ЯЗВА ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ – DUODENAL ULCER

To avoid wheat, you have to stop eating foods made entirely or mainly from it:

Breakfast wheat cereals Wheat bran Bread Wheat germ

Pasta Cracked wheat (bulgur)

Most of the following foods are commonly made with wheat;

unless you know for sure they are made totally without wheat, you must avoid them:

Biscuits Breadcrumb stuffing

Crackers Batter

Pastry Battered foods (e.g. fish)

Pies Pancakes

Sausage rolls Waffles

Cakes and bakery Yorkshire pudding

Puddings Dumplings

Breaded food (e.g. fish, chicken legs) Suet puddings

Gravies and mixes Pretzels

Sauces and mixes Snack foods

Stock cubes Croutons

Casserole sauces Melba toast

Soups Baking powder

Wheat is commonly used as a cereal filler and thickener in processed foods. Read labels and avoid foods containing the following which are usually wheat:

Cereal binder Cereal protein

Cereal filler Flour

Avoid the following ingredients which are derived either from wheat or corn:

Cereal starch Modified starch

Edible starch Starch

To avoid wheat as an ingredient in processed foods, you may have to avoid the following which often contain it. If not absolutely sure, avoid the food.

Sausages Pastes

Frankfurters Spreads

Luncheon meats Powdered beverages Pates

Wheat is often, with other cereals, a base material for beers, lagers and spirits. Avoid these while excluding wheat.

Wheat is used in tabletting some drugs and home medicines. Take advice from your doctor about avoiding prescribed medicines. Stop taking any home medicines.

Wheat is sometimes used as a glue on envelopes and similar uses. Avoid licking envelopes and stamps.

Communion wafers are made of wheat. It is best to avoid swallowing or licking these if you can. Your minister or priest will be able to advise you on what to do. Holding the wafer in your mouth without touching it, or touching it without licking it, is often a satisfactory solution.

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Laboratory tests for allergy include the eosinophil test. Eosinophils are white blood cells always present at the place where an allergic reaction takes place. Samples of blood, or of sputum, or of secretions from nose or eye, are taken. The cells are stained with a red dye, eosin, and are counted under a microscope. A high count indicates an allergic reaction is taking place, but it can be an indication of other diseases as well, and it can also be found in symptom-free individuals. Steroid tablets suppress the level of eosinophils and can cause misleading results. The eosinophil test cannot identify allergy to specific sub-stances.

A useful but expensive laboratory test for allergy is the radio-aller-gosorbent test, or RAST test. It can measure the levels of IgE antibodies in the blood specific to a particular allergen, such as pollens, house dust mites or food proteins. The blood sample is passed over an extract of the allergen attached to an inert substance. The IgE antibodies will bind to the allergen if they are present in the blood, as during an allergic reaction. Then another liquid, containing anti-IgE antibodies marked with radioactivity or colour, is passed over the sample. These will adhere to any IgE bound to the allergen, or will simply wash away if none is there. The level of IgE in the sample can then be taken by measuring the level of the marked anti-IgE that does not adhere.

The RAST test is more helpful than skin tests in cases of food allergy, and its results are not influenced by medication. However, results can vary – some people allergic to seasonal allergens, such as moulds or pollens, will have negative results outside the season, but positive results when exposed to their allergen. Similarly, if you have not eaten a problem food for some time, you may get a negative result, whereas you could get a positive result if you eat it regularly.

A modified version of the RAST test can identify false food allergy, as well as true allergy.

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What Are Resins?

A significant proportion of allergic reactions and sensitivity to clothing are caused by resins, applied to give easy-care properties. The resins used are mostly formaldehyde polymers. They make fabrics more resistant to shrinking, creasing, and going out of shape. They improve dye absorption and restrict fading. The feel of clothes, and the way they hang, can also be improved. Formaldehyde resins are used for stain and grease resistance, waterproofing, and permanent pleating and pressing.

Resins and additives other than formaldehyde resins can also be applied (such as acrylates to reduce creasing and silicates to improve the feel of fabric). Catalysts can also remain in the fabric but are removed when the garment is first washed. These are not generally known as major causes of reactions.

Which Clothes Are Treated?

Fabric resins are not applied to silk, nor to pure synthetics. They are rarely applied to wool or to linen. Virtually all cotton, viscose and polycotton fabrics are treated with formaldehyde resins.

Some sensitive people learn to develop the ability to judge whether a fabric is highly treated or not. There is often a distinctive, sweet, aromatic smell to the fabric which a sniff (gentle, just in case!) can detect. Some people can tell by the feel of the fabric; some say that their skin prickles when they hold it. Another test is to place one drop of water with an eye-dropper on the fabric. If it holds in place without being absorbed, then there is a finish to the fabric.

Generally speaking, the more glazed, stiff and shiny the fabric, the more likely it is to have high levels of resins. If clothes are labelled, ‘Easy Care’, ‘Permanent Press’, ‘Sanforised’ or any variant of these, then they will be treated heavily. Cotton poplin, stiff cotton drill and denim are often treated and may be best avoided.

Conversely, cotton jersey (including cotton loopback), cotton fleece, towelling, knitted cotton sweaters and cotton corduroy are much less treated and are often no problem once washed. Brushed cotton is also sometimes untreated. Some cotton lawns and voiles are treated; others are not. Indian and Third World cotton fabrics are less likely to be treated heavily, and thus are often acceptable to people who are sensitive to most other fabrics.

Watch out for shirt collars on men’s cotton shirts. These are sometimes much more highly treated than the shirt itself. Look for shirts with softer collars.

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If you do not know where to start, your simple course of action is to:

• Take precautions against house dust mites

• Use the Pillow Test to work out what fibres you react to before making any major changes

• Do not replace everything at once. Try out one piece (e.g. a pillowcase or pillow) of a new material to see how you go

• Use anti-dust mite bedding and covers if you tolerate synthetics

• Use pure cotton bedding unless you are allergic to cotton

• Test out bedding in small samples before making any major purchases

Allergy and chemical sensitivity are very idiosyncratic. What works for one member of your family or for a friend may not work for you.

So keep an open mind, stay flexible, take it one step at a time, and with luck you will not waste time and money. Use the Pillow Test to test out materials before deciding what to buy. Borrow bedding from relatives or friends to test them out before replacing yours. Buy one pillowcase, or one pillow rather than a whole set at once.

It is often enough just to replace the bedclothes that immediately surround your head, where you inhale. Some people find, for instance, that if they replace their pillow or pillowcase, or use an anti-mite pillow cover, it can be enough to stop problems. Another trick is to place a piece of fabric which you tolerate over the top of the sheet, duvet or blanket where you breathe in. If this works, you may not need to replace sheets or duvets. It is also a good way of testing out fibres fully before making a major purchase.

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If you are exceptionally sensitive, be careful about where you or your child go if you visit people who have animals, or be careful with visitors coming into your home. Get them to leave coats and jackets outside the door. Research has shown that cat allergens, for instance, have been found at surprisingly high levels in cat-free homes, brought in by visitors. Beware of travelling in cat owners’ cars.

When choosing holiday accommodation, ask whether pets are allowed in the place. If so, and you need to avoid them, stay elsewhere.

If looking for a new home, check whether pets have previously lived in the house or flat, and which parts of the place they have particularly used. If you have any concerns, do not move into somewhere where pet-owners lived previously. Remember that you can develop allergies to lingering allergens months or even longer after you have moved, and that you can be allergic to saliva and urine, not just to hair and fur. Be prepared to have to replace flooring and do a rigorous cleaning programme (see above) if you find that you do become sensitive to a new home.

Finally, if you have a strong family tendency to allergy to pets, it is preferable to avoid keeping a pet if you have a baby or young children. Children under two are particularly vulnerable. If you do have a family pet, then follow the avoidance measures above and keep your home as free as you can of allergens. Preventative measures with young children may help them avoid lifelong problems with allergy. If you must keep pets, try goldfish or tropical fish – maybe not as lovable as a cat, dog or small furry mammal – but allergy free!

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Some women attach enormous significance to their lover’s ability to get an erection. They think that a firm erection is a sign of genuine love. A woman who believes the penis is some type of emotional-sexual lie detector will feel threatened and rejected by a man with an erection problem. She may doubt herself intensely and she may jump to all types of conclusions about the cause of his problem.

