Herbal Health

As a general guideline, the chances of developing breast cancer increase with the length of time you take HRT, and also the higher the dose of oestrogen. There appears to be no significant risk to women in the population at large who take it for less than five years, but the risk increases slightly between 5 and 10 years, and taking it for more than 15 years gives a higher risk still. (It is this long-term risk that has attracted media attention, though often the scare-mongering headlines are quite unjustified medically.) This can cause problems, because long-term oestrogen use is important for preventing osteoporosis, heart attack and stroke; and many women also feel so good on it that they would be very reluctant to give it up after just a few years.

Cancer is a very real fear for doctors and patients alike. Nobody wants to get it, but the risk needs to be put into perspective. Under the age of 50, deaths in women from breast cancer out-number deaths from coronary heart disease and stroke combined. However, after the age of 50,

this ratio is reversed, and far more women die from a heart attack or stroke than from breast cancer. Oestrogen reduces by 50 per cent your chances of having a heart attack or stroke.

The risks of developing breast cancer as a direct result of taking HRT are small when set against the protection it confers against osteoporosis and arterial disease, although it is important to say here that if you take progestogen in the therapy, then some of the protection against heart attack may be reduced. Progestogen’s effect on breast cancer is not clearly known; some researchers have concluded that it offers some protective effect, others that it may have a negative effect, and others still that it has no effect at all. More research is clearly needed here.

It is thought that oestrogens neither increase nor decrease the risk of cancer of the ovaries in post-menopausal women compared with those who do not take it; and oestrogen and progestogen appear to have no effect on the incidence of cancer of the cervix.

One important thing that has been noted is that, although there is a higher rate of breast cancer among women who take HRT than among those who don’t, their survival rate is also higher. In other words, if you develop breast cancer and are on HRT, you have a better chance of surviving than if you develop breast cancer and are not on HRT. This is possibly because regular screening of women on HRT picks up any breast problems in the very early stages, when treatment is more likely to be effective. Some studies have also suggested that tumours linked to oestrogen therapy might be less virulent and invasive than other types of tumours, and that these particular tumours respond to treatment better than tumours not linked to oestrogen therapy.

A tremendous amount of research is being carried out into all aspects of HRT and the menopause. Hopefully, the time will come when doctors will know more clearly which particular sub-group of women would be more at risk of developing breast cancer if they took HRT, so that they can leave it well alone, and the rest can take it with confidence and safety.

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The muscles around the pelvis are very important in supporting the bladder, urethra, vagina and rectum. Regular practice of pelvic muscle exercises can help to strengthen these muscles. The first step is to identify the correct muscles to exercise.

• To identify the muscles around the rectum, sit or stand comfortably and imagine you are trying to control diarrhoea by consciously tightening the ring of muscles around the anus (back passage). Hold this ’squeeze’ for four seconds. Relax and repeat several times.

• Now go to the toilet and start passing urine. Try to stop the flow of urine in midstream. Once this is done recommence urinating until the bladder has emptied. The muscles used to stop or slow the flow of urine are the front pelvic muscles which help control the bladder.

• Some women find they can identify the correct pelvic muscles by inserting a finger into their vagina and then contracting the pelvic muscles to squeeze the finger. If there is no sensation of squeezing around the finger you may be exercising the wrong muscles. Note that you should not bear down as if trying to pass a bowel motion as this strengthens the wrong muscles. Do not despair if you do not seem to be making progress for several days; it may take a week or more to begin to identify the muscles that need to be exercised to strengthen and tone the pelvis.

The second step, having identified the target muscles, is to repeat the following series of exercises at least four times each day. Note that they should not be done while passing urine. With practice you will find that you can do them at any time — while waiting for a bus, watching television or setting the table.

1. While sitting or standing with thighs slightly apart, contract the muscles around the rectum followed by the front muscles around the vagina. Hold this contraction while counting to five slowly. Relax these muscles then repeat four more times. Try to be aware of the squeezing and lifting sensation in the pelvis that occurs when these exercises are done correctly.

