wise to bring a third party into it, rather than the girl having a confrontation with him herself, as this is only likely to raise hostility between them.

And as for the girl, the more she can do to reduce her level of tension, the better she withstands the frustration. And it is well to remember that we all have different characteristics in our personality. A woman can influence a man towards her values without expressing the ideas in words, but simply through the closeness of their being together, physical, intellectual and spiritual.

*8/98/5*

Hives or Urticaria

Hives is an illness characterized by itchy wheals on the skin accompanied, at times, by fever and nausea. It may be acute and last a few hours to a few days or chronic and last months or years. Its common causes are foods (fish, chocolate, nuts, cantaloupe, and corn), drugs (penicillin and aspirin), bee and insect bites, worms in the stool, bacteria in decayed teeth or infected gallbladders, and emotion. Its prevention is through avoidance of such sensitizing foods, drugs, infections, or emotional stress. Treatment (in acute hives caused by a food) is a light purge, to be followed by an allergy-free diet for a few days. In any other form of acute hives, adrenalin and antihistamines have to be used. Chronic hives respond to the long-range use of tranquilizers. Steroids in the treatment of hives should be reserved only for refractory cases that have not responded to the above treatments.

Unusual Forms of Hives

Hives may be caused by allergy to a physical agent such as cold, sunlight, or mechanical pressure. This is proven by the fact that many children who suffer from this kind of allergy have a family history of other allergic disorders as well; that generalized hives may occur even after local exposure to a physical agent; that a gradual desensitization against the causative allergens (with repeated exposure to the physical agent) is possible; that anti-allergic drugs (such as antihistamines) provide relief in this type of hives.

Cold may cause hives after cold showers, after touching ice cubes, or after bathing in the ocean. Accidental drownings have been related frequently to severe systemic reactions caused by massive histamine release while a person is swimming. Children with this sensitivity have to be desensitized against cold by plunging their hands into water that is 50°F. (Use a thermometer to check the temperature of the water.) The first week this must be done twice daily for one minute; the second week, twice daily for two minutes; the third week, twice daily for three minutes; the fourth week, twice daily for four minutes; the fifth week, twice daily for five minutes. If by the fifth week of treatment there is no improvement, the period of desensitization has to be increased by one minute each day until the child’s hands are submerged ten minutes per bath twice a day. If no relief is forthcoming, treatment has to be discontinued.

Sunlight may bring about urticaria caused by ultraviolet rays. The swelling and redness of this urticaria are present in the exposed skin; that is, on every part of the body except under the bathing suit. Sun-screening oils must be used before exposure, and antihistamines are also helpful if taken beforehand.

Overeating, gluttony, and excitement may cause hives by promoting the absorption of foods which are not properly digested.

Horse serum used in the treatment of tetanus may cause hives one week after the injection.

Inhalants (dust, molds, or pollen) may cause hives, a condition which usually responds to desensitization.

*38/99/5*

Foetal Alcohol Syndrome

In its most extreme form, a mother’s alcohol consumption can cause Foetal Alcohol Syndrome (FAS). The characteristics of this syndrome include abnormalities of growth, craniofacial, musculoskeletal, cardiac, nervous system and neuro-developmental delay or mental deficiency, with an average IQ of 65. Babies born with Foetal Alcohol Syndrome will look visibly different from other babies. They may have reduced weight, length and head circumference compared to healthy babies and may be labeled as ‘failing to thrive’. The nasal bridge can be poorly formed and the baby may have large ears which are simply formed. They may also have a cleft palate. Limb defects are also common, including such problems as congenital hip dislocations. Congenital heart disease is also a concern. As with any drug, the newborn baby may display signs of withdrawal symptoms, such as restlessness, and being fretful and tremulous.

Foetal Alcohol Effects

It is now recognized that some children do not bear the severe physical characteristics of FAS but still have subtle mental or behavioural difficulties caused by being exposed to alcohol in the womb. These characteristics have been identified as Foetal Alcohol Effects. And they are produced merely by ‘social drinking’.

One study looked at the effect of consuming two or more drinks most days during the pregnancy or binge drinking (drinking five or more drinks in one go, at a party for example) before the mother realized she was pregnant. The babies born from these mothers were followed over seven years to see how they progressed. From the beginning, the babies had a lower than average birth weight and were more jittery. They had difficulty establishing a good sucking pattern and had disrupted sleep patterns. From eight months, their ñî-ordination was not good and they still had disrupted sleep patterns.

A follow-up study at seven years old showed that those children whose mothers had been drinking two or more drinks a day were seven points lower in their IQ scores than the average seven-year-old. Children of mothers who had been binge drinking before they realized they were pregnant were approximately one to three months behind in reading and arithmetic. Other tests from this study showed a poor attention span, problems with memory and negative behaviour patterns.

In fact, they had some of the classic symptoms of hyperactivity, now called attention deficit hyperactive disorder (ADHD). Cause and effect can be so difficult to pinpoint when results may be present seven years after the actual cause. But, instead of focusing attention on drugs such as Ritalin to control hyperactivity, maybe funding should be ploughed into preventative measures which could be as simple as asking women not to drink at all during pregnancy.

Alcohol is also a diuretic so it increases the urinary excretion of valuable vitamins and minerals. Zinc, a very important mineral during pregnancy, is depleted with alcohol consumption, and studies show that when zinc levels are reduced, low birth weight and foetal malformations can follow. Folic acid deficiency can also result from the diuretic effect of alcohol and this is the nutrient known to help prevent spina bifida.

