Herbal Health

Symptoms

Sprains: pain, swelling, tenderness, stiffness, internal bleeding.

Dislocations: visible malformation, inability to use joint.

Home care

A dislocation should not be treated at home.

A sprain can be treated by immobilizing and then resting the affected area.

Cold compresses applied to the area help relieve swelling.

Aspirin or paracetamol can be given for pain.

Precautions

-    A sprain that does not improve rapidly may indicate a bone fracture and should be examined by a doctor.

-    After a dislocation has been corrected, the joint may remain unstable for some time.

-    A severe sprain that is improperly treated can result in a permanently weak joint.

-    A sprain that is still swollen or painful to move is not healed.

-    Elastic bandages do not adequately support or protect a sprained ankle.

All joints of the body are surrounded by ligaments, the tough connective tissues that hold bones together. These ligaments can be partially or completely torn when the joint is forcibly twisted beyond its normal range of movement. A partially or completely torn ligament is called a sprain.

If the ligaments are badly torn the bones of the joint may become dislocated (slip out of position). Besides the usual symptoms of a sprain, a dislocation causes a visible malformation of the area, and marked or total loss of function of the dislocated parts. Even after the dislocation has been corrected, the joint remains unstable for weeks.

Sprains are common during childhood, but dislocations other than a dislocated elbow are rare. Sprains most often occur in the fingers, toes, ankles, neck, and back. Dislocations can also occur in the fingers, toes, kneecaps, and shoulders.

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What is it?

There are basically two important types of skin cancer. The non-malignant type is the more common and is seen in fair-skinned people who expose themselves excessively to sunlight. It is easily treated and does not kill. The malignant type is called a malignant melanoma and is a killer. Skin cancers are most common on the face and other areas where the skin is exposed to the sun. Any skin damage that does not heal properly should be seen by a doctor. Also, should a pigmented patch of skin you have had for years start to become more pigmented, be suspicious and seek advice. One type of skin cancer starts as a pale, pearly, raised, translucent nodule that slowly enlarges and then ulcerates. The next most common type is a small, raised area or patch that can be reddened or darkened and hard. A common site for this latter type is on the lower lip.

What causes it?

Researchers at the University of Arizona (a very sunny site) found that the incidence of the malignant form of skin cancer jumped 34 per cent over a ten-year period. Since 1960 until the present day the incidence of the non-malignant type has also risen by a startling 500 per cent. Nearly half of all the tumours were found in people aged between 50 and 69. Malignant melanoma is rising in incidence at a rate of 5 per cent per year in the US.

Other researchers have found that pale-skinned, easily burned people with an estimated lifetime sun exposure of more than 30,000 hours have a twenty times greater risk of developing skin cancer than a comparable group with less than 10,000 hours of sun exposure. More than 200,000 cases of skin cancer occur in the US annually though the incidence is much less in the UK because there is less sun. Northern climates have less sun and so less cancer of the skin. For every 265 miles you go closer to the equator the incidence of skin cancer doubles.

Another form of skin change caused by sunlight is the breakdown of the normal connective, elastic tissue called collagen. This produces premature ageing of the skin and is a reason why Californian women so envy the skin of English women.

Prevention

• Use a sunscreen preparation if you are in the sun a lot.

• Be guided by the general rules for preventing sunburn.

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Most families now have a car and many have two. Of all our everyday activities, driving is one of the most dangerous, killing 5,599 people in 1984 in Great Britain and injuring a further 319,000. The cost to the nation of all these accidents is 2,650 million pounds. The fact is that by adopting some fairly commonsense preventive measures much of this illness, suffering and financial cost could be avoided. Here are the top twenty guidelines for safe driving drawn up in the UK by the Royal Society for the Prevention of Accidents.

•     Keep your vehicle in good condition with frequent inspection and regular servicing.

•     Ensure that you are fit and alert before driving. Do not drive after drinking and be sure that medicines will not affect your ability to drive.

•     Maintain your observation well ahead and plan your approach to hazards. Use mirrors frequently.

•     Handle your vehicle with positive precision and aim for the smoothest possible drive.

•     Give clear and early signals for all manoeuvres. Help other road users to understand your intentions.

•     Always think ahead and exercise caution. If in doubt-don’t.

•     Assess speed carefully to take account of all conditions. Avoid sudden changes of speed or direction on slippery surfaces.

•     Never drive so fast that you cannot stop safely in the distance you can see to be clear.

•     Remember the additional hazards of driving at night. Adjust your speed accordingly.

•     Know the problems which a truck driver faces and make due allowance when such vehicles are manoeuvring.

•     Traffic legislation has been developed to improve safety for all. Do not break the law.

