POLLENS CAUSING ALLERGIC RHINITIS: TREE AND GRASS POLLENS

January 13th, 2011

Tree Pollens
There are more than 50,000 species of trees worldwide. Some 600 to 700 of these are native to North America, but only the pollen from about 65 of these has been shown to cause allergic rhinitis. As you would expect, the trees causing symptoms are those most commonly found around and within inhabited areas.
Tree pollens generally show little cross reactivity: that is, in general, you must develop an allergy to each specific tree pollen in order for it to cause symptoms. However, there are two tree families that are exceptions: the family containing the alders, beeches, birches, and oaks, and the family of the junipers and cedars. With respect to these, if you are allergic to the pollen of one member of the family, you will probably experience symptoms from one or more other family members.

Grass Pollens
A grass is any member of the botanical family Gramineae, which contains some 4,500 species. However, the pollens of only a small percentage of the grasses – mostly members of the same subfamily – cause the majority of grass-induced allergic rhinitis. These do so because they are widely distributed and release enormous amounts of pollen into the air each season. These plants are so ubiquitous that none of us is safe from grass pollen anywhere in North America. Even in downtown New York City, you can become sufficiently exposed to grass pollen to develop allergic rhinitis.
Included in the grass family are the cereals (oats, barley, rice, corn, wheat). Most of the cereals have large, heavy pollens that can be carried on air currents only for very short distances, not the miles required of pollens that are going to cause widespread allergic reactions. Hence, grass pollen-allergic people are unlikely to be triggered by pollens from a cereal unless they are in proximity during the cereal’s pollination.
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CONVENTIONAL TREATMENTS FOR ARTHRITIS

December 30th, 2010

The goals of conventional treatments for all types of arthritis focus on relieving pain, reducing inflammation, maintaining normal function, and preventing deformities. Many treatments are used to accomplish these goals, including medications, physical therapy, and surgery.
The most widespread group of medications used to manage arthritis is non-steroidal anti-inflammatory drugs, or NSAIDs. NSAIDs are the most commonly prescribed class of drugs in the United States – between 70 and 75 million prescriptions are written annually. Aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan), and ketoprofen (Actron, Orudis KT) are common NSAIDs, but there are many others. NSAIDs are the primary treatment for osteoarthritis and are also used in mild cases of rheumatoid arthritis. They work both by relieving pain and controlling inflammation. However, they do not slow down the progression of rheumatoid arthritis; and as we shall see, there is some evidence that they may actually speed the progression of osteoarthritis.
Another category of drugs used to manage arthritis pain is analgesics, like Tylenol (acetaminophen) and Ultram (tramadol). These can also be used for any type of arthritis. They reduce pain but do not affect inflammation nor alter the course of the disease.
Many other drugs are available, particularly for the treatment of rheumatoid arthritis.
All these drugs, including over-the-counter acetaminophen and NSAIDs, can be quite useful, but they also have potential side effects ranging from mild to serious to life threatening.
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INTESTINAL DISORDERS: ILEITIS

December 23rd, 2010

This is an inflammation of the ileum. Food enters the body through the mouth, passes downward through the stomach into the intestines. The first portion of the small intestines is called the duodenum, next the jejunum and then the ileum. The ileum connects with the cecum from which juts off the appendix. The ileum may become blocked so that food does not pass through by masses of indigestible residue, by collections of round worms, by tumors, by having one part folding into another called intussusception. The walls may be infected by germs or viruses or become inflamed with swelling, redness due to congestion and pain. Such inflammation is called ileitis. The doctor diagnoses the conditions from his examinations including use of the X-ray, feeling the area, and listening for the movement of the tissues. According to the extent and severity of the condition the treatment may be palliative or radical which includes surgery. Surgery may involve removal of portions of the bowel, or by-passing the damaged portion through short circuiting which connects the bowel above the damaged portion to the bowel below it.
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EXERCISE FOR PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