2 While sitting or standing, tighten the muscles around the front and back passage together. Hold this contraction for just one second and relax. Repeat this exercise five times in quick succession. It is a good idea to return to the first step once every week or so, to check that you are using the correct muscles.

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So much for ordinary everyday stress, but what about extraordinary stress. This is like a hammer hitting an apple. We do not expect much of this stress in our lifetime, but when it comes, even if we are coconuts, we cannot help feeling the impact of the stress.

Loss of loved ones, loss of possessions, tragedies of any kind, or any events of similar magnitude are extraordinary and we are expected to feel the stress badly and most of us will be hurt. The normal biological and psychological reaction to stress as outlined earlier still applies, but is of much greater magnitude and lasts much longer. We call this grief reaction.

When we are hit with a stress hammer, there are two phases: the injury phase and the healing phase:

Injury phase. During the injury phase, we feel the pain. This pain can be in our head as headache or in our chest not unlike a heart attack. Of course, the pain is hurting most of all in the mind. It is a normal defence mechanism of the body to protect the psyche, and the immediate reaction is denial. What has happened is not true, we hope we are dreaming. There is a sense of disbelief: ‘Can somebody tell me this is not true’. This is a form of protection for us from the sudden shock of the extraordinary stress.

Healing phase. The healing phase starts when the body begins to react. We are angry at what has happened; we may be angry at ourselves or angry at the one we have lost. The biological reaction sets us on a chain of tension, anxiety, and depression all mixed up, until we feel exhausted. We are at battle stations all the time, but there is really no enemy. The enemy is ourselves. Some of us feel guilty and question whether there was anything we did wrong that may have led to this loss. We may cry and feel tired and exhausted. This may go on for days.

We need to let this energy out Hysterical crying and weeping is common. Sharing this locked up energy with someone is sometimes useful; just talking about it, airing our thoughts can be helpful. Some like taking long walks, some like rearranging and cleaning out their desks, or just doing something that may be purposeful but relaxing.

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Of course it is excessive pain which we desire to control, and which is the central subject of this study. A great number of different factors may combine to make pain excessive. Some of these are organic, depending upon the nerves concerned and their connections in the central nervous system; others are psychological and depend on our general mental health, as well as the particular significance which the pain has for us, both consciously and unconsciously. Constitutional factors also come into it. Some people are undoubtedly more sensitive to pain than others.

Some parts of our body are more copiously supplied with pain nerves than other parts. Any swelling due to inflammation is much more painful in a rigid tissue than in a soft tissue. This is so because pressure develops more easily in a rigid tissue. Thus an abscess at the apex of a tooth, or under the fingernail, is very painful, whereas a similar infection in the soft tissue under the skin causes relatively little pain.

If pain is coupled with distress, it quickly becomes excessive. It can be excessive, also, if it is associated with guilt, which often acts to prolong pain. The presence of a mild psychological depression makes the pain from some organic cause more severe, and tends to make the pain persist after the organic cause has ceased to operate. In fact, unrecognized depressive illness is one of the commonest causes of persistent pain for which no adequate organic cause can be found.

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Q. So we come to the final part of the intestinal system — the rectum and anus.

A. Correct. The rectum is simply a continuation of the large bowel or colon, and is the storehouse of the remnants of the food we have eaten, minus the nutrients and water which have been sucked up by the blood stream and used by the system. Material will remain in the rectum until a convenient time arises when it may be eliminated. This is termed defaecation, and the material excreted is technically referred to as faeces, or stools. It is interesting to note that faeces comes from an ancient Latin word which means “the dregs” — for correctly, it represents the dregs which were useless to the system. It is also commonly known by a more euphonious word stools, which comes from an ancient Anglo-Saxon word “stol” which means seat — for most Australians use a seat when defaecating — although in many eastern countries they still squat.

