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There is a list of relative contraindications to HRT, that is those conditions in which you and your doctor will need to consider the balance between the risks and the benefits:

• Endometriosis can lead to a difficult decision having to be made. If you had an oophorectomy, then you will probably have particularly troublesome hot flushes, and if you had the operation before about the age of 45 you will be at a much greater risk of developing osteoporosis, so HRT would seem an important treatment for you. However, the excess tissue that built up in endometriosis may get worse on HRT, even many years after the menopause, suggesting that you should not use this form of treatment. This is obviously something you should talk over with your doctor.

• If you have a family history of cancer of the breast or uterus, your doctor will want to consider what your chances are of developing either of these diseases if you take HRT. Once again, only you can decide by weighing the relative risks against the relative benefits. Benign breast disease needs careful monitoring, but HRT needn’t always be ruled out.

• Fibroids tend to get worse in the presence of oestrogen, and may enlarge if you take HRT. But this doesn’t usually cause extra problems and most women with fibroids who are on HRT find they just have heavier periods.

• The presence of gallstones means HRT has to be prescribed with caution, as it can lead to an increased risk of this condition becoming worse. A non-oral route, such as the patch or implant, avoids the digestive system, so may be acceptable. Oestrogen can make gallbladder disease worse.

• High blood pressure should be investigated before starting on HRT, but once it has been brought under control, your doctor will probably feel it is alright for you to be on HRT. High blood pressure is not in itself a contraindication.

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The preceding discussion has assumed heterosexual sexual behaviour. However, not everyone is primarily attracted to members of the opposite sex; some people, both males and females, are aroused by and form homosexual relationships with members of their own sex. Research on the effects of hysterectomy on the sexual relationships of lesbian women is extremely limited and deserves more attention.

Another area in which knowledge is limited is the previously mentioned role of the uterus in sexual response. Direct stimulation of the cervix during sexual intercourse also seems to have a role in the sexual response of some women and men.

More information exists about the effects of changes in hormone production after hysterectomy. Even when the ovaries are retained, oestrogen levels seem to be affected by hysterectomy in some women. About a quarter of women whose ovaries remain after hysterectomy experience early loss of ovarian function (on average four to five years earlier than in comparable women who have not had a hysterectomy) which can lead to vaginal dryness and hot flushes. In a bid to prevent or overcome these problems, many women with indications of low oestrogen levels are prescribed oestrogen therapy after a hysterectomy whether or not their ovaries have been removed.

A woman’s attitudes — and those of her partner — can be an extremely important influence on sexual relations after hysterectomy. In the aftermath of her hysterectomy, Kay was already questioning her femininity and attractiveness. She had regarded her main role in life as childbearing and suddenly, without the ability to do this, her life lost meaning. But her agitation grew when Kevin failed to respond to her attempts to arouse him sexually. She worried that she was now less attractive to him and new tensions entered their relationship. This unfortunate chain of events continued until the couple sat down and communicated their feelings and fears; Kevin explaining that he was worried about causing Kay pain when they made love, Kay coming to grips with the reasons why Kevin and others valued her.

In the case of Vin, talking did not help a great deal. He thought his wife Mary was less of a woman after undergoing hysterectomy but found it difficult to say exactly why. He understood that Mary had tried many other approaches to resolving her medical problems without success, and that something had to be done to relieve her pain and bleeding. In cases such as this, it can be helpful if a spouse or partner is involved in the decision-making

process, thus providing opportunities to discuss any concerns with the doctor. It may also alert women to the need for a concerted effort on all sides to overcome unforeseen barriers to reestablishing a satisfactory sexual relationship.

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One of the commonest causes of insomnia is stress.

The Oxford Dictionary defines ’stress’ as a force, an effort, a demand upon physical or mental energy. We use the word ’stress’ very often, but what is stress, what is it doing to us, and how do we react to stress and cope with it? Stress can be compared to a mechanical force or pressure exerted on an object To understand the relationship between stress and the object under stress, let us look at a simple example, such as what happens when pressure is exerted on a piece of fruit.

If you put a lot of apples in a bag, the apples exert pressure on each other, and each apple is subject to pressure from surrounding apples. This is a normal level of pressure and stress. However, if you take an apple out of the bag and drop it to the floor, the apple is bruised. If you accidentally step on this apple, you leave a big scar on it Dropping the apple and stepping on it are both extraordinary stresses not normally exerted on apples.

