Information on popular complementary and alternative medical topics

If you are at risk of developing osteoporosis you should start within about five years of the menopause for maximum effect, as these are the years of greatest bone loss; catch it then and your risks of a fractured hip or vertebra of the spine are greatly reduced. However, even starting much later will still give some benefit, and there are plenty of women who start after the age of 70 and still gain great benefit. There really is no time at which you are too old to start.

Much more research is needed into the effectiveness of HRT in older women, as most doctors in the UK seem reluctant to prescribe it to a woman over 65. This is a pity, as it can be of great benefit to them. The risk of developing osteoporosis and heart disease is much greater over the age of 65, so this would seem a good time of life to be taking HRT. Obviously, women with a uterus do not like the idea of returning to a monthly bleed, which may be heavy or painful, and they may also experience breast tenderness and leg cramps. An increase in sexuality can be quite disturbing after several years without it. This is balanced against an increased sense of wellbeing, less stiffness in joints and muscles, and more energy. Once again, it is a question of balancing the advantages to you against the disadvantages, and when no-bleed HRT is in general use this may greatly affect how older women feel about it.

How long you stay on HRT will depend on you, your symptoms and your long-term risks. For most women, two years is about average for hot flushes, etc, but if they return when you stop the HRT, then you will probably want to keep it on for a while longer. You may be one of those women who need HRT for five years, or even much longer, to keep flushes at bay.

For relief of vaginal dryness, vaginitis and recurrent vaginal infections, you will probably want to stay on HRT for as long as you choose to remain sexually active. Sex doesn’t have to stop in your fifties! For conditions which simply become worse as the years go by, such as incontinence,

osteoporosis and arterial disease, you may decide to stay on HRT for years, perhaps for the whole of your life. If you don’t like the idea of taking it for so long, it is thought that even five years’ treatment in the years immediately after the menopause will considerably reduce your chances of an osteoporotic fracture.

In the end, you will continue for as long as the benefits to you appear to outweigh the disadvantages or risks. Sadly, the majority of women stop taking HRT after about six months, perhaps because of side-effects, or a return of monthly periods, or because of scare stories in the media. In reality, there is no reason why most women should not be able to remain on it indefinitely. Should you develop conditions such as a coronary thrombosis, blood clotting, gallbladder disease, cancer of the breast or uterus or ovary, fiver or kidney disease, or if you have a big operation like a hip replacement, your doctor will probably advise you to stop taking it. Some doctors, however, feel HRT may safely be continued even in these circumstances, especially if coming off it might reduce your quality of life significantly more than suffering these various other diseases would. As with everything medical, in the end when you start taking HRT, and how long you remain on it, should be a joint decision made between you and your doctor.

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The research team was surprised to find how strikingly beneficial hysterectomy was for symptom relief, and concluded that ‘hysterectomy was associated with more marked improvement in symptoms and quality of life than nonsurgical therapy’. The women who had hysterectomies reported significant relief from bleeding problems, pelvic and back pain, pain during intercourse, abdominal swelling and urinary problems. Those who felt they benefited most from the surgery were those who had been most impaired by their symptoms. This impairment took the form of persistent discomfort or limitations on activity.

The study also found much lower rates of adverse effects of hysterectomy than expected. Earlier studies had reported problems with passing urine in 20-30% of women after hysterectomy, but the Maine study found this occurred in only 4%. Other studies have reported diminished sexual function in 15-30%, but although 7% of the Maine women reported being bothered by less interest in sex after their hysterectomy, only 1% reported less enjoyment of sexual activity, and the majority reported increased interest in, and enjoyment of, sex. Persistence of pelvic pain after hysterectomy has been reported to occur in 22% of women, but in Maine the figure was 5%. Importantly, 82% of women in the Maine study felt they had a choice about having the hysterectomy and, for most, six or more months elapsed between the decision to have surgery and the actual operation.

As a check on possible biases that might explain these sorts of findings, the Maine study authors looked at eligible patients who were not referred by their doctors to participate in the trial. They found that patients not in the study were more likely to feel that they had no choice about having a hysterectomy, and their mental health assessments were less positive than those of the women who had participated. It is possible that doctors selectively referred patients to the trial who were more involved in the treatment strategy and in a better state of mental health. It is also possible that improvements in surgical techniques and post-operative care are responsible for the more positive results that seem to be occurring. In the light of these uncertainties, the authors recommended that their study be repeated in other parts of the US.

