Archive for April, 2009

THE SELF-MANAGEMENT OF PAIN: CONDITIONING AGAINST PAIN AND THE ACCEPTANCE OF PAIN IN PURE FORM

Conditioning becomes possible through the calm state of mind induced by the exercises. We subject ourselves to minor painful stimuli. We are not disturbed. Gradually we use more severe stimuli; we maintain our calm of mind and we are still not disturbed. In a little while we can tolerate quite severe stimuli without discomfort. By the process of conditioning, we come to be less disturbed by pain in general. This is possible only by virtue of our relaxed and regressed state of mind while we are doing the conditioning.

The Acceptance of Pain in Pure Form-This is the last of our six principles in the

self-management of pain. You may find it more difficult than the others to understand. Actually it follows quite naturally from the practice of the other principles. If you have too much difficulty in believing that pure pain—that is, pain devoid of any psychological reaction—does not really hurt, then concentrate on the other principles which you can understand more easily. Then, when you have mastered them, you will come to realize of your own initiative the fundamental truth of this last proposition —that pure pain does not hurt.

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TUMMY TROUBLES: IRRITABLE BOWEL SYNDROME

Q. Whilst we are discussing bowel disorders, what is irritable bowel syndrome?

A. This is a common bowel problem in which no organic disease can be found. It is probably nervous or psychogenic in nature, although certain dietetic factors (such as inadequate fibre) may play a part.

Q. What are the symptoms?

A. They are fairly constant and consist of long bouts of diarrhoea, which is worse when under stress and anxiety, does not involve the passing of blood, constipation or abdominal pain. Pain is eased by a bowel action or the passage of wind. These symptoms may occur separately, or in succession, or together. The patient’s general health is usually good. Often a lot of mucus is passed but not blood.

Q. What about diagnosis and treatment?

A. Symptoms of this nature always require a full bowel check to exclude a serious disease. X-rays and endoscopic examinations may take place. Treatment includes a high fibre diet, rich in unprocessed bran and fibre foods. Foods which obviously upset should be excluded. Medical hypnotherapy by an experienced doctor often produces excellent results.

Q. What is aerophagy?

A. This means swallowing air but usually means the symptoms that occur when there is too much gas or air in the G.I. system and when there is no organic disease.

Q. Where does intestinal gas come from?

A. It may only come from a few sources. These are air that is swallowed or gas produced within the intestinal system itself. It is easy to unconsciously swallow air, specially at times of emotional stress, when chewing gum, smoking, with excessive salivation or with a dry throat. Many who like to belch often take in more air than they eliminate. Many foods, specially fizzy drinks and various sugary fruit juices and carbohydrates are notorious for increasing gas in the bowel system.

Q. What are the symptoms and how is it treated?

A. There is a feeling of fullness, maybe nausea. Belching, dyspepsia and “indigestion” are common. Much wind is passed by the bowel, a condition called flatulence. Treatment consists in avoiding the causes. Eat in a peaceful environment. Avoid fizzy drinks and alcohol with meals. Avoid gum chewing, smoking, or foods or vegetables that knowingly cause distress. Apples, grapes, raisins, bananas, leafy greens, onions, lentils, legumes and fried foods are best avoided. Experience is the best teacher. Drug therapy is not necessary. Fibre often helps, such as bran for breakfast each day.

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TIPS TO PREVENT BACK PAIN AND SCIATICA FOR HOME WORKERS

Bending over beds, heaving a vacuum cleaner around, dusting in corners and standing cooking in the kitchen are all ingredients that add up to a recipe for increased risk of back strain and other muscle pain.

It’s easy to mistreat your body as you give the carpet a clean -twisting from the waist to get the vacuum cleaner into position can harm the back and strain the arms. Keep the handle close to your body and use the machine’s wheels to move it around.

Beds are usually designed for the benefit of the sleeper, not the one who has to change the sheets. To make changing bed linen safer, don’t lean over to the other side to tuck sheets in, but go round to do it. Similarly, pictures are designed to be looked at, not cleaned; floors to be trodden on, not bent down to for cleaning. But a long-handled duster and brooms used with an upright back, with the handle held close to the body, will help you avoid strains.

The height of work surfaces such as ironing-boards and kitchen units is also important to avoid uncomfortable bending. The most efficient height is usually 2-4 inches below elbow height. In fact, ironing is often best done sitting down, with the chair close to the board.

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THE CRAMPS (SPASMODIC DYSMENORRHOEA): COPING WITH FAINTS

Some people feel dizzy and sick, but manage to stay conscious. Some feel dizzy for a little while and then faint; others just pass out cold without any warning; some recover very quickly and really don’t seem much the worse; others feel and look absolutely awful when they come round. Often the first sign of a fainting fit is a change of colour. White skins go very pale, often with a greenish tinge; brown skins turn grey-mauve. If you’re one of those who faint without warning you might find your family or friends will see the danger signals even before you feel them and can warn you to take action.