•     Be considerate of the comfort and safety of your passengers. Ensure that children are properly restrained and drive as you would wish to be driven. Remember that the law says you as the driver, and your front-seat passengers, must wear seat-belts at all times.

•     Know and understand signs, signals and road markings all have valuable information for the driver.

•     Remember that 95 per cent of the accidents are caused by human error. Always maintain maxi concentration on the task in hand.

•     Always drive within the limits of your capability and within the limits of your vehicle.

•     Park in such a way as to cause minimum inconvenience and danger to other road users.

•     Learn some basic first aid so that you know what to do if you an accident.

•     Maintain courtesy on the road. Be considerate towards the needs and problems of other road users.

•     Take a pride in your driving, but remember that all drivers have room for improvement.

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Anytime a patient notices a suspicious mass in his testicle, I suggest that he visit a urologist, who will do a sonogram of the mass to determine the exact site and whether the mass is hard or filled with fluid. If the urologist has any doubt, he will perform a biopsy. If the testicle is not cancerous—which is usually the case—it will be left in place.

If you have a cyst on the epididymis, your doctor will probably choose to leave it alone. If it continues to grow, however, it will eventually cause pain. At that point, your doctor will probably want to remove it surgically.

If the lump turns out to be cancerous, your doctor will need to treat it immediately by removing the entire testicle. This procedure is called an orchiectomy and is performed if the cancer has not spread beyond the testicle. Again, since only one testicle is usually affected, the other testicle will be left in place, meaning that your fertility will not be impaired. If your doctor feels that the cancer has spread, however, he will recommend that you also be treated with radiation or chemotherapy; this will result in sterility.

One of my patients is a 37-year-old man whom I diagnosed 10 years ago with testicular cancer; he was unmarried at the time. Before he was treated with surgery and radiation, he decided to have his sperm frozen so he would be able to father a child in the future, since the treatments would render him sterile. He also had a small testicular prosthesis placed into his testicular sac for cosmetic reasons.

Today, he’s been cancer free since the surgery; he needs only an annual blood test and physical exam. He hasn’t yet married, but his semen is intact if he needs it to become a father.

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Changing your diet or your medication will often correct chronic diarrhea.

If you think you have lactose intolerance, try eating some ice cream or drinking a large glass of milk. If you begin to have diarrhea an hour or two later, and you also feel pain and bloating in your abdomen, you probably have a lactose intolerance. You should then eliminate dairy products from your diet as much as you can. This, however, can be a problem, since you still need to get some calcium in your diet, especially if you are a woman. Fortunately, you can take calcium supplements, 1000 milligrams a day for premenopausal women and 1500 milligrams for postmenopausal women daily. You can also buy a lactose-free milk such as Lactaid in the supermarket or add Lactaid drops to your milk or take pills whenever you eat or drink foods that contain lactose.

If you have a gluten intolerance, your doctor will take an X ray of your small intestine to show the typical pattern of gluten malabsorption. An endoscope may also be used to take a biopsy to confirm the diagnosis. One of my patients came to me a few years back complaining of chronic weight loss, and we gave him every test in the book and came up empty-handed. Then I ordered an X ray of his small intestine, which immediately showed all the signs of gluten malabsorption. With the help of a dietitian, we changed his diet to avoid all gluten, and he recovered quickly.

If you have an intolerance to gluten, a gluten-free diet is easy to achieve, even though gluten is found in almost all bread products and cereals. You can eat rice cakes and buy gluten-free products at the health food store.

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Description and Possible Medical Problems

If you suddenly become short of breath and simultaneously begin to cough up a pinkish sputum, you need to call 911 for immediate medical attention. You may also be sweating, pale, and wheezing.

These are all signs of acute pulmonary edema, in which the lungs begin to fill with water. Acute pulmonary edema can be caused by a dietary change, a sudden change in or cessation of a medication, a reaction from mixing two or more kinds of medication, or a heart attack or change in heart rhythm. If you have phlebitis, acute pulmonary edema can also be the result of a clot that travels from the veins of the legs into the lung, a condition known as pulmonary embolus.

Treatment

Acute pulmonary edema is a life-and-death situation, and immediate medical attention is necessary. While waiting for medical help, the most important thing to do is to keep a sitting position. If you have any diuretics or water pills at home, there is no harm in taking two of these pills immediately.

Regardless of the cause of acute pulmonary edema, once professional help is on the scene, the treatment for acute pulmonary edema includes the injection of a diuretic, such as Lasix, which will remove excess fluid from your body, meaning the heart has to work less, and nitrates, which reduce the amount of effort the heart has to make. In severe cases, it will be necessary to put you on ventilator support.

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Description and Possible Medical Problems

Like gray hair, wrinkles are a normal part of aging. However, wrinkles tend to appear earlier than gray hair in most people and so are fought more rabidly and for a longer period of time.