If the above scenario strikes a chord in you, you should probably explore your feelings further, perhaps with the help of a counselor. It’s important to recognize just what messages you give yourself about the situation, and what you express to your lover. A woman who feels that erections are proof of a man’s love may feel too hurt to participate in treatment, She may resist facing the problem, fearing that ultimately, her husband is going to leave her. But our research indicates that couples who deal directly with potency problems often fare extremely well, both in resolving the sexual difficulty and in maintaining, and even strengthening, their relationship.

Whatever course of treatment you and your lover choose, get started as soon as you can. It is much better to get to the problem early. Even in the best of situations, the void left by not knowing what is causing a potency problem is often filled with anxiety, depression and debilitating self-doubt—for both the man and the woman. That’ s why we recommend that you take care of yourself—and help your partner—by getting qualified professional help early. You wouldn’t want a painful stomachache to go untreated, and the emotional pain that potency problems can cause is just as, or more, debilitating and serious.

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Scientists also know that libido is linked to the male sex hormone testosterone. Technically an androgen, a type of steroid that acts as a male sex hormone, testosterone provides the masculinizing elements that orchestrate development of muscle tissue, the lowering of the voice during puberty, and overall growth, including that of the penis. It has other consequential applications as well, affecting libido, memory, and lean body mass. Interestingly, at birth, boys have the same testosterone levels as young adult males. They drop quickly, however, and remain low until puberty. At that time they rise, setting in motion the development of masculine characteristics.

Testosterone production continues to climb as men get older, eventually tapering off at around the age of forty. At that point they drop off about 10 percent each decade. By the time a man reaches sixty, his level may be one third what it was between the ages of twenty and forty. In that period of time, his reading ranges from 300 to 1,000 nanograms per deciliter of blood. It’s estimated that about one third of men over the age of fifty have lowered testosterone levels, and by the age of sixty-five, more than 60 percent have low testosterone. Despite a lowering of testosterone, the «free» testosterone levels usually remain in the normal and adequate range. It’s only a distinct minority of men who require some testosterone supplementation. The hallmark of the testosterone-depleted man is decreased libido.

Nature may have intended testosterone to decline with age. The body may be guarding itself against the enlarging of the prostate gland —which grows in the presence of testosterone—by dropping down normal production of the hormone. Still, the significance of that decline remains unclear. Circulating in a man’s bloodstream and acting on his brain to enhance his sexual desire, the hormone may also intensify penile sensation. Testosterone levels rise and fall throughout the day; some researchers think there is an hourly difference. There is even a monthly variation. Typically, testosterone levels are lowest in February and highest in the autumn.

But despite the fact that testosterone has a very pronounced effect on libido, it has little to do with whether or not a man achieves an erection. Even so, some doctors mistakenly link diminished testosterone levels with erectile dysfunction and prescribe testosterone patches or monthly injections for their patients. Raising minimally depressed testosterone levels rarely, if ever, improves erections.

Testosterone replacement is highly controversial, except in cases of men with a condition known as hypogonadism. Men with this ailment have extremely low levels of testosterone—under 300 nanograms per deciliter—due to decreased function of the testes. Their symptoms include lessened libido, mood swings, insomnia, irritability, decreased bone mass, weakness, lethargy, and loss of lean body mass. These men also have decreased erection capability, an overall drop in sex drive, and are at risk for osteoporosis.

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Another antioxidant, Pycnogenol (pronounced pick-nah-geh-nol) is a patented formulation of nutrient-packed bioflavonoids extracted from the bark of French pine trees. It offers protection to the endothelial cells which line the heart and blood vessels from free radical damage. Flavonoids—vitamin-like compounds naturally found in fruits (especially citrus), vegetables, seeds, nuts, grains, soybeans, cocoa, tea, and wine—help thwart a host of health ravagers, including viruses, cancer, toxic substances, and heart disease.

Water-soluble, Pycnogenol is readily absorbed in the body and performs a particularly remarkable function by prolonging the quantity of vitamin C in the body. Recent research at the University of California saturated. But at the higher dose, less vitamin C was absorbed from the intestines and more was eliminated in the urine. Also, the urine contained oxalate and urate, two breakdown products of vitamin C that contribute to the formation of kidney stones. at Berkeley has shown that Pycnogenol can have a positive effect on nitric oxide regulation as well. It’s nitric oxide that is so critical for the dilation of penile blood vessels at the time of erection.

In addition to aiding the body in neutralizing free radicals, Pycnogenol also decreases blood pressure by inhibiting the formation of angiotensin, a substance in the blood that constricts vessels. Animal studies with Pycnogenol in Hungary have reported a pronounced decrease in both systolic and diastolic blood pressures. And new research is beginning to show that it may assist in lowering blood pressure without ED-producing side effects common to many antihypertensive drugs.

To receive maximum benefits, I strongly recommend Pycnogenol as part of your preventive antioxidant program. For my patients, I prescribe a two-phase schedule: the first part is the saturation phase, the second is the maintenance phase. To begin, the saturation dose schedule is followed for ten days. During that time, Pycnogenol is taken twice daily with meals. The most effective dosage is 1.5 milligrams per pound of body weight daily. For example, a person weighing 140 pounds would take 210 milligrams every day. Then, during the maintenance stage, the dosage is halved. This is the amount necessary to ensure continued maximum effectiveness. The new amount is also taken twice a day with meals.

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For women in long-term relationships, ED brings numerous problems, as well as opportunities. As Dr. Broad points out, «If physical attractiveness and sexuality have been the main glue of the relationship, then the narcissistically vulnerable woman may instantly doubt her worth as a human being. Fear of abandonment, staved off while the relationship was predictable and viable, may suddenly surface when the partner develops ED.»

This perspective was voiced by Amanda, a forty-eight-year-old woman who worried that her husband, Jeff, would blame his ED on her and leave. «He’ll find a younger woman, I know he will,» she told me. «We were such a great-looking couple—everybody said so. But now, after three children and twenty years of marriage I look different. He won’t respond to me anymore. I know he’s halfway out the door.»

Another outlook was stated by Joan, a very wealthy woman whose marriage to Victor was one of convenience. «I know he had a girlfriend before his ED kicked in. Frankly, it never bothered me. Sex isn’t a big part of our marriage. I expect him to accompany me when I need him —but then he’s on his own. Now he wants to spend all his time with me, which isn’t a part of our deal. We have what I think of as a business arrangement—not an emotional one.»

Both these women are intent on focusing solely on their own perspectives. Because they won’t—or can’t—consider the causes of their husbands’ ED, much less the emotional underpinnings of their marriages, they’re unable to figure out what to do. As Dr. Broad states, «For these women, ED is not a sign that their partners—or their relationship—is in crisis. Rather, they experience the ED as an injury to their self-esteem. The major failure of their partners is that they can’t function in a way that enhances their own self-esteem.»

What happens, then, when a solution to ED is readily at hand?

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Taking all these factors into account, let’s look at how another man more successfully handles a situation similar to William’s.

Jeff, 44, works for the state government in a middle-management position. He has a certain number of hassles to deal with every day on the job. He runs his department with efficiency, but budget cutbacks have left him short-staffed, and everyone is feeling crunched by the amount of work they must do.

Recently promoted, Jeff has to listen to his staffs complaints about the poor working conditions, and he finds this one of the most difficult parts of his job. His work day starts early but he usually tries to leave by five o’clock. Once a week he plays soccer with a neighborhood team, and at least twice a week he and a co-worker shed their business suits and jog out of the office during lunchtime.

Jeff has been married to Sara for 15 years. They have two children, Susie, 4, and Jeff, Jr., 10. Recent months have been filled with stressful events: the death of Sara’s father; the serious illness of another grandparent; Jeffs recent promotion, which hasn’t worked out as well as they had hoped; and tight finances, partly because Sara’s employer reduced her hours at work.

Jeff has never had any erection problems until recently. One Friday night, he found himself unable to become erect, despite the fact he was very aroused. But he didn’t panic. «I knew it was the beer I’d been drinking,» he says, smiling as he recalls the incident.