Recent Australian research on the outcomes of hysterectomy has also found high levels of satisfaction among women having the operation, although this was tempered by the belief that some new symptoms had arisen which were caused by the surgery itself. Research by an Australian team from the University of Newcastle and Macquarie University, published in the British Journal of Obstetrics and Gynaecology in 1991, asked women who had had a hysterectomy between two and ten years earlier to describe the impact of their experience. Of 175 women interviewed, 97% said the hysterectomy was worth the trouble and 88% said they would recommend a hysterectomy to others with similar problems, given their experience of it. The single most important benefit for 32% of the women was relief from heavy periods; for 25% it was relief from pain or painful periods; and for 4% it was improved emotional well-being.

An earlier Australian study, in which over 800 women who had had a hysterectomy (abdominal or vaginal) in New South Wales in 1976 or 1977 responded to a questionnaire, found that only about half were enthusiastic or very pleased that they had undergone the procedure. About 11% were not satisfied with the outcome of the operation and almost 12% complained of poor doctor or nurse communication. Post-operative recovery was frequently longer than expected, with 70% requiring up to three months for a return to normal activities and 16% more than six months. One impact that favourably impressed many women was sexual function, one-third indicating that this had improved after hysterectomy, while 3% reported a deterioration.

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Why do we have a biological clock? It has been suggested that, during the course of evolution, organisms have maximized their use of the environment so as to maximize their chances of survival. It has been shown that man’s efficiency varies during the 24 hour period. We perform best between 7 a.m. and 11 a.m. in the morning, and worst at 3 a.m. at night when most of us are sleeping. Hence, for man, sleep coincides with the time of lowest efficiency, which is at night. A phase map can be constructed for each bodily process within the 24 hour period. The phase map for body temperature shows that temperature is highest in the day and lowest at night. It has been suggested that the phase map of sleep coincides with the reduction of body temperature at night Dr Charles Czeisler of the Harvard Medical School claims that he can shift a person’s circadian rhythm quickly by exposing them to strong light and thus resetting the body block.

What about a natural body clock? Do we have one that is not under the influence of the sun? In one experiment, conducted in 1972, a French cave explorer, Michel Siffre, lived underground in a Texas cave for seven months, away from all noises and civilization. He was not permitted to have any watches, clocks, radios, or televisions. In other words, his external cues for time were removed completely. Under these experimental conditions, without an external time cue, the body clock was free running. After a period of days the natural body clock would emerge. It was found that under free running conditions the human body clock was about 25 hours.

However, once he returned to the natural environment, the body clock was reset to 24 hours again. This resetting of the biological dock depends on external cues, the strongest being the change from dark to light.

Experiments have also shown that if we are placed in an artificially lit day of 19 hours and an artificially dark night of 9 hours, we can be trained to live in a 28 hour clock. In this case the biological clock gradually becomes a 28 hour clock instead of a 24 hour clock, and the phase map of temperature shows a maximum once every 28 hours instead of once every 24.

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This is essential as we become more experienced in mental exercises. The aim is more complete relaxation of the mind. When we are in comfortable positions the relaxation of our mind comes largely from the feeling of bodily comfort. When we achieve this relaxation in situations of physical discomfort, the relaxation comes from the mind itself. This is what we aim to achieve.

We can practise in positions of varying discomfort according to our taste and the degree to which we have mastered the exercises. When we can do it well lying on the floor, we can try lying with a few pebbles under our back in the region of the shoulder blades. When we can do this, we are immediately aware of the much greater relaxation of our mind, and we soon notice that the relaxation remains with us for increasing periods in our everyday life.

In the sitting position we can put a small clip on the skin of our arm. We immediately relax deeply so as to avoid the feeling of discomfort. This soon passes off, and we come to feel a very complete relaxation of our mind. Young people can practise in the cross-legged, squatting position, and maintain a sufficient degree of discomfort by pulling their legs under their buttocks as the yogis do.