This, in reality, is a more natural method of elimination, and allows the muscles to work far more normally and naturally. Some eastern toilets are a cultural shock to Australians who travel abroad. Foot plates are present, so is a hole in the floor, but no seat — you simply squat down and hope for the best!

Q. Isn’t cancer becoming a major hazard with the large bowel?

A. The answer is a very definite ‘Yes’. In fact, many doctors claim that numerically speaking, cancers in this situation are growing quicker than in any other organ. Cancer, or carcinoma (to use the doctor’s term) is fairly common in the colon, as well as the next part of the bowel, the rectum. It is more likely in older people, specially those 45 years and more. That is the bad news. The good news is that we have on hand extremely effective methods of diagnosis today. We use x-rays, plus an ingenious device called the colonoscope. This enables rapid, early diagnosis, and it also enables effective treatment which in many early cases is extremely effective and definitely life-saving.

Q. What about diverticulosis. We seem to hear a great deal about this today.

A. That is another disorder of the large bowel. It means that small outcroppings like little balloons occur along the walls of the colon. The condition is called diverticulosis. Sometimes, if food and germs are trapped in the pockets, they become infected. These may produce considerable pain, a bit like appendicitis. Early diagnosis and treatment are effective, but it may be recurring and cause a lot of discomfort. I might add that the modern day use of unprocessed bran — chook food (as I call it), or fibre, which sounds much more euphonious, is often effective in checking symptoms from developing.

Q. What about the anus?

A. The rectum leads into a narrow tube called the anal canal, at the end of which is the anal sphincter or valve. This opens and closes voluntarily, so that material may be excreted under one’s conscious will. Sometimes if the contents are very watery, and there is excessive bowel activity (called peristalsis) such as with severe bowel infections, it may be difficult to control the valve and accidents may take place.

This is also common in infants, and it takes babies some time — usually around 18 to 30 months — to develop voluntary control over the anal valve. Incidentally, there is a great deal of social one-upmanship on baby’s bowel actions. Many young mothers claim they have “trained” their infants by the age of six months. But they are really fooling themselves. Simply because they manage to place a potty under little Sean just as he defaecates, this is not an indication of successful training. His nervous system has not developed to this point before at least the time span given above. So, good though these efforts are, little Sean will be like most of the other little fellows in the neighbourhood, and will learn proper bowel control when Nature decrees!

Q. So that is the story of the G.I. system, and some of the events that take place on a regular basis.

A. Correct. It is a wondrous system. The remarkable fact is that despite the way in which it is abused by the owners, it will continue to function in a magical manner. Heave down a terrible array of foodstuffs and fluids, and it will continue to stoically perform year in and year out. Finally it may rebel, but usually only when major abuse takes place for many years. In the main, it functions smoothly.

Q. Well, what now?

A. We plan to discuss some of the more common and more important disorders of this wondrous system. Because it affects so many people, it is our plan to concentrate for some time on the stomach and duodenum, and speak specifically about peptic ulcers. So, stay with us, for if you are an average Australian, there are very high chances that you will be an ulcer victim. It may only be a matter of time. In fact, you — the person reading this booklet right now — probably have an ulcer gnawing at your vitals!

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Just how difficulties in the back cause sciatic pain – this being a typical example of what is called ‘referred pain’ (medical name: synalgia), that is a pain that occurs in a part of the body other than where it might have been expected – will be explained in full in the next chapter. In the meantime, let us briefly note that referred pain is quite a common phenomenon: for example, we all know that some heart disorders can cause pain in the left arm and fingers. Equally, an abscess below the diaphragm may lead to referred pain in the shoulders. The confusion created by referred pain stems from the fact that the sensory nerves from different parts of the body share common pathways when they reach the spinal cord. To treat any referred pain successfully, its origin must be located first, because that’s where the treatment will have to be effective to bring about permanent relief.

