Doctorweblog. About Health & Medicine

Many speech problems may occur, from the child speaking indistinctly, to repetition of the same syllable, or to speech being delayed. Often overprotective parents may unconsciously retard their child’s speech ability by pursuing baby talk as their method of communication. This is no fault of the baby. Stuttering or stammering (in which certain words or syllables are compulsively repeated or there is a complete blockage of certain words) are almost always nervous in origin. There is usually nothing anatomically or physiologically wrong with the speech mechanism; it is simply because of tension and stress at the subconscious level.

Occasionally there may be a question of normal mental development, but this can usually be quickly evaluated. In most cases, this is not the cause. A changed attitude by the parents and their efforts at helping the child speak normally often helps, with avoidance of baby talk as the child gets older. Stuttering often starts in the 3-6 age group when the child is often subjected to emotional stresses or tensions.

Treatment

Like most other anxiety-induced symptoms, eliminating the cause, as much as possible, as early as possible, is the ideal. Special anxiety-producing situations and circumstances must be carefully sought out. It may take time to do this, for situations that are of little importance to a parent may be major to a child. A sense of being wanted, of security, warmth and affection, is important. Instilling confidence into the little person, reducing fears and dreads and removing frightening situations all assist. Stuttering and stammering in the older child and adult are often very difficult to treat. In recent years, considerable success has been achieved in older children with the use of medical hypnotherapy. This again indicates the emotional nature of the disability.

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This is a hormone, a chemical substance secreted into the bloodstream by the endocrine glands to direct the body’s functions and development. Oestrogen is one of the two female hormones which alter in balance with one another to control the reproductive cycle and the sexual characteristics in women.

Oestrogen is secreted by the follicles in the ovaries, one of which develops each month in sexually mature women to contain an unfertilised egg. Under direction itself from hormones released by the pituitary gland at the base of the brain, the follicle bursts and releases the egg into the woman’s fallopian tube for fertilisation by the male sperm. Throughout the egg’s development, the follicle has secreted oestrogen to direct the uterus to prepare a blood enriched lining ready for the egg to implant in once fertilised. If fertilisation does not take place, the follicle, now emptied of the egg and known as the corpus luteum, secretes a second hormone, progesterone, which will cause the uterus to shed its lining, a process familiar to most people as the monthly or menstrual period.

The enormous influence of oestrogen on many aspects of women’s health is often only fully appreciated after menopause, when the menstrual cycle ceases and the body’s production of oestrogen reduces dramatically. All kinds of side effects can result. The hot flushes, insomnia and mood swings experienced by many women during menopause are related to the fall in oestrogen levels, as are the more permanent conditions such as thinning hair and loss of skin elasticity. Similar side effects can accompany the surgical removal of the ovaries in younger women.

More serious is the increase in the risk of coronary heart disease experienced by post-menopausal women: an increase up to ten times greater than that of women just prior to menopause. Oestrogen, it seems, helps to limit fatty deposits in the arteries and relaxes the blood vessel walls to increase blood flow.

Receiving particular attention in the 1990s is the role oestrogen plays in the maintenance of bone mass and bone strength. Osteoporosis is caused when calcium leaches from the bone, leaving it porous and brittle. The condition is known to be accelerated by decreasing levels of oestrogen in the body, suggesting that oestrogen helps the cells maintain their calcium content.

To avoid this and other unpleasant and even dangerous conditions associated with aging, many women are turning to Hormone Replacement Therapy, a program whereby synthesised, plant or animal oestrogens and some progesterone supplements are taken regularly from the onset of menopause onward. While many women find that HRT removes all unwanted symptoms of the change of

life, it makes other women sick and may have serious side effects.

Oestrogens are powerful substances, particularly many of the synthesised forms, and they are far from fully understood. Oestrogen is now thought to play a significant role in the development of several kinds of cancer in women, including breast cancer, and in triggering conditions like thrombosis or blood clots in the veins. It is also believed that synthetic oestrogen given to women in the 1950s and 1960s to prevent miscarriage is responsible for a higher than normal incidence of rare cancers in their offspring. Naturopaths may suggest herbal alternatives to hormone replacement therapy. For example, the Chinese herb Dong quai contains plant oestrogens and can actually help to balance the body’s oestrogen levels by adding oestrogen to the system when concentrations are low and inhibiting oestrogen action when the levels are too high, competing as it does with the oestrogen molecule for binding sites. In China it has been used for centuries to treat menopausal symptoms and menstrual problems in women and dong quai is now gaining respect in the West.