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What not to eat is, perhaps, even more important that what to eat when planning a program of vital nutrition.

First and foremost, white sugar and all foods made with it should be totally excluded. Ice cream, candies, sodas, pastries, cakes, cookies, pies, sugared desserts—all must go. The astronomical use of refined white sugar and sugar syrups in the American diet is, to my mind, the greatest health-destroying factor causing the deplorable health condition of the nation.

Coffee, tea, and chocolate drinks, as well as all soft drinks, should be omitted and replaced by wholesome herb drinks and fruit juices. Health food stores carry a wide assortment of delicious herb teas: peppermint, alfalfa, camomile, rose hips, mate, white clover, fenugreek, etc. There you can also acquire a vegetable and fruit juicer, which will make it possible to squeeze fresh juices in your own home.

Salt and all sharp, irritating spices, such as white pepper, mustard, black pepper, etc. must be excluded. When you get accustomed to eating fresh, raw fruits and vegetables you will soon find that they taste delectable even without any seasoning. Even steamed vegetables and baked potatoes taste excellent without salt. This is also true with whole grain breads and cereals. If seasoning for salads or cooked dishes is desired, onions, garlic, dill, sage, watercress, paprika, red chili, and many other herb flavorings will give you a wide variety of choice. Kelp, powdered or granulated, can serve as a salt substitute for a beginner. This seaweed product has a mild, salty taste and could be added to various dishes. Of course, sufferers of arthritis should use a great amount of kelp as a food supplement—it is an extremely beneficial biological therapeutic agent in arthritis.

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Occasionally, a single, generalized tonic-clonic (grand mal) or generalized absence (petit mal) seizure may be prolonged (lasting more than 30 minutes) or the seizures may follow each other in rapid succession without full recovery between each one. When this happens, it is called status epilepticus. There are a number of different types of status epilepticus, the most common are:

convulsive status — prolonged tonic-clonic seizure

non-convulsive status — repeated myoclonic seizures

(non-convulsive means that — prolonged absence seizure

there are no jerks or abnormal — prolonged complex partial seizure

movements)

epilepsia partialis continua — continuous twitching of

one arm/leg

(this is rare) or one side of the face, or both.

The EEG is not usually helpful in convulsive status, but may be extremely valuable in

non-convulsive status. In this type of status, the diagnosis of epilepsy may not be immediately obvious. The patients may just appear confused or bewildered, with some inappropriate behaviour. An EEG recorded at this time will confirm the diagnosis.

Convulsive status epilepticus is a medical emergency which requires prompt treatment. When a convulsion is prolonged, or a patient does not recover fully between seizures there is a danger that a lack of an adequate oxygen supply to the brain may cause brain damage. There is also the risk of vomiting with aspiration of the vomit into the lungs. Although rare, patients may die in status epilepticus.

The longer the patient has been in status epilepticus, the harder it is to stop it.

Treatment consists of giving a fast-acting anti-epileptic drug as quickly as possible. This is usually given into a vein, or if this is difficult (which may be the case in young children), into the rectum. The most commonly used drug is diazepam (also called Valium, Diazemuls, or in a rectal tube preparation, Stesolid). Stesolid may be given by parents at home. This is useful as it means that treatment can be given early and before waiting for a doctor to arrive, or for the child to be taken to hospital. Other drugs that are sometimes used include lorazepam (Ativan), chlormethiazole (Heminevrin), and paraldehyde. This drug is usually given via the rectum but may, rarely be administered as an intramuscular injection into the buttocks. Paraldehyde is a very effective anticonvulsant but its main disadvantage is its unpleasant smell.

If the first dose of either diazepam, lorazepam, or paraldehyde does not terminate the status, then a second dose may be given. If this is not successful then the patient must be treated more urgently, and admitted to the intensive care unit. This is because the suppression of the seizure may require such considerable amounts of drugs that normal breathing may also be suppressed. In this situation, patients may require ventilator-assisted respiration, and intensive nursing. The longer-acting drugs which are most commonly used include phenytoin and phenobarbitone. They are usually given by a ‘drip’ intravenously to ensure that they work quickly. As the seizure comes under control, drugs can be given again by mouth.