Hence, to put it in plain language, there are two kinds of stresses in our lives: ordinary stress, which most of us experience every day, as in the example of the apples in the bag, and extraordinary stress, comparable to dropping the apple or stepping on it, which we only experience once or twice in our lives, and which some of us may never have to face at all.

However, we are not all apples. Some of us may be stronger, like a coconut, which when dropped on the floor will not be harmed as it takes a few strokes of a hammer to crack it. Or some of us may be weak, like a ripe tomato, that even ordinary pressure can bruise. People come in all shapes and sizes and possess different inner strengths and energies. Some of us may be like coconuts, some like apples, and some like ripe tomatoes. We have no choice as to what we are, as part of this is our inheritance from our parents and part is based on our life experience, just as an apple cannot change into a coconut, and a tomato cannot change into an apple. However, with some help we can strengthen ourselves a lot more and can deal with stress a lot better. Einstein reminded us that we use only 10 per cent of our potential, and there is a lot of strength inside us that we have not recognized.

Hence there are two factors in stress. The first factor is the kind of stress, whether it is ordinary stress or extraordinary stress. The other factor is how tough the person is. Some of us may not be able to face up to ordinary stress, just as the ripe tomato. But some of us may be extremely tough and need a hammer to crack us, like the coconut.

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A man of twenty-two came to see me in great distress. He quite openly said that he was a homosexual. He had been caught by the police picking up another homosexual in a public bar. The police had been very considerate and had made no charge against him, but had advised him to seek the help of a psychiatrist, and to report back to them in a month.

In spite of his distress he kept saying that he was glad he had been, caught. He described his furtive sexual life with casual men. He said he had been actively homosexual since aged twelve or thirteen. On one occasion four years ago, by great act of will he had had no homosexual experience for a month. On further questioning it became clear that he did not really enjoy these experiences. In a way he hated them. But he was so lonely, and so timid toward girls that this type of human contact was preferable to utter loneliness and isolation.

I explained to him that he had been driven to this form of sexual experience by his own introvert nature and not by true homosexuality. He learned to do the relaxing mental exercises. As his anxiety abated, he gradually became friendly with various girls. He found that he could like them and enjoy their company. It soon came about that he was talking of love, and he told me he was having normal sexual intercourse with the girl of his choice. With this there was a remarkable change in his personality.

This man had believed that he was destined to live a life in the shadows as a homosexual. Something happened to him beyond his wildest dreams. It is well to remember that there are many like him.

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Most people will say that they are all right, their bowels move once a day. Many are satisfied when they evacuate only once every two or three days. If your bowels move only once in two or three days you are badly constipated, even if you don’t feel pain or discomfort at present. Such delayed evacuation will eventually, more likely than not, lead to serious illnesses. But even if your bowels move once every day, intestinal sluggishness is definitely indicated.

People living under natural, primitive conditions move their bowels after each meal. Most animals do the same. Healthy infants follow the same pattern. Adults, too, should do likewise. They should at least evacuate twice a day, morning and evening.

Constipation can be corrected only by adopting a sound, commonsense program of natural foods, proper eating habits, plenty of exercise, plenty of liquids, and establishing a habit of regular routine. Laxatives will never solve this colossal health problem. They only weaken the natural functions of the intestines and ultimately cause more harm than good.

The sufferers of arthritis who avail themselves of biological treatments as outlined in this book, will have their constipation problems automatically solved. Fasting, enemas, and “eliminative diets” of raw foods will effectively rebuild and restore the normal function of the intestinal organs and bring about good elimination.

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The understanding and treatment of epilepsy has improved considerably over the past fifty years. Most of this improvement has resulted from basic scientific research into how and why epileptic seizures start, and from the development of safer and more effective anti-epileptic drugs by the pharmaceutical industry. However, there is still much work which needs to be carried out, not just to improve our understanding and knowledge, but to improve the quality of life of a child or man or woman with epilepsy.