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Although a common maxim holds that ’seeing is believing,’ this statement is actually not always true. Seeing can be quite deceptive, as anyone knows who has witnessed the tricks of a competent magician. Conversely, we believe many things that we do not actually see, for example that the earth revolves around the sun. But in some ways the maxim carries the weight of truth: Those things that we cannot see are hard to believe, which is one reason why they gave poor Galileo such a hard time when he maintained that the sun and not the earth was the centre of the solar system. Similarly, controlled treatment studies can appear quite unconvincing if one doesn’t believe in the treatment and the studies are performed by someone else. I encountered this phenomenon after conducting numerous light treatment studies in patients with seasonal affective disorder (SAD), or winter depression. The studies from my group at the National Institute of Mental Health, as well as those of numerous colleagues, told a clear story. Light therapy worked. Yet many psychiatrists who had never treated a single patient with light therapy remained sceptical. On the other hand, the successful treatment of a single patient with this modality was in certain instances more persuasive than all the published data on the topic. So, after studying SAD for several years and treating many hundreds of patients with light therapy, I was amused when an old colleague approached me at a meeting and said to me with an air of discovery, ‘You know that light therapy that you have been talking about all this time? I treated a patient with it and the damn thing works.’

In truth, though, it is wonderful to discover a phenomenon for oneself even if it has been described a thousand times before. And so it was for me with the use of St John’s Wort in depression. I had read about controlled studies performed in Europe and had actually seen some of the data. Yet it was only when I saw some of my own patients benefit from the herbal remedy that I felt the excitement that might be expected to greet the arrival of a novel form of treatment for an old and nasty adversary – depression.

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Plus-one cases are rarely seen by a physician. The plus-one patient is basically a happy person, mildly stimulated by a “natural high.” He rarely, if ever, thinks of himself as a candidate for serious illness.

Plus-three and plus-four cases, on the other hand, are sometimes brought to a physician, and such cases could be presented. (In her manic phase, for instance, Nora Barnes was a plus-four case.) These cases are relatively rare, however, since before the average food or chemical addict reaches this stage, his withdrawal symptoms have usually become more and more pronounced. It is this withdrawal phase which brings him to the doctor’s office—not the previous “high.”

This is why a discussion of stimulatory reactions focuses on the plus-two stage. It is here that we find at least three serious medical problems: hyperactivity in both children and adults; obesity; and alcoholism, the acme of the food-addiction problem.

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Since the end of World War Two, a staggering array of synthetic hormones, tranquilizers, and antibiotics, has been used to treat meat, poultry, and fish.

The most common hormone used for this purpose—diethylstilbesterol, or DES—was given as a medicine to pregnant women to prevent miscarriage. It is now known that the substance has caused cancer in the children of women who used it, the so-called “DES babies.” The United States government is now waging a major campaign to warn such children, the potential victims, of the danger that was incurred.

For years, however, this hormone and other related substances, such as Ralgro and Zeranol, were implanted in chickens, cattle, and sheep to make them grow fatter and come to market sooner. Industry has argued that only minute amounts of the chemicals were left in the meat which reached the consumer. But a growing number of scientists countered that it only took a few parts per billion to cause cancer in experimental animals.5

In addition to the use of hormones, it is common practice to inject animals with tranquilizers just before they are slaughtered and to dip certain foods (such as fish) in an antibiotic solution, to prevent them from spoiling. One of my patients became sick from eating store-bought fish. One day, her husband went deep sea fishing and brought back some fresh bluefish. She had no adverse reaction to this fish and soon learned that she could eat most freshly caught fish with impunity. She could also eat pieces of large commercial fish which were sawed into small portions while still frozen. Her problem apparently arose from the antibiotic solution which the industry routinely uses to treat smaller fresh fillets.

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Diarrhea refers to looseness of the stools, not to the frequency of bowel movements. (Frequent bowel movements with normal stools are not diarrhea.) The number of loose bowel movements per day measures the seriousness of the diarrhea.