But what action? If you feel faint and you’re in the middle of a crowd —in a busy office, or a shop, for example, or at a school assembly —you can keep yourself conscious for a few valuable seconds by clenching and unclenching your calf muscles as fast as you can. This could just give you enough time to get out of the crowd and into a chair where you can sit with your head between your knees and recover. If you have fainted, it’s a mistake to rush to get up when you come round or you run the risk of passing out again. Stay where you are and relax completely until you feel quite yourself again. Then get up slowly, a step at a time, as you do anyway after you’ve been relaxing.

Some fainting fits are caused by tension, so as you get used to relaxing and the relaxation takes effect, you may find that you don’t faint so often, if at all. Some fainting spells disrupt your breathing pattern. When you come round your breathing is upset, which can be alarming. A few deliberate deep breaths will often help you to breathe normally again and they will certainly make you feel calmer until you recover.

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CHILDREN’S TONSILLITIS: HOME CARE, PRECAUTIONS AND TREATMENT

Home care

Treat tonsillitis the same way as a common cold, a sore throat, or hay fever. A throat culture will usually be required to help your doctor identify the illness. Give aspirin or paracetamol and plenty of fluids. A peritonsillar abscess requires treatment by a doctor.

Precautions

• If drooling occurs with a sore throat, the child should be seen by a doctor immediately.

• Enlarged adenoids and tonsils are common in healthy children three to nine years of age.

• Tonsils often contain a white, cheesy material. This is normal and does not indicate infection.

• Tonsils and adenoids may be infected without becoming enlarged.

• Enlarged tonsils do not cause poor eating habits.

Medical treatment

The decision to remove tonsils and adenoids surgically requires careful evaluation. Some doctors insist that they should never be removed; others recommend routine removal. Both groups are mistaken.

The tonsils can be removed as part of the treatment of: a quinsy sore throat; frequent infections (for more than a year) of the tonsils; a tonsillar tumour; or a diphtheria bacilli-infected tonsil.

Upper airway obstruction resulting in sleep apnea (temporary halt in breathing) is an indication for removing the adenoids (adenoidectomy). The adenoids can also be removed to correct: a nasal obstruction that has led to facial peculiarities such as a pinched face, narrow nostrils, or constantly open mouth; snoring; or a nasal voice. In some cases, it also may be wise to have adenoids removed if their enlargement is causing a hearing loss or frequent middle ear infections. Alternatives to adenoidectomy include prolonged use of decongestants and antibiotics.

Your doctor will treat a peritonsillar abscess with antibiotics; occasionally surgical drainage is necessary.

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DIABETES: UNDERSTANDING OF COMPLICATIONS’ RISK

What are the late complications of diabetes?

Late complications may occur many years after diagnosis of diabetes. They are most worrying because they may result from damage to vital organs of the body such as eyes, kidneys, heart, blood circulation or the nervous system. On the other hand, these complications are often treatable and early detection may help to prevent their harmful effect.

How can complications develop?

They may develop in a number of ways:

1.     By weakening and blockage of small blood vessels that supply blood to the organs of the body. This is called ‘microvascular disease’ and can lead to impaired vision if they affect the eyes or reduce kidney function if they affect the kidneys.

2.     By thickening the wall of large arteries that supply blood to large organs such as the heart or the feet. This is called ‘macrovascular disease’.

3.     By changes within the cells of the body. This can lead to the ways that the body’s nervous system functions. This is called ‘neuropathy’. A similar process within the lens of the eye can cause clouding of the lens called a cataract.

Why do complications develop?

We do not always understand why complications develop. There is no doubt that constant high levels of glucose in the blood over a period of time leading to poor diabetic control, is a major factor in increasing the risk of complications.

Some people seem more at risk than others through no fault of their own. Perhaps this is because there is an inherited risk for some people to develop the complications of diabetes.

Other factors that can increase the risk of complications include physical inactivity, smoking, becoming overweight, high blood pressure and inappropriate diet.

What is the risk of myself or my child developing complications?

We cannot answer this question. We can only estimate risk on the basis of statistics from groups of people who have had diabetes a long time. New treatment that is now available will have diminished that risk so that the statistics may not apply to people developing diabetes now. A prediction based on a statistical risk also cannot reliably apply to an individual person in predicting their future.

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MANAGEMENT OF STRESS: THE DEEPER UNDERSTANDING

Night and day, the recurring seasons, our breathing, our heart beat, the natural cycle of women is recurring phenomena. Growth, maturity, age and death are equally a part of our biological lifespan, just as it is with all that is living around us, treasured plants in our garden, the trees in the park, our pet dog, our family, our friends, ourselves not least. All participate in the recurring cycle of growth, maturity, age and death.

What has all this to do with our experience of stress? Unlike these matters, stress is not a naturally recurring phenomenon. Problems and adverse circumstances in the biological sense are a natural part of life, but stress is essentially pathological. Something to be avoided, and which to a great extent can be avoided.

An awareness of these naturally recurring cycles in which we participate helps the living matter which is us to run more smoothly, as it were. The problems of life which could cause stress are seen rather as incidents on the background of what is around us, and their power to disturb us and create stress is so much the less.