It is unlikely that a single ‘cure’ for all epileptic seizures and epilepsies will be found, due to the fact that there are so many different causes and types of epilepsy. It is also very unlikely that epilepsies will ever be completely prevented from occurring in the first place. A proportion of the epilepsies are inherited. It is improbable that much can be done to prevent these epilepsies, and it may not be possible (or appropriate) to remove these abnormal genes by ‘genetic engineering’ techniques. However, improved medical care should reduce the numbers of patients who develop epilepsy after meningitis or encephalitis. Improved safety measures on the roads, in cars, and the wider use of cycle helmets and protective head gear on industrial sites should reduce the incidence of posttraumatic epilepsy. In developing countries, better obstetric care and public health measures to eradicate parasitic diseases, (particularly cysticercosis) and bacterial diseases (particularly tuberculosis and other causes of meningitis) will play a part.

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It has been known for some time that a small daily dose of aspirin reduces the incidence of stroke. It does this by affecting certain types of our blood cells.

Blood cells are of three types: red cells (which carry oxygen), white cells (which defend us against infection), and platelets (plate-shaped cells that seal holes in blood vessels). Whenever there is bleeding, thousands of platelets settle at the site of the broken vessel to plug the hole. They also release a chemical that starts blood clotting at the site of injury. Drugs like aspirin, that “stabilize” platelets by slowing up their sealing and clotting activities, therefore cause increased bruising and more prolonged bleeding than would be expected after minor trauma.

On the good side, daily doses of aspirin can help to prevent clots from forming spontaneously inside blood vessels, thereby also helping to prevent stroke (due to clotting in an artery of the brain) and myocardial infarction (heart attack due to blocking of a coronary artery).

During a recent study in France, Internal Medicine Alert (5#3:11) reports, either a daily aspirin or placebo (the patients did not know which) was taken by patients who had experienced transient ischemic attacks (warning symptoms of stroke, such as episodes of slurred speech, weakness on one side, loss of vision, etc). Results were clear cut, with only 10 percent of the aspirin group developing stroke, as compared to 18 percent in the placebo group.

This French study confirmed earlier studies in the United States and Canada but differed from them in showing that aspirin can prevent strokes not only in men but also in women. This was an important contribution. Women are more likely to benefit equally with men when their aspirin dosage is reduced in proportion to their lower weight. One baby aspirin (about 100 mg) daily is probably enough.

Aspirin as a preventive treatment may be much more powerful than has so far been suspected. A Georgetown University neurologist who is an expert on this subject believes that, until now, researchers have focused too much upon the number of strokes that occur on various preventive regimens. More meaningful information can be obtained, he believes, when one studies the severity of strokes as well as their numbers.

Thus, Modern Medicine (26#12:8) reports, a daily aspirin reduces the severity of strokes even more than it reduces their number. Preliminary clinical studies even suggest that daily aspirin cuts the number of strokes that are severe (fatal ones or those that leave the victim paralyzed) by 80 percent. The strokes that occur on this regimen have usually been mild ones from which most of the victims have recovered fully. Additional studies are now is progress to determine if this exciting preliminary work can be confirmed.

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Symptom: Pain and tenderness

Home care: Pad the heels of the child’s shoes and temporarily restrict activities such as running and jumping.

Precautions

-    Inability to move the foot up and down may indicate a torn Achilles tendon and needs medical attention.

-    Have the child see a doctor if home treatment does not promptly relieve the pain of Sever’s disease.

-    Pain may recur following a new injury. Repeat the treatment.

Painful heels are a common complaint before and during adolescence. Almost 90 percent of the time the pain is due to injury of the bony growth plate near the back of the heel bone (calcaneus). The injury is called Sever’s disease and may be due to a direct blow caused by the heels pounding the ground, or to the calf muscles pulling on the Achilles tendon and the back of the heel bone.

Signs and symptoms

In Sever’s disease, one or both heels hurt when walking and are tender to the touch on both sides and the bottom of the heel bone (about one to two centimeters away from the back of the heel). The heels are not swollen or red; the skin over the heels shows no abnormality. The diagnosis is based on the presence of pain and tenderness at the heel and the absence of other symptoms. Note that other problems that cause pain at the heel also cause other symptoms. For example, infection of the heel bone (osteomyelitis) produces severe pain that intensifies over time, redness and swelling of the infected heel, and a low-grade fever. Blisters, plantar warts, and wounds of the heel can also cause sore heels.