Because he knew the cause of his difficulty, Jeff did not experience performance anxiety. And he didn’t feel threatened as a man, but just took it in stride. His self-awareness was crucial in his response to the situation.

Jeff told his wife he thought the culprit was the six-pack and she agreed. Sara didn’t attribute any deep meaning to the problem, probably because she felt secure in her relationship with her husband.

And Jeff didn’t withdraw from his wife. Instead, he cuddled with her for a while, before they each drifted off to sleep.

Left’s suppose that a week later, the same problem recurs, but this time, alcohol isn’t in the picture. Jeffs response to the problem is crucial. He doesn’t immediately assume the worst. In his mind, he goes over recent changes in his life. He did just start taking a prescription drug. Feeling that ifs something of a long shot, he calls his physician. After consulting a reference book, the doctor somewhat apologetically confirms that impotence can be a side effect of the medication. Reducing the dosage solves the problem.

Even without such a simple explanation, Jeffs attitude remains a crucial element in how successful he is in solving his problem. In general, Jeff has a positive attitude towards sex, despite «zero» formal sex education. «I never took a class in high school or college where the physiology of erection was explained or even discussed.» Now, having read a lot on his own, he feels more knowledgeable.

Jeffs attitude towards lovemaking and his marriage is positive. «I have a certain philosophy about making love,» says this soft-spoken man. «When you don’t make love, you’ve lost the time, and it can’t ever be regained. So it’s nice to enjoy it often.» Unlike William, who takes his stresses and pressures to bed with him, Jeff is careful to leave the rest of the world behind when he wants to make love. «I shut off the office when I close the bedroom door,» he says. That’s such good advice, we might all do well to use it as a motto.

Jeffs and William’s stories are good examples of sexual success and failure. The moral of both is that the way to sexual success is to understand the factors behind erection problems and to deal with them in a logical, constructive way.

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Doctors at the University of Iowa College of Medicine have achieved a high rate of success in reversing vasectomies—a procedure that until now wasn’t often successful. The doctors have achieved an 85 percent success rate in rejoining the duct that carries sperm from each testicle to the urethra (vas deferens). The new method for reversal uses a laser to seal the rejoined ends of the duct. It also reduces the length and risk of the operation, and over half of the patients undergoing the new reversal surgery have gone on to father children.

New Technique For Easier Vasectomies

A new, no-scalpel operation developed in China may prove to be faster and less painful than a standard vasectomy. Experts say the new technique is just as effective as the old procedure and is much faster, taking only 5 to 10 minutes compared with a conventional vasectomy which takes 15 to 20 minutes. The new technique also usually does not require the use of stitches because it employs a tiny puncture instead of an incision.

Reports from doctors who have used the new technique indicate that their patients experience less bleeding and pain, both during and after the operation, compared with men who undergo standard vasectomies.

New Methods To Fight Male Infertility

Two new methods of identifying and combating male infertility provide encouraging news to men who have been unable to father children.

At the University of Oklahoma Health Sciences Center in Oklahoma City, a new sperm antibody diagnostic kit is being developed. The kit will enable doctors to identify antibody-related infertility. According to medical experts, abnormal antibodies produced in the male that attack his own sperm can cause sterility. Antibodies in the female which attack all sperm can also cause sterility.

Doctors at the Iowa College of Medicine are currently using «laparascopic» surgery to remove a varicose enlargement of the veins of the spermatic cord. A varicocele is the most common cause of male infertility. With the new surgical technique, patients have recovered in three days instead of ten to fourteen days.

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(1) Exercise

Exercise is extremely important for a diabetic person. It helps to improve your circulation, control blood sugar, control your weight, strengthen the heart, and reduce cholesterol. The best type of exercises included: Walking, jogging, swimming, or bicycling. Three times per week with 20-30 minute sessions are best. Do not do heavy exercises like weight lifting.

(2) Reduce Stress

Increased stress can cause additional problems for diabetics. Therefore, you should take steps to relax, remain calm, and reduce the amount of stress in your life.

(3) Dental Care

Some diabetic people are very susceptible to infection. Therefore, leading dentists like Roger Levin D.D.S. recommends that you pay particular attention to the care of your mouth. You should brush and floss frequently, and have regular checkups.

(4) Your Feet

A diabetic must pay close attention to their feet. A diabetic’s feet can become easily damaged and infected. This can often lead to amputation. Here is how to protect those feet:

(A) If you are overweight, then reduce your weight to take pressure off of your

(B) Wash your feet well every day.

(C) Keep your feet warm on cold days — A nice foot bath can help.

(D) Inspect your feet for bruises, cuts, swelling, and other damage — everyday.

(E) Wear comfortable — well fitting shoes.

(5) Magnesium for Type-ll diabetics

The mineral magnesium seems to help Type-ll diabetic sufferers. This can help by lowering high blood pressure. One of the best ways to get extra magnesium (and fiber) is by eating fresh green vegetables and salads. You should never take a magnesium pill supplement except under the advice of a doctor.

(6) Peas

A medical study in Denmark showed that the kind of fiber found in peas could help diabetics. This fiber helped by smoothing out the sharp rise in blood sugar after a meal.

(7) Your Lifestyle

A person with diabetics must pay close attention to diet, exercise, weight control, stress, and injuries. This can greatly reduce the many complications that can develop in a diabetic person. By taking all these factors into account, making gradual changes, and listening to your doctor you could greatly reduce diabetic complications.

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Here are 5 ways you can get rid of headache pain fast, naturally, without drugs:

1) Give your eyes a rest. Eyestrain headaches can be prevented by avoiding the circumstances that cause the condition. Reading in dim light, staring at a computer screen, using corrective lenses that are not right for you, or not using lenses when you need them, are among the leading causes of eyestrain. Under such circumstances, the muscles around the eyes contract in an attempt to help you «see» better. The contraction instigates headaches and triggers muscles in the face and scalp to contract as well—all making for a pretty powerful eyestrain headache.

You can prevent eyestrain headaches when you are reading or working at a computer terminal by taking periodic breaks and re-focusing your eyes on some distant object. If you feel eyestrain coming on, remove your glasses or contacts (if you wear them) and dim the lights. Then, keeping your eyes open, cup the palms of your hands over your eyes to create total darkness. Stare into this darkness for about 30 seconds. Then, close your eyes and lower your hands. Slowly open your eyes.

2) Give your muscles a rest. If your work requires that you maintain a fixed position—sitting or standing—for long periods of time and/or if you have poor posture, your muscles, including those in the head, face and neck, are likely to tighten up and in effect «freeze». This can in turn trigger or aggravate the misery of tension headaches.

To prevent muscle freeze, you should try to vary your position as much as possible. You should also take five-minute breaks at a minimum of every two hours. This will help you release both the physical and psychological tension that could lead to a headache. If you are standing for a long period of time, try to pace a little, tilt your pelvis forward and back, and rotate your shoulders. People who are in a sitting position for long periods of time should occasionally straighten and stretch their spines. Good posture can also help to further reduce the strain of maintaining one position for hours at a time—especially when sitting. You should sit with your shoulders square and your back straight against the back of your chair. Also keep your feet flat on the floor and your knees at hip level.

3) Try hot and cold treatments. While some people have discovered that applying cold helps to ease their headache pain, others prefer heat. You should try both treatments and find out which one works better for you.

To give your headache a cold treatment, wrap ice cubes in plastic and then in a damp towel. Apply the wrapped ice directly on the area that is generating the pain. You can also try applying cold to the back of your neck, the base of the skull and the top of your head. Cold may also be applied by using a damp washcloth which has been in a freezer for at least 10 minutes, or a frozen gel pack which you can find at most drug stores and some supermarkets.

Heat can be applied with a hot-water bottle, a heating pad, or with a hot, wet towel draped across the back of the neck. Another method of applying heat is to sit under a hot shower, with your arms resting on your bent knees, and your forehead resting on your arms. The hot water beating down on the back of your neck and shoulders should help ease your headache pain.

4) Learn to breathe deeply. You stand a good chance or can avoiding a tension headache if you learn to breathe slowly and deeply whenever you begin to feel stress. Most experts recommend breathing through the nose because it carries oxygen more directly to the brain. You should take a deep breath, filling your lungs completely as you inhale to a slow count of four. Hold the breath through a slow count of four, and then exhale to a slow count of four. If you do it properly, you should feel your stomach puff out slightly.