One factor we can’t control when it comes to wrinkles is the fact that skin becomes thinner as it ages, which hastens the appearance of wrinkles. Certain factors can speed up the initial appearance of wrinkles and make them worse once they do appear. Cigarette smoking and sun exposure ate often cited as the two best friends a wrinkle can have. Failing to drink enough water every day is also a significant factor, since adequately hydrated skin tends to wrinkle later and less often.

Most of the expensive skin creams that supposedly “turn back the clock” on wrinkles help keep the skin moist—if you apply the cream to damp skin—but the most important thing you can do is to hydrate your skin from within by drinking 8 to 10 glasses of water a day. It’s never too late to start. You should also stop smoking cigarettes and restrict your exposure to the sun.

Treatment

Wrinkles, of course, are irreversible, unless you decide to opt for cosmetic surgery.

Getting a face-lift has been a popular choice for both women and men for years, but the major drawback, besides the fact that any surgical procedure is dangerous, is the fact that it isn’t permanent, which necessitates a repeat performance in a number of years—and at regular intervals afterward. For some people, however, a face-lift is definitely worth it.

Dermatologists have prescribed the use of certain preparations for years, though the side effects can sometimes be harsh.

Again, more and more people today are deciding to let nature take its course and to age with grace—which includes getting wrinkles.

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We all get hoarse from time to time. Sometimes it’s due to over-enthusiastic cheering at a sporting event; at others it’s due to talking too much. Hoarseness can also result from a cold, perhaps accompanied by a sore throat. Whatever the cause, hoarseness occurs when the larynx— which contains the vocal cords—becomes irritated and inflamed, a condition that is known as laryngitis.

Whenever I hear hoarseness in a patient’s voice, I’ll immediately suspect he or she is a smoker. I always ask, “How many cigarettes do you smoke?” It always amazes my patients that I know they smoke. In turn, I’m surprised that they’re not aware of their smoker’s voice. From then on, at every checkup I’ll know to look for the possibility of polyps— abnormal growths that are common in smokers—on their larynxes.

For people who do not smoke but are frequently hoarse nonetheless, the cause is usually raising the voice or talking loudly. Like smokers, people who talk loudly or who frequently shout or scream are prone to developing polyps on the larynx.

While some folks may joke that the periodic bouts of laryngitis some people have finally allow others to get a word in edgewise, the fact is that persistent hoarseness and/or laryngitis may in fact be an indication of a more serious disease, such as polyps or a tumor on the larynx or in the lung.

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If you think you have temporal arteritis, you should see your doctor immediately, especially if you have experienced sudden blindness. He will conduct a blood test that includes a test for the erythrocyte sedimentation rate, or ESR, which will check how quickly red blood cells settle in the bottom of a test tube. A high ESR is an indication of an inflamed artery, as in temporal arteritis. Your doctor may also perform a biopsy of the temporal artery in order to make a positive diagnosis.

If you do have temporal arteritis, you will need to treat it with a regimen of corticosteroid medication such as prednisone on a long-term basis, possibly for months. This will help reduce the swollen artery to its normal size. In order to prevent future problems, however, you will need to continue taking the medication for a year or more; regular blood tests that monitor the ESR in addition to your symptoms will help your doctor to guide your treatment.

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Description and Possible Medical Problems

A sudden sharp, stabbing pain in your face that begins at your temple and radiates to your cheek or jaw can be frightening. But when the pain arrives for no apparent reason, occurs intermittently for up to several weeks, and then disappears completely for anywhere from a day to several months before striking again, you probably have a condition called trigeminal neuralgia.

Trigeminal neuralgia is characterized by its unpredictability and its sharp, sometimes brief ashes of pain. Men and women over the age of 50 tend to have the condition, and the frequency of attacks increases significantly over the age of 70.

The cause of trigeminal neuralgia is unknown. Though some studies point to a brain tumor or a blood vessel pressing on the nerve as the culprit, the exact cause cannot be determined.

Treatment

If the pain recurs with regularity and makes it difficult for you to functior your doctor may recommend you take phenytoin or carba-mazepine, anticonvulsant medications that may help reduce the number of attacks. You may need to take the medication for a number of weeks after the initial attack.

For severe cases of trigeminal neuralgia that don’t respond to anticonvulsants, your doctor may suggest you undergo an operation that either destroys the trigeminal nerve or reduces its sensitivity, though the final outcome of the operation is difficult to predict and may lead to permanent paralysis of one side of your face. However, in the entire time I’ve spent working as a physician, I have never seen this surgery performed. In addition to the anticonvulsant medications I’ve mentioned, some people with trigeminal neuralgia can also take the antidepressant Elavil to control their pain.

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