Diarrhea in children over the age of five differs in several ways from diarrhea in infants and younger children. Diarrhea is less likely to cause dehydration (a serious loss of body fluids) in older children. The older and large the child becomes, the smaller the chances of dehydration. Serious dehydration is unlikely past six years of age-unless diarrhea is combined with vomiting, which keeps the child from drinking enough liquids.

Viruses in the intestine are the most common cause of diarrhea in older children. Dysentery bacteria and parasites in the intestine are the next most common causes. Respiratory viruses and reactions to certain foods are the least likely cause of diarrhea in older children.

Other diseases may cause long-term, frequent diarrhea in older children (though they are rare or unknown in infants). Ulcerative colitis is a condition in which ulcers frequently appear in the colon (large intestine). Regional enteritis (Crohn’s disease) is a recurring inflammation in the small intestine. The cause of these two diseases is not known. Cystic fibrosis is an inherited disease that affects the lungs, pancreas, sweat glands, and sometimes the liver and other organs. It often causes frequent diarrhea with foul-smelling stools.

Signs and symptoms

Loose, watery stools are the major symptom. There may be mucus or flecks of red blood in the stools. The child may have cramps. There may also be fever, loss of appetite, vomiting, and weight loss, depending on the cause of the diarrhea.

Home care

If the child has both diarrhea and vomiting, treat vomiting first by restricting the child’s diet to clear liquids only. Once the vomiting stops treat the diarrhea by limiting or not reintroducing solid foods – especially those with roughage, fruits (except bananas and apples), vegetables, butter, fatty meats, and peanut butter. Do not give the child milk, since milk may further aggravate diarrhea.

Encourage the child to drink plenty of clear liquids: tea, water, flavored gelatin water, and commercial mineral and electrolyte mixtures.

Precautions

• Do not give anti-diarrheal medications to children, since side effects are common and can be dangerous.

• Isolate an infant from children who are ill with vomiting and diarrhea.

• If there is blood in the stools, high fever, prostration (extreme weakness or collapse), or severe or prolonged diarrhea (more than two to three days), call your doctor. Dysentery may be the cause.

• Report frequent, repeated diarrhea to your doctors. Frequent diarrhea may be a symptom of colitis, enteritis, or cystic fibrosis, especially if there is weight loss.

Medical treatment

Your doctor’s treatment will be the same as home treatment. If necessary, the doctor may request blood tests, X rays of the large and small intestines, and sigmoidoscopy (an examination of the large intestine). In severe cases, hospitalization may be ordered.

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Thinking faster, feeling harder. Some herbal experts see ginkgo biloba as a male godsend. Not only does it seem to help solve erectile difficulties in some men but also it improves cognition (thinking ability). It does this by increasing blood flow without affecting blood pressure. It is one of the most frequently prescribed drugs in Germany and France, says Adriane Fugh-Berman, M.D., former head of field investigations for the Office of Alternative Medicine at the National Institutes of Health in Bethesda, Maryland, and author of Alternative Medicine. It has been shown to help with memory problems, concentration difficulties, depression, and dizziness.

For the best results, take ginkgo in a 50-to-1 extract, says Dr. Willard. That means the label should say that it contains 24 percent flavonoid glycosides – the active ingredient that increases blood flow.

It’s best not to exceed 240 milligrams daily, warns botanist and herbalist James Duke, Ph.D., of Washington, D.C., in his book The Green Pharmacy. Higher doses can cause diarrhea and irritability.

Shrinking an enlarged prostate. Saw palmetto helps, Dr. Tyler says. However, he warns that we should not self-diagnose prostate problems. Let the doctor do that, then discuss alternative treatments, he advises. If the problem is enlarged prostate, then consider the herb. In Germany, doctors prescribe saw palmetto and other herbal remedies nearly 90 percent of the time to relieve enlarged prostates.

Read saw palmetto labels carefully, Dr. Tyler advises, and purchase a brand that contains 85 to 95 percent fatty acids and sterols. The fatty acids and sterols contain the plant medicine that benefits prostate tissue, so you want to be sure that you’re getting a potent percentage of that. A usual dose is 80 to l60 milligrams twice daily, says Dr. Tyler.

