ASTHMA DEVICES: THE ROTAHALERBronchodilators and topical steroid medicines are available in powder containing capsules (Rotacaps) as well as aerosols. This method of administrating medication is most commonly prescribed for poorly co-ordinated patients and for children. Most children over four years old are able to master the technique successfully. (The cleaning instructions that accompany inhalers and Rotahalers should be carefully followed.)TECHNIQUE FOR USE1. Remove a Rotacap from its packet and push it firmly into the raised hole on the top of the Rotahaler. The clear end of the Rotacap goes in first. The coloured end of the Rotacap should be even with the top of the hole;The Rotahaler is now ready for use. Hold the Rotahaler level (horizontally). To split open the Rotacap, turn the light end of the Rotahaler as far as it will go in one firm movement; Keep the Rotahaler level (horizontal) or the contents of the Rotacap will spill out. Breathe out until your lungs feel comfortably empty. Still keeping the Rotahaler level, raise it to your mouth. Place the mouthpiece between your lips. Close your lips and tilt your head back slightly;Breathe in as strongly as possible. Hold your breath and take the Rotahaler from your mouth.*26\148\2*

THE BONE DENSITY PROGRAM: CHOOSING THE RIGHT PRACTITIONERTo assemble the right health care team to ensure you get the best overall care, you must act as coordinator to make sure each practitioner has all the relevant information, and that they communicate with each other as necessary. You must tell each professional who else you are working with and what strategies you are using. If you don’t tell your cardiologist you’ve been seeing a homeopath, you won’t be able to maximize either approach. If your homeopath tries to convince you homeopathic remedies are all you need, and that whatever your cardiologist advises will only interfere with the treatment, you need a different homeopath. Likewise, if your cardiologist has a blanket “quackery” response for any suggestion of complementary methods, you need a different cardiologist. Otherwise, you have many lenses working on your behalf, but they are all looking at their own little piece and never merging into one view. That’s certainly not integrative or complementary or holistic, and you won’t reap all the benefits of coordinated health care.Conventional medicine has brought us many wonderful medicines and technologies. I wouldn’t want to diagnose or treat low bone density without access to DEXA machines and pharmaceutical options like raloxifene. But I wouldn’t want to do without qi gong or nutritional supplements, either. Both conventional and “alternative” therapies have their limits, and using them in true complementary fashion—according to their strengths and your beliefs and preferences—is the only way to achieve optimal health care and optimal health.*7\228\2*

IBS AND THE NERVOUS SYSTEM: NERVOUS DIARRHOEANervous diarrhoea is frequent loose bowel movements not caused by infection, irritation or food allergy. It can be one urgent movement on waking, or several small movements throughout the day. These can be with or without pain and they can often leave the sufferer exhausted.Nervous diarrhoea is caused by the nerves to the bowel getting the wrong messages. When the red alert button is pressed and the sympathetic nervous system springs into action, at first the message is to suspend activity in the bowel, but if the message carries on too long and becomes Tm very scared’, instead of, ‘I need to act’, so much adrenalin is poured in that the bowel opens. This is what is happening in nervous diarrhoea – the body is so hyped-up that the bowel cannot relax. Some people have to rush up each morning with diarrhoea – their parasympathetic nervous system is still too active even when they sleep.Is your bowel responding as though you were running from the charging bull all the time? If so, you are the only one who can do anything about this. The behaviour of your boss, your spouse or worry over money may be your ‘charging bull’ but whatever it is no person or situation can affect your nervous system unless you allow them to do so. As far as relationships go, if you have openly and honestly declared to the person concerned that you find their behaviour to you distressing, then it is up to you after that. If you spend your time trying to make those around you change then you are in for a frustrating time and you deserve diarrhoea. On the other hand if you change your reaction to the stress and look after your body in spite of it, you will realize that far from the action of your bowel being out of your control, you can learn how to restore it to normal functioning.*61\326\8*