5) Perhaps the best natural way to prevent headache pain is to exercise.

Regular physical activity helps keep your blood circulating through your body, delivering more oxygen and removing metabolic waste more efficiently.

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Diets that are high in fiber usually consist of foods such as pasta and cereals, whole-grain bread, beans and dried peas, fresh and dried fruits, and fresh vegetables, all of which contain plenty of fiber and complex carbohydrates. Such high-fiber foods are good for weight loss because they are more filling and contain fewer calories per gram than high-fat foods. As long as this diet contains a wide variety of low-calorie foods, it can be a safe and effective way to lose weight.

The only disadvantage of a high-fiber diet is that it may cause some initial indigestion and gas. These problems normally disappear in a relatively short time. They can also be effectively avoided in most cases by adding fiber to the diet gradually, and by not consuming an excessive amount of fiber.

Low-Fat Diet Tips

Here are some tips from the American Heart Association to help simplify a low-fat eating plan:

1) Limit your intake of lean meat, seafood and poultry (with no visible fat trimmed or drained) to no more than ounces a day.

2) Substitute meatless main dishes as entrees, or combine with small portions of meat.

3) Use no more than 5 to 8 teaspoons of fat and oils a day for cooking, baking, spreads and salads.

4) Cut back on egg-yolk consumption to three or four per week. (Egg whites are all right).

5) Eat five or more servings of fruits and vegetables a day.

6) Eat at least six servings of cereals and grains a day.

7) Use skim or 1% milk and other low-fat dairy products.

Limit your consumption of organ meats, such as kidney, liver, heart, and gizzards.

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Herbal Salt Substitutes

One good way to cut down or eliminate your intake of salt is to take advantage of several herbal combinations which can be placed in shakers and used as salt substitutes. Here are two basic herbal salt substitutes:

1) The most basic herbal salt substitute consists of garlic powder, basil, oregano and powdered lemon rind. Place 2 teaspoons of garlic powder and one teaspoon each of basil, oregano, and powdered lemon rind in a blender and mix thoroughly. Keep the mixture in a glass container with the addition of rice to ensure that it doesn’t cake.

2) For a more spicy salt substitute, place 1 teaspoon each of cloves, pepper, and crushed coriander seed, 2 teaspoons of paprika, and 1 tablespoon of rosemary in a blender and mix well. Keep the mixture in an airtight container.

Should You Use Real Sugar Or A Sweetener Substitute?

It’s true that, except for supplying calories and energy, sugar has no nutritional value. However, it is not true that sugar prompts hyperactivity in children or causes diabetes, heart disease, and acne. And while sugar can contribute to obesity, it is much less a factor than fatty foods in causing a person to be overweight. The problem with using sugar is that many people don’t know «when to say when». Consumed in small amounts, sugar actually provides some healthful benefits. Sugar can help relieve anxiety and stress, induce relaxation and sleep, act as an antidepressant, help heal wounds, and eliminate bacteria. New studies also suggest that small amounts of table sugar might even be safe for some people with diabetes.

On the negative side, sugar does promote cavities, and can cause sudden increases in insulin and blood glucose (although some vegetables, such as potatoes and carrots rank above sugar in ability to spur a quick rise in blood sugar). As mentioned earlier, sugar can promote weight gain if consumed in excess. It can also replace nutritional value when sugar-laden junk foods are a main part of one’s diet.

Unless a medical condition dictates the use of artificial sweeteners rather than sugar, it’s a matter of individual choice. If you do use sugar, do so moderately, and make sure you don’t replace nutritional value for the sake of a «sweet tooth».

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Compulsive eating can develop in those non-drinkers who developed their particular food sensitivity as children or young adults. Many young people when they leave home to live with friends are too busy socialising and having fun in their out of work hours to take the time to cook balanced meals with a good variation of foods. Eating on the go becomes the thing and the diet is usually made up of refined takeaway foods and TV dinners which are vitamin and mineral deficient and made up basically of the same things—white sugar and white flour. Chemical flavourings, colourings and preservatives give this monotonous diet its variety. Ambitious young high achievers fall into this food category as well. They’re too busy working to cook balanced meals.

Many of the over-weight compulsive eaters I’ve treated developed their food cravings as a result of over-exposure to a given food as a child (in the manner previously described) or as a young person who left the nest and Mum’s home cooking. These food cravings can manifest in one of two ways. Either as a craving for the food in question or as a craving for sugar. Allergic hypoglycaemia is the term used to describe this latter phenomenon. Hypoglycaemia means a sudden dropping in the levels of glucose in the blood. When this happens, a message is sent to the brain that glucose levels must be restored immediately, and a craving for sugar results. Those people whose allergy withdrawal symptoms trigger hypoglycaemia are driven by an unbelievable compulsion to eat sweets or white flour foods, lots of them and often. Uncontrollable over-weight soon becomes a problem for them, is of great benefit to people with allergic hypoglycaemia.

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A fixed allergy, to a food, chemical, gas, dust, pollen, grass or mould, is one that you are born with and will have till the day you die. It’s something you have inherited a propensity for. Sometimes it can be controlled so that its effects are minimised. This is particularly so in the ease of inhalant allergens, such as dust, grasses and moulds, where vaccines can be administered to desensitise the sufferer to the allergen. In the case of a fixed allergy to a food (for example, strawberries, tomatoes) the best treatment is to avoid the food completely. Fortunately, only 5 per cent of allergic people suffer from a fixed allergy.

Not everybody experiences their allergic reactions in the blood. Some allergic reactions are confined to the intestines and make up any or all of those symptoms listed under ‘Gastro-intestinal’ later in this chapter. Blood tests are of little use to these people as the foods causing the problem are seldom absorbed through the intestinal wall into the blood to register their presence there. However, the mechanism of the gut-mediated allergic reaction is the same as that of the blood-mediated one, except that in this case it is the white blood cells lining the intestinal wall that have become over-sensitive rather than those floating in the blood. Celiac disease (massive gluten sensitivity) and Crohn’s disease are extreme examples of gut-mediated allergies.

The trial and error removal and reintroduction of foods—one at a time—is the only way to test for the offending gut-mediated allergies. However, this can’t be done until the stress levels have been reduced and any existing Candida yeast infections in the intestines have been contained. Stress and Candida yeast infections give rise to the same symptoms as gut-mediated food allergies.

*19\18\9*

Although many over-exposure allergies can develop from a sudden massive exposure to a given substance (for example, by being overcome by fumes during an industrial accident, or getting smashed on a particular alcoholic beverage while tired or suffering from a cold or ‘flu), over-exposure allergies can develop slowly over a longer period of time. The continual eating of a given food, especially if it is a refined food such as white bread, can give us an allergy to wheat. In this case eating the white bread day in, day out, wears out the digestive enzymes in the wall of the small intestine and the liver, causing the semi-digested food to be absorbed into the blood. A semi-digested food is a foreign body and is recognised by an over-sensitive immune system as an allergen.

Because the digestive enzymes are made from vitamins and minerals, the cells need vitamins and minerals to replace enzymes that are wearing out. Refined foods (white bread, canned and frozen foods, processed meats, take-away foods) don’t carry the nutrients they need to build replacement enzymes. Thus malnutrition contributes significantly to over-exposure allergies. It is significant that stress and malnutrition go together—most highly stressed people skip meals altogether and so completely miss out on their vitamins and minerals.

The slow drip-feeding into the blood of the toxic waste products, particularly acetaldehyde, from the yeast Candida albicans, can produce over-exposure to this chemical over a long period of time. Allergic reactions thus ensue.

Cyclic allergies are those that develop as a result of over-exposure to a food, chemical, pollutant, fume, gas, pollen or grass. Cyclic allergies account for 95 per cent of all allergies (the remaining 5 per cent are fixed) and can usually be overcome if you haven’t been exposed to the allergen for too long. The majority of cyclic allergies begin as a result of over-exposure to a chemical or food. Many children are born with a cyclic allergy as their mothers were suffering from a cyclic allergy during pregnancy. As time goes by the sensitivity can spread to other foods and chemicals and on to grasses, pollens, dusts, yeasts, fungi and dust mites. Ninety days’ avoidance of the allergenic substance is usually enough to desensitise the body to that substance.