Coping with depression. Several active principles in the herbal remedy Saint-John’s-wort are proving to be effective antidepressants for mild to moderate depression. It doesn’t work instantly, though. Although it can be taken as a tea, it is best consumed in capsule or tablet form, standardized on the basis of hypericin, a marker, not necessarily an active component, advises Dr. Tyler. Follow label dosage directions carefully. The antidepressant effect should be evident within six weeks.

Solving stomach upset. Ginger, the cooking spice and the flavor in real ginger ale, is a great stomach-soother and a pleasant motion-sickness preventive, says Dr. Tyler. This root can stop nausea quickly. You can make a tea with 1/2 to 1 teaspoon grated fresh ginger, or with 1 teaspoon ground ginger.

Warning: It does have a pepper-like bite. If you prefer, you can eat some crystallized ginger candy. Or drink real ginger ale (not “artificially flavored”). For motion-sickness prevention, take the cure 20 to 25 minutes before you take off, of course.

Sleeping easier. Valerian is a mild tranquilizer that has been shown to help people fall asleep. And it doesn’t leave you with the morning hangover associated with other sleeping pills, Dr. Tyler says. Valerian smells terrible, so it is better taken in capsule form than in a tea. Follow the instructions on the label, advises Dr. Tyler.

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The anesthetist will then begin your anesthetic, and will remain with you throughout the whole operation to make sure you are asleep and that the function of your heart and lungs is satisfactory. Once the anesthetic has been injected into the tube in your hand or arm, you will fall asleep within seconds. The drug which makes you go to sleep may sting a little as it enters the vein from the cannula, but this feeling does not last long.

Several different types of drugs will be given to you during your operation:

1 induction agents to bring on sleep;

2 maintenance agents to keep you asleep;

3 analgesics to stop you feeling pain after the operation;

4 anti-emetics to help stop you feeling sick after the operation.

If local anesthetic is injected into the wound during surgery, you will have little or no pain for a few hours after you wake up.

After your operation

When your operation is over, the anesthetist will stop giving you the drugs that were keeping you asleep and you will probably be taken to a recovery room or step-down ward.

The recovery room

The nurses in the recovery room are specially trained to care for patients coming round from anesthetics after an operation. You will stay in this room, still watched over by monitoring equipment, until you are fully awake and ready to be returned to your own ward.

If you are in pain when you wake up, tell a nurse in the recovery room as you can be given an injection or tablets to relieve it.

The step-down ward

If you are going home on the same day as your operation, you may be taken to a step-down ward. The nurses on this ward will make sure that you are fit to go home and that your journey will be safe and pain free. They will also want to be sure that you have a responsible adult to care for you once you are at home, and should give you advice about how to manage your recovery over the next few days.

Back on the ward

If you are not going home the same day, you will be taken back to your own ward, where the anesthetist may visit you before you leave. This visit is to ensure that you are having adequate pain relief and have no ill-effects from your operation. Do tell the anesthetist if you have any concerns or questions.

Side-effects of the anesthetic

There are side-effects which can occur after anesthesia, but these do not normally last longer than a couple of days. A sore throat is quite common, and is caused by the dry gases breathed while you are asleep, or by the tube which may have been put down your throat to help you breathe during your operation.

If you feel unwell, or have pain anywhere other than at the site of your wound, do tell the anesthetist – or a nurse on your ward – so that the reasons for it can be discovered.

Pain relief

The house surgeon and nurses on your ward will be able to give you analgesics to control any pain. However, if these drugs are not enough, do tell the anesthetist or ward staff, which may be able to give you something more effective.

The amount of pain suffered after a breast operation varies from person to person. Some women have pain or slight discomfort for only 12 to 24 hours and will not need any pain-killing injections after this. Others may need injections for up to 3 days after their operation.

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Unfortunately, we know very little about the characteristics of women with endometriosis as no comprehensive research has been undertaken to study this issue. But the findings of several minor and non-comprehensive studies are outlined below.

Age

Endometriosis usually only affects women during their menstruating years. It does not occur before the onset of menstruation and it is rarely found in women following the menopause.