Once the patient has recovered and is stable, any factors which may have caused the status epilepticus must be identified to try and prevent a recurrence. In many situations, this will involve a review of the usual oral anti-epileptic medication, and ensuring that patients take their medication regularly.

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The sciatic nerves radiate down the buttocks and legs. Strains, sprains, pinched nerves and arthritis can send awful pains shooting along these nerves or even persist to a paralysing degree. The slightest movement can sometimes generate feelings like a knife has been plunged into the area.

Back pains are the second leading cause of doctor visits for adults over 45 years of age. If they’re caused by arthritis or chronic inflammation in the back or spine, CMO is very likely to help.

As we have discussed in great detail in earlier parts of this book, CMO will almost always correct the problems that cause neck, back, leg, knee, and foot pains. That also holds true for ankylosing spondylitis and the chronic inflammation caused by injured or dislocated spinal disks. In some cases, though, surgery may be necessary to correct some structural defects or injuries.

But surgery isn’t always the answer — at least not all by itself. One retired man was still suffering miserably despite seven back surgeries, including the insertion of a steel plate in his neck, before he found out about CMO. He also had numbness and large arthritic knobs on several of his fingers. His doctor told him they were caused by bone spurs and suggested injecting them with steroids or removing them surgically.

His back pains were so terrible he was getting nerve block injections just about every month to help control the pain. X-rays and scans revealed the existence of a large number of bone spurs. The doctors were now recommending even more surgery.

One bottle of CMO capsules reduced his pain and he has found no need for more nerve block injections. He finds that aspirin is now enough. He plans to take another set of CMO capsules to try for even better results. The knobs on his fingers are disappearing, and a throbbing in his hands that used to keep him up all night is gone completely. He no longer feels any need for surgery.

There have been thousands of similar cases, some worse, some less severe, and just about all have achieved complete or nearly complete recovery. It would take several volumes just to include a representative sample. Suffice it to say that virtually all chronic neck, back, leg, knee, and foot pain problems can be helped with CMO.

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Signs and symptoms

The diagnosis of poisoning depends primarily upon knowing what the child has eaten or drunk. Otherwise, the diagnosis relies on suspicion, a careful physical examination for telltale clues, and laboratory tests. Usually, the telltale signs of aspirin overdose are rapid breathing, ringing in the ears, nausea, over-excitement, and unconsciousness. Poisoning from acids and alkalis causes burns on the lips, mouth, and tongue. An overdose of an iron tonic produces abdominal pain and severe vomiting, often with blood in the vomited material, followed by collapse.

Home care

Two steps are vital. First, try to determine quickly what the substance is that your child has taken, how much of the substance your child has taken, and when the incident happened. Second, call your doctor or local poison control center for instructions. Read the label of the drug or other preparation over the phone. You will be told whether or not to induce vomiting.

If your child has not vomited, if the poison was neither a strong acid nor an alkali, and if your child is conscious, induce vomiting by giving two to three teaspoonful of syrup of ipecac followed by a half to a full glass of water. Do not give milk. If the child does not vomit within 20 to 30 minutes, repeat the syrup of ipecac liquid dose. It is not safe to induce vomiting after the child has swallowed volatile hydrocarbons (petrol, turpentine, and so on).

In general, if your child has taken a normally edible substance (medications, for example), induce vomiting. If your child has taken a substance that is not normally edible (petrol or furniture polish, for instance), do not induce vomiting. If your child is not fully conscious, do not induce vomiting.

Precautions

• The most important precaution is prevention: see that all poisonous substances are stored out of reach of children – under lock and key if necessary.

• Keep the telephone numbers of police and fire departments, your doctor, and the local poison control center near the telephone.

• Always have syrup of ipecac in the house.

• Do not transfer any poisonous substance to an ordinary glass or bottle and do not keep any medication in an unlabeled container.

• Insist upon childproof tops on all medicines, not just those intended for children.

• Make sure that the bottles containing turpentine and kerosene have safety tops.

• Be careful with iron tablets. They taste sweet, look like candy, and can be deadly.

• When visiting other people’s homes, do not let your children explore until you are sure there are no poisons within reach.

• When guests visit you, be certain their medications are out of reach of any children.