It follows from this that the treatment of sciatica must ultimately be addressed to its source, and this is invariably in the spine, and not where the pain may manifest itself. Having said that, some local treatments applied to the site of the pain – such as heat or gentle massage – can be extremely useful in reducing its severity, but these approaches will only reduce the pain temporarily, not cure it or improve its root cause. Nevertheless, palliatives – the name given to treatments that relieve or soothe the symptoms of a disease or disorder without effecting a cure – can be of great help. Pain-killing medicines, such as aspirin or paracetamol, are essentially palliatives, their effect limited either to making the pain disappear or at least lessening it, so that it becomes more bearable. Such simple remedies can, however, have an extremely important role to play in the management of sciatica, especially when the symptoms are fairly mild and/or occur but rarely and the main purpose of treatment is to stop them from interfering with the tasks of daily life.

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When elderly people become incontinent of urine, this is usually assumed to be permanent. Such pessimism, however, is unjustified since about 80-90 percent of these cases can be cured, the Annals of Internal Medicine (104:429) points out. Even the incontinence that follows a stroke can, in many instances, be overcome.

Before anything can be done, though, the patient must be seen by a physician who has special training (usually a geriatrician or urologist) to have the cause of the incontinence correctly determined. Some cases, of course, are “surgical” and can be cured with an operation for such things as prostate enlargement or a uterus that has slipped down out of place. For patients not needing surgery, treatment with an appropriate medicine, biofeedback, or habit training cures over 70 percent.

Older people whose incontinence is caused by muscular weakness can do a lot to help themselves with exercises that tone up the muscles of the pelvic floor. The exercises involved tightening and relaxing the muscles repeatedly for 15 minutes three times every day, the U.S. Pharmacist (12#8:92) reports. By stopping and starting the flow of urine, victims of incontinence can learn to identify those muscles that need to be strengthened. The same muscles control the passage of stools. Identical exercises, incidentally, are employed by women after childbirth to tone up muscles that support the uterus. To do any good, these exercises need to be performed three times every day for at least three months. Victims of incontinence should be aware of the fact that both constipation and alcohol can interfere with the function of the pelvic floor muscles. They should also avoid drinking coffee, tea and grapefruit juice, all of which can suddenly increase the need to pass more urine. Cranberry juice is a useful substitute.

In addition, they should routinely empty the bladder before and after every meal and at bedtime, even if they feel no need to do so. They should always respond promptly to the urge to urinate, and must never ignore it. In a few cases, surgical repair may be required, especially if the bladder has become displaced by repeated childbirth or by removal of the prostate.

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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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Tobacco

Smoking may create or aggravate existing respiratory allergy because cigarettes may contain (besides tobacco) many potentially allergenic ingredients, such as licorice and molasses.

An allergic person, child or adult, should avoid small rooms and enclosed spaces where crowds gather and smoke (such as the smoking section of movie houses) because hot tobacco smoke is a nonspecific irritant besides being a potential allergen.

Pyrethrum

Pyrethrum is a powder prepared from the dried flower of the pyrethrum plant, which is related to the ragweed plant. It is used as an insecticide to spray plants in backyards or in moth killers to preserve winter clothing and carpeting.

Kapok

These fibers are used for filling life preservers (because they remain afloat for hours without much absorption of water); for insulation purposes; and for less expensive sleeping bags and mattresses. (Kapok was used in the past as a filling for pillows to avoid highly allergenic feathers. However, this practice has now stopped because of the development of foam rubber, plastics, and synthetic fibers.) Kapok seeds provide an oil used in making soap and in the preparation of certain foods.

Flax

Flax is the Latin word for the linen plant which provides linseed oil and linen fibers. Linseed oil may cause allergies when eaten, inhaled, or touched, and linen fibers may cause eczema and rashes when they are used in clothing.