CONTROLLING YOUR OWN EPILEPTIC SEIZURES: LOOKING FOR LINKSIf you want to try to learn to control your own seizures, the first step is to learn to identify the things that are most likely to precipitate them. It will help you to keep a ‘seizure diary’ for at least a few months; and it will also help your doctor to have a record of your seizures and of what seems to trigger them off.Best of all is to try the ‘ABC programme, which is the driving force of any programme of behavioural treatment carried out in hospital.ABC CHARTSAn ABC chart is a detailed record of every seizure, describing what happens immediately before the seizure (A = Antecedents); behaviour (B) during the seizure; and what the consequences (C) of the seizure are for you. All you will need is a special A4 notebook to write your account in – and some honest observation. As well as this, mark every seizure you have on a wall chart or calendar which shows you the years at a glance. If your behavioural programme works, you should be able to watch your seizure frequency fall.AntecedentsThe antecedents of a seizure are particularly important. Try to remember exactly what was happening just before the seizure started. It will help if you ask yourself these questions:What were you doing just before the seizure/at seizure onset?How did you feel just before the seizure/at seizure onset?What were you thinking just before the seizure/at seizure onset?It is important to be as precise as possible when you are answering these questions. If you can recognize and record your emotions it may help you identify those that may give rise to a seizure. Supposing, for example, that you had been looking at photographs of a previous summer holiday. It is not enough simply to say, ‘I was looking through an old photograph album.’ A more precise answer might have been: ‘I was looking at a picture of Bob and me holding hands. I was feeling a bit sad.’ If you can recall just what you were thinking at the moment the seizure started, so much the better: ‘I was feeling jealous because Bob’s got a new girlfriend now.’ By analysing what happened in this way, you may be able to pinpoint the thoughts or feelings that led directly to the seizure.BehaviourYou need to note down in as much detail as possible how your behaviour changed at the onset of the seizure. This will be important when you are trying to find a counter measure to inhibit your seizures. For example, the first change in behaviour might have been the movement of a limb, or a thought or a feeling, or perhaps a strange feeling like butterflies in the pit of your stomach which moved up into the chest. To fill in the details you may have to ask someone who was with you at the time. List everything you can.If you are worried about your behaviour during a seizure – the fact that you may have been incontinent for example – do discuss this with your doctor or someone close to you. Sometimes video monitoring of a seizure can reassure you that whatever aspect of your behaviour in a seizure worries you is not so terrible after all.ConsequencesConsequences are important. Try to note down in detail not only what happened immediately after the seizure, but how it may have changed the situation for you, and also how you felt. People quite often feel despondent, even guilty, about having had another seizure, and, again, if your doctor knows how you feel he can help you tackle these feelings.If, as a parent, you are trying to keep an ABC chart for a child who has seizures, you may find that consequences are especially significant. The child who has a seizure in class, for example, and is taken out of class and given milk and biscuits by a sympathetic teacher, is being given a strong message – seizures are likely to be rewarded! It is far better to encourage the child to return to the classroom as soon as they have recovered, and to withold the milk and biscuits. But adults too are sometimes ‘rewarded’ by a seizure. If you discover from your chart that you regularly have a seizure after an argument with a partner for example, and always find that he or she is remorseful and attentive towards you afterwards, you could learn something useful!Interpreting your chartsOnce you start looking for links, it is very likely that you will be able to find some sort of relationship between the likelihood of a seizure occurring and your physiological state: whether you were particularly tired or hungry, for example, your emotions, what you were doing, or what was going on in your life with family and friends.*48\193\2*