December 16th, 2010

Gastroesophageal reflux disease is an important cause of morbidity in the U.S. Clark et al initially reported that acute vigorous physical activity (running) can induce gastrointestinal reflux in normal healthy subjects. Moreover, postprandial running exercises further exacerbated reflux symptoms (secondary to disorganized esophageal motility) and correlates with exercise intensity. However, in a survey of runners and age, gender-matched sedentary subjects, Sullivan et al reported that upper gastrointestinal symptoms of heartburn, vomiting, and bloating were rare in runners during training, but became more common when these same runners stopped training, and was similar in frequency to the sedentary control subjects. Indeed the findings from the National Health and Nutritional Examination Survey, which followed 12,349 participants over a 20-year period, showed that individuals who have been physically active over a long period of time have a lower risk of gastroesophageal reflux disease than do sedentary persons.
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OVERHEATING THERAPY: DO-IT-YOURSELF SAUNA

September 23rd, 2010
If you do not have your own sauna, and have no easy access to a sauna, you can make a do-it-yourself sauna in your own bedroom, as follows:
First take a hot bath, as hot as you can stand. Then dry yourself and wrap in a heavy bath towel. Put a plastic or rubber sheet on your bed to protect it from damage by perspiration. Lie on the rubber sheet, take a couple of hot water bottles and cover yourself with an electric blanket, turned on high, leaving just a crack for breathing. Use several heavy blankets, if necessary. Remain in bed while profuse sweating occurs – half an hour or more. Finish with a shower.
Note: Although fever is a natural, constructive, beneficial symptom, and fever therapy is one of the most effective means in the arsenal of biological modalities, I must stress the fact that fever therapy should always be supervised by an expert practitioner and undertaken on the advice of a doctor. The patient’s heart condition, his ability to perspire and his general vitality should be checked and his reaction during the therapy closely supervised. Also, the length of the overheating therapy, and the dosage of fever-inducing drugs (if they are used), should be determined by the doctor.
The above warning is in regard to patients who are ill. There is, of course, no danger for healthy people to take sauna or other steam or hot baths, or even a Schlenz-bath, on a regular basis as a preventive, cleansing and health-building measure, as millions of people are doing both here and in Europe.
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OVERHEATING THERAPY: SAUNA

September 23rd, 2010
A sauna, or Finnish steam bath, is another excellent way to benefit from overheating therapy. In addition to an artificially induced fever, which a prolonged steam bath always accomplishes, the sauna bath is specifically conducive to profuse therapeutic sweating.
The skin is our largest eliminative organ – “the third kidney.” It is generally considered that the skin should eliminate 30 percent of the body wastes by way of perspiration. Due to lack of physical work and an overly sedentary life, the skin of most people today has degenerated as an eliminative organ, since it is hardly ever subjected to sweating. If health is to be restored, it is of vital importance that the eliminative activity of the skin is revitalized. Taking sauna or steam baths regularly, once or twice a week will help to restore and revitalize the cleansing activity of the skin.
The therapeutic property of the sauna is attributed to the following facts:
• Overheating stimulates and speeds up the metabolic processes and inhibits the growth of virus and bacteria.
•   All the vital organs and glands are stimulated to increased activity.
• The body’s healing forces are aided and assisted, and healing is accelerated.
• The eliminative, detoxifying and cleansing capacity of the skin is dramatically increased by the profuse sweating.
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TRAVELS OF PEOPLE WITH DIABETES: TIME ZONES