Flax fibers, seeds, or oil may be inhaled when one is near flaxseed meal (which is a food given to cattle and poultry) ; in beauty salons and barber shops (as some wave sets, shampoos, and hair tonics (Kreml) may contain it); using bird lime, carron oil, flaxseed poultices, furniture polish, linseed oil, paints, varnishes, linoleum, printer’s and lithographic ink, some soft soaps, and some depilatories; or using damask, table linen, cambric, handkerchief linen, toweling, oilcloth, and sewing thread.

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This is the most common reason for a miscarriage and is usually the result of a one-off genetic abnormality in the baby that is unlikely to recur. In other words nature is working according to the law of survival of the fittest. When the baby is abnormal it will try to stop that pregnancy continuing.

You and your partner each contribute 23 chromosomes to the baby, making 23 pairs in total. Each chromosome pair determines specific characteristics of your child and geneticists have given a number to each pair. For example, number 23 is the pair which determines the sex of the baby.

Only a small portion of chromosomal abnormalities are inherited and these can be screened. The others can occur before, during and after fertilisation, as the chromosomes divide. It is thought that up to 50 per cent of miscarriages can be due to a genetic abnormality.

The most common chromosomal abnormality diagnosed is where there are three chromosomes in the pair instead of two. Depending on which pair this happens to, it will give rise to a specific abnormality. Not all abnormalities always end in a miscarriage. For instance, Down’s Syndrome is caused by an extra chromosome on pair number 21 and for that reason is also called trisomy 21. It is thought that most trisomies are caused by an abnormal division in the egg which occurs before fertilisation.

This may explain why older women have always been thought to have a higher risk of having a Down’s Syndrome baby, since older women’s eggs are more likely to be abnormal. But the Down’s Syndrome Association claims that eight out of ten babies with Down’s Syndrome are born to mothers under the age of 35.The extra chromosome can also come from the man’s sperm. So, at the moment, scientists do not know for sure what causes Down’s Syndrome.

However, there are links between Down’s Syndrome and mineral deficiencies. For example, people with Down’s Syndrome children have lower levels of zinc and selenium compared with others of the same age. It has also been found that in Down’s Syndrome blood levels of the ‘antioxidant defense system’ enzymes (super-oxide dismutase and glutathione peroxidase) are over-produced. Both these enzymes are produced by the body to disarm free radicals. The building blocks for these enzymes include the minerals zinc and selenium.

Selenium is known to protect against chromosome (DNA) damage by protecting the body against toxins and pollutants, and future research may demonstrate the importance of prospective parents having good levels of this mineral in the months before conception when both sperm and eggs are maturing.

The idea that toxin damage could be implicated in Down’s has been borne out by a study in the wake of the Chernobyl nuclear disaster. Babies born nine months later showed a six-fold increase in cases of Down’s Syndrome. Studies on animals have also shown it is possible to damage the chromosomes by introducing a toxin.

So the opposite may also be true: that you can protect your chromosomes from damage by stopping your intake of all the toxins we have been talking about and making sure that you have enough antioxidants to fight unavoidable pollution (like traffic fumes).

Turner’s Syndrome

If one chromosome of the pair is missing the condition is called monosomy. The most common abnormality of this type is where one X (female chromosome) is missing from the sex pair (number 23).This condition is called Turner’s syndrome. It does not usually cause a miscarriage but the baby, which is always a girl, will have certain physical characteristics. She can have heart defects and fertility problems, because her ovaries may be absent or fail to develop and because of this she will have under-developed breasts. As she gets older, she will need hormone treatment and counseling.

Inherited Genetic Problems

This is a much less common reason for a miscarriage, and chromosome testing (karyotype analysis) would be recommended for both partners where couples have experienced recurrent miscarriages. One of the most common structural changes in chromosomes is translocation, where part of one chromosome comes away and reattaches to a different chromosome.

Some gene defects can cause miscarriages but it is more likely that the genetic problem will cause abnormalities in the baby, such as cystic fibrosis or muscular dystrophy.

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