WHAT IS DIABETES? INCREASED BLOOD GLUCOSE, RENAL THRESHOLD AND URINE SUGARWhen blood glucose exceeds about 180 mg% and crosses renal threshold, glucose is lost in urine and forms the basis of urine test used either to diagnose or control diabetes.Kidney cannot eliminate solid material so it must be dissolved in water. The more sugar the kidney has to get rid of, the more urine must be passed to keep it dissolved. This leads to one of the main symptoms of diabetes which is “passing of too much urine” or polyurea, (from the Greek poly-much and urea-urine) too frequently to get up at night and go to bath rooms. Passing of large volume of urine causes dehydration and leads to the second main symptom ‘thirst’, the third main symptom of diabetes results from loss of water from body fat and muscles which also contributes to weight loss, lethargy, giddiness etc.”For all practical communication Diabetes is used as a short form of diabetes mellitus (DM). DM is also discipline maintaining (DM) disease both by doctors as well as by patients.”*6\329\8*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: EATING FOR BETTER HEALTH –HOW TO INTERPRET FOOD LABELS – LABELS FOCUS ON FATAs you seek out more healthful foods, labels can provide valuable information. Until now, many food labels provided incomplete or misleading nutrition information.In May 1993, the first parts of food label reform became effective. By May 1994, manufacturers will need to be in full compliance with the new labeling requirements from the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA).Before the new regulations, about half of food products had nutrition labels. Now nutrition information should be available for almost all types of packaged foods. The FDA is encouraging voluntary nutrition labeling for fresh foods also. The changes are designed to make food labels more accurate, clear, and useful.Even with the new regulations that tighten the rules on claims such as “low fat” and “low cholesterol,” the actual figures that show you the amount of calories, fat, saturated fat, cholesterol, and sodium are the most helpful. You can use that information, taking into account how much of the product you will actually eat, to plan heart-healthy meals.Here is a sampling of the changes that pertain directly to heart health.New labels focus on fat: Labels will be required to show the total amount of fat, saturated fat, and cholesterol in a serving. In addition, the new label shows the number of calories derived from fat (calculated by multiplying the grams of fat by 9—there are 9 calories per gram of fat). Use the information about fat to compare products and to add up the amount of fat you eat on a typical day.*304\252\8*

THE MIND, SOCIETY AND CANCERPeople are more than the sum of their chemical molecules and cells. They are social beings. As we have seen, the pattern of cancer varies from one society to another; and these different patterns reflect not only the different pool of genes in each society but also the environmental differences which may play a part in causing cancer. In this context, ‘environmental differences’ embrace the social, economic and political circumstances in which individuals find themselves. Such circumstances will determine many facets of their lives, including many of the physical features of their environment. Advanced industrial processes potentially expose people to more carcinogens (cancer-causing chemicals) but if the individuals who may in some way be affected by those processes happen to live in a country with a free press, pressure groups, ‘watchdog’ organizations and a government responsible to an electorate, there is a better chance of the necessary environmental safeguards being put in place. To take another example, prevailing social attitudes to smoking or being suntanned will have a direct influence on the extent to which individuals indulge in these risky habits. Variations in diet between countries, or between different groups within the same country, remain under investigation as a possible environmental explanation for different levels of cancer incidence. Such variations are the product of a complex web of social, economic and physical factors.*109\194\4*

JUVENILE RHEUMATOID ARTHRITIS: POLYARTICULAR AND PAUCIARTICULAR JRA AND MORE What is polyarticular JRA?Polyarticular juvenile rheumatoid arthritis is arthritis in five or more joints. About 40 percent of the children with JRA have this form and often have rheumatoid factor in their blood.Peculiarly, this rheumatoid-factor-positive form of arthritis is found mostly in little girls around 8 years of age. Boys do get this form of JRA, but girls outnumber them three to one. These little girls often have bone erosions, many nodules, and a more aggressive disease than the children without the rheumatoid factor. In that regard, this form of JRA resembles the adult form more than any other. These children often experience fatigue, listlessness, growth retardation, blanched bones (osteopenia), loss of appetite, and often extreme and unexplained weight loss.
What is pauciarticular JRA?In pauciarticular JRA, arthritis is present in four or fewer joints. This form is usually categorized as early onset or late onset. Early onset pauciarticular JRA strikes very young-usually around 1 to 5 years of age-and affects girls primarily at a ratio of four to one. The late onset form strikes children over the age of 5 and occurs mostly in boys. It is characterized by pain and inflammation of the large joints and the tendons and ligaments.
What eye problems affect those with JRA?For some reason, children with JRA can experience severe irreversible eye changes that include everything from cataracts to partial visual loss. Eye problems occur most commonly in children with early onset pauciarticular disease, although they can affect any child with JRA. The eye problems begin with painful red eyes and occur in four out of five children with pauciarticular JRA. Children with JRA should have their eyes examined regularly.*20/141/5*