Clearly, alcohol is a toxin and there is no limit below which it is safe. In this situation it is definitely not the case that ‘a little won’t harm’ and I cannot emphasize too strongly how important eliminating alcohol is to the health of your baby.

*114/73/5*

There are two forms of suicide. True suicide is when a person kills themselves; para-suicide occurs when someone makes an ‘attempt’ to commit suicide but does not succeed.

Suicide is as old as the human race, and over the centuries has been condemned by Church and State. It is, however, an uncommon form of death, causing only about 1 per cent of deaths in the UK. In the under 20 age group, though, it is the second most common cause of death-after accidents. Suicide is still a crime in several US states but in the UK it stopped being illegal in 1961.

Although the actual number of suicides is falling in the UK and the US there is no room for complacency. Suicide is still twice as common in the US as is homicide and the figures for homicide are not low. Overall, in the US and UK, suicide is the fifth most common cause of death.

Why do people do it?

• If three or more of the following factors apply to an individual, he or she must be considered to be at risk of committing suicide and should have professional help:

1. Depression (undoubtedly the major cause).

2. Severe insomnia.

3. Severe hypochrondriacal preoccupations.

4. A previous attempt at suicide.

5. A history of alcohol or drug abuse.

6. Schizophrenia.

7. A disabling painful disease or serious physical illness.

8. Social isolation.

9. Repeated suicidal thoughts.

10. A history of suicide in the family.

11. A history of bereavement, or recent bereavement.

12. Unemployment or financial problems.

13. Recovery from depression.

Suicide is three times more common among divorced people than among the married and is also more common in the single than the married. Minority racial groups have higher suicide rates in almost every country that has been studied.

Although at least twice as many women suffer from overt depression as do men, far more men than women kill themselves. In the 80-84-year-old group seven times as many men kill themselves as do women.

For a quarter of a century professionals and executives have headed the list of successful suicides and among these health professionals come high up. Twice as many doctors kill themselves as do other professionals, for example.

‘Why go on living?’ is a common thought when depressed people contemplate suicide. Life for them has reached a point where it appears to have little meaning and they can see no end to their problems or a future for themselves. These thoughts are especially indicative of trouble if they are out of character for the individual concerned.

• A sudden impulse after a disappointment or a row can lead to spur-of-the-moment suicide. This is relatively uncommon and the suicide is usually unsuccessful. Sometimes a person who has just learned of their partner’s infidelity or serious illness walks around in a daze of rage or distress and falls under a car, oblivious to its presence. Such ‘suicides’ are preventable if the individual is protected from him-or herself during this ‘at risk’ stage.

• Physical or mental exhaustion can trigger suicidal thoughts, even in non-depressed people. Repeated loss of sleep with endless mental and emotional trauma can wear down the most normal of people. This can happen, for example, in young mothers-the world simply gets on top of them temporarily. If they are not depressed, such people rarely want to die, and the opportunity to vent their feeling-perhaps by a good cry, a holiday, or the solving of practical problems-often alleviates their distress.

• Some people who try to commit suicide but are unsuccessful are trying to communicate something to those around them, and often to one person in particular. A husband or wife begging his or her partner to be faithful, a teenager trying to get some love and attention, are but two of the many examples. Such people rarely kill themselves, except accidentally as a result of dicing with death.

*230/72/5*

If you are not in a high-risk group the chances of contracting AIDS are negligible. The virus has been found in saliva, which gave rise to scares about catching it from poorly washed cups and glasses, but so far there is no evidence that people in close non-sexual contact with AIDS sufferers have contracted the disease.

Those most at risk are:

•     Homosexual males.

•     Drug addicts who ‘main-line’ (inject themselves).

•     Those who receive several or repeated blood transfusions, such as hemophiliacs.

•     Those who have intercourse with someone of the opposite sex with the disease.

•     Those who share a razor or a syringe with an AIDS sufferer.

As a result of this knowledge preventing AIDS is relatively straightforward, at least in theory.

•     If you are homosexual cut down or cut out altogether your promiscuous sexual activities. There is good evidence that both homosexual and heterosexual promiscuity has fallen since the AIDS scare began and the level of all venereal disease is falling as a result. If you are homosexual, stick to one partner.

•     If you are a woman, be aware of the possibility that a sex partner may be bisexual and a carrier of the disease. Although AIDS is very uncommon in women in the West it is estimated that about 100 women in the US have contracted AIDS from a bisexual partner.

•     Hemophiliacs have repeated blood transfusions for their condition and often use pooled blood products which may have been contributed to by hundreds or even thousands of donors’ blood. According to a US study virtually all hemophiliacs have been exposed to the virus yet only a tiny percentage goes on to develop AIDS. The only preventive measure possible here is to reduce the situations in which hemophiliac children hurt themselves and so require blood or clotting factors, thus reducing their chances of exposure to the AIDS virus. Various countries around the world are enacting laws to forbid homosexuals and drug addicts to give blood or to donate organs for transplant. In the UK all blood products are now screened for the AIDS virus and the special substances given to hemophiliacs are heat treated.

•     Don’t share a razor, or needles for administering drugs, with anyone who could be in a risk group.

•     Don’t have anal sex with anyone who could be infected. The delicate anal tissues are more easily torn than those of the vagina and thus let the virus in.

*91/72/5*