*13\18\9*

‘Not only will men of science have to grapple with the sciences that deal with man, hut—and this is a Jar more difficult matter— they will have to persuade the world to listen to what they have discovered. If they cannot succeed in this difficult enterprise, man will destroy himself by his halfway cleverness.’

Bertrand Russell, 1872-1970

An allergy is an over-reaction of the body’s immune system in its efforts to protect the body against what it (the immune system) perceives to be a threat. When resistance is down, sensitivities are up and allergies easily develop.

The immune system is the body’s main line of defense against invading foreign substances that can damage it. It is made up of the white blood cells, known as lymphocytes. These are clumped together in lymphoid tissue, which is found in the spleen, the lining of the small and large intestines and the lymph nodes of the neck, armpits and groin. The lymph nodes are well evident during periods of infection when they swell up arid are frequently referred to as ‘swollen glands’.

When a foreign substance enters the body, the lymphocytes become sensitised by its presence and produce special proteins, called antibodies, which circulate in the blood until they make contact with and destroy the foreign substance.

Collectively, these foreign substances are known as antigens and may come in many different shapes and forms—viruses, bacteria, fungi, toxic chemicals from polluted water and air, and the preservatives and colourings in artificial foods. Evidence suggests that the major toxin (acetaldehyde) released into the blood by the yeast Candida albicans is a potent antigen.

In rendering the antigen harmless to the body, the antibodies have given us an immunity to that antigen. Once sensitised by an antigen, the lymphocytes remember that antigen and, in some cases, are able to successfully produce antibodies against it for the rest of our lives. In this way we enjoy lifelong immune protection from that substance. The diseases measles and chicken pox are good examples. Once contracted in childhood, our resistance to them usually becomes so great that they seldom bother us again through life.

Unfortunately, not all immune systems function perfectly all of the time. Sometimes there are imbalances in the immune system (resulting from imbalances in the body’s metabolism) that give rise to excesses in the immune reaction. These excesses cause side effects and these side effects are known as allergic reactions.

Allergic reactions occur when there is an excess of histamine released into the blood and tissues.

*6\18\9*

‘Even your body knows its heritage and its rightful needs and will not be deceived. And your body is the harp of your soul, And it is yours to bring forth sweet music from it or confused sounds.’

Kahlil Gibran. The Prophet

As a 23-year-old woman living in the 80s, I have, like many other people, tried to eat well and get some exercise. The media had made me very body conscious, and if I didn’t keep my weight down, I became depressed, felt unattractive and my self-esteem plummeted. In order to keep it down, I had to eat very small amounts. I became convinced that I had a fat-storing metabolism and to keep my weight down I had to eat very little.

Like many women, I have agonised over my body, spending literally hundreds of dollars on cellulite treatments, and there have been many years of not a morsel passing my lips without a calorie count. Looking back on it, it was an awfully stressful, anti-social way to be treating food. You could say I was at war with my body.

At 60 kg in July 1987, I decided to go on one of my severe diets, which consisted of cereal and skim milk for breakfast, Ryvita, salmon and salad for lunch and steamed vegetables for dinner. By November I had lost 6.5 kg. I experienced weakness and hunger pains, but the psychological high I was on overrode feelings of drowsiness and lethargy.

At this time, I was studying part-time and had taken over the job of Section Head in a nursery caring for children under three years of age. Wanting to achieve recognition from my colleagues, I set myself the task of getting the nursery into good working order. Basically, I put my needs last and burnt the candle at both ends. I began a downhill run and by March 1988 I had deteriorated physically and mentally and needed a week off work for what the doctor diagnosed as stress. The week off work helped alleviate the severe headaches and back pain, but on returning to work I still did not feel 100 per cent better.

I spent the Easter weekend at my parents’ property on the outskirts of Bathurst, and all Mum’s lovely cooking went down very well. So well, in fact, that within three weeks I had gained the 6.5 kg I had lost and kept off over a nine month period. I was unable to start dieting again; I was tired of it all. Depression set in severely.

I was also extremely sensitive and emotional. I would snap at people without meaning to. Regarding the poor concentration and loss of memory, I can tell you, when you’re twenty-three and find it impossible to recall one bit of conversation you had ten minutes earlier, it’s very scary.

At the time I consulted Phil Alexander in May 1988, I was beginning to doubt my professional capabilities. Talking to Phil was very encouraging. Yes, he told me, I would recover, my symptoms would be alleviated; but I must rest, as I was suffering from stress as well. He told me that my sinusitis and resultant bad breath was of physiological, not psychological, origin and gave me a referral to an allergy clinic for tests.

Although I wasn’t allergic to any foods, I was allergic to moulds, house dust mites, grasses and pollens. Phil placed me on the Anti-Candida Program, with the prescribed drug Nystatin to kill off the Candida yeast over-growth in my body, and a vitamin supplement to help balance my out-of-kilter metabolism, unbalanced by my many years of crash/semi-starvation diets. To think that for years I thought I was doing the right thing by my body. How wrong I was!

The meals set out for me were incredibly substantial and I thought I would put on weight. Not so at all. Although the first week of my Anti-Candida Program was unpleasant, with headaches, sinusitis and stomach pain (all Candida yeast withdrawal symptoms), I lost 2.25 kg of fluid in five days, as I had more of a fluid problem than a fat problem. After a fortnight I felt 100 per cent better and had lost another 1.5 kg. I was sitting down to beautiful meals each night and I was very hungry in between meals. There was no bloating associated with eating and my metabolism was speeding up considerably. As well as sticking to the program religiously, I kept my house free of mould and dust and made sure I got plenty of rest.

By the time I went back to see Phil, after four weeks on my program, I was so excited I literally bounded into his office so eager to tell him how wonderful I was feeling, how much energy I had. I had lost 4.5 kg altogether, and the high I was experiencing was indescribable, very different from the highs I had experienced when I had lost weight before.

Phil was pleased for me and instructed me to carry on as I was. During the second month my appetite decreased a little and I no longer needed rice wafers in between meals. It was at this time that I came down with inflamed back muscles, due to heavy lifting. As rotten as I was feeling physically, I still felt mentally well and made sure I didn’t spend my days off work feeling sorry for myself. I kept busy with sewing and recovered rapidly without the aid of prescribed drugs from my doctor. I wondered if 1 would have recovered as well two months earlier, before my program.

To sum it all up, after being at war with my body for four years, I am discovering what it is like to have energy, not feel over-stressed, feel restored after a good night’s sleep and be happy. When people ask me if the program is working for me, I tell them that I am an entirely different person from what I was two and a half months ago. That is the absolute truth too! I feel attractive, confident; my self-esteem is riding high and I am learning not to compare myself to other women, to love me and my body for what it is.

I am discovering new, tasty nutritious meals and there are no guilt feelings attached to sitting down and eating a beautiful veal and veggie casserole. Farewell to calorie counting forever!

What is so exciting for me is that I am still in the healing process. I have some way to go, but I am already reaping the benefits. People are commenting on how well I look -my skin, my hair, my eyes. My parents are thrilled and relieved to see that, at last, the answer to my problem has been found. My boyfriend tells me how attractive I have been looking lately and I know my state of physical, and mental/ emotional health will improve more. Like my newly found love of cooking and eating, I am exercising more because I have the energy and really want to. I don’t feel I have to -there is now a challenge to be the healthiest person I can. My current exercise is martial arts and I love it more now that I am on my anti-allergy program. I feel better than I did when I lost weight on a diet at the ladies’ gym and was doing four aerobic classes a week, as well as weights.

I shudder to think what would have happened to my health if I had not investigated further the real cause of my complaints. I’m sure I would have crash dieted more, and in doing so deteriorated more, perhaps irreparably. I stick with this program and take it seriously, and so 1 should. This is my life and my body, the only one I have been given. I will not break this program.

Realising how biochemically different I am I would never again pick a diet that doesn’t have the research and experience of a practising physician backing it. Never again would I skip a meal. When I see young women skipping meals and eating minuscule amounts, I now try to explain what they are doing to themselves. They don’t listen, because they think they know it all, and know their body’s needs just like I thought I did.