Our awareness of these matters, in the way that it affects stress, is more than our knowledge of the subject. We all know of birth, growth and death. Such a knowing is a function of our intellect, and is little related to our experience of stress. Nor is the awareness, which is significant, simply our emotional involvement in these things. We have a feeling of attachment to the countryside, our forests, and the long sweep of the beach. We love our mate in life, our children, our family. But the awareness that affects our stress is something different. It is an understanding of these matters which relates neither to our intellect nor our emotions. It is just the naturalness and the simplicity of it all. So simple that it defies clear description in the sophistication of words. Those fortunate people who have something of this basic human awareness do not come under stress from the problems of life in the same way as others do.

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MAJOR PROBLEMS CAUSING STRESS: TAX AVOIDANCE

“It’s his responsibility. His responsibility, not mine. That’s what he is paid to do. That’s what accountants are for. If the tax people want to make a fuss, let them get on to him, not me. It’s his responsibility. But I can’t help worrying. Worrying and worrying. Worry that it was my responsibility. I knew they might say it wasn’t quite right. He was trying to do his job. Damn him! He thought I would sack him if he did not do it that way. What a mess!”

It is quite clear there are two problems. There is the major problem of being investigated by the tax authority and the likelihood of being fined. And then there is the associated problem – the inner disquiet of his own conscience. Without the augmentation from the associated problem, the major problem may not reach such a degree of intensity as to produce stress.

The whole situation may be further complicated by some background problem, such as his wife’s unexpected pregnancy. But in the individual’s mind his symptoms of stress are caused, simply and solely, by the tax problem.

The major problem, the tax trouble, must be dealt with, in a practical way, according to established business principles.

The secondary problem, his guilt, and the disturbing influences to his brain arising from it, need to be dealt with by letting his mind run freely for a short period each day to reduce his level of anxiety and so allow his mind to settle. And the background problem, his wife’s pregnancy, requires his mental adjustment to a changed situation.

The difficulty is that the individual sees only the major problem, and is loath to attend to the other matters, which in fact may be the key to resolving the whole situation.

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VARICOSE VEINS PREVENTION

•     Eat a high-fibre diet rich in fruit and vegetables, whole-grain breakfast cereals, and whole meal bread and other whole meal-flour products (including pasta), and cut down on refined sugar and refined flour.

•     Drink more fluid to ensure that constipation is a thing of the past.

•     Avoid long periods of sitting and standing if you have a history of varicose veins in your family or if you have early signs of them yourself. Do exercises frequently if you are in this group. Wiggle your toes a lot, raise and lower yourself on the balls of your feet while standing in a queue in the supermarket or at a bus stop. Raise your legs on to a table whenever you sit down (get them above heart level), break up long rail or car trips by walking every hour or so, and walk around on long plane journeys.

•     Get more exercise. Swim, run, jog, walk or cycle to improve nature’s muscle pump in your legs. Walking lowers the venous pressure to a third of standing pressure under normal conditions.

•     Go barefoot at home as much as possible to exercise your foot muscles and improve your venous flow.

•     If you have even a hint of varicose veins starting, shun tight boots, pants that are too tight at the groin and anything that restricts the legs such as self-supporting stockings.

•     Make trips to the lavatory short and to the point-don’t sit there reading for ages.

•     Avoid very hot baths – these seem to encourage varicose veins.

•     If you have a family history of varicose veins wear support stockings throughout pregnancy.

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SELF-HELP PREVENTION: BRONCHITIS AND EMPHYSEMA

What are they?

Bronchitis is an inflammation of the air passages of the lungs and emphysema is a condition in which the tiny air sacs (alveoli) at the ends of the passages become distended and weakened. They are usually thought of together because they so often occur alongside one another.

Bronchitis usually starts with a cold on the chest, often with a sense of ‘rawness’ behind the chest bone, tightness in the chest or pain or irritation between the shoulder blades. There is often a dry cough and a moderate fever. Gradually the cough becomes looser and the sufferer starts to produce phlegm. This cough and phlegm can continue for weeks. This type of bronchitis is called acute but it can keep on recurring and become chronic. When it becomes chronic the lungs begin to shrink and permanent damage reduces their efficiency.

Chronic bronchitis is extremely common, especially in the UK. About one in twenty of all deaths are caused by bronchitis and emphysema. The total number of deaths is the same as that caused by lung cancer. These conditions also result in the loss of about 300 million working days each year.

What causes them?

• Cigarette smoking. There is no doubt that the largest single culprit is smoking, though it should also be borne in mind that deaths from these conditions are more common in parts of the country where air pollution is high. No one knows why all smokers do not get the disease but some studies suggest a hereditary link. This has been traced to a deficiency of alpha 1-anti-trypsin in the blood of susceptible people. Such people are then especially sensitive to cigarette smoke and infection.

• Physical variations. The north of England has more bronchitis and emphysema than does the south and it appears that the wetness of the atmosphere could have something to do with it.

• Certain occupations are particularly connected with these diseases. Workers in the linen and cotton industry and those who are exposed to cadmium are especially at risk.

• Poor personal resistance to infections. This is caused by poor diet, bad breathing, poor posture, lack of exercise and smoking.

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