Traditionally, endometriosis was said to be a condition of women in their 30s and 40s. Since the introduction of laparoscopy the majority of gynaecologists now believe that endometriosis most commonly affects women in their late 20s and early 30s. Furthermore, most gynaecologists believe that endometriosis is rare in teenagers and uncommon in women under the age of 25. But this belief is also beginning to be questioned.

Research by the Endometriosis Association shows that most of the women with endometriosis were diagnosed in their late 20s and early 30s. In fact, 55% were diagnosed between the ages of 25 and 34. The average time from the onset of symptoms to diagnosis was 6.8 years and 43% of the women believed that they had first experienced their symptoms before the age of 20.

The study also revealed that the women who reported their symptoms to a doctor before the age of 20 took an average of 8.8 years to get a diagnosis. In contrast, those who were aged 30 to 34 when they first reported their symptoms took an average of only 1.4 years to get a diagnosis.

It would therefore seem that women with symptoms of endometriosis are being diagnosed when they reach their late 20s and early 30s because that is when their doctors consider endometriosis as a possible diagnosis for their symptoms — despite the fact that they may have reported their symptoms for many years previously.

Consequently, the Endometriosis Association believes that endometriosis is probably more common in teenagers and young women under the age of 25 than is generally acknowledged.

This belief is supported by several studies which have investigated the incidence of endometriosis in teenagers with chronic pelvic pain. These studies have found that approximately half of the teenagers investigated for chronic pelvic pain had endometriosis. It also appears that endometriosis is being diagnosed more frequently in teenagers as more of them are given the benefit of a laparoscopy.

Race

Traditionally, it was believed that endometriosis was a condition confined almost exclusively to white Caucasian women and that it was rare in Asian, Jewish and black women. Since the introduction of diagnostic laparoscopy it is now realized that endometriosis can affect women of all racial backgrounds.

Whether or not there are any differences in the incidence of endometriosis between various racial groups is not known because it is impossible to determine the incidence of endometriosis in women in general, let alone within particular groups.

Delayed childbearing

Traditionally, it was believed that endometriosis was a condition that affected women who had delayed childbearing and that having children provided some sort of protection against developing the condition. It has now been shown that endometriosis is frequently found in women who have had children.

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An increasing number of people in the West are finding that a spiritual dimension to their lives is invaluable to their physical and mental well-being. Since antiquity humans have felt the need to commune with supernatural beings, and almost every culture has a concept of God. To many, Christians included, an essential part of their God is his ability to heal sickness and even to prevent illness. Examples of miracles abound in historical and religious literature and there is little doubt, given the enormous power of the mind over the body, that such phenomena can be real enough. Current research into parapsychological phenomena makes it all much easier for us to believe in today than it would have been for those living in biblical times, but even so there are still sceptics.

There is little doubt that we are learning in the West that humans are far more remarkable than we previously thought. Telepathy, clairvoyance, clairaudience, psychokinesis and the ability to heal are so well documented that it is difficult to be sceptical about them any longer. What is interesting is the idea that we all possess such gifts as a part of being human beings but that most of us have lost them. Research in Russia, for example, has found that most people can be taught to dowse and to develop all kinds of parapsychological abilities they never knew they had. Susceptible people can learn such skills in as short a time as a weekend.

It appears that western thinking and behaviour inhibits these intrinsic-or some would say God-given-abilities. A doctor working in a very primitive area of Africa was astonished at how the local people regularly and quite naturally communicated with each other over long distances without speaking. They quickly lost this telepathic ability once they came into regular contact with westerners because, they said, they felt so much in awe of the cars, watches, explosives and so on. These things, they said, seemed to dwarf their ’simple powers’.

Much of the maintenance of good health and even the curing of ill health resides, I believe, in these realms of the mind that are currently called parapsychological. Some, in different parts of the world, attribute them to God or Gods, others to the wondrous nature of mankind. Needless to say I am in no position to say which is correct but I do recognize a higher force of health and ill health than man and his personal behaviour. The healing power of one person upon another is a skill that has been all but lost in many westernized cultures although it is being revived among certain Christian groups, especially in the charismatic wing of the church. Of course for many so-called primitive people the laying on of hands and absent healing are a long-established part of their culture. With the increasing interest in the mystical and the supernatural and with a growth of ‘natural’ medicine in the West I feel sure that all of this side of healing and maintaining health will be of greater importance in the future.

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