Thanks to the expertise and knowledge of the author of this book, I am learning to love me, and love my body for what it is. I am healthy, alive, vital, energetic and attractive. I am indebted to Phil Alexander for all his help in making what really is the ‘new me’.

I hope readers will see me as a success story and an inspiration to overcome their complaints.

As I re-read my words, the excitement and challenge builds up in me more. I really believe in what I am doing. It all may be hard for you to comprehend, it is even hard for me sometimes, but if you have success in overcoming your allergies, you will understand the message I am conveying.

Paula Jackson, 1988

POSTSCRIPT—1990

Paula is still fit and well though she’s been through a rough patch that saw her health decline for a while. Like so many people who’ve regained their vitality, Paula began to embrace life with great enthusiasm. Too much enthusiasm in fact. She burnt herself out. Tiredness, aches and pains, fluid retention and confusion began to return. Not because of allergy and Candida infection this time, but because of fatigue. Paula, like so many others, believed her new found energy was boundless and in an effort to make up for lost time began doing all those things she was too tired to do before. Admittedly pre-wedding nerves and adjusting to married life played it’s part but the major cause of her symptoms was overdoing it.

We human beings have a very short memory of matters pertaining to our former ill health. We easily forget what it was like to be down and Paula fell into this trap. She now realises that although the spirit may be willing the flesh has limitations. She has now learned to pace herself by recognising her particular early warning symptoms of stress and slowing down before these symptoms become full blown.

UPDATE—1995

Paula is now 30 and feeling better than she did at age 19. She’s married, pregnant, works part time and has a healthy two-year-old boy who shows all the signs of being an advanced, even gifted, child. All this she attributes to her continued adherence to the Metabolism-Balancing Program and supplements. She maintains high energy levels, trouble-free pregnancies (no toxaemia) and optimal weight levels during and between pregnancies. The learning experience of overcoming her previous illness has put her in tune with her body and there has been no return of her Candida and allergy symptoms.

*1\18\9*

How to prevent HIV infection

HIV is difficult to catch. Body fluids containing the virus must go directly into your blood or tissues through a break in the skin or body lining membranes such as the lining of the vagina or rectum. These fluids are:

• blood (including menstrual blood)

• semen

• fluid from the vagina and cervix

• breast milk.

The virus has been found in very small amounts in saliva, but there is little evidence that it has been passed on through saliva. Similarly, there have not been any reports of transmission associated with vomit, urine or faeces.

HIV is transmitted through:

• unprotected vaginal or anal sexual intercourse with an infected person

• injection with a needle or syringe contaminated with infected blood

• pregnancy, in the womb or during delivery, though less than one in five infants born to infected mothers are infected at birth

• breast-feeding, which doubles the risk of a baby becoming infected. The risk is less if the baby doesn’t have its mother’s milk for two weeks after delivery. This is because colostrum contains much more HIV than milk produced later.

Prevention seems straightforward. Never have any sort of injection with a needle or syringe that has been used by anyone else, and never have unprotected sex (that is without use of a condom) unless you are certain that your partner is not infected. These are the main risks. Also, we should all follow the habits of general hygiene that protect against the spread of all infectious diseases.

If you do accidentally come in contact with, say, the blood of an accident victim, don’t panic. It’s extremely unlikely that infection could occur under these circumstances, but if you’re worried, talk to your doctor about whether treatment or a test is advisable, even if only to reassure you that all is well.

Any woman known to carry HIV will have been well advised on how to prevent its spread to others and how best to look after her health.

The statisticians of the epidemic would be pleased if we were all tested so that the real prevalence of HIV infection could be known. I believe that such an enormously expensive exercise is at present unnecessary. Most women will know whether they have ever been at risk of infection.

Who should be tested?

If you have the slightest fear that you may have been infected, I would recommend a test so that you’ll know where you stand and not be wracked by uncertainly. Remember that over 99 of every 100 women at ‘high risk’ tested so far have been negative. Reasons for having the test include:

• if you had a blood transfusion between 1980 and 1985 in Australia. If you’ve ever had a transfusion overseas, ask your doctor whether you should be tested

• if you have ever shared needles or syringes

• if you have ever had a sexual partner whom you suspect may have had sex overseas, multiple female partners, any male partners or has ever injected drugs. Blood for the test can be collected by your doctor, any public hospital or at any sexual health or family planning clinic. Before taking the test, read the pamphlets (available wherever tests are done), which explain what the test and its results mean, and how you can avoid HIV. If you have any concerns about the test or whether you should have it, speak to a doctor, nurse or counsellor. You can be sure that any information you give when taking the test is confidential.

*307/31/5*

Acute cystitis

In every case of suspected cystitis the diagnosis should be confirmed by laboratory examination of the urine to identify any bacteria and see what antibiotics will get rid of them. A mid-stream urine specimen should be collected before any treatment is started. However, you will usually be given antibiotics at the first visit, especially if your doctor has looked at your urine under the microscope and seen that it contains pus and blood.

It’s important to check with your doctor when the laboratory report returns to make sure that you’re taking the right antibiotic, which should start to relieve symptoms within 24 hours. Most doctors also like to confirm that the infection has cleared completely by a follow-up urine test after you’ve finished the treatment course; this is particularly important if you’ve had recurrent infections.

It’s also very important to complete the full course of antibiotics. If you have a tendency to develop thrush when you take antibiotics, tell your doctor so that you can have some antifungal treatment on hand.

Here are some other ways to relieve the symptoms of an acute attack while waiting for specific treatment to work.

• Drink as much water as you can to dilute your urine and help flush out the infection.

• Empty your bladder whenever you feel the urge: never try to hold on if you have a urinary infection. Be sure to completely empty the bladder each time.

Endometritis

Endometritis is infection of the lining of the uterus. It can occur after childbirth or after spontaneous or induced abortion, especially if the uterus is not completely empty of all fragments of the placenta. It is treated by antibiotics and, if necessary, removal of any retained placental tissue.

Endometritis is also part of PID.

Prolapse

When the structures that hold the uterus in place become weakened or abnormally stretched (usually during pregnancy or delivery), the uterus may drop down from its normal position. This is called uterine prolapse. The cervix may move further down in the vagina, and may even protrude through the entrance to the vagina.

As the uterus moves downwards, it pulls the vaginal walls and often the bladder and rectum with it. When the front wall of the vagina and part of the bladder sag downwards, it is called a cystocoele. When the back wall of the vagina and part of the rectum sag downwards, a rectocoele has formed. Either or both may bulge outside the vagina. If the perineum has been torn during delivery and not repaired, cystocoele and/or rectocoele can occur without uterine prolapse.

Not all women who develop prolapse of the pelvic organs have had children. Anything that increases pressure in the abdomen, such as chronic cough, chronic constipation and obesity, puts excessive strain on the pelvic supports and can lead to prolapse. Also, the pelvic supports weaken with age and with reduced production of oestrogen. Many women with prolapse find that symptoms will begin or are aggravated after the menopause.

Symptoms of prolapse

Symptoms depend on which organs are prolapsed and how much. A mild prolapse may not cause any problems.

Prolapse of the uterus can cause a dragging feeling in the lower abdomen and back, increased vaginal discharge and perhaps the feeling that something is coming out of the vagina. Symptoms are usually relieved by lying down.

If cystocoele is present, symptoms include difficulty in starting and stopping urination, urinary frequency, feeling that
the bladder needs emptying again soon after you’ve been to the toilet, and problems controlling the bladder. Recurrent urinary infections can result if the blade never empties properly.

Rectocoele can cause difficulty emptying the bowel, in spite of a constant feeling that the rectum is full and needs to
be emptied. Constipation can become a problem.

Treatment of prolapse

This depends on how severe the symptoms are and the extent of the prolapse Slight prolapse of the uterus without symptoms needs no treatment. Moderate uterine prolapse can often be helped by wearing a strong ring pessary in the vagina to hold up the uterus and to help lift associated cystocoele and rectocoele. If the supports of the uterus are so stretched that the uterus protrudes from the vagina, surgical repair is usually needed.