June 3rd, 2010
Adjustment from home time to foreign time is complicated. If you are taking oral hypoglycaemicpills, work out the total dose of pills you take in twenty-four hours. Next consider the actual number of hours between breakfast on the day you leave home and the first breakfast in the country you are visiting. By breakfast, I mean the meal eaten on getting up in the morning, whatever it is called locally. If there are twenty-four hours or more between these two breakfasts take your total twenty-four hour dose of pills split at appropriate intervals. Do not take more than this, but wait until your first breakfast in your new country before you start taking your pills during the day as you would at home. If there are less than twenty-four hours between your breakfast at home and your first breakfast in your new country, take fewer pills. Thus, if there are twelve hours, take half your pills, eighteen hours, two-thirds of your pills and so on. You will need to use a bit of common sense to arrive at a practical division. Follow a similar process on the way home.
If you are taking insulin you can use the same calculation if you wish, but their type of insulin and its duration of action have to be considered. The main concern is not to have a hypoglycemic attack in some remote corner of a foreign airport. This is not a hypothetical worry. You are tired and the food on the aero-plane was indigestible; you may have had a couple of free drinks, you have lugged two suitcases, a shoulder bag, two carriers of duty free wine and a souvenir from Barcelona through endless miles of corridors; your next flight has just been delayed for four hours and the restaurant is shut. As always, check your blood glucose and do not care if anyone sees you.
How do you calculate your insulin? If you are on one injection of very long-acting insulin a day and two or more injections of rapid-acting insulin: Calculate the number of actual hours between breakfast at home and your first breakfast in the new country. If this is twenty-four hours or more, take your usual dose of very long-acting insulin; if less than this, take an appropriate proportion (for example, for twelve hours half the dose, twenty hours 80 per cent of the dose and so on). Take your usual short-acting insulin before breakfast at home and then check your blood glucose levels before each meal you have until the first breakfast. If they are 7 mmol/1 or more (126 mg/dl) take 2 to 4 units of rapid-acting insulin to cover each meal. If they are below 4 mmol/1 (72 mg/dl), eat a bigger meal and start it with some fast-acting carbohydrate. Before breakfast in the new country have your usual insulin and continue this, with frequent blood glucose measurements and adjustments as necessary, until you come home. Then follow a similar process when you arrive home.
If you are on two injections of medium-acting or long-acting insulin with short-acting insulin a day: twenty-four hours or more between your home breakfast and your next breakfast, take your usual insulin before breakfast at home and twelve hours later (or at the meal nearest to twelve hours later) take your ‘evening’ dose. It may be wise to reduce each dose by a small proportion, for example, 10 per cent, to make sure that you do not go hypoglycemic. Then have your usual insulin before the next breakfast as above.
Less than twenty-four hours between the two breakfasts, take your usual insulin before breakfast at home (reduced a little if you wish). Then take no more long-acting or medium-acting insulin until the next breakfast. Check your blood glucose level before each main meal and give 2 to 4 units of insulin if it is 7 mmol/1 or more. Have your usual medium-acting or long-acting insulin before your first breakfast in the new country. Reverse the process for your return trip.
This advice can be modified by your personal experience. If you make regular trips across a particular time zone, you should be able to work out your best insulin dose from experience. What I have suggested may cause you to run your blood glucose level a little high for the first few days, but that is better than going hypoglycemic in a strange country.
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DIABETES

TRAVELS OF PEOPLE WITH DIABETES: BUS, RAIL, SEA AND AIR

June 3rd, 2010
Travel by bus or rail
The main problem with bus journeys is keeping comfortable. Otherwise, once you have got on to a bus all you have to do is sit down until you reach your destination. Not all buses have lavatories so it is a good idea to make sure your blood glucose is below your renal threshold during the journey. You will, of course need your diabetes travel pack.
Most trains in the developed countries have lavatories but there may be none in Third World countries. Again you will need to make sure your blood glucose is below your renal threshold. If you are travelling in an out of the way place, you will also need a far larger food and fluid reserve, and should plan your trip more as I described for mountain expeditions.
Travel by sea
If you know you are a bad sailor, take a motion sickness pill before you step on board ship and keep taking them at the interval stated on the package until you are safely on dry land again. These pills, of which a range is available from pharmacies, drugstores or doctors, will not upset your diabetes, but sea sickness might. The pills may make you drowsy, though, and so you should not take them if, for example, you are planning to drive your car off the ferry.
What should you do if sea sickness strikes? Try to find somewhere to he down with some fresh air. Ask a steward for a motion sickness pill if you do not have any. Check your blood glucose level every couple of hours and suck some glucose tablets or have a glucose drink such as Lucozade if it is low. Take a few units of rapid-acting insulin every four hours if your blood glucose level is high. This is unlikely because motion sickness is not usually related to a generalized infection, like gastroenteritis, and so there is no increase in insulin resistance. Your glucose level will tend to go down in most cases. You may feel as if you want to die while you are sea sick, but you will recover quickly when you are back on land.
Travel by air
Air travel has several special problems for the person with insulin-treated (and, to some extent, the non-insulin-treated) diabetes:
1.   You are at the mercy of the airline and their timetable
2.   Your luggage is restricted
3.   You are more likely to have trouble with customs checks
4.   You may travel rapidly through time zones.
Unpredictability
The first problem is simply that of the unpredictability of air travel. Your diabetes travel pack and extra food should see you through this, and besides you will usually be able to buy food and drink at the airport. Your main luggage will be taken from you and put in the hold, where it may be frozen in flight. You must, therefore, have all your insulin with you inside the passenger compartment as it is destroyed by freezing. You must keep your diabetes travel pack with you.
Customs
Customs officers and airline officials using x-ray scanners frequently stop people with diabetes because syringes and needles show up on their screens. This is why you need your diabetic card and an explanation of it in the language of the country you are visiting. There should be no problem, once you have explained the situation, so do not get angry or upset.
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DIABETES