Home care

To relieve pain from Sever’s disease, pad the heels of all of your child’s shoes with a heel pad and temporarily restrict activities that involve running and jumping. Even if a child has pain in only one heel, be sure to pad the heels of both shoes.

Precautions

• If your child can’t move the affected foot up and down (by rising on tiptoes), he or she may have a torn Achilles tendon. Do not attempt home care. The child should see a doctor.

• With the proper home treatment Sever’s disease should subside in four to six weeks; however, pain should cease as soon as the heels of the shoes are padded, and if the pain isn’t promptly eased you should take your child to the doctor. • Pain may recur following a new injury. Don’t worry; just repeat the treatment.

Medical treatment

After a careful examination to rule out other causes of pain, your doctor will follow the same steps as you do in home treatment. If Sever’s disease is severe, the doctor will immobilize the ankles. X rays are seldom required.

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Molds are very small plants which nature uses as scavengers of the soil to convert dead leaves into fertilizer. They have no roots, stems, leaves, or chlorophyll, and they live as parasites because they nourish themselves from dead leaves, old shoes, walls of damp basements, old paper – almost anything except metal.

The mold plant is composed of threads that intertwine into a loose network on which grow the fruits of the plant, or its spores. When a spore lands on good soil, it sends some threads into the ground to form roots, while other threads grow upward and form a sort of a tree.

Molds live best at a temperature of 70° to 90 °F; they stop growing at 40°F. They are killed by high temperatures, but survive freezing for months.

Mold spores leave their mother-dwelling during the summer months and are scattered by winds and storms for miles around their locality. Each locality has its own brand of molds. It takes a special mold survey to determine the type of molds found in a particular place. This is done by exposing a plate, which contains mold food, to the open air for a number of minutes each day.

Here are the results of a survey made by Center Laboratories for the Port Washington area on Long Island, New York, regarding four common molds:

Alternaria. Out of 100 mold colonies grown in a culture plate, 80 contained alternaria (i.e., 80 percent). This is a mold which looks dirty gray and is found in decaying vegetation.

Horrnodendrum. Seventy-six percent. This mold on culture looks similar to alternaria. It is likewise found in decaying vegetation, as well as on dead tobacco leaves, tomatoes, or peaches.

Penicillium. Sixty-seven percent. This mold looks blue on culture. It is the common bread mold, as well as the factor in the ripening of the Camembert and Roquefort cheeses.

Aspergillus. Twenty-four percent. This is a black mold found on the walls of old, damp, and musty houses.

Mold allergy is a disorder which is similar in character to pollen allergy because molds do not have to attach themselves to an organ of the body to cause disease (fungi in feet cause disease, but not allergies); they simply have to be present in the air to do so.

Today there is a world increase in the number of people who are suffering from mold allergy. This is caused by two factors:

a.     The discovery of oil in the Middle East, which has caused a change in the kind of dwelling used in these countries (from open-air, tent-dwellings to air-conditioned skyscrapers which have cool and comfortable rooms, but which are not mold-free).

b.     The forceful displacement through war of millions of people who have been made to move from a dry desert area to a damp area near seashore where wind currents, climate, and vegetation are ideal for the growth of molds (Israel, Greece, India, etc.).

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Your egg is mixed together (not fertilised) with your partner’s sperm and put back into the fallopian tubes so that fertilisation takes place where it would happen naturally anyway.

Who Should Have It?

GIFT can only be used when a woman has open and healthy fallopian tubes.

What Happens?

The use of the drugs is identical to IVF but the difference is that the egg retrieval is done by a laparoscope (telescope) through the abdomen and so a general anesthetic is needed. A maximum of three eggs are put back in the fallopian tube.

The other difference between GIFT and IVF is that fertilisation, if successful, takes place inside the body. GIFT is more invasive and expensive than IVF.

Success Rate

There are no official success rates for GIFT treatment because it does not come under the HFEA which only monitors techniques involving an embryo outside the body.

One clinic estimates that GIFT is approximately one and a half times more successful than IVF because fertilisation takes place inside your fallopian tubes and the embryo does not reach the womb until approximately seven days later, as nature intended. (As we have seen, IVF fails most commonly at this crucial implantation stage.)

Frozen Eggs

Any excess eggs from a GIFT procedure can be fertilised with the sperm outside the body, as in IVF. This makes it possible to see whether fertilisation actually takes place, and the embryos can be frozen.

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