Mild and moderate degrees of cystocoele and rectocoele are often greatly helped by exercises and other physiotherapy to strengthen the muscles of the pelvic floor and improve emptying and control of the bladder and bowel. However, if these muscles are not only weak but also badly torn or otherwise damaged, surgery may be the only answer.

*249/31/5*

Absence or underdevelopment of the ovaries is rare, and is due to abnormal combinations of sex genes. The most common is failure of the sex gene from the sperm to be transferred at fertilisation, resulting in a single X sex chromosome. This is called Turner’s syndrome. Because XX is needed for ovaries to develop and Y for testis development, people with Turner’s syndrome have no gonads, but have tubes, uterus, vagina and female external genitals. There may be associated congenital problems such as heart and bone defects, webbing of the neck and growth retardation resulting in short stature.

Without ovaries to produce oestrogen, none of the characteristic female developments of puberty can take place. If Turner’s syndrome is diagnosed (by tests showing abnormal genes and absence of ovarian hormones, and if the ovaries can’t be found by laparotomy), hormone replacement treatment must be given to complete development and so that health can be maintained during adult life. If a woman without ovaries has a normal uterus and vagina, menstruation will follow hormone treatment.

It is always very hard to explain to a young woman that she was born without ovaries or without a uterus, because it means that she will never be able to have children of her own. If the vagina is also absent, the prospect of needing surgery or the use of dilators to be able to have intercourse is an additional distress. Very sensitive counselling is needed to help overcome grief and to try to prevent sexual maladjustment.

*220/31/5*

Most testing can be completed within few months. At the first visit your doctor will take a thorough medical history and will usually carry out on both you and your partner a general physical examination that will also include examining the reproductive system. This may indicate which tests you need. The reason for doing any test, what the test involves, its cost and the results will be fully explained to you: if not, ask.

Some of the following tests may be advised.

Starting a basal body temperature chart This is cheap, easy and no risk. If it shows that you’re ovulating, it’s reassuring and tells you when intercourse is most likely to result in conception.

Sperm count (semen analysis) This is the simplest test, needing only a sample of semen to be sent for examination. You’ll be given instructions on how to collect the specimen. Semen analysis is usually done early and may be repeated two weeks later if the first count is low. Sperm counts that are temporarily reduced, for example by a bout of high fever, will have returned to normal after about three months.

Blood tests for hormones If a woman’s blood contains the hormone progesterone during the second half of her menstrual cycle, that’s strong evidence that she has ovulated.

Hysterosalpingogram (HSG) This is an X-ray of the uterus and tubes, to see whether the shape of the uterine cavity is abnormal or there is tubal blockage.

Laparoscopy This is a surgical procedure in which the uterus, tubes and ovaries are inspected.

Hysteroscopy This is to check the shape and lining of the uterine cavity.

Falloposcopy This is to inspect the interior of the tubes.

Post-coital test (Sims-Huhner test) Within a few hours of having sex during the fertile phase of your cycle, some mucus is taken from the cervix and examined under the microscope immediately to see whether sperm are present and surviving.

Sperm migration test This is also called the mucus penetration test. Mucus from your cervix is collected during the fertile phase. The rate of progress of your partner’s and donor’s sperm through your mucus are compared with their rate of progress through a donor’s mucus.

Not all these tests may be necessary. The result of one test may suggest certain other tests such as looking for sperm antibodies, genetic tests, and biopsy of the testis, ovary or lining of the uterus. If no abnormality is found, it means that the subfertility is due to something we don’t know about reproduction.

Many people are distressed by the intrusiveness of the tests, and by a sense of being judged on their results. One woman expressed her anguish:

There is no inner recess of me left unexplored, unprobed, unmolested. Now when we haw sex I think that what used to be beautiful and very private is now degraded and very public. I take my charts to the doctor like a child bringing home a school report. Did I
do well? Did I ovulate? Did I have sex at the right times?

If you can air these feelings with your partner, doctor, counsellor or others in the same boat, you may feel better about them.

*190/31/5*

Conception

A new life begins when an ovum is fertilised by a sperm. Of the 200-400 million sperm in an ejaculation, only around a hundred make the 10-12 cm journey (which is believed to take about an hour) through the cervix and uterus to the outer part of the tube, and only one of these penetrates the ovum.

There’s more to conception than fertilisation. The fertilised egg, a single cell, must then travel down the tube to the uterus, dividing into many cells on the way to form a fluid-filled ball called the blastocyst. About three to four days are spent on the journey from fertilization to implantation site. Here the blastocyst buries in the lining of the uterus (endometrium). Within hours the placenta begins to form and conception is complete.

It’s believed that not every fertilised ovum implants. During if through the tube, the cells formed by its division release a protein called Early Pregnancy Factor (EPF) that changes mother’s immune response so that embryo won’t be rejected. EPF can be detected after ovulation in the bi women who don’t conceive.

For convenience, how far pregnant you are is stated in weeks from the beginning of the last normal menstrual period (LMP), which for most women is a certain date. It also marks the date when the egg began to mature. However, the LMP date is two weeks before the time of fertilisation, and about three weeks before the time of implantation.

The average time from LMP date to delivery is 40 weeks – about 10 days more than 9 calendar months. Pregnancy is divided into three stages, called trimesters, of roughly three months: the first trimester is from the LMP date to 12 weeks; the second or middle trimester is from 13-27 weeks; the third or last trimester is from 28-40 weeks.

A simple way to work out your expected date of delivery (EDD) is to add 10 days and 9 calendar months to the first day of your LMP date. For example, if your LMP date is 15 July, your EDD will be 25 April. In fact, only 5 per cent of women deliver on the EDD, but 80 per cent deliver within 10 days either side of it.

Confirming pregnancy

Gone are the days when we had to rely ; on an examination three to four weeks after a missed period to diagnose pregnancy. Pregnancy tests have become increasingly sensitive over the past decade. The developing placenta begins to produce pregnancy hormone within 24 hours of implantation. The newer blood tests can detect this hormone from the ninth day after ovulation, four to five days before your period is due. New urine tests (including some home tests) can confirm pregnancy from the eleventh day after ovulation. However, because it’s generally hard to be certain about the exact day of ovulation, results of these tests are not reliable until the date your period would have been due. And if for some reason you ovulated late (say, three weeks after the LMP date), a false negative result could come up for several days after the next period is due.

Apart from your burning curiosity, or if you’ve previously had problems very early, there’s generally little point in testing for pregnancy before or for a week or so after you miss a period, except for making changes in your lifestyle to safeguard the pregnancy: if you intend to give up smoking (you should!) and be careful with alcohol and other drugs (including medicines) when you’re pregnant, it’s best to do so as early as you can.

*154/31/5*

Some people don’t like the term ‘cervical barrier’, claiming that the word ‘barrier’ has a negative value and shouldn’t be used in association with sexual intercourse, which is concerned (we hope) with closeness. The alternative suggested ‘intra-vaginal occlusive devices (or pessaries)’ seems rather a mouthful to me and equally off-putting, so I shall use ‘cervical barriers’ to refer to the various types of intravaginal diaphragms and cervical caps. I believe the term is apt, as diaphragms and caps act as mechanical barriers that prevent sperm from mixing with cervical mucus and entering the cervical canal.

History of cervical barriers

Like condoms, cervical barriers have a colourful history that goes back for thousands of years. Many early cervical barriers incorporated something to act as a spermicide. The ancient Egyptians left descriptions on papyrus of a contraceptive pessary made of crocodile dung and honey. Women in the court of Louis XIV placed wads of cotton waste in their cleavage before dinner. At the end of the evening the wad, by this time well soaked with wine, was transferred to the vagina. Casanova is reputed to have given his partners a squeezed half lemon to cover the cervix. And Mae West used a pink satin rose petal!

The first rubber diaphragm appeared late in the nineteenth century and later evolved into a thinner, more pliable latex device with a flat steel watch-spring built into its rim. This became known as the Dutch cap because of its popularity with advocates of contraception in The Netherlands.

Attitudes to cervical barriers

Cervical barriers have never had easy acceptance. Those who opposed contraception in any form denounced the diaphragm even more loudly than condoms and withdrawal. Women controlling their own fertility – what was the world coming to! The first doctor to publish a book for the public about cervical barriers (The Wife’s Handbook, 1887) was struck off the

British Medical Register. Marie Stopes, the British firebrand advocate of cervical barriers, was involved in a court action for pornography for her efforts to provide information. Bitter controversy also raged in the USA. However, after 1920 diaphragms and caps gradually became more available for those who dared and knew where to get them.