THE MANIC SAVIOR: CHANGEWho should change? If Frau P. could concentrate on her own problems she would calm down the environment. If the official would study his own/ interaction difficulties he would realize that he, too, is unconscious and needs to change. When the therapist wakes up, he will change his attitude and stop concentrating solely on Frau P.I can only guess about Frau P.’s possible changes because we did not work therapeutically with her. One of her personal problems did come out in the midst of the interview which indicates how and where she needs help. Her ex-husband took her children from her custody and she could not defend herself properly. She did her best, however, by throwing an hysterical fit as the kids were taken away. She suffered immensely, but could not sufficiently support herself. Thus she swallowed the whole problem and became a manic helper for other women in the city who had been misunderstood.*101\227\8*

TINY MICROBES: LETHAL THREATSIn the 1950s and 1960s scientists thought that with an arsenal of antibiotics and infection control practices, they would conquer infectious diseases. But in the twenty-first century they know better. Today’s arsenal of antibiotics appears to be increasingly ineffective, with penicillin-resistant strains of diseases on the rise as microbes are able to outlast and outsmart even the best of our antibiotic weapons. Old scourges are back, and new ones are emerging, wreaking havoc from remote third world villages to modern first world cities. Consider the following:
“Mad Cow Disease” The British beef industry is in crisis, and meat eaters from Europe to the United States are nervous about the possibility of dying of that burger that they ate last year. Known as bovine spongiform encephalopathy (BSE), or “mad cow disease,” the disease is thought to have been transmitted when cows were fed a protein-based substance (slaughterhouse leftovers from sheep and other cows) to help them put on weight and grow faster. Failure to treat this protein by-product sufficiently to kill the BSE organism left it to proliferate in and eventually infect the cows to which it was fed. The disease is believed to be transmitted to humans through the meat of these slaughtered cows. The resultant variant of BSE in humans, known as Creutzfeldt-Jakob disease and characterized by progressively worsening neurological damage and possible death, was noted in ten people in England and linked by some studies to the BSE-diseased cows. With that, the mad-cow scare emerged. As scientists continue to look at this possible link, it should be noted that such a link has not yet been scientifically verified.
Dengue and Dengue Hemorrhagic Fever Dengue viruses are the most widespread arthropod viruses in the world and are transmitted by mosquitoes. Today, dengue is found on most continents, and over one half of all United Nations member states are threatened. Dengue symptoms include flu-like nausea, aches, and chronic fatigue and weakness. As urban areas become increasingly infected with mosquitoes, nearly 1.5 billion people, including about 600 million children, are at risk. Each year, it is estimated that over 100 million people are infected, and over 8,000 die. A more serious form of the disease, dengue hemorrhagic fever, can kill children in 6 to 12 hours, as the virus causes capillaries to leak and spill fluid and blood into surrounding tissue. Dengue is on the rise in the United States, largely due to increases in international travel by infected persons.
EbolaAlthough some may think the Ebola virus makes for a good movie plot, its shocking symptoms are grim reality. Ten recent victims in Gabon, Africa, pose grim testimony to its virulence. In 1995, an outbreak in Zaire killed 245 of the 316 people infected, forcing strict quarantine of the region. Subsequent infections in other regions of the world have caused increasing concern in the global community. Ebola virus, which causes fever and massive internal hemorrhaging, is fortunately not as prevalent worldwide as dengue fever.
CryptosporidiumIn 1993, the United States was shaken by the largest water-borne coccidian protozoan disease outbreak ever recognized in this country, as this once obscure intestinal parasite (Cryptosporidium) infected the municipal water supply of Milwaukee, Wisconsin, causing many deaths and illness for hundreds of thousands of people and over 4,500 hospitalizations. Exactly how the water supply became infected remains in question; however, the fact that humans, birds, and animals can carry the infective agent opens the door for many possible routes.*22/277/5*