Medical treatment

Your doctor may induce vomiting with syrup of ipecac or wash out the stomach by means of a tube. Further treatment varies with the substance taken and your child’s condition.

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There are many different syringes of varying sizes for various medical purposes, but the insulin syringe has a special shape and markings to ensure that the dose of insulin is measured accurately.

It is essential to obtain the correct insulin syringe and learn how to use it.

Syringes are made of plastic and are disposable; that means that they are designed to be used once and then thrown away. Whether they can be used more than once is discussed later.

There are a number of brands of syringes available, but there are only two sizes of syringe. There is a 1 ml syringe which holds up to 100 units, and a 0.5 ml syringe which holds up to 50 units. Standards for manufacture of syringes ensure that the markings of the different syringes are similar, any syringe can be used with any of the available insulins, and the numbers marked on the syringe always refer to the number of units that has been drawn up.

1. The 0.5 ml syringe (Lo Dose)

This syringe measures up to 50 units, it is the best syringe for those people who need a small dose of insulin (less than 50 units). It has a long narrow barrel and the numbers on the syringe refer to the numbers of units. Marks on the syringe each represent one unit. This allows very accurate measurement of small doses.

2. The 1 ml syringe

This syringe measures up to 100 units and is used for those people, particularly teenagers and adults, who may need more than 50 units of insulin in one dose. As with the smaller syringe, the numbers on the syringe refer to the number of units, but in this syringe the marks on the barrel each represent two units.

The needle

Syringes are supplied with a fine needle attached and ready to use. All the recommended syringes are designed so that there is very little wasted space left at the tip of the syringe and in the end of the needle; these syringes are called ‘minimal dead space’ syringes, and they have the advantage over older syringes in that virtually all the insulin you draw up is given and none remains in the tip after the injection. This means almost no insulin is wasted and if you have to mix two insulins in the syringe before injection, then you can be sure the mixture remains in the correct proportions.

Can single-use plastic syringes be re-used?

Single use or disposable plastic syringes were intended to be used once and discarded. This would certainly be the practice in hospital where there would be a risk of transferring germs from one person to another if the syringe or needle were used a second time. This is not a risk at home.

Very many people with diabetes have re-used the same disposable syringe many times without any harmful effects. This is not surprising, because the possible contamination of the needle or syringe will be confined to harmless germs that live on that person’s skin. Provided there is no infection in the skin (for example boils, pustules or infected scratches) then these germs are quite harmless. The body is used to them and they aren’t causing trouble. Insulin has a preservative added to the bottle which keeps it sterile and this preservative then protects the inside of the syringe after use. There is no need to wash out the syringe or sterilize it.

It is of course essential, if you use the syringe a second time, to replace the cap over the needle immediately and keep the syringe covered in a clean and cool place such as the refrigerator. If the syringe were handled by someone with dirty hands or contaminated in any way it must be discarded. One objection to using a syringe several times is that the needle may become blunt and may hurt more as it enters the skin. Few people find that this is a problem if the needle is just used twice.

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Aluminum

Aluminum has been linked to dementia because it has been found in patches of cell damage in the brains of people with Alzheimer’s. The results are not conclusive but we should perhaps be wary of it anyway.

The main sources of aluminum are indigestion tablets (antacids), deodorants and anti-perspirants, anti-caking agents found in some dried milk, aluminum cookware, soft drink cans and foil. High levels of aluminum can be seen from the analysis of a hair sample.

What You Can Do

• Buy aluminum-free deodorants at health food shops, where the ingredients will be listed on the containers.

• If you are taking indigestion tablets, have the cause of the problem investigated either medically or with a good nutritional therapist.

• Get rid of all your aluminum pans and buy cast iron, enamel, glass and stainless steel. (People used to cook rhubarb (a very acidic fruit) in an aluminum pan to ‘clean’ up the pan, which it did very nicely, as the aluminum was neatly absorbed into the rhubarb.)

•The same applies to acid drinks like colas in aluminum cans. They should be avoided for a number of reasons, including the leaching of aluminum into the drink.

Cadmium

This is an inorganic poison present in tobacco smoke and is a well-known mutagen. It interferes with your zinc levels which are crucial for both male and female fertility. The main answer is for both of you to stop smoking.

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