YOUR CHILD’S HEALTH/ASTHMA: OTHER FORMS OF MANAGEMENT

May 21st, 2009

Drugs form the mainstay of the modern treatment of asthma. Most other forms of treatment are unproven and have a limited place, if any, in the treatment of asthma in children. While allergens probably have a role in the triggering of asthma attacks, there is very little evidence that desensitisation (a series of injections designed to make the child less allergic to certain substances) makes any difference either to the frequency or the severity of attacks. Physiotherapy may occasionally have a role to play for some children with asthma, but generally the child is better off participating in regular exercise and sporting activities.

Consideration should be given to factors which may trigger attacks of asthma. Cigarette smoke should be avoided. Exposure to animals that cause symptoms (often household pets) should be minimised or avoided, and the child may be better with non-allergenic bedding if he is affected by goose-down or feathers. In some selected cases, carpets may need to be removed to minimise dust, but this is not usually necessary.

These measures should be balanced with the need to minimise drastic changes to the child’s and family’s living conditions. Change in environment of any significant degree may not be indicated in children with mild or minimal symptoms.

Some of these precipitating factors can and should be avoided. However, most trigger factors cannot be identified, let alone avoided. This means that the mainstay of management of asthma is pharmacological — the appropriate use of medications to prevent and treat symptoms.

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SEXUALITY, ILLNESS, AND HEALTH: ALCOHOLISM AND SEX – OUR SOCIETY’S EMPHASIS ON THE DRINKING/ SEXUALITY CONNECTION IS STRONG

May 19th, 2009

We must recognize that our society’s emphasis on the drinking/ sexuality connection is strong. “A few drinks and I can really get it on,” was one wife’s report. She means that she experiences sufficient anxiety and insecurity that a chemical is needed to facilitate sexual interaction. The natural chemicals from our own brains are available to us if we will learn to relax, to share, to give a priority to intimacy so that we do not need “quick drugs” to depress us just enough that we can have sex. There is no human activity that is helped by drinking, and if you doubt that, you may be taking very early steps toward a drinking problem yourself. Drinking is ingesting small doses of a toxic substance that affects our nutrition, judgment, speech, perception, coordination, and ability to be truly intimate. It is one of our society’s most serious problems, and the emphasis on the war against drugs should include alcohol as one of the major enemies.

During the treatment program for the couples, all alcohol was prohibited. Every one of the couples found that sex improved once

they were free of their “habit.” Our brains are preprogrammed to “get high,” but our own bodies and brains provide the natural internal chemicals for that high. We seem to have a natural reflex, a joy response, and this joy response is blocked by alcohol, not enhanced by it. The couples found an immediate improvement in communication without alcohol, although at first some couples were awkward, actually in a type of mutual withdrawal state.

“It was like a first date. We just always used to have a drink or two before sex. It was kind of frightening at first, but we really rediscovered each other.” This wife spoke for other spouses who at first resisted the sanction against drinking and then learned what it was like to respond drug-free in a sexual relationship.

If you have a drinking problem, even if you suspect one, get help now. You will not be able to stop alone later, and the earlier you get the help, the less suffering for all concerned. If you are drinking to change how you feel, you have a drinking problem. If you are fighting this issue as you read this material, you probably have a problem with alcohol.

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