During the Second World War all rubber manufacturing was diverted to the war effort, and cervical barriers became unobtainable. As recently as 1943 Marie Stopes recommended (as wartime emergency make-shifts) sponges, powder puffs or plugs of wool soaked in oil, soapsuds or vinegar, and even a child’s rubber ball cut in halves.

After the war cervical barriers were widely recommended by family planning providers, and reached peak popularity at the end of the 1950s, being used by about 12 per cent of Family Planning Association clients in the UK. With the advent of the Pill and IUDs in the 1960s, caps and diaphragms came to be considered an old-fashioned, bothersome method. This is not surprising: instructions for their use had become so complicated, compared with the ease of the newer methods, as to put off all but the most stalwart.

Since about 1980 cervical barriers have had a bit of a ‘comeback’. Women dissatisfied with other methods or worried by ‘scare’ reports of possible side-effects of hormones and IUDs have given the diaphragm or cap a try and found it easier than they had imagined. Simplified instructions for their use have helped make cervical barriers more acceptable.

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Pain with intercourse

Pain on entry is most commonly the result of insufficient arousal and lubrication. It can be particularly troublesome after the menopause for women who aren’t having hormone replacement. The solution is to ensure that you’re aroused enough before penetration. If you and your partner both want his penis in your vagina before you’re moist enough, use an additional lubricant such as K-Y Jelly on the penis and all around the introitus. If you don’t, the discomfort of dry penetration will turn you right off.

Entry can also be painful if there is any inflammation or ulceration of the vulva. It’s best to postpone intercourse until any genital inflammations have cleared up with treatment, both for your comfort and to prevent possible spread of infection.

Pain during deep penile thrusting is I symptom of pathology in the pelvis, and always needs medical investigation. Common causes are infections of the cervix, uterus, tubes or other pelvic organs and tissues; endometriosis; some ovarian conditions, pelvic scar tissue resulting from surgery or radiation treatment for cancer. A retroverted uterus is only likely to cause pain on deep thrusting if the uterus is stuck in the backwards position by scar tissue.

Pain after sex can also occur in conditions that cause pain on thrusting. Dull, prolonged aching in the pelvis can result from the pelvic congestion that follows arousal without orgasm, as described above.

Contractions of the uterus during orgasm are seldom painful. On the contrary, they’re believed to add to the pleasant sensations of orgasm.

Vaginismus

This is an involuntary, painful spasm of the muscles surrounding the entrance to the vagina. It begins as soon as sex (or pelvic examination) is anticipated. The contraction may be so powerful and persistent as to make sexual penetration impossible. This spasm can occur in women who have a deep-seated fear of sex. The dread may have developed after a traumatic sexual experience (often in childhood) or from having learned extreme negative attitudes towards sex. The fear may be buried so deeply in the mind that the woman is hardly aware of it.

Vaginismus can usually be overcome by psychotherapy and sexual counselling, though it can take months or years for a woman to learn that sex with a loving partner is ‘good’ and won’t harm her. Most sufferers recover to enjoy a normal sex life and bear children.

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Depression

This is worryingly common in teenagers. It usually comes on so gradually that it takes a long time or a desperate act before anyone realizes there’s a problem. When you’re depressed you feel worthless and hopeless. You become more and more sad, tearful, irritable and withdrawn. You lose all interests and can’t concentrate your thoughts. Schoolwork suffers. Depression is a really vicious cycle: the deeper it gets, the worse your feelings of hopelessness become; your behaviour becomes more withdrawn and unlikeable so that people avoid you. This convinces you even more that you’re unlovable.

Depression can be a reaction to thinking that you have an insoluble problem and that this means there must be something wrong with you. Often when teenagers and their families have had an easy life, they’ve had no experience of thinking their way through difficult situations, bit, by bit, and together. You may be depressed because you have no practice in facing difficulties. Others have faced the same human dilemmas, and have found their own answers. These may not be the right answers for you, but talking to others and learning how they’ve tackled problems can be a great help.

Depression can make you physically ill too. Common symptoms are headaches, muscle aches and pains, appetite disturbances leading to excess weight loss or gain, and stomach pains. Sleep is often disturbed: you sleep too much or can’t sleep.

Depressed kids often get up to uncharacteristic (for them), antisocial behaviour. Girls may ‘act out’ their depression sexually, becoming promiscuous or deliberately getting pregnant. They may become rude, aggressive, ill-tempered, disruptive and may even get into trouble with the law by stealing or damaging property. This confirms their belief that they are ‘no good’.

We all get the odd fit of the blues. Most of us can bounce back after a couple of days. Depression that continues to deepen for weeks or months is a dangerous illness with a high risk of suicide. If you feel that you or any of your friends may be depressed, speak to an adult you trust. Help is urgently needed. Depression can be associated with a chemical disorder in the brain, and this can be helped by medication. Drug treatments should always go along with counselling (psychotherapy) to help sort out and do something about problems that might be contributing to the depression.

Suicide

Over the past 20 years everyone’s become alarmed at the increase in suicide and suicidal behaviour among young people. The rate has tripled for young men, in whom it’s second only to road accidents as a cause of death. The rate for girls has stayed more or less the same, though more girls man boys attempt to kill themselves. Boys are more likely to use a successful method such as shooting or hanging themselves. Many road and drug-overdose ‘accidents’ are really disguised suicides.

Can something be done to save these young lives? I think that many suicides could be prevented by recognizing and treating depression earlier. The trouble is that many people don’t want to think about suicide or mental illness as things that could happen to them or anyone in their family. It’s something that happens to other people: that is, until it touches close to home.

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Holism

This is a belief that the body, intellect, emotions and spirit, as well as our relations with our families, society, the politics that influence our lives, our environment and the world are interconnected in promoting health and that none can be viewed in isolation.

It seems to me that holistic health care has become a bit of a bandwagon. The idea isn’t new (though the use of the word ‘holism’ in health care is): the philosophy that the whole is more than just the sum of its parts goes back a long way. People have always known that if the soul is unhappy, the body also ails. I hope that all health-care personnel would approach everyone as whole people whose health is influenced by everything in and around their lives.

Homeopathy

This therapy is based on several beliefs: that ‘like cures like’ or ‘what it can cause, it can cure’; that the more dilute a remedy is, the better it works; that people have an energy field that must be matched with the earth’s magnetic field to maintain health; that their treatments can make symptoms worse before they improve and can make old and different symptoms flare up to be healed; that during a cure, symptoms move from the inside to the outside of the body and from ‘more important to less important’ body systems.

It is very hard for someone (like myself) who is trained in conventional biology to understand homeopathic beliefs. But many people have great faith in the therapy, and a few studies have shown that in some cases it has produced benefits that could not be accounted for by placebo effect.

Homeopathic remedies are made from many substances, though mostly from plants. They are widely available in health-food shops and some pharmacies and: need not be prescribed by a homeopath. Because of their dilution, it’s unlikely that self-medication would be unsafe.

Hypnotherapy

Hypnotherapists use the state of mind between wakefulness and sleep. After inducing this trance-like state, the therapist attempts to influence a patient’s mind to improve health. Practitioners view the trance as a healing state that allows the mind and body to achieve changes that aren’t possible with full consciousness.

Hypnotherapy has been followed by physical healing, relief of some types of pain, and insight into present difficulties and past events that may be influencing health. Some orthodox health practitioners remain sceptical about hypnotherapy, in spite of its proven effectiveness in bringing about improvement in health, especially in phobias and physical symptoms associated with stress and anxiety.

Naturopathy

Naturopaths aim to help the body cure itself of disease. Like orthodox practitioners, they know that many illnesses occur when our natural resistance is reduced. While orthodox treatment concentrates on finding and eliminating the cause of illness, naturopaths concentrate on restoring resistance.

These days naturopaths often use a variety of alternative therapies as well as diet, exercise, relaxation and breathing techniques. They also encourage a natural’ lifestyle and positive attitudes to mental and physical health. Naturopathy forms a very good complement to orthodox health care.

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